bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Children With Firearm Injuries Admitted to the PICU in the United States*
Authors: Bagdure Dayanand , Foster Cortney B. , Garber Nan , Holloway Adrian , Day Jenni , Lee Jessica , Soto-Campos Gerardo , Brundage Nancy , Bhutta Adnan , Graciano Ana Lia 
Published: June 2021

OBJECTIVES:
Firearm-related injury is the second leading cause of injury and death for children 1–18 years old in United States. The objective of our study was to analyze the outcomes of children admitted to the PICU with firearm injuries.

DESIGN:
Retrospective study.

SETTING:
PICUs in United States contributing data to Virtual Pediatric Systems, LLC, from January 2009 to December 2017.

PATIENTS:
Children age 1 month to 18 years old admitted to the PICU with firearm injury, identified by external cause of injury E-codes and International Classification of Diseases, 9th Edition, and International Classification of Diseases, 10th Edition, codes were identified.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
There were 1,447 cases identified of which 175 (12%) died in the PICU. Unintentional firearm injury (67.7%) and assault with a firearm injury (20%) comprised 90% of the cases. Males comprised 78% of the cohort (1,122) and race distribution included 45% Black (646), 27% White (390), and 12% Hispanic (178). Among the children who died in the PICU, 55% were 13–18 years old. Children attempting suicide with a firearm were more likely to die in the PICU as compared to the other causes of firearm injury. Based on their Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores at discharge, there is high morbidity in children with firearm injuries.

CONCLUSIONS:
Mortality rate of children with firearm injury admitted to the PICU is high. Children admitted to the PICU with suicide attempt with a firearm carried the highest mortality. Further studies may help further define the epidemiology of firearm injuries in children and plan interventions to minimize these unnecessary deaths.
Pilot and Feasibility Studies in Rehabilitation Research
Authors: Lawson Daeria O. , Mellor Katie , Eddy Saskia , Lee Christopher , Kim Kwang Hyun , Kim Kunmo , Mbuagbaw Lawrence , Thabane Lehana 
Published: June 2021

Abstract
Pilot and feasibility studies are conducted early in the clinical research pathway to evaluate whether a future, definitive study can or should be done and, if so, how. Poor planning and reporting of pilot and feasibility studies can compromise subsequent research efforts. Inappropriate labeling of studies as pilots also compromises education. In this review, first, a systematic survey of the current state of pilot and feasibility studies in rehabilitation research was performed, and second, recommendations were made for improvements to their design and reporting. In a random sample of 100 studies, half (49.5%) were randomized trials. Thirty (30.0%) and three (3.0%) studies used “pilot” and “feasibility” in the study title, respectively. Only one third (34.0%) of studies provided a primary objective related to feasibility. Most studies (92.0%) stated an intent for hypothesis testing. Although many studies (70.0%) mentioned outcomes related to feasibility in the methods, a third (30.0%) reported additional outcomes in the results and discussion only or commented on feasibility anecdotally. The reporting of progression plans to a main study (21.0%) and progression criteria (4.0%) was infrequent. Based on these findings, it is recommended that researchers correctly label studies as a pilot or feasibility design based on accepted definitions, explicitly state feasibility objectives, outcomes, and criteria for determining success of feasibility, justify the sample size, and appropriately interpret and report the implications of feasibility findings for the main future study.
The Intermittent Abdominal Pressure Ventilator as an Alternative Modality of Noninvasive Ventilatory Support
Authors: Pierucci Paola , Di Lecce Valentina , Carpagnano Giovanna Elisiana , Banfi Paolo , Bach John R. 
Published: June 2021

Abstract
Noninvasive ventilation has become the initial treatment for symptomatic ventilatory pump failure but, when used at ventilatory support settings, can be an alternative to tracheostomy mechanical ventilation. The intermittent abdominal pressure ventilator, a corset with an internal air sack inflated by a ventilator, allows to increase tidal volumes through the raising of the diaphragm and its consequent passive descent. It has been used for daytime support for more than 70 yrs, but its knowledge among clinicians is scarce. A narrative review was performed by searching PubMed, Medline, and the Cochrane Database of Systematic Reviews using the terms “IAPV” or “pneumobelt.” One hundred forty patients were cited using the intermittent abdominal pressure ventilator from 1946 until it went off the market in the 1970s, although many continued to use it. There was only one publication on its use from 2003 to 2017, but three publications from 2017 through 2021. It has been used for full diurnal ventilatory support by some patients for more than 50 yrs and has even been used throughout the labor of a mother with no ventilator-free breathing ability. The intermittent abdominal pressure ventilator is a ventilatory support alternative for patients with ventilatory pump failure. It can be effective and well tolerated and maintain quality of life without facial interfaces. More widespread application is warranted.
Perceived Benefits of a Cadaver-Based Ultrasound Procedure Workshop for Physical Medicine and Rehabilitation Trainees
Authors: Bushi Sharon , Kirshblum Steven , Ezepue Tiffany , Ma Rex 
Published: June 2021

