bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Phase 3, Placebo-Controlled Trial of Once-Daily Viloxazine Extended-Release Capsules in Adolescents With Attention-Deficit/Hyperactivity Disorder
Authors: Nasser Azmi , Liranso Tesfaye , Adewole Toyin , Fry Nicholas , Hull Joseph T. , Busse Gregory D. , Chowdhry Fatima , Cutler Andrew J. , Jones Nandita Joshi , Findling Robert L. , Schwabe Stefan 
Published: May 2021

Abstract

Purpose
This phase 3 clinical trial evaluated the efficacy and safety of viloxazine extended-release capsules (VLX-ER) as a monotherapy for attention-deficit/hyperactivity disorder (ADHD) in adolescents (12–17 years).

Methods
Eligible subjects (n = 310) were randomized to receive once-daily 200 and 400 mg VLX-ER, or placebo for 6 weeks. The primary efficacy end point was change from baseline (CFB) at the end of study (EOS) in ADHD Rating Scale-5 Total score. Key secondary end points were Clinical Global Impression—Improvement score at EOS, CFB at EOS in Conners 3—Parent Short Form Composite T-score, and CFB at EOS in Weiss Functional Impairment Rating Scale—Parent Total average score.

Results
In the 200-mg/d and 400-mg/d VLX-ER treatment groups, a significant improvement was found in the CFB at EOS in ADHD Rating Scale-5 Total (P = 0.0232, P = 0.0091) and Inattention (P = 0.0424, P = 0.0390) and Hyperactivity/Impulsivity (P = 0.0069, P = 0.0005) subscale scores versus placebo. The Clinical Global Impression—Improvement score was significantly improved at EOS in the 200-mg/d and 400-mg/d VLX-ER groups versus placebo (P = 0.0042, P = 0.0003). The Conners 3—Parent Short Form composite T-score and Weiss Functional Impairment Rating Scale—Parent Total average score exhibited improvement in both VLX-ER groups; however, the difference versus placebo was not statistically significant. The most common treatment-related adverse events were somnolence, headache, decreased appetite, nausea, and fatigue. The adverse event–related discontinuation rates were <5% in all groups.

Conclusions
Viloxazine extended-release demonstrated statistically significant and clinically meaningful improvement in ADHD symptoms in adolescents and was generally well tolerated.
Pramipexole to Improve Cognition in Bipolar Disorder
Authors: Van Meter Anna R. , Perez-Rodriguez M. Mercedes , Braga Raphael J. , Shanahan Megan , Hanna Lauren , Malhotra Anil K. , Burdick Katherine E. 
Published: May 2021

Abstract

Background
Adults with bipolar disorder (BD) often experience neurocognitive impairment that negatively impacts functioning and quality of life. Previous trials have found that dopamine agonist agents improve cognition in healthy volunteers and that adults with BD who have stable mood and mild cognitive deficits may also benefit. We hypothesized that pramipexole, a dopamine agonist, would improve neurocognitive function in patients with BD.

Methods
We recruited 60 adults (aged 18–65 years) with a diagnosis of BD I or II for an 8-week, double-blind, placebo-controlled trial (NCT02397837). All had stable mood and clinically significant neurocognitive impairment at baseline. Participants were randomized to receive pramipexole (n = 31) or a placebo (n = 29), dose was initiated at 0.125 mg 2 times a day and increased to a target of 4.5 mg/d.

Results
At trial end, the primary outcome, MATRICS Consensus Cognitive Battery composite score, had not improved more in the pramipexole group (mean [SD] = 1.15 [5.4]) than in the placebo group (mean [SD] = 4.12 [5.2], Cohen’s d = 0.56, P = 0.049), and mixed models, controlling for symptoms, showed no association between treatment group and MATRICS Consensus Cognitive Battery scores. No serious adverse events were reported.

