bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cranio-orbital Resection Does Not Appear to Improve Survival of Patients With Lacrimal Gland Carcinoma
Authors: Rose Geoffrey E. , Gore Sri K. , Plowman Nicholas P. 
Published: August 2018

Purpose:
To ascertain long-term outcome of treatment for primary epithelial malignancies of the lacrimal gland and compare outcomes after cranio-orbital resection or after macroscopic tumor resection with radiotherapy.

Methods:
Comparative case series of 79 patients (49 male; 62%) treated for primary epithelial malignancies of the lacrimal gland at Moorfields Eye Hospital between 1972 and 2014. Patients were identified from clinical and pathological databases and, where available, the clinical, pathological, and imaging records reviewed. The primary outcome measures were overall survival after diagnosis, disease-free survival, and final visual acuity for patients having cranio-orbital resection (exenteration plus local bone removal), compared with macroscopic tumor resection plus radiotherapy.

Results:
The mean age at presentation was 48 years (median: 50 years; range: 13–84 years), with 53 (67%) having adenoid cystic carcinoma, 15 (19%), primary adenocarcinoma, and 11 (14%) carcinoma ex-pleomorphic adenoma (malignant mixed tumor). The overall survival probability of the cohort (79 patients) was 0.59 at 5 years and 0.52 at 10 years, with 36/79 (46%) patients suffering tumor-related deaths; 14 patients died from other causes, and 4 patients were lost to follow up after the minimum follow-up period. The probability of disease-free survival at 5 years for patients with adenoid cystic carcinoma, adenocarcinoma, and malignant mixed tumor was 0.52, 0.4, and 0.64, respectively, with the comparable figures at 10 years being 0.44, 0.40, and 0.64. Most importantly, the 9 patients undergoing cranio-orbital resection and the 44 having solely macroscopic tumor resection plus radiotherapy had similar overall survival (p = 0.59) and disease-free survival (p = 0.89). Subgroup analysis of the 2 treatment modalities for patients with adenoid cystic carcinoma (8 cranio-orbital resection and 32 debulking and radiotherapy) demonstrated similar results for disease-free survival (p = 0.87). Likewise, there were no significant differences between rates of recurrences between the 2 different treatments. For the 50 patients who had eye-preserving surgery and long-term visual acuity data, the final acuity was better or equal to 0.6 logMAR (6/24 Snellen) in 25 (50%).

Discussion:
There is no difference in either survival or tumor recurrence for lacrimal gland carcinoma treated with cranio-orbital resection, or eye-preserving tumor excision and radiotherapy. The authors, therefore, continue to advocate local resection and radiotherapy for almost all patients with primary epithelial malignancies of the lacrimal gland—this treatment having lower morbidity, causing less disfigurement, and, importantly, preserving useful vision in most patients.
Corneal Topographical Changes After Müller’s Muscle-conjunctival Resection Surgery
Authors: Ozturk Karabulut Gamze , Fazil Korhan 
Published: August 2018

Purpose:
To evaluate corneal refractive and topographical changes after Müller’s muscle conjunctival resection surgery on patients with mild ptosis.

Methods:
A total of 28 eyes of 28 patients with mild ptosis underwent Müller’s muscle conjunctival resection. Visual acuity, margin reflex distance, and cycloplegic refraction were analyzed preoperatively and at first, third, and sixth months postoperatively. Change in corneal topography was analyzed with Sirius System using parameters including corneal astigmatism (CYL), average simulated keratometry value (simK), apical keratometry front (AKf), symmetry index front (SIf), and central corneal thickness (CCT) at the same intervals.

Results:
Best-corrected visual acuity and cycloplegic refraction did not change significantly at all controls postoperatively. The mean change in corneal astigmatism, simK, SIf, and CCT did not show significant differences. Apical keratometry front showed a significant decrease at 3 and 6 months.

