bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Analysis of Retrograde Flexible Intramedullary Nail Constructs in a Simulated Pediatric Femur Fracture Model
Authors: Bland Daniel C. , Black Sheena R. , Pierce William A. , Wimberly Robert L. , Riccio Anthony I. 
Published: February 2017

Background:
Various flexible intramedullary nail (FIMN) constructs for pediatric femur fractures are described; however, no biomechanical study has compared stability of medial-lateral entry versus all-lateral entry retrograde nailing. Our purpose is to compare the rotational and bending stiffness of 2 different FIMN constructs and 2 different materials in a simulated pediatric femur fracture model.

Methods:
Eighty adolescent-sized composite femurs were used to simulate transverse (40 femurs) and oblique (40 femurs) mid-diaphyseal fractures. Retrograde FIMN of the femurs was performed using either 3.5 mm titanium (Ti) or 3.5 mm stainless-steel (SS) flexible nails in 2 configurations: 2 “C”-shaped nails (CC) placed through medial and lateral entry sites or 1 “C”-shaped nail and 1 “S”-shaped nail (CS) placed through a single lateral entry site. Models were first tested in 10 cycles of axial rotation to ±1 N m of torque at a rate of 0.5 degrees/s under 36 kg of compression. Axial compression was performed and bending stiffness defined as the force required to achieve 10 degrees varus at the fracture site.

Results:
No differences were noted in rotational stiffness comparing Ti and SS nails regardless of nail configuration or fracture pattern. Comparable rotational stability was found for CC and CS configurations with SS implants for both fracture patterns. The CS construct (0.60 N m/degree) was stiffer in rotation than the CC construct (0.41 N m/degree) with Ti implants in the transverse fracture model (P<0.005). SS nails provided greater bending stiffness than Ti nails in both oblique and transverse fracture patterns, regardless of nail construct. The all-lateral entry (CS) construct demonstrated statistically significant greater bending stiffness regardless of implant material or fracture pattern (P<0.03).

Conclusions:
An all-lateral entry (CS) FIMN construct demonstrated greater bending stiffness in both fracture patterns and materials. Ti and SS implants have comparable rotational stiffness in all fracture patterns and materials; however, SS nails were superior at resisting bending forces in both fracture patterns. CS nail configuration and SS implants demonstrated superior bending stiffness and rotational stiffness when compared with the more commonly used CC construct and Ti implants.

Level of Evidence:
NA (biomechanical study).
Correlates of Health Literacy and Its Impact on Illness Beliefs for Emergency Department Patients With Acute Heart Failure
Authors: Kumar Vijaya Arun , Albert Nancy M. , Medado Patrick , Mango Lynn Marie , Nutter Benjamin , Yang Dongsheng , Levy Phillip 
Published: February 2017

Objectives:
To study the relationship between health literacy (HL) and socioeconomic, demographic factors and disease-specific illness beliefs among patients who present to the emergency department with heart failure (HF).

Background:
Maintenance of well-being for patients with HF is partially dependent on appropriate self-care behaviors, which, in turn, are influenced by underlying illness beliefs. HL is a potential modifier of the interaction between behaviors and beliefs. There have been limited investigations studying this relationship among individuals with acute HF.

Methods:
A cross-sectional study of patients with hemodynamically stable acute HF was conducted. Demographic, education, and social support data were obtained from all patients along with self-reported responses to the 36-item STOFHLA survey, a 14 item HF-specific illness belief questionnaire, and a 5-item self-care adherence survey. General association was assessed using the χ2 or Fisher exact test, and comparisons were made using the Kruskal–Wallis test.

Results:
A total of 100 patients (51 females and 49 males) were included, 94% of whom were African-American (mean age [SD]: 57.5 [13.2] years). Inadequate, marginal, and adequate health literacy were present in 35%, 17%, and 48%, respectively, with increasing adequacy among the higher educated (P < 0.001). Overall, HF illness beliefs were considered to be “inaccurate” (mean score [SD] on a 4-point Likert scale: 2.8 [0.3]) but did correlate positively with improved HL (r = 0.26; P = 0.008).

