bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of HeartMath Resiliency Training on Health Care Providers
Authors: Buchanan Teresa M. , Reilly Patricia M. 
Published: October 2019

Background
Health care providers must think clearly and make critical decisions under stressful circumstances. Providing effective strategies for managing stress in the moment helps mitigate the physical, emotional, and psychological impacts associated with caring for others and promotes resiliency. Staff may also utilize these techniques with patients and their families to help alleviate the symptoms of stress that may be experienced as the result of illness.

Aim
The purpose of this study was to measure whether HeartMath techniques reduce stress and improve resiliency in health care providers.

Methods
Study participants were asked to complete the Personal and Organizational Quality Assessment–Revised 4 Scale (2016) immediately before the start of training and then again 4 to 6 weeks after completion of the class. Participants were also asked to voluntarily share their experiences using HeartMath techniques personally or with family, friends, and patients.

Results
Significant improvements were found in 3 of 4 primary scales (organizational stress, emotional stress, and physical stress) and in 6 of 9 subscales on the Personal and Organizational Quality Assessment–Revised 4 Scale indicating a positive impact on employee health, well-being, and performance. Stories shared by participants posttraining indicated that HeartMath techniques were being used personally and with patients as an adjunct in the management of pain, anxiety, and insomnia.

Conclusions
This study supports existing evidence that HeartMath techniques are effective in managing stress and increasing resiliency. These techniques are also valuable tools for health care providers to use with patients and their families in the management of symptoms such as pain, anxiety, and sleeplessness related to hospitalization and illness.
Nasal High Flow Versus Conventional Oxygen Therapy for Postoperative Cardiothoracic Surgery Patients
Authors: Fasolino Tracy , Whitten Joseph , Moylan Melanie 
Published: October 2019

Background
Reintubation and complications in postoperative cardiothoracic patients remain high despite medical advancements. A 2-year retrospective, observational study was conducted in postextubated cardiothoracic patients to assess the effectiveness of the current standard—conventional oxygen therapy (COT) compared with a nasal high flow (NHF) therapy.

Objectives
The objective of this study was to understand whether NHF therapy would reduce the need for reintubation and improve clinical outcomes after surgery.

Method
All consecutive postoperative patients who had same-day elective cardiothoracic surgery in a tertiary hospital were included. The 2013 data were from patients' charts who received COT, and the 2014 data were from patients' charts after the implementation of NHF therapy post extubation as a standard of care.

Results
A total of 400 patient charts were analyzed: 221 and 179 patients in the COT and NHF, respectively. No significant difference was seen in the frequency of reintubation (P = .48). Despite both cohorts having the same length of stay (P = .10), patients treated with NHF required less time on supplemental oxygen (P = .001). Day 1 postoperative chest x-ray results did not show any significant differences between groups, whereas day 2 x-rays showed worsening results in the COT cohort (P < .001). Furthermore, the incidence of ventilator-associated pneumonia (VAP) post extubation was significantly higher in the COT cohort, with zero VAP episodes reported in the NHF cohort (P = .02).

Discussion
Although this study was not able to demonstrate the reduction in reintubation between groups, the use of NHF compared with COT seems to reduce the time spent on oxygen therapy and decrease the rate of VAP. Further evidence including randomized controlled trials is required to determine the impact of NHF on reintubation and complications in postoperative cardiothoracic surgery.
Record Linkage Approaches Using Prescription Drug Monitoring Program and Mortality Data for Public Health Analyses and Epidemiologic Studies
Authors: Nechuta Sarah , Mukhopadhyay Sutapa , Krishnaswami Shanthi , Golladay Molly , McPheeters Melissa 
Published: October 2019

Background:
The use of Prescription Drug Monitoring Program (PDMP) data has greatly increased in recent years as these data have accumulated as part of the response to the opioid epidemic in the United States. We evaluated the accuracy of record linkage approaches using the Controlled Substance Monitoring Database (Tennessee’s [TN] PDMP, 2012–2016) and mortality data on all drug overdose decedents in Tennessee (2013–2016).

