bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Transverse Gravitational Deviation Index, a Novel Gravity Line-Related Spinal Parameter, Relates to Balance Control and Health-Related Quality of Life in Adults With Spinal Deformity
Authors: Moke Lieven , Overbergh Thomas , Severijns Pieter , Schelfaut Sebastiaan , Moens Pierre , Van de loock Kristel , Hermans Lore , Molenaers Guy , Jonkers Ilse , Scheys Lennart 
Published: December 2019

Study Design.
Prospective cross-sectional case-control study design.

Objective.
This study aims to analyze the relation between balance control as well as health-related quality of life (HRQOL) in patients with adult spinal deformity (ASD), with a novel gravity line (GL)-related 3D spinal alignment parameter, the transverse gravitational deviation index (TGDI), defined to quantify the transverse plane position of any vertebra with respect to the GL.

Summary of Background Data.
Demographic data and balance control have both been identified as important determinants of HRQOL in ASD patients during a preoperative setting. Therefore, a better understanding of the relation between spinal alignment and balance is required.

Methods.
After informed consent, 15 asymptomatic healthy volunteers (mean age 60.1 ± 11.6 years old) and 55 ASD patients (mean age 63.5 ± 10.1 years old) were included. Relation between performance on BESTest as well as core outcome measures index (COMI) with spinopelvic alignment was explored using General Linear Modeling (GLM). A P-value ≤0.05 was considered statistically significant.

Results.
The L3 TGDI was identified to relate to balance control in the total ASD population after correction for confounding demographic factors (P = 0.001; adjusted R
2 = 0.500) and explained 19% of the observed variance in balance performance. In addition, COMI is related to L3 TGDI in a subgroup of ASD patients with combined coronal and sagittal malalignment of L3 (P = 0.027; slope B = 0.047), despite significant influence of age (P = 0.020).

Conclusion.
In ASD patients with a combined coronal and sagittal malalignment of the L3 vertebra, both the level of balance impairment as well as HRQOL are related to the distance component of the L3 TGDI, that is, the offset between the center of the L3 vertebral body and the GL in the transverse plane.

Level of Evidence: 2
Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study
Authors: Johnson Nicholas J. , Danielson Kyle R. , Counts Catherine R. , Ruark Katelyn , Scruggs Sue , Hough Catherine L. , Maynard Charles , Sayre Michael R. , Carlbom David J. 
Published: December 2019

Objectives:
To determine the association between targeted temperature management goal temperature of 33°C versus 36°C and neurologic outcome after out-of-hospital cardiac arrest.

Design:
This was a retrospective, before-and-after, cohort study.

Setting:
Urban, academic, level 1 trauma center from 2010 to 2017.

Patients:
Adults with nontraumatic out-of-hospital cardiac arrest who received targeted temperature management.

Interventions:
Our primary exposure was targeted temperature management goal temperature, which was changed from 33°C to 36°C in April of 2014 at the study hospital. Primary outcome was neurologically intact survival to discharge. Secondary outcomes included hospital mortality and care processes.

Measurements and Main Results:
Of 782 out-of-hospital cardiac arrest patients transported to the study hospital, 453 (58%) received targeted temperature management. Of these, 258 (57%) were treated during the 33°C period (targeted temperature management 33°C) and 195 (43%) were treated during the 36°C period (targeted temperature management 36°C). Patients treated during targeted temperature management 33°C were older (57 vs 52 yr; p < 0.05) and had more arrests of cardiac etiology (45% vs 35%; p < 0.05), but otherwise had similar baseline characteristics, including initial cardiac rhythm. A total of 40% of patients treated during targeted temperature management 33°C survived with favorable neurologic outcome, compared with 30% in the targeted temperature management 36°C group (p < 0.05). After adjustment for demographic and cardiac arrest characteristics, targeted temperature management 33°C was associated with increased odds of neurologically intact survival to discharge (odds ratio, 1.79; 95% CI, 1.09–2.94). Targeted temperature management 33°C was not associated with significantly improved hospital mortality. Targeted temperature management was implemented faster (1.9 vs 3.5 hr from 911 call; p < 0.001) and more frequently in the emergency department during the targeted temperature management 33°C period (87% vs 55%; p < 0.001).

