bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effects of Cooling Time on the Dimensional Stability of Thermoforming Polypropylene
Authors: Ojeda Sersun David J. , Swafford Katie , Orosco Heather , Rodgers Chelsie , Davidson Michael , Bains Gurinder , Becerra Ben 
Published: March 2022

ABSTRACT

Introduction
Documented by the International Committee of the Red Cross, consolidation time for polypropylene (PP) plastic must be left on the plaster model for 24 hrs. If not followed, this will result in an incorrect shape and volume of PP plastic. To the best of our knowledge, there are no studies that address the comparison of PP plastic expansion at various time domains of plastic cooling after being thermoformed.
The purpose of this research was to compare plastic expansion or shrinkage and heat ratio (dimensional stability [DS]) of PP plastic through cooling periods of 6, 12, 18, and 24 hrs, respectively.

Materials and Methods
Forty-one identical plaster models were made. Vacuum was applied at times of 6, 12, 18, and 24 hrs, respectively. PP was cut and removed. Measurements were taken and recorded at initial times and after 24 hrs.

Results
DS was not significantly different across the four time groups of 6, 12, 18, and 24 hrs, respectively (P = 0.10). There was a statistically significant linear relationship between DS with room temperature (P = 0.01) and oven temperature (P = 0.04).

Conclusions
There is no scientific foundation to perform a 24-hr wait before finishing a device. This translates to an effective time frame for removing the plastic from the model, saving time and resources, quicker delivery to the patient, and improvement in whole patient care.

Clinical Relevance
This article has important implications for the O&P clinic. Creating more dimensionally stable PP devices faster translates to better fitting braces fabricated in a shorter time, thus benefiting patients and clinics and increasing the success rate when delivering this device.
Running During Pregnancy and Postpartum, Part B: How Does Running-Related Advice and Guidance Received During Pregnancy and Postpartum Affect Women's Running Habits?
Authors: Donnelly Gráinne M. , James Megan L. , Coltman Celeste E. , Brockwell Emma , Perkins Joanna , Moore Isabel S. 
Published: March 2022

Background:
Women are unsure about the suitability and safety of running when pregnant and postpartum, with advice from medical professionals often conflicting.

Aim:
To explore the exercise and running-related advice pregnant and postpartum women received and the impact it has on their running habits.

Study Design:
Observational, cross-sectional.

Methods:
A total of 883 postpartum women completed an online survey. Questions were developed using pregnancy exercise guidance and clinical postpartum running guidelines. Odds ratios (ORs) were used to assess associations between receiving prenatal advice and receiving postpartum advice, receiving prenatal advice and continuing to run through pregnancy and return-to-running postpartum and receiving broadly sourced running-related guidance.

Results:
Postpartum women who received prenatal exercise advice and broadly sourced postpartum running advice were 37% and 31%, respectively. Those who received prenatal advice were more likely to receive postpartum advice (OR: 1.78, 95% confidence interval [CI]: 1.33-2.38). Receiving exercise-related advice was not associated with continuing to run during pregnancy (OR: 1.17, CI: 0.89-1.54). Having returned to running postpartum was associated with receiving broadly sourced postpartum running-related guidance (OR: 2.19, CI: 1.45-3.32). Women who were aware of the return-to-running clinical guidelines took longer to return-to-running than those who were not aware [14 (10-20) vs 10 (6-16.5) weeks, respectively, U = 34 889, P < .001].

Conclusion:
Exercise and running guidance was only provided to a small proportion of women. To influence exercise habits and return-to-running, guidance needs to be individualized and specific to the needs of perinatal women.
Evaluating the Revised Work Rehabilitation Questionnaire in Cochlear Implant Users Cochlear Implant Outcome Assessment Based on the International Classification of Functioning, Disability, and Health (ICF)
Authors: Andries Ellen , Lorens Artur , Skarżyński Piotr Henryk , SkarZynski Henryk , Calvino Miryam , Gavilan Javier , Lassaletta Luis , Tavora-Vieira Dayse , Acharya Aanand , Kurz Anja , Hagen Rudolf , Anderson Ilona , Amann Edda , Van de Heyning Paul , Van Rompaey Vincent , Mertens Griet 
Published: March 2022

Objectives:
The 59-item Work Rehabilitation Questionnaire (WORQ) was developed based on the International Classification of Functioning, Disability and Health (ICF) core set for vocational rehabilitation to assess work related functioning. It was revised to include 17 questions, assigned to 14 ICF categories relevant to cochlear implant (CI) users. This cross-sectional multicenter study aimed to evaluate CI users’ responses on the WORQ questions to describe and generate ICF qualifiers for the revised WORQ in CI users, forming part of a broader framework of CI outcome measures linked to the ICF.