Methods:
We compared total, missed, and false positive (FP) matches (with manual verification of all FPs) across approaches that included a variety of data cleaning and matching methods (probabilistic/fuzzy vs. deterministic) for patient and death linkages, and prescription history. We evaluated the influence of linkage approaches on key prescription measures used in public health analyses. We evaluated characteristics (e.g., age, education, sex) of missed matches and incorrect matches to consider potential bias.

Results:
The most accurate probabilistic/fuzzy matching approach identified 4,714 overdose deaths (vs. the deterministic approach, n = 4,572), with a low FP linkage error (<1%) and high correct match proportion (95% vs. 92% and ~90% for probabilistic approaches not using comprehensive data cleaning). Estimation of all prescription measures improved (vs. deterministic approach). For example, frequency (%) of decedents filling an oxycodone prescription in the last 60 days (n = 1,371 [32%] vs. n = 1,443 [33%]). Missed overdose decedents were more likely to be younger, male, nonwhite, and of higher education.

Conclusion:
Implications of study findings include underreporting, prescribing and outcome misclassification, and reduced generalizability to population risk groups, information of importance to epidemiologists and researchers using PDMP data.
Rituximab in systemic sclerosis
Authors: Caldas Marina Maria Vieira de Figueiredo , Neto Francisco Alves Bezerra , Azevedo Kesley Pablo Morais de , Pimenta Isac Davidson Santiago Fernandes , Oliveira Ana Katherine Da Silveira Gonçalves De , Piuvezam Grasiela 
Published: October 2019

Abstract

Background:
Systemic sclerosis (SSc) is a clinically complex and challenging disease, the most frequent complication of which is interstitial lung disease, which leads to a worse prognosis. In this situation, cyclophosphamide is considered the criterion standard for treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. The objective is to describe a protocol of a systematic review (SR) that analyzes the scientific evidence on the effects of RTX on SSc.

Methods:
This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases to be searched are PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, COCHRANE, WHOLIS, PAHO, and EMBASE. The studies that would be included in SR are clinical trials that evaluate the use of RTX in patients with SSc who meet the classification criteria for the disease according to American College of Rheumatology and European League Against Rheumatism (2013) and/or LeRoy criteria will be included in the SR. The data to be extracted are related to the characteristics of the studies: authors, year of publication, study location, type of study, sample size and age, patient characteristics, duration of intervention, therapeutic scheme, follow-up time, main variables, and main results.

Results:
In our study, we hope to find articles presenting new evidence supporting treatment of SSc with RTX.

Conclusions:
The SR will present results of scientific evidence for the effects of RTX in SSc. We hope that the results could strengthen clinical decisions for the best treatment of SSc and guide future researches.

PROSPERO registration number:
CRD42019132018.
Strategic Development of the Public Health Workforce: A Unified Logic Model for a Multifaceted Program at the Centers for Disease Control and Prevention
Authors: Glynn M. Kathleen , Paek Margaret , Radkey Connor , Arvelo Wences , Greene Elinor , Hardwick Isabella , Neri Antonio 
Published: October 2019

Context:
Public health has a responsibility to ensure the ability of its workforce to deliver essential services, including mastering the core public health competencies.

Program:
The Division of Scientific Education and Professional Development (DSEPD) of the Centers for Disease Control and Prevention has a mission to improve health outcomes through a competent, sustainable, and empowered public health workforce. The DSEPD programs offer fellowships and other training opportunities, develop and disseminate quality public health training, and advance public health workforce development science.

Evaluation:
The DSEPD developed a unified division logic model to describe the combined activities and intended outcomes of all DSEPD programs and their intended contribution to a robust public health workforce and to support ongoing program planning and evaluation. The logic model has 4 streams of work that include (1) producing and disseminating quality learning products; (2) implementing and managing fellowship programs that support learning; (3) providing public health service through fellows; and (4) advancing workforce development science through collaboration with other public health leaders.
The underlying program theory is that a robust workforce has sufficient workforce, organizational, and systems capacity to deliver public health essential services and, therefore, to protect the public's health. Three scientific theories support the program theory: the quality of learning; the accepted practice of competency-based programs and the service-learning model; and use of evidence-guided decision making in workforce development programs.

