bluuebunny/crossref_metadata_2025 huggingface dataset:
Short-term Results of the Global C.A.P. Uncemented Resurfacing Shoulder Prosthesis
Authors: Geervliet Pieter , van den Bekerom Michel , Spruyt Paul , Curvers Maud , Visser Cornelis , van Noort Arthur
Published: February 2014

The authors report the 2-year results of an uncemented resurfacing shoulder prosthesis in 47 patients with primary glenohumeral osteoarthritis who underwent a cementless humeral resurfacing arthroplasty between 2007 and 2009. Constant scores (corrected for sex and age), shoulder function, visual analog pain scales, Dutch Simple Shoulder Tests, and physical SF-12 scores improved significantly (
P
<.05) from preoperatively to 2 years postoperatively. Mental SF-12 scores remained the same. Complications included 1 traumatic lesser tuberosity avulsion fracture, 1 intra-articular loose body due to a fractured osteophyte, and 1 subscapularis tendon rupture. No patient required revision surgery for any reason. Cementless humeral resurfacing arthroplasty is a viable treatment option for primary glenohumeral arthritis. [
Orthopedics.
2014; 37(1):42–47.]
Reprocessed Arthroscopic Shavers: Evaluation of Sharpness and Function in a Cadaver Model
Authors: Ledonio Charles G.T. , Arendt Elizabeth A. , Adams Julie E. , Matz Jennifer , Boers Arie , Miller Keith , Lester Bruce R.
Published: February 2014

This study was designed to test limited arthroscopic shaver reuse following reprocessing and to compare the functional performance between new and reprocessed arthroscopic shavers in arthroscopic procedures using fresh cadaveric knees. A trial using arthroscopic procedures (menisectomy, synovectomy, and debridements) was conducted by experienced surgeons using cadaveric knees to determine whether the surgeons could correctly identify reprocessed shavers. Thirty-nine shavers were tested; the surgeons were given both new and reprocessed shavers. Thirteen of the 39 shavers were new and 26 were reprocessed (13 of which had also been sharpened). The surgeons were asked to assess whether each shaver was new or reprocessed and to indicate whether the shaver was functional or not. Cadaveric shavers were subsequently used in an engineering test developed to measure shaver blade sharpness. Comparisons in sharpness were made between new and reprocessed cadaveric shaver blades. The success rate in identifying reprocessed shavers was determined to be 42% (11 of 26), with an upper confidence bound of 60%, demonstrating that the ability to detect a reprocessed shaver is no better than chance (50%), with a margin of error of 10% (
P
=.0328). In addition, engineering sharpness testing demonstrated that new and reprocessed cadaveric blades exhibit equivalent sharpness. Surgeons were unable to distinguish reprocessed arthroscopic shavers that passed acceptance tests from new shavers based on functional characteristics. This outcome is not unexpected due to the fact that engineering testing of shaver blades used in the study indicated that they exhibited similar sharpness.
Relationship Between Preservation of the Lateral Pillar and Collapse of the Femoral Head in Patients With Osteonecrosis
Authors: Sun Wei , Li Zi-rong , Wang Bai-liang , Liu Bing-li , Zhang Qi-dong , Guo Wan-shou
Published: February 2014

It is difficult to predict if and when the femoral head will collapse and whether the collapse can be minimized. This study examined the final outcome of early-stage osteonecrosis of the femoral head (ONFH) using magnetic resonance imaging to verify the relationship between preservation of the lateral pillar and collapse of the femoral head. A midcoronal section of the femoral head was divided into 3 pillars (medial, central, and lateral) on a T1-weighted image. According to the site of necrosis on the lateral pillar, the necrosis was divided into 3 types: I, the necrosis occupies the central and medial pillars, and the lateral pillar is preserved; II, the necrosis partially occupies the lateral pillar; and III, the necrosis totally occupies the lateral pillar. One group of 87 patients (127 hips) with Association for Research on Osseous Circulation (ARCO) stage I ONFH underwent nonoperative treatment and were followed for 3 to 8 years (average, 6.2 years). Another group of 42 patients (72 hips) with ARCO stage I ONFH underwent debridement and impacted bone graft and were followed for 5 to 9 years (average, 7.1 years). In both groups, the more preserved the lateral pillar, the less collapse occurred. The authors concluded that whether ONFH progressed to collapse is determined by preservation of the lateral pillar. The lateral pillar is the keystone for maintaining the sphere of the femoral head and its preservation.
Sensitivity of Physical Examination Versus Arthroscopy in Diagnosing Subscapularis Tendon Injury
Authors: Faruqui Sami , Wijdicks Coen , Foad Abdullah
Published: February 2014

