bluuebunny/crossref_metadata_2025_split huggingface dataset:
3D Knee Trochlear Morphology Assessment by Magnetic Resonance Imaging in Patients With Normal and Dysplastic Trochleae
Authors: Pennock Andrew T. , Chang Aileen , Doan Joshua , Bomar James D. , Edmonds Eric W. 
Published: May 2018

Background:
Trochlear dysplasia is recognized as a significant risk factor for patellar instability, but current imaging modalities fail to allow full visualization and classification of the complex 3-dimensional (3D) anatomy of the trochlea. The purpose of this study was to elucidate primary differences in trochlear morphology between patients with and without patellar instability by utilizing 3D magnetic resonance imaging (MRI) reconstructions of the trochlea.

Methods:
An institutional review board-approved retrospective review included 24 patients with a diagnosis of patellar instability and an age-matched and sex-matched control population of 12 patients. 3D models of the femoral trochlea were created from MRI images and measurements were performed. 3D measurements were trochlear groove volume and surface area that were normalized to the femoral width. 2D measurements were performed throughout the length of the trochlea including the bony and cartilaginous sulcus angles as well as the bony and cartilaginous trochlear depths. Differences were also assessed between sex, skeletal maturity, and trochlear dysplasia severity.

Results:
Surface topography of the trochlea varied significantly based on location with the trochlea becoming progressively more flat proximally away from the notch (P<0.05). Patients with patella instability had reduced trochlear volumes and trochlear depths compared with control patients (P<0.05). These differences were more pronounced with the cartilaginous measurements as well as more proximally within the trochlea. Patients with high-grade dysplasia had greater reductions in trochlear volumes and depth especially proximally in the trochlea (P<0.05). Once femoral size was standardized, minimal differences were observed based on sex or skeletal maturity (P>0.05).

Conclusions:
Novel 3D MRI reconstructions demonstrated that measurements of trochlear morphology varied significantly between patients with and without patellar instability. When trochlear dysplasia is present, it appears to affect the majority of the trochlear surface, but preferentially the proximal extent. Future trochlear dysplasia classification systems may benefit from assessment of articular cartilage surface measures rather than primarily osseous structure measurements.

Level of Evidence:
Level III—case-control prognostic study.
Firearm-associated Fractures in Children and Adolescents: Trends in the United States 2003-2012
Authors: Blumberg Todd J. , DeFrancesco Christopher J. , Miller Daniel J. , Pandya Nirav K. , Flynn John M. , Baldwin Keith D. 
Published: May 2018

Background:
Firearm-associated injuries are the second leading cause of death in children in the United States. Fractures are common comorbid injuries in young patients with firearm-associated injuries. The purpose of this study was to define the burden of firearm-associated fractures (FAFs) in children and adolescents in the United States.

Methods:
We analyzed the 2003-2012 Kids’ Inpatient Database. Patients were grouped into 4 age groups: 0 to 4, 5 to 9, 10 to 14, and 15 to 20 years old. Sample observations with both an external cause of injury code indicating gunshot injury and a diagnosis code indicating orthopaedic fracture (extremity, pelvis, or spine) were identified as cases of FAF. Sex, age, race, cause of injury, and fracture-related operating room procedures were catalogued. Population-level incidence was calculated for each year studied.

Results:
From 2003 to 2012, the incidence of FAF in patients 20 years and below of age increased from 73 to 96 cases per 100,000 admissions (P=0.009). The 0 to 4 age group saw the largest increase in injury frequency (141%, P=0.08). There was a 4-fold increase in the rate of unintentional injury in this subgroup. The most common age group affected by FAFs was 15 to 20 year olds. Minorities and male individuals were disproportionately affected. Assault and unintentional causes were the most common reasons for injury.

Conclusions:
The frequency of FAF in patients 20 years and below of age increased over the study period, with almost 1 case per 1000 admissions in 2012. The finding that certain subpopulations are disproportionately affected reflects the complex sociologic factors influencing gun violence in the United States.

Level of Evidence:
Level III—retrospective cohort study.
Comprehensive Assessment of Outcomes From Patients With Severe Early-onset Scoliosis Treated With a Vertebral Column Resection: Results From an SRS Global Outreach Site (FOCOS) in Ghana
Authors: Verma Kushagra , Slattery Casey , Duah Henry , Yankey Kawdwo P. , Mundis Gregory , Boachie-Adjel Oheneba 
Published: May 2018

Background:
Early-onset scoliosis (EOS) remains a challenging pediatric spine condition to manage. Some severe deformities can be managed with a vertebral column resection (VCR), which is fraught with high complication rates and the outcomes have not been well reported. The purpose of this study is to provide an assessment of operative, radiographic, and clinical outcomes from children diagnosed with severe EOS treated with a VCR.

