bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal disorders and back pain
Authors: Clunie Gavin , Wilkinson Nick , Nikiphorou Elena , Jadon Deepak R. 
Published: August 2018

The Oxford Handbook of Rheumatology, 4th edition, chapter on ‘Spinal disorders and back pain’ brings together a pragmatic approach to categorizing back pain, how to investigate disorders presenting with back pain, and how to treat adults, children, and adolescents with back pain. In the chapter, the management of back pain is separated into acute, subacute, and chronic presenting scenarios and the text makes reference to other chapters in the book where there may be some additional useful information (e.g. spondyloarthritis-associated back pain in Chapter 8 and chronic pain syndromes in Chapter 22). Notably the chapter is best read in conjunction with relevant sections in Chapter	3 (‘Regional musculoskeletal symptoms: making a working diagnosis’). The chapter makes reference to the need for a rigorous diagnostic approach to all the conditions which cause back pain, and at whatever age. There are subsections on how to assess paediatric spinal disorders and how to take a broad holistic approach to managing chronic back pain where there is no specific diagnosis.
Timing of Infectious Disease Clinical Rotation Is Associated With Infectious Disease Fellowship Application
Authors: Blyth Dana M , Barsoumian Alice E , Yun Heather C 
Published: August 2018

Abstract

Background
With declining interest in infectious disease (ID) noted among internal medicine (IM) residents, national attention has been directed at methods to recruit more prospective ID applicants. The factors driving the recent decline in ID fellowship applications have thus far only been evaluated in survey studies. Since 2008 at our institution, all IM interns were required to complete a 4-week inpatient ID rotation. We evaluated this rotation to determine if any experiential factors could be linked to future ID interest.

Methods
Categorical IM interns rotating on the mandatory ID rotation at our institution between July 1, 2008, and June 30, 2015, were included. Interns were grouped by eventual application to ID fellowship (IDA) and nonapplication (non-IDA). Consult numbers and types and characteristics of team members during the rotation were compared.

Results
Between July 2008 and June 2015, 143 IM interns met inclusion criteria. Ten (7%) were IDA. There was no difference in number of consults seen, intern, team member, faculty, or fellow characteristics among groups. However, 90% of IDA compared with 46% of non-IDA rotated during the first 6 months of internship (P = .01).

Conclusions
During a 7-year period, those interns randomly assigned to rotate on ID in the first 6 months of their intern year were more likely to become future ID applicants. This supports prior self-reported survey data that early exposure to the field may impact future career choice and suggests that incorporating ID early into the intern experience may increase recruitment.
Electoral Accountability, Responsibility Attributions, and the Democratic Deficit in Devolved Wales
Authors: Dafydd Einion , Badanjak Sanja 
Published: August 2018

Abstract
This study explores electoral accountability at the devolved level in Wales. The retrospective voting model assumes that electoral accountability requires that citizens assign responsibility accurately and vote on the basis of their evaluation of government performance. Drawing on data from the 2016 Welsh Election Study, we examine whether citizens in Wales can identify devolved policy competences and office holders, and identify factors that are linked to accurate attributions. We then examine whether voters seek to use devolved elections as a sanctioning tool, even if they do not have the information required to do so accurately. The findings indicate that there is an acute accountability deficit at the devolved level in Wales: few have the knowledge or the inclination to hold those in power to account. The conclusion discusses the implications of these findings for democracy in Wales and in other multi-level settings.
Noncontact Measurement of the Deformation of Sternal Skin During Shoulder Movements and Upper Extremity Activities Restricted by Sternal Precautions
Authors: Ge Weiqing , Hians Brittany , Sfara Alison 
Published: August 2018

Abstract

Background
Existing variation has been identified in the rehabilitation programs for patients following cardiac surgery. Sternal precautions are believed to be overly restrictive and detrimental to patient recovery both physically and psychologically.

Objective
The objective of this study was to determine the deformation of sternal skin during shoulder movements and upper extremity activities using a noncontact approach.

Design
This was a cross-sectional, nonexperimental observational study.

Methods
Two black dots were marked on participants’ skin overlying sternoclavicular joints using an erasable marker. The coordinates of the dots were recorded using a digital camera and obtained using ImageJ, a public domain image processing program. Skin deformation between the 2 dots was quantified as biomechanical strain.

