bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limited Sequence MRIs for Early Onset Scoliosis Patients Detected 100% of Neural Axis Abnormalities While Reducing MRI Time by 68%
Authors: Murgai Rajan R. , Tamrazi Benita , Illingworth Kenneth D. , Skaggs David L. , Andras Lindsay M. 
Published: December 2018

Study Design.
Diagnostic accuracy.

Objective.
The purpose of this study was to determine if neural axis abnormalities in early onset scoliosis (EOS) patients can be reliably detected with limited magnetic resonance imaging (MRI) sequences (sagittal T1, sagittal T2).

Summary of Background Data.
MRIs are often performed in EOS patients as studies have shown there are neural axis abnormalities in up to 40% of this population. MRIs are expensive, lengthy, and often require general anesthesia. In young children prolonged or repeated exposure to general anesthesia may be associated with neurocognitive damage.

Methods.
A retrospective review of consecutive EOS patients from February to December 2017 who received an MRI of the cervical, thoracic, and lumbar spine was conducted. MRI images were reviewed for neural axis abnormalities. Two sequences (sagittal T1, sagittal T2) of these previously reviewed MRIs were read at a separate time by an attending pediatric neuroradiologist. The imaging findings from these two select sequences were then compared with the prior radiology report based on all of the standard MRI sequences.

Results.
Fifty patients met criteria. Ten patients (20%) had neural axis abnormalities detected by the full MRI. All of these neural axis abnormalities were detected on the combination of sagittal T1 + sagittal T2 images. Standard MRIs lasted 66 ± 20 minutes and patients required 90 ± 22 minutes of anesthesia. Sagittal T1 + sagittal T2 sequences lasted 21 ± 7 minutes (P < 0.0001).

Conclusion.
Limited sequence MRIs with sagittal T1 and T2 sequences for EOS patients had 100% sensitivity for the detection of neural axis abnormalities and would allow for a 68% reduction in the length of MRI and significant reduction in anesthesia time.

Level of Evidence: 3
Nested Polymerase Chain Reaction and Cutaneous Tuberculosis
Authors: Maldonado-Bernal Carmen , Ramos-Garibay Alberto , Rios-Sarabia Nora , Serrano Héctor , Carrera Manuel , Navarrete-Franco Gisela , Jurado-Santacruz Fermín , Isibasi Armando 
Published: December 2018

Abstract:
The role of Mycobacterium tuberculosis in the etiology and pathogenesis of cutaneous tuberculosis is controversial because of the difficulties associated with demonstrating the presence of these mycobacteria in tuberculid cutaneous lesions by routinely available microbiological and histological techniques. In this study, we aimed to demonstrate the presence of M. tuberculosis in cutaneous tuberculosis. Multiple polymerase chain reaction (PCR) followed by nested PCR was used to amplify genomic fragments from 3 different mycobacteria species. DNA was isolated from 30 paraffin-embedded skin biopsies. Samples were selected randomly from patients with a clinical and histopathological diagnosis of the most frequent groups of cutaneous tuberculosis in Mexico as follows: 5 cases of scrofuloderma tuberculosis; 2 cases of lupus vulgaris tuberculosis; and 5 cases of tuberculosis verrucosa cutis. The other cases denominated tuberculids in some countries such as Mexico and included the following: 7 cases of rosacea-like tuberculosis; one case of papulonecrotic tuberculosis; and 10 cases of erythema induratum of Bazin. Four normal skin biopsies were included as controls. M. tuberculosis DNA was amplified successfully by nested PCR in 80% of the samples (24 of the 30 samples) assayed. Mycobacterial DNA was not detected in the normal skin biopsies used as controls. Detection of M. tuberculosis DNA in 80% of cutaneous tuberculosis analyzed implicates this mycobacterium in the pathogenesis of multiple clinical forms of cutaneous tuberculosis.
FLUORESCEIN ANGIOGRAPHY FINDINGS IN UNILATERAL PERSISTENT FETAL VASCULATURE
Authors: Shen Jen-Hsiang , Liu Laura , Wang Nan-Kai , Hwang Yih-Shiou , Chen Kuan-Jen , Chao An-Ning , Lai Chi-Chun , Chen Tun-Lu , Wu Wei-Chi 
Published: December 2018

Objective:
This study aims to examine retinal vascular findings for affected eyes and contralateral eyes as well in typical cases of unilateral persistent fetal vasculature.