Conclusion:
The pressure of upper eyelid in patients with ptosis appeared to have resulted in steepening of the superior cornea along this axis. The surgical correction of ptosis induces flattening of superior cornea as shown by significant decrease in apical keratometry front value postoperatively and restores corneal topography to a more regular state.
Psychosocial factors associated with persistent pain in people with HIV: a systematic review with meta-analysis
Authors: Scott Whitney , Arkuter Chinar , Kioskli Kitty , Kemp Harriet , McCracken Lance M. , Rice Andrew S.C. , de C. Williams Amanda C. 
Published: August 2018

Abstract
Chronic pain remains a prevalent and disabling problem for people living with HIV in the current antiretroviral treatment era. Psychosocial treatments may have promise for managing the impact of this pain. However, research is needed to identify psychosocial processes to target through such treatments. The current systematic review and meta-analysis examined the evidence for psychosocial factors associated with pain, disability, and quality of life in people living with HIV and persistent pain. Observational and experimental studies reporting on the association between one or more psychosocial factors and one or more pain-related variables in an adult sample of people living with HIV and pain were eligible. Two reviewers independently conducted eligibility screening, data extraction, and quality assessment. Forty-six studies were included in the review and 37 of these provided data for meta-analyses (12,493 participants). “Some” or “moderate” evidence supported an association between pain outcomes in people with HIV and the following psychosocial factors: depression, psychological distress, posttraumatic stress, drug abuse, sleep disturbance, reduced antiretroviral adherence, health care use, missed HIV clinic visits, unemployment, and protective psychological factors. Surprisingly, few studies examined protective psychological factors or social processes, such as stigma. There were few high-quality studies. These findings can inform future research and psychosocial treatment development in this area. Greater theoretical and empirical focus is needed to examine the role of protective factors and social processes on pain outcomes in this context. The review protocol was registered with PROSPERO (CRD42016036329).
Nursing Diagnoses Panorama in a Swedish Forensic Psychiatric Setting Using NANDA-International Taxonomy
Authors: Åling Maria , Nilsson Evelina R. , Garpstål Björn , Strömberg Lars 
Published: August 2018

ABSTRACT
More than 1,000 Swedish hospital beds are occupied by patients in forensic psychiatric settings; their average length of hospitalization is 3–7 years. In this context, nursing diagnoses could be extremely useful to make nursing care structured, measurable, and internationally comparable. The study aimed to describe nursing diagnoses in a Swedish forensic psychiatric setting.

Methods:
Data were collected from electronic patient records of 55 patients in a medium-secure forensic psychiatric setting in Sweden. Anonymized data were entered into a database where entries were transformed into figures. Descriptive statistics were used, and frequencies, means, and percentages were calculated. The variables employed were characteristics and related factors, according to NANDA-International (NANDA-I) and International Statistical Classification of Dieseases and Related Heatlh Problems, 10th Revision (ICD-10), diagnoses.

Results:
The patients had between 1 and 13 NANDA-I diagnoses each. Forty-one of the 55 patients had psychosis as the primary ICD-10 code. The identified nursing diagnoses described the patients' status upon arrival in the forensic psychiatric setting. Of the 55 patients, entries in the patient records describing 300 signs and symptoms (i.e., characteristics and related factors) were found. From these signs and symptoms, 371 entries that fit NANDA-I diagnoses were identified, representing 20 different NANDA-I diagnoses.

Conclusion:
NANDA-I diagnoses individualize patient care, making care person centered. NANDA-I is used all over the world and has the potential to make nursing care structured, measurable, and internationally comparable.
Addressing Human Papillomavirus Prevention During Pediatric Acute Sexual Assault Care
Authors: Deutsch Stephanie Anne , Benyo Sarah , Xie Sherlly , Carlin Eileen , Andalaro Bridgett , Clagg Bernadette , De Jong Allan 
Published: August 2018

ABSTRACT

Background/Objectives:
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Pediatric sexual assault (SA) victims are a special population eligible for HPV vaccination at the age of 9 years. National clinical practice guidelines advise clinicians to address HPV during emergency department (ED)-based SA care and at follow-up. At our institution, addressing HPV among suspected SA victims was highly variable, and HPV counseling was subsequently recommended on an ED-based acute SA clinical pathway as standard care. The aim of this study was to determine the proportion of age-eligible SA victims who received HPV counseling, determine victim characteristics associated with addressing HPV during SA care, and identify barriers to addressing HPV in the ED.

Methods:
This study used a retrospective chart review of 448 pediatric SA victims presenting to the ED for acute postassault care.

