bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Implementation Readiness and Success of an e-Resource to Improve Prelicensure Physical Therapy Workforce Capacity to Manage Rheumatoid Arthritis
Authors: Fary Robyn E. , Slater Helen , Jordan Joanne E. , Gardner Peter , Chua Jason , Payne Carly , Briggs Andrew M. 
Published: September 2017

Study Design Prospective within-subject, cross-sectional, between-group, nested qualitative designs within an implementation science framework. Background Physical therapy is recommended for rheumatoid arthritis (RA) care, yet prelicensure RA curriculum time remains limited. Objectives To determine readiness for, and success of, implementing an e-learning tool, Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL), within the prelicensure physical therapy curriculum. Methods All physical therapy students in a 1-year cohort in 2014 had RAP-eL embedded in their curriculum. Rheumatoid Arthritis for Physiotherapists e-Learning is an online platform that delivers RA disease information with translation to clinical practice. Implementation readiness, determined by acceptability of RAP-eL to students, was evaluated using focus groups (n = 23). Implementation success was measured using quantitative data from a previously validated questionnaire, including changes in students' self-reported confidence in knowledge (out of 45) and skills (out of 40) in managing RA after 4 weeks of access to RAP-eL, retention of learning over 14 months, and differences in workforce readiness between students in the cohort who had access to RAP-eL and a historical control cohort. Results Acceptability of RAP-eL was confirmed from qualitative data, demonstrating implementation readiness. Short-term improvements were observed in RA knowledge (mean difference, 16.6; 95% confidence interval [CI]: 15.7, 17.6) and RA skills (mean difference, 14.9; 95% CI: 13.9, 15.9; n = 137). Retention was demonstrated after 14 months (P<.001; n = 62). Students in the 1-year cohort who had RAP-eL embedded in the curriculum scored significantly higher on knowledge (mean difference, 3.6; 95% CI: 1.3, 5.9) and skills (mean difference, 3.3; 95% CI: 0.9, 5.7; n = 62) compared to those without RAP-eL (n = 36). Rheumatoid Arthritis for Physiotherapists e-Learning remains embedded in the curriculum. Conclusion This study demonstrated both readiness and success of the sustainable implementation of RAP-eL within a prelicensure physical therapy curriculum. J Orthop Sports Phys Ther 2017;47(9):652–663. doi:10.2519/jospt.2017.7281
Cervical Myelopathy Presenting as Bilateral Upper Extremity Weakness
Authors: McInerney Sean , Keil Aaron , Kim Jin Suh 
Published: September 2017

A 57-year-old man with insidious onset of progressive bilateral upper extremity weakness was referred to physical therapy by his primary care physician. Following examination, the physical therapist referred the patient back to his primary care physician with a request for cervical magnetic resonance imaging (MRI) and neurology consultation. Cervical radiographs demonstrated multilevel degenerative changes, while cervical spine MRI revealed compressive myelopathy, significant spinal canal stenosis, and severe spondylosis J Orthop Sports Phys Ther 2017;47(9):691. doi:10.2519/jospt.2017.7287
C6 Spinous Process Fracture in a Young Adult
Authors: Watson Daniel J. , Dolbeer Jeffery A. 
Published: September 2017

A 21-year-old male military academy cadet developed acute posterior neck pain after performing multiple sets of overhead shoulder presses and resting the bar on his lower neck and shoulders. He presented to a direct-access physical therapy clinic. Due to the acute onset and focal nature of pain in the setting of repetitive weightlifting, the physical therapist ordered radiographs of the cervical spine, which revealed a C6 spinous process fracture. J Orthop Sports Phys Ther 2017;47(8):578. doi:10.2519/jospt.2017.7277
Can p53 expression and staining intensity correlate with histopathological prognostic parameter and clinical staging in head and neck squamous cell carcinoma?
Authors: Kaur Jasmeet , Mannan Rahul , Manjari Mridu , Sharma Sonam , Kaur Jasmine , Bhasin Tejinder Singh , Kaur Amritpal 
Published: September 2017

