bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Application of Low-Dose Aspirin Affects Multiple Parameters of Three Blood Cellular Types and Antithrombin Activity: A 1:1:1 Propensity Score Matching Analysis
Authors: Li Xiao-li , Wang Qiang , Yin Hui-jun , Wang Yao-hui , Cao Jian , Fan Li 
Published: October 2020

Abstract:
The mechanisms of aspirin antithrombotic actions have not been fully elucidated. We re-analyzed the data from the project Aspirin Resistance in Patients with Ischemic Atherothrombotic Diseases from April 2008 to June 2010. A total of 530 subjects were classified into 3 groups, including 40 patients without aspirin use, 24 patients taking 25–50 mg/d aspirin, and 466 patients taking 75–100 mg/d aspirin over 1 month. By 1:1:1 propensity score matching adjusting 15 primary clinical covariates, 51 patients (n = 17 per group) comprised the final sample. Hemostasis-related parameters and high platelet reactivity as measured by arachidonic acid–induced and adenosine diphosphate–induced light transmission aggregometry were compared in the 3 groups. A dose-dependent relationship was observed between aspirin and decreased high platelet reactivity incidence (PAA < 0.001, PADP < 0.01, respectively), decreased monocyte ratio (P = 0.052), increased antithrombin activity (P < 0.001), and increased platelet distribution width (P < 0.05). Aspirin at 25–50 mg/d is related to the lowest red blood cell (RBC) count, whereas 75–100 mg/d aspirin showed the highest RBC count among the 3 groups (4.52 ± 0.35 × 1012/L vs. 4.35 ± 0.57 × 1012/L vs. 4.80 ± 0.59 × 1012/L, P = 0.046). Our finding demonstrated that aspirin exerts its antithrombotic effects at least by antiplatelet function, enhancing antithrombin activity and suppressing monocytes in vivo. In addition, 3 blood cell types, namely RBCs, monocytes, and platelets, are involved in the aspirin antithrombotic mechanism. The cellular response to aspirin partially enhances the antithrombotic effects while partially inhibiting the effects.
Cutaneous Blastomycosis and Systemic Findings
Authors: Han Jane J. , Lake Eden 
Published: October 2020

ABSTRACT
Blastomycosis is a disease that has the ability to affect nearly any organ system, most commonly causing pulmonary disease. Diagnosis of blastomycosis therefore presents a unique problem for clinicians because of its diverse array of presentations. Cutaneous disease secondary to pulmonary disease may be the initial manifestation of blastomycosis. Cutaneous disease also has variable presentations from pustules to warty verrucous or ulcerated lesions. This article will focus on the cutaneous presentation of blastomycosis, including primary inoculation and secondary disseminated types, as well as other manifestations of blastomycosis in other organ systems. Diagnostic methods and general treatment guidelines will also be discussed.
Vaping in the Workplace
Authors: Romberg Alexa R. , Diaz Megan C. , Briggs Jodie , Stephens Daniel K. , Rahman Basmah , Graham Amanda L. , Schillo Barbara A. 
Published: October 2020

Objective:
Describe workplace vaping, prevalence of observed use, attitudes, and perceptions among US adults.

Methods:
Employees of companies with more than 150 employees, drawn from an opt-in national online panel (N = 1607), ages 18 to 65, completed an online survey in November 2019.

Results:
Majority (61.6%) observed coworkers vaping at work and 19.1% reported vaping at work themselves. Participants perceived workplace vaping as moderately harmful (M = 1.9 out of 3), 63.2% were bothered by workplace vaping and 52.1% thought it decreased workplace productivity among non-users. Multiple regression models found workplace vaping prevalence varied by industry and participant characteristics, and attitudes about it varied by tobacco use status.

Conclusions:
Workplace vaping and vaping exposure is common in US workplaces. Employees, particularly non-users, hold generally negative perceptions of workplace vaping. Comprehensive policies to prevent workplace vaping are needed to protect workers.
Menstrual Cycle Patterns and Irregularities in Hired Latinx Child Farmworkers
Authors: Varnell Rebecca R. , Arnold Taylor J. , Quandt Sara A. , Talton Jennifer W. , Chen Haiying , Miles Christopher M. , Daniel Stephanie S. , Sandberg Joanne C. , Anderson Kim A. , Arcury Thomas A. 
Published: October 2020

Purpose:
This study identifies the menstrual cycle irregularities of Latinx child and adolescent farmworkers.

