bluuebunny/crossref_metadata_2025_split huggingface dataset:
Responsiveness to Change of Functional Limitation Reporting: Cross-sectional Study Using the Intermountain ROMS Scale in Outpatient Rehabilitation
Authors: Brennan Gerard P. , Hunter Stephen J. , Snow Greg , Minick Kate I. 
Published: November 2017

Abstract

Background
The Centers for Medicare and Medicaid Services (CMS) require physical therapists document patients’ functional limitations. The process is not standardized. &#x2028;A systematic approach to determine a patient's functional limitations and responsiveness to change is needed.

Objective
The purpose of this study is to compare patient-reported outcomes (PROs) responsiveness to change using 7-level severity/complexity modifier scale proposed by Medicare to a derived scale implemented by Intermountain Healthcare's Rehabilitation Outcomes Management System (ROMS).

Design
This was a retrospective, observational cohort design.

Methods
165,183 PROs prior to July 1, 2013, were compared to 46,334 records from July 1, 2013, to December 31, 2015. Histograms and ribbon plots illustrate distribution and change of patients’ scores. ROMS raw score ranges were calculated and compared to CMS’ severity/complexity levels based on score percentage. Distribution of the population was compared based on the 2 methods. Sensitivity and specificity were compared for responsiveness to change based on minimal clinically important difference (MCID).

Results
Histograms demonstrated few patient scores placed in CMS scale levels at the extremes, whereas the majority of scores placed in 2 middle levels (CJ, CK). ROMS distributed scores more evenly across levels. Ribbon plots illustrated advantage of ROMS’ using narrower score ranges. Greater chance for patients to change levels was observed with ROMS when an MCID was achieved. ROMS narrower scale levels resulted in greater sensitivity and good specificity.

Limitations
Geographic representation for the United States was limited. Without patients’ global rating of change, a reference standard to gauge validation of improvement could not be provided.

Conclusions
ROMS provides a standard approach to identify accurately functional limitation modifier levels and to detect improvement more accurately than a straight across transposition using the CMS scale.
Workplace-Based Interventions for Neck Pain in Office Workers: Systematic Review and Meta-Analysis
Authors: Chen Xiaoqi , Coombes Brooke K , Sjøgaard Gisela , Jun Deokhoon , O’Leary Shaun , Johnston Venerina 
Published: November 2017

AbstractBackgroundAt present, there is no consolidated evidence for workplace-based interventions for the prevention and reduction of neck pain in office workers.PurposeThe purpose of this review was to investigate the effectiveness of workplace-based interventions for neck pain in office workers.Data SourcesMEDLINE, PEDro, CINAHL, and CENTRAL were searched for trials published since inception and before May 31, 2016.Study SelectionRandomized controlled trials (RCTs) were considered when they met the following criteria: population consisted of office workers, intervention(s) was performed at the workplace, outcome measures included neck and/or neck/shoulder pain intensity and incidence/prevalence, and comparator groups included no/other intervention.Data ExtractionData were extracted by 1 reviewer using predefined data fields and checked by a second reviewer. Risk of bias was assessed by 2 independent reviewers using the 2015 Cochrane Back and Neck Group guidelines. Evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system.Data SynthesisTwenty-seven RCTs were included. There was moderate-quality evidence that neck/shoulder strengthening exercises and general fitness training were effective in reducing neck pain in office workers who were symptomatic, although the effect size was larger for strengthening exercises. Greater effects were observed with greater participation in exercise. Ergonomic interventions were supported by low-quality evidence.LimitationsData could not be obtained from some studies for meta-analysis and assessment of risk of bias. Reporting bias might have been present because only studies in the English language were included.ConclusionsWorkplace-based strengthening exercises were effective in reducing neck pain in office workers who were symptomatic, and the effect size was larger when the exercises were targeted to the neck/shoulder. Future RCTs of ergonomic interventions targeted at office workers who are symptomatic are required. More research on neck pain prevention is warranted.
Anticoagulant options in atrial fibrillation
Authors: Cole Connie S. , Zimmerman Richard 
Published: November 2017