Methods:
We performed a retrospective review of prospectively collected data. Basic demographic data was collected along with the diagnosis, procedure performed, FOCOS risk score, blood loss (estimated blood loss), operative time, neuromonitoring events, intraoperative complications, and clinical follow-up. Coronal and sagittal radiographic parameters were measured by the first author.

Results:
We identified 14 patients with posttuberculosis deformity (n=7) or congenital deformity (n=7) that underwent VCR between 2013 and 2016 (5 female; age, 7.7±3 y; body mass index, 17.7±2.8). There was significant improvement in coronal radiographic parameters (primary curve: 55 to 21 degrees, secondary: 37 to 13 degrees, T1-12 length: 137 to 151 mm, T1-S1 length: 219 to 271 mm, P<0.05) and sagittal parameters (kyphosis: 85 to 41 degrees, compensatory lordosis 56 to 39 degrees, P<0.001). There was no change in chest width, sagittal vertical axis, or pelvic tilt. Mean proximal junctional kyphosis (PJK) angle was 12±9 degrees and distal junctional kyphosis angle was 9±17 degrees. Estimated blood loss was 860±520 mL and operative time was 200±66 minutes. Seven cases had neuromonitoring changes that improved with corrective maneuvers and blood pressure elevation. Three patients required reoperation for junctional breakdown with 1 having a third operation for an infection, while 2 additional patients had evidence of radiographic PJK.

Conclusions:
VCR in the setting of EOS has excellent radiographic outcomes but a high complication profile. Half of these cases had neuromonitoring changes intraoperatively that improved without lasting neurological deficit. Three patients had PJK and 1 had an infection requiring reoperation.

Level of Evidence:
Level IV—case series.
Rectal Culture and Sensitivity Analysis for Reducing Sepsis Risk After Fiducial Marker Placement
Authors: Mendenhall William M. , Sarto Gail , Bryant Curtis M. , Morris Christopher G. , Williams Christopher R. , Costa Joseph A. , Bandyk Mark , Hoppe Bradford S. , Henderson Randal H. , Nichols R. Charles , Mendenhall Nancy P. 
Published: May 2018

Purpose:Placement of fiducial markers for prostate radiotherapy (RT) is associated with a 2% to 3% risk of bacterial urinary tract infection (UTI) that may progress to sepsis necessitating hospitalization. These bacterial UTIs are primarily due to flouroquinolone (FQ) resistantEscherichia coli(E. coli). The incidence of this complication has increased in recent years. The purpose of this study is to determine whether rectal culture and sensitivity (C&S) to identify FQ resistantE. coliobtained before placement of fiducial markers for prostate RT reduces the likelihood of this complication.Methods:In total, 412 patients treated with RT at the University of Florida Proton Therapy Institute between 2015 and 2017 were included in the study. Rectal C&S were obtained at the time of initial consultation which preceded placement of fiducial markers for planning and realignment for prostate RT. Patients in whom resistantE. coliwere identified had their prophylactic antibiotic regimen modified accordingly. Whether bacterial UTI requiring hospitalization following fiducial placement occurred was prospectively recorded in the medical record on the first day of RT.Results:One of 412 patients (0.2%) developed bacterial sepsis requiring hospitalization after fiducial placement.Conclusion:Rectal C&S to identify FQ resistantE. colibefore placement of fiducial markers for prostate RT likely reduces the risk of bacterial UTI necessitating hospitalization.
Risk effects of near-roadway pollutants and asthma status on bronchitic symptoms in children
Authors: Urman Robert , Eckel Sandrah , Deng Huiyu , Berhane Kiros , Avol Ed , Lurmann Fred , McConnell Rob , Gilliland Frank 
Published: May 2018

Background:
Bronchitic symptoms in children pose a significant clinical and public health burden. Exposures to criteria air pollutants affect bronchitic symptoms, especially in children with asthma. Less is known about near-roadway exposures.

