bluuebunny/crossref_metadata_2025_split huggingface dataset:
Permanent Versus Bioresorbable Implants in Orbital Floor Blowout Fractures
Authors: Seen Sophia , Young Stephanie Ming , Teo Shao Jin , Lang Stephanie S. , Amrith Shantha , Lim Thiam-Chye , Sundar Gangadhara 
Published: February 2018

Purpose:
To compare the outcomes of bioresorbable and permanent implants in the reconstruction of isolated orbital floor blowout fractures.

Methods:
Retrospective series of all patients who had orbital floor fracture repair in a single tertiary trauma center from January 2005 to December 2014. The authors reviewed the case notes and CT scans of patients with orbital floor fracture repair with either bioresorbable or permanent implants. Main outcome measures were enophthalmos, diplopia, and ocular motility restriction 1.5 years after fracture repair. Implant-related complications were collected for analysis.

Results:
There were a total of 88 patients in our study. Bioresorbable implants were used in 48 patients (54.5%) while 40 patients had permanent implants (45.5%). The authors analyzed the implants used in various sizes of orbital fractures: small (<13.3 mm), medium (13.3–20 mm), and large (>20 mm). One and a half years after fracture repair, both groups had comparable clinical outcomes (n = 2 and n = 0 for diplopia for permanent and bioresorbable implant groups, respectively, n = 0 for enophthalmos for both groups and n = 1 for ocular motility limitation for both groups) overall and across all fracture sizes.

Conclusion:
Bioresorbable implants degrade after fracture healing through hydrolysis and promote the gradual transfer of functional forces to healing bone during its disintegration. The clinical outcomes of diplopia, enophthalmos, and ocular motility restriction associated with the use of resorbable implants are comparable to that of permanent implants for all fracture sizes. Their study shows that bioresorbable and permanent implants are equally safe and effective for the treatment of patients with isolated orbital floor blowout fractures.
Neuroinflammation of the spinal cord and nerve roots in chronic radicular pain patients
Authors: Albrecht Daniel S. , Ahmed Shihab U. , Kettner Norman W. , Borra Ronald J.H. , Cohen-Adad Julien , Deng Hao , Houle Timothy T. , Opalacz Arissa , Roth Sarah A. , Melo Marcos F. Vidal , Chen Lucy , Mao Jianren , Hooker Jacob M. , Loggia Marco L. , Zhang Yi 
Published: February 2018

Abstract
Numerous preclinical studies support the role of spinal neuroimmune activation in the pathogenesis of chronic pain, and targeting glia (eg, microglia/astrocyte)- or macrophage-mediated neuroinflammatory responses effectively prevents or reverses the establishment of persistent nocifensive behaviors in laboratory animals. However, thus far, the translation of those findings into novel treatments for clinical use has been hindered by the scarcity of data supporting the role of neuroinflammation in human pain. Here, we show that patients suffering from a common chronic pain disorder (lumbar radiculopathy), compared with healthy volunteers, exhibit elevated levels of the neuroinflammation marker 18 kDa translocator protein, in both the neuroforamina (containing dorsal root ganglion and nerve roots) and spinal cord. These elevations demonstrated a pattern of spatial specificity correlating with the patients' clinical presentation, as they were observed in the neuroforamen ipsilateral to the symptomatic leg (compared with both contralateral neuroforamen in the same patients as well as to healthy controls) and in the most caudal spinal cord segments, which are known to process sensory information from the lumbosacral nerve roots affected in these patients (compared with more superior segments). Furthermore, the neuroforaminal translocator protein signal was associated with responses to fluoroscopy-guided epidural steroid injections, supporting its role as an imaging marker of neuroinflammation, and highlighting the clinical significance of these observations. These results implicate immunoactivation at multiple levels of the nervous system as a potentially important and clinically relevant mechanism in human radicular pain, and suggest that therapies targeting immune cell activation may be beneficial for chronic pain patients.
Correlates and importance of neglect-like symptoms in complex regional pain syndrome
Authors: Wittayer Matthias , Dimova Violeta , Birklein Frank , Schlereth Tanja 
Published: February 2018