Results
The sternal skin strain was − 15.3% (SD = 5.6) and − 12.0% (SD = 7.0) at 90 and 180 degrees of flexion; 0.0% (SD=0.0) and−12.8% (SD=5.8) at 90 and 180 degrees of abduction; and − 6.4% (SD=2.8), − 8.9% (SD=3.8), and − 9.8% (SD=4.6) when lifting the 0-, 5-, and 10-lb weights, respectively. The sternal skin strain was 7.9% (SD=3.9) for extension to the end range and−2.5% (SD=5.8) for pushing up from a chair. There is a trend of strain magnitude decrease with the increase of rhomboid strength, but no statistically significant association was found between them (R=0.12).

Limitations
Limitations included convenience sampling, small sample size, and using skin deformation as a proxy for mechanical loading of the bony structures.

Conclusions
The data do not support the restriction on most of the shoulder movements and upper extremity activities following cardiac surgery. The approach has the advantage of measuring skin deformation in the entire sternal region.
Maternal protein restriction induces gastrointestinal dysfunction and enteric nervous system remodeling in rat offspring
Authors: Aubert Philippe , Oleynikova Elena , Rizvi Hina , Ndjim Marième , Le Berre-Scoul Catherine , Grohard Pierre Antoine , Chevalier Julien , Segain Jean-Pierre , Le Drean Gwenola , Neunlist Michel , Boudin Helene 
Published: August 2018

ABSTRACTEarly‐life adversity is a major risk factor for the development of diseases later in life. Maternal protein restriction (MPR) is associated with morbidities in offspring affecting multiple organs, but its impact on the gastrointestinal (GI) tract remains poorly studied. Using a rat model, we examined the consequences of MPR on GI function and on the enteric nervous system (ENS) in the offspring at postnatal d 35 under basal state and following a water avoidance stress (WAS). Compared with control rats, MPR rats exhibited greater colonic motility, permeability, and corticosteronemia. In contrast to controls, MPR rats presented a blunted functional and corticosteronemic response to WAS. Furthermore, MPR rats showed an increased proportion of choline acetyltransferase–immunoreactive (ChAT‐IR) neurons and a reduced level of autophagy in colonic myenteric neurons. In ENS cultures, corticosterone treatment increased the proportion of ChAT‐IR neurons and reduced autophagy level in enteric neurons. Inhibition of autophagy in ENS cultures resulted in a higher vulnerability of enteric neurons to a cellular stress. Altogether, this study suggests that MPR induced GI dysfunction and ENS alterations in offspring rats and that MPR‐induced increased corticosteronemia might be involved in ENS remodeling and altered responsiveness of the gut to stressors later in life.—Aubert, P., Oleynikova, E., Rizvi, H., Ndjim, M., Le Berre‐Scoul, C., Grohard, P. A., Chevalier, J., Segain, J.‐P., Le Drean, G., Neunlist, M., Boudin, H. Maternal protein restriction induces gastrointestinal dysfunction and enteric nervous system remodeling in rat offspring. FASEB J. 33, 770–781 (2019). www.fasebj.org
Development of a Rubric for Evaluation of the DNP Portfolio
Authors: Melander Sheila , Hampton Debra , Hardin-Pierce Melanie , Ossege Julie 
Published: August 2018

Abstract
A doctor of nursing practice (DNP) portfolio rubric for faculty to use when evaluating student portfolios and for students to use to critique their work is described. No rubrics or tools were found in the literature that provided guidelines to evaluate the extent to which portfolio exemplars meet American Association of Colleges of Nursing Essentials of Doctoral Education for Advanced Nursing Practice. The rubric provides criteria to evaluate whether portfolio documents demonstrate achievement of the DNP Essentials at a “developing, proficient, or exceptional” level. It is valuable tool to illustrate how the competencies outlined in the essentials are met within a DNP program.
Walk patients through total hip arthroplasty
Authors: Hohler Sharon E. 
Published: August 2018