Conclusion:
In this cohort of relatively young, predominantly African-American patients with acute HF, HL was positively correlated with level of education and negatively associated with age and was an important determinant of disease-specific illness beliefs.
Care for Vulnerable Elderly in Cardiology: A Program for Daily Practice
Authors: Wit Mirjam A. M. , Bos-Schaap Annet J. C. M. , Umans Victor A. W. M. 
Published: February 2017

Background:
The percentage of cardiac patients aged ≥75 has increased considerably over the past decades. To optimize multidisciplinary care for these frail elderly, a program of intensive medical and nursing care was started at Noord West Ziekenhuisgroep department of cardiology.

Methods:
Patients over 70 years of age, admitted to the department of cardiology, were included and treated by the advanced practice nurse according to a redesigned care process that focused on expedite mobilization and care by an advanced practice nurse-headed team including the first outpatient visit.

Results:
A total of 951 patients over 70 years were included in the frail elderly project. The average length of stay of the frail elderly was 6 days (SD 5). In the first 30 days, after discharge, 12% of these patients were readmitted with heart failure and 2% with dehydration. Mortality during admission was 3%, and 11% died within 3 months after discharge.

Conclusions:
This observational study shows, during a 4-year period, the vulnerability of aged cardiac patients. They were mainly admitted for (diastolic) heart failure, usually in combination with atrial fibrillation and hypertension. Their length of stay was on average 6 days with 11% mortality at 90 days follow-up.
Reliability of Videoconferencing Administration of a Communication Questionnaire to People With Traumatic Brain Injury and Their Close Others
Authors: Rietdijk Rachael , Power Emma , Brunner Melissa , Togher Leanne 
Published: February 2017

Objectives:
To compare in-person with videoconferencing administration of a communication questionnaire for people with traumatic brain injury (TBI) and their close others.

Design:
Repeated-measures design with randomized order of administration.

Participants:
Twenty adults with severe TBI and their close others.

Methods:
Both participants with TBI and their close others completed the La Trobe Communication Questionnaire (LCQ) via interview with a clinician, once via Skype and once during a home visit.

Measures:
Total LCQ score and time taken for completion.

Results:
There were no significant differences between videoconferencing and in-person conditions in the total scores or time taken to complete the questionnaire.

Conclusions:
Videoconferencing-based administration of the LCQ is as reliable and efficient as in-person administration.
Assessment of Oculomotor Function in Patients With Postconcussion Syndrome: A Systematic Review
Authors: Taghdiri Foad , Varriano Brenda , Tartaglia Maria Carmela 
Published: February 2017

Background:
Concussion and its associated sequel, postconcussion syndrome (PCS), have a debilitating impact on the lives of concussed patients. However, a diagnostic biomarker for this condition is lacking. Recently, there has been a surge of interest in using oculomotor function testing as an objective assessment of patients with PCS.

Objectives:
To systematically synthesize, appraise, and summarize all published empirical studies that have assessed alteration of oculomotor functions in patients with PCS.

Methods:
Medline, Embase, PsychINFO, and CINAHL databases searched up to July 2016 for studies that used oculomotor function assessment in patients with postconcussion symptoms.

Results:
The search identified 1637 citations, and finally 8 case-control studies were included. Of these, 5 studies used a similar task with a target moving in a circular trajectory. Three other studies measured conventional oculomotor tasks such as saccade, vergence, and smooth pursuit eye movements.

Conclusions:
Currently, there is limited support for the recommendation of oculomotor function assessments for diagnosis and identification of patients with PCS following head trauma. Therefore, more rigorous studies assessing oculomotor function changes in patients with PCS are warranted.
Test-Retest Reliability of Traumatic Brain Injury Outcome Measures: A Traumatic Brain Injury Model Systems Study
Authors: Bogner Jennifer A. , Whiteneck Gale G. , MacDonald Jessica , Juengst Shannon B. , Brown Allen W. , Philippus Angela M. , Marwitz Jennifer H. , Lengenfelder Jeannie , Mellick Dave , Arenth Patricia , Corrigan John D. 
Published: February 2017

Objective:
Evaluate the test-retest reliability of measures that comprise the Traumatic Brain Injury Model Systems follow-up data set.

Participants:
A total of 224 persons with a moderate-severe traumatic brain injury (TBI) enrolled in the Traumatic Brain Injury Model Systems National Database.

Design:
Following standard administration of the follow-up interview, a second interview was administered 14 to 28 days later using the same interviewer and the same mode of administration.

