bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and Facilitators of Utilizing Research Among Nurses in Nepal
Authors: KC Srijana , Subramaniam Prithwi Raj , Paudel Sarita 
Published: April 2016

Background:
This study determined the perceived barriers to and facilitators of Nepalese nurses in utilizing research in the workplace. Evidence-based nursing practice provides the synergy for high-quality patient care, but it does not seem to be the case in underdeveloped countries, such as Nepal.

Method:
A descriptive, cross-sectional study involving 97 nurses from Nepal was conducted. Data were collected using the BARRIERS Scale and a facilitator questionnaire.

Results:
The top three barriers to research utilization in Nepalese nurses are (a) research reports and articles are not readily available (80.5%), (b) inadequate facilities for implementation (75.3%), and (c) research reports and articles are not published fast enough (71.6%). The top three facilitators perceived to encourage Nepalese nurses to utilize or participate in research are (a) initiation of nursing research projects (27.4%), (b) educational update on research methods (16.7%), and (c) provision of funding for research (15.5%).

Conclusion:
Findings from this study mirror the barriers to research utilization experienced by nurses in other countries. Macro- and micro-level support are needed to foster a culture of evidence-based practice among Nepalese nurses to empower them in making informed decisions based on research in providing quality patient care.

J Contin Educ Nurs.
2016;47(4):171–179.
The Relationship Between the California Critical Thinking Disposition Inventory and Student Learning Outcomes in Baccalaureate Nursing Students
Authors: Searing Lisabeth Meade , Kooken Wendy Carter 
Published: April 2016

Background:
Critical thinking is the foundation for nurses' decision making. One school of nursing used the California Critical Thinking Disposition Inventory (CCTDI) to document improvement in critical thinking dispositions.

Method:
A retrospective study of 96 nursing students' records examined the relationships between the CCTDI and learning outcomes. Correlational statistics assessed relationships between CCTDI scores and cumulative grade point averages (GPA) and scores on two Health Education Systems Incorporated (HESI) examinations. Ordinal regression assessed predictive relationships between CCTDI scores and science course grades and NCLEX-RN success.

Results:
First-year CCTDI scores did not predict first-year science grades. Senior-year CCTDI scores did not correlate with cumulative GPA or HESI RN Exit Exam scores, but were weakly correlated with HESI Pharmacology Exam scores. CCTDI scores did not predict NCLEX-RN success.

Conclusion:

This study did not identify meaningful relationships between critical thinking dispositions, as measured by the CCTDI, and important learning outcomes. The results do not support the efficacy of using the CCTDI in nursing education. [
J Nurs Educ.
2016;55(4):224–226.]
If You Teach It, They Will Screen: Advanced Practice Nursing Students' Use of Screening and Brief Intervention in the Clinical Setting
Authors: Agley Jon , McNelis Angela M. , Carlson Joan M. , Schwindt Rhonda , Clark Carol A. , Kent Kathleen A. , Lay Kathy , Gassman Ruth A. , Crabb David W. 
Published: April 2016

Background:
In the United States, approximately 30% of adults drink at risky levels or meet the criteria for harmful or dependent alcohol use. Screening, brief intervention, and referral to treatment (SBIRT) in primary care settings is indicated. This study assessed whether knowledge, attitudes, and beliefs about SBIRT, evaluated after a three-part, mixed-methods training, predicted whether 21 family nurse practitioner (FNP) students screened for alcohol use during clinical patient encounters.

Method:
After training, students completed a survey and documented implementation of SBIRT during their clinical practice-specific management courses.

Results:
FNP students who reported higher levels of perceived competence in their posttraining surveys were more likely to screen for alcohol in the clinical setting.

Conclusion:

Screening for alcohol misuse and identifying patients engaged in hazardous drinking meet important nurse practitioner competencies. Further research is needed to explore training programs that specifically emphasize activities to increase perceived competence, knowledge, and comfort regarding SBIRT. [
J Nurs Educ
. 2016;55(4):231–235.]
Graded Marginal Recession: A Surgical Technique to Correct Small Angle Vertical Deviations
Authors: Brooks Steven E. , Habib Larissa 
Published: April 2016

Purpose:
To describe a novel muscle recession technique to surgically correct small angle vertical deviations in symptomatic adults with fusion potential.

Methods:
A novel technique involving a graded recession of the medial and lateral poles of a vertical rectus muscle, combined with graded medial and lateral tenotomy of the muscle, was used to treat small vertical deviations. A surgical nomogram was developed based on the configuration of the procedure and its predicted effects. Four patients with small angle hypertropia ranging from 1 to 5 prism diopters (PD) underwent the graded marginal recession procedure and were observed for up to 3 years.

