bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Unite behind the Science!’ Climate movements’ use of scientific evidence in narratives on socio-ecological futures
Authors: Rödder Simone , Pavenstädt Christopher Niklas 
Published: August 2022

AbstractFollowing Greta Thunberg’s school strike in Stockholm in August 2018 and the October 2018 ‘declaration of rebellion’ by activists in the UK, 2019 saw several climate protest movements rise to public attention, including Fridays for Future (FFF), Extinction Rebellion (XR), and the US Sunrise Movement. What is striking about them is that they rather bluntly refer to science in their campaigns. In this paper, we present an in-depth and comparative study of how the new climate protest movements relate to scientific evidence. Employing a narrative analysis of different types of data (websites, press releases, and media coverage), we study the movements’ understandings of ‘the science’ as well as of science’s role in policy processes. We find that the movements in their initial phase predominantly rely on science for their legitimation and adopt a scientific worldview with very little ‘green ambivalence’. Notably, FFF and XR hold a deficit model of existing climate communication and enact roles as science communicators.
Gastrointestinal involvement in systemic sclerosis: pathogenesis, assessment and treatment
Authors: Volkmann Elizabeth R. , McMahan Zsuzsanna 
Published: August 2022

Purpose of review
The majority of patients with systemic sclerosis (SSc) will experience involvement of their gastrointestinal over the course of their disease. Despite the high prevalence of gastrointestinal involvement in SSc, the strategies pertaining to the assessment and treatment for this clinical dimension of SSc have historically been limited. However, the present review highlights recent research contributions that enhance our understanding of SSc-GI patient subsets and provides updates on pathogenic mechanisms of disease, assessment and symptom-directed management.

Recent findings
In the past few years, several studies have identified risk factors for more severe gastrointestinal disease in SSc and have provided insight to optimize diagnosis and management of SSc-GI symptoms. This article also provides a review of currently available investigations and therapies for individual SSc-GI disease manifestations and reflects on actively evolving areas of research, including our understanding the role of the gut microbiome in SSc.

Summary
Here, we provide important updates pertaining to the risk stratification, assessment, diagnosis and management of SSc patients with gastrointestinal symptoms. These findings provide opportunities to enhance patient care and highlight exciting opportunities for future research.
Negative Pressure Wound Therapy With Instillation: An Adjunctive Therapy for Infection Management in Orthopaedic Trauma
Authors: Kim Paul 
Published: August 2022

Summary:
Negative Pressure Wound Therapy with Instillation is a device that provides the benefits of standard negative pressure wound therapy and instillation of a topical wound solution. This combination can benefit acute and chronic wounds by continuously cleansing the wound and providing soft tissue stability between staged operations or in preparation for a single procedure. Although skeletal stability is important in orthopaedic trauma, the overlying soft tissue envelop may also be compromised, which can lead to contamination and infection. This review will discuss the growing body of evidence for the use of negative pressure wound therapy with instillation with a focus on infection and recommendations for its proper use.
Negative Pressure Wound Therapy With Instillation-Dwell in Orthopaedic Trauma: How to Avoid Leaks and Frustration
Authors: Duda Marcus , Kim Paul 
Published: August 2022

Summary:
Negative pressure wound therapy with instillation-dwell (NPWTi-d) is the natural evolution of NPWT. This therapy combines the benefits of instillation with negative pressure. Advancements in the drape and the foam dressing has further advanced the utility of this therapy for use in orthopaedic trauma wounds. The technique for drape application plays an important role in maximizing the benefits of NPWTi-d. This article provides tips and guidance to ensure a proper dressing seal and other helpful instructions to maximize the benefits of NPWTi-d.
Tibial Tuberosity Fracture: A Highly Selective Injury
Authors: Badin Daniel , Raad Micheal , Sponseller Paul D. 
Published: August 2022

Background:
Tibial tuberosity fracture (TTF) is an uncommon injury occurring mostly in adolescents. The association between race and TTF has not been investigated. We aimed to determine whether there is an association between race and hospital admission for pediatric TTF and to evaluate previously determined risk factors for TTF using a large sample.

