bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Surgical Overlap during Wound Closure with Patient Outcomes among Neurological Surgery Patients at a Large Academic Medical Center
Authors: Glauser Gregory , Agarwal Prateek , Ramayya Ashwin G , Chen H Isaac , Lee John Y K , Schuster James M , Osiemo Benjamin , Goodrich Stephen , Smith Lachlan J , McClintock Scott D , Malhotra Neil R 
Published: March 2019

Abstract

BACKGROUND
Several studies have explored the effect of overlapping surgery on patient outcomes, but impact of surgical overlap during wound closure has not been studied.

OBJECTIVE
To examine the association of overlap during wound closure and suture time overlap (STO) with patient outcomes in a heterogeneous neurosurgical population.

METHODS
Over 4 yr (7/2013-7/2017), 1 7689 neurosurgical procedures were retrospectively reviewed at a single, multihospital academic medical center. STO was defined as all surgeries for which an overlapping surgery occurred, exclusively, during wound closure of the index case being studied. We excluded nonelective cases and overlapping surgeries that involved overlap during surgical portions of the case other than wound closure. Tests of independence and Wilcoxon tests were used for statistical analysis.

RESULTS
Patients with STO had a shortened length of hospital stay (100.6 vs 135.1 h; P < .0001), reduced deaths in follow-up (1.59% vs 5.45%; P = .0004), and lower 30- to 90-d readmission rates (3.64% vs 7.47%; P = .0026). Patients with STO had no increase in revision surgery. Patients with STO had longer wound closure times (26.5 vs 23.9 min; P < .0001) but shorter total surgical times (nonclosure surgical time 101.8 vs 133.3 min; P < .0001; and total surgical time 128.3 vs 157.1 min; P < .0001).

CONCLUSION
Surgical overlap during wound closure (STO) is associated with improved or at least noninferior patient outcomes, as it pertains to readmissions and wound revisions.
Climate and litter C/N ratio constrain soil organic carbon accumulation
Authors: Zhou Guoyi , Xu Shan , Ciais Philippe , Manzoni Stefano , Fang Jingyun , Yu Guirui , Tang Xuli , Zhou Ping , Wang Wantong , Yan Junhua , Wang Gengxu , Ma Keping , Li Shenggong , Du Sheng , Han Shijie , Ma Youxin , Zhang Deqiang , Liu Juxiu , Liu Shizhong , Chu Guowei , Zhang Qianmei , Li Yuelin , Huang Wenjuan , Ren Hai , Lu Xiankai , Chen Xiuzhi 
Published: March 2019

AbstractSoil organic carbon (SOC) plays critical roles in stabilizing atmospheric CO2 concentration, but the mechanistic controls on the amount and distribution of SOC on global scales are not well understood. In turn, this has hampered the ability to model global C budgets and to find measures to mitigate climate change. Here, based on the data from a large field survey campaign with 2600 plots across China's forest ecosystems and a global collection of published data from forested land, we find that a low litter carbon-to-nitrogen ratio (C/N) and high wetness index (P/PET, precipitation-to-potential-evapotranspiration ratio) are the two factors that promote SOC accumulation, with only minor contributions of litter quantity and soil texture. The field survey data demonstrated that high plant diversity decreased litter C/N and thus indirectly promoted SOC accumulation by increasing the litter quality. We conclude that any changes in plant-community composition, plant-species richness and environmental factors that can reduce the litter C/N ratio, or climatic changes that increase wetness index, may promote SOC accumulation. The study provides a guideline for modeling the carbon cycle of various ecosystem scales and formulates the principle for land-based actions for mitigating the rising atmospheric CO2 concentration.
Growth Models and Female Labor in Post-Socialist Eastern Europe
Authors: Avlijaš Sonja 
Published: March 2019

AbstractEastern European women had the highest labor force participation in the world during socialism. With the onset of capitalism, significant shares of women permanently exited the labor market in some countries, while they stayed economically active in others. This article shows that the countries’ different capitalist growth models—defined as strategic national approaches to growth stimulation and job creation—can explain this divergence. Nonlinear interactions between national growth models and structuring of female labor are theoretically abstracted in this article, following which they are tested empirically using a statistical dataset that covers twelve Eastern European countries during the period 1997–2015.
Measuring Patient Safety Competence Among Nursing Students in the Classroom and Clinical Settings
Authors: Suliman Mohammad 
Published: March 2019

Abstract

BACKGROUND
Little is known of the extent to which patient safety (PS) education is addressed in nursing curricula in the classroom and clinical settings in Jordan.

