bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing Local Evidence About Faculty Written Exam Questions: Asian ESL Nursing Student Perceptions About Linguistic Modification
Authors: Mulready-Shick JoAnn , Edward Jean , Sitthisongkram Somporn 
Published: February 2019

Abstract
Limited studies address perspectives about exam-writing practices of nursing students for whom English is an additional language. The authors conducted a program-level study of perceptions of 26 nursing students of Asian background who identified as nonnative speakers of English regarding faculty-made, multiple-choice exam questions that had been linguistically modified. Linguistic modification promoted readability and comprehensibility; students preferred the linguistically modified versions 60 percent of the time. This inquiry attends to the need for greater responsiveness to student concerns about test-taking practices and for engendering their ongoing participation in creating local evidence for improving program outcomes.
Examining Relationships Between Resilience Protective Factors and Moral Distress Among Nursing Students
Authors: Krautscheid Lorretta , Mood Laura , McLennon Susan M. , Mossman Taylor C. , Wagner Marie , Wode Jessica 
Published: February 2019

Abstract
A correlation pilot study was conducted to examine relationships between resilience protective factors and moral distress associated with clinical practica in nursing students. Aggregate moral distress rating was x = 3.67. Two of four resilience protective factor subcategories demonstrated significant inverse correlations with moral distress rating. Inverse correlations were found between social support and moral distress (r = −.27, p < .05) and between goal efficacy and moral distress (r = −.37, p < .01). The findings should help educators prioritize resilience-enhancing educational strategies.
Severity of Analgesic Dependence and Medication-overuse Headache
Authors: Lundqvist Christofer , Gossop Michael , Russell Michael Bjørn , Straand Jørund , Kristoffersen Espen Saxhaug 
Published: February 2019

Background and Aims:
Medication-overuse headache (MOH) is a common chronic headache caused by overuse of headache analgesics. It has similarities with substance dependence disorders. The treatment of choice for MOH is withdrawal of the offending analgesics. Behavioral brief intervention treatment using methods adapted from substance misuse settings is effective. Here we investigate the severity of analgesics dependence in MOH using the Severity of Dependence Scale (SDS), validate the SDS score against formal substance dependence diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) and examine whether the SDS predicts successful withdrawal.

Methods:
Representative recruitment from the general population; 60 MOH patients, 15 chronic headache patients without medication overuse and 25 population controls. Headaches were diagnosed using the International Classification of Headache Disorders, medication use was assessed and substance dependence classified according to the DSM-IV. The SDS was scored by interviewers blinded to patient group. Descriptive statistics were used and validity of the SDS score assessed against a substance dependence diagnosis using ROC analysis.

Results:
Sixty-two percent of MOH patients overused simple analgesics, 38% centrally acting analgesics (codeine, opiates, triptans). Fifty percent of MOH patients were classified as DSM-IV substance dependent. Centrally active medication and high SDS scores were associated with higher proportions of dependence. ROC analysis showed SDS scores accurately identified dependence (area under curve 88%). Lower SDS scores were associated with successful withdrawal (P = 0.004).

Conclusions:
MOH has characteristics of substance dependence which should be taken into account when choosing treatment strategy.

Trial registration:
Based on data collected in previously reported randomized BIMOH trial (Kristoffersen et al., 2012
;
Kristoffersen et al., 2015 in the present manuscript, Clinical trials registration number: NCT01314768). The present part, however, represents observational data and is not a treatment trial.
Medication Adherence Monitoring Using Smartphone Video Dosing in an Open-label Pilot Study of Monthly Naltrexone Plus Once-daily Bupropion for Methamphetamine Use Disorder: Feasibility and Acceptability
Authors: Walker Robrina , Hillhouse Maureen , Perrochet Brian , Sparenborg Steven , Mooney Larissa , Ling Walter 
Published: February 2019

Objectives:
This article describes how smartphones were used to monitor and encourage medication adherence in a pilot study evaluating the potential efficacy of a combination pharmacotherapy for methamphetamine use disorder. We examine the feasibility, utility, and acceptability of using smartphones to capture dosing videos from the perspectives of participants and staff.

