bluuebunny/crossref_metadata_2025_split huggingface dataset:
Placement accuracy of resuscitative endovascular occlusion balloon into the target zone with external measurement
Authors: Matsumoto Shokei , Funabiki Tomohiro , Kazamaki Taku , Orita Tomohiko , Sekine Kazuhiko , Yamazaki Motoyasu , Moriya Takashi 
Published: April 2020

BackgroundResuscitative endovascular balloon occlusion of the aorta (REBOA) should be safely placed at zone 1 or 3, depending on the location of the hemorrhage. Ideally, REBOA placement should be confirmed via fluoroscopy, but it is not commonly available for trauma bays. This study aimed to evaluate the accuracy of REBOA placement using the external measurement method in a Japanese trauma center.MethodsA retrospective review identified all trauma patients who underwent REBOA and were admitted to our trauma center from 2008 to 2018. Patient characteristics, REBOA placement accuracy, and complications according to target zones 1 and 3 were reviewed.ResultsDuring the study period, 38 patients met our inclusion criteria. The in-hospital mortality rate was 57.9%. REBOA was mainly used for bleeding from the abdominal (44.7%) and pelvic (36.8%) regions. Of these, 30 patients (78.9%) underwent REBOA for target zone 1, and 8 patients (21.1%) underwent REBOA for target zone 3. The proportion of abdominal bleeding source in the target zone 1 group was greater than that in the target zone 3 group (56.7% vs. 0%). Overall, the proportion of REBOA placement was 76.3% in zone 1, 21.1% in zone 2, and 2.6% in zone 3. The total REBOA placement accuracy was 71.1%. At each target zone, the REBOA placement accuracy for target zone 3 was significantly lower than that for target zone 1 (12.5% vs. 86.7%, p<0.001). No significant associations between non-target zone placement and patient characteristics, complications, or mortality were found.ConclusionsThe REBOA placement accuracy for target zone 3 was low, and zone 2 placement accounted for 21.1% of the total, but no complications and mortalities related to non-target zone placement occurred. Further external validation study is warranted.Level of evidenceLevel IV.
Generalized scalar–tensor theory of gravity reconstruction from physical potentials of a scalar field
Authors: Fomin I. V. , Chervon S. V. , Tsyganov A. V. 
Published: April 2020

AbstractWe describe how to reconstruct generalized scalar–tensor gravity (GSTG) theory, which admits exact solutions for a physical type of potentials. Our consideration deals with cosmological inflationary models based on GSTG with non-minimal coupling of a (non-canonical) scalar field to the Ricci scalar. The basis of proposed approach to the analysis of these models is an a priori specified relation between the Hubble parameter H and a function of a non-minimal coupling $$F=1+\delta F$$F=1+δF, $$H\propto \sqrt{F}$$H∝F. Deviations from Einstein gravity $$\delta F$$δF induce corresponding deviations of the potential $$\delta V$$δV from a constant value and modify the dynamics from a pure de Sitter exponential expansion. We analyze the models with exponential power-law evolution of the scale factor and we find the equations of influence of non-minimal coupling, choosing it in the special form, on the potential and kinetic energies. Such a consideration allows us to substitute the physical potential into the obtained equations and then to calculate the non-minimal coupling function and kinetic term that define the GSTG parameters. With this method, we reconstruct GSTG for the polynomial, exponential, Higgs, Higgs–Starobinsky and Coleman–Weinberg potentials. Special attention we pay to parameters of cosmological perturbations and prove the correspondence of the obtained solutions to observational data from Planck.
Bacteriological Profile of Chronic Suppurative Otitis Media and Antibiotic Susceptibility in a Tertiary Care Hospital in Shanghai, China
Authors: Xu Jianghong , Du Qiang , Shu Yilai , Ji Jian , Dai Chunfu 
Published: April 2020