The purpose of this study was to examine the accuracy of physical examination in the detection of subscapularis tendon tears and compare it with the gold standard of arthroscopy to determine whether clinical examination can reliably predict the presence of subscapularis tendon tears. This was a retrospective analysis of 52 patients (52 shoulders) who underwent arthroscopic subscapularis tendon repairs between September 2008 and April 2012. Positive findings on any combination of the belly press, lift-off, and bear hug tests constituted a positive physical examination result. There was a positive finding on physical examination in 42 of 52 patients. The sensitivity of the physical examination as a whole was 81%. The literature has shown that the belly press, bear hug, and lift-off tests are specific to the subscapularis tendon. To the authors’ knowledge, this is the first study to evaluate the sensitivity of these 3 separate clinical tests as a composite. Knowledge regarding the sensitivity of the subscapularis-specific physical examination as a composite can lead practitioners to implement all 3 components, even when 1 test has a negative finding, thus promoting a more thorough physical examination. Because unrepaired subscapularis tendon tears can result in poor outcomes in the repair of other rotator cuff tendons, a complete physical examination would be beneficial to patients with shoulder pathology. The authors conclude that physical examination, when performed consistently by an experienced practitioner, can reliably predict the presence of subscapularis tendon tears.
Efficacy of rhBMP-2 Versus Iliac Crest Bone Graft for Posterior C1–C2 Fusion in Patients Older Than 60 Years
Authors: Yan Liang , Chang Zhen , He Baorong , Liu Tuanjiang , Wang Xiaodong , Guo Hua , Hao Dingjun
Published: February 2014

Few studies have specifically examined the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2)/absorbable collagen sponge (ACS) in posterolateral lumbar spine fusion. The purpose of this study was to report the clinical outcomes in elderly patients treated with posterior C1–C2 fusion with iliac crest bone graft (ICBG) plus rhBMP-2/ACS vs ICBG alone. One hundred forty patients older than 60 years were enrolled in this prospective, randomized trial and underwent instrumented C1–C2 fusion. Patients were divided into 2 groups based on fusion material. The ICBG group comprised patients who received ICBG alone, and the rhBMP-2/ACS group comprised patients who received ICBG plus rhBMP-2/ACS. The groups were compared based on operative time, estimated blood loss, hospital length of stay, clinical results, perioperative complications, fusion rate, fusion time, and revision rate. There were no significant differences in operative time, estimated blood loss, length of stay, and intraoperative complications between the 2 groups. Improvements in visual analog scale scores and Japanese Orthopaedic Association scores over the 2-year follow-up period were similar between groups. The fusion rate was 82.4% (56 of 68) in the rhBMP-2/ACS group and 78.7% (52 of 66) in the ICBG group (
P
=.782). Mean fusion time was 11 days shorter in the rhBMP-2/ACS group (81.8±29.4 days) than in the ICBG group (92.9±23.7 days) (
P
=.034). There were more wound complications requiring treatment in the rhBMP-2/ACS group (n=6; 8.8%) than in the ICBG group (n=2; 3.0%), although this was not statistically significant (
P
=.118). The use of rhBMP-2/ACS for posterior C1–C2 fusion appears to result in a relatively shorter fusion time, but there may be an increased risk of posterior cervical wound complications.
Isolated
Lactobacillus
Chronic Prosthetic Knee Infection
Authors: Bennett David M. , Shekhel Tatyana , Radelet Matt , Miller Michael D.
Published: February 2014

Lactobacillus
is a gram-positive rod bacteria found primarily in the gastrointestinal and female genital tracts. Prosthetic infections in implants are being increasingly reported. The authors present a case of a 58-year-old patient with
Lactobacillus s
eptic prosthetic knee joint infection. To the authors’ knowledge, this is the first reported case of chronic prosthetic knee infection with isolated
Lactobacillus
species.
Lactobacillus
has been most commonly implicated with bacteremia and endocarditis and rarely with pneumonia, meningitis, and endovascular infection, and a vast majority of the cases are reported in immunocompromised patients. In the current case, diabetes mellitus, hepatitis, malnutrition, anemia, and liver failure were comorbid conditions, placing the patient at increased risk of infection. The findings suggest that further case series are necessary to establish the significance of
Lactobacillus
as an etiologic agent in chronic low-virulence, and potentially vancomycin-resistant, prosthetic joint infection. The need also exists for further research aimed at the risk of prosthetic joint infection with oral intake of certain probiotic foods and supplements. The goal of this case report is to bring to light the potential of this organism to be a cause of subtle chronic prosthetic joint infection.
Chondroblastoma of the Patella With Aneurysmal Bone Cyst
Authors: Tan Honglue , Yan Mengning , Yue Bing , Zeng Yiming , Wang You
Published: February 2014

Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.
Osteochondritis Dissecans of the Lateral Tibial Condyle Associated With Agenesis of Both Cruciate Ligaments
Authors: Deroussen François , Hustin Charles , Moukoko Didier , Collet Louis-Michel , Gouron Richard
Published: February 2014

Osteochondritis dissecans is a rare cause of painful knees in children. Only 10 cases of lateral tibial condyle involvement have been reported in the literature. Congenital agenesis of both cruciate ligaments has been described even less, and its prevalence is unknown. The authors report an atypical association of osteochondritis dissecans of the tibia with congenital absence of both cruciate ligaments. A 12-year-old male soccer player presented with a painful right knee. Magnetic resonance imaging revealed the diagnosis. The child was treated conservatively. At 18-month follow-up, radiographs showed osseointegration of the osteochondritis dissecans, and the patient had resumed normal athletic activity without pain. To the authors’ knowledge, this is the only report describing such an association. The authors discuss the possible etiology of osteochondritis dissecans associated with agenesis of the cruciate ligaments and highlight the possibility of this association when osteochondritis dissecans of the tibia is diagnosed in a child with a painful knee. In this patient, the strain due to anteroposterior instability may have been the cause of osteochondritis. Conservative treatment should be considered in this setting.
Developing Standardized Patient Clinical Simulations to Apply Concepts of Interdisciplinary Collaboration
Authors: Koo Laura Warnock , Idzik Shannon Reedy , Hammersla Margaret Bernadette , Windemuth Brenda Faye
Published: February 2014

