bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a Long-Term, Physical Therapy Service-Learning Partnership in Ecuador: Inclusion of the Community Voice
Authors: Hayward Lorna M. , Schneider Jennifer , Gandhi Sonu , Per Samara , Donat Marcella , Hayward Julia K. 
Published: February 2019

Background and Purpose.
International service learning (ISL) is an instructional method used by physical therapist educators to increase the global perspective of students. Research exploring student experiences with ISL is plentiful, but evaluation of service outcomes from the community partner perspective is lacking. The purposes of this work were to evaluate the impact of a long-term community partnership through: (1) identification of benefits, drawbacks, and suggestions for sustaining the partnership and (2) gathering feedback on the immediate and short-term perspective of training provided to orphanage staff.

Method/Model Description and Evaluation.
The model consisted of a curriculum-based ISL experience involving a US-based physical therapy program and a service site at an Ecuadorian orphanage. For the current work, an evaluation component was added to the model. Three complementary approaches: the SOFAR Model, Exchange theory, and the partnership qualities of closeness, equity, and integrity informed the evaluation. Data consisted of 6 interviews conducted and 17 surveys administered to Ecuadorian community partner staff/administration. Data were analyzed using qualitative thematic content analysis, descriptive statistics, and paired t tests.

Outcomes.
Partnership benefits included: iterative pre-trip communication, a respectful and mutually beneficial relationship, capacity building through education, and physical therapy that positively affected the children's quality of life. Drawbacks were the potential for host site dependency due to lack of local capacity, negative impact of new technology on staff workload, and poor treatment carryover. Continued training was identified as critical for building capacity within orphanage staff.

Discussion and Conclusion.
As more US student teams deliver clinical services abroad, intentional evaluation approaches must include the community partner voice to maximize benefits, minimize burdens, build capacity, and addresses issues of vital importance to the service site.
Improving Interprofessional Communication Confidence Among Physical Therapy and Nurse Practitioner Students
Authors: Cooper Denise , Keiser Megan , Berg Karen , Sherman Erica 
Published: February 2019

Introduction.
Educators identified a deficiency in interprofessional communication education in a midwestern university's Doctor of Physical Therapy (DPT) and Doctor of Nursing Practice (DNP) programs. While several professional organizations stress the importance of interprofessional communication, few studies have focused on such communication between DPT and DNP students. The purpose of this study was to assess DNP and DPT students' knowledge and perception of confidence in interprofessional communication after a simulation-based learning activity conducted via telephone consultation. During the activity, students used the Situation, Background, Assessment, Recommendation (SBAR) method with a clinical case study.

Methods.
The study used a nonrandom sample of 52 first-year DPT and 19 second-year DNP students. Participants completed a questionnaire prior to an educational intervention consisting of SBAR and interprofessional education (IPE) modules. The activity was conducted using an online audio conferencing tool. Students then completed a postintervention questionnaire and reflective questions.

Results.
Data analysis (descriptive statistics, analysis of variance with change scores, and qualitative data analysis) showed that DPT students had significantly higher changes in SBAR combined knowledge and attitude scores compared to DNP students after simulation activity.

Discussion and Conclusion.
Introducing interprofessional communication such as SBAR approach in DPT and DNP curricula using realistic, simulation-based learning activities with clinical case studies may help students improve their confidence in interprofessional communication.
An Intraprocedural Endoscopic Cleansing Device for Achieving Adequate Colon Preparation in Poorly Prepped Patients
Authors: Pérez Jiménez Javier , Diego Bermúdez Lucas , Gralnek Ian M. , Martín Herrera Leopoldo , Libes Michael 
Published: February 2019

Background and Aims:
An effective bowel preparation is essential for quality colonoscopy. Inadequate preparation results in missed lesions, need for earlier repeat procedures, prolonged colonoscopy duration, an increased likelihood of adverse events, reduced patient satisfaction, and increased costs. The MOTUS GI Pure-Vu System (Tirat Carmel, Israel) is an Food and Drug Administration-cleared device designed to improve visualization in an inadequately prepared colon by facilitating intraprocedural cleaning. We evaluated the efficacy, safety, and usability of the Pure-Vu System in cleansing poorly prepared colons in human subjects.

