bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19
Authors: Lacy J. Matthew , Brooks Erin G. , Akers Joshua , Armstrong Danielle , Decker Lauren , Gonzalez Adam , Humphrey William , Mayer Romana , Miller Matthew , Perez Catherine , Arango Jose Antonio Ruiz , Sathyavagiswaran Lakshmanan , Stroh Wendy , Utley Suzanne 
Published: May 2020

Abstract
As a result of the 2019 novel human coronavirus (COVID-19) global spread, medical examiner/coroner offices will inevitably encounter increased numbers of COVID-19–infected decedents at autopsy. While in some cases a history of fever and/or respiratory distress (eg, cough or shortness of breath) may suggest the diagnosis, epidemiologic studies indicate that the majority of individuals infected with COVID-19 develop mild to no symptoms. Those dying with—but not of—COVID-19 may still be infectious, however. While multiple guidelines have been issued regarding autopsy protocol in cases of suspected COVID-19 deaths, there is some variability in the recommendations. Additionally, limited recommendations to date have been issued regarding scene investigative protocol, and there is a paucity of publications characterizing COVID-19 postmortem gross and histologic findings. A case of sudden unexpected death due to COVID-19 is presented as a means of illustrating common autopsy findings, as well as diagnostic and biosafety considerations. We also review and summarize the current COVID-19 literature in an effort to provide practical evidence-based biosafety guidance for medical examiner-coroner offices encountering COVID-19 at autopsy.
Prescribing Patterns of Oral Opioid Analgesic for Long Bone Fracture at Tertiary Care Children's Hospital Emergency Departments and Urgent Cares
Authors: Wang George Sam , Reese Jennifer , Bakel Leigh Anne , Leonard Jan , Bos Tod , Bielsky Alan , Nickels Sarah , Bajaj Lalit 
Published: May 2020

Objectives
Disparities in opioid prescribing in children can lead to underprescribing and poorly controlled pain. On the contrary, unnecessary overprescribing can increase the risk for misuse, abuse, and diversion. The primary objective of this study was to compare the demographics and clinical characteristics of children with an extremity fracture who did and did not receive an opioid prescription from a tertiary care children's hospital.

Methods
This was a retrospective cohort study of children younger than 22 years with extremity fracture evaluated at a tertiary care children's hospital emergency department (ED) and surrounding satellite locations (3 EDs and 4 urgent cares), from January 1, 2017, to December 31, 2017.

Results
There were 3325 patients younger than 22 years who were seen for evaluation of an extremity fracture. The overall median age of patients was 8 years (interquartile range [IQR], 4–11), and 1976 (59.4%) were male. Patients with extremity fractures who received opioid analgesics were older than those who did not receive opioids (median age of 10 years [IQR, 6–13 years] vs 7 years [IQR, 4–11 years], P < 0.001). There was a significant difference found between insurance types, specifically those patients receiving Medicaid and private insurance. Patients who received opioid analgesics had a higher initial pain score (7 [IQR, 4–9] vs 5 [IQR, 2–7], P < 0.001), were more likely to have an physician (MD/DO) provider (P < 0.001), and were more likely to present to the ED (P < 0.001).

Conclusions
Younger patients, patients with Medicaid insurance, patients treated by an advanced care provider, and patients who presented to an urgent care were less likely to receive opioid analgesics upon discharge. These findings demonstrate that more standardization and guidance on opioid prescribing are needed in pediatrics, to both adequately treat pain and reduce harms from overprescribing of opioid analgesics.
Association of Maternal Nativity Status and Race/Ethnicity on Emergency Department Utilization Among Children in Vulnerable Families
Authors: Cherian Teena , Crookes Danielle M. , Suglia Shakira F. 
Published: May 2020

Objectives
We aimed to determine the role of mothers' nativity and race/ethnicity on their children's emergency department utilization.

Methods
Data from the Fragile Families and Child Wellbeing Study was used for the analyses. Descriptive and regression analyses were conducted to compare use of ED services between children of foreign-born versus US-born mothers within different racial groups.

