bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity and reliability of sleep promotion questionnaire and predictors of quality of care
Authors: Kim Son Chae , Pedersen Chase , Yi Cassia 
Published: August 2018

Background: Sleep disturbance is common among hospitalized patients. However, sleep promotion is not a high priority for most healthcare providers, which potentially impacts quality of care. Due to a paucity of validated tools to assess sleep promotion, little is known about the relationship between sleep promotion and quality of care. This study was conducted to assess the validity and reliability of a newly-developed instrument, the Sleep Promotion Questionnaire, and to examine sleep promotion as a predictor of quality of care. The Sleep Promotion Questionnaire includes dimensions of attitude, control, unit norms, intention, and behavior that are associated with sleep promotion. Methods: A total of 302 nurses participated in an online survey. The survey included the initial 36-item Sleep Promotion Questionnaire, a quality of care question, Caring Behavior Inventory, and Professional Quality of Life scale. An exploratory factor analysis was performed to determine the factor structure of the Sleep Promotion Questionnaire. The internal consistency reliability as well as the convergent and divergent validities was assessed. Pearson’s correlations and hierarchical multiple regression procedures were performed to explore the predictors of perceived quality of care. Results: Exploratory factor analysis of the Sleep Promotion Questionnaire yielded 28 items in five subscales, comprising Attitude, Control, Unit Norms, Sleep-aid Intention, and Behavior. Convergent and divergent validities were supported ( r = 0.37; r = −0.38, respectively). The Cronbach’s alphas of internal consistency reliabilities of the Sleep Promotion Questionnaire subscales ranged from 0.70 to 0.89. Regression models showed that sleep-promoting Unit Norms was the only significant predictor of perceived quality of care among both ICU and non-ICU nurses ( β = 0.40; β = 0.28, respectively). Conclusion: The Sleep Promotion Questionnaire appears to be a reliable and valid instrument with satisfactory psychometric properties for assessing sleep promotion, and it seems that having unit norms conducive to sleep promotion may positively impact the quality of care. However, further studies are needed to confirm these results.
Treatment with proton pump inhibitors increases the risk for development of hepatic encephalopathy after implantation of transjugular intrahepatic portosystemic shunt (TIPS)
Authors: Sturm Lukas , Bettinger Dominik , Giesler Max , Boettler Tobias , Schmidt Arthur , Buettner Nico , Thimme Robert , Schultheiss Michael 
Published: August 2018

Background and objectiveTreatment with proton pump inhibitors (PPIs) has been associated with development of hepatic encephalopathy (HE). As development of HE is a major complication after implantation of a transjugular intrahepatic portosystemic shunt (TIPS), we hypothesized that PPI treatment may be associated with a higher risk of post‐TIPS HE.MethodsWe analyzed data of 397 patients with liver cirrhosis who received de novo TIPS implantation at the University Medical Center Freiburg, Germany. We assessed whether PPI medication and other patient characteristics are predictive factors for the development of post‐TIPS HE.ResultsPatients with PPI treatment at the time of TIPS implantation showed significantly higher rates of post‐TIPS HE than those without PPI medication (30.4% vs 11.7%, p < 0.001). The rate of post‐TIPS HE increased in a dose‐dependent manner. However, PPI medication did not directly affect transplant‐free survival. Remarkably, in 59.1% of patients who received PPIs there was no clear indication.ConclusionsPPI treatment may be an independent risk factor for the development of post‐TIPS HE and the risk increases with PPI dose. Indication for PPI treatment should be assessed carefully prior to TIPS implantation in patients with liver cirrhosis.
Esophageal shortening after rapid drink test during esophageal high‐resolution manometry: A relevant finding?
Authors: Biasutto Dario , Roman Sabine , Garros Aurelien , Mion Francois 
Published: August 2018