Abstract
Neglect-like symptoms (NLS) are frequently observed in complex regional pain syndrome (CRPS). The clinical meaning of NLS, however, is largely unknown. Therefore, this study sets out to assess the importance of NLS for patient outcome and to explore their clinical correlates. We assessed NLS in a group of 53 patients with CRPS and compared the results to 28 healthy volunteers. To define the origin of the NLS reports, we tested the subjective visual midline, performed a limb-laterality recognition test, and quantitative sensory testing. In addition, psychological and pain assessment scales were completed. Tests were analyzed with univariate and multivariate approaches. After 6 months, patients were reassessed and the influence of NLS on pain outcome was determined. Most patients reported NLS in the questionnaire, whereas subjective visual midline and limb-laterality recognition test in contrast to previous studies did not reveal perceptual disturbances. Neglect-like symptom scores were associated with pain and pain catastrophizing in acute CRPS and anxiety and thermal sensory loss in chronic CRPS. Furthermore, high NLS scores had a negative impact on pain outcome after 6 months. Our results indicate that NLS have a different meaning in acute and chronic CRPS and might be of prognostic value. Possibly, treatment should focus on reducing NLS.
Long-term use of naldemedine in the treatment of opioid-induced constipation in patients with chronic noncancer pain: a randomized, double-blind, placebo-controlled phase 3 study
Authors: Webster Lynn R. , Nalamachu Srinivas , Morlion Bart , Reddy Jyotsna , Baba Yuko , Yamada Tadaaki , Arjona Ferreira Juan C. 
Published: February 2018

Abstract
The long-term safety of naldemedine, a peripherally acting µ-opioid receptor antagonist, was evaluated in patients with opioid-induced constipation and chronic noncancer pain in a 52-week, randomized, double-blind, phase 3 study. Eligible adults who could be on a routine laxative regimen were randomized 1:1 to receive once-daily oral naldemedine 0.2 mg (n = 623) or placebo (n = 623). The primary endpoint was summary measures of treatment-emergent adverse events (AEs). Additional endpoints included opioid withdrawal on the Clinical Opiate Withdrawal Scale and the Subjective Opiate Withdrawal Scale, pain intensity on Numeric Rating Scale, frequency of bowel movements, and constipation-related symptoms and quality of life on the Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life scales, respectively. Treatment-emergent AEs (naldemedine, 68.4% vs placebo, 72.1%; difference: −3.6% [95% confidence interval: −8.7 to 1.5]) and treatment-emergent AEs leading to study discontinuation (6.3% vs 5.8%; difference: 0.5% [−2.2 to 3.1)] were reported for similar proportions of patients. Diarrhea was reported more frequently with naldemedine (11.0%) vs placebo (5.3%; difference: 5.6% [2.6-8.6]). There were no meaningful differences between groups in opioid withdrawal or pain intensity. Sustained significant improvements in bowel movement frequency and overall constipation-related symptoms and quality of life were observed with naldemedine (P ≤ 0.0001 vs placebo at all time points). Naldemedine was generally well tolerated for 52 weeks and did not interfere with opioid-mediated analgesia or precipitate opioid withdrawal. Naldemedine significantly increased bowel movement frequency, improved symptomatic burden of opioid-induced constipation, and increased patients' quality of life vs placebo.
Resilience and Coping After Hospital Mergers
Authors: Russo Cynthia , Calo Oriana , Harrison Georgia , Mahoney Kathleen , Zavotsky Kathleen Evanovich 
Published: February 2018

Objective:
The aim of this study was to explore the relationship between resilience and coping in frontline nurses working in a healthcare system that has recently undergone a merger.

Background:
Hospital mergers are common in the current healthcare environment. Mergers can provide hospital nurses the opportunity to use and develop positive coping strategies to help remain resilient during times of change.

Methods:
An anonymous-survey, quantitative, exploratory, descriptive study design was used. Data were obtained from an electronic survey that was made available to all nurses working in a 3-hospital system located in the northeast.

Results:
Overall, the results showed that, when nurses reported using positive coping strategies, they report higher levels of resilience. The levels of resilience also varied from campus to campus. The campus that has been through 2 recent mergers reported the highest levels of resilience.

