bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a patient-reported gout attack intensity score for use in gout clinical studies
Authors: Janssen Carly A , Oude Voshaar Martijn A H , ten Klooster Peter M , Vonkeman Harald E , van de Laar Mart A F J 
Published: February 2019

AbstractObjectiveInflammation-related symptoms such as pain, swelling and tenderness of the affected joint are frequently assessed using 5-point diary rating scales in gout clinical trials. Combining these into a single gout attack symptom intensity score may be a useful summary measure for these data, which is potentially more responsive to change compared with the individual components. The objective of this study was to develop a patient-reported gout flare intensity score, the Gout Attack Intensity Score (GAIS), for use in clinical studies, that includes components for gout-related pain, swelling and tenderness.MethodsData from a randomized controlled trial comparing anakinra to standard of care for the treatment of acute gout attacks were used for this study. A 7-day flare diary was completed by patients, including questions relating to intensity of pain, swelling and tenderness (5-point rating scales). Scalability of these items was assessed using Mokken Scale Analysis, and reliability using greatest lower bound reliability coefficients. Known-groups validity was evaluated, as well as the responsiveness to change and the presence of floor and ceiling effects.ResultsScalability of the single items was supported, and GAIS scores were reliable (greatest lower bound >0.80). GAIS scores demonstrated responsiveness to change with high effect sizes (>0.8), and discriminated better between responders and non-responders compared with its single-item components. No floor and ceiling effects were found.ConclusionThe GAIS seems to be a reliable and responsive instrument for assessing patient-reported gout attack intensity that may be used in gout clinical studies.
Cash Transfers and Management Advice for Agriculture: Evidence from Senegal
Authors: Ambler Kate , de Brauw Alan , Godlonton Susan 
Published: February 2019

Abstract
This study analyzes impacts of large, one-time cash transfers and farm management plans among farmers in Senegal. Farmers were randomized into groups receiving advisory visits; the visits and an individualized farm management plan; or the visits, the plan, and a cash transfer. After one year, crop production and livestock ownership were higher in the transfer group relative to the group that only received visits. Livestock gains persisted after two years. The evidence suggests the results were driven by increased investment, and, indeed, there is no robust evidence that the management plans alone affected agricultural outcomes.
Orientation Learning Needs of Adjunct Clinical Faculty in the United States
Authors: Sousa Monica P. , Resha Cheryl A. 
Published: February 2019

Abstract

AIM
The aim of the study was to examine the orientation learning needs of adjunct clinical faculty as they transition from expert clinicians to novice educators.

BACKGROUND
Schools of nursing are increasingly using adjunct clinical faculty because of the nurse faculty shortage. Retention is a concern.

METHOD
This descriptive quantitative study used the Needs Assessment Survey for Topic Inclusion in a Guide to Orientation. Adjunct clinical faculty rated the level of importance of orientation topics and if they received needed information.

RESULTS
The majority of topics were found to be rated very important or important. Several items deemed very important or important were either not discussed or not sufficiently discussed in orientation.

CONCLUSION
The information obtained demonstrates the vast amount of information that adjunct clinical faculty want and need in an orientation.
Lessons From the Heart: A Kinesthetic Activity for Practical Nursing Students
Authors: Hudson Sue 
Published: February 2019

Abstract
Current trends in health care delivery require nursing programs to change how education is presented to nursing students. Active learning strategies, such as discovery learning through kinesthetic activities, have been associated with increases in student engagement and satisfaction. A kinesthetic learning strategy was developed and implemented at a licensed practical nursing program to increase student engagement and provide knowledge of cardiovascular function and various etiologies associated with the heart. The goals of the activity were to provide deeper understanding and improve critical thinking and clinical application for the student.
Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery
Authors: Turan Alparslan , Chang Christine , Cohen Barak , Saasouh Wael , Essber Hani , Yang Dongsheng , Ma Chao , Hovsepyan Karen , Khanna Ashish K. , Vitale Joseph , Shah Ami , Ruetzler Kurt , Maheshwari Kamal , Sessler Daniel I. 
Published: February 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Intraoperative and postoperative hypotension are associated with myocardial and kidney injury and 30-day mortality. Intraoperative blood pressure is measured frequently, but blood pressure on surgical wards is usually measured only every 4 to 6 h, leaving long intervals during which hypotension and hypertension may be undetected. This study evaluated the incidence and severity of postoperative hypotension and hypertension in adults recovering from abdominal surgery and the extent to which serious perturbations were missed by routine vital-sign assessments.

