bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Metzenbaum scissors and Y‐shaped fasciotome for deep metatarsal fasciotomy for the treatment of proximal suspensory ligament desmopathy in horses
Authors: Sidhu Anhad B. S. , Rosanowski Sarah M. , Davis Alexandra M. , Griffith James F. , Robinson Paul 
Published: October 2018

AbstractObjectiveTo quantitate the iatrogenic injury associated with deep plantar metatarsal fasciotomy performed with Metzenbaum scissors compared with a Y‐shaped fasciotome.Study designExperimental ex vivo surgical study.Study populationCadaveric hind limbs (n = 20) from 10 sound thoroughbred racehorses.MethodsA plantar metatarsal fasciotomy was performed, extending from the proximal extent of the deep metatarsal fascia, distally. Hind limbs were randomly assigned to 2 groups, undergoing fasciotomy with straight Metzenbaum scissors (n = 10) or a Y‐shaped fasciotome (n = 10). Magnetic resonance imaging was performed before and after surgery to identify the maximal depth of any iatrogenic trauma. Gross examination of the surgical site included measuring the length of the incision in the deep metatarsal fascia and localizing iatrogenic trauma sustained by the plantar aspect of the proximal suspensory ligament (PSL) during the procedure.ResultsIatrogenic injury to the PSL was identified in 6 of 10 and 9 of 10 specimens prepared with the fasciotome and Metzenbaum scissors, respectively (P = .03), and was most commonly located in the distal third of the fascial incision. Differences between the length of incision (P = .02) and the maximal depth of signal (P = .03) for incisions created with Metzenbaum scissors or a fasciotome were identified.ConclusionThe use of a fasciotome resulted in longer fascial incisions and less severe iatrogenic trauma to the PSL compared with using Metzenbaum scissors.Clinical significanceA Y‐shaped fasciotome may be the preferred surgical instrument for successful desmopathy of the PSL fasciotomy because a greater release of compartmental pressure is possible through a longer incision with minimal iatrogenic trauma to the underlying PSL.
A Global Approach to Promoting Evidence‐Based Practice Knowledge: Validating the Translated Version of the Evidence‐Based Practice Knowledge Assessment in Nursing Into Spanish
Authors: Nick Jan M. , Wonder Amy H. , Suero Alfa R. , Spurlock Darrell 
Published: October 2018

AbstractBackgroundGovernment and professional organizations have issued a call for evidence‐based practice (EBP), prompting the development of competencies and expectations for knowledge, skills, and attitudes. However, EBP is still inconsistently implemented. To advance the science of nursing globally, educators and leaders need to use consistent, rigorous evaluation methods to assess the EBP knowledge of students and clinicians.AimsThis study sought to translate the Evidence‐based Practice Knowledge Assessment in Nursing (EKAN) instrument into Spanish, evaluate the psychometric performance of the newly translated instrument, and establish a baseline measure of EBP knowledge of baccalaureate nursing (BSN) students for future program improvement.MethodsThis study utilized a cross‐sectional, descriptive, correlational design. A total of 139 BSN students were recruited from a single study site in the Dominican Republic. Subjects completed the 20‐item EKAN‐Spanish, which was translated and back‐translated to promote semantic accuracy.Results and FindingsInfit and outfit statistics for the sample centered around 1.0 (weighted mean square = 0.978; unweighted mean square = 0.988), indicating strong evidence of validity. The individual items on the EKAN‐Spanish showed item reliability of 0.94. The mean EBP knowledge score was 6.52 (SD = 2.03) with scores ranging from 2 to 12 points (20 points maximum). Differential item functioning (DIF) analysis supported translational accuracy.DiscussionThis study provides validation support for an objective assessment of EBP knowledge in the Spanish language and will be useful for future studies of EBP in over 21 Spanish‐speaking countries.Linking Evidence to ActionWhile EBP is a global nursing concept, there has been no instrument to objectively measure EBP knowledge across levels of education in academe and practice in Spanish‐speaking countries until just recently. The availability of a validated instrument will promote global consistency in assessing EBP knowledge. Further, this will promote a collaborative approach in teaching EBP to nursing students and practicing nurses.
Proton magnetic resonance spectroscopy lactate/N-acetylaspartate within 2 weeks of birth accurately predicts 2-year motor, cognitive and language outcomes in neonatal encephalopathy after therapeutic hypothermia
Authors: Mitra Subhabrata , Kendall Giles S , Bainbridge Alan , Sokolska Magdalena , Dinan Mary , Uria-Avellanal Cristina , Price David , Mckinnon Katie , Gunny Roxana , Huertas-Ceballos Angela , Golay Xavier , Robertson Nicola J 
Published: October 2018