Conclusion:
This study suggests that, during times of change in the workplace, if nurses are encouraged to use positive coping strategies, they may have higher levels of resilience. This changing environment provides the clinical nurse specialists/clinical nurse educators the opportunity to foster and support frontline nurses in the use of healthy coping strategies and to help improve and maintain a high level of resilience, which is critical in today’s healthcare environment.
Assessment of Recovery Following Pediatric Traumatic Brain Injury
Authors: Slovis Julia C. , Gupta Nachi , Li Natasha Y. , Kernie Steven G. , Miles Darryl K. 
Published: February 2018

Objectives:
We analyzed a prospective database of pediatric traumatic brain injury patients to identify predictors of outcome and describe the change in function over time. We hypothesized that neurologic status at hospital discharge would not reflect the long-term neurologic recovery state.

Design:
This is a descriptive cohort analysis of a single-center prospective database of pediatric traumatic brain injury patients from 2001 to 2012. Functional outcome was assessed at hospital discharge, and the Glasgow Outcome Scale Extended Pediatrics or Glasgow Outcome Scale was assessed on average at 15.8 months after injury.

Setting:
Children’s Medical Center Dallas, a single-center PICU and Level 1 Trauma Center.

Patients:
Patients, 0–17 years old, with complicated-mild/moderate or severe accidental traumatic brain injury.

Measurements and Main Results:
Dichotomized long-term outcome was favorable in 217 of 258 patients (84%), 80 of 82 patients (98%) with complicated-mild/moderate injury and 133 of 172 severe patients (77%). In the bivariate analysis, younger age, motor vehicle collision as a mechanism of injury, intracranial pressure monitor placement, cardiopulmonary resuscitation at scene or emergency department, increased hospital length of stay, increased ventilator days (all with p < 0.01) and occurrence of seizures (p = 0.03) were significantly associated with an unfavorable outcome. In multiple regression analysis, younger age (p = 0.03), motor vehicle collision (p = 0.01), cardiopulmonary resuscitation (p < 0.01), and ventilator days (p < 0.01) remained significant. Remarkably, 28 of 60 children (47%) with an unfavorable Glasgow Outcome Scale at hospital discharge improved to a favorable outcome. In severe patients with an unfavorable outcome at hospital discharge, younger age was identified as a risk factor for remaining in an unfavorable condition (p = 0.1).

Conclusions:
Despite a poor neurologic status at hospital discharge, many children after traumatic brain injury will significantly improve at long-term assessment. The factors most associated with outcomes were age, cardiopulmonary resuscitation, motor vehicle collision, intracranial pressure placement, days on a ventilator, hospital length of stay, and seizures. The factor most associated with improvement from an unfavorable neurologic status at discharge was being older.
Application of Digital Diagnosis and Treatment Technique in Benign Mandibular Diseases
Authors: Ju Rui , Zeng Wei , Lian Xiaotian , Chen Gang , Yin Huaqiang , Tang Wei 
Published: February 2018

Purpose:
To explore the feasibility of preoperative planning for treatment of benign mandibular lesions (BML) using digital technologies such as three-dimensional (3D) reconstruction, measurement, visualization as well as image contrast and design of neural positioning protection template (NPPT) in combination with 3D printing technology in the BML diagnosis and treatment.

Methods:
The 3D models of BML and inferior alveolar nerves (IAN) of 10 BML patients were reconstructed based on their digital imaging and communications in medicine (DICOM) data using MIMICS16.0 software. The models were used to visualize lesions and nerve contrast measurement and guide design of personalized NPPT and osteotomy after operation modality was determined in order to achieve accurate, minimally invasive operation with shortened intraoperative time.

Results:
Intraoperative NPPT application could accurately locate lesions and their scope and assist osteotomy. The measurement results were consistent with those of preoperative reconstruction and measurement. The BML were curetted completely without damage IAN. The 10 BML patients had no numbness and other discomforts in the lower lip and mandibular teeth after operation.

