bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated Spanish Language Training: Learners' Expanded Spanish Vocabulary and Positive Perceptions After 4 Semesters
Authors: Villarreal Evelyn , Pechak Celia 
Published: December 2017

Introduction.
Spanish-speaking individuals with limited English proficiency face health disparities. In response, The University of Texas at El Paso (UTEP) Doctor of Physical Therapy (DPT) Program has integrated Spanish training across their curriculum to better serve this population. The purpose of this study was to evaluate the effects of this training.

Methods.
Participants were first-year students from the UTEP DPT Program. Students enrolled in a required 8-week, 1-credit beginner or advanced Spanish medical terminology course in their first semester. In addition, they practiced Spanish during laboratory and service-learning experiences. The students completed pretests in the first semester and posttests in their fifth semester: self-ratings of their ability to speak, understand, read, and write Spanish; a written Spanish vocabulary test; and a questionnaire about their beliefs and attitudes about Spanish language training. A repeated-measures two-way analysis of variance was used to analyze self-ratings and vocabulary test scores. Descriptive statistics and paired t tests were used to analyze the data from the pre- and post-questionnaires.

Results.
There were significant improvements in self-ratings of speaking, understanding, reading, and writing Spanish (P < .001). There was significant improvement in vocabulary test scores (P < .001); no significant difference was seen between beginning and advanced students (P = .097). Results from the questionnaires suggest that students recognize personal and professional benefits from learning Spanish.

Discussion and Conclusion.
This study supports that the UTEP DPT Program's Spanish language training model improved self-ratings of Spanish proficiency and increased Spanish vocabulary. In addition, students had an overall positive attitude about learning Spanish. Future research is indicated to determine whether self-ratings of proficiency are correlated with observed Spanish proficiency in a clinical setting.
Defining Underrepresented Minorities and Promoting Holistic Review Admission Strategies in Physical Therapist Education
Authors: Wise Denise , Dominguez Jesus , Kapasi Zoher , Williams-York Bernadette , Moerchen Victoria , Brooks Salome , Ross Libby J. 
Published: December 2017

Background and Purpose.
Given the changing demographics of the United States, it is important for Doctor of Physical Therapy (DPT) education programs to address how best to recruit and retain students who will be able to provide culturally competent and sensitive care. Compared with the general population, the racial and ethnic diversity of professional membership in the American Physical Therapy Association and applications to and acceptance in professional physical therapist education programs has remained relatively static and does not mirror the diversity of the population at large.

Position and Rationale.
To best determine effective recruitment and retention strategies to address this shortfall in PT education, it is necessary to have (1) a unifying definition of underrepresented minorities (URMs) in physical therapy education and (2) an understanding of what is currently being done to promote a diverse student body. The American Council of Academic Physical Therapy empaneled its Diversity Task Force in January 2013 to address these two issues. This position paper reports on the efforts of the Diversity Task Force in developing a working definition of URMs in physical therapy education that reaches beyond traditional racial and ethnic descriptors, along with supporting information from a survey of entry-level DPT program directors on barriers to increasing diversity within the professional PT student population and strategies currently in place to overcome them.

Discussion and Conclusion.
Based on a uniform definition of URMs and the current status of recruitment/retention policies and practices designed to foster a diverse student population, we conclude that ongoing work is needed to increase diversity within DPT education and that utilization of a holistic application review process for admissions is one method to increase diversity.
Student Perception of Preparedness for Clinical Management of Adults With Lifelong Disability Using a Standardized Patient Assessment
Authors: Dannemiller Lisa , Basha Elshimaa , Kriekels Wendy , Nordon-Craft Amy 
Published: December 2017

Background and Purpose.
A need exists to increase entry-level Doctor of Physical Therapy student exposure to adults with lifelong disability using novel educational methods. The purpose of this project was to determine whether student perception of preparedness with the knowledge, skills, and attitudes required for the management of lifelong disability was enhanced by the use of a standardized patient (SP) assessment experience with actors trained as adults with cerebral palsy (CP).