Interdisciplinary collaboration and interprofessional education (IPE) are essential for transforming health care. Students in nurse practitioner (NP) programs have limited exposure to IPE. Simulated clinical experiences, based on social learning theory, provide a safe and realistic environment to expose NP students to interdisciplinary collaboration as a step toward developing IPE. Faculty at a large university school of nursing developed a formative standardized patient experience to provide NP students with two opportunities to synthesize a patient assessment, to share patient problem-solving strategies, and to succinctly communicate with other health care professionals. This pilot project provided insight to better develop IPE and identified a growing interest to collaborate in future projects with faculty from other health care disciplines. [
J Nurs Educ.
2013;52(12):705–708.]
Preparing Prelicensure and Graduate Nursing Students to Systematically Communicate Bad News to Patients and Families
Authors: Little Jeanne , Bolick Beth Nachtsheim
Published: February 2014

Communicating bad news, otherwise known as difficult conversations, is a complex communication skill that requires didactic learning and practical application. Students learn that what may be interpreted as bad news is determined by the recipient and not by the person who is delivering the news. Learning a systematic approach, such as the SPIKES (
S
etting,
P
erception,
I
nvitation,
K
nowledge,
E
mpathy,
S
trategy/Summary) mnemonic, prepares prelicensure and graduate nursing students for difficult conversations with patients and families in the clinical setting. Role-playing commonly includes clinical scenarios, and using video recording and playback of the encounters in such scenarios is one method of learning the systematic approach to communicating bad news. Follow-up practice after application in the clinical setting and feedback from faculty and mentors are essential for nursing students to achieve competence in this complex set of communication skills. [
J Nurs Educ.
2014;53(1):52–55.]
Integrating Professional Apprentices Into an End-of-Life Course
Authors: Hold Judith L. , Ward Elizabeth N. , Blake Barbara J.
Published: February 2014

Nursing education faces several challenges in providing quality and meaningful education. Providing such an education is most important in teaching end-of-life care, as nurses are pivotal in helping patients to achieve a good death. A good death is often based on physical comfort, preparation for death, and completion of social and emotional tasks. Many obstacles hinder a patient’s wishes about dying, including how nurses perceive their role in end-of-life care situations and knowing how to intervene on behalf of the patient. Therefore, nursing education needs to create meaningful and relevant learning experiences to enable future nurses to effectively care for the dying patient. To this endeavor, the Palliative and End-of-Life Care course described in this article integrated knowledge through the use of three professional apprenticeships: (a) acquiring and using knowledge and science (cognitive), (b) using clinical reasoning and skilled know-how (practice), and (c) ethical comportment and formation (moral reasoning). [
J Nurs Educ.
2014;53(2):112–115.]
Evaluating the Effects of Intimate Touch Instruction: Facilitating Professional and Respectful Touch by Male Nursing Students
Authors: O’Lynn Chad , Krautscheid Lorretta
Published: February 2014

Nurses are expected to touch areas of patients’ bodies that are considered private and emotionally sensitive (intimate), yet little is known about how nursing students learn, rehearse, and incorporate appropriate touch strategies. Although touch education is important to all nurses, male students face additional challenges due to gender roles and negative stereotypes. The purpose of this quasi-experimental pilot study was to evaluate whether a 3-hour intimate touch instructional laboratory with subsequent clinical experience (intervention group) facilitated male students’ development of intimate touch knowledge, skills, and attitudes, compared with having only clinical experience and no laboratory (control group). Findings revealed that intervention group participants were significantly more comfortable with cleansing genitalia, less apprehensive about touch being misperceived as sexual, reported less gender requirement rigidity, and scored significantly higher on measures associated with client dignity, comfort, and respect than control group participants in a simulated perineal hygiene demonstration. [
J Nurs Educ
. 2014;53(3):126–135.]
Outcome of 23-Gauge Pars Plana Vitrectomy for Pediatric Vitreoretinal Conditions
Authors: Singh Ramandeep , Kumari Neha , Katoch Deeksha , Sanghi Gaurav , Gupta Amod , Dogra Mangat R.
Published: February 2014

Purpose:

To evaluate the feasibility and short-term outcome of 23-gauge vitrectomy in children for various vitreoretinal conditions.

Methods:

A retrospective chart review was conducted of consecutive children younger than 14 years who underwent 23-gauge transconjunctival sutureless vitrectomy for various vitreoretinal conditions from January 2008 to December 2011 at a tertiary care center.