Results:
Three of the four patients had successful correction of their strabismus and resolution of diplopia, with no complications or induced incomitance. One patient was initially orthotropic but showed a 2 PD regression 1 month postoperatively, eventually requiring additional surgery to achieve stable orthotropia.

Conclusions:
The graded marginal recession can be safely and effectively used to correct very small vertical deviations in adults with fusion potential. A surgical nomogram can be created to guide predicted corrections in increments of less than 0.5 PD.

[
J Pediatr Ophthalmol Strabismus
. 2016;53(2):85–89.]
Cytopathological Evaluation of Ocular Surface and Needle Washings Following Intravitreal Melphalan Injections for Retinoblastoma
Authors: Francis Jasmine H. , Mondesire-Crump Ijah , Marr Brian P. , Brodie Scott E. , Abramson David H. 
Published: April 2016

Purpose:There is concern that injections into eyes with retinoblastoma are dangerous and allow tumor escapement. This study attempted to determine this risk by investigating the presence of malignant cells in ocular surface and needle washings of eyes with retinoblastoma receiving intravitreal injections.Methods:Two hundred ocular surface and 202 needle washings were obtained from 280 injections into eyes with retinoblastoma. Each specimen underwent cytopathlogical assessment for the presence of malignant cells.Results:Cytopathological results revealed no malignant cells in all 200 ocular surface and 202 needle washing specimens. In the ocular surface washings, squamous cells, red blood cells, and inflammatory cells were found in 15, 2, and 2 specimens, respectively. In the needle washings, 4 specimens contained squamous cells but no red blood cells or inflammatory cells were found in any specimen.Conclusion:With this injection and evaluation technique, no malignant cells were recovered, highlighting the low risk of the procedure.[J Pediatr Opthalmol Strabismus. 2016;53(2):96–98.]
Repeatability of Keratometry Measurements Obtained With Three Topographers in Keratoconic and Normal Corneas
Authors: Guilbert Emmanuel , Saad Alain , Elluard Maud , Grise-Dulac Alice , Rouger Hélène , Gatinel Damien 
Published: April 2016

PURPOSE:
To assess the repeatability of the corneal topography functions of Orbscan II (Bausch & Lomb, Rochester, NY), OPD-Scan III (Nidek, Gamagori, Japan), and iTrace (Tracey Technologies, Houston, TX) in keratoconic eyes and in a control group of normal patients.

METHODS:
In this prospective cohort study, patients were recruited between November 2011 and May 2012. Measurements were performed with a combined Placido-scanning slit system (Orbscan II) and two combined Placido-aberrometer systems (OPD-Scan III and iTrace). Repeatability limit and intraclass correlation coefficients (ICCs) of keratometric readings were calculated.

RESULTS:
Fifty-nine keratoconic eyes of 34 patients and 54 normal eyes of 27 patients were included. Three groups were evaluated: all stage I–IV keratoconic eyes (59 eyes), a subgroup consisting of stage I–II keratoconic eyes (41 eyes), and normal eyes (54 eyes). For almost all parameters studied, the repeatability limit was higher in the two groups of keratoconic eyes compared to normal eyes with all three topographers, indicating lower repeatability. For the maximum keratometry measurement, repeatability limit was 1.73, 1.49, and 1.41 diopters (D) in the stage I–IV keratoconic eyes group, 1.11, 1.02, and 0.98 D in the stage I–II keratoconic eyes group, and 0.61, 0.37, and 1.02 D in the normal eyes group with Orbscan II, OPD-Scan III, and iTrace, respectively.

CONCLUSIONS:
Topographies performed in keratoconic eyes are less repeatable than those performed in normal eyes. Threshold values of keratometric changes used to ascertain keratoconus progression should be carefully considered. Caution should be taken when interpreting the topographies of such patients. The higher variability should be taken into account before performing any treatment.

[
J Refract Surg.
2016;32(3):187–192.]
Prospective Clinical Comparison of Patient Outcomes Following Implantation of Trifocal or Bifocal Intraocular Lenses
Authors: Cochener Béatrice 
Published: April 2016

PURPOSE:
To compare the visual results and patient satisfaction after bilateral implantation between a bifocal and a trifocal intraocular lens (IOL).