Methods:
Bronchitic symptoms (bronchitis, chronic cough, or phlegm) in the past 12 months were assessed annually with 8 to 9 years of follow-up on 6757 children from the southern California Children’s Health Study. Residential exposure to freeway and non-freeway near-roadway air pollution was estimated using a line-source dispersion model. Mixed-effects logistic regression models were used to relate near-roadway air pollutant exposures to bronchitic symptoms among children with and without asthma.

Results:
Among children with asthma, a 2 SD increase in non-freeway exposures (odds ratio [OR]: 1.44; 95% confidence interval [CI]: 1.17, 1.78) and freeway exposures (OR: 1.31; 95% CI: 1.06, 1.60) were significantly associated with increased risk of bronchitic symptoms. Among children without asthma, only non-freeway exposures had a significant association (OR: 1.14; 95% CI: 1.00, 1.29). Associations were strongest among children living in communities with lower regional particulate matter.

Conclusions:
Near-roadway air pollution was associated with bronchitic symptoms, especially among children with asthma and those living in communities with lower regional particulate matter. Better characterization of traffic pollutants from non-freeway roads is needed since many children live in close proximity to this source.
Vaspin Prevents Tumor Necrosis Factor-α–Induced Apoptosis in Cardiomyocytes by Promoting Autophagy
Authors: Ke Xuan , Hao Yanqin , Li Bingong , Zou Jin , Li Xuelian , Wei Chunying , Liu Fuyou , Zhang Zhiyong 
Published: May 2018

Abstract:
Visceral adipose tissue–derived serine protease inhibitor (Vaspin) is an adipocytokine that has been shown to exert anti-inflammatory effects and inhibits apoptosis under diabetic conditions. This study was designed to investigate the impact of vaspin on autophagy in tumor necrosis factor (TNF)-α–induced injury in cardiomyocytes and its cardioprotective effects in the pathogenesis of diabetic cardiomyopathy (DCM). H9C2 cells were treated with TNF-α with or without vaspin in vitro. Tumor necrosis factor-α treatment inhibited autophagy and promoted apoptosis in H9C2 cells after stimulating for 24 hours. Pretreatment with vaspin significantly mitigated apoptosis induced by TNF-α partly because of augment effects of vaspin on autophagy as demonstrated by a higher ratio of LC3-II/LC3-I, higher expression of Beclin-1, and increased autophagosomes formation. Furthermore, the AKT agonist IGF-1 significantly reversed the effect of vaspin on autophagy. In vivo DCM model was also developed by treating rats with streptozotocin followed by intraperitoneal injection with vaspin. In DCM rats, upregulation of vaspin reversed cardiac dysfunction, as identified by increased left ventricular ejection fractions and fractional shortening levels, a higher Em/Am ratio, and lower levels of TNF-α, lactate dehydrogenase, creatine kinase, and creatine kinase-myocardial isoenzyme. In conclusion, vaspin attenuated the TNF-α–induced apoptosis by promoting autophagy probably through inhibiting the PI3K/AKT/mTOR pathway and further ameliorated the cardiac dysfunction in DCM rats.
Cardiovascular Nursing Science Priorities
Authors: Piano Mariann R. , Artinian Nancy T. , DeVon Holli A. , Pressler Susan T. , Hickey Kathleen T. , Chyun Deborah A. 
Published: May 2018

Background:
The American Heart Association's (AHA) Council on Cardiovascular and Stroke Nursing (CVSN) plays a critical role in advancing the mission of the AHA in the discovery of new scientific knowledge. The aim was to identify priority research topics that would promote and improve cardiovascular (CV) health, provide direction for the education of future nurse scientists, and serve as a resource and catalyst for federal and organizational funding priorities.

Methods:
A Qualtrics survey, which included 3 questions about priorities for CVSN nurse researchers, was sent to the CVSN Leadership Committee and all CVSN Fellows of the AHA (n = 208). Responses to the questions were reviewed for word repetitions, patterns, and concepts and were then organized into thematic areas. The thematic areas were reviewed within small groups at the November (2016) in-person CVSN leadership meeting.

Results:
Seventy-three surveys were completed. Five thematic areas were identified and included (1) developing and testing interventions, (2) assessment and monitoring, (3) precision CV nursing care, (4) translational and implementation science, and (5) big data. Topic areas noted were stroke, research methods, prevention of stroke and CV disease, self-management, and care and health disparities.

