bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovation in Clinical Course Delivery and Impact on Students’ Clinical Decision-Making and Competence
Authors: Woda Aimee , Schnable Theresa , Alt-Gehrman Penny , Bratt Marilyn Meyer , Garnier-Villarreal Mauricio 
Published: August 2018

Abstract
The purpose of this study was to explore the differences in clinical decision-making and clinical competence between two different cohorts of graduating baccalaureate nursing students from a traditional prelicensure program in the United States. A quasi-experimental design was used to compare students who had substituted their traditional medical-surgical clinical experiences with simulation (Cohort 1, n = 35) with students who had supplementary simulation in addition to their traditional clinical experiences (Cohort 2, n = 36). The findings demonstrated that when simulation was used as a supplement to traditional clinical experiences, participants performed better patient assessments.
Predicting Procedure-specific Morphine Consumption of Intravenous Patient-controlled Analgesia With Random-effect Model Approach
Authors: Lin Shih-Pin , Chang Kuang-Yi , Chen Hsiu-Hsi , Tsou Mei-Yung 
Published: August 2018

Introduction:
Surgical procedure is an important predictor for analgesic consumptions of intravenous patient-controlled analgesia (IV-PCA) for acute pain.

Objectives:
The aim of this study was to better fit the analgesic consumptions of IV-PCA with regard to the different surgical procedures.

Materials and Methods:
A statistical model (random-effect model) was proposed to develop procedure-specific morphine consumptions for various surgical procedures of IV-PCA. After the model was developed, an independent data set was used for external validation.

Results:
The results showed a significant influence for morphine consumption coming from surgical procedures. Different surgical procedures resulted in a wide range of morphine consumptions. The surgical procedure with the highest morphine consumption was the resection of the pancreas with open approach (76.92 mg), while the lowest one was for the excision of the uterus with open method (34.3 mg). The external validation showed good model performance. The quantitative rank for surgical procedures was also presented.

Discussion:
Adopted IV-PCA regimens for different surgical procedures are therefore strongly recommended and incorporated into postoperative acute pain management.
Improving Neonatal Outcomes Through Global Professional Development
Authors: Riley Cheryl , Spies Lori A. , Prater Lyn , Garner Shelby L. 
Published: August 2018

Background:
Globally, stillbirths account for 2.7 million infant deaths each year, with the vast majority occurring in sub-Saharan Africa and South Asia. Approximately 900,000 infants die due to birth asphyxia. The focus of the Helping Babies Breathe (HBB) program is to help the nonbreathing infant to breathe within the first minute of life, termed the “Golden Minute.”

Purpose:
To present a multinational interprofessional development program utilizing the train-the-trainer methodology for HBB to address neonatal morbidity and mortality. Involving nursing students in collaboration with established global partners provided an innovative method of professional development. Lessons learned and challenges will be shared to enhance success of future efforts.

Project Implementation:
HBB train-the-trainer workshops were held to provide professional development for nurses and nursing students in 5 locations in 4 countries including Ethiopia, India, Vietnam, and Zambia. Workshop participants and the trainers participated in discussions and informal conversation to assess impact on professional development.

Results:
HBB training and train-the-trainer workshops were implemented in 4 counties. Equipment and supplies were provided in these countries through several internal university grants. All 145 participants demonstrated increased knowledge and skills at the end of the workshops through the HBB check off. Collaborative teaching and cross-cultural professional skills were enhanced in student and faculty trainers.

Implications for Practice:
Nurses, midwives, and advance practice nurses can engage globally and contribute to closing this gap in knowledge and skills by providing train-the-trainer workshops.