METHOD
An Arabic version of the Health Professional Education in Patient Safety Survey was administered to a convenience sample of 297 nursing students from two governmental universities in Jordan.

RESULTS
Nursing students were moderately satisfied about their knowledge and competencies regarding most PS dimensions; they also had more confidence about the knowledge and competencies they learned in the classroom than during the clinical training. Students in their advanced year had lower confidence about their PS knowledge and competencies than students in the earlier years.

CONCLUSION
The study suggests the need to close the gap between theory and practice in the nursing curriculum. The adoption of a comprehensive framework that integrates PS knowledge and competencies is recommended.
Predicting Physician Assistant Program Matriculation Among Diverse Applicants: The Influences of Underrepresented Minority Status, Age, and Gender
Authors: Yuen Cynthia X. , Honda Trenton J. 
Published: March 2019

Purpose
Health professions schools can foster a diverse medical workforce by ensuring equal educational access for students of varied backgrounds. This study examined how physician assistant (PA) applicants’ demographic characteristics and prior academic history affected likelihood of PA program matriculation.

Method
The authors used national application data from the 2015–2016 PA application cycle to investigate associations between applicants’ underrepresented minority (URM) status, age, and gender, and likelihood of matriculating into a PA program. Effects were examined alone and after adjusting for other demographics and potential confounders (number of applications submitted, patient care hours, academic achievement). The authors tested whether odds of matriculation differed among demographic subgroups with and without current Graduate Record Examinations (GRE) scores.

Results
In univariate models, likelihood of matriculation was lower among URM, older, and male applicants. In fully adjusted models, the URM effect became nonsignificant and the gender effect reversed, while older applicants remained less likely to matriculate. URM and age, but not gender, effects differed by GRE status; only URMs and older applicants without current GRE scores were less likely to matriculate than non-URMs and younger applicants.

Conclusions
Findings that URMs, older individuals, and men had lower matriculation odds changed when controlling for academic achievement and GRE status, indicating the importance of these components in the admissions process. URM and age findings were contingent on GRE status such that odds of matriculation decreased among URM and older applicants without GRE scores, suggesting that standardized test requirements may be a barrier to PA workforce diversity.
Frequency of Screening for Weaning From Mechanical Ventilation: Two Contemporaneous Proof-of-Principle Randomized Controlled Trials*
Authors: Burns Karen E. A. , Wong Jessica T. Y. , Dodek Peter , Cook Deborah J. , Lamontagne Francois , Cohen Ashley , Mehta Sangeeta , Kho Michelle E. , Hebert Paul C. , Aslanian Pierre , Friedrich Jan O. , Brochard Laurent , Rizvi Leena , Hand Lori , Meade Maureen O. , Amaral Andre C. , Seely Andrew J. 
Published: March 2019

Objectives:
It is unknown whether more frequent screening of invasively ventilated patients, identifies patients earlier for a spontaneous breathing trial, and shortens the duration of ventilation. We assessed the feasibility of conducting a large trial to evaluate screening frequency in critically ill adults in the North American context.

Design:
We conducted two contemporaneous, multicenter, pilot, randomized controlled trials (the LibeRation from MEchanicaL VEntilAtion and ScrEening Frequency [RELEASE] and Screening Elderly PatieNts For InclusiOn in a Weaning [SENIOR] trials) to address concerns regarding the potential for higher enrollment, fewer adverse events, and better outcomes in younger patients.