Method/Model Description and Evaluation.
An SP case about a young adult with CP was developed, and an assessment was implemented by a team of faculty members in a neuromuscular management track. Entry-level physical therapy students in their fifth of 7 semesters completed a survey about their perception of preparedness in the 3 learning domains at 3 time points, before (time 1) and after (time 2) the SP assessment and after a 10-week clinical education experience (time 3).

Outcomes.
Fifty-one students completed a series of 3 surveys. There was no change in student perception of preparation with the knowledge required for physical therapist management of an adult with CP at the 3 time points. Student perception of preparation with skills was increased significantly at time 2 and was maintained at time 3. Student perception of preparation with attitudes was also significantly increased at time 2, but returned to original levels at time 3.

Discussion and Conclusion.
Use of an SP experience was an educational assessment method that resulted in enhanced student perception of preparedness with the skills and attitudes necessary to work with adults with CP. Physical therapy programs may consider this method to address the need for creative educational strategies to address physical therapist management of lifelong disability.
Comparison of Surgical Strategies between Proximal Nerve Graft and/or Nerve Transfer and Distal Nerve Transfer Based on Functional Restoration of Elbow Flexion: A Retrospective Review of 147 Patients
Authors: Hu Ching-Hsuan , Chang Tommy Nai-Jen , Lu Johnny Chuieng-Yi , Laurence Vincent G. , Chuang David Chwei-Chin 
Published: December 2017

Background:
Surgical strategy to treat incomplete brachial plexus injury with palsies of the shoulder and elbow by using proximal nerve graft/transfer or distal nerve transfer is still debated. The aim of this study was to compare both strategies with respect to the recovery of elbow flexion.

Methods:
One hundred forty-seven patients were enrolled: 76 patients underwent reconstruction using proximal nerve graft/transfer, and 71 patients underwent reconstruction using distal nerve transfer. All patients were evaluated preoperatively and postoperatively to assess the recovery rate and muscle strength of elbow flexion. Shoulder abduction and hand grip power were also recorded to assess any concomitant postoperative changes between the two methods.

Results:
The best recovery rate for functional elbow flexion (p = 0.006) and the fastest recovery to M3 strength (p < 0.001) were found in the double fascicular transfer group. However, recovery of shoulder abduction with proximal nerve graft/transfer was significantly better than with distal nerve transfer (80.3 percent versus 66.2 percent in shoulder abduction ≥60 degrees; and 56.6 percent versus 38.0 percent in shoulder abduction ≥90 degrees). A significant decrease in grip strength between the operative and nonoperative hands was also found in patients undergoing distal nerve transfer (p = 0.001).

Conclusions:
Proximal nerve graft/transfer offers more accurate diagnosis and proper treatment to restore shoulder and elbow function simultaneously. Distal nerve transfer can offer more efficient elbow flexion. Combined, both strategies in primary nerve reconstruction are especially recommended when there is no healthy or not enough donor nerve available.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Evidence-Based Medicine: Current Practices in Rhinoplasty
Authors: Tanna Neil , Nguyen Khang T. , Ghavami Ashkan , Calvert Jay W. , Guyuron Bahman , Rohrich Rod J. , Gruber Ronald P. 
Published: December 2017

Learning Objectives:
After studying this article, the participant should be able to: 1. Perform aesthetic and functional nasal analysis to guide septorhinoplasty. 2. Recognize common complications associated with rhinoplasty. 3. Select appropriate septorhinoplasty techniques to refine nasal aesthetics and treat nasal airway obstruction. 4. Identify factors leading to poor patient satisfaction following rhinoplasty.

Summary:
Septorhinoplasty is among the most technically challenging procedures in the realm of plastic and reconstructive surgery. Moreover, it is a constantly evolving topic with extensive background literature. Surgeons must be comfortable with the traditional knowledge base and the current practices in the field. This article reviews the latest thinking on patient selection, functional indications, aesthetic analysis, and operative techniques in septorhinoplasty, with an emphasis on key cartilage grafting and tip suture techniques.
Involvement in Root Cause Analysis and Patient Safety Culture Among Hospital Care Providers
Authors: Boussat Bastien , Seigneurin Arnaud , Giai Joris , Kamalanavin Kevin , Labarère José , François Patrice 
Published: December 2017

Background
The experience feedback committee (EFC) is a tool designed to involve medical teams in patient safety management, through root cause analysis within the team.