METHODS:

This study is a prospective, randomized, controlled study involving bilateral implantation of one of two multifocal IOLs. Patients were assessed for uncorrected and distance-corrected near (33 cm), intermediate (66 cm), and distance visual acuity. Distance contrast sensitivity under photopic (85 cd/m
2
) conditions with and without glare was also measured. Using a subjective questionnaire, patient satisfaction, spectacle independence, and the perception of glare and halo phenomena were evaluated at the final follow-up; a defocus curve analysis was conducted.

RESULTS:

Fifteen patients (30 eyes) were implanted with the FineVision IOL (PhysIOL, Liége, Belgium) and 12 patients (24 eyes) received the Tecnis ZMB00 IOL (Abbott Medical Optics, Santa Ana, CA). The average follow-up was 6 months. The mean binocular uncorrected visual acuity was 0.02 ± 0.04 logMAR in the FineVision group and 0.04 ± 0.05 logMAR in the Tecnis group and the mean binocular uncorrected near visual acuity was 0.01 ± 0.00 logMAR in both groups. In the intermediate range of the defocus curve, there was a statistically significant difference between the two IOLs (
P
< .05). Contrast sensitivity was within normal limits under photopic conditions in both groups.

CONCLUSIONS:
Both the Tecnis and FineVision IOLs provide a satisfactory range of vision, including a high level of uncorrected distance, intermediate, and near acuity and improved contrast sensitivity under photopic conditions.

[
J Refract Surg.
2016;32(3):146–151.]
Analysis of the Optical Quality of Spherical and Aspheric Intraocular Lenses in Simulated Nanophthalmic Eyes
Authors: Trindade Bruno Lovaglio Cançado , Amaral Felipe Tayer , de Lima Monteiro Davies William 
Published: April 2016

PURPOSE:
To analyze the optical performance of different implant strategies in simulated nanophthalmic eyes.

METHODS:
An optical design software was used. Analysis included eye models that required 30.00, 45.00, and 60.00 diopters (D) intraocular lenses (IOLs) to achieve emmetropia. Spherical and aspheric IOLs were designed. They were tested either with a single implant setting S or by splitting the power into two lenses. Setting P1 had an even split of the power between the lenses and setting P2 had an uneven power split with one-third of the power in the anterior lens and two-thirds in the posterior IOL. The area under the modulation transfer function (MTF) curve was calculated and spherical aberration was recorded in each setting.

RESULTS:
Setting S had the worst optical performance in the spherical group and the best performance in the aspheric group. A statistically significant difference was found between setting S and the piggyback options (settings P1 and P2) in all analyzed variables for the spherical and aspheric groups for the 45.00 and 60.00 D IOL requirement. No statistically significant difference was found between the piggyback settings.

CONCLUSIONS:
Single aspheric IOLs had better optical performance than piggybacking lower-power aspheric IOLs. In the spherical lenses group, the results were the opposite, with the piggyback options having higher optical quality than the single IOL. MTF shows that single aspheric lenses provide the highest contrast sensitivity among all of the analyzed settings.

[
J Refract Surg.
2016;32(3):193–200.]
Predictors of Macular Atrophy Detected by Fundus Autofluorescence in Patients With Neovascular Age-Related Macular Degeneration After Long-Term Ranibizumab Treatment
Authors: Kuehlewein Laura , Dustin Laurie , Sagong Min , Hariri Amirhossein , Mendes Thais S. , Rofagha Soraya , Bhisitkul Robert B. , Sadda SriniVas R. 
Published: April 2016

BACKGROUND AND OBJECTIVE:
To study the relationship between baseline morphologic characteristics of the choroidal neovascular (CNV) lesion and long-term development of macular atrophy in eyes with neovascular age-related macular degeneration (AMD) treated with ranibizumab (Lucentis; Genentech, South San Francisco, CA).

PATIENTS AND METHODS:
Certified graders evaluated baseline and 7-year follow-up (SEVEN-UP study) images of 41 eyes from the MARINA/ANCHOR and HORIZON trials. Using GRADOR software and stepwise linear regression, graders correlated lesion characteristics on fluorescein angiography (FA) at both visits with areas of definite decreased autofluorescence (DDAF) on fundus autofluorescence (FAF) imaging at the SEVEN-UP visit.