Methods:
The study was an 8-week, open-label evaluation of extended-release injectable naltrexone combined with once-daily oral extended-release bupropion (BRP, Welbutrin XL, 450 mg/day). Participants attended visits twice-weekly for observed BRP dosing, assessments, and medical management. BRP was dispensed once weekly for dosing on nonclinic days. Medication adherence was assessed objectively (by observation in the clinic and smartphone videos for dosing at home) and subjectively (self-reports of dosing). Surveys assessing the smartphone component were completed by participants and study staff.

Results:
Participants (N = 49) reported taking 93.6% of the dispensed BRP doses while 86.6% of dispensed doses were confirmed via dosing video and in-person observations. Most participants who completed the survey agreed that the smartphone was easy to use (92.6%) and that taking the dosing videos helped to remember to take the study medication (80.5%). Staff agreed that the smartphone helped collect accurate dosing data for most (77.5%) participants.

Conclusions:
The use of smartphones for video-based oral medication dosing in this study provided a feasible and acceptable mechanism to encourage, monitor, and confirm medication adherence. Video-confirmed dosing adherence provides an objective numerical indicator of the lowest medication adherence rate participants achieve, allowing investigators to more confidently interpret results.
Psychological Changes and Employment Outcomes After Kyphosis Correction in Patients With Ankylosing Spondylitis
Authors: Park Jin-Sung , Kim Young-Ho , Yang Jae-Hyuk , Ko Young-Il , Park Ye-Soo 
Published: February 2019

Study Design.
A retrospective study.

Objective.
To evaluate the psychological changes and employment outcomes following corrective osteotomy in patients with ankylosing spondylitis (AS).

Summary of Background Data.
To date, no study has investigated the changes in psychological status and subsequent improvement in employment outcome after correction of kyphotic deformities in patients with AS.

Methods.
This study included 48 patients with AS who underwent corrective osteotomy for severe kyphotic deformity. Sagittal alignment was assessed radiographically. Clinical status was evaluated using the Short Form-36 Health Survey, psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS), and employment outcomes were assessed using the Lam Employment Absence and Productivity Scale (LEAPS). The degree of postoperative sagittal alignment correction was measured, and changes in clinical and employment outcomes and psychological status were evaluated. The relationship between the degree of sagittal alignment correction and each evaluation item was analyzed.

Results.
Following postoperative sagittal alignment correction, all patients could stand erect and look straight. Significant improvements were observed in the clinical and employment outcomes, as well as in patients’ psychological status. The degree of sagittal vertical axis correction was significantly correlated with the HADS depression and the LEAPS total scores. The degree of correction of the chin-brow vertical angle was significantly correlated with the Short Form-36 mental health score, the HADS depression and anxiety scores, and the LEAPS total and productivity subscores. Notably, the improvement in the HADS depression score was significantly correlated with the LEAPS total score.

Conclusion.
This study demonstrated the psychological changes and subsequent improvement in employment outcomes after corrective osteotomy in patients with AS. The degree of sagittal alignment correction was correlated with improvements in psychological status and employment outcomes.

Level of Evidence: 4
Ethical problems in nursing management: Frequency and difficulty of the problems
Authors: Aitamaa Elina , Suhonen Riitta , Iltanen Silja , Puukka Pauli , Leino-Kilpi Helena 
Published: February 2019

Background
Nurse managers (NMs) lead the biggest personnel group in health care—nurses. They have various responsibilities in clarifying an organization’s values to their staff and overseeing and supporting continuous upholding of ethical standards and nurses’ ethical competence.

Purpose
The purpose of the study was to investigate the frequency and difficulty of the ethical problems NMs encounter in their work and to determine the background factors correlating with the problems.

Methodology
Cross-sectional survey design was used. Ethical problems were approached by five categories related to patients, nursing staff, other professional groups, the organization, and the NMs themselves. The data collected with questionnaires from NMs in ward, middle, and strategic management (n = 214) in Finland from November 2014 to May 2015 were statistically analyzed.

