bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telerehabilitation in Physical Therapist Practice: A Clinical Practice Guideline From the American Physical Therapy Association
Authors: Lee Alan C , Deutsch Judith E , Holdsworth Lesley , Kaplan Sandra L , Kosakowski Heidi , Latz Robert , McNeary Lydia Lennox , O’Neil Jennifer , Ronzio Oscar , Sanders Kelly , Sigmund-Gaines Michelle , Wiley Michele , Russell Trevor 
Published: March 2024

Abstract
A clinical practice guideline on telerehabilitation was developed by an American Physical Therapy Association volunteer guideline development group consisting of international physical therapists and physiotherapists, a physician, and a consumer. The guideline was based on systematic reviews of current scientific literature, clinical information, and accepted approaches to telerehabilitation in physical therapist practice. Seven recommendations address the impact of, preparation for, and implementation of telerehabilitation in physical therapist practice. Research recommendations identify current gaps in knowledge. Overall, with shared decision-making between clinicians and patients to inform patients of service delivery options, direct and indirect costs, barriers, and facilitators of telerehabilitation, the evidence supports the use of telerehabilitation by physical therapists for both examination and intervention. The Spanish and Chinese versions of this clinical practice guideline, as well as the French version of the recommendations, are available as supplementary material (Suppl. Materials).
‘Never trust a Philologist’: C. S. Lewis, J. R. R. Tolkien, and the Place of Philology in English Studies
Authors: Horobin Simon 
Published: March 2024

Abstract
This article brings to light seven poems by C. S. Lewis that have never been published before. These poems, composed during the 1920s, form part of a lengthy campaign against the study of philology at Oxford, and specifically against its most eminent exponent, H. C. Wyld. Drawing on entries in his diary and personal correspondence, the article shows how Lewis’s antipathy for the subject grew out of his undergraduate studies, his frustration with Wyld’s published scholarship and prescriptive attitude towards language study, as well as a dislike of the man and his lecturing style. It was the appointment of J. R. R. Tolkien to the Rawlinson and Bosworth Professorship of Anglo-Saxon in 1925, and their subsequent friendship, that was to convert Lewis to the study of philology and convince him of its centrality to the discipline of English Studies. The remainder of the article describes how the two men engineered revisions to the Oxford English syllabus, which resulted in a much more prominent role for philology, at the expense of nineteenth-century literature.
The Occupational and Environmental Hazards of Uncovered Toilets
Authors: Eisenberg Seth , Walton AnnMarie , Connor Thomas Harry 
Published: March 2024

ABSTRACT
Substantial evidence demonstrates that plumes from uncovered toilets potentially expose nurses and other health care workers to aerosols containing infectious agents and hazardous drugs, including antineoplastic drugs. Most hospitals in the United States utilize flushometer-type toilets, which operate under high pressure and do not have a permanently attached closure or lid, which is known to reduce the aerosols generated by flushing. This article aims to raise awareness among nurses of the potential exposure risks associated with toilet plume aerosols, so they can educate other health care workers and take part in initiatives to address these risks.
Telehealth Potential in Pediatric Orthopaedics and Sports Medicine Care is Comparable to In-Person Care But Disparities Remain
Authors: Hogue Grant D. , Liu David S. , Kaushal Shankar G. , Tavabi Nazgol , Feldman Lanna , Stracciolini Andrea , Shore Benjamin , Hedequist Daniel , Bae Donald , Meehan William , Kim Young-Jo , Kocher Mininder , Murray Martha M. , Kiapour Ata M. 
Published: March 2024

