bluuebunny/crossref_metadata_2025_split huggingface dataset:
Profiles of Burnout and Response to the COVID-19 Pandemic Among General Surgery Residents at a Large Academic Training Program
Authors: Nguyen May-Anh , Castelo Matthew , Greene Brittany , Lu Justin , Brar Savtaj , Reel Emma , Cil Tulin D. 
Published: August 2022

Background COVID-19 has placed demands on General Surgery residents, who are already at high risk of burnout. This study examined the pandemic’s impact on burnout and wellness among General Surgery residents at a large training program. Methods General Surgery residents at our institution completed a survey focused on self-reported burnout, mental health, perceptions of wellness resources, and changes in activities during the pandemic. Burnout was measured using the Maslach Burnout Inventory (MBI). Unsupervised machine learning ( k-means clustering) was used to identify profiles of burnout and comparisons between profiles were made. Results Of 82 eligible residents, 51 completed the survey (62% response rate). During COVID-19, 63% of residents had self-described burnout, 43% had depression, 18% acknowledged binge drinking/drug use, and 8% had anxiety. There were no significant differences from pre-pandemic levels ( p all >.05). Few residents perceived available wellness resources as effective (6%). Based on MBI scores, the clustering analysis identified three clusters, characterized as “overextended”, “engaged”, and “ineffective”. Engaged residents had the least concerning MBI scores and were significantly more likely to exercise, retain social contact during the pandemic, and had less self-reported anxiety or depression. Research residents were overrepresented in the ineffective cluster (46%), which had high rates of self-reported burnout (77%) and was characterized by the lowest personal accomplishment scores. Rates of self-reported burnout for overextended and engaged residents were 73% and 48%, respectively. Conclusion Surgical residents have high rates of self-reported burnout and depression during the COVID-19 pandemic. Clusters of burnout may offer targets for individualized intervention.
Successful Recruitment to Qualitative Research: A Critical Reflection
Authors: Negrin Kelly A. , Slaughter Susan E. , Dahlke Sherry , Olson Joanne 
Published: August 2022

Recruitment to qualitative research is an important methodological consideration. However, the process of recruitment is under-communicated in qualitative research articles and methods textbooks. A robust recruitment plan enhances trustworthiness and overall research success. Although recruitment has recently received increased attention in the qualitative methodology literature, a more nuanced understanding is required. We realized successful recruitment to our focused ethnographic inquiry. Numerous nurse educators, researchers, and administrators volunteered within three months of study initiation. Using Gibbs’ Reflective Cycle, we conducted a critical reflection on the recruitment log and participant interview data to surface factors contributing to our success. This article offers our insights into the facilitators of successful recruitment. Our reflection revealed four themes contributing to successful enrollment: (a) laying the groundwork, (b) recruitment plan, (c) building rapport, and (d) participant motivations. Two new recruitment strategies accounted for over 60% of our sample. Reporting on successful strategies for recruiting participants to qualitative research and specifying participants’ motivations to volunteer, from their perspective, make important contributions to the recruitment literature. Our article offers guidance to qualitative researchers pursuing successful recruitment. Additional research is required to evaluate the relative influence of various recruitment strategies.
Safety and efficacy of remote ischemic conditioning combined with endovascular thrombectomy for acute ischemic stroke due to large vessel occlusion of anterior circulation: A multicenter, randomized, parallel-controlled clinical trial (SERIC-EVT): Study protocol
Authors: Guo Zhen-Ni , Abuduxukuer Reziya , Zhang Peng , Wang Chao , Yang Yi 
Published: August 2022