Results
The sample in this analysis contained 3426 mother-child pairs, of which 14.2% were foreign-born mothers. Adjusting for mother's race, education, and marital status, child's insurance coverage, and caregiver's perception of child's health, children of foreign-born mothers were less likely to use ED services compared with those born to US-born mothers (risk ratio [RR], 0.71 [0.54–0.94]). Emergency department utilization was lower among children of Hispanic, foreign-born mothers (RR, 0.67 [0.46–0.96]) and among children of non-Hispanic Asian or other race, foreign-born mothers (RR, 0.32 [0.14–0.74]) when compared with children of their US-born counterparts in the respective race.

Conclusions
Maternal nativity status and race influence child's use of emergency department services. Future research should explore the intersection of parental nativity, immigrant documentation status, and citizenship status and how that may influence children's health care usage.
Point-of-Care Procedures in Physiatry
Authors: Karri Jay , Seymour Michelle L. , Verduzco-Gutierrez Monica , Jayaram Prathap 
Published: May 2020

Abstract
Coronavirus disease 2019 is an active pandemic that has required rapid conversion of practice patterns to mitigate disease spread. Although recommendations have been released for physicians to postpone elective procedures, the utility of common physiatry procedures and their infectious risk profile have yet to be clearly delineated. In this article, we describe an update on existing national recommendations and outline considerations as practitioners and institutions strive to meet the needs of patients with disabilities.
Evaluation of Validity and Specificity of the Cottle Maneuver in Diagnosis of Nasal Valve Collapse
Authors: Das Avilash , Spiegel Jeffrey H. 
Published: May 2020

Background:
Despite the widespread use of the Cottle maneuver as a finding to define nasal valve collapse, no studies have confirmed the association between a positive Cottle maneuver and need for nasal valve repair. This study demonstrates the low construct validity of the Cottle maneuver.

Methods:
One hundred healthy volunteer students and employees at Boston Medical Center were recruited for this study. Participants were asked to evaluate their breathing on a 10-point scale, rating their subjective airflow in each nostril while occluding the contralateral nostril, where 0 indicated complete obstruction and 10 indicated complete patency. Following the baseline ratings, participants were asked to rate their breathing once again while examiners preformed the Cottle and modified Cottle maneuvers.

Results:
Overall, 97 percent of participants reported improved airflow in each nostril following the Cottle maneuver (p < 0.00001); 98 percent reported improved airflow in each nostril following the modified Cottle maneuver (p < 0.00001).

Conclusions:
If the clinical consensus regarding the observed improvement in nasal airflow is to be followed, nearly all the participants recruited are experiencing some surgically correctable nasal obstruction. Given the population from which our cohort was collected—students and residents from a medical campus—such a conclusion seems extremely unlikely. We believe the more likely explanation for the high positive test rate is flawed assumptions of the Cottle and modified Cottle maneuvers.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Correction of Severe Short Nose Using a Costal Cartilage Extension Framework
Authors: Wei Jiao , Zhang Jinsong , Herrler Tanja , Wei Shuyi , Chen Qinghua , Li Qingfeng , He Jinguang , Dai Chuanchang 
Published: May 2020

Background
Various techniques for the aesthetic correction of short noses have been described, but the selection of the adequate graft material remains controversial. Previous reports have mainly focused on the application of septal cartilage or alloplastic materials for short nose elongation, but the lengthening effect is often unsatisfactory for severe short noses. We propose costal cartilage as an alternative treatment for short noses, describe the technique, and discuss outcomes, patient selection, and complications based on our 15-year experience.

Methods
From February 2004 to December 2018, 611 patients with varying degrees of short noses were included in this retrospective study. All patients underwent nose elongation surgery using a costal cartilage graft. Nasal length before and after surgery was measured based on a 3-dimensional simulation technology. Outcomes and complications including possible underlying reasons were analyzed. Patient satisfaction was evaluated using a self-assessment survey.

