bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air pollution, neighborhood deprivation, and autism spectrum disorder in the Study to Explore Early Development
Authors: McGuinn Laura A. , Windham Gayle C. , Messer Lynne C. , Di Qian , Schwartz Joel , Croen Lisa A. , Moody Eric J. , Rappold Ana G. , Richardson David B. , Neas Lucas M. , Gammon Marilie D. , Schieve Laura A. , Daniels Julie L. 
Published: September 2019

Background:
To examine whether neighborhood deprivation modifies the association between early life air pollution exposure and autism spectrum disorder (ASD), we used resources from a multisite case–control study, the Study to Explore Early Development.

Methods:
Cases were 674 children with confirmed ASD born in 2003–2006; controls were 855 randomly sampled children born during the same time period and residents of the same geographic areas as cases. Air pollution was assessed by roadway proximity and particulate matter <2.5 µm (PM2.5) exposure during pregnancy and first year of life. To characterize neighborhood deprivation, an index was created based on eight census tract-level socioeconomic status-related parameters. The continuous index was categorized into tertiles, representing low, moderate, and high deprivation. Logistic regression was used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs).

Results:
Neighborhood deprivation modified (P
for interaction = 0.08) the association between PM2.5 exposure during the first year of life and ASD, with a stronger association for those living in high (OR = 2.42, 95% CI = 1.20, 4.86) rather than moderate (OR=1.21, 95% CI = 0.67, 2.17) or low (OR=1.46, 95% CI = 0.80, 2.65) deprivation neighborhoods. Departure from additivity or multiplicativity was not observed for roadway proximity or exposures during pregnancy.

Conclusion:
These results provide suggestive evidence of interaction between neighborhood deprivation and PM2.5 exposure during the first year of life in association with ASD.
Injectable contraception: emerging evidence on subcutaneous self-administration
Authors: Lerma Klaira , Goldthwaite Lisa M. 
Published: September 2019

Purpose of review
Injectable contraception is a widely available and popular family planning method globally. It has evolved to allow for subcutaneous self-injection (DMPA-SC, Depo medroxyprogesterone acetate-subcutaneous). In this review, we will focus on research evaluating DMPA-SC, with specific regard to continuation rates, safety, and satisfaction among users.

Recent findings
Emerging evidence from the United States, Malawi, Uganda, and Senegal has established safety and higher continuation rates among self-inject users, compared with provider-inject users. Continuation is 10–28% higher among DMPA-SC self-inject users. Self-inject users across studies were highly satisfied and reported DMPA-SC was easy to use. Studies indicate continuation is likely to be attributable to self-administration and user autonomy, rather than inherent properties of the DMPA-SC injection.

Summary
DMPA-SC should be made available in high-resource and low-resource settings. Future efforts should be focused on implementation and evaluating how to best add DMPA-SC to the method mix. Cost–benefit analyses will need to evaluate the up-front costs of DMPA-SC for clients, facilities, and health systems compared with the higher continuation rates and saved opportunity-costs over time. Task-shifting strategies and development of mobile phone technologies to assist users in adherence should be considered in future service scale-up.
Antepartum and intrapartum risk factors for neonatal hypoxic–ischemic encephalopathy: a systematic review with meta-analysis
Authors: Rossi A. Cristina , Prefumo Federico 
Published: September 2019

Purpose of review
To review literature about risk factors of neonatal hypoxic–ischemic encephalopathy (HIE).