Rationale/Aim: Many patients undergoing successful recanalization after endovascular thrombectomy (EVT) do not have a good outcome; additional neuroprotection might benefit this group. Remote ischemic conditioning (RIC) stimulates endogenous protective mechanisms and may have a neuroprotective in acute brain ischemia. The safety and efficacy of RIC combined with endovascular thrombectomy (SERIC-EVT) trial is investigating the safety and efficacy of RIC for patients with acute ischemic stroke (AIS) who underwent EVT due to large vessel occlusion of the anterior circulation. Methods: SERIC-EVT is a multicenter, randomized, parallel-controlled, and blinded endpoint clinical trial. Patients are recruited from 10 hospitals in Jilin Province, Northeast China. Patients with anterior circulation AIS undergoing EVT due to large vessel occlusion are randomized in a 1:1 ratio to RIC or sham-RIC. Participants will receive standard medical treatment and an inflation pressure of 200 mmHg (RIC group) or 60 mmHg (sham-RIC group) twice daily for seven consecutive days. Study outcomes: The primary outcome is the proportion of patients with modified Rankin Scale (mRS) score of 0–2 on day 90. Secondary outcome measures include the National Institute of Health Stroke Scale, Barthel Index, and mRS scores obtained at 24 h, 7 days, 30 ± 3 days, and 90 ± 3 days post-EVT, recanalization rate, expanded Thrombolysis in Cerebral Infarction score, and symptomatic intracranial hemorrhage post-EVT. Mortality and all adverse events, including skin changes and pain scores, within the first 90 days will be used as safety outcome measures. Sample size estimates: Based on previous studies, we estimate a 14% difference in functional independence (the mRS ⩽2) between RIC and sham-RIC groups. Considering a significance level of 5% and power of 80%, and one-fifth of patients lost to follow up, the planned sample size is 498 patients (249 per group). Discussion: RIC might be a strategy that improves 3-month clinical outcomes in AIS patients who have undergone EVT due to large vessel occlusion of anterior circulation. SERIC-EVT will determine whether this is the case.
Acute effects of ballistic and non-ballistic conditioning activities on the punching impact of amateur boxers
Authors: Yi Wenjuan , Wang Dexin , Chen Chao , Wu Rui 
Published: August 2022

Objectives This study investigated the postactivation performance enhancement (PAPE) effects of medicine ball throwing (MBT) and bench pressing (BP) on punching impact at different recovery times. Methods Fourteen amateur boxers performed three lead-hand (lead-hand) and rear-hand straight punches (rear-hand) at 3, 6, 9, 12, and 15 min after MBT or BP exercise. Peak force, time to the peak force, and rate of force development (RFD) of each punch was measured by a force plate. Results There was no significant condition × time interaction effect for any variables (lead-hand: F = 0.744–0.913, p = 0.448–0.542; rear-hand: F = 0.240–1.355, p = 0.245–0.944). No significant main effect for condition for any variables (lead-hand: F = 0.103–0.219, p = 0.644–0.751; rear-hand: F = 0.070–0.459, p = 0.504–0.793). The time effect was significant on peak force ( F = 4.411, p = 0.005) and RFD ( F = 5.002, p = 0.002) of lead-hand, time to the peak force ( F = 5.791, p = 0.001) and RFD ( F = 5.514, p = 0.001) of rear-hand. Peak force and RFD of the lead-hand, as well as time to the peak force and RFD of the rear-hand enhanced significantly at 6–15 min ( p = 0.001–0.042), compared to the baseline. Conclusions MBT and BP may equally enhance punching impact for amateur boxers; moreover, there was no difference in recovery time between conditioning activities.
Validation of the Simplified Disease Activity Index (SDAI) with a quick quantitative C-reactive protein assay (SDAI-Q) in patients with rheumatoid arthritis: a prospective multicenter cross-sectional study
Authors: Schally Julia , Brandt Henning Christian , Brandt-Jürgens Jan , Burmester Gerd R. , Haibel Hildrun , Käding Henriette , Karberg Kirsten , Lüders Susanne , Muche Burkhard , Protopopov Mikhail , Rios Rodriguez Valeria , Torgutalp Murat , Verba Maryna , Zinke Silke , Poddubnyy Denis , Proft Fabian 
Published: August 2022