Implications for Research:
Developing systems to integrate the HBB program within each country's existing healthcare infrastructure promotes in-country ownership. Joining the global effort to save the lives of neonates can be a meaningful opportunity for innovative professional development projects. While HBB education has been shown to save lives, a 1-time training is insufficient. Determining how often HBB updates or refreshers are required to maintain skills is an important next step. Another direction for research is to implement this project within prelicensure nursing programs.
Dermatomyositis etiopathogenesis: a rebel soldier in the muscle
Authors: Pinal-Fernandez Iago , Mammen Andrew L. 
Published: August 2018

Purpose of review
The purpose of this article is to review the etiopathogenesis of dermatomyositis, including the predisposing factors, triggers, inflammatory cells, pathways and target antigens associated with dermatomyositis.

Recent findings
During the last few years, we have made considerable progress in unveiling the etiopathogenesis of dermatomyositis. In the first place, we have defined genes within the major histocompatibility complex locus as the greatest genetic risk factor for the disease. Second, we have demonstrated that certain environmental factors, as well as tumors, may trigger certain dermatomyositis subtypes. Moreover, we have established the importance of the interferon pathway in dermatomyositis pathogenesis compared with other myositis subtypes. But probably, the most remarkable advance has been the discovery of multiple autoantibodies that define groups of patients with characteristic clinical features, prognosis and response to treatment.

Summary
Dermatomyositis cause and pathogenesis have proven to be a complex and fascinating task for the scientific community and the last decade has been full of new findings on how the disease starts and how it causes damage to different organ systems. However, we have still more questions than answers in this topic, answers that will be critical to understanding autoimmunity and finding effective therapies to dermatomyositis.
Attitudes of Spine Surgeons Regarding Management of Preoperative Anxiety
Authors: Musa Arif , Wang Jeffrey C. , Acosta Frank L. , Movahedi Rana , Melkonian Adana , Shahbazi Alan , Safani David , Gucev Gligor 
Published: August 2018

Study Design:This is a cross-sectional study.Objective:To investigate spine surgeons’ attitudes regarding preoperative anxiety measurement, management, and responsibility.Summary of Background Data:The vast majority of patients scheduled for spine surgery experience preoperative anxiety. However, there are currently no consensus guidelines for measure or management of preoperative anxiety in spinal operations.Materials and Methods:An anonymous questionnaire was sent online to spine surgeons of AO Spine North America to capture their views regarding preoperative anxiety.Results:Of 69 complete responses, most respondents were male (n=66, 95.7%), orthopedic surgeons (n=52, 75.4%), and practicing at an academic setting (n=39, 56.5%). Most spine surgeons practiced for at least 20 years (n=52, 75.4%), operated on 100–300 patients per year (n=48, 69.6%), and were attending physicians (n=61, 88.4%). Most did not measure preoperative anxiety (n=46, 66.7%) and would not use a rating scale to measure it (n=38, 55.1%). However, most would discuss it if mentioned by the patient (n=40, 58.0%). Other spine surgeons measured anxiety verbally (n=22, 31.9%) or with a rating scale or survey (n=6, 8.7%). Although preferences for preoperative anxiety management varied, most respondents used patient education (n=54, 78.3%) and permitting family members’ presence (n=36, 52.2%) to reduce patient anxieties. Spine surgeons held themselves, anesthesiologists, and patients most responsible to manage preoperative anxiety.Conclusions:The majority of spine surgeons surveyed did not regularly measure preoperative anxiety, but would discuss its management if the subject was broached by the patient. Spine surgeons relied on a variety of methods to manage a patient’s anxiety, but most preferred preoperative education and permitting the presence of family members. Responsibility for controlling preoperative anxiety was chiefly allocated to surgeons, anesthesiologists, and patients. Future avenues for research may include developing a preoperative anxiety measurement scale and management protocol specific to spine surgery.Level of Evidence:Level IV.
Molecular classification of adult gliomas: recent advances and future perspectives
Authors: Barritault Marc , Meyronet David , Ducray François 
Published: August 2018

Purpose of review
This review summarizes recent advances in the molecular classification of adult gliomas.