Results
Nasal elongation using costal cartilage was successfully achieved, with a mean increase in nasal length of 4.06 ±0.79 mm. Patients were followed up for a period of 8.5 months on average, ranging from 6 months to 8 years. Follow-up examinations demonstrated stable results. The overall complication rate was 3.8%. Complications included infection, implant extrusion, migration, deviation, visibility, prominence, and reddening of the nasal skin. Most patients (95.2%) rated their outcome as improved and much improved.

Conclusion
Nasal elongation using costal cartilage grafting is an effective therapeutic approach for patients with severe short noses. Reliable outcomes and the use of autologous tissue along with minimal donor site morbidity contribute to the high patient acceptance. Meticulous surgical technique and careful patient selection are prerequisites for successful results.
How to Establish Benchmarks for Surgical Outcomes?
Authors: Gero Daniel , Muller Xavier , Staiger Roxane D. , Gutschow Christian A. , Vonlanthen René , Bueter Marco , Clavien Pierre-Alain , Puhan Milo A. 
Published: May 2020

Objective:
To define a standardized methodology for establishing benchmarks for relevant outcomes in surgery.

Summary Background Data:
Benchmarking is an established tool to improve quality in industry and economics, and is emerging in assessing outcome values in surgery. Despite a recent 10-step approach to identify such benchmark values, a standardized and more widely agreed-on approach is still lacking.

Methods:
A multinational web-based Delphi survey with a focus on methodological requirements for establishing benchmarks for surgical outcomes was performed. Participants were selected among internationally renowned specialists in abdominal, vascular, and thoracic surgery. Consensus was defined as ≥70% agreement and results were used to develop a checklist to establish benchmarks in surgery.

Results:
Forty-one surgical opinion leaders from 19 countries and 5 continents were involved. Experts’ response rates were 98% and 80% in rounds 1 and 2, respectively. Upon completion of the final Delphi round, consensus was successfully achieved for 26 of 36 items covering the following areas: center eligibility, validation of databases, patient cohort selection, procedure selection, duration of follow-up, statistical analysis, and publication requirements regarding center-specific outcomes.

Conclusions:
This multinational Delphi survey represents the first expert-led process for developing a standardized approach for establishing benchmarks for relevant outcome measures in surgery. The provided consensual checklist customizes the methodology of outcome reporting in surgery and thus improves reproducibility and comparability of data and should ultimately serve to improve quality of care.
Neural Basis of Long-term Musical Memory in Cognitively Impaired Older Persons
Authors: Thaut Michael H. , Fischer Corinne E. , Leggieri Melissa , Vuong Veronica , Churchill Nathan W. , Fornazzari Luis R. , Schweizer Tom A. 
Published: May 2020

Objective:
The objective of this study was to determine whether exposure to long-known music would evoke more extensive activation of brain regions minimally affected by Alzheimer disease (AD) pathology and outside traditional memory networks using a functional magnetic resonance imaging paradigm involving listening to long-known and recently-learned music in older adults with cognitive impairment to provide insight into mechanisms of long-term musical memory preservation in cognitively impaired older persons.

Methods:
Seventeen subjects with a diagnosis of mild AD or mild cognitive impairment were recruited for this study. Subjects were scanned using functional magnetic resonance imaging while they performed a music listening task, which included short clips of personally selected music from the patient’s past and newly-composed music heard for the first time 60 minutes before scanning. From this task, we obtained group-level maps comparing brain areas associated with long-known and recently-heard music in all subjects.

Results:
Exposure to long-known music preferentially activated brain regions including the medial prefrontal cortex, precuneus, anterior insula, basal ganglia, hippocampus, amygdala, and cerebellum relative to recently-heard music. These areas are involved in autobiographical memory and associated emotional responses. In addition, they are minimally affected by early stage AD pathology, thus providing a neural basis for long-known musical memory survival.