Objective
The aim of the study was to determine whether patient safety culture, as measured by the Hospital Survey on Patient Safety Culture (HSOPS), differed regarding care provider involvement in EFC activities.

Methods
Using the original data from a cross-sectional survey of 5064 employees at a single university hospital in France, we analyzed the differences in HSOPS dimension scores according involvement in EFC activities.

Results
Of 5064 eligible employees, 3888 (76.8%) participated in the study. Among the respondents, 440 (11.3%) participated in EFC activities. Experience feedback committee participants had a more developed patient safety culture, with 9 of the 12 HSOPS dimension scores significantly higher than EFC nonparticipants (overall effect size = 0.31, 95% confidence interval = 0.21 to 0.41, P < 0.001). A multivariate analysis of variance indicated that all 12 dimension scores, taken together, were significantly different between EFC participants and nonparticipants (P < 0.0001), independently of sex, hospital department, and healthcare profession category. The largest differences in scores related to the “feedback and communication about error,” “organizational learning,” and “Nonpunitive response to error” dimensions. The analysis of the subgroup of professionals who worked in a department with a productive EFC, defined as an EFC implementing at least five actions per year, showed a higher patient safety culture level for seven of the 12 HSOPS dimensions (overall effect size = 0.19, 95% confidence interval = 0.10 to 0.27, P < 0.001).

Discussion and Conclusions
Participation in EFC activities was associated with higher patient safety culture scores. The findings suggest that root cause analysis in the team’s routine may improve patient safety culture.
Retention in HIV Care During Pregnancy and the Postpartum Period in the Option B+ Era: Systematic Review and Meta-Analysis of Studies in Africa
Authors: Knettel Brandon A. , Cichowitz Cody , Ngocho James Samwel , Knippler Elizabeth T. , Chumba Lilian N. , Mmbaga Blandina T. , Watt Melissa H. 
Published: December 2017

Background:
Under Option B+ guidelines for prevention of mother-to-child transmission of HIV, pregnant and breastfeeding women initiate antiretroviral therapy for lifelong use. The objectives of this study were: (1) to synthesize data on retention in care over time in option B+ programs in Africa, and (2) to identify factors associated with retention in care.

Methods:
PubMed, EMBASE, and African Index Medicus were systematically searched from January 2012 to June 2017. Pooled estimates of the proportion of women retained were generated and factors associated with retention were analyzed thematically.

Results:
Thirty-five articles were included in the final review; 22 reported retention rates (n = 60,890) and 25 reported factors associated with retention. Pooled estimates of retention were 72.9% (95% confidence interval: 66.4% to 78.9%) at 6 months for studies reporting <12 months of follow-up and 76.4% (95% confidence interval: 69.0% to 83.1%) at 12 months for studies reporting ≥12 months of follow-up. Data on undocumented clinic transfers were largely absent. Risk factors for poor retention included younger age, initiating antiretroviral therapy on the same day as diagnosis, initiating during pregnancy versus breastfeeding, and initiating late in the pregnancy. Retention was compromised by stigma, fear of disclosure, and lack of social support.

Conclusions:
Retention rates in prevention of mother-to-child transmission under option B+ were below those of the general adult population, necessitating interventions targeting the complex circumstances of women initiating care under option B+. Improved and standardized procedures to track and report retention are needed to accurately represent care engagement and capture undocumented transfers within the health system.
HBV or HCV Coinfection in HIV-1-Infected Pregnant Women in France: Prevalence and Pregnancy Outcomes
Authors: Benhammou Valérie , Tubiana Roland , Matheron Sophie , Sellier Pierre , Mandelbrot Laurent , Chenadec Jérôme Le , Marel Emmanuelle , Khoshnood Babak , Warszawski Josiane ,   for the ANRS CO1/CO11-EPF French Perinatal Cohort study group
Published: December 2017

Background:
Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection is frequent in HIV-infected persons but their impact on pregnant HIV-infected women is understudied. We explored whether these coinfections are associated with adverse pregnancy outcomes and lower response to antiretroviral therapy (ART).

