bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical therapy and opioid use for musculoskeletal pain management: competitors or companions?
Authors: George Steven Z. , Goode Adam P. 
Published: September 2020

Abstract
Musculoskeletal (MSK) pain conditions are highly prevalent and a leading cause of disability globally. When people with MSK pain seek health care, they often receive treatment not aligned with best practices, including initial management options such as opioids. In recent practice guidelines, nonpharmacological treatments have been emphasized for initial pain management, and physical therapists are providers who routinely deliver nonpharmacological treatments. The purpose of this review is to describe the current and future state for how physical therapy may be used to increase exposure to nonpharmacological treatments for MSK pain conditions. For the current state, we review existing observational evidence investigating early exposure to physical therapy and its influence on subsequent opioid use. For the future state, we propose clinical research questions that could define the role of physical therapy on interdisciplinary teams working towards improving effectiveness of nonpharmacological treatments through more rigorous study designs. These clinical questions are intended to guide health services research and clinical trials when building an evidence base of nonpharmacological care options for MSK pain conditions.
Physiotherapy for people with painful peripheral neuropathies: a narrative review of its efficacy and safety
Authors: Jesson Tom , Runge Nils , Schmid Annina B. 
Published: September 2020

Abstract
Pharmacological treatment for peripheral neuropathic pain has only modest effects and is often limited by serious adverse responses. Alternative treatment approaches including physiotherapy management have thus gained interest in the management of people with peripheral neuropathies. This narrative review summarises the current literature on the efficacy and safety of physiotherapy to reduce pain and disability in people with radicular pain and chemotherapy-induced peripheral neuropathy, 2 common peripheral neuropathies. For chemotherapy-induced peripheral neuropathy, the current evidence based on 8 randomised controlled trials suggests that exercise may reduce symptoms in patients with established neuropathy, but there is a lack of evidence for its preventative effect in patients who do not yet have symptoms. For radicular pain, most of the 21 trials investigated interventions targeted at improving motor control or reducing neural mechanosensitivity. The results were equivocal, with some indication that neural tissue management may show some benefits in reducing pain. Adverse events to physiotherapy seemed rare; however, these were not consistently reported across all studies. Although it is encouraging to see that the evidence base for physiotherapy in the treatment of peripheral neuropathic pain is growing steadily, the mixed quality of available studies currently prevents firm treatment recommendations. Based on promising preliminary data, suggestions are made on potential directions to move the field forward.
Evaluation of Spatial Resolution of Virtual Monochromatic Imaging In Vitro: Effect of Energy Level and Contrast
Authors: Suzuki Shigeru , Fukui Rika , Yamamoto Yuzo , Nakayama Suguru , Suzuki Mayuka , Kuwahara Sadatoshi 
Published: September 2020

Objective
Our aim was to evaluate effects of the energy level and contrast on the spatial resolution of virtual monochromatic imaging (VMI).

Methods
With 2 types of computed tomographic (CT) scanners (Discovery CT750 HD and Revolution CT), we scanned an elliptical cylinder acrylic phantom with 20- or 40-fold dilutions of contrast medium and obtained VMI data sets at 40, 50, 60, and 70 keV. We evaluated the effects of energy levels and contrast on modulation transfer function (MTF) and the effect of energy levels on noise power spectra (NPS).

Results
With both CT scanners, MTF decreased significantly as the energy level decreased. The effect of the dilution of contrast media on MTF varied with CT scanners. With both scanners, NPS curves demonstrate uniform increase in NPS across the entire spatial frequency as the energy levels decreased.

Conclusions
The energy level and contrast can affect the spatial resolution of VMIs.
Computed Tomography-Guided Biopsy for Small (≤20 mm) Lung Nodules: A Meta-Analysis
Authors: Liu Guang-Sheng , Wang Shao-Qing , Liu Hui-Ling , Liu Yi , Fu Yu-Fei , Shi Yi-Bing 
Published: September 2020

Purpose
This study was designed to evaluate the diagnostic accuracy of computed tomography (CT)-guided biopsy for small lung nodules (SLNs) (≤20 mm) and to assess related complication rates.

Methods
We reviewed the Pubmed, Embase, and Cochrane Library databases to identify all relevant studies published as of April 2020. Random effects modeling were then used to evaluate pooled data pertaining to technical success rates, diagnostic accuracy, pneumothorax rates, and rates of hemoptysis. The meta-analysis was conducted using Stata v12.0.

