bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Finnish abstract motion constructionmennäV-mA-An[go V-inf-ill] ‘do something unwished’
Authors: Sivonen Jari 
Published: December 2016

This paper addresses the usage, development and motivation of the Finnish mennä V-mA-An [go V-inf-ill] construction. In this construction, the literal motion sense of ‘going’ has been grammaticalized to evoke an affective meaning: the activity expressed in the construction’s infinitival element is considered as unwished (e.g. Johtaja-t men-i-vät lakkautta-ma-an ohjelma-n [manager- pl.nom go-pst-3pl shut.down-inf-ill show-acc] ‘Managers shut down the show [though they should not have]’). This paper uncovers the different ways the construction is used (for example, projecting the disapproving stance onto a specific element, such as the manner, objective or result of the activity, that the speaker finds especially inappropriate when compared to the desired course of events, or creating an ironic tone for the description of an event) and reveals its lexical profile in modern language. The role of the context in the interpretation of the construction as well as its grammaticalization process are also dealt with. It is argued that the affective meaning of the construction is metaphorically motivated by a previously undiscovered image-schematic pattern “deviant path – erroneous goal”. In this schema the trajector is conceived of abstractly deviating from a projected path and ending up at an unwished ending point, and this constitutes a contrast to the desired course of events, the core meaning of the construction. The analysis supports a tenet in cognitive semantics that linguistic structures are often motivated by general cognitive processes such as metaphor and image-schema patterns.
Learning disease relationships from clinical drug trials
Authors: Haslam Bryan , Perez-Breva Luis 
Published: December 2016

Objective: Our objective is to test the limits of the assumption that better learning from data in medicine requires more granular data. We hypothesize that clinical trial metadata contains latent scientific, clinical, and regulatory expert knowledge that can be accessed to draw conclusions about the underlying biology of diseases. We seek to demonstrate that this latent information can be uncovered from the whole body of clinical trials.
Materials and Methods: We extract free-text metadata from 93 654 clinical drug trials and introduce a representation that allows us to compare different trials. We then construct a network of diseases using only the trial metadata. We view each trial as the summation of expert knowledge of biological mechanisms and medical evidence linking a disease to a drug believed to modulate the pathways of that disease. Our network representation allows us to visualize disease relationships based on this underlying information.
Results: Our disease network shows surprising agreement with another disease network based on genetic data and on the Medical Subject Headings (MeSH) taxonomy, yet also contains unique disease similarities.
Discussion and Conclusion: The agreement of our results with other sources indicates that our premise regarding latent expert knowledge holds. The disease relationships unique to our network may be used to generate hypotheses for future biological and clinical research as well as drug repurposing and design. Our results provide an example of using experimental data on humans to generate biologically useful information and point to a set of new and promising strategies to link clinical outcomes data back to biological research.
Evaluating the lifestyles of physicians and PAs in orthopedics
Authors: Shannon Katherine M. , Merenstein Daniel J. 
Published: December 2016

ABSTRACT

Objective:
Limited current research is available comparing job satisfaction and lifestyles of physicians and physician assistants (PAs). Given the professional similarities and the upward trend in employment for both professions, this research is important in educating future professionals and employers. This study examined job contentment among orthopedic physicians and PAs.

Methods:
A cross-sectional survey was designed to assess career and lifestyle satisfaction. The survey was e-mailed to orthopedic clinics across the United States.

Results:
27 PAs and 50 physicians completed the survey. Compared with physicians, PAs were more likely to recommend their career and to desire to switch specialties. Physicians reported a higher level of agreement that the professional schedule overshadows personal life, and that the stress and demand of the profession impair personal health.

Conclusion:
PAs in orthopedics self-reported a higher lifestyle satisfaction than physicians. One specialty was examined and larger, more diverse studies should be conducted.
Individualized Developmental Care in the NICU
Authors: Macho Patricia 
Published: December 2016

Background:
Individualized developmental care (IDC) is a collection of evidence-based practices that include adapting care practices based on the infant's behavioral and developmental state, involving parents and families in the infant's care, and providing an environment that minimizes over stimulation of the infant.