BackgroundEsophageal shortening (ES) might be observed during high‐resolution manometry (HRM), in particular after the rapid drink test (RDT). We aimed to assess its diagnostic value in patients referred for HRM.MethodsHRM of patients without previous esophagogastric surgery or endoscopic treatment was retrospectively reviewed using the Chicago Classification v3.0. ES and pan‐esophageal pressurization were analyzed during the RDT (200‐ml free drinking in a sitting position).ResultsA total of 2141 cases (1291 females, mean age 54 years) were reviewed. During the RDT, ES occurred in 4% and pan‐esophageal pressurization in 14% of patients. ES was almost exclusively encountered in patients with impaired esophagogastric junction relaxation or major disorders of peristalsis. Among 31 patients with ES and no definite diagnosis of achalasia, 19 had follow‐up and 13 (68%) changed diagnostic category: two adenocarcinoma of the cardia, and 11 cases of atypical achalasia. The positive predictive value of ES for a significant esophageal disorder was 95%.ConclusionES is rarely observed during the RDT. When present, it is associated with major motility disorders, especially achalasia. When the diagnostic criteria for achalasia are not fulfilled, further complementary examinations should be performed to rule out incomplete forms of achalasia or an infiltrative process of the cardia.
Using the main elbow flexion skin crease as an intraoperative parameter to determine the degree of exorotation needed for humeral derotational osteotomies in upper-type brachial plexus patients
Authors: Ivalde Flavio César , Miguens Gustavo Nizzo , Socolovsky Mariano 
Published: August 2018

Even though one of the surgical techniques most frequently used to correct external rotation deformity of the shoulder in brachial plexus patients is a humeral derotational osteotomy, few intraoperative parameters has yet been identified to determine the appropriate degree of rotation. We present in this technical note our initial experience using the main elbow flexion skin crease to quantify the correct rotation of the humerus in four young, male patients with upper-type brachial plexus injuries. All patients had a functional elbow and a stable shoulder, but also an external rotation deficit. Via a deltopectoral approach, we used the main elbow flexion crease as an intraoperative surgical parameter to determine the degree of external rotation of the humerus required to achieve a better positioning of the hand in space. After surgery, increased elbow flexion range and enhanced hand-to-face movement was observed, while internal rotation was preserved for performing midline activities. Moreover, all patients exhibited increased active elbow flexion and osteotomy consolidation, with mean elbow flexion increasing from 66.3° to 97.5° pre to postoperatively, and a mean 56.3° of internal rotation correction ultimately achieved. We propose that the main elbow flexion crease is a useful intraoperative parameter to determine the degree of intraoperative external rotation necessary to restore the plane of hand–face movements in upper-type palsies. Level of evidence: IV; case series.
Vibration therapy versus standard treatment for tennis elbow: A randomized controlled study
Authors: Furness Nicholas Duncan , Phillips Alistair , Gallacher Sian , Beazley James Charles Sherard , Evans Jonathan Peter , Toms Andrew David , Thomas William , Smith Christopher David 
Published: August 2018

Aim: To determine whether a mechanical, high-frequency vibration device (Tenease™) can improve pain and function for the treatment of tennis elbow (TE), compared with standard treatment. Methods: Adults presenting to an elbow clinic with a clinical diagnosis of TE were randomized to standard treatment with physiotherapy, activity modification and analgesia or standard treatment plus Tenease therapy. Tenease therapy consisted of a 6-week period of treatment using the Tenease device with three 10-min episodes each day. The primary outcome measure was the quick Disabilities of the Arm, Shoulder and Hand score at 6 months, with scores also taken at 6 weeks. Secondary outcome measures were the Patient Rated Tennis Elbow Evaluation Score and EuroQol 5-Dimension Visual Analogue Scale at the same time points. Results: Fifty-four patients were recruited into the study. Following randomization and initial dropout, 18 patients were included in the standard group and 27 in the Tenease group. Both groups reported improvements in primary outcome measure scores. The control group had a mean score of 44.3 (standard deviation (SD) = 18.8) at baseline, which dropped to 31.2 (SD = 17.2) at 6 months ( p = 0.002). The Tenease group had a mean score of 43.2 (SD = 22.7) at baseline, which dropped to 23.4 (SD = 15.0) at 6 months ( p = 0.064). Similar improvements were seen in secondary outcome measures with none reaching statistical significance. There were no statistically significant differences seen between the primary outcome scores at 6 weeks ( p = 0.9) or 6 months ( p = 0.5). No complications were noted in either group. Conclusions: Vibration therapy did not result in any statistically significant improvement in functional outcome scores compared to standard treatment for TE. It is important to note that this was a relatively small cohort and a high dropout rate was observed.
Characteristics of Operative Shoulder Injuries in the National Collegiate Athletic Association, 2009-2010 Through 2013-2014
Authors: Gil Joseph A. , Goodman Avi D. , DeFroda Steven F. , Owens Brett D. 
Published: August 2018