Methods:
Child and adolescent farmworkers aged 13 to 20 years completed questionnaires about menstrual cycle patterns in 2019, and wore silicone passive collection wristbands for pesticide detection in 2018. Menstrual cycle irregularities were determined from the American College of Obstetricians and Gynecologists committee opinion.

Results:
Half of participants experienced any menstrual cycle irregularity; the most frequent irregularities were cycle length (38.6%) and having gone 90 days or more without a menstrual period (20.4%). Pesticides were detected in 92.9% of the wristbands; most participants were exposed to an endocrine disrupting chemical (EDC) pesticide.

Conclusion:
Half of Latinx children and adolescents hired farmworkers experience irregular menstrual cycles, and most are exposed to EDCs. Inclusion of occupational and menstrual histories in child and adolescent medical visits is critical.
Cardiorespiratory Fitness of Firefighters
Authors: McKinney Zeke J. , Bovard Ralph S. , Starchook-Moore Maria N. , Ronneberg Kevin , Xi Min , Bredeson Dani M. , Schwartz Erin C. , Thelen Sandra L. , Nash Trista L. , Dickinson Mark , McDonough Thomas , Hirdman Kara , Pronk Nicolaas P. 
Published: October 2020

Objective:
To address which body composition (BC) measures best correlate with cardiorespiratory fitness (CRF) in firefighters and develop a model for accurate CRF estimation compared with traditional methods.

Methods:
Career firefighters had body mass index (BMI) and waist circumference (WC) measured in addition to body fat percentage (FM%) by dual-energy x-ray absorptiometry (DXA). CRF as maximum oxygen uptake (VO2max) was estimated by rowing machine and measured by indirect calorimetry in a treadmill exercise test.

Results:
Fifty two firefighters participated (92.3% men). Univariate correlations with BMI were best with WC. Univariate correlations with VO2max were best with FM%. Obesity classifications by BC measures agreed weakly at best. Multivariate analysis of several variables yielded an improved VO2max estimate (R
2 = 0.70).

Conclusions:
Fire departments may benefit from more sophisticated measures of BC and CRF to evaluate firefighter fitness.
The Clinical Site Visit: Perspectives of Physical Therapist Students
Authors: Greco Jamie L. , Kupczynski Lori , Silberman Nicki , Hammock Amy 
Published: October 2020

Introduction.
Best practice in clinical education includes actions to ensure strong partnerships and close, consistent communication among all stakeholders. One way this can be accomplished is through a site visit. There is limited literature supporting the most preferred communication for conducting these visits. Perspectives of physical therapist students (PTS) about the site visit process are scarce. This study explored whether PTS perceive site visits as important, PTS' preferred method of communication used to conduct these visits, and the reasons underlying these preferences.

Number of Subjects.
One hundred thirty-five PTS.

Materials and Methods.
A mixed-methods, sequential explanatory design was used. A survey was sent to current PTS and recent graduates. Additional qualitative data were collected from a subset of 8 PTS from the sample using semistructured interviews.

Results.
Statistical analysis showed no relationship between the level of clinical experience and preferences for communication methods and no significant differences in levels of importance of site visits. A majority of PTS preferred future visits be conducted in person as opposed to other methods of communication or having no site visit. Students indicated that in-person site visits offer more truthful communication and that although a telephone call may be “sufficient” for a site visit, in-person site visits are necessary when students are having difficulties in the clinic.

Conclusions.
Students are cognizant of the nonverbal cues that occur with in-person communication and that these cues add to the transparency and truthfulness of conversations. Nonverbal communication may be most impactful for the PTS experiencing difficulties during a clinical experience. Given the barriers for conducting site visits, this study provides information that can assist in the decision-making process for communication methods used to conduct these visits. Further research is needed to determine if there is alignment between PTS' perspectives and those of other stakeholders.
A review of glucagon-like peptide 1 receptor agonist and sodium-glucose cotransporter 2 inhibitor cardiovascular trials: Implications for practice
Authors: Battise Dawn M. , Olin Jacqueline L. 
Published: October 2020

ABSTRACT

Background:
Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality for people with type 2 diabetes mellitus (T2DM). Previous pharmacological management recommendations focused primarily on glucose lowering. However, new data demonstrate that select glucagon-like peptide 1 receptor agonists (GLP1 RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) not only provide glucose lowering but also can reduce the risk of cardiovascular (CV) disease.