Methods
Blood pressure was recorded at 1-min intervals during the initial 48 h in adults recovering from abdominal surgery using a continuous noninvasive monitor. Caregivers were blinded to these measurements and depended on routine vital-sign assessments. Hypotension and hypertension were characterized as time under and above various mean arterial pressure thresholds.

Results
Of 502 available patients, 312 patients with high-quality records were analyzed, with a median measurement time of 48 [interquartile range: 41, 48] postoperative hours. Nearly a quarter experienced an episode of mean arterial pressure of less than 70 mm Hg lasting at least 30 min (24%; 95% CI, 20%, 29%), and 18% had an episode of mean arterial pressure of less than 65 mm Hg lasting at least 15 min. Nearly half the patients who had mean arterial pressure of less than 65 mm Hg for at least 15 min (47%; 95% CI, 34%, 61%) were undetected by routine vital-sign assessments. Episodes of mean arterial pressure greater than 110 mm Hg lasting at least 30 min were observed in 42% (95% CI, 37%, 48%) of patients; 7% had mean arterial pressure greater than 130 mm Hg for at least 30 min, 96% of which were missed by routine assessments. Episodes of mean arterial pressure less than 65 mm Hg and mean arterial pressure greater than 110 mm Hg captured by routine vital-sign assessments but not by continuous monitoring occurred in 34 and 8 patients, respectively.

Conclusions
Postoperative hypotension and hypertension were common, prolonged, profound, and largely undetected by routine vital-sign assessments in a cohort of adults recovering from abdominal surgery. Frequent or continuous blood pressure monitoring may detect hemodynamic perturbations more effectively and potentially facilitate treatment.
Anterior and Posterior Approaches for Cervical Myelopathy
Authors: Hitchon Patrick W. , Woodroffe Royce W. , Noeller Jennifer A. , Helland Logan , Hramakova Nataliya , Nourski Kirill V. 
Published: February 2019

Study Design.
A retrospective cohort study.

Objective.
The aim of this study was to identify advantages and disadvantages of the anterior and posterior approaches in the treatment of cervical stenosis and myelopathy.

Summary of Background Data.
Both anterior and posterior surgical approaches for cervical stenosis and myelopathy have been shown to result in improvement in health-related outcomes. Despite the evidence, controversy remains regarding the best approach to achieve decompression and correct deformity.

Methods.
We retrospectively reviewed patients with cervical stenosis and myelopathy who had undergone anterior cervical fusion and instrumentation (n = 38) or posterior cervical laminectomy and instrumentation (n = 51) with at least 6 months of follow-up. Plain radiographs, magnetic resonance imaging, and computed tomography scans, as well as health-related outcomes, including Visual Analog Scale for neck pain, Japanese Orthopedic Association score for myelopathy, Neck Disability Index, and Short Form-36 Health Survey, were collated before surgery and at follow-up (median 12.0 and 12.1 months for anterior and posterior group, respectively).

Results.
Both anterior and posterior approaches were associated with significant improvements in all studied quality of life parameters with the exception of general health in the anterior group and energy and fatigue in the posterior group. In the anterior group, follow-up assessment revealed a significant increase in C2–7 lordosis. Both approaches were accompanied by significant increases in C2–7 sagittal balance [sagittal vertical axis (SVA)]. There were two complications in the anterior group and nine complications in the posterior group; the incidence of complications between the two groups was not significantly different.

Conclusion.
When the benefits of one approach over the other are not self-evident, the anterior approach is recommended, as it was associated with a shorter hospital stay and more successful restoration of cervical lordosis than posterior surgery.

Level of Evidence: 3
Morphometric Characteristics of Sacral-2 Alar Iliac Screw Fixation in Pediatric Population
Authors: Shen Zhi-Hao , Wang Kai , Chen Dong , Zheng Xuan-Qi , Huang Jin-Feng , Wu Ai-Min 
Published: February 2019

Study Design.
A computed tomographic assessment.

Objective.
To establish morphometric data of sacral-2 alar iliac (S2AI) screw fixation in pediatric population.

Summary of Background Data.
Studies on morphometric parameters of S2AI screw fixation are mostly based on adult population. The pediatric scoliosis also needs the S2AI screw fixation, however, without the previous morphometric information of among pediatric population.