RESULTS:

Three of 41 eyes (7.3%) had macular atrophy on FA at baseline (mean ± standard deviation [SD] size: 0.29 mm
2
± 1.50 mm
2
), 29 (70.7%) at SEVEN-UP (mean ± standard deviation [SD] area: 7.42 mm
2
± 7.97 mm
2
). On FAF imaging at the SEVEN-UP visit, all 41 eyes (100%) had DDAF (mean ± SD size: 10.29 mm
2
± 8.07 mm
2
). Variables significantly associated with area of DDAF at the SEVEN-UP visit were the area of leaking CNV lesion components (coefficient: 0.953;
P
< .001), the area of other lesion components (coefficient: 1.094;
P
= .038), and the area of retinal pigment epithelial (RPE) atrophy (coefficient: 1.334;
P
= .040) on baseline FA imaging.

CONCLUSION:
The area of DDAF at more than 7 years after initiation of ranibizumab therapy was 35% larger than the original CNV lesion. The baseline area of leaking CNV and other components of the CNV lesion and the baseline area of RPE atrophy were important predictors of the area of definite decreased autofluorescence, presumably corresponding to areas of photoreceptor and RPE loss. The findings from this study may guide hypothesis generation for future AMD trials.

[
Ophthalmic Surg Lasers Imaging Retina
. 2016;47:224–231.]
Diabetic Macular Edema Diagnosis and Treatment in the Real World: An Analysis of Medicare Claims Data (2008 to 2010)
Authors: Dugel Pravin U. , Layton Andrew , Varma Rohit 
Published: April 2016

BACKGROUND AND OBJECTIVE:
To characterize vascular endothelial growth factor (VEGF) inhibitor treatment patterns in patients with diabetic macular edema (DME) using a Medicare Standard Analytic Files Part B or Outpatient Claims database to understand treatment frequency and DME persistence.

PATIENTS AND METHODS:
A retrospective analysis of treatment patterns for patients diagnosed with DME receiving their first anti-VEGF injection was performed.

RESULTS:
The average number of anti-VEGF injection claims for DME per patient rose from 3.1 to 4.6 per year (mean: 4.2). Within 1 year of diagnosis, 46% of patients received their final DME diagnosis (mean: 1.9 anti-VEGF claims), and 65% of patients received their final anti-VEGF treatment for DME. Patients who received treatment for DME through years 2 and 3 submitted a mean of four and 7.2 anti-VEGF claims, respectively.

CONCLUSION:
VEGF inhibitor treatment was less frequent than in landmark trials, but did resolve DME in a proportion of patients.

[
Ophthalmic Surg Lasers Imaging Retina.
2016;47:258–267.]
En Face Spectral-Domain Optical Coherence Tomography Imaging of Outer Retinal Hard Exudates in Diabetic Macular Edema Based on Optical Coherence Tomography Patterns
Authors: Kim Yonguk , Yu Seung-Young , Kwak Hyung Woo 
Published: April 2016

BACKGROUND AND OBJECTIVE:
To evaluate en face spectral-domain optical coherence tomography (SD-OCT) findings of the outer retinal hard exudates in diabetic macular edema (DME).

PATIENTS AND METHODS:
Exploratory analyses of prospective and consecutive case series. Fifty-five eyes treated with intravitreal ranibizumab (IVR) (Lucentis; Genentech, South San Francisco, CA) for 12 months were classified according to OCT features of DME: diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD). Area fraction of outer nuclear layer (ONL) hard exudates (HEs) was assessed from en face OCT images.

RESULTS:

Area fraction of ONL HEs increased from 1.45% ± 1.22% to 2.24% ± 1.31% in DRT and from 2.24% ± 1.85% to 3.25% ± 1.52% in CME. HE gain was greatest during first 3 months (DRT = 0.83%; CME = 1.25%). SRD showed no difference in HEs (
P
= .462).

CONCLUSIONS:
ONL HEs increased in DRT and CME at month 12 following IVR. Rapid gain of HEs was found during the initial loading phase of IVR.

[
Ophthalmic Surg Lasers Imaging Retina
. 2016;47:313–321.]
OCT Angiography Findings in Acute Central Serous Chorioretinopathy
Authors: Feucht Nikolaus , Maier Matthias , Lohmann Chris P. , Reznicek Lukas 
Published: April 2016

BACKGROUND AND OBJECTIVE:
To describe optical coherence tomography angiography (OCTA) findings in patients with acute central serous chorioretinopathy (CSC) compared to conventional imaging methods.

PATIENTS AND METHODS:
A consecutive series of 11 eyes from 10 healthy patients with acute CSC were included and underwent fluorescein angiography (FA), indocyanine green angiography (ICGA), OCT, fundus autofluorescence (FAF), and OCTA. Obtained OCTA images were evaluated for the presence of serous detachments of the neurosensory retina, leakage points, or other altered findings and compared to conventional imaging devices.