Objectives:
The purpose of this study was to evaluate the current data regarding CV benefits of GLP1 RA and SGLT2i in select patients with T2DM and the impact on clinical guidelines so that nurse practitioners may optimize pharmacologic management of patients with T2DM.

Data sources:
A literature review was conducted using the PubMed and CINAHL complete databases to identify studies with CV benefits of GLP1 RA and SGLT2i. Pivotal clinical trials were selected for review.

Conclusions:
Select GLP1 RA and SGLT2i can reduce the risk of major adverse CV events, death from CV cases, or hospitalization due to heart failure (HF) in patients with a history of, or at high risk for, CV disease.

Implications for practice:
Based on data from major CV outcomes trials, clinical guidelines recommend GLP1a or SGLT2i in select patients for glucose lowering and CV risk reduction. In addition, even in patients who have achieved glycemic goals, these agents can provide additional benefit by reducing the incidence of major CV adverse events or hospitalization for HF. Understanding the data will help nurse practitioners select the most appropriate agent for a given individual based on comorbidities.
A national study of personal accomplishment, burnout, and satisfaction with work–life integration among advance practice nurses relative to other workers
Authors: Dyrbye Liselotte N. , West Colin P. , Kelsey Elizabeth A. , Gossard Andrea A. , Satele Daniel , Shanafelt Tait 
Published: October 2020

ABSTRACT

Background:
There is a high prevalence of burnout among health care professionals, but little remains known about burnout and satisfaction with work–life integration (WLI) among advance practice nurses (APNs).

Purpose:
To evaluate burnout and satisfaction with WLI among APNs compared with other US workers.

Methods:
A national sample of APNs and a probability-based sample of US workers completed a survey that measured burnout and satisfaction with WLI.

Results:
Of the 976 (47%) APNs who completed the survey 64% had high personal accomplishment, 36.6% had symptoms of overall burnout, and 60.6% were satisfied with their WLI. In multivariable analysis, work hours (for each additional hour odds ratio [OR] 1.03, 95% confidence interval [CI] 1.02–1.04, p < .001) and working in an outpatient setting (overall p = .03; referent hospital: outpatient, OR 1.80, 95% CI 1.17–2.18; other/unknown, OR 1.41, 95% CI 0.90–2.22, p = .13) were independently associated with having higher odds of burnout. Work hours were also independently associated with lower odds of satisfaction with WLI (for each additional hour OR 0.94, 95% CI 0.94–0.95, p < .001). Advance practice nurses were not more likely to have burnout or have greater struggles with WLI than other workers.

Implications for practice:
Findings from this study suggest APNs have high levels of personal accomplishment and a favorable occupational health profile. Advance practice nurses do not appear at higher risk of burnout or dissatisfaction with WLI than other US workers.
Ambulatory blood pressure monitoring: A nurse practitioner run program
Authors: Burke Christine , Haut Catherine , Hussong Kelly , Zaritsky Joshua 
Published: October 2020

ABSTRACT

Background:
Ambulatory blood pressure monitoring (ABPM) is a standard screening tool for the diagnosis of hypertension in children, adolescents, and adults. However, there is confusion and misunderstanding about which guidelines can provide the most accurate diagnostic values.

Local problem:
At a large, free-standing pediatric hospital, ABPM testing was historically being conducted by both nephrology and cardiology departments. The nephrology service was using the American Heart Association (AHA) guidelines, published in 2014 for interpretation of results and for diagnosis of hypertension, whereas the cardiology service depended on the 2004 National High Blood Pressure Education Program (NHBEP) fourth report, which led to discrepancies in diagnosis of hypertension in this patient population.

Methods:
A nurse practitioner–led quality improvement project was designed and implemented to determine the best method of ABPM monitoring and test interpretation based on comparing results of patients using height, gender, and application of either the 2004 NHBEP fourth report or 2014 AHA guidelines.

Interventions:
Using a retrospective chart review, ABPM monitoring results from both cardiology and nephrology services were reviewed and compared to identify the most accurate methods and to recommend changes to practice.

Results:
Accuracy of interpretation for ABPM is best accomplished using the 2014 AHA guidelines.

