bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Novel and Existing Measures of Sensitivity to Physical Activity Among People With Chronic Musculoskeletal Pain
Authors: Woznowski-Vu Arthur , Uddin Zakir , Flegg Daniel , Aternali Andrea , Wickens Rebekah , Sullivan Michael J.L. , Sweet Shane N. , Skou Søren T. , Wideman Timothy H. 
Published: May 2019

Objectives:
Increasing pain during physical activity is an important, but often poorly assessed, barrier to engaging in activity-based rehabilitation among people with chronic musculoskeletal pain. Preliminary work has addressed this problem by developing new clinical measures of sensitivity to physical activity (SPA). Indices of SPA are generated by evaluating how pain changes in relation to brief physical tasks. Three strategies have been identified for structuring SPA-related physical tasks (self-paced, standardized, and tailored). This cross-sectional study aimed to comparatively estimate the extent of the 3 SPA tasks’ evoked pain responses, predictive value of pain severity and pain interference, and their underlying psychological and sensory constructs, among 116 adults with chronic musculoskeletal pain.

Materials and Methods:
Testing included questionnaires, quantitative sensory testing, and the 3 SPA measures (self-paced, standardized, and tailored). The primary analysis estimated the predictive value of each SPA measure for pain severity and pain interference. Correlational analyses were first conducted between all variables of interest to determine what variables will be included in the hierarchical regression analysis, which in turn was conducted for each outcome.

Results:
Analyses revealed that the tailored SPA index was most effective at evoking activity-related pain, was uniquely associated with temporal summation of pain, and was a unique predictor of pain and pain-related interference, even when controlling for established psychological and sensory risk factors.

Discussion:
This study further emphasizes SPA as an important and unique attribute of the pain experience and reveals the added value of using a tailored approach to assess SPA.
Further Examination of the Pain Stages of Change Questionnaires Among Chronic Low Back Pain Patients
Authors: Mun Chung Jung , Otis John D. , Concato John , Reid M. Carringotn , Burg Matthew M. , Czlapinski Rebecca , Kerns Robert D. 
Published: May 2019

Objectives:
In order to maximize the therapeutic benefits of cognitive-behavioral therapy (CBT) for chronic pain, individuals need to be motivated to adopt a self-management approach. The Pain Stages of Change Questionnaire (PSOCQ) was developed to measure patients’ readiness to adopt a self-management approach to chronic pain. The present study examined whether pretreatment and posttreatment PSOCQ change scores among chronic low back pain patients could predict 6- and 12-month follow-up outcomes, and the stability of posttreatment PSOCQ scores during follow-up.

Methods:
Participants were recruited from a VA primary care clinic. Data from 60 participants assigned to either regular CBT or a modified CBT (ie, PRIME CBT) condition were analyzed in the present study. Self-report measures including PSOCQ, pain severity, disability, and depressive symptom severity were administered at pretreatment, 10 weeks posttreatment, 6-month and follow-up assessments.

Results:
Multiple regression analyses showed that pretreatment and posttreatment changes in the Action/Maintenance scores significantly predicted pain severity at 6 months, and changes in the Precontemplation scores significantly predicted disability at 6 months. None of the PSOCQ change scores significantly predicted depressive symptom severity. Posttreatment Precontemplation and Action/Maintenance scores were quite stable, even at 12-month follow-up.

Conclusions:
Changes in patients’ attitudes toward adopting a pain self-management approach may serve as one of the therapeutic mechanisms and predict long-term function. This study also revealed that changed attitudes toward chronic pain self-management remain quite stable over time. Adoption of beliefs consistent with chronic pain self-management during treatment may promote sustained benefits.
Validity and Reliability of the Banff Patellofemoral Instability Instrument 2.0 in an Adolescent Population
Authors: Lafave Mark R. , Hiemstra Laurie A. , Parikh Shital N. , Peterson Devin , Kerslake Sarah 
Published: May 2019

Background:
Lateral patellofemoral instability is a relatively common problem in the adolescent population. Subjective and objective patient outcomes are commonly used to evaluate treatment success or failure. The Banff Patellofemoral Instability Instrument (BPII) and Paediatric International Knee Documentation Committee (Pedi-IKDC) Subjective Knee Form are patient-reported outcome measures that have been used with an adolescent population previously. The BPII 2.0 is a shortened version of the BPII and has not been validated in an adolescent population. The purpose of the current study was to validate the BPII 2.0 with an adolescent population.