Purpose:
To clarify the definition of IDC in the neonatal intensive care unit (NICU) and to provide guidelines for implementation of IDC for healthcare professionals through a concept analysis.

Method/Search Strategy:
A literature review involving a search of multiple electronic databases from January 1982 to November 2016 was performed along with presentation of a model case and attributes of IDC.

Conclusions:
This concept analysis defines and provides guidelines for implementing an individualized developmentally sound environment for infants born premature and their families.

Implications for Practice:
All NICUs need to strive to provide an environment that supports and promotes IDC. Education needs to be provided to healthcare providers and parents regarding IDC practices.

Implications for Research:
Further research into short- and long-term outcomes of IDC is needed. Research into whether IDC is being implemented by NICUs is also needed.
Effect of General Anesthesia on Neurodevelopmental Abnormalities in Children Undergoing Treatment of Vascular Anomalies With Laser Surgery: A Retrospective Review
Authors: Terushkin Vitaly , Brauer Jeremy , Bernstein Leonard , Geronemus Roy 
Published: December 2016

BACKGROUND
Multiple exposures to general anesthesia may be neurotoxic to the developing brain. This relationship has not been evaluated in children undergoing laser surgery for vascular anomalies.

OBJECTIVE
To evaluate the prevalence of neurodevelopmental abnormalities in children who received multiple laser procedures under general anesthesia before the age of 4 years for the treatment of vascular anomalies.

METHODS AND MATERIALS
Retrospective chart review of patients with contact of parents for telephone interview.

RESULTS
Thirty-three patients were eligible. Average age at the time of survey was 7.8 years. Twenty-three (84.8%) patients were female, with average age at the time of first treatment at 1.9 years. Average number of treatments received before the age of 4 years was 6.7. Anesthetics included inhalational nitrous oxide and isoflurane and intravenous propofol. Seven patients carried one or more of the following diagnoses: attention-deficit hyperactivity disorder (3.0%), anxiety (6.1%), behavioral disorder (3.0%), language disorder (3.0%), speech disorder (3.0%), and motor disorder (6.1%). These prevalence rates are similar to those found in the US population.

CONCLUSION
This is the first report on the prevalence of neurodevelopmental disorders in children undergoing multiple laser treatments under general anesthesia. Although the study sample is small, no increased risks when comparing with prevalence rates reported in the literature were noted.
Comparing Azole Plasma Trough Levels in Lung Transplant Recipients: Percentage of Therapeutic Levels and Intrapatient Variability
Authors: Stelzer Daniela , Weber Alexandra , Ihle Franziska , Matthes Sandhya , Ceelen Felix , Zimmermann Gregor , Kneidinger Nikolaus , Schramm Rene , Winter Hauke , Zoller Michael , Vogeser Michael , Behr Juergen , Neurohr Claus 
Published: December 2016

Background:
This study compared therapeutic azole plasma trough levels (APL) of the azole antimycotics itraconazole (ITR), voriconazole (VOR), and posaconazole (POS) in lung transplant recipients and analyzed the influencing factors. In addition, intrapatient variability for each azole was determined.

Methods:
From July 2012 to July 2015, 806 APL of ITR, VOR, posaconazole liquid (POS-Liq), and posaconazole tablets (POS-Tab) were measured in 173 patients of the Munich Lung Transplantation Program. Therapeutic APL were defined as follows: ITR, ≥700 ng/mL; VOR, 1000–5500 ng/mL; and POS, ≥700 ng/mL (prophylaxis) and ≥1000 ng/mL (therapy).