Methods:
In total, 50 patients with poorly prepared colons undergoing colonoscopy were prospectively enrolled to evaluate the Pure-Vu System at 2 clinical sites [Spain (N=41) and Israel (N=9)]. Cleansing quality was measured using the Boston Bowel Preparation Score (BBPS).

Results:
In total, 50 patients (64% male individuals), mean age 51.9±10.4 years, and mean body mass index of 26.6±3.1 were enrolled. The Pure-Vu System significantly increased the BBPS median score from 5.0 at baseline to 9.0 after the use of Pure-Vu (P<0.0001). Patients with an adequate cleansing level (BBPS≥2 in each colon segment) increased significantly from 31% (15/49) at baseline to 98% (48/49) after use of Pure-Vu (P<0.001). Cecal intubation was achieved in 48/49 (98%) patients. Colonoscopists were satisfied with the Pure-Vu System. No serious adverse events were reported.

Conclusions:
The Pure-Vu System was found to be safe, efficacious, and easy to use in cleansing inadequately prepared colons, enabling the colonoscopist to conduct a complete examination.
POEM in Latin America
Authors: Kahaleh Michel , Xu Ming-ming , Zamarripa Felipe , Martínez Guadalupe , Arantes Vitor N. , Rodriguez Fernando Casas , Castillo Bismarck , Andalib Iman , Tyberg Amy , Lambroza Arnon , Saumoy Monica , Carames Juan C. , Baptista Alberto , Robles-Medranda Carlos , Lukashok Hanna , Gaidhane Monica , Valencia Juan M.B. , Moura Eduardo T.H.d. , Moura Eduardo G.H.d. 
Published: February 2019

Background:
Per-oral endoscopic myotomy (POEM) has become the preferred alternative treatment to standard Heller myotomy for patients with esophageal achalasia, in Latin American countries. The aim of our study was to evaluate the efficacy and safety of a POEM in the management of achalasia with and without Chagas disease in patients receiving POEM.

Methods:
Patients who underwent POEM from tertiary centers in Latin America were included in a dedicated registry. Countries included Brazil, Colombia, Ecuador, Mexico, Nicaragua, and Venezuela. Patients enrolled needed to have a preoperative manometry and swallow contrast study confirming achalasia. Clinical success was defined as significant improvement in Eckardt score after therapy.

Results:
POEM was technically successful in 81/89 (91%) patients (mean age, 44 y). There was a significant decrease in preprocedure and postprocedure Eckardt score from 8.7 (range, 3 to 12) to 2.15 (0 to 10) (P<0.001), preprocedure and postprocedure barium swallow evaluation (98% vs. 89%; P=0.017), and preprocedure and postprocedure lower esophageal sphincter pressure measurement (from 35 to 13.8 mm Hg; P<0.001). Clinical success was achieved in 93% of patients. Patients with Chagas disease (n=58) were 9.5 times more likely to respond to POEM (P=0.0020; odds ratio, 9.5).

Conclusions:
POEM is an efficacious and safe therapeutic modality for treatment of achalasia in Latin America. Chagas disease-related achalasia seems to particularly respond better to POEM when it is performed by experienced endoscopists.
Noninvasive Assessment of Portal Hypertension Using Spectral Computed Tomography
Authors: Wang Jun , Gao Feng , Shen Jia Lin 
Published: February 2019

Background:
Early diagnosis of portal hypertension is imperative for timely treatment to reduce the mortality rate. However, there is still no adequate method to noninvasively and accurately assess the portal hypertension in routine clinical practice.

Purpose:
We aimed to evaluate the accuracy of parameters measured using dual energy spectral computed tomography (LightSpeed CT750 HD) in assessing portal venous pressure in patients with liver cirrhosis.

Study:
Forty-five patients with liver cirrhosis who underwent percutaneous transhepatic portal vein puncture as part of their treatment for liver disease were enrolled in this study. Measurement of direct portal venous pressure was performed preoperatively. All patients underwent dual energy spectral computed tomography within 3 days before their operations.