Background:Understanding the challenges and potential of telehealth visits (THVs) in a large population can inform future practice and policy discussion for pediatric orthopaedic and sports medicine (OSM) care. We comprehensively assess telehealth challenges and potential in a large pediatric OSM population based on access, visit completion, patient satisfaction, and technological challenges.Methods:Demographics, address, insurance, visit information, patient feedback, experience with video visits, and technical challenges of all 2019 to 2020 visits at our hospital were assessed (3,278,006 visits). We evaluated the differences in rate of telehealth utilization, rate of patient adherence, disparities in care access and patient satisfaction, and technological issues.Results:Compared with in-person prepandemic visits, THVs had lower ratios of non-White patients (by 5.8%;P<0.001), Hispanic patients (by 2.8%;P<0.001) and patients with public insurance (by 1.8%;P<0.001), and a higher mean distance between the patient’s residence and clinic (by 18.8 miles;P<0.001). There were minimal differences in median household income (average $2297 less in THV;P<0.001) and social vulnerability index (average 0.01 points lower in THV;P<0.001) between groups. THVs had comparable patient satisfaction to in-person visits. Non-White patients, Hispanics, and those with public insurance had lower ratings for both in-person visits and THVs and had more technical difficulties during their THV.Conclusions:Telehealth is a viable method of care for a range of pediatric OSM conditions, providing a similar quality of care as in-person visits with a greater geographic reach. However, in its current format, reduced disparities were not observed in pediatric OSM THVs.Level of Evidence:Level III.
Renin Levels and Angiotensin II Responsiveness in Vasopressor-Dependent Hypotension*
Authors: See Emily J. , Chaba Anis , Spano Sofia , Maeda Akinori , Clapham Caroline , Burrell Louise M. , Liu Jasmine , Khasin Monique , Liskaser Grace , Eastwood Glenn , Bellomo Rinaldo 
Published: March 2024

OBJECTIVES:The relationship between renin levels, exposure to renin-angiotensin system (RAS) inhibitors, angiotensin II (ANGII) responsiveness, and outcome in patients with vasopressor-dependent vasodilatory hypotension is unknown.DESIGN:We conducted a single-center prospective observational study to explore whether recent RAS inhibitor exposure affected baseline renin levels, whether baseline renin levels predicted ANGII responsiveness, and whether renin levels at 24 hours were associated with clinical outcomes.SETTING:An academic ICU in Melbourne, VIC, Australia.PATIENTS:Forty critically ill adults who received ANGII as the primary agent for vasopressor-dependent vasodilatory hypotension who were included in the Acute Renal effects of Angiotensin II Management in Shock study.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:After multivariable adjustment, recent exposure to a RAS inhibitor was independently associated with a relative increase in baseline renin levels by 198% (95% CI, 36–552%). The peak amount of ANGII required to achieve target mean arterial pressure was independently associated with baseline renin level (increase by 46% per ten-fold increase; 95% CI, 8–98%). Higher renin levels at 24 hours after ANGII initiation were independently associated with fewer days alive and free of continuous renal replacement therapy (CRRT) (–7 d per ten-fold increase; 95% CI, –12 to –1).CONCLUSIONS:In patients with vasopressor-dependent vasodilatory hypotension, recent RAS inhibitor exposure was associated with higher baseline renin levels. Such higher renin levels were then associated with decreased ANGII responsiveness. Higher renin levels at 24 hours despite ANGII infusion were associated with fewer days alive and CRRT-free. These preliminary findings emphasize the importance of the RAS and the role of renin as a biomarker in patients with vasopressor-dependent vasodilatory hypotension.
Real-world effectiveness of mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction: a retrospective, non-interventional cohort analysis
Authors: Fu Michael , Pivodic Aldina 
Published: March 2024

Background and purpose:
Mineralocorticoid receptor antagonists (MRAs) have been shown in clinical trials to improve outcomes in heart failure with reduced ejection fraction (HFrEF). Yet, it is still uncertain how effective they are in real-world patients with HFrEF. This study aimed to investigate the association between MRAs and outcomes in the overall population and a propensity score-matched cohort, based on patient-level data from the Swedish Heart Failure Registry (SwedeHF).

Methods:
Patients diagnosed with HFrEF were included from the SwedeHF spanning from 2003 to 2020. Enrollment was based on medication dispensation within 3 months before and 6 months after the index date recorded in the register. Endpoints included all-cause mortality, cardiovascular death, and hospital re-admissions, tracked from the index date until censoring or occurrence of an event.