Results
The most frequently encountered ethical problems were related to nursing staff and organization: About half of NMs encountered those problems at least weekly. The most difficult ethical problems were related to the organization—the mean value of the sum score being significantly higher compared to the four other sum scores (p < .0001). When combining information on the frequency and difficulty of the encountered ethical problems, organization-related problems were the most significant. The more positively NMs assessed their work-related background factors, the fewer ethical problems they encountered and the easier they considered them.

Conclusion
Awareness of the frequency and difficulty of ethical problems in nursing, especially those related to organization, needs to be increased in health care organizations to find solutions for dealing with them.

Practice Implications
Strengthening resources for ethics, like ethics experts and multiprofessional committees, may be helpful. Ethical consideration and discussion of prioritization should be routinely used in administrative decision-making. Ethics education and instructions for repetitive situations could increase NMs’ ability to manage with ethical problems. Support mechanisms are needed for situations where difficult value clashes appear.
Chronic Conjunctivitis From a Retained Contact Lens
Authors: Arshad Jawad I. , Saud Asma , White Darrell E. , Afshari Natalie A. , Sayegh Rony R. 
Published: February 2019

Purpose:
To help clinicians diagnose and manage unilateral recalcitrant chronic bacterial conjunctivitis secondary to a retained soft contact lens and describe the first report of Gram-negative bacteria causing this condition.

Methods:
Chart review of successive cases presenting with unilateral chronic conjunctivitis with positive cultures and a retained contact lens.

Results:
Three cases were identified and described. Culturing of the retained contact lenses grew Pseudomonas aeruginosa in the first case, Achromobacter xylosoxidans in the second, and Staphylococcus epidermidis in the third. All three patients were successfully treated with removal of the retained lens and targeted antibiotic eyedrop therapy.

Conclusions:
Unilateral chronic recurrent or recalcitrant purulent papillary conjunctivitis is rare, and a retained contact lens should be suspected in patients with a history of wearing contact lenses. Careful examination with double eversion of the upper eyelid and sweeping of the fornices can recover the offending lens. Although only Gram-positive organisms have been isolated in previous reports, two of our three cultures grew Gram-negative organisms, highlighting the importance of broad-spectrum antibiotic usage for these cases.
RSVpredict: An Online Tool to Calculate the Likelihood of Respiratory Syncytial Virus Infection in Children Hospitalized With Acute Respiratory Disease
Authors: Manuel Britta , Hackbusch Matthes , Tabatabai Julia , Hoos Johannes , Peters Rebecca , Valerie Schnee Sarah , Marlene Ihling Clara , Schnitzler Paul , Pfeil Johannes 
Published: February 2019

Background:
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection in young children. Early detection of RSV infection can avoid unnecessary diagnostic and therapeutic intervention and is required to prevent the nosocomial spread of RSV infection in pediatric hospitals. We developed a web tool to calculate the probability of RSV infection in children hospitalized with acute respiratory tract infection (ARTI) (RSVpredict).

Methods:
During winter seasons 2014/2015 to 2017/2018, 1545 children hospitalized with clinical symptoms of ARTI at the University Hospital Heidelberg/Germany were prospectively included. Medical information was reported on a standardized data sheet, and nasopharyngeal swabs were obtained for multiplex real-time polymerase chain reaction analyses. We applied logistic regression to develop a prediction model and developed a web-based application to predict the individual probability of RSV infection.

Results:
Duration of clinical symptoms ≥2 days on admission, calendar month of admission, admission for lower respiratory tract infection, the presence of cough and rale and younger age were associated with RSV infection (P < 0.05). Those data were included in the prediction model (RSVpredict, https://web.imbi.uni-heidelberg.de/rsv/). RSVpredict is a web-based application to calculate the risk of RSV infection in children hospitalized with ARTI. The prediction model is based on easily accessible clinical symptoms and predicts the individual probability of RSV infection risk immediately.

