bluuebunny/crossref_metadata_2025_split huggingface dataset:
Force Testing of Explanted Magnetically Controlled Growing Rods
Authors: Rushton Paul R.P. , Smith Simon L. , Forbes Liam , Bowey Andrew J. , Gibson Michael J. , Joyce Thomas J. 
Published: July 2018

Study Design.
Laboratory analysis of explanted MAGnetic Expansion Control (MAGEC) growing rods.

Objective.
The aim of this study was to measure the force produced by explanted MAGEC rods compared with new rods and assess the influence of clinical variables.

Summary of Background Data.
MAGEC rods are increasingly used in early-onset scoliosis. Some data are available describing the structure of explanted MAGEC rods, but to date, no study has assessed their function.

Methods.
Explanted MAGEC rods were received from seven UK and one Danish center. The force produced by explanted rods on activation with the external remote controller was measured using a dedicated jig. Forces were compared with two unused rods as well as the manufacturer's defined standard (42 Ibf). Clinical variables were collected from contributing centers where possible and correlated with the force measurements.

Results.
Forty-five MAGEC rods from 25 cases were received for analysis. The mean age at insertion was 8.6 years and rods were in vivo for a mean of 2.7 years in predominantly dual rod constructs. Two unused MAGEC rods produced a mean force of 45.3 (0.25) and 50.2 (1.4) Ibf, above the manufacturer's stated standard. Of the 45 explanted rods, 10 (22%) produced force greater or equal to manufacturer's standard, mean 46.7 (2.7) Ibf. Six rods (13%) produced some force but less than the manufacturer's standard, mean 34.8 (3.6) Ibf. Twenty-nine rods (64%) produced no force. The duration the rods were in vivo was significantly negatively correlated with the force produced on testing (r = −0.63, P < 0.005). Of the 12 rods implanted longer than 38 months, none produced any force.

Conclusion.
This is the first study of the force, and hence likely function, of explanted MAGEC rods. The majority of explanted rods produced no force, while others produced reduced force. These findings raise questions regarding the longevity of the implant and further clinical outcome studies are recommended.

Level of Evidence: 4
Radiological Characteristics and Clinical Outcome of Ossification of Posterior Longitudinal Ligament Involving C2 After Posterior Laminoplasty and Instrumented Fusion Surgery
Authors: Wang Liang , Jiang Yunpeng , Li Mu , Si Haipeng , Li Le , Qi Lei 
Published: July 2018

Study Design.
Retrospective study.

Objective.
To analyze the radiological characteristics and surgical outcome of cervical ossification of posterior longitudinal ligament (OPLL) involving C2 level.

Summary of Background Data.
The study and report focused on the OPLL involving C2 level are rare. Therefore, the radiological characteristics and surgical outcome remain unclear.

Methods.
The records of the patients with OPLL involving C2 level who underwent posterior surgery from July 2006 through October 2015 were retrospectively reviewed. The types, longitudinal and transverse extent, occupation ratio, K-line classification of OPLL, and high-intensity zone of spine cord on magnetic resonance imaging were analyzed to evaluate the radiological characteristics. All the cases received posterior open-door laminoplasty and instrumented fusion surgery. The Japanese Orthopedic Association (JOA) score and recovery rate (RR) were used to evaluate neurological function after surgery.

Results.
A total of 45 patients with OPLL involving C2 level were enrolled in the study. Their radiological data were carefully analyzed. The mixed (73.3%) and continuous type (24.5%) were observed. The mean number of involved segments was 5.1. The narrowest spinal canal mostly located in the level of C3-C4 and mean occupying ratio was 65.3%. Thirty-two patients were followed up for at least 2 years and the mean follow-up time was 46.2 months. The mean JOA score was 10.3 preoperatively and 15.2 at the final follow-up and the mean RR was 70.7%. The K-line (+) and (−) subgroups showed similar preoperative JOA score and RR. The high-intensity zone (+) subgroup showed lower preoperative JOA score but equal RR with (−) subgroup.