Results:

Thirty-seven eyes of 31 children were included. There were 20 boys and 11 girls, aged between 1.25 months and 14 years (median: 10 years, mean: 7.23 years). The surgical indications were subluxated crystalline lens, retinopathy of prematurity stage 4, post-traumatic cataract with ruptured capsule, vitreous hemorrhage, dislocated crystalline lens, endophthalmitis, retinal detachment with vitreous hemorrhage, dislocated intraocular lens, epiretinal membrane, and increased intraocular pressure after intravitreal steroid implantation. Postoperative complications included loose blood, retinal detachment, early postoperative hypotony, and preretinal bleeding.

Conclusions:

The 23-gauge transconjunctival sutureless vitrectomy approach in children appears safe and effective.

[J Pediatr Ophthalmol Strabismus 2014;51(1):27–31.]
Effects of Visual Noise on Binocular Summation in Patients With Strabismus Without Amblyopia
Authors: Pineles Stacy L. , Lee Patrick J. , Velez Federico , Demer Joseph
Published: February 2014

Purpose:

Patients with strabismus often complain of difficulty navigating through visually stimulating environments without clear explanation for this symptom. Binocular summation (BiS), defined as the superiority of binocular over monocular viewing on visual threshold tasks, is decreased in conditions that cause large interocular differences in visual acuity, but is not well studied in strabismic populations without amblyopia. The authors hypothesized that strabismus may lead to decreased BiS for tasks related to discrimination within increased background complexity. The goal of this study was to test the extent of BiS in patients with strabismus during discrimination of a luminance target disk embedded in visual noise.

Methods:

Participants included 10 exotropic, 10 esotropic, and 13 age-matched control patients. Performance of a task detecting a luminance-target was measured at 0, 10, and 20 μdeg
2
of visual noise for binocular and monocular conditions. BiS was calculated as the ratio of binocular contrast sensitivity to monocular contrast sensitivity for the target embedded in noise.

Results:

Patients with strabismus had lower BiS values than controls, with a significant decrease on linear regression in patients with strabismus at 20 μdeg
2
of noise (
P
= .05), with a trend toward significance at 10 μdeg
2
of noise (
P
= .07). Patients with strabismus showed a mean binocular inhibition (summation ratio < 1) at both noise levels.

Conclusions:

These findings support the hypothesis that strabismus can lead to decreased BiS and even binocular inhibition. Despite literature showing enhanced BiS in visually demanding situations such as high levels of visual noise or low contrast, BiS was not significantly affected by visual noise in either group.

[J Pediatr Ophthalmol Strabismus 2014;51(2):100–104.]
Evidence-Based Solution-Focused Care for School-Age Children Experiencing Cyberbullying: Using the Omaha System to Guide and Document Psychiatric Nursing Interventions
Authors: Kvarme Lisbeth Gravdal , Monsen Karen A. , Eboh Winifred Oluchukwu
Published: February 2014

Cyberbullying is a global phenomenon. The experiences of bullied children are the same across cultures and languages, and psychiatric nursing interventions are known to be effective. It is critical to widely disseminate effective interventions to identify and address cyberbullying. Therefore, evidence-based care plans addressing cyberbullying at the individual and community levels were developed using the Omaha System, a terminology that is used internationally to guide and document care. This article presents a case study in which an evidence-based intervention was used to help a bullied child arrive at a solution, and demonstrates the use of the Omaha System to document evidence-based cyberbullying interventions with individuals and communities. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(3), 34–41.]
The Nurse’s Role in Primary Care Antidepressant Medication Adherence
Authors: Heise Barbara A. , van Servellen Gwen
Published: February 2014

Depression remains one of the most common conditions seen in primary care settings. Antidepressant medications (ADMs) are considered standard treatment for moderate to severe depression, and in some instances, for minor depression. When ADM adherence is low, patients are at risk for treatment failure and poor quality of life. Nurses may be key in ensuring the success of ADM therapy; however, little is known about the interventions nurses use or the consequent patient outcomes. The objectives of this article were to identify studies in which nurses managed ADM adherence and to collect evidence about the efficacy of these interventions. A systematic literature review of clinical trial studies was conducted, which specifically included the role of the nurse. Nurse interventions identified were: patient care management, medication monitoring, depression education, and referrals to specialty providers. Nurses use a range of interventions to manage ADM adherence. In most studies, these approaches, including collaborative care, were efficacious. [
Journal of Psychosocial Nursing and Mental Health Services, 52
(4), 48–57.]
Assessment of Axial Length Before and After Myopic LASIK With the IOLMaster
Authors: Tay Eugene , Li Xiang , Gimbel Howard V. , Kaye Geoffrey
Published: February 2014

PURPOSE:

To assess the relationship between theoretical ablation depth and axial length change after LASIK with the IOLMaster (Carl Zeiss Meditec, Dublin, CA).

METHODS:

Ninety-nine eyes were examined preoperatively and 1 and 3 months after LASIK.

RESULTS:

Mean ± standard deviation (SD) spherical equivalent before LASIK was −4.06 ± 1.91 diopters (D). Mean ± SD ablation depth was 83.13 ± 30.31
μ
m. Mean ± SD postoperative axial length of 25.11 ± 0.14 mm at 1 month was significantly shorter than mean ± SD preoperative axial length of 25.20 ± 0.14 mm (
P
< .001) with no subsequent change thereafter (
P
= .450). An increase in ablation depth of 1
μ
m led to a decrease in axial length of 0.00118 ± 0.00005 mm. Ablation depth correlated strongly with change in axial length (adjusted R
2
= 0.9039).

