bluuebunny/crossref_metadata_2025 huggingface dataset:
Norms, Reasons, and Reasoning
Authors: Besson Corine
Published: July 2018

This chapter concerns the connection between knowledge of a logical principle, such as Modus Ponens, and actions of reasoning with it. Contemporary discussions of this issue typically mention Lewis Carroll’s regress. There is widespread agreement that the regress shows something important about the connection between knowing logical principles and reasoning with them—and, more generally, between knowing epistemic or practical principles and actions involving them. My first aim is to address key interpretations of Carroll’s regress in order to assess its relevance to the question of how knowing logical principles connects to reasoning with them, and, more generally, of how knowing epistemic or practical principles might be action-guiding. My second aim is to show that the regress fails to establish anything of substance about such connections unless substantive, contentious, and typically undefended assumptions are made.
Epistemic Reasons, Evidence, and Defeaters
Authors: Lord Errol
Published: July 2018

After Edmund Gettier’s “Is Justified True Belief Knowledge?”, epistemology was dominated by attempts to explain what is needed in order to make justified true belief knowledge. The post-Gettier literature contained many views that tried to solve the Gettier problem by appealing to the notion of defeat. Unfortunately, all of these views are false. The failure of these views greatly contributed to a general distrust of reasons in epistemology. However, reasons are making a comeback in epistemology, both in general and in the context of the Gettier problem. There are two main aims of this chapter. First, I will argue against a natural defeat-based resolution of the Gettier problem. Second, I will defend my own defeat-based solution. This solution appeals to a modal anti-luck condition. I will argue that this condition captures anti-luck intuitions, and has virtues that rival modal anti-luck conditions lack.
Reasons and Testimony
Authors: Goldberg Sanford
Published: July 2018

This chapter explores the nature of the sort of reason another’s say-so or testimony provides. The key question concerns the epistemic significance of S’s having testified that p. According to the reductionist view, the epistemic significance of another’s say-so is reduced to the epistemic significance of the audience’s reasons to think that say-so was reliable. Anti-reductionism, by contrast, holds that testimony that p stands by default, in a way analogous to S’s having perceived that p standing by default as a defeasible reason to believe that p. In this chapter I develop the case for each position, and the topic is connected to other issues at the heart of the epistemology of testimony.
Agent-Relative and Agent-Neutral Reasons
Authors: Bykvist Krister
Published: July 2018

The distinction between agent-relative and agent-neutral reasons, at least in its explicit form, is a fairly recent contribution to normative ethics. That the distinction is both well-defined and significant is often taken for granted in contemporary normative ethics. For example, it is supposed to help us characterize many aspects of common-sense morality, such as personal duties, and deontological restrictions or constraints. The main question of this chapter is whether there is a well-defined distinction between agent-relative and agent-neutral reasons that has this high level of significance. Is the distinction really “an extremely important one,” as Nagel said, or perhaps even one of “the greatest contributions of recent ethics,” as Tom Hurka suggests? A variety of accounts of this distinction is discussed and it is argued that none live up to this hype, at least if the distinction is supposed not to beg other important questions in normative ethics.
Reasons to Intend
Authors: Heuer Ulrike
Published: July 2018

Donald Davidson writes that “[r]easons for intending to do something are very much like reasons for action, indeed one might hold that they are exactly the same except for time.” That the reasons for forming an intention and the reasons for acting as intended are in some way related is a widely accepted claim. This chapter is concerned with exploring the claim that reasons to act provide reasons to intend and the various versions it can take, as well as the related question whether there can be reasons to intend of a different kind. The so-called “exclusivity claim” that only reasons to act provide reasons to intend has been much discussed recently, often in parallel to exclusivity claims concerning reasons for belief. Shah argues in favor of, and Schroeder and McHugh against, exclusivity, for instance. The chapter investigates this discussion in some detail.
Social Complexity and Political Capitals in Ancient Eurasia
Authors: Negus Cleary Michelle
Published: July 2018

This article draws upon archaeological evidence of settlement and enclosure sites as key indicators of social complexity in agro-pastoral societies of Central Asia and Inner Eurasia during the Late Iron Age–Late Antique periods. Large fortified enclosures (kalas) were the political capitals of mobile states and empires, embodying and displaying the power, status, and prestige of ruling elites. Low-density “urban” sites were located in dispersed settlement zones associated with rivers or water management systems in the Eurasian steppe and oases. These capitals were an alternative form of urbanism suited to the political organization of mobile ruling elites. This analysis provides insights into the varied modes of settlement utilized by agro-pastoral and mobile societies in extreme environmental zones.
School Counselors’ Perceptions of Necessary Attributes of Middle and High School Students Interested in a Career in Nursing
Authors: Williams Cheryl , Dickstein-Fischer Laurie
Published: July 2018

AIM

The focus of this study was to examine which attributes school counselors perceive as necessary for middle and high school students interested in a career in nursing.

BACKGROUND

School counselors play a pivotal role in secondary students’ career development but were found to have limited knowledge about the need for increased academic rigor in nursing.

METHOD

A national sample of 204 school counselors responded to a web-based survey that examined perceptions of necessary attributes of prospective nursing students.

RESULTS

This is the first national study to identify school counselors’ perceived attributes of prospective nursing students. Results included trustworthiness and caring; academic attributes ranked lower.

