bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterizing the use of osteopathic manipulative medicine in the obstetric population by trimester and indications for use
Authors: Faloon Jordan , Bishop Karly , Craig Wendy , Brock Julia 
Published: February 2021

AbstractContextOsteopathic manipulative medicine (OMM) has been shown to successfully alleviate some pregnancy-related pain. However, most of the published data focuses on the third trimester and postpartum period or musculoskeletal indications.ObjectiveTo explore OMM use among obstetrical providers and determine the frequency of use by trimester and by clinical indications across multiple types of women’s healthcare practices in Southern and Central Maine.MethodsAn anonymous, 43-item survey, presented in English, was emailed to 172 eligible providers (physicians, nurse practitioners, and certified nurse midwives with obstetrics privileges at one of two main delivery centers in southern and central Maine) via an encrypted database system in January 2018. Follow-up email reminders were sent weekly for three weeks. Questions addressed use of OMM for specific indications, knowledge of OMM, and perceived barriers use of OMM.ResultsThe survey response rate was 73 of 172 (42%); 95% of respondents were physicians (n=69). Due to the low response rate of non-physicians, only data from physicians was included in the study. Data were summarized descriptively as frequencies (n [%]). The highest rates of OMM utilization were during the third trimester (35 [51.5%]) and postpartum (41 [60.3%]) periods, while the lowest rates of utilization were in the intrapartum (eight [11.9%]) and first trimester periods (26 [38.3%]). Osteopathic physicians (n=19) used OMM more frequently in the first, second, and third trimesters, as well as the intrapartum period (10 [52.6%]; 11 [57.9%]; 14 [73.7%]; and six [31.6%], respectively) compared with their allopathic physician (n=50) counterparts (nine [8%]; 15 [30%]; 21 [42%]; and two [4%], respectively). While osteopathic physicians reported higher frequencies of OMM use and referral for non-musculoskeletal indications such as constipation, edema, and nasal congestion (13 [68.4%]; 11 [57.9%]; 10 [52.6%], respectively), musculoskeletal complaints were the most frequently cited indication for OMM use among both osteopathic and allopathic physicians (low back, 67 [97.1%]; pelvis, 65 [94.2%]; coccyx, 50 [72.5%]; and head, 49 [71%]).ConclusionThese results suggest that more education is needed about OMM use in the obstetric population, particularly during early trimesters and the intrapartum period, as well as for visceral and lymphatic complaints of pregnancy.
Pilot study assessing the effect of osteopathic manipulative treatment (OMT) on length of stay in neonates after therapeutic hypothermia
Authors: Bendixen Kira , Beinlich Alexis , Beck Bryan , Hashmi Nabeel , Craig Alexa 
Published: February 2021

Abstract

Context
Term neonates treated with therapeutic hypothermia (TH) may experience delays in acquiring skills for oral feeding, thus prolonging hospital admission.

Objective
To determine whether osteopathic manipulative treatment (OMT) can decrease the overall length of stay (LOS) for term neonates by accelerating the transition to full oral feeds.

Methods
A pilot study was conducted to compare LOS in term neonates treated with OMT to matched historical controls. Eligibility criteria were gestational age greater than or equal to 37 weeks, mild to moderate encephalopathy, absent seizure activity, and no brain injury on magnetic resonance imaging. Treated neonates had OMT twice between day of life four and seven, then twice per week on nonconsecutive days until hospital discharge. Secondary outcomes were to compare the number of days with nasogastric tube in both OMT and historically matched control groups and to characterize somatic dysfunction patterns in the primary affected areas of the craniosacral mechanism.

Results
Twelve of 28 neonates treated with TH between October 2017 and August 2018 met eligibility criteria for the study and were matched 3:1 to 36 historical controls. On average, mothers of neonates who received OMT were older than the historical control mothers (31.3 years [SD, ±6.0] vs. 27.4 [SD, ±4.5]; p=0.02) Nineteen of the 36 historical control neonates, but no neonates in the OMT group, were intubated for a median of two days (interquartile range 1, 4). The mean LOS in the OMT group was 9.1 vs. 11.6 days for historical controls (p=0.048); however, in a sensitivity analysis excluding intubated neonates from the historical controls, the difference was 9.1 vs. 10.1 days (p=0.21). All neonates were orally feeding at discharge. Neonates given OMT had between two and four treatments lasting 8–20 minutes. By the final treatment, the craniosacral mechanism’s intraosseous and cranial base compressions and physiologic motion were improved. There were no adverse effects noted during OMT sessions.