Methods:
This was a cross-sectional analysis of the Agency for Healthcare Research and Quality/Healthcare Cost and Utilization Project 2016 Kids’ Inpatient Database (KID). We compared admissions for TTF to admissions for all other diagnoses. Because forearm fracture has not been found to be associated with race, univariate and multivariate analyses comparing admissions for TTF to admissions for forearm fracture were also performed. Sample weights were used to preserve national estimates.

Results:
Of 692 patients admitted for TTF in 2016, 93.2% were male. Factors associated with TTF admission compared with other admission diagnoses on multivariate analysis included male sex (adjusted odds ratio (aOR) 17.67, confidence interval (CI) 12.25-25.47), age 13 to15 (aOR 10.33, CI 5.67-18.82, reference: age 8-12), and black (aOR 8.04, CI 3.91-16.49) and Hispanic (aOR 2.69, 95% CI 1.30-5.55) races/ethnicities (reference: Caucasian). Compared with forearm fracture admission, black race had an aOR of 22.05 (CI 10.08-48.21) for TTF admission on multivariate analysis. The effect of race on TTF admission also varied significantly with age, with 12 years carrying the strongest association of black race with TTF admission.

Conclusion:
Black race is a previously unreported, strong independent risk factor for TTF. Male sex and age 13 to 15 are also strong risk factors for TTF, making this a highly selective fracture.

Level of Evidence:
Prognostic Level III.
Immunization for midlife women
Authors: Brown Vivien 
Published: August 2022

Abstract

Objective
Menopause occurs at a critical juncture in life when preventative health care can have a major impact. However, recommendations for immunizations are often neglected, leading to unnecessary morbidity and mortality in aging women. The aim of this review is to highlight the importance of immunization checkpoints at menopause to optimize the quality of care and health maintenance in older women and to provide an overview of the impact of immunizations on women's health.

Methods
This is an opinion article based on the current US and Canadian guidelines. A review of various guidelines from the Centers for Disease Control and Prevention and National Advisory Committee on Immunizations were conducted for each vaccine.

Results and Conclusions
Disease prevention benefits are well established for several diseases, such as hepatitis A, hepatitis B, tetanus, human papillomavirus, streptococcus pneumonia, shingles, and COVID-19. During clinical encounters, a needs assessment regarding vaccinations should be conducted. However, barriers to adult vaccination including lack of patient and provider knowledge about the need for vaccination, lack of priority for preventive services, and concerns regarding costs, insurance coverage, and reimbursement all contribute to the adult immunization gap. Given the importance of immunization and the need to decrease vaccine-preventable diseases, it is the obligation of healthcare practitioners to recommend vaccines and provide education on vaccination guidelines and associated risks. As women often seek medical attention at menopause because of changes in their physiology that require attention, it is the ideal time to discuss the importance of immunization.
The Effect of a Self-Management Program on Care Burden and Self-Efficacy in Family Caregivers of People With Multiple Sclerosis
Authors: BANITALEBI Soheila , ETEMADIFAR Shahram , KHEIRI Soleiman , MASOUDI Reza 
Published: August 2022

ABSTRACT

Background
Family caregivers of patients with multiple sclerosis (MS) face many caring-related problems that increase their care burden and decrease their self-efficacy. Evidence-based self-management interventions may be used to improve care processes and resolve caregiver concerns.

Purpose
The aim of this study was to investigate the effect of a self-management program on care burden and self-efficacy in family caregivers of people with MS.

Methods
This study was performed in Iran in 2018–2019. The participants were selected using convenience sampling and assigned to control and intervention groups of 35 participants each using stratified randomization by gender. The intervention group participated in an eight-session self-management program. Data were collected using the Zarit Burden Interview and Scherrer Self-efficacy Questionnaire. Data were analyzed using descriptive and inferential statistics in SPSS Version 16.

Results
No significant difference in care burden scores was found between the two groups at baseline (p = .953). However, mean scores for care burden in the intervention group were significantly higher (p < .001) both immediately after completion of the intervention (42.6 ± 3) and at 3 months after completion of the intervention (36 ± 3), with the most significant improvement found immediately after the intervention. Similarly, no significant difference in self-efficacy scores was found between the groups at baseline (p = .976). However, mean scores for self-efficacy in the intervention group were significantly higher (p < .001) both immediately after and at 3 months after completion of the intervention (60.6 ± 4.7 and 72.7 ± 4, respectively), with the most significant improvement found at 3 months postintervention.

