bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction and validation of a short multidisciplinary research performance questionnaire (SMRPQ)
Authors: Daumiller Martin , Siegel Stefan , Dresel Markus
Published: March 2019

Research is often specialized and varies in its nature between disciplines, making it difficult to assess and compare the performance of individual researchers. Specific qualitative and quantitative indicators are usually complex and do not work equally well for different research fields. Therefore, the aim of the present study was to develop an economical questionnaire that is valid across disciplines. We constructed a Short Multidisciplinary Research Performance Questionnaire (SMRPQ), with which researchers can briefly report 11 quantitative and qualitative performance aspects from four areas (research quality, facilitation, transfer/exchange, and reputation) in relation to their peer reference groups (fellow researchers with the same status and discipline). To validate this questionnaire, 557 German researchers from Physics, History, and Psychology fields (53% male, 34% post-docs, and 19% full professors) completed it, and for the purpose of convergent and discriminant validation additionally made assessments regarding specific quantitative and qualitative indicators of research performance as well as affective, cognitive, and behavioural aspects of their research activities (perceptions of positive affect, help-seeking, and procrastination). The results attested reliable measurement, endorsed the postulated structure of the newly developed instrument, and confirmed its invariance across the three disciplines. The SMRPQ and the validation measure were strongly positively correlated, and both demonstrated similar associations with affect, cognition, and behaviour at work. Therefore, it can be considered a valid and economical approach for assessing research performance of individual researchers across different disciplines, especially within nomothetic research (e.g. regarding personal antecedents of successful research).
An Optimized Microsatellite Scheme for Assessing Populations of Xanthomonas phaseoli pv. manihotis
Authors: Rache Leidy , Blondin Laurence , Flores Carolina , Trujillo Cesar , Szurek Boris , Restrepo Silvia , Koebnik Ralf , Bernal Adriana , Vernière Christian
Published: March 2019

Diverse molecular markers have been used to analyze the genetic diversity of plant pathogens. Compared with traditional fingerprinting methods, multiple loci variable number of tandem repeat analyses (MLVAs) have gained importance recently due to their reproducibility, high discriminatory power, ease of performance, low cost, and throughput potential. These characteristics are desirable for continuous pathogen monitoring, especially for pathogens with relatively low genetic diversity, and for disease epidemiology studies. Genetic diversity studies of Xanthomonas phaseoli pv. manihotis, which is the causal agent of cassava bacterial blight, have shown variability and changes in the bacterial population over time. Thus, an easy and fast method needs to be developed to type populations of this pathogen in different countries of the world, especially on small scales. In this study, we developed an MLVA scheme to analyze X. phaseoli pv. manihotis variability on a local scale. The MLVA-15 scheme comprises 15 variable number of tandem repeat loci grouped into four multiplex polymerase chain reaction pools. We showed that the MLVA-15 scheme had slightly higher discriminatory ability at the locality level when compared with amplified fragment length polymorphisms. The MLVA-15 scheme allowed for an accurate determination of the number of genotypes in the sample and showed reproducibility and portability. Additionally, this scheme could be used to analyze numerous strains in a reasonable timeframe. The MLVA-15 scheme was highly specific to X. phaseoli but up to eight tandem repeat loci could be amplified from other Xanthomonas spp. Finally, we assessed the utility of the scheme for analyses of X. phaseoli pv. manihotis genetic variability in the Colombian Caribbean region. MLVA-15 distinguished 88.9% of the haplotypes in our sample. Strains originating from the same field and isolated at the same time could be discriminated. In this study, the advantages of the MLVA-15 scheme targeting 6- or 7-bp repeats were demonstrated. Moreover, this scheme was a fast method that was appropriate for routine monitoring of X. phaseoli pv. manihotis populations on a local scale and, thus, was useful for addressing epidemiological questions.
An update on shellfish allergy
Authors: Wong Lydia , Tham Elizabeth Huiwen , Lee Bee Wah
Published: March 2019

Purpose of review

Shellfish is an important cause of food allergy worldwide, and a major cause of food-triggered anaphylaxis. Despite the wide variety of shellfish, there is considerable serological and clinical cross-reactivity of major shellfish allergens, and accurate diagnosis remains a challenge in the management of shellfish allergy.

Recent findings

Novel minor allergens have been discovered and characterized, and advances in component resolved diagnostics have provided insights into the prevalence of sensitization and their clinical importance in shellfish allergy. The extensive cross-reactivity between tropomyosin of house-dust mite and crustacean shellfish has been postulated to be the cause of a proposed mite-shellfish oral allergy syndrome.

More studies in food challenge-proven patients are required to establish the true prevalence and natural history of shellfish allergy. Refinement of component resolved diagnostics and testing for minor allergens may be helpful in developing more precise species-specific tests. Further investigation into the role of tropomyosin in house-dust mite and shellfish allergies may provide novel immunotherapeutic approaches for shellfish allergy.
The AAMC Standardized Video Interview: Reactions and Use by Residency Programs During the 2018 Application Cycle
Authors: Gallahue Fiona E. , Hiller Katherine M. , Bird Steven B. , Calderone Haas Mary Rose , Deiorio Nicole M. , Hern H. Gene , Jarou Zachary J. , Pierce Ava , Geiger Thomas , Fletcher Laura
Published: March 2019

Purpose

To evaluate how emergency medicine residency programs perceived and used Association of American Medical Colleges (AAMC) Standardized Video Interview (SVI) total scores and videos during the Electronic Residency Application Service 2018 cycle.