Setting:
Ten and 11 ICUs in Canada, respectively.

Patients:
Parallel trials of younger (RELEASE < 65 yr) and older (SENIOR ≥ 65 yr) critically ill adults invasively ventilated for at least 24 hours.

Interventions:
Each trial compared once daily screening to “at least twice daily” screening led by respiratory therapists.

Measurements and Main Results:
In both trials, we evaluated recruitment (aim: 1–2 patients/month/ICU) and consent rates, reasons for trial exclusion, protocol adherence (target: ≥ 80%), crossovers (aim: ≤ 10%), and the effect of the alternative screening frequencies on adverse events and clinical outcomes. We included 155 patients (53 patients [23 once daily, 30 at least twice daily] in RELEASE and 102 patients [54 once daily, 48 at least twice daily] in SENIOR). Between trials, we found similar recruitment rates (1.32 and 1.26 patients/month/ICU) and reasons for trial exclusion, high consent and protocol adherence rates (> 92%), infrequent crossovers, and few adverse events. Although underpowered, at least twice daily screening was associated with a nonsignificantly faster time to successful extubation and more successful extubations but significantly increased use of noninvasive ventilation in both trials combined.

Conclusions:
Similar recruitment and consent rates, few adverse events, and comparable outcomes in younger and older patients support conduct of a single large trial in North American ICUs assessing the net clinical benefits associated with more frequent screening.
Palisaded Neutrophilic Granulomatous Dermatitis Leading to Diagnosis of Hodgkin Lymphoma: Report of Rare Case and Literature Review of Paraneoplastic Granulomatous Dermatitides
Authors: Pei Susan , Hinshaw Molly A. 
Published: March 2019

Abstract:Palisaded neutrophilic granulomatous dermatitis (PNGD) presents as skin-colored to erythematous papules symmetrically distributed on extensor extremities. Histologically, interstitial and/or palisaded granulomatous infiltrates are present with neutrophils and leukocytoclasis. Together with interstitial granulomatous dermatitis (IGD), PNGD is considered a reactive granulomatous dermatitis to a systemic trigger including connective tissue disease, infection, medication reaction, and less commonly malignancy. We present the second case of PNGD leading to diagnosis of Hodgkin lymphoma. A 47-year-old woman presented with a new asymptomatic eruption of erythematous, nonscaly papules and thin plaques with variable annular configuration, symmetrically distributed on extremities. Biopsies revealed mid-dermal focal degeneration of collagen and leukocytoclasis in association with a palisaded mixed inflammatory infiltrate of neutrophils, lymphocytes, and histiocytes, some forming small granulomas. She had associated fevers, night sweats, weight loss, arthralgias and malaise. Imaging revealed retroperitoneal adenopathy. Excisional lymph node biopsy led to diagnosis of Hodgkin lymphoma. Paraneoplastic PNGD is rare with only 9 reported cases. In all cases, PNGD presented concurrently or before presentation of clinical signs/symptoms of underlying neoplasm. We reviewed a total of 37 cases of paraneoplastic PNGD/IGD, summarizing clinical presentation, histology, associated neoplasm, and response of the skin lesions to treatment. The most commonly associated neoplasia is hematologic, with myelodysplastic syndrome (9 of the 37 cases or 24%) being the most frequent. Seven cases of solid tumor malignancies (prostate, esophageal, hypopharyngeal, breast, endometrial, and lung cancers) have been reported. Recognition of paraneoplastic PNGD/IGD may allow dermatopathologists, pathologists, and dermatologists to direct further workup that reveals underlying malignancy.
The Legacy for Children™ Randomized Control Trial: Effects on Cognition Through Third Grade for Young Children Experiencing Poverty
Authors: Perou Ruth , Robinson Lara R. , Danielson Melissa L. , Claussen Angelika H. , Visser Susanna N. , Scott Keith G. , Beckwith Leila , Katz Lynne , Smith D. Camille 
Published: March 2019

ABSTRACT:

Objective:
In an effort to promote the health and developmental outcomes of children born into poverty, the Centers for Disease Control and Prevention (CDC) conceptualized and designed the Legacy for Children™ (Legacy) public health prevention model. This article examines the impact of Legacy on children's cognitive and language development (intelligence quotient [IQ], achievement, language skills, and early reading skills) using both standardized assessments and parent-reported indictors through third grade.