Conclusions
These results suggest that pramipexole is not an efficacious cognitive enhancement agent in BD, even in a sample enriched for characteristics that were associated with a beneficial response in prior work. There are distinct cognitive subgroups among adults with BD and may be related differences in neurobiology that affect response to pramipexole. Additional research to better understand the onset and nature of the cognitive deficits in people with BD will be an important step toward a more personalized approach to treatment.
Accessing Healthcare Services During the COVID-19 Pandemic: The Plight of Sexual Assault Survivors
Authors: Munro-Kramer Michelle L. , Cannon Lindsay M. , Scheiman Lisa , St Ivany Amanda R. , Bailey Joanne M. 
Published: May 2021

ABSTRACT

Introduction
Despite a global focus on intimate partner violence during the COVID-19 pandemic, there has been little exploration into how the pandemic and its associated restrictions have impacted sexual assault survivors and their ability to access specialized care and resources. The purpose of this research brief is to use longitudinal data to compare the number of medical forensic examinations done seasonally prepandemic and during the COVID-19 pandemic shelter-in-place order.

Methods
This analysis uses retrospective data on medical forensic examinations from January 2010 through November 2020 from one large academic Midwestern hospital.

Results
Results show that monthly medical forensic examinations have increased over time, from a mean of 4.5 cases per month (range: 1–9) in 2010 to a mean of 9 cases per month (range: 7–11) in 2019. In April 2020, when COVID-19-related shutdowns were at their first peak, cases dropped to a historic low of 0 examinations (the lowest number of cases in the past 10 years).

Conclusions
The data show an initial drop in the number of survivors seeking postassault care after the COVID shutdown; however, cases rebounded through the second full month of shutdown orders. Programs that provide medical forensic examinations need to be prepared for subsequent waves of survivors, who may be COVID-19 positive. We must be better prepared for many of the adverse consequences impacting individuals around the country related to COVID-19 responses.
Hospital Partnerships for Population Health: A Systematic Review of the Literature
Authors: Hilts Katy Ellis , Yeager Valerie A. , Gibson P. Joseph , Halverson Paul K. , Blackburn Justin , Menachemi Nir 
Published: May 2021

EXECUTIVE SUMMARY
The U.S. healthcare system continues to experience high costs and suboptimal health outcomes that are largely influenced by social determinants of health. National policies such as the Affordable Care Act and value-based payment reforms incentivize healthcare systems to engage in strategies to improve population health. Healthcare systems are increasingly expanding or developing new partnerships with community-based organizations to support these efforts. We conducted a systematic review of peer-reviewed literature in the United States to identify examples of hospital–community partnerships; the main purposes or goals of partnerships; study designs used to assess partnerships; and potential outcomes (e.g., process- or health-related) associated with partnerships. Using robust keyword searches and a thorough reference review, we identified 37 articles published between January 2008 and December 2019 for inclusion. Most studies employed descriptive study designs (n = 21); health needs assessments were the most common partnership focus (n = 15); and community/social service (n = 21) and public health organizations (n = 15) were the most common partner types. Qualitative findings suggest hospital–community partnerships hold promise for breaking down silos, improving communication across sectors, and ensuring appropriate interventions for specific populations. Few studies in this review reported quantitative findings. In those that did, results were mixed, with the strongest support for improvements in measures of hospitalizations. This review provides an initial synthesis of hospital partnerships to address population health and presents valuable insights to hospital administrators, particularly those leading population health efforts.
Enhancing Residents' Warmth in Greeting Caregivers: An Inpatient Intervention to Improve Family-Centered Communication
Authors: Bayer Nathaniel D. , Taylor April , Atabek Zoey , Santolaya Jacobo L. , Bamat Tara W. , Washington Nicole 
Published: May 2021

