bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitions in Care Model for a Senior-Level Clinical Immersion Experience
Authors: Fleming Louise , Lorenzen Rachael , Stanek Joan , Williams Megan , Mendel Hilary 
Published: February 2019

Background
RN precepted clinical immersion experiences have become a mainstay of prelicensure nursing education, as they increase autonomy and confidence as students prepare to graduate and enter the workforce.

Problem
Nursing students are often assigned a hospital unit that neither enables them to work with their preferred patient population nor appreciates the patient care continuum.

Approach
A clinical immersion experience was developed using an innovative model focused on specific patient populations across the care continuum.

Outcomes
Five clinically immersive experiences were developed. More than 50 students transitioned through varied areas across the care continuum, based on their chosen focus.

Conclusion
Senior-level nursing students were able to care for patients along the care continuum in both acute and community settings through a new model.
“Learning How to Teach” in Nursing: Perspectives of Clinicians After a Formal Academy
Authors: Jarosinski Judith M. , Seldomridge Lisa A. , Reid Tina P. , Hinderer Katherine A. 
Published: February 2019

Background
The nursing faculty shortage is expected to persist throughout the next decade. Understanding what influences transition from clinician to educator and retention can improve approaches used in nursing programs for those aspiring to careers in nursing education.

Purpose
This qualitative study elicited the experiences of participants who completed a structured program to prepare clinicians to become clinical faculty for prelicensure students.

Methods
Focus groups uncovered participant perspectives on “learning how to teach.”

Results
Using interpretive phenomenological analysis, the themes (1) I'm not sure I can do this, (2) changing perspectives-learning to teach, and (3) instilling confidence emerged.

Conclusions
Novice educators reported benefitting most from exposure to multiple teaching methods, simulated teaching encounters, and group debriefing as they learned to become educators.
Prevalence of Myopia and Associated Risk Factors in Schoolchildren in North India
Authors: Singh Neeraj Kumar , James Ritika M. , Yadav Avdhesh , Kumar Rishikesh , Asthana Smita , Labani Satyanarayana 
Published: February 2019

SIGNIFICANCEStudies reporting the prevalence and associated risk factors of myopia among schoolchildren in India are limited. Knowledge about the prevalence and the modifiable risk factors associated with myopia development will help in planning cost-effective strategies to prevent its progression in India.PURPOSEThe purpose of this study was to assess the prevalence and associated behavioral risk factors of myopia in schoolchildren in Gurugram, Haryana, in north India.METHODSThis cross-sectional study was conducted on schoolchildren (aged 5 to 15 years) from two private schools in Gurugram. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study chart. Myopia was defined as the spherical equivalent refractive error of at least −0.50 D in the better eye. Information on the child's habits and lifestyle, study hours, hours of playing video games, and outdoor playtime were obtained using a questionnaire. Association of behavioral risk factors was analyzed for children with and without myopia, and adjusted odds ratio (OR) for each factor was estimated.RESULTSA total of 1234 children (mean ± SD age, 10.5 ± 3 years; 59% boys) were screened. Myopia prevalence was found to be 21.1% (n = 261; mean ± SD age, 11 ± 2 years; 52% boys). The mean ± SD myopic spherical error was −1.94 ± 0.92 D. The prevalence of myopia was found to be higher (27%; 95% confidence interval, 23 to 30.6; OR, 3.19 [2.13 to 4.76]) among older children (9 to 12 years). Prevalence of myopia was more in boys (25%; 95% confidence interval, 21.1 to 28.8) compared with girls (P< .01). A positive association of presence of myopia was observed with children studying more than 4 hours per day (P< .008) and with children playing computer/video/mobile games more than 2 hours per day (P< .001). A protective effect was observed in children with outdoor activities/play for more than 1.5 hours per day (OR, 0.01 [0.00 to 0.06]).CONCLUSIONSMyopia is a major public health concern, and its prevalence is increasing rapidly among schoolchildren in India. There is a pressing need to develop cost-effective strategies to prevent this cause of vision impairment, which can be easily treated with optical interventions.
Serous Retinal Detachment Causes a Transient Reduction on Spectral Domain OCT Estimates of Ganglion Cell Layer Thickness
Authors: Nam Ki Yup , Kim Jung Yeul 
Published: February 2019

SIGNIFICANCE
During the acute stage of central serous chorioretinopathy (CSC) with retinal elevation, the spectral domain optical coherence tomography (SD-OCT) estimate of ganglion cell layer complex thickness is reduced. Thickness returns to normal after resolution of the event. Measurement error is at least partially responsible for this effect. The reduction in ganglion cell layer complex thickness does not represent atrophy and is not predictive of a poor outcome.

