bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Care Provider Communication and the Duration of Time Loss Among Injured Workers
Authors: Lane Tyler J. , Lilley Rebbecca , Black Oliver , Sim Malcolm R. , Smith Peter M. 
Published: July 2019

Background:
In addition to providing injured workers with biomedical treatment, health care providers (HCPs) can promote return to work (RTW) through various communications.

Objectives:
To test the effect of several types of HCP communications on time loss following injury.

Research Design:
The authors analyzed survey and administrative claims data from a total of 730 injured workers in Victoria, Australia. Survey responses were collected around 5 months postinjury and provided data on HCP communication and confounders. Administrative claim records provided data on compensated time loss postsurvey. The authors conducted multivariate zero-inflated Poisson regressions to determine both the odds of having future time loss and its duration.

Measures:
Types of HCP communications included providing an estimated RTW date, discussing types of activities the injured worker could do or ways to prevent a recurrence, and contacting other RTW stakeholders. Each was measured in isolation as well as modified by a low-stress experience with the HCP. Time loss was the count of cumulative compensated work absence in weeks, accrued postsurvey.

Results:
RTW dates reduced the odds of future time loss [odds ratio, 0.26; 95% confidence interval (CI), 0.09–0.82] regardless of the stressfulness of the experience. Communications that predicted shorter durations of time loss only did so with low-stress experiences: RTW date [incidence rate ratio (IRR), 0.56; 95% CI, 0.50–0.63], stakeholder contact (IRR, 0.78; 95% CI, 0.70–0.87), and prevention discussions (IRR, 0.87; 95% CI, 0.78–0.98).

Conclusions:
HCPs may reduce time loss through several types of communication, particularly when stress is minimized. RTW dates had the largest and most robust effect.
Bedside Music Therapy for Women during Antepartum and Postpartum Hospitalization
Authors: Corey Kristen , Fallek Ronit , Benattar Maya 
Published: July 2019

Abstract

Purpose:
Stress and anxiety are prevalent during pregnancy and postpartum with adverse effects on mothers and newborns, yet women's psychological and emotional needs are often given a lower priority than their physical wellbeing. The purpose of this study was to assess feasibility of implementing a bedside music therapy intervention to alleviate stress and anxiety, provide emotional support, and facilitate mother–baby bonding for women during antepartum and postpartum hospitalization at a large urban medical center.

Study Design and Methods:
Over 15 months, women on three units who were hospitalized during antepartum or postpartum were referred for music therapy and received a single bedside session from a credentialed music therapist (MT-BC), including tailored interventions and education in relaxation techniques. A retrospective analysis of postintervention feedback questionnaires and process notes was conducted to assess participant receptivity and satisfaction, and the feasibility of implementing the program on the units.

Results:
Music therapy was provided to 223 postpartum and 97 antepartum patients. The program was found to be feasible and well received, including high satisfaction, positive effects on participants' relaxation and sense of connection with their baby, and enthusiastic reception from providers and staff. Qualitative feedback revealed salient themes including the effect of the intervention on mothers' mental, emotional and physical states, and the soothing effect of music on their newborns.

Clinical Implications:
Hospitals are in a unique position to provide support services and self-care education for women during their antepartum and postpartum hospitalization. Music therapy can be integrated successfully into inpatient care as a nurturing and patient-centered form of psychosocial support.
Implementation of a Dedicated Education Unit Model for ADN Students in a Rural Primary Care Setting
Authors: Goslee Ellen , Chesak Sherry , Forsyth Diane McNally , Foote Jane , Bergen Silas 
Published: July 2019

Background
Dedicated education unit (DEU) clinical education models are an innovative, evidence-based approach to create effective learning environments for students. These models have been implemented primarily in acute care settings.

Problem
The gap between nursing education and clinical practice in rural health care settings is a growing concern, compounded by a nursing faculty shortage and decreased availability of clinical sites.

Approach
A descriptive study design was used to assess the outcomes of a DEU model of clinical practice with associate degree nursing students in a rural primary care clinic, using registered nurses (RNs) who were prepared as clinical nurse teachers.