Methods:
This was a multicenter study where patients were recruited from 3 tertiary orthopaedic surgery clinics. A convenience sample (n=140 adolescent patients) with a confirmed diagnosis of lateral patellofemoral instability and who had failed conservative treatment was referred to one of the 3 orthopaedic surgeons. All patients completed the BPII 2.0 and Pedi-IKDC before their clinic appointment. Cronbach’s alpha and floor/ceiling effects were used to determine the content validity of both instruments. Patients were also interviewed to ask questions about the BPII 2.0 comprehension and importance of items. One clinic site sent out the BPII 2.0 to 30 additional patients twice in 2 weeks to measure the test-retest reliability (intraclass correlation coefficient 2,k). A Pearson r correlation coefficient was used to determine the relationship between the BPII 2.0 and the Pedi-IKDC and criterion validity.

Results:
Cronbach’s alpha values were 0.95 and 0.76 for the BPII 2.0 and Pedi-IKDC, respectively. There was no evidence of floor or ceiling effects for either the BPII 2.0 or the Pedi-IKDC. The Pearson r correlation coefficient between the BPII 2.0 and IKDC baseline scores taken at the initial consultation was 0.65 (P<0.001; 95% confidence interval, 0.94-0.97). The intraclass correlation coefficient (2,k) for the test-retest subsample (n=30) was 0.94. Patient interviews revealed that they thought the BPII 2.0 questions were both important and comprehensible.

Conclusions:
The BPII 2.0 is a valid, reliable, and disease-specific patient-reported outcome measure that can be used with an adolescent population with lateral patellofemoral instability. The BPII 2.0 has demonstrated criterion validity through its moderately strong correlation to the Pedi-IKDC for adolescents.
Lichen Planus Pemphigoides Mimicking Toxic Epidermal Necrolysis
Authors: Ondhia Chandni , Kaur Charanjit , Mee John , Natkunarajah Janakan , Singh Manuraj 
Published: May 2019

Abstract:
Lichen planus pemphigoides (LPP) is an immunobullous disorder characterized by a combination of lesions resembling bullous pemphigoid and lichen planus (LP). Immunofluorescence studies typically show linear deposition of IgG and C3 along the basement membrane zone and circulating antibodies to the hemidesmosome protein BP180 also known as type XVII collagen. It is now recognized that drug-induced linear IgA disease may present with lesions mimicking toxic epidermal necrolysis (TEN). However, to date, there have been no reported cases of LPP presenting with TEN-like lesions. This report describes a 70-year-old woman with LPP who presented with extensive erosions mimicking TEN. This case also highlights the need to consider important etiologies such as drug-induced and paraneoplastic LPP.
The PEST Model
Authors: Lin Yongxing Patrick , Wu Man 
Published: May 2019

Background
Self-extubation is an adverse patient event that can lead to severe complications. Gaps in clinical practice from the lack of nursing awareness and decision making capacity have often resulted in cases of preventable self-extubation. Review of current evidence suggests that initiatives to support nursing clinical decision making can help prevent adverse patient events such as self-extubation.

Aims
The aim of this study was to reduce the incidence of self-extubation by 50% in a cardiology intensive care unit over 1 year.

Methods
A quality improvement project was undertaken with a PEST model of nursing care introduced from January 2017 to December 2017 in the cardiology intensive care unit to guide nursing staff to assess and render appropriate interventions along patient domains such as pain, endotracheal tube securement, sedation, and tie to prevent incidences of self-extubation.

Results
Incidences of self-extubation have reduced to 5 cases in 2017, reflecting a 50% improvement from 10 cases in 2016.

Conclusions
Formalizing practice standards into an easy-to-remember mnemonics or framework can improve patient outcomes. Policy makers must be aware that initiatives to facilitate decision making can improve patient safety.
Interventions for the Management of Respiratory Distress in Late Preterm and Term Infants Experiencing Delayed Respiratory Transition
Authors: Bedwell Susan , Leasure A. Renee , Gibson Theresa L. 
Published: May 2019

Objectives
To examine the best available evidence for interventions used to manage mild to moderate respiratory distress in late preterm and term infants experiencing delayed respiratory transition.