ABSTRACT
Hospitals are increasingly motivated to improve the patient and family experience and increase patient satisfaction scores. The manner by which a provider greets patients and their families sets the tone for the hospital stay. This study aimed to improve residents' greetings of caregivers in the inpatient pediatric setting to improve family-centered communication. The study was conducted from October 2017 to April 2018 at a single, urban children's hospital on a unit with patients primarily <5 years old. The intervention consisted of posting a prominent board outside of patients' rooms that (1) listed caregivers' preferred names (e.g., Mom/Dad, first names), (2) instructed residents to greet caregivers warmly by their preferred names, and (3) identified residents for families by name and photograph. During implementation, we conducted 5 Plan-Do-Study-Act cycles and surveyed 114 caregivers. Improvement was assessed using run charts. The primary outcome was the percentage of caregivers who rated residents' warmth of greetings as “excellent.” This measure increased from a baseline median of 62.5%–84.4% with ≥6 consecutive postintervention points above the baseline median. The intervention improved caregiver-perceived quality of residents' greetings and could serve as a model for other hospitals to enhance provider-family rapport and improve communication.
Improving Operating Room Start Times
Authors: Duffy Melissa , Capusan Karen Y. , Shea Ann 
Published: May 2021

Abstract
The Pre-Surgical Testing program at Cohen Children's Medical Center launched in 2012. We evaluate approximately 7,000 patients per year who are scheduled for outpatient and inpatient surgeries from all pediatric surgical services. The Pre-Surgical Testing program providers are pediatric and family nurse practitioners (NPs). In 2017, the NP role expanded into the inpatient setting. We started to evaluate patients scheduled for emergency procedures, sedated radiology studies, and invasive procedures. We identified high-risk patients, which provided anesthesiologists with the critical information they needed to deliver safe patient care. In 2018, the NPs further expanded into the ambulatory setting. Our role includes preoperative orders, managing postoperative pain, entering discharge medications, and providing continuing education to nursing staff. From February 2018 to August 2018, first-case start times have improved by 20%. The combination of clinical knowledge and experience makes NPs uniquely qualified to identify high-risk patients scheduled for surgery. Other institutions may consider NPs in their postoperative areas to improve OR start times and, more generally, patient safety.
Development and Evaluation of a Novel Patient-Reported Outcome Implementation Process in a Student-Led Pro Bono Clinic: Acceptability and Adoption
Authors: Staples Trevor , Beran-Maryott Gillian , Brinkerhoff Alan , Bradford Misha , Ward R. Scott , Thackeray Anne 
Published: May 2021

Background and Purpose.
Although patient-reported outcomes (PROs) are increasingly implemented to inform care and demonstrate the value of care across disciplines and settings, no previous reports have assessed PRO implementation and acceptability to student clinicians in a pro bono physical therapy clinic. The purpose of this case report was to describe the development and evaluation of an implementation process for an electronically administered PRO in a pro bono physical therapy clinic.

Case Description.
A student-faculty team used the consolidated framework for implementation research to identify barriers to PRO implementation in one student-run pro bono clinic and develop strategies to address identified barriers. The change management theoretical framework was used to develop an implementation process that addressed all general and local contextual needs. Acceptability and adoption of the Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF) computer adaptive test to student clinicians were assessed to evaluate implementation effectiveness.

Outcomes.
Implementation barriers included rotating student teams, limited knowledge, need for workflow modifications, and PRO translation to Spanish. Student clinician training, workflow adaptation, and use of English and Spanish versions of PROMIS PF addressed all barriers, general and local contextual needs. Student clinician responses suggested that implementation strategies were acceptable, citing increase efficiency and simplicity. Patient-Reported Outcome Measurement Information System Physical Function adoption was 81% (per month range = 47–100%) over the 6-month implementation period.

Discussion and Conclusion.
Acceptance and adoption rates by student clinicians indicate that implementation of PROMIS PF was successful at improving PRO collection and influencing student clinician education about PROs.
A Novel Physical Therapy Learning Experience in Pediatrics Via Telehealth: A Qualitative Case Analysis
Authors: Fergus Andrea , Hartsook Katherine , Smith Julianna , Hale Mary , Kellar Daniel 
Published: May 2021

Background and Purpose.
While the integration of experiential learning with patients and clients into the physical therapy (PT) curriculum is beneficial to student learning particularly in the area of pediatrics, the implementation of such experiences can be extremely challenging. Telehealth is rapidly expanding given the emerging technology, health care needs for individuals in remote settings, and the current pandemic situation. The purpose of the present evaluation was to examine the perspectives of the students, supervising PTs and the caregiver on a method/model for the telehealth delivery of pediatric PT, and the collaborative experiential learning experience in this setting using a qualitative grounded theory approach.