Objective: Chronic suppurative otitis media (CSOM) is mostly caused by bacterial infection of the middle ear and antibiotics are generally used empirically, which may lead to the emergence of resistant bacterial strains. The objective of the study is to assess the bacteriological profile of and evaluate the antibiotic susceptibility of strains isolated in a tertiary care hospital in Shanghai, China. Methods: This study included 289 individuals with clinical diagnosis of CSOM. Middle ear purulent discharge was obtained with sterile swabs and cultured for bacterial pathogens. The susceptibility of the isolated microorganisms to antibiotics was assessed by a microdilution method. Results: Bacterial pathogens were found in 223 (77.2%) of the 289 cases. A total of 236 strains were isolated. Staphylococcus aureus was the commonest bacteria (44.9%) followed by Pseudomonas aeruginosa (16.9%) and coagulase-negative Staphylococcus (8.5%). There were 18.9% methicillin-resistant S aureus (MRSA) among the obtained S aureus organisms. Multidrug-resistant P aeruginosa was found in 4 patients, making up 10% of all detected P aeruginosa. Staphylococcus aureus showed highest susceptibility to vancomycin (100%), then gentamicin (98.1%) and rifampicin (97.2%) and was most resistant to penicillin (61.3%) and erythromycin (50%). All isolated P aeruginosa showed susceptibility to piperacillin, piperacillin/tazobactam, and meropenem. High degree of resistance in P aeruginosa was observed toward levofloxacin (42.5%), ciprofloxacin (40%), and ceftriaxone (30%). Conclusion: The high prevalence of MRSA and fluoroquinolone-resistant P aeruginosa indicated cephalosporins and fluoroquinolone as primary empirical antibiotic drugs in CSOM to be cautiously used. In order to reduce the incidence of resistant strains and promote effective usage of antibiotics, all aural discharges should be cultured to determine antibacterial susceptibility patterns before treatment.
Dizziness and vertigo during the prodromal phase and headache phase of migraine: A systematic review and meta-analysis
Authors: Iljazi Afrim , Ashina Håkan , Lipton Richard B , Chaudhry Basit , Al-Khazali Haidar M , Naples James G , Schytz Henrik W , Vukovic Cvetkovic Vlasta , Burstein Rami , Ashina Sait 
Published: April 2020

Objective To assess the proportion of individuals who report dizziness and/or vertigo during the prodromal phase or headache phase of migraine. Methods The databases of MEDLINE and EMBASE were searched for studies on dizziness and/or vertigo during the prodromal phase or headache phase of migraine. Pooled relative frequencies were estimated using a random-effects meta-analysis. Results We identified nine articles eligible for inclusion. Of these, one study reported results for the prodromal phase, seven studies for the headache phase and one study for both the prodromal and headache phase. In the prodromal phase, 9.0% of individuals with migraine reported dizziness, while 3.3% reported vertigo. During the headache phase, relative frequency of dizziness ranged from 6.7% to 59.6%, while vertigo ranged from 6.4% to 44.7%. The meta-analysis showed a relative frequency of 35.7% for dizziness (95% CI = 13.7–61.5%, I2 = 99%) and 33.9% for vertigo (95% CI = 26.7–41.5%, I2 = 87%). Study quality was rated 5/9 or below for seven studies and 6/9 or above for two studies. Conclusion We found that there is a scarcity of literature on dizziness and vertigo as prodromal- and headache-associated symptoms in individuals with migraine. Methodological variations confound comparisons of epidemiological patterns, although it appears that dizziness and vertigo are more frequent during the headache phase of migraine, compared with the prodromal phase. Future studies should ensure use of standardized definitions and rigorous methodology to enable accurate measurements of dizziness and vertigo in migraine.
Evaluation and Supporting Inquiry Courses in MSW Programs
Authors: McAdaragh Mary O’Brien , LaVelle John M. , Zhang Lixin 
Published: April 2020

Purpose: To examine the extent to which evaluation and supporting inquiry courses are included in master of social work (MSW) curricula. Methods: This study analyzed the course titles and descriptions for 674 courses across 262 Council on Social Work Education accredited colleges and universities that offer MSW training in the United States and Puerto Rico. Results: The results indicate a robust presence of evaluation-specific courses in MSW programs, as well as skills that are further supported by inquiry and analysis courses; 51.1% of MSW programs required at least one evaluation course ( n = 134) for at least some of their students. On average, MSW programs required 2.0 credit hours in evaluation and 4.5 credit hours in inquiry courses for at least some of their students. Discussion: The findings suggest that evaluation education research should include social work programs and that educators should discuss the role of inquiry and evaluation in social work practice.
Opioid Prescribing After Discharge in a Previously Mechanically Ventilated, Opioid-Naïve Cohort
Authors: Academia Emmeline C. , Gabriel Christian J. , Mueller Amanda , Schwarz Kerry A. , Bartels Karsten , Valuck Robert J. , Reynolds Paul M. 
Published: April 2020

