bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice scholarship engagement as reported by nurses holding a doctor of nursing practice degree
Authors: Kesten Karen , Moran Katherine , Beebe Sarah L. , Conrad Dianne , Burson Rosanne , Corrigan Catherine , Manderscheid Amy , Pohl Elizabeth 
Published: June 2021

ABSTRACT

Background:
Nearly 15 years after the introduction of the doctor of nursing practice (DNP) degree, stakeholders anticipate practice scholarship outcomes from graduates.

Purpose:
To examine the frequency of engagement in practice scholarship, the relationship between the knowledge gained in DNP programs and the frequency of engagement in practice scholarship and the relationship between engagement in practice scholarship, work role, and years since graduation with a DNP degree, as reported by practicing nurses.

Methodology:
This cross-sectional study recruited 306 practicing DNP graduates via a national organization and employed an electronic survey. Descriptive and inferential statistics, correlational analysis, and a one-way analysis of variance were conducted on demographics and outcome variables for 269 completed surveys.

Results:
The practice scholarship activity reported most frequently was evaluation of current clinical evidence and least frequently was dissemination of policy papers. Reported knowledge gained from DNP programs and frequency of engagement in practice scholarship indicate a weak positive correlation. There was a significant difference in the direct care work role and practice scholarship engagement compared with other roles, and between those practicing greater than 10 years and those with less experience.

Conclusions:
Results highlight the underutilization of knowledge gained in DNP programs and engagement in practice scholarship. The study emphasizes the complexity of realizing practice scholarship outcomes of DNP-prepared nurses to influence patients, populations, systems, and policy as well as the advancement of the nursing profession.

Implications:
This is a call to action for DNP graduates, academia, practice, and the nursing profession to support and value practice scholarship.
Biodegradable polymer drug-eluting stents versus durable polymer drug-eluting stents for percutaneous coronary intervention: a contemporary registry-based analysis
Authors: Levi Amos , Kheifets Mark , Bental Tamir , Perl Leor , Codner Pablo , Witberg Guy , Talmor-Barkan Yeela , Landes Uri , Samara Abed , Greenberg Gabriel , Erez Aharon , Vaknin-Assa Hanna , Kornowski Ran 
Published: June 2021

Aims
We aimed to compare the long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) with biodegradable polymer drug-eluting stents (BP-DES) versus durable polymer drug-eluting stents (DP-DES).

Methods and results
Among 11 517 PCIs with second-generation DES performed in our institution between 2007 and 2019, we identified 8042 procedures performed using DP-DES and 3475 using BP-DES. The primary outcome was target lesion failure, the composite target lesion revascularization (TLR), target vessel myocardial infarction and death. Propensity score matching was used to create a well-balanced cohort. Mean follow-up was 4.8 years. Of the 3413 matched pairs, 21% were females, and the mean age was 66 years. At 1 year, the primary outcome occurred in 8.3% patients versus 7.1% (P = 0.07), and TLR rate was 3% versus 2% (P = 0.006) in patients with DP-DES and BP-DES respectively. Within 5 years, the primary outcome occurred in 23.1% versus 23.4% (P = 0.44), and the rate of TLR was 7.2% versus 6.5% (P = 0.07) in patients with DP-DES and BP-DES, respectively.

Conclusion
Similar rates of the composite outcome were observed throughout the entire follow-up. Target lesion revascularization rates were lower in the BP-DES group at 1-year but equalized within 5 years.
Comparison of bone SPECT/CT and MRI in detection of pain generator in ankle and foot pain: a retrospective diagnostic study
Authors: Agrawal Kanhaiyalal , Swaroop Shakti , Patro P. Sai Sradha , Tripathy Sujit Kumar , Naik Suprava , Velagada Sandeep 
Published: June 2021

Objective
To study the sensitivity and specificity of MRI and bone SPECT-CT in detecting the pain generator in ankle and foot pain with diagnostic dilemma.