Data Sources
EMBASE, MEDLINE, Cochrane Review, Joanna Briggs, PubMed, CINAHL, and Google Scholar online databases were searched for articles related to delayed respiratory transition. Reference lists were reviewed to identify additional articles for inclusion.

Study Selections
Randomized, blinded, placebo-controlled, randomized prospective, prospective observational, and retrospective cohort studies published in English-language, peer-reviewed journals between 2007 and August 2017 were reviewed for inclusion. Studies were included if they examined respiratory focused interventions that could potentially prevent admission to the neonatal intensive care unit (NICU) of the term or late preterm infant transitioning to extrauterine life.

Data Extraction
The CASP tools were utilized for appraisal of individual studies. Data were extracted from the 5 studies included in this review.

Data Synthesis
In 4 of the 5 studies, prevention of NICU admission was the primary aim. The observational study observed videos of newborn resuscitations and described the effect of early intervention with continuous positive-airway pressure (CPAP) ventilation on prevention of NICU admission for respiratory distress. One randomized controlled trial used adrenaline injections to prevent development of respiratory distress. The 3 remaining randomized controlled trials used prophylactic CPAP or sustained inflation as a method for preventing development of delayed respiratory transition. Three of the 5 studies focused exclusively on cesarean born infants. Among the interventions studied, early or prophylactic CPAP shows the most promise for prevention of NICU admission in late preterm and term infants with mild to moderate respiratory distress.

Conclusion
The lack of safety and efficacy data for either adrenaline injections or prophylactic CPAP precludes either method for current use in the prevention of respiratory distress for the late preterm or term infant transitioning to extrauterine life. Two randomized trials, both using prophylactic CPAP, had a significant decrease in NICU admissions. Both studies were conducted at a single center and exclusive to infants born by cesarean delivery. A single study using sustained lung inflation showed no significant difference in the need for respiratory support or NICU admission. A single study using adrenaline also showed no benefit to the prevention of respiratory distress related to transition. Further multicenter randomized controlled trials are needed before broad adoption of early or prophylactic CPAP can be recommended.
Cross-sectional International Multicenter Study on Quality of Life and Reasons for Abandonment of Upper Limb Prostheses
Authors: Yamamoto Michiro , Chung Kevin C. , Sterbenz Jennifer , Shauver Melissa J. , Tanaka Hirotaka , Nakamura Takashi , Oba Jumpei , Chin Takaaki , Hirata Hitoshi 
Published: May 2019

Background:
This multicenter study aimed to examine the reasons for prosthesis rejection and assess the quality of life (QOL) among patients with upper limb deficiency.

Methods:
Three rehabilitation centers in Japan and 1 academic medical center in the United States participated. Patients between the age of 12 and 75 years with unilateral or bilateral upper limb absence from the level of wrist to shoulder disarticulation were included. Two questionnaires were used, an original questionnaire on prosthesis use and the EQ-5D, which were completed by both the participant and a live-in proxy.

Results:
Of the 367 patients with upper limb loss invited, 174 patients participated in this study. Eighty percent of the study population were male patients. The most common amputation level was transradial. Trauma was the most common cause of limb loss. The prosthesis rejection rate was 9% (n = 16). The most common reason for abandonment was a lack of prosthesis functionality. Ten of 16 prosthesis nonusers (63%) and 59 prosthesis users (38%) were unemployed or students. The mean EQ-5D utility score was significantly higher in prosthesis users than in nonusers (0.762 versus 0.628, P < 0.01). Live-in proxies significantly overestimated QOL in male patients (0.77 versus 0.807, P=0.01).

Conclusions:
The current prosthesis rejection rate is low. QOL was significantly higher in prosthesis users than in nonusers. More prosthesis users were employed compared with nonusers. Care should be taken not to overestimate the QOL of male patients with upper limb loss as their proxies often did.
Real-time Indocyanine Green Videolymphography Navigation for Lymphaticovenular Anastomosis
Authors: Seki Yukio , Kajikawa Akiyoshi , Yamamoto Takumi , Takeuchi Takayuki , Terashima Takahiro , Kurogi Norimitsu 
Published: May 2019