Abstract
Ultrasound-guided musculoskeletal and spasticity injections have become common procedures in physical medicine and rehabilitation practices, but there are currently no guidelines for teaching these procedures in residency and fellowship training programs. As part of a quality improvement initiative, the authors aimed to assess the educational value of a hands-on cadaver-based workshop for enhancing these skills in residents and fellows. Twenty-seven physical medicine and rehabilitation trainees in a single institution were asked to complete surveys before and after the workshop to assess self-perceived benefits. After the workshop, the overwhelming majority felt improvement in their overall knowledge of ultrasound-guided musculoskeletal (93%) and spasticity (78%) procedures. In addition, the workshop improved the level of comfort of trainees both in planning (70%) and performing (59%) the procedures independently. Improving these skills is especially important considering most trainees plan to incorporate ultrasound-guided musculoskeletal (81%) and spasticity (74%) procedures into their future practices. The framework for this workshop can serve as a template for other programs to incorporate into their own training.
Disrupted Access to Therapies and Impact on Well-Being During the COVID-19 Pandemic for Children With Motor Impairment and Their Caregivers
Authors: Sutter Ellen N. , Francis Linda Smith , Francis Sunday M. , Lench Daniel H. , Nemanich Samuel T. , Krach Linda E. , Sukal-Moulton Theresa , Gillick Bernadette T. 
Published: June 2021

Objectives
The aim of this study was to determine the impact of the COVID-19 pandemic on access to rehabilitation therapies and the impact of changes in therapy access on the physical and mental well-being of children with motor impairment and their caregivers.

Design
Caregivers of children younger than 18 yrs with childhood-onset motor impairment (primarily cerebral palsy) completed an anonymous survey through the online platform REDCap between May 5 and July 13, 2020.

Results
The survey was completed by 102 participants. Before the pandemic, 92 of 102 children (90%) were receiving one or more therapies; at the time surveyed, 55 children (54%) were receiving any therapies (P < 0.001). More than 40% of the sample reported increased child stress, decreased physical activity, and/or decline in mobility/movement. Participants who reported a decrease in number of therapies at the time surveyed more frequently reported lower satisfaction with treatment delivery (P < 0.001), a decline in child’s mobility (P = 0.001), and increased caregiver stress (P = 0.004). Five qualitative themes were identified from open-ended question responses related to therapies and well-being.

Conclusions
Access to pediatric rehabilitation therapies was disrupted during COVID-19. Disrupted access may be related to impact on physical and mental health. With the expansion of telehealth, caregiver and child feedback should be incorporated to optimize benefit.
Short-term Outcomes After Spleen-preserving Minimally Invasive Distal Pancreatectomy With or Without Preservation of Splenic Vessels
Authors: Korrel Maarten , Lof Sanne , Al Sarireh Bilal , Björnsson Bergthor , Boggi Ugo , Butturini Giovanni , Casadei Riccardo , De Pastena Matteo , Esposito Alessandro , Fabre Jean Michel , Ferrari Giovanni , Fteriche Fadhel Samir , Fusai Giuseppe , Koerkamp Bas Groot , Hackert Thilo , D’Hondt Mathieu , Jah Asif , Keck Tobias , Marino Marco V. , Molenaar I. Quintus , Pessaux Patrick , Pietrabissa Andrea , Rosso Edoardo , Sahakyan Mushegh , Soonawalla Zahir , Souche Francois Regis , White Steve , Zerbi Alessandro , Dokmak Safi , Edwin Bjorn , Hilal Mohammad Abu , Besselink Marc ,   for the European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)
Published: June 2021

Objective:
To compare short-term clinical outcomes after Kimura and Warshaw MIDP.

Background:
Spleen preservation during distal pancreatectomy can be achieved by either preservation (Kimura) or resection (Warshaw) of the splenic vessels. Multicenter studies reporting outcomes of Kimura and Warshaw spleen-preserving MIDP are scarce.

