bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrical Injuries in Children: A 10-Year Experience at a Tertiary Pediatric Burn Center
Authors: Demir Sabri , Demir Tugba Ornek , Erturk Ahmet , Oztorun Can İhsan , Guney Dogus , Erten Elif Emel , Altinok Metin Kaan , Azili Mujdem Nur , Senel Emrah 
Published: January 2021

Abstract
Electrical injuries comprise 4% of cases but have higher morbidity and mortality. This study aims to share our experiences with pediatric electrical injuries and propose strategies to prevent them. The files of pediatric electrical injuries between 2010 and 2020 were reviewed retrospectively. The following were investigated: age, gender, cause, length of stay in the pediatric burn center, total burned surface area, voltage-type, and surgical procedures performed. The patients from low- and high-voltage groups were compared. Eighty-five patients were treated in the last 10 years. Seventy were males, the mean age was 9.9 years, the average length of stay in pediatric burn center was 18.2 days, and the average total burned surface area was 11.7%. Forty-three patients were injured with high-voltage and 42 with low-voltage electricity. Fasciotomy was performed in 25 patients, grafting in 40 patients, and amputation in 12 patients. The most often amputated limb was the right arm/forearm. Psychiatric disorders developed in 24 patients. One patient died. In conclusion, the incidence of high-voltage electrical injuries increases with age. They are more prevalent in males, more often accompanied by additional trauma, and have higher total burned surface area, surgical procedures are performed more often, and hospitalization times are longer. For prevention, precautions should be taken by governments and families, and education is critical.
Suicidality After Burn Injuries: A Systematic Review
Authors: Lerman Sheera F , Sylvester Scott , Hultman C Scott , Caffrey Julie A 
Published: January 2021

Abstract
Burn survivors may be at increased risk for suicide due to the nature of their injury and psychiatric comorbidities. The purpose of this review is to assess the evidence as to the prevalence of suicidal ideations and behaviors (attempts and completed suicides) in burn survivors as well as evaluate risk and protective factors. PubMed, EMBASE, CINAHL, Cochrane, PsycINFO, and Web Science databases were searched using search terms regarding suicide, suicidality, and burn. Fourteen full-text manuscripts and two published abstracts were included in the review. Overall, burn survivors demonstrate elevated suicidal ideations and a higher lifetime prevalence of suicide attempts compared to the general population. There is mixed evidence as to rates of completed suicide postburn injury, though rates appear to be relatively low. Risk factors include pain at discharge, perceived level of disfigurement, premorbid psychiatric comorbidities, and past suicide attempts. Results of this systematic review shed light on the scarcity of data on rates of suicidality among burn survivors, which is surprising given the multiple risk factors burn survivors possess including chronic pain, sleep disturbances, history of substance abuse, posttraumatic stress disorder, social isolation, and depression which are linked to suicidality in the general population. Suicide risk screening should be included as an integral part of burn survivors’ care, and more research is needed to better understand the magnitude of this phenomenon and offer targeted interventions to vulnerable individuals.
Errors in Breast Imaging: How to Reduce Errors and Promote a Safety Environment
Authors: Sivarajah Rebecca , Dinh Mary L , Chetlen Alison 
Published: January 2021

Abstract
Medical errors have a significant impact on patient care, worker safety, and health care finances. Breast imaging has the most common cause of organ-related misdiagnosis subject to malpractice suits. In order to effectively develop strategies to prevent errors, breast imaging radiologists must first understand the underlying causes of the errors that occur in the breast imaging setting. Errors in breast imaging can be related to errors in interpretation, improper workup of imaging findings, procedural errors, or errors in communication to the patient or other medical staff. The Yorkshire contributory factors framework was developed to identify factors that contribute to the errors in a hospital setting and can be adapted for use in the breast imaging setting. Within this framework, active failures refer to errors that directly affect the patient. Active errors include slips (including biases), lapses, and mistakes. The framework describes how active errors often result from factors that occur uphill from these active errors at different levels within the system. Once error causes are understood, there are concrete strategies and tools that breast imaging radiologists can implement to decrease adverse events, reduce medical errors, and promote a safety environment in the breast imaging clinic. Error mitigation tools can be summarized using the acronym SAFE, which includes support the team, ask questions, focus on a task, and effectively communicate/ensure equipment optimization/safe environment. Knowledge of errors commonly seen in a breast imaging clinic represent an opportunity for constructive changes and, ultimately, improved health care delivery.
Impact of COVID-19 on Breast Imaging Practice Operations and Recovery Efforts: A North American Study
Authors: Dodelzon Katerina , Grimm Lars J , Tran Khai , Dontchos Brian N , Destounis Stamatia , Dialani Vandana , Dogan Basak , Sonnenblick Emily , Zuley Margarita , Milch Hannah S 
Published: January 2021