Summary:
Indocyanine green (ICG) lymphography is a useful imaging modality for evaluation of lymphedema and detection of lymphatic vessels. It also allows us to ensure patency of the anastomosed vessels intraoperatively. However, strong light from the operating microscope usually disturbs ICG fluorescence imaging. Only some built-in ICG camera systems with specific operating microscopes make real-time ICG lymphography possible in lymphaticovenular anastomosis (LVA). We applied a new high-resolution ICG videolymphography system, which is separated from the operating microscope. Because the system can divide near-infrared fluorescence light of ICG from visible light of the operating microscope, real-time ICG videolymphography-navigated LVA under operating microscope illumination is possible regardless types of operating microscopes. The study involved 10 patients with upper extremity lymphedema characterized by International Society of Lymphology stage 2 and treated by 3 lymphaticovenular anastomoses at the forearm (30 lymphaticovenular anastomoses incorporating 30 lymphatic vessels) under real-time ICG videolymphography. The rate of intraoperative detection of lymphatic vessels using real-time ICG videolymphography was 86.7% (0.25–0.85 mm in diameter), and that of lymph flow through the lymphaticovenular anastomoses was 76.7%. None of lymphatic vessels and no flow were detected under the microscope light by means of another non-built-in ICG lymphography camera. Real-time ICG videolymphography in LVA is beneficial, because the surgeon could find lymphatic vessels easily by checking dual images of original view and ICG fluorescent view and ensure accuracy of the LVA in a suture by a suture without any pauses of the surgical procedures.
Extra-articular Metacarpal Fractures: Closed Reduction and Percutaneous Pinning Versus Open Reduction and Internal Fixation
Authors: Vasilakis Vasileios , Sinnott Catherine J. , Hamade Malack , Hamade Hassan , Pinsky Brian A. 
Published: May 2019

Background:
There is no consensus on the optimal operative treatment of isolated closed metacarpal fractures as every technique is associated with advantages and shortcomings. This retrospective study aims to compare the outcomes of single metacarpal, extra-articular fractures treated with closed reduction and percutaneous pinning (CRPP) versus open reduction and internal fixation (ORIF).

Methods:
The charts of all patients who underwent surgical repair of closed metacarpal fractures at our institutions from 2009 to 2016 were reviewed. 70 patients met the inclusion criteria, 44 had undergone CRPP and 26 ORIF with plate or lag screws. Subgroup analyses of all patients stratified by both fracture pattern and fracture location were performed. Additionally, subgroup analyses of outcomes based on the time from injury to surgery were conducted. Clinical outcomes included immobilization time, total active motion, stiffness, complication and reoperation rates, as well as occupational therapy referral rates and duration. Functional outcomes were determined using the Quick-DASH (Disabilities of the Arm, Shoulder and Hand) score via telephone questionnaire administered retrospectively.

Results:
Overall, there was no significant difference in functional outcome parameters including total active motion (CRPP 91% of normal vs. ORIF 87% of normal), stiffness, therapy referrals, and complications between treatment groups. Patients treated with CRPP, regardless of fracture pattern or location, were operated on earlier than those treated with ORIF (avg. 7 days vs. 15 days). The immobilization time for patients treated with ORIF was significantly less than those treated with CRPP (19.7 vs. 30.7 days; p=0.001). This difference in the immobilization time also reflected the outcomes of the subgroup analyses based on the post-injury time of surgery. When transverse shaft fractures were examined independently as a subgroup, ORIF resulted in improved post-operative range of motion vs. CRPP (100% normal vs. 91% normal). The mean DASH score for each group was satisfactory and the difference was not statistically significant (16.3 for the CRPP and 18.7 for the ORIF group, p=0.805).

Conclusion:
Both CRPP and ORIF are viable techniques with good clinical outcomes and low complication rates. ORIF of closed metacarpal fractures allowed for earlier mobilization when compared with CRPP without compromising fracture stability, clinical or functional short-term outcomes.
Outcome of Beveled versus Vertical IncisionTechnique after Reconstructive or Aesthetic Facial Surgery
Authors: Feinendegen Dominik L. , Waldkircher Natascha J. , Bannwart Fridolin , Kalbermatten Daniel F. , Tremp Mathias 
Published: May 2019

Background:
We suggest that the degree of scar improvement with a beveled incision technique with an angle of about 20 degrees to the skin can be translated for various reconstructions on the face and can be verified by a validated clinical assessment scale and histology.

