bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of Dynamic Voice CT Scan for Complex Airway Patients Undergoing Voice Surgery
Authors: Bergeron Mathieu , Fleck Robert J. , Zacharias Stephanie R. C. , Tabangin Meredith E. , de Alarcon Alessandro 
Published: May 2019

Introduction: Dynamic voice computerized tomography (DVCT) is a novel technique that provides additional information to characterize laryngeal function for patients with complex airway history that may alter surgical decisions. The goal of this study was to evaluate the impact of DVCT on decision making for reconstructive voice surgery for a cohort of post-airway reconstruction dysphonia patients. Methods: Retrospective chart review at a pediatric tertiary care center for patients with history of complex airway surgery and subsequent reconstructive voice surgery for dysphonia between 2010 and 2016. The study group had a DVCT prior to surgery while the control group underwent surgery without a DVCT. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and pediatric Voice Handicap Index (pVHI) scores were evaluated by the voice clinic team (otolaryngologist, speech therapist) before and after voice surgery. Results: Twenty-one patients were analyzed (14 female, 67%) with a mean age (SD) of 14 (4.5) years old. Ninety percent (17/21) had a prior tracheostomy and a mean (SD) of 2.6 (1.3) airway surgeries. Twelve patients (57%) underwent DVCT prior to reconstructive voice surgery. CAPE-V baseline scores were similar between study and controls (means [SE] = 49 [4.6] and 57 [6.0], P = .72). However, scores significantly improved for the study group after voice surgery (mean [SE] = 31 (4.7), P < .0001) while controls did not improve (58 [5.7], P = .99). Baseline VHI scores were similar between both groups: mean (SE) = 54 (5.4) versus 52 (6.2), respectively, P = .99. Postsurgically, VHI scores were also similar between both groups (means [SE]: 46 [7.1] vs 47 [4.5], P = .99). Reconstructive voice surgery for study patients included posterior cricoid reduction (46%), vocal fold medialization/augmentation (46%), and laryngeal reinnervation (7.7%) while all controls underwent a single treatment (vocal fold medialization/augmentation). Conclusion: Patients with preoperative DVCT were more likely to have improvement. DVCT appeared to have altered surgical decision making and has allowed tailoring of reconstructive surgery to specific patients’ needs. DVCT could represent an important tool prior to reconstructive surgery to guide the choice of surgical procedures for complex airway patients.
Community stroke education practices in New York State designated stroke centres
Authors: Williams Olajide , Leighton-Herrmann Quinn Ellyn , Colello Anna , Perdomo Crismely , Chong Ji , Thompsen Bill , Wyrick Tiana , Brissette Ian , Labovitz Daniel 
Published: May 2019

Objective: Community stroke education is a regulated, integral component of stroke systems of care. However, little is known about the types of activities conducted by hospitals. This study was designed to examine the annual requirement for community stroke education among New York State’s 119 designated Primary Stroke Centres and identify areas for improvement that may have an implication on stroke outcomes. Design: Cross-sectional survey design Setting: All 119 New York State designated Primary Stroke Centres were invited to participate. Methods: Participating hospitals completed a 29-item online questionnaire assessing multiple domains related to community stroke education including hospital characteristics, allocated resources, implementation barriers, current community stroke education practices and willingness to adopt best practice guidelines. Data were analysed using univariate descriptive and chi-square statistics. Results: Eighty-eight percent of hospitals completed the survey (105/119). Respondents were mostly stroke coordinators and stroke directors. Stroke outreach education was conducted two to four times per year in 58% of the hospitals ( n = 69). Community stroke education included behavioural risk factor modification, the detection of stroke risk through screening and stroke preparedness education at health fairs. Although 95% of hospitals ( n = 98) reported using at least one best practice approach for these activities, evaluation was generally poor, with only about 23% ( n = 24) implementing outcome-specific assessments. Major barriers to stroke outreach were inadequate staffing, time constraints and lack of funding. Conclusion: Hospital-driven community stroke education efforts occur infrequently and are poorly evaluated. This component of stroke systems of care would benefit from guidelines from regulatory agencies, which currently do not exist.
Applying the nutrition education DESIGN procedure to the development of the In Defence of Food Curriculum
Authors: Luesse Hiershenee B , Koch Pamela , Contento Isobel R 
Published: May 2019