ObjectiveBrain proton (1H) magnetic resonance spectroscopy (MRS) lactate/N-acetylaspartate (Lac/NAA) peak area ratio is used for prognostication in neonatal encephalopathy (NE). At 3 Tesla in NE babies, the objectives were to assess: (1) sensitivity and specificity of basal ganglia and thalamus (BGT) 1H MRS Lac/NAA for the prediction of Bayley III outcomes at 2 years using optimised metabolite fitting (Tarquin) with threonine and total NAA; (2) prediction of motor outcome with diffusion-weighted MRI; (3) BGT Lac/NAA correlation with the National Institute of Child Health and Human Development (NICHD) MRI score.Subjects and methods55 (16 inborn, 39 outborn) infants at 39w+5 d (35w+5d–42w+0d) with NE admitted between February 2012 and August 2014 to University College London Hospitals for therapeutic hypothermia underwent MRI and 1H MRS at 3T on day 2–14 (median day 5). MRIs were scored. Bayley III was assessed at 24 (22–26) months.Results16 babies died (1 inborn, 15 outborn); 20, 19 and 21 babies had poor motor, cognitive and language outcomes. Using a threshold of 0.39, sensitivity and specificity of BGT Lac/NAA for 2-year motor outcome was 100% and 97%, cognition 90% and 97% and language 81% and 97%, respectively. Sensitivity and specificity for motor outcome of mean diffusivity (threshold 0.001 mm2/s) up to day 9 was 72% and 100% and fractional anisotropy (threshold 0.198) was 39% and 94%, respectively. Lac/NAA correlated with BGT injury on NICHD scores (2A, 2B, 3).ConclusionBGT Lac/NAA on 1H MRS at 3T within 14 days accurately predicts 2-year motor, cognitive and language outcome and may be a marker directing decisions for therapies after cooling.
Autologous internal limiting membrane flap for retinal detachment due to posterior retinal tears over choroidal atrophy in highly myopic eyes
Authors: Rossi Tommaso , Caporossi Tomaso , Rizzo Stanislao , Trillo Carlandrea , Telani Serena , Barca Francesco , Ripandelli Guido 
Published: October 2018

PurposeTo review a series of highly myopic eyes with retinal detachment undergoing pars plana vitrectomy with autologous internal limiting membrane (ILM) flap placed over posterior retinal breaks located in areas of choroidal atrophy.MethodsRetrospective review of 13 consecutive patients receiving pars plana vitrectomy with ILM flap over causative breaks, compared with 19 controls receiving the same surgery with ILM peeling but no ILM flap. Main outcome measures included anatomical success rate, visual acuity, number of surgeries and the rate of silicone oil removal.ResultsPatients in the ILM group required 2.08±0.37 interventions versus 2.58±0.75 in the control group (p=0.037). One (1/13; 7.6%) patient in the ILM group required additional unplanned surgery versus 8/19 (42.10%) in the control group (p=0.038). Final anatomical success rate defined as attached retina after silicone oil (SiO) removal was 13/13 in the I-ILM group and 14/19 (73.6%) in the control group (p=0.052). No patients (0/13) in the I-ILM group retained SiO at the end of follow-up versus 4/19 (21.1%) patients in the control group (p=0.061). Best-corrected visual acuity at the end of follow-up was logMAR 0.65±0.36 (20/91 Snellen) in the ILM group and logMAR 0.89±0.44 (20/158 Snellen) in the control group (p=0.20).ConclusionAutologous ILM may help seal posterior retinal breaks and improve the surgical prognosis of retinal detachment due to breaks located over areas of choroidal atrophy within the myopic staphyloma.
Cam morphology in young male football players mostly develops before proximal femoral growth plate closure: a prospective study with 5-yearfollow-up
Authors: van Klij Pim , Heijboer Marinus P , Ginai Abida Z , Verhaar Jan A N , Waarsing Jan H , Agricola Rintje 
Published: October 2018