Abstract:
Osteoarthritis is the most common cause for hip pain. Total hip arthroplasty (THA) can relieve pain and enhance mobility and quality of life for patients with arthritic hip pain. The focus of this article is THA in patients with osteoarthritis using Mr. H's case as an illustration. It reviews indications and contraindications for THA and other treatment options as well as nursing care for patients undergoing THA.
Health-Related Quality of Life in Mandarin-Speaking Children With Cochlear Implants
Authors: Zhao Yawen , Li Ying , Zheng Zhipeng , Li Jing , Nie Xiaolu , Jin Xin , Zheng Jun , Zhang Jie , Chen Min , Hao Jinsheng , Yang Yang , Liu Wei , Liu Haihong , Ni Xin 
Published: August 2018

Objectives:
The primary aim of this study was to evaluate the health-related quality of life (HRQoL) of children with cochlear implants (CIs) from the parental perspective. The secondary objective was to explore possible relationships between demographic variables (such as age at assessment, gender, age at implantation, and duration of language rehabilitation) and the HRQoL. The third objective was to determine the developmental trajectories of HRQoL.

Design:
This study included parents of 123 children with CIs (mean age, 40.45 months; mean age of CI implantation, 24.74 months; mean device experience, 16.34 months). The time periods for follow-up were at 0, 1, 2, 3, 6, and 12-month intervals of CI use. The Mandarin Children with Cochlear Implants: Parental Perspectives questionnaire was employed to assess HRQoL.

Results:
Parents were satisfied with HRQoL, especially with the domain of social relations; however, education received a less positive rating. The duration of CI use was positively correlated with 5 domains, suggesting that children who used CIs for a longer time had higher HRQoL ratings. Children with longer language rehabilitation received more positive ratings in the domains of social relations and education (p < 0.05); children whose mothers had higher education levels received more positive ratings in the domain of general functioning (p < 0.05); children living in cities received more positive ratings in the domains of communication, general functioning and self-reliance (p < 0.05). Girls received more positive rating than boys in the domain of well-being (p < 0.05). No significant correlation was found between age at implantation, age at assessment, only child status, and HRQoL. All domains showed clear increases in the duration of CI use; the majority of the domains showed steeper progress over the first 3 months of CI use. Communication exhibited the most rapid progress, with education progressing at a slower rate.

Conclusions:
Parents were satisfied with all domains of HRQoL. Almost all domains exhibited rapid progress over the first 3 months of CI use, with education progressing at a slower rate. This research underscores the importance of language rehabilitation by revealing that strengthening language rehabilitation could be an effective means of improving the HRQoL of children with CIs.
The Role of the Basement Plate in Physeal Bar Formation
Authors: Wattenbarger John Michael , Marshall Amanda , Cox Michael D. , Gruber Helen 
Published: August 2018

Background:
Physeal fractures and resultant physeal bars can pose significant problems in skeletal development for the injured growing child. Although now well-recognized, only a small body of experimental literature covering this problem is available. The goal of this study was to help further develop an understanding of the different regions of the physis and the way in which each region responds to injury/fracture.

Methods:
This Institutional Animal Care and Use Committee (IACUC)-approved study assessed bar formation using radiologic and histologic methods and measured leg lengths of skeletally immature rats. The right tibia was used as the control to measure leg length discrepancy (LLD), and the left tibia received either a fracture only (F), an epiphyseal scrape (ES), an epiphyseal drilling procedure (ED), or metaphyseal drilling (MD). Radiographs and LLD measurements were obtained at postoperative days 0, 21, and 56.

Results:
A significant LLD was present at day 56 in the ED group (P=0.01). Radiographic identification of bars showed significant evidence of bar formation for the ES and ED groups at 21 days and the ED group at 56 days (P<0.05). Histologic examination showed a high incidence of histologic physeal bar formation in the ES, ED, and MD groups at 21 and 56 days.

Conclusions:
Findings showed that the physis was able to continue to grow following an injury to the physis’ hypertrophic region. MD produced little effects with few physeal bars and little LLD. By postoperative day 56, ED animals showed greater LLD than ES animals. Penetration of the basement plate was more likely to lead to bar formation/growth retardation than was ablation of the epiphyseal region of the physis (including resting cells).