Methods:
We retrospectively reviewed all patients evaluated at Chang Gung Memorial Hospital, Linkou, for unilateral persistent fetal vasculature between January 2008 and July 2017. All patients underwent fluorescein angiography (FA) examination under general anesthesia. FA was performed using RetCam 3 (Clarity Medical Systems, Inc, Pleasanton, CA).

Results:
Ten patients (eight male and two female) were identified as having adequate clinical data for the final analysis. The mean age at diagnosis was 13.7 ± 17.2 months (range 1–58). The mean axial length was shorter in the affected eyes as compared to the fellow eyes (17.27 ± 2.8 vs. 20.2 ± 1.7 mm; P = 0.024). In the affected eyes, nine cases (90.0%) showed a concomitant retrolental stalk, avascular peripheral retina, regional capillary dropout, and absence of foveal avascular zone. Hyperfluorescent stalk was seen in seven cases (70.0%). Four eyes (40.0%) showed leaking vessels. Terminal supernumerary branching was seen in two cases (20.0%). Popcorn hyperfluorescence was noted in one case (10.0%). In the fellow eyes, peripheral avascular zone was noted in nine eyes (90.0%), of which six (60.0%) had peripheral zones greater than two-disk diameters. Seven eyes (70.0%) presented with regional capillary dropout and abnormal choroidal filling. Three eyes (30.0%) had abnormal vessel straightening. Aberrant circumferential vessels and leaking spots were seen in two eyes (20.0%). Regional dilation of disk vessels, peripheral vessel dilation, and terminal bulbing were noted in one eye (10.0%). The mean best-corrected visual acuity of the fellow eyes was 20/39 (0.29 in logarithm of the minimum angle of resolution).

Conclusion:
Retinal vascular abnormalities in the affected eyes and fundoscopically normal fellow eyes of unilateral persistent fetal vasculature patients were found in 100% and 90.0% of patients, respectively. Fellow eyes had some subtle abnormalities that were only revealed through FA. These unilateral persistent fetal vasculature cases were still bilaterally affected.
How Do Race and Insurance Status Affect the Care of Pediatric Anterior Cruciate Ligament Injuries?
Authors: Bram Joshua T. , Talathi Nakul S. , Patel Neeraj M. , DeFrancesco Christopher J. , Striano Brendan M. , Ganley Theodore J. 
Published: December 2018

Objective:
To identify associations between race or insurance status and preoperative, intraoperative, and postoperative findings in a large cohort of pediatric anterior cruciate ligament (ACL) reconstructions.

Design:
Retrospective cohort study.

Setting:
Division of Orthopaedics at an urban tertiary care children's hospital.

Patients:
915 pediatric (<21) patients undergoing primary ACL reconstruction between January 2009 and May 2016.

Independent Variables:
Insurance status and race.

Main Outcome Measures:
Delay to surgery, concurrent meniscal injury, sports clearance, postoperative complications, physical therapy, range of motion, and isokinetic strength reduction.

Results:
Multivariate analysis revealed a significantly longer delay to surgery for black/Hispanic and publicly insured children compared to their counterparts (P = 0.02 and P = 0.001, respectively). Black/Hispanic patients were more likely to sustain irreparable meniscus tears resulting in meniscectomy than white/Asian patients (odds ratio 2.16, 95% confidence interval, 1.10-2.29, P = 0.01). Black/Hispanic and publicly insured children averaged fewer physical therapy (PT) visits (P < 0.001 for both). Nine months after surgery, black/Hispanic patients had significantly greater strength reduction than white/Asian patients. There were no differences in postoperative complications, including graft rupture, contralateral ACL injury, or new meniscus tear along the lines of race, although privately insured patients were more likely to suffer a graft rupture than publicly insured patients (P = 0.006).

Conclusions:
After ACL rupture, black/Hispanic children and publicly insured children experience a greater delay to surgery. Black/Hispanic patients have more irreparable meniscus tears and less PT visits. Black/Hispanic patients have greater residual hamstrings and quadriceps weakness 9 months after surgery.
An integrative review of nurse practitioner education models: Part three of a four-part series on critical topics identified by the 2015 Nurse Practitioner Research Agenda
Authors: Kostas-Polston Elizabeth A. , Rawlett Kristen , Miedema Joy , Dickins Kirsten 
Published: December 2018

ABSTRACT

Background and purpose:
Critical research topics were identified after nurse practitioner (NP) organization stakeholders participated in the Fellows of the American Association of Nurse Practitioner, 2015 Nurse Practitioner Research Agenda Roundtable. Strategies and recommendations were identified to support further work examining NP outcomes-based research priorities in four areas: 1) policy and regulation; 2) workforce; 3) education; and 4) practice. For the purpose of this article, we focus on NP education. Important contrasts became evident after critiquing, analyzing, and synthesizing the literature. Meaningful differences were discovered in the understanding of the complexity of the construct, NP Education Models. Our results are presented as an integrative review. This is the third article in a four-part series investigating FAANP research priorities.