Method/Model Description.
A 24-month-old boy with spastic hemiplegia was treated for 6 weeks in his home via Zoom videoconferencing in a collaborative clinical education experience. Interventions included constraint-induced movement therapy, bimanual training, dynamic balance training, and facilitation of postural control. Caregiver education was provided throughout. The chat and recording features were used throughout each session to provide direction, feedback, and education while minimizing the distraction during sessions. Semi-structured interviews were completed with the 2 PTs, 6 students, and mother after the experience. Interviews were transcribed and theme coded until saturation was achieved. A concept map was developed through consensus.

Outcomes.
Themes emerged for telehealth and telehealth learning experiences. Considerations included the home environment, technology, lack of physical contact and importance of verbal communication, preparation, instantaneous feedback, and active participation. The active participation of the caregiver seemed to empower the family and provide them with a therapeutic viewpoint. Communication via the chat feature provided a means for instantaneous feedback that was considered less disruptive to the student–family interaction resulting in student empowerment, confidence, and skill development.

Discussion and Conclusion.
The telehealth delivery of service seems to enhance the empowerment and buy-in of the patient/caregiver resulting in improved outcomes and carryover for PT. Telehealth PT experiential learning provides a venue for collaborative learning and enhanced student autonomy resulting in improved confidence while fostering student analytical skills, communication skills, and creativity. Telehealth PT provides unique opportunities for growth and learning in a collaborative learning experience and may also serve as a venue for clinical education experiences.
Examining Demographic and Preadmission Factors Predictive of First Year and Overall Program Success in a Public Physical Therapist Education Program
Authors: Mitchell Katy , Ellison Jennifer , Schaumberg Elke , Gleeson Peggy , Bickley Christina , Naiki Anna , Travis Severin 
Published: May 2021

Introduction.
Despite an increase in the rigor of entry-level Doctor of Physical Therapy (DPT) program admission, programs still struggle with student retention and success. The purpose of this study was to examine demographic and preadmission factors predictive of first year and overall program success in an entry-level public physical therapist education program.

Subjects.
Retrospective data from 473 DPT students at the Texas Woman’s University in Houston, TX, who entered the program between 2010 and 2018.

Methods.
This study included the following predictor variables: last 60 hours undergraduate (UG) grade point average (GPA), UG math/science GPA, overall UG GPA, science/nonscience major, Graduate Record Examination (GRE) component scores, GRE summed score (GRE-S), size and type of UG institution (dichotomized), gender, age, and personal grit score. Success in the program was measured by first-semester GPA, cumulative third-semester GPA, final program GPA, three-tiered ranking of academic and clinical education (CE) standing, completion of first-year program, and completion of the entire 3-year program.

Results.
First-year program success (first-semester GPA, cumulative third-semester GPA, and first-year completion) was predicted by age, overall UG GPA, GRE-S, and all GRE components. GRE scores and UG GPA when entered together predicted 45.8% of the first-year GPA. Overall program success was predicted by UG GPA, GRE-S, and all GRE components. GRE-S and UG GPA when entered together predicted 34.8% of final program GPA. Academic standing was predicted by multiple predictors, whereas CE performance was only predicted by 2 components of the GRE and GRE-S. When comparing students who completed the program versus those who did not, significant differences were found in all GRE components and overall UG GPA. Receiver-operating-characteristics analysis was used to determine cutoff scores for the GRE and overall UG GPA, which best predict first-year and program retention.