Results:
The iodine concentrations of portal vein and hepatic parenchyma during the portal venous phase and the alanine aminotransferase level were found to be independently correlated with the direct portal venous pressure according to stepwise multivariate linear regression analysis (P<0.001, 0.004, and 0.024, respectively). In a receiver operating characteristic analysis, the area under the receiver operating characteristic of iodine concentrations of the portal vein (ICPV) for identifying clinically significant portal hypertension (≥10 mm Hg) was significantly higher than that of iodine concentrations of hepatic parenchyma (ICliver) and the alanine aminotransferase level (0.944, 0.825, and 0.301, respectively). The threshold ICPV of 58.27 yielded a sensitivity of 93.8%, specificity of 69.2%, positive predictive value of 88.2%, and negative predictive value of 81.8%, respectively.

Conclusions:
ICPV values may be a useful tool in noninvasively assessing the portal venous pressure and identifying clinically significant portal hypertension in liver cirrhosis.
Technological advances shaping diabetes care
Authors: Akturk Halis Kaan , Garg Satish 
Published: February 2019

Purpose of review
To emphasize the current unmet needs for patients with diabetes and evaluate the recent technological advances in the diabetes field and summarize upcoming technologies in diabetes care. This review highlights emerging diabetes technologies and patient-centered diabetes management.

Recent findings
A review of the literature showed that there is a clear benefit of using diabetes technologies in diabetes care. Recently, the US Food and Drug Administration (FDA) created a new category of Class II integrated continuous glucose monitoring (iCGM) devices and announced new guidelines to accelerate the approval of future products. With the first-generation hybrid-closed loop, a new era opened in automated insulin delivery systems. Diabetes coaching, apps, and remote monitoring technologies eased access to the providers and increased patient's self-confidence for diabetes management.

Summary
Improvements in diabetes technologies will hopefully overcome unmet needs for patients with diabetes and improve health outcomes. Patients will benefit from the upcoming technologies in their day-to-day diabetes management while providers may monitor patients remotely with ease and efficiently. These developments will decrease diabetes burden, improve quality of life, and open a new era of personalized diabetes care.
The neurointensive nursery: concept, development, and insights gained
Authors: Glass Hannah C. , Ferriero Donna M. , Rowitch David H. , Shimotake Thomas K. 
Published: February 2019

Purpose of review
With the advent of therapeutic hypothermia for treatment of hypoxic ischemic encephalopathy, and improvements in neuroimaging and bedside neuromonitoring, a new era of neonatal brain-focused care has emerged in recent years. We describe the development of the first neurointensive care nursery (NICN) as a model for comanagement of neonates with identified neurologic risk factors by a multidisciplinary team constituted of neurologists, neonatologists, specialized nurses, and others with the goal of optimizing management, preventing secondary injury and maximizing long-term outcomes.

Recent findings
Optimizing brain metabolic environment and perfusion and preventing secondary brain injury are key to neurocritical care. This includes close management of temperature, blood pressure, oxygenation, carbon dioxide, and glucose levels. Early developmental interventions and involvement of physical and occupational therapy provide additional assessment information. Finally, long-term follow-up is essential for any neurocritical care program.

Summary
The NICN model aims to optimize evidence-based care of infants at risk for neurologic injury. Results from ongoing hypothermia and neuroprotective trials are likely to yield additional treatments. New technologies, such as functional MRI, continuous neurophysiological assessment, and whole genomic approaches to rapid diagnosis may further enhance clinical protocols and neonatal precision medicine. Importantly, advances in neurocritical care improve our ability to provide comprehensive information when counseling families. Long-term follow-up data will determine if the NICN/Neuro-NICU provides enduring benefit to infants at risk for neurologic injury.
Healthy Body Weights With Corticosteroid‐free Immunosuppression Is the Best Predictor of Cardiovascular Health in Children After Liver Transplantation
Authors: Mager Diana R. , Hager Amber , Siminoski Kerry , Yap Jason K. , Gilmour Susan M. 
Published: February 2019