Results:
Of 47,103 patients identified through the SwedeHF with HFrEF, 22,368 individuals were not treated with MRA (referred to as MRA naive patients), 21,893 were treated with MRA at a dosage of 25 mg, and 1,423 were treated with MRA at 50 mg once daily. In the overall cohort, the administration of MRA at 25 mg was associated with modest reductions in the risk of all-cause mortality (hazard ratio: 0.92 [0.89–0.95], P < 0.0001) and cardiovascular death (hazard ratio: 0.93 [0.89–0.98], P < 0.01) compared to the MRA naive group. However, both dosages of MRA (25 and 50 mg) were associated with a slight increase in the risk of hospital re-admissions due to heart failure 10% compared to MRA naive patients. These findings were consistent when examining a propensity score-matched cohort. Interaction analysis showed a significantly improved survival rate for patients receiving MRA at 25 mg compared to MRA naive individuals, particularly among those with an estimated glomerular rate ≥30 mL/min/1.73 m2 across all patients and in those aged 70 years and above.

Conclusions:
The administration of MRA treatment at 25 mg once daily was linked to a modestly improved survival in a real-life HFrEF population, with even more pronounced benefits observed within a specific subgroup. This finding highlights the importance of personalized medicine in providing customized therapeutic advantages.
Chronic Radiation Dermatitis Secondary to Narrow-Band Ultraviolet B Therapy in a Patient With Primary Cutaneous CD8+ T-Cell Lymphoma With Cytotoxic Granules
Authors: Edelson Mia P. , Gay Jane J. , Thiel Robert W. , Grider Douglas J. 
Published: March 2024

Abstract:
Conventional therapies for CD8+ cutaneous T-cell lymphoma include topical steroids, topical nitrogen mustard, topical bexarotene, ultraviolet B therapy, psoralen and ultraviolet A therapy, local radiotherapy, and interferon alfa; however, these treatments are often found to be ineffective. Presented is a case of CD8+ cutaneous T-cell lymphoma with near-complete response to narrow-band ultraviolet therapy because of chronic radiation dermatitis initially believed to be possible progression of a CD8+ cutaneous epidermotropic cytotoxic T-cell lymphoma.
Relationship Status and Quality Are Associated With Perceived Benefits of Caregiving for People With Heart Failure
Authors: Glickman Amanda , Mikulich-Gilbertson Susan , Abshire Saylor Martha , DeGroot Lyndsay , Bekelman David B. 
Published: March 2024

Background
“Benefit finding” is a strengths-based strategy for coping with medical illness that may be particularly useful for caregivers of people with heart failure given the highly fluctuating disease course.

Objective
The aim of this study was to investigate benefit finding's association with the caregiver–care recipient relationship, depression, and burden at baseline and longitudinally.

Methods
This is a longitudinal observational study of caregivers' benefit finding, relationship quality, depression, and burden. Correlation and multiple regression analyses identify baseline associations and predictors of 12-month change in benefit finding.

Results
At baseline (n = 100; median, 60 years [interquartile range, 46–69]; 81% female, 70% partner/spouse), increased benefit finding correlated with higher relationship quality (r = 0.53; 95% confidence interval [CI], 0.38–0.67), lower depression (r = −0.33; 95% CI, −0.49 to −0.14), and lower burden (r = −0.31; 95% CI, −0.47 to −0.11). Twelve-month change in benefit finding was predicted by change in relationship quality (ß = 7.12; 95% CI, 0.62–13.61) but not depression or burden.

Conclusions
Relationship quality and benefit finding changed together over time. Interventions strengthening the caregiver–care recipient bond may be especially impactful for heart failure caregivers.
Physical Demands of Walking Football in Patients With Cardiovascular Risk Factors and Diseases
Authors: Egger Florian , Ditscheid Anja , Schwarz Markus , Meyer Tim 
Published: March 2024

Objective:
To compare the exercise intensity of walking football (WF) with walking (WA) and to describe specific movement characteristics of WF.

Design:
Cross-sectional study.

Setting:
Sports facilities Saarland University, Germany.

Patients:
Eighteen patients with cardiovascular risk factors CVRFs and diseases (13 men and 5 women, age: 69 ± 10 years).

Independent variables:
Patients completed a WF match and WA session of 2 x 10 min each. Video analysis was used to characterize movements during WF.

Main Outcome Measures:
Rate of perceived exertion (RPE, Borg Scale 6-20), % maximum heart rate (HRmax), musculoskeletal pain on a visual analog scale (VAS, 1-100 mm) before and up to 72 hours after exercise, and movement patterns during WF.