Discussion:
A unified division logic model allows DSEPD to describe its combined approaches to workforce development as a coherent portfolio with well-defined goals and measureable outcomes. The logic model effectively communicates the relationship among division programs, their shared outcomes, and their combined contributions to developing and maintaining a robust public health workforce. A unified logic model can serve as effective frame of reference for division evaluation and as evidence in public health workforce development science.
Surveillance to Monitor the Impact of the Trump Administration on the Health of New York City Residents
Authors: Gould L. Hannah , Sun Eric , Germain Patrick , Gallego Ana , Adams Loren , Huynh Mary , Van Wye Gretchen , Gwynn R. Charon , Barbot Oxiris 
Published: October 2019

Context:
The Trump administration has enacted or proposed many policies that could impact public health. These include attempts to dismantle or repeal the Patient Protection and Affordable Care Act (ACA), restricting funding for women's health care, and loosening of environmental regulations.

Objective:
To develop a surveillance system to monitor the public health impacts of the Trump administration in New York City.

Design:
Epidemiologic assessment. Public health surveillance system.

Setting:
New York City.

Participants:
New York City residents.

Main Outcomes Measures:
We identified approximately 25 indicators across 5 domains: access to care, food insecurity, reproductive health, environmental health, and general physical and mental health. Sources of data include the New York City Department of Health and Mental Hygiene's (DOHMH's) health and risk behavior telephone survey, vital statistics, emergency department visits, DOHMH sexual health clinics, Federally Qualified Health Centers, lead and diabetes registries, Medicaid claims, Supplementary Nutrition Assistance Program enrollment, Women, Infant, and Children program enrollment, and 311 call records. Data are collected monthly or quarterly where possible. We identified measures to stratify indicators by individual and area-based measures of immigration and poverty.

Results:
Since April 2017, we have compiled quarterly reports, including establishing a historical baseline of 10 years to account for secular trends and encompass the establishment and enactment of the ACA. Indicators are interpreted within the context of changes in programming or local policy that might explain trends.

Conclusions:
We have successfully established an adaptive surveillance system that is poised to rapidly detect changes in the health of New York City residents resulting from changes by the Trump administration to public health policy. The development of such systems is a critical function for health departments across the country to play a role in the current political and policy environment.
Responding to a Mumps Outbreak Impacting Immigrants and Low–English-Proficiency Populations
Authors: Koeller Sarah , Meyer Diane , Shearer Matthew P. , Hosangadi Divya , Snyder Michael , Nuzzo Jennifer B. 
Published: October 2019

Objectives:
To examine outbreak response–associated costs, lessons learned, and challenges encountered during a local health department's response to a mumps outbreak.

Design:
We conducted semistructured interviews with individuals directly involved in the response to a mumps outbreak and analyzed outbreak response–associated cost data.

Setting:
In March-July 2018, a mumps outbreak occurred in Chester County, Pennsylvania. The outbreak primarily affected an immigrant community, some of whom spoke little or no English and were uninsured and/or undocumented. This necessitated an urgent response from the Chester County Health Department, which implemented a variety of public health interventions, including outreach to local health care providers and the execution of vaccination clinics at 2 local mushroom farms where case contacts worked. A total of 39 suspected or confirmed mumps cases were reported in Chester County, and 22 suspected or confirmed cases were reported by 2 neighboring jurisdictions.

Participants:
Health department employees (n = 7) and community partners (n = 2). Areas of expertise included emergency preparedness, nursing, medicine, disease surveillance, and epidemiology.

Main Outcome Measure:
Operational challenges encountered and lessons learned during the mumps outbreak response, including outbreak response–associated costs, which could inform other communities' planning and preparedness for outbreaks in similar populations and improve outbreak response operations.

Results:
Immigration status emerged as a key challenge, which highlighted the importance of building trust through community outreach and partnerships and the need for culturally competent communication. In addition, vaccine availability, accessibility, and cost played a major role in response operations and necessitated the involvement of community partners to mitigate these barriers. Outbreak response–associated costs totaled $35 305.