Methods:
Data were collected from 2001 to 2014 from 541 mother-child dyads who were recruited into the 2 concurrent randomized controlled trials of Legacy in Miami and Los Angels. Cognitive and/or language outcomes of children were assessed annually from age 2 to 5 years as well as during a follow-up visit in the third grade.

Results:
Children experiencing Legacy at the Los Angeles site had significantly higher IQ and achievement scores at 2 and 6 years postintervention, equivalent to approximately one-third of an SD (4 IQ points). IQ results persisted over time, and the difference between intervention and comparison groups on achievement scores widened. There were no significant differences in cognitive outcomes in the Miami sample. There were no significant differences in language outcomes for either site.

Conclusion:

Legacy shows evidence of effectiveness as an intervention to prevent cognitive delays among children living in poverty. The mixed findings across sites may not only reflect the impact of heterogeneous risk profiles noted by other intervention research programs but also warrant additional study.
Depressive Symptoms and Care Demands Among Primary Caregivers of Young Children with Evidence of Congenital Zika Virus Infection in Brazil
Authors: Kotzky Kim , Allen Jacob E. , Robinson Lara R. , Satterfield-Nash Ashley , Bertolli Jeanne , Smith Camille , Ornelas Pereira Isabela , Faria e Silva Santelli Ana Carolina , Peacock Georgina 
Published: March 2019

ABSTRACT:

Objective:
Evidence suggests that caring for a child with special health care needs can affect many domains of family life, including caregiver mental health. However, few studies have examined these outcomes among families impacted by the Zika virus (ZIKV). This study examines depressive symptom severity and care demands among primary caregivers of children, aged 15 to 26 months, with evidence of congenital Zika virus infection (ZVI).

Methods:
A sample of primary caregivers of children with evidence of congenital ZVI in northeastern Brazil (n = 150) reported on depressive symptoms, care demands, and their children's development. Children were categorized into groups according to their developmental delay status. Bivariate analyses were run to test for differences between groups. A path analysis model was used to examine the indirect effects of developmental delay on depressive symptoms through economic challenges and time spent providing health care at home and whether these associations varied by child care support.

Results:
Compared to primary caregivers of children without developmental delay, primary caregivers of children with developmental delay had higher depression scores (p = 0.002), reported more economic (p < 0.001) and child care (p < 0.001) challenges, and spent more time providing health care at home (p < 0.001). Among primary caregivers who did not have child care support, developmental delay had a significant indirect effect on depressive symptoms through economic challenges but not through time spent providing health care at home.

Conclusion:
For families impacted by the ZIKV outbreak in Brazil, economic and child care challenges may be associated with primary caregiver mental health.
Augmented Subscleral Trabeculectomy With Beta Radiation and Mitomycin C in Egyptian Glaucoma Patients
Authors: El Mazar Hesham M. , Mandour Sameh S. , Mostafa Mohamed I. , Elmorsy Osama A. 
Published: March 2019

Purpose:
Subscleral trabeculectomy is the most common surgical treatment for glaucoma. However, wound healing and scar formation may result in bleb fibrosis, leading to bleb failure. The healing response of the wound is reported to be the single most important risk factor in determining the final intraocular pressure (IOP) after glaucoma filtration surgery. Thus, we aimed to evaluate the effect of preoperative beta irradiation and intraoperative mitomycin C (MMC) treatment as combined adjuncts to subscleral trabeculectomy in the management of glaucoma in Egyptian patients.