CONCLUSIONS:

The IOLMaster showed a decrease in axial length after LASIK that correlated well with theoretical ablation depth.

[
J Refract Surg.
2013;29(12):838–841.]
Optical Quality Differences Between Three Multifocal Intraocular Lenses: Bifocal Low Add, Bifocal Moderate Add, and Trifocal
Authors: Madrid-Costa David , Ruiz-Alcocer Javier , Ferrer-Blasco Teresa , García-Lázaro Santiago , Montés-Micó Robert
Published: February 2014

PURPOSE:

To compare the in vitro optical quality at different focal points of two new bifocal intraocular lenses (IOLs) and one new trifocal IOL.

METHODS:

The AcrySof ReSTOR SV25T0 (+2.5 diopter [D] add) and the AcrySof ReSTOR SN6AD1 (+3.0 D add) with two main foci (Alcon Laboratories, Fort Worth, TX) and the AT LISA tri 839MP with three main foci (Carl Zeiss Meditec, Dublin, CA) were evaluated. The optical quality of the IOLs was measured with the PMTF optical bench (LAMBDA-X, Nivelles, Belgium). The optical quality of the IOLs was quantified by the modulation transfer function (MTF) at five different focal points (0.0, −1.5, −2.0, −2.5, and −3.0 D) and for 3.0- and 4.5-mm apertures. The through-focus MTF of the IOLs was also recorded.

RESULTS:

For the 0.0 D focal point, the AcrySof ReSTOR (+2.5 D add) obtained the highest MTF values for all apertures. For the −2.5 D focal point, the AcrySof ReSTOR (+3.0 D add) showed the highest MTF values for 3.0 mm. For the −3.0 D focal point at 3.0- and 4.5-mm aperture, the best values were obtained with the AcrySof ReSTOR (+3.0 D add) and the AT LISA, respectively. For the −1.5 D focal point, the trifocal IOL provided better values. For the −2.0 D focal point, all IOLs provided comparable results. The through-focus MTF curves showed three and two peaks for the trifocal and bifocal IOLs, respectively.

CONCLUSIONS:

The trifocal IOL provides a better optical quality at the −1.5 D focal point. However, the optical quality of the trifocal IOL significantly decreases compared to the bifocal IOLs at far distance and −2.5 D focal points.

[
J Refract Surg.
2013;29(11):749–754.]
Accuracy and Reproducibility of Cap Thickness in Small Incision Lenticule Extraction
Authors: Reinstein Dan Z. , Archer Timothy J. , Gobbe Marine
Published: February 2014

PURPOSE:

To evaluate the accuracy and reproducibility of cap thickness for small incision lenticule extraction (SMILE) with the VisuMax femtosecond laser (Carl Zeiss Meditec, Inc., Jena, Germany).

METHODS:

Artemis very high-frequency digital ultrasound (ArcScan Inc., Morrison, CO) measurements were obtained before and 3 months after SMILE in 70 eyes of 37 patients with intended cap thickness between 80 and 140
μ
m. True cap thickness at the time of creation was calculated as the addition of the preoperative epithelial thickness and the postoperative stromal component of the flap and mapped for the central 5-mm diameter zone. Cap thickness accuracy was calculated as the difference between the mean and intended cap thickness. Reproducibility was evaluated as the cap thickness standard deviation between eyes. Accuracy and reproducibility of cap thickness were calculated for all eyes and grouped by intended cap thickness. Within-eye variation in cap thickness was calculated as the standard deviation of all data within the central 5-mm diameter zone.

RESULTS:

Mean cap thickness accuracy was between −2.3 and 6.5
μ
m and was −0.7
μ
m centrally (range: −11 to +14
μ
m), including all eyes. Cap thickness reproducibility was 6
μ
m or less for the majority of the central 5-mm diameter zone and was 4.4
μ
m centrally. Cap thickness accuracy and reproducibility were similar for different intended cap thicknesses. Average within-eye variation in cap thickness was 4.3
μ
m.

CONCLUSIONS:

SMILE cap thickness using the VisuMax femtosecond laser was found to be accurate and reproducible across the central 5-mm diameter zone for intended cap thicknesses over the range of 80 to 140
μ
m.

[
J Refract Surg.
2013;29(12):810–815.]
Refractive and Topographic Fluctuations Due to Intracorneal Ring Segments Motility
Authors: Diakonis Vasilios F. , Kankariya Vardhaman P. , Woreta Fasika , Yoo Sonia H. , Lubahn Jordon G. , Kymionis George D. , Srur Lana
Published: February 2014

PURPOSE:

To describe a patient with refractive and topographic fluctuations 5 years after intracorneal ring segments (ICRS) implantation for the management of corneal ectasia after LASIK.

METHODS:

Case report.

RESULTS:

A 48-year-old woman presented complaining of intermittent decreased vision over 1 year that improved with eye rubbing. Slit-lamp and optical coherence tomography (OCT) examinations revealed overriding ring segments that could be restored to normal position after minor corneal massage. Topographic and refractive findings were significantly influenced by the ICRS positioning and caused decreased visual function when overriding. To avoid ICRS override, surgical dissection of the corneal tunnel along with ring segment repositioning was performed. A suture was placed through the ring’s positioning hole to stabilize the ICRS at its optimal position and to avoid recurrence of this phenomenon.

