bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal Coronal and Sagittal Balance in 584 Healthy Individuals During Growth: Normal Plumb Line Values and Their Correlation With Radiographic Measurements
Authors: Negrini Alessandra , Vanossi Massimiliano , Donzelli Sabrina , Zaina Fabio , Romano Michele , Negrini Stefano 
Published: August 2019

Abstract

Background
Plumb line distances (PDs) are widely used in conservative clinical practice to evaluate the sagittal shape of the spine.

Objective
The objective was to assess the normative values of PDs in a large, healthy population in an age range representative of the adolescent population with spinal deformities, and to correlate it with x-ray measurements.

Design
This was a cross-sectional study.

Methods
Participants were 584 healthy individuals (341 females) with x-rays showing no spine deformities. The whole sample (OVERALL) was divided into 5 groups: 6 to 9 years old (n = 106); &gt;10 years, Risser 0 with triradiate cartilage open (n = 129) or closed (n = 104); Risser 1 to 2 (n = 126); and Risser 3 to 5 (n = 119).
PDs were taken by maintaining a tangent to the thoracic kyphosis apex at C7, T12, L3, and S2. Sagittal index (C7 + L3), and sagittal and coronal balances (C7 related to S2) were calculated.

Results
In OVERALL, PDs at C7, T12, L3, and S2 were 39.9 ± 16.7, 21.4 ± 15.3, 39.9 ± 15, 20.6 ± 17.0 mm, respectively. Sagittal index was 79.8 ± 26.8, sagittal balance was 19.3 ± 17 mm anterior to S2 plumb line; 13.5% had a coronal imbalance of 11.4 ± 5.4 mm to the right and 24.7% of 13.2 ± 6.0 mm to the left. C7 and L3 PDs, sagittal index, and sagittal balance were significantly lower in ages 6 to 9 compared to older patients in Risser 1 to 2 group. C7 and S2 PDs and sagittal index were significantly larger in males. Sagittal index correlated with thoracic kyphosis Cobb degrees (r = 0.47).

Limitations
The participants were not randomly chosen from the general population; and they had an x-ray because of spine pathology suspicion.

Conclusions
This study shows normative data to be used in clinical practice. Sagittal spinopelvic alignment has gained more and more importance in the last decades because of its high correlation to Health-Related Quality of Life scores in adults. 1
An Evidence-Based Perspective on Movement and Activity Following Median Sternotomy
Authors: El-Ansary Doa , LaPier Tanya Kinney , Adams Jenny , Gach Richard , Triano Susan , Katijjahbe Md Ali , Hirschhorn Andrew D , Mungovan Sean F , Lotshaw Ana , Cahalin Lawrence P 
Published: August 2019

AbstractCardiac surgery via median sternotomy is performed in over 1 million patients per year worldwide. Despite evidence, sternal precautions in the form of restricted arm and trunk activity are routinely prescribed to patients following surgery to prevent sternal complications. Sternal precautions may exacerbate loss of independence and prevent patients from returning home directly after hospital discharge. In addition, immobility and deconditioning associated with restricting physical activity potentially contribute to the negative sequelae of median sternotomy on patient symptoms, physical and psychosocial function, and quality of life. Interpreting the clinical impact of sternal precautions is challenging due to inconsistent definitions and applications globally. Following median sternotomy, typical guidelines involve limiting arm movement during loaded lifting, pushing, and pulling for 6 to 8 weeks. This perspective paper proposes that there is robust evidence to support early implementation of upper body activity and exercise in patients recovering from median sternotomy while minimizing risk of complications. A clinical paradigm shift is encouraged, one that encourages a greater amount of controlled upper body activity, albeit modified in some situations, and less restrictive sternal precautions. Early screening for sternal complication risk factors and instability followed by individualized progressive functional activity and upper body therapeutic exercise is likely to promote optimal and timely patient recovery. Substantial research documenting current clinical practice of sternal precautions, early physical therapy, and cardiac rehabilitation provides support and the context for understanding why a less restrictive and more active plan of care is warranted and recommended for patients following a median sternotomy.
A longitudinal study of the protective influence of youth assets on juvenile arrest
Authors: Lensch Taylor , Clements-Nolle Kristen , Oman Roy F , Lu Minggen 
Published: August 2019

Abstract

Background
The objective of this study was to determine the separate and cumulative influence of individual, family and community assets on juvenile arrest rates in a cohort of youth.

