bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Prohibited Questions during Plastic Surgery Residency Interviews
Authors: Rogers Ashley E. , Mantilla-Rivas Esperanza , Duarte-Bateman Daniela , Manrique Monica , McGrath Jennifer L. , Sohel Rana Md , Oh Albert K. , David Lisa R. , Janis Jeffrey E. , Rogers Gary F. 
Published: June 2023

Background:
Despite rules set forth by the National Resident Matching Program and American Association of Medical Colleges (AAMC), prohibited questions during the residency interview process are well documented. This study describes the prevalence of these encounters by surveying residency applicants to integrated plastic and reconstructive surgery (PRS) programs for the 2022 match cycle.

Methods:
An anonymous 16-question REDCap survey was distributed to 2022 cycle applicants of a single PRS program. The applicants were queried about demographic information, interview experience, and questions deemed illegal by the AAMC/NRMP guidelines.

Results:
One hundred survey responses were attained for a 33.1% response rate. The majority of respondents were aged 26-30 (76%), women (53%), and white (53%); 33% received 15+ interviews for the application cycle. Seventy-eight percent of respondents reported being asked a prohibited question during at least one interview, with the most common "illegal" question categories being number/ranking of interviews (42%), marital status (33%), career balance (25%), and race/ethnicity (22%). Only 25.6% of applicants considered the subject matter inappropriate, whereas 42.3% were unsure. Although no applicant took action to report the potentially illegal scenarios, 30% said that their experiences influenced their rank list.

Conclusions:
Our survey study revealed that prohibited interview questions in PRS residency interviews are common. Permissible lines of questioning and discussion between programs and applicants during residency interviews have been defined by AAMC. Institutions should provide guidance and training to all participants. Applicants should be made aware of and empowered to utilize available anonymous reporting tools.
How Postoperative Infection Affects Reoperations after Implant-based Breast Reconstruction: A National Claims Analysis of Abandonment of Reconstruction
Authors: Francis Shannon D. , Thawanyarat Kometh , Johnstone Thomas M. , Yesantharao Pooja S. , Kim Trudy S. , Rowley Mallory A. , Sheckter Clifford C. , Nazerali Rahim S. 
Published: June 2023

Background:
Infection after implant-based breast reconstruction adversely affects surgical outcomes and increases healthcare utilization. This study aimed to quantify how postimplant breast reconstruction infections impact unplanned reoperations, hospital length of stay, and discontinuation of initially desired breast reconstruction.

Methods:
We conducted a retrospective cohort study using Optum’s de-identifed Clinformatics Data Mart Database to analyze women undergoing implant breast reconstruction from 2003 to 2019. Unplanned reoperations were identified via Current Procedural Terminology (CPT) codes. Outcomes were analyzed via multivariate linear regression with Poisson distribution to determine statistical significance at P < 0.00625 (Bonferroni correction).

Results:
In our national claims-based dataset, post-IBR infection rate was 8.53%. Subsequently, 31.2% patients had an implant removed, 6.9% had an implant replaced, 3.6% underwent autologous salvage, and 20.7% discontinued further reconstruction. Patients with a postoperative infection were significantly associated with increased incidence rate of total reoperations (IRR, 3.11; 95% CI, 2.92–3.31; P < 0.001) and total hospital length of stay (IRR, 1.55; 95% CI, 1.48–1.63; P < 0.001). Postoperative infections were associated with significantly increased odds of abandoning reconstruction (OR, 2.92; 95% CI, 0.081–0.11; P < 0.001).

Conclusions:
Unplanned reoperations impact patients and healthcare systems. This national, claims-level study shows that post-IBR infection was associated with a 3.11× and 1.55× increase in the incidence rate of unplanned reoperations and length of stay. Post-IBR infection was associated with 2.92× increased odds of abandoning further reconstruction after implant removal.
Among Patients Taking Beta-Adrenergic Blockade Therapy, Use Measured (Not Predicted) Maximal Heart Rate to Calculate a Target Heart Rate for Cardiac Rehabilitation
Authors: Keteyian Steven J. , Steenson Katherina , Grimshaw Crystal , Mandel Noah , Koester-Qualters Wanda , Berry Robert , Kerrigan Dennis J. , Ehrman Jonathon K. , Peterson Edward L. , Brawner Clinton A. 
Published: June 2023

Purpose:
Among patients in cardiac rehabilitation (CR) on beta-adrenergic blockade (βB) therapy, this study describes the frequency for which target heart rate (THR) values computed using a predicted maximal heart rate (HRmax), correspond to a THR computed using a measured HRmax in the guideline-based heart rate reserve (HRreserve) method.

