bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION BETWEEN INJURY AND SPORTS SPECIALIZATION AMONG FEMALE HIGH SCHOOL VOLLEYBALL PLAYERS
Authors: Biese Kevin , McGuine Timothy , Kliethermes Stephanie , Bell David , Watson Andrew , Brooks M. Alison , Post Eric , Lang Pamela 
Published: April 2020

Background: Volleyball participation has increased and unlike other team sports, its popularity among high school girls continues to grow. With its rise in popularity, the number of girls playing club volleyball outside of school has also grown. Sports specialization in youth athletes, or year-round intensive training in a single sport at the exclusion of others has become a concern. Overuse injuries are common among female volleyball players and specialization may be one factor that puts girls at risk of injury. Hypothesis/ Purpose: Evaluate the level of sports specialization among female high school volleyball players and examine its association with injury history. Design: Retrospective cohort study. Methods: Female students in grades 9-12 at 78 high schools who were committed to trying out for their high school volleyball team were recruited to participate in this study prior to the 2018 fall high school season. Athletes completed baseline assessments of sport related injuries within the previous 12 months. The athletes were asked to report their participation in interscholastic and club volleyball, including training volume and self-reported specialization. Finally, specialization of the athletes was determined using Jayanthi’s 3-point specialization scale. Athletes who had an injury that kept them out of the first day of tryouts were excluded. Univariate and multivariate analysis was performed. Results: 2216 female high school volleyball players completed baseline evaluations (Age=15.6 ± 1.1 years old, BMI= 22.5± 3.5 kgs/m2) of whom 1588 identified volleyball as their primary sport (72%). Both moderately and highly specialized volleyball athletes were about twice as likely to report a musculoskeletal injury in the previous 12 months (Moderate: OR=1.84, 95%CI=1.29-2.62; High: OR=2.30, 95%CI=1.64-3.24). Similarly, those who played club volleyball were two times more likely to report a musculoskeletal injury in the past year (OR=2.00, 95%CI=1.48-2.71). Multisport athletes were also more likely to report a previous musculoskeletal injury (OR=1.69, 85%CI=1.24-2.32). Highly specialized volleyball players were more likely to participate in club volleyball (p<0.001), summer camps (p<0.001), and participate in both club and summer camps in the same year (p<0.001). Conclusions: High school girls’ volleyball players who are highly specialized were more likely to report a musculoskeletal injury in the past 12 months. Similarly, those who played club volleyball were more likely to report an injury in the past year. While sports specialization seems to be associated with increased risk of injury, it may be at least partially related to increased training volume.
FUNCTIONAL NEUROCOGNITIVE DEFICITS AND CORTICAL EVOKED POTENTIALS IN PEDIATRIC PATIENTS WITH PROLONGED POST CONCUSSIVE SYMPTOMS
Authors: Mortazavi Mo , Oakley David , Minor Jon , Thirunagari Prem Kumar , Koucheki Nassar , Prabhaker Nitin 
Published: April 2020