Results:
VOR and POS-Tab reached the highest number of therapeutic APL, whereas POS-Liq showed the lowest percentage (therapy: ITR 50%, VOR 70%, POS-Liq 38%, and POS-Tab 82%; prophylaxis: ITR 62%, VOR 85%, POS-Liq 49%, and POS-Tab 76%). Risk factors for subtherapeutic APL of all azoles were the azole dose (ITR, P < 0.001; VOR, P = 0.002; POS-Liq, P = 0.006) and age over 60 years (ITR, P = 0.003; VOR, P = 0.002; POS-Liq, P = 0.039; POS-Tab, P < 0.001). Cystic fibrosis was a significant risk factor for subtherapeutic APL for VOR and POS-Tab (VOR, P = 0.002; POS-Tab, P = 0.005). Double lung transplantation (LTx) was significantly associated with less therapeutic APL for VOR and POS-Liq (VOR, P = 0.030; POS-Liq, P < 0.001). Concomitant therapy with 80 mg pantoprazole led to significantly fewer therapeutic POS APL as compared to 40 mg (POS-Liq, P = 0.015; POS-Tab, P < 0.001). VOR displayed the greatest intrapatient variability (46%), whereas POS-Tab showed the lowest (32%).

Conclusions:
Our study showed that VOR and POS-Tab achieve the highest percentage of therapeutic APL in patients with LTx; POS-Tab showed the lowest intrapatient variability. APL are significantly influenced by azole dose, age, cystic fibrosis, type of LTx, and comedication with proton-pump inhibitors. Considering the high number of subtherapeutic APL, therapeutic drug monitoring should be integrated in the post-LTx management.
Disparities in Utilization of Jaw Surgery for Treatment of Sleep Apnea: A Nationwide Analysis
Authors: Garg Ravi K. , Shan Ying , Havlena Jeffrey A. , Afifi Ahmed M. 
Published: December 2016

Background:
Maxillomandibular advancement has been shown to be one of the most effective operations for management of severe obstructive sleep apnea, yet pharyngeal surgery is more commonly performed. The goal of this study was to identify socioeconomic factors associated with this phenomenon.

Methods:
Patients aged 14 or older with a primary hospital diagnosis of sleep apnea were identified using the National Inpatient Sample from 2005 to 2012. ICD9 codes were used to determine whether a pharyngeal or jaw procedure was performed. Patient demographics, comorbidities, and complications were compared.

Results:
Among 6316 sleep surgeries, 5964 (94.4%) were pharyngeal and 352 (5.6%) were jaw procedures. Women were significantly more likely to receive jaw surgery than men (odds ratio [OR] = 1.68, P = 0.0007). African Americans (OR = 0.19, P < 0.0001), Hispanics (OR = 0.42, P = 0.0009), Asians (OR = 0.41, P = 0.0009), and other non-Caucasians (OR = 0.19, P = 0.0008) had a significantly lower odds of receiving jaw surgery than Caucasians. Patients falling into lower-income brackets (OR = 0.39 and 0.57, P = 0.02 and 0.04) and patients with Medicare compared with private or Health Maintenance Organization insurance (OR = 0.46, P = 0.008) also had significantly decreased odds of undergoing jaw surgery. Comorbidities were similar between surgical groups, and there were no significant differences in bleeding, infection, or cardiopulmonary complications.

Conclusions:
We identified no significant difference in complication rates between pharyngeal and jaw procedures. Nonetheless, African American, Hispanic, and Asian patients, in addition to lower-income patients and patients with Medicare, had a significantly lower odds of receiving jaw surgery. Awareness of these disparities may help guide efforts to improve patients’ surgical options for sleep apnea.
Anatomical and Clinical Study of the Posterior Auricular Artery Angiosome: In Search of a Rescue Tool for Ear Reconstruction
Authors: Gómez Díaz Oswaldo J. , Cruz Sánchez Mario D. 
Published: December 2016

Background:
The retroauricular tissues have been used for a long time for ear reconstruction, but the anatomical bases of flaps of this region are not completely clear. The aim of this study was to estimate blood supply area and location of this on the skin and fascia retroauricular dependent of posterior auricular artery (PAA) to establish safe margins to design flaps for auricular reconstruction.

Methods:
Dissection under magnification (×3.5) of the PAA through a cervical approach; injection of methylmethacrylate in the PAA as a staining technique; retroauricular approach to identify the territory of irrigation of PAA in the retroauricular skin and fascia; measuring and location of the stained area; and report of 2 cases of ear reconstruction with fasciocutaneous and fascia flaps based on PAA, designed according to the anatomical study.

