bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calculated Blood Loss and Transfusion Requirements in Primary Open Repair of Craniosynostosis
Authors: Lopez Marcos M. , Lee James , Morrison Kerry , Hoffman Caitlin , Souweidane Mark , Ascherman Jeffrey A. 
Published: February 2019

Background:
Open surgical correction is effective in the treatment of craniosynostosis but may result in significant blood loss and transfusions. This study seeks to compare surgeon estimated blood loss with calculated blood loss and provide contemporary data that objectively quantify blood loss and transfusion rate associated with open repair of craniosynostosis.

Methods:
A retrospective review of patients undergoing primary open repair of craniosynostosis between May 2011 and November 2016 was performed. The medical records of 43 patients were reviewed to obtain the operative age, weight, affected suture, pre- and postoperative hematocrit, blood transfusion volume, estimated blood loss, and syndromic status. Estimated blood volume (EBV) and red cell mass were calculated for analysis.

Results:
The median age and weight at the time of surgery were 9 months and 8.6 kg, respectively. Mean surgeon estimated blood loss was 207.4 mL (28.1% of EBV). Mean calculated blood loss was 318 mL (44.3% of EBV). The mean transfusion volume was 188 mL (26.5% of EBV). The mean transfusion as a percent of estimated red cell mass was 59.1%. Fourteen percent of patients did not require any transfusion.

Conclusions:
We report intraoperative blood losses and transfusion requirements that are lower than those of many previous studies of open repair of craniosynostosis. Additionally, we found that calculated blood loss estimates may be more reliable than surgeon-derived estimated blood loss. We hope that these updated, objective data will be useful in comparisons of open repair to minimally invasive surgery or to new blood loss reducing procedures.
Spatial and Temporal Variations of Indoor Airborne Radon Decay Product Dose Rate and Surface-Deposited Radon Decay Products in Homes
Authors: Steck Daniel J. , Sun Kainan , William Field R. 
Published: February 2019

Abstract
The temporal variations of the airborne radon decay product dose rate and deposited radon decay product activities, as well as the within-house and house-to-house variations of radon concentrations, were evaluated through repeated field measurements. Long-term average radon and surface-deposited radon decay product concentrations were measured in 76 rooms of 38 houses. Temporal variation of radon, as well as airborne and surface-deposited radon decay products, were measured in 11 of the 38 houses during two different seasons. Environmental factors that have the potential to influence airborne dose rate and deposited radon decay products were also studied. Airborne dose rates were calculated from the unattached and attached potential alpha energy concentrations using two dosimetric models. For one model, the observed dose variations were 103%, 74%, 58%, and 60% for the total, house-to-house, within-house, and within-room temporal variations, respectively. For the other model, the dose variations were 100%, 66%, 61%, and 46%, respectively. Surface-deposited 214Po showed variations of 79%, 57%, 42%, and 48%, respectively. These substantial radon decay product concentration variations suggest that multiple locations and time-integrated measurements are needed to make an accurate assessment of the chronic radon-related doses in homes. Smoking was the environmental factor that had the largest temporal and spatial effect on airborne radon decay product dose rates.
Vision-Related Quality of Life in Keratoconus: A Save Sight Keratoconus Registry Study
Authors: Tan Jeremy C. K. , Nguyen Vuong , Fenwick Eva , Ferdi Alex , Dinh Amanda , Watson Stephanie L. 
Published: February 2019

Purpose:
To assess vision-related quality of life using the Impact of Vision Impairment Questionnaire (IVI) in patients with keratoconus enrolled in the Save Sight Keratoconus Registry.

Methods:
In this cross-sectional study, data on 107 keratoconic patients were collected through a prospectively designed web-based registry from a quaternary referral eye hospital and 2 corneal subspecialty practices. Vision-related quality of life was evaluated using the IVI. Rasch analysis was used to transform the IVI responses into interval-level measures comprising reading, mobility, and emotional well-being subscales. Associations between best-corrected visual acuity (BCVA), maximum simulated keratometry (Kmax), steep keratometry (K2), and pachymetry for each eye and IVI subscale scores were evaluated with univariate (Pearson correlations) and multivariable regression adjusted for age and gender.