Objectives: The Simplified Disease Activity Index (SDAI) is a recommended composite score for assessing the remission status in patients with rheumatoid arthritis (RA). However, determination of C-reactive protein (CRP) levels takes several hours and sometimes days and limits the use of the SDAI in the clinical setting. The aim of this study was to validate the SDAI using a quick quantitative C-reactive protein (qCRP) assay (as SDAI-Q) in RA patients. Design: This is a multicenter, prospective, cross-sectional pilot study in RA patients. Methods: Adult patients (⩾18 years) with a clinical diagnosis of RA were recruited between January 2020 and September 2020 from five rheumatologic centers located in Berlin, Germany. SDAI, SDAI-Q, Clinical Disease Activity Index (CDAI), and DAS28 scores comprising CRP, qCRP, or erythrocyte sedimentation rate (ESR) were calculated. The agreement of disease activity categories was analyzed using cross tabulations and weighted Cohen’s kappa. The agreement of numerical values was analyzed with Bland–Altman plots and intraclass correlation coefficients (ICCs). Results: Overall, 100 RA patients were included in the statistical analysis. The mean value of qCRP (7.89 ± 16.98 mg/l) was slightly higher than that of routine laboratory CRP (6.97 ± 15.02 mg/l). Comparing SDAI and SDAI-Q, all patients were assigned to identical disease activity categories. Agreement of disease activity categories by CDAI and SDAI/SDAI-Q was observed in 93% with a weighted Cohen’s kappa of 0.929 (95% confidence interval (CI) = 0.878; 0.981). Conclusion: The SDAI-Q showed an absolute agreement regarding the assignment of disease activity categories in comparison with the conventional SDAI. Therefore, the SDAI-Q may facilitate the application of a treat-to-target concept in clinical trials and clinical routine as a quickly available disease activity score incorporating CRP as an objective parameter.
Evaluating the impact of coronavirus disease on burnout among healthcare workers using maslach burnout inventory tool: A systematic review
Authors: Tang Reanne , Feng Ouyuan , Chong Jin Jian , Wang Aiwen 
Published: August 2022

Background Burnout has been prevalent among healthcare workers (HCWs). However, the effect of the Coronavirus Disease (COVID-19) pandemic on this phenomenon in HCWs is unclear. Objective This systematic review aims to evaluate the impact of COVID-19 on burnout of HCWs using Maslach Burnout Inventory (MBI). Methods A systematic search was performed on PubMed database for articles published between 1 December 2019 and 30 June 2021. Search strategy combined terms for HCWs, COVID-19, burnout, and MBI. The main outcome of interest was burnout, including both mean prevalence and MBI scores for high emotional exhaustion (EE), high depersonalisation (DP) and low personal accomplishment (PA). Results Four cohort studies, 90 cross-sectional studies and one randomised-controlled trial were included for review. Only one cohort study compared burnout data among HCWs before and during COVID-19. It reported a statistically significant increase in mean EE and PA scores from 21.9 to 24.8 ( p = .001), and 42.7 to 48.7 ( p = .001), respectively. The remaining studies only evaluated burnout data during COVID-19 but were missing burnout data prior to the pandemic for comparison. Across these studies, the overall mean prevalence of burnout among HCWs was 39.95%, with mean MBI EE scores of 22.07, DP scores of 7.83, and PA scores of 32.53. Burnout outcomes were generally comparable across specific healthcare professions such as doctors and nurses. Conclusion Whilst quality research elucidating the effect of pandemic on burnout is lacking, current burnout prevalence among HCWs during COVID-19 is notable.
Tele-yoga for the management of Parkinson disease: A safety and feasibility trial
Authors: James-Palmer Aurora M , Daneault Jean-Francois 
Published: August 2022

ObjectivesDespite current standard treatments, persons with Parkinson disease (PD) still experience motor and non-motor symptoms that impact daily function and quality of life, warranting the investigation of additional interventions. Holistic complementary interventions such as yoga have been shown to be beneficial for persons with PD. However, there are multiple barriers to in-person interventions such as transportation difficulties and disease-related mobility impairments which may be mitigated by digital health applications. Therefore, this study’s purpose was to assess the safety and feasibility of a synchronous tele-yoga intervention for persons with PD.MethodsSixteen participants were enrolled in a single group safety and feasibility trial. The entire study was conducted remotely and consisted of a baseline assessment followed by a six-week waiting period, then a second assessment, a six-week tele-yoga intervention period, a post-intervention assessment, a six-week follow-up period, and lastly a follow-up assessment. During the tele-yoga period, participants completed two one-on-one 30-minute tele-yoga sessions weekly for a total of 12 sessions. Primary outcomes included adverse events, adherence, technological challenges, and usability. Secondary outcomes included enjoyment and clinically relevant outcome measures assessing both motor and non-motor symptoms.ResultsNo severe adverse events were attributed to the intervention. Retention was 87.5%, assessment session adherence was 100%, and intervention session adherence was 97%. Technological challenges did not impact feasibility. The intervention was usable and enjoyable. While this study was not powered or designed to assess the efficacy of the intervention, preliminary improvements were shown for some of the clinically relevant outcome measures.ConclusionsOverall, this study showed that the implementation of a synchronous one-on-one tele-yoga intervention was safe, feasible, usable, and enjoyable for persons with PD. Randomized control trials investigating its efficacy should be initiated. The study was registered with ClinicalTrials.gov (NCT04240899, https://clinicaltrials.gov/ct2/show/NCT04240899).
Segmental Slope is a Predictor of Fusion Rate in Single Level Anterior Cervical Discectomy and Fusion
Authors: Sheng Xia-Qing , Ding Chen , Wang Bei-Yu , Meng Yang , Liu Hao 
Published: August 2022