Methods:
One hundred seventy-seven adults over the age of 18 years with a minimum of one year's device experience were included in the analysis. The WORQ was completed by the participants at a routine visit to the clinic, via email, or via post.

Results:
Most of the CI users perceived no problem on the WORQ questions (53.7%-91%), finished secondary school (54.2%) or obtained a college or university degree (32.8%) and are either employed (41.2%) or retired (34.5%). CI users that are currently working mostly have a full-time position (34.5%). Subjects reported no problem (91%) with sensation of falling, while handling communication devices and techniques (10.9%) and tinnitus (9.6%) showed the highest number of subjects reporting a complete problem.

Conclusions:
Overall, most of the CI users experienced no impairment, restriction or limitation on the WORQ questions and their assigned ICF categories. Their education level resembles the education level of the general population and they seem to integrate or reintegrate well in professional life postoperatively.
Symptom Burden and Recovery in the First Year After Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Eriksson Linda Victoria , Holmberg Katarina , Lundh Hagelin Carina , Wengström Yvonne , Bergkvist Karin , Winterling Jeanette 
Published: March 2022

Background
Patients are affected by various symptoms after allogeneic hematopoietic stem cell transplantation (allo-HSCT) that can affect recovery. Research has mainly focused on symptom occurrence; thus, little is known about patients’ overall symptom burden.

Objective
The aim of this study was to examine patient-reported symptom burden in the first year after allo-HSCT and whether a high symptom burden 4 months after allo-HSCT predicts recovery, that is, general health and sick leave, 1 year after transplantation.

Methods
Allo-HSCT patients aged 18 to 65 years were included (n = 189). Questionnaire data were collected on admission to the allo-HSCT unit, as well as 4 and 7 months and 1 year after allo-HSCT. Logistic regression evaluated relationships between demographic characteristics, chronic graft-versus-host disease, physical activity, and a high symptom burden.

Results
Tiredness, susceptibility to infection, disinterest in sex, and physical weakness remained the most frequent symptoms, while distressing symptoms varied during the first year after allo-HSCT.
Poor general health 1 year after allo-HSCT was associated with older age, low physical activity, and a high symptom burden 4 months after allo-HSCT. Full-time sick leave 1 year after allo-HSCT was associated with chronic graft-versus-host disease, low physical activity, and a high symptom burden 4 months after transplantation.

Conclusions
Experiencing a high symptom burden 4 months after allo-HSCT can affect recovery 1 year after transplantation. Furthermore, low physical activity 4 months after allo-HSCT can predict both general health and sick leave 1 year after transplantation.

Implications for Practice
Repeated symptom assessment, including experienced distress, is central for reducing overall symptom burden and supporting recovery after allo-HSCT.
Exploring Clinicians’ Perspectives of Barriers to Chemotherapy-Induced Peripheral Neuropathy Assessment and Management in Oncology Practice
Authors: Knoerl Robert , Wallar Jessica , Fox Erica , Hong Fangxin , Salehi Elahe , McCleary Nadine , Ligibel Jennifer A. , Reyes Kaitlen , Berry Donna L. 
Published: March 2022

Background
Quantitative reports suggest that the assessment and management of chemotherapy-induced peripheral neuropathy (CIPN) in practice is suboptimal.

Objective
The purpose of this qualitative analysis was to explore clinician-related perspectives of CIPN assessment, management, and the use of a CIPN decision support tool.

Methods
Clinicians from the breast oncology, gastrointestinal oncology, or multiple myeloma disease centers at Dana-Farber Cancer Institute who interacted with a CIPN clinician decision support algorithm were eligible to participate in the semi-structured interviews. The interview guide included questions about CIPN assessment, management, and clinician-decision support tool use. All interviews were audio-recorded, transcribed, and analyzed using inductive content analysis.