Conclusion
Our findings suggest that OMT performed on term neonates treated with TH may decrease the amount of time needed to acquire the necessary skills for oral feeding. Although this result was not statistically significant, it may be clinically significant. A larger prospective clinical trial may have the power needed to detect a statistically significant reduction in LOS and number of days to full oral feeds in this patient population.
Osteopathic manipulative treatment (OMT) use among osteopathic physicians in the United States
Authors: Healy Colson J. , Brockway Matthew D. , Wilde Benjamin B. 
Published: February 2021

Abstract

Context
Updated data on the use of Osteopathic Manipulative Treatments (OMT) by osteopathic physicians in the United States is overdue. This data would provide an up-to-date point of reference for evaluating the current use of OMT as a distinguishing feature of the osteopathic profession.

Objective
To determine the prevalence of OMT use, barriers to its use, and factors that correlate with increased use.

Methods
The American Osteopathic Association (AOA) distributed its triannual survey on professional practices and preferences of osteopathic physicians, including questions on OMT, to a random sample of 10,000 osteopathic physicians in August 2018 through Survey Monkey (San Mateo, CA). Follow-up efforts included a paper survey mailed to nonrespondents one month after initial distribution and three subsequent email reminders. The survey was available from August 15, 2018 to November 5, 2018. The OMT questions focused on frequency of OMT use, perceived barriers, and basic demographic information of osteopathic physician respondents. Statistical analysis (including a one sample test of proportion, chi-square, and Spearman’s rho) was performed to identify significant factors influencing OMT use.

Results
Of 10,000 surveyed osteopathic physicians, 1,683 (16.83%) responded. Of those respondents, 1,308 (77.74%) reported using OMT on less than 5% of their patients, while 958 (56.95%) did not use OMT on any of their patients. Impactful barriers to OMT use included lack of time, lack of reimbursement, lack of institutional/practice support, and lack of confidence/proficiency. Factors positively correlated with OMT use included female gender, being full owner of a practice, and practicing in an office-based setting.

Conclusion
Our data suggest that OMT use among osteopathic physicians in the US continues to decline. Barriers to its use appear to be related to the difficulty that most physicians have with successfully integrating OMT into the country’s insurance-based system of healthcare delivery. Follow-up investigations on this subject in subsequent years will be imperative in the ongoing effort to monitor and preserve the distinctiveness of the osteopathic profession.
Red blood cell distribution width and outcome in trauma patients
Authors: Brown McKenzie , Nassoiy Sean , Plackett Timothy , Luchette Fred , Posluszny Joseph 
Published: February 2021

Abstract

Context
Red blood cell distribution width (RDW) has been used to predict mortality during infection and inflammatory diseases. It also been purported to be predictive of mortality following traumatic injury.

Objective
To identify the role of RDW in predicting mortality in trauma patients. We also sought to identify the role of RDW in predicting the development of sepsis in trauma patients.

Methods
A retrospective observational study was performed of the medical records for all adult trauma patients admitted to Loyola University Medical Center from 2007 to 2014. Patients admitted for fewer than four days were excluded. Admission, peak, and change from admission to peak (Δ) RDW were recorded to determine the relationship with in-hospital mortality. Patient age, development of sepsis during the hospitalization, admission to the intensive care unit (ICU), and discharge disposition were also examined.

Results
A total of 9,845 patients were admitted to the trauma service between 2007 and 2014, and a total of 2,512 (25.5%) patients fit the inclusion criteria and had both admission and peak values available. One-hundred twenty (4.6%) died while in the hospital. RDW values for all patients were (mean [standard deviation, SD]): admission 14.09 (1.88), peak 15.09 (2.34), and Δ RDW 1.00 (1.44). Admission, peak, and Δ RDW were not significant predictors of mortality (all p>0.50; hazard ratio [HR], 1.01–1.03). However, trauma patients who eventually developed sepsis had significantly higher RDW values (admission RDW: 14.27 (2.02) sepsis vs. 13.98 (1.73) no sepsis, p<0.001; peak RDW: 15.95 (2.55) vs. 14.51 (1.97), p<0.001; Δ RDW: 1.68 (1.77) vs. 0.53 (0.91), p<0.001).