Results:
HPV was discussed in 10 of 56 (18%) and 37 of 49 (76%) cases in the control versus intervention groups, respectively. To verify vaccination status, caregiver recall was relied upon for 32 of 56 patients in the control group (57%) and 24 of 49 patients in the intervention group (48.9%). Factors associated with failure to discuss HPV during postassault care were younger age at encounter (OR = 0.78, 95% CI [0.67, 0.90], p < 0.001), verbal report of vaccination status verification (OR = 2.98, 95% CI [1.51, 6.01]), and male gender of the victim (OR = 3.35, 95% CI [1.20, 11.94]).

Conclusions:
Significant barriers to addressing HPV in the ED setting exist, most significantly reliance on caregiver recall to guide vaccination administration, raising concern for overvaccination and undervaccination.
Evaluation of a Standardized Patient Simulation on Undergraduate Nursing Students’ Knowledge and Confidence Pertaining to Intimate Partner Violence
Authors: Blumling Amber , Kameg Kirstyn , Cline Thomas , Szpak Janene , Koller Cora 
Published: August 2018

ABSTRACT

Introduction:
Intimate partner violence (IPV) is a serious and preventable public health problem. Nurses are at the front lines of assessing and intervening with patients subjected to IPV. Lack of training and confidence is cited as a major barrier to assessing for IPV.

Objective:
The purpose of this study was to evaluate a standardized patient (SP) simulation experience depicting a victim of IPV on undergraduate nursing student knowledge and confidence in assessment and intervention of IPV.

Methods:
The Physician Readiness to Manage Intimate Partner Violence Survey tool was adapted to measure confidence, and a 10-item multiple-choice test was developed to measure knowledge, completed pretest, postlecture, and post-SP simulation.

Results:
There was a statistically significant increase in confidence from pretest to postlecture, 14.04 (SD = 3.01) to 20.61 (SD = 2.39), F(1, 56) = 345, p < 0.001, to postsimulation, 14.04–21.93 (SD = 2.18), F(1, 56) = 21.1, p < 0.001. Only statistically significant increases in knowledge occurred from pretest to postlecture, 6.96 (SD = 1.36) to 7.95 (SD = 1.47), F(1,56) = 29.84, p < 0.001. Increase in knowledge from postlecture to postsimulation was not found to be statistically significant, 7.95 (SD = 1.47) to 8.05 (SD = 1.27), F(1,56) = 0.632, p > 0.10.

Conclusion:
Healthcare professionals need to be adequately educated and trained to screen for IPV. This study provides preliminary evidence that the addition of an SP simulation appears to enhance nursing student confidence and knowledge of assessing and intervening with victims of IPV.
Moving Into Action: The Master Key to Patient Education
Authors: FEREIDOUNI Zhila , SABET SARVESTANI Raheleh , HARIRI Gholamreza , KUHPAYE Seyed Amin , AMIRKHANI Mehdi , KALYANI Majid NAJAFI 
Published: August 2018

ABSTRACT

Background:
Illness and hospitalization are situations that increase the need for assistance and education. Poor education is currently the most common source of patient complaints in the health sector in Iran.

Purpose:
The aim of this study was to explore the perspectives and recommendations of nurses to improve patient education.

Methods:
This research followed a qualitative exploratory design with a qualitative content analysis approach. The study participants, including eight head nurses and 16 staff nurses, were selected through purposive sampling. The data were collected through semistructured interviews, focus group sessions, and observations during 2016.

Results:
Coding and analysis of the data generated one main theme, two subthemes, and four categories. The subthemes were “strengthen total commitment” and “reconstructing the infrastructure,” and the categories were “developing motivational factors,” “facilitating change by every impetus,” “systematizing activities,” and “contextual promotion.”

Conclusions:
Study findings provide a complete picture of patient education and challenge managers to develop new strategies to plan and implement appropriate changes.
Lack of Benefit of Lactobacillus reuteri DSM 17938 as an Addition to the Treatment of Functional Constipation
Authors: Jadrešin Oleg , Sila Sara , Trivić Ivana , Mišak Zrinjka , Hojsak Iva , Kolaček Sanja 
Published: August 2018