Patients and Methods:
This prospective, interventional, comparative masked clinical study was performed between October 2016 and January 2018. This study included 50 subjects, 25 of whom underwent trabeculectomy augmented by MMC intraoperatively and beta radiation preoperatively at the bleb area (patient group #1). The remaining 25 subjects underwent trabeculectomy with MMC alone (control group #2). Beta radiation was administered 5 to 7 days before the surgery as a single dose (1000 cGy) using a strontium-90 probe. MMC (0.2 mg/mL) was administered for 2 minutes.

Results:
There was a statistically significant difference in postoperative IOP between the groups from the second week. Intraoperative hyphema occurred in 6 cases in the control group #2, whereas no intraoperative hyphema was observed in patient group #1; this difference was statistically significant.

Conclusions:
Subscleral trabeculectomy augmented by beta radiation and MMC gives greater control over IOP. Therefore, we recommend using beta radiation before trabeculectomy in patients who may have a high risk of developing conjunctival fibrosis.
Implementation of an Activity-Monitoring System in Hospital-Based COPD Patients: A Retrospective Cohort Study
Authors: Wilson Christopher M. , Burns Grace , Bove Jonathon , Ferranti Vincenzo , McCown Benjamin , Wiechec Seidell Janet , Colombo Reyna 
Published: March 2019

Introduction:
Patients with chronic obstructive pulmonary disorder are at risk of complications after hospitalization, including readmissions. The purpose of this study was to assess the effects of an activity-monitoring device on the outcomes of patient with chronic obstructive pulmonary disorder during and after a hospital admission.

Methods:
During a hospitalization, 52 patients (experimental group) diagnosed with chronic obstructive pulmonary disorder were provided with an activity monitor (Tractivity; (Kineteks Corporation, Vancouver, British Colombia, http://tractivity-online.squarespace.com/)) and 99 usual care patients were chosen as controls. Following hospital discharge, retrospective chart analysis examined patient demographics including falls, length of stay, discharge disposition, and hospital readmissions.

Results:
No difference in number of falls, length of stay, discharge disposition, and hospital readmissions could be found between groups (P > .05). Within the experimental group, those who were discharged home (n = 45) displayed a greater daily activity, number of steps, and ambulation distance as compared with patients who were discharged to another facility (n = 7, P < .05).

Discussion:
Readmissions are multifactorial and activity during a hospitalization may not be the primary cause of readmissions. Activity monitoring can help quantify ambulation and may be useful as a means to predict discharge disposition.

Conclusion:
No clear effect of using an activity monitor could be found on length of stay, readmission rates, and discharge disposition between the 2 groups. However, less activity and shorter ambulation distance were associated with discharge to another facility instead of home.
A retrospective analysis of the prevalence of dental diseases in patients with digestive system cancers
Authors: Sakai Hironori , Yamada Shin-Ichi , Gibo Takahiko , Yoshimura Nobuhiko , Nishimaki Fumihiro , Kondo Eiji , Kamata Takahiro , Kurita Hiroshi 
Published: March 2019

Abstract
The relationship between dental diseases and the prevalence of digestive system cancers remains unclear. The aim of the present study was to examine the prevalence of dental diseases in patients treated for digestive system cancers.
The medical and dental records of patients treated for digestive system cancers were retrospectively reviewed, and the results obtained (decayed/filled/missing teeth [DMFT] indices and community periodontal index [CPI] codes) were compared with data from the national survey of dental diseases in order to investigate the relationship between oral health and digestive system cancers.
DMFT, D, and F indices were significantly lower, while the M index was slightly higher in digestive system cancer patients than in the national survey. The proportions of individuals with more than 20 residual teeth and denture wearers were significantly lower in cancer patients than in the national survey. The prevalence of periodontitis (CPI codes 3 and 4) and severe periodontitis (CPI code 4) were significantly higher in cancer patients than in the national survey.
The present results showed that digestive system cancers were closely associated with multi-tooth loss and/or a low denture-wearing rate. The prevalence of severe periodontitis was also found to be higher in cancer patients. These results suggest that periodontitis and associated multi-tooth loss play a potential role in digestive system cancers.