Methods:
A total of 5 patients (2 men and 3 women) with a mean age of 68 years (range 54–84 years) undergoing elective surgeries on the face for tumor excision or cosmetic procedures were included. The beveled incision technique was compared with the conventional vertical incision (control group). Outcome measures were major and minor complications, pain and scar quality using the Patient and Observer Scar Assessment Scale, and histomorphologic scar assessment.

Results:
After a mean follow-up of 7.6 months (range 6–13 months), all patients healed uneventfully without pain, hypertrophic scars, or infection. We found a better overall Patient and Observer Scar Assessment Scale score in the beveled incision technique group (15 ± 3.4) compared with the conventional vertical incision group (18.4 ± 7.8, P = 0.7). Histomorphologic analyses showed after 6 months less scar zone, less inflammatory reaction, fewer macrophages, less foreign body reaction, and more hair follicles in the beveled incision technique group compared with the vertical incision group.

Conclusion:
We showed that the beveled incision technique using a 20-degree angle in elective surgeries on the face yields a cosmetic pleasant result for both the patient and the surgeon, which also goes in line with our histomorphologic analyses.
Correction of Irregular Astigmatism With New-Generation Hybrid Contact Lenses
Authors: Uçakhan Ömür Ö. , Yeşiltaş Yağmur Seda 
Published: May 2019

Purpose:
To evaluate the safety, efficacy, and on-eye performance of new-generation hybrid contact lenses (HCLs) in visual rehabilitation of eyes with irregular astigmatism and rigid gas-permeable (RGP) contact lens intolerance or failure.

Methods:
The charts of patients who had been fit with new-generation HCLs were retrospectively reviewed. The reason for HCL fit and previous method of correction were noted. After the initial on-eye evaluation, visual and refractive outcomes, slit-lamp biomicroscopy, and lens comfort were evaluated at the last follow-up examination.

Results:
Forty-seven eyes of 33 patients could be fit successfully with EyeBrid silicone (LCS, Cane, France) or Airflex (SwissLens, Prilly, Switzerland) lenses. The mean number of trial lenses required for ideal fit was 1.4±0.6 (range; 1–3) lenses. The reason for fit was either centration problems with RGP lenses or RGP intolerance. Twenty-nine eyes of 20 patients (72.5%) continued wearing their lenses more than 10 hr a day and for more than 3 months. In these successful wearers, the visual acuity (VA) improved significantly compared with the baseline uncorrected and spectacle-corrected VA (P<0.01), and no serious adverse events were encountered during the mean follow-up period of 10.1±6.4 months. At the last follow-up examination, patients preferred the new-generation HCLs over their habitual correction in regard to both VA and quality (P<0.05).

Conclusion:
New-generation HCLs seem to provide a viable alternative for visual rehabilitation of irregular astigmatism in selected eyes with RGP intolerance or RGP failure. The ease of the fitting process similar to fitting soft toric lenses and high patient satisfaction seem to be major advantages of these designs.
Short-Term Results of Trial of Topical Insulin for Treatment of Dry Eyes in Diabetics
Authors: Aniah Azmi Noor , Bastion Mae-Lynn Catherine 
Published: May 2019

Objectives:
To assess the short-term effects of topical insulin (TI) 1 unit/drop 4 times per day for 4 weeks on the symptoms and signs of diabetic with dry eye disease (DED).

Methods:
In this randomized, double-blind interventional study, diabetics with DED aged 18 to 60 years were randomly assigned to TI or standard artificial tears (SAT). Baseline Ocular Surface Disease Index (OSDI), Schirmer I test (ST), tear break-up time (TBUT), and ocular Sjögren's International Collaborative Clinical Alliance (SICCA) score were compared 4 weeks after treatment.

Results:
A total of 160 participants (involving 320 eyes) received either TI (n=80) or SAT (n=80). After 4 weeks of treatment, a significant number of participants in both TI and SAT groups showed improvement in their OSDI score, 66% and 63%, respectively (P=0.0001), but were not significantly better than each other (P=0.453). However, most participants in both groups showed worsening of ST and TBUT (P>0.05). Most of the participants in both groups showed no change in their ocular SICCA score (P>0.05).

Conclusion:
The study has shown a significant and similar improvement in the OSDI score for TI 1 unit/drop four times daily and SAT in treating diabetics with DED. Further research is required to understand the long-term effects of TI on the ocular surface.