Methods
Five waves of data were collected from 1111 youth and their parents living in randomly sampled census tracts in a Midwestern state. Computer-assisted, in-person data collection methods were used to measure assets within individual (six assets), family (four assets) and community (six assets) domains. Extended Cox models were used to assess the relationship between the number of assets and time to first juvenile arrest, while controlling for known confounders.

Results
Nine of 16 assets across individual, family and community domains were prospectively associated with a reduction in arrest rates. There was a relationship between the number of assets youth possess within individual, family and community domains and rates of arrest. For example, compared to youth with zero to one community assets, those with three [adjusted hazard ratio (AHR): 0.52; 95% confidence interval (CI): 0.30–0.88], four [AHR: 0.57; 95% CI: 0.34–0.97] or five to six [AHR: 0.45; 95% CI: 0.25–0.82] community assets had lower risk of arrest.

Conclusions
Public health efforts focused on developing policies and programs to promote asset building across multiple domains of influence are warranted.
INDOOR RADON CONCENTRATION AND RISK ASSESSMENT IN SOME DWELLINGS OF OBUASI, MINING TOWN
Authors: Opoku-Ntim Irene , Andam Aba Bentil , Roca Vicenzo , Fletcher J J , Akiti T T 
Published: August 2019

Abstract
222Rn concentration indoors was measured in 40 dwellings in the Obuasi municipality, a gold-mining town in the Ashanti Region of Ghana using the LR 115 type II strippable detectors for the two major seasons in Ghana, rainy and dry. The detectors were placed in the bed rooms of dwellers for 6 months each. Average indoor radon concentration varied from 63.9 to 364.9 Bqm−3 with a mean of 152.2 ± 10.9 Bqm−3 in the rainy season and 26.1–119.0 Bqm−3 with a mean of 50.5 ± 3.9 Bqm−3 in the dry season. The effective dose of 3.90 ± 0.3 mSvy−1 for the rainy season and for the dry season, effective dose of 0.6 mSvy−1 were recorded. The seasonal variation of 222Rn concentration indoors showed higher values in the rainy season than the dry season. A dependence was observed between the type of building materials used in building and the indoor radon level.
Positioning AIDS Activism in India: Civil Society Responses Between Development Aid, Global Health and the State, 1989 to 2001
Authors: Kanazawa Reiko 
Published: August 2019

Abstract
This article brings histories of medical activism in conversation with studies of international development to understand Ford Foundation-supported AIDS non-governmental organisations in India. While there were organisations with far-reaching visions for change through the voluntary sector, the article argues that the advocacy, caught between political critique and service delivery, was ultimately awkward and ambiguous. It demonstrates this by focusing on the Foundation’s support for Indian civil society after the Emergency, how it ‘learned’ activism from mainstream global and national responses and how AIDS was subsequently subsumed under a resurgent reproductive health movement after the 1994 Cairo Conference on Population and Development. Finally, it argues that AIDS activism declined after the early 2000s because the Indian government absorbed the developmental rhetoric and services of the NGOs. Ultimately, Ford’s career in AIDS activism showcases the limitations of sustained political critique by civil society and non-governmental actors.
Why People Feel Younger: Motivational and Social-Cognitive Mechanisms of the Subjective Age Bias and Its Implications for Work and Organizations
Authors: Weiss David , Weiss Mona 
Published: August 2019

Abstract
The term subjective age bias describes the phenomenon that from adolescence to old age most people feel significantly younger or older than their chronological age. Although recent advances in life-span development research demonstrate the fundamental role of subjective age bias for well-being, performance, and health, the underlying mechanisms are not well understood. By highlighting the motivational and social-cognitive mechanisms of the subjective age bias, we answer 3 crucial questions and discuss implications for work and organizations. We conclude with recommendations for future research.
What is in the Myopathy Literature?
Authors: Lacomis David 
Published: August 2019