Results
Of the 39 eligible clinicians, 15 agreed to be interviewed. Interviewed clinicians were mainly physicians (73.3) and White, non-Hispanic (93.3%). Main themes from the interviews included (1) CIPN management practice patterns (eg, endorsement of non-recommended management strategies or lack of standardization for chemotherapy dose reduction) and barriers (eg, insurance prior authorizations required for duloxetine prescription), (2) CIPN assessment practice patterns (eg, use of subjective instead of objective CIPN assessment approaches) and barriers (eg, difficult to interpret patients’ CIPN report between visits), and (3) utilization of the clinician decision support tool (eg, all assessment tasks lead to same management options).

Conclusions
There are several barriers to clinicians’ use of evidence-based CIPN assessment and management strategies.

Implications for Practice
Future work should be focused on addressing barriers to duloxetine prescription, developing evidence-based CIPN assessment and management strategies, improving symptom monitoring, and facilitating referrals to existing supportive care services.
Retiring From Pediatric Emergency Medicine Too Soon?
Authors: Bansal Bharati Beatrix , Mathew Matthew Sunil , Booker-Nubie Quiera , Messiah Sarah E. , Wang Vincent J. 
Published: March 2022

Objective
Pediatric emergency medicine is a subspecialty known for high acuity, high stress, and variable scheduling that may be difficult to maintain as one gets older. This survey sought to gain information on the reasons or plans for early retirement in pediatric emergency medicine and offer ways to address these concerns to improve longevity in the field.

Methods
A cross-sectional survey was sent via email to board-certified pediatric emergency medicine physicians who were older than 50 years to assess preretirement and postretirement considerations. Results were collected from October 3, 2019, through March 15, 2020.

Results
Pediatric emergency medicine physicians who find it more difficult to perform simple procedures are 3.02 (1.23–7.36) times more likely to retire before the age of 66 years. In addition, women were significantly more likely to report an intention to retire before the age of 66 years versus men (50% vs 31%, P = 0.022).

Discussion
The topic of retirement in a field that requires a wide range of procedural skills as well as constantly evolving technology is important. Understanding when and why physicians choose to retire may identify strategies to make it possible for pediatric emergency medicine physicians to prolong their careers. This may involve changes in work hours, a shift in responsibilities to a greater educational or mentor role, and/or providing opportunities to maintain skills.

Conclusions
Perceived basic procedure skills deterioration significantly increased the risk for early retirement. In addition, women were significantly more likely to express intention to retire before the age of 66 years. Further research should be directed toward obtaining more detailed information to develop strategies to retain pediatric emergency medicine physicians in a capacity that benefits the physician, their institution, and their patients.
The chronic disease helplessness survey: developing and validating a better measure of helplessness for chronic conditions
Authors: Yessick Lindsey R. , Salomons Tim V. 
Published: March 2022

Abstract

Introduction:
Learned helplessness develops with prolonged exposure to uncontrollable stressors and is therefore germane to individuals living with pain or other poorly controlled chronic diseases. This study has developed a helplessness scale for chronic conditions distinct from previous scales that blur the conceptualization of control constructs. Extant measures commonly examine controllability, not the three pillars of helplessness identified by Maier and Seligman (1976): cognitive, emotional, and motivational/motor deficits.

Methods:
Individuals who self-report a chronic pain condition (N = 350) responded to a Chronic Disease Helplessness Survey (CDHS) constructed to capture cognitive, motivational/motor, and emotion deficits. Exploratory factor analysis (EFA; N = 200) and confirmatory factor analysis (CFA; N = 150) were performed. The CDHS was assessed for convergent and discriminant validity.

Results:
A three-factor solution corresponding to cognitive, emotional, and motivational/motor factors was identified by EFA. The solution exhibited sufficient model fit and each factor had a high degree of internal consistency. The CDHS was significantly associated with greater pain intensity and interference, PCS helplessness, lower perceived pain control, and lower general self-efficacy. Individuals with diabetes generally experience greater control strategies over daily symptoms (e.g., diet, oral medications, and insulin) than patients with chronic pain and in this study displayed significantly lower CDHS scores compared to individuals with chronic pain, demonstrating discriminant validity.