Conclusions:
Comatose, adult out-of-hospital cardiac arrest patients treated during the targeted temperature management 33°C period had higher odds of neurologically intact survival to hospital discharge compared with those treated during the targeted temperature management 36°C period. There was no significant difference in hospital mortality.
A Faith-Based Intervention to Improve Hypertension Management Among African Americans
Authors: Harvin Lori A. , Winter Dorothea M. , Hoover Evelyn L. , Lewis Lisa M. 
Published: December 2019

ABSTRACT:
High mortality rates continue among African Americans related to complications of uncontrolled hypertension. The purpose of this study was to determine if a faith-based self-management education program would improve self-care activities related to the management of hypertension among African American adults. Ten African American adults who reported a diagnosis of hypertension for 6 months or longer completed an 8-week education program focused on strategies for hypertension management. The education program was enhanced with the utilization of spiritual components of prayer, Scripture reading, and journaling.
When Partners Turn Violent
Authors: McCarthy Jessica , Stagg Denise 
Published: December 2019

ABSTRACT:
Intimate partner violence (IPV) occurs across all cultures, ethnicities, socioeconomic classes, and educational backgrounds. Nurses should be aware of IPV and causative factors that include personal attributes, stressors, and community issues. The Intimate Partner Exposome conceptual model is used to identify exogenous and endogenous IPV risk factors. In addition, distinctive environmental factors can increase risk for IPV. The purpose of this article is to increase recognition of causative factors and presenting signs to enhance the nurse's ability to identify and assist IPV victims.
Living with Crohn's
Authors: Jefferson Khará 
Published: December 2019

ABSTRACT:
The lifelong, chronic nature of Crohn's disease produces incessant stress that affects individuals physically, emotionally, and socially. Coping with the symptoms and treatment is improved when persons engage their faith and spiritual resources. Clear understanding of the physical and emotional aspects of Crohn's can support a person's ability to manage the disease. Knowledge of emerging treatments also provides nurses with hopeful input to share with their patients.
Reliability of Periocular Anthropometry: A Comparison of Direct, 2-Dimensional, and 3-Dimensional Techniques
Authors: Guo Yongwei , Hou Xiaoyi , Rokohl Alexander C. , Jia Renbing , Heindl Ludwig M. 
Published: December 2019

BACKGROUND
Three-dimensional (3D) imaging has become increasingly popular in aesthetic surgery. However, few studies have emphasized its application in the periocular region.

OBJECTIVE
To provide evidence supporting the reliability of generalizing periocular measurements obtained using caliper-derived direct anthropometry and 2-dimensional (2D) photogrammetry to 3D stereophotogrammetry.

MATERIALS AND METHODS
Periocular surfaces were captured using a stereophotogrammetry system for 46 normal Caucasian individuals. Twenty-two periocular variables were directly, 2-dimensionally, and 3-dimensionally measured. Reliability of these measurements was evaluated and compared with each other.

RESULTS
The results revealed that, for direct (intra-rater reliability only), 2D, and 3D anthropometry, overall intra-rater and inter-rater intraclass correlation coefficient estimates were 0.88, 0.99 and 0.97, and 0.98 and 0.92, respectively; mean absolute differences were 0.84 mm, 0.26 and 0.36 units, and 0.35 and 0.67 units, respectively; technical error of measurement (TEM) estimates were 0.85 mm, 0.25 and 0.36 units, and 0.32 and 0.65 units, respectively; relative error measurement estimates were 6.46%, 1.69% and 2.74%, and 1.67% and 5.11%, respectively; and relative TEM estimates were 6.25%, 1.62% and 2.78%, and 2.12% and 5.12%, respectively.