PURPOSE
We investigated the effects of serous retinal detachment on the ganglion cell layer complex analysis (GCA) by SD-OCT in CSC patients during the acute episodes and after resolution of fluid.

METHODS
We retrospectively reviewed medical records of 30 patients who visited the hospital with a first episode of CSC. We analyzed GCA maps using SD-OCT (Cirrus; Carl Zeiss Meditec, Dublin, CA) at the initial visit with serous retinal elevation and after the absorption of subretinal fluid. For repeatability analysis, we used the intraclass correlation and repeatability coefficient from two consecutive measurements 5 minutes apart in 12 patients.

RESULTS
At the initial visit, an average thickness of ganglion cell layer complex was thinner than that measured in the fellow eye (67.4 ± 27.4 μm), but after the absorption of subretinal fluid, it normalized to 87.0 ± 6.7 μm; the difference was statistically significant. The intraclass correlation and repeatability coefficient were low during the period of serous elevation but normalized after fluid resorption. Abnormalities of GCA resulted from the segmentation error of ganglion cell layer and inner plexiform layer during the acute phase of CSC.

CONCLUSIONS
Serous retinal detachment can affect the GCA and repeatability measurements of the GCA. Clinicians should consider this finding when using the GCA measurement in the diagnosis and management of the patients with retinal contour changes such as retinal elevation including CSC.
Optometric Applications for Three-dimensional Printing: A Technical Report from Low Vision Rehabilitation Practice
Authors: Hopkins Gregory Robert , Irvin Brett C. 
Published: February 2019

SIGNIFICANCEDelivering personalized three-dimensional (3D)–printed solutions for our patients is easier now than it has ever been. This technological revolution makes things possible that it would be extremely challenging to achieve using traditional approaches.PURPOSEThe purpose of this study was to increase awareness among the optometric and vision science community of opportunities to apply 3D printing to enhance clinical practice and research.METHODSA widely available fused deposition modeling 3D printing approach was used to fabricate several plastic items for use in optometric practice and low vision rehabilitation.RESULTSThe authors will share nine optometric extensions of 3D printing: (1) an attachment for glare-acuity testing, (2) a disposable cover paddle to limit infection spread for red-eye visits, (3) ophthalmic equipment repair/modification, (4) ophthalmic lens thickness calipers, (5) NoIR lens filter flipper, (6) Optivisor faceplate, (7) EasyPocket lanyard card holder, (8) dome magnifier handle, and (9) a phoropter near card holder.CONCLUSIONSDesigning customized solutions and problem-solving for our patients and offices are becoming easier to do using 3D printing every year. The possible applications for this technology are constantly being expanded. This technology allows for cost-effective production of solutions, some of which would not be feasible otherwise.
Using Small Samples to Evaluate Normative Reference Ranges for Retinal Imaging Measures
Authors: Swanson William H. , King Brett J. , Horner Douglas G. 
Published: February 2019

SIGNIFICANCE
Retinal nerve fiber layer (RNFL) deviation maps often incorrectly score healthy eyes as having wedge defects. This study shows how to identify such problems early in the development of normative databases.

PURPOSE
After reference values are embedded in devices, clinicians and researchers often learn about issues that cause false-positive rates in healthy eyes. Here we show a way to detect and address such issues early on.

METHODS
The thickness of the RNFL was measured for both eyes of 60 healthy younger adults aged 20 to 31 years and one eye each of 30 healthy older adults aged 54 to 82 years. Deviation maps were developed from the left eyes of the first 30 younger adults, and between-subject variability in the shape of the RNFL was assessed. This was repeated in their right eyes, in the second group of younger adults and in the older adults.