Main Measures:
Traumatic Brain Injury Model Systems follow-up interview that includes 66 variables comprised (a) single item measures of demographics; employment; general health as well as specific health conditions; rehospitalization; tobacco, alcohol, and other drug use; transportation; and mental health and (b) multi-item instruments: FIM; Participation Assessment With Recombined Tools-Objective; Disability Rating Scale; Glasgow Outcome Scale—Extended; Supervision Rating Scale; Satisfaction With Life Scale; TBI Quality of Life Anxiety and Depression items; and The Ohio State University TBI Identification Method.

Results:
Intraclass correlation coefficient values ranged from 0.65 to 0.99, weighted kappa values ranged from 0.54 to 0.99, and kappa values ranged from 0.43 to 1.00. Four kappa/weighted kappa estimates fell below 0.60: arrested, psychiatric hospitalization, number of days not in good physical health, and rating of general emotional health.

Conclusions:
With few exceptions, good to excellent test-retest reliability estimates were obtained. The findings support the use of these measures in prior and future studies and indicate that persons with moderate-severe TBI can provide reliable self-report.
Treatment Charges for Traumatic Brain Injury Among Older Adults at a Trauma Center
Authors: Albrecht Jennifer S. , Slejko Julia F. , Stein Deborah M. , Smith Gordon S. 
Published: February 2017

Objective:
To provide charge estimates of treatment for traumatic brain injury (TBI), including both hospital and physician charges, among adults 65 years and older treated at a trauma center.

Methods:
We identified older adults treated for TBI during 2008–2012 (n = 1843) at Maryland's Primary Adult Resource Center and obtained hospital and physician charges separately. Analyses were stratified by sex and all charges were inflated to 2012 dollars. Total TBI charges were modeled as a function of covariates using a generalized linear model.

Results:
Women comprised 48% of the sample. The mean unadjusted total TBI hospitalization charge for adults 65 years and older was $36 075 (standard deviation, $63 073). Physician charges comprised 15% of total charges. Adjusted mean charges were lower in women than in men (adjusted difference, −$894; 95% confidence interval, −$277 to −$1512). Length of hospital and intensive care unit stay were associated with the highest charges.

Conclusions:
This study provides the first estimates of hospital and physician charges associated with hospitalization for TBI among older adults at a trauma center that will aid in resource allocation, triage decisions, and healthcare policy.
INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP
Authors: Casini Giamberto , Mura Marco , Figus Michele , Loiudice Pasquale , Peiretti Enrico , De Cillà Stefano , Fuentes Taiusha , Nasini Francesco 
Published: February 2017

Purpose:
To determine whether surgical manipulation steps of the internal limiting membrane (ILM) flap, such as ILM trimmed, ILM tuck inside the hole, ILM massage, are mandatory to obtain satisfactory outcomes for the repair of large stage IV idiopathic macular hole using the inverted ILM flap technique.

Methods:
In this interventional comparative prospective single-masked study, 81 eyes were randomized into 2 treatments groups. In Group 1 (41 eyes), the classic inverted ILM flap technique was performed. In Group 2 (40 eyes), a modified procedure was used: after ILM peeling, no extra flap manipulation was performed. The macular hole was covered by the inverted ILM flap because of the air pressure at the time of the fluid–air exchange.

Results:
At 12 months, macular hole closure was observed in 40 eyes (97.6%) in Group 1 and in 39 eyes in Group 2 (97.5%). U-shape closure rate, ellipsoid zone defects, and external limiting membrane defects were similar in both groups. The results indicate no statistical difference in anatomical and functional success between both groups.

Conclusion:
The macular hole closure rate, improved visual acuity, and no extra complications indicate noninferiority of the modified inverted ILM technique. Internal limiting membrane finishing, tucking, and massage may not be required to obtain surgical success.
LONGITUDINAL CHANGES IN THICKNESSES OF THE MACULA, GANGLION CELL–INNER PLEXIFORM LAYER, AND RETINAL NERVE FIBER LAYER AFTER VITRECTOMY
Authors: Lim Hyung-Bin , Lee Min-Woo , Kwak Baek-Soo , Jo Young-Joon , Kim Jung-Yeul 
Published: February 2017

Purpose:
To analyze longitudinal changes in the thicknesses of the macula, ganglion cell–inner plexiform layer (GC-IPL), and peripapillary retinal nerve fiber layer (RNFL) after vitrectomy.

