bluuebunny/crossref_metadata_2025_split huggingface dataset:
Image Guidance for Ventricular Shunt Surgery: An Analysis of Ventricular Size and Proximal Revision Rates
Authors: Khan Nickalus R , DeCuypere Michael , Vaughn Brandy N , Klimo Paul 
Published: February 2018

Abstract

BACKGROUND
Image guidance is a promising technology that could lead to lower rates of premature shunt failure by decreasing the rate of inaccurate proximal catheter placement.

OBJECTIVE
To perform a detailed radiographic analysis of ventricular size using 3 well-described methods and compare proximal revision rates.

METHODS
Our shunt surgery research database was queried to identify procedures (new placement or revision) where frameless stereotactic electromagnetic neuronavigation was used (January 2010-June 2016). A randomly selected cohort of surgeries done without image guidance during the same time period served as the comparison group. A radiographic analysis utilizing the following indices was used to classify ventricular size: bifrontal, bicaudate, and frontal-occipital horn ratio. The primary outcome was shunt failure due specifically to proximal catheter malfunction at 90 and 180 days.

RESULTS
A total of 108 stereotactic and 95 free-hand cases were identified. Overall, there was no difference in ventricular size between the 2 groups. Neuronavigation yielded improved accuracy rates (73% grade 1; P < .001). Although there was no statistically significant difference in proximal revision rates when all patients were analyzed, there was a clinically beneficial reduction in the 90- and 180-day failure rates across all radiographic indices in children with small-to-moderate ventricular sizes when using image guidance.

CONCLUSION
Electromagnetic neuronavigation results in more accurate placement of catheters, but did not result in an overall reduction in proximal shunt failure at 90 and 180 days after the index surgery. However, subgroup analysis suggests a clinically important benefit in those patients with harder to cannulate ventricles.
Learning Through Boundary Crossing: Professional Identity Formation of Pharmacists Transitioning to General Practice in the Netherlands
Authors: Hazen Ankie C.M. , de Groot Esther , de Bont Antoinette A. , de Vocht Simone , de Gier Johan J. , Bouvy Marcel L. , de Wit Niek J. , Zwart Dorien L.M. 
Published: February 2018

Purpose
To unravel boundary crossing as it relates to professional identity formation in pharmacists transitioning from a community pharmacy to working as nondispensing clinical pharmacists in general practice, with the aim of optimizing their education.

Method
This was a multiple-case study, including two-stage interviews, peer feedback, and individual reflection, that collected data in 2014–2016 from eight clinical pharmacists working in general practice in the Netherlands. These pharmacists acted—without a workplace role model—as pharmaceutical care providers in general practices during a 15-month training program. In within-case and cross-case analysis, data were collected regarding pharmacists’ role development in practice and perceptions of learning processes, and examined through the lens of professional identity formation and boundary crossing.

Results
Analysis of data collected during and after the training program demonstrated that the clinical pharmacists who applied the learning mechanisms of reflection and transformation developed a patient-care-oriented professional identity. Some clinical pharmacists, who learned mainly through the mechanism of identification, did not integrate the new patient-care-oriented role into their professional identity. They felt that their workplace provided limited opportunities for reflection and transformation. Learning with peers on formal training days was seen as highly valuable for professional identity formation; it counterbalanced the lack of a role model in the workplace.

Conclusions
Professional identity formation in the transition from community pharmacist to clinical pharmacist in general practice benefited from reflective, on-the-job training. This permitted transformative, boundary-crossing learning with peers and supported professional identity formation oriented to providing practice-based pharmaceutical care.
Current Practices and Attitudes Regarding Use of Inhaled Nitric Oxide in the NICU
Authors: Kayton Allyson , Timoney Paula , Vargo Lyn , Perez Jose A. 
Published: February 2018

Background:
Excessive supplemental oxygen exposure in the neonatal intensive care unit (NICU) can be associated with oxygen-related toxicities, which can lead to negative clinical consequences. Use of inhaled nitric oxide (iNO) can be a successful strategy for avoiding hyperoxia in the NICU. iNO selectively produces pulmonary vasodilation and has been shown to improve oxygenation parameters across the spectrum of disease severity, from mild to very severe, in neonates with hypoxic respiratory failure associated with persistent pulmonary hypertension of the newborn.