Objective: This study describes the use of the Nutrition Education DESIGN Procedure for developing the In Defence of Food Curriculum, a health education curriculum serving as the companion guide to the In Defence of Food documentary film based on the book with the same title. Design: The DESIGN Procedure is a systematic stepwise framework that produces behaviourally focused, theory-driven health education programmes and evaluation plans. Methods: DESIGN begins with an audience assessment and literature review that guides the selection of desired behaviours and psycho-social theory. For the In Defence of Food Curriculum, the desired behaviour changes were increased intake of whole/minimally processed plant-based foods and decreased intake of highly processed foods. A theoretical framework combining social cognitive and social determination theories guided programme development and evaluation plans. Education theory guided translating this framework into a ready-to-deliver curriculum. DESIGN aims to ensure alignment of theory determinants/mediators, behaviour change strategies, objectives, instructional activities and evaluation measures for systematically addressing desired behaviour changes. Over the course of 10 lessons, young people participate in interactive activities that explore the benefits of healthy eating, while appreciating how the ubiquity of heavily marketed and highly processed foods make healthy eating challenging. The evaluation plan guides measurement of target behaviours and the theory-based determinants/mediators. Results: This case study describes the development of the In Defence of Food curriculum using the DESIGN Procedure and demonstrates how a comprehensive and structured method for health education curriculum development and evaluation planning can be applied. Conclusion: The DESIGN Procedure has relevance for researchers, practitioners and programme planners.
Validation of a photophobia symptom impact scale
Authors: Cortez Melissa M , Digre Kathleen , Uddin Durin , Hung Man , Blitzer Andrea , Bounsanga Jerry , Voss Maren W , Katz Bradley J 
Published: May 2019

Background Routine assessment of photophobia in the clinical setting may underestimate the presence and severity of this condition. We aimed to develop and validate a questionnaire to improve evaluation of the impact of photophobia on activities of daily living, and to determine the relationship of this questionnaire to psychophysical assessment of light sensitivity thresholds. Methods We developed the 17-item Utah Photophobia Symptom Impact Scale (UPSIS-17) and compared its psychometric properties to the 8-item Korean Photophobia Questionnaire (KUMC-8). Ninety five subjects with or without light sensitivity completed both questionnaires; 72 also completed laboratory-based assessment of light sensitivity thresholds. We used Rasch analysis to evaluate instrument targeting, including internal consistency and reliability. Correlation analysis was used to assess the relationship between questionnaire scores and light sensitivity thresholds. Results We observed correlation between UPSIS-17 and KUMC-8, r = 0.72 ( p < 0.0001). Higher UPSIS-17 scores correlated with light sensitivity thresholds, r = −0.42 ( p < 0.0001), whereas KUMC-8 scores did not significantly correlate with light sensitivity thresholds, r = −0.21 ( p = 0.072). UPSIS-17 showed better instrument targeting than KUMC-8 on Rasch analysis. Person-item maps allowed for identification of questions that could be removed without affecting questionnaire validity measures. Conclusion This study resulted in a shortened, 12-item questionnaire. The UPSIS-12 retained significant correlation with both the KUMC-8 and light sensitivity thresholds, yielding a simpler tool for symptom assessment, while retaining validity. This expanded tool may be useful in clinical, as well as research settings, for collection of data about disability due to photophobia.
Do ‘standard laparoscopic box trainers’ represent real-life conditions during transperitoneal laparoscopical interventions of the upper tract?
Authors: Tas Tuncay , Cakiroglu Basri 
Published: May 2019