CONCLUSION

School counselors in this study perceived nursing as a caring profession but not necessarily an academic one. Early intervention in middle school may alter preconceived images of nursing as exclusively female and caring but also as a profession that requires much academic preparation.
Missed Nursing Care as a Quality Indicator During Transition to a Dedicated Education Unit Model
Authors: Jones Cynthia , Chesak Sherry , Forsyth Diane , Meiers Sonja
Published: July 2018

This pilot study compared the implementation of the innovative dedicated education unit (DEU) clinical model on quality of care with the traditional clinical model using missed nursing care as a quality indicator. A university and academic medical center partnered to conduct this quasiexperimental study, which is the first to use missed nursing care as a quality indicator when assessing transition to the DEU model. Evidence suggests that quality of care was maintained during DEU implementation.
Ondansetron for Treatment of Nausea and Vomiting of Pregnancy and the Risk of Specific Birth Defects
Authors: Parker Samantha E. , Van Bennekom Carla , Anderka Marlene , Mitchell Allen A. ,   for the National Birth Defects Prevention Study
Published: July 2018

OBJECTIVE:

To use data from two large studies of birth defects to describe time trends in ondansetron use for the treatment of first-trimester nausea and vomiting of pregnancy and to investigate associations, either previously reported or undescribed, between first-trimester ondansetron use and major birth defects.

METHODS:

We used data from two case–control studies, the National Birth Defects Prevention Study (1997–2011) and the Slone Birth Defects Study (1997–2014). The prevalence of ondansetron use for the treatment of first-trimester nausea and vomiting of pregnancy among control patients was calculated in 2-year intervals. Using women with untreated first-trimester nausea and vomiting of pregnancy as the reference, we calculated adjusted odds ratios (ORs) and 95% CIs for associations between first-trimester ondansetron use for treatment of nausea and vomiting of pregnancy and specific birth defects. A secondary exposure group of other prescription antiemetics was used to address confounding by indication.

RESULTS:

In the National Birth Defects Prevention Study and Slone Birth Defects Study, respectively, 6,751 and 5,873 control mothers and 14,667 and 8,533 case mothers who reported first-trimester nausea and vomiting of pregnancy were included in the analysis. Among women in the control group, ondansetron exposure increased from less than 1% before 2000 to 13% in 2013–2014. Ondansetron use was not associated with an increased risk for most of the 51 defect groups analyzed. Modest increases in risk were observed for cleft palate (adjusted OR 1.6, 95% CI 1.1–2.3) in the National Birth Defects Prevention Study and renal agenesis–dysgenesis (adjusted OR 1.8, 95% CI 1.1–3.0) in the Birth Defects Study, although these findings may be the result of chance.

CONCLUSION:

Off-label use of ondansetron for the treatment of nausea and vomiting of pregnancy increased to 13% by the end of the study period. For the majority of specific birth defects investigated, there was no increased risk associated with first-trimester use of ondansetron for treatment of nausea and vomiting of pregnancy compared with no treatment, although modest associations with cleft palate and renal agenesis–dysgenesis warrant further study.
Use of the STROBE Checklist to Evaluate the Reporting Quality of Observational Research in Obstetrics
Authors: Adams April D. , Benner Rebecca S. , Riggs Thomas W. , Chescheir Nancy C.
Published: July 2018

OBJECTIVE:

To evaluate observational research manuscripts submitted to Obstetrics & Gynecology to determine the level of adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and highlight specific areas that could be improved.

METHODS:

A scoring system based on the STROBE checklist was developed and validated for consistency by volunteer medical students or doctors. Using this scoring system, we performed a cross-sectional analysis on 198 observational research manuscripts submitted to Obstetrics & Gynecology from 2008 to 2016. Each manuscript was given a score based on the STROBE checklist. Comparisons were made among acceptance status, country of origin, and study type. Descriptive statistics (means, medians, and frequencies) were calculated for each manuscript category. The t test or Wilcoxon rank-sum test was used to compare differences between two groups and analysis of variance or the Kruskal-Wallis test was used to compare differences among three or more groups.

RESULTS:

There was a statistically significant difference between the mean score for accepted (23.2±2.7) compared with rejected (19.7±4.1) manuscripts (P<.001). This difference was not seen when comparing country of origin and study type. Poor reporting was seen among all manuscript categories for objectives, study size, missing data, study participants, and translation of risk. Additionally, rejected manuscripts had poor reporting for eligibility criteria, variables, bias and confounding, statistical methods, unadjusted and adjusted estimates, and category boundaries.

CONCLUSION:

Overall, accepted manuscripts show better adherence to the STROBE checklist, but there are several critical items that are poorly reported in all manuscripts.
Fatal and Nonfatal Overdose Among Pregnant and Postpartum Women in Massachusetts
Authors: Schiff Davida M. , Nielsen Timothy , Terplan Mishka , Hood Malena , Bernson Dana , Diop Hafsatou , Bharel Monica , Wilens Timothy E. , LaRochelle Marc , Walley Alexander Y. , Land Thomas
Published: July 2018

OBJECTIVE:

To estimate fatal and nonfatal opioid overdose events in pregnant and postpartum women in Massachusetts, comparing rates in individuals receiving and not receiving pharmacotherapy for opioid use disorder (OUD).