Recent findings
According to the 2016 WHO classification, five main molecular subgroups of adult diffuse gliomas can be distinguished based on the 1p/19q codeletion, isocitrate dehydrogenase (IDH), and histone H3.3 mutation status. In the future, this classification may be further refined based on the integration of additional biomarkers, in particular CDKN2A/B homozygous deletion in IDH-mutant astrocytomas, TERT promoter mutations, EGFR amplification, chromosome 7 gain and chromosome 10 loss in IDH-wildtype astrocytomas, and FGFR1 mutations in midline gliomas. Histone H3.3 G34R/V defines a distinct subgroup of hemispheric IDH-wildtype high-grade gliomas occurring in young patients and FGFR gene fusions characterize a subgroup of IDH-wildtype glioblastomas that could benefit from specific treatment approaches. RNA sequencing may identify targetable gene fusions in circumscribed gliomas lacking classical BRAF alterations. In chordoid gliomas, recurrent PRKCA mutations could serve as a new diagnostic marker. Among comprehensive molecular analysis methods, DNA methylation profiling appears as a particularly powerful approach to identify new molecular subgroups of gliomas and to classify difficult cases.

Summary
The classification of adult gliomas may be improved by the integration of additional biomarkers and/or by comprehensive molecular analysis, in particular DNA methylation profiling. The most relevant approach, however, remains to be established.
Development of AN On-site, Rapid, Environmental Radiation-distribution Monitoring System for Decision Making during a Radiation Emergency
Authors: Lee UkJae , Kim Hee Reyoung 
Published: August 2018

Abstract
An on-site, rapid, measurement-based, radiation-distribution visualization system with radionuclide recognition was developed for quick decision making during a radiation emergency. After scanning of the area was complete, radionuclide-specific radiation-distribution contours were displayed in two and three dimensions on a map of the measurement area, in a few tens of seconds, by clicking once on an execution file, which was programmed using MathWorks’ MATLAB software. The contours were fundamentally verified using 137Cs and 60Co standard sources. Radiation distribution in the measurement area was simultaneously displayed in the main office using code division multiple access. It was demonstrated that rapid decision making for public safety is possible through the prompt display of radiation distribution in a nuclear emergency environment. This can also be applied to establish an environmental restoration plan for decontamination and decommissioning of nuclear power plants.
Optimization of the ICRP 67 and NCRP 156 Transfer Rates Applied to Nonhuman Primates Intramuscularly Injected With 241Am
Authors: Alomairy Nada A. , Brey Richard R. , Guilmette Raymond A. 
Published: August 2018

Abstract
Nonhuman primates intramuscularly injected with 241Am have been investigated using the International Commission on Radiological Protection Report 67 model coupled with National Council on Radiation Protection and Measurements Report 156 model. Default parameters from these models were input into the Integrated Modules for Bioassay Analysis software to predict the intake and skeleton retention in 20 tested nonhuman primates. The predictions generated were compared to the experimental data from the Durbin nonhuman primate studies. A previous study conducted by Alomairy in 2017 indicated that the early behavior of 241Am(NO3)3 in wound cases can be explained using the default transfer rates. However, these transfer rates were not able to predict the intake and skeleton retention at the time of sacrifice after 100 d postintake due to differences in the amount of activity translocated or deposited in liver tissue and nonliver tissues (primarily skeleton). This is likely due to the physiological differences between the nonhuman primate and human. The objective of this study was to develop new transfer rate parameters for wound and systemic models in an effort to improve biokinetic predictions. Estimates of new transfer rates appropriate for nonhuman primate data were estimated by employing a companion software program called Integrated Modules for Bioassay Analysis Uncertainty Analyzer. During validation of the suggested transfer rates, it was observed that the optimized parameters predicted the intake in 66% of the tested animals used in this investigation. The activity retained in the skeleton improved in almost all cases where the differences between predicted and measured activity is less than 20%.
A Holistic Approach to Assessment of Population Exposure to Radiation: Challenges and Initiatives of a Regulatory Authority
Authors: Askounis P. , Boziari A. , Carinou E. , Drikos G. , Economides S. , Hourdakis C.J. , Housiadas C. , Kalathaki M. , Kamenopoulou V. , Karabetsos E. , Kehagia K. , Kolovou M. , Koukorava C. , Lasithiotakis M. , Makridakis T. , Maltezos A. , Mitrakos D. , Nikolaki M. , Nikolaou M. , Nicolaou P. , Petri A. , Potiriadis C. , Raftopoulos S. , Simantirakis G. , Tafili V. , Veltsos C. , Vogiatzi S. , Xarchoulakos D.C. , Zourari K. 
Published: August 2018

