bluuebunny/crossref_metadata_2025_split huggingface dataset:
IN VITRO FLOW ANALYSIS OF NOVEL DOUBLE-CUTTING, OPEN-PORT, ULTRAHIGH-SPEED VITRECTOMY SYSTEMS
Authors: Zehetner Claus , Moelgg Marion , Bechrakis Emmanouil , Linhart Caroline , Bechrakis Nikolaos E. 
Published: October 2017

Purpose:
To analyze the performance and flow characteristics of novel double-cutting, open-port, 23-, 25-, and 27-gauge ultrahigh-speed vitrectomy systems.

Methods:
In vitro fluidic measurements were performed to assess the volumetric aspiration profiles of several vitrectomy systems in basic salt solution and egg white.

Results:
Double-cutting open-port vitrectomy probes delivered stable aspiration flow rates that were less prone to flow variation affected by the cutting speed. Increase in cutting frequency to the maximum level resulted in flow reduction of less than 10% (0.0%–9.5%). Commercially available 23-, 25-, and 27-G double-cutting probes exhibited higher egg-white and basic salt solution flow rates at all evaluated cut rates, with aspirational efficiencies being 1.1 to 2.9 times the flow rates of standard single-blade vitrectomy probes of the same caliber at the maximum preset vacuum. The highest relative differences were observed at faster cut rates.

Conclusion:
The newly introduced double-cutting open-port vitrectomy probes delivered stable aspiration flow rates that were less prone to flow variation affected by the cutting speed. The fluidic principle of constant flow even at the highest cut rates and low vacuum levels might impact surgical strategies, especially when performing manipulations close to the retina.
REABSORPTION OF ACQUIRED VITELLIFORM LESIONS IN VITREOMACULAR DISORDERS AFTER VITRECTOMY
Authors: Bamonte Giulio , Appeltans Andrea , Cicinelli Maria Vittoria , Querques Giuseppe 
Published: October 2017

Purpose:
To describe cases of reabsorption of subretinal acquired vitelliform material (acquired vitelliform lesion [AVL]) associated with vitreomacular disorders after 25-gauge pars plana vitrectomy and peeling of internal limiting membrane.

Methods:
Data of consecutive patients who underwent 25-gauge transconjunctival pars plana vitrectomy for vitreomacular disorders at the Department of Ophthalmology of the University Hospital of Brussels (Belgium) were collected. Patients featuring AVL on fundus examination or on spectral domain optical coherence tomography were recruited. Patients were followed up for 12 months after surgery.

Results:
Four eyes of three consecutive white patients presenting AVL were included. Three cases were affected by macular pucker, whereas one case featured vitreomacular traction syndrome. Progressive flattening of the AVL after surgery was observed in three eyes of three patients. One eye did not show any resorption of the submacular accumulation. In two eyes, atrophy of the retinal pigment epithelium and the outer retinal layers was observed along with resolution of the AVL, with significant worsening of visual acuity postoperatively.

Conclusion:
The outcome of surgery in cases of submacular AVL associated with vitreomacular interface syndromes could be heterogeneous and may depend on the duration of the disease and baseline optical coherence tomography characteristics of the lipofuscin accumulation.
The Development and Psychometric Testing on Psychiatric Nurses of a Nurse Case Management Competence Scale in Taiwan
Authors: Chen Shing-Chia , Lee Shih-Kai , Rong Jiin-Ru , Wu Chien-Chang , Liu Wen-I 
Published: October 2017

ABSTRACT

Background:
Case management is a complex process involving multiple activities. It is vital that nurses are competent in all related tasks for case management. A competence scale is a valuable tool for assessing task-related competency.

Purpose:
The aims of this study were to examine the reliability and validity of an assessment scale for nurse case management competence and to use this scale to assess the current competency of nurses.