ABSTRACTIntroduction:Cardiometabolic dysregulation (CMD) influences morbidity and mortality risk in adults post‐liver transplantation (LTx). CMD is reported in 10% to 25% of pediatric LTx recipients, but no information regarding the longitudinal expression of CMD is available. The study objective was to examine the longitudinal expression of CMD and associations with body composition and growth in children post‐LTx.Methods:A retrospective review was conducted in youth (34 F/30 M) who underwent LTx between 1994 and 2015 at the Stollery Children's Hospital. Primary outcomes included serum markers of CMD (insulin, glucose, hemoglobin A1C [A1C], homeostasis model assessment for insulin resistance [abnormal >3], lipid panel triglycerides, total cholesterol, high‐density lipoprotein‐cholesterol, low‐density lipoprotein‐cholesterol) and systolic/diastolic blood pressure (BP: absolute/z scores).Results:Mean (±SD) age, weight z, height z, body mass index z was 9.7 ± 3.4 years (3.5–17.9), 0.26 ± 1.03, 0.017 ± 1.2, and 0.41 ± 1.05, respectively. The majority of children had percentage fat mass, percentage fat‐free mass within normal reference ranges. Systolic/diastolic BP was within healthy references ranges in 83.1% and 93.5% of children, respectively. Serum insulin (83.4%) and high‐density lipoprotein‐cholesterol (43.9%) concentrations were low, with abnormal findings of other laboratory markers found in <5% of participants. Abnormal findings for metabolic parameters were independent of weight z, body mass index z, fat mass, and corticosteroids but were positively related to child's age (>9.7 years) and fat‐free mass (total, arms). Insulin levels decreased significantly in the first 4 years post‐LTx, but no changes in lipid panel, A1C and glucose were noted over 10 years.Conclusions:Pediatric LTx recipients with healthy body weights and corticosteroid‐free immunosuppression have a low expression of CMD over 10 years.
Prevalence of Gastroesophageal Reflux Disease Symptoms in Infants and Children
Authors: Singendonk Maartje , Goudswaard Eline , Langendam Miranda , van Wijk Michiel , van Etten‐Jamaludin Faridi , Benninga Marc , Tabbers Merit 
Published: February 2019

ABSTRACTObjectives:Gastroesophageal reflux disease (GERD) is defined as gastroesophageal reflux causing troublesome symptoms or complications. In this study we reviewed the literature regarding the prevalence of GERD symptoms in infants and children.Methods:Databases of PubMed, EMBASE, and Cochrane were systematically searched from inception to June 26, 2018. English‐written studies based on birth cohort, school‐based, or general population samples of ≥50 children aged 0 to 21 years were included. Convenience samples were excluded.Results:In total, 3581 unique studies were found, of which 25 studies (11 in infants and 14 in children) were included with data on the prevalence of GERD symptoms comprising a total population of 487,969 children. In infants (0–18 months), GERD symptoms are present in more than a quarter of infants on a daily basis and show a steady decline in frequency with almost complete disappearance of symptoms at the age of 12 months. In children older than 18 months, GERD symptoms show large variation in prevalence between studies (range 0%‐38% of study population) and overall, are present in >10% and in 25% on respectively a weekly and monthly basis. Of the risk factors assessed, higher body mass index and the use of alcohol and tobacco were associated with higher GERD symptom prevalence.Conclusions:This systematic review demonstrates that the reported prevalence of GERD symptoms varies considerably, depending on method of data collection and criteria used to define symptoms. Nevertheless, the high reported prevalence rates support better investment of resources and educational campaigns focused on prevention.
Psychologic Distress and Anxiety in Mothers of Children With Gastroesophageal Reflux Undergoing Antireflux Surgery
Authors: Kvello Morten , Åvitsland Tone Lise , Knatten Charlotte K. , Fyhn Thomas J. , Malt Ulrik , Emblem Ragnhild , Bjørnland Kristin 
Published: February 2019