Method

Study 1 (November 2017) used a program director survey to evaluate user reactions to the SVI following the first year of operational use. Study 2 (January 2018) analyzed program usage of SVI video responses using data collected through the AAMC Program Director’s Workstation.

Results

Results from the survey (125/175 programs; 71% response rate) and video usage analysis suggested programs viewed videos out of curiosity and to understand the range of SVI total scores. Programs were more likely to view videos for attendees of U.S. MD-granting medical schools and applicants with higher United States Medical Licensing Examination Step 1 scores, but there were no differences by gender or race/ethnicity. More than half of programs that did not use SVI total scores in their selection processes were unsure of how to incorporate them (36/58; 62%) and wanted additional research on utility (33/58; 57%). More than half of programs indicated being at least somewhat likely to use SVI total scores (55/97; 57%) and videos (52/99; 53%) in the future.

Conclusions

Program reactions on the utility and ease of use of SVI total scores were mixed. Survey results indicate programs used the SVI cautiously in their selection processes, consistent with AAMC recommendations. Future user surveys will help the AAMC gauge improvements in user acceptance and familiarity with the SVI.
Multimethod Formative Research to Improve the Training and Delivery of Tobacco-cessation Interventions in Behavioral Health Settings
Authors: Allen Alicia Marie , Muramoto Myra L. , Campbell Jean , Connolly Timothy E. , McGuffin Beverly A. , Bernstein Andrew D.
Published: March 2019

Introduction:

Despite progress in reducing tobacco use within the general population, high prevalence of tobacco use continues in individuals with mental health and substance use disorders (“clients”). Tobacco use persists as the leading cause of premature mortality in this population. While behavioral health providers have frequent contacts with this population, they lack training in tobacco cessation counseling.

Methods:

We conducted multimethod formative data collection consisting of key informant interviews with providers, field observations at clinical sites, and structured group interviews with behavioral health providers, and, separately, clients. Activities were conducted at 4 behavioral health agencies with 9 behavioral health clinic sites in southern Arizona. Recurring phrases and level of repetition were quantified to identify themes. These themes were then used to adapt the method of training delivery and revise the curriculum content for providers at the participating sites.

Results:

Results indicated that providers had “training fatigue” and low satisfaction with multiple, online trainings. Further, providers noted issues including time constraints, competing clinical priorities, and low access to tobacco-cessation materials. Clients demonstrated high self-awareness around the importance of quitting smoking and professed frustration at being unable to quit, despite multiple attempts. Finally, both providers and clients agreed that a personal, supportive approach to cessation counseling was preferred.

Conclusions:

Using results from this formative research to revise delivery and content of existing smoking-cessation training for behavioral health providers may address barriers to assisting clients with smoking cessation. Additional research to determine the efficacy of the adapted training is needed.
Clarifying the Concept of Depression in Women With Coronary Heart Disease
Authors: Buckland Sydney , Pozehl Bunny , Yates Bernice
Published: March 2019

The concept of depression in women with coronary heart disease has been poorly defined for several reasons: numerous widely variable instruments that operationalize the concept, divergent proposed instrument cutoff scores, and continued lack of female participants and data analysis by gender in coronary heart disease research. In the forty articles from 1990 to 2018 evaluating depression in women with coronary heart disease, the concept is defined by specific somatic and cognitive symptoms, preceded by particular physiological and psychosocial vulnerabilities, and leads to poorer outcomes. Concept clarification is necessary for accurate diagnosis of depression, leading to more timely and appropriate interventions for women.
Pediatric femoral osteotomy: a review
Authors: Kotb Ahmed , Abdelgawad Amr A. , Elghonimy Mohamed B. , Elsobky Ihab A.
Published: March 2019

The aim of proximal femoral osteotomies in pediatrics is to restore normal anatomy and obtain joint congruency to prevent long-term degenerative hip problems. These osteotomies play an important role in the management of hip dislocations or subluxations due to neurological and other conditions that affect the hip. Femoral derotational osteotomy is an effective treatment in decreasing femoral anteversion. Derotational osteotomy may be indicated in patients with hip pain, gait disturbances, or cosmetic deformity. Distal femoral osteotomies are used for the correction of deformities in all directions of the distal femur: malalignment in the frontal plane, flexion deformities of the knee and rotational abnormalities and various combinations. Our study aimed to review femoral osteotomy techniques in the pediatric population in relation to the different pathological challenges around the hip and knee joints.
Quality Improvement in Online Course Development
Authors: King Tara Spalla , Nininger Jami M.
Published: March 2019

Online courses and programs in higher education, including nursing education, continue to multiply exponentially in the United States. In order to meet accreditation standards and build internal standards of quality in online course delivery, nursing administrators and faculty must keep abreast of evidence and best practice in online course design. Awareness and adoption of online standards of excellence may be a departure from standard operating procedure with faculty adept at creating face-to-face courses and mavericks self-taught in online course development. The Plan-Do-Study-Act process for improvement is a viable and scalable method to achieve national certification of online course quality, improving ability to compete in a dynamic online education environment. Considerations of infrastructure and multiple stakeholder groups are critical to successful implementation. The case of one nursing program that used faculty development, team building, and continuous quality improvement to successfully reach national online quality benchmarks is presented.
WHO Surgical Checklist in Dermatology: Compliance, Barriers, and Attitudes
Authors: Tian Tina M. , Bray Adam P.J.J. , Bogucki Pawel , Myers Lynne , de Berker David
Published: March 2019

BACKGROUND

The World Health Organization (WHO) surgical checklist is associated with reduced morbidity and mortality. Efficacy correlates with compliance.

