bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors That Influence Mandatory Child Abuse Reporting Attitudes of Pediatric Nurses in Korea
Authors: Lee In Sook , Kim Kyoung Ja 
Published: February 2018

ABSTRACT

Purpose:
This study aimed to identify knowledge of child abuse, awareness of child abuse reporting, factors that influence attitudes toward mandatory reporting, and professionalism among a sample of pediatric nurses in Korea.

Methods:
One hundred sixteen pediatric nurses working at two university hospitals in Korea took part in the study and completed self-administered questionnaires. The data were analyzed using descriptive statistics, t tests, analysis of variance, Pearson correlation coefficients, and hierarchical regression analysis.

Results:
Knowledge of child abuse, awareness of child abuse reporting, and attitudes toward mandatory reporting were low. Regarding nursing professionalism, social perceptions had the lowest mean score and nursing autonomy had the highest mean score. Attitudes toward mandatory reporting significantly correlated with professionalism. In the hierarchical regression model, the influences of nursing autonomy and intentions to report child abuse on attitudes toward mandatory reporting were statistically significant (F = 2.176, p = .013), explaining 32% of the variation in attitudes toward mandatory reporting.

Conclusion:
The results of this study could be used to improve systems and policies addressing child abuse and to further develop reporting procedures for identifying children at risk of abuse, to ensure their protection as a professional responsibility.
Nasal Bridling of Nasoenteric Feeding Tubes
Authors: Kang Kristin A. , Elger Breanna M. , Medina Melissa G. , DiSomma Nerina M. , Esparaz Joseph R. , Aprahamian Charles J. , Pearl Richard H. 
Published: February 2018

Introduction
A trend of dislodged nasogastric tubes was noted in children at a high risk for loss of enteral feeding access. There is known morbidity associated with early nasogastric tube dislodgement. Despite nursing and family education regarding the importance of these surgically placed tubes, the optimal method of securing nasogastric tubes is undetermined.

Methods
A nasal bridling program was implemented from February 2015 to February 2017 for pediatric surgical patients less than 1 year old requiring nasoenteric feeding tubes. The pediatric surgical service oversaw education and implementation of the program. Retrospective data collection was performed. Variables included weight and age at the time of tube placement, indications, method of placement, bridle duration, associated complications, unintended dislodgement, and diagnosis outcomes.

Results
Fourteen bridle systems were placed in 12 children with diagnoses including tracheoesophageal fistula, congenital diaphragmatic hernia, congenital heart disease with poor oral skills/feeding, and duodenal atresia and stenosis for 444 patient days. The average duration of bridling was 31.7 days per patient. Of the 14 bridles placed, only one unintended tube removal occurred.

Discussion
Bridling of nasoenteric feeding tubes is a safe and effective method for preventing unintended tube dislodgement, leading to improved patient care in the pediatric surgical population less than 1 year old. On the basis of our institution's results, ongoing continuing education for use and care of nasoenteric feeding tubes is recommended for the pediatric surgical population.
Use of Pocket-Sized Ultrasound Device in the Diagnosis of Shoulder Pathology
Authors: Lau Brian C. , Motamedi Daria , Luke Anthony 
Published: February 2018

Objective:
Musculoskeletal ultrasound imaging is increasingly being used for static and dynamic imaging of tendons, muscles, ligaments, and bones. New, hand-held, pocket-sized ultrasounds are more portable and affordable. The purpose of this study was to evaluate the feasibility of pocket-sized ultrasound to diagnose shoulder pathology.

Design:
Prospective cohort study.

Setting:
Tertiary Care Hospital.

Methods:
Ten consecutive patients (mean age 54; range 42-68 years) referred for a shoulder ultrasound for evaluation of shoulder pain were recruited. A diagnostic ultrasound was performed first with a pocket-sized ultrasound machine (VScan; General Electric, Northville, MI) and cine images saved for later review. Next, standard diagnostic ultrasound by a radiology technician specialized in musculoskeletal ultrasound was performed using (LOGIQ; General Electric, Northville, MI) ultrasound. The radiology report from the standard diagnostic ultrasound was used as the gold standard for diagnoses. Two independent evaluators, a musculoskeletal-trained radiologist and a sports-medicine–trained physician with over 8 years of experience with musculoskeletal ultrasound, reviewed the images from the pocket-sized ultrasound.

