bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Team Approach to Improving Tissue Management
Authors: Sions Jacqueline A. , Cheuvront Kimberly A. , Grove Georgiana L. , Beach Myra J. , Bowers Jay W. , Cendaña Cinthia R. , Hixson Jesse R. , Wilson Mary C. 
Published: March 2016

AbstractTissue implant management can be labor intensive because of multiple storage locations and cumbersome tracking systems. The purpose of this quality improvement (QI) project was to enhance patient safety and nursing satisfaction by upgrading our tissue‐management facility and processes. We created a centralized storage room for tissue implants and staffed this room during all shifts. Tissue management was executed using tracking software and transportation devices that supported tissue receipt, storage, disposition, documentation, and reporting. Our project resulted in our full compliance with tissue implant requirements from the US Food and Drug Administration (FDA) and The Joint Commission. We also reduced our documentation error rate from 3% to less than 1%, and decreased the tissue‐expiration rate by 1.1%. Tissues are now delivered to ORs, which allows RNs to focus on patient care rather than retrieval of implants. Monitoring of the tissue inventory has improved, resulting in the reduction of tissue wastage.
Absence seizure associated with coloprep consumption in colonoscopy
Authors: Chandrakumar Abin , Tharakan Pretty Geevarghese , Thomas Bittu , Albert Anu , Jacob Teena 
Published: March 2016

AbstractColoprep is a bowel preparatory solution given before endoscopic procedures to get a unobscured internal vision. It has among its constituents’ sodium sulphate, potassium sulphate and magnesium sulphate which produce an osmotic effect in the bowel. However, the use of such agents in hyponatremic and patients predisposed to seizures can have adverse ramifications. The current case outlines manifestation of absence seizure in a 52-year-old male patient who was administered Coloprep for colonoscopy. There was absence of other predisposing factors and the symptoms were ameliorated using timely identification and rectification of the underlying derangements.
Homophobia: An Impulsive Attraction to the Same Sex? Evidence From Eye-Tracking Data in a Picture-Viewing Task
Authors: Cheval Boris , Radel Remi , Grob Emmanuelle , Ghisletta Paolo , Bianchi-Demicheli Francesco , Chanal Julien 
Published: March 2016

ABSTRACTIntroductionSome models suggest that homophobia can be explained as a denied attraction toward same-sex individuals. While it has been found that homophobic men have same-sex attraction, these results are not consistent.AimThis study drew on the dual-process models to test the assumption that sexual interest in homosexual cues among men high in homophobia will depend on their specific impulses toward homosexual-related stimuli.MethodsHeterosexual men (N = 38) first completed a scale measuring their level of homonegativity. Then, they performed a manikin task to evaluate their impulsive approach tendencies toward homosexual stimuli (IAHS).Main outcomes measuresA picture-viewing task was performed with simultaneous eye-tracking recording to assess participants' viewing time of the visual area of interest (i.e., face and body).ResultsIAHS positively predicted the viewing time of homosexual photographs among men with a high score of homonegativity. Men with a high homonegativity score looked significantly longer at homosexual than at heterosexual photographs but only when they had a high IAHS.ConclusionThese findings confirm the importance of considering the variability in impulsive processes to understand why some (but not all) men high in homophobia have homosexual interest. These findings reinforce the theoretical basis for elaborating a dual-process model for behaviors in the sexual context.
Effects of Prone Position and Positive End-Expiratory Pressure on Noninvasive Estimators of ICP: A Pilot Study
Authors: Robba Chiara , Bragazzi Nicola Luigi , Bertuccio Alessandro , Cardim Danilo , Donnelly Joseph , Sekhon Mypinder , Lavinio Andrea , Duane Derek , Burnstein Rowan , Matta Basil , Bacigaluppi Susanna , Lattuada Marco , Czosnyka Marek 
Published: March 2016

Background:
Prone positioning and positive end-expiratory pressure can improve pulmonary gas exchange and respiratory mechanics. However, they may be associated with the development of intracranial hypertension. Intracranial pressure (ICP) can be noninvasively estimated from the sonographic measurement of the optic nerve sheath diameter (ONSD) and from the transcranial Doppler analysis of the pulsatility (ICPPI) and the diastolic component (ICPFVd) of the velocity waveform.

