bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Utilization of Image Guidance for Hip Joint Injections
Authors: Henne Michelle , Centurion Alejandro , Zeini Ibrahim Mamdouh , Youmans Donald Harrison , Osbahr Daryl Christopher 
Published: February 2020

Objective:
This study aims to evaluate trends in utilization of image guidance for intraarticular hip injections and to compare the cost efficiency of ultrasound-, fluoroscopic-, and landmark-guided injections in the management of hip osteoarthritis (OA) and femoroacetabular impingement (FAI).

Design:
Retrospective descriptive epidemiology study.

Setting:
The information was collected from Humana private payer insurance claims database encompassing all practice settings.

Patients or Participants:
A total of 302 855 patients for years 2007 to 2015.

Interventions or Assessment of Risk Factors or Independent Variables:
Primary diagnosis of hip OA or FAI.

Main Outcome Measures:
Injection type [corticosteroid (CS) or hyaluronic acid (HA)], imaging modality (landmark, ultrasound, or fluoroscopic guidance), and costs.

Results:
Landmark-guided CS and HA injections for the management of hip OA decreased, whereas fluoroscopic and ultrasound guidance increased. Similar trends were demonstrated in the management of FAI using CS. In the management of FAI using HA, landmark- and ultrasound-guided injections decreased and fluoroscopic-guided injections increased. Cost analysis revealed lower reimbursement of landmark and ultrasound guidance compared with fluoroscopic guidance.

Conclusions:
During the study period, there was an increase in the use of image guidance and decline in landmark guidance for the treatment of OA and FAI using CS and HA. Fluoroscopic guidance demonstrated increased reimbursement compared with landmark and fluoroscopic guidance. There is an opportunity to mitigate cost and reduce radiation exposure by using ultrasound-guided injections rather than fluoroscopic guidance.
Iliopsoas Release: A Systematic Review of Clinical Efficacy and Associated Complications
Authors: Longstaffe Robert , Hendrikx Shawn , Naudie Douglas , Willits Kevin , Degen Ryan M. 
Published: February 2020

Objective:
To perform a systematic review of the findings of iliopsoas release as it relates to resolution of snapping, improvement of groin pain, and associated complications.

Design:
Systematic review.

Data Sources:
Four electronic databases PubMed/MEDLINE, EMBASE, CINAHL, and Web of Science were searched, identifying all literature pertaining to surgical treatment of a snapping hip/coxa saltans, iliopsoas impingement, or iliopsoas tendinitis. A total of 818 studies were identified. Two reviewers independently screened the titles, abstracts, and full-text articles for eligibility.

Eligibility Criteria:
All studies published in English that reported on iliopsoas release for snapping hip/coxa saltans, iliopsoas impingement, or iliopsoas tendinitis reporting outcomes or associated complications were eligible.

Results:
A total of 48 articles were included in this review. Three surgical indications were identified for iliopsoas release, internal snapping hip, labral tear secondary to iliopsoas impingement, and iliopsoas tendinopathy after total hip arthroplasty. Arthroscopic techniques seemed to be superior to open techniques with regards to reoccurrence of snapping (5.1% vs 21.7%) and groin pain relief (89.1% vs 85.6%) with fewer complications (4.2% vs 21.1%) overall.

Conclusions:
Both open and arthroscopic iliopsoas releases have been shown to be successful treatment options regardless of the surgical indications identified in this review. Arthroscopic release demonstrated a decreased failure rate, fewer complications, and improved outcomes when compared with open procedures.
Video Analysis of Acute Injuries in Elite Field Hockey
Authors: Theilen Till-Martin , Mueller-Eising Wiebke , Bettink Peter W. , Rolle Udo 
Published: February 2020

Objective:
With this study, we aim to determine the value of video assessment of acute injuries in field hockey.

Design:
Retrospective video analysis for acute injuries.

Setting:
Professional field hockey.

Participants:
Seven women and men's field hockey tournaments (World League, Champions Trophy) in 2015.

Interventions:
Not applicable.

Outcome Measures:
An injury was defined as any new musculoskeletal complaint leading to time stoppage and medical attention. The outcome measures were time at play, location on the pitch, type of injury, injured body part, and injury mechanism.