Methods.
Computed tomography (CT) scans of 120 pediatric patients without spinal deformities are obtained and imported to Mimics software for 3D reconstruction. Then, a cylinder (radius of 3.25 mm) is drawn to imitate the screw trajectory of S2AI screw and adjusted to a maximum upward and downward angle to obtain the feasible region. Nine parameters of the S2AI screw are measured. Differences between age groups are compared and significant statistical correlations are carefully studied to determine the potentially important clinical relationships.

Results.
The mean values and standard deviations (SD) for nine parameters at the maximum upward and downward angles were determined. With age increased, the S2AI screw trajectory becomes more caudal in the coronal (44.03 ± 4.43°–53.15 ± 4.68°) and sagittal planes (50.33 ± 5.89°–57.69 ± 4.21°) and more lateral in the transverse plane (49.40 ± 5.90°–54.44 ± 2.99°), and all of the distance parameters include max-length, sacral distance, iliac width, S2 midline, iliac wing, and skin distance increased. Age has a more significant effect on other parameters than transverse angle and skin distance (P < 0.05).

Conclusion.
The S2AI screw fixation could be used on pediatric population too, but the pediatric population had smaller size of pelvis than adults, surgeons should choose the smaller diameters and the shorter length of screws for pediatric population depends on their age.

Level of Evidence: N/ A
Dual Modality Radiation With External Beam Radiation Therapy and Transarterial Radioembolization for Hepatocellular Carcinoma With Gross Vascular Invasion
Authors: McGee Heather M. , King Michael J. , Özbek Umut , Olson Ashley , Kim Edward , Fischman Aaron M. , Schwartz Myron , Rosenzweig Kenneth E. , Buckstein Michael 
Published: February 2019

Objectives:
Patients with hepatocellular carcinoma (HCC) and gross vascular invasion (GVI) have poor outcomes with systemic therapy such as sorafenib. Both external beam radiation therapy (EBRT) and transarterial radioembolization (TARE) have been utilized for this patient population. We sought to compare outcomes using dual modality radiation (EBRT+TARE) versus EBRT alone in patients with HCC and GVI.

Materials and Methods:
Between 2011 and 2017, 45 patients with HCC and GVI were treated with EBRT±TARE at our institution. Progression-free survival (PFS) and overall survival (OS) were assessed and compared using Kaplan-Meier method and log-rank test. Univariable and multivariable Cox proportional hazards regression was used to assess the impact of the variables stage, etiology of cirrhosis, Child-Pugh (CP) score, and Karnofsky Performance Score (KPS) on PFS and OS.

Results:
Patient characteristics were well-balanced except for KPS (80 vs. 90) and CP score. Median OS for patients receiving EBRT+TARE was 263 days (95% confidence interval [CI]: 167, -) versus 193 days (95% CI: 51, 262) for EBRT alone (P=0.049). However, this did not hold up on MVA. When EBRT and TARE were delivered within 2 months as planned (n=12), median PFS was 218 days (95% CI: 44, -) for dual modality radiation versus 63 days (95% CI: 38, 137) for EBRT alone (P=0.048). When EBRT and TARE were delivered within 6 months, the difference in PFS was no longer seen (P=NS), because some patients received TARE as a salvage therapy.

Conclusions:
Dual modality radiation with EBRT and TARE may be associated with improved OS in patients with HCC and GVI. Dual modality radiation may be associated with improved PFS in patients with HCC and GVI compared with EBRT alone when EBRT and TARE are delivered within 2 months of each other as part of a planned dual modality treatment strategy. However, since this is a retrospective study with inherent selection bias, these findings need further validation in a prospective clinical trial for patients with HCC and GVI.
Longitudinal Evaluation of the Progression of Keratoconus Using a Novel Progression Display
Authors: Kosekahya Pinar , Caglayan Mehtap , Koc Mustafa , Kiziltoprak Hasan , Tekin Kemal , Atilgan Cemile Ucgul 
Published: February 2019

Objectives:
To evaluate the longitudinal tomographic changes and to compare the discriminatory potential of a novel progression display between progressive and nonprogressive keratoconic eyes.