Conclusions:
This study provides preliminary evidence that the three-factor CDHS is a psychometrically sound measure of helplessness in individuals with chronic pain.
Safety of Mandibular Osteotomies in Infants with Pierre Robin Sequence: Computer-Aided Modeling to Characterize the Risks of Various Techniques
Authors: Siska Robert C. , Prabhu Shamit S. , Lor Lyfong S. , Emmerich Veronica , Massary Dominic , Pan Brian S. , Flores Roberto L. , Runyan Christopher M. 
Published: March 2022

Background:
Mandibular distraction osteogenesis is effective for the correction of severe tongue-based airway obstruction in infants with Pierre Robin sequence. Involved osteotomies may damage developing tooth buds and/or the inferior alveolar nerve. The authors evaluated the theoretical safety of various osteotomy techniques to better define infantile mandibular anatomy using computer-aided modeling.

Methods:
Seven mandibular osteotomy techniques (oblique, inverted-L, multiangular, walking stick, high oblique, vertical/high inverted-L, and horizontal) were simulated using computed tomography studies from infants with Pierre Robin sequence and without other associated conditions. Software was used to manually segment the mandibular bone, inferior alveolar nerve, and tooth buds.

Results:
Sixty-five computed tomography scans were included, yielding 130 hemimandibles. The horizontal osteotomy pattern had significantly lower theoretical risk of tooth bud (p < 0.001) and inferior alveolar nerve involvement (p < 0.001) than all other patterns. Osteotomies with high vertical components (i.e., vertical, walking stick, and multiangular) had lower theoretical tooth bud involvement than the more proximal oblique and inverted-L osteotomies (p < 0.001). Average lingula location was measured at a point 65 percent of the mandibular width from anterior mandibular border and 63 percent of the mandibular height from the inferior mandibular border.

Conclusions:
Surgical planning with computed tomography scans can help evaluate an infant’s mandibular anatomy to select an osteotomy that reduces morbidity risks. Regardless of technique, tooth buds and the inferior alveolar nerve are often included in osteotomies. The lingula location in this study demonstrates a position more superior and posterior than that previously described.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Buccal Fat Pad: Adjunctive Procedure for Lateral Defect Coverage following Primary Palatoplasty
Authors: Thanapaisal Chantaramon , Punyavong Pattama , Jenwitheesuk Kamonwan , Surakunprapha Palakorn , Winaikosol Kengkart 
Published: March 2022

Background:
The buccal fat flap is an encapsulated mass originating from a specific fat tissue that is easily accessed and richly vascularized. The aim of this study was to report the effect of using the buccal fat flap on the oronasal fistula rate in primary palatoplasty.

Methods:
A case-controlled study of 94 patients who underwent primary cleft palate repair. Patients were divided into two groups: (1) two-flap palatoplasty with buccal fat flap for coverage of lateral hard palate defect and (2) conventional two-flap palatoplasty. The incidence of oronasal fistula and postoperative complications were compared between groups. Multivariate analysis was performed to determine the risk factors of oronasal fistula development.

Result:
Forty-seven patients in each group demonstrated the same baseline characteristics. The buccal fat group showed a significant lower postoperative oronasal fistula rate (2.13 percent versus 21.28 percent, p = 0.008) and smaller fistula size (2 mm versus 4 mm, p = 0.049). A cleft width wider than 11.5 mm increased the odds ratio of fistula formation by 8.44-fold (p = 0.047), and the use of buccal fat protected against postoperative palatal fistula formation (OR, 0.08, p = 0.019).

Conclusion:
The use of buccal fat flaps for lateral hard palatal defect coverage in primary palatoplasty can reduce the rate of postoperative palatal fistula, especially in cases of wide palatal cleft.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Evolving patterns of antiretroviral drug interactions in people with HIV in British Columbia, Canada
Authors: Lepik Katherine J. , Wang Lu , Harris Marianne , McLinden Taylor , Guliani Sidhant , Akagi Linda , Toy Junine , Sereda Paul , Lima Viviane D. , Montaner Julio S.G. , Barrios Rolando 
Published: March 2022

Objectives:
To characterize the annual prevalence of antiretroviral/nonantiretroviral drug interactions in relation to antiretroviral therapy (ART)-prescribing patterns, and to describe drug interaction-related ART changes.