OBJECTIVE

This study aims to (1) establish completion rate and (2) identify and address barriers to use.

METHODS

Records of patients undergoing dermatological surgery were studied. Staff completed attitude and barriers questionnaires. Checklist process was modified, and use was reassessed twice.

RESULTS

Cycle 1 involved 217 subjects; 72% had excisions. Thirteen percent had surgery to multiple sites. Five percent of checklists were fully completed, with an average of 76% of available points per checklist marked as checked. The lowest single field use included “patient identity” (76%) and “surgical site” (72%). Questionnaire responses from 25 staff showed the checklist to be “important” and “relevant” in dermatology; key barrier to completion was lack of time. Checklist modifications and educational sessions were undertaken; checklist use was reassessed twice more with 103 and 134 patients. Average use increased to 96% and 98%; full completion increased to 71% and 70%; “surgical site” and “identity” completion increased to 100%.

CONCLUSION

The WHO checklist is relevant and important in dermatology. Introduction must be supported by repeated training sessions. Adequate time and training can significantly improve checklist completion and patient safety.
Radiofrequency Therapy and Noncosmetic Cutaneous Conditions
Authors: Ekelem Chloe , Thomas Logan , Van Hal Michele , Valdebran Manuel , Lotfizadeh Ali , Mlynek Karolina , Mesinkovska Natasha Atanaskova
Published: March 2019

BACKGROUND

The need for noninvasive methods in treatment of cutaneous disease has continued to evolve exponentially. Amidst the search for technologies, radiofrequency (RF) has proven efficacious in numerous skin disease processes. Although RF is well known for its cosmetic utility, its mechanism is valued in the treatment of many noncosmetic cutaneous conditions of various etiologies.

OBJECTIVE

To identify and describe studies in which RF was used to treat noncosmetic skin conditions and to explore the potential of this modality for further application in dermatologic diseases.

MATERIALS AND METHODS

The PubMed database was used to find relevant articles.

RESULTS

This search strategy yielded 54 articles that met the eligibility criteria. Noncosmetic indications discussed in these articles include varicose veins (n = 10,550), lymphangioma circumscriptum (n = 72), cutaneous neoplasms (n = 42), cutaneous leishmaniasis (n = 743), acne and acne scarring (n = 158), non–acne scarring (n = 43), primary axillary hyperhidrosis (n = 76), and acute and chronic wounds (n = 94).

CONCLUSION

Treatment with RF is an effective, generally noninvasive modality with a relatively short postprocedure recovery time and little potential for severe adverse effects in the treatment of several cutaneous conditions. Further clinical studies would prove useful to assess the efficacy and cost-effectiveness of this treatment.
An Overview of Analytical Methods for in Vitro Bioassay of Actinides
Authors: Thakur P. , Ward A.L.
Published: March 2019

The bioassay of urine and fecal samples has been used since the 1940s to determine an individual’s uptake of uranium and actinide elements such as americium and plutonium. Over the years, several analytical separation methods and techniques have been employed for these types of analyses. Analytical separations, ranging from solvent extraction and anion exchange to chromatography, and analytical techniques, ranging from autoradiography to kinetic phosphorescence to fission-track analysis and high-resolution solid-state alpha spectroscopy, have been used at one time or another. Over the last few decades, there have been significant advances in radiochemical separations, as well as an increased use of mass spectroscopy, to determine trace and ultratrace levels of actinides in urine and fecal samples. This review summarizes and discusses developments in radiochemical separation methods and advancements in analytical techniques for actinide bioassay since the early 1940s to the present, followed by a recent development and trend in the bioassay of actinides—particularly in urine and fecal samples.
Determination of Whole-Body and Lens Dose Conversion Factors for Japanese Field Mice, Apodemus Speciosus
Authors: Perri Brian J. , Johnson Thomas E.
Published: March 2019

The 11 March 2011 Fukushima nuclear accident in Japan resulted in widespread radioactive contamination within the 20 km evacuation zone. Japanese field mice (Apodemus speciosus) living within the contaminated region received radiation doses from external environmental contamination as well as internally deposited radionuclides. Cataract formation in the lens of eyes of these mice is a possible deterministic effect of ionizing radiation; however, determination of actual doses is difficult. Since no dose conversion factors currently exist for the lens of the eyes of Japanese field mice, lens dose conversion factors were created using a Monte Carlo N-Particle simulation and compared to the International Commission on Radiological Protection Publication 108 reference rat whole-body dose conversion factors. Monte Carlo N-Particle simulations included doses to the lens of the eyes from external sources (received while both above and below ground), as well as doses from internal contamination. Although the Publication 108 reference rat is almost twice the average mass of the Japanese field mouse, all dose conversion factor calculations using Monte Carlo N-Particle methods were within approximately 37% of the Publication 108 values for the reference rat.
COMPARISON OF VISUAL/ANATOMICAL OUTCOMES AND RECURRENCE RATE BETWEEN ORAL SPIRONOLACTONE AND PHOTODYNAMIC THERAPY FOR NONRESOLVING CENTRAL SEROUS CHORIORETINOPATHY
Authors: Kim Dong Yoon , Lee Jong Young , Lee Eun Kyoung , Kim Jin Young
Published: March 2019