Methods
Retrospectively data of patients with ankle or foot pain who underwent both MRI and Bone SPECT-CT were analyzed. The lesions and probable pain generator sites were reported as per MRI and bone SPECT-CT findings. These lesions were correlated clinically, managed accordingly and followed up. The patients who had significant improvement in response to the treatment provided were considered to have been diagnosed accurately. The foot and ankle disability index (FADI) was used to evaluate the patient’s pre- and postintervention condition.

Results
The study included 37 patients retrospectively (18 women and 19 men). The lesions were classified into soft tissue lesions (ligaments/tendons), joint lesions (arthritis) and bony lesions (fractures/osteomyelitis/osteochondral lesions). Overall, MRI had sensitivity, specificity, positive predictive value and negative predictive value of 82, 31, 74 and 42%, respectively, and SPECT-CT had sensitivity, specificity, positive predictive value and negative predictive value of 84, 60, 84 and 60%, respectively. The mean FADI score pretreatment for all patients was 61.5 (SD = 13.8) and posttreatment 88.4 (SD = 13.01) showing significant improvement in the score (P < 0.05), suggesting that the final diagnosis of these patients was accurate. Overall, management change due to bone SPECT-CT over MRI was seen in 26% of patients.

Conclusion
Bone SPECT-CT has incremental value over MRI in the diagnosis of pain generator in foot and ankle pain. The overall specificity of bone SPECT-CT is higher than MRI in detection of pain generators. Bone SPECT-CT performed better than MRI in detection of culprit pathology in the bone, whereas MRI is better in soft tissue lesions.

Advances in knowledge
There are only a few published literature with direct comparison of bone SPECT-CT scintigraphy and MRI in detection of foot and ankle pain generator. This study directly compares diagnostic utility of bone SPECT-CT scintigraphy and MRI in foot and ankle pain. In the present study, the bone SPECT-CT performed better than MRI in detection of culprit pathology in the bone, whereas MRI is better in soft tissue lesions.
Protective Factors to Promote Health and Flourishing in Black Youth Exposed to Parental Incarceration
Authors: Boch Samantha J. , Ford Jodi L. 
Published: June 2021

Abstract

Background
Mass incarceration of Black fathers and mothers in the United States has had an undeniably negative effect on the health and well-being of their children, families, and communities. Nearly 1 in every 9 Black youth in the United States has had an incarcerated parent compared to 1 in every 17 White youth. To mitigate the consequences of such historical and structural racism, family and community protective factors that promote health and flourishing in Black youth need exploration.

Objectives
The aim of this study was to understand the associations of protective family, school, and neighborhood factors of overall health and flourishing in Black youth ever exposed to parental incarceration.

Methods
Using the 2016–2019 National Survey of Children’s Health, secondary data analyses were conducted of Black youth ages 6–17 years exposed to parental incarceration (n = 839). Multivariable logistic regression models predicted the associations among protective family and community factors and two child outcomes of interest: overall good health status and flourishing. Overall good health status was measured dichotomously comparing children in “good, very good, or excellent” health to children in “fair or poor” health. Flourishing was measured as a count score using three survey questions designed to assess the child’s curiosity and discovery about learning, resilience, and self-regulation. Protective factors of interest included family resilience and connectedness, neighborhood support and safety, and school safety. Other child and caregiver demographics and health characteristics were also included as covariates.

Results
Across all models, higher levels of family connectedness were associated with greater odds of having overall good health and flourishing in Black youth exposed to parental incarceration after adjusting for covariates and neighborhood and school protective characteristics. No significant associations were found between neighborhood or school protective factors and either outcome.

Discussion
To achieve health equity and maximize opportunities for all youth, we must remove the obstacles and consequences of mass incarceration. Improving the health and flourishing of Black youth who have had incarcerated parents requires greater investment in structural supports to bolster family connectedness and better evidence on how to support families affected by mass incarceration and structural racism.
The Association Between Neighborhood Social Vulnerability and Cardiovascular Health Risk Among Black/African American Women in the InterGEN Study
Authors: Basile Ibrahim Bridget , Barcelona Veronica , Condon Eileen M. , Crusto Cindy A. , Taylor Jacquelyn Y. 
Published: June 2021

Background
Black/African American women in the United States are more likely to live in neighborhoods with higher social vulnerability than other racial/ethnic groups, even when adjusting for personal income. Social vulnerability, defined as the degree to which the social conditions of a community affect its ability to prevent loss and suffering in the event of disaster, has been used in research as an objective measure of neighborhood social vulnerability. Black/African American women also have the highest rates of hypertension and obesity in the United States.