Methods:
A systematic literature review summarizing the literature for NP Education Models was conducted. PRISMA evidence-based methods were used to identify relevant studies. Of the 3,374 studies identified, 133 duplicate studies were eliminated, yielding a total of 3,241 articles. A team of three reviewers conducted screening and reviewing processes using defined eligibility criteria.

Conclusions:
A lack of clarity regarding use of the construct, NP Education Models, was discovered. The construct was broadly defined and represented different meanings. There is a paucity of theoretical development in current NP education that should be core to practice-focused NP educational programs.

Implications for practice:
Theoretical and conceptual NP education models and frameworks would bridge the gap between practice- and research-focused graduate programs. Overarching theoretical and conceptual models and frameworks promote critical thinking and decision-making across settings and populations.
Biomarkers of rejection in kidney transplantation
Authors: Singh Neeraj , Samant Hrishikesh , Hawxby Alan , Samaniego Millie D. 
Published: December 2018

Purpose of review
To provide an update of the literature on the use of new biomarkers of rejection in kidney transplant recipients.

Recent findings
The kidney allograft biopsy is currently considered the gold standard for the diagnosis of rejection. However, the kidney biopsy is invasive and could be indeterminate. A significant progress has been made in discovery of new biomarkers of rejection, and some of them have been introduced recently for potential use in clinical practice including measurement of serum donor-derived cell free DNA, allo-specific CD154 + T-cytotoxic memory cells, and gene-expression ‘signatures’. The literature supports that these biomarkers provide fair and reliable diagnostic accuracy and may be helpful in clinical decision-making when the kidney biopsy is contraindicated or is inconclusive.

Summary
The new biomarkers provide a promising approach to detect acute rejections in a noninvasive way.
The Molecular and Clinical Landscape of Pancreatic Neuroendocrine Tumors
Authors: Batukbhai Bhavina D.O. , De Jesus-Acosta Ana 
Published: December 2018

Abstract
Pancreatic neuroendocrine tumors are rare tumors of the pancreas originating from the islets of the Langerhans. These tumors comprise 1% to 3% of all newly diagnosed pancreatic cancers every year and have a unique heterogeneity in clinical presentation. Whole-genome sequencing has led to an increased understanding of the molecular biology of these tumors. In this review, we will summarize the current knowledge of the signaling pathways involved in the tumorigenesis of pancreatic neuroendocrine tumors as well as the major studies targeting these pathways at preclinical and clinical levels.
Emerging Evidence for the Clinical Relevance of Pancreatic Cancer Exosomes
Authors: Massoumi Roxanne L. , Hines O. Joe , Eibl Guido , King Jonathan C. 
Published: December 2018

Abstract
The last 5 years have seen a dramatic increased interest in the field of exosome biology. Although much is unknown about the role of exosomes in human health and disease, disparate scientific disciplines are recognizing the highly conserved role that exosomes play in fundamental biological processes. Recently, there have been intriguing discoveries defining the role of exosomes in cancer biology. We performed a structured review of the English-language literature using the PubMed database searching for articles relating to exosomes and pancreatic ductal adenocarcinoma (PDAC). Articles were screened for relevance and content to judge for inclusion. Evidence implicates exosomes in the pathogenesis, local progression, metastasis, immune evasion, and intercellular communication of PDAC. Basic science discoveries in exosome biology have the potential to change the clinical management of PDAC, where, despite advances in early detection, diagnosis, staging, chemotherapy, and surgery, survival rates have been stagnant for decades and PDAC remains the most deadly human gastrointestinal malignancy.
Gastric Neuroendocrine Tumor and Duodenal Gastrinoma With Chronic Autoimmune Atrophic Gastritis
Authors: Chen William C. , Warner Richard R. P. , Harpaz Noam , Zhu Hongfa , Roayaie Sasan , Kim Michelle Kang 
Published: December 2018