Results:
Nine of the studies were diagnosed with a pathologic entity during the standard diagnostic ultrasound and 1 was found to be normal. Diagnoses ranged from biceps tendinopathy, calcific tendonitis, and partial-articular–sided rotator cuff tear. Evaluator 1 correctly identified 7/10 diagnoses and evaluator 2 correctly identified 8/10 diagnoses. The evaluators also rated their confidence in diagnosis as 4.2/5 and the image quality as 3.7/4 from the pocket-sized ultrasound.

Discussion:
The findings from this study demonstrate that pocket-sized, hand-held ultrasound machines may be used to identify shoulder pathology.
A Behavioral Physical Activity Intervention to Manage Moderate and Severe Fatigue Among Head and Neck Cancer Patients—Pre-efficacy Study in the National Institutes of Health ORBIT Model
Authors: Wang Hsiao-Lan , McMillan Susan C. , Vijayakumar Nisha , McDonald Sally , Huang Li-Ting , Gwede Clement , Padhya Tapan , Russell Jeffery , Vondruska Karen , Buck Harleah G. , Huang Yangxin , Visovsky Connie 
Published: February 2018

Background
Cancer-related fatigue (CRF) reduces head and neck cancer (HNC) survival rates and is the most common, severe, and distressing symptom negatively impacting activities of daily living (ADLs) dependence among HNC patients. These patients remain physically inactive after their cancer treatment, although there is consensus that physical activity mitigates CRF in cancer patients.

Objective
A home-based personalized behavioral
p
hysical
a
ctivity intervention with
fit
ness graded
m
otion
e
xergames (PAfitME) was evaluated for its intervention components, intervention delivery mode, and intervention contact time/duration with initial assessment of the feasibility, acceptability, safety, and outcomes.

Methods
This study (N = 8) was a single-group, pre-post design to evaluate a 6-week PAfitME at the end of HNC treatment. Health outcomes were CRF, ADL dependence, and fitness performance. Behavioral outcomes were exergame adherence.

Results
Positive health and behavioral outcomes support the PAfitME protocol including intervention components, intervention delivery mode, and intervention contact times/duration. The PAfitME intervention is feasible and acceptable with promising adherence rates. No adverse events were reported. There was marked improvement in CRF, ADL dependence, cardiorespiratory fitness, balance, muscle strength, and shoulder forward flexion, with large to moderate effect sizes as a result of the PAfitME intervention.

Conclusion
The PAfitME protocol is ready for additional testing in a randomized clinical trial.

Implications for Practice
The PAfitME intervention is a nurse-led nonpharmacological intervention. It can be integrated into home care or telehealth care for HNC patients at the end of their cancer treatment once effectiveness is established.
Metabolic Syndrome Among Asian Indians in the United States
Authors: Savadatti Sanghamitra S. , Bell Erin M. , Gates Margaret A. , Hosler Akiko S. , Yucel Recai M. , Misra Ranjita 
Published: February 2018

Introduction:
Metabolic syndrome (MetS), a clustering of cardiometabolic risk factors of type 2 diabetes and cardiovascular disease, disproportionately affects Asian Indians (AIs). We examined prevalence of MetS using 3 ethnicity-specific MetS criteria among immigrant AIs in the United States. We also examined associations between MetS and health promotion behaviors.

Objective:
To present MetS prevalence estimates by the 3 ethnicity-specific criteria and investigate differences in health promotion behaviors among AIs with and without MetS to highlight the critical need for lifestyle modification strategies for this population.

Design:
We analyzed data from a national cross-sectional study of 1037 AIs in the United States (2004-2006). We used the consensus criteria, International Diabetes Federation criteria, and modified criteria to estimate MetS prevalence. The Health Promotion Lifestyle Profile II scale measured health promotion behaviors. Bioclinical data (fasting blood glucose, triglyceride levels) were collected. Directed acyclic graphs and Likelihood Ratio Test assisted with model selection. Multiple imputation inference incorporated uncertainty due to missing data and made use of all available data. Adjusted multivariable logistic regression analysis tested for associations.