Results
In total, we identified 25 relevant studies for incorporation into this meta-analysis, incorporating 2922 total CT-guided lung biopsy. Pooled technical success rates, diagnostic accuracy, pneumothorax rates, and hemoptysis rates were 94% (95% confidential interval [CI], 0.91–0.98), 90% (95% CI, 0.88–0.93), 19% (95% CI:, 0.15–0.24), and 12% (95% CI, 0.08–0.15), respectively. We observed significant heterogeneity among these studies for all 4 of these parameters (I2
= 90.0%, 82.7%, 88.6%, and 88.4%, respectively). When we conducted a meta-regression analysis, we did not identify any variables that influenced diagnostic accuracy or technical success, pneumothorax, or hemoptysis rates. Publication bias risk analyses suggested that there was relatively little risk of publication bias pertaining to pneumothorax rates (P = 0.400) or hemoptysis rates (P = 0.377). In contrast, we detected a high risk of publication bias pertaining to reported technical success rates (P = 0.007) and diagnostic accuracy (P = 0.000).

Conclusions
A CT-guided biopsy can be safely and effectively used to diagnose SLNs.
The Evaluation of Radiomic Models in Distinguishing Pilocytic Astrocytoma From Cystic Oligodendroglioma With Multiparametric MRI
Authors: Zhao Yajing , Lu Yiping , Li Xuanxuan , Zheng Yingyan , Yin Bo 
Published: September 2020

Purpose
To assess whether a machine-learning model based on texture features extracted from multiparametric magnetic resonance imaging could yield an accurate diagnosis in differentiating pilocytic astrocytoma from cystic oligodendrogliomas.

Materials and Methods
The preoperative images from multisequences were used for tumor segmentation. Radiomic features were extracted and selected for machine-learning models. Semantic features and selected radiomic features from training data set were built, and the performance of each model was evaluated by receiver operating characteristic curve and accuracy from isolated testing data set.

Results
In terms of different sequences, the best classifier was built by radiomic features extracted from enhanced T1WI-based classifier. The best model in our study turned out to be the gradient boosted trees classifier with an area under curve value of 0.99.

Conclusion
Our study showed that gradient boosted trees based on texture features extracted from enhanced T1WI could become an additional tool for improving diagnostic accuracy to differentiate pilocytic astrocytoma from cystic oligodendroglioma.
Detection of Shunting Into Pulmonary Artery on Multidetector Row Computed Tomography Arteriography Before Bronchial Arterial Embolization: A Preliminary Study
Authors: Takeuchi Hitoshi , Matsumoto Tomohiro , Morimoto Kozo , Osawa Takeshi , Tanaka Yoshiaki , Yoshimori Kozo , Kamei Shunsuke , Yamamoto Shota , Kurosaki Atsuko , Hasebe Terumitsu 
Published: September 2020

Objective
The aim of this study was to investigate the diagnostic performance of detecting systemic arterial pulmonary circulation shunts on multidetector row computed tomography arteriography (MDCTA).

Methods
Thirty-five consecutive bronchial artery embolization sessions with preprocedural MDCTA were performed for 32 patients and 35 sessions. The MDCTA studies with computed tomography value of pulmonary trunk visually lower than that of ascending aorta were defined as “diagnostic MDCTA.” Angiographic studies and “diagnostic MDCTA” were evaluated, respectively, for shunting into pulmonary artery. Based on the results of angiographic studies, diagnostic performance of “diagnostic MDCTA” was evaluated.

Results
The rate of diagnostic MDCTA was 63% (23 of 35). On “diagnostic MDCTA,” sensitivity, specificity, and positive and negative predictive values for detecting shunts were 83% 100%, 100%, 94%, respectively.

Conclusions
Systemic arterial pulmonary circulation shunts were detected on “diagnostic MDCTA” with high sensitivity and specificity.
Accuracy of Pulmonary Nodule Volumetry Using Noise-Optimized Virtual Monoenergetic Image and Nonlinear Blending Image Algorithms in Dual-Energy Computed Tomography: A Phantom Study
Authors: He Changjiu , Liu Jieke , Hu Shibei , Qing Haomiao , Qiao Liang , Luo Hongbing , Chen Xiaoli , Zhou Peng 
Published: September 2020

Objective
The aim of the study was to assess accuracy of pulmonary nodule volumetry using noise-optimized virtual monoenergetic image (VMI+) and nonlinear blending image (NBI) algorithms in dual-energy computed tomography (DECT).

