bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Beliefs About Bladder Dysfunction Among Health-Care Professionals Influence Clinical Practice Development
Authors: Browne Catherine , Kehoe Maria , Salmon Nancy 
Published: September 2016

Background:
Bladder dysfunction can affect up to 75% of people with multiple sclerosis (MS) on several important life domains. It is a multifaceted problem that remains underdiagnosed by health-care professionals. The aims of this study were to understand the perceptions of Irish health-care professionals regarding bladder dysfunction and to explore current service provision for people with MS.

Methods:
Two focus groups, three dyadic interviews, and one semistructured interview with 14 health-care professionals lasting up to 90 minutes were audio-recorded. Participants included eight physiotherapists, two occupational therapists, three nurses, and one clinical case manager from acute and community settings.

Results:
Thematic analysis of transcripts yielded two key themes. The first theme involves the underlying beliefs of health-care professionals, their clinical practice, and experiential knowledge in the model of clinical practice development in relation to bladder management. The second theme addresses the pivotal points in this model where change can be implemented to optimize bladder management. The first element of change encompasses the interaction between clinical practice and experiential knowledge of health-care professionals. The second element of change incorporates how acknowledgment of individual beliefs of health-care professionals can further inform clinical practice and experiential knowledge.

Conclusions:
These findings suggest that health-care professionals need to be aware of their beliefs in relation to bladder dysfunction. Examining these beliefs may influence how people with MS access health service provision for this disabling symptom. This type of reflexive practice may facilitate changes to existing perceptions and reduce the reluctance to discuss bladder symptoms.
Foot Temperature Trends in Normal, Diabetic, and Neuropathic Foot Populations
Authors: Alalwee Azza , LeSar Jonathan D. , Ghassemi Mina , Cheng Eugene , Stuto Steven , Osher Lawrence , Bastian Scott , Hetherington Vincent J. , Kawalec Jill 
Published: September 2016

INTRODUCTION AND OBJECTIVES: Patients with underlying peripheral neuropathy are subject to changes in foot temperature. (1,2) Of the many forms of neuropathy that affect the lower extremity, the most notable are those types associated with diabetes. The aim of this study was to look for differences in temperatures between uncomplicated diabetic, diabetic neuropathic, and non-diabetic neuropathic feet.
METHODS: The feet of 75 subjects were divided into 3 groups: 1) normal (n=50 feet), 2) diabetic (n=50 feet), and 3) neuropathic (n=49 feet). The neuropathic group was further subdivided into diabetic neuropathies (n=20 feet) and non-diabetic neuropathies (n=29 feet). To properly assign subjects to groups, all participants underwent vibratory threshold testing with a biothesiometer. In addition, all diabetic subjects had added glycosylated hemoglobin (hemoglobin A1C) studies performed. Temperature measurements were recorded at nine distinct foot locations (six plantar and three dorsal). Data was statistically analyzed using the Kruskal-Wallis test.
RESULTS: For five of the plantar pedal sites tested, temperatures in the diabetic foot were significantly greater than those for the normal controls (p&lt;0.05). At most sites, temperatures in the diabetic foot population tended to be higher than those in both diabetic and non-diabetic neuropathic feet, with the differences between the diabetic foot and non-diabetic neuropathic foot being statistically significant at one dorsal and five plantar sites. Patients in the non-diabetic neuropathic group were not stratified according to their specific neuropathic types.
CONCLUSIONS: Diabetic feet, with and without neuropathy, tend to be warmer than the feet of patients with other non-diabetic neuropathies. The finding of no statistical difference between non-neuropathic diabetic and neuropathic diabetic feet is unexpected in that a number of these patients were projected to have an autonomic system component. These null findings suggest the need to further investigate neuropathy solely determined by sensory testing versus tests for autonomic system involvement.
The Rare Lesser Metatarsal Bipartite Sesamoid – A Case Report and Literature Review
Authors: Hood Christopher R. , Eldridge Stephanie , Tran Matthew , Miller Jason R. 
Published: September 2016

