bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Outpatient Pain Plan and Emergency Department Pain Pathway for Adults With Sickle Cell Disease
Authors: Mercado Stephanie Harris 
Published: May 2023

Sickle cell disease (SCD), one of the most common inherited diseases, is associated with lifetime morbidity and reduced life expectancy. In the United States, SCD primarily affects Black patients and, to a lesser degree, those of Hispanic descent
These populations are known to have health care disparities related to lower socioeconomic status, limited access to health care, and racial bias. The quality-adjusted life expectancy of patients with SCD is less than 35 years, because of progressive complications of the disease. The most common complication is severe episodic pain related to vaso-occlusive ischemic events. Despite guidelines, pain management often is delayed as patients struggle with resistance from clinicians based on concerns over opioid use or abuse, overdose, or drug-seeking behavior. Effective pain management can be accomplished with collaboration between clinicians and patients, a documented outpatient pain management plan, and when necessary, an emergency department clinical pain pathway for acute SCD pain management
Orbital and Eyelid Characteristics, Strabismus, and Intracranial Pressure Control in Apert Children Treated by Endoscopic Strip Craniectomy versus Fronto-Orbital Advancement
Authors: Dohlman Jenny C. , Prabhu Sanjay P. , Staffa Steven J. , Kanack Melissa D. , Mackinnon Sarah , Warkad Vivekanand U. , Meara John G. , Proctor Mark R. , Dagi Linda R. 
Published: May 2023

Background:
Apert syndrome is characterized by eyelid dysmorphology, V-pattern strabismus, extraocular muscle excyclorotation, and elevated intracranial pressure (ICP). We compare eyelid characteristics, severity of V-pattern strabismus, rectus muscle excyclorotation, and ICP control in Apert syndrome patients initially treated by endoscopic strip craniectomy (ESC) at about 4 months of age versus fronto-orbital advancement (FOA) performed about 1 year of age.

Methods:
Twenty-five patients treated at Boston Children’s Hospital met inclusion criteria for this retrospective cohort study. Primary outcomes were magnitude of palpebral fissure downslanting at 1, 3, and 5 years of age, severity of V-pattern strabismus, rectus muscle excyclorotation, and interventions to control ICP.

Results:
Before craniofacial repair and through 1 year of age, none of the studied parameters differed for FOA versus ESC treated patients. Palpebral fissure downslanting became statistically greater for those treated by FOA by 3 (P < 0.001) and 5 years of age (P = 0.001). Likewise, severity of palpebral fissure downslanting correlated with severity of V-pattern strabismus at 3 (P = 0.004) and 5 (P = 0.002) years of age. Palpebral fissure downslanting and rectus muscle excyclorotation were typically coexistent (P = 0.053). Secondary interventions to control ICP were required in four of 14 patients treated by ESC (primarily FOA) and in two of 11 patients initially treated by FOA (primarily third ventriculostomy) (P = 0.661).

Conclusions:
Apert patients initially treated by ESC had less severe palpebral fissure downslanting and V-pattern strabismus, normalizing their appearance. Thirty percent initially treated by ESC required secondary FOA to control ICP.
Donor and Recipient Nerve Axon Counts in Gender-affirming Radial Forearm Phalloplasty: Informing Choice of Nerve Coaptations
Authors: Krasnoff Chloe , Ferrin Peter , Peters Blair R. 
Published: May 2023

Background:
A key component of success of a nerve transfer is the innervation density, which is directly affected by the donor nerve axonal density and donor-to-recipient (D:R) axon ratio. Optimal D:R axon ratio for a nerve transfer is quoted at 0.7:1 or greater. In phalloplasty surgery, there are currently minimal data available to help inform selection of donor and recipient nerves, including unavailability of axon counts.

Methods:
Five transmasculine people who underwent gender-affirming radial forearm phalloplasty had nerve specimens processed with histomorphometric evaluation to determine axon counts and approximate donor-to-recipient axon ratios.

Results:
Mean axon counts for recipient nerves were 6957 ± 1098 [the lateral antebrachial (LABC)], 1866 ± 590 [medial antebrachial (MABC)], and 1712 ± 121 [posterior antebrachial cutaneous (PABC)]. Mean axon counts for donor nerves were 2301 ± 551 [ilioinguinal (IL)] and 5140 ± 218 [dorsal nerve of the clitoris (DNC)]. D:R axon ratios using mean axon counts were DNC:LABC 0.739 (0.61–1.03), DNC:MABC 2.754 (1.83–5.91), DNC:PABC 3.002 (2.71–3.53), IL:LABC 0.331 (0.24–0.46), IL:MABC 1.233 (0.86–1.17), and IL:PABC 1.344 (0.85–1.82).