Results:
Of the 107 patients, 37 (34.5%), 41 (38.0%) and 29 (26.9%) had mild, moderate, and severe keratoconus, respectively. On uni- and multivariable analysis, BCVA in the better eye had the strongest association with reading [r = 0.51; 95% confidence interval (CI), 0.35–0.64, P = 0.004] and mobility (r = 0.55; 95% CI, 0.41–0.67, P < 0.001) subscale scores. BCVA in the better and worse eye, both had the joint strongest associations with emotional scores on univariate analysis, but only the latter was significant on multivariable analysis (r = 0.37; 95% CI, 0.20–0.53, P < 0.001). K2 and Kmax in the better eye also displayed significant associations with reading and mobility scores.

Conclusions:
In patients with keratoconus, BCVA in the better eye had the strongest correlation with reading and mobility scores, whereas BCVA in the worse eye was significantly correlated with emotional scores.
The medial temporal lobe in nociception: a meta-analytic and functional connectivity study
Authors: Ayoub Lizbeth J. , Barnett Alexander , Leboucher Aziliz , Golosky Mitchell , McAndrews Mary Pat , Seminowicz David A. , Moayedi Massieh 
Published: February 2019

AbstractRecent neuroimaging studies implicate the medial temporal lobe (MTL) in nociception and pain modulation. Here, we aim to identify which subregions of the MTL are involved in human pain and to test its connectivity in a cohort of chronic low-back pain patients (CBP). We conducted 2 coordinate-based meta-analyses to determine which regions within the MTL showed consistent spatial patterns of functional activation (1) in response to experimental pain in healthy participants and (2) in chronic pain compared with healthy participants. We followed PRISMA guidelines and performed activation likelihood estimate (ALE) meta-analyses. The first meta-analysis revealed consistent activation in the right anterior hippocampus (right antHC), parahippocampal gyrus, and amygdala. The second meta-analysis revealed consistently less activation in patients' right antHC, compared with healthy participants. We then conducted a seed-to-voxel resting state functional connectivity of the right antHC seed with the rest of the brain in 77 CBP and 79 age-matched healthy participants. We found that CBP had significantly weaker antHC functional connectivity to the medial prefrontal cortex compared with healthy participants. Taken together, these data indicate that the antHC has abnormally lower activity in chronic pain and reduced connectivity to the medial prefrontal cortex in CBP. Future studies should investigate the specific role of the antHC in the development and management of chronic pain.
Compared to limb pain of other origin, ultrasonographic osteodensitometry reveals loss of bone density in complex regional pain syndrome
Authors: Bazika-Gerasch Bojana , Maier Christoph , Kumowski Nina , Fiege Carolin , Kaisler Miriam , Vollert Jan , Dietrich Johannes W. 
Published: February 2019

Abstract
Local osteopenia and altered bone metabolism are major complications of complex regional pain syndrome (CRPS), but quantitative assessment is difficult unless using X-ray or dual-energy X-ray absorptiometry. Ultrasound-based measurement of bone density (UBD) is a possible alternative but has never been used to detect unilateral disease such as CRPS. Therefore, the main outcome measure of this prospective study was the diagnostic utility of UBD in patients with lower-limb CRPS. Second, we compared the extent of unilateral and contralateral calcaneal bone density to that of other conditions with unilateral pain, general osteoporosis, and healthy subjects. Calcaneal osteodensitometry was bilaterally examined using ultrasound-based methodology. Bone mineral density values were converted to Z-scores based on age- and sex-dependent reference values. All patients completed a functional and an osteoporosis risk questionnaire. In patients with CRPS (n = 18), the bone mineral density values and Z-scores were significantly lower in both the affected (mean ± SD: 0.40 ± 0.08 and −1.1 ± 0.8, respectively) and nonaffected (0.46 ± 0.09 and −0.6 ± 0.9, respectively) limbs than in patients (n = 40) with other unilateral pain syndromes (affected: 0.51 ± 0.1 and −0.2 ± 1.1, respectively; nonaffected: 0.54 ± 0.11 and 0 ± 0.9, respectively) and healthy subjects (right side: 0.6 ± 0.1 and 0.1 ± 0.9, respectively). Conversely, in patients with known systemic osteoporosis, the Z-scores were lower bilaterally with smaller side-to-side differences than in those with CRPS (P < 0.05). Compared with subjects suffering from long-term CRPS (≥2.4 years), patients with shorter disease duration exhibited significantly lower Z-scores (P < 0.05). In conclusion, UBD revealed that CRPS is associated with both local and systemic alterations of bone metabolism.
Differential activation of ascending noxious pathways associated with trigeminal nerve injury
Authors: Okada Shinji , Katagiri Ayano , Saito Hiroto , Lee Jun , Ohara Kinuyo , Iinuma Toshimitsu , Bereiter David A. , Iwata Koichi 
Published: February 2019