Results:
A total of 190 injuries occurred in 179 matches (55/73 female and 135/106 male matches). There were 0.75 injuries per match for women [confidence interval (CI, 0.31-1.13)] and 1.27 injuries per match for men (CI, 0.88-1.61). The number of injuries per 1000 player match hours was 34.20 for women (CI, 14.04-51.29) and 57.89 for men (CI, 29.78-73.12). The highest injury frequency occurred within the third quarter and within the circle. Contusion was the most common injury type (90.9% in women and 96.3% in men). The leading causes of injuries were hits by the ball or stick and collisions with another player. The head/face was the most affected body part in both sex groups (32.7% in women and 29.6% in men).

Conclusions:
Video analysis revealed data on injury incidence within the same range of previous reports in elite field hockey. Its advantages, such as slow motion and repetitive play of injury scenes, could contribute valuable information if incorporated into the injury recording process.
Providing a Medical Definition of Concussion: Can a Simple Intervention Improve Self-Reported Concussion History in Youth Athletes?
Authors: Wicklund Alissa , Roy Ashley , Coatsworth J. Douglas 
Published: February 2020

Objective:
Providing a medical definition of concussion improves reliability of self-reported history of concussion in adult former athletes. We examine whether providing a medical definition of concussion to youth athletes increases the number of concussions reported, and whether reporting differs by age, sex, or sport type.

Design:
Cross-sectional survey.

Setting:
Concussion specialty clinic.

Participants:
Convenience sample of youth athletes (n = 301; mean age = 15.1 ± 1.6 years) presenting for evaluation of sports-related concussion.

Independent Variables:
Number of concussions reported before and after presentation of the medical definition of concussion (“vignette”).

Outcome Measures:
Number of concussions reported after vignette. Paired-sample t test examined for main effect of the vignette on reporting behavior. One-way between-subjects analysis of variance with pairwise comparisons assessed for group differences.

Results:
Thirty percent of youth athletes reported an increase in number of concussions after vignette overall (P < 0.000). There was no significant difference in reporting behavior by age, sex, or sport type.

Conclusions:
Providing the medical definition of concussion, a simple and brief intervention, gives youth athletes context to understand when a concussion has occurred. This results in an increase in the number of concussions reported when gathering a self-reported history. Reporting behavior after a vignette does not differ across sex, sport type, or age of the athlete.
The Influence of Time of Season on Injury Rates and the Epidemiology of Canadian Football Injuries
Authors: Robbins Shawn M. , Bodnar Camille , Donatien Pierre , Mirza Rabia , Zhao Zhen Yuan , Hoeber Shane , Naidu Dhiren , Redelmeier Annabelle , Steele Russell J. , Shrier Ian 
Published: February 2020

Objective:
To describe injury rates and injury patterns in the Canadian Football League (CFL) according to time during the season, player position, injury type, and injury location.

Design:
Prospective, cohort study.

Setting and Participants:
Eight seasons from CFL injury surveillance database.

Independent Variables:
Depending on the analysis, time of season (preseason, regular, and playoffs), player position, injury type, and injury location.

Main Outcome Measures:
Medical attention and time-loss injury rates per 100 athletes at risk (AAR), and prevalence of time-loss injuries per week.

Results:
The average game injury rate was 45.2/100 AAR medical attention injuries and 30.7/100 AAR time-loss injuries. Injury rates declined by 1% per week over the season for both medical attention (rate ratio = 0.99) and time-loss (rate ratio = 0.99) injuries, with a substantial decline during the playoffs compared with preseason (rate ratio = 0.70-0.77). The number of ongoing time-loss injuries increased over the course of the regular season. Quarterbacks, offensive backs, and linebackers had the highest game injury rates. Joint/ligament and muscle/tendon injuries were the most common injury types for games and practices, respectively. The lower extremity was the most commonly affected area, specifically the lower leg/ankle/foot and hip/groin/thigh.