Conclusion
Admission, peak, and Δ RDW were not associated with in-hospital mortality in adult trauma patients with a length of stay (LOS) ≥four days. However, the development of sepsis in trauma patients is closely linked to increased RDW values and in-hospital mortality.
First-time sports-related concussion recovery revisited: management changes and impact on recovery
Authors: Neidecker John M. , Gealt David B. , Lambert Kathryn , Luksch John R. , Weaver Martin D. 
Published: February 2021

AbstractContextConcussion is among the most common injuries in athletes. Over the past 10 years, concussion knowledge has expanded, and guidelines for management have changed. Recent changes include recommendations against strict mental and physical rest after sustaining a concussion, a better recognition of preexisting conditions predisposing protracted concussion recovery, and the addition of preliminary patient counseling and education about the expected course of concussion recovery.ObjectiveTo assess the impact of changes in concussion management on the duration of symptoms in middle school and high school athletes after sustaining a first-time, sports-related concussion.MethodsA retrospective review was performed of medical records of athletes who sustained a concussion between 2016 and 2018 and were treated by the same primary care physician (J.M.N) using the revised approach to concussion management described. Patients were included if they were 11 to 18 years old and had a diagnosis of first-time concussion sustained while playing organized sports. Athletes who sustained a concomitant injury or sustained a concussion outside of organized sports were excluded from the study; athletes lost to follow-up or with incomplete forms were also excluded. Each athlete’s length of symptomatic time from his or her concussion was calculated. This data was then compared with a previously-published data set of athletes who sustained a concussion between 2011 and 2013, with the same inclusion criteria but a different approach to concussion management.ResultsA total of 110 male and 72 female athletes (N=182) met the study’s eligibility criteria. Collectively, athletes of both sexes from the 2016–2018 data set reported a higher incidence of preexisting conditions associated with prolonged concussion recovery compared with the data set of 2011–2013 athletes. However, both sexes from the 2016–2018 data set also reported a shorter median duration of concussion symptoms compared with the 2011–2013 athletes (median duration 5 vs. 11 days for male athletes and 7 vs. 28 days for female athletes, respectively; p<0.001).ConclusionRecent changes in concussion management have led to decreased duration of symptoms among 11- to 18-year-old athletes with first-time, sports-related concussions. These management changes include advocating for early activity, recognizing preexisting conditions, and educating athletes about the realities of concussion recovery.
Evaluating disease outbreaks with syndromic surveillance using medical student clinical rotation patient encounter logs
Authors: Bruzda Gabrielle , Rawlins Fred , Sumpter Cameron , Garner Harold R. 
Published: February 2021

Abstract

Context
While the data generated by medical students at schools that require electronic patient encounter logs is primarily used to monitor their training progress, it can also be a great source of public health data. Specifically, it can be used for syndromic surveillance, a method used to analyze instantaneous health data for early detection of disease outbreaks.

Objective
To analyze how the International Classification of Diseases, 10th Revision (ICD-10) codes input by medical students at the Edward Via College of Osteopathic Medicine into the Clinical Rotation Evaluation and Documentation Organizer (CREDO) patient encounter logging system could act as a new syndromic surveillance tool.

Methods
A CREDO database query was conducted for ICD-10 codes entered between November 1, 2019 and March 13, 2020 using the World Health Organization’s 2011 revised case definitions for Influenza Like Illness (ILI). During that period, medical students had an approximated mean of 3,000 patient encounters per day from over 1,500 clinical sites. A cumulative sum technique was applied to the data to generate alert thresholds. Breast cancer, a disease with a stable incidence during the specified timeframe, was used as a control.

Results
Total ILI daily ICD-10 counts that exceeded alert thresholds represented unusual levels of disease occurred 11 times from November 20, 2020 through February 28, 2020. This analysis is consistent with the COVID-19 pandemic timeline. The first statistically significant ILI increase occurred nine days prior to the first laboratory confirmed case in the country.

Conclusion
Syndromic surveillance can be timelier than traditional surveillance methods, which require laboratory testing to confirm disease. As a result of this study, we are installing a real-time alert for ILI into CREDO, so rates can be monitored continuously as an indicator of possible future new infectious disease outbreaks.
Osteopathic students and graduates matching into pathology residency, 2011–2020
Authors: Jajosky Ryan Philip , Coulson Hannah C. , Rosengrant Abric J. , Jajosky Audrey N. , Jajosky Philip G. 
Published: February 2021

AbstractContextIn the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency.ObjectiveTo determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade.MethodsPathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs.ResultsOver the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM “postgraduate year 1” (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties.ConclusionThe proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.
SGLT2 inhibitors: a narrative review of efficacy and safety
Authors: Nelinson Donald S. , Sosa Jose M. , Chilton Robert J. 
Published: February 2021