Abstract
Our group observed the first case of synchronous gastric neuroendocrine tumor (NET) and duodenal gastrinoma with autoimmune chronic atrophic gastritis (CAG), in the absence of Helicobacter pylori infection. Demographic, clinical, endoscopic, and pathologic data were abstracted from the electronic medical record at Mount Sinai Hospital from 2013 to 2015. The patient's anonymity was carefully protected, and informed consent was obtained for publication of protected health information. A 53-year-old woman with hypertension presented to Mount Sinai Hospital in June 2013 for a second opinion for management of gastric and duodenal NETs. After evaluation by gastroenterology and surgery, repeat upper endoscopy with ultrasound and fine-needle aspiration revealed multiple diminutive type I gastric NETs and 2 duodenal NETs, against a background of autoimmune CAG, with biopsy pathology negative for H. pylori. She subsequently underwent a transduodenal resection of the duodenal NETs, confirming low-grade, gastrin-positive, stage T2 duodenal NET. On routine follow-up over the next 2 years, clinical, radiographic, and endoscopic surveillance revealed no recurrent or metastatic gastric or duodenal disease. This first report of synchronous duodenal gastrinoma and gastric NET in the setting of autoimmune CAG can broaden our understanding of gastric NET pathophysiology.
Pediatric Eosinophilic Esophagitis
Authors: Hoofien Assaf , Dias Jorge A. , Malamisura Monica , Rea Francesca , Chong Sonny , Oudshoorn Johanna , Nijenhuis‐Hendriks Danielle , Otte Sebastian , Papadopoulou Alexandra , Romano Claudio , Gottrand Frederic , Miravet Victor V. , Orel Rok , Oliva Salvatore , Junquera Carolina G. , Załęski Andrzej , Urbonas Vaidotas , Garcia‐Puig Roger , Gomez Maria J.M. , Dominguez‐Ortega Gloria , Auth Marcus K.‐H. , Kori Michal , Ben Tov Amir , Kalach Nicolas , Velde Saskia V. , Furman Mark , Miele Erasmo , Marderfeld Luba , Roma Eleftheria , Zevit Noam 
Published: December 2018

ABSTRACTObjectives:Recommendations for diagnosing and treating eosinophilic esophagitis (EoE) are evolving; however, information on real world clinical practice is lacking. To assess the practices of pediatric gastroenterologists diagnosing and treating EoE and to identify the triggering allergens in European children.Methods:Retrospective anonymized data were collected from 26 European pediatric gastroenterology centers in 13 countries. Inclusion criteria were: Patients diagnosis with EoE, completed investigations prescribed by the treating physician, and were on stable medical or dietary interventions.Results:In total, 410 patients diagnosed between December 1999 and June 2016 were analyzed, 76.3% boys. The time from symptoms to diagnosis was 12 ± 33.5 months and age at diagnosis was 8.9 ± 4.75 years. The most frequent indications for endoscopy were: dysphagia (38%), gastroesophageal reflux (31.2%), bolus impaction (24.4%), and failure to thrive (10.5%). Approximately 70.3% had failed proton pump inhibitor treatment. The foods found to be causative of EoE by elimination and rechallenge were milk (42%), egg (21.5%), wheat/gluten (10.9%), and peanut (9.9%). Elimination diets were used exclusively in 154 of 410 (37.5%), topical steroids without elimination diets in 52 of 410 (12.6%), both diet and steroids in 183 of 410 (44.6%), systemic steroids in 22 of 410 (5.3%), and esophageal dilation in 7 of 410 (1.7%). Patient refusal, shortage of endoscopy time, and reluctance to perform multiple endoscopies per patient were noted as factors justifying deviation from guidelines.Conclusions:In this “real world” pediatric European cohort, milk and egg were the most common allergens triggering EoE. Although high‐dose proton pump inhibitor trials have increased, attempted PPI treatment is not universal.
Attitudes of Physicians, Midwives, and Nurses About Doulas
Authors: Lucas Laura , Wright Erin 
Published: December 2018

Abstract

Introduction:
Evidence supports numerous positive clinical benefits of doula care. There are varying attitudes among physicians, midwives, and nurses toward support of doulas in a collaborative approach with women in labor. Tension and conflict with use of doulas may occur in some intrapartum settings in the United States.

Methods:
A scoping review of the literature between January 2008 and January 2018 was conducted using PubMed, CINAHL, Google Scholar, and Scopus database to identify specific attitudes of physicians, midwives, and nurses toward doulas; 1,810 records were identified and initially reviewed. Inclusion criteria included original research published in the last 10 years and in the English language. Articles were excluded if the research was not original and if obstetrical providers' or nurses' attitudes toward doulas were not included.