Purpose:

To compare long-term visual/anatomical outcomes and recurrence rate between oral spironolactone (SPRL) treatment and half-dose photodynamic therapy for nonresolving central serous chorioretinopathy.

Methods:

This retrospective, interventional, comparative study included 50 nonresolving central serous chorioretinopathy patients who had exhibited subretinal fluid (SRF) accumulation for >3 months. Of the 50 patients, 26 (26 eyes) received oral SPRL treatment and 24 (24 eyes) received half-dose photodynamic therapy. Best-corrected visual acuity, central subfield thickness, SRF height, and subfoveal choroidal thickness were compared between groups at 1, 2, 3, 6, and 12 months after treatment by using repeated-measures analysis of variance.

Results:

After treatment, best-corrected visual acuity, central subfield thickness, and SRF height significantly improved in both groups, compared with baseline. There were no significant differences in best-corrected visual acuity, central subfield thickness, or SRF height between the two groups, with the exception of 3 and 12 months of follow-up for central subfield thickness (P = 0.016 and P = 0.028, respectively) and 3 months of follow-up for SRF height (P = 0.039). However, recurrence was more likely to occur in the oral SPRL group than in the half-dose photodynamic therapy group (P = 0.002).

Conclusion:

Oral SPRL treatment for nonresolving central serous chorioretinopathy showed good long-term visual/anatomical outcomes, compared with half-dose photodynamic therapy. However, recurrence was more likely to occur when using oral SPRL.
Herpes Zoster Ophthalmicus Review and Prevention
Authors: Davis Andrew R. , Sheppard John
Published: March 2019

Varicella-zoster virus (VZV) is the etiologic agent of both chickenpox and Herpes zoster (HZ). In the United States, there are around one million cases of HZ per year. Ten percent of HZ cases are subtyped as herpes zoster ophthalmicus (HZO) specifically and involve the V1 distribution. Herpes zoster ophthalmicus is a significant cause of blindness in the United States. This article will provide a basic overview of VZV, HZ, and HZO with a focus on preventative measures in an effort to prevent blindness through improving clinician awareness and education. The differences in clinical effectiveness and duration of effectiveness of the live (Zostavax) and recombinant vaccines (Shingrix) are illustrated. There is now a trend toward using the recombinant vaccine as recommended by the Advisory Committee for Immunization Practices (ACIP) for healthy adults 50 or older.
Improving Coping Styles in Family Caregivers of Psychiatric Inpatients Using Planned Behavior Problem-Solving Training
Authors: Abedi Zahra , Alavi Mousa , Ghazavi Zahra , Visentin Denis , Cleary Michelle
Published: March 2019

Background:

The consequences and high costs of psychiatric disorders impact family caregivers greatly. Health services should identify and provide accessible support programs to facilitate effective caregiver coping.

Purpose:

The aim of this study was to determine the effectiveness of a theory-of-planned-behavior-based problem-solving training program on the coping styles of family caregivers of psychiatric inpatients.

Methods:

In this two-group, randomized control trial, 72 family caregivers were randomly assigned to either a control group receiving standard care or an intervention group receiving a training program (eight sessions over 4 weeks). Demographic information was recorded at baseline, and the Coping Inventory for Stressful Situations was administered to both groups at baseline, immediately postintervention, and 1-month follow-up.

Results:

Immediately after the intervention, the intervention group earned significantly higher task-oriented coping style scores (mean difference = 5.03, p = .015) than the control group, but no significant difference was detected between the two groups for either emotion- or avoidance-oriented coping style scores. At 1-month follow-up, the intervention group earned significantly higher scores than the control group for task-oriented (mean difference = 8.56, p < .001) and emotion-oriented (mean difference = 7.14, p = .002) coping styles. No improvement in avoidance-oriented coping style at the postintervention or follow-up time points was detected.

Conclusions:

Implementation by nurses and other health professionals of problem-solving training programs that are based on the theory of planned behavior is recommended to strengthen the use of task- and emotion-oriented approaches that help family caregivers of psychiatric patients better cope with stress.
Partial Pericardial Agenesis Mimicking Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Castelletti Silvia , Crotti Lia , Dagradi Federica , Rella Valeria , Salerno Sabrina , Parati Gianfranco , Cecchi Franco
Published: March 2019

Absence of the pericardium is a rare congenital disease in which the fibroserum membrane covering the heart is partially or totally absent. It is characterized by few echocardiography (ECG) and imaging features that can mislead the diagnosis to an inherited cardiac disease, such as arrhythmogenic right ventricular cardiomyopathy. Although it has often a benign course, this congenital defect should be identified as in some cases herniation and strangulation can be life-threatening and cause sudden cardiac death. Red flags on ECG (sinus bradycardia, variable T-wave inversion), chest x-ray (Snoopy sign, absence of tracheal deviation, and esophagus impression), and transthoracic echocardiogram (unusual windows, teardrop left ventricle, and elongated atria) should rise the suspicion of pericardium absence. The correct diagnosis, confirmed by cardiac magnetic resonance, is mandatory as the consequences on the sport activity certification, the management, and the treatment are extremely different.
The Relationship Between Completion of Postprofessional Orthopedic Manual Physical Therapy Education and Core Values of Professionalism
Authors: Thomas Dawn , Krauss John , Thompson Kristine , Stiller Christine
Published: March 2019

Purpose.