Results:
Out of all participants, 40.3% met the consensus criteria, 34.8% met the International Diabetes Federation criteria, and 52.5% met the modified criteria. We found no statistically significant associations between engagement in health promotion measures and the prevalence of MetS and its criteria.

Conclusion:
Our study confirmed the high prevalence of MetS in the immigrant AI population in the United States. Our results showed that AIs with MetS did not exhibit an increased level of engagement in health promotion behaviors. We recommend continued refining of criteria for diagnosis and culturally suitable, age-appropriate strategies to increase engagement in healthier lifestyles among this high-risk population.
Hemodynamic Assessment with SPY-Indocyanine Green Angiography in Expansion Period: A Study for Expansion Capsule Pressure Optimization
Authors: Guo Jihan , Gao Yashan , Li Haizhou , Wang Zhichao , Zan Tao , Li Qingfeng 
Published: February 2018

Abstract
Tissue expansion-related severe complication exists, and the poor blood supply is one of the causes. After decades of negative correlation between capsule pressure and blood flow was verified, the widely recognized expansion capsule pressure is still absent. A prospective randomized controlled trial was performed to explore the optimal expanding capsule pressure. Thirty subjects were randomly divided into 5 groups, received a weekly expanding on 60-, 70-, 80-, 90-, and 100-mm Hg capsule pressure, respectively. All patients achieved 8-week follow-up; hemodynamic assessment by SPY-indocyanine green (ICG) angiography was taken every 2 weeks. Standardized indexes from SPY-ICG angiography were used to assess the blood supply, in which the ratio of ingress rate and the ingress rate of normal skin (IR/NIR) reflects the arterial perfusion level, and the ratio of Engress Rate and IR (ER/IR) indicates the venous reflux level. The expansion-related adverse events during the trial were recorded. The IR/NIR and the ER/IR are both obviously negatively correlated to the capsule pressure of tissue expander (P ≤ 0.05, the ER/IR's correlation coefficient = −0.453; the IR/NIR's correlation coefficient = −0.482). The post-expansion IR/NIR increased significantly after 8 weeks of expansion (P ≤ 0.05) in 90-mm Hg group. And the post-expansion ER/IR was significantly elevated (P ≤ 0.05) in 80 and 90-mmHg groups. There were 2 expansion-related complications reported in 100-mm Hg group, whereas no complication occurred in 4 other lower groups. SPY-ICG angiography is an objective measurement for tissue expansion hemodynamic monitoring. The expanding capsule pressure of 80 to 90 mm Hg is a reasonable upper limit.
Parotid Mucoepidermoid Carcinoma Mimicking a Large Mucocele
Authors: Ata Nurdoğan , Ünverdi Hatice 
Published: February 2018

Abstract
Mucoepidermoid carcinoma is a malign tumor involving the parotid gland and minor salivary glands. Parotid pure cystic mucoepidermoid carcinoma can also masquerade mucocele, and hence, histopathological examination is crucial to distinguish the 2. Herein, the authors report a patient of mucoepidermoid carcinoma presenting as an asymptomatic mucocele-like cystic parotid mass. A 69-year-old female presented with cystic parotid mass; her examination findings and diagnostic imaging were consistent with that of mucocele. Histological examination revealed mucoepidermoid carcinoma. This case indicates that parotid mucocele-like cysts should be included in the differential diagnosis of malign salivary gland tumors.
Total Lower Lip Reconstruction With Functional Gracilis Free Muscle Flap
Authors: Cakmak Mehmet Akif , Cinal Hakan , Barin Ensar Zafer , Sakat Muhammed Sedat , Karaduman Harun , Tan Onder 
Published: February 2018

