bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effekt von Muskeltranspositionen nach dem Hummelsheim-Prinzip mit und ohne zeitgleiche Rücklagerung des M. rectus internus
Authors: Hedergott Andrea , Wild Dana , Fricke Julia , Neugebauer Antje 
Published: November 2017

Zusammenfassung
Hintergrund Wir berichten über Ergebnisse einer modifizierten Muskeltransposition nach dem Hummelsheim-Prinzip mit und ohne einzeitige M.-rectus-internus-Rücklagerung bei unilateralen Abduzensparesen/-paralysen. Der Einfluss von Paresedauer, Schielwinkelgröße und präoperativer Abduktionsfähigkeit auf die Auswahl und Effektivität der Verfahren wird untersucht.
Patienten und Methoden Retrospektiv wurden die Daten von 29 konsekutiven Patienten mit unilateraler Abduzensparese/-paralyse ausgewertet, bei denen im Zeitraum von 2001 – 2012 zur Korrektur des Schielwinkels erstmals eine modifizierte Muskeltransposition nach dem Hummelsheim-Prinzip (HUM: n = 21) oder diese Operation kombiniert mit einer zeitgleichen M.-rectus-internus-Rücklagerung (HUM+I: n = 8) durchgeführt wurde. Die Operationen fanden frühestens 9 Monate nach Paresebeginn statt (HUM: von 9 – 98, Median 19, Mittelwert [MW] 30 Monate; HUM+I: von 12 – 65, Median 25, MW 29 Monate).
Ergebnisse Präoperativ betrug der Schielwinkel (Ferne) im Median für die HUM-Gruppe 27,0° (von 20,0 – 45,0; MW 28,1°), für die HUM+I-Gruppe 30,5° (von 21,8 – 50,0; MW 33,4°). Die mediane präoperative Abduktion betrug in der HUM-Gruppe − 1,6 mm vor Mittellinie (von − 8,0 bis + 1,2; MW − 1,8 mm), in der HUM+I-Gruppe − 3,0 mm vor Mittellinie (von − 10,0 bis − 1,0; MW − 4,1 mm). Postoperativ betrug der Schielwinkel (Fernblick) im Median für die HUM-Gruppe 0° (von − 11,3 bis + 20,0; MW 0,1°), für die HUM+I-Gruppe − 2,3° (von − 11,3 bis + 12,0; MW − 2,1°). Die mediane postoperative Abduktion betrug in der HUM-Gruppe 1,0 mm (von 0 bis + 3,0; MW + 1,1 mm), in der HUM+I-Gruppe 1,1 mm (von − 1,2 bis + 3,0; MW + 0,9 mm). Der Effekt der Schielwinkelveränderung war in der HUM-Gruppe im Median 27,0° (von 9,1 – 45,0; MW 28,0°), in der HUM+I-Gruppe 36,8° (von 25,2 – 41,4; MW 35,5°). Die Abduktion verbesserte sich im Median in der HUM-Gruppe um 2,5 mm (von 0 – 11,0; MW + 2,9 mm), in der HUM+I-Gruppe um 4,6 mm (von 2,4 – 8,8; MW + 5,0 mm). Die Effektstärke fiel in der HUM-Gruppe in Abhängigkeit von der Paresedauer ab, während in der HUM+I-Gruppe eine Zunahme der Effektstärke mit längerer Paresedauer zu verzeichnen war.
Schlussfolgerung Bei unilateralen Abduzensparalysen steigert die einzeitige M.-rectus-internus-Rücklagerung den Effekt einer Operation nach dem Hummelsheim-Prinzip. Die Paresedauer ist ein relevanter Parameter zur Auswahl eines isolierten oder mit M.-rectus-internus-Rücklagerung kombinierten Eingriffs.
‘The Capital Object of the Public’: The 1766–7 Parliamentary Inquiry into the East India Company
Authors: Leonard Spencer A 
Published: November 2017

