bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Swimming Goggles Wearing on Intraocular Pressure, Ocular Perfusion Pressure, and Ocular Pulse Amplitude
Authors: Paula Ana P.B. , Paula Jayter S. , Silva Marcelo J.L. , Rocha Eduardo M. , De Moraes Carlos G. , Rodrigues Maria L.V. 
Published: July 2016

Purpose:
To evaluate changes in the ocular pulse amplitude (OPA) and ocular perfusion pressure (OPP), and investigate factors associated with intraocular pressure (IOP) elevation due to periorbital compression during swimming goggles (SG) use.

Methods:
This cross-sectional study evaluated 35 eyes of 35 healthy volunteers during the wearing of a drilled SG. OPP calculation, Goldman applanation tonometry, and OPA measurements (using Pascal dynamic contour tonometer) were performed before, during, and after SG use. Scleral rigidity (calculated with Schiotz tonometry readings), orbital rim area, exophthalmometry, spherical equivalent, axial length, corneal thickness, and the goggles’ rubber elastic force were considered in the multivariable analysis as potentially related to IOP changes.

Results:
SG significantly increased IOP after 2 minutes of use (13.34±2.67 vs. 23.46±7.20 mm Hg, P<0.0001). After removal, IOP decreased significantly (10.20±5.85 mm Hg, P<0.0001). A inverse correlation between IOP and OPP differences was observed with the SG wearing (r=−0.57; P=0.0003). Mean OPA was significantly higher during compared with before SG wear (2.57±1.34 vs. 1.82±0.55 mm Hg for the timepoints 2 and 1, respectively; P=0.0064). Only orbital rim area (P=0.0052) and elastic force (P=0.0019) were significantly associated with IOP elevation.

Conclusions:
SG provoked acute IOP elevation and disturbance in the ocular hemodynamics, which was associated with larger orbital rim area and greater SG elastic force. These findings could have implications for subjects at high risk for glaucoma onset or progression.
Psychological interventions in managing postoperative pain in children: a systematic review
Authors: Davidson Fiona , Snow Stephanie , Hayden Jill A. , Chorney Jill 
Published: July 2016

Abstract
Pediatric surgeries are common and painful for children. Postoperative pain is commonly managed with analgesics; however, pain is often still problematic. Despite evidence for psychological interventions for procedural pain, there is currently no evidence synthesis for psychological interventions in managing postoperative pain in children. The purpose of this review was to assess the efficacy of psychological interventions for postoperative pain in youth. Psychological interventions included Preparation/education, distraction/imagery, and mixed. Four databases (PsycINFO, PubMed, EMBASE, and Certified Index to Nursing and Allied Health Literature) were searched to July 2015 for published articles and dissertations. We screened 1401 citations and included 20 studies of youth aged 2 to 18 years undergoing surgery. Two reviewers independently screened articles, extracted data, and assessed risk of bias. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using RevMan 5.3. Fourteen studies (1096 participants) were included in meta-analyses. Primary outcome was pain intensity (0-10 metric). Results indicated that psychological interventions as a whole were effective in reducing children's self-reported pain in the short term (SMD = −0.47, 95% CI = −0.76 to −0.18). Subgroup analysis indicated that distraction/imagery interventions were effective in reducing self-reported pain in the short term (24 hours, SMD = −0.63, 95% CI = −1.04 to −0.23), whereas preparation/education interventions were not effective (SMD = −0.27, 95% CI = −0.61 to 0.08). Data on the effects of interventions on longer term pain outcomes were limited. Psychological interventions may be effective in reducing short-term postoperative pain intensity in children, as well as longer term pain and other outcomes (eg, adverse events) require further study.
Strategies to Alleviate Anxiety Before the Placement of a Stereotactic Radiosurgery Frame
Authors: Avbovbo Ufuoma E. , Appel Susan J. 
Published: July 2016