INTRODUCTION AND OBJECTIVES: There are several various accessory ossicles and sesamoid bones that can be seen throughout the foot and ankle, with reported incidence of 21.2% and 9.6%, respectively. Accessory ossicles and sesamoid bones usually remain asymptomatic until an inciting event (trauma, overuse) occurs and can then cause pain or degenerative changes. They can also be found in routine imaging. One of these confusing findings are lesser metatarsal sesamoids, which are a rare occurrence. Here radiographically we demonstrate the first such case of a fifth metatarsal bipartite sesamoid.
METHODS: A 31-year old female presented to the senior authors office for evaluation of the right foot after a motor vehicle accident (MVA). She was told she sustained a foot fracture at an outside emergency department. Her case was reviewed for presentation.
RESULTS: Physical exam did not elicit any pain to the forefoot as all symptoms were in the patients ankle. The initial radiograph was reviewed which revealed a bipartite sesamoid of the fifth metatarsal. No pedal fractures to the foot or ankle were appreciatd. MRI was ordered and confirmed this diagnosis with no active pathology to the forefoot.
CONCLUSIONS: number one at 7.6% and foot and ankle at 51.4%, respectively. One study found that initial emergency room diagnosis and final foot and ankle outpatient clinic diagnosis did not match in 21.4% of patients evaluated. Lesser metatarsal sesamoids are more common in the 2nd and 5th metatarsal and overall range between 0.2–15%. However, no literature to the authors knowledge exists demonstrating a bipartite lesser sesamoid, and more specifically to 5th metatarsal.
The Advantages of Dermoscopy in the Diagnosis of Acral Melanoma from Other Podiatric Lesions: A Literature Review
Authors: Patel Mansi , Boo HyunJi , Kandasamy Suganthi , Patel Dhagash , Iorio Anthony 
Published: September 2016

INTRODUCTION AND OBJECTIVES: Melanoma is one of the most common primary malignant tumors arising in the lower extremity. It is crucial to diagnose melanoma as quickly and as efficiently as possible for a better prognosis. The use of dermoscopy is helpful in diagnosing such conditions. Dermoscopy is a non-invasive, in-vivo technique primarily used in the examination of pigmented skin lesions. This procedure allows the visualization of subsurface skin structures in the epidermis, dermoepidermal junction, and upper dermis - structures not visible to the naked eye. This poster presents the advantages of dermoscopy in the field of podiatry by assessing the dermoscopic criteria with positive predictive values for distinguishing acral melanoma from acral nevus. Additionally it analyzes cases of melanomas misdiagnosed as a plantar-pigmented wart and a diabetic ulcer.
METHODS: The authors used PubMed to perform an English language literature search. The exclusion criteria included articles older than 10 years. Inclusion criteria consisted of research done on humans and the terms dermoscopy and foot lesions or melanoma. After retrieving a total of 140 articles, 14 articles were found to meet both the inclusion and exclusion criteria.
RESULTS: Qualitative analysis of relevant articles demonstrates that the detection of malignant dermoscopic patterns enhances quick and correct diagnosis.
CONCLUSIONS: The use of dermoscopy is slowly evolving in podiatry. It aims to minimize the amount of biopsies taken, thereby decreasing the risk of creating an ulcer and reducing the patients exposure to anesthesia. While controversy remains over sensitivity and specificity of using a dermatoscope alone to diagnose pedal lesions, particular attention should be paid to the accuracy of diagnosing a lesion when dermoscopy is used in conjunction with a biopsy. With the continued usage of a dermatoscope along with experience and expertise in the field, the need for a biopsy could eventually be eliminated.
Type IV Cell-Mediated Hypersensitivity Reaction Caused by Titanium Implant Following Medial Displacement Calcaneal Osteotomy and First Metatarsal-Cuneiform Arthrodesis
Authors: Kriger Stephen J. , Behan Shontal A. , Bhakta Parth J. , Bruning Nicholas G. , Menninger Brennan A. , Razzante Mark C. 
Published: September 2016

