bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric Properties and The Best Form of The Revised Short-Form Mc-Gill Pain Questionnaire in Iranian Burn Patients
Authors: Gardashkhani Sevda , Imani khangah Nafiseh , Ebrahimi Belil Fatemeh 
Published: February 2023

Abstract
Pain is the most important factor that forces patients to seek help from health care systems. Burn injuries are associated with severe pain and the assessment and interventions are a focus of nursing care. The aim of this study was to evaluate the psychometric properties of the revised short-form Mc-Gill Pain Questionnaire (MPQ) in burn patients. The present study is a methodological study in which 153 burn patients were included by convenience sampling. To evaluate the psychometric properties of the 22-item revised MPQ, face validity, construct validity (exploratory factor analysis), and reliability were determined by Cronbach’s α coefficient and split-half method. Data analysis was performed using SPSS22.0 software. During the quantitative face validity test, four items were removed from the instrument due to the impact score of less than 1.5 by burn patients. The results of exploratory factor analysis showed five factors (emotional, neuropathic, continuous, stimulatory, and shooting), which explained 72.32% of the total variance. The overall Cronbach’s instrument was 0.836 and the coefficient obtained by the split-half method was 0.81. According to the validity and reliability, the 18-item MPQ obtained in the present study can be used to assess pain in Persian-speaking adult burn patients.
Flesh Flies (Diptera: Sarcophagidae) of Forensic Importance Collected From Pig Carcasses in the Cerrado of Northeastern Brazil
Authors: Silva José Orlando de A , Brasil Leandro S , Carvalho-Filho Fernando da S 
Published: February 2023

AbstractSarcophagidae is a family of true flies frequently found colonizing carcasses and corpses as adults and/or larvae, therefore, they are of great forensic value in the medico-legal field. Thus, this study aims to inventory the sarcophagids species and describe their succession process in the decomposition of swine carcasses in the Cerrado (savanna-like vegetation), Brazilian Northeastern region. A total of 10,819 specimens were collected, belonging to 45 sarcophagid species. Of this total, one species was recently described (Helicobia neuzalmeidae Silva, Brasil, De-Souza & Carvalho-Filho), two [Blaesoxipha (Acanthodotheca) denieri (Blanchard) and Dexosarcophaga pusilla Lopes] are new records for the Cerrado biome, five [Argoravinia (Argoravinia) catiae Carvalho Filho & Esposito, B. (A.) denieri, Nephochaetopteryx orbitalis (Curran & Walley), Peckia (Sarcodexia) tridentata (Hall) and Tricharaea (Sarcophagula) ramirezi (Lopes)] are new records for the Northeast region and eight are new records for the state of Maranhão. The species A. (A.) catiae, Blaesoxipha (Gigantotheca) stallengi (Lahille), D. pusilla, H. neuzalmeidae, Lipoptilocnema misella Lopes, Oxysarcodexia bakeri (Aldrich) and Retrocitomyia retrocita (Hall) were collected for the first time in pig carcasses. Peckia (Sarcodexia) lambens (Wiedemann) and Oxysarcodexia thornax (Walker) were the most abundant species. In both collection seasons, five species were carcasses pioneers at an early stage. The majority of species (42 spp.) were collected during the dry season, primarily during the black putrefaction (39 spp.) and butyric fermentation (30 spp.) stages. The greatest number specimens (n = 6,484) were recorded during the rainy season, at the butyric fermentation (n = 2,517) and black putrefaction (n = 2,080).
The tidal excitation ofrmodes in a solar-type star orbited by a giant planet companion and the effect on orbital evolution I: the aligned case
Authors: Papaloizou J C B , Savonije G J 
Published: February 2023