ObjectivesCam morphology is not completely understood. The aim of this study was threefold: (1) to investigate if cam morphology development is associated with growth plate status; (2) to examine whether cam morphology continues to develop after growth plate closure; and (3) to qualitatively describe cam morphology development over 5-year follow-up.MethodsAcademy male football players (n=49) participated in this prospective 5-year follow-up study (baseline 12–19 years old). Anteroposterior and frog-leg lateral views were obtained at baseline (142 hips), 2.5-year (126 hips) and 5-year follow-up (98 hips). Cam morphology on these time points was defined as: (A) visual scores of the anterior head-neck junction, classified as: (1) normal, (2) flattening, and (3) prominence; and (B) alpha angle ≥60°. Proximal femoral growth plates were classified as open or closed. Cam morphology development was defined as every increase in visual score and/or increase in alpha angle from <60° to ≥60°, between two time points. This resulted in 224 measurements for cam morphology development analysis.ResultsCam morphology development was significantly associated with open growth plates based on visual score (OR: 10.03, 95% CI 3.49 to 28.84, p<0.001) and alpha angle (OR: 2.85, 95% CI 1.18 to 6.88, p=0.020). With both definitions combined, cam developed in 104 of 142 hips during follow-up. Of these 104 hips, cam developed in 86 hips (82.7%) with open growth plate and in 18 hips (17.3%) with a closed growth plate. Cam morphology developed from 12 to 13 years of age until growth plate closure around 18 years.ConclusionCam morphology of the hip is more likely to develop with an open growth plate.
Specialist emergency care and COPD outcomes
Authors: Lane Nicholas David , Brewin Karen , Hartley Tom Murray , Gray William Keith , Burgess Mark , Steer John , Bourke Stephen C 
Published: October 2018

IntroductionIn exacerbation of chronic obstructive pulmonary disease (ECOPD) requiring hospitalisation greater access to respiratory specialists improves outcome, but is not consistently delivered. The UK National Confidential Enquiry into Patient Outcome and Death 2015 enquiry showed over 25% of patients receiving acute non-invasive ventilation (NIV) for ECOPD died in hospital. On 16 June 2015 the Northumbria Specialist Emergency Care Hospital (NSECH) opened, introducing 24/7 specialty consultant on-call, direct admission from the emergency department to specialty wards and 7-day consultant review. A Respiratory Support Unit opened for patients requiring NIV. Before NSECH the NIV service included mandated training and competency assessment, 24/7 single point of access, initiation of ventilation in the emergency department, a door-to-mask time target, early titration of ventilation pressures and structured weaning. Pneumonia or hypercapnic coma complicating ECOPD have never been considered contraindications to NIV. After NSECH staff-patient ratios increased, the NIV pathway was streamlined and structured daily multidisciplinary review introduced. We compared our outcomes with historical and national data.MethodsPatients hospitalised with ECOPD between 1 January 2013 and 31 December 2016 were identified from coding, with ventilation status and radiological consolidation confirmed from records. Age, gender, admission from nursing home, consolidation, revised Charlson Index, key comorbidities, length of stay, and inpatient and 30-day mortality were captured. Outcomes pre-NSECH and post-NSECH opening were compared and independent predictors of survival identified via logistic regression.ResultsThere were 6291 cases. 24/7 specialist emergency care was a strong independent predictor of lower mortality. Length of stay reduced by 1  day, but 90-day readmission rose in both ventilated and non-ventilated patients.ConclusionProvision of 24/7 respiratory specialist emergency care improved ECOPD survival and shortened length of stay for both non-ventilated and ventilated patients. The potential implications in respect to service design and provision nationally are substantial and challenging.
Epidemiology of injuries among Italian footballers: the role of the playing field
Authors: Bianchi Francesco Paolo , Veneziani Valter , Cantalice Michele Alberto , Notarnicola Angela , Tafuri Silvio 
Published: October 2018

