bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand Hygiene Compliance in the ICU: A Systematic Review
Authors: Lambe Kathryn Ann , Lydon Sinéad , Madden Caoimhe , Vellinga Akke , Hehir Aoife , Walsh Mary , O’Connor Paul 
Published: June 2019

Objectives:
To synthesize the literature describing compliance with World Health Organization hand hygiene guidelines in ICUs, to evaluate the quality of extant research, and to examine differences in compliance levels across geographical regions, ICU types, and healthcare worker groups, observation methods, and moments (indications) of hand hygiene.

Data Sources:
Electronic searches were conducted in August 2018 using Medline, CINAHL, PsycInfo, Embase, and Web of Science. Reference lists of included studies and related review articles were also screened.

Study Selection:
English-language, peer-reviewed studies measuring hand hygiene compliance by healthcare workers in an ICU setting using direct observation guided by the World Health Organization’s “Five Moments for Hand Hygiene,” published since 2009, were included.

Data Extraction:
Information was extracted on study location, research design, type of ICU, healthcare workers, measurement procedures, and compliance levels.

Data Synthesis:
Sixty-one studies were included. Most were conducted in high-income countries (60.7%) and in adult ICUs (85.2%). Mean hand hygiene compliance was 59.6%. Compliance levels appeared to differ by geographic region (high-income countries 64.5%, low-income countries 9.1%), type of ICU (neonatal 67.0%, pediatric 41.2%, adult 58.2%), and type of healthcare worker (nursing staff 43.4%, physicians 32.6%, other staff 53.8%).

Conclusions:
Mean hand hygiene compliance appears notably lower than international targets. The data collated may offer useful indicators for those evaluating, and seeking to improve, hand hygiene compliance in ICUs internationally.
Management of Peripheral Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock
Authors: Keller Steven P. 
Published: June 2019

Objectives:
Cardiogenic shock is a highly morbid condition in which inadequate end-organ perfusion leads to death if untreated. Peripheral venoarterial extracorporeal membrane oxygenation is increasingly used to restore systemic perfusion despite limited understanding of how to optimally titrate support. This review provides insights into the physiologic basis of extracorporeal membrane oxygenation support and presents an approach to extracorporeal membrane oxygenation management in the cardiogenic shock patient.

Data Sources, Study Selection, and Data Extraction:
Data were obtained from a PubMed search of the most recent medical literature identified from MeSH terms: extracorporeal membrane oxygenation, cardiogenic shock, percutaneous mechanical circulatory support, and heart failure. Articles included original articles, case reports, and review articles.

Data Synthesis:
Current evidence detailing the use of extracorporeal membrane oxygenation to support patients in cardiogenic shock is limited to isolated case reports and single institution case series focused on patient outcomes but lacking in detailed approaches to extracorporeal membrane oxygenation management. Unlike medical therapy, in which dosages are either prescribed or carefully titrated to specific variables, extracorporeal membrane oxygenation is a mechanical support therapy requiring ongoing titration but without widely accepted variables to guide treatment. Similar to mechanical ventilation, extracorporeal membrane oxygenation can provide substantial benefit or induce significant harm. The widespread use and present lack of data to guide extracorporeal membrane oxygenation support demands that intensivists adopt a physiologically-based approach to management of the cardiogenic shock patient on extracorporeal membrane oxygenation.

Conclusions:
Extracorporeal membrane oxygenation is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach based physiologic principles provides a basis for care.
Fourier Analysis of Corneal Irregular Astigmatism After Small Incision Lenticule Extraction and Comparison to Femtosecond Laser-Assisted Laser In Situ Keratomileusis
Authors: Sideroudi Haris , Sekundo Walter , Kozobolis Vassilios , Messerschmidt-Roth Anke , Lazaridis Apostolos 
Published: June 2019

Purpose:
Evaluation of spherical component (SC), regular astigmatism (RA), and irregular astigmatism (IA, ie, Asymmetry and Irregularities) 3 years after small incision lenticule extraction (SMILE) and comparison to femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).