Background: In recent years, p53 has emerged as an important tool for not only diagnosis and predicting prognosis in head and neck squamous cell carcinoma. The aim of this study was to find the role of p53 staining intensity in determining prognosis. Materials and Methods: Fifty histopathologically proven cases of squamous cell carcinoma of head and neck were studied. The findings of the study were analyzed particularly in reference to p53 expression and their correlation with age, sex, anatomical site, tumor size, histological grading, vascular, peri-neural, muscle invasion, lymph node metastasis and staining intensity.Results: Immunopositivity rate of p53 was 64% with percentage positive cells varying from 5-76% with mild, moderate and strong staining intensity. A positive correlation of p53 independently was seen with oral cavity, grade, lymph node metastasis and pathological staging.Conclusion: p53 immunoexpression is an important independent variable of prognostication.
Prevalence of anemia in children aged 6 months to 15 years: a hospital based study
Authors: Sharma Anna , Giri Abhishek , Pudasaini Sujata 
Published: September 2017

Background: Anemia is a common problem in small children and in adolescents in Nepal. We conducted this study to estimate the prevalence of anemia in hospitalized children in our setup.Materials and Methods: Children aged 6 months to 15 years with hemoglobin < 11 gm/dl were enrolled. Clinical details of patients including the demographic characteristics, anthropometry, final diagnosis and laboratory results were recorded and retrieved for analysis.Results: Prevalence of anemia was 42.3%. Mean hemoglobin was 9.51 gm/dl. Anemia was more common in children more than five years (53.3%). 73.3% had mild, 20.9% had moderate and 5.7% had severe anemia. Grade I malnutrition was seen in 24.8%, Grade II in 20.9% and grade III in 5.7%. Pneumonia was seen more commonly in children with mild and moderate anemia.Conclusion: Anemia is a common problem in children and may be associated with respiratory infections.
Prevalence of Thyroid Dysfunction in Community of Duwakot, Bhaktapur
Authors: Pradhan Binita , Pradhan Sailesh Bahadur 
Published: September 2017

Background: Thyroid dysfunction is one of the major public health problems in the Nepalese community and of the common endocrine disorders diagnosed in community primary health care centres. The aim of this study is to analyze the prevalence of Thyroid dysfunction in Duwakot, NepalMaterials and Methods: All the patients from Duwakot community who presented with the history of weight gain with tiredness and weight loss with palpitation were subjected to thyroid function test free triiodothyronine, free thyroxine and thyroid stimulating hormone. Results: Thyroid dysfunction was found in 26% with M:F ratio of 1:5. Subclinical hypothyroidism 62 (11.44%) was the most prevalent one followed by Primary hypothyroidism 48 (8.85%), primary hyperthyroidism 16 (2.95%) and subclinical hyperthyroidism 15 (2.76%).Conclusion: Thyroid dysfuntion has been observed despite of nationwide program regarding supplementation of micronutrient iodised salt. Key words: Euthyroid, Hyperthroidism, Hypothyroidism, Iodine, Prevalence, Thyroid dysfunction
Langerhans cell histiocytosis; an institutional study
Authors: Karki Shovana , Rajbhandari Aasia 
Published: September 2017

Background: Langerhans cell histiocytosis is a complex rare disease of the dendritic cell system.The disease can occur at any age, with a peak at 5-10 years. Here, we present the spectrum of this uncommon disease with different sites of involvement and its histopathological differential diagnosis. Material and Methods: Study included 24 cases of Langerhans cell histiocytosis out of approximately 50,000 biopsies received in the department.Results: The male to female ratio was 1.6:1 with mean age of 12 years. Commonest site of involvement was skin 37.5%, followed by bone 33.4%. Lymph nodes 20.9%, bone marrow 4.1% and thyroid 4.1% involvement was seen. Among the 9 cases of bone involvement, commonest site was humerus (3 cases), sternum (2 cases) and one case each in frontal bone, fibula, temporal bone and rib.Conclusion: Langerhans cell histiocytosis should be considered in the differential diagnosis of histiocytic lesions involving various organs, especially in childhood.
Screening of Hemoglobin disorder in non-endemic region
Authors: K.C. Shiva Raj 
Published: September 2017