INTRODUCTION AND OBJECTIVES: Due to its inert character and desired biocompatibility, titanium (Ti) implants have been universally accepted as safer alternatives to the previous conventional orthopedic hardware implants. However, a recent emergence of Type IV hypersensitivity reactions to Ti have displayed symptoms that include eczema, contact dermatitis, prolonged fever, sterile osteomyelitis, and impaired fracture and wound healing. The following case presents a patient with postoperative incision dehiscence and devascularization of cortical surfaces in contact with Ti hardware after undergoing a medial displacement calcaneal osteotomy and a first metatarsal-cuneiform arthrodesis. To our knowledge, this is the only reported case of an allergic reaction to a Ti implant in the foot or ankle in the United States.
METHODS: Diagnostic tools to confirm a Ti hypersensitivity reaction include a patch test and lymphocyte transformation test. The lymphocyte transformation test can be utilized if a false negative patch test is suspected. Potential treatment options include immunosuppressants, removal or substitution of the Ti hardware, and external fixation.
RESULTS: In this case, the patient's allergy to Ti was confirmed with a patch test, and all hardware was subsequently removed with no other complications.
CONCLUSIONS: A hypersensitivity reaction to Ti should remain a differential diagnosis for a patient presenting with symptoms such as prolonged fever, contact dermatitis, sterile osteomyelitis, and impaired wound healing. Preoperative diagnostic tools, such as the patch test, can be utilized to prevent allergic reactions from occurring. Treatments for Ti hypersensitivity should be tailored to fit the patient's needs and can include removal or substitution of the Ti hardware, external fixation, and immunosuppressants.
Corynebacterium Striatum: A Concerning Pathogen of Osteomyelitis in the Diabetic Patient
Authors: Patel Sneha A. , Iacovella Jackeline , Cornell Rhonda S. 
Published: September 2016

INTRODUCTION AND OBJECTIVES: Corynebacterium striatum (C. striatum) is known to colonize the skin and mucous membranes of most normal human hosts. While it is frequently isolated in clinical laboratories, the clinical significance of C. striatum is often unknown with respect to diabetic foot infections with osteomyelitis. There have been very few studies published on this topic, and even fewer that report on treatment courses. To our knowledge, there has been no study published reporting diabetic foot osteomyelitis with isolation of C. striatum from bone culture.
METHODS: Four patients were known to have been treated at our facility for C. striatum diabetic foot osteomyelitis. The medical records for each patient were thoroughly reviewed with close attention directed towards the past medical history, wound duration, wound and bone cultures, antimicrobial therapy and clinical outcomes.
RESULTS: Bone cultures of all 4 patients were notable for C. striatum. Diphtheroids were also noted on wound cultures for 3 patients which were not speciated. All bone cultures were obtained during surgical treatment of the diabetic foot infection. All patients were type II diabetics but varied with respect to age and gender. All patients were treated with an extended course of antibiotics and/or surgical resection of osteomyelitis. Patients were followed until complete wound closure.
CONCLUSIONS: We report four cases of diabetic foot osteomyelitis in which C. striatum was noted and treated as a pathogen. Diphtheroids are often overlooked as a potential pathogen in diabetic foot infections and rarely treated as such. However, our findings suggest that clinicians should consider C. striatum as a possible cause of osteomyelitis, especially when patients fail to completely heal wounds in a timely manner that have previously and repeatedly displayed Diphtheroids from cultures.
What is the Standard of Treatment for Plantar Psoriasis?
Authors: Birdwell Thomas B. , Hoque Sadiah M. , Kennedy Mara C. , Sim Jane H. , Vlahovic Tracey C. 
Published: September 2016

INTRODUCTION AND OBJECTIVES: Psoriasis is a systemic condition with several dermatological manifestations that affect many individuals on a daily basis. According to Langley et al in a study titled “Psoriasis: epidemiology, clinical features, and quality of life,” psoriasis affects 2% of the American population, which is approximately 6 million people. Out of these 6 million people, approximately 2–3% are affected by palmoplantar psoriasis (Farber et al). Plantar psoriasis in particular can cause significant functional and social disabilities. To date there is paucity of information regarding the standard of treatment for plantar psoriasis. We will attempt to compile and summarize the research that will help doctors treat patients with plantar psoriasis using evidence-based medicine.
METHODS: A thorough review of the literature that has been published regarding the care of plantar psoriasis will be investigated and summarized. In this effort, we aim to create a resource to aid the physician in designing a treatment plan for the patient that will be most effective with the highest rate of successful skin clearance.
RESULTS: Although many studies have been done about psoriasis and its many forms, not much has been published focusing on plantar psoriasis. There lacks one concise source in regards to which treatment is most efficacious. We predict that through a thorough literature review an effective treatment protocol can be developed for plantar psoriasis.
CONCLUSIONS: The intent of this study is to perform a literature review on various treatment modalities to develop a protocol to medically manage plantar psoriasis.
Student perceptions of osteopathic manipulative treatment after completing a manipulative medicine rotation
Authors: Gamber RG , Gish EE , Herron KM 
Published: September 2016