Methods:
The effect of the prone positioning and positive end-expiratory pressure on ONSD, ICPFVd, and ICPPI was assessed in a prospective study of 30 patients undergoing spine surgery. One-way repeated measures analysis of variance, fixed-effect multivariate regression models, and receiver operating characteristic analyses were used to analyze numerical data.

Results:
The mean values of ONSD, ICPFVd, and ICPPI significantly increased after change from supine to prone position. Receiver operating characteristic analyses demonstrated that, among the noninvasive methods, the mean ONSD measure had the greatest area under the curve signifying it is the most effective in distinguishing a hypothetical change in ICP between supine and prone positioning (0.86±0.034 [0.79 to 0.92]). A cutoff of 0.43 cm was found to be a best separator of ONSD value between supine and prone with a specificity of 75.0 and a sensitivity of 86.7.

Conclusions:
Noninvasive ICP estimation may be useful in patients at risk of developing intracranial hypertension who require prone positioning.
The 6-Hour Rule for Surgical Debridement of Open Tibial Fractures: A Systematic Review and Meta-Analysis of Infection and Nonunion Rates
Authors: Prodromidis Apostolos D. , Charalambous Charalambos P. 
Published: March 2016

Objectives:
The aim of this study was a systematic review and meta-analysis of studies comparing early (<6 hours) versus late (>6 hours) surgical debridement of open tibial fractures, with regards to infection and nonunion rates.

Methods:
A systematic literature search of MEDLINE, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature (1961 to present), Allied and Complementary Medicine, and COCHRANE databases was conducted using any combination of the key words: “open,” “tibial,” and “fractures.” After appropriate screening, 7 studies were included for analysis. Inclusion criteria were studies assessing the relation between time to debridement from injury and infection and/or nonunion rates.

Results:
Three studies (n = 365) evaluated overall infection rates that varied from 7.7% to 8.9% in the early group versus 1%–18.5% in the late group. Three studies (n = 197) evaluated deep infection rates that varied from 13% to 18.5% in the early group versus 7.1%–18.6% in the late group. Four studies (n = 245) evaluated nonunion rates that varied from 13.2% to 26.1% in the early group versus 0%–32.6% in the late group. Meta-analysis showed no statistical difference between groups with regards to overall infection rates (risk ratio = 1.32; 95% CI, 0.54–3.23; P = 0.55), deep infection rates (risk ratio = 0.99; 95% CI, 0.48–2.07; P = 0.98), and nonunion rates (risk ratio = 1.49; 95% CI, 0.64–3.49; P = 0.36).

Conclusions:
The available literature suggests that there is no obvious difference in the overall/deep infection and nonunion rates between open tibial fractures debrided within 6 hours and those debrided at more than 6 hours. The findings presented here would appear to indicate that judicious delays of greater than 6 hours may not result in a significantly increased risk of adverse events or peri-operative morbidity.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Efficacy of Local Administration of Tranexamic Acid for Blood Salvage in Patients Undergoing Intertrochanteric Fracture Surgery
Authors: Drakos Athanasios , Raoulis Vasilios , Karatzios Konstantinos , Doxariotis Nikolaos , Kontogeorgakos Vasilios , Malizos Konstantinos , Varitimidis Sokratis E. 
Published: March 2016

Objectives:
The primary aim of this study was to assess whether local administration of tranexamic acid (TXA) reduced the need for a blood transfusion in elderly patients treated with an intramedullary (IM) nail for an intertrochanteric fracture.

Design:
Randomized prospective trial.

Setting:
Academic level 1 trauma center.

Patients:
Two hundred patients (200 fractures) over 65 years with an intertrochanteric fracture treated by IM nail between April 1, 2012, and March 31, 2014.

Intervention:
Subfascial administration of 3 g of TXA around the fracture site at the end of the surgical procedure, versus a control group without TXA. Follow-up ranged from 12 to 24 months.

Main Outcome Measures:
Group differences in number of transfused packed red blood cell (PRBC) units, and hematocrit, hemoglobin, and platelet count.

Results:
There was a 43% reduction in transfusion requirements in the TXA group (P < 0.01). Twenty-seven units of PRBC were transfused in 22/100 patients in the TXA group, whereas 48 PRBC units were transfused in 29/100 patients in control group. There was no difference between the 2 groups in terms of late complications and overall mortality rate.