METHODS:

We conducted a population-based retrospective cohort study using linked administrative and vital statistics databases in Massachusetts to identify women with evidence of OUD who delivered a liveborn neonate in 2012–2014. We described maternal sociodemographic, medical, and substance use characteristics, computed rates of opioid overdose events in the year before and after delivery, and compared overdose rates by receipt of pharmacotherapy with methadone or buprenorphine in the prenatal and postpartum periods.

RESULTS:

Among 177,876 unique deliveries, 4,154 (2.3%) were to women with evidence of OUD in the year before delivery, who experienced 242 total opioid-related overdose events (231 nonfatal, 11 fatal) in the year before or after delivery. The overall overdose rate was 8.0 per 100,000 person-days. Overdoses were lowest in the third trimester (3.3/100,000 person-days in the third trimester) and then increased in the postpartum period with the highest overdose rate 7–12 months after delivery (12.3/100,000 person-days). Overall, 64.3% of women with evidence of OUD in the year before delivery received any pharmacotherapy in the year before delivery. Women receiving pharmacotherapy had reduced overdose rates in the early postpartum period.

CONCLUSION:

Pregnant women in Massachusetts have high rates of OUD. The year after delivery is a vulnerable period for women with OUD. Additional longitudinal supports and interventions tailored to women in the first year postpartum are needed to prevent and reduce overdose events.
Frequency of Opioid Dispensing After Vaginal Delivery
Authors: Prabhu Malavika , Garry Elizabeth M. , Hernandez-Diaz Sonia , MacDonald Sarah C. , Huybrechts Krista F. , Bateman Brian T.
Published: July 2018

OBJECTIVE:

To describe nationwide patterns in outpatient opioid dispensing after vaginal delivery.

METHODS:

Using the Truven Health Analytics MarketScan database, we performed a large, nationwide retrospective cohort study of commercially insured beneficiaries who underwent vaginal delivery between 2003 and 2015 and who were opioid-naive for 12 weeks before the delivery admission. We assessed the proportion of women dispensed an oral opioid within 1 week of discharge, the associated median oral morphine milligram equivalent dose dispensed, and the frequency of opioid refills during the 6 weeks after discharge. We evaluated predictors of opioid dispensing using multivariable logistic regression.

RESULTS:

Among 1,345,244 women undergoing vaginal delivery, 28.5% were dispensed an opioid within 1 week of discharge. The most commonly dispensed opioids were hydrocodone (44.7%), oxycodone (34.6%), and codeine (13.1%). The odds of filling an opioid were higher among those using benzodiazepines (adjusted odds ratio [OR] 1.87, 95% CI 1.73–2.02) and antidepressants (adjusted OR 1.63, 95% CI 1.59–1.66), smokers (adjusted OR 1.44, 95% CI 1.38–1.51), and among those undergoing tubal ligation (adjusted OR 3.77, 95% CI 3.67–3.87), operative vaginal delivery (adjusted OR 1.52, 95% CI 1.49–1.54), and higher order perineal laceration (adjusted OR 2.15, 95% CI 2.11–2.18). The median (interquartile range, 10th–90th percentile) dose of opioids dispensed was 150 (113–225, 80–345) morphine milligram equivalents, equivalent to 20 tablets (interquartile range 15–30, 10th–90th percentile 11–46) of 5 mg oxycodone. Six weeks after discharge, 8.5% of women filled one or more additional opioid prescriptions.

CONCLUSION:

Opioid dispensing after vaginal delivery is common and often occurs at high doses. Given the frequency of vaginal delivery, this may represent an important source of overprescription of opioids in the United States.
Improving Patient Knowledge of Aneuploidy Testing Using an Educational Video
Authors: Mulla Bethany M. , Chang Olivia H. , Modest Anna M. , Hacker Michele R. , Marchand Karen F. , O’Brien Karen E.
Published: July 2018

OBJECTIVE:

To evaluate the effectiveness of an educational video explaining aneuploidy testing.

METHODS:

This was a randomized controlled trial of women with singleton pregnancies having aneuploidy testing at less than 14 weeks of gestation from September 2016 to March 2017 at our prenatal ultrasound center. We developed an educational video on aneuploidy testing. Participants, stratified by age younger than or 35 years or older at estimated delivery date, were randomized to either view or not view the video before their ultrasonogram. Participants 35 years or older also met with a genetic counselor at the ultrasound appointment. All participants completed a survey assessing knowledge of genetic testing (score of 0–15) at baseline and after the appointment. The primary outcome was change in knowledge score after the intervention. A sample size of 23 per group (n=92) was planned for a total of 46 women younger than 35 years of age and 46 women aged 35 years or older. Data are presented as median (interquartile range).

RESULTS:

Of 104 eligible women who were approached, 92 were randomized. Forty women aged younger than 35 years and 41 women aged 35 years or older completed the study. Baseline characteristics were similar across groups. In women younger than 35 years, the video group had a significant improvement in knowledge score (+2.0 [1.0–5.0]) compared with the control group (0 [−1.0 to 1.0]; P=.01) and reported better understanding of the information compared with the control group (P<.001) with no change in patient satisfaction (P=.25). In women 35 years or older, change in knowledge score was similar for the video and control groups (P=.98) with no difference in self-reported understanding (P=.49) or patient satisfaction (P=.30).