Background: Injuries to the upper extremity among collegiate athletes are reported to account for approximately 20% of all injuries; however, little is known about the proportion of these injuries that require surgery. Purpose/Hypothesis: The purpose of this study was to examine all shoulder injuries that required a surgical intervention and were recorded in the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). We hypothesized that contact would be the mechanism causing injuries most at risk for needing surgery and that dislocations would be the injuries most likely to require an operative intervention. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Injury surveillance data between 2009-2010 and 2013-2014 for operative collegiate shoulder injuries and their associated sport exposures were analyzed. Results: A total of 185 operative shoulder injuries occurred over 3,739,004 athlete-exposures (AEs), for an overall incidence of 0.49 per 10,000 AEs. The sports with the highest incidence of operative injuries were men’s football (1.31/10,000 AEs), men’s wrestling (1.14/10,000 AEs), men’s ice hockey (0.60/10,000 AEs), women’s gymnastics (0.44/10,000 AEs), and men’s swimming (0.41/10,000 AEs). Men were significantly more likely than women to sustain operative injuries for all sports combined. Of the injuries that required surgical treatment, superior labrum from anterior to posterior (SLAP) tears (46.4%), other non-SLAP glenoid labrum tears (46.2%), anterior shoulder dislocations (33.3%), and posterior shoulder dislocations (30.0%) were seen most often. There was no significant difference in injury proportion ratios (IPRs) for injuries requiring surgery when comparing contact versus noncontact mechanisms of injury (IPR, 1.0 [95% CI, 0.6-1.6]). The incidence of operative injuries sustained during competition was significantly higher compared with during practice. Conclusion: The sports with the highest incidence of operative shoulder injuries were men’s football, men’s wrestling, men’s ice hockey, and women’s gymnastics. Operative shoulder injuries were more likely to occur during competition. SLAP tears, other non-SLAP glenoid labrum tears, and anterior shoulder dislocations had the highest incidence of requiring surgery. Athletes sustaining these injuries, along with their coaches and medical providers, may benefit from identifying collegiate sport participants who are at highest risk for sustaining an operative injury. This may assist in planning medical care and setting expectations, which may be critical to a young athlete’s career.
Financial capability and functional financial literacy in young adults with developmental language disorder
Authors: Winstanley Maxine , Durkin Kevin , Webb Roger T , Conti-Ramsden Gina 
Published: August 2018