Outcomes
Associate degree nursing students experienced the RN role in primary care, worked with nurses who wanted to teach them, and improved their nursing skills.

Conclusions
The DEU model is a positive clinical teaching pedagogy for students and staff nurses.
Two Cases of Tandem Bullets—One Homicide and One Suicide
Authors: Khau Allyson , Melinek Judy 
Published: July 2019

Abstract
We report 2 unusual cases of tandem bullets. Case 1 is a homicide involving a piggyback screw. Case 2 is a suicide involving multiple tandem bullets as a result of improper ammunition size. Tandem bullet injuries can have a wide variety of presentations. Therefore, it is essential that forensic pathologists understand the mechanisms of tandem bullet wounds and familiarize themselves with the autopsy and radiological findings seen in tandem bullet injuries. This report supports that use of incorrect caliber ammunition and the lodgment of foreign objects in the barrel of a gun are possible causes of tandem bullet injuries.
Fatal Rupture of Brachial Pseudoaneurysm in a Drug Abuser
Authors: Trotta Silvia , Sorrentino Antonella , Bertozzi Giuseppe , Angiletta Domenico , Solarino Biagio 
Published: July 2019

Abstract
The injection of drugs of abuse causes many millions of deaths each year; deaths are mostly due to fatal overdose and the trauma and infection caused by repeated injections. The scientific literature widely reports cases of infected pseudoaneurysm in injecting drug abusers; however, most of these autopsy cases deal with the rupture of pseudoaneurysm of the femoral artery. We present fatal hemorrhagic shock in a heroin-cocaine abuser subsequent to rupture of pseudoaneurysm of the brachial artery; the man collapsed just before injecting himself with a dose of heroin-cocaine (speedball).
Extracorporeal Membrane Oxygenation for Severe Adenoviral Pneumonia in Neonatal, Pediatric, and Adult Patients
Authors: Ramanathan Kollengode , Tan Chuen Seng , Rycus Peter , MacLaren Graeme 
Published: July 2019

Objectives:
We examined data on patients with severe adenoviral pneumonia from the international registry of the Extracorporeal Life Support Organization to identify risk factors for mortality in patients receiving extracorporeal membrane oxygenation.

Design:
Retrospective analysis.

Setting:
International Registry of Extracorporeal Life Support Organization.

Patients:
We collected de-identified data on all patients with adenoviral pneumonia who needed extracorporeal membrane oxygenation from 1992 to 2016 using International Classification of Diseases, 9th Edition, criteria.

Interventions:
Our primary outcome measure was in-hospital mortality. We also collected data on demographics, preextracorporeal membrane oxygenation ventilator settings, biochemical variables, extracorporeal membrane oxygenation mode, duration, and complications. Initial bivariate analysis assessed potential associations between mortality and various preextracorporeal membrane oxygenation variables as well as extracorporeal membrane oxygenation factors. Variables with p values of less than 0.1 were considered for logistic regression analysis that identified predictors of mortality.

Measurements and Results:
There were 542 patients with adenoviral pneumonia who were supported with extracorporeal membrane oxygenation. Overall mortality was 58% (307/529 patients) (neonates 86.4% [108/125 patients], children 49% [158/327 patients], and adults 49% [41/83 patients]). Multivariate regression identified hypercapnia (Pco
2 > 45.7; odds ratio > 3.2; p < 0.001), immunosuppression (odds ratio, 4.44; 95% CI, 1.69–11.61; p = 0.002] and lack of pharmacologic paralysis (odds ratio, 0.30; 95% CI, 0.16–0.57; p < 0.001] as significant preextracorporeal membrane oxygenation factors for mortality. Neonatal patients had significantly higher mortality than pediatric or adult patients (odds ratio, 10.9; 95% CI, 3.2–37.3; p < 0.001). The presence of renal (odds ratio, 4.4; 95% CI, 2.5–7.7; p < 0.001), neurologic (odds ratio, 2.5; 95% CI, 1.2–5.1; p = 0.014), hemorrhagic (odds ratio, 2.2; 95% CI, 1.2–4.0; p = 0.014), or cardiovascular complications (odds ratio, 2.4; 95% CI, 1.3–4.6; p = 0.006) was associated with higher mortality on extracorporeal membrane oxygenation.