ABSTRACTObjectives:Parents of children with a chronic illness are at risk for impaired psychosocial functioning. Gastroesophageal reflux disease (GERD) is such a disease, and no studies have investigated effects of antireflux surgery on parental psychological distress. The aims of this study were to assess psychological distress and state and trait anxiety in mothers of children with GERD, and to explore possible changes after antireflux surgery.Methods:Mothers of children referred for antireflux surgery were included in this prospective study. Standardized questionnaires were used to evaluate psychological distress and state and trait anxiety before and 12 months after antireflux surgery.Results:Of 87 eligible mothers of children with GERD, 62 (71%) agreed to participate. All children had objectively verified GERD by 24‐hour pH‐monitoring and/or upper gastrointestinal contrast study and unsatisfactory symptom relief of pharmacological treatment. Thirty‐one (50%) mothers returned questionnaires postoperatively. Preoperatively, mothers of children undergoing antireflux surgery reported high levels of psychological distress and state anxiety, and 54% had scores indicating clinically significant psychological distress. None of the preoperative child characteristics were found to significantly influence maternal psychological distress or state anxiety. Twelve months postoperatively, both psychological distress and state anxiety were reduced.Conclusions:Mothers of children undergoing antireflux surgery reported reduced levels of psychological distress and state anxiety 12 months after the operation.
The “Obsessive Paradox”
Authors: Tonna Matteo , Ottoni Rebecca , Pellegrini Clara , Bettini Elena , Accardi Valeria , Ossola Paolo , De Panfilis Chiara , Marchesi Carlo 
Published: February 2019

Abstract
The objective of the study was to investigate the relationship between cognitive functions and obsessive-compulsive dimension in schizophrenia and a possible moderating effect of schizophrenia symptom dimensions on this association. Sixty-one schizophrenia patients were administered the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and the Matrics Consensus Cognitive Battery. A U-shaped curve described a gradual transition from an inverse association to a positive relationship between YBOCS and processing speed scores, along a severity gradient of obsessive dimension. This effect (“the obsessive paradox”) was not moderated by other symptom dimensions. The present study suggests that severe obsessive-compulsive symptoms may participate to counterbalance processing speed impairment independently from other symptom dimensions. These results highlight the complexity of the relationship between cognitive and obsessive dimensions in schizophrenia.
The Nose Knows… or Does it? Olfactory Reference Syndrome in Patients Presenting for Assessment of Unusual Body Odor
Authors: McNiven Vanda , Mamane Sarah , Zai Gwyneth , So Joyce 
Published: February 2019

Abstract
Olfactory reference syndrome (ORS) is a rarely diagnosed psychiatric disorder in which individuals falsely believe that they emit an offensive body odor. This retrospective cohort study characterizes the clinical and demographic features of 54 individuals who presented to a Canadian genetics clinic for query trimethylaminuria (TMAU), an inherited disorder in which a pungent fishy odor is produced. The majority (83%) were found to have a likely diagnosis of ORS and a high rate (73.3%) of concomitant psychiatric disorders; only two patients were diagnosed with TMAU. This study highlights the genetics clinic as an unexpected and major ascertainment point for ORS, and shows that ORS can be differentiated from TMAU by age of onset (~28 years), odor characterization (refuse-related), and the presence of associated comorbid psychiatric diagnoses. There is a low diagnostic rate of ORS, attesting to the need for improved education and awareness.
Can Social Anxiety Impact Facial Emotion Recognition in Schizophrenia?
Authors: Lecomte Tania , Théroux Laurence , Paquin Karine , Potvin Stéphane , Achim Amélie 
Published: February 2019

Abstract
Social anxiety is highly prevalent in individuals with schizophrenia, with studies suggesting rates of 30%. This study aimed at determining if social anxiety is linked to specific emotion recognition deficits and to specific social functioning deficits. A total of 47 participants with a diagnosis of schizophrenia and receiving outpatient services answered measures of facial recognition (Ekman; Facial Emotion Identification Test), facial discrimination (Facial Emotion Discrimination Test), role-play, social anxiety (Social Interaction Anxiety Scale and Brief Social Phobia Scale), psychiatric symptoms (Brief Psychiatric Rating Scale), self-esteem (Self-Esteem Rating Scale–Short Form), and social functioning (Social Functioning Scale). A total of 22 (47%) participants were rated as socially anxious. Those with social anxiety had worse social functioning in the domains of interpersonal communication (t[45] = 2.28, p = 0.025) and engagement (in conversations) (t[45] = 2.89, p = 0.000) and had lower self-esteem (t[45] = 4.05, p = 0.001). Participants with social anxiety also had more difficulties in recognizing neutral emotional faces (t[31] = 2.19, p = 0.036). More studies are warranted to better understand the link between neutral expression recognition and social anxiety in schizophrenia.