Results:
The mean RPE during WF (12.1 ± 2.7) and WA (11.9 ± 3.0) did not differ (P = 0.63). The mean HR during WF (79 ± 12% of HRmax) was higher than during WA (71% ± 11%; P < 0.01). The HR variability coefficient of variation during WF (10.3% ± 5.8%) and WA (7.1 ± 5.5%) did not differ (P = 0.13). There was no influence of exercise mode (WF vs WA) on musculoskeletal pain perception (P = 0.96 for interaction). Injury-inciting activities such as lunges (median: 0.5 [interquartile range (IQR) 0-1.3]) and goal kicks (median: 4 [IQR: 1.8-5.3]) occurred rarely during WF.

Conclusions:
Walking football might represent an alternative to WA for health prevention programs in patients with CVRF and diseases as it is characterized by a manageable cardiocirculatory strain, moderate RPE, low pain induction, and a low number of injury-inciting activities.
Integration of a nurse practitioner and physician associate leadership structure within an academic cancer center
Authors: Jackson Heather J. , West Olivia , Harrell Shelton , Skotte Emily , Hande Karen 
Published: March 2024

ABSTRACT

Background:
Nurse practitioners and physician associates are an essential part of the multidisciplinary cancer care team with expanding and evolving roles within cancer specialties.

Local problem:
As these clinicians flourish, a parallel need for leadership rises to optimize scope of practice, mentor, and retain this crucial workforce. The purpose of this quality improvement project was to development a nurse practitioner and physician associate leadership structure within an academic cancer center.

Methods:
Development of this nurse practitioner and physician associate leadership structure was guided by transformational leadership theory. In collaboration with nursing, business, and physician leadership, a quad structure was supported.

Interventions:
Implementation of a leadership structure included the establishment of eight team leaders and two managers. These leaders identified multiple opportunities for improvement including improved communications, offload of nonbillable work, development of incentive programs, provision of equipment, specialty practice alignment, hematology/oncology fellowship, and professional development.

Results:
Overall, a nurse practitioner and physician associate leadership structure allowed for representation across the cancer center. Such inclusion supported multiple quality improvement projects developed in partnership with nursing, business, and physician leaders. Cumulatively, these interventions yielded efficient workflows and expansion of services. Consistent with reported evidence, these efforts contributed to nurse practitioner and physician associate retention as well as improved job satisfaction.

Conclusions:
Advanced practice leadership is essential to recruiting, developing, supporting, and retaining nurse practitioner and physician assistant colleagues in cancer care.
Sequelae Treatment Needs Following Peripheral Facial Palsy: Retrospective Analysis of 525 Patients
Authors: Ohm Rebecka , Stark Birgit , Brännström Fredrik , Marsk Elin 
Published: March 2024

Objective
This study uses retrospective longitudinal data from a large unselected cohort of patients with peripheral facial paralysis to determine the prevalence and patient characteristic predictors of sequelae receiving intervention.

Study Design
Retrospective case review.

Setting
Karolinska University Hospital in Stockholm Sweden serves as the only tertiary facial palsy center in the region. Here, patients are diagnosed, are followed up, and undergo all major interventions.

Patients
All adult patients presenting with peripheral facial palsy due to idiopathic, zoster, or Borrelia origin at Karolinska, January 1, 2010 to December 31, 2011 with follow-up until December 2022.

Interventions
Patient charts were studied to identify patient characteristics, etiology, initial treatment, severity of palsy, and treatments targeting sequelae.

Main Outcome Measures
Types of initial and late treatments were noted. Sunnybrook and/or House–Brackmann scales were used for palsy grading.

Results
Five hundred twenty-five patients were included. Thirty-three patients (6.3%) received botulinum toxin injections and/or surgical treatment. In this subgroup, 67% received corticosteroids compared to 85% of all patients (p = 0.005), cardiovascular disease prevalence was higher (23 and 42%, respectively, p = 0.009). For 81 patients (15%), follow-up was discontinued although the last measurement was Sunnybrook less than 70 or House–Brackmann 3 to 6.