Methods:
Before CR, patients completed a cardiopulmonary exercise test to measure HRmax, with the data used to determine THR via the HRreserve method. Additionally, predicted HRmax was computed for all patients using the 220 − age equation and two disease-specific equations, with the predicted values used to calculate THR via the straight percent and HRreserve methods. The THR was also computed using resting heart rate (HR) +20 and +30 bpm.

Results:
Mean predicted HRmax using the 220 − age equation (161 ± 11 bpm) and the disease-specific equations (123 ± 9 bpm) differed (P < .001) from measured HRmax (133 ± 21 bpm). Also, THR computed using predicted HRmax resulted in values that were infrequently within the guideline-based HRreserve range calculated using measured HRmax. Specifically, 0 to ≤61% of patients would have had an exercise training HR that fell within the guideline-based range of 50-80% of measured HRreserve. Use of standing resting HR +20 or +30 bpm would have resulted in 100% and 48%, respectively, of patients exercising below 50% of HRreserve.

Conclusions:
A THR computed using either predicted HRmax or resting HR +20 or +30 bpm seldom results in a prescribed exercise intensity that is consistent with guideline recommendations for patients in CR.
Placebo effects contribute to brief online mindfulness interventions for chronic pain: results from an online randomized sham-controlled trial
Authors: Davies Jonathan N. , Colagiuri Ben , Sharpe Louise , Day Melissa A. 
Published: June 2023

Abstract
Mindfulness apps are becoming popular treatments for chronic pain and mental health, despite mixed evidence supporting their efficacy. Furthermore, it is unclear whether improvements in pain are due to mindfulness-specific effects or placebo effects because no trials have compared mindfulness against a sham control. The objective of this study was to compare mindfulness against 2 sham conditions with differing proximity to mindfulness to characterize the relative contributions of mindfulness-specific and nonspecific processes on chronic pain. We assessed changes in pain intensity and unpleasantness and mindfulness-specific and nonspecific pain-related processes in 169 adults with chronic or recurrent pain randomized to receive a single 20-minute online session of mindfulness, specific sham mindfulness, general sham mindfulness, or audiobook control. Mindfulness was not superior to shams for reducing pain intensity or unpleasantness, and no differential engagement of theorized mindfulness-specific processes was observed. However, mindfulness and both shams reduced pain unpleasantness relative to audiobook control, with expectancy most strongly associated with this effect. Sham specificity had no influence on expectancy or credibility ratings, pain catastrophizing, or pain effects. These findings suggest that improvements in chronic pain unpleasantness following a single session of online-delivered mindfulness meditation may be driven by placebo effects. Nonspecific treatment effects including placebo expectancy and pain catastrophizing may drive immediate pain attenuation rather than theorized mindfulness-specific processes themselves. Further research is needed to understand whether mindfulness-specific effects emerge after longer durations of online training.
Preclinical effects of cannabidiol in an experimental model of migraine
Authors: Sturaro Chiara , Fakhoury Bianca , Targowska-Duda Katarzyna M. , Zribi Gilles , Schoch Jennifer , Ruzza Chiara , Calò Girolamo , Toll Lawrence , Cippitelli Andrea 
Published: June 2023