Clinical Relevance:
Data presented here provides insight into the importance of different regions of the physis and its repair/continued growth after physeal fracture. We suggest that a better understanding of the physiological cause of physeal arrest after physeal fracture will be important for the development of treatments to prevent physeal arrest or to treat physeal arrest after it occurs.
Consequences Following Distal Femoral Growth Plate Violation in an Ovine Model With an Intramedullary Implant: A Pilot Study
Authors: Knapik Derrick M. , Zirkle Lewis G. , Liu Raymond W. 
Published: August 2018

Background:
Retrograde femoral nailing in skeletal immature patients would broaden the surgical options for fracture care and reconstructive procedures but involves violation of the open, active distal femoral physis with the potential for growth disturbance. The tolerance for putting a large diameter metal implant across the physis is largely unknown. The purpose of this pilot investigation was to define the upper limit of cross-sectional violation with a metal implant before causing premature growth arrest or inhibition using a sheep model.

Methods:
Eighteen sheep underwent placement of a retrograde, intramedullary implant at 3-months of age through an open distal femoral physis. The cross-sectional area of the physis was measured preoperatively and implants were selected that violated 3% to 8% of the cross-sectional area of the physis. Growth across the distal femoral physis was examined radiographically following surgery. Following euthanasia, both operative and no operative femurs were removed to compare differences in maximal lengths.

Results:
The distal femora grew an average of 10.6±2.2 mm radio graphically after implantation. When compared with control specimens, only operative specimens with 8% of physeal violation demonstrated significant growth discrepancy with operative femurs measuring <2.1 mm in length compared with the contralateral control femur. Histologic analysis did not demonstrate any significant physeal bars formation.

Conclusion:
Distal femoral growth continues across the physis when 3% to 7% of the cross-sectional area of the physis is violated using a retrograde intramedullary implant. Specimens with 8% of growth violation demonstrated significant growth inhibition. As such, retrograde nailing through the distal femoral physis appears safe up to 7%. On the basis of previous anatomic data in humans and average nail sizes, violations of >6% of the physis with pediatric retrograde nailing would be uncommon. These findings suggest that retrograde nailing may be a viable option and merits further study.

Level of Evidence:
Level IV—case series.
Nurses' Perceptions of Barriers to Rapid Response System Activation
Authors: Padilla Ricardo M. , Urden Linda D. , Stacy Kathleen M. 
Published: August 2018

Background
The rapid response system (RRS) was designed to identify and intervene on patients exhibiting clinical deterioration in the non–critical-care setting but is not always effectively activated by nurses, leading to adverse patient outcomes.

Objectives
The objective of this systematic review was to explore nurses' perceived barriers to RRS activation in the acute adult inpatient setting.

Method
A systematic review was completed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist. Six different search terms were used in the following electronic databases: Academic Search Premier, the Cumulative Index to Nursing and Allied Health Literature, Healthsource: Nursing/Academic Edition, MEDLINE, and PubMed. Limiters applied to search methods included years 2007 to current, full text, scholarly (peer reviewed), and English language. This review was further limited to quantitative studies in the adult inpatient setting.

Results
The initial electronic database search yielded 149 articles. After duplicate exclusion, 87 article abstracts were reviewed for inclusion and eligibility, and a total of 8 articles were used for this systematic review. Themes to nurses' perceived barriers to RRS activation include RRS activator-responder interaction, physician influence, nurse education, and nurse experience.

Discussion
Nurses play a vital role in patient care by providing continuous surveillance and are the frontline for early detection including prompt intervention should a patient's condition deteriorate. Inconsistent RRS activation has been associated with negative patient outcomes. Exploring nurses' perceived barriers to RRS activation may contribute to interventions that lead to nurses appropriately activating the RRS and potentially decreasing adverse patient outcomes.
STRUCTURAL AND FUNCTIONAL CHARACTERISTICS OF LAMELLAR MACULAR HOLES
Authors: Nguyen Justin H. , Yee Kenneth M.P. , Nguyen-Cuu Jeannie , Sebag J. 
Published: August 2018

Purpose:
Lamellar macular holes (LMHs) can been subdivided into tractional and degenerative subtypes. This cross-sectional cohort study compared structural and functional characteristics in these subtypes hypothesizing that tractional LMH has a higher prevalence of vitreopapillary adhesion and tangential traction (macular pucker), whereas degenerative LMH has more ellipsoid zone disruption and worse vision, measured three different ways.