Methods:
Multicenter retrospective study including consecutive MIDP procedures intended to be spleen-preserving from 29 high-volume centers (≥15 distal pancreatectomies annually) in 8 European countries. Primary outcomes were secondary splenectomy for ischemia and major (Clavien-Dindo grade ≥III) complications. Sensitivity analysis assessed the impact of excluding (“rescue”) Warshaw procedures which were performed in centers that typically (>75%) performed Kimura MIDP.

Results:
Overall, 1095 patients after MIDP were included with successful splenic preservation in 878 patients (80%), including 634 Kimura and 244 Warshaw procedures. Rates of clinically relevant splenic ischemia (0.6% vs 1.6%, P = 0.127) and major complications (11.5% vs 14.4%, P = 0.308) did not differ significantly between Kimura and Warshaw MIDP, respectively. Mortality rates were higher after Warshaw MIDP (0.0% vs 1.2%, P = 0.023), and decreased in the sensitivity analysis (0.0% vs 0.6%, P = 0.052). Kimura MIDP was associated with longer operative time (202 vs 184 minutes, P = 0.033) and less blood loss (100 vs 150 mL, P < 0.001) as compared to Warshaw MIDP. Unplanned splenectomy was associated with a higher conversion rate (20.7% vs 5.0%, P < 0.001).

Conclusions:
Kimura and Warshaw spleen-preserving MIDP provide equivalent short-term outcomes with low rates of secondary splenectomy and postoperative morbidity. Further analyses of long-term outcomes are needed.
The Association of Postoperative Opioid Prescriptions with Patient Outcomes
Authors: Howard Ryan , Brown Craig S. , Lai Yen-Ling , Gunaseelan Vidhya , Chua Kao-Ping , Brummett Chad , Englesbe Michael , Waljee Jennifer , Bicket Mark C. 
Published: June 2021

Objective:
To compare outcomes after surgery between patients who were not prescribed opioids and patients who were prescribed opioids.

Summary of Background Data:
Postoperative opioid prescriptions carry significant risks. Understanding outcomes among patients who receive no opioids after surgery may inform efforts to reduce these risks.

Methods:
We performed a retrospective study of adult patients who underwent surgery between January 1, 2019 and October 31, 2019. The primary outcome was the composite incidence of an emergency department visit, readmission, or reoperation within 30 days of surgery. Secondary outcomes were postoperative pain, satisfaction, quality of life, and regret collected via postoperative survey. A multilevel, mixed-effects logistic regression was performed to evaluate differences between groups.

Results:
In a cohort of 22,345 patients, mean age (standard deviation) was 52.1 (16.5) years and 13,269 (59.4%) patients were female. About 3175 (14.2%) patients were not prescribed opioids, of whom 422 (13.3%) met the composite adverse event endpoint compared to 2255 (11.8%) of patients not prescribed opioids (P = 0.015). Patients not prescribed opioids had a similar probability of adverse events {11.7% [95% confidence interval (CI) 10.2%−13.2%] vs 11.9% (95% CI 10.6%–13.3%]}. Among 12,872 survey respondents, patients who were not prescribed an opioid had a similar rate of high satisfaction [81.7% (95% CI 77.3%–86.1%) vs 81.7% (95% CI 77.7%– 85.7%)] and no regret [(93.0% (95% CI 90.8%–95.2%) vs 92.6% (95% CI 90.4%–94.7%)].

Conclusions:
Patients who were not prescribed opioids after surgery had similar clinical and patient-reported outcomes as patients who were prescribed opioids. This suggests that minimizing opioids as part of routine postoperative care is unlikely to adversely affect patients.
The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma
Authors: Raman Vignesh , Voigt Soraya L. , Jawitz Oliver K. , Farrow Norma E. , Rhodin Kristen E. , Yang Chi-Fu Jeffrey , Tong Betty C. , D’Amico Thomas A. , Harpole David H. 
Published: June 2021

Background:
The outcomes associated with receipt of adjuvant radiation in patients after surgery for MPM are poorly understood.

Objective:
The objective of this study was to use 2 registries to compare the outcomes of patients receiving adjuvant radiation or no radiation after definitive surgery for pathologic stage I–III MPM.

Methods:
Patients with resected pathologic stage I–III MPM were identified from the Duke University registry (1996–2016) and National Cancer Database (NCDB) (2004–2015). The primary outcome was overall survival. Propensity score-matched and landmark subgroup analyses were performed.