Abstract

Objective
To assess the impact of the COVID-19 pandemic on breast imaging facilities’ operations and recovery efforts across North America.

Methods
A survey on breast imaging facilities’ operations and strategies for recovery during the COVID-19 pandemic was distributed to the membership of the Society of Breast Imaging and National Consortium of Breast Centers from June 4, 2020, to July 14, 2020. A descriptive summary of responses was performed. Comparisons were made between demographic variables of respondents and questions of interest using a Pearson chi-square test.

Results
There were 473 survey respondents (response rate of 13%). The majority of respondents (70%; 332/473) reported 80%–100% breast imaging volume reduction, with 94% (447/473) reporting postponement of screening mammography. The majority of respondents (97%; 457/473) continued to perform biopsies. There were regional differences in safety measures taken for staff (P = 0.004), with practices in the West more likely reporting no changes in the work environment compared to other regions. The most common changes to patients’ experience included spacing out of furniture in waiting rooms (94%; 445/473), limiting visitors (91%; 430/473), and spacing out appointments (83%). A significantly higher proportion of practices in the Northeast (95%; 104/109) initiated patient scheduling changes compared to other regions (P = 0.004).

Conclusion
COVID-19 had an acute impact on breast imaging facilities. Although common national operational patterns emerged, geographic variability was notable in particular in recovery efforts. These findings may inform future best practices for delivering breast imaging care amid the ongoing and geographically shifting COVID-19 pandemic.
Burden of Behavioral Health Comorbidities on Outpatient Health Care Utilization by Active Duty Service Members With a First Documented mTBI
Authors: Kasuske Lalon M , Hoover Peter , Wu Tim , French Louis M , Caban Jesus J 
Published: January 2021

ABSTRACT

Objective
More than 280,000 Active Duty Service Members (ADSMs) sustained a mild traumatic brain injury (mTBI) between 2000 and 2019 (Q3). Previous studies of veterans have shown higher utilization of outpatient health clinics by veterans diagnosed with mTBI. Additionally, veterans with mTBI and comorbid behavioral health (BH) conditions such as post-traumatic stress disorder, depression, and substance use disorders have significantly higher health care utilization than veterans diagnosed with mTBI alone. However, few studies of the relationship between mTBI, health care utilization, and BH conditions in the active duty military population currently exist. We examined the proportion of ADSMs with a BH diagnosis before and after a first documented mTBI and quantified outpatient utilization of the Military Health System in the year before and following injury.

Materials and Methods
Retrospective analysis of 4,901,840 outpatient encounters for 39,559 ADSMs with a first documented diagnosis of mTBI recorded in the Department of Defense electronic health record, subsets of who had a BH diagnosis. We examined median outpatient utilization 1 year before and 1 year after mTBI using Wilcoxon signed rank test, and the results are reported with an effect size r. Outpatient utilization is compared by BH subgroups.

Results
Approximately 60% of ADSMs experience a first mTBI with no associated BH condition, but 17% of men and women are newly diagnosed with a BH condition in the year following mTBI. ADSMs with a history of a BH condition before mTBI increased their median outpatient utilization from 23 to 35 visits for men and from 32 to 42 visits for women. In previously healthy ADSMs with a new BH condition following mTBI, men more than tripled median utilization from 7 to 24 outpatient visits, and women doubled utilization from 15 to 32 outpatient visits.