Recent findings
Search in PubMed, MEDLINE, Embase, Clinicaltrials.gov and reference lists from 1999 to 2018. Inclusion criteria: study population composed of neonates who manifested HIE within 28 days from delivery, data reported as proportional rate. Studies were excluded if they included preterm pregnancies, postnatal conditions leading to HIE and/or fetal malformations, focused on a single risk factor, were not in English language. PRISMA guidelines were followed. Interstudies heterogeneity was assessed and a random/fixed models were generated as appropriate. Comparison between neonates with HIE vs. controls was performed by calculating odds ratio–95% confidence interval (OR–95% CI). Differences were significant if 95% CI did not encompass 1. Twelve articles were included. Fetuses with growth restriction (OR: 2.87; 95% CI: 1.77–4.67), nonreassuring cardiotocography (OR: 6.38; 95% CI: 2.56–15.93), emergency cesarean section (OR: 3.69; 95% CI: 2.75–4.96), meconium (OR: 3.76; 95% CI: 2.58–5.46) and chorioamnionitis (OR: 3.46: 95% CI: 2.07–5.79) were at higher risk of developing HIE. Nulliparity, gestational diabetes, hypertension, oligohydramnios, polyhydramnios, male sex, induction of labor, labor augmentation, premature rupture of membrane, and vacuum delivery were not significantly different.

Summary
Neonatal HIE has multifactorial origin and its cause is often undetermined and not preventable.
PROSPERO (Registration number: CRD42018106563).
The efficacy of using acupuncture in managing polycystic ovarian syndrome
Authors: Chen Hui , Lim Chi Eung Danforn 
Published: September 2019

Purpose of review
Polycystic ovarian syndrome (PCOS) is a common reproductive disorder, which significantly impairs the fertility of 3–10% of women at reproductive age. It is getting very popular for women with PCOS to seek alternative therapies to treat PCOS, for example, acupuncture. This review examines the currently available evidence from the randomized controlled trial to guide future recommendation on using acupuncture to assist the treatment of PCOS.

Recent findings
PCOS is manifested by oligo-amenorrhoea, infertility, and hirsutism. The standard treatment of PCOS includes oral pharmacological agents, lifestyle changes, and surgical modalities. Pharmacologically based therapies are only effective in 60% of the patients, which are also associated with different side-effects. As such, acupuncture offered an alternative option. Acupuncture can affect β-endorphin production, which may, in turn, affect gonadotropin-releasing hormone secretion and affecting ovulation and menstrual cycle. Therefore, it is postulated that acupuncture may induce ovulation and restore menstrual cycle via increasing β-endorphin production.

Summary
Although modern medical science has discovered the action mechanisms underlying how acupuncture may manage the symptoms of PCOS, majority of the trials are small in sample size and lack of consistency in the choice of acupoints. Larger scale trials are needed to provide standardized protocols.
Practices of Exemplary Leaders in Clinical Education: A Qualitative Study of Director and Site Coordinator of Clinical Education Perspectives
Authors: Silberman Nicki , LaFay Vicki , Zeigler Stacey 
Published: September 2019

Introduction.
Frequent turnover in director of clinical education (DCE) and site coordinator of clinical education (SCCE) positions may affect excellence in physical therapist (PT) clinical education (CE). Recognized CE leaders have demonstrated longevity and success in these roles. Understanding excellence in CE leadership may enhance delivery of PT CE. The purposes of this qualitative study were to explore characteristics of recognized PT CE leaders and identify the behaviors, thoughts, and actions of successful DCEs and SCCEs with demonstrated longevity.

Methods.
Purposeful sampling was used to identify PTs who have been either a DCE or a SCCE for at least 10 years and were recognized by their peers as a leader in PT CE. An interpretive phenomenological inquiry was conducted to explore the lived experience of CE leaders. Cognitive mapping and unstructured interviews were used to elicit perspectives on the factors that contributed to longevity and success. Using an inductive approach, DCE and SCCE data were analyzed separately. Due to substantial overlap in themes, the DCE and SCCE data were combined. Member checks and a peer review were conducted.

Results.
Seven DCEs and 6 SCCEs from the Northeast United States, with 8–26 (average 17) years in their position, completed the study. Five themes identifying their role success were the following: (1) Professional identity as a bridge between academic and clinical practices, (2) strong work ethic for excellence, (3) build meaningful relationships, (4) “bring-it-on” attitude, and (5) influence.