Conclusions:
Patients with adenoviral pneumonia supported on extracorporeal membrane oxygenation had mortality of 58% over a 25-year-old period. We identified risk factors both before and during extracorporeal membrane oxygenation which were associated with higher mortality. Mortality in neonatal patients was particularly high.
Aripiprazole Toxicity With a Biphasic Course of Somnolence
Authors: Gupta Divya , O'Hara Chris 
Published: July 2019

Introduction
Aripiprazole is an atypical antipsychotic with partial agonism at dopamine and serotonin receptors. In pediatrics, it is approved to treat irritability associated with autistic disorder along with other neuropsychological conditions. Compared with other atypical antipsychotics, it has a favorable side effect profile, but overdose experience is limited.

Case Report
A 3-year-old drug-naive patient accidentally ingested 200 mg of aripiprazole. This ingestion resulted in immediate lethargy with brief improvement 16 hours after ingestion and subsequent decline 2 hours later. Patient returned to baseline 72 hours after ingestion.

Discussion
Unlike previous case reports, this patient displayed a biphasic course of somnolence. Previous reports have described delayed onset and prolonged sedation in response to an aripiprazole overdose. Current recommendations regarding monitoring after ingestion do not account for possible worsening of symptoms after improvement.

Conclusion
It is important to recognize the need for a longer observation period after a significant aripiprazole overdose as a variable course of somnolence may be witnessed.
Factors Associated With Antibiotic Prescribing and Outcomes for Pediatric Pneumonia in the Emergency Department
Authors: Lipshaw Matthew J. , Florin Todd A. , Krueger Sara , Belsky Michael A. , Epperson Thomas , Crotty Eric J. , Lipscomb Jessi , Jacobs Judd , Rattan Mantosh S. , Ruddy Richard M. , Shah Samir S. , Ambroggio Lilliam 
Published: July 2019

Objectives
Chest radiographs (CXRs) are often performed in children with respiratory illness to inform the decision to prescribe antibiotics. Our objective was to determine the factors associated with clinicians' plans to treat with antibiotics prior to knowledge of CXR results and the associations between preradiograph plans with antibiotic prescription and return to medical care.

Methods
Previously healthy children aged 3 months to 18 years with a CXR for suspected pneumonia were enrolled in a prospective cohort study in the emergency department. Our primary outcomes were antibiotic prescription or administration in the emergency department and medical care sought within 7 to 15 days after discharge. Inverse probability treatment weighting was used to limit bias due to treatment selection. Inverse probability treatment weighting was included in a logistic regression model estimating the association between the intention to give antibiotics and outcomes.

Results
Providers planned to prescribe antibiotics prior to CXR in 68 children (34.9%). There was no difference in the presence of radiographic pneumonia between those with and without a plan for antibiotics. Children who had a plan for antibiotics were more likely to receive antibiotics than those without (odds ratio [OR], 6.39; 95% confidence interval [CI], 3.7–11.0). This association was stronger than the association between radiographic pneumonia and antibiotic receipt (OR, 3.49; 95% CI, 1.98–6.14). Children prescribed antibiotics were more likely to seek care after discharge than children who were not (OR, 1.85; 95% CI, 1.13–3.05).

Conclusions
Intention to prescribe antibiotics based on clinical impression was the strongest predictor of antibiotic prescription in our study. Prescribing antibiotics may lead to subsequent medical care after controlling for radiographic pneumonia.
Onset and Resolution of Chiari Malformations and Hydrocephalus in Syndromic Craniosynostosis following Posterior Vault Distraction
Authors: Lin Lawrence O. , Zhang Rosaline S. , Hoppe Ian C. , Paliga J. Thomas , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A. 
Published: July 2019

Background:
Patients with syndromic craniosynostosis have an increased incidence of progressive hydrocephalus and Chiari malformations, with few data on the relative benefit of various surgical interventions. The authors compare the incidence and resolution of Chiari malformations and hydrocephalus between patients undergoing posterior vault distraction osteogenesis (PVDO) and patients undergoing conventional cranial vault remodeling.