Methods
An anthropomorphic chest phantom with 10 simulated nodules (5 solid nodules and 5 ground-glass opacities) was scanned using DECT80/Sn140kV, DECT100/Sn140kV, and single-energy CT (SECT120kV/200mAs), respectively. The dual-energy images were reconstructed using VMI+ (70 keV) and NBI algorithms. The contrast-to-noise ratio and absolute percentage error (APE) of nodule volume were measured to assess image quality and accuracy of nodule volumetry. The radiation dose was also estimated.

Results
The contrast-to-noise ratio of SECT120kV/200mAs was significantly higher than that of NBI80/Sn140kV and VMI+80/Sn140kV (both corrected P < 0.05), whereas there were no significant differences between NBI100/sn140kV and SECT120kV/200mAs and between VMI+100/sn140kV and SECT120kV/200mAs (both corrected P > 0.05). The APE of SECT120kV/200mAs was significantly lower than that of NBI80/Sn140kV and VMI+80/Sn140kV in both types of nodules (all corrected P < 0.05), whereas there were no significant differences between VMI+100/sn140kV and SECT120kV/200mAs in solid nodules and between NBI100/Sn140kV and SECT120kV/200mAs in ground-glass opacities (both corrected P > 0.05). The radiation dose of DECT100/Sn140kV and DECT80/Sn140kV were significantly lower than that of SECT120kV/200mAs (both corrected P < 0.05).

Conclusions
The DECT100/sn140kV can ensure image quality and nodule volumetry accuracy with lower radiation dose compared with SECT120kV/200mAs. Specifically, the VMI+ algorithm could be used in solid nodules and NBI algorithm in ground-glass opacities.
Urinary Cellular Profile as a Biomarker for Lupus Nephritis
Authors: Abdelati Abeer Ali , Eshak Nouran Y. , Donia Hanaa M. , El-Girby Amira H. 
Published: September 2020

Background/Objective
A search for the ideal biomarker for lupus nephritis (LN) is still underway, one that can be used for early detection and correlate with the class and activity of LN. Urine is normally devoid of leukocytes; however, it has been observed that macrophages and T lymphocytes are routinely present in the urine of LN patients and those with other proliferative renal diseases. This provides the idea for their potential use as biomarkers for proliferative LN. Here, we measured the urinary CD4+, CD8+ T lymphocytes, and CD14+ monocytes in patients with systemic lupus erythematosus (SLE) as potential biomarkers for LN.

Methods
A longitudinal case-control study included 30 SLE patients with LN, 30 SLE patients without past or current LN, and 20 healthy subjects as a control group. The flow cytometric analysis was done using BD FACS Calibur multiparameter flow cytometer equipped with BD CellQuest Pro software for data analysis.

Results
CD14+ cells were the most abundant cells in the urine of LN patients. The mean numbers of urinary CD8+, CD4+, and CD14+ cells/mL were significantly higher in patients with LN than in those without. The cell counts correlated significantly with proteinuria. Urinary CD14+ cells seem to occur in much higher counts in class IV than class III LN.

Conclusions
Urinary CD8+, CD4+, and CD14+ cells are highly sensitive and specific markers for detecting proliferative LN. A low CD4:CD8 ratio provides a further clue. Urinary CD14 cell counts may be a potential biomarker to differentiate between the different classes of proliferative LN.
A New Visual Transient Elastography Technique for Grading Liver Fibrosis in Patients With Chronic Hepatitis B
Authors: Ren Xinping , Zhang Lu , Xia Shujun , Chen Zhijie , Zhou Wei , Ji Ri , Zhou Jianqiao , Lin Yanyan , Zhan Weiwei 
Published: September 2020