CONCLUSIONS:

Patients undergoing femtosecond laser-assisted ICRS implantation may experience ring segment migration and override of the segments that could lead to decreased visual function. Proper surgical repositioning and ring segment fixation may address this complication and offer satisfactory visual and refractive outcomes along with avoidance of ICRS migration and override.

[
J Refract Surg.
2014;30(2):140–142.]
The Impact of Autism Services on Mothers' Occupational Balance and Participation
Authors: Hodgetts Sandra , McConnell David , Zwaigenbaum Lonnie , Nicholas David
Published: February 2014

This mixed-methods study examined the impact of professional services on employment and leisure participation of mothers of children with autism. In Phase 1, 139 mothers with a child with autism completed a comprehensive survey addressing their experiences with services and occupational participation. In Phase 2, in-depth interviews, informed by grounded theory methodology, were conducted with a sub-sample of 19 mothers to discuss their experiences with services and the relationship between services, employment, and leisure participation. Findings revealed that discontinuity of services was a significant predictor of disrupted employment and/or leisure. A process of occupational imbalance and sacrifice emerged related to mothers' foregoing participation in personally meaningful occupations to focus time on navigating and participating in professional services for their child. Our findings suggest that many professionals who work with individuals with autism conceptually value family-centered care; yet, actual services often ignore family issues and focus exclusively on the child.
Impact of Nursing Care Services on Self-Efficacy Perceptions and Healthy Lifestyle Behaviors of Nursing Home Residents
Authors: Kulakçi Hülya , Emiroğlu Oya Nuran
Published: February 2014

The purpose of this study was to evaluate the impact of tailored individualized nursing care services on the self-efficacy perceptions and healthy lifestyle behaviors of older adults living in a nursing home in Turkey. This outcomes evaluation research used a quasi-experimental study design in which outcomes evaluations were repeated within time intervals in a single group. The study sample included 30 older adults. Nursing diagnoses and interventions were identified using the Omaha System. The impact of implemented nursing care services was evaluated using the Self-Efficacy Scale and Healthy Life-Style Behaviours Scale II. A total of 3,024 nursing interventions were performed, and self-efficacy perceptions and healthy lifestyle behaviors of older nursing home residents were significantly increased in a positive manner (
p
< 0.05). The results suggest that nurses should assess self-efficacy perceptions and healthy lifestyle behaviors of older adults and that nursing care services directed at health promotion of older adults should be maintained.

[Res Gerontol Nurs. 2013; 6(4):242–252.]
Validation of the Professional Issues Scales with Portuguese Nurses
Authors: de Almeida Tavares João Paulo , Silva Alcione Leite da , Sá-Couto Pedro , Boltz Marie , Capezuti Elizabeth A.
Published: February 2014

The Professional Issues (PI) scales were designed to measure potential barriers that nurses perceive as obstacles to providing quality care to hospitalized older adults. This study involved validation of the PI scales among 1,068 Portuguese nurses and evaluated the influence of hospital and nurse characteristics on the perception of PI related to nursing care. A six-factor solution was obtained (i.e., staff/family/patient disagreement, perceived legal vulnerability, burden of upsetting behaviors, staff disagreement, perceived upsetting behaviors, use of geriatric services), with Cronbach’s alpha coefficients ranging from 0.857 to 0.716. These factors were significantly associated with the following variables: sex, hospital type, hospital location, unit type, perceived institutional support for geriatric-specific education, perceived staff knowledge, and the burden of caring for older adults. The PI scales are reliable and valid for assessing the geriatric-related PI of nurses working in Portuguese hospitals and are useful for developing, planning, and implementing geriatric programs.

[Res Gerontol Nurs. 2013; 6(4):264–274.]
Using Multisensory Technology to Create a Therapeutic Environment for People with Dementia in an Adult Day Center: A Pilot Study
Authors: Riley-Doucet Cheryl K. , Dunn Karen S.
Published: February 2014

This quantitative pilot study examined the feasibility of using a multisensory environment (MSE) as a nonpharmacological intervention for people with behavioral and psychological symptoms of dementia (BPSD) within an adult day care center. Outcome measures were participant agitation, participant reaction to MSE, and caregiver satisfaction with MSE as a management strategy for older adults with BPSD. A within-subjects, repeated measures research design was used to obtain results from a total of 8 older adults with BPSD and 4 formal caregivers. Results indicated that the majority of participants enjoyed the MSE and improvements in some BPSD were observed after using the MSE. Reports from formal caregivers indicated that they believed the MSE was a useful nonpharmacological therapy for reducing anxiety and agitation among the day care participants who exhibited BPSD. Caregivers also suggested that this intervention should be incorporated into the design of the building and that a dedicated staff be assigned to facilitate the intervention for older adults each day.