Methods:
Patients with syndromic craniosynostosis who underwent cranial vault surgery from 2004 to 2016 at a single academic hospital, with adequate radiographic assessments, were reviewed. Demographics, interventions, the presence of a Chiari malformation on radiographic studies and hydrocephalus requiring shunt placement were recorded. Mann-Whitney U and Fisher’s exact tests were used as appropriate.

Results:
Forty-nine patients underwent PVDO, and 23 patients underwent cranial vault remodeling during the study period. Median age at surgery (p = 0.880), sex (p = 0.123), and types of syndrome (p = 0.583) were well matched. Patients who underwent PVDO had a decreased incidence of developing Chiari malformations postoperatively compared with the cranial vault remodeling cohort (2.0 percent versus 17.4 percent; p = 0.033). Not surprisingly, no significant difference was found between the groups with regard to the incidence of postoperative hydrocephalus requiring shunt placement (PVDO, 4.1 percent; cranial vault remodeling, 4.3 percent; p = 0.999).

Conclusions:
As expected, PVDO did not significantly affect intracranial hydrodynamics to the extent that hydrocephalus shunting rates were different for patients with syndromic craniosynostosis. However, PVDO was associated with a reduced risk of developing a Chiari malformation; however, prospective evaluation is needed to determine causality.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Nasal Reconstruction Using the Integra Dermal Regeneration Template
Authors: Seth Akhil K. , Ratanshi Imran , Dayan Joseph H. , Disa Joseph J. , Mehrara Babak J. 
Published: July 2019

Summary:
The reconstruction of nasal defects following oncologic resection has traditionally involved the use of locoregional flaps or full-thickness skin grafts. However, these options are not always feasible because of limitations in donor tissues, defect size or shape, oncologic issues, or patient preference. Reconstruction in this setting has been limited and unsatisfactory. In this report, the authors present their experience in reconstruction of nasal defects using the dermal regeneration template Integra. In most cases, reconstruction with Integra enabled a single-stage, satisfactory reconstruction. The authors present a simple, standardized technique for application and postoperative care, which has resulted in good aesthetic outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Duration of Perseverative Thinking as Related to Perceived Stress and Blood Pressure: An Ambulatory Monitoring Study
Authors: Birk Jeffrey L. , Cornelius Talea , Edmondson Donald , Schwartz Joseph E. 
Published: July 2019

ABSTRACT

Objective
Psychological distress may be intensified and prolonged by perseverative thinking (e.g., rumination, worry). The tendency to engage frequently in perseverative thinking has been linked to increased blood pressure (BP). Research is needed to investigate the physiological consequences of time spent perseverating by testing the momentary association between the duration of perseverative thinking and BP. The present study examines the extent to which the duration of perseverative thinking is associated with momentary perceived stress and ambulatory BP elevations during daily life.

Methods
Participants (N = 373) drawn from a larger project on BP and cardiovascular health completed 24-hour ambulatory BP monitoring accompanied by ecological momentary assessments of their perseverative thoughts and feelings. Multilevel models tested associations among perseveration duration, momentary perceived stress, and systolic and diastolic BP, adjusting for person-level and momentary covariates.

Results
Higher within-subject perseveration duration was associated with higher stress (B = 0.29; 95% confidence interval [CI] = 0.24–0.33; p < .001). Although higher perseveration duration was not associated with substantially higher systolic (B = 0.16 mm Hg; 95% CI = 0.00–0.33 mm Hg; p = .056) or diastolic (B = 0.07 mm Hg; 95% CI = −0.05 to 0.19 mm Hg; p = .25) BP, the associations between higher perseveration duration and higher systolic (p = .032) and diastolic (p = .036) BP were significantly mediated by a higher intensity of momentary perceived stress.