Methods:
Pregnancies in HIV-1–infected women included in the ANRS French Perinatal Cohort between 2005 and 2013 were analyzed if HBV and HCV infection statuses were available.

Results:
Among 4236 women, the prevalence of HBV (HBs Ag+) and HCV (RNA+) were 6.2% (95% confidence interval: 5.4 to 6.8) and 1.7% (1.3 to 2.1), respectively. HCV coinfection was strongly associated with a history of drug use; HBV coinfection was 6 times more frequent in women born in Sub-Saharan Africa than in European France. Baseline HIV viral load, CD4 count, and HIV care during pregnancy were similar in coinfected and monoinfected HIV mothers, except that 90% of HBV/HIV women were receiving tenofovir and/or lamivudine or emtricitabine. HCV coinfection was significantly associated with cholestasis [adjusted odds ratio: 4.1 (1.5–10.8), P = 0.005], preterm delivery [3.0 (1.6–5.7), P < 0.001], lower CD4 [2.6 (1.0–6.4), P < 0.001], and detectable viral load [2.3 (1.0–5.5), P = 0.06] at the end of pregnancy. HBV coinfection was not associated with any of these outcomes.

Conclusions:
In HIV-infected women, chronic HBV infection, mostly treated using targeted ART, had no major impact on the course of pregnancy. By contrast, chronic HCV infection was associated with a higher risk of obstetrical complications and a poorer immune–virological response to ART. It is yet unknown whether cure of HCV infection before conception can limit these adverse outcomes.
Low-Dose Noncontrast Examination of the Paranasal Sinuses Using Volumetric Computed Tomography
Authors: Pirimoglu Berhan , Sade Recep , Sakat Muhammed Sedat , Ogul Hayri , Levent Akin , Kantarci Mecit 
Published: December 2017

Objectives
The objective of this study was to evaluate image quality of low dose in noncontrast paranasal sinus computed tomography (CT) using single volumetric 320-row multidetector CT technique.

Methods
The low-dose protocol including tube voltage of 135 kV and tube current of 5 mAs was chosen based on results of the present phantom study. Forty-six patients were assigned to control group with factory standard settings (120 kVp, 75 mAs), and 46 patients were assigned to study group and underwent noncontrast CT of paranasal sinus with low-dose protocol using single volumetric 320-row multidetector CT device. Objective and subjective image qualities were performed.

Results
Effective radiation dose calculated for control group scans was 0.45 (SD, 0.39) mSv. It was 0.038 (SD, 0.004) mSv for study group scans. The effective radiation dose of study group was statistically significant lower than control group (P < 0.001).

Conclusions
Noncontrast paranasal sinus CT imaging can be performed at very low radiation exposure maintaining high image quality with 135 kVp and 5 mAs.
Preliminary Results of High-Precision Computed Diffusion Weighted Imaging for the Diagnosis of Hepatocellular Carcinoma at 3 Tesla
Authors: Akagi Motonori , Nakamura Yuko , Higaki Toru , Matsubara Yoshiko , Terada Hiroaki , Honda Yukiko , Tatsugami Fuminari , Baba Yasutaka , Iida Makoto , Awai Kazuo 
Published: December 2017

Objective
To compare the utility of high-precision computed diffusion-weighted imaging (hc-DWI) and conventional computed DWI (cc-DWI) for the diagnosis of hepatocellular carcinoma (HCC) at 3 T.

Methods
We subjected 75 HCC patients to DWI (b-value 150 and 600 s/mm2). To generate hc-DWI we applied non-rigid image registration to avoid the mis-registration of images obtained with different b-values. We defined c-DWI with a b-value of 1500 s/mm2 using DWI with b-value 150 and 600 s/mm2 as cc-DWI, and c-DWI with b-value 1500 s/mm2 using registered DWI with b-value 150 and 600 s/mm2 as hc-DWI. A radiologist recorded the contrast ratio (CR) between HCC and the surrounding hepatic parenchyma.

Results
The CR for HCC was significantly higher on hc- than cc-DWIs (median 2.0 vs. 1.8, P < 0.01).