Conclusions:
Subfascial administration of TXA around the fracture site in elderly patients undergoing IM nailing for intertrochanteric fractures is safe and cost-effective. A significant reduction in blood loss and transfused blood units, and health care cost can be achieved.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Clinical Features and Prognostic Factors of Pediatric Spine Tumors
Authors: Song Dianwen , Meng Tong , Lin Zaijun , Fan Tianqi , Yin Huabin , Li Bo , Li Zhenxi , Xu Wei , Huang Quan , Zhou Lei , Li Song , Yang Xinghai , Wei Haifeng , Liu Tielong , Yan Wangjun , Zhou Wang , Xiao Jianru 
Published: March 2016

Study Design.
A retrospective study was performed.

Objective.
The aim of the study was to illustrate the characteristics of pediatric spine tumors (PSTs) and obtain better insight into therapeutic strategies of such kinds of tumors.

Summary of Background Data.
PSTs, a heterogeneous group of tumors occurred among pediatric group, are relatively uncommon and rarely reported in the literature.

Methods.
A retrospective study was performed to analyze clinical features and prognostic factors of patients with PSTs who were treated in our center between 2000 and 2013. Local relapse-free survival (LRFS) and overall survival (OS) rate were estimated using the Kaplan-Meier method to identify potential prognostic factors. Factors with P values of 0.1 or lower were subjected to multivariate analysis by Cox regression analysis. P values of 0.05 or lower were considered statistically significant.

Results.
A total of 190 patients with PSTs were included in the study. The mean follow-up period was 53.5 months. Of the 190 patients, 127 cases (66.8%) were diagnosed as benign lesions or tumor-like lesions, with 19 cases as aggressive lesions and 44 cases as malignant lesions. Recurrence was detected in 30 patients after initial surgery in our center, whereas death occurred in 24 cases. Implant failure and spinal deformity occurred in 3 and 5 patients, respectively. The statistical analysis suggested that multiple segments involvement (n ≥ 3), aggressive and malignant lesion were independent prognostic factors for LRFS, whereas malignant lesion was the only unfavorable factors for OS. In the subgroup analysis, multiple segments involvement (n ≥ 3) and Enneking stages III were independent factors for LRFS of patients with benign or aggressive lesions.

Conclusion.
Malignant lesion was significantly associated with decreased OS and LRFS of PSTs, whereas multiple segments involvement (n ≥ 3) and aggressive lesions were significantly associated with LRFS.

Level of Evidence: 4
Structural Equation Model of Disability in Low Back Pain
Authors: Melton Brittany L. , Moqbel Murad , Kanaan Saddam , Sharma Neena K. 
Published: March 2016

Study Design.
The effects of participant characteristics along with descriptions of pain and psychological involvement, such as fear avoidance, were assessed using structural equation modeling (SEM) to identify relationships between these factors and disability as a result of low back pain (LBP).

Objective.
The aim of this study was to evaluate the relationship between factors related to pain description, participants’ characteristics, psychological involvement, and disability through SEM.

Summary of Background Data.
LBP is a complex multifactorial condition that can lead to disability. Understanding which factors contribute to disability and how those factors interact is important for predicting and minimizing disability in patients with LBP.

Methods.
We analyzed data from 156 participants (63% female) with LBP. A stepwise SEM was built with patient characteristics, pain intensity, depression, anxiety, and fear avoidance to predict disability in LBP.

Results.
Participants were 23–84 years (49.7 ± 15.1 yrs) of age and experienced 0.03 to 300 months duration (25.5 ± 36.4 months) of current LBP. The final model explained 62% of the variance in disability and included female gender, full-time employment, depression, and fear avoidance beliefs as significant predictors. Full-time employment was the only significant predictor that reduced disability; all other significant predictors increased disability in the model.

Conclusion.
Understanding the relationship between these predictors and disability provides a foundation for predicting and managing disability for individual patients who suffer from LBP.

Level of Evidence: 3
Association Between Lumbar Spine Sagittal Alignment and L4-L5 Disc Degeneration Among Asymptomatic Young Adults
Authors: Menezes-Reis Rafael , Bonugli Gustavo Perazzoli , Dalto Vitor Faeda , da Silva Herrero Carlos Fernando Pereira , Defino Helton Luiz Aparecido , Nogueira-Barbosa Marcello Henrique 
Published: March 2016

Study Design.
Cross-sectional observational study on the relationship between the degrees of disc degeneration and sagittal alignment in asymptomatic healthy individuals.