CONCLUSION
Stereophotogrammetry and the authors' landmark location protocol yield very good reliability for a series of 2D and 3D measurements.
Therapeutic Drug Monitoring-Guided Crushed Sofosbuvir-Velpatasvir Treatment: A Case Study
Authors: Lalanne Sébastien , Jézéquel Caroline , Tron Camille , Verdier Marie-Clémence , Mercerolle Marion , Pronier Charlotte , Guyader Dominique , Lemaitre Florian 
Published: December 2019

Abstract:
In this study, the authors report the case of a patient diagnosed with hepatitis C virus who was treated with sofosbuvir–velpatasvir (400/100 mg). As the patient was unable to swallow whole tablets, therapeutic drug monitoring was performed to evaluate the effect of crushing sofosbuvir–velpatasvir tablets on drug absorption and global exposure.
The Microbiome of the Nasolacrimal System and Its Role in Nasolacrimal Duct Obstruction
Authors: Curragh David Stephen , Bassiouni Ahmed , Macias-Valle Luis , Vreugde Sarah , Wormald Peter-John , Selva Dinesh , Psaltis Alkis James 
Published: December 2019

The authors have demonstrated a decreased relative abundance of Corynebacterium at the middle meatus of patients with ipsilateral nasolacrimal duct obstruction (NLDO), compared with controls, and that the lacrimal sac microbiome is similar to the sinonasal microbiome. An altered microbial state may, therefore, be associated with NLDO, either as a consequence or a risk factor, and merits future research.

Purpose:
Acquired nasolacrimal duct obstruction (NLDO) is a common problem leading to epiphora, the pathophysiology of which remains unclear. Culture-based studies have found Staphylococcal species to be the most prevalent organisms, reported in 47% to 73% of patients with NLDO. Recently, culture-independent molecular methods of have allowed more comprehensive detailing of local microbiota. This study aims to evaluate the sinonasal and lacrimal microbiome of patients undergoing dacryocystorhinostomy for NLDO using 16S-amplicon sequencing.

Methods:
Guarded intraoperative swabs were taken from the middle meatus (MM), inferior meatus, and the opened lacrimal sac of 14 NLDO patients undergoing dacryocystorhinostomy and from the inferior meatus and MM on the contralateral unaffected side. MM swabs from 12 control patients were compared with NLDO patients.

Results:
Comparing microbiota at lacrimal sac to MM and inferior meatus sites reveals that the lacrimal sac microbiome is dominated by Staphylococci (36.3%) and Corynebacterium (35.8%). No significant genus differential abundance between the 3 sites, and between the ipsilateral and contralateral sinonasal swabs, and no convincing evidence of reduced alpha diversity in all comparisons. There was a statistically significant lower relative abundance of Corynebacterium (37.6% vs. 65.1%; p = 0.035) in the MM of NLDO patients compared with controls.

Conclusions:
The lacrimal sac microbiome in acquired NLDO is similar to the sinonasal microbiome. The relative abundance of Corynebacterium was reduced compared with controls. These findings suggest that an altered sinonasal microbiome may be associated with NLDO, either as a consequence or a risk factor, and merits future research.
Standardizing Multidisciplinary Rounds
Authors: Brown Lauren , Saini Virender , Carter Chris 
Published: December 2019

OBJECTIVE
To describe the impact of a standardized rounding process on rounding time and multidisciplinary member attendance.

BACKGROUND
Rounding efficiency and effectiveness are often compromised by lack of standardization of important elements including start time and location, the attendance of multidisciplinary representatives, patient presentation highlights, and physician workflow. In 2017, the study authors noted inefficiencies and process failures in multidisciplinary rounds within our ICU.

METHODS
We conducted a retrospective review of rounding data before and after the implementation of a simplified and streamlined rounding template for ICU nurses and measures to standardize rounding processes and attendance.

RESULTS
Rounding time was decreased by 25% in postimplementation phase. Additionally, attendance of respiratory therapists, clinical dietitians, and case managers improved.

CONCLUSIONS
We suggest the piloting of these strategies in other ICUs that experience similar inefficiencies and process failures during multidisciplinary rounds.
Exploring the Relationship Between Patient Falls and Levels of Nursing Education and Certification
Authors: Coto Jeffrey A. , Wilder Coleen R. , Wynn Leanna , Ballard Maria C. , Webel Daniel , Petkunas Heather 
Published: December 2019

OBJECTIVE
To examine if increasing the percentage of nurses with bachelor degrees (BSNs) and/or certified nurses leads to improved patient outcomes, specifically the number of reported falls.

BACKGROUND
Research suggests a link between higher levels of education and expertise and positive patient outcomes, including falls. The Institute of Medicine recommends an increase in BSN nurses.