Abstract
Trigeminal spinal subnucleus caudalis (Vc) neurons that project to the ventral posteromedial thalamic nucleus (VPM) and parabrachial nucleus (PBN) are critical for orofacial pain processing. We hypothesized that persistent trigeminal nerve injury differentially alters the proportion of Vc neurons that project to VPM and PBN in a modality-specific manner. Neuroanatomical approaches were used to quantify the number of Vc neurons projecting to VPM or PBN after chronic constriction injury of the infraorbital nerve (ION-CCI) and subsequent upper-lip stimulation. Male rats received injections of retrograde tracer fluorogold into the contralateral VPM or PBN on day 7 after ION-CCI, and at 3 days after that, either capsaicin injection or noxious mechanical stimulation was applied to the upper lip ipsilateral to nerve injury. Infraorbital nerve chronic constriction injury rats displayed greater forelimb wiping to capsaicin injection and mechanical allodynia of the lip than sham rats. Total cell counts for phosphorylated extracellular signal-regulated kinase-immunoreactive (pERK-IR) neurons after capsaicin or mechanical lip stimuli were higher in ION-CCI than sham rats as was the percentage of pERK-IR PBN projection neurons. However, the percentage of pERK-IR VPM projection neurons was also greater in ION-CCI than sham rats after capsaicin but not mechanical lip stimuli. The present findings suggest that persistent trigeminal nerve injury increases the number of Vc neurons activated by capsaicin or mechanical lip stimuli. By contrast, trigeminal nerve injury modifies the proportion of Vc nociceptive neurons projecting to VPM and PBN in a stimulus modality-specific manner and may reflect differential involvement of ascending pain pathways receiving C fiber and mechanosensitive afferents.
Attentional Bias, “Cool” and “Hot” Executive Functions in Obese Patients
Authors: Fang Ching-Tzu , Chen Vincent Chin-Hung , Ma Hsiang-Ting , Chao Hse-Huang , Ho Ming-Chou , Gossop Michael 
Published: February 2019

AbstractPurpose/BackgroundObesity is recognized as an important risk factor for many chronic diseases and is a major health issue. The current study examined attentional bias to food and the “cool” (inhibitory control and mental flexibility) and “hot” (affective decision making) executive functions (EFs) in obese patients preparing for bariatric surgery. In addition to body mass index (BMI), this study examined the impact of the binge-eating tendency and eating styles.MethodsThe study population comprised 21 morbidly obese patients preparing to undergo bariatric surgery (BMI ≥30 kg/m2) and 21 normal-weight controls (24 kg/m2> BMI ≥ 18.5 kg/m2). The Visual Probe Task was adopted to examine attentional bias toward food-related cues. The Stop-Signal Task and the Color Trails Test were used to assess inhibitory control and mental flexibility, respectively. The Iowa Gambling Task was administered to assess the affective decision making.Results(1) The obese patients showed poorer performances on cool EFs (for Color Trails Test,P= 0.016,ηp2= 0.136; for Stop-Signal Task,P= 0.049,ηp2= 0.093) and hot EF (for Iowa Gambling Task, normal controls showed progressed performance,P= 0.012,ηp2= 0.077, but obese patients did not show this progress,P= 0.111,ηp2= 0.089) compared with the normal controls; (2) participants with low binge-eating tendency had larger attentional biases at 2000 milliseconds than at 200 milliseconds on food-related cues (P= 0.003,ηp2= 0.363); and (3) low-restrained participants exhibited attentional bias toward the low-calorie food cues, compared with the high-restrained group (P= 0.009,ηp2= 0.158).ConclusionsThe current study contributes to the development of a different therapeutic focus on obese patients and binge eaters.
Nursing Students' Perceptions of Nursing Metaparadigms: A Phenomenological Study
Authors: DELIKTAS Ayse , KORUKCU Oznur , AYDIN Ruveyde , KABUKCUOGLU Kamile 
Published: February 2019

ABSTRACT

Background:
The paradigm is a vital concept steering the development of a scientific discipline. Paradigms that shape the education, research, and practice steps of a discipline are defined as metaparadigms.