Background: The purpose of this study is to investigate the representativeness of the conventional laparoscopic standard box trainers in terms of real-life circumstances in transperitoneal laparoscopical interventions of the upper tract, using questionnaire inquiries with experienced surgeons. Materials and methods: The study was conducted with 44 laparoscopists, whose level of renal surgery experience was either high (primary surgeon in >100 cases), moderate (primary surgeon in >50 cases) or basic (primary surgeon in >20 cases). We used the box widely preferred in international training courses, which consists of a 10-mm 30° laparoscope, real endoscopic instruments, light source, monitor and chicken bone materials. Participants were asked whether they represent real-life situations while performing tasks by means of standard box trainers. Results: The medians of ‘restrained body posture of the surgeon’, ‘position of monitor’, ‘trocars entry slots’, ‘tissue distance and region’ and ‘limited field of movement and restricted working space’ were analysed on their difference from the ideal value. All the variables were shown to be significantly different from the ideal value of 5 (p < 0.001). These results suggest that experienced surgeons in our study did not find the box simulation conditions similar to real surgery conditions. Conclusion: Conventional laparoscopic trainer box, which is currently being used, is far from representing for the real situation in transperitoneal laparoscopical interventions of the upper tract.
Outcomes of High-Dose Steroid Therapy for Infantile Spasms in Children With Trisomy 21
Authors: Armstrong Dallas , Said Rana R. 
Published: May 2019

Objective: We performed a retrospective chart review of patients with trisomy 21 and infantile spasms in our university-based pediatric epilepsy center between 2002 and 2016 in order to describe the clinical characteristics of children with these diagnoses as well as to evaluate their response to first-line treatments. Methods: Patients with infantile spasms were identified via the neurophysiology database. Charts were reviewed with attention to infantile spasms diagnosis, presence of trisomy 21, age of reported clinical onset, treatment lag, treatments used, response to treatment, imaging findings, electroencephalography (EEG) data, and developmental outcomes. Results: Of the 310 patients with infantile spasms, 24 also had trisomy 21. Three patients did not meet inclusion criteria. Ten of the 21 patients received nonstandard therapies first line; 2 of the 10 (20%) achieved spasm control, and 4 of the 8 who failed therapy (50%) progressed to Lennox-Gastaut syndrome. Eleven of the 21 patients received standard therapies as first-line treatments (10 with prednisolone according to the protocol in the United Kingdom Infantile Spasms Study [UKISS] and 1 with adrenocorticotrophic hormone [ACTH]). Nine of the 10 patients (90%) who received prednisolone achieved spasm resolution, 6 (60%) of these without relapse. The final patient (10%) failed prednisolone as well as ACTH. One patient received ACTH first line with success. Conclusion: This is the only series to follow children with trisomy 21 and infantile spasms in which a significant proportion received UKISS-protocol prednisolone. It adds to current knowledge about safety, tolerability, and effectiveness of prednisolone in this group.
The advocacy role of nurses in cardiopulmonary resuscitation
Authors: Tíscar-González Verónica , Gea-Sánchez Montserrat , Blanco-Blanco Joan , Moreno-Casbas María Teresa , Peter Elizabeth 
Published: May 2019

Background: The decision whether to initiate cardiopulmonary resuscitation may sometimes be ethically complex. While studies have addressed some of these issues, along with the role of nurses in cardiopulmonary resuscitation, most have not considered the importance of nurses acting as advocates for their patients with respect to cardiopulmonary resuscitation. Research objective: To explore what the nurse’s advocacy role is in cardiopulmonary resuscitation from the perspective of patients, relatives, and health professionals in the Basque Country (Spain). Research design: An exploratory critical qualitative study was conducted from October 2015 to March 2016. Thematic analysis was used to analyse the data. Participants: Four discussion groups were held: one with patients and relatives (n = 8), two with nurses (n = 7 and n = 6, respectively), and one with physicians (n = 5). Ethical considerations: Approval was obtained from the Basque Country Clinical Research Ethics Committee. Findings: Three significant themes were identified: (a) accompanying patients during end of life in a context of medical dominance, (b) maintaining the pact of silence, and (c) yielding to legal uncertainty and concerns. Discussion: The values and beliefs of the actors involved, as well as pre-established social and institutional rules reduced nurses’ advocacy to that of intermediaries between the physician and the family within the hospital environment. On the contrary, in primary health care, nurses participated more actively within the interdisciplinary team. Conclusion: This study provides key information for the improvement and empowerment for ethical nursing practice in a cardiac arrest, and provides the perspective of patients and relatives, nurses and physicians.
Evaluation of Cognitive Behavioral Intervention for Chinese International Students in Hong Kong
Authors: Xie Qiuyuan , Wong Daniel Fu Keung 
Published: May 2019