METHODS
This was a retrospective cross-sectional cohort analysis using data from the National Database of Nursing Quality Indicators from 2010 to 2016 from multiple medical centers in Central and Southern Illinois.

RESULTS
With every 1-unit increase in the percentage of BSN nurses or certified nurses, a reduction in total patient falls per 1000 patient-days can be expected in the amount of 0.02 to 0.04 and 0.01 to 0.03, respectively, all else held constant.

CONCLUSIONS
Improvements to patient outcomes may be optimized with increased percentages of nurses with bachelor degrees and/or certifications.
Effectiveness of Elastic Taping in Patients With Knee Osteoarthritis
Authors: Ye Wenwen , Jia Chengsen , Jiang Junliang , Liang Qiu , He Chengqi 
Published: December 2019

Objective
The aim of the study was to assess the effects of elastic taping on pain, physical function, range of motion, and muscle strength in patients with knee osteoarthritis.

Design
We searched the PubMed, the Cochrane Central Register of Controlled Trials, Web of Science, Physiotherapy Evidence Database, Scopus, EMBASE, OVID, CNKI, and WANFANG to identify relevant randomized controlled trials. The primary outcome measures were pain and physical function. The secondary outcome measures were range of motion and muscle strength.

Results
Eleven randomized controlled trials involving 490 patients with knee osteoarthritis were included. A statistically significant difference was detected in pain (standardized mean difference = −0.78, 95% confidence interval = 1.07 to −0.50, P < 0.00001), physical function (standardized mean difference = 0.73, 95% confidence interval = −1.03 to −0.43, P < 0.00001), range of motion (mean difference = 2.04, 95% confidence interval = 0.14 to 3.94, P = 0.04), and quadriceps muscle strength (mean difference = 2.42, 95% confidence interval = 1.09 to 3.74, P = 0.0004). No significant differences were found for the hamstring muscle strength.

Conclusions
Elastic taping has significant effects on pain, physical function, range of motion, and quadriceps muscle strength in patients with knee osteoarthritis. The current evidence is insufficient to draw conclusions on the effects of elastic taping combined with other physiotherapy for knee osteoarthritis. Further studies are needed to investigate the long-term effects of elastic taping combined with other physiotherapy compared with elastic taping alone for knee osteoarthritis.
Effects of Home Exercises on Shoulder Pain and Pathology in Chronic Spinal Cord Injury
Authors: Cardenas Diana D. , Felix Elizabeth R. , Cowan Rachel , Orell Melanie F. , Irwin Robert 
Published: December 2019

Objective
The aims of this study were to replicate findings that a home exercise program intervention improved shoulder pain and function and to assess changes in supraspinatus tendon pathology associated with the home exercise program in persons with chronic spinal cord injury.

Design
The study is a single-blind randomized controlled trial. Individuals with spinal cord injury of at least 1 yr and chronic shoulder pain of moderate or greater average intensity were enrolled. Participants were randomized to a 12-wk home exercise program consisting of strengthening and stretching exercises or to an education-only control group, with immediate postintervention and 4-wk postintervention (16 wks) follow-ups. The main outcome measures were self-report measures of shoulder pain and impairment, the Physical Examination of the Shoulder Scale, quantitative ultrasound metrics of the supraspinatus tendon, and the Ultrasound Shoulder Pathology Rating Scale.

Results
Thirty-two participants were randomized to home exercise program or education-only control condition. The mean ± SD age was 44.8 ± 12.5; 81.3% were male; 65.6% had motor complete paraplegia. Using a per-protocol, within-group analysis method, significant differences were observed between baseline and postintervention for the home exercise program group for the least pain intensity (P = 0.02), number of days with shoulder pain (P = 0.042), Physical Examination of the Shoulder Scale scores (dominant side, P = 0.036; nondominant side, P = 0.008), the Disabilities of the Arm, Shoulder, and Hand (P = 0.028), and the Patient Global Impression of Change (P = 0.015). The education-only control condition group demonstrated significant changes in average unpleasantness of shoulder pain after the intervention period (P = 0.049). Comparisons in changes from baseline between groups showed that the home exercise program group had greater improvements in nondominant-side Physical Examination of the Shoulder Scale scores and global impression of change, whereas the education-only control condition group had greater improvements in depressive symptoms.
For quantitative ultrasound measures, no significant changes were found with within-group analyses for the home exercise program group, although the education-only control condition group demonstrated a decrease in tendon width in the nondominant-side supraspinatus tendon (P = 0.036). Comparison of changes between groups suggests that the education-only control condition group had a greater increase in dominant shoulder supraspinatus tendon ultrasound contrast at the end of the study.