RESULTS:
In four out of 11 eyes, it was possible to detect detached retina adjacent to the leakage point in OCTA images, compared with four of 11 eyes using FA, five of 11 eyes using ICGA, 11 of 11 eyes using SD-OCT, and four of 11 eyes using FAF. In five out of 11 eyes, irregular flow patterns were observed on OCTA images through the choriocapillaris. OCTA images could not identify leakage points in any of the included eyes, compared with 11 out of 11 eyes on FA, five out of 11 eyes on ICGA, eight out of 11 eyes on SD-OCT, and zero out of 11 eyes on FAF.

CONCLUSION:
OCTA images of the superficial and deep retinal plexus, outer retina, and choriocapillaris did not reveal altered flow patterns directly associated with the leakage point in acute CSC. However, OCTA was able to visualize altered choroidal flow in some of the included eyes.

[
Ophthalmic Surg Lasers Imaging Retina
. 2016;47:322–327.]
Co-maximal Graphs of Subgroups of Groups
Authors: Akbari Saieed , Miraftab Babak , Nikandish Reza 
Published: April 2016

AbstractLet H be a group. The co-maximal graph of subgroups of H, denoted by Γ(H), is a graph whose vertices are non-trivial and proper subgroups of H and two distinct vertices L and K are adjacent in Γ(H) if and only ifH = LK. In this paper, we study the connectivity, diameter, clique number, and vertex chromatic number of Γ(H). For instance, we show that if Γ(H) has no isolated vertex, then Γ(H) is connectedwith diameter at most h. Also, we characterize all ûnite groupswhose co-maximal graphs are connected. Among other results, we show that if H is a ûnitely generated solvable group and Γ(H) is connected, and moreover, the degree of a maximal subgroup is finite, then (H) is finite. Furthermore, we show that the degree of each vertex in the co-maximal graph of a general linear group over an algebraically closed ûeld is zero or infinite.
Four Cases of Cervical Sympathetic Chain Schwannoma and Review of Literature
Authors: Ramachandran K , Divya GM , Nampoothiri P Muraleedharan , Kumar KP Sunil 
Published: April 2016

ABSTRACT
Schwannomas are benign, solitary and well-differentiated tumors originating from schwann cells. They may originate from any of the peripheral, cranial or autonomic nerves of the body with the exception of the olfactory and the optic nerves. This tumor most often presents as a slow growing asymptomatic solitary neck mass which rarely undergoes malignant transformation. Schwannomas arising from the cervicalsympathetic chain are very rare. Only < 65 cases have been reported in the literature to date. Computed tomography with contrast medium or magnetic resonance imaging is essential to the initial workup for cervical sympathetic chain schwannoma (CSCS). Surgical excision is the treatment of choice for this tumor. Only surgical observation of the lesion and the nerve from where it originates, and histologic examination of the specimen, can lead to a correct diagnosis. We report four cases of cervical sympathetic chain schwannomas presented in our department during last two and half years which were treated by surgical excision.

How to cite this article
Divya GM, Ramachandran K, Nampoothiri PM, Sunil Kumar KP. Four Cases of Cervical Sympathetic Chain Schwannoma and Review of Literature. Int J Head Neck Surg 2015;6(2):86-89.
A Case Study on Vacuolated Oocytes Intracytoplasmic Sperm Injection and its Outcome
Authors: Deene Vishnukanth , Mudaraddi Tulasigiriyappa Yashvant , Gaur Shivani S 
Published: April 2016

ABSTRACTThis is a case study showing effects of oocyte morphological abnormalities in the form of homogenous vacuoles on intracytoplasmic sperm injection (ICSI) outcomes and its implications. Characteristic vacuoles of different size were identified in all oocytes obtained after egg collection in this patient. Eighteen oocytes were retrieved, 15 were metaphase-II and three were metaphase-I. All the oocytes were injected with sperm; out of 18 oocytes, 12 oocytes had embryo quality of grade A and three were grade B. Fifteen embryos exhibited maturation on 24 to 36 hours of incubation and showed two to four-celled stages, and after 48 to 60 hours of incubation, the embryos showed six to eight-celled stage. Grade A quality of three embryos was transferred nearly in an ongoing singleton pregnancy was confirmedHow to cite this articleDeene V, Mudaraddi TY, Gaur SS. A Case Study on Vacuolated Oocytes Intracytoplasmic Sperm Injection and its Outcome. Int J Infertil Fetal Med 2016;7(1): 23-26.