Professionalism is defined by the American Physical Therapy Association using behavioral sample indicators representing 7 core values in its core document, Professionalism in Physical Therapy: Core Values (PCV). The purpose of this study was to examine the graduates' perceived effect of graduation from a university-based postprofessional certificate in Orthopedic Manual Physical Therapy (OMPT) on sample indicators representing the core values of accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility as well as their perception of recognition by others as providing excellence in physical therapy.

Methods:

178 graduates of the OMPT program participated in the study. An OMPT Graduate Survey developed for this study included 29 Likert items and one open ended question. Constructs were established to represent each core value as well as an additional construct representing recognition by others as providing excellence in physical therapy. Quantitative analysis included descriptive statistics. The constant comparative method was used for qualitative analysis.

Results:

Six core value constructs and the recognition construct yielded a mean of 4 (agreement) or greater and social responsibility yielded a mean of 3.37 (neutral). Qualitative data revealed four themes: relationships with clients and others, knowledge/expanded understanding, skills/outcomes, and perception of self/personal growth.

Discussion:

Graduates' perceptions of enhanced core values except social responsibility, increased recognition of excellence by others, and improved perception of self and personal growth could lead to overall enhancement of professionalism through increased opportunities for graduates to be influential to peers, institutions, the profession of physical therapy, health care and society. Strategies could be developed within post professional programs to further facilitate social responsibility into the profession of physical therapy.

Conclusion:

The completion of a post professional program may contribute to development of the core values except social responsibility, an increased recognition by others as providing excellence in physical therapy, enhanced job satisfaction, increased confidence, and personal growth.
May-Thurner Syndrome: An often-missed cause of chronic pelvic pain
Authors: Ruel Jennifer
Published: March 2019

May-Thurner syndrome (MTS), or iliac vein compression syndrome, is a pelvic condition that involves compression of the iliac veins resulting in endothelial damage. This condition is typically asymptomatic and often missed in primary care. As progression occurs over time, symptoms related to venous hypertension may be present including acute extremity pain and swelling, pelvic pain, venous claudication, deep venous thrombosis, or chronic development of venous insufficiency. A case report is provided to enhance primary health care providers' knowledge of MTS and promote early detection and recognition to enhance positive and expedited outcomes.
The E3 ubiquitin ligase inducible degrader of the LDL receptor/myosin light chain interacting protein in health and disease
Authors: van Loon Nienke M. , Lindholm Dan , Zelcer Noam
Published: March 2019

Purpose of review

The RING E3 ubiquitin ligase inducible degrader of the LDL receptor (IDOL, also known as MYLIP) promotes ubiquitylation and subsequent lysosomal degradation of the LDL receptor (LDLR), thus acting to limit uptake of lipoprotein-derived cholesterol into cells. Next to the LDLR, IDOL also promotes degradation of two related receptors, the very LDL receptor (VLDLR) and apolipoprotein E receptor 2 (APOER2), which have important signaling functions in the brain. We review here the emerging role of IDOL in lipoprotein and energy metabolism, neurodegenerative diseases, and the potential for therapeutic targeting of IDOL.

Recent findings

Genetic studies suggest an association between IDOL and lipoprotein metabolism in humans. Studies in rodents and nonhuman primates support an in-vivo role for IDOL in lipoprotein metabolism, and also uncovered an unexpected role in whole-body energy metabolism. Recent evaluation of IDOL function in the brain revealed a role in memory formation and progression of Alzheimer's disease. The report of the first IDOL inhibitor may facilitate further investigations on therapeutic strategies to target IDOL.

IDOL is emerging as an important determinant of lipid and energy metabolism in metabolic disease as well as in Alzheimer's disease. IDOL targeting may be beneficial in treating these conditions.
Perspectives on optimizing radiotherapy dose to the dysphagia/aspiration-related structures for patients with head and neck cancer
Authors: Barnhart Molly K. , Hutchison Alana R.
Published: March 2019

Purpose of review

The purpose of this study is to provide an overview on the methodologies, outcomes and clinical implications of studies that have investigated swallowing outcomes after head and neck cancer (HNC) treatment when reducing radiotherapy dose to specific dysphagia/aspiration-related structures (DARS).

Recent findings

Overall, there is limited recent evidence, with a lack of high-quality studies, which examine the outcomes of DARS-optimized radiotherapy treatment. Large variations exist in the methodology of these studies in regards to which DARS are delineated and how swallowing outcomes are measured. Consequently, there is a wide range of dose limits recommended to a variety of DARS structures. Despite these limitations, there appears to be a general consensus that optimizing dose to the DARS will result in some reduction of dysphagia after radiotherapy without compromising on treatment to the tumour.