Methods:
Thirty-two eyes of 21 patients who underwent SMILE for myopia and astigmatism were compared with 32 eyes of 21 patients treated with FS-LASIK. Scheimpflug images were obtained preoperatively and 3 years postoperatively. Fourier analysis of keratometric-derived parameters (SC, RA, Asymmetry, and Irregularities) of the anterior, posterior, and total cornea were evaluated at 4 concentric rings (ring 1, 2 mm diameter; ring 2, 4 mm; ring 3, 6 mm; ring 4, 8 mm) and over the entire 8-mm zone.

Results:
After FS-LASIK, over the 8-mm zone, the RA and IA of the anterior cornea increased significantly (P ≤ 0.002), whereas SMILE induced an insignificant increase in RA and Asymmetry (P ≥ 0.276) and a decrease in Irregularities (P = 0.770). At the 8-mm zone of the posterior cornea, the Irregularities increased significantly (P = 0.027) after FS-LASIK, whereas SMILE induced no significant changes in the examined variables (P ≥ 0.347). RA and IA of the total cornea increased significantly after FS-LASIK (P ≤ 0.001), whereas SMILE induced an insignificant increase in RA and Asymmetry (P ≥ 0.092) and a significant decrease in Irregularities (P < 0.001). FS-LASIK induced a greater decrease in SC of the total cornea at ring 4 (P = 0.009).

Conclusions:
FS-LASIK resulted in a greater increase in RA and Irregularities and greater flattening of the midperiphery of the anterior and total cornea compared with SMILE. The posterior cornea remained unaffected after SMILE, whereas more Irregularities were induced after FS-LASIK over the 8-mm zone.
Long-term Prognosis of Tuberculosis Infection and Disease in Swedish Children
Authors: Bennet Rutger , Jonsson Jerker , Nejat Sahar , Olsson-Åkefeldt Selma , Eriksson Margareta 
Published: June 2019

Background:
Reports of the outcome of treatment of tuberculosis (TB) disease and infection (TBI) in children are scarce. Since 2010, we routinely use interferon-gamma release assays in addition to clinical history for the exclusion of TBI, although the safety of this approach has been questioned. We present the frequency of recurrent TB or progression to TB after treatment for TB disease or TB infection, respectively, and progression to disease in children considered TB uninfected at our pediatric TB clinic.

Methods:
We included 4707 patients from 1990 to 2017. At the initial assessment, 96 (2.0%) had previously received TB treatment, 253 (5.4%) had TB disease, 1625 (35%) had TBI and 2733 (58%) children were considered uninfected. Patients were passively followed at our clinic, at the adult TB clinics in Stockholm and at the Swedish national TB registry.

Results:
During a median follow-up time of 8.4 years, we found 36 cases of TB disease, with true relapses in 3/243 (1.2%) successfully treated TB patients. Preventive treatment of TBI reduced the risk of progression to TB by 85%, from 4.3% (15/349) to 0.6% (8/1262). In children considered uninfected, the risk of later developing TB was 0.07% (2/2733).

Conclusions:
The effectiveness of TB management was acceptable. Our routine procedures for the exclusion of TBI appear safe.
Invasive Pneumococcal Infections in Children with Nephrotic Syndrome in Bangladesh
Authors: Malaker Roly , Saha Senjuti , Hanif Mohammed , Ahmed ASMNU , Saha Shampa , Hasanuzzaman Md. , Khondakar Tarannum , Islam Maksuda , Baqui Abdullah H. , Santosham Mathuram , Darmstadt Gary L. , Whitney Cynthia G. , Saha Samir K. 
Published: June 2019

Introduction:
Children with nephrotic syndrome are susceptible to invasive bacterial infections. In this study, we aimed to: (1) determine the pathogens associated with infections in children with nephrotic syndrome and (2) describe antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae to guide evidence-based treatment and prevention policies.

Methods:
From June 2013 to March 2015, we collected blood and/or ascitic fluid from children hospitalized with nephrotic syndrome and suspected bacterial disease in the largest pediatric hospital of Bangladesh. We cultured all samples and performed polymerase chain reaction (PCR) and immunochromatographic test on ascitic fluid for detection of S. pneumoniae. Pneumococcal isolates were tested for antibiotic susceptibility using disc diffusion and serotyped using Quellung reaction and PCR.