Conclusions:
The DNC is the more powerful donor nerve with greater than two times the axon count of the IL. The IL nerve may be under-powered to re-innervate the LABC based on an axon ratio consistently less than 0.7:1. All other mean D:R are more than 0.7:1. DNC axon counts may be excessive for re-innervation of the MABC or PABC alone with D:R of more than 2.5:1, potentially increasing risk of neuroma formation at the coaptation site.
Patient Utilization of Premium Intraocular Lenses Before and During the COVID-19 Pandemic
Authors: Cha Eumee , Arsiwala-Scheppach Lubaina T. , Srikumaran Divya , Prescott Christina R. 
Published: May 2023

Purpose:
To compare the choice of intraocular lens (IOL) and sociodemographic characteristics between patients who underwent elective cataract surgery before the COVID-19 pandemic and during the pandemic at the Wilmer Eye Institute.

Methods:
A retrospective chart review of patients who underwent cataract surgery before the COVID-19 pandemic (June 1 to November 30, 2019) and during the pandemic (June 1 to November 30, 2020) was conducted. Sociodemographic information, including age, sex, race, and insurance, and choice of IOL (premium or standard) were analyzed. The association between timing of surgery and choice of IOL was analyzed using multivariable logistic regression.

Results:
The study included 2,877 patients (3,946 eyes) before COVID-19 and 2,564 patients (3,605 eyes) during COVID-19. However, 9.0% (357/3,946) of surgeries before COVID-19 used premium IOLs compared with 11.1% (399/3,605) during COVID-19 (P=0.004). There was no difference in the racial characteristics of patients between before and during COVID-19. After adjusting for time of surgery and demographics, the odds of choosing premium IOLs for black patients was 0.32 times the odds for white patients (P<0.001). There was an increase in private-insured patients but a decrease in Medicare-insured patients during COVID-19. After adjusting for time of surgery and demographics, private-insured patients had higher odds of choosing premium IOLs (P<0.001), whereas Medicaid-insured patients had lower odds (P=0.007) when compared with Medicare-insured patients.

Conclusion:
More patients chose premium IOLs during COVID-19 than before COVID-19, concurrent with change in insurance status. White patients were more likely to choose premium IOLs than black patients, as were private-insured patients compared with Medicare-insured patients.
Video-Assisted Versus Traditional Problem-Based Learning: A Quasi-Experimental Study Among Pediatric Nursing Students
Authors: YANG Sun-Yi , OH Yun-Hee 
Published: May 2023

ABSTRACT

Background
The text-assisted problem-based, methods traditionally used to teach nursing students cannot adequately simulate holistic clinical situations and patient symptoms. Although video-assisted, problem-based learning methods combined with text have shown positive results in terms of improving comprehension and cognitive abilities, some studies have shown these methods to be inferior to text-assisted methods in terms of promoting deep critical thinking in medical students.

Purpose
This study was designed to assess the benefits in nursing education of video-assisted, problem-based learning using online multimedia technologies compared with text-assisted, problem-based learning using traditional face-to-face classes.

Methods
A quasi-experimental, nonequivalent control group, preintervention-and-postintervention design was used. The experimental group (n = 31) received video-assisted, problem-based learning materials with multimedia technologies (video scenarios, Google Docs worksheets, Google slides, Zoom cloud meetings, and e-learning management system) and weekly online lectures (100 minutes) for 4 weeks. The control group (n = 35) received text-assisted, problem-based learning materials with traditional face-to-face classes and weekly lectures (100 minutes) for 4 weeks. The study data were analyzed using chi-square, Fisher's exact, and independent t tests as well as analysis of variance.

Results
At posttest, learning motivation (t = 3.25, p = .002), academic self-efficacy (t = 2.41, p = .019), and self-directed learning (t = 3.08, p = .003) were significantly higher in the experimental group than in the control group.