Methods:
Tractional LMH (n = 22) and degenerative LMH (n = 15) were distinguished by optical coherence tomography criteria. Separate spectral domain optical coherence tomography scanning of the macula and optic disk was performed. Visual acuity, contrast sensitivity function (Weber Index, %W), and the degree of visual distortions (3-dimensional threshold Amsler grid; % volume lost [%VL]) were quantified.

Results:
Vitreopapillary adhesion was present in 14/22 (64%) tractional, but in only 3/15 (20%) degenerative LMH (P = 0.006). Macular pucker was present in 19/22 (86%) tractional, but in only 8/15 (53%) degenerative LMH (P = 0.011). Ellipsoid zone disruption was present in 13/15 (87%) degenerative, but in only 2/22 (9%) tractional LMH (P = 0.0001). Visual acuity was better in tractional than degenerative LMH (P = 0.006), as was contrast sensitivity function (tractional = 3.44 ± 1.07 %W, degenerative = 4.66 ± 1.73 %W; P = 0.015). Visual distortions were less in tractional (0.33 ± 0.61 %VL) than in degenerative (0.85 ± 0.68 %VL) LMH (P = 0.014).

Conclusion:
Structure and visual function differ significantly in subtypes of LMH. Tractional LMH has 3-fold higher prevalence of vitreopapillary adhesion and 2-fold higher prevalence of macular pucker. Degenerative LMH has 9-fold more ellipsoid zone disruption, worse visual acuity and contrast sensitivity function, and 3-fold more distortions. Thus, outer retinal integrity seems more closely correlated with vision than anterior structural abnormalities in LMH.
RESPONSE TO INTRAVITREAL AFLIBERCEPT IN A PATIENT WITH PERIPHERAL EXUDATIVE HEMORRHAGIC CHORIORETINOPATHY
Authors: Sax James , Karpa Michael , Reddie Ian 
Published: August 2018

Purpose:
To draw attention to a novel treatment agent for vision loss associated with peripheral exudative hemorrhagic chorioretinopathy.

Methods:
The case of an 83-year-old man suffering with loss of left visual acuity vision in the context of vitreous hemorrhage secondary to peripheral exudative hemorrhagic chorioretinopathy is described.

Results:
Resolution of vitreous hemorrhage and subretinal hemorrhage was demonstrated after treatment with aflibercept.

Conclusion:
Peripheral exudative hemorrhagic chorioretinopathy is discussed in terms of its presentation, pathophysiology, and existing treatment methodologies.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGING OF A CONGENITAL SIMPLE HAMARTOMA OF THE RETINAL PIGMENT EPITHELIUM
Authors: Zola Marta , Ambresin Aude , Zografos Leonidas 
Published: August 2018

Purpose:
To report the case of a small pigmented tumor in the macular region investigated using optical coherence tomography angiography (OCT-A) in the context of a multimodal approach.

Methods:
Case report

Results:
A 24-year-old man was referred for evaluation of an asymptomatic unilateral round comma-shaped pigmented tumor located in the macular region of his right eye. Spectral-domain OCT revealed an irregular hyperreflective mass within the retina, with a thickened hyaloid membrane and abrupt margins, and a complete posterior shadowing effect. On fluorescein angiography, early hyperfluorescence without leakage in the middle and late phases and a subtle halo of hyperfluorescence in the late phase were observed. OCT-A revealed the presence of intrinsic vascularization at the level of the inner capillary plexus, with signal intensity present at the level of the outer capillary plexus. In the superficial scans, the retinal vessels were oriented radially to the lesion and were in continuity with the vascular network within the tumor mass. No choroidal vessels could be identified.

Conclusion:
We report the case of a congenital simple hamartoma of the retinal pigment epithelium investigated using OCT-A as part of multimodal imaging. OCT-A provided a new insight in the assessment of the lesion, differential diagnosis, and follow-up of the patient. This imaging modality could be an important non-invasive tool in the management of congenital hamartomas of the retinal pigment epithelium.