Objectives
The purpose of this study was to examine the relationship between neighborhood social vulnerability and cardiovascular risk (hypertension and obesity) among Black/African American women.

Methods
We conducted a secondary analysis of data from the InterGEN Study that enrolled Black/African American women in the Northeast United States. Participants’ addresses were geocoded to ascertain neighborhood vulnerability using the Centers for Disease Control and Prevention’s Social Vulnerability Index at the census tract level. We used multivariable regression models to examine associations between objective measures of neighborhood quality and indicators of structural racism and systolic and diastolic blood pressure and obesity (body mass index > 24.9) and to test psychological stress, coping, and depression as potential moderators of these relationships.

Results
Seventy-four percent of participating Black/African American women lived in neighborhoods in the top quartile for social vulnerability nationally. Women living in the top 10% of most socially vulnerable neighborhoods in our sample had more than a threefold greater likelihood of hypertension when compared to those living in less vulnerable neighborhoods. Objective neighborhood measures of structural racism (percentage of poverty, percentage of unemployment, percentage of residents >25 years old without a high school diploma, and percentage of residents without access to a vehicle) were significantly associated with elevated diastolic blood pressure and obesity in adjusted models. Psychological stress had a significant moderating effect on the associations between neighborhood vulnerability and cardiovascular risk.

Discussion
We identified important associations between structural racism, the neighborhood environment, and cardiovascular health among Black/African American women. These findings add to a critical body of evidence documenting the role of structural racism in perpetuating health inequities and highlight the need for a multifaceted approach to policy, research, and interventions to address racial health inequities.
Detection of Lymphogranuloma Venereum–Associated Chlamydia trachomatis L2 Serovars in Remnant Rectal Specimens Collected from 7 US Public Health Laboratories
Authors: Chi Kai H. , de Voux Alex , Morris Monica , Katz Samantha S. , Pillay Allan , Danavall Damien , Bowden Katherine E. , Gaynor Anne M. , Kersh Ellen N. 
Published: June 2021

Abstract
The frequency of lymphogranuloma venereum or invasive Chlamydia trachomatis infection with serovar L1, L2, or L3 is unknown in the United States. While no diagnostic test is commercially available, we used a laboratory-developed test and detected lymphogranuloma venereum–associated serovar L2 in 14% of 132 remnant C. trachomatis–positive rectal swabs.
Assessing Public Health Workforce Informatics Competencies: A Study of 3 District Health Departments in Georgia
Authors: Adewale Olatanwa , Apenteng Bettye A. , Shah Gulzar H. , Mase William A. 
Published: June 2021

Context:
Despite the increased recognition of the importance of having informatics-competent public health professionals, the competency level of the public health workforce in public health informatics (PHI) has not been examined extensively in the literature.

Objective:
The purpose of this study was to assess public health workforce informatics competencies in select Georgia health districts and determine the correlates of PHI proficiency.

Methods:
This study is based on a cross-sectional quantitative study design. We conducted an online self-administered survey of employees from 3 selected district health departments to assess proficiency in foundational PHI competency domains. Three hundred thirty-three respondents completed the survey, with a response rate of 32.5%. A gap score was calculated as a proxy to identify informatics training needs. A path analysis was conducted to assess the relationships among contextual factors and foundational PHI competency domains.

Results:
The public health employees participating in this study reported relatively high proficiency in foundational PHI competency. Psychometric testing of the competency assessment instrument revealed 2 foundational informatics competency domains—effective information technology (IT) use and effective use of information. The effective use of IT mediated the relationship between employee-level factors of age and past informatics training and the effective use of information.