Conclusions
Findings support the clinically important notion that physiological consequences of perceived stress can be maintained and even heightened by maladaptively prolonged mental activity.
The Microsurgical Calcaneus Osteocutaneous Fillet Flap After Traumatic Amputation in Lower Extremities
Authors: Wu Fan , Wen Gen , Chai Yimin , Han Pei 
Published: July 2019

Background
Attempts to salvage upper and lower extremities have performed more frequently in recent decades, although there are clear cases that cannot be salvaged. The purpose of this retrospective study was to present our experience in using free calcaneus osteocutaneous fillet flap for preserving below-knee amputation stump after traumatic amputations or functional preserving after nonsalvageable lower extremities.

Methods
Between January 2012 and May 2017, 11 free calcaneus osteocutaneous fillet flap were used to preserving or lengthening below-knee amputation stump secondary to amputation on 8 males and 3 females. Patients' information and postoperative data were collected, including age of patient, sex, amputation site, flap survival, sensation recovery, and number of complications.

Result
All amputations were trauma related and secondary to motor vehicle accidents (n = 8) and industrial accidents (n = 3). The age of the patients ranged from 16 to 59 years, with a mean of 34.4 years. Free calcaneus osteocutaneous fillet flap were designed and harvested from all patients. All flaps survived and 2 complications developed in 2 patients. Nine of 11 patients obtained protective sensory recovery during the period of follow-up.

Conclusions
The free calcaneus osteocutaneous fillet flap harvested from the amputated limb provides reliable and robust tissue for reconstruction of large defects of the residual limb without additional donor-site morbidity.
Facial Gender Affirmation Surgery: Craniomaxillofacial Imaging
Authors: Morris David E. , Zhao Linping 
Published: July 2019

Abstract
Facial procedures directed at gender affirmation are uniquely tailored to the individual patient and may affect soft tissue and skeletal structures over the entire face—from the chin through the upper forehead. Complete photographic and radiographic documentation that addresses these areas is important from the perspectives of surgical planning, evaluation of outcomes, research purposes, and communication between patient and provider, and amongst treating professionals. This work outlines pertinent skeletal anatomy that is uniquely addressed in gender affirmation procedures and means by which it can be effectively imaged. It provides historical insight into the evolution of computerized-tomography-based imaging. The authors provide detailed protocols for photodocumentation and computerized-tomography based skeletal imaging at their center.
Anatomical Basis and Surgical Techniques Employed in Facial Feminization and Masculinization
Authors: Facque Alexander R. , Atencio Daniela , Schechter Loren S. 
Published: July 2019

Abstract
Increasingly, facial feminization and masculinization techniques are being employed in the treatment of gender dysphoria. For the facial surgeon, knowledge of the anatomical differences between masculine and feminine facial skeletal structures is of utmost importance. Combining this knowledge with the various surgical and non-techniques that may be employed in order to achieve each patient's goals will allow the facial surgeon to greatly impact the lives of persons of transgender and gender diverse experience. Below, this article discusses these anatomical differences as well as current surgical practices employed in order to masculinize or feminize the face.
Cephalometric Evaluation of the Upper Airway in Different Skeletal Classifications of Jaws
Authors: Gholinia Faeghe , Habibi Laleh , Amrollahi Boyouki Maryam 
Published: July 2019

Background:
Respiratory system is an important section in development of maxillofacial components and many studies indicated its effect on normal growth of the jaws. The aim of this study is to evaluate upper airway in different skeletal classifications of jaws in lateral cephalogram and its relation to age and gender.

Materials and Methods:
Study samples were 105 digital cephalometric radiographies, 72 females and 33 males. Lateral cephalograms were hand traced and based on Stainer analysis, there were 30 samples in Class I, 30 samples in Class II and 45 samples in Class III subgroup. Vertical linear measurements, horizontal linear measurements, and angular measurement, proportions and space measurements of the airway in the Cephalograms were analyzed by AutoCAD software.

Results:
Data were analyzed using SPSS software version 20. Two horizontal linear measurement (the hypo pharyngeal airway depth, the nasopharyngeal airway depth) and one space measurement (soft palate space) were significantly different in skeletal classes. Vertical and horizontal linear measurements in the 3 groups were increased significantly in men rather than women. The developmental age of groups showed some significant differences.

Conclusion:
Upper airway dimension is different in different skeletal classes, developmental ages, and gender.