Background: Prolonged neurophysiological impairments have been demonstrated after brain injury utilizing tools such as auditory evoked response potentials. The objectivity and sensitivity of such tools can provide clinicians a unique perspective on patients with prolonged post concussive symptoms (PPCS), and help determine optimal management strategies. Limited research currently exists on evoked potentials and pediatric PPCS. Purpose: Illustrate the clinical utility of abnormal evoked potentials in adolescents with PPCS. Methods and Study Design: The study is a retrospective cross-sectional analysis of pediatric PPCS cases from 7/2018 to 7/2019 at a private concussion clinic in Tucson AZ. Patients were included if they had prolonged symptoms beyond 30 days from date of injury date, were 13-16 years old, and diagnosed with PPCS based on SCAT5 assessment and clinical evaluation. All patients with PPCS had moderate to severe clinical symptoms with limited academic and exertional tolerance. Patients were excluded if they had a history of learning disorders, seizure disorder, or complex concussions with a skull fracture or intracranial hemorrhage. Patients were tested using the standard oddball audio P300 EEG protocol. Measures extracted included P300 latency, P300 amplitude, and coherence frequency on mapping. The PPCS cohort (n=71) was then compared to age-matched references (n=73) obtained during baseline testing of non-injured athletes using the same protocol (and hardware) from a multitude of sites. Results: There was a significant correlation between PPCS and reduced P300 amplitude along with an increased coherence. The PPCS group had an average P300 amplitude of 13.7uV compared to 16.9uV in the reference group (p<0.001, CohD=.51). Increased coherence (in the alpha frequency) was observed where the average PPCS patient had 9.1 connected pairs (scalp sites) with coherences that were >2σ, compared to the expected 3.1 connections in reference group >2 σ (p<0.001, CohD=.86). There was no significant difference in P300 latency between the groups. Conclusions: Pediatric patients with PPCS showed decreased P300 amplitude and increased coherence on average compared to the reference group. Reduced voltages and/or increased coherence likely represent ongoing primary brain dysfunction, adaptability, and recovery. These findings suggest the need for ongoing care, and should guide a conservative care approach towards return to high-risk activities. Evoked potentials may be a critical tool to help identify primary neurologic dysfunction in PPCS and help guide management strategies. This tool may also aide in differentiating ongoing neurophysiologic recovery from commonly reported secondary psychosocial symptoms after PPCS. [Figure: see text]
PERIOPERATIVE OPIOID EXPOSURE PATTERNS IN PEDIATRIC ACL PATIENTS: A TEN YEAR ADMINISTRATIVE DATABASE STUDY
Authors: Anandarajan Dharman , Williams Brendan A. , Markiewitz Nathan , Talwar Divya , Wells Lawrence 
Published: April 2020

Background: Pediatric patients sustaining anterior cruciate ligament (ACL) or related injuries are at high risk for opioid exposure in the acute, perioperative and postoperative phases of injury. Early and repeated exposure to these medications may increase the risk of future misuse. While variation in opioid prescribing practices has been documented in the outpatient setting and other realms of pediatric care, perioperative opioid exposure in this procedural cohort has not been previously examined on a national level. Purpose: To assess for demographic, temporal, regional, and hospital-level variability in perioperative opioid exposure in pediatric ACL patients. Methods: The Pediatric Health Information Systems Database (PHIS) was used to identify pediatric patients (≤18 years old) undergoing surgical treatment for ACL injury between January 2008 and December 2017. Perioperative opioids were converted to a morphine equivalent dose (MED) and summed for each patient. A hierarchical bayesian regression was performed to identify demographic factors that predicted opioid exposure while adjusting for the effect of hospital. Results: The study cohort included 23,071 patients across 52 hospitals. We report model estimates in Table 1 and mean MME by hospital in Figure 1. Compared to older adolescents (15-18yo), younger adolescents (11-14yo; b=-0.13 95% Credible Interval[-0.19, -0.07]) and children <10yo (b=-1.62 [-1.72, -1.52]) received less MED. Patients located in an observation unit (b=-1.15 [-1.25, -1.06]) or an inpatient unit (b=-1.31;[-1.42, -1.20]) received less MED than patients in an ambulatory surgical setting. Patients with commercial insurance also were dispensed more MED compared to those with other payers (b=0.10 [0.04, 0.16]). Female patients received less opioids than male patients (b=-0.08 [-0.13, -0.02]). Of the hospital random effects, the 95% credible intervals of 24 (46%) intercepts and 21 (40%) slopes did not include zero. Conclusions: This administrative database study identified hospital and patient-level characteristics predictive of perioperative narcotic exposure among pediatric ACL patients. Those who were older, in an ambulatory surgery setting, or had commercial insurance received more opioids. Cumulative perioperative opioid exposure has not declined on a national level in recent years and significant variability in opioid exposure exists between hospitals. Future work should seek to identify and utilize opioid-minimizing practices that appear present in some clinical settings. [Table: see text][Figure: see text]
INCIDENCE OF 2nd SURGERY AFTER MPFL RECONSTRUCTION AND SIMULTANEOUS OSTEOCHONDRAL FRACTURE FIXATION IN PEDIATRIC PATIENTS TREATED FOR PATELLAR DISLOCATION
Authors: Schlichte Lindsay M. , Aitchison Alexandra H. , Green Daniel W. 
Published: April 2020