Conclusion:
The study highlights the importance of improving the ability of public health professionals to leverage IT and information to advance population health. Periodic assessment of staff PHI competencies can help proactively identify competency gaps and address needs for additional training. Short assessment tools, such as presented in this study, can be validated and used for such assessments.
Combined Symphyseal and Condylar Fractures: Considerations for Treatment in Growing Pediatric Patients
Authors: Yesantharao Pooja S. , Lopez Joseph , Reategui Alvaro , Jenny Hillary , Najjar Omar , Yu Jason W. , Yang Robin , Manson Paul N. , Dorafshar Amir , Redett Richard J. 
Published: June 2021

Background:
Combined symphyseal-condylar mandible fractures are relatively common but difficult to manage in children. This study investigated the cause and management of symphyseal-condylar fractures in pediatric patients.

Methods:
This study presents a retrospective review and expert opinion of pediatric symphyseal-condylar mandibular fracture management at the authors’ institution between 1990 and 2019. National data from the Healthcare Cost and Utilization Project Kids’ Inpatient Database (2000 to 2016) were used to determine whether institutional data had national applicability.

Results:
Twenty-one patients at the authors’ institution met inclusion criteria. Of these patients, 26.7 percent of deciduous dentition patients underwent open reduction and internal fixation, 40 percent underwent closed treatment (maxillomandibular fixation), and 33.3 percent received a soft diet. All mixed dentition patients underwent open reduction and internal fixation or closed treatment; all permanent dentition patients underwent open reduction and internal fixation. The national database (n = 1708) demonstrated similar treatment patterns: most permanent dentition patients (88.7 percent) underwent open reduction and internal fixation, most mixed dentition patients (79.2 percent) underwent closed treatment, and among deciduous dentition patients, 53.5 percent patients received a soft diet; 38 percent received closed treatment. In this study, the overall posttreatment complication rate was 62.5 percent among open reduction and internal fixation patients, 14.3 percent among closed treatment patients, and 16.7 percent among patients treated with a soft diet.

Conclusions:
Symphyseal-condylar mandibular fractures were associated with substantial morbidity in children. The authors created a treatment algorithm to maximize outcomes in children who suffer from this challenging fracture pattern.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Assessment of Plastic Surgery Residency Applications without United States Medical Licensing Examination Step 1 Scores
Authors: Irwin Timothy J. , Friedrich Jeffrey B. , Nguyen Vu T. , Ko Jason H. , Phillips Brett T. , Eberlin Kyle R. 
Published: June 2021

Summary:
The United States Medical Licensing Examination announced the changing of Step 1 score reporting from a three-digit number to pass/fail beginning on January 1, 2022. Plastic surgery residency programs have traditionally used United States Medical Licensing Examination Step 1 scores to compare plastic surgery residency applicants. Without a numerical score, the plastic surgery residency application review process will likely change. This article discusses advantages, disadvantages, and steps forward for residency programs related to the upcoming change. The authors encourage programs to continue to seek innovative methods of objectively and holistically evaluating applications.
Computer-Aided Design and Manufacturing versus Conventional Surgical Planning for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis
Authors: Padilla Pablo L. , Mericli Alexander F. , Largo Rene D. , Garvey Patrick B. 
Published: June 2021

Background:
Virtual surgical planning and computer-aided design/computer-aided manufacturing (CAD/CAM) for complex head and neck reconstruction has a number of cited advantages over conventional surgical planning, such as increased operative efficiency, fewer complications, improved osseous flap union, immediate osseointegrated dental implant placement, and superior functional and aesthetic outcomes. The authors performed a systematic review and meta-analysis of the available evidence on CAD/CAM maxillofacial reconstruction with the primary purpose of determining which approach is more efficacious.

Methods:
In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a PubMed and Embase database search was performed to identify English-language, human-subject studies of CAD/CAM–assisted head and neck reconstruction. All comparative studies were included in a meta-analysis to identify differences in operative time, ischemia time, surgical-site occurrence, microvascular complication, and partial or total flap loss between the two groups. All included studies (comparative and noncomparative) were used in the systematic review, summarizing the various flap characteristics, technical nuances, and functional and aesthetic outcomes.