Methods:
A nurse case management competence scale was developed in three stages: (a) selection of assessment items according to standards of practice for case management and literature review, (b) determination of content validity using the Delphi technique with a panel of experts, and (c) psychometric testing of the developed competence scale using a cross-sectional design. Convenience sampling was used to recruit psychiatric nurses at seven psychiatric centers in Taiwan to complete the scale anonymously. An exploratory factor analysis was performed to analyze construct validity. Discriminant validity, internal consistency, and 2-week test–retest reliability were also examined.

Results:
Two hundred eighty-five psychiatric nurses completed an assessment scale comprising 18 items (originally 25 items). The content validity index reached 0.96 after the Delphi technique was applied twice in the expert panel. Seventy-eight percent of the total variance was explained by two dimension factors: coordination facilitation competence and direct care competence. Participants who had undertaken case management courses had superior case management ability compared with those who had not, indicating that the scale possesses excellent discriminant validity. Cronbach’s α and the test–retest results showed excellent reliability. Of the two competence factors, direct care competence (3.03) was better than coordination facilitation competence (2.81).

Conclusions/Implications for Practice:
There is a dearth of studies investigating the development and psychometric testing of case management competence scales. The results of this study provide evidence to support the reliability and validity of the developed case management competence scale among Taiwanese psychiatric nurses. It is a reliable and valid assessment instrument that may help identify educational needs and improve the case management competencies of nurses.
Relationship Between Lifestyles That Promote Health and Quality of Life in Patients With Chronic Schizophrenia: A Cross-Sectional Study
Authors: LIN Shih-Pi , LIU Chieh-Yu , YANG Chiu-Yueh 
Published: October 2017

ABSTRACT

Background:
Over the last few decades, an increasing number of studies have examined quality of life in patients with chronic schizophrenia. However, little research has addressed the relationship between lifestyles that promote health and quality of life issues in these patients.

Purpose:
The aim of this study was to investigate the relationships between lifestyles that promote health and quality of life in patients with chronic schizophrenia.

Methods:
A cross-sectional study design was used. The study was conducted at 10 hospital-based psychiatric rehabilitation units in northern Taiwan. In total, 357 participants completed the World Health Organization Quality of Life–BREF and the Health-Promoting Lifestyle Profile. This study examined the relationships among the six domains of the Health-Promoting Lifestyle Profile and the four domains of the Quality of Life–BREF using canonical correlation analysis. Data collection occurred between April 2013 and April 2014.

Results:
The results of the canonical correlation analysis showed that the Health-Promoting Lifestyle Profile domains of nutrition, health responsibility, self-actualization, interpersonal support, exercise, and stress management were significantly related to the Quality of Life–BREF results, specifically in the physical, psychological, and social relationships and environment domains. Two canonical correlations were identified (the canonical correlation coefficients were .622 and .317), which showed that 38.6% of the variance in lifestyles that promote health and quality of life was shared.

Conclusions/Implications for Practice:
The results of this study may be useful to practitioners who are responsible for lifestyles that promote health and quality of life issues in patients with chronic schizophrenia.
Spleen and liver injuries: when to operate?
Authors: Gaarder Christine , Gaski Iver A. , Næss Pål A. 
Published: October 2017

Purpose of review
Although nonoperative management (NOM) is the safest option in most patients with liver and splenic injuries or splenic injuries, some cases still need operative intervention. The aim of this review is to address the most recent literature and the evidence it provides for indications and timing of operative treatment for liver and spleen injuries.

Recent findings
There seems to be a decrease in publication rate on these topics over the last years, parallel to the acceptance of NOM as the ‘gold standard’, with little added to the existing body of evidence over the last 12–24 months. Most published studies are retrospective descriptions or comparisons with historical controls, some observational studies, but no randomized control trials (RCTs).
There is a striking lack of high-level evidence for the optimal treatment of solid organ injuries. The role of angiographic embolization as an adjunct to the treatment of liver and spleen injuries is still a matter of discussion.