Conclusions:
Using a single method of interpretation provides consistent diagnosis and treatment of hypertension in children. Nurse practitioners can apply this knowledge in other settings to manage hypertension and provide similar services in different settings, including primary care.
Telemedicine and adherence monitoring in children with asthma
Authors: Blake Kathryn V. 
Published: October 2020

Purpose of review
Telemedicine, defined as synchronous video visits between a provider and a child with asthma, often takes place in the school setting. This review examines the new electronic sensors for adherence monitoring and studies that used telemedicine in the school setting to improve asthma outcomes.

Recent findings
School-based telemedicine provides an important service to families of school-aged children who have difficulty due to time and distance in planning and keeping in-person appointments with primary or specialty providers. Significant improvements in objective measures of asthma control are inconsistently observed although caregiver and parent quality of life and child self-management behaviors are improved and satisfaction is high. Assessment and outcomes related to adherence are mentioned in studies but results are not often reported. However, it appears that adherence interventions are beneficial while maintained but the effects are not sustained upon intervention discontinuation.

Summary
The school setting provides a convenient and suitable environment to conduct telemedicine visits between school-aged children and their primary care or specialty provider. Electronic adherence sensors allow review of controller and rescue medication use through a cloud-based dashboard and provides an opportunity for real-time assessment and intervention by providers to improve asthma outcomes.
Managing chronic rhinosinusitis in severe asthma
Authors: Ramaswamy Uma S. , Patel Vijay A. , Lee Stella E. 
Published: October 2020

Purpose of review
Over half of all patients with severe asthma have chronic rhinosinusitis (CRS). Although distinct and specialized in function and form, the upper and lower airways share similar and inter-related pathophysiologic mechanisms. The severity of CRS particularly in patients with nasal polyps can correlate with that of asthma and vice versa. The purpose of this review is to elucidate the relationship between these conditions and summarize key elements in the management of these patients.

Recent findings
Several advances have been made in the evaluation and treatment of patients with CRS and asthma. Further understanding of inflammatory endotypes common to both CRS and severe asthma hopefully will provide appropriate and effective treatments and improve patient outcomes.

Summary
CRS significantly impairs quality of life, and therapies are targeted toward improving patient symptoms, and hopefully in the future, treating the underlying immune dysfunction. Management of CRS and severe asthma requires a multidisciplinary approach. Further real-world studies are necessary to determine the best treatment algorithm for these patients.
Current management of type III and IV laryngotracheoesophageal clefts: the case for a revised cleft classification
Authors: Jáuregui Emmanuel J. , Propst Evan J. , Johnson Kaalan 
Published: October 2020

Purpose of review
This review summarizes the paediatric laryngotracheoesophageal cleft (LTEC) literature, with an emphasis on recent trends, evaluation and management, surgical techniques, postoperative care of Type III and IV LTECs, and to propose a revised cleft classification system that more accurately reflects our current understanding of these anomalies.

Recent findings
There are a number of techniques described to address Type III and IV LTEC, from endoscopic to open approaches with thoracotomy. The surgical approach should be tailored to the length of the cleft and its proximity to important anatomical structures. On the basis of review of the literature, we propose a modified Benjamin-Inglis classification (MBI) with subcategories to address this issue. Postoperative complications are common, namely, tracheoesophageal fistulae and tracheomalacia, which may necessitate subsequent procedures or prolonged tracheostomy dependence.

Summary
The medical and surgical management of Type III and IV LTEC is challenging with a high rate of morbidity and mortality. The rarity and difficulties in management of these malformations have made large cohort studies difficult, thus generalizable recommendations have been elusive. Experience and patient selection are critical for successful endoscopic repair. Anterior cervical approach, often with complete laryngofissure, appears to be the most common and preferred method for open repairs, though some use a lateral approach. The proposed MBI classification appears to be a useful adjunct to aid in surgical decision-making for deeper LTEC.
Use of the SIGN IM nail system to stabilize tibiotalocalcaneal arthrodesis in two African hospital settings
Authors: Burke Sydney E. , Wangai Isaac K. , Koech Geoffrey K. , Galat Jeremiah D. , Galat Daniel D. , Lundy Douglas W. 
Published: October 2020

Abstract

Objectives:
To determine the effectiveness and describe the technique of using the Surgical Implant Generation Network (SIGN) nail to augment tibiotalocalcaneal (TTC) arthrodesis in the developing world.