Methods:
Retrospective evaluation was made of 81 eyes of 81 patients with keratoconus who had undergone Scheimpflug measurements at least twice with an interval of 12 months or longer between each measurement. The progressive group was defined as 36 eyes, which showed progression according to the definition of the global consensus on keratoconus and ectatic diseases when 2 of the 3 criteria were met, and the other 45 eyes were considered the nonprogressive group. The main outcome measures from progression display were “A” for anterior radius of curvature, “B” for posterior radius of curvature, “C” for thinnest pachymetry, “D” for distance visual acuity; Kmax; Q-value front and back; index of surface variance (ISV), vertical asymmetry, height asymmetry, and height decentration; overall deviation of normality (final D); average pachymetric progression index; and maximum Ambrósio relational thickness.

Results:
The rate of change per year of A, B, C, thinnest pachymetry, Kmax, final D, and ISV was significantly different between groups (P≤0.01 for all values). It was determined that yearly change rates greater than 0.12 for A, 0.14 for B, 10.04 μm for thinnest pachymetry, 0.68 D for Kmax, 0.15 for final D, and 2.11 for ISV might indicate progression in keratoconus management.

Conclusions:
Belin progression display parameters may be useful in discriminating progressive from nonprogressive keratoconic eyes.
Does Herpes 6 Infection Have a Role in Bell’s Palsy Among Children and Adolescents?
Authors: Genizi Jacob , Golan-Shany Orit , Tarazov Tanya , Pechter Sarel , Assaf Nurit , Segal Idan , Srugo Isaac , Bamberger Ellen 
Published: February 2019

Background:
Bell’s palsy is a peripheral paralysis of the seventh cranial nerve, whose etiology is unknown. Using polymerase chain reaction technology, it is possible to sample accessible body fluids and identify possible viral factors. The purpose of this research is to investigate its connection to the herpes virus family by testing for the presence of the virus in the saliva and tear fluid of Bell’s palsy patients.

Methods:
Saliva and tears were collected from 42 children and adolescents suffering from idiopathic facial nerve paralysis. Polymerase chain reaction was used to test for the presence of the viruses Epstein-Barr virus, cytomegalovirus, herpes simplex virus 1 and 2, varicella zoster virus and human herpes virus 6 (HHV-6). Samples were also taken from a control group without paralysis. A second specimen was taken from patients who tested positive for HHV-6 several months after their recovery.

Results:
Of the 42 patients in the study group, 71% (30 patients) tested positive for HHV-6, compared with only 37% of the control group (P = 0.001). The prevalence of the other 5 viruses tested was low—herpes simplex virus 1: 9.5%, Epstein-Barr virus: 9.5%, cytomegalovirus: 4.8%, varicella zoster virus: 2.3% and herpes simplex virus 2: 0%. Twenty-four of the 30 patients who were HHV-6-positive during their illness were reexamined following recovery. Only 13 patients (54.2%) excreted the virus after recovery from the paralysis.

Conclusions:
Herpes 6 virus appears to play some role in the etiology of facial nerve paralysis. The virus was detected in the saliva of children during acute illness and decreased with resolution. Our research opens new insights linking HHV-6 to the etiology of Bell’s palsy in children.
Entecavir and other nucleos(t)ide analogs prophylaxis in hepatitis B virus-related liver transplantation: long-term efficacy and safety
Authors: Darweesh Samar K. , Gad Amal A. , Akroof Kafya , ElLatif Zainab A. 
Published: February 2019

Background and aim
Although hepatitis B virus (HBV) recurrence after liver transplantation (LTx) has been reduced since the application of the combination of hepatitis B immunoglobulin (HBIG) and nucleos(t)ide analogs (NUCs), the optimum regimen to prevent HBV recurrence with LTx favorable outcome is still not clear.

Aim
The aim was to evaluate the efficacy and safety of NUCs prophylaxis (±HBIG) against HBV recurrence after LTx.

Patients and methods
This was a retrospective cohort-longitudinal study on 44 HBV-related post-LTx patients on anti-HBV prophylactic therapy. They included the entecavir (ETV)-based (n=34, 30 males) and the other NUC-based (n=10, 7 males) groups±HBIG.