Abstract
Migraine is a disabling disorder characterized by recurrent headaches, accompanied by abnormal sensory sensitivity and anxiety. Despite extensive historical use of cannabis in headache disorders, there is limited research on the nonpsychoactive cannabidiol (CBD) for migraine and there is no scientific evidence to prove that CBD is an effective treatment. The effects of CBD are examined here using a calcitonin gene-related peptide (CGRP)-induced migraine model that provides measures of cephalic allodynia, spontaneous pain, altered light sensitivity (photophobia), and anxiety-like behavior in C57BL/6J mice. A single administration of CGRP induced facial hypersensitivity in both female and male mice. Repeated CGRP treatment produced progressively decreased levels in basal thresholds of allodynia in females, but not in males. A single CBD administration protected both females and males from periorbital allodynia induced by a single CGRP injection. Repeated CBD administration prevented increased levels of basal allodynia induced by repeated CGRP treatment in female mice and did not lead to responses consistent with migraine headache as occurs with triptans. Cannabidiol, injected after CGRP, reversed CGRP-evoked allodynia. Cannabidiol also reduced spontaneous pain traits induced by CGRP administration in female mice. Finally, CBD blocked CGRP-induced anxiety in male mice, but failed in providing protection from CGRP-induced photophobia in females. These results demonstrate the efficacy of CBD in preventing episodic and chronic migraine-like states with reduced risk of causing medication overuse headache. Cannabidiol also shows potential as an abortive agent for treating migraine attacks and headache-related conditions such as spontaneous pain and anxiety.
Additive Manufacturing and Upper-Limb Orthoses: A Scoping Review
Authors: Gehner Amy , Lunsford Dianna 
Published: June 2023

ABSTRACT

Introduction
Additive manufacturing has the potential to revolutionize the orthotic fabrication process for health professionals. Although there is evidence to suggest the benefits of additive manufacturing in rehabilitation-related fields, there is still fairly limited evidence supporting the use of 3D-printed orthoses as an effective and feasible alternative to manually fabricated devices used for the upper limb (UL). The purpose of this scoping review was to examine how 3D printers are currently being used in UL orthotic fabrication within the scope of rehabilitation professionals.

Methods
A literature search was conducted using five databases from 2011 to 2021. Two independent researchers reviewed the abstracts and full text of the articles. The PRISMA process was used to report findings, and data extraction and charting were completed according to the JBI-suggested scoping review protocol.

Results
Thirty-three studies were reviewed as determined by inclusion criteria from various disciplines and countries. Eight diagnostic categories identifying indications for use were derived from the studies including arthritic conditions, burns/contractures and wound care, finger deformities, neurological and neuromuscular disorders, and traumatic, strain, and nerve injuries. Both benefits and challenges are identified with the use of 3D-printed orthoses.

Conclusions
The scope of the 3D-printed orthoses produced in this review is broad and internationally widespread. More evidence is needed to determine the effectiveness of 3D-printed orthoses for each of the identified conditions, but the benefits outside of healing are obvious. The current state of the evidence suggests that this technology remains exploratory in respect to UL orthoses and is therefore not yet ready to be implemented in clinics. With appropriate supports and more evidence, 3D printing still has the potential to revolutionize the UL orthotic fabrication process.

Clinical Relevance
It may be unrealistic for rehabilitation professionals to design and fabricate 3D-printed orthoses without the proper education or time, but it is important for health care professionals to have an emphasized presence in this conversation, as it is their responsibility to treat the patients. This suggests that co-design, combining professionals' expertise, might be the best approach to fabricating these devices for patients.
Risk Selection and Care Fragmentation at Medicare Accountable Care Organizations for Patients With Dementia
Authors: Johnston Kenton J. , Loux Travis , Joynt Maddox Karen E. 
Published: June 2023

Background:
Patients with dementia are a growing and vulnerable population within Medicare. Accountable care organizations (ACOs) are becoming Medicare’s dominant care model, but ACO enrollment and care patterns for patients with dementia are unknown.

Objective:
The aim of this study was to compare differences in ACO enrollment for patients with versus without dementia, and in risk profiles and ambulatory care among patients with dementia by ACO enrollment status.

Research Design:
Cohort study assessing the relationships between patient dementia, following-year ACO enrollment, and ambulatory care patterns.

Subjects:
A total of 13,362 (weighted: 45, 499,049) person-years for patients [2761 (weighted: 6,312,304) for dementia patients] ages 65 years and above in the 2015–2019 Medicare Current Beneficiary Survey.

Measures:
We assessed differences in ACO enrollment rates for patients with versus without dementia, and in dementia-relevant ambulatory care visit rates and validated care fragmentation indices among patients with dementia by ACO enrollment status.