ABSTRACTIt has been suggested that tidal interaction is important for shaping the orbital configurations of close orbiting giant planets. The excitation of propagating waves and normal modes (dynamical tide) will be important for estimating time-scales for orbital evolution. We consider the tidal interaction of a Jupiter mass planet orbiting a solar-type primary. Tidal and rotational frequencies are assumed comparable making the effect of rotation important. Although centrifugal distortion is neglected, Coriolis forces are fully taken into account. We focus in detail on the potentially resonant excitation of r modes associated with spherical harmonics of degrees three and five. These are mostly sited in the radiative core but with a significant response in the convective envelope where dissipation occurs. Away from resonance significant orbital evolution over the system lifetime is unlikely. However, tidal interaction is enhanced near resonances and the orbital evolution accelerated as they are passed through. This speed up may be sustained if near resonance can be maintained. For close orbits with primaries rotating sufficiently rapidly, this could arise from angular momentum loss and stellar spin-down through a stellar wind bringing about significant orbital evolution over the system lifetime.
A Predictive Model to Identify ComplicatedClostridiodes difficileInfection
Authors: Berinstein Jeffrey A , Steiner Calen A , Rifkin Samara , Alexander Perry D , Micic Dejan , Shirley Daniel , Higgins Peter D R , Young Vincent B , Lee Allen , Rao Krishna 
Published: February 2023

AbstractBackgroundClostridioides difficile infection (CDI) is a leading cause of health care–associated infection and may result in organ dysfunction, colectomy, and death. Published risk scores to predict severe complications from CDI demonstrate poor performance upon external validation. We hypothesized that building and validating a model using geographically and temporally distinct cohorts would more accurately predict risk for complications from CDI.MethodsWe conducted a multicenter retrospective cohort study of adults diagnosed with CDI. After randomly partitioning the data into training and validation sets, we developed and compared 3 machine learning algorithms (lasso regression, random forest, stacked ensemble) with 10-fold cross-validation to predict disease-related complications (intensive care unit admission, colectomy, or death attributable to CDI) within 30 days of diagnosis. Model performance was assessed using the area under the receiver operating curve (AUC).ResultsA total of 3646 patients with CDI were included, of whom 217 (6%) had complications. All 3 models performed well (AUC, 0.88–0.89). Variables of importance were similar across models, including albumin, bicarbonate, change in creatinine, non-CDI-related intensive care unit admission, and concomitant non-CDI antibiotics. Sensitivity analyses indicated that model performance was robust even when varying derivation cohort inclusion and CDI testing approach. However, race was an important modifier, with models showing worse performance in non-White patients.ConclusionsUsing a large heterogeneous population of patients, we developed and validated a prediction model that estimates risk for complications from CDI with good accuracy. Future studies should aim to reduce the disparity in model accuracy between White and non-White patients and to improve performance overall.
Using Large-Group Simulation Incorporating a Variety of Media Formats in Innovating Interprofessional Education
Authors: Watts Sarah Owens , Sewell Jeanna , Ellison Kathy Jo 
Published: February 2023

Abstract
Innovative teaching strategies incorporated into curricula can prepare students for interprofessional practice and have a positive impact on patient outcomes and team dynamics in health care. Our team of faculty from nursing, social work, and pharmacy developed and implemented an activity using simulation in the large classroom to improve students’ perceptions of working in interprofessional teams. Effectiveness was assessed using the Interprofessional Collaborative Competencies Attainment Survey with a pretest-posttest design. Our experience indicated that this teaching approach can be an effective strategy for maximizing resources and providing meaningful interprofessional student experiences.
An Innovative Academic-Practice Partnership Using Simulation to Provide End-of-Life Education for Undergraduate Nursing Students in Rural Settings
Authors: Graham Lucy , Emerson Kristy 
Published: February 2023

Abstract
Innovations that foster academic-practice partnerships can fill direct clinical care gaps and supplement faculty expertise, particularly in rural settings. An end-of-life simulation was cocreated by nursing faculty and regional certified hospice and palliative care nurses (CHPNs) as a course improvement project for traditional baccalaureate students who lacked direct care experience. Groups of students experienced skills-based pain management and end-of-life conversation-based scenarios using CHPNs as standardized patients. The simulation conformed to current standards in health care simulation, including prebriefing and debriefing components. Feedback from students and CHPNs supports the partnership as an effective teaching/learning strategy.
The Use of Interactive Technology to Improve Student Accuracy on Electrocardiographic Interpretation
Authors: Dzikowicz Dillon J. , Carey Mary G. 
Published: February 2023

Abstract
Electrocardiography (ECG) instruction relies heavily on memorization of interpretation rules and lacks opportunities for hands-on practice. Consequently, nursing students struggle with ECG interpretation. In an online undergradute nursing course, we implemented interactive technology to facilitate kinesthetic pedagogy. Accuracy was evaluated at midterm and during final assessments by two experts using a standardized rubric. Students who engaged with interactive technology at both assessments demonstrated consistent accuracy of ECG interpretation; students who did not failed to demonstrate consistent accuracy with ECG interpretation. Incorporating interactive technology to facilitate psychomotor learning may be essential in improving the accuracy of ECG interpretation.
Integrating Artificial Intelligence (AI) Simulations Into Undergraduate Nursing Education: An Evolving AI Patient
Authors: Lebo Chelsea , Brown Norma 
Published: February 2023