Conclusions
Behavioral health comorbidities affect approximately one-third of ADSMs following a first mTBI, and approximately 17% of previously healthy active duty men and women will be diagnosed with a new BH condition in the year following a first mTBI. Post-mTBI outpatient health care utilization is highly dependent on the presence or absence of BH condition and is markedly higher is ADSMs with a BH diagnosis in the year after a first documented mTBI.
A Comparison of Nonhuman Primate Injuries in Horizontal Versus Vertical Sled +Gz (Head-to-Foot) Impact Accelerations
Authors: Abraczinskas Alicia , Olszko Ardyn , Beltran Christine , Baisden Jamie L , Yoganandan Narayan , McGhee James , McGovern Shannon , Lidl Grace , Vasquez Kimberly B , Chancey Valeta C 
Published: January 2021

ABSTRACT

Introduction
Accelerative events commonly expose military pilots to potentially injurious + Gz (axial, caudal to cranial) accelerations. The Naval Biodynamics Laboratory exposed nonhuman primates (NHPs) to + Gz loading in two subject orientations (supine or upright) to assess the effect of orientation and accelerations associated with injury at accelerations unsafe for human participation.

Materials and Methods
Archived care records, run records, and necropsy and pathology reports were used to identify acceleration-related injuries. Injuries were categorized as central nervous system (CNS), musculoskeletal (MSK) system, or thoracic (THR). The occurrence of injuries relative to corresponding peak sled acceleration (PSA) and subject orientation were compared. A t-test was applied within each injury category to test for a significant difference in mean PSA between orientations.

Results
For all 63 + Gz runs conducted, PSA ranged between 6 and 86 G. Of these runs, 17 (6 supine, 11 upright) resulted in acceleration-related injury. The lowest PSAs associated with injury for supine and upright were 69.8 G and 39.6 G, respectively. Individual injury occurrences for supine runs (CNS [n = 5], MSK [n = 6], and THR [n = 6]) occurred at/above 75.7 G, 69.8 G, and 69.8 G, respectively. For upright runs, injury occurrences (CNS [n = 3], MSK injuries [n = 9], and THR injuries [n = 6]) occurred at/above 60.1 G, 39.6 G, and 50.5 G, respectively. The applied t-test showed significant difference between the mean orientation accelerations within each category. Injuries to supine NHPs included compression fracture, organ damage, brain hemorrhage, spinal cord hemorrhage, cervical hemorrhage, paresis/paraplegia, and THR bruising, whereas injuries to upright NHPs included compression fracture, organ damage, spinal cord hemorrhage, paresis/paraplegia, THR bruising, and difficulty breathing.

Conclusions
Axial loading to supine occupants produced more CNS injuries, whereas upright produced more MSK injuries. Both orientations produced equal THR injuries. NHP injuries reported reflected those reported following human + Gz acceleration events, highlighting the importance of orientation during acceleration to mitigate injury for next generation equipment design and testing.
Novel Phototherapy Kiosk Shows Promise as a Treatment Option for Low Vitamin D
Authors: McCarthy Mary S , Elshaw Evelyn B , Szekely Barbara M , Beltran Thomas 
Published: January 2021

ABSTRACT

Introduction
The purpose of this study was to demonstrate the feasibility of a phototherapy kiosk (PK) to engage community adults in health promotion and to stimulate production of circulating 25-hydroxyvitamin (OH)D as effectively as a vitamin D3 oral supplement (OS). Although optimal production of vitamin D comes from sun exposure, ultraviolet B radiation with a wavelength of 290 to 320 nm penetrates exposed skin and may produce vitamin D3 using a PK.

Materials and Methods
A prospective study was conducted with adults randomized to either six PK treatments or D3 OS for 10 weeks. Serum 25(OH)D was drawn at baseline, 10 weeks, and 14 weeks. Primary outcome was serum 25(OH)D level. Mann–Whitney test was used to assess continuous data and Chi squared test for pairwise comparisons of categorical data. Significance was set at P &lt; .05.

Results
With 18% attrition, final sample size was 88; OS, n = 45, PK, n = 43. Sample was mostly female (60%), median age 35 years, with no differences observed between groups for age, race/ethnicity, marital status, military affiliation, or season of enrollment. Median daily intake of calcium and vitamin D was well below the recommended daily allowance for each nutrient, and group. Baseline median serum 25(OH)D levels were similar. By 10 weeks, PK median level was 30 ng/mL (interquartile range [IQR] 25.8-37.0) and OS was 26 ng/mL (IQR 21.5-30.5), P = .02. The difference in 25(OH)D levels persisted at 14 weeks; the PK group returned to baseline, 27 ng/mL (IQR 22.0-32.5), and OS group declined to 21 ng/mL (IQR 17.0-30.0), P = .02.