Purpose:
An online survey was conducted among members of the National Association of Neonatal Nurse Practitioners to gain insight into the level of understanding and knowledge among neonatal nurse practitioners (NNPs) about optimizing supplemental oxygen exposure and the use of iNO in the NICU setting.

Results:
Of 937 NNP respondents, 51% reported that their healthcare team typically waits until the fraction of inspired oxygen level is 0.9 or more before adding iNO in patients not responding to oxygen ventilation alone. Among respondents with 1 or more iNO-treated patients per month, only 35% reported they know the oxygenation index level at which iNO should be initiated. Less than 20% of NNPs reported perceived benefits associated with early initiation of iNO for preventing progression to use of extracorporeal membrane oxygenation or reducing the length of hospital stay, and about one-third of respondents reported they believe early iNO use minimizes hyperoxia.

Implications for Practice:
More education is needed for NNPs regarding the negative effects of oxidative stress in neonates.

Implications for Research:
Additional clinical trials investigating the most beneficial strategies for avoiding neonatal hyperoxia are warranted.
Patient With 2 Hematologic Malignancies Presenting as Neurolymphomatosis
Authors: Daher Ahmad , Kamiya-Matsuoka Carlos , Woodman Karin 
Published: February 2018

Abstract
Peripheral nervous system damage from hematologic malignancies is related to neoplastic cells infiltration of peripheral nerves or to monoclonal antibody production cross-reacting with peripheral nerves' antigens. Neurolymphomatosis (NL), a rare manifestation of hematologic malignancies, occurs when malignant cells invade the peripheral nerves leading to various manifestations. Here, we report a case of NL with 2 hematologic malignancies in a 79-year-old woman presenting with lower extremity pain/weakness. Investigation revealed anemia, IgM kappa monoclonal gammopathy, and elevated anti-MAG titer. Electrodiagnostic studies were consistent with mononeuropathy multiplex while imaging suggested malignancy in her ovaries and right S1 nerve root. Bone marrow and ovarian biopsies revealed chronic myelomonocytic leukemia, Waldenstrom macroglobulinemia, and diffuse large B-cell lymphoma. She received standard chemotherapy resulting in radiographic resolution of disease and symptomatic relief. NL can precede the diagnosis of hematologic malignancy but its symptoms are not easily identifiable, whereas management depends on the treatment of the underlying tumor.
Mitochondrial DNA Deletions With Low-Level Heteroplasmy in Adult-Onset Myopathy
Authors: Leung Doris G. , Cohen Julie S. , Michelle Elizabeth Harlan , Bai Renkui , Mammen Andrew L. , Christopher-Stine Lisa 
Published: February 2018

Abstract
We report the cases of 2 patients who presented to our Myositis Center with myalgias and elevated creatine kinase levels. Muscle biopsy showed pathological features consistent with mitochondrial myopathy. In both cases, a single large deletion in mitochondrial DNA at low-level heteroplasmy was identified by next-generation sequencing in muscle tissue. In 1 case, the deletion was identified in muscle tissue but not blood. In both cases, the deletion was only identified on next-generation sequencing of muscle mitochondrial DNA and missed on array comparative genome hybridization testing. These cases demonstrate that next-generation sequencing of mitochondrial DNA in muscle tissue is the most sensitive method of molecular diagnosis for mitochondrial myopathy due to mitochondrial DNA deletions.
A Systematic Review of Exercise Training in Patients With Cardiac Implantable Devices
Authors: Alswyan Afnan Hamad , Liberato Ana Carolina Sauer , Dougherty Cynthia M. 
Published: February 2018

Purpose:
This systematic review identified exercise-based intervention studies in patients with cardiac implantable devices (CIDs): implantable cardioverter defibrillator (ICD), cardiac resynchronization pacemaker or defibrillator (cardiac resynchronization therapy [CRT]), or ventricular assist device (VAD) and assessed evidence for the safety and efficacy of exercise-based interventions alone or in combination with psychoeducational components.

Methods:
PubMed, EMBASE, CINAHL Plus, Web of Science, Cochrane, and PEDro databases were searched from database inception to September 2016. Data were extracted and validity was assessed by 2 reviewers. Study quality was evaluated using the JADAD scale for randomized controlled trials. A total of 3991 articles for all CIDs (ICD: 1015; pacemaker: 1630; and VAD: 1346) were screened for relevance. Subsequently, 24 full-text articles (ICD: 14; CRT: 4; and VAD: 6) were deemed eligible for this review.