Methods:
Thirty-eight patients diagnosed with intraocular lens (IOL) dislocation without evidence of other vitreoretinal diseases were included. They underwent conventional vitrectomy and IOL transscleral fixation, with a follow-up of 12 months. Using spectral domain optical coherence tomography, the thicknesses of the macula, GC-IPL, and peripapillary RNFL in the vitrectomized and fellow control eyes were measured. Various optic nerve head parameters were also determined.

Results:
Optical coherence tomography showed that there were no significant differences in postoperative central macular thickness compared with baseline values. The average GC-IPL thickness increased 1 month after surgery from baseline (P = 0.038). The average RNFL thickness increased from baseline at 1 month (P = 0.001) and 3 months (P = 0.011) after vitrectomy. The mean foveal, GC-IPL, and RNFL thicknesses of the study eyes compared with the fellow control eyes increased at 1 month (P = 0.034), 1 month (P = 0.048), and 1 month (P = 0.013) to 3 months (P = 0.038), respectively, after surgery. However, no significant differences were found in intraocular pressure or optic nerve head parameters between the study and fellow control eyes at 12 months after surgery.

Conclusion:
Transient increases in the thickness of the macula and GC-IPL were observed at 1 month after vitrectomy, and the postoperative RNFL thickness increased until 3 months after surgery, after which it returned to preoperative levels. There was no significant change in intraocular pressure or optic nerve head parameters before and after surgery.
METAMORPHOPSIA AND OUTER RETINAL MORPHOLOGIC CHANGES AFTER SUCCESSFUL VITRECTOMY SURGERY FOR MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT
Authors: Okuda Tetsuhiko , Higashide Tomomi , Sugiyama Kazuhisa 
Published: February 2017

Purpose:
To evaluate the correlation between metamorphopsia and outer retinal morphologic changes after successful vitrectomy for rhegmatogenous retinal detachment (RRD).

Methods:
Forty eyes from 40 patients with macula-off (26 eyes) or macula-on (14 eyes) RRDs that underwent pars plana vitrectomy were included. Metamorphopsia was quantified with M-CHARTS. The relationship between the integrity of the outer retinal layers examined by spectral domain optical coherence tomography and metamorphopsia at 6 and 12 months postoperatively was evaluated.

Results:
Metamorphopsia was significantly more frequent in eyes with macula-off RRD (88%) than in eyes with macula-on RRD (21%) at 6 months postoperatively (P < 0.001) and became significantly less frequent in macula-off RRD eyes from 6 months to 12 months (64%) postoperatively (P = 0.041). Horizontal metamorphopsia scores in eyes with continuous interdigitation zone and ellipsoid zone bands were significantly smaller than in eyes with a disrupted interdigitation zone band and a continuous ellipsoid zone band or in eyes with disrupted ellipsoid zone and interdigitation zone bands (P = 0.003 and P <0.001, respectively), which was consistent with the results of vertical metamorphopsia scores.

Conclusion:
Restoration of both the ellipsoid zone and interdigitation zone bands seems to be an important factor for the reduction of metamorphopsia after successful vitrectomy for macula-off RRD.
ACUTE ZONAL OCCULT OUTER RETINOPATHY
Authors: Duncker Tobias , Lee Winston , Jiang Fan , Ramachandran Rithambara , Hood Donald C. , Tsang Stephen H. , Sparrow Janet R. , Greenstein Vivienne C. 
Published: February 2017

Purpose:
To assess structure and function across the transition zone (TZ) between relatively healthy and diseased retina in acute zonal occult outer retinopathy.

Methods:
Six patients (6 eyes; age 22–71 years) with acute zonal occult outer retinopathy were studied. Spectral-domain optical coherence tomography, fundus autofluorescence, near-infrared reflectance, color fundus photography, and fundus perimetry were performed and images were registered to each other. The retinal layers of the spectral-domain optical coherence tomography scans were segmented and the thicknesses of two outer retinal layers, that is, the total receptor and outer segment plus layers, and the retinal nerve fiber layer were measured.