Abstract
Liver fibrosis is evaluated to assess the prognosis and guide the treatment of chronic hepatitis B (CHB). To compare the efficiency of 2 transient elastography techniques for grading liver fibrosis in CHB: visual transient elastography (ViTE) with real-time image guidance and FibroScan (FS) with no image guidance. All of the CHB patients in this study underwent both FS and ViTE examinations. The final diagnosis was based on the histological findings of a liver biopsy. According to the severity of liver fibrosis (based on the Scheuer criteria), the area under the receiver operating characteristic curve values for diagnostic efficiency were calculated for the 2 elastography techniques. This study enrolled 227 patients (79 [39.1%] women; mean age, 45.8 ± 16.8 years). The ViTE and FS liver elasticity measurements were highly correlated with liver fibrosis stage (r = 0.852 and r = 0.813, respectively). The area under the receiver operating characteristic curve value was larger for ViTE compared with FS, with respect to differentiating liver fibrosis stage, but not significantly (P > 0.05). The ViTE and FS can be used to detect and stage liver fibrosis. ViTE, easier and quicker to perform with superior interoperator reproducibility, is a stable and reliable elastography technique that benefits from real-time visual guidance.
Reflections on the Ultrasound Mirror Image Artifact
Authors: Kerr Dana Middleton , Middleton William Dana 
Published: September 2020

Abstract
A key assumption in ultrasound is that the reflected echoes that return to the transducer travel in a straight line. Mirror image artifacts occur when the transmitted pulse and returning echo reflect off of a highly reflective interface (an acoustic mirror) and change direction before returning to the transducer, thereby breaking this assumption. Mirror image artifacts are seen throughout the body on gray scale, color Doppler, power Doppler, and spectral Doppler. They may closely duplicate the true structure in shape and echo strength, may distort the true structure, may appear weaker than the true structure, or may appear on images that do not simultaneously show the true structure. If not properly recognized, mirror image artifacts can be misinterpreted as true pathology and lead to additional unnecessary tests and potentially harmful interventions.
Accuracy of Bedside Lung Ultrasound as a Rapid Triage Tool for Suspected Covid-19 Cases
Authors: Karagöz Arif , Sağlam Caner , Demirbaş Hakan Bariş , Korkut Semih , Ünlüer Erden Erol 
Published: September 2020

Objectives
The novel coronavirus disease 2019 (Covid-19) outbreak began in China. The characteristic of the disease is development of pneumonia. We aimed to investigate the accuracy of bedside lung ultrasound (BLUS) for diagnosing Covid-19 pneumonia, and its effectiveness for the correct triage of patients with suspected Covid-19 in the emergency department (ED).

Methods
This study was a prospective, cross-sectional cohort study. During their shifts, 3 accredited and certificated emergency physicians performed BLUS using BLUE protocol at the triage area of the ED on patients with suspected Covid-19. All of the patients underwent chest computed tomography. The BLUS findings were statistically compared with formal radiology reports of computed tomographies as the criterion standard for the diagnosis of Covid-19 pneumonia. Kolmogorov-Smirnov analysis, Shapiro-Wilk test, and Q-Q plots were performed with 95% confidence intervals (CIs) for statistical analysis.

Results
A total of 72 patients were included in the study. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of BLUS were 96.9% (95% CI, 84.2%–99.9%), 92.3% (95% CI, 79.1%–98.3%), 84.3% (95% CI, 64.5%–94.1%), 98.6% (95% CI, 91.1%–99.8%), and 93.7% (95% CI, 85.3%–98.0%), respectively. The positive and negative predictive values were 84.3% (95% CI, 64.5%–94.1%) and 98.6% (95% CI, 91.1%–99.8%), respectively. The area under curve was found to be 0.946 (95% CI, 0.866–0.986; P < 0.0001).

Conclusions
Bedside lung ultrasound can be used to detect the presence of pulmonary involvement in suspected cases of Covid-19 for the effective triage of patients in the ED.
Host phylogeny and host ecology structure the mammalian gut microbiota at different taxonomic scales
Authors: Rojas Connie A. , Ramírez-Barahona Santiago A. , Holekamp Kay E. , Theis Kevin. R. 
Published: September 2020