ABSTRACTThe aim of this study was to investigate the role of Lactobacillus reuteri DSM 17983 in the treatment of functional constipation in children. The trial was a single‐center randomized, double‐blind, placebo‐controlled study. Patients were allocated into the 2 groups; intervention group which received L reuteri DSM 17983 and lactulose and placebo group which received placebo and lactulose. Due to small recruitment rate study was terminated prematurely; therefore, only 33 children (12 girls, median age 4.5 years, range 2–16) were randomized. There was no difference between groups in the stool frequency, stool consistency, pain, soiling rate and dose of the lactulose. This study found that L reuteri DSM 17938 adds no benefit to the treatment of constipation in children. Due to small sample size, these results, however, should be interpreted with caution.
Student Perceptions of Classic and Game-Based Online Student Response Systems
Authors: Wang Weiwen , Sun Ran , Huang Linda , Swigart Valerie 
Published: August 2018

Background
Online student response systems (OSRSs), driven by the Internet and cell phone technology, provide a free, easily accessible method to increase student engagement, facilitate active learning, and provide learners and teachers with instant feedback about learning progress.

Purpose
This article describes undergraduate nursing students' use of 2 OSRSs and their perceptions of the impact of the tools on class participation and engagement.

Methods
Students used their own mobile phones or computers to access 2 types of OSRSs: a classic and a game-based OSRS.

Results
Students indicated that both systems increased participation and engagement. The game-based OSRS was favored over the classic OSRS. The potential for use of the game-based OSRS for assessing rapid-answer fact-based knowledge and the classic OSRS for assessing more complex learning tasks is discussed.

Conclusion
Nurse educators are encouraged to consider integrating online response system technology into their classroom teaching.
A Traumatic Quinceañera
Authors: Russell Eric A. , Braverman Richard M. , Vasudevan Sanjeev A. , Patel Binita 
Published: August 2018

Abstract
A 15-year-old girl presented with 3 days of progressive abdominal distention, pain, and bilious hematemesis. Her symptoms began after her quinceañera, during which she wore a tight corset. On examination, she was thin and had significant abdominal distention and pain. A computed tomography revealed a massively dilated stomach and proximal duodenum to the region of the superior mesenteric artery (SMA) with distal decompression. An upper gastrointestinal fluoroscopy demonstrated marked dilation of the stomach through the mid third portion of the duodenum with distal decompression and an associated linear compression on her duodenal wall. We believe that she developed acute SMA syndrome. Superior mesenteric artery syndrome is a partial bowel obstruction caused when the third portion of the duodenum is compressed as it passes between the SMA and the aorta. Although the SMA syndrome is most commonly described as a condition associated with chronic, severe weight loss resulting in a narrowing of the SMA to aorta angle and subsequent duodenal compression, it can present acutely from causes such as a postoperative complication, blunt trauma, or external compression. Previously described acute SMA syndrome from external compression has been the result of medically necessary causes, such as body casting. In this case, the tight gown was likely the inciting factor for her development of SMA syndrome; however, she was placed at high risk for the condition by being underweight at baseline and experiencing food restriction for several days preceding her quinceañera. She was treated conservatively with nasogastric decompression and parenteral nutrition, and has since completely recovered.
Dechelation (Transmetalation)
Authors: Runge Val M. 
Published: August 2018