Conclusions:
Pediatricians might use the RSVpredict to take informed decisions on further diagnostic and therapeutic intervention, including targeted RSV testing in children with relevant RSV infection risk.
Ultrasonography Features of Normal Submandibular Parenchyma and Incidental Diffuse Submandibular Disease
Authors: Kim Dong Wook 
Published: February 2019

Abstract
This study aimed to assess ultrasonography (US) features of normal submandibular parenchyma (NSP) and incidental diffuse submandibular disease (DSD). From January 2013 to December 2017, 39 patients underwent preoperative US of the submandibular gland before submandibular surgery in our hospital. Among them, 9 were excluded because of inadequate histopathologic data (n = 7) or poor US image quality (n = 2). The US features of the resected submandibular glands were retrospectively investigated by a single radiologist, blinded to clinicoserological information and the histopathologic result, using a picture archiving and communication system. Histopathologic analysis of the submandibular gland was retrospectively performed by a single pathologist. After histopathologic analysis, 11 of the 30 patients were classified as DSD and 19 as NSP. Of the individual US features, only parenchymal echotexture exhibited a statistically significant difference between NSP and DSD (P < 0.0001), whereas the other US features showed no significant differences (P > 0.05). There was no significant relationship between diffuse fibrosis and glandular size (P = 0.310) or the other US features (P = 1.000). In conclusion, US may be helpful for differentiating incidental DSD from NSP.
A Nomogram of Lateral Abdominal Wall Fat Thickness in Normal Third Trimester Fetuses
Authors: Dubinsky Theodore J. , O'Regan Jeremiah , Sonneborn Rachelle , Hippe Dan S. , Dighe Manjiri , Moshiri Mariam 
Published: February 2019

Abstract

Objectives
The objective of this study is to establish a nomogram of fetal abdominal wall fat thickness in fetuses with known normal neonatal outcomes.

Methods
After IRB approval (HSD-49496), 157 ultrasound examinations in 100 patients, 41 of whom had multiple examinations during the same pregnancy were reviewed. The thickness of the fetal lateral abdominal wall fat Interreader agreement was summarized using the intraclass correlation coefficient (ICC). Fat thickness growth curve equations were estimated to quantify the relationship between fat thickness and gestational age.

Results
The abdominal wall fat had an intraclass correlation coefficient of 0.93 (95% confidence interval, 0.90–0.96) for 2 readers. Fat thickness increased in all 41 fetuses with multiple examinations (P < 0.001). Fat thickness increased 0.19 mm per week on average (95% confidence interval, 0.17–0.21 mm; P < 0.001) from an average of 1.7 mm at 22 weeks and 4.3 mm at 36 weeks.

Conclusions
Lateral wall abdominal fat can be reproducibly measured with good inter observer correlation, and fat does increase with increasing gestational age in normal fetuses. We believe the utility of fetal fat is the documentation of its presence as a reassuring finding indicative of normal fetal health, particularly when prior dating is discrepant or not available during the third trimester.
Burn-Induced Microglia Activation is Associated With Motor Neuron Degeneration and Muscle Wasting in Mice
Authors: Ma Li , Zhou Yinhui , Khan Mohammed A.S. , Yasuhara Shingo , Martyn J. A. Jeevendra 
Published: February 2019

ABSTRACT

Introduction:
Burn injury (BI) leads to both systemic and neuro-inflammation and is associated with muscle wasting and weakness, which increase morbidity and mortality. Disuse atrophy is concomitantly present in BI patients. Most studies have focused on muscle with little attention to role of central nervous system (CNS) in the neuromuscular changes. We tested the hypothesis that BI-induced muscle wasting stems from CNS microglia activation and cytokines and chemokine release, which is associated with spinal ventral horn motor neuron degeneration.

Methods:
Body surface (35%) BI, immobilization alone (Immob), BI with immobilization (BI + Immob), or Sham BI were administered to mice. Spinal cord (L3–L4 segments) and skeletal muscle tissues were harvested on days 7 and 14 after perturbations to examine microglia, motor neuron, and skeletal muscle changes.

Results:
BI and BI + Immob significantly (P < 0.05) activated microglia, evidenced by its increased density around motor neurons, upregulated neuroinflammation-marker, translocator protein 18 kDa expression and inflammatory cytokines (interleukin-1β, tumor necrosis factor-α) and/or chemokines (CXCL2) expression at days 7 and 14. Ventral horn motor neurons apoptosis and downregulation were observed at both periods after BI and was significantly magnified by concomitant BI + Immob. BI and more prominently BI + Immob disintegrated and fragmented the pretzel-shaped synapse and was associated with significantly decreased gastrocnemius, tibialis, and soleus muscle masses.