CONCLUSION:

A patient-centered educational video explaining aneuploidy testing options improved knowledge and self-reported understanding of the information in women younger than 35 years with no change in patient satisfaction. No difference was seen for women 35 years or older, likely as a result of genetic counseling provided to these women.
Damage-Control Surgery for Obstetric Hemorrhage
Authors: Pacheco Luis D. , Lozada M. James , Saade George R. , Hankins Gary D. V.
Published: July 2018

Damage-control surgery (abdominopelvic packing followed by a period of medical stabilization in the intensive care unit) is a life-saving intervention usually reserved for critically injured patients who may not survive an attempt to achieve hemostasis and complete repair of the damage in the operating room. Most obstetricians have little or no experience in this area, although the use of damage-control surgery in selected cases may be life-saving. This approach should be considered when arterial bleeding has been controlled and persistent bleeding is deemed to be secondary to coagulopathy that is refractory to blood product replacement, particularly in the presence of hypothermia, acidosis, and vasopressor requirement. A prototypical (albeit hypothetical) case is described here in which damage-control surgery is indicated.
Cardiac Involvement in Systemic Sclerosis
Authors: Smolenska Zaneta , Barraclough Rufus , Dorniak Karolina , Szarmach Arkadiusz , Zdrojewski Zbigniew
Published: July 2018

The heart is one of the major organs commonly involved in systemic sclerosis (SSc). Myocardial fibrosis has been identified in a high percentage of these patients. Most SSc patients with cardiac involvement (CI) are subclinical, especially early on in the course of their disease. To accurately identify CI and improve diagnosis and treatment, imaging techniques should be implemented on a regular basis following diagnosis. In this review, we discuss the up-to-date pathophysiologic basis of CI, the cardiac manifestations, and the diagnostic methods that have been published in the literature. Recent studies have shown that tissue Doppler imaging is a promising evaluation technique in the bedside detection of CI. Cardiovascular magnetic resonance is an operator-independent method used for detecting SSc CI. It is an especially useful tool in the early stages of the disease when patients may be asymptomatic. At present, it is the most promising imaging technique for the diagnosis, follow-up, and response to therapy in clinical practice.
Comparison of Mesenteric Lengthening Techniques in IPAA: An Anatomic and Angiographic Study on Fresh Cadavers
Authors: İsmail Erkin , Açar Halil İbrahim , Arslan Murat Nihat , Çoban İsmail , Cömert Ayhan , Aşlar Ahmet Keşşaf , Kuzu Mehmet Ayhan
Published: July 2018

BACKGROUND:

The IPAA technique restores anal functionality in patients who have had the large intestine and rectum removed; however, 1 of the most important reasons for pouch failure is tension on the anastomosis.

OBJECTIVE:

The aim of this study was to compare technical procedures for mesenteric lengthening used for IPAA to reduce this tension.

DESIGN:

After randomization, 4 different techniques for mesenteric lengthening were performed and compared on fresh cadavers.

SETTING:

This was a cross-sectional cadaveric study.

MAIN OUTCOME MEASURES:

In the first group (n = 5), stepladder incisions were made on the visceral peritoneum of the mesentery of the small intestine. In the second and third groups, the superior mesenteric pedicle was divided, whereas the ileocolic pedicle (n = 7) or marginal vessels (n = 6) were preserved during proctocolectomy. In the fourth group (n = 7), the superior mesenteric pedicle was cut without preserving any colic vessels. Mesenteric lengthening was analyzed. Angiography was performed to visualize the blood supply of the terminal ileum and pouch after mesenteric lengthening.

RESULTS:

Average mesenteric lengthening was 5.72 cm (± 1.68 cm) in group 1, 3.63 cm (± 1.75 cm) in group 2, 7.03 cm (± 3.47 cm) in group 3, and 7.29 cm (± 1.73 cm) in group 4 (p = 0.011 for group 2 when compared with the others).

LIMITATIONS:

The study was limited by nature of being a cadaver study.

CONCLUSIONS:

Stepladder incisions through superior mesenteric pedicle trace are usually sufficient for mesenteric lengthening. In addition, division of the superior mesenteric pedicle with either a preserving marginal artery or without preserving ileocolic and marginal arteries leads to additional mesenteric lengthening.
Bone Resorption after Use of Silicone Chin Implants, Long-term Follow-up Study with Lateral Chin Radiography
Authors: Sciaraffia Carlos E. , Ahumada Macarena F. , Parada Francisco J. , Gonzalez Esteban , Prado Arturo
Published: July 2018

Silicone chin implants are frequently used in cosmetic surgery to enhance a harmonic face. Obtaining an aesthetically pleasing face is increasingly becoming more important for people, and a considerable part of this goal can be achieved through different aesthetic modifications of the chin. The purpose of this study was to analyze the presence of bone resorption after the insertion of silicone chin implants, with lateral chin radiographs. Fifteen patients were studied, all of whom had a chin silicone implant inserted at least 1 year ago using the same surgical technique. The surgery was done intraorally with insertion of the silicone implant under the periosteum of the chin. Fourteen patients presented bone erosion, with the maximum of 2.0 mm erosion. However, none of them manifested any symptoms of this erosion. In conclusion, even though the majority of the patients presented with bone erosion, the results were minimal and completely asymptomatic; thus, this technique produced an excellent final result.
Anti–nerve growth factor does not change physical activity in normal young or aging mice but does increase activity in mice with skeletal pain
Authors: Majuta Lisa A. , Mitchell Stefanie A.T. , Kuskowski Michael A. , Mantyh Patrick W.
Published: July 2018