Conclusions
Changes in several measures of shoulder pain and function occurred after the home exercise program intervention, although the magnitude of changes was only significantly greater than those of the education-only control condition group for two measures. Significant changes in supraspinatus pathology were not detected with quantitative ultrasound metrics.
The Impact of Concurrent Antiretroviral Therapy and MDR-TB Treatment on Adverse Events
Authors: Smith Jonathan P. , Gandhi Neel R. , Shah N. Sarita , Mlisana Koleka , Moodley Pravi , Johnson Brent A. , Allana Salim , Campbell Angela , Nelson Kristin N. , Master Iqbal , Brust James C.M. 
Published: December 2019

Background:
South Africa has among the highest incidence of multidrug-resistant tuberculosis (MDR-TB) and more than 70% of patients are HIV co-infected. MDR-TB treatment is associated with frequent adverse events (AEs). Although guidelines recommend concurrent treatment of MDR-TB and HIV, safety data on concurrent therapy are limited.

Methods:
We conducted a prospective observational study of MDR-TB patients with and without HIV-coinfection in South Africa between 2011 and 2015. Participants received standardized MDR-TB and HIV regimens. Participants were followed monthly for the duration of MDR-TB therapy and screened for clinical and laboratory AEs. Audiometry was performed monthly during the intensive phase; color discrimination testing was performed every 2 months.

Results:
We enrolled 150 HIV-infected and 56 HIV-uninfected participants. Nearly all experienced at least one clinical (93%) or laboratory (96%) AE. The most common clinical AEs were peripheral neuropathy (50%) and difficulty sleeping (48%); the most common laboratory AEs were hypokalemia (47%) and decreased creatinine clearance (46%). Among 19 clinical and lab AEs examined, there were no differences by HIV status, except for diarrhea (27% HIV-infected vs. 13% HIV-uninfected, P = 0.03). Hearing loss was experienced by 72% of participants (8% severe loss). Fourteen percent experienced color discrimination loss (4% severe loss). There were no differences in frequency or severity of hearing or vision loss by HIV status.

Conclusions:
AEs were common, but not more frequent or severe among MDR-TB/HIV co-infected participants receiving concurrent antiretroviral therapy. Given the favorable treatment outcomes associated with concurrent treatment, antiretroviral therapy initiation should not be delayed in MDR-TB patients with HIV-coinfection.
Atrial fibrillation and stroke: how much atrial fibrillation is enough to cause a stroke?
Authors: Healey Jeff S. , Amit Guy , Field Thalia S. 
Published: December 2019

Purpose of review
The association between atrial fibrillation and stroke is firmly established, and anticoagulation reduces stroke risk in patients with atrial fibrillation. However, the role of anticoagulation in very brief durations of atrial fibrillation (subclinical atrial fibrillation) is an area of controversy.

Recent findings
Stroke risk increases alongside burden of atrial fibrillation. Ongoing trials will clarify if 24 h or less of atrial fibrillation on extended monitoring necessitates lifelong anticoagulation. Trials examining empiric anticoagulation for individuals with ESUS did not demonstrate benefit over antiplatelet agents. However, hypothesis-generating sub-analyses suggest that certain at-risk groups may benefit. Atrial cardiopathy is associated with subclinical atrial fibrillation and research examining anticoagulation after ESUS in this population is underway.

Summary
Stroke risk increases alongside burden of ectopic atrial activity. However, this risk may in part be because of prothrombotic dysfunction associated with atrial cardiopathy in addition to the arrhythmia itself. The minimal amount of subclinical atrial fibrillation to warrant anticoagulation for stroke prevention, and how this may be modified by the total duration of monitoring, will be clarified by the results of ongoing clinical trials. Currently research will also help identify whether a select group of ESUS patients who have structural and electrophysiological markers of atrial cardiopathy warrant anticoagulation for secondary prevention.