Abstract:
Direct oral anticoagulants (DOACs) have expanded options for treating patients with atrial fibrillation (AF). However, DOACs are not warfarin substitutes, and NPs need to be aware of the difference. DOACs are first-line agents when treating AF, yet warfarin has not been replaced. Individualized patient characteristics drive current guidelines.
Nitrous Oxide Versus Oral Sedation for Pain Management of First-Trimester Surgical Abortion—A Randomized Study
Authors: Singh Rameet H. , Montoya Maria , Espey Eve , Leeman Lawrence 
Published: November 2017

(Abstracted from Contraception 2017;96:118–123)
Of the approximately 700,000 abortions performed in the United States during 2012; 91.4% were at less than 13 weeks' gestational age. Many first-trimester surgical abortions take place in outpatient clinics.
Cervical Cancer: A Global Health Crisis
Authors: Small William , Bacon Monica A. , Bajaj Amishi , Chuang Linus T. , Fisher Brandon J. , Harkenrider Matthew M. , Jhingran Anuja , Kitchener Henry C. , Mileshkin Linda R. , Viswanathan Akila N. , Gaffney David K. 
Published: November 2017

(Abstracted from Cancer 2017;123:2404–2412)
One of the common malignancies in women and causes of cancer death worldwide is cervical cancer. Infection with the human papillomavirus is responsible for nearly all cases of cervical cancer.
The Actual Versus Idealized Self: Exploring Responses to Feedback About Implicit Bias in Health Professionals
Authors: Sukhera Javeed , Milne Alexandra , Teunissen Pim W. , Lingard Lorelei , Watling Chris 
Published: November 2017

Purpose
Implicit bias can adversely affect health disparities. The implicit association test (IAT) is a prompt to stimulate reflection; however, feedback about bias may trigger emotions that reduce the effectiveness of feedback interventions. Exploring how individuals process feedback about implicit bias may inform bias recognition and management curricula. The authors sought to explore how health professionals perceive the influence of the experience of taking the IAT and receiving their results.

Method
Using constructivist grounded theory methodology, the authors conducted semistructured interviews with 21 pediatric physicians and nurses at the Schulich School of Medicine and Dentistry, Western University, Ontario, Canada, from September 2015 to November 2016 after they completed the mental illness IAT and received their result. Data were analyzed using constant comparative procedures to work toward axial coding and development of an explanatory theory.

Results
When provided feedback about their implicit attitudes, participants described tensions between acceptance and justification, and between how IAT results relate to idealized and actual personal and professional identity. Participants acknowledged desire for change while accepting that change is difficult. Most participants described the experience of taking the IAT and receiving their result as positive, neutral, or interesting.

Conclusions
These findings contribute to emerging understandings of the relationship between emotions and feedback and may offer potential mediators to reconcile feedback that reveals discrepancies between an individual’s actual and idealized identities. These results suggest that reflection informed by tensions between actual and aspirational aspects of professional identity may hold potential for implicit bias recognition and management curricula.
Collaboration and Teamwork in the Health Professions: Rethinking the Role of Conflict
Authors: Eichbaum Quentin 
Published: November 2017

Whereas the business professions have long recognized that conflict can be a source of learning and innovation, the health professions still tend to view conflict negatively as being disruptive, inefficient, and unprofessional. As a consequence, the health professions tend to avoid conflict or resolve it quickly. This neglect to appreciate conflict’s positive attributes appears to be driven in part by (1) individuals’ fears about being negatively perceived and the potential negative consequences in an organization of being implicated in conflict, (2) constrained views and approaches to professionalism and to evaluation and assessment, and (3) lingering autocracies and hierarchies of power that view conflict as a disruptive threat.
The author describes changing perspectives on collaboration and teamwork in the health professions, discusses how the health professions have neglected to appreciate the positive attributes of conflict, and presents three alternative approaches to more effectively integrating conflict into collaboration and teamwork in the health professions. These three approaches are (1) cultivating psychological safety on teams to make space for safe interpersonal risk taking, (2) viewing conflict as a source of expansive learning and innovation (via models such as activity theory), and (3) democratizing hierarchies of power through health humanities education ideally by advancing the health humanities to the core of the curriculum.
The author suggests that understanding conflict’s inevitability and its innovative potential, and integrating it into collaboration and teamwork, may have a reassuring and emancipating impact on individuals and teams. This may ultimately improve performance in health care organizations.
Online Ratings of Spine Surgeons
Authors: Zhang Jun , Omar Adan , Mesfin Addisu 
Published: November 2017

Study Design.
Observational study.