Conclusions/Implications for Practice
Providing self-management programs to caregivers of people with MS is an effective approach to reducing their burden of care and increasing their self-efficacy. Enhancing self-management by learning adaptation skills, self-care skills, social support, and spiritual support promote improved self-efficacy and reduce the care burden of these caregivers.
Recurrent Dysplasia After a Loop Electrosurgical Excision Procedure: Local Versus General Anesthesia
Authors: Tzur Yossi , Berkovitz-Shperling Roza , Laskov Ido , Grisaru Dan , Michaan Nadav 
Published: August 2022

Objective
This study aimed to compare the rates of positive specimen margins and postconization recurrent dysplasia between loop electrosurgical excision procedures (LEEPs) performed under general anesthesia (GA) and LEEP under local anesthesia (LA).

Methods
This retrospective cohort study included all consecutive women who underwent LEEP between 2011 and 2019. Collected data included demographics, LEEP indication, cone dimensions, and margin involvement as well as recurrence rate. Women who had undergone previous conization, cold-knife conization, or those who were lost to follow-up during the first 2 years after the procedure were excluded.

Results
Overall, 71 women who underwent LEEP under GA and 75 women under LA were included. Demographic characteristics were similar between the groups, as were the rates of preceding abnormal cytology and high-grade dysplasia before conization. Although cone depth and volume were higher for LEEP specimens done under GA compared with LA, the rate of positive specimen margins was comparable both for the endocervical margin (16/71 [22.5%] vs 16/75 [21.3%], respectively; p = .861) and the ectocervical margin (14/71 [19.7%] vs 11/75 [14.7%], respectively; p = .418). During the first 2 years after conization, the rates of high-grade dysplasia (cervical intraepithelial neoplasia ≥ 2) in repeat biopsy and the need for repeat conization were also not significantly different between the GA and LA groups (4.2% vs 1.3%, p = .356; 7.0% vs 9.3%, p = .614, respectively).

Conclusions
Anesthesia mode does not seem to affect the rate of positive LEEP margins and the need for repeat conization. Our study findings suggest that LA should be preferred instead of GA in LEEP.
Moderating the Relationship Between Ulcerative Colitis and Crohn’s Disease and Symptoms of PTSD
Authors: Fuss Alexandra , Lease Suzanne 
Published: August 2022

Goals:
This study examined whether inflammatory bowel disease (IBD) patients endorse clinically significant symptoms of post-traumatic stress disorder (PTSD), and tested whether remission status and remission expectations effectively moderate the relationship between endorsements of PTSD symptoms and aspects of IBD.

Background Study:
The enduring somatic threat model speaks to the presentation of symptoms of trauma that result from ongoing somatic concerns rather than discrete external events. Literature shows patients living with acute conditions experience symptoms of PTSD; however, few studies extend this to the IBD population. In addition, literature suggests remission may serve as a protective factor for the impact of IBD; as such, aspects of remission may serve as moderators in the relationship between aspects of IBD and PTSD symptoms.

Results:
Among a sample of adults with IBD, results showed that 32.8% of participants met the established cutoff for PTSD symptoms warranting further diagnostic evaluation. The findings further showed several aspects of remission moderated the relationship between multiple distinct IBD related concerns and PTSD symptoms.

Conclusions:
Given the results of this study, it would be beneficial for providers to maintain awareness of the potential impact of PTSD symptoms, including the ways in which these symptoms may influence patient engagement/presentation. Ultimately, these results inform efforts to continue appropriate referral to mental health professionals for follow up.
Optimizing Care Teams by Leveraging Advanced Practice Providers Through Strategic Workforce Planning
Authors: Kuriakose Clair , Stringer Meredith , Ziegler Amy , Hsieh Chuyun , Atashroo Megan , Hendershott Joan , Tippett Vicki , Shah Deepa , Cianfichi Lisa , Katznelson Laurence , Mahoney Megan 
Published: August 2022

INTRODUCTION
Advanced practice providers (APPs) are integral members of the healthcare delivery team. However, there has been a lack of standardization and uniformity in how they are utilized across inpatient, ambulatory, and procedural settings.