Hemoglobinopathies are group of inherited disorders which can broadly be classified into qualitative and quantitative defects. Qualitative defects include Sickle cell anemia whereas quantitative defect includes Thalassemia. Sickle cell anemia is characterised by abnormality in the structure of haemoglobin in particular substitution of adenine in sixth codon of β gene (GAG-GTG), thereby encoding valine instead of glutamic acid in sixth position of β chain.1 In thalassemia there is reduced production of one or more globin chains. Thalassemia is generally classified into two broad categories: α-thalassemia and β-thalassemia usually caused by deletions of one or all four alleles of α- genes and point mutation β gene respectively. This results in reduction or absence in globin chain synthesis.Hemoglobinopathies can be either in trait or disease condition. People with traits do not require medical or follow-up care after the initial diagnosis is made. People with β-thalassemia trait should be warned that their condition can be misdiagnosed as the more common iron deficiency anemia and should avoid routine use of iron supplements. Counselling is indicated in all persons with genetic disorders, especially when the family is at risk of a severe form of disease that may be prevented.In Nepal, though actual data is not available, increased incidence of hemoglobinopathies is observed among the ethnic community of Terai region. As we know, inherited haemoglobin disorders (sickle-cell disorders and thalassaemias) were originally characteristic of the tropics and subtropics. However, due to migration it has become common worldwide.2-5 In Nepal; hemoglobinopathies are seen in other population than from Terai. Hemoglobinopathies can be controlled cost-effectively by programmes that integrate treatment with carrier detection and genetic counselling, WHO has recommended global development of these services.5 A policy of detecting carriers and informing them of their risk, and possibilities for reducing it, usually leads to a fall in births and deaths of affected children. Requirements are the same for thalassaemias and sickle-cell disorders. To prevent and minimize the disease regular screening; in all the communities; should be conducted at least in anaemic individuals with microcytic hypochromic anaema. Population screening is not the only useful strategy: family studies can be cost-effective.The effects of screening depend on the choices made by informed individuals. Birth prevalence of thalassaemia can fall by over 90%6,7 because most at-risk couples limit their family to two healthy children,6,7 there is very high uptake of prenatal diagnosis, and some carriers avoid risk by selecting a non-carrier partner.6,7 Available data for sickle-cell disorders shows lower use of prenatal diagnosis8 and improved survival of affected children with neonatal diagnosis.
Physical startup tests for VVER-1200 of Novovoronezh NPP: advanced technique and some results
Authors: Afanasiev D. A. , Kraynov Yu. A. , Pinegin A. A. , Tsyganov S. V. 
Published: September 2017

Abstract
The intention of the startup physics tests was to confirm design characteristics of the core loading and their compliance with safety analysis preconditions. The program of startup tests for the leading unit is usually composed in such a way that is is possible to study as much neutron-physical characteristics as possible in the safest condition of zero power. State-of-the-art safety analysis is including computer codes that use three dimensional neutron kinetics and thermohydraulics models. For the substantiation of such models, for its validation and verification there is a need in reactor experiments that implementing spatially distributed transients. We based on such statements when composing hot zero power physical startup program for the new VVER-1200 unit of Novovoronezh NPP. Several tests unconventional for VVER were developed for that program. It includes measuring the worth for each of control rod groups and measuring of single rod worth from the inserted groups – test that models rod ejection event in some sense.
Porosity, microstructure and mechanical behavior of NiO–YSZ composite anode for solid oxide fuel cells
Authors: Tanhaei Mohammad , Mozammel Mahdi , Javanshir Ehsan , Ilkhechi Nasrollah Najibi 
Published: September 2017

Abstract
In this study, NiO–yttria stabilized zirconia (YSZ) composite anodes were prepared by using ball-milling followed by a sintering process. For this purpose, two different weight percent ratios of NiO and YSZ powders (50 : 50 and 60 : 40) were mixed by the cost-effective ball-milling method. The morphology and particle size distribution of the mixed powders were investigated using scanning electron microscopy and dynamic light scattering methods, respectively. The powders were then uniaxially pressed to form pellets with a thickness and diameter of around 1 and 22 mm, respectively. Sintering of the pellets was conducted at 1 100 °C and the microstructure and porosity, as well as phase analysis of bulk composites, were then investigated using scanning electron microscopy and X-ray diffraction, respectively. More importantly, the microhardnesses of the prepared pellets were obtained and compared with literature values to evaluate the accuracy of the sintering process. The results showed that the open porosity of the samples varied between 30 to 40 percent, which makes them suitable for anode application in solid oxide fuel cells. The prepared NiO–YSZ composites with a uniform distribution of Ni particles showed a value of microhardness above 0.5 GPa, and these results were discussed in detail.
Isolated abducens nerve palsy associated with subarachnoid hemorrhage: a localizing sign of ruptured posterior inferior cerebellar artery aneurysms
Authors: Burkhardt Jan-Karl , Winkler Ethan A. , Lasker George F. , Yue John K. , Lawton Michael T. 
Published: September 2017