Background: Osteochondral fractures occur in 5-15% of cases of acute or recurrent patellar dislocations. In these settings, early surgical intervention with biodegradable fixation nails is recommended to optimize healing. Purpose: The purpose of this study was to determine the incidence of recurrent instability and second surgery following osteochondral fracture fixation with concomitant medial patellofemoral ligament (MPFL) reconstruction. Methods: We conducted a retrospective cohort study of 321 MPFL reconstructions performed by a single surgeon between 2011 and 2019. Thirty-eight knees underwent MPFL reconstruction with osteochondral fixation. Demographic data, surgical details, date of latest radiographic and clinical follow-up, and subsequent surgical procedures were collected. Results: Thirty-seven MPFL reconstructions with osteochondral fracture fixation in 36 patients were performed by a single surgeon from 2011 to 2019 (1 bilateral). The average age at surgery was 14.8 years (range 10.6– 19.6 years). The average length of clinical follow-up was 1.9 years (range .1– 5.5 years). The average number of biodegradable fixation nails used was 4.4 (range: 2-8). Twenty-seven (72.9%) fractures were fixed to the patella and 10 were fixed to the lateral femoral condyle or trochlea There was 1 report of recurrent instability. Ten (27%) patients required a second surgery on the ipsilateral knee, and underwent chondroplasty (n=8), removal of biodegradable fixation nails (n=4), removal of hemi-epiphysiodesis or TTO hardware (n=2), revision MPFL with tibial tubercle osteotomy (n=1), lateral meniscus repair (n=1). The one patient who required revision MPFL reconstruction has juvenile idiopathic arthritis and underwent 3 additional surgeries after the initial MPFL procedure. Eight patients (22%) underwent a second surgery to address cartilage damage or removal of nails. The mean time to second surgery was 40.0 weeks (range:11-82.7). Of the four patients who required removal of nails, the average number of nails initially placed was 7 ± 1.7. This was significantly more than the patients who did not require second surgery related to nail removal (4.1 ± 1.6, p < .05). Conclusion: Approximately 78% of patients undergoing MPFL reconstruction and osteochondral fracture fixation with biodegradable nails showed good fracture healing and patellar stability while 22% went on to require a second surgery. The second surgery most commonly involved debridement of an unhealed portion of the cartilage.
OUTCOMES OF CORE DECOMPRESSION WITH INJECTION OF BONE MARROW ASPIRATE FOR PEDIATRIC FEMORAL HEAD OSTEONECROSIS
Authors: Atkins Myles , Thimothee Josny , McDonald Tyler , Wright Patrick , Brooks Jaysson T. 
Published: April 2020

Background: Pediatric patients with femoral head osteonecrosis (FHON) often suffer from significant pain with decreased mobility. Once femoral head collapse occurs, few options are available short of a total hip arthroplasty (THA).[1,2] Core decompression by drilling of the femoral head is used to improve pain and prevent further femoral head collapse, however most of the literature on this technique involves adult patients.[3-5] Purpose: To date, there is no description of this technique or its outcomes in pediatric patients with FHON secondary to other etiologies other than sickle cell disease (SCD).[6] The purpose of our study is to determine outcomes in patients with FHON after undergoing core decompression with injection of bone marrow aspirate (BMA). Methods: A retrospective chart review was performed of all pediatric patients at our institution between 2007-2019 with FHON that underwent core decompression with injection of BMA. The following etiologies were identified: SCD, steroid-induced, Perthes disease (PD), slipped capital femoral epiphysis (SCFE), trauma, idiopathic, or other. To determine if core decompression with injection results in cessation of further femoral head collapse, two outcomes were assessed: Stulberg classification and number of cases that required THA. Furthermore, we evaluated whether core decompression with injection occurred in combination with any additional surgical procedure. Results: Twenty-six hips with FHON were identified with the following etiologies: 12 SCD (46.3%), 8 steroid-induced (30.8%), 2 PD (7.7%), 1 SCFE (3.8%), 1 trauma (3.8%), 1 idiopathic (3.8%), 1 other (3.8%). Mean age at the time of surgery was 12.7 years (range: 8-18). Twenty hips (76.9%) were seen in males and 6 (23.1%) were seen in females. Twenty-two hips (84.6%) were seen in black patients and 4 (15.4%) in white patients. Mean follow-up was 37.9 months (range: 0.6-77.8). Mean Stulberg classification was 3.15 (SD: 1.26). Twelve hips (46.2%) required concomitant femoral and/or pelvic osteotomies while 14 hips (53.8%) underwent core decompression with injection alone. Six hips required conversion to THA after initial core decompression and injection. All hips requiring THA were seen in patients with core decompressions and injections but no additional femoral and/or pelvic osteotomies. Conclusion: Most hips undergoing core decompression with injection did not require THA. Of the hips that required THA, all were seen in patients who only had core decompression and injection of BMA but no concomitant femoral and/or pelvic osteotomies. [Figure: see text][Figure: see text][Figure: see text]
Retrograde Drilling for Osteochondral Lesion of the Talus in Juvenile Patients
Authors: Ikuta Yasunari , Nakasa Tomoyuki , Ota Yuki , Kanemitsu Munekazu , Sumii Junichi , Nekomoto Akinori , Adachi Nobuo 
Published: April 2020