Results
The median age was 63.5 (60–70) years in ETV and 62.5 (55–65) years in other NUCs groups. The mean follow-up duration was 6.09±1.83 years in ETV-based group and 6.3±1.89 years in other NUCs-based group. The mean ETV duration was 3.47±3.04 years. In ETV+HBIG patients, none of them developed HBV recurrence throughout the ±8 years. In the 14 patients on ETV+other NUC+HBIG, four developed HBsAg positive and then transformed to HbsAb positive at the end of ±8 years without hepatitis or detectable HBV-DNA. Liver graft function showed nonsignificant difference for ETV-based patients, in comparison with other NUC groups (P=0.09). With subdivision, the graft function was maintained significantly better in ETV+HBIG or other NUCs+HBIG (P=0.04) groups. None of our patients reported NUCs-related complications or adverse effects.

Conclusion
ETV and other NUCs were effective and safe as a long-term prophylaxis of HBV recurrence after LTx, leading to a good graft function. HBsAg temporally reappeared in a minority of patients, where all showed HBsAb seroconversion without detectable HBV-DNA or clinical hepatitis.
Cultural Identity Confusion and Psychopathology
Authors: Groen Simon P.N. , Richters Annemiek J.M. , Laban Cornelis J. , van Busschbach Jooske T. , Devillé Walter L.J.M. 
Published: February 2019

Abstract
Although there is ample empirical evidence that traumatic events, postmigration stress, and acculturation problems have a great impact on the mental health of refugees, so far no studies have included cultural identity after migration in the equation. This mixed-methods study conducted among Afghan and Iraqi refugee and asylum-seeker psychiatric patients aims to fill this gap. Associations between postmigration stress, symptoms of anxiety and depression disorders, and symptoms of posttraumatic stress disorder were significant. When differentiated for the two groups, associations with postmigration stress were no longer significant for Afghan patients, who were predominantly younger and more often single, lower educated, and without resident status compared with Iraqi patients. Qualitative results indicate that, in addition to psychopathology and postmigration stress, acculturation problems contribute to confusion of cultural identity. The findings suggest that reduction of postmigration stress and acculturation problems may clarify cultural identity and as such may contribute to posttraumatic recovery.
Compressed Sensing and Parallel Imaging for Double Hepatic Arterial Phase Acquisition in Gadoxetate-Enhanced Dynamic Liver Magnetic Resonance Imaging
Authors: Yoon Ja Kyung , Kim Myeong-Jin , Lee Sunyoung 
Published: February 2019

Objectives
The aim of this study was to investigate the utility of a combined compressed sensing and parallel imaging (C-SENSE) technique for single breath-hold, double arterial phase (AP) examinations in gadoxetate-enhanced magnetic resonance imaging (MRI) of the liver.

Materials and Methods
We retrospectively reviewed single breath-hold, double AP images obtained by using a C-SENSE technique for gadoxetate-enhanced dynamic liver MRI in a total of 127 patients (89 men and 38 women; mean age, 62.6 ± 7.5 [range, 29–87] years). For qualitative analysis, 3 readers independently scored the timing of the AP images, degree of artifacts, and overall image quality on both the first and second AP images (AP1 and AP2, respectively). The combined scores of AP1 and AP2 (AP1 + AP2) were determined by using the better scores from the 2 sets. Focal lesion detectability was assessed for 124 lesions with arterial enhancement on AP1 and AP2, and on simultaneous review of both AP1 and AP2. Then, in 62 patients whose previous gadoxetate-enhanced single AP images were available, AP timing and overall image quality were compared between single and double AP images. Wilcoxon signed rank test was performed for each comparison. Fleiss kappa value was calculated for analysis of interreader agreement.

Results
Optimal AP timing was achieved in 86% of AP1, 65% of AP2, and 90% of AP1 + AP2 images; results were significantly better for AP1 and AP1 + AP2 images than for AP2 images (P < 0.001 for both comparisons). Respiratory motion artifacts were negligible in 73% of the AP1 + AP2 images, which was significantly better than the corresponding values for the AP1 (61%, P < 0.001) or AP2 (50%, P < 0.001) images. Overall image quality was significantly better for AP1 + AP2 (excellent in 54%) than for AP1 (49%, P < 0.001) or AP2 (39%, P < 0.001) images. Lesion detectability was comparable between AP1 and AP2 images and was significantly better on AP1 + AP2. Comparison of single and double AP imaging techniques showed better AP timing (P = 0.004) and fewer respiratory motion artifacts (P < 0.001) for AP1 + AP2 than for the single AP images.

Conclusions
The C-SENSE technique may facilitate single breath-hold, double AP imaging with optimal timing and reduced respiratory motion artifacts in gadoxetate-enhanced dynamic MRI of the liver.