Results:
A total of 212 institutional and 1615 NCDB patients met criteria. In both cohorts, patients who underwent radiation were more likely to have margin-negative resection and more advanced pathologic stage. At a landmark time of 4.4 and 4.7 months from surgery, Duke [hazard ratio (HR) 1.14; 95% confidence interval (CI) 0.62–2.11] and NCDB patients (HR 0.97; 95% CI 0.81–1.17) who received adjuvant radiation did not experience improved survival compared to those who did not receive radiation in multivariable analysis. Duke patients who received radiation had similar incidence of recurrence and time to both overall recurrence and ipsilateral recurrence (HR 0.87; 95% CI 0.43–1.77) compared to those who did not. Duke patients experienced 100 grade 1/2, 21 grade 3/4, and one grade 5 toxicity events during radiation.

Conclusions:
In this dual registry analysis of patients with resected stage I–III MPM, the receipt of adjuvant hemithoracic radiation was not associated with improved survival compared to no radiation.
Small Bowel Obstruction After Laparoscopic Roux-en-Y Gastric Bypass Caused by Hemobezoar: A Case Series and Review of Literature
Authors: Caputo Viviana , Facchiano Enrico , Soricelli Emanuele , Leuratti Luca , Quartararo Giovanni , Lucchese Marcello 
Published: June 2021

Background:
The development of an intraluminal blood clot (hemobezoar), represents a rare cause (0.05% to 1.9%) of small bowel obstruction (SBO) after laparoscopic Roux-en-Y gastric bypass (LRYGB). We present a case series of 6 cases of SBO caused by hemobezoar.

Methods:
A retrospective analysis of a prospective database including patients who underwent LRYGB from January 2010 to December 2019 has been performed. All the patients who underwent reoperation because of an SBO caused by an intraluminal blood clot were included in the present study.

Results:
Six of 843 LRYGB patients developed an hemobezoar (0.71%). Primary LRYGB was uneventful in all cases. SBO symptoms developed after a mean interval of 26.6 hours from the primary procedure. All reoperations were performed with the laparoscopic approach. In all cases, the hemobezoar was located at the level of the jejunojejunal anastomosis (JJA) and was removed through an enterotomy performed at the distal end of the biliopancreatic stump. Three postoperative complications occurred: 1 ab-ingestis pneumonia, 1 leak of the JJA requiring further reoperation, and 1 pelvic abscess treated with radiologic drainage. The mean hospital stay was 11 days.

Discussion:
SBO due to hemobezoar is a rare but worrisome early complication after LRYGB. It almost always affects the JJA and requires a prompt diagnosis to avoid dreadful sequelae. In the absence of anastomotic leak or stenosis, surgical management may consist of the removal of the blood clot without refashioning the anastomosis and it may be accomplished with the laparoscopic approach.
Antibody responses to BNT162b2 mRNA COVID-19 vaccine in 2,015 healthcare workers in a single tertiary referral hospital in Japan
Authors: Kageyama Takahiro , Ikeda Kei , Tanaka Shigeru , Taniguchi Toshibumi , Igari Hidetoshi , Onouchi Yoshihiro , Kaneda Atsushi , Matsushita Kazuyuki , Hanaoka Hideki , Nakada Taka-Aki , Ohtori Seiji , Yoshino Ichiro , Matsubara Hisahiro , Nakayama Toshinori , Yokote Koutaro , Nakajima Hiroshi 
Published: June 2021

AbstractWe measured antibody responses in 2,015 healthcare workers who were receiving 2 doses of BNT162b2 mRNA vaccine against SARS-CoV-2. The vast majority (99.9%) had either seroconversion or a substantial increase in antibody titer. A multivariate linear regression model identified predictive factors for antibody responses which may have clinical implications.
Physical body experiences questionnaire simplified for active aging (PBE-QAG): Validation with Rasch measurement theory
Authors: Deng Wei , Carpentier Sydney , Van de Winckel Ann 
Published: June 2021

