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Status of Antimicrobial Stewardship Programs in Korean hospitals including small to medium-sized hospitals with the awareness and demands by physicians: A nationwide survey in 2020.

J Glob Antimicrob Resist 2021 Jun 18. Epub 2021 Jun 18.

Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Objectives: This study aimed at identifying the status of ASPs in Korean hospitals with medium- to small-sized hospitals, as well as the awareness and demands about ASPs by physicians.

Methods: The questionnaire was designed based on a questionnaire from a previous nationwide survey in 2018 targeting large hospitals in Korea, and modified to reflect the results of in-depth interviews with non-infectious diseases physicians at secondary care hospitals. The survey targeted all hospitals with ≥ 150 beds in South Korea and performed in May-June 2020. Read More

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Workplace Incivility and Its Effects on the Physical and Psychological Health of Nursing Faculty.

Nurs Educ Perspect 2021 Jun 17. Epub 2021 Jun 17.

About the Authors Jayme Trocino Sherrod, PhD, RN, was a student at the University of North Carolina-Greensboro when this study was conducted. Lynne Porter Lewallen, PhD, RN, CNE, ANEF, is a professor and associate dean for academic affairs, University of North Carolina-Greensboro School of Nursing. Dr. Lewallen, a guest editor for this issue of Nursing Education Perspectives, did not participate in review or decision for this article. For more information, contact Dr. Sherrod at

Aim: The aim was to explore 1) the relationship between nursing faculty attributes and their experiences with workplace incivility and 2) the impact of experiences with workplace incivility on the physical and psychological health of nursing faculty.

Background: Qualitative evidence suggests that workplace incivility impacts the physical and psychological health of nursing faculty. This has not been explored in a quantitative manner. Read More

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Safety, efficacy, and tolerability of efgartigimod in patients with generalised myasthenia gravis (ADAPT): a multicentre, randomised, placebo-controlled, phase 3 trial.

Lancet Neurol 2021 Jul;20(7):526-536

Department of Neuroimmunology and Neuromuscular Diseases, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy.

Background: There is an unmet need for treatment options for generalised myasthenia gravis that are effective, targeted, well tolerated, and can be used in a broad population of patients. We aimed to assess the safety and efficacy of efgartigimod (ARGX-113), a human IgG1 antibody Fc fragment engineered to reduce pathogenic IgG autoantibody levels, in patients with generalised myasthenia gravis.

Methods: ADAPT was a randomised, double-blind, placebo-controlled, phase 3 trial done at 56 neuromuscular academic and community centres in 15 countries in North America, Europe, and Japan. Read More

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Trends in HIV incidence between 2013-2019 and association of baseline factors with subsequent incident HIV among gay, bisexual, and other men who have sex with men attending sexual health clinics in England: A prospective cohort study.

PLoS Med 2021 Jun 18;18(6):e1003677. Epub 2021 Jun 18.

UCL Institute for Global Health, London, United Kingdom.

Background: Prospective cohort studies of incident HIV and associated factors among gay, bisexual, and other men who have sex with men (GBMSM) in the United Kingdom are lacking. We report time trends in and factors associated with HIV incidence between 2013 and 2019 among a cohort of GBMSM: the AURAH2 prospective study.

Methods And Findings: Participants were recruited through 1 of 3 sexual health clinics in London and Brighton (July 2013 to April 2016) and self-completed a baseline paper questionnaire and subsequent 4-monthly and annual online questionnaires (March 2015 to March 2018), including information on sociodemographics, lifestyle, health and well-being, HIV status, sexual/HIV-related behaviours, and preexposure prophylaxis and postexposure prophylaxis (PrEP/PEP). Read More

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From zero to hero and back to zero: The consequences of status inconsistency between the work roles of multiple jobholders.

J Appl Psychol 2021 Jun 10. Epub 2021 Jun 10.

W. P. Carey School of Business, Arizona State University.

The surge of opportunities available through the gig economy has increased the sizeable population of people who hold multiple jobs. Many of these multiple jobholders are full-time employees who have adopted side-hustles-income-generating work performed alongside full-time work. A core and ubiquitous feature of both full-time work and side-hustles is status, or membership in a social hierarchy. Read More

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Reference equations for tidal breathing parameters using structured light plethysmography.