Background Financial capability is an essential feature of the organisation of one’s personal life and engagement with society. Very little is known of how adequately individuals with developmental language disorder handle financial matters. It is known that language difficulties place them at a disadvantage in many aspects of their development and during their transition into adulthood, leading to the possibility that financial issues may prove burdensome for them. This study examines the financial capability and functional financial literacy of young adults with developmental language disorder and compares them to those of age matched peers. We tested the expectation that those with developmental language disorder would find financial management more challenging than would their peers, and that they would need to seek greater support from family members or other people. Methods Participants completed a detailed individual interview, which included items drawn from the British Household Panel Survey and additional measures of financial capability, functional financial literacy and of perceived support. Nonverbal IQ, language, reading and numeracy measures were also collected. Results Compared to typically developing age matched peers, young people with developmental language disorder report less extensive engagement with financial products and lower competence in functional financial literacy. A considerably higher proportion of those with developmental language disorder (48% vs. 16% of age matched peers) report that they draw on support, primarily from parents, in various financial tasks, including paying bills, choosing financial products, and taking loans from family or friends. Conclusions This is the first study to consider the financial capability skills and functional financial literacy of young adults with developmental language disorder. We provide novel evidence that some young adults with developmental language disorder lack functional financial skills and require support to successfully manage their finances. This has policy implications that relate not only to engaging affected individuals in discussions about financial management but also to wider familial support.
The inter‐ and intra‐rater reliability of the Maestro and Barroco metatarsal length measurement techniques
Authors: Ali Zainab , Karim Hassan , Wali Navid , Naraghi Reza 
Published: August 2018

AbstractBackgroundThe relationship between metatarsal length and various forefoot pathologies is a topic of contention in Orthopaedics. The results of such investigations have been shown to depend on the method of metatarsal length measurement used. The aim of this study was to assess the inter‐ and intra‐rater reliability of the Maestro and Barroco metatarsal length measurement techniques.MethodsA retrospective and quantitative study was performed on 15 randomly selected radiographs to determine the reliability of the two measurement techniques across all five metatarsals (M1 to M5). This was done at one week apart for three weeks by three raters. The intraclass correlation coefficient (ICC), and the 95% lower confidence limit (95% LCL) were calculated.ResultsThe Maestro and Barroco techniques produced high to very high ICC vlaues for length measurements across all metatarsals. The 95% lower confidence limit for inter‐rater measurements ranged between 0.92–0.98 for Maestro's and 0.86–0.99 for Barroco's technique. For intra‐rater measurements the 95% LCL ranged between 0.83–0.99 for Maestro's and 0.75–0.99 for Barroco's technique.ConclusionsOur study found that both the Maestro and Barroco methods of measurements produced high to very high inter‐ and intra‐rater reliability. Both methods may be suitable for the use of peri‐operative planning and clinical research relating metatarsal length and forefoot pathology. Besides having a more simplistic method of application, the novel Barroco technique is comparable to the more established Maestro method in both repeatability and reproducibility.
What is the available evidence for the application of genome editing as a new tool for plant trait modification and the potential occurrence of associated off-target effects: a systematic map protocol
Authors: Modrzejewski Dominik , Hartung Frank , Sprink Thorben , Krause Dörthe , Kohl Christian , Schiemann Joachim , Wilhelm Ralf 
Published: August 2018

Abstract
Background
Plant breeding is a developing process and breeding methods have continuously evolved over time. In recent years, genome editing techniques such as clustered regularly interspaced short palindromic repeats/CRISPR associated proteins (CRISPR/Cas), transcription activator-like effector nucleases (TALENs), zinc-finger nucleases (ZFN), meganucleases (MN) and oligonucleotide-directed mutagenesis (ODM) enabled a precise modification of DNA sequences in plants. Genome editing has already been applied in a wide range of plant species due to its simplicity, time saving and cost-effective application compared to earlier breeding techniques including classical mutagenesis. Although genome editing techniques induce much less unintended modifications in the genome (off-target effects) compared to classical mutagenesis techniques, off-target effects are a prominent point of criticism as they might cause genomic instability, cytotoxicity and cell death.