Results:
All eyes showed a TZ on multimodal imaging. On spectral-domain optical coherence tomography, the TZ was in the nasal retina at varying distances from the fovea. For all eyes, it was associated with loss of the ellipsoid zone band, significant thinning of the two outer retinal layers, and in three eyes with thickening of the retinal nerve fiber layer. On fundus autofluorescence, all eyes had a clearly demarcated peripapillary area of abnormal fundus autofluorescence delimited by a border of high autofluorescence; the latter was associated with loss of the ellipsoid zone band and with a change from relatively normal to markedly decreased or nonrecordable visual sensitivity on fundus perimetry.

Conclusion:
The results of multimodal imaging clarified the TZ in acute zonal occult outer retinopathy. The TZ was outlined by a distinct high autofluorescence border that correlated with loss of the ellipsoid zone band on spectral-domain optical coherence tomography. However, in fundus areas that seemed healthy on fundus autofluorescence, thinning of the outer retinal layers and thickening of the retinal nerve fiber layer were observed near the TZ. The TZ was also characterized by a decrease in visual sensitivity.
CHOROIDAL THICKNESS IN DIABETIC RETINOPATHY ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Laíns Inês , Talcott Katherine E. , Santos Ana R. , Marques João H. , Gil Pedro , Gil João , Figueira João , Husain Deeba , Kim Ivana K. , Miller Joan W. , Silva Rufino , Miller John B. 
Published: February 2017

Purpose:
To compare the choroidal thickness (CT) of diabetic eyes (different stages of disease) with controls, using swept-source optical coherence tomography.

Methods:
A multicenter, prospective, cross-sectional study of diabetic and nondiabetic subjects using swept-source optical coherence tomography imaging. Choroidal thickness maps, according to the nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields, were obtained using automated software. Mean CT was calculated as the mean value within the ETDRS grid, and central CT as the mean in the central 1 mm. Diabetic eyes were divided into four groups: no diabetic retinopathy (No DR), nonproliferative DR (NPDR), NPDR with diabetic macular edema (NPDR + DME), and proliferative DR (PDR). Multilevel mixed linear models were performed for analyses.

Results:
The authors included 50 control and 160 diabetic eyes (n = 27 No DR, n = 51 NPDR, n = 61 NPDR + DME, and n = 21 PDR). Mean CT (ß = −42.9, P = 0.022) and central CT (ß = −50.2, P = 0.013) were statistically significantly thinner in PDR eyes compared with controls, even after adjusting for confounding factors. Controlling for age, DR eyes presented a significantly decreased central CT than diabetic eyes without retinopathy (β = −36.2, P = 0.009).

Conclusion:
Swept-source optical coherence tomography demonstrates a significant reduction of CT in PDR compared with controls. In the foveal region, the choroid appears to be thinner in DR eyes than in diabetic eyes without retinopathy.
NORMAL ELECTROOCULOGRAPHY IN BEST DISEASE AND AUTOSOMAL RECESSIVE BESTROPHINOPATHY
Authors: Khan Kamron N. , Islam Farrah , Holder Graham E. , Robson Anthony , Webster Andrew R. , Moore Anthony T. , Michaelides Michel 
Published: February 2017

Purpose:
To evaluate the electrooculogram (EOG) in a large series of patients with Best disease and autosomal recessive bestrophinopathy.

Methods:
A retrospective review of consecutive cases at Moorfields Eye Hospital, London, United Kingdom. Patients with Best disease or autosomal recessive bestrophinopathy who, after electrophysiologic testing, had a normal or atypical EOG light rise were identified. Main outcome measure was EOG amplitude, clinical phenotype and genotype.

Results:
One hundred thirteen patients were identified with likely disease-causing sequence variants in BEST1 (99 Best disease and 14 autosomal recessive bestrophinopathy). Electrooculograms had been performed in 75 patients. Twenty patients (27%) had no detectable light rise (Arden ratio of 100%) and 49 (65%) had Arden ratios of between 100% to 165%. Six patients (8%) were found to have an EOG light rise of >165%. No cases demonstrated significant interocular asymmetry in EOG amplitude.

Conclusion:
The current work provides significant clinical evidence that the EOG phenotype in Best disease and autosomal recessive bestrophinopathy is more variable than currently appreciated. As a normal EOG may occur in the presence of a classical fundus appearance, the consequences of BEST1 mutation may be independently expressed, possibly mediated through differential effects on intracellular calcium homeostasis.