Summary
Unstable patients with suspected ongoing bleeding from liver and spleen injuries or spleen injuries with inadequate effect of resuscitation should undergo immediate explorative laparotomy.
More RCTs are needed to further determine the role of angiographic embolization and who can be safely be treated nonoperatively and who needs surgical intervention.
Lumen Apposing Metal Stents (LAMSs) for Drainage of Pancreatic and Gallbladder Collections
Authors: Han Dennis , Inamdar Sumant , Lee Calvin W. , Miller Larry S. , Trindade Arvind J. , Sejpal Divyesh V. 
Published: October 2017

Background and Aims:
Endoscopic ultrasound-guided transmural drainage using lumen apposing metal stents (LAMSs) is becoming a popular and promising therapeutic approach for drainage of intra-abdominal fluid collections. There has been an increasing number of studies evaluating LAMS for drainage of pancreatic pseudocysts (PP), walled-off pancreatic necrosis (WOPN), and gallbladder (GB) drainage. The aim of this meta-analysis is to analyze the literature to date regarding the clinical success, technical success, and adverse events of LAMS in treatment of pancreatic fluid collections and GB drainage.

Methods:
A comprehensive search of multiple literature databases through November 2016 was performed. Human studies with at least 10 subjects that examined the clinical success, technical success, and adverse events of LAMS in treating PP, WOPN, and GB drainage were included.

Results:
A total of 993 patients (608—WOPN; 204—PP; 181—GB drainage) underwent drainage from 20 trials. For drainage of WOPN, the pooled technical success was 98.9% [95% confidence interval (CI): 98.2% to 99.7%] and clinical success was 90% (95% CI: 87% to 93%) (τ2=0.001). For drainage of PP, the pooled technical success was 97% (95% CI: 95% to 99%) and clinical success was 98% (95% CI: 96% to 100%), (τ2=0.001). For GB drainage, the pooled technical success was 95% (95% CI: 91% to 99%) and clinical success was 93% (95% CI: 90% to 97%), (τ2=0.001). Total adverse events occurred in 11% of patients with higher complication rates observed in GB drainage. There was no evidence of publication bias in this meta-analysis.

Conclusions:
Endoscopic ultrasound-guided transmural drainage using LAMS is becoming a widely accepted therapeutic approach for the treatment of PP, WOPN, and GB drainage with high clinical and technical success rates and acceptable adverse events. Further prospective randomized trials reporting long-term clinical efficacy and cost-effectiveness are needed to validate LAMS as a therapeutic modality for pancreatic and GB collections.
State Variation in Quality Outcomes and Disparities in Outcomes in Community Health Centers
Authors: Cole Megan B. , Wilson Ira B. , Trivedi Amal N. 
Published: October 2017

Background:
Prior studies have reported that community health centers perform as well as other sites of care, despite serving more vulnerable patient populations. However, there is little prior study of geographic variation in quality outcomes and disparities in outcomes in this setting. Quantifying geographic variation is important so as to target quality improvement efforts and funding and to learn from states where total quality is highest and racial/ethnic disparities are lowest.

Objectives:
To estimate between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients.

Methods:
Using data on all US health centers from 2010 to 2014 (N=1047 health centers/year, or 21.2 million patients in 2014), we used linear regression models to estimate adjusted quality outcomes and racial/ethnic disparities in quality outcomes by state for hypertension control, diabetes control, and normal birthweight.

Results:
We found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers. For instance, between states, the mean proportion of patients with hypertension control ranged from 58% to 70% for white patients, from 49% to 64% for black patients, and from 53% to 74% for Hispanic patients (P<0.001). Racial/ethnic disparities in outcomes ranged from negative or nonsignificant in some states to positive in others.

Conclusions:
Wide variation in health center patient outcomes and disparities in outcomes is observed between states. This variation suggests that policymakers should target funding and interventions to underperforming states, and identify determinants of high quality in higher performing states.
The New Age of Bullying and Violence in Health Care: Part 3
Authors: Fink-Samnick Ellen 
Published: October 2017

Purpose/Objectives:

This article:

Primary Practice Setting(s):
Applicable to all health care sections where case management is practiced.