More rigorous study must be completed to determine the true extent of clinical benefit from this practice. Institutions must take into consideration the limitations of the evidence as well as logistical costs of implementing this technique into practice. However, optimizing dose to the DARS appears to be a well-tolerated practice that may have substantial positive benefits for patients’ swallowing function and quality of life after HNC treatment.
Energy Balance in Critically Ill Children With Severe Sepsis Using Indirect Calorimetry
Authors: Ismail Javed , Bansal Arun , Jayashree Muralidharan , Nallasamy Karthi , Attri Savita V.
Published: March 2019

Objectives:

Energy needs in critically ill children are dynamic and variable. Data on energy balance in children with severe sepsis using indirect calorimetry (IC) is lacking. Thus, we planned to study the energy needs and balance of this cohort.

Methods:

Prospective observational study conducted in ventilated children aged 5 to 12 years, admitted in pediatric intensive care unit with severe sepsis from May 2016 to June 2017. Measured resting energy expenditure (mREE) was measured with IC (Quark RMR, COSMED) till 7 days or pediatric intensive care unit discharge. Predicted energy expenditure (pREE) was estimated using Schofield, Harris and Benedict, and FAO/WHO/UNU equations. Primary outcome was to study the daily energy balance. Secondary outcome was to determine nitrogen balance and agreement of mREE with pREE.

Results:

Forty children (24 boys) with median age of 7 (5.2, 10) years were enrolled. All received enteral nutrition; 35 (87.5%) received inotropic support. Median ventilation‐free days were 19 days and 4 children died (10%). A total of 176 IC measurements were obtained with an average of 4 per patient. The mean mREE was 51 ± 17 kcal/kg and mean respiratory quotient was 0.77 ± 0.07. There was persistent negative energy balance from days 1 to 7 and negative nitrogen balance from days 1 to 5. There was poor agreement of pREE with mREE using Bland Altman plots. None of severity of illness scores (PRISM III, daily Sequential Organ Function Assessment, daily Vasoactive Inotropic Score) showed correlation with mREE.

Conclusions:

Persistent negative energy and nitrogen balance exist during acute phase of severe sepsis. Predictive equations are inaccurate compared with IC as the criterion standard.
Passenger Lymphocyte Syndrome After Pediatric Liver Transplantation
Authors: Woolfson Jessica P. , Vandriel Shannon M. , Stephens Derek , Dharmaraj Blossom G. , De Angelis Maria , Cattral Mark S. , Ghanekar Anand , Grant David R. , Avitzur Yaron , Ng Vicky L.
Published: March 2019

Background:

Passenger lymphocyte syndrome (PLS) is a less known etiology of acute onset anemia following ABO‐compatible (ABO‐c) liver transplantation (LT). Available literature on PLS after pediatric LT is limited. Therefore, we evaluated the prevalence, clinical course, and risk factors of PLS in children following ABO‐c LT.

Methods:

A single‐center retrospective review of all children who underwent LT between 2000 and 2017 was performed. PLS was defined as a drop‐in hemoglobin >20 g/L within 30 days of LT, with positive direct antiglobulin test and 1 laboratory test confirming hemolysis. Chi square and student t tests compared variables between subjects with and without PLS.

Results:

Amongst 333 pediatric LT performed, 51 children received an ABO‐c graft. PLS was diagnosed in 7 (14%) subjects at a median of 10 days after LT. There were no significant differences in patient demographics, graft type, or immunosuppression between those who did and did not develop PLS. Recipient blood group A+ receiving a donor O+ graft was a risk factor for PLS (P = 0.015). All PLS subjects recovered with blood transfusions (median 2), and no additional interventions. Three subjects initially received recipient (instead of donor) blood group red cells.

Conclusions:

We report a 14% prevalence of PLS following pediatric ABO‐c LT. Recipient blood group A+ receiving a donor O+ graft is a risk factor for PLS. Recognition of PLS as a cause of early acute anemia in pediatric ABO‐c LT enables timely transfusion with donor (rather than recipient) blood group red cells.
Three-dimensional path of the body centre of mass during walking in children: an index of neural maturation
Authors: Malloggi Chiara , Rota Viviana , Catino Luigi , Malfitano Calogero , Scarano Stefano , Soranna Davide , Zambon Antonella , Tesio Luigi
Published: March 2019

Few studies have investigated the kinematic aspects of the body centre of mass motion, that is, its three-dimensional path during strides and their changes with child development. This study aimed to describe the three-dimensional path of the centre of mass in children while walking in order to disentangle the effect of age from that of absolute forward speed and body size and to define preliminary pediatric normative values. The three-dimensional path of the centre of mass during walking was compared across healthy children 5–6− years (n = 6), 7–8 years (n = 6), 9–10 years (n = 5), and 11–13 years of age (n = 5) and healthy adults (23–48 years, n = 6). Participants walked on a force-sensing treadmill at various speeds, and height normalization of speed was conducted with the dimensionless Froude number. The total length and maximal lateral, vertical, and forward displacements of the centre of mass path were calculated from the ground reaction forces during complete strides and were scaled to the participant’s height. The centre of mass path showed a curved figure-of-eight shape. Once adjusted for speed and participants’ height, as age increased, there was a decrease in the three-dimensional parameters and in the lateral displacement, with values approaching those of adults. At each step, lateral redirection of the centre of mass requires brisk transient muscle power output. The base of support becomes relatively narrower with increasing age. Skilled shortening of the lateral displacement of the centre of mass may therefore decrease the risk of falling sideways. The three-dimensional path of the centre of mass may represent maturation of neural control of gait during growth.
Oxytocin Guidelines Associated with Compliance to National Standards
Authors: Jackson Jodi K. , Wickstrom Elizabeth , Anderson Betsi
Published: March 2019