Conclusions/Implications for Practice
Video-assisted, problem-based learning using multimedia technologies was shown to be effective in increasing learning motivation, academic self-efficacy, and self-directed learning in nursing students. These findings have implications for the development and planning of contactless classes in response to the coronavirus pandemic. Notably, no intergroup differences were found in terms of problem-solving skills. Future studies should include in-depth reviews and assessments of the difficulties faced in producing problem scenarios as well as the methods of instruction.
Exploring Mental Health and Psychosocial Well-Being in Recovered Jordanian Individuals With COVID-19: A Phenomenological Study
Authors: HAMDAN MANSOUR Ayman M. , KHALIFEH Anas H. , ALSHIBI Ahmad N. , HAMAIDEH Shaher H. , ABU AL-KHAIR Feda' M. , KHRAISAT Omar , ALHALAIQA Fadwa N. 
Published: May 2023

ABSTRACT

Background
COVID-19-related healthcare services focus primarily on medical and physical treatments. Related treatments for psychosocial and mental health needs have not been a priority for healthcare professionals. Understanding the process by which individuals who have recovered from COVID-19 adapt psychologically will allow better planning for mental healthcare and healthcare outcomes.

Purpose
The purpose of this study was to explore how recovered individuals with COVID-19 adapted to related psychological and social stressors during the infection period.

Methods
A descriptive phenomenological approach was used to investigate a purposive sample of 13 individuals in Jordan who had recovered from COVID-19. Data were collected using semistructured interviews.

Results
Perceptions related to being diagnosed with COVID-19 were distinguished into four major themes: conscious awareness (acceptance, victimization, and normalizing), uncertainty (apprehension and poor communication), sources of psychosocial support (caring family, healthcare professionals' support, and self-grieving), and resilience (optimism, positive thinking, and spirituality).

Conclusions
The findings of this study indicate the need to integrate psychosocial and mental healthcare services into healthcare plans provided to individuals with COVID-19 and similar pandemic infections.
The Department of Veterans’ Affairs Depleted Uranium Cohort in the Time of COVID-19
Authors: McDiarmid Melissa A. , Hines Stella , Cloeren Marianne , Gucer Patricia , Condon Marian , Oliver Marc , Roth Tracy , Lewin-Smith Michael R. , Strathmann Frederick , Velez-Quinones Maria A. , Gaitens Joanna M. 
Published: May 2023

Objective
In 2021, 37 members of a cohort of depleted uranium-exposed Gulf War I veterans were evaluated using a protocol tailored to accommodate COVID-19 safety practices on a telehealth platform.

Methods
Individual elements of the legacy protocol were reviewed for urgency and feasibility of inclusion in a modified, telehealth platform.

Results
The redesigned protocol included a participant readiness for telehealth assessment, nurse and physician telehealth visits, collection of usual health questionnaires, and urine collections for exposure monitoring for uranium and other fragment-related metal measures.

Conclusions
Despite some limitations in scope, the telehealth platform permitted a visual “visit” with surveillance participants who expressed a high comfort level with the format. The telehealth platform has apparent utility for occupational surveillance and should be explored as a standard approach for surveillance outside of public health emergencies.
Absenteeism Due to Mental Disorders in Agents Fighting Endemic Diseases in Ceará/Northeast Brazil
Authors: Bastos Maria Luiza Almeida , Silva de Carvalho Thalyta Gleyane , Mattos Lacerda Eliana , Monteiro Ferreira Marcelo José 
Published: May 2023

Objective
The purpose of this study is to quantify the days away from work by mental disorders (MDs) in endemic fighting agents (EFAs) in the state in Northeast Brazil.

Methods
This is a historical cohort carried out from the survey of 584 expert medical records of EFA. The association measures were performed using Poisson regression models.

Results
The days away from work increased over time. Endemic fighting agents who have been on sick leaves by mood disorders ([cumulative incidence like relative risk (IRR)], 21.37; 95% CI, 12.36–36.93), alcoholism (IRR, 17.12; 95% CI, 10.04–29.34), and stress-related disorders (IRR, 10.32; 95% CI, 6.05–17.63) have a higher risk of absenteeism longer than 15 days.

Conclusion
This study reinforces the importance of actions for coping with MD in EFA.
The Effectiveness of the DeskCycle in Reducing Sedentary Behavior Among Female Office Workers
Authors: Odhiambo Lorriane A. , Marion Alexander J. , Callihan Thomas R. , Harmatz Alison E. , Yala Joy A. , Bundy Kristina , Zullo Melissa D. 
Published: May 2023