Conclusion:
BI induces microglia proliferation and activation (cytokine and chemokine release), degeneration of ventral horn motor neurons and muscle mass loss, all of which were accentuated by concomitant immobilization. The mechanisms connecting microglia activation and motor neuron degeneration to muscle mass loss require further delineation.
Different Bactericidal and Inflammatory Activities of Human and Mouse Blood
Authors: Lin Tian , Moorlag Simone J.C.F.M. , Liu Jialin , Ahmed Mohamed Yehia Hassan , Thundivalappil Sujatha R. , Riley Frank E. , Warren H. Shaw 
Published: February 2019

ABSTRACT
We performed side-by-side experiments to compare the behavior of four strains of Escherichia coli and one strain of Pseudomonas aeruginosa in fresh human and mouse blood. Bacteria were multiplied in mouse whole blood and plasma but were killed in human whole blood and plasma. The percentage of granulocytes associated with fluorescence-labeled heat-killed E coli relative to total leukocytes counted was higher in human compared to mouse blood as assessed by flow cytometry analysis. Concentrations of proinflammatory cytokines were high in human blood, but undetectable in mouse blood despite high concentrations of bacteria. We conclude that bacterial killing, phagocytosis, and cytokine induction in blood during human bacteremia with these organisms are probably not mimicked in mouse models of bacterial challenge. Understanding the mechanisms for low cytokine induction with high bacterial loads in mouse blood may be helpful to interpret murine models of bacteremia and develop new approaches for treating sepsis in humans.
Effect of Pravastatin Pretreatment and Hypercapnia on Intestinal Microvascular Oxygenation and Blood Flow During Sepsis
Authors: Schulz Jan , Vollmer Christian , Truse Richard , Bauer Inge , Beck Christopher , Picker Olaf , Herminghaus Anna 
Published: February 2019

ABSTRACT

Introduction:
In septic patients, adequate microvascular oxygenation (μHBO2) of the intestine is vital for their outcome. Recent studies suggest that statins can ameliorate septic microcirculation in a variety of tissues. However, the effect on intestinal microvascular oxygenation and blood flow is largely unknown. Furthermore, there are indications that statin therapy might not be beneficial in the presence of hypercapnia, as observed in septic acute respiratory distress syndrome (ARDS) patients. Therefore, the present study explores the effect of pravastatin with and without additional moderate acute hypercapnia on intestinal microvascular oxygenation and blood flow in experimental sepsis.

Methods:
Forty male Wistar rats were randomized into four groups. Half of the animals received 0.2 mg • kg−1 pravastatin s.c., the other half received the same volume as vehicle (NaCl 0.9%). After 18 h, colon ascendens stent peritonitis surgery was conducted in all animals to induce sepsis. Twenty-four hours after surgery, baseline was established and the animals were subjected to either 120 min of normocapnic (pCO2 40 ± 6 mm Hg) or moderate hypercapnic (pCO2 72 ± 10 mm Hg) ventilation. Microcirculatory oxygenation (μHBO2) and perfusion (μflow) of the colon were continuously recorded using tissue reflectance spectrophotometry and laser Doppler, respectively.

Results:
In normocapnic septic animals μHBO2 decreased over time (−8.4 ± 8.7%; P < 0.05 vs. baseline), whereas after pravastatin pretreatment μHBO2 remained constant (−1.9 ± 5.7% vs. baseline). However, in hypercapnic septic animals pretreated with pravastatin μHBO2 declined significantly over time (−8.9 ± 11.8%; P < 0.05 vs. baseline) and was significantly lower compared with normocapnic pravastatin-pretreated animals. μflow did not change over time in any group.

Conclusion:
Pravastatin pretreatment ameliorates the intestinal microvascular oxygenation in sepsis and thus seems to prevent intestinal hypoxia. Furthermore, we demonstrated that additional hypercapnia abolishes this effect, indicating why septic ARDS patients might not benefit from pravastatin therapy.