Discussion and Conclusion.
The participants shared common characteristics as exemplary leaders in CE. The main themes were in remarkable alignment with The 5 Practices of Exemplary Leaders, a well-established leadership model. These findings provide a framework to identify and develop the leadership qualities needed to fulfill these positions. These exemplary practices should be incorporated into leadership training for DCEs and SCCEs.
Begin With the End in Mind: Implementing a Series of Integrated Clinical Experience Courses
Authors: Colgrove Yvonne M. , Rucker Jason 
Published: September 2019

Background and Purpose.
The evolving nature of clinical education requires program evaluation to inform intentional curriculum development. However, descriptions of the application of curriculum development frameworks in physical therapy are sparse. We used the context/input/process/product (CIPP) model to guide a didactic and clinical education curriculum reorganization that included the creation of a series of five integrated clinical experience (ICE) courses threaded throughout the first two years of a Doctor of Physical Therapy (DPT) program.

Method/Model Description and Evaluation.
The CIPP model guided comprehensive program evaluation. Context evaluation summarized strengths, weaknesses, opportunities, and threats. Input evaluation of information from multiple stakeholders and external influences, including accreditation standards, practices at other academic institutions, and published literature, was used to guide changes in the clinical education curriculum. Goals, objectives, and themes were developed for intentional alignment of didactic and clinical education curricula, alongside clinical site development and logistical planning. Process evaluation monitored the implementation of the new clinical education program to identify and address problems. The program is currently in the process of detailed product evaluation.

Outcomes.
ICE courses were initially implemented at eight clinical sites. Course assessments were selected and administered at established intervals. Program outcome measures were identified and administered to 2 control cohorts from the original DPT curriculum, and the first cohort in the new DPT curriculum.

Discussion and Conclusion.
The process used a structured approach to curriculum development. It emphasized the necessity of engaging multiple stakeholders, developing strong clinical partnerships, and intentional design and placement of courses within the overall curriculum to ensure the quality of ICE courses.
Massive pulmonary embolism: embolectomy or extracorporeal membrane oxygenation?
Authors: Tahir Usman A. , Carroll Brett , Pinto Duane S. 
Published: September 2019

Purpose of review
To highlight updates on the use of extracorporeal membrane oxygenation (ECMO) and surgical embolectomy in the treatment of massive pulmonary embolism.

Recent findings
Outcomes for surgical embolectomy for massive pulmonary embolism have improved in the recent past. More contemporary therapeutic options include catheter embolectomy, which although offer less invasive means of treating this condition, need further study. The use of ECMO as either a bridge or mainstay of treatment in patients with contraindications to fibrinolysis and surgical embolectomy, or have failed initial fibrinolysis, has increased, with data suggesting improved outcomes with earlier implementation in selected patients.

Summary
Although surgical embolectomy continues to be the initial treatment of choice in massive pulmonary embolism with contraindications or failed fibrinolysis, the use of ECMO in these high-risk patients provides an important tool in managing this often fatal condition.
Initial management of severe burn injury
Authors: Tejiram Shawn , Romanowski Kathleen S. , Palmieri Tina L. 
Published: September 2019

Purpose of review
Patients with severe burn injuries pose significant challenges for the intensivist. Though average burn sizes have decreased over time, severe burn injuries involving greater than 20% of the total body surface area still occur. Verified burn centers are limited, making the management of severely burn injured patients at nonspecialized ICUs likely. Current practices in burn care have increased survivability even from massive burns. It is important for intensivists to be aware of the unique complications and therapeutic options in burn critical care management. This review critically discusses current practices and recently published data regarding the evaluation and management of severe burn injury.

Recent findings
Burn patients have long, complex ICU stays with accompanying multiorgan dysfunction. Recent advances in burn intensive care have focused on acute respiratory distress syndrome from inhalation injury, acute kidney injury (AKI), and transfusion, resulting in new strategies for organ failure, including renal replacement therapy and extracorporeal life support.