Conclusions:
The digital diagnosis and treatment technology is an effective method for functional treatment of BML patients and its application could achieve personalized, minimally invasive and precise treatment and save intraoperation time.
Comparison of Three Methods Used for Estimating Area of Foramen Magnum
Authors: Gocmen Mas Nuket , Cirpan Sibel , Aksu Funda , Yonguc Demirci Goksin Nilufer , Lafci Fahrioglu Sevda , Durmaz Ozan , Karabekir Selim 
Published: February 2018

Objective:To compare whether there are any differences between the 3 methods used for measure area of foramen magnum (FM) in skulls.Methods:The FMs of 150 skulls were examined. Antero-posterior diameter, transverse diameter were measured using by Vernier caliper. The area of the FM was calculated by using 2 different formulas as described previously by Radinsky and Teixeira.The authors also applied stereological assessment method for estimating the surface area of FMs. The area was calculated 3 times manually using stereological point grid system for each skull.The authors compared the mean surface area of FMs obtained from each of these 3 methods estimating surface area of FMs whether there were any significant differences in between their results.Results:The mean areas of the FMs estimated according to Teixeria formula, Radinsky formula, and Cavalieri stereological method were respectively as follows: 790.47 ± 99.86 mm2, 783.66 ± 99.34 mm2, and 748.06 ± 100.19 mm2. The authors observed significant differences (P < 0.05) in between the mean surface areas of FMs obtained from each of these 3 methods used for estimating the area.Conclusion:There were significant differences (P < 0.05) in between the mean surface areas of FMs obtained from each of these 3 methods used for estimating the area.
Refinements in Elevation of the Reconstructed Auricle: The “Zigzag Incision”
Authors: Han So-Eun , Eom Yeseul , Oh Kap Sung 
Published: February 2018

Objective:
Auricular elevation with superficial temporal fascia and skin graft is widely used in microtia reconstruction using costal cartilage. However, in some patients, there has been occurrence of contraction of skin graft, which led to insufficient projection of the elevated auricle and diminished auriculocephalic angle with unfavorable long-term results. In this article, the authors introduce their multiple triangular flaps with zigzag incision to maintain stable projection and natural retroauricular sulcus appearance in auricular reconstruction patients.

Methods:
The authors have designed zigzag incision along the lateral margin of the ear framework to prepare triangular flaps targeting the root of the helix or inferior half of the auricle. Depending on the extent of remnant skin coverage, the number of triangular flaps is varied. The posterior raw surface of the ear framework was covered with triangular flaps and full-thickness skin graft.

Results:
Zigzag incision was conducted in 22 microtia patients who underwent auricular elevation using superficial temporal fascia and skin graft. Mean follow-up period was 2 years and there were no reports of occurrence of surgery-related complications, specifically skin necrosis, infection, or hematoma. The auricular projections were well maintained and auriculocephalic angle of the constructed auricles was similar to the healthy ears.

Conclusions:
The author's method comprises comparatively easy techniques and leads to good projection of the auricular angle. A zigzag incision using the triangular flaps could be an attractive surgical option for preventing shrinkage of grafted site and in achieving sufficient projection in autologous reconstructed auricle.
Endoscopic Approach for Excision of Venous Malformation of the Orbital Apex
Authors: Ruiz Devin , Rebeiz Elie E. 
Published: February 2018

Introduction:
Venous malformation is a common tumor of the orbit, presenting with visual impairment and proptosis. These lesions can be excised via an external or transcranial approach, but recent advances in minimally invasive surgery have led to increased popularity of endoscopic approach.

Patient:
The authors report a 62-year-old female presenting with diplopia and proptosis, found to have a 1.7-cm venous malformation of the orbital apex. An endoscopic trans-nasal approach was undertaken for surgical resection.

Results:
The tumor was successfully removed in a single specimen, without injury to the nearby orbital anatomy. The patient experienced resolution of her presenting symptoms 3 weeks after the procedure, with no adverse effects. A review of the literature demonstrates increasing reports of similar successful cases.

Conclusion:
A minimally invasive, endoscopic resection of orbital venous malformation is possible and provides a reasonably safe and effective approach. Further large-scale studies are needed to fully explore its outcomes relative to traditional approaches
Competitive or cooperative relationships in clusters
Authors: Ayakwah Anthony , Sepulveda Leandro , Lyon Fergus 
Published: February 2018

Purpose
An efficient policy supporting clustered business operations necessitates an appreciation of the dynamics of rivalry and collaborations among businesses. This paper postulates that variation in competition and cooperation can significantly influence the nature of business relationships among clustered businesses, which is essential for cluster policy particularly (Newlands, 2003) as most research on rivalry and cooperation in clusters have been in developed economies. The purpose of this paper is to seek to fill the gap in the literature in African clusters based on original empirical research.