Objectives: This study aims to test the effectiveness of a culturally attuned cognitive behavioral intervention (CBI) in promoting mental health and quality of life (QOL) among Chinese international students in Hong Kong. Method: A waitlist control designed was adopted. Sixty-five Chinese international students in a university in Hong Kong were assigned to experimental groups and control groups. The intervention consisted of eight weekly 3-hr sessions. All the participants were assessed preintervention, postintervention, and at a 3-month follow-up. Results: Participants in the experimental group showed a significant and continuous increase in mental health and overall QOL compared to those in the control group. Changes of dysfunctional attitudes mediated the effect of CBI on mental health and QOL. Conclusion: The current culturally attuned CBI may be useful in improving mental health and QOL among Chinese international students in Hong Kong.
Effect of the variability in implantation depth of intracorneal ring segments using the femtosecond laser technology in corneal ectasia
Authors: Peris-Martínez Cristina , Dualde-Beltrán Cristina , Fernández-López Ester , Roig-Revert Maria José , Hernández-Díaz Mikhail , Piñero David P 
Published: May 2019

Purpose: To analyze the impact of the depth of implantation of intracorneal ring segments on morphological, biomechanical, and clinical outcomes in ectatic corneas. Methods: This prospective longitudinal study enrolled 40 eyes of 29 patients (age 20–51 years) with corneal ectasia that underwent intracorneal ring segments implantation (KeraRing, Mediphacos). Changes in visual acuity, refraction, corneal tomography, and corneal biomechanics (Ocular Response Analyzer, Reichert) were evaluated during a 6 month follow-up. Likewise, changes in ring segment implantation depth measured by optical coherence tomography (Visante OCT, Carl Zeiss Meditec) were also evaluated. Results: Mean relative depth of implantation was 71.6 ± 5.8%, 71.5 ± 6.5%, and 71.9 ± 6.3% at 1, 3, and 6 months after surgery, respectively (p = 0.827). The difference between the real relative depth of implantation and the theoretical attempted value of 70% was not statistically significant (p = 0.072). Differences in spherical equivalent during the follow-up changed significantly depending on the level of relative depth of implantation (p = 0.036), with an increase of 0.114 D per each 1% increase in relative depth of implantation. Likewise, a decrease of –0.194 D in the steepest keratometric reading was found per each decrease of 1% in relative depth of implantation (p = 0.026). Changes in corneal thickness (p = 0.092) and biomechanics (p = 0.080) were not related to relative depth of implantation. Conclusion: The effect on visual acuity and refraction of intracorneal ring segments when implanted in corneal ectasia is less clinically relevant when the implantation is done at a very deep plane. The variability of the depth of intracorneal ring segments implantation when using femtosecond laser technology is minimal and with no clinically significant effect on clinical outcomes.
Inverse Associations of Schistosoma mansoni Infection and Metabolic Syndromes in Humans: A Cross-Sectional Study in Northeast Ethiopia
Authors: Wolde Mistire , Berhe Nega , Medhin Girmay , Chala Feyissa , van Die Irma , Tsegaye Aster 
Published: May 2019

Background: Recent animal and retrospective human studies have demonstrated that Schistosoma mansoni infection may have potential to protect against development of metabolic syndromes. Thus, the aim of this study was to assess metabolic panel among S. mansoni egg positives and egg negatives in stool examinations. This study was a cross-sectional study, conducted involving 120 participants from S. mansoni endemic town (Kemise) and 61 from non-endemic town (Kombolcha), Northeast Ethiopia. Stool samples were collected and examined for S. mansoni and other helminths using Kato-Katz method. Furthermore, blood samples were collected and used for determination of blood sugar, lipid profile tests, insulin, and C-reactive protein. Data were analyzed using SPSS software version 20. Chi-square test, independent mean t-test, and logistic regression models were employed on data. P values less than .05 were considered as statistically significant. Results: S. mansoni infected participants (n = 41; all from Kemise) had significantly lower levels of fasting blood sugar, low prevalence of dyslipidemia (at least one or more abnormal lipid profile tests; total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides) as compared with controls (n = 79 in Kemise and 61 in Kombolcha). Moreover, logistic regression model indicated that with the adjusted odds ratios, there was significant inverse association between S. mansoni infection and impaired fasting glucose (adjusted odds ratio −0.181, 95% confidence interval: 0.042-0.774). Conclusions: Low fasting blood sugar and reduced prevalence of dyslipidemia in S. mansoni egg positive participants might suggest inverse association of S. mansoni infection and development of metabolic syndromes. Furthermore, large-scale studies are recommended to assess the role of S. mansoni egg and/or worm antigens in modulating the host metabolic profile and reducing the risk of metabolic syndromes, including diabetes mellitus and cardiovascular diseases.
Pediatric brachial artery injury due to supracondylar humerus fractures: A case series
Authors: Grant Courtney , Theiss Mark , Mukherjee Dipankar 
Published: May 2019