Conclusion.
When OPLL involve C2 level, it often presented different radiological characteristics. The posterior open-door laminoplasty and instrumented fusion surgery could achieve favorable clinical outcomes. Further researches and long-term clinical follow-up are needed to better appreciate the OPLL involving C2 level.

Level of Evidence: 4
Traumatic Neuroma With Melanoma Perineural Invasion
Authors: Al-Zaid Tariq , Salah Haneen Thabit 
Published: July 2018

Abstract:
Traumatic neuroma is a reactive non-neoplastic neural proliferation that results from trauma. Although such type of lesions found surgical scars due to different reasons, its involvement by residual or recurrent malignancies is rarely reported. In this article, we describe an unusual case of traumatic neuroma with perineural invasion by invasive melanoma.
The boundary-spanning behavior of nurses: The role of support and affective organizational commitment
Authors: De Regge Melissa , Van Baelen Freek , Aerens Sander , Deweer Tine , Trybou Jeroen 
Published: July 2018

Aim:
The aim of this study was to examine the relationship between organizational, supervisor, and coworker support, as perceived by registered nurses and their boundary-spanning behaviors. Furthermore, this article examines the mediating role of the affective organizational commitment of nurses in these relationships.

Background:
Registered nurses play a key role in hospitals, as they have an important impact on the quality of the services delivered. For nurses to perform at their best, they need organizational, leader, and coworker support. To date, few studies have explored the link between nurses’ perceived support, affective organizational commitment, and boundary-spanning behaviors.

Methods:
This cross-sectional research used a questionnaire survey to explore the hypothesized relationships in a sample of 273 nurses from a hospital in Belgium. Structural equation modeling was used for statistical analysis of the mediation model.

Results:
One hundred forty-seven (53.5%) nurses responded to the survey. Perceived support from the organization, supervisors, and coworkers positively influences nurses’ boundary-spanning behaviors. Affective organizational commitment was found to mediate the positive relationship between perceived organization support, perceived coworker support, and boundary-spanning behaviors. Perceived supervisor support and boundary-spanning behaviors showed a direct relationship not mediated by affective organizational commitment.

Conclusions:
Perceived support has an important influence on the boundary-spanning behavior of nurses. This study emphasizes the importance on how support exerts an influence on boundary-spanning behavior and underscores the importance of affective organizational commitment. Health care organizations, supervisors, and coworkers are essential in fostering boundary-spanning behaviors of nurses, both directly and through the development of affective organizational commitment. These actors should therefore be aware of the way they behave and the implications their behavior may have.
Compliance with the U.S. Nuclear Regulatory Commission Revised Licensing Guidance for Radioactive Seed Localization
Authors: Sheetz Michael , Steiner Cynthia 
Published: July 2018

Abstract
The use of radioactive seed localization (RSL) as a reliable alternative to wire localization (WL) for guiding the surgical excision of non-palpable lesions has become more popular because of its demonstrated advantages for both the patient and surgeon. RSL is regulated under 10 CFR 35.1000 (Other Medical Uses) for which the U.S. Nuclear Regulatory Commission (U.S. NRC) issued its original licensing guidance entitled “I-125 and Pd-103 Low Dose Rate Brachytherapy Seeds Used for Localization of Non-palpable Lesions” in 2006. At that time, RSL was performed as an off-label use of the same radioactive 125I seeds used for brachytherapy, so the focus of this initial guidance was to establish the same requirements for RSL as for brachytherapy. Strict compliance with the licensing guidance was burdensome and made it difficult for some licensees to implement an RSL program. In response to a request from the user community and recommendations from an Advisory Committee on the Medical Use of Isotopes (ACMUI) subcommittee, the U.S. NRC formed a working group to consider revisions to its RSL guidance to make it more relevant to the conduct of the procedure. On October 7, 2016, the U.S. NRC issued a revised licensing guidance document titled “Low Activity Radioactive Seeds Used for Localization of Non-Palpable Lesions and Lymph Nodes.” This manuscript highlights the changes in the latest U.S. NRC licensing guidance for RSL, including authorized user training and experience, written directives, surveys, instrumentation, and medical event criteria, and presents practical ways to satisfy the new requirements.
Real-Time Monitoring of Gross Beta Radioactivity in Tap Water and Committed Effective Dose
Authors: Lv Wen-hui , Zeng Zhi , Yi Hongchang , Ma Hao , Li Jun-li , Zhang Hui 
Published: July 2018