BackgroundFootball has a higher injury rate compared with other team sports such as rugby, in terms of two main categories: intrinsic (individual) and extrinsic (environmental) factors. The playing field is an extrinsic risk factor which has been poorly investigated in the literature.PurposeThe aim of our study was to define the incidence and risk factors of injuries in a cohort of footballers comparing the role of three different types of playing field (hard court, natural grass or synthetic grass).Study designThis was a cross sectional prevalence study.MethodsThe population comprised footballers recruited by a convenience sample; the instrument used for the survey was an anonymous self-administered questionnaire.Results267 football players were enrolled (average age 23.4±4.8 years), of whom 33.7% (n=90/267) played on hard court, 33.0% (n=88/267) on natural grass and 33.3% (n=89/267) on synthetic grass. The overall incidence of injury was 40.1 (95% CI 34.1 to 46.8) ×1000 person-years of training, with higher values for ankle and knee injuries. Ankle injuries (aOR 0.4; P=0.021) were associated with playing on natural grass as a protective factor, while playing on natural grass seemed to be a risk factor for muscular injuries (aOR 2.3; P=0.026).ConclusionOur study showed a high lifetime prevalence of injury among footballers (57%), in particular among athletes who play and train on a hard court. We have studied a topic poorly investigated previously and provide the opportunity to understand interventions to increase the capacity of stakeholders in preventing injuries.
De novo pathogenic variants in neuronal differentiation factor 2 (NEUROD2) cause a form of early infantile epileptic encephalopathy
Authors: Sega Annalisa G , Mis Emily K , Lindstrom Kristin , Mercimek-Andrews Saadet , Ji Weizhen , Cho Megan T , Juusola Jane , Konstantino Monica , Jeffries Lauren , Khokha Mustafa K , Lakhani Saquib Ali 
Published: October 2018

BackgroundEarly infantile epileptic encephalopathies are severe disorders consisting of early-onset refractory seizures accompanied often by significant developmental delay. The increasing availability of next-generation sequencing has facilitated the recognition of single gene mutations as an underlying aetiology of some forms of early infantile epileptic encephalopathies.ObjectivesThis study was designed to identify candidate genes as a potential cause of early infantile epileptic encephalopathy, and then to provide genetic and functional evidence supporting patient variants as causative.MethodsWe used whole exome sequencing to identify candidate genes. To model the disease and assess the functional effects of patient variants on candidate protein function, we used in vivo CRISPR/Cas9-mediated genome editing and protein overexpression in frog tadpoles.ResultsWe identified novel de novo variants inneuronal differentiation factor 2(NEUROD2) in two unrelated children with early infantile epileptic encephalopathy. Depletingneurod2with CRISPR/Cas9-mediated genome editing induced spontaneous seizures in tadpoles, mimicking the patients’ condition. Overexpression of wild-type NEUROD2 induced ectopic neurons in tadpoles; however, patient variants were markedly less effective, suggesting that both variants are dysfunctional and likely pathogenic.ConclusionThis study provides clinical and functional support forNEUROD2variants as a cause of early infantile epileptic encephalopathy, the first evidence of human disease caused byNEUROD2variants.
Specific combinations of biallelic POLR3A variants cause Wiedemann-Rautenstrauch syndrome
Authors: Paolacci Stefano , Li Yun , Agolini Emanuele , Bellacchio Emanuele , Arboleda-Bustos Carlos E , Carrero Dido , Bertola Debora , Al-Gazali Lihadh , Alders Mariel , Altmüller Janine , Arboleda Gonzalo , Beleggia Filippo , Bruselles Alessandro , Ciolfi Andrea , Gillessen-Kaesbach Gabriele , Krieg Thomas , Mohammed Shehla , Müller Christian , Novelli Antonio , Ortega Jenny , Sandoval Adrian , Velasco Gloria , Yigit Gökhan , Arboleda Humberto , Lopez-Otin Carlos , Wollnik Bernd , Tartaglia Marco , Hennekam Raoul C 
Published: October 2018