AbstractPurposeTo validate the Physical body experiences questionnaire simplified for active aging (PBE-QAG) with Rasch measurement theory. PBE-QAG measures body awareness during physical activity and includes dimensions of body-mind relationship, body acceptance, and awareness of physical skills and limits.MethodsAdults without pain (n=269), with pain (n=61), with mental health conditions (n=200), and with stroke (n=36) were recruited at the Minnesota State Fair, Highland Fest, and in the Brain Body Mind Lab (University of Minnesota) and completed demographic and clinical questionnaires as well as the PBE-QAG. The PBE-QAG has 12 items, with scores ranging between 0 (totally true) to 4 (totally false). A low total score on the PBE-QAG reflects better body awareness. We evaluated item and person fit, targeting, unidimensionality, person separation reliability (PSR), local item dependence (LID), and differential item functioning (DIF) for demographic and clinical characteristics. We compared with Kruskal-Wallis ANOVA the person mean location in four groups: Adults with or without mental health conditions; and whether those groups did body awareness training.ResultsUnidimensionality and item fit were obtained after deleting 2 and rescoring 5 items. Seven participants did not fit the model (1.23%). There was minimal floor (5.72%), no ceiling effect (0.00%), and no LID. No DIF was greater than 0.50 logits for any of the variables. The Wright-corrected PSR was 0.96. The person mean location was -1.71±1.21 logits. Adults with mental health conditions who did not practice body awareness had a higher person mean location [Median (IQR)=0.83(0.89) logits, p<0.0001] versus the other three groups, reflecting lower body awareness.ConclusionsPBE-QAG demonstrated good item and person fit, but the targeting is off. Therefore, the current version of PBE-QAG is not recommended for use in the general population. We encourage further validation of PBE-QAG in adults with mental health conditions who do not practice body awareness.
Prenatal smoking, alcohol and caffeine exposure and offspring externalising disorders: A systematic review and meta-analysis
Authors: Haan Elis , Westmoreland Kirsten E. , Schellhas Laura , Sallis Hannah M. , Taylor Gemma , Zuccolo Luisa , Munafò Marcus R. 
Published: June 2021

ABSTRACTBackground and aimsSeveral studies have indicated that there is an association between maternal prenatal substance use and offspring externalising disorders. However, it is uncertain whether this relationship is causal. Therefore, we updated a previously conducted systematic review to determine if the literature supports 1) a causal role of maternal prenatal substance use on offspring externalising disorders and 2) whether these associations differ across externalising disorders.MethodsWe searched Web of Science, Embase, PsycINFO and Medline databases. We included studies that examined smoking, alcohol or caffeine use during pregnancy as an exposure, and diagnosis of attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD) and oppositional-defiant disorder (ODD) in offspring as an outcome. Studies on non-English language, fetal alcohol syndrome and comorbid autism spectrum disorders were excluded. Risk of bias assessment was conducted using Newcastle Ottawa Scale (NOS) and where possible meta-analysis was conducted for studies classed as low risk of bias.ResultsWe included 63 studies. All studies were narratively synthesised, and 7 studies were meta-analysed on smoking and ADHD. The majority of studies (46 studies) investigated the association between smoking and ADHD. Studies which accounted for genetic effects indicate that the association between smoking and ADHD is unlikely to be causal. Studies on alcohol exposure in all the outcomes reported inconsistent findings and no strong conclusions on causality can be made. Studies on caffeine exposure were mostly limited to ADHD and these studies do not support a causal effect.ConclusionsThere is no causal relationship between maternal smoking during pregnancy and attention-deficit hyperactivity (ADHD) in offspring. However, given that the majority of identified studies investigated the association between ADHD and smoking exposure, findings with alcohol and caffeine exposures and conduct disorder (CD) and oppositional-defiant disorder (ODD) need more research, especially using more genetically sensitive designs.
A Cluster-based Model of COVID-19 Transmission Dynamics
Authors: Shayak B , Sharma Mohit M 
Published: June 2021

AbstractMany countries have manifested COVID-19 trajectories where extended periods of constant and low daily case rate suddenly transition to epidemic waves of considerable severity with no correspondingly drastic relaxation in preventive measures. Such solutions are outside the scope of classical epidemiological models. Here we construct a deterministic, discrete-time, discrete-population mathematical model which can explain these non-classical phenomena. Our key hypothesis is that with partial preventive measures in place, viral transmission occurs primarily within small, closed groups of family members and friends, which we call clusters. Inter-cluster transmission is infrequent compared to intra-cluster transmission but it is the key to determining the course of the epidemic. If inter-cluster transmission is low enough, we see stable plateau solutions. Above a cutoff level however, such transmission can destabilize a plateau into a huge wave even though its contribution to the population-averaged spreading rate still remains small. We call this the cryptogenic instability. We also find that stochastic effects when case counts are very low may result in a temporary and artificial suppression of an instability; we call this the critical mass effect. Both these phenomena are absent from conventional infectious disease models and militate against the successful management of the epidemic.