Conclusion:
Five thematic areas and 24 topic areas were identified as priorities for CV nursing research. These findings can provide a guide for CV nurse scientists and for federal and foundational funders to use in developing funding initiatives. We believe additional research and discovery in these thematic areas will help reduce the rising global burden of CV disease.
Nursing Challenges in Interactions With Patients Receiving Mechanical Circulatory and Respiratory Support
Authors: Wrigley Cara , Straker Karla , Nusem Erez , Fraser John F. , Gregory Shaun D. 
Published: May 2018

Background:
Mechanical circulatory and respiratory support (MCRS) systems provide short- to long-term life support for patients with severe cardiac or respiratory failure. Whereas the challenges of patients with these lifesaving systems are well understood, the challenges faced by nurses of patients receiving MCRS remain relatively unidentified.

Objectives:
In this study, we investigated the challenges and experiences of MCRS nurses, with the aim of informing the design of future interventions.

Design:
A qualitative approach was taken to develop an in-depth understanding of the emotional issues nurses experience in their daily interactions with patients.

Participants and Setting:
Nine MCRS nurses ranging in clinical experience were recruited from Australian hospitals.

Methods:
Participants were divided into 3 focus groups, with design prompts being used in the focus groups to facilitate discussion. Data from these focus groups were analyzed through a thematic analysis protocol.

Results:
The nurses’ accounts were clustered around 2 themes, including (1) patient connection and (2) compassion vitality and fatigue. Each theme elicits a conflicting compromise that MCRS nurses face daily.

Conclusion:
The challenges of nurses who support patients with MCRS are complex, multifaceted, emotionally stimulating, and exhausting. We therefore contributes a set of design criteria to support such nurses, setting a direction for future research.
Patient and Professional Factors That Impact the Perceived Likelihood and Confidence of Healthcare Professionals to Discuss Implantable Cardioverter Defibrillator Deactivation in Advanced Heart Failure
Authors: Hill Loreena , McIlfatrick Sonja , Taylor Brian J. , Jaarsma Tiny , Moser Debra , Slater Paul , McAloon Toni , Dixon Lana , Donnelly Patrick , Stromberg Anna , Fitzsimons Donna 
Published: May 2018

Background:Rate of implantable cardioverter defibrillator (ICD) implantations is increasing in patients with advanced heart failure. Despite clear guideline recommendations, discussions addressing deactivation occur infrequently.Aim:The aim of this article is to explore patient and professional factors that impact perceived likelihood and confidence of healthcare professionals to discuss ICD deactivation.Methods and Results:Between 2015 and 2016, an international sample of 262 healthcare professionals (65% nursing, 24% medical) completed an online factorial survey, encompassing a demographic questionnaire and clinical vignettes. Each vignette had 9 randomly manipulated and embedded patient-related factors, considered as independent variables, providing 1572 unique vignettes for analysis. These factors were determined through synthesis of a systematic literature review, a retrospective case note review, and a qualitative exploratory study. Results showed that most healthcare professionals agreed that deactivation discussions should be initiated by a cardiologist (95%, n = 255) or a specialist nurse (81%, n = 215). In terms of experience, 84% of cardiologists (n = 53) but only 30% of nurses (n = 50) had previously been involved in a deactivation decision. Healthcare professionals valued patient involvement in deactivation decisions; however, only 50% (n = 130) actively involved family members. Five of 9 clinical factors were associated with an increased likelihood to discuss deactivation including advanced age, severe heart failure, presence of malignancy, receipt of multiple ICD shocks, and more than 3 hospital admissions during the previous year. Furthermore, nationality and discipline significantly influenced likelihood and confidence in decision making.Conclusions:Guidelines recommend that healthcare professionals discuss ICD deactivation; however, practice is suboptimal with multifactorial factors impacting on decision making. The role and responsibility of nurses in discussing deactivation require clarity and improvement.
Reflections on 50 Years of Neuroscience Nursing: Neuro-Oncology, Moving Forward by Looking Back
Authors: Reed Marilyn E. , Anthony Patricia P. , Rosenfeld Priscilla B. , Ligon Brandi L. , Doris Estelle M. , Fox Sherry W. 
Published: May 2018