BackgroundWiedemann-Rautenstrauch syndrome (WRS) is a form of segmental progeria presenting neonatally, characterised by growth retardation, sparse scalp hair, generalised lipodystrophy with characteristic local fatty tissue accumulations and unusual face. We aimed to understand its molecular cause.MethodsWe performed exome sequencing in two families, targeted sequencing in 10 other families and performed in silico modelling studies and transcript processing analyses to explore the structural and functional consequences of the identified variants.ResultsBiallelic POLR3A variants were identified in eight affected individuals and monoallelic variants of the same gene in four other individuals. In the latter, lack of genetic material precluded further analyses. Multiple variants were found to affect POLR3A transcript processing and were mostly located in deep intronic regions, making clinical suspicion fundamental to detection. While biallelic POLR3A variants have been previously reported in 4H syndrome and adolescent-onset progressive spastic ataxia, recurrent haplotypes specifically occurring in individuals with WRS were detected. All WRS-associated POLR3A amino acid changes were predicted to perturb substantially POLR3A structure/function.ConclusionBiallelic mutations in POLR3A, which encodes for the largest subunit of the DNA-dependent RNA polymerase III, underlie WRS. No isolated functional sites in POLR3A explain the phenotype variability in POLR3A-related disorders. We suggest that specific combinations of compound heterozygous variants must be present to cause the WRS phenotype. Our findings expand the molecular mechanisms contributing to progeroid disorders.
Job strain and cognitive change: the Baltimore Epidemiologic Catchment Area follow-up study
Authors: Dong Liming , Eaton William W , Spira Adam P , Agnew Jacqueline , Surkan Pamela J , Mojtabai Ramin 
Published: October 2018

ObjectivesTo investigate the association between job strain and subsequent cognitive change over approximately 11 years, using data from the population-based Baltimore Epidemiologic Catchment Area follow-up study.MethodsThe sample ranged from 555 to 563 participants, depending on the outcome, who reported psychosocial characteristics corresponding to the full-time job they held at baseline (1993–1996). Overall cognitive performance was measured by the Mini-Mental State Examination (MMSE), and verbal memory was measured by the ImmediateWord Recall Task and Delayed Word Recall Task at baseline and follow-up (2004–2005). Multiple linear regression was used to examine the association between job strain and cognitive change, and inverse probability weighting was used to account for differential attrition.ResultsParticipants with high job demands (psychological or physical demands) and/or low job control had greater decrease in the MMSE and memory scores than those with low job demands and high job control. After adjustment for baseline outcome scores, age and sex, the greatest decrease was observed in participants with high job demands and low job control (MMSE: −0.24, 95% CI −0.36 to –0.11; verbal memory scores: −0.26, 95% CI −0.44 to –0.07). The differences were partially explained by sociodemographic characteristics, occupational prestige and health factors.ConclusionsFindings from this prospective study suggest that job strain is associated with and may be a potential modifiable risk factor for adverse cognitive outcomes.
Multisite musculoskeletal pain trajectories from midlife to old age: a 28-year follow-up of municipal employees
Authors: Neupane Subas , Nygård Clas-Håkan , Prakash K C , von Bonsdorff Mikaela B , von Bonsdorff Monika E , Seitsamo Jorma , Rantanen Taina , Ilmarinen Juhani , Leino-Arjas Päivi 
Published: October 2018

ObjectivesWe studied the developmental trajectories of multisite musculoskeletal pain (MSP) to learn whether pain in midlife persists to old age, and whether pain trajectories associate with midlife work or lifestyle exposures or retirement from work.MethodsMunicipal employees aged 44–58 years were studied in 1981 (n=6257) with follow-ups in 1985, 1992, 1997 and 2009. Pain in the neck, low back, and upper and lower limbs was assessed in each survey. Trajectories of the number (0–4) of pain sites were defined using growth mixture modelling (n=3093). Workload, lifestyle and morbidity were elicited by questionnaire and retirement from registries. Associations of baseline factors with pain trajectories were assessed by multinomial logistic regression. Cumulative hazard curves for retirement by trajectory group were calculated.ResultsThree trajectories of pain over 28 years emerged: low (25%), moderate (52%) and high-decreasing (23%). In the latter, the number of pain sites first decreased sharply, stabilising to a moderate level after most subjects had retired. The disability pension rate was highest in this trajectory, which associated with high baseline morbidity, particularly musculoskeletal disorder (OR 8.06; 95% CI 5.97 to 10.87). Also high biomechanical exposure (2.86;95% CI 2.16 to 3.78), high job demands (1.79; 95% CI 1.39 to 2.30), high job control (OR 0.70; 95% CI 0.54 to 0.90), body mass index (BMI) ≥25.0 kg/m2 (1.40; 95% CI 1.09 to 1.80) and low leisure-time physical activity (LTPA) (1.39; 95% CI 1.09 to 1.78) at baseline were associated with this trajectory. However, high LTPA and BMI in repeated surveys also associated with the high-decreasing trajectory.ConclusionMSP in midlife often persists to old age. However, high widespreadness of pain may decrease with retirement from work.