Conclusions:
There was a 1% decline in injury rate per week during the season and a 30% decline during the playoffs. The number of ongoing time-loss injuries increased over the regular season. Current results can aid league officials and medical staff in making evidence-based decisions concerning player safety and health.
Identification of Pediatric Sepsis for Epidemiologic Surveillance Using Electronic Clinical Data*
Authors: Weiss Scott L. , Balamuth Fran , Chilutti Marianne , Ramos Mark Jason , McBride Peter , Kelly Nancy-Ann , Payton K. Joy , Fitzgerald Julie C. , Pennington Jeffrey W. 
Published: February 2020

Objectives:
A method to identify pediatric sepsis episodes that is not affected by changing diagnosis and claims-based coding practices does not exist. We derived and validated a surveillance algorithm to identify pediatric sepsis using routine clinical data and applied the algorithm to study longitudinal trends in sepsis epidemiology.

Design:
Retrospective observational study.

Setting:
Single academic children’s hospital.

Patients:
All emergency and hospital encounters from January 2011 to January 2019, excluding neonatal ICU and cardiac center.

Exposure:
Sepsis episodes identified by a surveillance algorithm using clinical data to identify infection and concurrent organ dysfunction.

Interventions
None.

Measurements and Main Results:
A surveillance algorithm was derived and validated in separate cohorts with suspected sepsis after clinician-adjudication of final sepsis diagnosis. We then applied the surveillance algorithm to determine longitudinal trends in incidence and mortality of pediatric sepsis over 8 years. Among 93,987 hospital encounters and 1,065 episodes of suspected sepsis in the derivation period, the surveillance algorithm yielded sensitivity 78% (95% CI, 72–84%), specificity 76% (95% CI, 74–79%), positive predictive value 41% (95% CI, 36–46%), and negative predictive value 94% (95% CI, 92–96%). In the validation period, the surveillance algorithm yielded sensitivity 84% (95% CI, 77–92%), specificity of 65% (95% CI, 59–70%), positive predictive value 43% (95% CI, 35–50%), and negative predictive value 93% (95% CI, 90–97%). Notably, most “false-positives” were deemed clinically relevant sepsis cases after manual review. The hospital-wide incidence of sepsis was 0.69% (95% CI, 0.67–0.71%), and the inpatient incidence was 2.8% (95% CI, 2.7–2.9%). Risk-adjusted sepsis incidence, without bias from changing diagnosis or coding practices, increased over time (adjusted incidence rate ratio per year 1.07; 95% CI, 1.06–1.08; p < 0.001). Mortality was 6.7% and did not change over time (adjusted odds ratio per year 0.98; 95% CI, 0.93–1.03; p = 0.38).

Conclusions:
An algorithm using routine clinical data provided an objective, efficient, and reliable method for pediatric sepsis surveillance. An increased sepsis incidence and stable mortality, free from influence of changes in diagnosis or billing practices, were evident.
Outcomes of Acute Inpatient Rehabilitation After Ventricular Assist Device Placement
Authors: Johnson Shelby E. , Del Fabro A. Sophia , Reeves Ronald K. 
Published: February 2020

Objective
The aim of the study was to compare outcomes of inpatient rehabilitation after ventricular assist device placement with outcomes for other cardiac diagnoses.

Design
This was a retrospective review of the electronic health records of 265 patients admitted to inpatient rehabilitation: 166 patients were admitted after ventricular assist device placement and 99 were admitted for other cardiac disease. Data collected included functional independence measure score on admission and discharge, dates of admission and discharge, and disposition.

Results
Patients admitted after ventricular assist device placement had a mean functional independence measure gain of 25.7 and length of stay of 8.7 days. Patients admitted for other cardiac diagnoses had a mean functional independence measure gain of 25.9 and length of stay of 9.4 days. These differences were not statistically significant. Change in functional independence measure from admission to discharge was statistically significant within each group (P < 0.001). Most patients were discharged home, and the proportions who returned to acute care or home were not different between groups.