Anti–nerve growth factor (anti-NGF) therapy has shown significant promise in attenuating several types of skeletal pain. However, whether anti-NGF therapy changes the level of physical activity in individuals with or without skeletal pain is largely unknown. Here, automated day/night activity boxes monitored the effects of anti-NGF treatment on physical activity in normal young (3 months old) and aging (18-23 months old) mice and mice with bone fracture pain. Although aging mice were clearly less active and showed loss of bone mass compared with young mice, anti-NGF treatment had no effect on any measure of day/night activity in either the young or aging mice. By contrast, in mice with femoral fracture pain, anti-NGF treatment produced a clear increase (10%-27%) in horizontal activity, vertical rearing, and velocity of travel compared with the Fracture + Vehicle group. These results suggest, just as in humans, mice titrate their level of physical activity to their level of skeletal pain. The level of skeletal pain may in part be determined by the level of free NGF that seems to rise after injury but not normal aging of the skeleton. In terms of bone healing, animals that received anti-NGF showed an increase in the size of calcified callus but no increase in the number of displaced fractures or time to cortical union. As physical activity is the best nondrug treatment for many patients with skeletal pain, anti-NGF may be useful in reducing pain and promoting activity in these patients.
Peripherally administered calcitonin gene–related peptide induces spontaneous pain in mice: implications for migraine
Authors: Rea Brandon J. , Wattiez Anne-Sophie , Waite Jayme S. , Castonguay William C. , Schmidt Chantel M. , Fairbanks Aaron M. , Robertson Bennett R. , Brown Cameron J. , Mason Bianca N. , Moldovan-Loomis Maria-Cristina , Garcia-Martinez Leon F. , Poolman Pieter , Ledolter Johannes , Kardon Randy H. , Sowers Levi P. , Russo Andrew F.
Published: July 2018

Migraine is the third most common disease in the world (behind dental caries and tension-type headache) with an estimated global prevalence of 15%, yet its etiology remains poorly understood. Recent clinical trials have heralded the potential of therapeutic antibodies that block the actions of the neuropeptide calcitonin gene–related peptide (CGRP) or its receptor to prevent migraine. Calcitonin gene–related peptide is believed to contribute to trigeminal nerve hypersensitivity and photosensitivity in migraine, but a direct role in pain associated with migraine has not been established. In this study, we report that peripherally administered CGRP can act in a light-independent manner to produce spontaneous pain in mice that is manifested as a facial grimace. As an objective validation of the orbital tightening action unit of the grimace response, we developed a squint assay using a video-based measurement of the eyelid fissure, which confirmed a significant squint response after CGRP injection, both in complete darkness and very bright light. These indicators of discomfort were completely blocked by preadministration of a monoclonal anti-CGRP–blocking antibody. However, the nonsteroidal anti-inflammatory drug meloxicam failed to block the effect of CGRP. Interestingly, an apparent sex-specific response to treatment was observed with the antimigraine drug sumatriptan partially blocking the CGRP response in male, but not female mice. These results demonstrate that CGRP can induce spontaneous pain, even in the absence of light, and that the squint response provides an objective biomarker for CGRP-induced pain that is translatable to humans.
Validity and Reliability of the Korean Version of the Dialysis Symptom Index for Hemodialysis Patients
Authors: CHO Mi-Kyoung , KIM Se Young , SHIM Hye Yeung
Published: July 2018

Background:

Hemodialysis patients experience physical and psychosocial symptoms caused by comorbid illnesses, treatment-related side effects, lifestyle alteration, and the psychosocial impacts of living with end-stage renal disease. The Dialysis Symptom Index (DSI) is the most frequently used instrument to assess symptoms of chronic kidney disease and end-stage renal disease in patients.

Purpose:

The aims of this study were to develop the Korean version of the DSI, to verify the reliability and validity of the developed tool, and to use the tool to evaluate the symptoms of hemodialysis patients in Korea.

Methods:

A methodological study was performed on 230 hemodialysis patients from three hospitals who agreed to participate in the study from October 1 to 30, 2015. The Symptom Checklist-90-Revised was used to verify the convergent validity, whereas the total score of Kidney Disease Quality of Life Questionnaire-Short Form, Version 1.3, was used to verify the divergent validity. Data were analyzed using descriptive analysis, Cronbach’s alpha, confirmatory factor analysis, and Pearson’s correlation analysis.

Results:

The internal consistency reliability of the Korean DSI assessed by Cronbach’s alpha was .90. The Korean DSI showed a high positive correlation coefficient of .80 with symptom severity using the Symptom Checklist-90-Revised, which confirmed the convergent validity. Finally, the correlation coefficient with the quality of life of the participants using the Kidney Disease Quality of Life Questionnaire-Short Form, Version 1.3, was −.68, which confirmed the divergent validity.