Purpose:
The purpose of this study was to explore the perception of nursing students regarding metaparadigms in nursing at Akdeniz University in Antalya, Turkey.

Methods:
This was designed as a descriptive phenomenological study, and data were collected from 13 fourth-year students who were chosen via a purposeful sampling method and interviewed face-to-face using a semistructured format. Data were analyzed using the data analysis steps of Giorgi, who is an expert in descriptive phenomenological studies.

Results:
Most of the participants in this study associated nursing with humanism. Some of the participants stated that a fundamental building block of the nursing profession is conscience, whereas others stated that nursing is a way to touch people's lives and is now regarded as a professional practice. It has been reported that students have difficulties identifying metaparadigms in nursing and that they believe that human beings have the potential to widen their horizons with wisdom and social skills. According to the participants, the health metaparadigm refers to the harmony between human beings and their environment and to the autonomy of the individual. Moreover, the participants emphasized the well-being of individuals.

Conclusions/Implications for Practice:
The participants in this study characterized humans with well-being, transcendence, adaptation and interaction skills with their environment, and harmony beyond physiological mechanisms, which was considered to be promising for the perception of future nurses. It is recommended for nursing educators to enable their students to raise their professional awareness and to internalize professional values.
Neuromuscular Training Improves Biomechanical Deficits at the Knee in Anterior Cruciate Ligament–Reconstructed Athletes
Authors: Nagelli Christopher V. , Wordeman Samuel C. , Di Stasi Stephanie , Hoffman Joshua , Marulli Tiffany , Hewett Timothy E. 
Published: February 2019

Objective:
Athletes who return to sport after anterior cruciate ligament reconstruction (ACLR) demonstrate persistent biomechanical and neuromuscular deficits of the knee. There is limited evidence on what effect a neuromuscular training (NMT) program has on knee biomechanics in a cohort of athletes with ACLR. Therefore, the primary aim of this study was to quantify the effect of an NMT program on knee biomechanics in a cohort of ACLR athletes. Second, the post-training knee biomechanics were compared between the cohort of ACLR and control athletes.

Design:
Cohort study.

Setting:
Controlled laboratory setting.

Participants:
Eighteen athletes with ACLR and 10 control athletes.

Interventions:
Neuromuscular training.

Main Outcome Measures:
Knee kinematics and kinetics during a double-limb jump-landing task.

Results:
There were no significant interactions (P > 0.05) observed for the athletes with ACLR. However, there was a significant main effect of biomechanics testing session (P < 0.05) for knee flexion angle and moments; athletes with ACLR demonstrated greater knee flexion angle and lower knee flexion moment during the post-training biomechanics testing session. Post-training comparison between the ACLR and control athletes demonstrated no significant interactions (P > 0.05) between the groups. There was a significant main effect of group (P < 0.05) for knee frontal angle, as athletes with ACLR landed with greater knee adduction than the control athletes.

Conclusions:
Significant improvements in knee sagittal plane biomechanical measures were observed after the NMT program by the athletes with ACLR. In addition, post-training comparison of the ACLR and control groups demonstrates comparable knee biomechanics.
Impact of Medicaid on Cochlear Implant Access
Authors: Sorkin Donna L. 
Published: February 2019

Objective:
The study documented the role of Medicaid in the provision of cochlear implants and identified access barriers due to states’ adopted rules. An historical review of federal legislation provided a basis for evaluating the original Congressional intent and how this national purpose aligns with how state programs are currently operating.

Study Design:
A SurveyMonkey questionnaire was used to facilitate data collection from 47 clinics across 35 states after an initial inquiry was made to each clinic to determine an appropriate point of contact, generally a cochlear implant audiologist. Respondents were from all regions of the United States and represented a diversity of clinic types of varying program size. Data were collected for two calendar years—2015 and 2016.