Conclusion.
Admissions committees of DPT should analyze their program-specific data to better guide their admissions decisions. Overall UG GPA and GRE continue to be strong predictors of physical therapist program success. In order to increase retention rates, DPT programs should consider additional resources for students who may be at risk.
Use of fibrin monomer and D-Dimer in assessing overt and nonovert disseminated intravascular coagulation
Authors: Zheng Xiaohe , Chen Shaoqian , Zhang Fan , Ye Manman , Chen Jianlong , Zhang Shihong 
Published: May 2021

Introduction
Early diagnosis of disseminated intravascular coagulation (DIC) before its progression to an overt stage is beneficial for its treatment and prognosis.
This retrospective study aimed to evaluate the diagnostic performance of D-dimer and fibrin monomer in the early stage of DIC.
A total of 707 patients suspected of having DIC, 302 healthy people were enrolled and divided into four groups: overt DIC, nonovert DIC, non-DIC based on the International Society of Thrombosis and Hemostasis scoring for overt DIC and the modified nonovert DIC criteria, healthy people as control group. Quantitative determination was done by immunoturbidimetry for D-dimer and fibrin monomer.
The median of fibrin monomer in overt, nonovert and non-DIC was 41.65, 26.89 and 8.68 μg/ml, respectively. The median of D-dimer in overt, nonovert and non-DIC was 9.69, 3.98 and 3.08 μg/ml, respectively. D-dimer and fibrin monomer values were higher in overt DIC than other groups, but there was no difference between nonovert DIC and non-DIC in D-dimer. Unlike D-dimer, statistically significant differences were found in fibrin monomer between nonovert and non-DIC. At receiver operator characteristic curve–generated cutoff values, fibrin monomer had much excellent predictive performance compared with D-dimer for distinguishing nonovert DIC from non-DIC. D-dimer and fibrin monomer had same diagnostic performance in distinguishing overt DIC from non-DIC.
Fibrin monomer is a better indicator compared with D-dimer in distinguishing patients with nonovert DIC from non-DIC. Hence, it might serve as an excellent negative exclusion marker to provide a reference for early clinical diagnosis and intervention through more studies.
Effect of bariatric surgery on blood pressure response to exercise in a severely obese population
Authors: Sénéchal-Dumais Isabelle , Auclair Audrey , Leclerc Jacinthe , Poirier Paul 
Published: May 2021

Background
Exaggerated blood pressure response to exercise is a cardiovascular risk factor associated to higher morbidity and mortality. Severely obese patients have an increased risk of exercise-induced hypertension (EIH). We aimed to assess the blood pressure response to exercise in patients with severe obesity who underwent bariatric surgery as well as the main determinants of this response.

Methods
We used data from the ACTIVE clinical trial, in which 60 severely obese patients who underwent bariatric surgery were enrolled. Anthropometric measurements, abdominal and mid-thigh computed tomography scans and maximal exercise testing were performed before bariatric surgery, as well as 3 and 6 months post-surgery. EIH was defined as a maximal SBP ≥210 mmHg for men and ≥190 mmHg for women.

Results
At baseline, 62% of patients had EIH. At 6 months, we observed an EIH resolution rate of 39%. The main determinant of EIH resolution was sex. Actually, patients with EIH resolution were mostly women without resting hypertension and a lower amount of visceral adipose tissue.

Conclusion
These results suggest that bariatric surgery is efficient to resolve EIH, particularly in women with initially a better anthropometric profile.
Monitoring muscle mass using ultrasound: a key role in critical care
Authors: van Ruijven Isabel M. , Stapel Sandra N. , Molinger Jeroen , Weijs Peter J.M. 
Published: May 2021

Purpose of review
The loss of muscle mass in critically ill patients contributes to morbidity and mortality, and results in impaired recovery of physical functioning. The number of publications on the topic is increasing. However, there is a lack of consistent methodology and the most optimal methodology remains unclear, hampering its broad use in clinical practice.

Recent findings
There is a large variety of studies recently published on the use of ultrasound for assessment of muscle mass. A selection of studies has been made, focusing on monitoring of muscle mass (repeated measurements), practical aspects, feasibility and possible nutrition and physical therapy interventions. In this review, 14 new small (n = 19–121) studies are categorized and reviewed as individual studies.

Summary
The use of ultrasound in clinical practice is feasible for monitoring muscle mass in critically ill patients. Assessment of muscle mass by ultrasound is clinically relevant and adds value for guiding therapeutic interventions, such as nutritional and physical therapy interventions to maintain muscle mass and promote recovery in critically ill patients.