Objective:

Develop a multidisciplinary, consensus-driven, evidence-based approach to oxytocin use, while adhering to national guidelines.

Design:

This was a quality improvement project that used the Plan Do Study Act method to create cycles of change over several years. To initiate discussion, a survey was administered at a social event for providers from divergent community practices that addressed the controversial aspects of oxytocin use. Graphic feedback was provided showing divergences between answers and the evidence. The perinatal team directed design and implementation of this project with specific involvement of a nurse quality improvement coordinator and nurse educator.

Measures:

Process, outcome, and balancing measures were used to evaluate the program. Process measure: use of a standardized order-set. Outcome measure: rate of adherence to the resultant protocol. Balancing measures: 1) maximum oxytocin dose, 2) time from oxytocin initiation to birth, 3) cesarean birth rates, and 4) Apgar scores.

Results:

An initial increase in adherence to the protocol decreased with the loss of the “paper” order-set. Adherence improved when computerized physician order entry was adjusted: 2006: 73%, 2007: 95%; 2011: 57%, 2013: 100% (p = 0.007, 2006 vs. 2007) (p < 0.001, 2006 vs. 2013). Compliance with the protocol was associated with a decrease in maximum oxytocin dose and in time between oxytocin initiation and birth (p < 0.001).

Conclusion:

Consistency and safety in patient care can be accomplished using literature-based evidence and active consensus building among members of the perinatal team. A standardization process must be integrated into the electronic medical record to become a sustained part of a practice culture.
Smartphone-Related Accidents in Children and Adolescents
Authors: Wagner Richard , Gosemann Jan-Hendrik , Sorge Ina , Hubertus Jochen , Lacher Martin , Mayer Steffi
Published: March 2019

Objectives

Smartphones have become an integral part of daily life, often grabbing full attention of its user. We hypothesized that smartphone-associated trauma in children and adolescents has increased in the last decade. The objective of this study was to analyze smartphone-related injuries in children at two German centers for pediatric emergency care.

Methods

Smartphone-related injuries were recorded between January 2008 and March 2018 at two centers of pediatric surgery in Germany. Data were assessed for patient demography, cause of accident, type of injury, treatment, and outcome.

Results

Ten children (8 girls, 2 boys; mean ± SD age, 10.6 ± 6.0 years; range, 10 weeks to 17 years) were included. Two patients were injured in 2008 to 2015, eight in 2016 to 2018, of which three required hospital admissions. Six accidents happened in public spaces, and four within domestic environments. Eight children (mean ± SD age, 13.3 ± 2.4 years; 7 girls) were injured while using their smartphone, therefore being distracted. Two children (mean ± SD age, 6.5 ± 6.4 months) were involuntarily hurt by the smartphone of their caregivers. The causes of accident and related injuries were highly variable and ranged from minor trauma (mild head injury [n = 3], abrasions [n = 2], bruises of fingers [n = 2]/hand [n = 1]/ankle [n = 2]) to major injuries requiring intensive care treatment (pelvic [n = 1] or vertebral body fractures [n = 1]).

Conclusions

Smartphone-associated injuries mainly caused by distraction gain increasing importance in pediatric traumatology. The frequency is higher in females compared with their male counterparts. The prevention of these accidents should become part of educational programs for children and adolescents.
Safety, Biodistribution, and Dosimetry of 123I-6-Deoxy-6-Iodo-D-Glucose, a Tracer of Glucose Transport, in Healthy and Diabetic Volunteers
Authors: Calizzano Alex , Perret Pascale , Desruet Marie-Dominique , Ahmadi Mitra , Reboulet Ghislaine , Djaileb Loïc , Vanzetto Gérald , Fagret Daniel , Barone-Rochette Gilles , Ghezzi Catherine
Published: March 2019

Purpose

Insulin resistance is a key feature of the metabolic syndrome and type 2 diabetes, in which noninvasive assessment is not currently allowed by any methodology. We previously validated an iodinated tracer of glucose transport (6DIG) and a new methodology for the in vivo quantification of cardiac insulin resistance in rodents. The aim of this study was to investigate the safety, biodistribution, and radiation dosimetry of this method using 123I-6DIG in 5 healthy and 6 diabetic volunteers.

Methods

The collection of adverse effects (AEs) and medical supervision of vital parameters and biological variables allowed the safety evaluation. Biodistribution was studied by sequentially acquiring whole-body images at 1, 2, 4, 8, and 24 hours postinjection. The total number of disintegrations in each organ normalized to the injected activity was calculated as the area under the time-activity curves. Dosimetry calculations were performed using OLINDA/EXM.