Background: Retrograde drilling (RD) is generally used for treating osteochondral lesion of the talus (OLT) with a stable osteochondral fragment and nearly normal articular cartilage surface. Previous studies that included participants of various ages have reported good clinical results. This study aimed to clarify the clinical outcomes of RD for OLT in juvenile patients whose bone-forming ability and physical activity might affect the healing process. Methods: This retrospective study included 8 juvenile patients who underwent RD for OLT (5 boys and 3 girls, mean age 14.9 years, mean follow-up 2 years, 7 medial and 1 central lesion). American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and ankle activity score were evaluated, and arthroscopic findings were graded according to the International Cartilage Research Society (ICRS) classification system. The condition of the underlying bone was assessed on preoperative computed tomographic images. The stability, incorporation, and subsidence of the osteochondral fragment, articular surface congruity, and the area of the bone marrow lesion (BML) were evaluated using magnetic resonance imaging (MRI). Results: AOFAS ankle-hindfoot score and ankle activity score significantly improved postoperatively. Arthroscopically, the lesions were classified as ICRS grade 0 or 1. Bone sclerosis or multiple small cysts of the underlying bone were observed in all patients. MRI demonstrated no signs of osteochondral fragment instability or subsidence, good or fair fragment incorporation, good articular surface congruity, or slight irregularity. The postoperative BML was reduced; however, these BMLs were still detectable at 1 year after surgery. Conclusion: Our data suggested that RD is an option for treating juvenile patients with OLT refractory to nonoperative treatment at short-term follow-up. Although bone sclerosis or multiple small cysts were identified in the underlying bone preoperatively and the BML under the osteochondral fragment remained postoperatively, clinical status such as pain and physical activity level were improved by RD. Level of Evidence: Level IV, retrospective case series.
Glikinite, Zn3O(SO4)2, a new anhydrous zinc oxysulfate mineral structurally based on OZn4 tetrahedra.
Authors: Nazarchuk Evgeny V. , Siidra Oleg I. , Nekrasova Diana O. , Shilovskikh Vladimir V. , Borisov Artem S. , Avdontseva Evgeniya Y. 
Published: April 2020

AbstractA new mineral glikinite, ideally Zn3O(SO4)2, was found in high-temperature exhalative mineral assemblages in the Arsenatnaya fumarole, Second scoria cone of the Great Tolbachik Fissure Eruption (1975–1976), Tolbachik volcano, Kamchatka Peninsula, Russia. Glikinite is associated closely with langbeinite, lammerite-β, bradaczekite, euchlorine, anhydrite, chalcocyanite and tenorite. It is monoclinic, P21/m, a = 7.298(18), b = 6.588(11), c = 7.840(12) Å, β = 117.15(3)°, V = 335.4(11) Å3 and R1 = 0.046. The eight strongest lines of the powder X-ray diffraction pattern [d in Å (I) (hkl)] are: 6.969(56)(00$\bar{1}$), 3.942(52)(101), 3.483(100)(00$\bar{2}$), 3.294(49)(020), 2.936(43)(120), 2.534(63)(201), 2.501(63)(20$\bar{3}$) and 2.395(86)(02$\bar{2}$). The chemical composition determined by electron-microprobe analysis is (wt.%): ZnO 42.47, CuO 19.50, SO3 39.96, total 101.93. The empirical formula calculated on the basis of O = 9 apfu is Zn2.07Cu0.97S1.98O9 and the simplified formula is Zn3O(SO4)2. Glikinite is a Zn,Cu analogue of synthetic Zn3O(SO4)2. The crystal structure of glikinite is based on OZn4 tetrahedra sharing common corners, thus forming [Zn3O]4+ chains. Sulfate groups interconnect [Zn3O]4+ chains into a 3D framework.
Reverse Genetics Assembly of Newcastle Disease Virus Genome Template Using Asis-Sal-Pac BioBrick Strategy
Authors: Tavassoli Amin , Soleymani Safoura , Haghparast Alireza , Hashemi Tabar Gholamreza , Bassami Mohammad Reza , Dehghani Hesam 
Published: April 2020