Results:
We identified 1342 children hospitalized with nephrotic syndrome. Among them, 608 children had suspected bacterial disease from whom blood and/or ascitic fluid were collected. A pathogen was identified in 8% (48/608) of cases, 94% (45/48) of which were S. pneumoniae. Most (73%, 33/45) pneumococcal infections were identified through culture of blood and ascitic fluid and 27% (12/45) through immunochromatographic test and PCR of ascitic fluid. In total, 24 different pneumococcal serotypes were detected; 51% are covered by PCV10 (+6A), 53% by PCV13 and 60% by PPSV23. All pneumococcal isolates were susceptible to penicillin.

Conclusions:
Because S. pneumoniae was the primary cause of invasive infections, pneumococcal vaccines may be considered as a preventive intervention in children with nephrotic syndrome. Additionally, penicillin can be used to prevent and treat pneumococcal infections in children with nephrotic syndrome in Bangladesh.
Migraine understood as a sensory threshold disease
Authors: Peng Kuan-Po , May Arne 
Published: June 2019

AbstractMigraine encompasses a broader spectrum of sensory symptoms than just headache. These “other” symptoms, eg, sensory phobias, cognitive and mood changes, allodynia, and many others indicate an altered sensitivity to sensory input which can be measured, in principle, by quantifying sensory threshold changes longitudinally over time. Photophobia, for example, can be quantified by investigating the discomfort thresholds towards the luminance of light. The aim of this review is to look into how thresholds change in patients with migraine. We performed a PubMed search up to June 2018 targeting all peer-reviewed articles evaluating the changes in threshold, sensory phobia, or sensitivity in patients with migraine. Migraineurs, in general, exhibit lower sensory thresholds compared with healthy controls. These threshold changes seem to follow the different phases during a migraine cycle. In general, thresholds reach a nadir when the headache starts (the ictal phase), rise after the headache ends, and then gradually descend towards the next attack. The sensory modality of measurement—mechanical, thermal, or nociceptive—and the location of measurement—trigeminal vs somatic dermatome—also influence the sensory threshold. Functional imaging studies provide evidence that the hypothalamo-thalamo-brainstem network may be the driving force behind the periodic threshold changes. In summary, there is evidence in the literature that migraine could be understood as a periodic sensory dysregulation originating from the brain. Nevertheless, the interstudy discrepancy is still high due to different study designs and a lack of focus on distinct migraine phases. Further well-designed and harmonized studies with an emphasis on the cyclic changes still need to be conducted.
Time Out of Play Due to Illness in Major and Minor League Baseball
Authors: Conway Justin J. , Curriero Frank C. , Camp Christopher L. , Toresdahl Brett G. , Coleman Struan , Kinderknecht James J. 
Published: June 2019

Objective:
To generate a summative report on the most commonly diagnosed illnesses in Major League Baseball (MLB) and Minor League Baseball (MiLB) athletes with specific attention to their impact based on time out of play.

Design:
Retrospective analysis.

Setting:
Injury and illness data from the MLB Health and Injury Tracking System.

Participants:
All MLB and MiLB athletes active between 2011 and 2016.

Assessment of Risk Factors:
Illnesses were defined as atraumatic medical diagnoses that occurred during the MLB or MiLB season and resulted in at least 1 day out of play.

Main Outcome Measures:
Incidence of illness diagnoses and resulting time out play.

Results:
Eight thousand eight hundred thirty-four illnesses were reported, representing 14.7% of all diagnoses resulting in time out of play. Total days missed (DM) due to illness were 39 614, with a mean of 4.6 (SD 9.9 days) and median 2 DM per diagnosis. The annual incidence of illness per season was 20.3 per 100 athletes. The most common diagnosis was nonspecific viral illness (15.3%), followed by gastroenteritis (13.6%), other gastrointestinal illness (8.3%), influenza (7.0%), and upper respiratory infection (6.2%). Appendicitis (15.2%) and Epstein–Barr virus/cytomegalovirus (9.1%) were the most common season-ending diagnoses.