RESULTS
For the first group of 30 healthy young adults, between-subject variability in the location of the region of greatest thickness meant that 58% of the pixels below the fifth percentile in the left eyes were from four people whose deviation maps had wedge-shaped patterns, as did the deviation maps for the nine right eyes with 87% of the pixels below the fifth percentile. Wedge patterns were also seen in deviation maps for 8 left eyes and 11 right eyes of the second group of young adults and for 9 eyes of the older adults.

CONCLUSIONS
Evaluation of RNFL thickness maps from 30 young adults was sufficient to determine that between-subject variability in the shape of the RNFL can cause wedge patterns in RNFL deviation maps in many healthy eyes.
Could the Clinical Effectiveness Be Improved Under the Integration of Orthotic Intervention and Scoliosis-Specific Exercise in Managing Adolescent Idiopathic Scoliosis?
Authors: Gao Chengfei , Zheng Yu , Fan Chunjiang , Yang Yan , He Chengqi , Wong Mansang 
Published: February 2019

Objective
The aim of the study was to compare the effectiveness of the integration of orthotic intervention and scoliosis-specific exercise with orthotic intervention only via assessing the spinal deformity, back muscle endurance, and pulmonary function of the patients with adolescent idiopathic scoliosis.

Design
It is a prospective randomized controlled study. Patients who fulfilled the SRS criteria for orthotic intervention were randomly assigned to the orthosis combined with exercise group (combined orthotic and exercise intervention) or the orthotic intervention group (orthotic intervention only). All the subjects were prescribed with a rigid thoracolumbosacral orthosis and scoliosis-specific exercise program was provided to the subjects in the orthosis combined with exercise group. Cobb angle, back muscle endurance, and pulmonary function of subjects were measured at baseline, 1-mo, and 6-mo follow-up visits.

Results
After 6 mos of intervention, the subjects in the orthosis combined with exercise group showed better Cobb angle correction than those in the orthotic intervention group. The back muscle endurance and pulmonary function decreased in the subjects of the orthotic intervention group, whereas some improvement happened in the subjects of the orthosis combined with exercise group. Between-group statistical significance was detected at the 6-mo follow-up among back muscle endurance time and parameters of pulmonary function.

Conclusions
In this study, orthotic intervention combined with scoliosis-specific exercise offered better Cobb angle correction and improvement of the respiratory parameters and back muscle endurance of the patients with adolescent idiopathic scoliosis as compared with orthotic intervention only.
Improved Mobility, Cognition, and Disease Severity in Corticobasal Degeneration of an African American Man After 12 Weeks of Adapted Tango
Authors: Silverstein Hayley A. , Hart Ariel R. , Bozorg Ariyana , Hackney Madeleine E. 
Published: February 2019

Abstract
Corticobasal degeneration (CBD) has no available treatment to slow disease progression and generally resists drug therapy. Corticobasal degeneration has symptoms and decreased quality of life similar to Parkinson disease. Adapted Tango, a successful rehabilitation for Parkinson, may address CBD. A 63-yr-old African American man with CBD (alias: YD; CBD duration = 2 yrs) was evaluated for motor, cognitive, and psychosocial function before, immediately after, 1 mo after, and 6 mos after 12 wks of 20, biweekly 90-min adapted-tango lessons. After intervention, disease-related motor symptoms improved and YD reported fewer problems in nonmotor experiences of daily living, which include mood, cognition, pain, fatigue, etc. Motor symptoms remained above baseline at 6-mo posttest. YD's balance confidence improved after intervention but declined below baseline at 6-mo posttest. Quality of life was maintained despite worsened depression. YD improved or maintained executive function, and visuospatial function and attention at posttest and 1-mo posttest. At posttest, YD maintained mobility and improved on dynamic balance. At 1-mo posttest, most mobility measures had improved relative to baseline. However, YD showed executive function and overall motor decline 6 mos after intervention. Adapted tango may have temporarily slowed disease progression and improved or maintained mobility and cognition. Gains were poorly maintained after 6 mos. Further study is warranted.
Barriers of Access to Breast Reconstruction: A Systematic Review
Authors: Retrouvey Helene , Solaja Ogi , Gagliardi Anna R. , Webster Fiona , Zhong Toni 
Published: February 2019

Background:
The purpose of this systematic review was to comprehensively summarize barriers of access to breast reconstruction and evaluate access using the Penchansky and Thomas conceptual framework based on the six dimensions of access to care.