Abstract
Of all the eighteenth-century parliamentary inquiries into the post-Plassey East India Company, the most poorly understood is the first, the one that took place during, and contributed directly to, the dissolution of Chatham’s ill-fated ministry of 1766–7. Though it is now little remembered, produced no lengthy report and resulted in comparatively insignificant legislation, the 1767 inquiry held the greatest promise to change the course of imperial history. This is because it contemplated the abolition of the Company, if not as a commercial enterprise, then as a monopoly-state. In 1766–67 British politics formulated, and came closest to addressing, the post-Plassey India question in its fundamentals. Just how different was this inquiry from later eighteenth-century debates, including even that surrounding Fox’s failed bill (the only other that approaches it in significance), is indicated by the fact that parliament explicitly debated, and the Prime Minister himself supported, not simply government intrusion in, or oversight over, Company operations, but liberating Bengali society (and, indeed, British society) from the tentacles of the emerging Company state. This would have allowed for something approaching the rule of law to be established in the conquered domains. Regarding the course and dynamics of Chatham’s attempt to address the India question, much merits reconsideration. But it is clear that the ministry splintered because of Chatham’s insistence that parliament conduct a full and informed debate on the general question of the Company’s right to rule the Indian territories.
Psychometric Evaluation of the Service-Learning in Nursing Inventory
Authors: Nickitas Donna M. , Fealy Gerard M. , De Natale Mary L. 
Published: November 2017

Abstract

AIM
The aim was to develop an instrument to assess undergraduate nursing students’ experience of service-learning to reveal benefits and identify service-learning as a professional value that leads to civic and social responsibility.

BACKGROUND
Service-learning is a teaching and learning approach that integrates academic learning with experiential community-centered foci. It provides structured opportunities for reflection on broader social and cultural dimensions of health. There is no valid and reliable instrument to measure service-learning experience of nursing students.

METHOD
A psychometric evaluation was conducted through item analysis, validity, and reliability.

RESULTS
Face validity agreement was 80 percent; the content validity index was adjusted until 1 was achieved for each item. Two factors explained 58.64 percent of the total variance. Cronbach’s α was .940 for the skills subscale and .932 for the personal insight subscale.

CONCLUSION
The inventory demonstrated strong psychometric properties. Future research should focus on replication on diverse populations.
Culturally Competent Nurse Educators in Clinical Teaching
Authors: Shin Cha-Nam , Fine Julie , Chen Angela Chia-Chen 
Published: November 2017

Abstract
Having culturally competent nurse educators is crucial to preparing future nurses to meet the health needs of a diverse and multicultural United States population. The authors explored the perspectives of 21 clinical nurse educators on a variety of clinical nursing situations related to cultural diversity. They identified five themes that emerged from a content analysis and represented a range of perspectives. The authors recommend three strategies to be integrated into programs that will educate nursing students in providing care to a diverse patient population.
Lessons Learned From Expansion of a Public Health Nursing Doctorate in Nursing Practice Program
Authors: Tipton Nathan G. , Speck Patricia M. , Bowdre Trimika L. , Connor Pamela D. 
Published: November 2017

Abstract
Despite nurses’ demonstrated expertise in the public health workforce, there has been a continued erosion of public health nursing (PHN) positions in health departments and academe. The need for a strong public health infrastructure and well-educated public health workforce remains vital in meeting PHN research challenges. In response to these needs, our college of nursing undertook a six-year Health Resources and Services Administration-funded expansion of the PHN Doctor of Nursing Practice (DNP) program. This article illustrates program evaluation, lessons learned, and PHN DNP graduate and workforce outcomes related to supplying culturally diverse PHN leaders, assuring quality improvement, creating sustainable partnerships, and improving poor health outcomes.
An Innovative Approach Using Clinical Simulation to Teach Quality and Safety Principles to Undergraduate Nursing Students
Authors: Cantrell Mary Ann , Mariani Bette , Meakim Colleen 
Published: November 2017

Abstract
The aim of this learning experience was to enhance students’ knowledge of safety practices. A threefold approach was used, which involved viewing a prerecorded scenario in which safety practices were violated and another scenario that consistently depicted safe practice behaviors. Students then performed an environmental safety check of the physical simulated scene and then participated in a debriefing session. The conceptual basis for this project was the teaching-learning strategy “What’s Wrong With This Patient,” which requires the learner to evaluate a simulated learning environment to identify safety practices that were not followed and suggest strategies to correct these errors.
Integrating Bar-Code Medication Administration Competencies in the Curriculum
Authors: Angel Vini M. , Friedman Marvin H. , Friedman Andrea L. 
Published: November 2017