Abstract
Utilizing an evolving artificial intelligence (AI) virtual patient that will age with students as they progress throughout the nursing program is an innovative use of simulation. The students are introduced to the AI patient as sophomores where they begin with basic patient interviewing and assessment skills. They revisit the AI patient as juniors and seniors in their medical-surgical courses, where they see the patient aging and developing complex medical conditions. As the AI patient and the student grow together, student competence increases. Students complete an evaluation at the conclusion of each simulation experience.
Evaluating Knowledge of Public Health Nursing Competencies in Baccalaureate Nursing Students
Authors: Brown Robin , Plemmons Christina , Abuatiq Alham , Hultman Cassy , Currier Danielle , Schmit Marie , Kvigne Valborg , Walstrom Beth , Horsley Leann , Mennenga Heidi 
Published: February 2023

Abstract
Community health workers are projected to grow in number by 17 percent by 2030. A baccalaureate degree in nursing (BSN) provides a foundation for public health nursing practice. The Competencies for Public Health Nursing Practice instrument was distributed to BSN students at a Midwestern university before and after an educational intervention. Students completed a pretest (n = 269) and posttest (n = 154). All four subscales and total score indicated a significant increase in competence (p < .001). There is a need to develop interactive public health nursing simulations with an interprofessional venue to help students improve teamwork and communication competencies.
Assessment of COVID-19–Driven Changes in an Integrated OBGYN-Addiction Treatment Clinic and Future Implications
Authors: Smarony Sumaya , Parlier-Ahmad Anna Beth , Shadowen Hannah , Thakkar Bhushan , Scheikl Marjorie O. , Martin Caitlin E. 
Published: February 2023

Objective
The COVID-19 pandemic prompted healthcare delivery changes, but the associated impacts on substance use disorder treatment outcomes among pregnant and parenting people are unknown. This study aims to (1) describe COVID-19–driven clinical practice changes, (2) evaluate clinic-level visit attendance patterns, and (3) compare patient-level treatment engagement outcomes across 3 COVID-19 pandemic phases in an OBGYN-addiction treatment clinic.

Methods
COVID-19 phases include pre–COVID-19 (August 2019–February 2020), early COVID-19 (March–December 2020), and COVID-19 vaccine (January–July 2021). OBGYN-addiction treatment clinical practice changes were summarized. Clinic-level attended medical provider visits were analyzed. Patient-level treatment engagement outcomes (buprenorphine continuation, visit attendance, and virtual visits) were assessed in a cohort of pregnant and parenting people enrolled in a clinic research registry. Mixed-level logistic regression models determined the relationship between the COVID-19 phases and the patient-level outcomes.

Results
The study site made several COVID-19–driven clinical practice changes, including implementing a hybrid virtual/in-person system for medical visits. Clinic-level medical provider appointments increased between the first and second COVID-19 phases and remained high in the third phase. Among participants included in patient-level outcome analyses (N = 27), there were no differences in the early COVID-19 phase compared with the pre–COVID-19 phase in buprenorphine continuation, any visits, or medical visits. There was a decrease in all patient-level outcomes in the COVID-19 vaccine phase compared with pre–COVID-19 (P < 0.05). Virtual visits increased between the first 2 phases and remained high during the third.

Conclusion
Within our OBGYN-addiction treatment clinic, implementation of tailored, patient-centered treatment strategies supported clinic- and patient-level treatment engagement throughout the pandemic.
Homelessness and Treatment Outcomes Among Black Adults With Opioid Use Disorder: A Secondary Analysis of X:BOT
Authors: Justen Marissa , Scodes Jennifer , Pavlicova Martina , Choo Tse-Hwei , Gopaldas Manesh , Haeny Angela , Opara Onumara , Rhee Taeho Greg , Rotrosen John , Nunes Edward V. , Hawk Kathryn , Edelman E. Jennifer 
Published: February 2023

Objective
We sought to identify the sociodemographic and clinical characteristics associated with homelessnesss, and explore the relationship between homelessnesss and treatment outcomes among Black individuals.