Results:
Patients with versus without dementia were less likely to be enrolled in (38.3% vs. 44.6%, P<0.001), and more likely to exit (21.1% vs. 13.7%, P<0.01) ACOs. Among patients with dementia, those enrolled versus not enrolled in ACOs had a more favorable social and health risk profile on 6 of 16 measures (P<0.05). There were no differences in rates of dementia-relevant, primary, or specialty care visits. ACO enrollment was associated with 45.7% higher wellness visit rates (P<0.001), and 13.4% more fragmented primary care (P<0.01) spread across 8.7% more distinct physicians (P<0.05).

Conclusion:
Medicare ACOs are less likely to enroll and retain patients with dementia than other patients and provide more fragmented primary care without providing additional dementia-relevant ambulatory care visits.
Delivery of Cervical and Colorectal Cancer Screenings During the Pandemic in Community Health Centers
Authors: Huguet Nathalie , Danna Maria , Baron Andrea , Hall Jennifer , Hodes Tahlia , O’Malley Jean , Holderness Heather , Marino Miguel , DeVoe Jennifer E. , Cohen Deborah J. 
Published: June 2023

Background:
The coronavirus disease 2019 pandemic led to clinical practice changes, which affected cancer preventive care delivery.

Objectives:
To investigate the impact of the coronavirus disease 2019 pandemic on the delivery of colorectal cancer (CRC) and cervical cancer (CVC) screenings.

Research Design:
Parallel mixed methods design using electronic health record data (extracted between January 2019 and July 2021). Study results focused on 3 pandemic-related periods: March–May 2020, June–October 2020, and November 2020–September 2021.

Subjects:
Two hundred seventeen community health centers located in 13 states and 29 semistructured interviews from 13 community health centers.

Measures:
Monthly up-to-date CRC and CVC screening rates and monthly rates of completed colonoscopies, fecal immunochemical test (FIT)/fecal occult blood test (FOBT) procedures, Papanicolaou tests among age and sex-eligible patients. Analysis used generalized estimating equations Poisson modeling. Qualitative analysts developed case summaries and created a cross-case data display for comparison.

Results:
The results showed a reduction of 75% for colonoscopy [rate ratio (RR) = 0.250, 95% CI: 0.224–0.279], 78% for FIT/FOBT (RR = 0.218, 95% CI: 0.208–0.230), and 87% for Papanicolaou (RR = 0.130, 95% CI: 0.125–0.136) rates after the start of the pandemic. During this early pandemic period, CRC screening was impacted by hospitals halting services. Clinic staff moved toward FIT/FOBT screenings. CVC screening was impacted by guidelines encouraging pausing CVC screening, patient reluctance, and concerns about exposure. During the recovery period, leadership-driven preventive care prioritization and quality improvement capacity influenced CRC and CVC screening maintenance and recovery.

Conclusions:
Efforts supporting quality improvement capacity could be key actionable elements for these health centers to endure major disruptions to their care delivery system and to drive rapid recovery.
Shared Decision-making Lowers Medical Expenditures and the Effect Is Amplified in Racially-Ethnically Concordant Relationships
Authors: Brown Timothy T. , Hurley Vanessa B. , Rodriguez Hector P. , Lee Jadyn , Gupta Neel , Toolsie Grace , Markarian Sione , Valenzuela Sofia 
Published: June 2023

Background:Racial-ethnic disparities are pervasive in health care. One mechanism that may underlie disparities is variation in shared decision-making (SDM), which encompasses high-quality clinician-patient communication, including deliberative discussions about treatment options.Objectives:To determine whether SDM has causal effects on outcomes and whether these effects are stronger within racial-ethnic concordant clinician-patient relationships.Research Design:We use instrumental variables to estimate the causal effect of SDM on outcomes.Subjects:A total of 60,584 patients from the 2003–2017 Integrated Public Use Microdata Series Medical Expenditure Panel Survey. Years 2018 and 2019 were excluded due to changes in the Medical Expenditure Panel Survey that omitted essential parts of the SDM index.Measures:Our key variable of interest is the SDM index. Outcomes included total, outpatient, and drug expenditures; physical and mental health; and the utilization of inpatient and emergency services.Results:SDM lowers annual total health expenditures for all racial-ethnic groups, but this effect is only moderated among Black patients seen by Black clinicians, more than doubling in size relative to Whites. A similar SDM moderation effect also occurs for both Black patients seen by Black clinicians and Hispanic patients seen by Hispanic clinicians with regard to annual outpatient expenditures. There was no significant effect of SDM on self-reported physical or mental health.Conclusions:High-quality SDM can reduce health expenditures without negatively impacting overall physical or mental health, supporting a business case for health care organizations and systems to improve racial-ethnic clinician-patient concordance for Black and Hispanic patients.
Nurse Disrespect and Abuse Toward Laboring and Child-Birthing Women
Authors: Alzyoud Fatima A. , McCurry Mary K. , Hunter Revell Susan M. , Kellogg Marni 
Published: June 2023