ABSTRACT
This article describes an innovative project involving the integration of bar-code medication administration technology competencies in the nursing curriculum through interprofessional collaboration among nursing, pharmacy, and computer science disciplines. A description of the bar-code medication administration technology project and lessons learned are presented.
Effects of Global Payment and Accountable Care on Medication Treatment for Alcohol and Opioid Use Disorders
Authors: Donohue Julie M. , Barry Colleen L. , Stuart Elizabeth A. , Greenfield Shelly F. , Song Zirui , Chernew Michael E. , Huskamp Haiden A. 
Published: November 2017

Objectives:
The Alternative Quality Contract (AQC) implemented in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA) is intended to improve quality and control costs by putting providers at risk for total medical spending and tying payment to performance on specified quality measures. We examined the AQC's early effects on use of and spending on medication treatment (MT) for addiction among individuals with alcohol use disorders (AUDs) and opioid use disorders (OUDs), conditions not subject to any performance measurement in the AQC.

Methods:
Using data from 2006 to 2011, we use difference-in-difference estimation of the effect of the AQC on MT using a comparison group of enrollees in BCBSMA whose providers did not participate in the AQC. We compared AQC and non-AQC enrollees with AUDs (n = 37,113 person-years) and/or OUDs (n = 12,727 person-years) on any use of MT, number of prescriptions filled, and MT spending adjusting for demographic and health status characteristics.

Results:
There was no difference in MT use among AQC enrollees with OUD (38.7%) relative to the comparison group (39.1%) (adjusted difference = −0.4%, 95% confidence interval −3.8% to 3.0%, P = 0.82). Likewise, there was no difference in MT use for AUD between the AQC (6.3%) and comparison group (6.5%) (P = 0.64). Similarly, we detected no differences in number of prescriptions or spending.

Conclusions:
Despite incentives for improved integration and quality of care under a global payment contract, the initial 3 years of the AQC showed no impact on MT use for AUD or OUD among privately insured enrollees with behavioral health benefits.
Nursing Care of Infants With a Ventriculoperitoneal Shunt
Authors: Joseph Rachel A. , Killian Michaela R. , Brady Emily E. 
Published: November 2017

Background:
Infants with congenital or posthemorrhagic hydrocephalus may require a ventriculoperitoneal (VP) shunt to divert the flow of cerebrospinal fluid, thus preventing increase in intracranial pressure. Knowledge on various aspects of caring for a child with a VP shunt will enable new and experienced nurses to better care for these infants and equip parents for ongoing care at home.

Purpose:
To review the nurses' role in care of infants with hydrocephalus, care after VP shunt placement, prevention of complications, and parental preparation for home care.

Methods/Search Strategy:
A literature review involving electronic databases, such as CINAHL and MEDLINE, Cochrane Database Systematic Reviews, and resources from the Web sites of the National Hydrocephalus Foundation and Hydrocephalus Association, was performed to gather evidence for current practice information.

Findings and Implications for Practice and Research:
Vigilant care can help with early identification of potential complications. The younger the infant at VP shunt placement, the higher the occurrence of complications. All neonatal intensive care unit nurses must be equipped with knowledge and skills to care for infants with hydrocephalus and those who undergo VP shunt placement. Monitoring for early signs of increased intracranial pressure can facilitate timely diagnosis and prompt surgical intervention. Equipping families will be helpful in early identification and timely management of shunt failure. Research on infants with VP shunt placement is essential to develop appropriate guidelines and explore experiences of families to identify caregiver burden and improve parental preparation.
A-Frame free Vascularized Fibular Graft and Femoral Lengthening for Osteosarcoma Pediatric Patients
Authors: Cashin Megan , Coombs Christopher , Torode Ian 
Published: November 2017

Background:
Pediatric limb reconstruction after resection of a malignant tumor presents specific challenges. Multiple surgical techniques have been used to treat these patients. This paper describes a staged surgical technique for the reconstruction of large distal femoral defects due to tumor resection in skeletally immature patients.

Methods:
Three pediatric patients with osteosarcoma of the distal femur underwent staged reconstruction. Neoadjuvant chemotherapy was followed by en bloc tumor resection and immediate reconstruction of the distal femoral defect with a vascularized free fibular autograft utilizing a unique A-frame construct combined with intramedullary nail fixation. The second stage was a planned gradual lengthening of the healed construct, over a custom-made magnetically driven expandable intramedullary nail.