Abstract
A regulatory authority for radiation safety should continuously evaluate and improve the national safety framework, in line with current requirements and standards. In this context, the Greek Atomic Energy Commission initiated a series of concerted actions. The radiation dose to the population due to public and medical exposures was assessed. The assessment of dose due to public exposure was based on measurements of radon concentrations in dwellings, radionuclide concentrations in environmental samples, and air dose rates; the assessment of dose due to medical exposure was based on dose measurements for typical examinations or procedures and data on their frequency. The mean effective dose to a member of the population was found to be 4.5 mSv (1.8 mSv and 2.7 mSv from medical and public exposures, respectively). Regarding occupational exposure, aircrew dose assessment, eye lens monitoring, and the national dose registry were significantly improved. With respect to artificial tanning (sun beds), the ultraviolet radiation produced was assessed and the practices followed were observed. Results demonstrated exceedance of the 0.3 W m−2 erythema effective irradiance limit set in European Union standards by 63.5% of the sun beds measured, along with general noncompliance with standards. An overarching activity was the upgrade of the Greek Atomic Energy Commission information system in order to collect and disseminate radiation data electronically, launch a networking strategy for interaction with stakeholders, and facilitate the process of regulatory control. In response to the above findings, regulatory actions have been initiated.
Characterization of Prosthetic Liner Products for People with Transtibial Amputation
Authors: Cagle John C. , Hafner Brian J. , Taflin Nicholas , Sanders Joan E. 
Published: August 2018

ABSTRACT

Introduction
Typical practitioners choose from among only two to three products when selecting liners for their patients. A lack of comparable objective information about similarities and differences among elastomeric liner products may be part of the reason.

Methods
Commonly used, commercially available polyurethane, silicone, and thermoplastic elastomer (TPE) liners were tested for their compressive, shear, tensile, and volumetric elasticities as well as their coefficients of friction (CoFs) and thermal conductivities.

Results
Polyurethane and silicone liners tended to be stiffer in compression and shear than TPE liners. Fabric backings contributed primarily to increased tensile elasticity (and thus reduced pistoning). Polyurethane liners demonstrated relatively low CoFs, whereas silicone and TPE liners had higher CoFs and wider ranges. All materials tested were essentially incompressible. Thermal conductivities of all materials were comparable and similar to that of leather.

Conclusions
Polyurethane liners are softer and less sticky than 16 years ago, and TPE liners have higher tensile stiffness than previously. A stiff fabric backing can increase tensile stiffness by more than 200%. Compressive stiffness may be used to characterize a liner’s ability to flow. Elastomeric liners move heat almost exclusively via conduction.
Can infected pancreatic necrosis really be managed conservatively?
Authors: Al-Sarireh Bilal , Mowbray Nicholas G. , Al-Sarira Ali , Griffith David , Brown Timothy H. , Wells Toby 
Published: August 2018

Objectives
Guidelines advocate minimally invasive drainage rather than open surgery for infected pancreatic necrosis (IPN) after acute pancreatitis. We hypothesized that the conservative approach could be extended even further by treating patients using an antibiotics-only protocol.

Patients and methods
Between June 2009 and July 2017, patients with IPN were selectively managed with carbapenem antibiotics for a minimum of 6 weeks. We compared these patients with patients who underwent minimal access retroperitoneal pancreatic necrosectomy (MARPN) for IPN to identify characteristics of this patient group.