Objective.
This study sought to determine whether the sagittal spine alignment subtype is related to the prevalence of lumbar disc degeneration.

Summary and Background Data.
Sagittal balance and spinopelvic parameters might be risk factors for disc degeneration.

Methods.
A total of 70 asymptomatic participants (36 women and 34 men) without regular physical activity were categorized according to the four subtypes of sagittal alignment proposed by Roussouly. All participants underwent magnetic resonance imaging of the lumbar spine (1.5T) and panoramic radiography of the spine. The degree of disc degeneration was graded using T2-weighted images according to the Pfirrmann classification. Spinopelvic parameters and vertebral curvatures were measured on digital panoramic radiographs using Surgimap software. Interobserver analyses for the Pfirrmann classification and spinopelvic parameters were assessed using the weighted Kappa and intraclass correlation coefficient (ICC), respectively.

Results.
The Kappa associated with disc degeneration classification was 0.79 (95% confidence intervals 0.72–0.87). The ICCs were excellent, with small confidence intervals for all spinopelvic parameters. The type II group (flat lordosis) showed a higher frequency of degenerated discs at L4-L5 (P = 0.03) than the type IV group (long and curved lumbar spine). No significant differences in disc degeneration were observed among the four subtypes at the other disc levels. We found a negative, moderate correlation between the spinopelvic parameters and the occurrence of disc degeneration in the type II group.

Conclusion.
The Roussouly subtype II sagittal alignment is significantly associated with disc degeneration at L4-L5 in asymptomatic young adults. Our results support the hypothesis that spinal sagittal alignment plays a role in early disc degeneration.

Level of Evidence: 3
Outcome Measurement in ICU Survivorship Research From 1970 to 2013: A Scoping Review of 425 Publications*
Authors: Turnbull Alison E. , Rabiee Anahita , Davis Wesley E. , Nasser Mohamed Farhan , Venna Venkat Reddy , Lolitha Rohini , Hopkins Ramona O. , Bienvenu O. Joseph , Robinson Karen A. , Needham Dale M. 
Published: March 2016

Objectives:
To evaluate the study designs and measurement instruments used to assess physical, cognitive, mental health, and quality of life outcomes of survivors of critical illness over more than 40 years old as a first step toward developing a core outcome set of measures for future trials to improve outcomes in ICU survivors.

Design:
Scoping review.

Setting:
Published articles that included greater than or equal to one postdischarge measure of a physical, cognitive, mental health, or quality of life outcome in more than or equal to 20 survivors of critical illness published between 1970 and 2013. Instruments were classified using the World Health Organization’s International Classification of Functioning, Disability, and Health framework.

Subjects:
ICU survivors.

Interventions:
None.

Measurements and Main Results:
We reviewed 15,464 abstracts, and identified 425 eligible articles, including 31 randomized trials (7%), 116 cross-sectional studies (27%), and 278 cohort studies (65%). Cohort studies had a median (interquartile range) sample size of 96 survivors (52–209), with 38% not fully reporting loss to follow-up. A total of 250 different measurement instruments were used in these 425 articles. Among eligible articles, 25 measured physical activity limitations (6%), 40 measured cognitive activity limitations (9%), 114 measured mental health impairment (27%), 196 measured participation restriction (46%), and 276 measured quality of life (65%).

Conclusions:
Peer-reviewed publications reporting patient outcomes after hospital discharge for ICU survivors have grown from 3 in the 1970s to more than 300 since 2000. Although there is evidence of consolidation in the instruments used for measuring participation restriction and quality of life, the ability to compare results across studies remains impaired by the 250 different instruments used. Most articles described cohort studies of modest size with a single follow-up assessment using patient-reported measures of participation restriction and quality of life. Development of a core outcome set of valid, reliable, and feasible measures is essential to improving the outcomes of critical illness survivors.
Mast Cell Inhibition Attenuates Cardiac Remodeling and Diastolic Dysfunction in Middle-aged, Ovariectomized Fischer 344 × Brown Norway Rats
Authors: Wang Hao , da Silva Jaqueline , Alencar Allan , Zapata-Sudo Gisele , Lin Marina R. , Sun Xuming , Ahmad Sarfaraz , Ferrario Carlos M. , Groban Leanne 
Published: March 2016