AbstractThe issue of dechelation (transmetallation) in vivo after administration of the linear gadolinium-based contrast agents, and potential safety concerns, is considered on the basis of an extensive, focused literature review. Early indications of potential problems included the high level of excess ligand used in the formulation of 2 agents (indeed the 2 least stable thermodynamically) and interference with laboratory tests when blood was drawn from patients relatively soon after administration of these same agents. The advent of nephrogenic systemic fibrosis in the late 2000s raised additional major concerns.The correlation in 2014 of dentate nucleus hyperintensity on precontrast T1-weighted scans with multiple prior injections of linear gadolinium chelates, in patients with normal renal function, has driven subsequent research concerning dechelation of these agents in vivo. Unexpectedly high levels of gadolinium in the bone, skin, and liver have been found long term after administration, in animal models and in humans, although the latter data are limited. Bone may serve as a long-term reservoir, with a residual excretion phase for gadolinium after intravenous injection of the linear agents due to a subsequent slow release from bone. Many different patient populations could be vulnerable and potentially later develop clinical symptoms, although at this stage there are only limited data and small retrospective uncontrolled studies. Possible vulnerable populations include children, menopausal women, patients with osteoporosis (who are predisposed to fractures and often slow to heal or heal poorly), those receiving multiple doses, those with proinflammatory conditions, moderate renal dysfunction, or an undefined genetic predisposition. Of particular concern would be nephrogenic systemic fibrosis–like symptoms—including particularly pain and skin/joint symptoms, or disease related to the incorporation of gadolinium in hydroxyapatite in bone, in small subgroups of patients with a not yet defined propensity and/or cofactor. These concerns have led to withdrawal of the linear agents from the largest clinical market, Europe, with the exception of the hepatobiliary agents for delayed liver imaging, an indication that cannot be fulfilled by the current macrocyclic gadolinium chelates (for which these concerns do not apply).
Islet Allotransplantation in the Bone Marrow of Patients With Type 1 Diabetes: A Pilot Randomized Trial
Authors: Maffi Paola , Nano Rita , Monti Paolo , Melzi Raffaella , Sordi Valeria , Mercalli Alessia , Pellegrini Silvia , Ponzoni Maurilio , Peccatori Jacopo , Messina Carlo , Nocco Angela , Cardillo Massimo , Scavini Marina , Magistretti Paola , Doglioni Claudio , Ciceri Fabio , Bloem Stef J. , Roep Bart O. , Secchi Antonio , Piemonti Lorenzo 
Published: August 2018

Background.
Results in murine and nonhuman primate suggested that the bone marrow (BM) might be an alternative site for pancreatic islet transplantation.

Methods.
We report the results of 2 clinical studies in patients with type 1 diabetes receiving an intra-BM allogeneic islet transplantation: a feasibility study in patients with hepatic contraindications for liver islet allotransplantation receiving a single intra-BM islet infusion (n = 4) and a pilot randomized trial (1:1 allocation using blocks of size 6) in which patients were randomized to receive islets into either the liver (n = 6) or BM (n = 3) to evaluate islet transplant function and survival.

Results.
We observed no adverse events related to the intrabone injection procedure or the presence of islets in the BM. None of the recipient of an intra-BM allogeneic islet transplantation had a primary nonfunction, as shown by measurable posttransplantation C-peptide levels and histopathological evidence of insulin-producing cells or molecular markers of endocrine tissue in BM biopsy samples collected during follow-up. All patients receiving islets in the BM except 1 lost islet function during the first 4 months after infusion (2 with an early graft loss). Based on biopsies and immunomonitoring, we concluded that the islet loss was primarily caused by the recurrence of autoimmunity.

Conclusions.
Bone marrow is not a suitable alternative site for pancreatic islet allotransplantation in patients with type 1 diabetes.
Temporal Changes in the Impact of HLA Mismatching Among Pediatric Kidney Transplant Recipients
Authors: Ruck Jessica M. , Jackson Annette M. , Massie Allan B. , Segev Dorry L. , Desai Niraj , Garonzik-Wang Jacqueline 
Published: August 2018

Background.
Allocation for pediatric deceased-donor kidney transplantation (pDDKT) in the United States now de-emphasizes HLA matching to improve equality in access to transplantation, but other national systems still consider HLA matching due to concerns about graft survival. We hypothesized that the impact of HLA mismatching has decreased over time due to advances including improved immunosuppression.

Methods.
Using Scientific Registry of Transplant Recipient data, we analyzed whether the association between the number of HLA mismatches and outcomes of first-time pDDKTs changed between 2 eras: 1995 to 2004 (N = 2854) and 2005 to 2014 (N = 4643).

Results.
Between eras, the median number of mismatches increased from 4 to 5 (P < 0.001). Overall graft failure risk was higher among HLA-mismatched versus HLA-matched transplants (adjusted hazard ratio 1.211.431.69 for 3–6 versus 0–2 mismatches; P < 0.001), and this association was similar pre-2005 and post-2005 (P
interaction = 0.5). Median panel-reactive antibody change at relisting increased from 79 to 85 (P = 0.01), but the association between number of HLA mismatches and panel-reactive antibody change was similar between eras (P
interaction = 0.6).

Conclusions.
Our finding that increased HLA mismatching continues to impact graft survival, with 43% higher risk of graft failure, highlights the tradeoff between transplant access equity and outcomes and calls into question the deemphasis on HLA matching in pDDKT allocation in the United States.