Abstract
Type 2 diabetes mellitus (T2DM) is a cardio-renal-metabolic condition that is frequently associated with multiple comorbidities, including atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD). The sodium-glucose co-transporter-2 (SGLT2) inhibitors, which lower glycated hemoglobin, fasting and postprandial plasma glucose levels, body weight, and blood pressure, as well as reduce the risk of a range of cardiovascular and renal outcomes without increasing hypoglycaemic risk, have heralded a paradigm shift in the management of T2DM. These drugs are compatible with most other glucose-lowering agents and can be used in patients with a wide range of comorbid conditions, including ASCVD, HF, and CKD, and in those with estimated glomerular filtration rates as low as 30 mL/min/1.73 m2. However, there are misunderstandings surrounding the clinical implications of SGLT2 inhibitors’ mechanism of action and concerns about the key adverse events with which this class of drugs has been associated. This narrative review summarizes the data that support the efficacy of SGLT2 inhibitors in reducing the risks of cardiovascular and renal outcomes in patients with T2DM and comorbid conditions and clarifies information relating to SGLT2 inhibitor-related adverse events.
The history of medical education: a commentary on race
Authors: Daher Yasmeen , Austin Evan T. , Munter Bryce T. , Murphy Lauren , Gray Kendra 
Published: February 2021

AbstractThe institution of medicine was built on a foundation of racism and segregation, the consequences of which still permeate the experiences of Black physicians and patients. To predict the future direction of medical inclusivity, we must first understand the history of medicine as it pertains to race, diversity, and equity. In this Commentary, we review material from publicly available books, articles, and media outlets in a variety of areas, including undergraduate medical education and professional medical societies, where we found an abundance of policies and practices that created a foundation of systemic racism in medical training that carried through the career paths of Black physicians. The objective of this Commentary is to present the history of race in the medical education system and medical society membership, acknowledge the present state of both, and offer concrete solutions to increase diversity in our medical community.
Toward the use of medical scent detection dogs for COVID-19 screening
Authors: Dickey Tommy , Junqueira Heather 
Published: February 2021

Abstract
Current testing for the presence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), which causes the novel coronavirus 2019 (COVID-19) infection, is typically reliant upon collection of nasal swab samples from subjects. These tests (reverse transcription polymerase chain reaction [RT-PCR] and antigen) are intrusive, can take significant time to process, and can give deleterious false negative and false positive results. Alternative methods for COVID-19 testing and screening are being studied, including the use of trained scent detection dogs to detect volatile organic compounds (VOCs) associated with the COVID virus. In August 2020 and October 2020, the first author (T.D.) searched MEDLINE/PubMed, Cochrane Library, Google Scholar, and additional news articles using keyword phrases including “COVID scent dogs,” “COVID sniffer dogs,” and “COVID detection dog,” returning a total of 13 articles, nine of which were duplicates. Four remaining peer-reviewed studies dedicated to determining the feasibility and efficacy of detecting and screening individuals who may be infected by the COVID-19 virus with scent detection dogs were then examined. In this narrative review, the authors describe the methodologies and results of the remaining four studies, which demonstrated that the sensitivity, specificity, and overall success rates reported by the summarized scent detection studies are comparable to or better than the standard RT-PCR and antigen testing procedures, meaning that scent detection dogs can likely be effectively employed to nonintrusively screen and identify individuals infected with the COVID-19 virus in hospitals, senior care facilities, schools, universities, airports, and even large public gatherings for sporting events and concerts.
Writing Esther: How do Writing, Power and Gender Intersect in the Megillah and its Literary Afterlife?
Authors: Wood Sorrel 
Published: February 2021

Abstract
There are two instances in the entire Hebrew Bible in which women feature as the to write. “One is Esther (Esther 9:29) and the other is:” כתב subject of the verb Jezebel (1 Kgs 21:8). This paper takes this fact as a starting point from which to illuminate the narrative and thematic junctures of writing, power and gender in Esther and its literary afterlife. It utilizes the hermeneutical framework of feminist literary theory, as well as drawing upon narratology and linguistic theory related to gender and power, and textual theory related to metatextuality and intertextuality, in order to explore the ways in which the narrator, the canonization process and the reception history of the text have functioned to constrain and restrain Esther’s authorial identity and status, and conversely the places and spaces where it has been developed and emphasised. Key areas of exploration include the writing culture of the Late Persian and Early Hellenistic periods, creative rewritings of Esther in the Targums and in Rabbinic Haggadah, and a consideration of the implications of the fact that Esther and Jezebel are the only explicitly identified female writers in the Hebrew Bible (Esther. (9:29, 1 Kings 21:8–9)).