Design/methods:
This cohort study included ART-treated adults in British Columbia, Canada between 01 January 2010 and 31 December 2016. Medication dispensing records were abstracted from a population-based, linked administrative-health dataset and used to identify antiretroviral-comedication drug interactions (’caution’/’avoid’ drug interactions in HIV-focused drug interaction checkers). We identified temporal trends in annual drug interaction prevalence and quantified the association between taking higher drug interaction-risk ART and receiving nonrecommended antiretroviral-comedication combinations using Poisson regression models, modified for binary outcomes and correlated data. Clinician-reported, drug interaction-related ART changes and associated adverse events were abstracted from an HIV drug treatment registry and summarized descriptively.

Results:
Among 8571 ART-treated adults who received nonantiretroviral comedications, prevalence of having any drug interaction or receiving nonrecommended drug combination(s) significantly declined from 85 to 71% and 5.6 to 3.2%, respectively, between 2010 and 2016 (P < 0.001). This paralleled a shift from higher drug interaction-risk ART (e.g. ritonavir/cobicistat-boosted protease inhibitors) to lower drug interaction-risk ART (e.g. unboosted integrase inhibitors). Risk of receiving a nonrecommended antiretroviral-comedication combination was greater for persons taking higher vs. lower drug interaction-risk ART [adjusted risk ratio (aRR) 3.12, 95% confidence interval (CI) 2.24–4.35]. Boosted antiretroviral-inhaled corticosteroid drug interactions accounted for the most commonly dispensed, nonrecommended drug combinations, and the most commonly reported drug interaction-related adverse events (adrenal insufficiency).

Conclusion:
The prevalence of antiretroviral-comedication drug interactions is declining as ART shifts towards antiretrovirals with lower drug interaction potential but nonrecommended drug combinations remain a concern. Healthcare providers should screen for drug interactions whenever drugs are prescribed or dispensed.
Five-year Outcome of an Early Everolimus-based Quadruple Immunosuppression in Lung Transplant Recipients: Follow-up of the 4EVERLUNG Study
Authors: Kneidinger Nikolaus , Valtin Christina , Hettich Ina , Frye Björn Christian , Wald Alexandra , Wilkens Heinrike , Bessa Vasiliki , Gottlieb Jens 
Published: March 2022

Background.
Everolimus-based quadruple low calcineurin inhibitor (CNI) maintenance immunosuppression has been shown to be effective in preserving short-term renal function without compromising efficacy or safety after lung transplantation; however, long-term benefit remains unknown.

Methods.
An investigator-initiated 5-y follow-up analysis of the 4EVERLUNG study (NCT01404325), comparing everolimus-based quadruple low CNI with standard triple regimen, was performed. Patients who remained on the randomized drug regimen until the end of the 5-y observation were analyzed as the per protocol (PP) population. Patients in whom the assigned regimen was switched were analyzed as the intention-to-treat (ITT) population.

Results.
In total, 123 patients (95%) from the core study were analyzed. During the observation period in 11 patients (19%) of the standard triple regimen and in 30 patients (46%) of the quadruple low CNI regimen, the assigned immunosuppressive regimen was switched (P = 0.002). Estimated glomerular filtration rate at 5-y follow-up did not differ between the groups in both the ITT (56 [48–73] versus 58 [48–69] mL/min; P=0.951) and PP (59 [50–73] versus 59 [48–69] mL/min; P = 0.946) populations. Thromboembolic events occurred more frequently in the quadruple low CNI regimen (ITT: 11% versus 24%, P = 0.048; PP: 11% versus 22%, P = 0.162). There was a trend for a higher chronic lung allograft dysfunction–free survival for the quadruple low CNI regimen in the PP population (P = 0.082). No difference in the graft survival was found.

Conclusions.
Initiation of an early everolimus-based quadruple low CNI regimen may have no long-term benefit on renal function. The immunosuppressive efficacy and safety profile seems comparable with the standard triple regimen.