Study design Retrospective study Objectives To explore preoperative segmental slope as a predictor of fusion rate after single-level anterior cervical discectomy and fusion (ACDF). Methods Data of consecutive patients with single-level cervical spondylosis who underwent ACDF between 2011 and January 2019 were retrospectively reviewed. Preoperative parameters including baseline characteristics, segment slope, T1 slope, range of motion, intervertebral disk height, and bone density were evaluated. Data were analyzed using Student’s t-test, Mann–Whitney U test, χ2 test, Fisher’s exact test, multivariate logistic regression analysis, and receiver operating characteristic curve. Results In total, 253 patients were selected. The mean follow-up was 32.1 months (range 24-99 months). Male sex, body mass index, preoperative segment slope, T1 slope, operative levels, and osteoporosis or osteopenia were associated with non-fusion at an early stage after surgery. However, no statistically significant difference was observed at the last follow-up. Multivariate logistic regression analysis revealed that the preoperative segment slope was an independent predictor for non-fusion at 3, 6, and 12 months postoperatively. Osteoporosis or osteopenia was an independent predictor of non-fusion at 6 and 12 months postoperatively. The area under the curve was .874 at 3 months ( P < .001, cutoff value 10.21°), .888 at 6 months ( P < .001, cutoff value 14.56°), and .825 at 12 months ( P < .001, cutoff value 21.08°). Conclusion Preoperative segment slope can be used as a predictor of early fusion rate after single-level ACDF. We determined detailed cutoff values. This study may help surgeons take measures to promote early fusion in advance.
Rotator Cuff Repair With a Bioinductive Patch
Authors: Forsythe Brian , Knapik Derrick M. , Patel Harsh H. , Berlinberg Elyse J. , Chahla Jorge , Freehill Michael T. , Riboh Jon 
Published: August 2022

Background: As a degenerative condition, symptomatic rotator cuff disease is frequently seen in the aging population, often requiring arthroscopic repair to eliminate pain and restore function. Repair integrity remains a concern in both short- and long-term postoperative periods due to high rates of primary repair failures, leading to increased interest in biologic patch augmentation to improve healing. Indications: Patch augmentation during rotator cuff repair is indicated in patients at high risk for repair failure or incomplete healing, including patients with poor quality, degenerative tendon tissue, those undergoing revision repair, and patients with large or massive rotator cuff tears. Technique Description: Standard arthroscopic portals are established and following diagnostic arthroscopy, the rotator cuff tear is identified, mobilized, and the humeral head gently debrided to a bleeding surface. Medial row suture anchors are placed, and following suture passage through the rotator cuff, the medial row sutures are tied. A bioinductive augmentation patch is introduced and provisionally secured medial to the enthesis utilizing spinal needles. Sutures are shuttled over the patch and incorporated into the lateral row repair utilizing 2 knotless suture anchors, effectively securing the patch over the bone-tendon interface. Results: Utilization of the described patch augmentation technique may improve repair healing by stimulating collagen formation and tissue vascularity, while providing structural support during the immediate postoperative period, effectively facilitating new tissue formation. Discussion/Conclusion: Incorporation of the bioinductive patch into the lateral row suture repair, directly over the tendon-bone interface, may assist in repair healing and decrease issues related to patch migration, while minimizing operative time and materials cost.
Mutations of TFPI-binding exosites on factor VII cause bleeding phenotypes in factor VII deficiency
Authors: Seanoon Karnsasin , Payongsri Panwajee , Vivithanaporn Pornpun , Sirachainan Nongnuch , Chuansumrit Ampaiwan , Hongeng Suradej , Tanratana Pansakorn 
Published: August 2022