AbstractIn this issue, an article describing a newly defined entity, myoglobinopathy, is covered. This autosomal-dominant, adult-onset, proximal-predominant myopathy may be associated with cardiac involvement and is due to a mutation inMB. The presence of sarcoplasmic bodies is distinctive in muscle biopsy specimens. Next, variability in phenotypes and genotypes in patients withRYR1andTTNmutations is described. Several articles address respiratory dysfunction in myotonic dystrophy type 1, reporting that its severity is associated with the CTG-repeat size, age, and degree of muscle weakness. Several articles focus on muscle pain, including myalgias in mitochondrial disorders and the presence of inflammation in muscle biopsy specimens from patients with myalgias and abnormal electrodiagnostic testing. Finally, a form of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) myopathy mimicking limb-girdle muscular dystrophy is highlighted.
Peripheral Reconstructive Lamellar Keratoplasty for Late Ectasia After Penetrating Keratoplasty in Keratoconus Eyes
Authors: Malbran Enrique S. , Price Francis W. , Argañaraz Olivero Joaquín E. , Malbran Enrique , Malbran Jorge , Malbran Marcos , Rogel Leandro N. , Price Marianne O. , Gordillo Carlos H. 
Published: August 2019

Purpose:
To describe outcomes of customized peripheral anterior lamellar keratoplasty (PALK) for late ectasia of the donor–recipient junction after penetrating keratoplasty (PK) for keratoconus.

Methods:
This was a single-center, retrospective review of 33 eyes (28 patients) that developed ectasia restricted to the graft–host junction; 17 eyes underwent PALK using lamellar resections of 8- to 11-mm width starting at the external margin of the previous PK and suturing a same-size donor graft (annular or segmental). Five eyes were excluded from analysis because of postoperative complications unrelated to the technique.

Results:
The average time between PK and diagnosis of secondary ectasia was 28 years (range 9–49 years). Slit-lamp examination showed localized thinning and elongation of the scar at the graft–host junction with well-defined biomicroscopic limits. Preoperatively, the mean keratometric measures were K1: 44.8 ± 4.8 D and K2: 54.1 ± 4.8 D and postoperatively K1: 47.5 ± 3.5 D and K2: 50.8 ± 2.6 D. The mean improvement in corrected visual acuity was 10 lines, and mean cylinder improved from 9.3 ± 2.1 D to 3.3 ± 1.4 D. All cases showed anatomical and refractive improvement.

Conclusions:
With long-term follow-up, late post-PK ectasia becomes an increasing problem. PALK can be a successful surgical option to reinforce the ectatic area while preserving a functional clear PK. By adding donor corneal tissue, PALK restores the ectatic area, improves visual acuity, keratometric values, and astigmatism, and preserves the functional graft while avoiding the higher risks of a larger diameter PK.
Effect of Foveal Location on Retinal Nerve Fiber Layer Thickness Profile in Superior Oblique Palsy Eyes
Authors: Akbari Mohammadreza , Nikdel Mojgan , Moghimi Sasan , Subramanian Prem S. , Fard Masoud Aghsaei 
Published: August 2019

Précis:
Superior oblique palsy (SOP) eyes show thinner inferotemporal retinal nerve fiber layer (RNFL) without adjusting for foveal position. There was a strong correlation between the degree of torsion and the difference in the RNFL thickness before and after adjusting foveal location.

Purpose:
The impact of foveal position on RNFL thickness has been shown. In this study, we evaluate RNFL thickness profiles according to the disc-foveal angle in SOP and control eyes.

Materials and Methods:
In 44 eyes of 22 patients with unilateral congenital SOP and 42 eyes of 42 normal controls, the position of the fovea relative to the optic disc was calculated by optical coherence tomography using FoDi (fovea-to-disc) technology. After measuring RNFL thickness with FoDi alignment technology, each optical coherence tomography image was reevaluated with FoDi turned off, and the measurements were repeated to determine RNFL values according to the disc-foveal angle.

Results:
The average disc-foveal angle was −10.85±6.60 degrees and −10.71±6.63 degrees in the affected and fellow eyes of SOP patients; these values were significantly greater than control subjects (−5.88±4.09 degrees). There was no significant difference in RNFL sector values between SOP and control eyes with FoDi. From all RNFL sectors, the measured inferotemporal thickness was less in SOP eyes without FoDi than in SOP eyes with FoDi (129.7±20.5 µm vs. 144.6±17.8 µm, respectively, P=0.001). Differences of the RNFL thicknesses with and without FoDi in SOP eyes in the superotemporal and inferotemporal sectors were 5.40±13.42 and 14.84±15.00, respectively, which were significantly more than the same changes in control eyes with amount of 0.30±6.57 and 8.52±10.4 (P=0.02 for both sectors).