[Res Gerontol Nurs. 2013; 6(4):225–233.]
Multiple Evanescent White Dot Syndrome: Multimodal Imaging and Correlation With Proposed Pathophysiology
Authors: Thomas Benjamin J. , Albini Thomas A. , Flynn Harry W.
Published: February 2014

The clinical presentation of multiple evanescent white dot syndrome (MEWDS) was described nearly 30 years ago; however, our understanding of its pathophysiology continues to change, evolving with our imaging modalities. Initially, electroretinography and fluorescein angiography indicated retinal pigment epithelium (RPE) and outer retinal damage. But with indocyanine green angiography, theories shifted to a primary choroidopathy. Only spectral-domain optical coherence tomography (SD-OCT) directly demonstrated the primary effect on RPE and outer retina, although enhanced depth-imaging OCT (EDI-OCT) may further modify our understanding. The authors present a case of unilateral MEWDS with imaging including SD-OCT and EDI-OCT.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:584–587.]
Comparison of Two Scleral Incision Techniques in 23-Gauge Transconjunctival Vitrectomy
Authors: Ünal Metin , Balikoglu Melike , Teke Mehmet Yasin , Koklu Gultekin
Published: February 2014

BACKGROUND AND OBJECTIVE:

To compare two 23-gauge transconjunctival vitrectomy incision techniques, parallel and perpendicular to the alignment of scleral fibers, in terms of hypotony and postoperative intraocular pressure (IOP).

PATIENTS AND METHODS:

Fifty-three eyes of 53 patients who underwent 23-gauge one-step trocar pars plana vitrectomy were randomly assigned to undergo scleral incision parallel (group 1, 26 eyes) or perpendicular (group 2, 27 eyes) to the limbus. Patients were observed postoperatively for wound healing, leakage, endophthalmitis, IOP, and hypotony at 1 day, 1 week, and 1, 3, 6, and 9 months.

RESULTS:

No difference in preoperative IOP was observed (
P
= .229). Postoperative IOP was significantly lower in group 2 (
P
= .009). Hypotony rates did not differ between the groups. Intraocular gas or silicone tamponade was used intraoperatively in 26 cases. In cases in which no gas or silicone was given (n = 27), IOP measurements were significantly lower in group 2 (
P
= .021). There was no difference in hypotony ratios for gas/silicone injection versus no injection (
P
= 1.00) or in postoperative visual acuity (
P
= .350). Visual acuity improved significantly in both groups at follow-up examinations.

CONCLUSION:

Parallel and perpendicular incisions resulted in similar postoperative hypotony rates, but perpendicular incisions were associated with lower IOP.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:572–576.]
Submacular Choroidal Varix Simulating Chorioretinal Folds With Metamorphopsia
Authors: Adam Christopher R. , Sigler Eric J. , Randolph John C. , Calzada Jorge I.
Published: February 2014

A novel case description of an isolated unilateral submacular choroidal varix simulating chorioretinal folds and inducing metamorphopsia in a 74-year-old phakic Caucasian man. Posterior segment examination revealed focal choroidal elevations corresponding to a deep, large choroidal vessel in the inferotemporal subparafoveal region. Fundus photography demonstrated a pigment epithelial detachment-like elevation inferior to the fovea, continuous with the course of a large choroidal vessel. Angiographic, indocyanine green (ICG), and spectral-domain optical coherence tomography (SD-OCT) imaging revealed an isolated unilateral submacular choroidal varix with direct connection to an inferior vortex vein. The diagnosis of submacular choroidal varix should be considered when the presence of metamorphopsia and corresponding choroidal elevations that remain unchanged through gaze direction or contact lens ophthalmoscopy occur. If present, angiographic, ICG, and SD-OCT imaging are recommended for proper evaluation of submacular choroidal varix that may enhance the characteristics of this lesion.

[
Ophthalmic Surg Lasers Imaging Retina.
2013;44:596–598.]
“Geyser” Leakage on Fluorescein Angiography
Authors: Levy Jaime , Fagan Xavier J. , Lifshitz Tova , Schneck Marina
Published: February 2014

An 82-year-old patient with diabetes was followed up due to moderate nonproliferative diabetic retinopathy with macular edema in the right eye. Visual acuity was 6/36. Focal macular laser was conducted (A). Three years later, the patient presented with blurry vision in the right eye. Visual acuity was 3/60. Vitreous hemorrhage was observed (B), and neovascularization of the disc was suspected (C). Fluorescein angiography (D, mid venous phase; E-F, recirculation phase) confirmed neovascularization of the disc and depicted a striking vertical leakage. Panretinal photocoagulation was started. Possible explanations for the “geyser” leakage may be either a partial posterior vitreous detachment allowing the fluorescein to track upwards but not elsewhere or a pocket of syneretic vitreous allowing the fluorescein passage in which to diffuse, much like the passage the blood would have taken.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;44:E23.]
Optical Coherence Tomography Findings of Pigmented Fundus Lesions in Familial Adenomatous Polyposis
Authors: Tzu Jonathan H. , Cavuoto Kara M. , Villegas Victor M. , Dubovy Sander R. , Capo Hilda
Published: February 2014