Results:
Studies of aerobic exercise training demonstrated an average increase in peak oxygen uptake of 2.61 mL/kg/min, (ICD = 2.43, VAD = 2.2, and CRT = 3.2 mL/kg/min). These incremental increases were statistically significant when compared with the usual care or other comparison groups. Adverse event rates were very low at 1.1% to 2.2% for all CIDs.

Conclusion:
Exercise interventions tested to date in the CID population (ICD, CRT, and VAD) indicate that exercise training at moderate to high intensity is safe and effective in improving cardiopulmonary outcomes without adverse events. Future investigations should include a more diverse sample of participants, designs that include translation of exercise to routine practice, the destination therapy VAD population, and measurement of costs and patient-centered outcomes.
INTRAVITREAL INJECTION OF PROPRANOLOL FOR THE TREATMENT OF RETINAL CAPILLARY HEMANGIOMA IN A CASE OF VON HIPPEL–LINDAU
Authors: Karimi Saeed , Nikkhah Homayoun , Ahmadieh Hamid , Safi Sare 
Published: February 2018

Purpose:
The purpose of this study was to evaluate the safety and efficacy of intravitreal propranolol for the management of retinal capillary hemangioma in a patient with Von Hippel–Lindau.

Methods:
Two intravitreal injections of 50 μg/0.05 mL propranolol were administered 6 weeks apart in the left eye of a 26-year-old patient with bilateral multiple retinal capillary hemangiomas. Safety and response to therapy were evaluated using electroretinogram, fluorescein angiography, and measurement of visual acuity. Laser photocoagulation was performed in the right eye.

Results:
One month after the second intravitreal injection of propranolol, fluorescein leakage decreased from the tumors located on the optic nerve head and in the inferonasal retinal periphery. Reduction of the retinal capillary hemangioma vascularity and enhancement of its fibrosis associated with the attenuation of the feeder vessel were also observed. Ophthalmic examination showed no adverse effect except for a mild transient vitreous haziness after each injection. Electroretinogram performed 4 weeks after the first injection revealed no retinal toxicity.

Conclusion:
Intravitreal propranolol showed a therapeutic effect on retinal capillary hemangioma with no short-term adverse effects except a mild transient inflammatory response in a patient with Von Hippel–Lindau.
Long-Term Clinical and Computed Tomography Angiographic Follow-Up after Totally Endoscopic Coronary Artery Bypass Grafting
Authors: Stastny Lukas , Kofler Markus , Dumfarth Julia , Basaran Alim , Wiedemann Dominik , Schachner Thomas , Feuchtner Gudrun , Bonatti Johannes , Bonaros Nikolaos 
Published: February 2018

Objective Totally endoscopic coronary artery bypass grafting was shown to be feasible and safe, with excellent clinical and angiographic mid-term results. Data on long-term outcome are lacking. Therefore, we aimed to investigate the long-term rate of major adverse cardiac and cerebrovascular events and left internal mammary artery patency rate in patients undergoing arrested heart totally endoscopic coronary artery bypass grafting. Methods From 2001 to 2012, a total of 208 arrested heart-totally endoscopic coronary artery bypass grafting patients were prospectively included. Mean ± SD age was 58.8 ± 9.4 years, and mean ± SD Society of Thoracic Surgeons score was 0.5 ± 0.5%. Major adverse cardiac and cerebrovascular events were defined as a composite of death, myocardial infarction, stroke, re-percutaneous coronary intervention, re-coronary artery bypass graft, and target vessel revascularization. Left internal mammary artery patency was assessed using cardiac computed tomography and depicted according to the established Fitzgibbon classification. Mean ± SD follow-up was 6.9 ± 2.3 years. Results At 1, 5, and 10 years, survival rate was 100%, 98.3%, and 95.8%, respectively. The freedom from clinical events at 1, 5, and 10 years were major adverse cardiac and cerebrovascular events (93.5%, 85.9%, and 83.0%), myocardial infarction (99.0%, 97.4%, and 95.9%), target vessel revascularization (96.0%, 94.3%, and 91.7%), re-percutaneous coronary intervention (94.5%, 91.6%, and 84.2%), and re-coronary artery bypass graft (100%, 99.5%, and 99.5%), respectively. Left internal mammary artery patency rate at 1, 5, and 10 years was 100%, 94.9%, and 88.1%, respectively. Conclusions Arrested heart-totally endoscopic coronary artery bypass grafting shows excellent clinical long-term results with a left internal mammary artery patency rate comparable with conventional coronary artery bypass graft at 10 years after surgery.
Perspectives on voice treatment for unilateral vocal fold paralysis
Authors: Walton Chloe , Carding Paul , Flanagan Kieran 
Published: February 2018