Conclusions:
Long-known music activates a bilateral network of prefrontal, emotional, motor, auditory, and subcortical regions (cerebellum, putamen, limbic structures). This extensive activation, relative to recently-heard music, may offer structural and functional clues as to why long-term musical memory appears to be relatively preserved among cognitively impaired older persons.
Incidence of Pressure Injury in Individuals With Spinal Cord Injury
Authors: Chen Hong-Lin , Cai Ji-Yu , Du Lin , Shen Hong-Wu , Yu Hai-Rong , Song Yi-Ping , Zha Man-Li 
Published: May 2020

PURPOSE:
The purpose of this systematic review and quantitative analysis of pooled data was to assess the global incidence of pressure injury (PI), across time frames and countries, in individuals with spinal cord injury (SCI).

DESIGN:
Systematic review and meta-analysis.

SEARCH STRATEGY:
PubMed, Web of Science, and EMBASE databases were systematically searched for studies published from database inception to January 2019, with only English language studies that reported the incidence of PIs in individuals with SCI were included. Study quality was assessed by a 14-item standardized checklist. We calculated the incidence of PIs as the number of new PIs in individuals with SCI and the total number of individuals with SCI during the study period. Findings are presented as incidence rate with 95% confidence intervals (CIs).

RESULTS:
The search yielded 1652 studies; after studies were reviewed for inclusion criteria, 29 studies representing N = 82,722 patients were retained for data extraction. The global incidence of PIs was 0.23 (95% CI, 0.20-0.26). Data for regional distribution by country showed a pooled incidence of 0.43 (95% CI, 0.28-0.57) in individuals with SCI in South American countries, 0.36 (95% CI, 0.16-0.56) in African countries, 0.25 (95% CI, 0.14-0.37) in European countries, 0.23 (95% CI, 0.19-0.27) in North American countries, and 0.16 (95% CI, 0.06-0.25) in Asian countries. The incidence was 0.22 (95% CI, 0.19-0.26) in developing countries versus 0.27 (95% CI, 0.17-0.37) in developed countries. From 2000 to 2009, the incidence of PIs in individuals with SCI was 0.28 (95% CI, 0.09-0.47). The incidence rate of PIs before 2000 and after 2009 was 0.23. The hospital- and community-acquired PI incidence was 0.22 (95% CI, 0.19-0.26) and 0.26 (95% CI, 0.20-0.32), respectively.

CONCLUSIONS:
Study findings indicate that more than 1 in 5 individuals with SCI will develop a PI. Individuals with SCI are at high risk of developing PI, especially in community settings or low- and middle-income developing countries. The findings highlight the importance of further investigation of risk factors and prevention and management strategies for PIs in individuals with SCI.
Topical Almond Oil for Prevention of Pressure Injuries
Authors: Borzou Seyed Reza , Amiri Sheller , Azizi Azim , Tapak Leili , Rahimi Bashar Farshid , Moradkhani Shirin 
Published: May 2020

PURPOSE:
The aim of our study was to determine the effect of topical almond oil for prevention of pressure injuries.

DESIGN:
Single-blind randomized clinical trial.

SAMPLE AND SETTING:
Patients admitted to an intensive care unit in Besat Hospital, Hamadan, Iran, were invited to participate in the trial. Data were collected over an 8-month period.

METHODS:
A convenience sample of 108 patients, using a permuted block randomization method was assigned to 3 equal groups that received the intervention almond oil, placebo (liquid paraffin), or control (standard of care). Data included demographic information, Braden Scale score, and National Pressure Ulcer Advisory Panel—European Pressure Ulcer Advisory Panel (NPUAP—EPUAP) pressure injury staging system classification score. The intervention and placebo groups received daily application of 6.5 cc of topical almond oil or paraffin to the sacrum, heels, and shoulders for 7 consecutive days. The skin was evaluated for pressure injuries by an expert nurse who was blinded to groups. Chi-square test, analysis of variance, and regression analyses were used to evaluate relationships within and between groups for study variables, incidence of pressure injuries, and duration of time of onset of pressure injuries. P values less than .05 were deemed statistically significant.

RESULTS:
The incidence of pressure injury in the almond oil group (n = 2; 5.6%) was lower than that in the placebo (n = 5; 13.9%, P = .189) or control groups (n = 9; 25.1%, P = .024). The incidence of pressure injuries in the control group was 6.8 and 2.12 (P = .227) times higher than that in the almond and placebo groups, respectively. The onset day of a pressure injury occurred 5.4 days after initiation of the protocol in the almond oil group compared to 4.22 days in the control group (P = .023) and 5 days in the placebo group (P = .196).

