bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity Measured with Accelerometer and Self-Rated Disability in Lumbar Spine Surgery: A Prospective Study
Authors: Mobbs Ralph J. , Phan Kevin , Maharaj Monish , Rao Prashanth J. 
Published: October 2015

Study Design Prospective observational study. Objective Patient-based subjective ratings of symptoms and function have traditionally been used to gauge the success and extent of recovery following spine surgery. The main drawback of this type of assessment is the inherent subjectivity involved in patient scoring. We aimed to objectively measure functional outcome in patients having lumbar spine surgery using quantitative physical activity measurements derived from accelerometers. Methods A prospective study of 30 patients undergoing spine surgery was conducted with subjective outcome scores (visual analog scale [VAS], Oswestry Disability Index [ODI] and Short Form 12 [SF-12]) recorded; patients were given a Fitbit accelerometer (Fitbit Inc., San Francisco, California, United States) at least 7 days in advance of surgery to record physical activity (step count, distance traveled, calories burned) per day. Following surgery, postoperative activity levels were reported at 1-, 2-, and 3-month follow-up. Results Of the 28 compliant patients who completed the full trial period, mean steps taken per day increased 58.2% ( p = 0.008) and mean distance traveled per day increased 63% ( p = 0.0004) at 3-month follow-up. Significant improvements were noted for mean changes in VAS back pain, VAS leg pain, ODI, and SF-12 Physical Component Summary (PCS) scores. There was no significant correlation between the improvement in steps or distance traveled per day with improvements in VAS back or leg pain, ODI, or PCS scores at follow-up. Conclusions High compliance and statistically significant improvement in physical activity were demonstrated in patients who had lumbar decompression and lumbar fusion. There was no significant correlation between improvements in subjective clinical outcome scores with changes in physical activity measurements at follow-up. Limitations of the present study include its small sample size, and the validity of objective physical activity measurements should be assessed in future larger, prospective studies.
Upper Cervical Epidural Abscess in Clinical Practice: Diagnosis and Management
Authors: Al-Hourani Khalid , Al-Aref Rami , Mesfin Addisu 
Published: October 2015

Study Design Narrative review. Objective Upper cervical epidural abscess (UCEA) is a rare surgical emergency. Despite increasing incidence, uncertainty remains as to how it should initially be managed. Risk factors for UCEA include immunocompromised hosts, diabetes mellitus, and intravenous drug use. Our objective is to provide a comprehensive overview of the literature including the history, clinical manifestations, diagnosis, and management of UCEA. Methods Using PubMed, studies published prior to 2015 were analyzed. We used the keywords “Upper cervical epidural abscess,” “C1 osteomyelitis,” “C2 osteomyelitis,” “C1 epidural abscess,” “C2 epidural abscess.” We excluded cases with tuberculosis. Results The review addresses epidemiology, etiology, imaging, microbiology, and diagnosis of this condition. We also address the nonoperative and operative management options and the relative indications for each as reviewed in the literature. Conclusion A high index of suspicion is required to diagnose this rare condition with magnetic resonance imaging being the imaging modality of choice. There has been a shift toward surgical management of this condition in recent times, with favorable outcomes.
The Research on Medical Education Outcomes (ROMEO) Registry: Addressing Ethical and Practical Challenges of Using “Bigger,” Longitudinal Educational Data
Authors: Gillespie Colleen , Zabar Sondra , Altshuler Lisa , Fox Jaclyn , Pusic Martin , Xu Junchuan , Kalet Adina 
Published: October 2015

Problem
Efforts to evaluate and optimize the effectiveness of medical education have been limited by the difficulty of designing medical education research. Longitudinal, epidemiological views of educational outcomes can help overcome limitations, but these approaches require “bigger data”—more learners, sources, and time points. The rich data institutions collect on students and residents can be mined, however, ethical and practical barriers to using these data must first be overcome.

Approach
In 2008, the authors established the Research on Medical Education Outcomes (ROMEO) Registry, an educational data registry modeled after patient registries. New York University School of Medicine students, residents, and fellows provide consent for routinely collected educational, performance, quality improvement, and clinical practice data to be compiled into a deidentified, longitudinal database. As of January 2015, this registry included 1,225 residents and fellows across 12 programs (71% consent rate) and 841 medical students (86% consent rate). Procedures ensuring voluntary informed consent are essential to ethical enrollment and data use. Substantial resources are required to provide access to and manage the data.

Outcomes
The registry supports educational scholarship. Seventy-two studies using registry data have been presented or published. These focus on evaluating the curriculum, quality of care, and measurement quality and on assessing needs, competencies, skills development, transfer of skills to practice, remediation patterns, and links between education and patient outcomes.

Next Steps
The authors are working to integrate assessment of relevant outcomes into the curriculum, maximize both the quantity and quality of the data, and expand the registry across institutions.
Is a Drain Tip Culture Required After Spinal Surgery?
Authors: Kobayashi Kazuyoshi , Imagama Shiro , Ito Zenya , Ando Kei , Yagi Hideki , Hida Tetsuro , Ito Kenyu , Ishikawa Yoshimoto , Tsushima Mikito , Ishiguro Naoki 
Published: October 2015

Study Design:
The efficacy of use of a drain tip culture for early detection of surgical-site infection (SSI) was investigated in 329 patients after spinal surgery.

Objective:
To examine the efficacy of a wound drain tip culture for detection of SSI in spinal surgery.

Summary of Background Data:
A complication of SSI after spinal surgery has high associated morbidity and mortality, and is often difficult to treat.

Materials and Methods:
The subjects were patients who underwent spinal surgery at our institution between January 2010 and March 2013. All subjects were treated with antimicrobial prophylaxis based on evidence-based guidelines and were followed for at least 6 months after surgery. Data from culture studies using the distal tip of the wound drain were used for analysis.

Results:
Drain tip cultures were positive in 34 cases and there were 19 SSIs. Ten of the 34-tip culture-positive wounds developed SSI. Drain tip cultures had a sensitivity of 52%, specificity of 92%, positive predictive value (PPV) of 29%, and negative predictive value of 97% for predicting a wound infection. The association between a positive suction tip culture and wound infection was significant (P<0.05). The PPV for SSI was 60% in cases in which methicillin-resistant bacteria were detected in a drain tip, and the SSI rate in these cases differed significantly compared with those with non–methicillin-resistant bacteria (P=0.01).

Conclusions:
A drain tip culture is useful for early detection of SSI caused by methicillin-resistant bacteria.
Nutritional Intake, Energy Expenditure, and Growth of Infants Following Congenital Diaphragmatic Hernia Repair
Authors: Haliburton Beth , Chiang Monping , Marcon Margaret , Moraes Theo J. , Chiu Priscilla P. , Mouzaki Marialena 
Published: October 2015

ABSTRACTBackground/Objectives:The pathophysiology of failure to thrive in congenital diaphragmatic hernia (CDH) has not been fully elucidated, and the nutritional care of these infants is hindered by paucity of data on the optimal calorie requirements for growth. The primary objective of this study was to investigate the energy intake required for infants with CDH to grow optimally at the time of first hospital discharge. The secondary objectives were to assess their measured resting energy expenditure in infancy, and their long‐term growth outcomes.Methods:Nutritional intake, anthropometrics, indirect calorimetry results, and respiratory status of infants with CDH from 2011 to 2014 were collected retrospectively. Data on confounders (gastroesophageal reflux disease and feeding intolerance, respiratory rate and pulmonary hypertension) were also collected. Analyses were performed using Stata (College Station, TX).Results:Of the 72 infants diagnosed with CDH during that period of time, 43 met the inclusion criteria. A caloric intake of 125.0 ± 20 kcal · kg−1 · day−1 was required to meet discharge weight gain criteria (25–35 g · kg−1 · day−1). In a subset of 17 patients, measured resting energy expenditure was higher than predicted resting energy expenditure (58.0 ± 18 vs 46.6 ± 3 kcal · kg−1 · day−1, P < 0.05), and 59% of infants were hypermetabolic (measured resting energy expenditure >110% of predicted resting energy expenditure) in early infancy. Failure to thrive prevalence at discharge was 16.2% compared to 3.6% and 4.2% at 12‐ and 24‐months of age, respectively (P = 0.03; P = 0.005, respectively).Conclusions:Optimal weight gain can be achieved with higher than predicted calorie provision. Most infants with CDH are hypermetabolic. Despite this, failure to thrive prevalence can improve during the first year of life.
Choline Supplementation With a Structured Lipid in Children With Cystic Fibrosis
Authors: Schall Joan I. , Mascarenhas Maria R. , Maqbool Asim , Dougherty Kelly A. , Elci Okan , Wang Dah‐Jyuu , Altes Talissa A. , Hommel Kevin A. , Shaw Walter , Moore Jeff , Stallings Virginia A. 
Published: October 2015

ABSTRACTBackground:Choline depletion is seen in cystic fibrosis (CF) and pancreatic insufficiency in spite of enzyme treatment and may result in liver, fatty acid, and muscle abnormalities. This study evaluated the efficacy and safety of an easily absorbed choline‐rich structured lipid (LYM‐X‐SORB™ [LXS]) to improve choline status.Methods:Children with CF and pancreatic insufficiency were randomized to LXS or placebo in a 12‐month double blind trial. Dietary choline intake, plasma cholines, plasma and fecal phospholipids, coefficient of fat absorption, pulmonary function, growth status, body composition, and safety measures were assessed. Magnetic resonance spectroscopy for calf muscle choline and liver fat were assessed in a subgroup and compared with a healthy comparison group matched for age, sex, and body size.Results:A total of 110 subjects were enrolled (age 10.4 ± 3.0 years). Baseline dietary choline, 88% recommended, increased 3‐fold in the LXS group. Plasma choline, betaine, and dimethylglycine increased in the LXS but not placebo (P = 0.007). Plasma lysophosphatidylcholine and phosphatidylcholine increased, and fecal phosphatidylcholine/phosphatidylethanolamine ratio decreased (P ≤ 0.05) in LXS only, accompanied by a 6% coefficient of fat absorption increase (P = 0.001). Children with CF had higher liver fat than healthy children and depleted calf muscle choline at baseline. Muscle choline concentration increased in LXS and was associated with improvement in plasma choline status. No relevant changes in safety measures were evident.Conclusions:LXS had improved choline intake, plasma choline status, and muscle choline stores compared with placebo group. The choline‐rich supplement was safe, accepted by participants, and improved choline status in children with CF.
Effects of workaholism on satisfaction among US managerial and professional women
Authors: Levy Daniele V 
Published: October 2015

Purpose– The purpose of this paper is to evaluate relationships between workaholism and satisfaction outcomes with job, career and life overall among managerial and professional women and explore the moderating role of social support in these associations.Design/methodology/approach– Self-report measures collected online from 350 alumnae from top-ranked business schools currently in the US labor force were analyzed through hierarchical multiple regression analyses.Findings– Workaholism components explained significant amounts of variance in job, career and life satisfaction. Specifically, lower levels of work enjoyment were consistently associated with detrimental outcomes and high drive impacted both job and life satisfaction negatively. Social support moderated the relationship between job satisfaction and workaholism through work enjoyment, with women with greater social support demonstrating higher job satisfaction at equivalent work enjoyment levels versus those with low social support.Research limitations/implications– This paper shares methodological weaknesses involving the nature of the sample and self-report methods of measurement common to workaholism research.Practical implications– In the context of today’s competitive workplaces, results provide a cautionary message of the harmful effects of workaholic dispositions for a certain segment of professional women. It emphasizes the importance of work enjoyment and positive intrinsic motivation, while suggesting that job designs that reflect the work involvement predispositions of each woman can be beneficial.Originality/value– This paper extends the understanding of workaholism correlates to female MBA graduates from top management schools in the USA and investigates, for the first time, the role of social support in those relationships.
Personalisation in children’s social work: from family support to “the child’s budget”
Authors: Whitaker Emilie Morwenna 
Published: October 2015

Purpose– The purpose of this paper is to explore the changing meaning of personalisation from the New Labour era of bespoke, integrated family support to the more recent implementation of personal budgets for disabled children to deliver “choice and control”. The paper explores the discursive change from early help to “intervention”, the shifting conceptualisation of parents and the turn away from family support towards a focus upon individualised commissioning to meet needs.Design/methodology/approach– In addition to a literature review of policy shifts, findings presented are taken from an ethnographic case study of one team of children’s disability social workers. Observations were undertaken of the team in the office space and at meetings, in addition interviews were conducted with all team members and with seven families. An interpretivist and qualitative approach was adopted throughout.Findings– Findings reveal the frontline and familial challenges of delivering choice and control in a climate of austerity and child-centricism. Salient points for integration around families and between organisations as personalisation narrows in scope are also considered.Research limitations/implications– Findings are taken from one case study site; further research in different sites is required to consider the array of understandings and experiences across the social care landscape and to provide a strong empirical baseline.Originality/value– The paper reports on one of the first ethnographic studies of personalisation in children’s services. The paper is of value to practitioners and managers in social care and the NHS. It is also of value to academics exploring the conceptual and practical issues of individualised care.
Investigation of Microbial Communities of Chinese Sourdoughs Using Culture‐Dependent and DGGE Approaches
Authors: Zhang Guohua , Sadiq Faizan A. , Zhu Liying , Liu Tongjie , Yang Huanyi , Wang Xin , He Guoqing 
Published: October 2015

AbstractSourdough is typically characterized by the complex microbial communities mainly comprising of yeasts and lactic acid bacteria (LAB). The objective of this study was to explore the microbiota of Chinese traditional sourdoughs collected from different areas of China using culture‐dependent and denaturing gradient gel electrophoresis (DGGE) methods. A total of 131 yeasts, 2 molds, and 106 LAB strains were isolated and identified. Based on the culture‐dependent analysis, the populations of yeasts and LAB were at the level of 105 to 107 and 106 to 107 cfu/g, respectively. Similarly, the results of RT‐qPCR showed that the values of total yeasts and LAB populations were in the range of 106 to 107 and 107 to 108 copies/g, respectively. Using culture‐dependent method, a total of 7 yeasts, 2 molds and 7 LAB species were identified. Results showed that Saccharomyces cerevisiae and Lactobacillus plantarum were the predominant species among the yeasts and LAB microflora. Similarly, using PCR‐DGGE approach, 7 yeasts, 1 mold and 9 LAB species were detected. The yeast, S. cerevisiae, represented the predominant, while the yeast Candida tropicalis represented the subdominant species of the yeast community. Among the LAB community, Lactobacillus sanfranciscensis was the predominant species, while Lactococcus qarvieae, Enterococcus faecium, Lactobacillus delbrueckii and Enterococcus cecorum were among the less dominant species.
Early Onset Alcohol Use and Self‐Harm: A Discordant Twin Analysis
Authors: Few Lauren R. , Werner Kimberly B. , Sartor Carolyn E. , Grant Julia D. , Trull Timothy J. , Nock Matthew K. , Bucholz Kathleen K. , Deitz Sarah K. , Glowinski Anne L. , Martin Nicholas G. , Nelson Elliot C. , Statham Dixie J. , Madden Pamela A. F. , Heath Andrew C. , Lynskey Michael T. , Agrawal Arpana 
Published: October 2015

BackgroundSelf‐harm has considerable societal and economic costs and has been extensively studied in relation to alcohol involvement. Although early onset alcohol use (EAU) has been causally linked to maladaptive clinical outcomes, its association with self‐harm is less well characterized. This study aimed to further examine the link between EAU and both nonsuicidal self‐injury (NSSI) and suicide attempt (SA), and elucidate shared familial and causal/individual‐specific pathways that explain this co‐occurrence.MethodsUsing data from 6,082 Australian same‐sex twin pairs (1,732 monozygotic [MZ] and 1,309 dizygotic [DZ]), ages 23 to 40, we examined prevalence rates of NSSI and SA among twin pairs concordant and discordant for EAU. Conditional logistic regression, controlling for early clinical covariates and the influence of zygosity on EAU, was used to examine the odds ratio (OR) of self‐harm within twin pairs discordant for EAU.ResultsPrevalence rates of both NSSI and SA were highest among twin pairs concordant for EAU and for twins who reported EAU within discordant twin pairs. Results from discordant twin analyses revealed nearly 4‐fold increased odds of SA for the twin who endorsed EAU, and this OR was equal across MZ and DZ twins. EAU also was associated with elevated odds of NSSI (OR = 7.62), although this was only the case for DZ twins in discordant pairs.ConclusionsThe equivalent increase in odds of SA for both MZ and DZ twins suggests that causal or individual‐specific influences explain the link between EAU and SA. For NSSI, elevated odds for DZ twins and nonsignificant findings for MZ twins implicate correlated genetic factors in the association between EAU and NSSI. Future studies should test mechanisms through which EAU may causally influence SA, as well as examine whether genetic risk for third variables (e.g., negative urgency, stress reactivity) may explain the genetic overlap between EAU and NSSI.
Prevalence and reversibility of lung hyperinflation in adult asthmatics with poorly controlled disease or significant dyspnea
Authors: Perez T. , Chanez P. , Dusser D. , Devillier P. 
Published: October 2015

AbstractBackgroundIn asthma, inflammation affects both the proximal and distal airways and may induce significant hyperinflation (HI). This study sought to evaluate the prevalence of HI in asthmatic patients with poorly controlled disease and/or dyspnea.MethodsPoor asthma control was defined by an Asthma Control Test (ACT) score <20 (n = 287), and dyspnea was defined as a modified Medical Research Council score ≥1 (n = 18). HI was defined as either a residual volume/total lung capacity (RV/TLC) above the upper limit of normal (RV‐HI) or a functional residual capacity (FRC) >120% predicted (FRC‐HI). HI reversibility after administration of salbutamol (400 μg) was defined as a decrease in RV >20% or a reduction in FRC >10%. Changes in dyspnea and chest tightness were evaluated on a visual analogue scale.ResultsBoth RV‐HI and FRC‐HI were observed in 48% of the 305 patients (mean ± SD age: 49 ± 17; FEV1: 75 ± 18% predicted) included in the study. The prevalence of HI was higher in patients with a FEV1 <60% predicted (93% for RV‐HI and 71% for FRC‐HI, vs 21% and 41% in patients with a FEV1 > 80%). In patients with HI, the ACT score was lower and chest tightness higher. HI reversibility was obtained in 38% of the asthmatics with FRC‐HI and 29% of the asthmatics with RV‐HI, whereas FEV1 reversibility was obtained in half of these patients.ConclusionsHI is highly prevalent in poorly controlled asthmatics suggesting small airway dysfunction and may represent an additional criteria for evaluating responsiveness to bronchodilators.
Organizational form and output quality
Authors: Dubrovinsky Mati , Winter Ralph A. 
Published: October 2015

AbstractThis paper re‐examines the relationship between a firm's organizational form, not‐for‐profit versus for‐profit, and its output quality. The Arrow‐Hansmann theory of hidden action on the part of providers predicts higher quality for not‐for‐profit suppliers. This prediction has a puzzling lack of support in the empirical literature. We propose a theory that resolves the empirical puzzle and generates additional testable implications. The theory starts with the traditional assumptions of hidden action and supplier altruism. It then incorporates two additional features of real‐world markets: hidden information on supplier ability to provide high quality and a variation across buyers in the degree of informational asymmetry. The central prediction of the theory is that quality has a higher variance across for‐profits than across not‐for‐profits. Preliminary evidence from the US market for hospital care is consistent with this prediction.
The Impact of Maternal Gestational Stress on Motor Development in Late Childhood and Adolescence: A Longitudinal Study
Authors: Grace Tegan , Bulsara Max , Robinson Monique , Hands Beth 
Published: October 2015

The number and timing of stressors experienced during pregnancy were investigated using longitudinal data from the Western Australian Pregnancy (Raine) Study cohort (N = 2,900). Motor development data were collected at 10 (n = 1,622), 14 (n = 1,584), and 17 (n = 1,222) years using the McCarron Assessment of Neuromuscular Development. Linear mixed models were used to examine the effect of stress on motor development, accounting for repeated measures. Number of stressful events and mean Neuromuscular Development Index were negatively related (β = −1.197, p = .001). Stressful events experienced in late pregnancy were negatively related with offspring motor development (β = −0.0541, p = .050), while earlier stressful events had no significant impact.