Results:
All patients achieved bony union and satisfactory length with minimal complications. The patients all returned to full, unlimited physical activities.

Conclusions:
The early results confirm that the described technique is a safe and reliable procedure for the reconstruction of large femoral defects in pediatric patients with osteosarcoma.

Level of Evidence:
Level IV—therapeutic.
Biomechanical Comparison of Fifth Carpometacarpal Fusion Methods: Kirschner Wires Versus Plate and Screws
Authors: Yoshida Ryu , Obopilwe Elifho , Rodner Craig M. 
Published: November 2017

Background:
Fractures and dislocations of the base of the fifth metacarpal can lead to arthritis of the fifth carpometacarpal (CMC) joint. For patients who are symptomatic and fail conservative management, arthrodesis of the fifth CMC joint can be offered. The fusion can be performed using Kirschner wires (K-wires), but can lead to complications such as pin tract infection and pin migration. A low-profile locking plate may represent an attractive alternative. The purpose of this study was to compare the biomechanical stability of these 2 fusion techniques.

Methods:
Twelve fresh frozen cadaver hands were divided into 2 groups. The first group underwent fixation of the fifth CMC joint using 2 1.6 mm (0.062 inches) diameter K-wires in a cross-pin configuration. The second group underwent fixation using a 2.0 mm locking plate with 2 locking screws in the hamate and 3 nonlocking screws in the fifth metacarpal shaft. The specimens were then loaded in extension until failure.

Results:
The stiffness was 15.0±7.2 N/mm for the K-wire group and 14.7±6.0 N/mm (mean±SD) for the plate group (P=0.9366). The peak loads were 62.5±40.0 N and 64.6±24.8 N for K-wire and plate groups, respectively (P=0.9181). The energy to peak load was 294±281 N mm for the K-wire group and 418±190 N mm for the plate group (P=0.3904).

Conclusions:
Fifth CMC fusion using either K-wires or plate and screws showed no significant difference in stiffness, peak load, and energy to peak load. These results suggest the 2 methods provide similar biomechanical stability.
Impact of Quality Bundle Enforcement by a Critical Care Pharmacist on Patient Outcome and Costs*
Authors: Leguelinel-Blache Géraldine , Nguyen Tri-Long , Louart Benjamin , Poujol Hélène , Lavigne Jean-Philippe , Roberts Jason A. , Muller Laurent , Kinowski Jean-Marie , Roger Claire , Lefrant Jean-Yves 
Published: November 2017

Objectives:
Surgical and medical ICU patients are at high risk of mortality and provide a significant cost to the healthcare system. The aim of this study is to describe the effect of pharmacist-led interventions on drug therapy and clinical strategies on ICU patient outcome and hospital costs.

Design:
Before and after study in two French ICUs (16 and 10 beds).

Patients:
ICU patients.

Intervention:
From January 1, 2013, to June 30, 2015, a pharmacist observation period was compared with an intervention period in which a critical care pharmacist provided recommendations to clinicians regarding sedative drugs and doses, choice of mechanical ventilation mode and related settings, antimicrobial de-escalation, and central venous and urinary catheters removal. Differences in ICU and hospital length of stay, duration of mechanical ventilation, mortality rate, and hospital costs per patient were quantified between groups with patients matched for severity of illness (Simplified Acute Physiology Score II) at admission.

Measurements and Main Results:
From the 1,519 and 1,268 admitted patients during the observation and intervention periods, respectively, 1,164 patients were evaluable in both groups after matching for Simplified Acute Physiology Score II score. The intervention period was associated with mean (95% CI) reductions in patient hospital length of stay (3.7 d [5.2–2.3 d]; p < 0.001), ICU length of stay (1.4 d [2.3–0.5 d]; p < 0.005), duration of mechanical ventilation (1.2 d [2.1–0.3 d]; p < 0.01), and hospital costs per stay (2,560 euros [3,728–1,392 euros]; p < 0.001). The overall cost savings were 10,840 euros (10,727–10,952 euros) per month, mostly due to reduced consumption of sedatives and antimicrobials. No impact on mortality rate was identified.