Conclusions/Implications for Practice:

This study developed the Korean version of the DSI and verified its validity and reliability. The Korean version of the DSI showed good properties and may be used to assess the symptoms of hemodialysis patients. Nurses may use this self-report tool to better understand and help relieve the prevalence and severity of symptoms in hemodialysis patients in Korea.
Prosthetists’ Perceptions of Information Obtained From a Lower-Limb Prosthesis Monitoring System: A Pilot Study
Authors: Balkman Geoffrey S. , Vamos Andrew C. , Sanders Joan E. , Larsen Brian G. , Hafner Brian J.
Published: July 2018

Introduction

Prosthetists have limited knowledge of their patients’ use of a prosthesis outside of the clinical environment. Prosthesis-mounted monitors can be used to directly measure patients’ prosthesis use and activity. Prosthetists’ opinions regarding potential clinical applications for sensor-based information may inform further development of this technology. A pilot study was conducted to assess prosthetists’ perceptions of prosthesis use and activity information obtained by a monitoring system.

Materials and Methods

Three local prosthetists were recruited to participate in the study. One patient with transtibial amputation from each prosthetist volunteered to wear limb presence and activity monitors for 2 weeks. Collected data were used to determine prosthesis use and activity. Each prosthetist completed a survey, examined clinical reports of their patient’s prosthesis use and activity, and participated in a semistructured interview. Survey results and interview transcripts were analyzed to identify and compare prosthetists’ perceptions.

Results

Prosthesis use and activity varied among patients. Prosthetists overestimated and underestimated patient activity relative to measurements recorded by the monitors. All three prosthetists selected multiple clinical applications for the prosthesis use and activity information in the survey, and several additional applications were suggested during the interviews.

When presented with multiple report formats, prosthetists found features of each to be clinically useful.

Conclusions

Prosthesis-mounted monitors may provide prosthetists with a better understanding of their patients’ prosthesis use and activity. Information provided by the monitoring system may inform clinical decisions and promote evidence-based practices.
Revisiting Arthroscopic Partial Meniscectomy for Degenerative Tears in Knees With Mild or No Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Lee Seung Hoon , Lee O-Sung , Kim Sung Taeck , Lee Yong Seuk
Published: July 2018

Objective:

The purpose of this systematic review and meta-analysis was to evaluate the efficacy of arthroscopic partial meniscectomy (APM) for symptomatic degenerative meniscal tear (DMT) in knees with mild or no osteoarthritis.

Study Design:

A systematic review and meta-analysis.

Methods:

MEDLINE, EMBASE, and Cochrane databases were systematically searched. The inclusion criteria were as follows: (1) English language; (2) randomized controlled trial (RCT); (3) comparison between APM and other treatment modalities as a primary objective; and (4) complete DMT in knees with mild or no osteoarthritis. Mild or no arthritis was defined as Kellgren–Lawrence grade 0 to 2 or Ahlbäck 0 to 1 on radiography. Statistical analysis of functional activity and pain after APM and conservative treatment or sham operation was performed using R version 3.3.1.

Results:

Five articles were included in the final analysis, and they were all RCTs. Four studies compared clinical results of APM with those for physical therapy, and one study compared APM with sham operation. The functional activity was not better in the APM group (296 cases) than in the conservative treatment or sham operation group (284 cases) (I
2: 0%, small level of heterogeneity). Pain was not reduced significantly in the APM group compared with that in the conservative treatment or sham operation group (I
2: 0∼90%, high level of heterogeneity).

Conclusions:

This systematic review and meta-analysis of high-quality literature provides relatively strong evidence that APM did not improve functional activity or reduce pain compared with the results with conservative treatment or sham operation in knees with mild or no osteoarthritis.
The Early Postoperative Effects of Cochlear Implantation on Horizontal Semicircular Canal Function
Authors: Shute William Graham , McOwan Benjamin , O’Leary Stephen John , Szmulewicz David
Published: July 2018

Objectives:

To use video head impulse testing to examine the effect of cochlear implantation (CI) on horizontal SCC vestibulo-ocular reflex (VOR) gain early after surgery, and to relate outcomes to subjective imbalance.

Study Design:

Prospective cohort study.

Setting:

Academic tertiary referral center.

Patients:

Thirty-seven (23F:14M) adult cochlear implant recipients (mean age, 55; age range, 20–80).

Intervention:

Cochlear implantation.

Main Outcome Measure:

The VOR of the horizontal semicircular canal of both the operated and non-operated ears was examined using video head impulse testing before surgery and at days 1, 7, and 28 following surgery. VOR gain, VOR gain asymmetry, and the change in VOR gain from preoperative baseline where the primary outcome measures. Subjective imbalance was assessed using a structured questionnaire.

Results:

VOR gain value for the operated ear was 0.88 ± 0.21. Mean VOR gain on day 1 postoperatively was 0.86 ± 0.19; on day 7, 0.87 ± 0.17, and on day 30, 0.91 ± 0.21. Before surgery median asymmery was −5.50%, on day 1 it was –5.30%, at day 7, −6.44%, and at day 30 it was −2.61%. There was no significant difference between these measures for the cohort across the four time points. Thirteen of 37 (35%) of patients experienced imbalance in the follow-up period, but this was not correlated to changes in VOR gain.

Conclusion:

Horizontal semicircular canal function is preserved in the immediate and early postoperative period. This suggests that horizontal semicircular canal impairment is not likely to be responsible for postoperative imbalance.
Round Window Occlusion Affects Bone Conduction in Cadaver Heads
Authors: Chen Keguang , Lyu Huiying , Yin Dongming , Yang Lin , Zhang Tianyu , Dai Peidong
Published: July 2018

Objective:

To explore the feasibility of ear mold glue in the molding of round window occlusion (RWO) in cadaver heads and to study the effect on bone conduction (BC).