Conclusions:
In SOP eyes with large amounts of torsion, a correction for the disc-foveal angle is necessary for accurate determination of the RNFL thickness profile.
Optimizing impact through the Tiered Doctor of Nursing Practice Project Model
Authors: Melander Sheila , Howard Patricia B. , Williams Tracy E. , Tharp-Barrie Kim , El-Mallakh Peggy , MacCallum Tricia 
Published: August 2019

ABSTRACT
Colleges of Nursing (CONs) and health care organizations (HCOs) are increasingly embracing academic-practice partnerships (AcaPP). An HCO's workforce development plan prompted an AcaPP agreement with a CON for the purpose of increasing the number of doctor of nursing practice (DNP) advanced practice nurses in the HCO. Over a period of 6 years, 4 consecutive cohorts of approximately 100 HCO baccalaureate prepared nurses were enrolled in the CON DNP program. The AcaPP environment facilitates large-scale DNP projects among successive cohorts of students. The purpose of this article is to describe the innovative Tiered DNP Project Model, defined as the process by which current students build on and expand select DNP projects implemented by students in initial cohorts. The tiered approach to the DNP project is facilitated by an advising model that occurs in the context of mutually agreed-upon goals and compatible with the HCO strategic plan and CON DNP program objectives. In the Tiered DNP Project Model, select studies are chosen for continuation by DNP students in subsequent cohorts based on nursing leadership guidance of alignment with HCO strategic goals. The model has resulted in driving improvements in HCO patient and systems outcomes, promoted practice scholarship, and contributed to the quality of the CON DNP program.
Trends in the Use of Skilled Nursing Facility and Home Health Care Under the Hospital Readmissions Reduction Program
Authors: Popescu Ioana , Sood Neeraj , Joshi Sushant , Huckfeldt Peter , Escarce José , Nuckols Teryl K. 
Published: August 2019

Background:
Medicare’s Hospital Readmission Reduction Program (HRRP) penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction (AMI), heart failure (HF), or pneumonia. To reduce readmissions, hospitals may have increased referrals to skilled nursing facilities (SNFs) and home health care.

Research Design:
Outcomes included 30-day postdischarge utilization of SNF and home health care, including any use as well as days of use. Subjects included Medicare fee-for-service beneficiaries aged 65 years and older who were admitted with AMI, HF, or pneumonia to hospitals subject to the HRRP. Using an interrupted time-series analysis, we compared utilization rates observed after the announcement of the HRRP (April 2010 through September 2012) and after the imposition of penalties (October 2012 through September 2014) with projected utilization rates that accounted for pre-HRRP trends (January 2008 through March 2010). Models included patient characteristics and hospital fixed effects.

Results:
For AMI and HF, utilization of SNF and home health care remained stable overall. For pneumonia, observed utilization of any SNF care increased modestly (1.0%, P<0.001 during anticipation; 2.4%, P<0.001 after penalties) and observed utilization of any home health care services declined modestly (−0.5%, P=0.008 after announcement; −0.7%, P=0.045 after penalties) relative to projections. Beneficiaries with AMI and pneumonia treated at penalized hospitals had higher rates of being in the community 30 days postdischarge.

Conclusions:
Hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals’ efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
Validating Reports of Chronic Conditions in the Medicare CAHPS Survey
Authors: Brault Matthew W. , Landon Bruce E. , Zaslavsky Alan M. 
Published: August 2019

Background:
The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey includes items about chronic conditions, health history, and self-rated health. Questions remain about the concordance between patient reports and administrative sources on questions related to health history.

Objective:
To validate CAHPS measures of chronic conditions against claims-based measures from the Medicare Chronic Conditions Warehouse (CCW).

Methods:
We linked CAHPS responses from 301,050 fee-for-service Medicare beneficiaries in 2010–2012 with summaries of their claims in the CCW and identified nearest equivalent measures of conditions across sources. We calculated sensitivities and specificities for conditions and estimated regression models to assess the effects of patient characteristics on the sensitivity.

Results:
The sensitivity of CAHPS measures differed across conditions, ranging from 0.513 for history of stroke to 0.773 for history of cancer. Sensitivity was generally lower for older beneficiaries, those reporting good self-rated health, and those with fair or poor mental health. Specificity was 0.904 or greater for all conditions, up to 0.961 for stroke.