Methods
This is a secondary analysis of the subgroup of Black participants (n = 73) enrolled in “X:BOT,” a 24-week multisite randomized clinical trial comparing the effectiveness of extended-release naltrexone versus sublingual buprenorphine-naloxone (n = 570). Outcomes included medication initiation, return to extramedical use of opioids assessed by both self-report and urine toxicology, and engagement in medications for opioid use disorder (MOUD) treatment at 28 weeks postrandomization. Descriptive statistics were performed.

Results
Black participants were mostly unmarried and male, and about a third were aged 21–30 years. Among people experiencing homelessnesss, more were uninsured (45.5% [10/22] vs 19.6% [10/51]), unemployed (77.3% [17/22] vs 64.7% [33/51]), and reported alcohol (40.9% [9/22] vs 23.5% [12/51]) and sedative use (54.5% [12/22] vs 17.6% [9/51]) within the previous 30 days. Compared with housed Black individuals, a slightly higher proportion of Black individuals experiencing homelessnesss successfully initiated study medication (81.1% [18/22] vs 72.6% [37/51]); similar proportions returned to opioid use during the trial (68.2% [15/22] vs 68.6% [35/51]) and were engaged in MOUD at 28 weeks after trial entry (72.2% [13/18] vs 69.7% [23/33]) among participants located for follow-up.

Conclusions
These descriptive results among Black patients participating in a trial of MOUD suggest that efficacious MOUD is possible despite homelessnesss with additional clinical supports such as those provided by a clinical trial.
Trends in the Prioritization and Implementation of Substance Use Programs by Nonprofit Hospitals: 2015–2021
Authors: Chang Ji Eun , Cronin Cory E. , Pagán José A. , Simon Janet , Lindenfeld Zoe , Franz Berkeley 
Published: February 2023

Objectives
Hospitalizations are an important opportunity to address substance use through inpatient services, outpatient care, and community partnerships, yet the extent to which nonprofit hospitals prioritize such services across time remains unknown. The objective of this study is to examine trends in nonprofit hospitals’ prioritization and implementation of substance use disorder (SUD) programs.

Methods
We assessed trends in hospital prioritization of substance use as a top five community need and hospital implementation of SUD programing at nonprofit hospitals between 2015 and 2021 using two waves (wave 1: 2015–2018; wave 2: 2019–2021) by examining hospital community benefit reports. We utilized t or χ2 tests to understand whether there were significant differences in the prioritization and implementation of SUD programs across waves. We used multilevel logistic regression to evaluate the relation between prioritization and implementation of SUD programs, hospital and community characteristics, and wave.

Results
Hospitals were less likely to have prioritized SUD but more likely to have implemented SUD programs in the most recent 3 years compared, even after adjusting for the local overdose rate and hospital- and community-level variables. Although most hospitals consistently prioritized and implemented SUD programs during the 2015–2021 period, a 11% removed and 15% never adopted SUD programs at all, despite an overall increase in overdose rates.

Conclusions
Our study identified gaps in hospital SUD infrastructure during a time of elevated need. Failing to address this gap reflects missed opportunities to engage vulnerable populations, provide linkages to treatment, and prevent complications of substance use.
Widespread Distribution of Xylazine Detected Throughout the United States in Healthcare Patient Samples
Authors: Holt Andrew C. , Schwope David M. , Le Kathy , Schrecker Joshua P. , Heltsley Rebecca 
Published: February 2023

Objectives
Xylazine is a tranquilizer commonly added into the illicit drug supply and a likely contributor to overdoses because it does not respond to naloxone reversal. The objective of this study was to perform a retrospective data analysis on xylazine-positive samples collected from patients in various outpatient healthcare settings to illustrate geographic distribution and common copositive substances, which may also contribute to risk of adverse events.

Methods
Samples for which providers ordered testing for xylazine were subjected to enzymatic hydrolysis, extracted, and analyzed using liquid chromatography–tandem mass spectrometry. Retrospective analysis was performed on xylazine-positive samples collected from April 2021 to March 2022, to include geographic location and copositive substances.