Abstract
Recent studies have demonstrated a decline in the use of osteopathic manipulative treatment (OMT) by osteopathic physicians, reflecting a trend that may begin in medical school. The authors used a questionnaire to examine the teaching and use of OMT in five rotations and the perceptions of 86 graduating osteopathic medical students of their experiences following their core manipulative medicine rotation. Most students indicated that they applied osteopathic principles sometimes (39.5%) or often (29.1%) during rotations. Forty-three percent of students rated their ability to apply osteopathic principles as average. The number of students who indicated that they rarely used OMT during their rotations was 31 (36.0%) for internal medicine, 21 (24.4%) for surgery, 23 (26.7%) for pediatrics, and 24 (27.9%) for obstetrics/gynecology. When asked why OMT was not used during a rotation, 47.2% of respondents cited time constraints, and 21.7% stated that their attending physicians discouraged the use of OMT. These results demonstrate a distinction between students' perceived level of osteopathic principles and skills and their application during clinical rotations.
Orientation control of barium titanate films using metal oxide nanosheet layer
Authors: Uchida Hiroshi , Oi Tomotake , Noguchi Keito , Moki Shota , Kim Jin Woon , Shima Hiromi , Nishida Ken , Kiguchi Takanori , Akama Akihiko , Konno Toyohiko J. , Funakubo Hiroshi 
Published: September 2016

Abstract
In the present work, we aim to achieve the preferred crystal orientation of chemical solution deposition (CSD)-derived BaTiO3 films on ubiquitous Si wafers with the assistance of Ca2Nb3O10 nanosheet (ns-CN) template layers. The ns-CN on platinized Si (Pt/Si) substrates aligned the BaTiO3(100) plane to the substrate surface, because of the favorable lattice matching of the ns-CN (001) plane. The CSD process in air required a high crystallization temperature of 900 °C for the preferred crystal orientation of BaTiO3(100) because of the BaCO3 byproduct generated during the combustion reaction of the precursor gel. The processing in vacuum to remove CO2 species enhanced the crystal orientation even at the crystallization temperature of 800 °C, although it can generate oxygen vacancies (

) that cause distorted polarization behavior under an applied field higher than approximately 150 kV/cm. The relative dielectric constant (εr) of the (100)-oriented BaTiO3 film on the ns-CN-supported Pt/Si substrate (ns-CN/Pt/Si) was generally larger than that of the randomly oriented film on Pt/Si, depending on the degree of crystal orientation.
Short-term MRI measurements as predictors of EDSS progression in relapsing-remitting multiple sclerosis: grey matter atrophy but not lesions are predictive in a real-life setting
Authors: von Gumberz Johanna , Mahmoudi Mina , Young Kim , Schippling Sven , Martin Roland , Heesen Christoph , Siemonsen Susanne , Stellmann Jan-Patrick 
Published: September 2016