Methods:
The authors performed a systematic review that focused on (1) breast reconstruction, (2) barriers, and (3) breast cancer. Eight databases (i.e., EMBASE, MEDLINE, PsycINFO, CINHAL, ePub MEDLINE, ProQuest, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials) were searched. English peer-reviewed articles published between 1996 and 2016 were included.

Results:
The authors’ search retrieved 4282 unique articles. Two independent reviewers screened texts, selecting 99 articles for inclusion. All studies were observational and qualitative in nature. The availability of breast reconstruction was highest in teaching hospitals, private hospitals, and national cancer institutions. Accessibility affected access, with lower likelihood of breast reconstruction in rural geographic locations. Affordability also impacted access; high costs of the procedure or poor reimbursement by insurance companies negatively influenced access to breast reconstruction. Acceptability of the procedure was not universal, with unfavorable physician attitudes toward breast reconstruction and specific patient and tumor characteristics correlating with lower rates of breast reconstruction. Lastly, lack of patient awareness of breast reconstruction reduced the receipt of breast reconstruction.

Conclusions:
Using the access-to-care framework by Penchansky and Thomas, the authors found that barriers to breast reconstruction existed in all six domains and interplayed at many levels. The authors’ systematic review analyzed this complex relationship and suggested multiprong interventions aimed at targeting breast reconstruction barriers, with the goal of promoting equitable access to breast reconstruction for all breast cancer patients.
Hip Asymmetry: Implications in Body Contouring Surgery
Authors: Maia Munique , Shikowitz-Behr Lauren , Matarasso Alan 
Published: February 2019

Background:
Asymmetry of the hips and its implication in body contouring procedures has not yet been reported. Hip asymmetry is common in the general population and may account for uneven abdominoplasty scar and the apparent discrepancies in volume following liposuction of the hips and flanks. The goal of this study was to determine the presence of hip asymmetry in women presenting for abdominal contouring surgery.

Methods:
Analysis of preoperative photographs of 100 female patients was performed by three independent plastic surgeons. They were asked to evaluate for hip asymmetry and, when present, determine which side was higher. Adobe Photoshop was also used to objectively measure hip asymmetry. Patients were women with no known history of hip abnormalities; age ranged from 17 to 64 years and the body mass index ranged from 16 to 47 kg/m2.

Results:
All three plastic surgeon reviewers found that the majority of patients had hip asymmetry, with raters 1, 2, and 3 documenting discrepancies in hip height in 88, 60, and 76 percent of patients, respectively. The interrater reliability was 0.713. Chi-square statistical analysis suggested that the raters were not statistically different from one another (p = 0.086). The objective analysis found asymmetry in 82 percent of patients.

Conclusions:
The results showed that the majority of patients who present for abdominal contouring surgery have asymmetric hips. Patients are usually unaware of the unevenness of their own hips; however, they often notice postoperative discrepancies in scar height after abdominoplasty or volume differences after liposuction.
Effect of Breast Size on Upper Torso Musculoskeletal Structure and Function: A Cross-Sectional Study
Authors: Coltman Celeste E. , Steele Julie R. , McGhee Deirdre E. 
Published: February 2019

Background:
Research has shown that women with large and hypertrophic breast sizes report an increased prevalence and severity of musculoskeletal pain in the upper torso. Despite this evidence, factors contributing to the development of musculoskeletal pain among these women are poorly understood, and the threshold at which breast size becomes problematic in terms of musculoskeletal pain is currently unknown.

Methods:
Three hundred Australian women (aged 18 to 82 years) who volunteered as participants were divided into four breast size groups (small, breast volume <350 ml; medium, breast volume 350 to 700 ml; large, breast volume 701 to 1200 ml; and hypertrophic, breast volume >1200 ml). The thoracic flexion torque, thoracic kyphosis angle, total upper torso musculoskeletal pain score, and regional upper torso musculoskeletal pain scores derived for participants in the four groups were compared using an analysis of covariance design, controlling for age and body mass index.