ABSTRACT
During the past 50 years, there have been more than 100 articles published in the Journal of Neuroscience Nursing covering the topic of neuro-oncology. This article will explore the historical implications and milestones from these articles. The analysis highlights the scope and depth of the many articles as they relate to the advancements in neuro-oncology.
Sexual Function in Young Individuals With Multiple Sclerosis: Does Disability Matter?
Authors: Calabrò Rocco Salvatore , Russo Margherita , Dattola Vincenzo , De Luca Rosaria , Leo Antonino , Grisolaghi Jacopo , Bramanti Placido , Quattrini Fabrizio 
Published: May 2018

ABSTRACT

Introduction: Studies on the prevalence of sexual dysfunction (SD) in multiple sclerosis (MS) have shown that 40% to 80% of women and 50% to 90% of men have had sexual complaints. Sexual function is often disregarded during consultation with healthcare professionals, and SD is frequently underdiagnosed. The aim of this study was to investigate the prevalence of SD and its relationship to sociodemographic and disease-related factors, with regard to disability state, in a hospital cohort of MS patients, by using a semistructured interview. Methods: Of 130 screened outpatients, 87 met the inclusion criteria and completed the study. The mean age of the participants was 39.3 ± 8.3 years, with a disease duration of 8.3 ± 5.4 years and a mean Expanded Disability Status Scale (EDSS) score of 2.04 ± 0.19. Sexual function was evaluated by means of a semistructured interview, investigating a patient’s 3 main life areas: sociodemographic information, illness perception, and sexuality. Results: Approximately 70% of the patients complained at least 1 SD (decreased libido, erectile dysfunction, premature or retarded ejaculation, painful penetration), and 22% of them reported the disorder as frequent. The disease duration was associated with lower satisfaction in sexual function, and lack of sexual interest was the most common problem having a negative correlation with EDSS. Conclusions: Healthcare professionals involved in MS, should assess patients for SD. Further studies should be fostered to better quantify SD etiology, the degree of sexual impairment, and its impact on patients’ quality of life to “overcome” this problem.
Reliability and Validity of National End of Rotation Examinations: An Update
Authors: Gietzen Lindsay , Roman Christopher , Hegmann Theresa 
Published: May 2018

Purpose
This study sought to evaluate the reliability of the PAEA End of Rotation™ exam scores used as a combined scale. The study also investigated how closely the individual exam scores and the combined scale correlate with Physician Assistant National Certifying Exam (PANCE) performance to validate their use as tools for assessing physician assistant (PA) students during their clinical training.

Methods
Deidentified PAEA End of Rotation examination and PANCE scores were used to calculate Pearson correlations, Cronbach's alpha, and value of Cronbach's alpha if individual exams were removed from the analysis. A linear regression model was generated to predict certification exam scores.

Results
End of Rotation examinations are a reliable predictor of certification examination performance independent of PA program or test version, with Cronbach's alpha at 0.847.

Conclusions
The mean of all 7 examinations may be used, but the mean of just 4 examinations (Emergency Medicine, Family Medicine, General Surgery, and Internal Medicine) is also a valid predictor of certification examination performance.
Perceived Discrimination, Harassment, and Abuse in Physician Assistant Education: A Pilot Study
Authors: DiBaise Michelle , Tshuma Lisa , Ryujin Darin , LeLacheur Susan 
Published: May 2018

Purpose
A 2014 meta-analysis found that by graduation, 16.6% of medical students had reported abuse, harassment, or discrimination and that this hostile environment caused an increase in depression and anxiety. The purpose of this research study was to increase the understanding of discrimination and psychological/physical abuse in physician assistant (PA) education programs and the potential impact on student attrition.

Methods
Information was collected using an online, anonymous survey that asked about witnessed or experienced discrimination and psychological or physical abuse during the didactic and clinical years of training in PA programs in the United States.

Results
The survey received 1159 respondents, which represents 6.1% of total PA student enrollment. Up to 30% of respondents had witnessed or experienced discrimination, and up to 2.3% had experienced psychological abuse while in PA school. The majority of witnessed or experienced discrimination during PA education was not reported (<2%). Reports were not made because students feared retribution or they simply did not know who to report to, particularly if the incident involved faculty.

Conclusion
Reducing the prevalence of discrimination in PA education requires recognition of this issue and targeted efforts to ensure that the infrastructure of every program is inclusive and values diversity of all kinds. The authors advocate that PA programs discuss their current institutional reporting structure; develop a universal curriculum on workplace violence, discrimination, and harassment; and develop value statements that explicitly identify diversity and equity as a core value as an important first step to improving the overall “climate” and culture of the program.