Background
Disrespect and abuse of laboring and child-birthing women in healthcare is a global problem that violates a woman’s right to respectful care. The abuse can be life-threatening and jeopardizes their rights to health, bodily integrity, and freedom from discrimination. This study aimed to understand the factors influencing nurse and midwife disrespect and abuse of child-birthing women in healthcare settings.

Methods
An exploratory, nonexperimental, cross-sectional design was used to identify correlates and predictors of disrespect and abuse of child-birthing women by nurses/midwives. Pearson product–moment correlation and hierarchical multiple regression analyses were used to explore the relationships between nurse intrapersonal, interpersonal (Nursing Incivility Scale), organizational/structural factors (Professional Practice Work Environment Inventory), and disrespect and abuse (Disrespect and Abuse Scale) toward women during labor and childbirth.
An online electronic survey was used to collect data from an international nursing and midwifery population from May 2021 to September 2021. Data were collected from 231 nurses and midwives.

Results
The standardized regression coefficients showed that gender, number of hours worked per week, and organizational/structural factors were all predictors of disrespect and abuse. Organizational/structural factors were the strongest predictor of disrespect and abuse, accounting for 20% of the variance in the regression model.

Discussion
These findings support the patient abuse in healthcare model, where researchers hypothesized that nurse/midwife intrapersonal, interpersonal, and organizational/structural factors contribute to patient abuse in healthcare settings. Work environment, gender, and number of hours worked per week were significant predictors of disrespect and abuse. The results of this study support future research that addresses unhealthy work environments and develops policies to transform the values and norms of labor and delivery.
Psychological distress in a Portuguese sample of cancer patients during the COVID-19 pandemic: a cross-sectional study
Authors: Paredes Tiago F. , Silva Sonia M. , Pacheco Ana F. , de Sousa Bruno C. , Pires Carlos A. , Dias Albina S. , Costa Ana L. , Mesquita Ana R. , Fernandes Eloisa E. , Marques Graciete F. , Vieira Marla S. , Leal Monick B. , Amaral Natalia J. , Rodrigues Vitor J. 
Published: June 2023

Abstract

Objective:
Considering the lack of studies exploring the psychological impact of COVID-19 on patients living with and beyond cancer, this study aimed to explore the levels of emotional distress, anxiety, and depression in patients with cancer and survivors during the COVID-19 pandemic and to identify psychological risk factors.

Methods:
Data for this cross-sectional study were collected through an online questionnaire comprised a self-report questionnaire and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics and linear regression models were used to characterize the sample and identify the determinants of emotional distress, depression, and anxiety. Statistical analyses were performed using R, version 4.1.1.

Results:
The sample included 940 patients with cancer and survivors, mostly female (87.1%), with a mean age of 49.7 years. More than half of the patients were survivors (55.1%); 56.7% were diagnosed with breast cancer, and 35.0% had other chronic diseases. Most participants believed that they were more likely to be infected with COVID-19 (53.9%) and that they may have more complications if they were infected (76.7%). Approximately half of the participants revealed significant emotional distress (49.3%), 18.1% revealed significant depression, and 29.2% revealed significant anxiety. Female patients, participants with lower education levels, unemployed/lay-off, or in a medical leave with a chronic disease, taking care of someone with a chronic disease, or perceiving a higher risk of being infected with COVID-19 had higher levels of emotional distress, depression, and anxiety.

Conclusions:
This study provides useful information regarding the impact of the COVID-19 pandemic on the mental health of patients with cancer and survivors, showing that an increased number of patients experienced significant emotional distress during the pandemic.