Objective.
To evaluate the online ratings of spine surgeons and variables that may affect online ratings.

Summary of Background Data.
Physician review Web sites (PRW) are rapidly growing for-profit businesses. Most orthopedic surgeons are rated on at least one PRW as are other surgical specialists. To date the online ratings of spine surgeons have not been evaluated.

Methods.
Cervical Spine Research Society surgeon ratings on five physician rating Web sites were performed in April 2016: “healthgrade.com,” “vitals.com,” “ratemd.com,” “webmd.com,” and “yelp.com.” Numeric ratings from the PRWs were standardized on a scale of 0 to 100 with a higher score indicating positive ratings. Sex, practice sector (academic or private), specialty (orthopedics or neurosurgery), geographic location, and years of practice were also collected.

Results.
A total of 209 spine surgeons were included in our study. Of the 209 spine surgeons, 208 (99.52%) were rated at least once in one of the five PRWs. Average number of ratings per surgeon was 2.96. Average rating was 80 (40–100). There were four female (1.92%) and 204 male surgeons (98.1%). There were 121 (58.2%) in academic practice and 87 (41.8%) in private practice. There were 175 (84.1%) orthopedic surgeons and 33 (15.9%) neurosurgeons. Most of the surgeons were Caucasian 163 (78.4%) and worked in the South and Northeast 135 (64.9%). Those in academic practice had significantly higher ratings (81.6 vs. 77.65; P
= 0.026). Number of years in practice was significantly associated with ratings (P
= 0.0003) with those in practice for 21 or more years having significantly lower ratings.

Conclusion.
In this first study evaluating the online ratings of spine surgeons, we found that 99.5% of spine surgeon had at least one rating on a PRW. The average score, 80, indicated mostly positive ratings. Being in practice for 20 years or less and being in academic practice significantly associated with higher ratings.

Level of Evidence: 4
Increased Kawasaki Disease Incidence Associated With Higher Precipitation and Lower Temperatures, Japan, 1991–2004
Authors: Abrams Joseph Y. , Blase Jennifer L. , Belay Ermias D. , Uehara Ritei , Maddox Ryan A. , Schonberger Lawrence B. , Nakamura Yosikazu 
Published: November 2017

Background:
Kawasaki disease (KD) is an acute febrile vasculitis, which primarily affects children. The etiology of KD is unknown; while certain characteristics of the disease suggest an infectious origin, genetic or environmental factors may also be important. Seasonal patterns of KD incidence are well documented, but it is unclear whether these patterns are caused by changes in climate or by other unknown seasonal effects.

Methods:
The relationship between KD incidence and deviations from expected temperature and precipitation were analyzed using KD incidence data from Japanese nationwide epidemiologic surveys (1991–2004) and climate data from 136 weather stations of the Japan Meteorological Agency. Seven separate Poisson-distributed generalized linear regression models were run to examine the effects of temperature and precipitation on KD incidence in the same month as KD onset and the previous 1, 2, 3, 4, 5 and 6 months, controlling for geography as well as seasonal and long-term trends in KD incidence.

Results:
KD incidence was negatively associated with temperature in the previous 2, 3, 4 and 5 months and positively associated with precipitation in the previous 1 and 2 months. The model that best predicted variations in KD incidence used climate data from the previous 2 months. An increase in total monthly precipitation by 100 mm was associated with increased KD incidence (rate ratio [RR] 1.012, 95% confidence interval [CI]: 1.005–1.019), and an increase of monthly mean temperature by 1°C was associated with decreased KD incidence (RR 0.984, 95% CI: 0.978–0.990).