Results
Xylazine was identified in 413 of 59,498 samples from adults aged 20–73 years and originated from 25 of the 39 states where xylazine testing was ordered. The most common routine substances detected with xylazine were fentanyl, buprenorphine, naloxone, cocaine, d-methamphetamine, and delta-9-tetrahydrocannabinol. The most common designer drugs detected included fentanyl analogs, isotonitazene, and designer benzodiazepines.

Conclusions
Xylazine is geographically spread throughout the United States, indicative of a wide incorporation into the illicit drug supply. These findings differ from previous studies in that these samples originated from healthcare providers in routine care settings, where other reports typically involve overdose deaths. This analysis illustrates that routine testing for xylazine in outpatient settings can afford providers the opportunity to educate individuals and adjust harm reduction measures to potentially mitigate overdose risk.
The Routine Use of Running Subcuticular Closures in Orthopaedic Trauma Patients Does Not Increase Wound Complications
Authors: Aravindan Shreyaas , Kim Ye Joon , Tucker Nicholas J. , Heare Austin , Parry Joshua A. 
Published: February 2023

Objective:
To investigate whether the routine use of running subcuticular closures (RSC) in orthopaedic trauma patients increases the rate of wound complications and reoperations.

Design:
Retrospective comparative study.

Setting:
Urban Level 1 trauma center.

Patients/Participants:
Two hundred sixty-six patients undergoing orthopaedic trauma procedures between June 2020 and March 2022.

Intervention:
Adoption of an RSC protocol where any incision/wound that could be approximated with interrupted subcuticular 2-0 monofilament sutures was closed with a running subcuticular 3-0 monofilament suture.

Main Outcome Measurements:
Wound complications and subsequent reoperations.

Results:
With adoption of the RSC protocol, 91.0% of all orthopaedic trauma procedures were closed with RSC compared with 7.5% of the historical control group. There were no observed differences in the rate of wound complications (proportional difference (PD) 6.0%, confidence interval (CI) −2.3% to 14.1%; P = 0.15) or reoperations (PD 5.2%, CI −1.9% to 12.2%; P = 0.14) between the RSC and the control group. Wound complications were not associated with RSC on univariate analysis (PD 7.2%, CI −10.0% to 24.0%; P = 0.41). On multivariate analysis, an ASA>2 (odds ratio (OR) 2.4, CI 1.0 to 5.7; P = 0.03), lower extremity injuries (OR 4.9, CI 1.3 to 17.8; P = 0.01), and open reduction internal fixation procedures (OR 2.8, CI 1.1 to 7.2; P = 0.02) were found to be independently associated with wound complications.

Conclusion:
RSC for orthopaedic trauma procedures was not associated with increased wound complications when compared a historical cohort.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
How Many Patients Do We Need? Predictors of Consent to Participate in Clinical Research Studies in Orthopaedic Trauma
Authors: Wally Meghan K. , Seymour Rachel , Roomian Tamar , Churchill Christine , Haines Nikkole , Hsu Joseph R. , Bosse Michael , Karunakar Madhav A. ,   and Evidence-Based Musculoskeletal Injury & Trauma Collaborative (EMIT)
Published: February 2023

Objectives:
To characterize the recruitment rates at a Level I trauma center enroling for multiple prospective orthopaedic trauma research studies and identify patient-related and study-related predictors of consent.

Design:
We conducted a case–control study to identify predictors of study consent. The authors categorized studies based on intensity of the study intervention (low, intermediate, or high). A 2-level generalized linear model with random intercept for study was used to predict study consent.

Setting:
This analysis includes data from 10 federally funded studies conducted as part of a large, national consortium that were enroling patients in 2013–2014.

Patients/Participants:
Three hundred thirty-four patients were approached for at least 1 study and included in the analysis.

Intervention:
N/A.

Main Outcome Measures:
Consent to participate in the research study.

Results:
A total of 315 patients consented to be in a study (71% of approached patients). Consent rate varied by study (45%–95%). No patient characteristics (race, age, or sex) were associated with consent. Patients approached for studies of intermediate intensity were 83% less likely to consent (odds ratio = 0.17; 95% confidence interval: 0.04–0.67), and those approached for studies of high intensity were 91% less likely to consent (odds ratio = 0.09; 95% confidence interval: 0.03–0.32).

Conclusion:
Patient factors were not associated with consent. Study intensity is a major driver of consent rates. Studies of higher intensity will require the study team to approach up to twice as many patients as the target enrolment. This study provides a framework that can be used in study planning and determination of feasibility.