ERJ Open Res 2021 Apr 7;7(2). Epub 2021 Jun 7.

Lung Function and Sleep, Queen Elizabeth Hospital, Birmingham, UK.

Tidal breathing measurements can be used to identify changes in respiratory status. Structured light plethysmography (SLP) is a non-contact tidal breathing measurement technique. Lack of reference equations for SLP parameters makes clinical decision-making difficult. Read More

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The impact of organizational culture on professional fulfillment and burnout in an academic department of medicine.

PLoS One 2021 9;16(6):e0252778. Epub 2021 Jun 9.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Physician wellness is vital to career satisfaction, provision of high quality patient care, and the successful education of the next generation of physicians. Despite this, the number of physicians experience symptoms of burnout is rising. To assess the impact of organizational culture on physicians' professional fulfillment and burnout, we surveyed full-time Department of Medicine members at the University of Toronto. Read More

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Recent Trends in Faculty Promotion in U.S. Medical Schools: Implications for Recruitment, Retention, and Diversity and Inclusion.

Acad Med 2021 Jun 1. Epub 2021 Jun 1.

I.M. Xierali is associate professor, Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; ORCID: https://orcid.org/0000-0002-3378-8063. M.A. Nivet is executive vice president, Institutional Advancement, University of Texas Southwestern Medical Center, Dallas, Texas. Z.A. Syed is associate professor and director, Family Medicine Residency Program, Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas. A. Shakil is professor, Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas. F.D. Schneider is professor and chair, Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.

Purpose: Faculty promotion is important for retention and has implications for diversity. This study provides an update on recent trends in faculty promotion in U.S. Read More

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Organisation and timeline of measures in French psychiatric establishments during the first wave of the COVID-19 epidemic: EvOlu'Psy study.

BMC Psychiatry 2021 06 2;21(1):284. Epub 2021 Jun 2.

Association Hospitalière Sainte-Marie, Centre Hospitalier Sainte-Marie de Clermont-Ferrand, 33 Rue Gabriel Péri, 63000, Clermont-Ferrand, France.

Background: The onset of COVID-19 required rapid organisational changes in the mental health domain. Most mental health-care departments appear to have set up infection control measures and also organised planning, coordination and measures that enabled them to provide psychiatric care in a restrictive environment. Our objective was to assess the organisation by psychiatric facilities in France of their response to COVID-19, during the first wave. Read More

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Is Self-Reported Return to Duty an Adequate Indicator of Return to Sport and/or Return to Function in Military Patients?

Clin Orthop Relat Res 2021 06 1. Epub 2021 Jun 1.

B. H. Zalneraitis, N. Drayer, M. Nowak, K. Ardavanis, B. Masini, D. Kang, Department of Orthopaedic Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA.

Background: In the military, return-to-duty status has commonly been used as a functional outcome measure after orthopaedic surgery. This is sometimes regarded similarly to return to sports or as an indicator of return to full function. However, there is variability in how return-to-duty data are reported in clinical research studies, and it is unclear whether return-to-duty status alone can be used as a surrogate for return to sport or whether it is a useful marker for return to full function. Read More

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High incidence of lost workdays in patients with subacromial impingement syndrome.

Dan Med J 2021 May 28;68(6). Epub 2021 May 28.

Introduction: Loss of workdays is the main societal cost related to shoulder disorders with nine lost workdays per six months on average. The most common shoulder disorder is subacromial impingement syndrome (SIS), but it remains unknown if SIS is also a leading cause of shoulder-related loss of worktime. We aimed to investigate the incidence of workdays lost due to SIS during the six months following a SIS diagnosis in specialised care. Read More

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Iranian superwomen's career experiences: a qualitative study.

BMC Womens Health 2021 05 31;21(1):227. Epub 2021 May 31.

Department of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Superwoman refers to the identity of a woman who performs several important roles simultaneously and full-time, such as being a wife, mother, and homemaker while holding a job. This study aims to examine the career experiences of Iranian superwomen who maintained their mental health while holding multiple roles.