ObjectiveTo evaluate the effectiveness of the DeskCycle in reducing sedentary behavior among female office workers at an educational institution.MethodsThis was a randomized control trial with a crossover design (N = 80). The intervention was conducted in two 8-week phases and included the DeskCycle and an informational handout with benefits and suggestions about the frequency of use. The primary outcome was weekly average nonsedentary time. Secondary outcomes included weight and mood.ResultsDeskCycle users reported significantly higher weekly average nonsedentary time compared with nonusers (phase I: 402.3 ± 72.4 vs 169.3 ± 17.5,P< 0.00; phase II: 282 ± 45 vs 216 ± 23,P= 0.00). There were no significant differences in weight or mood.ConclusionsThe DeskCycle is effective in reducing sedentary behavior, suggesting workers in sedentary office occupations could integrate it into their workday, where possible, to prevent negative health outcomes.
Residual or recurrent obstruction after septal myectomy in young children and infants with hypertrophic cardiomyopathy: cohort study
Authors: Dong Shuo , Du Chuhao , Song Jiangping , Dong Jie , Meng Hong , Xu Haitao , Sun Yangxue , Zou Mengxuan , Li Shoujun , Yan Jun 
Published: May 2023

Background:
The outcomes after septal myectomy in young children and infants with hypertrophic obstructive cardiomyopathy (HOCM) are not clear. The study sought to report the outcomes after septal myectomy in young children and infants and identify the mechanisms of residual or recurrent obstruction after surgery.

Methods:
The authors performed an observational cohort study of children and infants under the age of 14 who underwent septal myectomy for HCOM from January 2013 to December 2020. Mean follow-up among 94.3% (n=50) of hospital survivors was 42.09±24.38 months.

Results:
In total, 56 children and infants [mean (SD) age, 5.38 (3.78) years; 29 (58.1%) were male] underwent septal myectomy for HOCM. Cumulative survival was 100, 96.6, 93.0, and 81.4% at 1, 3, 5, and 7 years, respectively, among hospital survivors. The incidence of residual and recurrent obstruction was 14.3% (8/56) and 13.0% (6/46), respectively. The mechanisms of residual obstruction were identified as subaortic obstruction caused by inadequacy of previous septal excision in two patients, midventricular obstruction caused by inadequacy of septal excision in five patients, and untreated abnormal papillary muscles in one patient. Recurrent obstruction was caused by isolated midventricular obstruction (n=4) and newly emerged systolic anterior motion (SAM)-related subaortic obstruction combining abnormal mitral valve apparatus (n=2). Residual or recurrent obstruction was associated with age less than 2 years at surgery (OR=6.157, 95% CI: 1.487–25.487, P=0.012) and biventricular outflow obstruction (OR=6.139, 95% CI: 1.292–29.172, P=0.022). Recurrent obstruction was associated with age less than 2 years at surgery (OR=6.976, 95% CI: 1.233–39.466, P=0.028).

Conclusions:
Septal myectomy is still effective and safe in young children and infants. The rate of residual or recurrent obstruction with diverse causes is relatively high, which is more likely to occur in children aged less than 2 years at surgery and those with biventricular obstruction.
Professional Development for Associated Faculty: A National Assessment of Available Resources
Authors: Bilyeu Catherine , Niski Jessica , Reilly Michelle 
Published: May 2023

Introduction.
Faculty development has been identified as an important initiative in Doctor of Physical Therapy (DPT) education. However, little is known about opportunities available for associated faculty (AF). These unique educators who make notable contributions to physical therapist education often lack formal preparation for teaching. The purpose of this study was to explore AF development opportunities across physical therapist education programs nationally.

Review of Literature.
Formal faculty development programs have been successful in medical and nursing education programs to enhance educator identity, skill, and retention in both core and clinical faculty. No evidence of faculty development programs for AF in physical therapy education was found in the literature.

Subjects.
Participants were program directors or identified faculty development leads from CAPTE accredited and in-candidacy physical therapist education programs. Seventy participants completed an anonymous survey and 10 participated in semistructured interviews following the completion of the survey.

Methods.
A parallel, convergent, mixed methods approach was used to assess the national state of formal AF development opportunities. A survey was developed to assess development opportunities available to AF. Descriptive statistics and Chi square analyses were performed to analyze quantitative data. An instrumental collective case study further explored development opportunities. Deductive and inductive thematic analysis techniques were used to analyze qualitative data from interview transcripts. Quantitative and qualitative approaches were integrated in the data analysis.

Results.
Survey data, aligned with interview outcomes, suggest that despite ideologic support for faculty development, low percentages of AF have access to formal development activities, and even fewer are receiving adequate breadth of educational content related to proficiency in their role.