Abstract
Free flaps based on static slings principles cannot provide esthetic and functional outcomes at a desired level in total or close to total lip loss. Therefore, dynamic methods have become a current issue in recent years and especially the idea of functional gracilis free muscle flap has been suggested. In this study, we present a case of a successful total lower lip repair with this flap.
In a 78-year-old female patient who was diagnosed with squamous cell carcinoma involving the entire lower lip, bilateral modified radical neck dissection and full-thickness total resection with 1 cm surgical margin so as to include both commissures of the tumor were performed and then a free gracilis muscle flap was transferred from the same side. After microvascular anastomoses, the motor nerve of the flap was coapted to the marginal mandibular branch of the fascial nerve. The entire intra- and extraoral surfaces of the flap were covered with a partial-thickness skin graft which was taken from the right thigh. There was no any intra- or early postoperative complication. The skin graft and flap survived without any problem.
In the controls of the patient who was followed-up for 8 postoperative months, it was observed that the gracilis muscle flap was well-adapted to its place, gained a very good tonus, its volume reduced over time and reached to ideal dimensions, and the overlying skin graft provided a good color and texture match with the surrounding tissues. The motor activity of the muscle was monitored with the Tinel's test. The speech and facial expressions of the patient were very clear. Despite the patient has an edentulous mandible and was not using prosthesis, her feeding with fluid and solid foods was free of problems, oral competence was highly sufficient, and there was no any drooling. Esthetic appearance was very good and intraoral vestibular depth was sufficient. The mouth opening was 3 cm. When comparing with upper orbicularis oculi muscle on the electroneuromyography (ENMG) ordered at the 8th month, a similar nerve conduction time (3.3 versus 3.8 ms) and contraction amplitude (0.5 versus 0.4 mV) values were obtained from the gracilis muscle. Follow-up of the patient is still continued with no tumor recurrence observed during this period.
Being the real dynamic flap and its tonus of the functional gracillis free muscle flap in opposite to the static methods provides a significant superiority over the other options in terms of oral functions; moreover, the overlying skin graft presents a very good color and texture harmony aesthetically. This method is a candidate to be an exclusive surgical technique in the repair of total or close to total lip losses in the future.
Crushed Cartilage: A Rescue Procedure in Rhinoplasty
Authors: Boccieri Armando , Marianetti Tito M. , Pascali Michele 
Published: February 2018

Abstract
While the use of crushed cartilage is now universally recognized as a valid procedure in rhinoplasty to mask irregularities and eliminate slight deficits, there is still no consensus as to the optimal degree of crushing and the rate of graft resorption over time. With a view to casting light on these 2 important aspects and providing some guidelines, the authors present a study of 123 patients subjected to grafts of cartilage with different degrees of crushing in the different areas of the nasal pyramid: upper third (45 patients), middle third (40), and lower third (38). The degree of crushing was medium for 95 patients and high for 28 who presented thinner and less elastic skin. Comparison of the performance over time of the cartilage grafts inserted in the same areas but with different degrees of crushing provides important indications as regard the best way of preparing the material. The results proved satisfactory with improvements for all of the 95 patients subjected to grafts of moderately crushed cartilage. The initial defect was instead still present, albeit with some partial improvement, at a distance of 12 months in 17 of the 28 patients where highly crushed cartilage was used. The study suggests that a moderate degree of crushing offers better results as regard flexibility and stability over time.
Distinct encoding of decision confidence in human medial prefrontal cortex
Authors: Bang Dan , Fleming Stephen M. 
Published: February 2018

AbstractOur confidence in a choice and the evidence pertaining to a choice appear to be inseparable. An emerging computational consensus is, however, that the brain should maintain separate estimates of these quantities for adaptive behavioural control. Here we devised a psychophysical task to decouple confidence in a perceptual decision from both the reliability of sensory evidence and the relation of such evidence with respect to a choice boundary. Using human fMRI, we found that an area in medial prefrontal cortex (perigenual anterior cingulate cortex, pgACC) tracked expected performance, an aggregate signature of decision confidence, whereas neural areas previously proposed to encode decision confidence instead tracked sensory reliability (posterior parietal cortex and ventral striatum) or boundary distance (pre-supplementary motor area). Supporting that information encoded by pgACC is central to a subjective sense of decision confidence, we show that pgACC activity does not simply co-vary with expected performance but is also linked to within-subject and between-subject variation in explicit confidence estimates. Our study is consistent with the proposal that the brain maintains choice-dependent and choice-independent estimates of certainty, and sheds light on why dysfunctional confidence often emerges following prefrontal lesions and/or degeneration.Significance StatementRecent computational models propose that our sense of confidence in a choice reflects an estimate of the probability that the choice is correct. However, it has proven difficult to experimentally separate decision confidence from its component parts, such as our certainty about perceptual evidence or choice requirements. Here we devised a task to dissociate these quantities and isolate a distinct encoding of decision confidence in the medial prefrontal cortex of the human brain. We show that activity in this area not only tracks expected performance on a task but is also related to both within-subject and between-subject variation in a subjective sense of confidence. Our study illuminates why dysfunctional confidence often emerges following damage to prefrontal cortex.
From the cage to the wild: Introductions of Psittaciformes to Puerto Rico with emphasis on the invasive ecology of the white-winged parakeet
Authors: Falcón L. Wilfredo , Tremblay Raymond L. 
Published: February 2018