Results:
Medicaid was the funding source for an average of 55% of pediatric surgeries based on 36 US clinics. For the 23 clinics returning information on adults, Medicaid was the health insurer for an average (mean) of 22% of cochlear implants (CI) surgeries; the median was 13%. Four access concerns were identified: 1) equipment replacement and processor upgrade policies; 2) low reimbursement by state Medicaid for cochlear implant surgery and related services; 3) Medicaid Managed Care (MCO) and the complexity these providers can add for a specialized service like CI that is offered at a limited number of facilities; and 4) obtaining authorization for CI surgery and related services.

Conclusions:
The intent of the 1989 legislative changes in Medicaid was to ensure that children received appropriate healthcare services wherever they lived in the country. What has transpired over the years, vis-à-vis CI, is a Medicaid system that varies depending upon the state's individual rules.
Magnetically Controlled Capsule Endoscopy in Children
Authors: Gu Zhujun , Wang Yizhong , Lin Kai , Wang Xing , Cheng Weiwei , Wang Ling , Zhang Ting , Liu Haifeng 
Published: February 2019

ABSTRACTObjective:Capsule endoscopy (CE) is a noninvasive diagnostic tool for the digestive tract. We aim to investigate the feasibility and safety of newly developed magnetically controlled capsule endoscopy (MCE) in children.Methods:A total of 129 children who underwent MCE in Shanghai Children's Hospital were retrospectively recruited between March 2016 and August 2018. The feasibility, positive findings, and safety of MCE were evaluated and systematically analyzed.Results:Of all those children, 68 were boys, and 61 were girls with a mean age of 9.8 ± 1.9 years (6–14 years). The MCE procedure was feasible in all children. The mean esophageal transit time was 6.0 ± 4.6 seconds. The mean gastric examination time was 14.4 ± 3.9 minutes, and the average gastric transit time was 83.9 ± 59.1 minutes. Positive findings were detected in 82 children (82/129, 63.6%), 1 had esophageal lesions, 30 had superficial gastritis, 14 had superficial gastritis with bile reflux, 18 had nodular gastritis, 1 had ulcers, and 2 had heterotopic pancreas. There were 5 patients who had duodenal bulbar ulcers. One had lymphatic follicle, 1 had celiac disease, 1 had blue rubber bleb nevus syndrome, and 2 polyps were detected in 16 patients who were examined the small bowel. No serious adverse event was reported during the MCE examination and follow‐up, and all subjects excreted the capsules spontaneously within 2 weeks.Conclusions:We showed that MCE is feasible and safe in children above 6 years. More studies are needed to further investigate the efficacy of MCE in children.
Computed Tomography Diagnostic Abilities for Open-Globe Injuries in Pediatric Versus Adult Patients
Authors: Dikci Seyhan , Yildirim İsmail Okan , Firat Murat , Firat Penpe Gül , Demirel Soner , Yilmaz Turgut , Tuncer İlknur , Genç Oğuzhan 
Published: February 2019

Objectives
The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups.

Methods
Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups.

Results
We included 47 eyes of 47 cases aged 18 years and below (pediatric group) and 85 eyes of 82 cases over 18 years (adult group). The mean ± SD age was 10.80 ± 5.11 years (range, 2–18 years) in the pediatric group and 46.34 ± 19.01 years (range, 19–82 years) in the adult group. Computed tomography images revealed 21.7% of the cases with corneal lacerations, 55.5% with scleral lacerations, and 91.6% with corneoscleral lacerations in the pediatric group, whereas the respective numbers were 48.4%, 66.6%, and 61.9% in the adult group. The detection rates of corneal penetrations and vitreous hemorrhage with CT were significantly lower in the pediatric group than in the adult group (P < 0.05). The CT scans diagnosed 66.6% of the pediatric cases and 90% of the adult cases with an IOFB.

Conclusions
Corneal lacerations and IOFBs can be missed, especially in the pediatric group, because the eye is smaller in adults. Pediatric patients with a history of ocular trauma should undergo an examination under general anesthesia followed by surgical exploration if necessary.