Summary
Initial evaluation and treatment of acute severe burn injury remains an ongoing area of study. This manuscript reviews current practices and considerations in the acute management of the severely burn injured patient.
Vitamin C in surgical sepsis
Authors: Anand Tanya , Roller Lauren K. , Jurkovich Gregory J. 
Published: September 2019

Purpose of review
The current review discusses the supplemental use of vitamin C as an adjunct in the management of sepsis and septic shock.

Recent findings
The antioxidant properties of vitamin C are touted to be useful in modulating the inflammatory response, decreasing vasopressor requirements, and improving resuscitation. Current resuscitation practices are focused on addressing the hemodynamic instability and ensuring adequate oxygen delivery to tissues. The conceptual framework of the use of vitamin C during a resuscitation is to modulate in a beneficial fashion the inflammatory response to sepsis while concomitantly resuscitating and treating the infection. While there is promising animal and burn-related data on improved fluid resuscitation with the use of vitamin C as an adjunct, the most recent meta-analyses of the available data fail to show a survival benefit in sepsis, and concerns regarding nephrotoxicity remain.

Summary
Although there are large number of animal studies, only a few small prospective and retrospective studies in humans address the use of vitamin C to treat sepsis. Further research in a controlled and randomized fashion is needed to determine if vitamin C is effective in this role. While there is a promise of ascorbate's addition to the sepsis bundle as an adjunct to resuscitation, the evidence is not conclusive.
Failure to rescue in the surgical patient: a review
Authors: Lafonte Marc , Cai Jenny , Lissauer Matthew E. 
Published: September 2019

Purpose of review
Evaluating patient outcomes is essential in a healthcare environment focused on quality. Mortality after surgery has been considered a useful quality metric. More important than mortality rate, failure to rescue (FTR) has emerged as a metric that is important and may be improveable. The purpose of this review is to define FTR, describe patient and hospital level factors that lead to FTR, and highlight possible solutions to this problem.

Recent findings
FTR is defined as a death following a complication. Depending on the patient population, FTR rates vary from less than 1% to over 40%. Numerous patient factors including frailty, congestive heart failure (CHF), renal failure, serum albumin <3.5, COPD, cirrhosis, and higher ASA class may predispose patients to FTR. Hospital factors including technology, teaching status, increased nurse-to-patient ratios, and closed ICUs may help reduce FTR. More difficult to measure variables, such as hospital culture and teamwork may also influence FTR rates. Early warning systems may allow earlier identification of the deteriorating patient.

Summary
FTR is a major clinical concern and efforts aimed at optimizing patient and hospital factors, culture and communication, as well as early identification of the deteriorating patient may improve FTR rate.
Acute respiratory failure: nonintubation assist methods for the acutely deteriorating patient
Authors: Frat Jean-Pierre , Marie Damien , Thille Arnaud W. 
Published: September 2019

Purpose of review
Noninvasive ventilation is strongly recommended in acute hypercapnic respiratory failure, whereas high-flow nasal oxygen therapy could be an alternative in de novo respiratory failure.

Recent findings
High-flow nasal oxygen may improve the outcome of patients de novo respiratory failure as compared with standard oxygen. Its success within 2 h after initiation is well predicted by a ROX index (ratio of SpO2/FiO2 to respiratory rate) greater than 4.88, as failure when less than 3.85 at 12 h after initiation. However, the superiority of high-flow nasal oxygen to standard oxygen has not been confirmed in immunocompromised patients. Although noninvasive ventilation may be deleterious through barotrauma in patients with de novo respiratory failure, its use seems to be an optimal strategy for preoxygenation before intubation in preventing severe hypoxemia in most hypoxemic patients. In mild hypoxemic patient, high-flow nasal oxygen may be more efficient than bag-valve mask in preventing severe adverse events. After anesthetic induction further positive-pressure ventilation can better secure intubation procedure than absence of ventilation.