Design/methodology/approach
The study adopts a mixed-method research design allowing for data triangulation to study two food processing clusters. The approach comprises a survey and in-depth interview with key actors along the supply chain.

Findings
The findings show that business clusters with more formal business structures tend to have minimal horizontal competition but higher vertical cooperation. Comparatively, clusters with more socially embedded milieu tend to have higher levels of cooperation and minimal competition in both vertical and horizontal relationships. The research also shows that such variations in inter-business relationships have an effect on cluster operations in terms of business access to finance, formal contract, sharing of innovation and the way they relate to different stakeholders in their supply chain.

Originality/value
This paper advances a critical case for international business theory on clusters in Africa to incorporate the distinctive business relationships in small and medium enterprises (SME) clusters. It also demonstrates how unique location-specific attributes of developing economies hold the key to sustaining the operations of SME-based clusters.
Denial of racism and the Trump presidency
Authors: Konrad Alison M. 
Published: February 2018

PurposeThe purpose of this paper is to document the racist undertones of Donald Trump’s Presidential campaign rhetoric and draw implications regarding its impact on equality, diversity, and inclusion. Most contemporary individuals reject explicitly racist beliefs and strive to present themselves as having egalitarian attitudes toward other races and ethnicities. However, commonly held implicit biases toward historically marginalized racioethnic groups drive negative effect that is often unconscious and unacknowledged. Inconsistency between the conscious and unconscious aspects of contemporary racism generates a population of individuals who are uncomfortable with their attitudes, creating an opening for politicians willing to leverage racist rhetoric and gain support by resolving this inconsistency.Design/methodology/approachThis paper applies social psychological theory and research to address the questions of what attracts otherwise non-racist individuals to racist-tinged rhetoric. The paper also provides theory-based interventions for reducing the attractiveness and impact of racist political campaigns.FindingsSupporters of racist politicians resolve the conflict between their negative feelings toward racioethnic minorities and their espoused anti-racist views by distancing themselves from racist rhetorical content in three ways: by denying that racist statements or actions occurred, denying that the statements or actions are racist, and/or by denying responsibility for racism and its effects. These techniques provide supporters with validation from an authority that they can express their negative affect toward out-groups and still consider themselves to be good people and not racists.Practical implicationsDistancing from racism has allowed contemporary American extremists to reframe themselves as victims of closed-minded progressives seeking to elevate undeserving and/or dangerous out-groups at the in-group’s expense. Effective anti-racism techniques are needed to counter implicit biases in order to limit the attractiveness of extremist views. Implicit biases can be effectively reduced through training in counter-stereotypic imaging, stereotype replacement, and structured inter-group interaction. Effectively countering denial of the facts involves affirming the audience’s belief system while building skepticism toward the sources of misinformation.Social implicationsWhile countering racist politicians requires commitment, these efforts are essential for protecting the identity of the USA as a society striving toward equality, diversity, and inclusion.Originality/valueBy articulating the social psychological principles underpinning racist-tinged populist rhetoric, this paper explains the attractiveness of racist statements by politicians, which tends to be under-estimated.
Boom or bust: demystifying Trump’s deplorable economics
Authors: ogilvie dt 
Published: February 2018

Purpose
Two questions broadly drove this research: Donald Trump promised to fix the economy and create jobs, and he is ending or renegotiating trade treaties. Is he creating more jobs? How can Trump create a more inclusive economy? The paper aims to discuss these issues.

Design/methodology/approach
This paper closely examines Trump’s economic policies and draws from past Democratic and Republication track records to explain how Trump’s policies will contribute to greater income inequality.

Findings
By all measures, President Trump fails on measures of equality, diversity, and inclusion.

Originality/value
This original paper examines the implications of the Trump administration’s policies in the areas of tax cuts (for small- and medium-sized enterprises rather than large corporations), incentives to support small business growth, entrepreneurship training, education and skills training (to retool Americans), and infrastructure spending.