Methods
The aim of this systematic map is to address the following primary question: “What is the available evidence for the application of genome editing as a new tool for plant trait modification and the potential occurrence of associated off-target effects”? The primary question will be considered by two secondary questions: One is aimed at the traits being modified by genome editing in plants and the other explores the occurrence of off-target effects. The systematic map will focus on model plants as well as on plants produced for agricultural production that were subjected to genome editing techniques. Academic and grey literature will be searched in English and German language. Inclusion/exclusion criteria were developed for the two secondary questions and will be applied on title/abstract and full text stage. Included studies will be catalogued in a searchable and open access database and study results will be summarized using descriptive statistics. Furthermore, the extracted data will serve as a preparatory step for further in-depth analysis, e.g. by a systematic review.
Is living in the community associated with better nutritional status than living in long-term care facilities?
Authors: Nascimento Costa Fernanda , Vaz de Arruda Silveira Liciana , Ferrari Jacinto Alessandro 
Published: August 2018

Abstract
Background
Currently, Brazil has 26 million people aged ≥ 60 years. Population aging is associated with a higher prevalence of chronic health conditions which, in turn, are associated with functional dependence and the need for institutionalization. The aim of the study was to evaluate the nutritional status of a sample of institutionalized and non-institutionalized older people in the Brazilian city of Bauru and determine whether the institutionalized individuals had more inadequate nutritional status compared to the community dwellers.

Methods
Ninety-five individuals from 10 long-term care homes in Bauru, São Paulo state, and 101 community-dwelling users of three centers for the aged in Bauru, São Paulo state, were assessed. After collection of sociodemographic and clinical data, the evaluation of nutritional status was conducted using body mass index.

Results
Sixty-one (60.4%) non-institutionalized and 51 (53.9%) community dwellers were classified as inadequate (underweight or overweight) based on nutritional status. In the multivariate analysis, an ordinal logistic regression model was adjusted for the variable “nutritional status.” Regarding body mass index, elderly living in the community were 2.9 times more likely to shift from the underweight to overweight category [OR = 2.9, 95%CI 1.0–8.0, P = 0.0477)].

Conclusions
In this study, it was concluded that institutionalization was not associated with poorer nutritional status compared to community dwellers.
Use of schizophrenia and bipolar disorder polygenic risk scores to identify psychotic disorders
Authors: Calafato Maria Stella , Thygesen Johan H. , Ranlund Siri , Zartaloudi Eirini , Cahn Wiepke , Crespo-Facorro Benedicto , Díez-Revuelta Álvaro , Forti Marta Di ,   Genetic Risk and Outcome of Psychosis (GROUP) consortium, Hall Mei-Hua , Iyegbe Conrad , Jablensky Assen , Kahn Rene , Kalaydjieva Luba , Kravariti Eugenia , Lin Kuang , McDonald Colm , McIntosh Andrew M. , McQuillin Andrew ,   Psychosis Endophenotypes International Consortium (PEIC), Picchioni Marco , Rujescu Dan , Shaikh Madiha , Toulopoulou Timothea , Os Jim Van , Vassos Evangelos , Walshe Muriel , Powell John , Lewis Cathryn M. , Murray Robin M. , Bramon Elvira ,   Wellcome Trust Case Control Consortium 2 (WTCCC2)
Published: August 2018

BackgroundThere is increasing evidence for shared genetic susceptibility between schizophrenia and bipolar disorder. Although genetic variants only convey subtle increases in risk individually, their combination into a polygenic risk score constitutes a strong disease predictor.AimsTo investigate whether schizophrenia and bipolar disorder polygenic risk scores can distinguish people with broadly defined psychosis and their unaffected relatives from controls.MethodUsing the latest Psychiatric Genomics Consortium data, we calculated schizophrenia and bipolar disorder polygenic risk scores for 1168 people with psychosis, 552 unaffected relatives and 1472 controls.ResultsPatients with broadly defined psychosis had dramatic increases in schizophrenia and bipolar polygenic risk scores, as did their relatives, albeit to a lesser degree. However, the accuracy of predictive models was modest.ConclusionsAlthough polygenic risk scores are not ready for clinical use, it is hoped that as they are refined they could help towards risk reduction advice and early interventions for psychosis.Declaration of interestR.M.M. has received honoraria for lectures from Janssen, Lundbeck, Lilly, Otsuka and Sunovian.