Conclusions:
KD incidence was significantly affected by temperature and precipitation in previous months independent of other unknown seasonal factors. Climate data from the previous 2 months best predicted the variations in KD incidence. Although fairly minor, the effect of temperature and precipitation independent of season may provide additional clues to the etiology of KD.
Risk Factors for Women Being Under the Influence of Alcohol Compared With Other Illicit Substances at the Time of Committing Violent Crimes
Authors: Brewer-Smyth Kathleen , Pohlig Ryan T. 
Published: November 2017

ABSTRACT

Purpose:
We investigated women under the influence of alcohol compared with other illicit substances at the time of committing a crime to identify predictors of being under the influence of alcohol and female-enacted crime.

Methods:
Analyses of data, obtained from private interviews and examinations of female prison inmates, included regression analyses exploring predictors of being under the influence of alcohol at the time of the crime and predictors of violent crime. In addition, a reanalysis of a previously reported model, predicting conviction of a violent crime, was conducted including a new variable, being under the influence of alcohol at the time of the crime.

Results:
Those under the influence of alcohol at the time of their crime had experienced greater nonfamilial childhood sexual abuse and traumatic brain injuries with loss of consciousness predating their crime. They were more likely to have committed a violent, rather than nonviolent, crime compared with those under the influence of other substances, with the latter being not significantly different for those not under the influence of any substance. Being under the influence of alcohol increased the risk of committing a violent crime, adjusting for other predictors of female violence.

Conclusion:
Women under the influence of alcohol are at a greater risk for committing violent crimes than those under the influence of other substances. Female nonfamilial childhood sexual abuse and traumatic brain injury victims were at a higher risk for being under the influence of alcohol, in comparison with other substances, at the time of committing a violent crime.
Dissipation of energy during the respiratory cycle: conditional importance of ergotrauma to structural lung damage
Authors: Marini John J. 
Published: November 2017

Purpose of review
To describe and put into context recent conceptual advances regarding the relationship of energy load and power to ventilator-induced lung injury (VILI).

Recent findings
Investigative emphasis regarding VILI has almost exclusively centered on the static characteristics of the individual tidal cycle – tidal volume, plateau pressure, positive end-expiratory pressure, and driving pressure. Although those static characteristics of the tidal cycle are undeniably important, the ‘dynamic’ characteristics of ventilation must not be ignored. To inflict the nonrupturing damage we identify as VILI, work must be performed and energy expended by high stress cycles applied at rates that exceed the capacity of endogenous repair. Machine power, the pace at which the work performing energy load is applied by the ventilator, has received increasing scrutiny as a candidate for the proximate and integrative cause of VILI.

Summary
Although the unmodified values of machine-delivered energy or power (which are based on airway pressures and tidal volumes) cannot serve unconditionally as a rigid and quantitative guide to ventilator adjustment for lung protection, bedside consideration of the dynamics of ventilation and potential for ergotrauma represents a clear conceptual advance that complements the static parameters of the individual tidal cycle that with few exceptions have held our scientific attention.
Inflammatory processes during acute respiratory distress syndrome: a complex system
Authors: Reiss Lucy K. , Schuppert Andreas , Uhlig Stefan 
Published: November 2017

Purpose of review
ARDS is a severe pulmonary disease characterized by inflammation. However, inflammation-directed therapies have yet failed to improve the outcome in ARDS patients. One of the reasons may be the underestimated complexity of inflammation. Here, we summarize recent insights into the complex interrelations between inflammatory circuits.

Recent findings
Gene expression analysis from animal models or from patients with ARDS, sepsis or trauma show an enormous number of differentially expressed genes with highly significant overlaps between the various conditions. These similarities, however, should not obscure the complexity of inflammation. We suggest to consider inflammation in ARDS as a system controlled by scale-free networks of genome-wide molecular interaction with hubs (e.g. NFκB, C/EBPβ, ATF3), exhibiting nonlinear emergence and the ability to adapt, meaning for instance that mild and life-threatening inflammation in ARDS are distinct processes. In order to comprehend this complex system, it seems necessary to combine model-driven simulations, data-driven modelling and hypothesis-driven experimental studies. Recent experimental studies have illustrated how several regulatory circuits interact during pulmonary inflammation, including the resolution of inflammation, the inflammasome, autophagy and apoptosis.