Discussion and Conclusion.
A lack of formal development opportunities exists for AF. Excellence in DPT education requires deeper development across all levels of faculty, including opportunities tailored specifically to the unique needs and role of AF.
Massive spontaneous portosystemic shunt is a solid, easily identifiable prognostic factor in patients with cirrhosis
Authors: García-Villarreal Luis , Ortega-Quevedo Vanesa , Pérez-Aguado Guillermo , Saavedra-Santana Pedro , Quiñones Ildefonso , Chang WooRym , Hernández-Socorro Carmen R. , Cabrera-Cabrera Juan 
Published: May 2023

Objectives
Spontaneous portosystemic shunts (SPSSs) are associated with complications and death in cirrhosis. We evaluated chronic portosystemic encephalopathy (CPSE) and survival in cirrhotic patients with massive (>10 mm diameter) SPSS (MSPSS).

Methods
We have retrospectively compared 77 cirrhotic patients with MSPSS and 77 paired-matched patients without SPSS.

Results
More patients with MSPSS presented with CPSE (40.3% vs. 20.8%, P = 0.010) or died (33.8% vs. 18.2%, P = 0.039). Model for Endstage Liver Disease (MELD) score [hazard ratio (HR) 1.146, 95% confidence interval (CI) 1.099–1.195], follow-up (FU) ascites (HR 5.128, 95% CI 2.396–10.973) and age (HR 1.048, 95% CI 1.017–1.080) were associated with CPSE; and MELD score (HR 1.082, 95% CI 1.035–1.131), FU renal failure (HR 9.319, 95% CI 3.595–24.158), and FU ascites (HR 4.320, 95% CI 1.615–11.555) were associated with death. Liver function worsened faster in the MSPSS group. Among patients with better liver function (MELD < 11.5), MSPSS patients presented worse survival (P = 0.048, Breslow test). Comparing patients by the Child-Pugh group, we did not find differences in survival; in patients from Child-Pugh group B + C, the MSPSS group presented less time free of CPSE (P < 0.05, log-rank test). Patients with splenorenal MSPSS presented better survival (P = 0.04, log-rank test), and patients with umbilical MSPSS had shorter time free of CPSE (P < 0.016, log-rank test).

Conclusion
MSPSS increased CPSE and death risks during long FU. Even with better liver function (MELD < 11.5), MSPSS was associated with lower survival. Splenorenal MSPSS presented better survival and the umbilical type was associated with shorter time free of CPSE.
In-home Visits and Subsequent Health Outcomes in Medicare Advantage Beneficiaries With Coronary Artery Disease, Diabetes, Hypertension, and Depression
Authors: Smolderen Kim G. , Heath Kevin , Ameli Omid , Spencer Donna , Natwick Tanya , Musich Shirley , Miedico Tania M. , Mena-Hurtado Carlos 
Published: May 2023

Background:
Coronary artery disease, diabetes, hypertension, and depression are common burdensome conditions.

Objectives:
To examine whether multidimensional preventive in-home visits were associated with fewer emergency and inpatient care episodes and higher quality of care.

Research Design:
An observational, retrospective data analysis.

Subjects:
A nationwide Medicare Advantage population from the Optum Labs Data Warehouse.

Measures:
We compared beneficiaries with 1 or more of the conditions with an in-home visit in 2018 (“Exposure”) with those without a visit in 2018 but with a future visit in 2019 (“Wait List Control”) using a difference-in-differences analysis. Primary outcomes were 1-year all-cause inpatient care and emergency visit counts. Secondary outcomes included primary care visits, major adverse cardiovascular events, and select quality-of-care metrics. An exploratory outcome was the time-to-first primary care visit after the index date.

Results:
Among those eligible to receive an in-home visit, a total of 48,566 patients had an in-home visit in 2018 (the “Exposure” group), and 36,549 beneficiaries constituted the “Wait List” control group. Receiving an in-home visit early was associated with a greater decrease in inpatient stays for all 4 conditions (change score range for any stay: −5.22% to −2.47%) (P<0.001, depression <0.05); decrease in emergency visits (change score range for any stay: −4.39% to −3.67%) (P<0.0.001, depression <0.05); and fewer major adverse cardiovascular events for coronary artery disease and depression (P<0.001 and <0.025, respectively) 1 year later. Minimal differences were noted for change in ambulatory and primary care visits, with no consistent increase in quality-of-care metrics. Time-to-first primary care visit was shorter for the “Exposure” versus the Wait List control group in all conditions (difference between 2.45 and 4.95 d).

Conclusions:
The feasibility and impact of a nationwide multidimensional preventive in-home visit were demonstrated, targeting common and high morbidity conditions. Benefits were observed against a Wait List control group, resulting in less resource-intense care.