ABSTRACT

Background: Patients scheduled for stereotactic radiosurgery (SRS) need the placement of a head frame for accurate treatment of brain metastases and other abnormalities in the brain. These patients frequently experience anxiety before frame placement. Although there is evidence that preprocedure education can alleviate anxiety, less is known about education for patients undergoing head frame placement. Objective: The aim of this study was to determine whether a preprocedure educational intervention can reduce/alleviate anxiety for patients undergoing head frame placement for SRS. Methods: This study was a practice improvement project using a nonrandomized controlled design to evaluate patients (N = 28) diagnosed with metastasized brain cancer or other abnormalities in the brain. Patients aged ≥19 and <75 years were recruited, and all participants had been radiographically diagnosed and were dispositioned for SRS. The control group (n = 14) received the standard preprocedure teaching, and the intervention group (n = 14) received both the standard preprocedure teaching and an additional educational intervention. Data collecting tools included the Hospital Anxiety and Depression Scale and a visual analog scale to measure the patient’s anxiety. Results: It was found that, on average, anxiety levels were lower in the intervention group on both the visual analog scale and Hospital Anxiety and Depression Scale. However, the findings did not reach statistical significance, p < .05. Conclusion: On the basis of existing literature, preprocedure education has been shown to decrease patient anxiety. This study aimed to determine whether an additional educational intervention impacted anxiety in patients undergoing SRS for metastatic cancer. Although we found that anxiety levels were decreased in the intervention group, this finding did not reach statistical significance. A larger randomized study is needed to confirm the efficacy of such an intervention in this unique patient population.
Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: a randomized-controlled study
Authors: Sheta Elshazly , El-Kalla Ferial , El-Gharib Mohamed , Kobtan Abdelrahman , Elhendawy Mohammed , Abd-Elsalam Sherief , Mansour Loai , Amer Ibrahim 
Published: July 2016

Background
Globally, hepatocellular carcinoma (HCC) is the third most frequent cause of cancer-related mortality. In recent years, transarterial chemoembolization, radiofrequency ablation, and microwave ablation (MWA) have been accepted as treatment modalities for patients with surgically unresectable HCC.

Aim of this work
This study aimed to compare combination treatment with radiofrequency or MWA, followed by transarterial chemoembolization, and performed in a single session.

Patients and methods
This study was carried out on 50 patients with nonresectable single-lesion HCC, who were divided into three groups: group A included 20 patients treated by transcatheter hepatic arterial chemoembolization, group B included 20 patients treated by radiofrequency thermal ablation combined with transcatheter arterial chemoembolization, and group C included 10 patients treated by MWA combined with transcatheter arterial chemoembolization. The combined treatments were performed in a single session, with the ablation performed first.

Results
The total success rate in this study at 6 months following the procedure was 50% in group A, 70% in group B, and 80% in group C. Major complications were recorded in 22% of patients. The number of complications was the highest in group A.

Conclusion
Combined ablation with chemoembolization is superior in the treatment of nonresectable single masses larger than 4 cm. Transcatheter arterial chemoembolization and ablation can be performed safely and successfully during a single session, which has not been found to decrease the response rates to treatment. Combined treatment with MWA is more effective in terms of tumor response, and results in the same complication rate as with radiofrequency, but less than chemoembolization alone.
Does the get up and go test improve predictive accuracy of the Triage Risk Screening Tool or Rowland questionnaire in older patients admitted to the emergency department?
Authors: Devriendt Els , Deschodt Mieke , Delaere Maarten , Flamaing Johan , Sabbe Marc , Milisen Koen 
Published: July 2016

ObjectivesTo assess the diagnostic characteristics of the get up and go test (GUGT) as a stand-alone test and in combination with the Flemish Triage Risk Screening Tool (fTRST) and Rowland questionnaire. One aim was to determine whether the diagnostic accuracy of these instruments could be improved for predicting unplanned emergency department (ED) readmission following ED discharge.MethodsWe carried out a prospective cohort study at the ED of the University Hospitals Leuven, Belgium. All patients aged at least 75 years (n=380) completed fTRST, Rowland, and GUGT testing at the index ED admission. Diagnostic characteristics for unplanned ED readmission were determined for hospitalized and discharged patients 1 and 3 months after the index ED visit.ResultsIn both hospitalized and discharged patients, fTRST and Rowland (cut-off ≥2) had good to excellent sensitivity and negative predictive value (NPV) but low to moderate specificity and accuracy; GUGT had low sensitivity and good to excellent NPV and specificity. The combined fTRST/GUGT or Rowland/GUGT had moderate to excellent NPV (56.3–94.3%). The combined fTRST (cut-off ≥2)/GUGT had low sensitivity and moderate to excellent specificity. Sensitivity of the combined Rowland (cut-off ≥4)/GUGT was good at the 1-month follow-up and moderate at the 3-month follow-up for hospitalized patients; it was low for discharged patients. Specificity was low for hospitalized patients and good for discharged patients.ConclusionNeither the objective measure of mobility (GUGT) nor the combined fTRST/GUGT or Rowland/GUGT improved the results. Our analysis shows that the predictive accuracy of the stand-alone, self-reported screening instruments fTRST and Rowland (cut-off=2) is still good. This study also confirmed their previously known limitations.
Low Use of Oral Anticoagulant Prescribing for Secondary Stroke Prevention
Authors: Shah Reema , Li Shudong , Stamplecoski Melissa , Kapral Moira K. 
Published: July 2016