Objectives Two to 20% of pediatric supracondylar humerus fractures present with abnormal vascular examinations ranging from ischemic hands to perfused pulseless hands. Management of perfused pulseless hands with observation or surgical exploration remains debatable. We report management and outcomes of five cases at our institution. Methods Charts of patients <18 years old with supracondylar humerus fractures undergoing brachial artery exploration from 2009 to 2016 were reviewed. Results Five patients presented with supracondylar humerus fracture after falls. Closed reduction and percutaneous pinning resulted in five pink hands, one with a palpable pulse and one with return of radial Doppler signal. Two were admitted for observation and one underwent immediate brachial artery exploration. The four cases initially managed non-operatively underwent exploration. Intraoperative findings included three brachial artery entrapments, one arterial compression due to hematoma, and one complete arterial transection requiring thrombectomy and venous interposition graft. At follow-up, all patients had palpable radial pulses. Conclusions Perfused pulseless hands after supracondylar humerus fracture reduction require close monitoring. Cases without return of radial Doppler signals should undergo immediate brachial exploration. We recommend duplex ultrasound for the diagnosis of brachial artery injury as an early guide to surgical exploration to prevent treatment delay and arm or hand ischemia.
User Satisfaction and Insulin Pump Handling With a Prefilled Insulin Cartridge in Adults and Adolescents With Type 1 Diabetes
Authors: Gupta Jitendra , Fuchs Gitte Schøning , Jenkins Michael , van Geel Brenda , Jensen Morten Lind , Sparre Thomas 
Published: May 2019

Background: This comparative handling study investigated user satisfaction and insulin pump handling with a prefilled insulin cartridge versus a self-filled insulin reservoir in insulin pump users with type 1 diabetes (T1D). Methods: Adult (n = 105) and adolescent (n = 25) participants performed insulin pump preparations using a prefilled insulin cartridge and self-filled insulin reservoir. User satisfaction, insulin pump preparation time, and residual air in infusion set tubing were assessed for each insulin filling method. Post hoc analysis evaluated training time. Results: User satisfaction scores were statistically significantly different in favor of the prefilled insulin cartridge versus the self-filled insulin reservoir (mean [SD]: overall, 4.0 [0.5] vs 3.3 [0.9]; burden on the user, 1.8 [0.6] vs 2.9 [1.0]; user inconvenience, 2.0 [0.7] vs 2.8 [1.1]; device effectiveness, 3.9 [0.7] vs 3.6 [0.9]; all P < .001). Insulin pump preparation time and residual air measurements were significantly different and numerically lower for the prefilled insulin cartridge versus the self-filled insulin reservoir (mean [SD]: preparation time, 124.4 [30.3] vs 237.8 [64.2] seconds, P < .001; residual air, 2.3 [26.3] vs 10.0 [63.3] mm, P = .007). Training time was shorter with the prefilled insulin cartridge versus the self-filled insulin reservoir (mean [min; max]: 193.1 [36; 453] vs 535.8 [124; 992] seconds). Conclusions: Adult and adolescent insulin pump users were more satisfied with the prefilled insulin cartridge versus the self-filled insulin reservoir when preparing an insulin pump. The prefilled insulin cartridge was associated with reduced insulin pump preparation time and reduced training time versus the self-filled insulin reservoir.