Conclusions:
Despite difference in timeframes and definitions of conditions, the measured sensitivities demonstrated reasonable validity. Variation in sensitivity is consistent with covariates that either directly measure health severity within a diagnosis or can be construed as a proxy for severity of illness.
Transfusion support and alternatives for Jehovah's Witness patients
Authors: Crowe Elizabeth P. , DeSimone Robert A. 
Published: August 2019

Purpose of review
Jehovah's Witness patients with critical anemia or undergoing major surgery are challenging for healthcare providers to manage, as most will decline transfusion of whole blood and its main components. Recent advances in our understanding of hemostatic agents, alternative hemoglobin-based oxygen carriers, and patient blood management have culminated in a complex array of options to manage critical anemia and bleeding in this patient population.

Recent findings
Refusal of blood products in the setting of critical anemia is associated with significant risk of morbidity and mortality. With implementation of patient blood management measures, targeted treatment of anemia and coagulopathy has reduced the need for transfusions. Likewise, increased clinical experience with hemoglobin-based oxygen carriers in Jehovah's Witnesses with critical anemia has provided new insights into their potential benefits and pitfalls.

Summary
Options and alternatives to manage the Jehovah's Witness patient in the perioperative setting or in the setting of critical anemia will be reviewed.
Agent-Based Modeling
Authors: McLean Allen , McDonald Wade , Goodridge Donna , Osgood Nathaniel 
Published: August 2019

Background
For all our successes, many urgent health problems persist, and although some of these problems may be explored with established research methods, others remain uniquely challenging to investigate—maybe even impossible to study in the real world because of practical and pragmatic obstacles inherent to the nature of the research question.

Objectives
The purpose of this review article is to introduce agent-based modeling (ABM) and simulation and demonstrate its value and potential as a novel research method applied in nursing science.

Methods
An introduction to ABM and simulation is described. Examples of current research literature on the subject are provided. A case study example of community nursing and opioid dependence is presented.

Results
The use of ABM and simulation in human health research has increased dramatically over the past decade, and meaningful research is now commonly found published widely in respected, peer-reviewed journals. Absent from this list is innovative ABM and simulation research published by nurse researchers in nursing-specific journals.

Discussion
ABM and simulation is a powerful method with tremendous potential in nursing research. It is vital that nursing embrace and adopt innovative and advanced research methods if we are to remain a progressive voice in health research, practice, and policy.
Intraosseous Hibernoma: Five Cases and a Review of the Literature
Authors: Myslicki Francisco A. , Rosenberg Andrew E. , Chaitowitz Ivan , Subhawong Ty K. 
Published: August 2019

Abstract
We present 5 cases of intraosseous hibernoma, a rare benign tumor of brown fat. Our literature review reveals that the average age at presentation is 58.6 years, and 69.7% of patients are female. Lesions are most often located in the spine and pelvis. Computed tomography usually demonstrates sclerotic changes, although lesions can be lytic. Magnetic resonance imaging findings include heterogeneous T2 hyperintensity. Technetium 99m-methyl diphosphonate bone scan reveals variable radiotracer uptake, whereas 18F-labeled fluoro-2-deoxyglucose (FDG) PET-CT shows mild uptake. Intraosseous hibernoma should be considered when imaging demonstrates a fat-containing lesion in bone, especially one exhibiting FDG avidity.
The Role of Positron Emission Tomography/Magnetic Resonance Imaging in Gynecological Malignancies
Authors: Virarkar Mayur , Viswanathan Chitra , Iyer Revathy , de Castro Faria Silvana , Morani Ajaykumar , Carter Brett , Ganeshan Dhakshinamoorthy , Elsherif Sherif , Bhosale Priya R. 
Published: August 2019

Abstract
Accurate oncological staging for early detection is of utmost importance in patient care and increasing the overall patient survival outcome. Hybrid imaging in the form of positron emission tomography (PET)/computed tomography has been successfully implemented in oncological imaging and, where available, has been used consistently in patients with gynecologic malignancies. The implementation of PET/magnetic resonance imaging (MRI) enables high-quality assessment of gynecological malignancies by combining the diagnostic advantages of metabolic information of PET along with the high-resolution anatomical and functional information from the MRI to provide precise information about staging, recurrence, and metastases. This article will review the various applications of PET/MRI in gynecological cancer.