Methods: Data for this qualitative study were collected via semi-structured interview and analyzed using conventional content analysis. Read More

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Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial.

Lancet Oncol 2021 May 27. Epub 2021 May 27.

Department of Medical Oncology, Gustave Roussy, Villejuif, France.

Background: Understanding patients' experience of cancer treatment is important. We aimed to evaluate patient-reported outcomes (PROs) with atezolizumab plus bevacizumab versus sorafenib in patients with advanced hepatocellular carcinoma in the IMbrave150 trial, which has already shown significant overall survival and progression-free survival benefits with this combination therapy.

Methods: We did an open-label, randomised, phase 3 trial in 111 hospitals and cancer centres across 17 countries or regions. Read More

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Return to Work After Coronavirus Disease 2019 Acute Respiratory Distress Syndrome and Intensive Care Admission: Prospective, Case Series at 6 Months From Hospital Discharge.

Crit Care Med 2021 May 26. Epub 2021 May 26.

Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Milan, Italy. Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. William Harvey Research Institute, Queen Mary University of London, London, United Kingdom. Department of Biomedical Sciences, Humanitas University, Milan, Italy. Department of Internal Medicine and Hepatology, Humanitas Clinical and Research Center-IRCCS, Milan, Italy. Department of Cardiovascular Medicine, Humanitas Clinical and Research Center-IRCCS, Milan, Italy.

Objectives: Joblessness is common in survivors from critical care. Our aim was to describe rates of return to work versus unemployment following coronavirus disease 2019 acute respiratory distress syndrome requiring intensive care admission.

Design: Single-center, prospective case series. Read More

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Predictors of six-month inability to return to work in previously employed subjects after mild traumatic brain injury: A TRACK-TBI pilot study.

J Concussion 2021 Jan-Dec;5. Epub 2021 Apr 6.

Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.

Introduction: Return to work (RTW) is an important milestone of mild traumatic brain injury (mTBI) recovery. The objective of this study was to evaluate whether baseline clinical variables, three-month RTW, and three-month postconcussional symptoms (PCS) were associated with six-month RTW after mTBI.

Methods: Adult subjects from the prospective multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with mTBI (Glasgow Coma Scale 13-15) who were employed at baseline, with completed three-and six-month RTW status, and three-month Acute Concussion Evaluation (ACE), were extracted. Read More

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Teriflunomide in relapsing-remitting multiple sclerosis: outcomes by age and pre-treatment status.

Ther Adv Neurol Disord 2021 18;14:17562864211005588. Epub 2021 May 18.

Department of Neurology, Bern University Hospital, University of Bern, Switzerland.

Background And Aims: To investigate effectiveness and safety of teriflunomide (14 mg once daily) in association with age and pre-treatment in unselected MS patients.

Methods: Prespecified analysis of a non-interventional, prospective, real-world study in Germany.

Results: A total of 558 (49. Read More

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6-month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study.

Lancet Child Adolesc Health 2021 Jul 25;5(7):473-482. Epub 2021 May 25.

Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK. Electronic address:

Background: Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a new, rare, post-infectious complication of SARS-CoV-2 infection in children. We aimed to describe the 6-month outcomes of PIMS-TS.

Methods: This retrospective cohort study comprised children (aged <18 years) who fulfilled the UK Royal College of Paediatrics and Child Health (RCPCH) diagnostic criteria for PIMS-TS and were admitted to Great Ormond Street Hospital (London, UK) between April 4 and Sept 1, 2020. Read More

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Chemotherapy de-escalation using an F-FDG-PET-based pathological response-adapted strategy in patients with HER2-positive early breast cancer (PHERGain): a multicentre, randomised, open-label, non-comparative, phase 2 trial.

Lancet Oncol 2021 06 18;22(6):858-871. Epub 2021 May 18.

Medica Scientia Innovation Research, Barcelona, Spain; Medica Scientia Innovation Research, Ridgewood, NJ, USA; Hospital Arnau de Vilanova, Universidad Catolica, Valencia, Spain.