Conclusions:
Critical care pharmacist-led interventions were associated with decreases in ICU and hospital length of stays and ICU drug costs.
Preventive, Cumulative Effects of Botulinum Toxin Type A in Facial Aesthetics
Authors: Humphrey Shannon , Jacky Birgitte , Gallagher Conor J. 
Published: November 2017

BACKGROUND
Botulinum toxin Type A (BoNTA) is the gold standard for the treatment of dynamic rhytides in the face. Recently, clinical observation suggests that individuals who receive regular injections of BoNTA experience ongoing wrinkle reduction and improvements in overall skin quality not observed in those treated sporadically.

OBJECTIVE
To review scientific evidence of qualitative changes in the skin and the possibility of indirect or direct effects on fibroblasts affecting fibroblast activity, including collagen production, after repeated treatment with BoNTA.

MATERIALS AND METHODS
We examined the literature for supporting evidence of the effect of repeated treatment cycles on wrinkle reduction and skin quality; histological changes in collagen structure; alterations in biomechanical features of the skin; and potential fibroblastic response.

RESULTS
Apparent cumulative improvement on wrinkle reduction and additional skin quality attributes with regular BoNTA treatments suggests an ongoing process of dermal repair. Clinical observation suggests that BoNTA injections stimulate collagen production and lead to a reorganization of the collagen network within the extracellular matrix, which in turn may produce improvements in features associated with more youthful skin. Moreover, evidence suggests that BoNTA may have a direct or indirect effect on fibroblast activity.

CONCLUSION
Clinical observation of progressive wrinkle reduction and qualitative improvements in a number of skin attributes that accumulate with more frequent injections of BoNTA suggest an ongoing process of repair leading to prolonged and cumulative effects.
Botulinum Toxin for Eyebrow Shaping: A Systematic Review
Authors: Jabbour Samer , Awaida Cyril , Kechichian Elio , Rayess Youssef , Abdelmassih Youssef , Noel Warren , Hachem Lena el , Nasr Marwan 
Published: November 2017

BACKGROUND
Currently, there is no standardized approach for eyebrow shaping with botulinum toxin, and controversies still exist regarding this subject.

OBJECTIVE
The objective of this systematic review is to summarize and compare all the published data regarding eyebrow shaping with botulinum toxin.

METHODS
On March 10, 2017, an online search of published articles in the Medline, Embase, and Cochrane databases were conducted. All articles that used objective measurements to quantify the eyebrow changes after botulinum toxin injection were included in this review.

RESULTS
Eleven studies were selected for inclusion with a total of 585 patients. All the included studies used onabotulinumtoxin A. Seven studies injected both the lateral and the medial eyebrow depressors, 2 studies injected the lateral depressors alone, and 2 studies injected the medial depressors alone. The highest elevation was observed in the lateral brow (0.4–4.8 mm). Bruising and headache were the most frequently reported complications, and only 5 cases of eyelid ptosis were noted.

CONCLUSION
Botulinum toxin injection for eyebrow shaping is a noninvasive, safe, and reproducible procedure. Eyebrow reshaping can be achieved by targeting different muscle groups. However, further randomized controlled trials are warranted.
Risk Factors for Complications in Expander-Based Breast Reconstruction: Multivariate Analysis in Asian Patients
Authors: Suga Hirotaka , Shiraishi Tomohiro , Tsuji Naoko , Takushima Akihiko 
Published: November 2017

Background:
There have been many studies examining risk factors for complications in expander-based breast reconstruction after mastectomy, and some patient factors have been identified as risk factors. However, most of the previous studies were based on Caucasian patients.

Methods:
Asian patients who had a tissue expander placed for immediate breast reconstruction between January 2006 and December 2015 (363 patients and 371 expanders) were analyzed retrospectively. Univariate and multivariate analyses were performed to elucidate risk factors for complications.

Results:
The rate of skin necrosis was significantly higher in nipple-sparing mastectomy than in other types of mastectomies (12 patients among 107 patients, P = 0.001). The weight of the resected specimen was significantly higher in the group with complications than in the group without complications (444 g compared with 363 g, P = 0.027). Other factors (age, body mass index, smoking, expander type, preoperative chemotherapy, axillary dissection) had no significant effect on complications. Multivariate analysis with a logistic regression showed that a large breast (over 500 g) was the only significant risk factor for complications, with an odds ratio of 3.20 and a 95% confidence interval of 1.33–7.54 (P = 0.010).

Conclusion:
In this series of Asian patients, breast size, rather than body mass index, is the most important predictor for complications in expander-based breast reconstruction.