The pigmented fundus lesions associated with familial adenomatous polyposis (FAP) often resemble those characteristic of congenital hypertrophy of the retinal pigment epithelium (CHRPE). However, some fundus lesions in FAP resemble hamartomatous lesions of the retinal pigment epithelium (RPE). Intraretinal extension of the RPE is a feature not seen in CHPRE lesions that may be unique to some of the pigmented lesions of FAP. The authors report the spectral-domain optical coherence tomography findings of the pigmented ocular lesions associated with FAP in a 10-year-old boy.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;45:69–70.]
Bilateral Cotton Wool Spots After Use of an Endothelin Receptor Antagonist
Authors: Khan Mohammed A. , Pitcher John D. , Kawut Steven M. , Ho Allen C.
Published: February 2014

Ambrisentan (Letairis; Gilead Sciences, Foster City, CA) is an endothelin receptor antagonist approved by the U.S. Food and Drug Administration for the treatment of pulmonary arterial hypertension. The authors describe the occurrence of bilateral cotton wool spots soon after initiation of ambrisentan treatment in a 29-year-old woman. Fluorescein angiography, optical coherence tomography, and fundus autofluorescence were performed. After discontinuation of ambrisentan, the cotton wool spots resolved without recurrence. To the authors’ knowledge, this is the first report of retinopathy in the form of cotton wool spots associated with the use of an endothelin receptor antagonist.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;45:156–159.]
Natural History of Premacular Hemorrhage Due to Severe Acute Anemia: Clinical and Anatomical Features in Two Untreated Patients
Authors: Turco Claudia Del , La Spina Carlo , Mantovani Elena , Gagliardi Marco , Lattanzio Rosangela , Pierro Luisa
Published: February 2014

Premacular retrohyaloid hemorrhage is a rare complication of acute severe anemia. The authors report two cases of premacular hemorrhage in which no treatment other than clinical and spectral-domain optical coherence tomography observation was performed. The natural history of this condition reveals that complete clinical resolution is not accompanied by full anatomical restoration.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;45:E5–E7.]
Sectoral System of Innovation and Technological Upgrading Strategies
Authors: Tuncel Cem Okan
Published: February 2014

Latecomer sectors in late-industrializing economies follow different patterns in their development and growth processes, which largely determine the share acquired from the global value chain. The development and growth process of the sectors are generally argued to be the result of the interaction of a macro-level specific institutional context (e.g., system of intellectual property rights, labor market regulations) and micro-level firm strategic choices. In this study, the authors argue that meso-level sectoral systems also play a critical role in the development and growth process of latecomer sectors. Accordingly, they attempt to integrate three theoretical perspectives: Resource-Based View (RBV) of the firm, Sectoral System of Innovation (SSI) perspective, and Technological Capability Perspective (TCP) for late industrializing economies to explain the relative developmental failure of the Turkish automotive industry compared to other successful latecomer industries such as the South Korean automotive industry. In light of theoretical framework, the authors investigate sectoral technological upgrading trajectory and compare Korean and Turkish automotive industry development paths using the case study method. They conclude by discussing how a multilevel framework that takes into account the systemic factors can guide research on sectoral development in late-industrializing countries. In light of a comparative historical analysis of development of the Turkish and Korean automotive industries, it is argued that a pace of industrial transformation can be accelerated by multilevel proactive state intervention.
Significance of Innovation Policies
Authors: Tuncel Cem Okan , Gürsel Volkan
Published: February 2014

Over the past 50 years, low-income countries have increased their national incomes by shifting their production from the agricultural sector in which the efficiency of labor and capital is low to the manufacturing sector in which efficiency is higher. However, underemployment in the rural regions has decreased in parallel to the attainment of the middle-income level by these countries, wages have increased, and the level of international competitiveness has decreased. The countries which could not increase the level of productivity through innovation could not succeed in passing from the middle-income to the high-income level. Therefore, these countries have fallen into the middle-income trap because of their failure to compete with the developed countries regarding innovative products, which require a high level of skill, and with the low-income countries where the labor cost is low regarding labor-intensive products. The purpose of this study is to discuss the policy alternatives required to be followed by developing countries and to expose the inadequacy of the neoclassic approach on which the industrialization strategy is based in the light of the experiences of the countries that have discarded the middle-income trap. The eastern Asian countries that have managed to exceed this middle-income trap have based that achievement on effective industrial and technological policies. For that reason, an examination of the experience of especially Asian countries is very important from the point of view of the countries that intend to get rid of the middle-income trap.
Internal Structure Changes of Nylon 12 in Balloon Forming Process
Authors: Li Zhen , Xu Li Xia , Lu Chun Lan , Liu Guo Zhu , Li Xin Yue
Published: February 2014

Medical balloon has been widely used for the treatment of cardiovascular and cerebrovascular diseases, but the theoretical studies in processing process of medical balloon have reported less in the domestic. This paper briefly introduce in the processing process of medical balloon from the nylon 12 as raw materials, through control the conditions of primary molding, secondary molding and final molding process of the operating, then investigate the stress-strain curve of each sample in the molding process by Hydraulic Pressure Tester. And further investigated the material's lattice parameter, melting point, crystallinity and the structure changes of internal groups during the molding process separately by X-ray diffraction (XRD), differential scanning caborimetry (DSC) and infrared transmission spectroscopy (FTIR) experiment. It could be founded that the acting force between the polymeric chain of nylon 12 reduced at first, so that the material has better plasticity and machinability for forming, and then the acting force of polymer chain is enhanced, so that the final balloon has higher strength and stability were discovered during the balloon forming process.