Conclusions:
Illnesses represent a significant cause of time out of play in MLB and MiLB. Prevention efforts should focus on limiting the spread of communicable viral, respiratory, and gastrointestinal disease among players, as the majority of diagnoses fell into these categories. This work may be used to guide future research into illness treatment and prevention in professional baseball.
Outcome of Cochlear Implantation in Children With Narrow Bony Cochlear Nerve Canal
Authors: Kang Byung Chul , Lee Jee Yeon , Kim Yehree , Park Jun Woo , Kang Woo Seok , Ahn Joong Ho , Park Hong Ju , Chung Jong Woo 
Published: June 2019

Objective:
To investigate the diameter of the bony cochlear nerve canal (BCNC) as a prognostic indicator of cochlear implantation (CI) in children.

Study Design:
Retrospective study.

Setting:
Tertiary referral center.

Patients:
Two hundred ninety two prelingual deaf children (323 ears) who received CI before the age of 5 years.

Interventions:
CI in pediatric patients.

Main Outcome and Measures:
Postoperative auditory performance was analyzed according to the diameter of the BCNC using the Mann–Whitney U test. Using the images of temporal bone computed tomography, patients were grouped according to the diameter of the BCNC: narrow (<1.4 mm, Group 1), normal (Group 2), and other anomalies (Group 3).

Results:
Group 1 (10.5%) showed a less significant degree of improvement in category of audiological performance (CAP) score than Groups 2 (57.3%) and 3 (32.2%). Scores obtained from both the open-set monosyllabic words and sentence tests were lower in Group 1 than Groups 2 and 3. Of the patients with narrow BCNC, the CAP score of patient with complete stenosis of BCNC (<0.2 mm) was lower than that of patients with BCNC between 0.2 and 0.8 mm, also 0.8 and 1.4 mm.

Conclusions:
The improvement in auditory performance was limited in children with narrow BCNC and the narrower the BCNC, the more severe the limitation. However, gradual improvement can be expected and even children with narrow BCNC may be candidates for early CI and rehabilitation.
First MRI With New Cochlear Implant With Rotatable Internal Magnet System and Proposal for Standardization of Reporting Magnet-Related Artifact Size
Authors: Cass Nathan D. , Honce Justin M. , O’Dell Alexandra L. , Gubbels Samuel P. 
Published: June 2019

Objective:
To report on the first known magnetic resonance imaging (MRI) with a new cochlear implant (CI) with rotatable internal magnet system, to review the literature on MRI in cochlear implantees, and to advocate for standardization of reporting magnet-related artifact size.

Study Design:
Case report and review of literature.

Setting:
Tertiary care hospital.

Results:
A patient with congenital rubella and bilateral profound hearing loss was incidentally found to have a petroclival meningioma. After resection and radiosurgery, she underwent cochlear implantation with the Advanced Bionics HiRes Ultra 3D device (Advanced Bionics LLC, Valencia, CA) with rotatable internal magnet system, due to need for imaging surveillance of residual meningioma. During 1.5 T MRI brain scan without a head wrap, she experienced no adverse events. The images obtained were adequate for visualization of residual tumor. Implant recipients with non-rotatable magnets who undergo MRI, with or without recommended head wrap, may suffer various complications. All images in patients with retained internal magnets are subject to magnet-related artifact, but reports regarding its size are variable and lack detail on how measurements are made.

Conclusions:
MRI in patients with a new CI device with rotatable magnet system may be performed without discomfort or device dislodgement at 1.5 T, even without a head wrap, though external magnet replacement may require multiple attempts due to internal magnet realignment. Despite significant artifact, the structure of interest may still be visualized for accurate diagnosis. Measuring magnet-related artifact size should be standardized by reporting artifact in radii at the image level of maximal signal loss.
The future of apolipoprotein E mimetic peptides in the prevention of cardiovascular disease
Authors: Valanti Eftaxia-Konstantina , Chroni Angeliki , Sanoudou Despina 
Published: June 2019

Purpose of review
This review aims to discuss the recent developments in the area of apolipoprotein E (apoE) mimetics and their therapeutic potential for treating cardiovascular disease, the leading cause of mortality worldwide.

Recent findings
Ongoing research efforts target the development of novel therapies that would not only reduce circulating levels of atherogenic lipoproteins, but could also increase high density lipoprotein cholesterol (HDL-C) levels and/or improve HDL function. Among them, synthetic peptides that mimic the structure of natural human apoE, a component of triglyceride-rich lipoproteins and HDL, have been designed and proven to be functionally similar to apoE. In specific, apoE mimetic peptides mediate hepatic clearance of circulating atherogenic lipoproteins, dramatically reduce plasma cholesterol, and lead to attenuation of atherosclerosis development in vivo. These peptides also exhibit pleiotropic antiatherogenic properties, such as macrophage cholesterol efflux capacity, as well as anti-inflammatory and antioxidative functions.