Background: Opioids are utilized for pain management during and after mechanical ventilation in the intensive care unit (ICU). Objective: The purpose of this study was to determine the percentage of potentially unnecessary opioid prescriptions on discharge in previously opioid-naïve patients. Methods: This retrospective cohort study included mechanically ventilated, opioid-naïve ICU patients who received opioids. The primary outcome of this study was the discrepancy between the amounts of opioids prescribed at discharge versus those likely required based on actual 24-hour prehospital discharge opioid requirements. Results: A total of 71 patients were included. Of these, 63.3% (n = 45) of discharge prescriptions were in alignment with 24-hour predischarge requirements, and 36.7% (n = 26) of discharge prescriptions were in excess of calculated predischarge requirements. At discharge, 57.7% (n = 41) of patients received a nonopioid analgesic. Multivariable linear regression revealed that cardiothoracic ICU admission was associated with an increased risk of inappropriate discharge opioid prescribing, whereas a shorter duration of inpatient oral opioid therapy decreased risk of inappropriate discharge prescribing. Conclusion and Relevance: Opioid prescribing for previously mechanically ventilated patients warrants improvement as a part of the discharge planning process. Application of these data may aid in the reduction of opioid overprescribing at discharge after an ICU stay.
Evaluation of Serratus Anterior Plane Block for Pain Relief in Patients Undergoing MIDCAB Surgery
Authors: Gautam Sujeet , Pande Shantanu , Agarwal Anil , Agarwal S. K. , Rastogi Amit , Shamshery Chetna , Singh Ankita 
Published: April 2020

Objective The minimally invasive direct coronary artery bypass (MIDCAB) surgery is associated with severe chest pain in the first 2 to 3 postoperative days; this may delay the patient recovery. In this randomized controlled trial we evaluated the role of serratus anterior plane (SAP) block for postoperative pain relief in patients undergoing MIDCAB surgery. Methods Patients undergoing MIDCAB surgery were randomized into 2 groups of 25 each; SAP group received 20 mL of 0.2% ropivacaine with 1 μg/mL fentanyl as bolus followed by infusion at 8 mL/h; control group received saline for both bolus and infusion. Primary outcome measure was postoperative pain when supine, and during deep inspiration, coughing, and patient movement; secondary outcome measures were requirement of postoperative intravenous fentanyl and opioid-related side effects. All patients were followed at 6-hourly intervals for 48 hours in the postoperative period. Results were analyzed by the Student’s t -test, χ 2 test, Mann–Whitney U-test and Kruskall–Wallis test. A P-value <0.05 was considered significant. Results The 2 groups were similar with respect to patient characteristics. Static and dynamic pain visual analog scale scores were significantly reduced in the SAP group as compared to the control group at most of the time points of assessment ( P < 0.05). Patient-controlled fentanyl requirements were reduced in the SAP group as compared to control group on the second postoperative day ( P < 0.05). Conclusions SAP block reduced the postoperative pain scores and opioid requirements in patients undergoing MIDCAB surgery.
Chemokine receptor CXCR4 activates the RhoA/ROCK2 pathway in spinal neurons that induces bone cancer pain
Authors: Xu Heng , Peng Chong , Chen Xue-Tai , Yao Ying-Ying , Chen Li-Ping , Yin Qin , Shen Wen 
Published: April 2020

Background Chemokine receptor CXCR4 has been found to be associated with spinal neuron and glial cell activation during bone cancer pain. However, the underlying mechanism remains unknown. Furthermore, the RhoA/ROCK2 pathway serves as a downstream pathway activated by CXCR4 during bone cancer pain. We first validated the increase in the expressions of CXCR4, p-RhoA, and p-ROCK2 in the spinal dorsal horn of a well-characterized tumor cell implantation-induced cancer pain rat model and how these expressions contributed to the pain behavior in tumor cell implantation rats. We hypothesized that spinal blockade of the CXCR4-RhoA/ROCK2 pathway is a potential analgesic therapy for cancer pain management. Methods Adult female Sprague–Dawley rats (body weight of 180–220 g) and six- to seven-week old female Sprague–Dawley rats (body weight of 80–90 g) were taken. Ascitic cancer cells were extracted from the rats (body weight of 80–90 g) with intraperitoneally implanted Walker 256 mammary gland carcinoma cells. Walker 256 rat mammary gland carcinoma cells were then injected (tumor cell implantation) into the intramedullary space of the tibia to establish a rat model of bone cancer pain. Results We found increased expressions of CXCR4, p-RhoA, and p-ROCK2 in the neurons in the spinal cord. p-RhoA and p-ROCK2 were co-expressed in the neurons and promoted by overexpressed CXCR4. Intrathecal delivery of CXCR4 inhibitor Plerixafor (AMD3100) or ROCK2 inhibitor Fasudil abrogated tumor cell implantation-induced pain hypersensitivity and tumor cell implantation-induced increase in p-RhoA and p-ROCK2 expressions. Intrathecal injection of stromal-derived factor-1, the principal ligand for CXCR4, accelerated p-RhoA expression in naive rats, which was prevented by postadministration of CXCR4 inhibitor Plerixafor (AMD3100) or ROCK2 inhibitor Fasudil. Conclusions Collectively, the spinal RhoA/ROCK2 pathway could be a critical downstream target for CXCR4-mediated neuronal sensitization and pain hypersensitivity in bone cancer pain, and it may serve as a potent therapeutic target for pain treatment.
Factors associated with health-related quality of life in Japanese patients with hip osteoarthritis: A cross-sectional study
Authors: Tanaka Shigeharu , Robbins Shawn M , Inoue Yu , Tanaka Ryo 
Published: April 2020