Conclusions
Both the ventricular assist device and nonventricular assist device groups had significant and equivalent improvements in functional outcomes after inpatient rehabilitation. This study found that ventricular assist device patients benefit from inpatient rehabilitation with similar disposition rates as patients with other cardiac diagnoses. Inpatient rehabilitation is the appropriate setting for this group.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
Upon completion of this article, the reader should be able to: (1) Describe the role of rehabilitation in the care of individuals after ventricular assist device (VAD) placement; (2) Compare the outcomes of inpatient rehabilitation for individuals after VAD placement to those admitted for other cardiac reasons; and (3) Recognize potential complications that may occur during the course of a VAD patient’s inpatient rehabilitation stay.

Level
Advanced

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Performance of Computed Tomographic Pulmonary Angiography Compared With Standard Chest Computed Tomography for Identification of Solid Organ, Serosal, and Nodal Findings
Authors: Anderson John F. , Raptis Constantine , Bhalla Sanjeev 
Published: February 2020

Purpose:
Computed tomographic pulmonary angiography (CTPA) is the test of choice for patients with acute chest pain and suspected pulmonary embolism (PE). This examination is excellent for the diagnosis of PE and can also often identify alternative diagnoses. The early phase of contrast, however, may not allow for optimal evaluation of lymph nodes, serosal surfaces, and solid organs, leading to the nonvisualization of important findings and the potential for missed diagnoses. The purpose of this study was to determine the frequency of relevant findings only identified on standard portal venous phase CT compared with CTPA.

Materials and Methods:
The reports for all patients in the previous 10 years who underwent both standard CT and CTPA within 7 days, for a total of 675 pairs of scans, were tabulated according to the presence of PE, serosal abnormalities, solid organ abnormalities, and lymphadenopathy. All findings were categorized as present on both scans, standard CT only, or CTPA only. The scans were manually evaluated to exclude findings that were new or resolved on the second study or outside the field of view on one of the studies.

Results:
Significantly more PEs were identified only on CTPA examinations. However, significantly more pleural, peritoneal, and solid organ abnormalities, and abnormal mediastinal and abdominal lymph nodes were identified on standard CT only. There was no significant difference in the identification of pericardial abnormalities or abnormal hilar lymph nodes between the two scans.

Conclusions:
Many serosal abnormalities, solid organ abnormalities, and lymphadenopathy were only reported on standard portal venous phase CT compared with CTPA.
Preresection Stained Glue Injection to Localize Pulmonary Small Nodules and Ground-glass Opacities
Authors: Wang Jian , Gao Li-Bin , Zhang Hong , Wang Jian , Liu Liang , Shi Wan-Yin 
Published: February 2020

Objective:
We sought to introduce a localization procedure (methylene blue-stained N-butyl cyanoacrylate and N-octyl cyanoacrylate glue) in localizing pulmonary small nodules and ground-glass opacities before thoracoscopic resection, and to evaluate its efficacy.

Methods:
A total of 20 patients with pulmonary small nodules and/or ground-glass opacities, who underwent video-assisted thoracoscopic surgery from August 1, 2017 to March 1 2018, were included in the study.

Results:
A total of 24 lesions in 20 patients underwent blue-stained glue localization. The success rate of localization was 100%, with a mean dose of 0.04±0.01 mL blue dye and 1 mL glue used for each lesion. The average time for the whole localization procedure was 15.4±6.3 minutes. All lesions were intraoperatively localized by visual inspection in combination with palpation. The complications related to the localization procedure included mild pneumothorax occurring in 9 patients and minor pulmonary hematoma in 4 patients. No pain or distress was reported.

Conclusions:
Blue-stained glue injection is technically feasible and safe to localize pulmonary small nodules and ground-glass opacities before thoracoscopic resection.
Mortality review of US Special Operations Command battle-injured fatalities
Authors: Mazuchowski Edward L. , Kotwal Russ S. , Janak Jud C. , Howard Jeffrey T. , Harcke Howard T. , Montgomery Harold R. , Butler Frank K. , Holcomb John B. , Eastridge Brian J. , Gurney Jennifer M. , Shackelford Stacy A. 
Published: February 2020

BACKGROUND
Comprehensive analyses of battle-injured fatalities, incorporating a multidisciplinary process with a standardized lexicon, is necessary to elucidate opportunities for improvement (OFIs) to increase survivability.