METHODS
A multidisciplinary workforce planning committee was formed in March 2021 to evaluate all new and replacement full-time equivalent APP positions at Stanford Health Care (SHC), an academic medical center of more than 600 APPs, to optimize and standardize the role of APPs as per national benchmarks.

RESULTS
Six months since the launch of the committee, there has been a 10% increase in the number of visits and procedures performed by APPs providing better access for patients. In addition, there has been a 38.7% improvement in ambulatory APPs meeting their productivity target, 19.4% improvement in ambulatory APPs meeting utilization targets, and 36.8% improvement in ambulatory APPs meeting the 50th percentile and above as per the relative value unit benchmark published by the Medical Group Management Association for Academic Medical Centers. For inpatient APPs, there has been a 38.8% improvement in APPs meeting the average daily census target.

DISCUSSION
APP utilization is an important topic that has not been consistently addressed in the literature. Inappropriate utilization and lack of top of licensure practice have been associated with increased turnover, decreased job satisfaction, and professional development. By developing a multidisciplinary workforce planning committee, full-time employee positions are evaluated with a goal of optimizing and standardizing the role of APPs at SHC.
Psychometric Evaluation of The Irritability Scale-Initial Version in Chinese Cancer Patients
Authors: Zhang Amy Y. , Tang Lili , Ganocy Stephen , Chung Min-Huey , Chang Wen-Pei 
Published: August 2022

Abstract

Background
Irritability is a common experience of depressed Chinese patients but is understudied and poorly measured.

Objective
We aimed to assess psychometric properties of a new measure of irritability in Chinese cancer patients across the social and political spectrum.

Methods
The Irritability Scale-Initial Version (TISi) was translated into Chinese and tested in two samples of Chinese cancer patients undergoing treatments: 52 patients in Beijing, China, between 2018 and 2019 and 65 patients in Taipei, Taiwan, in 2020.

Results
The Chinese version of TISi demonstrated high internal consistency, high reliability based on the split-half method in the two samples, and satisfactory discriminant validity using the Chinese version of the 17-item Hamilton Rating Scale for Depression and the 7-item depression subscale of the Hospital Anxiety and Depression Scale in the Beijing sample. A confirmatory factor analysis produced factor loadings in both samples, which resembled a sample of American cancer patients. Three TISi items were loaded more highly on the physical instead of the original behavioral subscale in the Beijing sample. A possible influence of cultures was explained.

Conclusion
The Chinese version of TISi has satisfactory psychometric properties for assessing the level of irritability in Chinese cancer patients. Future large-sample studies are needed to further determine TISi’s factorial structure, test–retest reliability, sensitivity to change, and predictive validity for depression in Chinese cancer patients.
Pediatric injury trends and relationships with social vulnerability during the COVID-19 pandemic: A multi-institutional analysis
Authors: Flynn-O'Brien Katherine T. , Collings Amelia T. , Farazi Manzur , Fallat Mary E. , Minneci Peter C. , Speck K. Elizabeth , Van Arendonk Kyle , Deans Katherine J. , Falcone Richard A. , Foley David S. , Fraser Jason D. , Gadepalli Samir , Keller Martin S. , Kotagal Meera , Landman Matthew P. , Leys Charles M. , Markel Troy A. , Rubalcava Nathan , St. Peter Shawn D. , Sato Thomas T. ,   On behalf of the Midwest Pediatric Surgery Consortium
Published: August 2022

BACKGROUND
The impact of the COVID-19 pandemic on pediatric injury, particularly relative to a community's vulnerability, is unknown. The objective of this study was to describe the change in pediatric injury during the first 6 months of the COVID-19 pandemic compared with prior years, focusing on intentional injury relative to the social vulnerability index (SVI).