Abstract:
The incidence of left ventricular diastolic dysfunction (LVDD) increases in women after menopause, yet the mechanisms are unclear. Because mast cells participate in the pathological processes of various cardiac diseases, we hypothesized that mast cell inhibition would protect against estrogen loss-induced LVDD. The mast cell stabilizer, cromolyn sodium (30 mg·kg−1·d−1), or vehicle was administered subcutaneously by osmotic minipump to ovariectomized (OVX) female Fischer 344 × Brown Norway (F344BN) rats starting at 4 weeks after surgery. Eight weeks after OVX, systolic blood pressure increased by 20% in OVX versus sham rats, and this effect was attenuated after 4 weeks of cromolyn treatment. Also, cromolyn mitigated the adverse reductions in myocardial relaxation (e′) and increases in left ventricle (LV) filling pressures (E/e′), LV mass, wall thicknesses, and interstitial fibrosis from OVX. Although cardiac mast cell number was increased after OVX, cardiac chymase activity was not overtly altered by estrogen status and tended to decrease by cromolyn. Contrariwise, Ang II content was greater in hearts of OVX versus sham rats, and cromolyn attenuated this effect. Taken together, mast cell inhibition with cromolyn attenuates LV remodeling and LVDD in OVX-Fischer 344 × Brown Norway rats possibly through actions on the heart level and/or through vasodilatory effects at the vascular level.
A NEW TECHNIQUE WITH AUTOLOGOUS FIBRIN FOR THE TREATMENT OF PERSISTENT OPTIC PIT MACULOPATHY
Authors: Ozdek Sengul , Ozdemir Huseyin Baran 
Published: March 2016

Purpose:
To report the use of autologous fibrin for the treatment of persistent optic pit maculopathy.

Methods:
The authors report two patients with an optic pit–related serous macular detachment, which persisted after vitrectomy and internal limiting membrane peeling. Autologous fibrin was prepared from the patients' whole blood and injected over the optic disk pit area to seal the pit/coloboma area followed by fluid–air–gas exchange.

Results:
Retina stayed attached starting from the first postoperative visit till the last visit at 27 (Case 1) and 14 (Case 2) months after surgery.

Conclusion:
The use of autologous fibrin for the treatment of optic disk pit–related serous macular detachment seems a worthy contribution to the treatment of persistent cases.
A Study on Comparative In Vitro Activity of Carbapenem Sparers Against Extended-Spectrum Beta Lactamase–Producing Enterobacteriaceae
Authors: Jessani Laxman G. , Devarajan Vidyalakshmi , Ghafur Abdul 
Published: March 2016

Background
In the era of increasing carbapenem resistance, there is an urgent need to explore alternative options (carbapenem sparers) such as various betalactam/beta-lactamase (BL/BLI) agents, aminoglycosides, fosfomycin, and chloramphenicol to treat infections due to extended-spectrum beta lactamase (ESBL)-producing Enterobacteriaceae. We evaluated the in vitro activities of these agents in comparison to carbapenem against ESBL-producing Enterobacteriaceae blood culture isolates.

Methods
A retrospective analysis on the comparative susceptibility of ESBL-producing Escherichia coli and Klebsiella blood culture isolates against various antibiotics such as cefoperazone-sulbactam, piperacillin-tazobactam, cefepime-tazobactam (C/T), colistin, tigecyline, aminoglycosides, ciprofloxacin, and chloramphenicol was carried out in a tertiary care oncology setting over a span of 18 months (January 2013 to June 2014). Identification of the isolates and susceptibility testing were done using VITEK 2 compact autoanalyzer. Colistin sensitivity was done using Etest, as per Clinical and Laboratory Standards Institute (CLSI) 2013 guidelines.

Results
A total of 125 ESBL E coli and Klebsiella isolates were analyzed, (E coli, 67; Klebsiella, 58). Cefepime-tazobactam and carbapenem sensitivities were similar against E coli as well as Klebsiella isolates. E coli had good sensitivity to amikacin (70%) and chloramphenicol (88.5%). Among all BL/BLI agents, C/T had the highest sensitivity.

Conclusions
Betalactam/beta-lactamase agents and carbapenem had similar susceptibility against ESBL Enterobacteriaceae. Among the BL/BLI combinations, C/T had the highest susceptibility, followed by cefoperazone-sulbactam. Betalactam/beta-lactamase agents may have significant potential as carbapenem sparers.