Results:
Three records met criteria for inclusion. All used a cross-sectional survey design. Two were set in Canada exclusively and one was inclusive of nurses and doulas in both Canada and the United States. Themes emerged that may explain the influence and variances in attitudes toward doulas and the support they provide to laboring women.

Clinical Implications:
More research is needed to identify attitudes of members of the maternity care team toward doulas and to better understand implications of their attitudes on working together collaboratively and on patient outcomes.
Nurses' Perspective on Caring for Women Experiencing Perinatal Loss
Authors: Willis Patricia 
Published: December 2018

Abstract

Purpose:
The purpose of this study was to describe the experience of caring for women with a perinatal loss from the perspective of the nurse and to determine the extent to which the response to perinatal loss reflects a process.

Study Design and Methods:
A purposive study was conducted with nine labor and birth nurses with experience in caring for women with a perinatal loss. The nurses were from two acute care hospitals within one healthcare system in Southeastern Massachusetts. A qualitative descriptive design with in-depth interviewing based on Rubin and Rubin (2012) was used to gather and analyze data.

Results:
Several themes depicting nurses' experience were identified: struggling with emotions, carrying on in the moment, being present for the patient, expressing conflict, and taking care of self. A process was identified by nurses describing their response to perinatal loss. The process began with recognition of the loss and progressed through phases including the recognition of their emotional impact, connecting with the mother, dealing with emotions, acting professionally, preparing to return to work, and never forgetting the woman.

Clinical Implications:
Nurses identified a need for more education and managerial support for excellence in care of women with a perinatal loss. Education to prepare nurses to meet the physical, psychological, and spiritual needs of women is recommended. Debriefing after caring for a woman with a loss was suggested by the nurses. When nurses' needs are met, they are better prepared to care for women experiencing a perinatal loss.
The Paramedian Forehead Flap for Nasal Reconstruction: From Antiquity to Present
Authors: Shokri Tom , Kadakia Sameep , Saman Masoud , Habal Mutaz B. , Kohlert Scott , Sokoya Mofiyinfolu , Ducic Yadranko , Wood-Smith Donald 
Published: December 2018

Abstract
Nasal reconstruction is considered the historic foundation of facial plastic surgery, and the forehead flap remains the workhorse of repair. To recreate both the aesthetic contour and function of the nose, all anatomic layers must be addressed—covering, lining, and structural support. This article reviews the noteworthy history underlying the development of the paramedian forehead flap as the primary tool in reconstruction of large nasal defects while highlighting its implications on modern nasal repair. Current developments in the use of 2-staged paramedian forehead flap reconstruction are examined and a modern technique is presented.
The Influence of Melatonin on Sleep Quality After Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials
Authors: Zhang Juyi , Wang Yubin , Xu Hao , Yang Juan 
Published: December 2018

Introduction:
The efficacy of melatonin to improve sleep quality after laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of melatonin intervention versus placebo on sleep quality after laparoscopic cholecystectomy.

Methods:
We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through July 2018 for randomized controlled trials assessing the effect of melatonin intervention versus placebo on sleep quality after laparoscopic cholecystectomy. This meta-analysis is performed using the random-effect model.

Results:
Five randomized controlled trials involving 250 patients are included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, melatonin intervention shows no substantial impact on well-being [standard mean difference (std MD)=0.05; 95% confidence interval (CI)=−0.26 to 0.36; P=0.76], sleepiness (std MD=−0.10; 95% CI=−0.44 to 0.23; P=0.54), sleep quality (std MD=0.10; 95% CI=−0.21 to 0.41; P=0.53), pain scores after 1 hour (std MD=−0.26; 95% CI=−1.08 to 0.56; P=0.53) and 3 hours (std MD=−0.86; 95% CI=−2.69 to 0.97; P=0.36), headache [risk ratio (RR)=1.25; 95% CI=0.42-3.71; P=0.68], depression (RR=1.03; 95% CI=0.15-7.21; P=0.97), dizziness (RR=1.09; 95% CI=0.14-9.40; P=0.94).

Conclusions:
Melatonin intervention has no significant influence on well-being, sleepiness, sleep quality, pain intensity after 1 and 3 hours, headache, depression, and dizziness for laparoscopic cholecystectomy.