Summary
Despite the growing use of high-flow nasal oxygen, new studies are needed to confirm its superiority to standard oxygen in de novo respiratory failure and others causes of acute respiratory failure in place of standard oxygen.
Emergency bedside ultrasound-benefits as well as caution: Part 2: Echocardiography
Authors: Godement Mathieu , Malbrain Manu L.N.G. , Vieillard-Baron Antoine 
Published: September 2019

Purpose of review
Critical care echocardiography (CCE) has become an important component of general critical care ultrasonography, and a current review of its performance is presented.

Recent findings
Basic CCE should be performed as a goal-directed examination to better identify specific signs and to answer important clinical questions concerning acute hemodynamic concerns. It has evolved in the ICU and also in the emergency department not only for improved diagnostic capability but also as an effective part of the triage process. It remains an efficacious procedure even in patients with respiratory failure when combined with lung ultrasonography. Numerous acronyms were proposed, but in all cases, CCE responds to the same rules as fundamental echocardiography. Basic CCE requires accessible and comprehensive training for physicians and is mandatory for all intensivists. Development of pocket echo devices may increase the use of basic CCE as has miniaturization of other medical technologies. Performance should be managed by guidelines, and the CCE training program should be standardized worldwide. More trials are welcome to evaluate its impact on patient outcomes.

Summary
Thanks to its ability to quickly obtain a diagnostic orientation at the bedside and to implement targeted therapy, basic CCE over the past decade has become an essential tool for hemodynamic assessment of the cardiopulmonary unstable patient. Its more recent incorporation into the education of trainees in medical school and residencies/fellowships has reinforced its perceived importance in critical care management, despite the relative paucity as yet of rigorous scientific evidence demonstrating positive outcome modification from its use.
Medications and the larynx
Authors: Harounian Jonathan , Postevka Eugene , Jamal Nausheen 
Published: September 2019

Purpose of review
The larynx is a complex organ that houses some of the most intricate structures of the human body. Owing to its delicate nature, the larynx is affected by different medications to varying degrees. Many of these effects manifest in subjective complaints in one's voice or swallow. This review article invokes the present available literature to describe the effects different medical agents have on the functionality of the laryngeal structures.

Recent findings
Multiple available studies explore the effects of inhaled corticosteroids on the larynx. While laryngeal candidiasis is a well known complication of chronic steroid use, other rarer fungal infections have also demonstrated themselves as risks. Among anesthetics, the literature suggests that sevoflurane in standard and high doses does not appear to significantly reduce the risk of laryngospasm. The use of topical and intravenous lidocaine appear to have conflicting evidence regarding their use in laryngospasm prevention, whereas postoperative sore throat, hoarseness, and cough may be prevented with preinduction nebulization of ketamine and magnesium sulfate or budesonide.

Summary
Further study is warranted to explore the effects that these and other classes of agents, such as antibiotics, have on the structure and function of the larynx.
Gastric inlet patches: symptomatic or silent?
Authors: Cock Charles , Hamarneh Zaki 
Published: September 2019

Purpose of reviewThe purpose of this review is to assess recent literature on the clinical relevance of the gastric inlet patch with particular focus on endoscopic diagnosis and treatment, the relationship of the inlet patch to laryngopharyngeal reflux disease and the association of proximal esophageal adenocarcinoma with inlet patch.Recent findingsRecent studies suggest endoscopic diagnosis of inlet patch increases with endoscopist awareness (up to 10-fold) and when using enhanced imaging techniques such as narrow band imaging (up to three-fold). The literature remains mixed on the association of inlet patch with laryngopharyngeal symptoms or globus sensation. Studies of endoscopic ablation, using argon plasma coagulation or radiofrequency ablation have shown improved laryngopharyngeal reflux symptom scores posttreatment. Proximal esophageal adenocarcinomas are rare but often associated with inlet patch when they occur. Case studies have described endoscopic resection of malignant lesions related to inlet patch, using endoscopic mucosal resection or submucosal dissection.SummaryProspective, multicenter studies of symptom association with inlet patch using validated symptom questionnaires and blinded sham-controlled treatments are needed to further clarify the role of such treatments, which to date are limited to a small numbers of centers with a special interest.