OBJECTIVECompressive cranial nerve syndromes can be useful bedside clues to the diagnosis of an enlarging intracranial aneurysm and can also guide subsequent evaluation, as with an acute oculomotor nerve (cranial nerve [CN] III) palsy that is presumed to be a posterior communicating artery aneurysm and a surgical emergency until proven otherwise. The CN VI has a short cisternal segment from the pontomedullary sulcus to Dorello’s canal, remote from most PICA aneurysms but in the hemodynamic pathway of a rupturing PICA aneurysm that projects toward Dorello’s canal. The authors describe a cranial nerve syndrome for posterior inferior cerebellar artery (PICA) aneurysms that associates subarachnoid hemorrhage (SAH) and an isolated abducens nerve (CN VI) palsy.METHODSClinical and radiological data from 106 surgical patients with PICA aneurysms (66 ruptured and 40 unruptured) were retrospectively reviewed. Data from a group of 174 patients with other aneurysmal SAH (aSAH) were analyzed in a similar manner to control for nonspecific effects of SAH. Univariate statistical analysis compared incidence and risk factors associated with CN VI palsy in subarachnoid hemorrhage.RESULTSOverall, 13 (4.6%) of 280 patients had CN VI palsy at presentation, and all of them had ruptured aneurysms (representing 13 [5.4%] of the 240 cases of ruptured aneurysms). CN VI palsies were observed in 12 patients with ruptured PICA aneurysms (12/66 [18.1%]) and 1 patient with other aSAH (1/174 [0.1%], p < 0.0001). PICA aneurysm location in ruptured aneurysms was an independent predictor for CN VI palsy on multivariate analysis (p = 0.001). PICA aneurysm size was not significantly different in patients with or without CN VI palsy (average size 4.4 mm and 5.2 mm, respectively). Within the PICA aneurysm cohort, modified Fisher grade (p = 0.011) and presence of a thick cisternal SAH (modified Fisher Grades 3 and 4) (p = 0.003) were predictors of CN VI palsy. In all patients with ruptured PICA aneurysms and CN VI palsy, dome projection and presumed direction of rupture were directed toward the ipsilateral and/or contralateral Dorello’s canal, in agreement with laterality of the CN palsy. In patients with bilateral CN VI palsies, a medial projection with extensive subarachnoid blood was observed near bilateral canals.CONCLUSIONSThis study establishes a localizing connection between an isolated CN VI palsy, SAH, and an underlying ruptured PICA aneurysm. CN VI palsy is an important clinical sign in aSAH and when present on initial clinical presentation may be assumed to be due to ruptured PICA aneurysms until proven otherwise. The deficit may be ipsilateral, contralateral, or bilateral and is determined by the direction of the aneurysm dome projection and extent of subarachnoid bleeding toward Dorello’s canal, rather than by direct compression.
Sex differences in delayed cerebral ischemia after subarachnoid hemorrhage
Authors: Germans Menno R. , Jaja Blessing N. R. , de Oliviera Manoel Airton Leonardo , Cohen Ashley H. , Macdonald R. Loch 
Published: September 2017