Background/Purpose: Chronic symptoms related with hip osteoarthritis (OA) can negatively affect health-related quality of life (HRQoL). The purpose of this study was to examine factors related to a HRQoL measure that considers an Asian lifestyle in Japanese patients with hip OA. Methods: Forty-seven female subjects participated. The dependent variable was the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), which assessed HRQoL. Potential factors were measured as independent variables. After screening, potential variables were entered into a multiple regression analysis to determine which variables were related to HRQoL. Results: In the regression model, knee extension muscle strength on the unaffected side and hip flexion range of motion (ROM) on the affected side were associated with HRQoL. Higher strength and higher ROM were related to greater HRQoL. Conclusion: Results can help health-care providers develop appropriate rehabilitation programs for improving HRQoL in patients with hip OA.
EFFECTS OF A SIMULATED GAME ON PITCHING KINEMATICS IN YOUTH FEMALE SOFTBALL PITCHERS
Authors: Oliver Gretchen D. , Downs Jessica L. , Friesen Kenzie B. , Anz Adam W. , Dugas Jeff R. , Andrews James R. 
Published: April 2020

Background: Despite evidence that overuse is the most common mechanism of injury, softball pitchers currently have no pitch count regulations. Pain has been associated with certain pitching pathomechanics, and some reports indicate increased pain following a single pitching bout. Hypothesis/Purpose: The purpose of this study was to analyze kinematic variables such as center of mass (COM), trunk, and stride length during the first and last inning of a simulated game in youth softball pitchers. We hypothesized COM to be shifted back toward the drive leg, stride length would be increased, and trunk kinematics would be altered during the last inning of a simulated game as compared to the first inning. Methods: Participants included thirty-two softball pitchers (12.4±1.6yrs., 159.4±8.9cm, 62.0±13.6kg). Participants were deemed injury and surgery free for the past six months and were currently active as a pitcher on their teams’ roster. Kinematic data were collected at 100Hz using an electromagnetic system. After warm-up, participants were instructed to throw random game situations, provided by the investigator, with the catcher located at regulation distance (43ft). Participants were required to produce three outs an inning as per a regulation softball game. Three fastballs from the first and last inning were recorded and used for analysis. Kinematics were analyzed at five different pitch events including: start of pitch, top of pitch, foot contact, ball release, and follow through. Results: A paired samples t-test revealed a statistically significant difference in trunk rotation during the first three pitching events from the first and last inning. Specifically, pitchers exhibited less trunk rotation towards the pitching arm side. A bivariate Pearson’s correlation showed volume of pitches was correlated with stride length (r=.367, p=.039) and COM (r=.364, p=.041) at the start of the pitch, and trunk flexion at top of pitch (r=-.392, p=.026), foot contact (r=-.413, p=.019), and follow-through (r=-.436, p=.013). Conclusion/Significance: Trunk kinematics, stride length, and COM were altered as pitch volume increased. These results provide clinical importance as the trunk pathomechanics seen may be indicative of poor trunk control and fatigue. Although it is out of the realm of this study to state whether the kinematic changes seen are associated with injury, we do know that deficits in the kinetic chain are associated with injury and that trunk pathomechanics are associated with pain in collegiate softball pitchers. Research should continue to investigate the effects of pitch count, pitch mechanics, and injury in youth softball pitchers.
Characterizing the Prevalence of Cam-Type Hip Impingement in Professional Women’s Ice Hockey Players
Authors: Carter Cordelia W. , Whitney Darryl , Campbell Abigail , Feder Oren , Kingery Matthew , Baron Samuel , Lomas Guillem 
Published: April 2020