Design:
Retrospective review of the SIGN database and description of surgical technique.

Setting:
Two centers in rural Kenya, East Africa.

Patients:
Fifty-seven patients with ankle/hindfoot arthritis or severe trauma. We were able to follow 17 through complete arthrodesis.

Invention:
TTC arthrodesis stabilized with SIGN nail.

Main outcome measure:
Radiographic arthrodesis and return to function.

Result:
Of the patients with significant follow-up, arthrodesis occurred in an average of 19.3 ± 7.5 weeks from the date of surgery.

Conclusions:
Recognizing the obstacles to follow-up, the SIGN nail placed with the Herzog curve apex posterior is shown to be an effective device to stabilize a TTC arthrodesis in a limited subgroup of patients with full follow-up.
Association of Risk of Mortality in Pediatric Patients Transferred From Scene by Helicopter With Major But Not Minor Injuries
Authors: Duffens Ali , Grigorian Areg , de Virgilio Christian , Chin Theresa , Kim Dennis , Lekawa Michael , Schubl Sebastian D. , Nahmias Jeffry 
Published: October 2020

Objectives
Helicopter emergency medical services (HEMS) are used for 16% of pediatric trauma. National HEMS guidelines advised that triage criteria be standardized for pediatric patients. A national report found pediatric HEMS associated with decreased mortality compared with ground emergency medical services (GEMS) but did not control for transport time. We hypothesized that the rate of HEMS has decreased nationally and the mortality risk for HEMS to be similar when adjusting for transport time compared with GEMS.

Methods
The Pediatric Trauma Quality Improvement Program (2014–2016) was queried for patients younger than 16 years transported by HEMS or GEMS. A multivariable logistic regression was used.

Results
From 25,647 patients, 4527 (17.7%) underwent HEMS. The rate of HEMS from scene decreased from 21.2% in 2014 to 18.2% in 2016. The rate of HEMS for minor trauma (Injury Severity Score <15) decreased from 14.9% in 2014 to 13.5% in 2016 and major trauma (Injury Severity Score > 15) from 38.4% in 2014 to 35.9% in 2016. After controlling for predictors of mortality and transport time, HEMS was associated with decreased risk of mortality for only those with major injuries transferred from scene (odds ratio, 0.48; 95% confidence interval, 0.26–0.88; P = 0.01) compared with GEMS.

Conclusions
The rate of HEMS in pediatric trauma has decreased. However, there is room for improvement as 14% of those with minor trauma are transported by HEMS. Given the similar risk of mortality compared with GEMS, further development of guidelines that avoid the unnecessary use of HEMS appears warranted. However, utilization of HEMS for transport of pediatric major trauma should continue.
Do Victims of Abusive Head Trauma Visit Emergency Departments More Often Than Children Hospitalized for Fever? A Case-Control Study
Authors: Bailhache Marion , Lafagne Ambre , Lagarde Marie , Richer Olivier 
Published: October 2020

Objective
During the first years of life, infant crying is a common trigger of abusive head trauma (AHT). Emergency department (ED) use by AHT victims before visits for child abuse symptoms is not well known, particularly for infant crying. Furthermore, diagnosis could be missed. In the same period, fever is a common reason for hospitalization unconnected with AHT. The main goal of our study was to compare the ED use by AHT victims before visits for child abuse symptoms and by children of the same age hospitalized for fever.

Methods
We conducted a retrospective case-control study from 2011 to June 2018 in a French hospital. We compared cases of AHT selected using the International Classification of Diseases and control subjects hospitalized in the general pediatric unit for fever without immunodeficiency matched in age. Univariate and multivariate analyses were performed.

Results
Among the 75 victims of AHT, 5 had at least 1 previous ED visit not linked with abuse. None had visited for infant crying. Among the control subjects, 34 had at least 1 previous ED visit, including 6 for infant crying. Among the 57 dyads of controls and cases living in the hospital's area, the controls had significantly more previous ED visits than the cases (P < 0.001). There were more male infants among the cases (72% vs. 55%, P = 0.033).

Conclusions
Our study suggests that AHT victims had no more ED visits before visits for child abuse symptoms, particularly not for infant crying.