Results:
Thoracic flexion torque significantly increased as breast size group increased. Women with hypertrophic breasts reported significantly higher total upper torso musculoskeletal pain scores compared with women who had small, medium, and large breasts, and this was significant for the upper back, shoulders, neck, and breasts. No significant difference was found in thoracic kyphosis angle among the four groups.

Conclusions:
Musculoskeletal pain became most pronounced in women with hypertrophic breasts who had the greatest breast volume and displayed the greatest thoracic flexion torque. Clinical and/or surgical treatment for symptomatic relief should aim to either counteract thoracic flexion torque or reduce breast volume.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, I.
Eruption of Maxillary Posterior Permanent Molars following Early Conventional Le Fort III Advancement and Early Le Fort III Distraction Procedures Compared to Late Surgical Intervention
Authors: Gonchar Marina N. , Bekisz Jonathan M. , Grayson Barry H. , McCarthy Joseph G. , Shetye Pradip R. 
Published: February 2019

Background:
Le Fort III advancement and/or distraction involve osteotomies and dysjunction in the region of the maxillary tuberosity in proximity to the maxillary posterior tooth buds. The purpose of this study was to determine the effect of early conventional Le Fort III advancement and/or distraction on development and eruption of the maxillary posterior permanent molars.

Methods:
A retrospective review of patients diagnosed with syndromic craniosynostosis, who underwent early Le Fort III or early midface distraction and late surgical intervention, was analyzed.

Results:
In the early conventional Le Fort III surgery group, 93 percent of maxillary second molars and 28 percent of maxillary first molars experienced a disturbance in eruption. In the early distraction group, 82 percent of maxillary second molars and 20 percent of maxillary first molars experienced a disturbance in eruption. In the control group, the late conventional Le Fort III and the late distraction groups, only 26 percent of maxillary second molars and none of maxillary first molars experienced a disturbance in eruption.

Conclusions:
A common disruption seen postoperatively in the early Le Fort III and distraction groups was displacement of the second molars. The majority of the displaced tooth buds were located in the maxillary sinus. Overall, the early Le Fort III surgery groups experienced more frequent disturbances for both first and second molars, with the common sequela of displacement in the maxillary sinus, leading to the question of whether presurgical planning in cases of early intervention to address midface retrusion should include extraction/enucleation of the second molar tooth buds.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Utility of Two Surgical Techniques Using a Lateral Intercostal Artery Perforator Flap after Breast-Conserving Surgery: A Single-Center Retrospective Study
Authors: Kim Jae Bong , Eom Jeung Ryeol , Lee Jeong Woo , Lee Jeeyeon , Park Ho Yong , Yang Jung Dug 
Published: February 2019

Background:
Immediate partial breast reconstruction after breast-conserving surgery has become a new paradigm in treating breast cancer. Among the volume replacement techniques used for small to moderate-sized breasts, the perforator flap method has many advantages. The authors present anatomical studies and two surgical techniques using lateral intercostal artery perforator flaps.

Methods:
Data from 40 patients who underwent breast reconstruction using the lateral intercostal artery perforator flap between January of 2011 and June of 2016 were included. The authors conducted comparative analyses of the propeller flap and the turnover flap. They used three-dimensional computed tomography in lateral intercostal artery perforator flap anatomical studies, analyzing the distribution probability of the dominant perforator, the vertical distance from the axillary fold, and the horizontal distance from the anterior border of the latissimus dorsi.

Results:
The most dominant perforator used for lateral intercostal artery perforator flaps was the sixth lateral intercostal artery perforator (43.6 percent of cases), followed by the seventh lateral intercostal artery perforator (39.1 percent of cases); their mean distances from the latissimus dorsi and the axillary folds were determined and reported. Complications included three cases requiring additional treatment for fat necrosis (propeller method, two cases; turnover method, one case) and venous congestion in only two cases that used the propeller method. Cosmetic satisfaction was 90 percent or greater for both techniques, indicating that results were rated as either excellent or good.

Conclusion:
The authors believe that their study results can broaden the application of partial breast reconstruction by using the lateral intercostal artery perforator flap after breast-conserving surgery, with three-dimensional computed tomography for anatomical studies, and using one of the authors’ two described surgical techniques.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.