Abstract
To achieve real-time monitoring of gross beta radioactivity in drinking water, a scintillating fiber array system was developed. Using this system, the gross beta radioactivity in tap water at Tsinghua University campus in Beijing was monitored, and the same water samples were measured using the evaporation concentration method as a comparison experiment. Finally, the annual committed effective doses to children and adults who drank the tap water for a long time were estimated. The results showed that the gross beta radioactivity in tap water was 0.09 ± 0.03 Bq L−1 using the scintillating fiber array system and 0.076 ± 0.009 Bq L−1 using the evaporation concentration method. The annual committed effective dose values were less than the dose reference level of 0.1 mSv y−1, as suggested by the World Health Organization. The scintillating fiber array system can be used for measuring gross beta radioactivity in drinking water and protecting public health.
Balance and Mobility Improvements During Inpatient Rehabilitation Are Similar in Young-Old, Mid-Old, and Old-Old Adults With Traumatic Brain Injury
Authors: Perry Susan B. , Billek-Sawhney Barbara , Woollard Jason , Little Susan , Szalinski Amy 
Published: July 2018

Objective:
To compare balance, mobility, and functional outcomes across 3 age groups of older adults with traumatic brain injury; to describe differences between those discharged to private residences versus institutional care.

Setting:
Acute inpatient rehabilitation facility.

Participants:
One hundred adults, mean age of 78.6 ± 7.9 years (range = 65-95 years), with an admitting diagnosis of traumatic brain injury.

Design:
Retrospective case series.

Main Measures:
Functional Independence Measure (FIM) for Cognition and Mobility; Berg Balance Scale; Timed Up and Go; and gait speed, at admission to and discharge from an inpatient rehabilitation facility.

Results:
Statistically significant improvements (P < .01) were made on the Timed Up and Go, Berg Balance Scale, and gait speed for young-old, mid-old, and old-old adults, with no differences among the 3 age groups. Substantial balance and mobility deficits remained. The FIM cognition (P = .013), FIM Walk (P = .009), and FIM Transfer (P = .013) scores were significantly better in individuals discharged home or home with family versus those discharged to an institution.

Conclusion:
Preliminary outcome data for specific balance and mobility measures are reported in 3 subgroups of older adults following traumatic brain injury, each of which made significant and similar improvements. Some FIM item scores discriminated between those discharged to a private residence versus a higher level of care.
A Review of Smartphone Applications for Persons With Traumatic Brain Injury: What Is Available and What Is the Evidence?
Authors: Kwan Vivian , Bihelek Nicoline , Anderson Vicki , Yeates Keith 
Published: July 2018

Objectives:To map the number and type of smartphone applications available for persons with traumatic brain injury (TBI), evaluate validity of app content, and investigate evidence for any claims made.Methods:We searched iTunes and Google Play and also completed a web search. The purpose of each app and any claims were extracted, and a search for best available evidence was performed.Results:Seventy apps met our inclusion criteria (35 related to assessment, 11 to education, 9 to treatment/management, 8 to impact sensors, and 7 to symptom tracking). To the best of our knowledge, no empirical research has been published to demonstrate that the use of any particular TBI-related app leads to clinically meaningful benefits compared with not using the app. Other problems include potential biases in self-report leading to possible app misuse, lack of references for app content, and inappropriate marketing to laypersons not trained to interpret the findings of tools validated for use by healthcare professionals.Conclusions:The current evidence for benefit from using TBI-related apps is minimal. More collaborative research is needed among clinicians, scientists, and app developers to determine whether, and how, apps may be helpful to individuals at risk for or following TBI.
Sleep Disturbance in Children With Moderate or Severe Traumatic Brain Injury Compared With Children With Orthopedic Injury
Authors: Bogdanov Stefan , Brookes Naomi , Epps Adrienne , Naismith Sharon L. , Teng Arthur , Lah Suncica 
Published: July 2018

Objectives:
To characterize the sleep disturbance in children with moderate or severe traumatic brain injury (TBI), and to identify associated factors.