Conclusion
Programmed ultraviolet B phototherapy appears to be an efficacious alternative to oral vitamin D supplementation with consistent use.
Algorithm Directed Troop Medical Care Manual Application for Desktop and Smartphone
Authors: Chrosniak James , Olsen Christian , Galdi Andrew 
Published: January 2021

ABSTRACT

Introduction
The U.S. Army medics are often the first responders in the care of sick and injured soldiers on the battlefield, sick call in a Role 2 aid station and garrison clinics. Sick call medics are required to utilize the Algorithm Directed Troop Medical Care (ADTMC) to care for and then render a disposition for these soldiers. The current ADTMC manual is a thick, heavy paper manual. A desktop and smartphone application has been developed that contains the entire ADTMC manual algorithm–based content. Our goal is to enhance the medics’ clinical learning and critical thinking skills while improving their evaluation, disposition, and documentation during patient encounters.

Materials and Methods
The application was field-tested with the 173rd IBCT (A) while attending a field exercise at Grafenwoehr, Germany. At the unit’s Role 2 tent setup, the use of the paper manual to the utilization of the same material via the ADTMC application was compared by observing the medics’ workflows directly while they were caring for ill and injured soldiers.

Results
Medics, while examining patients, would demonstrate 50% faster exam time using the application compared to medics using only the manual. Moreover, a 50% decrease in document processing time as a result of digitization of the paper documentation process was confirmed. The application (“app”) enabled the medics to continue their screening assessments and patient disposition duties on a desktop computer or a smartphone without the need to refer to the paper manual.

Conclusion
Medics, by adopting this tool, will become quicker, more efficient, and develop critical thinking skills. In other words, the ability to objectively evaluate patients in order to form a proper disposition of sick and injured soldiers during training, in the field, as well as in garrison. When utilized properly, the ADTMC application ensures that soldiers reporting to sick call are expeditiously routed to the appropriate level of care, and is a vehicle for further training for medics in the care of soldiers.
Manganese Breaks the Immune Tolerance of HBs-Ag
Authors: Lin Mengxin , Guo Ruyi , Ma Cuiping , Zeng Dawu , Su Zhijun 
Published: January 2021

Abstract

Background
Manganese (Mn2+) has been shown to promote type I interferon (IFN) production and activate the cyclic GMP-AMP synthase (cGAS)/Stimulator of Interferon Genes (STING) signaling pathway, suggesting that Mn2+ could be used as an adjuvant for vaccination.

Methods
In present study, the effects of Mn2+ on vaccination against hepatitis B virus (HBV) were evaluated. We treated mouse hepatocytes and kuppfer cells with Mn2+ with or without adeno-associated virus (AAV)–HBV infection. Expression of IFN-α and IFN-β and activation of TBK1 and IRF3 were monitored. Wild-type and STING-/- mice were treated with Mn2+ and then infected with AAV-HBV. Serum levels of HBV surface antigen (HBsAg), alanine aminotransferase (ALT) activity, IFN-α, and IFN-β were detected. Lymphocyte infiltration in the liver was evaluated. HBsAg-Tg mice were vaccinated with Mn2+ and HBsAg. The serum levels of HBsAg antibody, alanine transaminase activity, and IFN-β were monitored after vaccination.

Results
Mn2+ promoted IFN-α and IFN-β production in mouse hepatocytes and kuppfer cells. Mn2+ failed to promote IFN-α and IFN-β production in kuppfer cells deficient in STING. Mn2+ promoted activation/phosphorylation of TBK1 and IRF3 during AAV-HBV infection. Mn2+ decreased serum levels of HBsAG, increased serum levels of alanine aminotransferase (ALT), IFN-α and IFN-β, and enhanced lymphocyte infiltration and the percentage of IFN-γ-producing CD8+ T cells in the liver of AAV-HBV-infected mice. In contrast, Mn2+ treatment did not affect serum levels of HBsAG, ALT, IFN-α, or IFN-β in STING-deficient mice.