Results

No major adverse events were observed. The average dose corresponding to the 2 injections of 123I-6DIG used in the protocol was 182.1 ± 7.5 MBq. A fast blood clearance of 123I-6DIG was observed. The main route of elimination was urinary, with greater than 50% of urine activity over 24 hours. No blood or urine metabolite was detected. 123I-6DIG accumulation mostly occurred in elimination organs such as kidneys and liver. Mean radiation dosimetry calculations indicated an effective whole-body absorbed dose of 3.35 ± 0.57 mSv for the whole procedure.

Conclusions

123I-6DIG was well tolerated in human with a dosimetry profile comparable to that of other commonly used iodinated tracers, thereby allowing further clinical development of the tracer.
Fabrication of Poly(l-Lactic Acid)/Chitosan Scaffolds by Solid–Liquid Phase Separation Method for Nerve Tissue Engineering: An In Vitro Study on Human Neuroblasts
Authors: Salehi Majid , Farzamfar Saeed , Bozorgzadeh Shaghayegh , Bastami Farshid
Published: March 2019

Polymeric scaffolds that support neural cell behaviors are attracting more attention. In the present study, solid–liquid phase separation technique is used to fabricate scaffolds made of poly(l-lactic acid) (PLLA) and chitosan (CS) blends to mimic both cellular microenvironment and anatomical structure of nerve tissue. The fabricated scaffolds favor characteristics of both natural and synthetic polymers. Different tests and assays including physical and mechanical ones (in vitro degradation rate, free radical release, hydrophilicity, and porosity measurements, microstructure observation, and mechanical tests) and cellular assays (cell attachment measurement and viability assessment) suggest that blend scaffolds prepared with this method support nerve cells for tissue engineering applications adequately and even better than scaffolds prepared with the same method but from pure PLLA or CS.
Surgical Treatment Strategy and Perioperative Analysis of Patients With Intracranial Mirror Aneurysms
Authors: Zhou Han , Cheng Jing , Liu Hengjian , Lu Donglin , Feng Yugong
Published: March 2019

Object:

Intracranial mirror aneurysm is a type of multiple aneurysms, which is rare in clinical and literature. There is no unified conclusion on the treatment strategy of mirror aneurysms. Therefore, our study evaluated the surgical approach and prognosis of a series of mirror aneurysms, and explored the clinical features and treatment strategies of mirror aneurysms.

Methods:

This study retrospectively analyzed the clinical features, imaging data, treatment methods and post-hospital results of 67 cases of mirror aneurysms admitted to our department from December 1997 to April 2018.

Results:

There were 20 males and 47 females with an average age of 53.6 years. Mirror aneurysms are mainly located in the posterior communicating artery and middle cerebral artery. Of 67 patients, 1-stage unilateral craniotomy with bilateral aneurysms in 18 cases, 1-stage bilateral craniotomy with bilateral aneurysms in 17 cases, staged treatment of bilateral aneurysms in 13 cases, and 19 cases only treated the responsible aneurysms. 57 cases with good recovery; 7 cases were self-care; 1 case was heavy disability; 2 cases were dead. In parallel, 8 cases had different degrees of cerebral infarction, 3 cases of hydrocephalus, 3 cases of oculomotor nerve injury, 2 cases died of cerebral hernia resulted from intracranial hypertension, and the remaining 53 cases were better.

Conclusions:

The treatment of the mirror aneurysm should be based on the location, size, shape of the aneurysm, the patient's clinical manifestations and the surgeon's experience to choose a personalized treatment.
Morphometric Analysis of Sphenoid Sinus in Patients With Nasal Septum Deviation
Authors: Orhan Israfil , Ormeci Tugrul , Bilal Nagihan , Sagiroglu Saime , Doganer Adem
Published: March 2019

This retrospective study aimed to assess the association of the volume and types of the sphenoid sinus with deviated nasal septum by analyzing multislice computed tomography images. A total of 93 patients with a deviated nasal septum and 70 healthy controls were included in the study. Patients with sinonasal morbidities other than deviation were excluded. Three-dimensionally reconstructed computed tomography images of the study participants were acquired. A total of 326 sphenoid sinus volumes from the patient and control groups were obtained and compared between the groups. Sphenoid sinus volumes and the angle of the deviation were measured for standardization and assessment of the severity. Deviated nasal septum was found on the right in 49.5% (n = 46) and on the left in 50.5% (n = 47) of the study participants. Deviation angles were in the range from 7.2° to 22.4° and the mean value was 13.2° ± 5.0°. The measured volumes were in the range from 1.8 cm3 to 9.6 cm3 with a mean of 4.8 ± 1.5 cm3. In the control group, the median values for the sphenoid sinus volumes were 4.40 cm3 (0.80–8.90 cm3) on the right and 4.20 cm3 (0.90–8.70 cm3) on the left. In the study group, sphenoid sinus volumes were found to be statistically significantly different between those on the ipsilateral and contralateral side of the septal deviation. Sphenoid sinus volumes were significantly smaller on the same side with septal deviation compared with those on the contralateral side. There was no statistical relationship between the presence of septal deviation, age and gender, and the type of sphenoid sinus.