Methods:

Ten cadaver heads were selected to establish RWO model. Ear mold glue was used to immobilize round window niche. The vibration properties of the stapes footplate (VST) in response to the acoustic stimulation, and the vibration properties of the stapes footplate and cochlear promontory (VCP) in response to the B-71 stimulation were assessed by laser Doppler vibrometer in both pre-RWO and post-RWO.

Results:

The mean velocities of the stapes footplate in response to the acoustic stimulation in post-RWO were decreased significantly beyond 14 dB for frequency from 0.5k to 3k Hz and decreased beyond 11 dB for frequency above 4 kHz compared with pre-RWO (p<0.05). The stapes footplate relative velocity (VST/VCP) for pre-RWO and post-RWO conditions showed almost no difference (the difference was around 0.5 dB for 0.5k, 1k, 2k, 5k, 6k, and 7k Hz frequencies), except a slight decrease of around 1.5 dB at 3k and 8k Hz frequencies in post-RWO. However, the VST/VCP was a significant decrease of 1.7 dB at 4k Hz in post-RWO compared with Pre-RWO (p<0.05).

Conclusion:

Ear mold glue was available for the immobilization of round window niche in cadaver heads. The RWO have an impact on the BC hearing threshold. The effect of RWO on the BC was similar to that of otosclerosis, but the feature frequency for the depressed BC threshold at 4k Hz.
Overview of Prescription Opioid Deaths in the Oklahoma State Medicaid Population, 2012–2016
Authors: Pham Timothy T. , Skrepnek Grant H. , Bond Christopher , Alfieri Thomas , Cothran Terry J. , Keast Shellie L.
Published: July 2018

Background:

Medicaid members are predisposed to unintentional prescription opioid overdose. However, little is known about their individual risk factors.

Objectives:

To describe demographic and clinical characteristics, medical utilization, opioid use, concurrent use of benzodiazepines, risk factors, and substances involved in death for Oklahoma’s Medicaid members who died of unintentional prescription opioid poisoning.

Subjects:

Decedents who were Medicaid eligible in Oklahoma during the year of death, had an opioid recorded in cause of death, and had ≥1 opioid prescription claim between January 1, 2011 and June 30, 2016 were cases. Controls were living Medicaid members and were matched 3:1 to cases through propensity score matching.

Measures:

Demographics, clinical characteristics, and medical/pharmacy utilization were examined in the 12 months before the index date.

Results:

Of 639 members with fatal unintentional prescription opioid overdoses, 321 had ≥1 opioid prescription claim in the year before death; these were matched to 963 controls. Compared with controls, decedents had significantly greater proportions of nonopioid substance use disorders, opioid abuse/dependence, hepatitis, gastrointestinal bleeding, trauma not involving motor vehicle accidents, nonopioid poisonings, and mental illness disorders. Decedents had significantly higher daily morphine milligram equivalent doses (67.2±74.4 vs. 47.2±50.9 mg) and greater opioid/benzodiazepine overlap (70.4% vs. 35.9%). Benzodiazepines were involved in 29.3% of deaths.

Conclusions:

Several comorbidities indicative of opioid use disorder and greater exposure to opioids and concomitant benzodiazepines were associated with unintentional prescription opioid overdose fatalities. Prescribers and state agencies should be aware of these addressable patient-level factors among the Medicaid population. Targeting these factors with appropriate policy interventions and education may prevent future deaths.
Pleiotropic effects of proprotein convertase subtilisin/kexin type 9 inhibitors?
Authors: Filippatos Theodosios D. , Christopoulou Eliza C. , Elisaf Moses S.
Published: July 2018

Purpose of review

Current data suggest that proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may affect many metabolic pathways beyond lowering LDL cholesterol. The aim of the present manuscript is to present these so-called pleiotropic effects of PCSK9 inhibitors.

Recent findings

PCSK9 may affect the activity of other receptors beyond LDL receptors (LDLR), such as cluster of differentiation 36 (CD36), very-low-density-lipoprotein (VLDL) receptors, apolipoprotein (Apo) E receptors, LDLR-related protein 1 (LRP-1) and ATP-Binding Cassette Transporter (ABCA1). Thus, a role of PCSK9 in the development of atherosclerosis, in vascular wall inflammation and in platelet function has been suggested. Additionally, PCSK9 inhibitors may affect lipid variables beyond LDL cholesterol, carbohydrate variables, as well as they may affect brain and kidney function. Additionally, a controversial role of PCSK9 in sepsis, hepatitis C infection and Alzheimer's disease has been suggested.