Conclusions:
The challenges that occurred in this outbreak are broadly relevant to outbreaks that affect similar immigrant communities. Health departments that serve such populations can utilize these lessons to develop improved outbreak response plans that account for these challenges.
Analysis of Escherichia coli and Listeria monocytogenes Isolate Subtyping and Reporting Capacity by Public Health Laboratories, United States (2013-2017)
Authors: Martinez DeAndrea , LeBlanc Tanya Telfair , Hise Kelley B. 
Published: October 2019

Objectives:
To demonstrate the performance of 53 laboratories required to submit 90% or more of their pulsed-field gel electrophoresis (PFGE) subtyping results for Escherichia coli O157:H7 (E coli O157:H7) and Listeria monocytogenes (L monocytogenes) to the PulseNet national databases at the Centers for Disease Control and Prevention (CDC) within 4 working days of receiving isolates.

Methods:
We examined data from 53 laboratories during 2013-2017 to ascertain whether E. coli O157:H7 and L monocytogenes PFGE data were reported to the PulseNet national databases within 4 working days.

Results:
In the study period, 45 laboratories that submitted reports during the period (86.8%) met the target for timely submission of 10 606 (94.85%) E coli O157:H7 isolates into the PulseNet national database. For L monocytogenes isolates, 32 laboratories submitted reports (76.95%) that achieved timely submission of 3119 (93.35%) isolates.

Conclusions:
This study uncovered areas for improvement to advance public health in the CDC-funded laboratories.
Reliability and Validity of Upper Extremity Patient-Reported Outcome Measures in Assessing Traumatic Finger Amputation Management
Authors: Yoon Alfred P. , Kaur Surinder , Chou Ching-Han , Chung Kevin C. 
Published: October 2019

Background:
This study investigates the psychometric properties of patient-reported outcome instruments for assessing outcomes in postsurgical traumatic digit amputation patients. The authors hypothesize that the Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire are the most valid and reliable instruments.

Methods:
The authors studied traumatic digit amputation patients as part of the Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness (FRANCHISE) study initiated by The Plastic Surgery Foundation. The MHQ, DASH questionnaire, Patient-Reported Outcomes Measurement Information System (PROMIS), and 36-Item Short-Form Health Survey were used to assess patients at least 1 year postoperatively. Internal consistency was measured by Cronbach’s alpha and criterion validity with Pearson correlation coefficient (r). Construct validity was tested with four predefined hypotheses. Discriminant validity was analyzed by receiver operating characteristic curves.

Results:
One hundred sixty-eight replantation and 74 revision amputation patients met the inclusion criteria. All instruments demonstrated fair to good internal consistency in both cohorts (0.7 < α < 0.9). The MHQ and DASH questionnaire scores correlated strongly (r > 0.60) in both cohorts. The 36-Item Short-Form Health Survey had moderate to weak correlation with the remaining instruments, and its mental component had poor discriminant validity (area under the curve, 0.64 to 0.67). The MHQ, DASH questionnaire, and PROMIS demonstrated good construct validity confirming 75 to 100 percent of predefined hypotheses, whereas the 36-Item Short-Form Health Survey confirmed only 25 percent.

Conclusions:
The authors recommend using the Michigan Hand Outcomes Questionnaire or the Disabilities of the Arm, Shoulder and Hand questionnaire when assessing patient-reported outcomes in digit amputation patients based on good internal consistency and validity. The Patient-Reported Outcomes Measurement Information System has fair validity and reliability but should be an adjunct instrument. The 36-Item Short-Form Health Survey should not be used as a primary assessment tool, but as an adjunct to assess overall quality of life.
Social Integration, Marital Status, and Ovarian Cancer Risk: A 20-Year Prospective Cohort Study
Authors: Trudel-Fitzgerald Claudia , Poole Elizabeth M. , Sood Anil K. , Okereke Olivia I. , Kawachi Ichiro , Kubzansky Laura D. , Tworoger Shelley S. 
Published: October 2019

ABSTRACT

Objective
Low social integration and divorce/widowhood are chronic psychosocial stressors that may affect health. When assessed after cancer diagnosis, they have been associated with poorer survival, but their role in cancer development, particularly ovarian cancer (OvCA), is less understood. We investigated whether social integration and marital status were related to OvCA risk in a large population-based study.