Abstract
Tissue factor (TF) pathway inhibitor (TFPI) is a Kunitz-type anticoagulation protein that inhibits activated factor VII (FVIIa)/TF complex. Incidentally, many different F7 gene variants, including TFPI-binding exosite mutations, have been reported in patients with congenital FVII deficiency and clinical bleeding variabilities. Here, TFPI-binding exosites (R147 and K192) on FVII zymogen were selectively disrupted to understand their roles in the pathogenesis of bleeding phenotypes. Expression of recombinant FVII variants (R147A, K192A, and R147A/K192A) demonstrated markedly reduced secretion of FVII owing to intracellular retention in the endoplasmic reticulum, as demonstrated by upregulation of the unfolded protein response genes in all FVII variants. FVII variants showed a similar FVII activation pattern and FVIIa amidolytic activity than FVII wild-type (WT). In contrast to FVII activation, R147A and K192A showed a 90% reduction in FX activation relative to WT, whereas the R147A/K192A variant demonstrated a 99% decrease in FX activation. The clotting time was markedly prolonged with R147A and K192A than WT, and no FVII coagulant activity was detected in R147A/K192A. In addition, the thrombin generation assay revealed a significant prolongation of lag time in all FVII variants. Our study explains how mutations of TFPI-binding exosites of FVII can lead to bleeding phenotypes in individuals carrying these aberrancies.
Efficacy comparison of tisagenlecleucel vs usual care in patients with relapsed or refractory follicular lymphoma
Authors: Salles Gilles , Schuster Stephen J. , Dreyling Martin , Fischer Luca , Kuruvilla John , Patten Piers E. M. , von Tresckow Bastian , Smith Sonali M. , Jiménez-Ubieto Ana , Davis Keith L. , Anjos Carla , Chu Jufen , Zhang Jie , Lobetti Bodoni Chiara , Thieblemont Catherine , Fowler Nathan H. , Dickinson Michael , Martínez-López Joaquin , Wang Yucai , Link Brian K. 
Published: August 2022

Abstract
The ELARA trial indicates tisagenlecleucel (tisa-cel) is an effective anti-CD19 chimeric antigen receptor T-cell therapy for relapsed or refractory follicular lymphoma (r/r FL). As ELARA is a single-arm trial, this study compares tisa-cel outcomes from the ELARA trial with usual care from a real-world cohort. ELARA enrolled 98 patients as of 29 March 2021 (median follow-up: 15 months from enrollment). Usual care data were obtained from ReCORD-FL, a global retrospective study of patients with r/r FL, who met similar eligibility criteria to ELARA. With a data cutoff date of 31 December 2020, 187 patients with ≥2 preceding treatment lines were included in the ReCORD-FL (median follow-up: 57 months from third-line) study. An indirect treatment comparison was performed for 97 patients from the ELARA trial and 143 patients from the ReCORD-FL study with no missing data on baseline factors. The line of therapy for which outcomes were assessed was selected or matched between cohorts using propensity score modeling. After baseline factor adjustment via weighting by odds, complete response rate (CRR; 95% confidence interval) was 69.1% (59.8%-78.3%) for tisa-cel vs. 37.3% (26.4%-48.3%) for usual care; overall response rate was 85.6% (78.7%-92.5%) vs. 63.6% (52.5%-74.7%). Kaplan-Meier probability of being progression/event-free at 12 months was 70.5% (61.4%-79.7%) for tisa-cel vs. 51.9% (40.6%-63.3%) for usual care, with hazard ratio (HR)=0.60 (0.34-0.86); 12-month overall survival was 96.6% (92.9%-100%) vs. 71.7% (61.2%-82.2%), with HR=0.2 (0.02-0.38). In conclusion, tisa-cel was associated with a 1.9-fold higher complete response rate and a 1.4-fold higher rate of being progression or event free at 12 months vs usual care, as well as a death risk reduction of 80%. The findings provide additional evidence on the benefit of tisa-cel in patients with r/r FL after ≥2 treatment lines. This trial was registered at www.clinicaltrials.gov as NCT03568461