Summary
ApoE mimetics are undergoing preclinical and clinical evaluation with promising results to date that render them attractive candidates in cardiovascular disease prevention and treatment.
Improving the Patient Experience Following Total Knee and Total Hip Arthroplasty
Authors: Burley Gwen , Torres Lizbeth , Heligman Jessica 
Published: June 2019

Background:
The paradigm shift that has occurred for patients with total hip (THA) and knee (TKA) arthroplasty through enhanced recovery programs underscores the need for redesigning care provision.

Local Problem:
In this hospital, the patient outcomes and experience anticipated from the implementation of enhanced recovery medical protocols were not fully realized.

Methods:
The Practice Development in Nursing and Healthcare model guided this project.

Interventions:
A nurse-led team designed a new care delivery model with patient/family-centered interventions based on the best evidence.

Results:
Outcomes included an increase in discharges of postoperative day 1 or less of 154% THA and 41.8% TKA and an increase in discharge to home by 24.6% THA and 18.7% TKA. In addition, 90-day readmissions were reduced for both patient groups.

Conclusions:
An interprofessional team of clinicians made sustainable improvements in the experience and outcomes for the surgical patients with THA and TKA.
Does Performance on the American Board of Physical Medicine and Rehabilitation Initial Certification Examinations Predict Future Physician Disciplinary Actions?
Authors: Kinney Carolyn L. , Raddatz Mikaela M. , Sliwa James A. , Clark Gary S. , Robinson Lawrence R. 
Published: June 2019

Objective
The aim of the study was to determine the relationship between performance on the American Board of Physical Medicine and Rehabilitation primary certification examinations and the risk of subsequent disciplinary actions by state medical boards over a physician's career. The hypothesis is that physicians who do not pass either or both of the two initial specialty certification examinations are at higher risk of disciplinary action from a state medical licensing board.

Design
This is a retrospective cohort study that analyzed board certification examination data from all physicians who completed physical medicine and rehabilitation residency between 1968 and 2017.

Results
Matching examination and license data were available for 9889 physical medicine and rehabilitation physicians, who received a total of 547 disciplinary action reports through the Federation of State Medical Boards. The results showed a significant correlation between failing an American Board of Physical Medicine and Rehabilitation certification examination and the risk of subsequent disciplinary action by a state medical board. Failure to pass either the written (Part I) or oral (Part II) examination increased the risk of subsequent disciplinary action by 5.77-fold (P < 0.0001, 95% confidence interval = 4.07–8.18).

Conclusions
Physicians in physical medicine and rehabilitation who do not pass initial certification examinations and become board certified are at higher risk of disciplinary action from a state medical licensing board throughout their careers.
Caring for Patients With Physical Disabilities
Authors: John Janice Thomas , Block Lauren , Stein Adam , Vasile Elizabeth , Barilla-LaBarca Maria-Louise 
Published: June 2019

Abstract
Despite the fact that one fifth of Americans live with disability, caring for these patients is not routinely part of the undergraduate medical student curriculum. An innovative session addressing care of patients with spinal cord injury was developed for medical students and led by physiatrists, faculty experts in communications, and individuals with spinal cord injury. A mixed-method design was used in evaluating students' knowledge, skills, and attitudes following this curriculum. Quantitative evaluation was performed with a written essay question and checklist items from an objective structured clinical examination station. The session was given to 296 students from 2016 to 2018. On the objective structured clinical examination, 94% asked about sexual function, 85% asked about activities of daily living, 77% asked about instrumental activities of daily living, and 47% of students evaluated skin health. Students demonstrated respectful (99%) and nonjudgmental (99%) attitudes with spinal cord injury standardized patients and 91% interacted with the standardized patients caretaker appropriately. Themes emerged from the student survey including the following: the value of having real patients present during the session, exposure to physical medicine and rehabilitation as a specialty, and the advantage of a small group format. This session provided students with tools necessary to care for patients with spinal cord injury.