Setting:
An urban tertiary pediatric healthcare facility.

Participants:
Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n =38) comparable in age, gender, and socioeconomic status.

Design:
Cohort study.

Measures:

Primary: Sleep Disturbance Scale for Children (SDSC). Secondary: Injury-specific factors (TBI severity, age at injury, and time since injury), and other factors of interest (sleep hygiene; pain intensity; difficulties with internalizing, externalizing, or attention/hyperactivity; parental distress; and parental knowledge of TBI).

Results:
On the SDSC, parents rated children with moderate TBI (but not severe TBI) as experiencing greater overall sleep disturbance, as well as excessive somnolence and sleep breathing disturbance, relative to OI controls. Children with severe TBI (but not moderate TBI) were rated as experiencing greater disturbance with initiating and maintaining sleep. The moderate and severe TBI groups did not differ on any of the sleep outcomes. Only 3 factors were associated with sleep disturbance in the combined TBI group: (1) lower TBI severity with greater excessive somnolence; (2) greater internalizing difficulties with greater overall sleep disturbance, and disturbance with initiating and maintaining sleep specifically; and (3) younger age at injury with greater overall sleep disturbance, and sleep breathing disturbance specifically.

Conclusion:
Children with moderate or severe TBI experience greater overall and/or specific forms of sleep disturbance. Different forms of sleep disturbance may be associated with different factors.
MINIMAL INVASIVE DRAINAGE TECHNIQUE FOR LARGE EXPANDING SUBRETINAL GAS BUBBLE
Authors: Ajlan Radwan , Arbour Jean-Daniel , Hammamji Karim 
Published: July 2018

Purpose:
To report a minimally invasive drainage technique for large expanding subretinal gas bubble and conduct a review of the literature.

Methods:
Case report, with schematic diagrams and multimodal imaging including fundus photography and spectral domain optical coherence tomography. Controlled drainage of large subretinal gas bubble using a 30-gauge needle introduced through cryotherapy-treated area in office-based setting.

Results:
Forty-year-old male patient presented with bullous rhegmatogenous retinal detachment and had gas inadvertently injected into the subretinal space during cryo-pneumatic retinopexy. After successful drainage of subretinal gas in clinic, 0.3cc of perfluoropropane (C3F8) gas was injected in different quadrants near the attached retina. The macula remained attached on immediate fundus examination. The gas bubbles of fish eggs coalesced into a single large bubble within 1 week. Spectral domain optical coherence tomography showed unremarkable foveal scans. After 45 days, the gas bubble completely disappeared, the retina remained attached, and vision in the treated eye was 20/20.

Conclusion:
To the best of our knowledge, this is the first case report of a large expanding gas bubble injected into the subretinal spaces being drained successfully by the described minimal invasive technique. Although it may offer a possible office-based approach to a rare complication, it is generally recommended that surgeons capable of dealing with its possible complications may attempt such technique when immediate vitrectomy is not accessible.
OPTICALLY EMPTY CHOROIDAL SPACES IN HIGH HYPEROPIA
Authors: Pichi Francesco , Sarraf David 
Published: July 2018

Purpose:
To describe the progressive optical coherence tomography findings of atypical choroidal cavitation in the inner choroid.

Methods:
Case report.

Results:
A 29-year-old asymptomatic woman was noted to display two flat translucent whitish subretinal lesions along the superotemporal arcade of the right eye, during routine retinal examination. Cross-sectional spectral domain optical coherence tomography of the choroid illustrated two hyporeflective lesions consistent with atypical choroidal cavitation of the Sattler layer, associated with corresponding thickening and bulging of the underlying choroid. En face optical coherence tomography through the lesions illustrated hyporeflectivity at the level of the inner choroid, compatible with choroidal cavitation. Progressive enlargement of these two choroidal lesions was noted with cross-sectional and en face optical coherence tomography.