Background: Several de-escalation approaches are under investigation in patients with HER2-positive, early-stage breast cancer. We assessed early metabolic responses to neoadjuvant trastuzumab and pertuzumab using F-fluorodeoxyglucose (F-FDG)-PET (F-FDG-PET) and the possibility of chemotherapy de-escalation using a pathological response-adapted strategy.

Methods: We did a multicentre, randomised, open-label, non-comparative, phase 2 trial in 45 hospitals in Spain, France, Belgium, Germany, the UK, Italy, and Portugal. Read More

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Deep learning predicts chromosomal instability from histopathology images.

iScience 2021 May 3;24(5):102394. Epub 2021 Apr 3.

Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York 10065, USA.

Chromosomal instability (CIN) is a hallmark of human cancer yet not readily testable for patients with cancer in routine clinical setting. In this study, we sought to explore whether CIN status can be predicted using ubiquitously available hematoxylin and eosin histology through a deep learning-based model. When applied to a cohort of 1,010 patients with breast cancer (Training set: n = 858, Test set: n = 152) from The Cancer Genome Atlas where 485 patients have high CIN status, our model accurately classified CIN status, achieving an area under the curve of 0. Read More

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Screening for Children's Chronic Health Conditions and Their Strengths and Difficulties in Primary Care.

J Dev Behav Pediatr 2021 May 12. Epub 2021 May 12.

Boonshoft School of Medicine, Wright State University, Dayton, OH; Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, OH; Community Research, Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, OH.

Objective: This study explores parents' perceptions of their child's health status and their strengths and difficulties using 2 validated instruments in primary care settings.

Methods: This cross-sectional study was conducted between February 2018 and October 2019. Parents of children aged 2 to 18 years completed the Children with Special Health Care Needs (CSHCN) screener and the Strengths and Difficulties Questionnaire (SDQ) as well as demographics. Read More

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Comparing CSF amyloid-beta biomarker ratios for two automated immunoassays, Elecsys and Lumipulse, with amyloid PET status.

Alzheimers Dement (Amst) 2021 1;13(1):e12182. Epub 2021 May 1.

Department of Clinical Chemistry Neurochemistry Laboratory Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam the Netherlands.

Introduction: We evaluated for two novel automated biomarker assays how cerebrospinal fluid (CSF) amyloid beta (Aβ)-ratios improved the concordance with amyloid positron emission tomography (PET) positivity compared to Aβ alone.

Methods: We selected 288 individuals from the Amsterdam Dementia Cohort across the Alzheimer's disease clinical spectrum when they had both CSF and amyloid PET visual read available, regardless of diagnosis. CSF Aβ, phosphorylated tau (p-tau), and total tau (t-tau) were measured with Elecsys and Lumipulse assays, and Aβ with Lumipulse. Read More

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Improving Employment Through Interpersonal Psychotherapy: A Case Series of Patients With Treatment-Refractory Depression.

Front Psychiatry 2021 23;12:617305. Epub 2021 Apr 23.

Department of Neuropsychiatry, School of Medicine, Kyorin University, Tokyo, Japan.

Patients with treatment-refractory depression (TRD) have significantly great losses in work productivity and employment. Interpersonal psychotherapy (IPT) is considered an approach for the treatment of TRD. However, the effectiveness of IPT in patients with TRD remains unclear. Read More

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The age of surgical operative video big data - My bicycle or our park?

Surgeon 2021 May 4. Epub 2021 May 4.

Nuffield Department of Surgery, University of Oxford, Royal College of Surgeons of England, UK.

Background: Surgery is a major component of health-care provision. Operative intervention often employs minimally invasive approaches incorporating digital cameras creating a 'digital twin' of both intracorporeal appearances and operative performance. Video recordings provide richer detail than the traditional operative note and can couple with advanced computer technology to unlock new analytic capabilities capable of driving surgical advancement via quality improvement initiatives and new technology design. Read More

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Terminations in Primary Care: a Retrospective Observational Study of 16 Primary Care Clinics.

J Gen Intern Med 2021 May 4. Epub 2021 May 4.

Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.