Results
Of 33 patients with radiologically proven IPN, 13 patients received antibiotics without any surgical or radiological intervention and resulted in no disease-specific mortality and one case of pancreatic insufficiency. In comparison, 44 patients underwent MARPN with a mortality of 20%, and 81.8% developed pancreatic insufficiency. The modified Glasgow score and computed tomography severity score was less in the antibiotic-only group (P<0.001 and P=0.014, respectively). Patients who underwent MARPN had lower serum haemoglobin and albumin levels (P=0.030 and 0.001, respectively), and a higher C-reactive protein (P=0.027).

Conclusion
Conservative treatment of IPN with antibiotics is a valid management option for haemodynamically stable patients experiencing less severe disease, requiring careful selection by experienced clinicians.
High frequency of secondary, but not primary ocular manifestations of inflammatory bowel disease in patients treated at a tertiary care center
Authors: Walldorf Jens , Twarz Maria , Schober Celestina , Michl Patrick , Hammer Thomas 
Published: August 2018

Objective
Ocular manifestations of inflammatory bowel disease (IBD) are relevant complications of IBD. Only a few prospective studies are available on the characteristics of these manifestations. The aim of this study was to characterize the frequency of eye disease in patients with IBD, including primary and secondary ocular manifestations of IBD, and to identify patients who may need specialized ophthalmologic care.

Patients and methods
In a prospective observational study, patients with IBD were examined for ocular symptoms in comparison with control participants without IBD. All patients with IBD underwent a thorough ophthalmologic examination (including slit-lamp, tonometry, tear breakup time, Schirmer’s test, and coherence tomography). The results were analyzed with respect to sociodemographic and disease-related characteristics.

Results
A total of 61 patients (33 women, 39 Crohn’s disease, 22 ulcerative colitis, age 43.3±12.9 years, disease duration 12.4±9.3 years) were included. Ophthalmologic symptoms were reported by 53 patients (86.9%, most frequently deterioration of vision 42.6%, foreign body sensation 36.1%) compared with 60.6% in healthy controls (P=0.001). A clinically relevant, previously undetected ophthalmologic diagnosis was identified in 56 patients (91.8% – dry eye syndrome 75.4%, cataract 67.2%, blepharitis 45.9%, fundus hypertonicus 14.8%, other 16.4%).

Conclusion
Although primary ocular manifestations of IBD are rare in intensively treated patients, the high frequency of unrecognized secondary manifestations should give reason to refer especially patients with longstanding or complicated IBD to an eye specialist – irrespective of ocular symptoms.
Surfactants Improve Live Cell Imaging of Human Pancreatic Islets
Authors: Komatsu Hirotake , Omori Keiko , Kandeel Fouad , Mullen Yoko 
Published: August 2018

Objectives
Newport Green is a zinc-specific fluorescent dye developed to monitor cellular zinc transport. In pancreatic islets with zinc-rich β-cells, Newport Green is expected to be useful as an islet-specific indicator for live imaging. However, the low penetration of Newport Green into islets hinders clear detection. The aim of this study was to develop a practical method of live islet imaging by using surfactants to enhance the penetration efficiency.

Methods
Surfactants (F127, Tween 20, and Triton X-100) were co-incubated with Newport Green for fluorescent imaging of live isolated human islet and nonislet tissues. Toxicity, enhancement of Newport Green fluorescence, and effects on specificity to islets were examined.

Results
Newport Green fluorescent intensity was increased after co-incubation with all surfactants tested (0.2–3.2 mM); however, surfactants were toxic to islets at high concentrations. Within the nontoxic range, high specificity to islets was observed when co-incubated with Tween 20 at 0.2–0.4 mM, compared with F127 and Triton X-100. This optimized range successfully distinguished islets from nonislet tissues using statistically calculated cutoff value of Newport Green fluorescent intensity.

Conclusions
Surfactants, particularly Tween 20 in the optimized range, effectively and selectively enhanced Newport Green fluorescence in live islets without increasing islet toxicity.