OBJECTIVEIn this study the authors sought to investigate the sex differences in the risk of delayed cerebral ischemia (DCI), delayed cerebral infarction, and the role of hormonal status.METHODSTen studies included in the SAHIT (SAH International Trialists) repository were analyzed using a fitting logistic regression model. Heterogeneity between the studies was tested using I2 statistics, and the results were pooled using a random-effects model. Multivariable analysis was adjusted for the effects of neurological status and fixed effect of study. An additional model was examined in which women and men were split into groups according to an age cut point of 55 years, as a surrogate to define hormonal status.RESULTSA pooled cohort of 6713 patients was analyzed. The risk of DCI was statistically significantly higher in women than in men (OR 1.29, 95% CI 1.12–1.48); no difference was found with respect to cerebral infarction (OR 1.17, 95% CI 0.98–1.40). No difference was found in the risk of DCI when comparing women ≤ 55 and > 55 years (OR 0.87, 95% CI 0.74–1.02; p = 0.08) or when comparing men ≤ 55 and > 55 years (p = 0.38). Independent predictors of DCI were World Federation of Neurosurgical Societies (WFNS) grade, Fisher grade, age, and sex. Independent predictors of infarction included WFNS grade, Fisher grade, and aneurysm size.CONCLUSIONSFemale sex is associated with a higher risk of DCI. Sex differences may play a role in the pathogenesis of DCI but are not associated with menopausal status. The predictors of DCI and cerebral infarction were identified in a very large cohort and reflect experience from multiple institutions.
History of psychosurgery at Sainte-Anne Hospital, Paris, France, through translational interactions between psychiatrists and neurosurgeons
Authors: Zanello Marc , Pallud Johan , Baup Nicolas , Peeters Sophie , Turak Baris , Krebs Marie Odile , Oppenheim Catherine , Gaillard Raphael , Devaux Bertrand 
Published: September 2017

Sainte-Anne Hospital is the largest psychiatric hospital in Paris. Its long and fascinating history began in the 18th century. In 1952, it was at Sainte-Anne Hospital that Jean Delay and Pierre Deniker used the first neuroleptic, chlorpromazine, to cure psychiatric patients, putting an end to the expansion of psychosurgery. The Department of Neuro-psychosurgery was created in 1941. The works of successive heads of the Neurosurgery Department at Sainte-Anne Hospital summarized the history of psychosurgery in France.Pierre Puech defined psychosurgery as the necessary cooperation between neurosurgeons and psychiatrists to treat the conditions causing psychiatric symptoms, from brain tumors to mental health disorders. He reported the results of his series of 369 cases and underlined the necessity for proper follow-up and postoperative re-education, illustrating the relative caution of French neurosurgeons concerning psychosurgery.Marcel David and his assistants tried to follow their patients closely postoperatively; this resulted in numerous publications with significant follow-up and conclusions. As early as 1955, David reported intellectual degradation 2 years after prefrontal leucotomies.Jean Talairach, a psychiatrist who eventually trained as a neurosurgeon, was the first to describe anterior capsulotomy in 1949. He operated in several hospitals outside of Paris, including the Sarthe Psychiatric Hospital and the Public Institution of Mental Health in the Lille region. He developed stereotactic surgery, notably stereo-electroencephalography, for epilepsy surgery but also to treat psychiatric patients using stereotactic lesioning with radiofrequency ablation or radioactive seeds of yttrium-90.The evolution of functional neurosurgery has been marked by the development of deep brain stimulation, in particular for obsessive-compulsive disorder, replacing the former lesional stereotactic procedures.The history of Sainte-Anne Hospital’s Neurosurgery Department sheds light on the initiation—yet fast reconsideration—of psychosurgery in France. This relatively more prudent attitude toward the practice of psychosurgery compared with other countries was probably due to the historically strong collaboration between psychiatrists and neurosurgeons in France.
Psychosurgery, ethics, and media: a history of Walter Freeman and the lobotomy
Authors: Caruso James P. , Sheehan Jason P. 
Published: September 2017

At the peak of his career, Walter J. Freeman II was a celebrated physician and scientist. He served as the first chairman of the Department of Neurology at George Washington University and was a tireless advocate of surgical treatment for mental illness. His eccentric appearance, engaging personality during interviews, and theatrical demonstrations of his surgical techniques gained him substantial popularity with local and national media, and he performed more than 3000 prefrontal and transorbital lobotomies between 1930 and 1960. However, poor patient outcomes, unfavorable portrayals of the lobotomy in literature and film, and increased regulatory scrutiny contributed to the lobotomy’s decline in popularity. The development of antipsychotic medications eventually relegated the lobotomy to rare circumstances, and Freeman’s reputation deteriorated. Today, despite significant advancements in technique, oversight, and ethical scrutiny, neurosurgical treatment of mental illness still carries a degree of social stigma.This review presents a historical account of Walter Freeman’s life and career, and the popularization of the lobotomy in the US. Additionally, the authors pay special attention to the influence of popular literature and film on the public’s perception of psychosurgery. Aided by an understanding of this pivotal period in medical history, neurosurgeons are poised to confront the ethical and sociological questions facing psychosurgery as it continues to evolve.