Background:
Oral anticoagulation reduces the risk of stroke in atrial fibrillation but is often underused.

Objectives:
To identify factors associated with oral anticoagulant prescribing and adherence after stroke or transient ischemic attack (TIA).

Research Design:
Retrospective cohort study using linked Ontario Stroke Registry and prescription claims data.

Subjects:
Consecutive patients with atrial fibrillation and ischemic stroke/TIA admitted to 11 stroke centers in Ontario, Canada between 2003 and 2011.

Measures:
We used modified Poisson regression models to determine predictors of anticoagulant prescribing and multiple logistic regression to determine predictors of 1-year adherence.

Results:
Of the 5781 patients in the study cohort, 4235 (73%) were prescribed oral anticoagulants at discharge. Older patients were less likely to receive anticoagulation [adjusted relative risk (aRR) for each additional year=0.997; 95% confidence interval (CI), 0.995–0.998], as were those with TIA compared with ischemic stroke (aRR=0.904; 95% CI, 0.865–0.945), prior gastrointestinal bleed (aRR=0.778; 95% CI, 0.693–0.873), dementia (aRR=0.912; 95% CI, 0.856–0.973), and those from a long-term care facility (aRR=0.810; 95% CI, 0.737–0.891). After limiting the sample to those without obvious contraindications to anticoagulation, age, dementia, and long-term care residence continued to be associated with lower prescription of oral anticoagulants. One-year adherence to therapy was similar across most patient groups.

Conclusions:
Age, dementia, and long-term care residence are predictors of lower oral anticoagulant use for secondary stroke prevention and represent key target areas for quality improvement initiatives.
Exploring the Lived Experience of Women Immediately Following Mastectomy
Authors: Davies Claire C. , Brockopp Dorothy , Moe Krista , Wheeler Peggy , Abner Jean , Lengerich Alexander 
Published: July 2016

Background:
In 2014, it is estimated that 232,670 new cases of breast cancer occurred in the United States. Unilateral or bilateral mastectomy is a frequently chosen option for treating this disease.

Objective:
The purpose of this study was to explore, through an in-depth interview process, the lived experience of women immediately following mastectomy when they see their scars for the first time.

Methods:
Purposeful sampling was used until saturation was reached. In-depth interviews were conducted with 10 women related to their mastectomy experience. The data were analyzed using a phenomenological approach.

Results:
The following 8 themes emerged from the data; lasting impact, personal impact, relational impact, gratitude, support system, coping strategies, timing, and discomfort.

Conclusions:
The results of the study provide evidence that women face ongoing challenges following seeing their mastectomy scars for the first time that is not adequately addressed by healthcare professionals.

Implications for Practice:
Nurses and other healthcare professionals need to gain a better understanding of the difficulties perceived by women following seeing the scars from mastectomy and implement strategies to assist in successful adaptation to the experience.
Variations in Clinical Presentation of Ocular Syphilis: Case Series Reported From a Growing Epidemic in the United States
Authors: Marx Grace E. , Dhanireddy Shireesha , Marrazzo Jeanne M. , Tuddenham Susan A. , Rompalo Anne M. , Leone Peter A. , Gaydos Charlotte A. , Rietmeijer Cornelis A. 
Published: July 2016

Abstract
Ocular syphilis, a form of neurosyphilis, has been increasingly diagnosed in the United States. This case series summarizes the course of 6 patients recently diagnosed with ocular syphilis, emphasizing the varied sociodemographic factors and the wide range of symptoms and outcomes that are seen in patients with this disease.
Trichomonas vaginalis Nucleic Acid Amplification Testing at an Urban HIV Clinic
Authors: Muzny Christina A. , Burkholder Greer A. , Fry Karen R. , Austin Erika L. , Schwebke Jane R. 
Published: July 2016