Conclusions
Of patients with peripheral facial palsy, 6.3% underwent injections and/or surgical treatment within 12 years. However, due to a rather large proportion not presenting for follow-up, this might be an underestimation. Patients receiving late injections and/or surgical treatment had more comorbidities and received corticosteroid treatment to a significantly lower extent in the acute phase of disease.
Standard and Extend High-Frequency Audiometry in Sudden Sensorineural Hearing Loss: Impacts on Tinnitus and Mental Health
Authors: Tomaz Andreza , Peron Kelly Abdo , Suzuki Flavia Alencar de Barros , Monteiro Silvia Roberta Gesteira , Chandrasekhar Sujana S. , Penido Norma Oliveira 
Published: March 2024

Objective
To analyze the results of auditory assessment in standard (SA) and extended high-frequency (EHF) audiometry, associating the findings with sudden tinnitus and mental health of patients with unilateral sudden sensorineural hearing loss (SSNHL).

Study Design
Prospective, cohort study.

Setting
Outpatient otology clinic in a tertiary care hospital.

Subjects and Methods
Patients experiencing unilateral SSNHL were evaluated with pure-tone audiometry performed at frequencies of 250 to16,000 Hz, tinnitus pitch and loudness matching tests, Tinnitus Handicap Inventory (THI), Analog and Visual Scale (AVS) for bothersome tinnitus, and the Hospital Anxiety and Depression Scale (HADS).

Results
Eighteen patients with unilateral SSNHL were assessed. After starting treatment, there was a significant improvement in the SA (71.1 dB to 50 dB; p < 0.001*) and EHF audiometry (64.5 dB to 54.4 dB; p < 0.001*) thresholds at 15 days, and this persisted at 30 days of follow-up. Significant improvements were seen for tinnitus in loudness, VAS, and THI and for mental health in the realms of anxiety and depression by HADS. Despite improvements in SA, persistent EHF hearing loss was accompanied by persistent tinnitus, but it was of diminished loudness.

Conclusion
Despite improvement in pure-tone thresholds by SA, a subset of unilateral SSNHL patients did not experience hearing recovery in EHF thresholds and reported persistent tinnitus. We postulate that their diminished anxiety and better mental health may be related to both hearing improvement in standard audiometry and reduction in tinnitus loudness. This pilot prospective study investigates the utility of performing EHF audiometry to better understand outcomes in patients with SSNHL.
Auditory Outcomes Following Cochlear Implantation in Children with Unilateral Hearing Loss
Authors: Wu Shannon S. , Dunn-Johnson Camille , Zeitler Daniel M. , Schwartz Seth , Sutliff Suzanne , Appachi Swathi , Jamis Carmen , Petter Karen , Vovos Rachel , Goldberg Donald , Anne Samantha 
Published: March 2024

Objective
Unilateral hearing loss (UHL) in children is associated with speech and language delays. Cochlear implantation (CI) is currently the only rehabilitative option that restores binaural hearing. This study aims to describe auditory outcomes in children who underwent CI for UHL and to determine the association between duration of hearing loss and auditory outcomes.

Study Design
Retrospective case series.

Setting
Three tertiary-level, academic institutions.

Patients
Children <18 years with UHL who underwent CI between 2018 and 2021.

Intervention
Cochlear implantation.

Main Outcome Measures
Speech perception and Speech, Spatial and Qualities of Hearing Scale (SSQ) were assessed postimplantation. Scores >50% on speech perception and SSQ scores >8 points were considered satisfactory. Associations between duration of UHL and implantation age and outcomes were assessed using Spearman’s rank correlation.

Results
Of the 38 children included, mean age at CI was 7.9 ± 3.2 years and mean UHL duration was 5.0 ± 2.8 years. Mean datalogging was 8.1 ± 3.1 hours/day. Mean auditory testing scores were SSQ, 7.9 ± 1.2; BABY BIO, 68.1 ± 30.2%; CNC, 38.4 ± 28.4%; WIPI, 52.5 ± 23.1%. Scores >50% on CNC testing were achieved by 40% of patients. SSQ scores >8 points were reported by 78% (7/9) of patients. There were no significant correlations between UHL duration and auditory outcomes.

Conclusion
Overall, children with UHL who undergo CI can achieve satisfactory speech perception scores and SSQ scores. There were no associations between duration of hearing loss and age at implantation with auditory outcomes. Multiple variables may impact auditory outcomes, including motivation, family support, access to technology, and consistent isolated auditory training postactivation and should be taken into consideration in addition to age at implantation and duration of UHL in determination of CI candidacy.