BackgroundMagnetic resonance imaging (MRI) is the best biomarker of inflammatory disease activity in relapsing remitting Multiple Sclerosis (RRMS) so far but the association with disability is weak. Appearance of new MRI-lesions is used to evaluate response to immunotherapies in individual patients as well as being the most common primary outcome in phase-2 trials. Measurements of brain atrophy show promising outcomes in natural cohort studies and some phase-2 trials. From a theoretical perspective they might represent irreversible neurodegeneration and be more closely associated with disability. However, these atrophy measurements are not yet established as prognostic factors in real-life clinical routine. High field MRI has improved image quality and resolution and new methods to measure atrophy dynamics have become available.ObjectiveTo investigate the predictive value of MRI classification criteria in to high/low atrophy and inflammation groups, and to explore predictive capacity of two consecutive routine MRI scans for disability progression in RRMS in a real-life prospective cohort.Methods82 RRMS-patients (40 untreated, 42 treated with immunotherapies, mean age 40 years, median Expanded Disability Status Scale (EDSS) of 2, underwent two clinically indicated MRI scans (3 Tesla) within 5–14 months, and EDSS assessment after a mean of 3.0 (1.5–4.2) years. We investigated the predictive value of predefined classifications in low/high inflammatory and atrophy groups for EDSS progression (≥1.5 if baseline EDSS = 0, ≥1.0 if baseline EDSS <5, ≥0.5 for other) by chi-square tests and by analysis of variance (ANOVA). The classifications were based on current scientific or clinical recommendation (e.g., treatment response criteria). Brain atrophy was assessed with three different methods (SIENA, SIENAX, and FreeSurfer). Post-hoc analyses aimed to explore clinical data and dynamics of MRI outcomes as predictors in multivariate linear and logit models.ResultsProgression was observed in 24% of patients and was independent from treatment status. None of the predefined classifications were predictive for progression. Explorative post-hoc analyses found lower baseline EDSS and higher grey matter atrophy (FreeSurfer) as best predictors (R2= 0.29) for EDSS progression and the accuracy was overall good (Area under the curve = 0.81).ConclusionBeside EDSS at baseline, short-term grey matter atrophy is predictive for EDSS progression in treated and untreated RRMS. The development of atrophy measurements for individual risk counselling and evaluation of treatment response seems possible, but needs further validation in larger cohorts. MRI-atrophy estimates from the FreeSurfer toolbox seem to be more reliable than older methods.
Costs of Transfer From Nontrauma to Trauma Centers Among Patients With Minor Injuries
Authors: Tillmann Bourke W. , Nathens Avery B. , Guttman Matthew P. , Pequeno Priscila , Scales Damon C. , Pechlivanoglou Petros , Haas Barbara 
Published: September 2024

ImportanceNearly half the patients transferred from nontrauma centers to trauma centers have minor injuries, yet trauma center care is not associated with a difference in morality among patients with minor injuries. Consequently, reducing the frequency of such transfers has been postulated as a method to improve resource allocation. Currently, the economic implications of these transfers are not well understood.ObjectiveTo estimate health care costs associated with the transfer of patients with minor injuries from nontrauma to trauma centers.Design, Setting, and ParticipantsThis retrospective, population-based cohort study was conducted from April 1, 2009, to March 31, 2020, in Ontario, Canada. Participants included individuals aged 16 years or older who were transferred to a trauma center after presenting to a nontrauma center with a minor injury (survival &amp;gt;24 hours, Injury Severity Score [ISS] &amp;lt;16, and absence of an American College of Surgeons–defined critical injury). Statistical analysis was conducted from March 2022 to June 2024.Main Outcomes and MeasuresThe main outcome was total health care costs within 30 days of injury, standardized to 2015 Canadian dollars (CAD$). Propensity scoring was used to match transferred patients with controls admitted to nontrauma centers. Negative binomial models were used to estimate differences in costs between transferred patients and matched controls.ResultsOf the 14 557 patients with minor injuries transferred to a trauma center (mean [SD] age, 48.1 [20.9] years; 5367 female patients [36.9%]; median ISS, 4 [IQR, 2-5]), 12 652 (86.9%) were matched with a control. Thirty days after injury, mean health care costs among transferred patients were CAD$13 540 (95% CI, CAD$13 319-CAD$13 765), a 6.5% (95% CI, 4.4%-8.5%) increase relative to controls (CAD$12 719 [95% CI, CAD$12 582-CAD$12 857]). Half the transferred patients (54.9% [7994 of 14 557]) were admitted, while the remainder were discharged after evaluation in the trauma center emergency department. Among patients admitted to a trauma center, mean 30-day costs were CAD$19 602 (95% CI, CAD$19 294-CAD$19 915), a 54.6% (95% CI, 51.5%-57.8%) increase relative to controls.Conclusions and RelevanceThis cohort study of patients with minor injuries transferred from nontrauma centers to trauma centers found that the transfer of these patients was associated with increased costs to the health care system. Given the high prevalence of such transfers, these findings suggest that the development of systems to support the care of patients with minor injuries at their local hospitals is essential to the sustainability of trauma systems.