These possible pleiotropic effects of PCSK9 inhibitors need further research, as they may affect cardiovascular risk and provide further insights in the development of atherosclerosis and other diseases such as Alzheimer's disease or chronic viral infection and sepsis.
Game analysis and clinical use of the Xbox-Kinect for stroke rehabilitation
Authors: Givon Schaham Noa , Zeilig Gabi , Weingarden Harold , Rand Debbie
Published: July 2018

Whole-body movement is required to interact (play) with Microsoft Xbox with the 3D Kinect sensor (Xbox-Kinect) and, therefore, may be suitable for encouraging and practicing movements as part of stroke rehabilitation. We aimed to describe (i) game analysis, (ii) clinical use, and (iii) to characterize the Xbox-Kinect game experience with individuals with chronic stroke. Four therapists played the Xbox-Kinect games and then carried out a games analysis on the basis of the categories suggested by Deutsch. Eleven participants (age 29–69 years) with chronic stroke and varying motor deficits played Xbox-Kinect games for 4–22 sessions as part of a video-game group intervention and the clinical use was documented. The game experience of ‘Bowling’ (Kinect-Sport) and ‘20 000 leaks’ (Kinect Adventures) was characterized by self-report questionnaires. Detailed tables of game analysis are provided. The clinical use of the console with the participants is presented. Participants reported high enjoyment and ‘somewhat-high’ perceived exertion after playing the two games and stated that overall the console suited their therapeutic goals. This information can assist clinicians with their clinical reasoning and decision-making for incorporating the Xbox-Kinect into stroke rehabilitation. Potentially, the Xbox-Kinect could be used as an on-going tool to facilitate whole-body movement and physical activity of individuals with chronic stroke.
Is physical rehabilitation effective for Wernicke–Korsakoff syndrome? A case report
Authors: Genç Aysun , Özdemir Elif C. , Moustafa Esra , Küçükdeveci Ayşe A.
Published: July 2018

Wernicke–Korsakoff syndrome is a type of brain disorder caused by the lack of thiamine, most commonly because of chronic alcohol misuse. It consists of two separate conditions including Wernicke’s encephalopathy and Korsakoff syndrome. Various levels of cognitive impairments are associated with the severity of the syndrome. Although the effectiveness of thiamine replacement in the early phases of the syndrome is proven, the efficacy of subsequent treatments, which mainly include rehabilitation protocols after the development of Korsakoff syndrome, is not clear. This is the first report showing the positive effects of physical rehabilitation in a 48-year-old male patient with Wernicke–Korsakoff syndrome.
ACTing in Partnership to Accelerate Impact
Authors: Harrison Kate , Robinson Joanna , Marks Lauren , Blander Jeffrey , McDermott Peter
Published: July 2018

Partnership between funders plays a vital role in tackling the AIDS epidemic and can help partners deliver “more than the sum of their parts.” But how do partnerships form? How is value leveraged and maximized? How can partnerships achieve policy change? This article addresses these questions through the example of the Accelerating Children's HIV/AIDS Treatment Initiative, an ambitious $200 million public private partnership with a goal of doubling the number of children living with HIV on treatment in 9 priority African countries over a 2-year period. It describes how the partnership formed between the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Children's Investment Fund Foundation (CIFF), and the differing styles, vision, and resources each organization contributed. It also gives examples of policy influence at global level and policy change at national level. Finally, the article considers whether working in partnership was more or less effective than independent funding, with reflections on the value and challenges of collaboration.
Strategies for Identifying and Linking HIV-Infected Infants, Children, and Adolescents to HIV Treatment Services in Resource Limited Settings
Authors: Medley Amy M. , Hrapcak Susan , Golin Rachel A. , Dziuban Eric J. , Watts Heather , Siberry George K. , Rivadeneira Emilia D. , Behel Stephanie
Published: July 2018

Many children living with HIV in resource-limited settings remain undiagnosed and at risk for HIV-related mortality and morbidity. This article describes 5 key strategies for strengthening HIV case finding and linkage to treatment for infants, children, and adolescents. These strategies result from lessons learned during the Accelerating Children's HIV/AIDS Treatment Initiative, a public–private partnership between the President's Emergency Plan for AIDS Relief (PEPFAR) and the Children's Investment Fund Foundation (CIFF). The 5 strategies include (1) implementing a targeted mix of HIV case finding approaches (eg, provider-initiated testing and counseling within health facilities, optimization of early infant diagnosis, index family testing, and integration of HIV testing within key population and orphan and vulnerable children programs); (2) addressing the unique needs of adolescents; (3) collecting and using data for program improvement; (4) fostering a supportive political and community environment; and (5) investing in health system–strengthening activities. Continued advocacy and global investments are required to eliminate AIDS-related deaths among children and adolescents.
Sustainability and Accelerating Children's HIV/AIDS Treatment (ACT) Initiative: Lessons for the Next Treatment Surge
Authors: Kaliel Deborah , McCarthy Erin , Tayag Josef , Berry Ariel
Published: July 2018

The Accelerating Children's HIV/AIDS Treatment (ACT) Initiative was an ambitious joint donor initiative to increase the number of HIV-positive children and adolescents on treatment over a 2-year period from 2014 to 2016. The funding was provided by the US Government's President's Emergency Plan for AIDS Relief (PEPFAR) and the private Children's Investment Fund Foundation (CIFF). Great gains were achieved across the 9 ACT focus countries in pediatric treatment coverage. This article assesses the status of sustainability in the ACT countries after the pediatric treatment surge using PEPFAR sustainability data and a CIFF independent evaluation of sustainability. Although a focus on treatment is critical for pediatric HIV and HIV broadly, there is also a need to support the host country ability to maintain the progress gained once donor funds and initiatives transition. It uses the case of the ACT Initiative to argue that although surge activities are successful in rapidly scaling treatment results, there are concerns related to the health system's ability to maintain the progress along the full cascade. It shares important lessons for planning for and management of transition to support future donor efforts in pediatric HIV, overall HIV programming, and broader global health initiatives.