Background Recent studies have demonstrated a high prevalence of femoroacetabular impingement (FAI) in elite men’s ice hockey players, yet little is known about the hips of elite women’s ice hockey players. Purpose The primary purpose of this study was to determine the prevalence of radiographic cam-type FAI in professional women’s ice hockey players in the National Women’s Hockey League (NWHL). The secondary purpose was to analyze the relationship between the presence of cam deformity and both hip range-of-motion (ROM) and age of menarche. Methods Clinical, radiographic and demographic data were collected during player pre-participation physicals. ROM measurements were performed with a goniometer. Alpha angles were measured on 45° Dunn radiographs, with alpha angles >55° defined as cam-positive ( Figure 1). Measurements were performed 3 separate times by 4 investigators. One-way ANOVA, independent means t-test and Pearson correlation coefficients were calculated, with statistical significance set at p<0.05. Results Twenty-six female athletes were included. Average menarchal age was 13.8 ±1.5 years. 24 (92%) had alpha angles >55°; 20 (77%) had bilateral cam deformity. Inter-rater reliability was excellent at 0.86. Intra-rater reliability was also excellent, with mean ICC=0.87 (range= 0.82-0.90 for each rater). There was a significant positive association between age of menarche and alpha angle (p<0.02, Figure 2). There was no association between alpha angle and hip ROM. Conclusion Elite female ice hockey players have a higher prevalence of cam morphology than the general population. The positive association between alpha angle and age of menarche supports the etiological hypothesis of the cam lesion resulting from activity-related stress at the proximal femoral physis during a period of physiologic vulnerability. Professional women’s ice hockey players have a high risk of developing cam morphology of the proximal femur, although each player’s age of menarche may mediate her individual risk for cam lesion development. [Figure: see text][Figure: see text]
THE UTILITY AND VALIDATION OF THE FREQUENCY OF CONCUSSION SYMPTOMS (FOCS) QUESTIONNAIRE
Authors: Burkhart SO , Ellis CS , Jones CA , Smurawa TM , Polousky JD 
Published: April 2020

Background: Individuals with concussion show elevated scores on symptom checklists as long as the impairment is detectable (Peterson et al., 2003). The research question was to examine whether a questionnaire based on concussion symptom frequency (FOCS) would demonstrate sensitivity and specificity in differentiating concussion from non-concussion and provide beneficial clinical data when added to symptom severity measures such as the PCSS. Purpose: The purpose of this study was to determine the clinical utility of concussion symptom frequency using the Frequency of Concussion Symptoms (FOCS) Questionnaire in a sample of pediatric patients. Methods: Pediatric patients ages 13-18 diagnosed with a concussion (n=250) and orthopedic controls (n=250) presenting to an outpatient orthopedic clinic were administered the FOCS and PCSS at the time of initial clinical evaluation. All patients were administered the FOCS and PCSS by certified athletic trainers who were educated and trained on administration. The Frequency of Concussion Symptoms (FOCS) Questionnaire is a self-report measure consisting of 28 items, rated on a 5-point scale from 4 ( constantly) to 0 ( never). The PCSS is a self-report measure consisting of 22 items rated on a 7-point scale from 0 ( none) to 6 ( severe). Demographic data were summarized using descriptive statistics. Point estimates and 95% confidence intervals were calculated for all end points. Pearson correlations were calculated based on numerical values from the FOCS and PCSS data to establish validity. A regression analysis was performed to examine the coefficient of determination for FOCS and PCSS scores. Results: The total concussion sample consisted of 103 females and 147 males (mean age=15.03, SD=1.38), the orthopedic control sample consisted of 92 females and 158 males (mean age=15.46, SD=1.12). There was a positive correlation between the FOCS and PCSS in concussion patients (r=0.73, p=0.002) and in orthopedic controls (r=0.68, p=<0.001). Concussion and orthopedic control samples were not correlated on the FOCS (r=0.09, p<0.001) and PCSS (r=0.21, P=0.02). Multiple regression analysis was used to measure FOCS and PCSS scores in concussion patients (R2=0.78, p=<0.001). Conclusions: This is the first study of its kind examining concussion symptom frequency and severity to improve clinical symptom reporting. Adding frequency to symptom severity accounted for 78% of the variance. This may be the result of less subjectivity in frequency versus severity. This study was limited by sample size, further research is warranted to explore the relationship between symptom frequency and severity.