Conclusions
Mn2+ promoted HBsAG antibody, ALT, and IFN-β production after HBsAG immunization. Mn2+ promoted type I IFN production in AAV-HBV infection and HBsAG immunization and could be used as an adjuvant for vaccination.
How housing affects the association between low income and living conditions-deprivation across Europe
Authors: Dewilde Caroline 
Published: January 2021

Abstract
To explain an emerging trend towards deteriorating living conditions among low-income households across several (West-)European countries, it makes sense to investigate domains of socio-economic regulation that impact on expenditures, rather than incomes. I focus specifically on the domain of housing. Multilevel analyses for 28 countries (EU-SILC) demonstrate that redistributive housing policies such as rental market regulation and housing allowances weaken the cross-sectional (between-country) positive association between a low-income and living conditions-deprivation, while also benefiting living conditions across the broader population. Regarding changes over time, increased uptake of housing allowances throughout the Great Financial Crisis (2008/2009) seems to have shielded in particular renters from deteriorating living conditions, and might have compensated for declining availability of social housing. Higher house prices and price volatility, indicating housing market financialization, are associated with increased living conditions-deprivation for renters and low-income owners, both cross-sectionally and within countries over time. Anti-poverty policies should thus take a broader perspective, and take better account of provision for housing and other basic needs.
Evaluating the effectiveness of a physical activity social media advertising campaign using Facebook, Facebook Messenger, and Instagram
Authors: Northcott Celine , Curtis Rachel , Bogomolova Svetlana , Olds Timothy , Vandelanotte Corneel , Plotnikoff Ronald , Maher Carol 
Published: January 2021

AbstractTechnology-based physical activity programs are a novel solution to the major public health issue of physical inactivity. However, to be successful, there must be a large and population-appropriate uptake, which depends heavily on promotion. This study evaluates the effectiveness of an advertising campaign to disseminate a physical activity smartphone app. The experiment used a 3 × 3 × 3 full-factorial design, examining platforms (Facebook; Facebook Messenger; Instagram), selling-techniques (hard-sell—sending viewers directly to (a) Apple Store or (b) Google Play, and soft-sell—sending viewers from an ad to a (c) landing-page, then to an app store) and themes (Health and Wellbeing; Body and Self-Confidence; Social Enjoyment). Outcomes were reach, click-through, and app downloads. Advertisements reached 1,373,273 people, achieving 2,989 clicks and 667 downloads. Instagram and Facebook Messenger had higher reach compared to Facebook (F[2,27] = 27.17, p &lt; .001), whilst Facebook and Facebook Messenger both produced higher click-through (F[2,27] = 8.98, p &lt; .001) and downloads (F[2,27] = 4.649, p = .018). Selling-technique differed, with soft-selling ads producing greater reach (F[2,27] = 4,616.077, p &lt; .001); however, both hard-selling ads (Apple Store and Google Play) had greater click-through (F[2,27] = 10.77, p &lt; .001) and downloads (F[2,27] = 3.791, p &lt; .001). Advertising theme varied, with Social Enjoyment themes producing less click-through (F[2,27] = 5.709, p = .009) and downloads (F[2,27] = 5.480, p = .010). We recommend future studies to consider Facebook and Facebook Messenger, using hard-selling techniques, with themes relating to Health and Wellbeing and Body and Self-Confidence.
Becoming an Antiracist Neonatal Community
Authors: Vance Ashlee J. , Bell Tracey 
Published: January 2021

Background:
There are pervasive and documented disparities in maternal and infant outcomes related to race and ethnicity. Critical awareness is growing in our current cultural environment about strategies to improve health equity, the need to challenge implicit bias, and dismantle racism in healthcare to decrease racial health inequities.

Methods:
In this article, we provide a summary of health inequities that exist within the perinatal/neonatal population and offer strategies for initiating conversations and improving health equity by challenging bias and increasing diversity.

Results:
Transformative leaders must understand the evidence related to health disparities, understand social drivers of inequity issues, and identify solutions to influence change.

Implications for Practice:
With heightened awareness and examination of implicit bias, we can improve care for all infants and their families.

Implications for Research:
We need to continue research and quality improvement efforts to improve health equity. Furthermore, research is needed that focus on social determinants of health as drivers of preterm delivery and birth complications, rather than biological (eg, racialized) factors.

Video Abstract available at:
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=42