METHODS
A mortality review was conducted on United States Special Operations Command battle-injured fatalities who died from September 11, 2001, to September 10, 2018. Fatalities were analyzed by demographics, operational posture, mechanism of injury, cause of death, mechanism of death (MOD), classification of death, and injury severity. Injury survivability was determined by a subject matter expert panel and compared with injury patterns among Department of Defense Trauma Registry survivors. Death preventability and OFI were determined for fatalities with potentially survivable or survivable (PS-S) injuries using tactical data and documented medical interventions.

RESULTS
Of 369 United States Special Operations Command battle-injured fatalities (median age, 29 years; male, 98.6%), most were killed in action (89.4%) and more than half died from injuries sustained during mounted operations (52.3%). The cause of death was blast injury (45.0%), gunshot wound (39.8%), and multiple/blunt force injury (15.2%). The leading MOD was catastrophic tissue destruction (73.7%). Most fatalities sustained nonsurvivable injuries (74.3%). For fatalities with PS-S injuries, most had hemorrhage as a component of MOD (88.4%); however, the MOD was multifactorial in the majority of these fatalities (58.9%). Only 5.4% of all fatalities and 21.1% of fatalities with PS-S injuries had comparable injury patterns among survivors. Accounting for tactical situation, a minority of deaths were potentially preventable (5.7%) and a few preventable (1.1%). Time to surgery (93.7%) and prehospital blood transfusion (89.5%) were the leading OFI for PS-S fatalities. Most fatalities with PS-S injuries requiring blood (83.5%) also had an additional prehospital OFI.

CONCLUSION
Comprehensive mortality reviews of battlefield fatalities can identify OFI in combat casualty care and prevention. Standardized lexicon is essential for translation to civilian trauma systems.

LEVEL OF EVIDENCE
Epidemiological, level IV.
X-ray fluorescence detection for serial macromolecular crystallography using a JUNGFRAU pixel detector
Authors: Martiel Isabelle , Mozzanica Aldo , Opara Nadia L. , Panepucci Ezequiel , Leonarski Filip , Redford Sophie , Mohacsi Istvan , Guzenko Vitaliy , Ozerov Dmitry , Padeste Celestino , Schmitt Bernd , Pedrini Bill , Wang Meitian 
Published: February 2020

Detection of heavy elements, such as metals, in macromolecular crystallography (MX) samples by X-ray fluorescence is a function traditionally covered at synchrotron MX beamlines by silicon drift detectors, which cannot be used at X-ray free-electron lasers because of the very short duration of the X-ray pulses. Here it is shown that the hybrid pixel charge-integrating detector JUNGFRAU can fulfill this function when operating in a low-flux regime. The feasibility of precise position determination of micrometre-sized metal marks is also demonstrated, to be used as fiducials for offline prelocation in serial crystallography experiments, based on the specific fluorescence signal measured with JUNGFRAU, both at the synchrotron and at SwissFEL. Finally, the measurement of elemental absorption edges at a synchrotron beamline using JUNGFRAU is also demonstrated.
Beyond supervisors’ support: influencing (international) technical training transfer
Authors: Richter Svenja , Kauffeld Simone 
Published: February 2020

Purpose
This paper aims to provide an understanding of influencing motivation and volition in the transfer of learning within the context of technical training in different countries by controlling predictors.

Design/methodology/approach
In six countries, employees from one automotive company’s service centres were asked to complete two online questionnaires after a blended learning training program with technical content (t1: 7 to 12 days after the training, t2: 5 to 7 weeks after). In total, 441 technical staff members participated.

Findings
Results suggest that motivation and volition mediate the effects of peer support, content validity and supervisor support on training transfer after a technical training. The outcomes show that peer support has an important influence on motivation and that national culture is less important than company culture.

Research limitations/implications
The results should be tested further in different trainings, companies and countries.

Originality/value
This is one of the first international studies to confirm peer support and content validity as predictors for motivation to transfer after technical training. It is also the first instance of exploring possible mediation by motivation and volition on peer support and content validity after technical training in an intercultural context.