CONCLUSION:
The topical application of almond oil was associated with a lower incidence of pressure injuries and that developed later during the study compared to participants who received paraffin or standard of care only. Further study is recommended to advance this work in populations at risk for pressure injury.
Foot Care Education Among Patients With Diabetes Mellitus in China
Authors: Liu Jin , Lu Qian , Pang Dong , Yang Ping , Jin Sanli , Yuan Geheng , Qi Xin , Wen Bing , Ding Yanming , Guo Xiaohui 
Published: May 2020

PURPOSE:
To investigate the foot care knowledge and behavior of patients with diabetes to determine effect and current challenges of foot care education, as a basis to improve education and reduce diabetic foot complications.

DESIGN:
Quantitative, cross-sectional study.

METHODS:
A convenience sampling method was used to recruit 200 patients with diabetes from the endocrinology clinic of a tertiary general hospital in Beijing between September 2014 and January 2015. Demographic and disease-related data, foot care education, foot risk stratification status, and knowledge and behavior (K&B) scores were collected using investigator-designed questionnaires.

RESULTS:
Of the 200 patients, 128 (64.0%) patients received routine diabetes education, and 73 (36.5%) received foot care education. The mean ± standard deviation (SD) for K&B scores were 63.76 ± 14.85, and 59.78 ± 11.17, respectively. The K&B scores of patients who received foot care education (69.54 ± 14.32 and 65.27 ± 11.90) were significantly higher than those who received diabetic education only (60.75 ± 15.27 and 57.54 ± 10.25) and those with no diabetic education (60.21 ± 13.37 and 55.94 ± 8.74) (P < .01). The K&B scores did not differ for patients based on diabetic foot risk strata (P > .05).

CONCLUSION:
The foot care K&B scores of patients with diabetes were low to moderate levels, particularly on items that pertained to self-foot examination, prompt treatment of foot problems, and regular foot inspection by professionals. Individuals with high risk of developing foot complications did not score higher on the K&B questionnaire. These data suggest there is need for improvement in instruction and patient uptake and application of knowledge. We recommend further study on the effectiveness of the delivery of foot care education based on foot risk stratification, and the implications of foot ulcer prevention in community settings.
Relationship between a single measurement at baseline of body mass index, glycated hemoglobin, and the risk of mortality and cardiovascular morbidity in type 2 diabetes mellitus
Authors: Brown Oliver , Costanzo Pierluigi , Clark Andrew L. , Condorelli Gianluigi , Cleland John G.F. , Sathyapalan Thozhukat , Hepburn David , Kilpatrick Eric S. , Atkin Stephen L. 
Published: May 2020

Objective
This study aims to evaluate the relationship between a single measurement at baseline of body mass index (BMI), glycated hemoglobin (HbA1c) and subsequent clinical outcomes in patients with type 2 diabetes mellitus (T2DM).

Method
Patients with T2DM were recruited from an outpatient diabetes clinic in a single large teaching hospital in Kingston upon Hull, UK. At baseline, demographics and HbA1c were recorded. Patients were categorized by BMI: normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (>30 kg/m2). Multivariable Cox regression models that included demographic, risk factors, and comorbidities were separately constructed for all-cause, cardiovascular, cancer and sepsis-related mortality, using four groups of HbA1c (<6%, 6.0–6.9%, 7.0–7.9%, and >8%).

Results
In total, 6220 patients with T2DM (median age 62 years, 54% male) were followed for a median of 10.6 years. HbA1c levels >8.0% were associated with increased risk of all-cause mortality and cardiovascular death. However, this increased risk was not consistent across the weight categories and reached statistical significance only in overweight patients (BMI 25–29.9 kg/m2).

Conclusions
In a large cohort of patients with T2DM elevated HbA1c levels at baseline did not consistently predict increased risk of all-cause and cardiovascular mortality across the different BMI categories.