Background

Trichomonas vaginalis is the most common nonviral sexually transmitted infection. T. vaginalis nucleic acid amplification testing (NAAT) recently became available at the University of Alabama at Birmingham human immunodeficiency virus (HIV) clinic. The objective of this study was to determine the uptake of T. vaginalis NAAT testing among clinic providers during the first year of test availability in addition to T. vaginalis prevalence and predictors based on NAAT results.

Methods
This was a retrospective review of HIV+ women and men ages ≥16 years at the University of Alabama at Birmingham HIV Clinic, including those receiving a T. vaginalis NAAT on a genitourinary specimen.

Results
Between August 2014 and August 2015, 3163 HIV+ patients were seen (768 women, 2395 men), of whom 861 (27.3%) received a T. vaginalis NAAT; 402 women (52.3%) and 459 men (19.2%). Among those with T. vaginalis NAAT results, 70 (17.4%) of 402 women and 12 (2.6%) of 459 men (9 men who have sex with women, 1 man who has sex with men, 2 unknown) tested positive. In adjusted analyses for women, age ≤40 years (odds ratio [OR], 2.93; 95% confidence interval [CI], 1.23–6.96), current cocaine use (OR, 4.86; 95% CI, 1.57–15.06), and CD4 < 200 cells/mm3 (OR, 6.09; 95% CI, 1.68–22.11) were significantly associated with increased odds of a positive T. vaginalis NAAT. For those with a positive T. vaginalis NAAT, treatment was prescribed for 65 (92.9%) of 70 women and 10 (83.3%) of 12 men.

Conclusions
Initial uptake of T. vaginalis NAAT testing was modest at this HIV clinic yet identified a high prevalence among women tested. Emphasis on the need for testing in HIV+ women is necessary.
Ocular and Environmental Factors Associated with Eye Growth in Childhood
Authors: Read Scott Andrew 
Published: July 2016

ABSTRACT
Recent advances in measurement technology have improved our ability to quantify a range of ocular components and some environmental exposures that are relevant to myopia. In particular, environmental sensors now allow the dense sampling of personal ambient light exposure data, and advances in ocular imaging, such as developments in optical coherence tomography (OCT), enables high resolution measures of the choroid to be captured in human subjects. The detailed, objective information produced by these noninvasive measurement technologies has the potential to provide important new insights into the complex array of factors underlying eye growth, and myopia development and progression in childhood.
Wearable light sensors and enhanced depth imaging OCT were both employed in a recently completed prospective, observational longitudinal study examining factors associated with eye growth in myopic and non-myopic children. Personal light exposure, choroidal thickness, and axial eye growth were quantified in 101 children over an 18-month period. A significant association was found between objectively measured personal daily ambient light exposure and eye growth (independent of refractive status), consistent with greater light exposure protecting against rapid growth of the eye in childhood. Variations in the thickness of the choroid also appeared to be closely linked to the growth of the eye, with choroidal thinning typically being associated with more rapid eye growth, and choroidal thickening with a slowing of eye growth in childhood. The implications of these findings for our understanding of human eye growth regulation, along with their potential importance for our understanding of myopia control interventions, are discussed.
Adipocere—The Fat of Graveyards
Authors: Byard Roger W. 
Published: July 2016

AbstractAdipocere is an unusual product of fatty tissue decomposition that may occasionally be found in bodies. Two cases of diving fatalities in a limestone cave filled with fresh water are reported to demonstrate the features of adipocere, with a literature review. The bodies of a 20-year-old male and 22-year-old female diver were retrieved 11 and 10 months after their deaths, respectively. Both bodies were putrefied with extensive adipocere formation characterized by the absence of epidermis with loss of cellular detail, with residual collagen fibers, and occasional hair follicles in the dermis. The most likely cause of death was accidental drowning possibly contributed to by equipment malfunction at depth. Adipocere formation is an unusual finding in bodies, particularly in Australia, that is facilitated by cold, wet, and anaerobic environments. If found at autopsy, it may give some indication of the environmental conditions that a body has been exposed to.
A Hanged From the Past
Authors: Gaeta Raffaele , Fornaciari Antonio 
Published: July 2016