Findings/Conclusions:
This article is the third of a 4-part series on the topic of bullying in the health care workplace. Part 3 addresses the dimensions of the bullying boss and leadership, posing major implications for patient safety plus the mental health of staff members. The complex constructs and dynamics broached by the bullying boss and department leadership are explored. These include the underlying forces at play such as power, gender, leadership styles, plus weaves in assessment models. Strategic and proactive management of bullying by leadership is vital to workforce retention and well-being.

Implications for Case Management Practice:
The increasing incidence and impact of bullying across all sectors have made it a major workforce performance management challenge. Health care settings are especially tense environments, often making it difficult for individuals to distinguish between bullying behavior and high expectations for staff. Bullying impacts both direct targets and bystanders who witness the assaultive behaviors, with ethical implications as well.
Case management is poised to promote a safe health care workplace for patients and practitioners alike amid these intricate circumstances. Understanding types of bullying bosses and leadership styles is integral to a case manager's success in the workplace.
Low-Intensity Pulsed Ultrasound Stimulation for Tendon-Bone Healing
Authors: Lu Hongbin , Liu Fei , Chen Can , Wang Zhanwen , Chen Huabin , Qu Jin , Zhang Tao , Xu Daqi , Hu Jianzhong 
Published: October 2017

Objective
The aim of the study was to evaluate the dosage effect of low-intensity pulsed ultrasound stimulation on tendon-bone healing.

Design
Standard partial patellectomies were performed on 120 mature New Zealand rabbits randomly assigned into the following three groups: a control group (daily mock sonication, 20 mins), a qd group (daily ultrasonication, 20 mins), and a bid group (ultrasonication twice a day, 20 mins each time). The rabbits were killed 8 or 16 wks postoperatively, and the microarchitectural, histological, and mechanical properties of the patella-patellar tendon interface were evaluated.

Results
Microcomputed tomography analysis showed that the bid group exhibited more new bone formation and mineralization than the other groups in the tendon-bone healing position at both 8 and 16 wks postoperatively. Histological assessments confirmed that the bid group exhibited a significantly better patella-patellar tendon interface than the other groups, as shown by the increased formation and remodeling of newly formed bone and a fibrocartilage layer. The biomechanical properties of the regenerated patella-patellar tendon interface significantly improved in the bid group.

Conclusions
Low-intensity pulsed ultrasound stimulation treatment twice a day was more effective than the once-a-day treatment on tendon-bone healing.
Brief Report: PrEP Use During Periods of HIV Risk Among East African Women in Serodiscordant Relationships
Authors: Pyra Maria , Haberer Jessica E. , Heffron Renee , Kidoguchi Lara , Brown Elizabeth R. , Bukusi Elizabeth A. , Asiimwe Stephen , Celum Connie , Katabira Elly , Mugo Nelly R. , Baeten Jared M. ,   for the Partners Demonstration Project Team
Published: October 2017

Background:
Pre-exposure prophylaxis (PrEP) is efficacious for African women at risk for HIV, but data on adherence outside clinical trials are sparse. We describe the persistence and execution of PrEP use among women participating in a large open-label PrEP demonstration project, particularly during periods of HIV risk.

Setting and Methods:
Three hundred ten HIV-uninfected women in HIV serodiscordant couples in Kenya and Uganda were offered and accepted PrEP. Electronic monitoring caps were used to measure daily PrEP adherence. Time on PrEP while at risk for HIV (when the HIV-infected partner was on antiretroviral therapy <6 months) and weekly adherence while on PrEP were calculated and compared among older and younger (<25 years old) women.

Results:
As defined above, women were at risk for HIV for an average of 361 days; 54% took PrEP during their entire risk period and 24% stopped but restarted PrEP during their risk period. While on PrEP, women took ≥6 doses/wk for 78% of weeks [67% of weeks for women aged <25 years, 80% of weeks for women aged ≥25 years (P < 0.001)], and ≥4 doses for 88% of weeks [80% for those <25, 90% for those ≥25, (P < 0.001)]. Compared with historical, risk-matched controls, HIV incidence was reduced 93% (95% confidence interval: 77% to 98%) for all women and 91% (95% confidence interval: 29% to 99%) among women aged <25 years.