METHODS
All patients younger than 18 years meeting inclusion criteria for the National Trauma Data Bank between January 1, 2016, and September 30, 2020, at nine Level I pediatric trauma centers were included. The COVID cohort (children injured in the first 6 months of the pandemic) was compared with an averaged historical cohort (corresponding dates, 2016–2019). Demographic and injury characteristics and hospital-based outcomes were compared. Multivariable logistic regression was used to estimate the adjusted odds of intentional injury associated with SVI, moderated by exposure to the pandemic. Interrupted time series analysis with autoregressive integrated moving average modeling was used to predict expected injury patterns. Volume trends and observed versus expected rates of injury were analyzed.

RESULTS
There were 47,385 patients that met inclusion criteria, with 8,991 treated in 2020 and 38,394 treated in 2016 to 2019. The COVID cohort included 7,068 patients and the averaged historical cohort included 5,891 patients (SD, 472), indicating a 20% increase in pediatric injury (p = 0.031). Penetrating injuries increased (722 [10.2%] COVID vs. 421 [8.0%] historical; p < 0.001), specifically firearm injuries (163 [2.3%] COVID vs. 105 [1.8%] historical; p = 0.043). Bicycle collisions (505 [26.3%] COVID vs. 261 [18.2%] historical; p < 0.001) and collisions on other land transportation (e.g., all-terrain vehicles) (525 [27.3%] COVID vs. 280 [19.5%] historical; p < 0.001) also increased. Overall, SVI was associated with intentional injury (odds ratio, 7.9; 95% confidence interval, 6.5–9.8), a relationship which increased during the pandemic.

CONCLUSION
Pediatric injury increased during the pandemic across multiple sites and states. The relationship between increased vulnerability and intentional injury increased during the pandemic.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Mandrake: visualizing microbial population structure by embedding millions of genomes into a low-dimensional representation
Authors: Lees John A. , Tonkin-Hill Gerry , Yang Zhirong , Corander Jukka 
Published: August 2022

In less than a decade, population genomics of microbes has progressed from the effort of sequencing dozens of strains to thousands, or even tens of thousands of strains in a single study. There are now hundreds of thousands of genomes available even for a single bacterial species, and the number of genomes is expected to continue to increase at an accelerated pace given the advances in sequencing technology and widespread genomic surveillance initiatives. This explosion of data calls for innovative methods to enable rapid exploration of the structure of a population based on different data modalities, such as multiple sequence alignments, assemblies and estimates of gene content across different genomes. Here, we present Mandrake, an efficient implementation of a dimensional reduction method tailored for the needs of large-scale population genomics. Mandrake is capable of visualizing population structure from millions of whole genomes, and we illustrate its usefulness with several datasets representing major pathogens. Our method is freely available both as an analysis pipeline (https://github.com/johnlees/mandrake) and as a browser-based interactive application (https://gtonkinhill.github.io/mandrake-web/).This article is part of a discussion meeting issue ‘Genomic population structures of microbial pathogens’.
Physical activity, balance, and bicycling in older adults
Authors: Baughn Maya , Arellano Victor , King Greg , Lightner Joseph S. , Grimes Amanda R. , Hawthorne-Crosby Brieanna 
Published: August 2022

AbstractFalls are a critical public health issue among older adults. One notable factor contributing to falls in older adults is a deterioration of the structures supporting balance and overall balance control. Preliminary evidence suggests older adults who ride a bicycle have better balance than those who do not. Cycling may be an effective intervention to prevent falls among older adults. This study aims to objectively measure the relationship between bicycling, physical activity, and balance for older adults. Older adult cyclists (n=19) and non-cyclists (n=27) were recruited to (1) complete a survey that assessed demographics; (2) wear an accelerometer for 3 weeks to objectively assess physical activity; and (3) complete balance-related tasks on force platforms. Mann-Whitney U-tests were performed to understand differences in balance and physical activity between cyclists and non-cyclists. Cyclists are significantly more physically than non-cyclists (U = 102.00, p = .015; U = 81.00, p=.002). Cyclists had less sway velocity in eyes open conditions than non-cyclists (U = 360.00, p=.009), indicating a more tightly regulated postural control strategy that may relate to higher stability in cyclists. Task duration among cyclists in single-leg stand was longer than non-cyclists (left leg: p<.001 and right leg: p<.005) indicating increased postural stability. This study demonstrates the possible implications for cycling on balance and reducing fall risk.