Results:
Twelve articles were included in the meta-analysis, representing 277 patients in the CAD/CAM group and 419 patients in the conventional group. CAD/CAM was associated with 65.3 fewer minutes of operating room time (95 percent CI, −72.7 to −57.9 minutes; p < 0.0001) and 34.8 fewer minutes of ischemia time (95 percent CI, −38 to −31.5 minutes; p < 0.0001). There were no significant differences in surgical-site occurrence, nonunion, flap loss, microvascular complications, or hardware-related complications.

Conclusions:
CAD/CAM is associated with shorter operating room and ischemia times. There are no significant differences in flap or hardware-related complications between CAD/CAM and conventional surgical planning.
Using Black Bone Magnetic Resonance Imaging for Fibula Free Flap Surgical Planning: A Means to Reduce Radiation Exposure with Accurate Surgical Outcomes
Authors: Suchyta Marissa A. , Gibreel Waleed , Sabbagh M. Diya , Hunt Christopher H. , Gorny Krzysztof R. , Lu Aiming , Mardini Samir 
Published: June 2021

Summary:
Advances in virtual surgical planning and three-dimensionally–printed guides have enabled increased precision in vascularized free fibula flap reconstruction of the mandible and valuable preoperative planning. However, virtual surgical planning currently requires high-resolution computed tomographic scans, exposing patients to ionizing radiation. The aim of this study was to determine whether black bone magnetic resonance imaging can be used for accurate surgical planning and three-dimensionally–printed guide creation, thus reducing patient radiation exposure. This study included 10 cadaver heads and 10 cadaver lower extremities. A mock fibula free flap for mandible reconstruction was performed. Five operations were planned with guides created using black bone magnetic resonance imaging, whereas the other five were planned and performed using guides created with computed tomographic scan data. All specimens underwent a postoperative computed tomographic scan, and three-dimensional reconstruction of scans was performed and surgical accuracy to the planned surgery was assessed. Guides created from black bone magnetic resonance imaging demonstrated high accuracy to the surgical plan. There was no statistically significant difference in postoperative deviation from the plan when black bone magnetic resonance imaging versus computed tomographic scanning was used for virtual surgical planning and guide creation. Both modalities led to a postoperative positive or negative deviation from the virtual plan within 0.8 mm. This study demonstrates that virtual surgical planning and three-dimensionally–printed guide creation for free fibula flaps for mandible reconstruction can be performed using black bone magnetic resonance imaging with comparable accuracy to computed tomographic scanning. This could reduce radiation exposure for patients and enable a more streamlined imaging process for head and neck cancer patients.
Coronavirus disease 2019 vaccination in transplant recipients
Authors: Eberhardt Christiane S. , Balletto Elisa , Cornberg Markus , Mikulska Malgorzata 
Published: June 2021

Purpose of review
Coronavirus disease 2019 (COVID-19) vaccination is considered one of the most promising and socioeconomically sustainable strategy to help control the pandemic and several vaccines are currently being distributed in nationwide mass immunization campaigns. Very limited data are available on benefits and risks of COVID-19 vaccination in immunocompromised patients and in particular in solid organ or hematopoietic stem cell transplant recipients as they were excluded from phase III trials. This review summarizes current knowledge, international guidelines and controversies regarding COVID-19 vaccination in these vulnerable populations.

Recent findings
Various COVID-19 vaccine platforms showed good efficacy in phase III trials in the immunocompetent and there are data arising on the safety and immunogenicity of these vaccines in the immunocompromised population.

Summary
Transplant recipients could benefit significantly from COVID-19 vaccination, both through active immunization provided they elicit protective vaccine responses, and probably through cocooning by immunization of caregivers and healthcare personnel and thus reducing the risk of SARS-coronavirus-2 exposure. Although awaiting more data on the safety and efficacy of COVID-19 vaccines to inform potential adaptations of vaccine regimens, we strongly recommend prioritizing COVID-19 vaccination of solid and hematopoietic stem cell transplant recipients to decrease COVID-19-related morbidity and mortality.