Abstract
Background
The BioBrick construction as an approach in synthetic biology provides the ability to assemble various gene fragments. To date, different BioBrick strategies have been exploited for assembly and cloning of a variety of gene fragments. We present a new BioBrick strategy, here referred as Asis-Sal-Pac BioBrick, which we used for the assembly of NDV as a candidate for single-stranded non-segmented, negative-sense RNA genome viruses.

Results
In the present study, we isolated three NDVs from clinical samples which were classified into the VIId genotype based on their pathogenicity and phylogenetic analyses. Then, SalI, AsisI, and PacI enzymes were used to design and develop a novel BioBrick strategy, which enabled us to assemble the NDV genome, adopting the “rule of six”. In this method, in each assembly step, the restriction sites in the newly formed destination plasmid are reproduced, which will be used for the next insertion. In this study using two overlapping PCRs, the cleavage site of the F gene was also modified from 112RRQKRF117to 112GRQGRL117 in order to generate the attenuated recombinant NDV. Finally, in order to construct the recombinant NDV viruses, the plasmids harboring the assembled full-length genome of the NDV and the helper plasmids were co-transfected into T7-BHK cells. The rescue of the recombinant NDVwas confirmed by RT-PCR and HA tests.

Conclusions
These findings suggest that the combination of reverse genetic technology and BioBrick assembly have the potential to be applied for the development of novel vaccine candidates. This promising strategy provides an effective and reliable approach to make genotype-matched vaccines against specific NDV strains or any other virus.
The novel coronavirus (COVID-19) pneumonia with negative detection of viral ribonucleic acid from nasopharyngeal swabs: a case report
Authors: Zhang Peiyan , Cai Zhao , Wu Weibo , Peng Ling , Li Yinfeng , Chen Chuming , Chen Li , Li Jianming , Cao Mengli , Feng Shiyan , Jiang Xiao , Yuan Jing , Liu Yingxia , Yang Liang , Wang Fuxiang 
Published: April 2020

Abstract
Background
The novel coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, Hubei, China since Dec 2019 and cases of infection have been continuously reported in various countries. It is now clear that the SARS-COV-2 coronavirus is transmissible from human to human. Nucleic acid detection is considered as the gold standard for the diagnosis of COVID-19. In this case report, we describe our experience in detection of SARS-COV-2 from a confirmed patient using nucleic acid test of bronchoalveolar-lavage fluid (BALF) samples but not nasopharyngeal swabs.

Case presentation
We present a case of severely ill SARS-COV-2 infected 46-year-old man with fever, coughing and chest tightness. We performed viral detection using his BALF samples and imaging method (CT) for confirmation. The patient received combination of interferonalfa-1b and ribavirin, lopinavir and ritonavir for antiviral treatment at different stages. Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes. We provided oxygen supply to him using BIPAP ventilator and high-flow humidification oxygen therapy instrument to facilitate respiration. The patient was cured and discharged.

Conclusion
This case report described an effective supportive medication scheme to treat SARS-COV-2 infected patient and emphasized the necessity of detection of the viral genome using BALF samples and its significance in the diagnosis and prognosis of the disease.
Severe pain at the end of life: a population-level observational study
Authors: Hagarty A. Meaghen , Bush Shirley H. , Talarico Robert , Lapenskie Julie , Tanuseputro Peter 
Published: April 2020

Abstract
Background
Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain.

Methods
Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity.

Results
Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66).

Conclusion
Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention.