bluuebunny/crossref_metadata_2025_split huggingface dataset:
An unusual complication of quadriparesis after trigger point injection: a case report
Authors: Sangondimath Gururaj , Varma Kalidindi Kalyan Kumar , Pandrakula Phani , Kumar Vivek , Hari Krishan Mahajan 
Published: October 2020

Abstract:
Quadriparesis after intramuscular trigger point injections for myofascial pain syndrome has been rarely reported in the literature. A 37-year-old male patient presented with myofascial pain syndrome and was given trigger point injections in trapezius muscles under ultrasound guidance. The patient noticed weakness in all the 4 limbs at approximately 12 hours after the procedure, which gradually progressed to functional quadriplegia at the time of presentation to the emergency department. On examination, he had quadriparesis with no sensory involvement and superficial reflexes were normal. MRI screening of the whole spine was unremarkable, and MRI brain suggested an incidental granuloma, which could not explain his symptoms. Blood tests revealed severe hypokalemia (2.2 mEq/L) and deranged thyroid function tests. Immediate potassium correction with intravenous and oral potassium chloride was initiated, and the patient showed improvement within 6 hours of initiating correction. Stress of the procedure, use of steroids with mineralocorticoid effects such as methylprednisolone, or deranged thyroid function tests may have acted as triggers to precipitate hypokalemic paralysis in the patient. Knowledge of this complication is essential as prompt diagnosis and timely management of hypokalemia can result in complete resolution of the symptoms.
Effect of a brief scenario-tailored educational program on parents' risk knowledge, perceptions, and decisions to administer prescribed opioids: a randomized controlled trial
Authors: Voepel-Lewis Terri , Malviya Shobha , Grant John A. , Dwyer Sarah , Becher Asif , Schwartz Jacob H. , Tait Alan R. 
Published: October 2020

Abstract
This randomized, controlled trial evaluated whether a brief educational program (ie, Scenario-Tailored Opioid Messaging Program [STOMP]) would improve parental opioid risk knowledge, perceptions, and analgesic efficacy; ensure safe opioid use decisions; and impact prescription opioid use after surgery. Parent–child dyads (n = 604) who were prescribed an opioid for short-term use were randomized to routine instruction (Control) or routine plus STOMP administered preoperatively. Baseline and follow-up surveys assessed parents' awareness and perceived seriousness of adverse opioid effects, and their analgesic efficacy. Parents' decisions to give an opioid in hypothetical scenarios and total opioid doses they gave to children at home were assessed at follow-up. Scenario-Tailored Opioid Messaging Program parents gained enhanced perceptions of opioid-related risks over time, whereas Controls did not; however, risk perceptions did not differ between groups except for addiction risk. Scenario-Tailored Opioid Messaging Program parents exhibited marginally greater self-efficacy compared to Controls (mean difference vs controls = 0.58 [95% confidence interval 0.08-1.09], P = 0.023). Scenario-Tailored Opioid Messaging Program parents had a 53% lower odds of giving an opioid in an excessive sedation scenario (odds ratio 0.47 [95% confidence interval 0.28-0.78], P = 0.003), but otherwise made similar scenario-based opioid decisions. Scenario-Tailored Opioid Messaging Program was not associated with total opioid doses administered at home. Instead, parents' analgesic efficacy and pain-relief preferences explained 7%, whereas child and surgical factors explained 22% of the variance in opioid doses. Scenario-tailored education enhanced parents' opioid risk knowledge, perceptions, and scenario-based decision-making. Although this may inform later situation-specific decision-making, our research did not demonstrate an impact on total opioid dosing, which was primarily driven by surgical and child-related factors.
SARS-CoV-2 spike protein co-opts VEGF-A/neuropilin-1 receptor signaling to induce analgesia
Authors: Moutal Aubin , Martin Laurent F. , Boinon Lisa , Gomez Kimberly , Ran Dongzhi , Zhou Yuan , Stratton Harrison J. , Cai Song , Luo Shizhen , Gonzalez Kerry Beth , Perez-Miller Samantha , Patwardhan Amol , Ibrahim Mohab M. , Khanna Rajesh 
Published: October 2020

Abstract
Global spread of severe acute respiratory syndrome coronavirus 2 continues unabated. Binding of severe acute respiratory syndrome coronavirus 2's spike protein to host angiotensin-converting enzyme 2 triggers viral entry, but other proteins may participate, including the neuropilin-1 receptor (NRP-1). Because both spike protein and vascular endothelial growth factor-A (VEGF-A)—a pronociceptive and angiogenic factor, bind NRP-1, we tested whether spike could block VEGF-A/NRP-1 signaling. VEGF-A-triggered sensory neuron firing was blocked by spike protein and NRP-1 inhibitor EG00229. Pronociceptive behaviors of VEGF-A were similarly blocked through suppression of spontaneous spinal synaptic activity and reduction of electrogenic currents in sensory neurons. Remarkably, preventing VEGF-A/NRP-1 signaling was antiallodynic in a neuropathic pain model. A “silencing” of pain through subversion of VEGF-A/NRP-1 signaling may underlie increased disease transmission in asymptomatic individuals.
Leydig stem cells and future therapies for hypogonadism
Authors: Achua Justin K. , Frech Fabio S. , Ramasamy Ranjith 
Published: October 2020

Purpose of review
In this review, we outline the most recent advances in the development of Leydig stem cells (LSCs) and summarize the current and upcoming treatments for hypogonadism.

Recent findings
In-vitro and in-vivo studies show that inducing stem cells to differentiate into testosterone-producing adult Leydig cells is possible. In addition, LSCs can be grafted with Sertoli cells to increase testosterone levels in vivo. This therapy causes minimal effects on luteinizing hormone and follicle stimulating hormone levels. Novel therapies for hypogonadism include varying methods of testosterone delivery such as intranasal and oral agents, as well as novel selective estrogen and androgen receptor modulators.

Summary
LSC therapies provide an effective way of increasing testosterone levels without detrimentally affecting gonadotropin levels. Next steps in developing viable Leydig cell grafting options for the treatment of hypogonadism should include the assessment of efficacy and potency of current animal models in human trials. Recently, both intranasal and oral testosterone have been made available and shown promising results in treating hypogonadism while maintaining fertility. Enclomiphene citrate and selective androgen receptor modulators have been suggested as future therapies for hypogonadism; however, further studies assessing efficacy and adverse effects are needed.
Establishing Reference Values for Lean Muscle Mass in the Pediatric Patient
Authors: Metzger Gregory A. , Sebastião Yuri V. , Carsel Alex C. , Nishimura Leah , Fisher Jeremy G. , Deans Katherine J. , Minneci Peter C. 
Published: October 2020

ABSTRACTObjectives:Adults with decreased muscle mass experience worse outcomes and more frequent complications. The effects of sarcopenia on pediatric outcomes are unknown. Our objective was to define reference values for lean muscle mass in a healthy pediatric population to facilitate future studies on the impact of lean muscle mass on pediatric outcomes.Patients and Methods:Bilateral psoas muscle surface area was measured by computed tomography in a healthy pediatric population undergoing evaluation after trauma. Pearson correlation coefficients (PCCs) were calculated for age, weight, height, body mass index (BMI), total psoas muscle area, and psoas muscle index (PMI; defined as psoas muscle area divided by height squared). Quantile regression was used to determine age‐ and sex‐specific percentiles of psoas muscle area and PMI.Results:Analysis of 494 male and 288 female patients with available imaging (median age: 9.3 years, interquartile range: 5.4–13.4; 63.1% male) was performed. For males, age correlated strongly with total psoas volume (PCC = 0.87), height (0.95), and weight (0.88) and poorly with BMI (0.45). In females, age correlated strongly with total psoas volume (0.88), height (0.92), weight (0.88) and poorly with BMI (0.19). Gender‐specific curves and charts were created using output from the quantile regression from reference values of the total psoas muscle area corresponding to the 25th, 50th, and 75th percentiles across all ages.Conclusions:We created gender‐specific reference charts for total and height‐normalized psoas muscle area in healthy children based on age. These results can be used in future studies to establish the effects of sarcopenia in pediatric patients.
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the Society for Pediatric Radiology Joint Position Paper on Noninvasive Imaging of Pediatric Pancreatitis
Authors: Trout Andrew T. , Anupindi Sudha A. , Freeman A. Jay , Macias‐Flores Jorge Alberto , Martinez J. Andres , Parashette Kalyan R. , Shah Uzma , Squires Judy H. , Morinville Veronique D. , Husain Sohail Z. , Abu‐El‐Haija Maisam 
Published: October 2020

ABSTRACTThe reported incidence of pediatric pancreatitis is increasing. Noninvasive imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), play important roles in the diagnosis, staging, follow‐up, and management of pancreatitis in children. In this position paper, generated by members of the Pancreas Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the Abdominal Imaging Committee of The Society for Pediatric Radiology (SPR), we review the roles of noninvasive imaging in pediatric acute, acute recurrent, and chronic pancreatitis. We discuss available evidence related to noninvasive imaging, highlighting evidence specific to pediatric populations, and we make joint recommendations for use of noninvasive imaging. Further, we highlight the need for research to define the performance and role of noninvasive imaging in pediatric pancreatitis.
Quality of Life and Its Influencing Factors Among Chinese Patients With Permanent Colostomy in the Early Postoperative Stage
Authors: Yan Ming-hui , Lv Lin , Zheng Mei-chun , Jin Ying , Zhang Jun-e 
Published: September 2020

Background
Colorectal cancer is one of the most common cancers worldwide. Although colostomies are necessary for disease treatment, they unavoidably affect patient quality of life (QOL), especially in the early postoperative stage.

Objective
The aim of this study was to investigate the dynamic changes and factors influencing QOL among Chinese patients with permanent colostomy.

Methods
We investigated 74 patients before discharge and at 1 and 3 months after discharge. Instruments included the Quality of Life Questionnaire for People With Ostomy–Chinese version, Stoma Self-efficacy Scale, Stoma Self-care Scale–Early Stage Version, and a demographic and stoma-related information questionnaire.

Results
The average QOL increased significantly after discharge (P < .01). Multivariate linear regression showed that the influencing factor of QOL was self-efficacy (before discharge, explained 22.9% of the variance); self-efficacy, truth-telling, average time of stoma care, communicating with friends with colostomy, and family relationship (1 month after discharge, explained 48.8% of the variance); and self-efficacy, body image loss, and participating in activities of patients with colostomy (3 months after discharge, explained 85.2% of the variance).

Conclusions
Clinicians need to give attention to improving the QOL of colostomy patients especially 1 month after discharge. Interventions aimed at improving self-efficacy, preoperative education regarding the surgery, colostomy care ability, family relationship, stoma self-acceptance, and involvement in activities of friends with colostomy should be considered to improve QOL among Chinese patients in this setting.

Implications for Practice
Transitional care should be provided for colostomy patients especially 1 month after discharge. Interventions should focus on enhancing self-efficacy, stoma self-management, and social-environmental support.
The Lived Experiences of Mothers Who Are Parenting Children With Leukemia
Authors: Al Omari Omar , Roach Erna Judith , Shakman Lina , Al Hashmi Aysha , Sunderraj Sheeba John , Francis Frincy , Joseph Mickael Antoine 
Published: September 2020

Background
Mothers parenting children with leukemia face innumerable challenges in meeting their own personal needs, as well as the needs of their ill child.

Objective
To explore the lived experiences of Omani mothers who are parenting children with leukemia, using interpretative phenomenological analysis design.

Methods
Data were collected from 10 mothers who were parenting children with leukemia who shared their experiences through a face-to-face recorded interview. Data were analyzed using the interpretative phenomenological analysis approach methods.

Results
Three main themes emerged from the mothers’ experiences: (1) unexpected shocking diagnosis; (2) life is not the same anymore; and (3) viable support systems. Mothers found their child’s diagnosis to be shocking and terrifying. The diagnosis and treatment cast a shadow on the mothers’ lives. Mothers abandoned their work and left their healthy children to their spouses. Mothers relied on other mothers also parenting children with cancer and on the support of the extended family and health team members to cope and prayed to God to help them overcome the calamity.

Conclusion
The mothers perceived their life as changing immediately upon hearing their child’s cancer diagnosis as they experienced a plethora of emotions. They sought support at various points during their child’s illness to cope and overcome the challenges during the cancer treatment journey.

Implications for Practice
Pediatric oncology nurses can support mothers during their transition to caring for a child with leukemia and can provide the needed support to reduce maternal distress and increase effective coping with the challenges.
Predicting Clinical Practice Change: An Evaluation of Trainings on Sexually Transmitted Disease Knowledge, Diagnosis, and Treatment
Authors: Voegeli Christopher , Fraze Jami , Wendel Karen , Burnside Helen , Rietmeijer Cornelis A. , Finkenbinder Allison , Taylor Kimberly , Devine Sharon ,   on behalf of the National Network of STD Clinical Prevention Training Centers
Published: October 2020

Background
Sexually transmitted disease clinical training for working professionals requires substantial time and resources. Understanding the predictors of change in worksite practices and barriers to change will allow educators, learners, and clinical leadership to aid in ensuring learned practices are implemented and barriers are addressed.

Methods
Data for this analysis come from the first standardized national evaluation of a Centers for Disease Control and Prevention–funded clinical prevention training network, including precourse registration and responses to immediate postcourse (1–3 days) and 90-day postcourse evaluations from 187 courses. Univariate statistics describe the trainees and their workplace. Bivariate statistics describe their intention to change and actual change stratified by functional role and employment setting. Logistic regression identified predictors of self-reported changes in practice.

Results
The strongest predictors for practice change included an intention to change and attendance at a training lasting 4 hours or more. Functional role was a weaker predictor of change in practice; employment setting did not predict change. More than half of the trainees (65.9%; n = 912) stated their intention to make a change in their practice immediately after training. At 90 days after a course, 62.4% (n = 863) reported making a practice change. Trainees that took courses lasting 4 hours or more reported making a change more often (70%) compared with trainees from shorter courses (53%). We also report on trainees’ barriers to practice change.

Conclusions
Results suggest that longer trainings may result in more practice change than shorter trainings, recruitment of trainees should focus on those more likely to make a change in their practice, and future trainings should focus on organizational capacity building and assessing change at the organizational level.
Survey of Health Care Providers’ Practices and Opinions Regarding Bacterial Sexually Transmitted Infection Testing Among Gay, Bisexual, and Other Men Who Have Sex With Men
Authors: Rana Jayoti , Guiang Charlie B. , Lisk Ryan , Shahin Rita , Brunetta Jason , Mitterni Leo , Grewal Ramandip , Tan Darrell H.S. , Gilbert Mark , Yeung Anna , Kwag Michael , Logie Carmen H. , Bacon Jean , Gesink Dionne , Burchell Ann N. 
Published: October 2020

Background
Rates of bacterial sexually transmitted infections (STIs) continue to rise among gay, bisexual, and other men who have sex with men (GBMSM) globally. Testing and treatment can prevent morbidity and transmission. However, testing rates remain suboptimal.

Methods
In 2018, we conducted an online cross-sectional survey to explore STI testing ordering practices, 14 potential barriers for testing and 11 possible ways to improve testing from the perspective of health care providers in Toronto, Ontario. An estimated 172 providers were invited from primary care and sexual health clinic settings. Providers were eligible to complete the survey if they provided care for ≥1 GBMSM per week and were involved in the decision-making process in providing STI tests. We used descriptive statistics to summarize survey responses.

Results
Ninety-five providers (55% response rate) participated, of whom 68% worked in primary care and 32% in sexual health settings. Most (66%) saw ≤10 GBMSM clients per week. In primary care (65%) and sexual health (40%) clinic settings, insufficient consultation time was the most common barrier to STI testing. In primary care, other common barriers included difficulty introducing testing during unrelated consultations (53%), forgetting (47%), and patients being sexually inactive (31%) or declining testing (27%). The following were most likely to improve testing: express/fast-track testing services (89%), provider alerts when patients are due for testing (87%), patient-collected specimens (84%), nurse-led STI testing (79%), and standing orders (79%).

Conclusions
Promising interventions to improve bacterial STI testing included initiatives that simplify and expedite testing and expand testing delivery to other health care professionals.
Characteristics of the Largest Network Component of Individuals With or Exposed to Early Syphilis in Central Indiana: 2016 to 2017
Authors: Hanley Shane , Parmar Samir , Dawson Bodashus , Haecker Kari , Rios Mackie , Arno Janet N. 
Published: October 2020

Background
The surge of syphilis infections in the United States continues. This study examined the sexual networks of early syphilis cases to determine whether repeat infection, demographics, or behaviors differed among network components (groups of connected persons).

Methods
We examined a retrospective cohort of all early syphilis cases in Central Indiana reported from January, 1, 2016, to January 24, 2018, in the state's reporting database. Cases were linked to their sexual partners and analyzed using UCINET and NetDraw. Attributes of network members were derived from disease intervention specialist interviews. Repeat cases were defined as those who also had ≥1 early syphilis infection at any time between 2011 and 2017. The resulting network included 1140 unique individuals, 436 cases and 704 contacts. We compared members of the main component, that is, the largest one, with the rest of the network using multiple logistic regression and network analyses.

Results
The network formed 197 separate components. The main component contained 473 individuals (41% of the cohort). Main component members were more likely to have repeat early syphilis, gonorrhea, Black race, male sex, and a history of methamphetamine use, and be HIV positive by multiple logistic regression. Results from multiple centrality measures indicated persons who might be most effective at disseminating information or fragmenting the main component.

Conclusions
Network analysis identified a group of linked individuals most likely to be reinfected with syphilis in Central Indiana. Further investigation is needed to determine whether engaging such a high-risk group could better focus resources and decrease infections.
Estimating Recommended Gonorrhea and Chlamydia Treatment Rate Using Linked Medical Claims, Prescription, and Laboratory Data in US Private Settings
Authors: Tao Guoyu , Workowski Kimberly , Bowden Katherine E. , Pearson William S. , Sullivan Jane M. , Henk Henry J. , Gift Thomas L. 
Published: October 2020

Background
The Centers for Disease Control and Prevention (CDC) recommends specific regimens for chlamydia and dual therapy for gonorrhea to mitigate antimicrobial-resistant gonorrhea in the CDC 2015 sexually transmitted disease treatment guidelines. Only limited studies examining adherence to these recommendations have been conducted at private practices in the United States.

Methods
We used the OptumLabs Data Warehouse, a comprehensive, longitudinal data asset with deidentified persons with linked commercial insurance claims and clinical information, to identify persons aged 15 to 60 years who had valid nucleic acid amplification testing results demonstrating urogenital or extragenital gonorrhea or chlamydia in 2016 to 2018. We defined valid laboratory results as positive or negative. We then assessed the time of their first positive test result and the type of treatment within 30 days to determine if there was evidence in the claims record that the CDC-recommended treatment was provided. We defined presumed treatment if the date of treatment was before the date of the positive test result within 30 days.

Results
Among 6476 patients with positive gonorrhea test results and 26,847 patients with positive chlamydia test results only, 34.8% and 64.2% had evidence of receiving the CDC-recommended therapy, respectively. Approximately 11.6% of patients with positive gonorrhea test results with recommended dual treatment and 7.1% of patients with positive chlamydia test results only with recommended chlamydia treatment were presumptively treated.

Conclusion
Analysis of treatment claims and medical records from private settings indicated low rates of recommended gonorrhea and chlamydia treatment. Validation of treatment claims is needed to support further quality of care interventions based on these data.