Background: The relationship between clinician and patient is the cornerstone of primary care. Breakdown and termination of this relationship are understudied yet important, undesirable outcomes.

Objective: To better understand the nature and extent of provider and clinic termination of the primary care relationship. Read More

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Vocational Outcomes After Traumatic Brain Injury; Prevalence and Risk Factors After 1 Year in a Multivariable Model.

J Head Trauma Rehabil 2021 Apr 30. Epub 2021 Apr 30.

School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom (Drs Singh, Humphries, Mason, and Lecky); Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine (Drs Singh and Humphries), and Occupational Health Department, Northern General Hospital (Dr Basu), Sheffield Teaching Hospitals, Sheffield, United Kingdom; and Institute of Work Psychology, Sheffield University Management School, Sheffield, United Kingdom (Dr Dawson).

Objective: To determine the prevalence of employment status (ES) or full-time study after traumatic brain injury (TBI) in a representative population and its predictive factors.

Design: Prospective cohort study.

Setting: Regional Major Trauma Centre. Read More

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Palliative Medicine Specialization in Latin America: A Comparative Analysis.

J Pain Symptom Manage 2021 Apr 30. Epub 2021 Apr 30.

Dieter Scheffner Center for Medical Education and Educational Research (H.P.), Dean´s Office of Study Affairs, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Background: Formal recognition of palliative medicine as a specialty has been one of the main drivers in the development of palliative care.

Aim: To provide a comparative, comprehensive overview on the status of palliative medicine as medical specialty across Latin America.

Methods: We conducted a comparative study of 19 Latin American countries. Read More

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Clinical Outcomes of Pediatric Acute Sport- and Non-Sport-Related Concussions.

Can J Neurol Sci 2021 Apr 27:1-7. Epub 2021 Apr 27.

Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.

Objectives: The objectives were to examine clinical characteristics, length of recovery, and the prevalence of delayed physician-documented recovery, compare clinical outcomes among those with sport-related concussion (SRC) and non-sport-related concussion (nSRC), and identify risk factors for delayed recovery.

Methods: Included patients (8-18 years) were assessed ≤14 days post-injury at a multidisciplinary concussion program and diagnosed with an acute SRC or nSRC. Physician-documented clinical recovery was defined as returning to pre-injury symptom status, attending full-time school without symptoms, completing Return-to-Sport strategy as needed, and normal physical examination. Read More

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Return to Work Among Young Adult Survivors of Allogeneic Hematopoietic Cell Transplantation in the United States.

Transplant Cell Ther 2021 Apr 22. Epub 2021 Apr 22.

Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota.

Young adult (YA) survivors of allogeneic hematopoietic cell transplantation (HCT) are at risk for late psychosocial challenges, including the inability to return to work post-HCT. Work-related outcomes in this population remain understudied, however. We conducted this study to assess the post-HCT work status of survivors of allogeneic HCT who underwent HCT as YAs and to analyze the patient-, disease-, and HCT-related factors associated with their work status at 1 year post-HCT. Read More

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Etiologies of genital inflammation and ulceration in symptomatic Rwandan men and women responding to radio promotions of free screening and treatment services.

PLoS One 2021 20;16(4):e0250044. Epub 2021 Apr 20.

Project San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda.

Introduction: The longstanding inadequacies of syndromic management for genital ulceration and inflammation are well-described. The Rwanda National Guidelines for sexually transmitted infection (STI) syndromic management are not yet informed by the local prevalence and correlates of STI etiologies, a component World Health Organization guidelines stress as critical to optimize locally relevant algorithms.

Methods: Radio announcements and pharmacists recruited symptomatic patients to seek free STI services in Kigali. Read More

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Burnout and Professional Fulfillment in Early and Early-Mid-Career Breast Surgeons.

Ann Surg Oncol 2021 Apr 19. Epub 2021 Apr 19.

Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Background: Prior work has shown that burnout among breast surgeons is prevalent and highest in those earlier in their clinical practice career. Therefore, we sought to better understand and identify specific contributors to early-career breast surgeon burnout.

Methods: We analyzed data from our 2017 survey of members of the American Society of Breast Surgeons. Read More

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