Purpose of review
Unilateral vocal fold paralysis (UVFP) is a common cause of neurogenic dysphonia resulting in glottal insufficiency. To restore glottal sufficiency and reduce the presenting dysphonia, treatment involving either surgical intervention, voice therapy or a combination of the two is typically provided. Currently, there is no consensus for the most effective voice treatment for UVFP. This results in an inability to compare current studies, and a lack of treatment effectiveness for the management of UVFP. This study aims to review the most recent literature for the management of dysphonia due to UVFP to establish the current evidence base for voice treatment options.

Recent findings
There was found to be a lack of consistency in the rationale, selection and timing of the surgical intervention and/or voice therapy being provided for patients with UVFP.

Summary
Further consensus is required for the rationale and selection of voice treatment prescriptions for the management of UVFP in order to improve treatment effectiveness and voice outcomes in patients with UVFP.
Novel therapeutics for bronchopulmonary dysplasia
Authors: Strueby Lannae , Thébaud Bernard 
Published: February 2018

Purpose of review
This review provides a concise summary of recent literature pertaining to emerging therapies for bronchopulmonary dysplasia (BPD). To provide context for the presented therapies, a brief overview of recently proposed changes to the definition of BPD and the concept of expanded respiratory outcomes is included.

Recent findings
New or redefined respiratory outcomes are required to improve accuracy in evaluating new therapies and correlating results with long-term clinical outcomes of importance. Dexamethasone is no longer the only steroid-based therapy showing promise for impacting BPD. Early trials indicate hydrocortisone, inhaled budesonide, and a budesonide-surfactant combination may be of benefit to preterm infants. Additionally, simple approaches like increasing utilization of mother's own milk may deserve more emphasis. Of significant interest is the traction stem cell therapies are acquiring as one of the more anticipated treatments for BPD. A new preclinical meta-analysis demonstrates the benefits of mesenchymal stromal cell therapy in animal models while the results of early clinical trials remain eagerly awaited.

Summary
BPD continues to be the most frequently occurring significant morbidity for extremely preterm infants, yet highly effective therapies remain elusive. Promising new treatments are on the horizon, but only continued efforts to complete well-designed clinical trials will determine the true impact of these emerging therapies.
Recurrent Abdominal Pain in Children
Authors: Abbott Rebecca A. , Martin Alice E. , Newlove‐Delgado Tamsin V. , Bethel Alison , Whear Rebecca S. , Thompson Coon Jo , Logan Stuart 
Published: February 2018

ABSTRACTObjectives:Between 4% and 25% of school‐aged children complain of recurrent abdominal pain (RAP) severe enough to interfere with their daily activities.Methods:We carried out a systematic review of randomised controlled trials (RCTs) in eleven databases and 2 trials registries from inception to June 2016. An update search was run in November 2017. All screening was performed by 2 independent reviewers. Included studies were appraised using the Cochrane risk of bias tool and the evidence assessed using GRADE. We included any dietary, pharmacological or psychosocial intervention for RAP, defined by Apley or an abdominal pain‐related functional gastrointestinal disorder, as defined by the Rome III criteria, in children and adolescents.Results:We included 55 RCTs, involving 3572 children with RAP (21 dietary, 15 pharmacological, 19 psychosocial, and 1 multiarm). We found probiotic diets, cognitive‐behavioural therapy (CBT) and hypnotherapy were reported to reduce pain in the short‐term and there is some evidence of medium term effectiveness. There was insufficient evidence of effectiveness for all other dietary interventions and psychosocial therapies. There was no robust evidence of effectiveness for pharmacological interventions.Conclusions:Overall the evidence base for treatment decisions is poor. These data suggest that probiotics, CBT, and hypnotherapy could be considered as part of holistic management of children with RAP. The evidence regarding relative effectiveness of different strains of probiotics is currently insufficient to guide clinical practice. The lack of evidence of effectiveness for any drug suggests that there is little justification for their use outside of well‐conducted clinical trials. There is an urgent need for high‐quality RCTs to provide evidence to guide management of this common condition.
Medium‐term Outcome of Laparoscopic Kasai Portoenterostomy for Biliary Atresia With 49 Cases
Authors: Li Yanan , Xiang Bo , Wu Yang , Wang Chuan , Wang Qi , Zhao Yiyang , Chen Siyuan , Ji Yi , Xu Zhicheng 
Published: February 2018