Abstract
The medieval chapel of Notre Dame-des-Fontaines (Our Lady of the Fountains), in the French Maritime Alps, is entirely covered by the fresco cycle of the Passion (15th century) that depicts the last days of Jesus from the Last Supper to the Resurrection. Under a small window, there is the brutal representation of the suicide of Judas Iscariot, hanging from a tree, with the abdomen quartered from which his soul, represented by a small man, is kidnapped by a devil. The author, Giovanni Canavesio, represented the traitor's death with very detailed anatomical structures, differently thus from other paintings of the same subject; it is therefore possible to assume that the artist had become familiar with the human anatomy. In particular, the realism of the hanged man's posture, neck bent in an unnatural way, allows us to hypothesize that it probably comes from direct observation of the executions of capital punishment, not infrequently imposed by the public authorities in low medieval Italy.
Admission Plasma Troponin I Is Associated With Mortality in Pediatric Intensive Care*
Authors: Wilson Clare , Sambandamoorthy Ganesh , Holloway Paul , Ramnarayan Padmanabhan , Inwald David P. 
Published: July 2016

Objectives:
Assessment of whether admission plasma troponin I level is associated with mortality or requirement for vasoactive drugs in pediatric intensive care.

Design:
Retrospective cohort study.

Setting:
Single centre, tertiary referral general PICU, without a cardiac surgical program.

Patients:
Three hundred and nineteen patients 0–18 years old in two cohorts. Cohort 1 was admitted between January 2009 and September 2012 and the cohort 2 between April 2014 and April 2015.

Interventions:
None.

Measurements and Main Results:
Plasma troponin I was measured in patients in cohort 1 only if the attending physician ordered the test due to clinical concern regarding myocardial injury. The second cohort had plasma troponin I routinely measured at admission. The primary outcome was death during PICU admission, and the secondary outcome was maximum inotrope requirement during PICU stay, measured by Vasoactive Inotrope Score. Plasma troponin I was a discriminator for mortality in both cohorts (area under the receiver-operating characteristic curve of 0.73 and 0.86 in cohorts 1 and 2, respectively). In an adjusted analysis using Cox regression, accounting for Pediatric Index of Mortality 2 risk of mortality and age, elevated plasma troponin I was significantly associated with death in both cohorts (hazard ratio, 4.99; p = 0.033; hazard ratio, 10.5; p = 0.026 in cohorts 1 and 2, respectively). Elevated plasma troponin I was only associated with increased Vasoactive Inotrope Score following multivariate analysis in the cohort 2.

Conclusions:
Detectable plasma troponin I at admission to PICU is independently associated with death. The utility of troponin I as a stratification biomarker requires further evaluation.
Development and Assessment of an Advanced Pediatric Airway Management Curriculum With Integrated Intubation Videos
Authors: Nagler Joshua , Nagler Alisa , Bachur Richard G. 
Published: July 2016

Objectives
Opportunities to learn advanced airway management skills on pediatric patients in the emergency department are limited. Current strategies have focused largely on traditional didactics coupled with procedural skills training using simulation. However, these approaches are limited in their exposure to anatomic variation and realism. Here, we describe the development and assessment of an advanced airway curriculum that integrates videolaryngoscopic recordings obtained during actual patient intubations into a series of interactive educational sessions.

Methods
Trainees and attending physicians were surveyed anonymously to assess the impact of participation in the curriculum. A mixed methods approach to statistical analysis was used. Rating questions were used to evaluate the relative impact of this approach over other traditional strategies and recurrent themes within open-ended questions were identified.

Results
Participants reported this to be a highly effective means of learning about pediatric laryngoscopy and endotracheal intubation and regarded it more highly than other traditional educational approaches. Identified benefits included repetitive exposure, approaches to laryngoscopy, the realism of teaching using real and varied anatomy, and the opportunities to identify and troubleshoot difficulty in a learning environment.

Conclusions
An advanced pediatric airway curriculum that integrates intubation videos obtained during videolaryngoscopy was highly regarded by pediatric emergency medicine providers. Content emphasis can be shifted to meet the needs of pediatric emergency medicine providers with all levels of skill and experience.