Conclusion
The CR of HCC can be improved with image registration, indicating that hc-DWI is more useful than cc-DWI for the diagnosis of HCC.
Divergent Effects of Hypertonic Fluid Resuscitation on Renal Pathophysiological and Structural Parameters in Rat Model of Lower Body Ischemia/Reperfusion-Induced Sterile Inflammation
Authors: Ergin Bulent , Zuurbier Coert J. , Kapucu Aysegul , Ince Can 
Published: December 2017

ABSTRACT
The pathogenesis of acute kidney injury (AKI) is characterized by the deterioration of tissue perfusion and oxygenation and enhanced inflammation. The purpose of this study was to investigate whether or not the hemodynamic and inflammatory effects of hypertonic saline (HS) protect the kidney by promoting renal microcirculatory oxygenation and possible deleterious effects of HS due to its high sodium content on renal functional and structural injury following ischemia/reperfusion. Mechanically ventilated and anesthetized rats were randomly divided into four groups (n = 6 per group): a sham-operated control group; a group subjected to renal ischemia for 45 min by supra-aortic occlusion followed by 2 h of reperfusion (I/R); and I/R group treated with a continuous i.v. infusion (5 mL/kg/h) of either % 0.9 NaCl (IR+NS) or %10 NaCl (I/R+HS) after releasing the clamp. Systemic and renal hemodynamic, renal cortical (CμPO2), and medullar microcirculatory pO2 (MμPO2) are measured by the oxygen-dependent quenching of the phosphorescence lifetime technique. Renal functional, inflammatory, and tissues damage parameters were also assessed. HS, but not NS, treatment restored I/R-induced reduced mean arterial pressure, CμPO2, renal oxygen deliver (DO2ren), and consumption (VO2ren). HS caused a decrease in tubular sodium reabsorption (TNa+) that correlated with an elevation of fractional sodium excretion (EFNa+) and urine output. HS had an anti-inflammatory effect by reducing the levels TNF-α, IL-6, and hyaluronic acid in the renal tissue samples as compared with the I/R and I/R+NS groups (P < 0.05). HS treatment was also associated with mild acidosis and an increased renal tubular damage. Despite HS resuscitation improving the systemic hemodynamics, microcirculatory oxygenation, and renal oxygen consumption as well as inflammation, it should be limited or strictly controlled for long-term use because of provoking widespread renal structural damage.
Prehospital spine immobilization/spinal motion restriction in penetrating trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma (EAST)
Authors: Velopulos Catherine G. , Shihab Hasan M. , Lottenberg Lawrence , Feinman Marcie , Raja Ali , Salomone Jeffrey , Haut Elliott R. 
Published: December 2017

BACKGROUND
Spine immobilization in trauma has remained an integral part of most emergency medical services protocols despite a lack of evidence for efficacy and concern for associated complications, especially in penetrating trauma patients. We reviewed the published evidence on the topic of prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma to structure a practice management guideline.

METHODS
We conducted a Cochrane style systematic review and meta-analysis and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology to construct recommendations. Qualitative and quantitative analyses were used to evaluate the literature on the critical outcomes of mortality, neurologic deficit, and potentially reversible neurologic deficit.

RESULTS
A total of 24 studies met inclusion criteria, with qualitative review conducted for all studies. We used five studies for the quantitative review (meta-analysis). No study showed benefit to spine immobilization with regard to mortality and neurologic injury, even for patients with direct neck injury. Increased mortality was associated with spine immobilization, with risk ratio [RR], 2.4 (confidence interval [CI], 1.07–5.41). The rate of neurologic injury or potentially reversible injury was very low, ranging from 0.002 to 0.076 and 0.00034 to 0.055, with no statistically significant difference for neurologic deficit or potentially reversible deficit, RR, 4.16 (CI, 0.56–30.89), and RR, 1.19 (CI, 0.83–1.70), although the point estimates favored no immobilization.

CONCLUSION
Spine immobilization in penetrating trauma is associated with increased mortality and has not been shown to have a beneficial effect on mitigating neurologic deficits, even potentially reversible neurologic deficits. We recommend that spine immobilization not be used routinely for adult patients with penetrating trauma.

Level of Evidence
Systematic review with meta-analysis study, level III.