ABSTRACTObjective:The aim of this study was to evaluate the mid‐term results of laparoscopic Kasai portoenterostomy (LKPE) for biliary atresia (BA) at our hospital.Methods:From May 2009 to May 2012, the charts of infants with BA who underwent LKPE were reviewed retrospectively. The clearance of jaundice (CJ) as well as 3‐year, and 5‐year survival with native liver (SNL) rates were analyzed and compared with those after open Kasai portoenterostomy (OKPE).Results:Forty‐nine patients with BA who underwent LKPE were assigned to group A, and 40 patients with BA who underwent OKPE were assigned to group B. All patients in both groups had type III non‐syndromic BA, and the LKPE and OKPE procedures were performed by 2 different surgical teams at our hospital. After median follow‐up periods of 77 months in group A and 79 months in group B, the CJ and 3‐ and 5‐year SNL rates were 61.2%, 55.1%, and 36.7% in group A, and 45.0%, 37.5%, and 25.0% in group B, respectively. The difference of CJ between group A and group B was not significant. The Kaplan‐Meier method analysis showed that the difference in SNL between group A and group B was not significant either.Conclusions:LKPE for patients with BA was a technically feasible and alternative procedure to OKPE. The 3‐ and 5‐year SNL rates after LKPE were not different compared to those after OKPE.
Posterior Reversible Encephalopathy Syndrome
Authors: Sundin Courtney Stanley , Johnson Michelle Laurane 
Published: February 2018

Abstract
Posterior reversible encephalopathy syndrome (PRES) is a newly defined syndrome; therefore, this transient clinical condition is not well known and probably underdiagnosed. It develops quickly with symptoms that are usually indistinguishable from eclampsia. Nurses need to be knowledgeable and aware of identifying symptoms and appropriate treatment. The condition is thought to share pathophysiology with eclampsia, and it is suggested that endothelial dysfunction combined with hypertension causes disruption in the blood brain barrier resulting in cerebral edema. Seizures develop secondary to cerebral edema, and mark later stages of the disease. Treatment is aimed at reducing blood pressure (BP) with antihypertensive therapy and seizure control with magnesium sulfate. When PRES is treated early, symptoms typically disappear within a few days and imaging studies normalize in several weeks. Permanent brain damage can occur if diagnosis and treatment are delayed. If PRES is suspected, thorough focused assessments and increased communication among the healthcare team are essential for patient care. When pregnant or postpartum women present with elevated BP accompanied with neurologic symptoms, imaging studies should be considered. An exemplar case is presented of a woman with normal prenatal course that is complicated by rapidly developing preeclampsia, eclampsia, and PRES.
A Tool to Identify Key Behaviors and Attributes of High-Performing Nurses
Authors: Cain Linda B. , Cronin Sherill Nones , Nelson Debbie , Meredith Darla A. , Newman Karen Profitt , Rudolf Steven 
Published: February 2018

OBJECTIVE
The purpose of this project was to identify key behaviors and attributes that distinguish high-performing nurses to develop a tool for employment screening, staff development, and performance management.

BACKGROUND
Selecting nurses who will complement an organization's mission and philosophy is a key step toward achieving quality and safety goals, ensuring patient and family satisfaction, and improving retention rates and overall costs.

METHODS
Focus group methodology was used to determine perceptions of high-performing nurses' behaviors and attributes. Content analysis of the meeting transcripts was performed to aggregate data into categories and items.

RESULTS
Following several phases of testing with various groups, a 16-item scale has been developed.

CONCLUSIONS
This tool has received positive ratings from nurse managers currently using it to interview nurse applicants who best “fit” into the organization's nursing culture. Results will be monitored over time including hiring decisions, preceptor ratings, and retention rates.