AbstractThe gut microbiota is critical for host function. Among mammals, host phylogenetic relatedness and diet are strong drivers of gut microbiota structure, but one factor may be more influential than the other. Here, we used 16S rRNA gene sequencing to determine the relative contributions of host phylogeny and host dietary guild in structuring the gut microbiotas of 11 herbivore species from 5 families living sympatrically in southwest Kenya. Herbivore species were classified as grazers, browsers, or mixed-feeders. We found that gut microbiotas were highly species-specific, and that host taxonomy accounted for more variation in the gut microbiota (30%) than did host dietary guild (10%) or sample month (8%). Overall, similarity among gut microbiotas increased with host phylogenetic relatedness (r=0.73), yet this relationship was not consistent among seven closely related Bovid host species (r=0.21 NS). Within bovids, host dietary guild explained more of the variation in the gut microbiota than did host species. Lastly, while we found that the gut microbiotas of herbivores residing in southwest Kenya converge with those of distinct populations of conspecifics from central Kenya, fine-scale differences in the abundances of bacterial amplicon sequence variants (ASVs) between individuals from the two regions were also observed. Overall, our findings suggest that host phylogeny and taxonomy strongly structure the gut microbiota, but these gut microbial communities could be furthered modified by host ecology, especially among closely related host species.
Extracting the phylogenetic dimension of coevolution reveals hidden functional signal
Authors: Colavin Alexandre , Atolia Esha , Bitbol Anne-Florence , Huang Kerwyn Casey 
Published: September 2020

AbstractDespite the structural and functional information contained in the statistical coupling between pairs of residues in a protein, coevolution associated with function is often obscured by artifactual signals such as genetic drift, which shapes a protein’s phylogenetic history and gives rise to concurrent variation between protein sequences that is not driven by selection for function. Here, we introduce a method for explicitly defining a phylogenetic dimension of coevolution signal, and demonstrate that coevolution can occur on multiple phylogenetic timescales within a single protein. Our method, Nested Coevolution (NC), can be applied as an extension to any coevolution metric. We use NC to demonstrate that poorly conserved residues can nonetheless have important roles in protein function. Moreover, NC improved structural-contact prediction over gold-standard coevolution-based methods, particularly in subsampled alignments with fewer sequences. NC also lowered the noise in detecting functional sectors of collectively coevolving residues. Sectors of coevolving residues identified after NC correction were more spatially compact and phylogenetically distinct from the rest of the protein, and strongly enriched for mutations that disrupt protein activity. Our conceptualization of the phylogenetic separation of coevolution represents an advance from previous pragmatic attempts to reduce phylogenetic artifacts in measurements of coevolution. Application of NC broadens the application of protein coevolution measurements, particularly to eukaryotic proteins with fewer naturally available sequences, and further elucidates relationships among protein evolution and genetic diseases.
Characteristics, Management And Outcomes Of Critically Ill Covid-19 Patients Admitted To Icu In Hospitals In Bangladesh: A Retrospective Study
Authors: Saha Ayan , Ahsan Mohammad Moinul , Tarek-Ul-Quader  , Sharif Shohan Mohammad Umer , Naher Sabekun , Dutta Preya , Akash Al-Shahriar , Mehedi H M Hamidullah , Chowdhury A S M Arman Ullah , Karim Hasanul , Rahman Tazrina , Parvin Ayesha 
Published: September 2020

ABSTRACTObjectivesThis study aimed to analyse the epidemiological and clinical characteristics of critical COVID-19 cases and investigate risk factors including comorbidities and age in relation with the clinical aftermath of COVID-19 in critical cases in Bangladesh.MethodsIn this retrospective study, epidemiological and clinical characteristics, complications, laboratory results, and clinical management of the patients were studied from data obtained from 168 individuals diagnosed with an advanced prognosis of COVID-19 admitted in two hospitals in Bangladesh.ResultsIndividuals in the study sample contracted COVID-19 through community transmission. 56.5% (n = 95) cases died in intensive care units (ICU) during the study period. The median age was 56 years and 79.2% (n=134) were male. Typical clinical manifestation included Acute respiratory distress syndrome (ARDS) related complications (79.2%), fever (54.2%) and cough (25.6%) while diabetes mellitus (52.4%), hypertension (41.1%) and heart diseases (16.7%) were the conventional comorbidities. Clinical outcomes were detrimental due to comorbidities rather than age and comorbid individuals over 50 were at more risk. In the sample, oxygen saturation was low (< 95% SpO2) in 135 patients (80.4%) and 158 (93.4%) patients received supplemental oxygen. Identical biochemical parameters were found in both deceased and surviving cases. Administration of antiviral drug Remdesivir and the glucocorticoid, Dexamethasone increased the proportion of surviving patients slightly.ConclusionsSusceptibility to developing critical illness due to COVID-19 was found more in comorbid males. These atypical patients require more clinical attention from the prospect of controlling mortality rate in Bangladesh.