Conclusion:
Women, including young women, in HIV-serodiscordant couples took PrEP successfully over sustained periods of risk. Although young women had lower adherence than older women, they achieved strong protection, which suggests that women can align PrEP use to periods of risk and imperfect adherence can still provide substantial benefit.
Design and Evaluation of a Low-Cost Speculum Examination Training Model
Authors: Benson James E. , Hillebrand Allix M. , Auguste Tamika 
Published: October 2017

Introduction
Learning how to perform a speculum examination is a key component of the medical student curriculum, yet there is a paucity of data on the validity of available speculum examination models. This purpose of this study is to design, evaluate, and improve a low-cost speculum examination model.

Methods
A speculum examination training model was created using low-cost or recycled materials from other simulators. A total of 54 medical students, residents, and faculty in the obstetrics and gynecology department of a single academic institution performed speculum examinations on the model. Each participant completed a survey to provide qualitative and quantitative data. Using this feedback from participants, adjustments were made to the model and a similar survey was repeated with a total of 35 medical students and residents.

Results
The first iteration of the model was viewed positively by most participants. Eighty-three percent gave the model either a very realistic or realistic rating. Ninety-four percent thought the model was a very useful or useful teaching device. There were few significant differences in quantitative data based on experience level. Qualitative feedback yielded generally positive remarks with areas for improvement. The second iteration of the model was successful in differentiating between novice and skilled participants: residents were significantly better at identifying cervical position compared with students. Eighty-nine percent of participants thought the model was very useful or useful, whereas 49% thought the model was very realistic or realistic.

Discussion
The first iteration of the model demonstrated realism and usefulness; however, it lacked construct validity. Participant feedback yielded several helpful suggestions to improve the model. The second and final iteration of the model differentiated between novice and skilled participants at the cost of realism. This low-cost model is a useful tool to aid in teaching the speculum examination. Further development and study of the model could lead to a valid tool to evaluate speculum examination skills.
Anterior Ischemic Optic Neuropathy Due to Calciphylaxis
Authors: Sivertsen Magne S. , Strøm Erik H. , Endre Kim M. A. , Jørstad Øystein K. 
Published: October 2017

Abstract:
A 72-year-old woman experienced anterior ischemic optic neuropathy in her left eye. The funduscopic and fluorescein angiographic findings were strongly suggestive of giant cell arteritis. Temporal artery biopsy revealed extensive calcification in the vessel wall consistent with calciphylaxis. This unusual disorder should be considered in the differential diagnosis of anterior ischemic optic neuropathy, particularly the arteritic form.
Two sides of a coin: ecological and chronobiological perspectives of timing in the wild
Authors: Helm Barbara , Visser Marcel E. , Schwartz William , Kronfeld-Schor Noga , Gerkema Menno , Piersma Theunis , Bloch Guy 
Published: October 2017

Most processes within organisms, and most interactions between organisms and their environment, have distinct time profiles. The temporal coordination of such processes is crucial across levels of biological organization, but disciplines differ widely in their approaches to study timing. Such differences are accentuated between ecologists, who are centrally concerned with a holistic view of an organism in relation to its external environment, and chronobiologists, who emphasize internal timekeeping within an organism and the mechanisms of its adjustment to the environment. We argue that ecological and chronobiological perspectives are complementary, and that studies at the intersection will enable both fields to jointly overcome obstacles that currently hinder progress. However, to achieve this integration, we first have to cross some conceptual barriers, clarifying prohibitively inaccessible terminologies. We critically assess main assumptions and concepts in either field, as well as their common interests. Both approaches intersect in their need to understand the extent and regulation of temporal plasticity, and in the concept of ‘chronotype’, i.e. the characteristic temporal properties of individuals which are the targets of natural and sexual selection. We then highlight promising developments, point out open questions, acknowledge difficulties and propose directions for further integration of ecological and chronobiological perspectives through Wild Clock research.This article is part of the themed issue ‘Wild Clocks: integrating chronobiology and ecology to understand timekeeping in free-living animals’.