Results:
In a sample of 10 cadaveric specimens, the PAA irrigated an area of the retroauricular skin and fascia of 10.7 cm length × 7.07 cm wide equivalent to 60.44 cm2 (95% CI, 37.07–83.81), with a distribution posterior to external auditory canal of 7.15 cm (95% CI, 5.53–8.77) and posterior to the helix insertion of 6.12 cm (95% CI, 4.89–7.35). In the 2 patients treated with fascia and fasciocutaneous flaps based on the PAA, these were good options for ear reconstruction.

Conclusion:
A fascia or fasciocutaneous flap from the retroauricular region based on PAA within the dimensions and location found in this study will be a safe option for reconstruction of the ear.
All Seasons Vertical Augmentation Mastopexy: A Simple Algorithm, Clinical Experience, and Patient-reported Outcomes
Authors: Swanson Eric 
Published: December 2016

Background:
The safety of augmentation mastopexy has been questioned. Staging has been recommended for women deemed to be at higher risk, such as women with greater degrees of ptosis. Most existing studies evaluate women treated with multiple methods, including the traditional Wise pattern. This retrospective study specifically evaluates vertical augmentation mastopexy. A simple algorithm is introduced.

Methods:
From 2002 to 2016, 252 women underwent consecutive vertical augmentation mastopexies performed by the author, with no staged surgery. All patients underwent a vertical mastopexy using a medially based pedicle and intraoperative nipple siting. A subset of women treated from 2012 to 2016 were surveyed to obtain outcome data; 90 patients (inclusion rate, 90%) participated.

Results:
The complication rate was 32.9%, including persistent ptosis, delayed wound healing, scar deformities, and asymmetry. There were no cases of nipple loss. An increased risk of complications was detected for smokers (P < 0.01), but not for combined procedures, secondary breast augmentations, or secondary mastopexies. The revision rate was 15.5%. Persistent nipple numbness was reported by 13.3% of respondents. Eighty percent of women were self-conscious about their breast appearance before surgery; 22% of respondents were self-conscious about their breasts after surgery. Seventy percent of respondents reported an improved quality of life, 94.4% would repeat the surgery, and 95.6% would recommend it.

Conclusions:
A simple algorithm may be used to guide treatment in women who desire correction of ptosis and upper pole fullness. An "all seasons" vertical augmentation mastopexy is safe and widely applicable. Staging is unnecessary.
CONSTRUCT AND FACE VALIDITY OF THE EYESI INDIRECT OPHTHALMOSCOPE SIMULATOR
Authors: Chou Jonathan , Kosowsky Tova , Payal Abhishek R. , Gonzalez Gonzalez Luis A. , Daly Mary K. 
Published: December 2016

Purpose:
To evaluate construct and face validity of the Eyesi Binocular Indirect Ophthalmoscope Simulator.

Methods:
The performance of 25 medical students (Group A) was compared with that of 17 ophthalmology and optometry trainees (Group B) on the Eyesi Binocular Indirect Ophthalmoscope Simulator. During the course of a single session, each participant viewed an orientation module followed by an instruction session and a demonstration case, and performed 6 cases of progressively increasing difficulty (4 levels) and a 10-question face validity questionnaire. Outcomes included total score, total examination time, percent retina examined, and duration of eye exposure to light.

Results:
Group B achieved significantly better total scores than Group A on all difficulty levels (P = 0.02, P = 0.001, P = 0.001, and P = 0.0001, for Levels 1–4, respectively) and had a significantly faster mean duration of examination (8 minutes 58 seconds vs. 5 minutes 21 seconds, P < 0.0001). Medical students reported higher scores in the face validity questionnaire for the simulator experience being helpful at orienting them to true indirect ophthalmology, and that further training on the simulator would improve their skills in the clinic (P = 0.03 for all).