Conclusion:
Intrachoroidal cavitation has been described in association with inferior peripapillary conus in myopic eyes. Progressive enlargement of these lesions has not been noted. The lesions reported herein are atypical for choroidal cavitation because they affect a young hyperopic woman and display progression. A common pathogenesis with myopic choroidal cavitation may be possible. These lesions may be secondary to a localized bulge in the sclera, or may be a “cavernous” space secondary to a congested choroid, that is, leaking fluid.
Indications and Outcomes of Penetrating Keratoplasty in Infants and Children of Beijing, China
Authors: Zhang Yingnan , Liu Yang , Liang Qingfeng , Miao Sen , Lin Qi , Zhang Jing , Pan Zhiqiang , Lu Qingxian 
Published: July 2018

Purpose:
To retrospectively investigate the indications and outcomes of pediatric penetrating keratoplasty (PKP) and to explore factors that affect graft survival.

Methods:
Patients who had undergone PKP from May 2010 to December 2016, aged ≤12 years were categorized as infants (≥3 months and <4 years) or children (≥4 years and ≤12 years). Clinical data including patient demographics, indications, surgical procedures, postoperative follow-up, and graft clarity were recorded and analyzed.

Results:
Among 160 eyes of 146 patients, 79 eyes and 81 eyes were treated from the infant and child groups, respectively, and followed up for 33.7 ± 21.7 months (range, 6 months to 7 years). The most common indication for PKP was congenital corneal opacity (71.9%). The survival rate of all corneal grafts was 68.1%. The rejection reaction rate was 33.8%. More children than infants underwent PKP that was combined with other intraocular surgeries (P < 0.05). The graft failures were in the regraft (52.0%), congenital opacities (30.4%), and acquired opacities (15.0%) groups. The rate of graft failure in patients who received PKP combined with other intraocular surgery (40.0%) was higher than those who received PKP only (30.0%). The univariate logistic regression analysis revealed that the graft failure was associated with the graft indication (P < 0.05).

Conclusions:
The most common indication for PKP in children younger than 12 years was congenital corneal opacity in Beijing, China. The graft survival was 68.1%, with a mean follow-up of 33.7 months. Graft failure was associated with the indication.
Molecular Bioburden of the Lens Storage Case for Contact Lens–Related Keratitis
Authors: Hsiao Yu-Ting , Fang Po-Chiung , Chen Jiunn-Liang , Hsu Shiuh-Liang , Chao Tsai-Ling , Yu Hun-Ju , Lai Yu-Hsuan , Huang Yu-Ting , Kuo Ming-Tse 
Published: July 2018

Purpose:
To elucidate the bioburden of a lens care system in patients with contact lens (CL)-related keratitis.

Methods:
In this prospective case–control study, the CL storage case was used as the target of bioburden assessment. Participants were CL wearers with (n = 26) or without (n = 24) keratitis in southern Taiwan. The case fluid sample was consecutively collected and assessed using a dot hybridization assay (DHA) for bioburden assessment. The DHA was composed of 3 universal bacterial probes for detecting all bacteria, genus-specific probes for Pseudomonas and Acinetobacter, and 1 probe for Acanthamoeba. The receiver operating characteristic curve was used to analyze the differentiating performance of a probe.

Results:
The storage case bioburden was significantly higher in those with CL-related keratitis than in control subjects; patients with CL-related keratitis had stronger standardized signals in all universal bacterial probes. Moreover, in the cases of these patients, the bioburden was significantly heavier in confirmed infectious keratitis than in presumed noninfectious keratitis. Receiver operating characteristic analysis showed that stronger signals in all 3 universal bacterial probes and the Pseudomonas probe might suggest that the wearers have infectious keratitis. Only the storage case of the Acanthamoeba keratitis case showed positive detection by the Acanthamoeba probe.

Conclusions:
A heavier bioburden in the lens storage case was associated with a higher risk of CL-related keratitis and infectious keratitis. Inappropriate maintenance of the CL will lead to microbial contamination and transfer the pathogen onto the ocular surface causing keratitis accordingly. The DHA assessment for the lens storage case might provide an alternative way to differentiate infectious from noninfectious CL-related keratitis.