Methods
Women from the Nurses’ Health Study completed the Berkman-Syme Social Network Index and reported their marital status every 4 years starting in 1992 (N = 72,206), and were followed up until 2012 (20-year follow-up period). Multivariate Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of OvCA risk, considering relevant potential confounders, in lagged analyses whereby psychosocial indicators were assessed 4 to 8 years (n = 436 cases) and 8 to 12 years (n = 306 cases) before diagnosis to account for the effects of prediagnostic symptoms on social measures. Secondary analyses evaluated the stability of and cumulative exposure to these social factors on OvCA risk.

Results
Being socially isolated versus integrated was related to an increased OvCA risk 8 to 12 years later (HR = 1.51, 95% CI = 1.07–2.13), but not 4 to 8 years later. Compared with married women, OvCA risk was significantly higher in widowed but not in separated/divorced individuals, with both time periods (e.g., 8–12 years later: HRwidowed = 1.57 [95% CI = 1.15–2.14] versus HRseparated/divorced = 1.13 [95% CI = 0.74–1.72]). Estimates were comparable or stronger when investigating stability in and cumulative effects of social indicators.

Conclusions
Results suggest higher OvCA risk among socially isolated and widowed women, particularly when such psychosocial stressors were experienced a decade before diagnosis or were sustained over time.
Defining Benchmark Outcomes for ALPPS
Authors: Raptis Dimitri A. , Linecker Michael , Kambakamba Patryk , Tschuor Christoph , Müller Philip C. , Hadjittofi Christopher , Stavrou Gregor A. , Fard-Aghaie Mohammad H. , Tun-Abraham Mauro , Ardiles Victoria , Malagó Massimo , Campos Ricardo Robles , Oldhafer Karl J. , Hernandez-Alejandro Roberto , de Santibañes Eduardo , Machado Marcel Autran , Petrowsky Henrik , Clavien Pierre-Alain 
Published: October 2019

Objective:
The aim of this study was to use the concept of benchmarking to establish robust and standardized outcome references after the procedure ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy).

Background and Aims:
The recently developed ALPPS procedure, aiming at removing primarily unresectable liver tumors, has been criticized for safety issues with high variations in the reported morbidity/mortality rates depending on patient, disease, technical characteristics, and center experience. No reference values for relevant outcome parameters are available.

Methods:
Among 1036 patients registered in the international ALPPS registry, 120 (12%) were benchmark cases fulfilling 4 criteria: patients ≤67 years of age, with colorectal metastases, without simultaneous abdominal procedures, and centers having performed ≥30 cases. Benchmark values, defined as the 75th percentile of the median outcome parameters of the centers, were established for 10 clinically relevant domains.

Results:
The benchmark values were completion of stage 2: ≥96%, postoperative liver failure (ISGLS-criteria) after stage 2: ≤5%, ICU stay after ALPPS stages 1 and 2: ≤1 and ≤2 days, respectively, interstage interval: ≤16 days, hospital stay after ALPPS stage 2: ≤10 days, rates of overall morbidity in combining both stage 1 and 2: ≤65% and for major complications (grade ≥3a): ≤38%, 90-day comprehensive complication index was ≤22, the 30-, 90-day, and 6-month mortality was ≤4%, ≤5%, and 6%, respectively, the overall 1-year, recurrence-free, liver-tumor-free, and extrahepatic disease-free survival was ≥86%, ≥50%, ≥57%, and ≥65%, respectively.

Conclusions:
This benchmark analysis sets key reference values for ALPPS, indicating similar outcome as other types of major hepatectomies. Benchmark cutoffs offer valid tools not only for comparisons with other procedures, but also to assess higher risk groups of patients or different indications than colorectal metastases.