Conclusion:
The Eyesi Binocular Indirect Ophthalmoscope Simulator has significant construct and face validity and shows promise for medical education.
POSTOPERATIVE HEMORRHAGIC OCCLUSIVE RETINAL VASCULITIS: A FORME FRUSTE VARIANT?
Authors: Goldberg Roger A. , Crawford Courtney , Heier Jeffrey S. 
Published: December 2016

Purpose:
To present a forme fruste variant of hemorrhagic occlusive retinal vasculitis (HORV) after uncomplicated cataract surgery performed with vancomycin in the irrigating solution.

Methods:
A report of a single patient who developed HORV; the clinical features and course are described and compared with previously reported cases.

Results:
Ultra–widefield fluorescein angiography demonstrated an occlusive vasculitis in both eyes 1 week after uncomplicated cataract surgery in which vancomycin was added to the irrigating solution. An extensive systemic evaluation including a hypercoagulable workup, serum electrophoresis, complete blood count, and carotid and cardiac ultrasound was negative. Visual acuity was unaffected, and the patient remained 20/20 in each eye one year after surgery without treatment. This is a markedly different outcome than seen in previously reported cases of HORV.

Conclusion
Ultra–widefield angiography was helpful to confirming the diagnosis of HORV in this milder case example in a patient who maintained excellent vision. This forme fruste variant of HORV after exposure to vancomycin suggests that the incidence of HORV after cataract surgery may be more common than previously reported. Vigilance, close observation, and broad reporting can help further clarify the incidence and potential adverse effects of routinely using intracameral vancomycin during cataract surgery.
The Effects of Kangaroo Care on the Sleep and Wake States of Preterm Infants
Authors: Bastani Farideh , Rajai Nahid , Farsi Zahra , Als Heidelise 
Published: December 2016

ABSTRACT

Background:
Developing interventions that improve deep sleep and quit awake is important to improve the quality of care that is provided to preterm infants.

Purpose:
The aim of this study was to compare the effects of kangaroo care and in-arms-holding on the sleep and wake states of preterm infants.

Methods:
A randomized controlled trial design was employed in 2011–2012. Seventy-two stable preterm infants with gestational ages of 32–37 weeks and their mothers were recruited from the neonatal intensive care unit of Valiasr Hospital in Tehran, Iran. Seventy participants completed the trial. In the preintervention phase, nurses placed all of the infants, clad only in diapers, in supine position in their incubator for 20 minutes. Next, the infants in the kangaroo care group were placed onto their mothers’ bare chest, whereas those infants in the in-arms-holding group were cradled in their mothers’ arms, with the head and back supported by the mother’s left arm. The intervention period lasted for 70 minutes. In the postintervention phase, the infants were returned to their incubators and placed in supine position for 20 minutes. The observer recorded the status of the infants during the three phases of study.

Results:
There were no significant differences between the two groups in terms of state distribution in the preintervention phase. However, the kangaroo care group had longer periods in deep sleep (p < .001) and in the quiet awake/alert state (p = .004) during the intervention phase and less time in the light sleep or drowsy state (p < .001) and in the actively awake state (p = .02) than the in-arms-holding group. No significant group differences were found in terms of crying.

Conclusions:
Kangaroo care appears to increase the length of time that preterm infants spend in deep sleep and quiet awake states as compared with simply being held in their mothers’ arms. Replication of this research will strengthen the results.
Acute Dystonia Versus Neuroleptic Malignant Syndrome Without Fever in an Eight-Year-Old Child
Authors: Sridaran Rita , Nesbit Chadd E. 
Published: December 2016

Abstract
Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication of the use of certain medications. It is being seen more often in the pediatric population because of the increasing use of both typical and atypical antipsychotics in children. Rapid recognition of NMS is important to emergency physicians because timely treatment can be life saving. Acute dystonia is also a well-known and more common adverse effect of certain types of antipsychotics, more commonly seen with the typical antipsychotics versus the atypical antipsychotics. We describe a case of a pediatric patient who developed an acute dystonic reaction versus NMS soon after starting aripiprazole. We compare this case with the other documented cases of acute dystonia and NMS after initiating aripiprazole in the pediatric population.