AbstractIn this study, we assessed invasions of Psittaciformes in Puerto Rico. We reviewed the literature, public databases, citizen science records, and performed in situ population surveys across the island to determine the historical and current status and distribution of psittacine species. We used count data fromEbirdto determine population trends. For species whose populations were increasing, we modelled their potential distribution using niche modeling techniques. Focusing on the white-winged parakeet(Brotogeris versicolurus), which was considered the most successful psittacine species by the year 2000, we evaluated the population size, calculated growth rates and estimated the breeding proportion in two populations by performing roost counts for four consecutive years. We found a total of 46 Psittaciformes present in Puerto Rico, of which 26% are only present as pets, at least 29 species have been reported in the wild, and of those, there is evidence that at least 12 species are breeding. Our results indicate that most introduced species which have been detected as established still persist, although mostly in localized areas and small populations. Clear evidence of invasiveness was found forB. versicolurusandMyiopsitta monachus, which have greatly expanded their range. Moreover,Psittacara erythrogenysandEupsittacula canicularisalso showed population increase. The niche models predicted suitable areas for the four species, and also indicate the potential for range expansion. Population estimates of the white-winged parakeet during the study period showed a steady increase, and exhibited exponential growth, with geometric mean population growth rates of 1.25 per year. Currently growth rate of the white-winged parakeet does not appear to be limited by any predator, resources or nest availability, and we expect them to continue increasing and expanding their range. We discuss the factors leading to invasion success, assess the potential impacts, and we discuss possible management strategies and research prospects.
An Augmented Aging Process in Brain White Matter in HIV
Authors: Kuhn T. , Kaufmann T. , Doan N.T. , Westlye L.T. , Jones J. , Nunez R.A. , Bookheimer S.Y. , Singer E.J. , Hinkin C.H. , Thames A.D. 
Published: February 2018

AbstractObjectiveHIV infection and aging are both associated with neurodegeneration. However, whether the aging process alone or other factors associated with advanced age account for the progression of neurodegeneration in the aging HIV-positive (HIV+) population remains unclear.MethodsHIV+ (n=70) and HIV-negative (HIV-, n=34) participants underwent diffusion tensor imaging (DTI) and metrics of microstructural properties were extracted from regions of interest (ROIs). A support vector regression model was trained on two independent datasets of healthy adults across the adult life-span (n=765, Cam-CAN = 588; UiO = 177) to predict participant age from DTI metrics, and applied to the HIV dataset. Predicted brain age gap (BAG) was computed as the difference between predicted age and chronological age, and statistically compared between HIV groups. Regressions assessed the relationship between BAG and HIV severity/medical comorbidities. Finally, correlation analyses tested for associations between BAG and cognitive performance.ResultsBAG was significantly higher in the HIV+ group than the HIV-groupF(1, 103) = 12.408, p = 0.001). HIV RNA viral load was significantly associated with BAG, particularly in older HIV+ individuals (R2= 0.29, F(7, 70) = 2.66, p = 0.021). Further, BAG was negatively correlated with domain-level cognitive function (learning: r = −0.26, p = 0.008; memory: r = −0.21, p = 0.034).ConclusionsHIV infection is associated with augmented white matter aging, and greater brain aging is associated with worse cognitive performance in multiple domains.