Summary
We suggest that therapeutic interventions in ARDS should be based on a systems approach to inflammation.
New developments in immunotherapy for pediatric leukemia
Authors: Foster Jessica B. , Maude Shannon L. 
Published: November 2017

Purpose of review
Immunotherapy for the treatment of cancer has advanced at a tremendous pace over the last decade. In this review, we provide an overview of recent progress in immunotherapy for the treatment of leukemia, focusing on antibody–drug conjugates (ADC), bi-specific T-cell engagers (BiTE), and chimeric antigen receptor (CAR) T cells.

Recent findings
Ongoing clinical trials of CAR T cells directed against CD19 have produced complete remission rates as high as 93%, prompting global multicenter phase 2 trials and the first FDA approval of a CAR T-cell therapy. Insights into cytokine release syndrome, a toxicity of CAR T-cell therapy, and the cause for relapse after CAR T-cell therapy are evolving. The bispecific antibody blinatumomab and the ADCs inotuzumab and gemtuzumab have also recently received FDA approval for ALL and AML, respectively, moving these agents into a more prominent role in the relapse setting.

Summary
The use of immunotherapy for leukemia has been successful in creating durable remissions for multiply relapsed and refractory patients who previously had little chance of cure. The ongoing clinical and preclinical work continues to advance our understanding of these immune-based therapies, and will shape the next generation of clinical trials.
Incorporating Nurse Input and Evidence Into a Newly Designed Unit to Improve Patient and Nursing Outcomes
Authors: Tafelmeyer Jennifer , Wicks Robin , Brant Jeannine , Smith Laurie 
Published: November 2017

OBJECTIVE
The aim of this study was to identify processes, outcomes, and lessons learned from designing a new evidence-based unit. A research study was conducted simultaneously to rigorously measure changes in patient and staff outcomes.

BACKGROUND
Nursing leadership and frontline nursing engagement are critical in evidence-based design to promote positive outcomes and workflow.

METHODS
Quality indicators were tracked premove and postmove. Nursing workflow was tracked, and teamwork was examined.

RESULTS
The incidence of falls and methicillin-resistant Staphylococcus aureus decreased on the new unit. Patient satisfaction improved; the greatest improvement was noise reduction. Teamwork remained stable. Nurses spent significantly more time in the patient rooms on the new unit.

CONCLUSIONS
This hospital found nursing engagement in the unit design process to be imperative to promote positive patient outcomes and stable or improved teamwork. Nursing leaders should be involved at the onset of the design process to facilitate optimal outcomes.
Social Return on Investment
Authors: Laing Catherine M. , Moules Nancy J. 
Published: November 2017

OBJECTIVE
To determine whether the methodology of social return on investment (SROI) could be a way in which the value of a healthcare-related program (children's cancer camp) could be captured, evaluated, and communicated.

BACKGROUND
The value of healthcare goes beyond what can be captured in financial terms; however, this is the most common type of value that is measured. The SROI methodology accounts for a broader concept of value by measuring social, environmental, and economic outcomes and uses monetary values to represent them.

METHODS
The steps/stages of an SROI analysis were applied to the context of a children's camp for this article.

RESULTS
Applying the SROI methodology to this healthcare-related program was feasible and provided insight and understanding related to the impacts of this program.

CONCLUSIONS
Because of SROI's flexibility, it is a tool that has great potential in a healthcare environment and for leaders to evaluate programmatic return on investment.
Asymptomatic Microscopic Hematuria in Women
Authors: Nager Charles W. , Sung Vivian W. , Whiteside James L. 
Published: November 2017

(Abstracted from Female Pelvic Med Reconstr Surg 2017;23:228–231)
This article presents new guidelines from the American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice and the American Urogynecologic Society on when women with microscopic blood in their urine should be evaluated and tested for urologic cancers.