bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-time dynamic changes in intraocular pressure after occlusion break: comparing 2 phacoemulsification systems
Authors: Vasavada Vaishali , Vasavada Abhay R. , Vasavada Viraj A. , Vasavada Shail A. , Bhojwani Deepak 
Published: April 2021

Purpose:
To compare real-time intraocular pressure (IOP) response to occlusion break event in 2 phacoemulsification systems.

Setting:
Iladevi Cataract and IOL Research Center, India.

Design:
Randomized, experimental study.

Methods:
Rabbits were randomized to:Group I (n = 10 eyes), Centurion Vision system with active fluidics, or, Group II (n = 10 eyes), Centurion with Active Sentry. Within each group, parameter set 1 (IOP 30 mm Hg, aspiration flow rate [AFR] 20 mL/min, and vacuum 600 mm Hg) and parameter set 2 (IOP 50 mm Hg, AFR 25 mL/min, and vacuum 600 mm Hg) were tested. Real-time rate of drop and rise of IOP after occlusion break event (mm Hg per second) and percentage reduction of IOP from maximum during nuclear fragment removal were compared.

Results:
10 rabbits (20 eyes) were included. Rate of drop of IOP after occlusion break was not significantly different between groups. Rate of rise of IOP was statistically significantly higher in Group II with both parameter sets (199.09 ± 69.28 vs 94.33 ± 45.66 in parameter set 1, P = .006; and 256 ± 45.05 vs 165.25 ± 51.80 in parameter set 2, P = .005), suggesting faster recovery to baseline IOP after occlusion break. The mean percentage reduction of IOP from maximum was significantly higher in Group I (P = .003).

Conclusions:
Rise of IOP to baseline after occlusion break event was faster and mean percentage reduction of IOP from maximum during nuclear fragment removal was lower when using the Centurion Vision system with the Active Sentry upgrade compared with the traditional handpiece. The ability to sense IOP at the level of the handpiece with the Active Sentry upgrade allows faster mitigation of surge response.
Membrane potential instabilities in sensory neurons: mechanisms and pathophysiological relevance
Authors: Velasco Enrique , Alvarez Julio L. , Meseguer Victor M. , Gallar Juana , Talavera Karel 
Published: April 2021

Abstract
Peripheral sensory neurons transduce physicochemical stimuli affecting somatic tissues into the firing of action potentials that are conveyed to the central nervous system. This results in conscious perception, adaptation, and survival, but alterations of the firing patterns can result in pain and hypersensitivity conditions. Thus, understanding the molecular mechanisms underlying action potential firing in peripheral sensory neurons is essential in sensory biology and pathophysiology. Over the past 30 years, it has been consistently reported that these cells can display membrane potential instabilities (MPIs), in the form of subthreshold membrane potential oscillations or depolarizing spontaneous fluctuations. However, research on this subject remains sparse, without a clear conductive thread to be followed. To address this, we here provide a synthesis of the description, molecular bases, mathematical models, physiological roles, and pathophysiological implications of MPIs in peripheral sensory neurons. Membrane potential instabilities have been reported in trigeminal, dorsal root, and Mes-V ganglia, where they are believed to support repetitive firing. They are proposed to have roles also in intercellular communication, ectopic firing, and responses to tonic and slow natural stimuli. We highlight how MPIs are of great interest for the study of sensory transduction physiology and how they may represent therapeutic targets for many pathological conditions, such as acute and chronic pain, itch, and altered sensory perceptions. We identify future research directions, including the elucidation of the underlying molecular determinants and modulation mechanisms, their relation to the encoding of natural stimuli and their implication in pain and hypersensitivity conditions.
Prevalence of chronic pain among adults in the United States
Authors: Yong R. Jason , Mullins Peter M. , Bhattacharyya Neil 
Published: April 2021

Abstract:
Chronic pain is associated with reduced quality of life, increased medical expenditures, and significant economic costs. Chronic pain is among the most common chronic conditions in the United States, although estimates vary widely regarding its precise prevalence. Understanding the scope of the problem using the most contemporaneous data is therefore an important goal. This study sought to determine the prevalence of chronic pain and its impacts among adults in the United States using the National Health Interview Survey, a household-based annual survey of self-reported health status of U.S. adults that can be used to generate national-level estimates. Using a chronic pain module introduced in the 2019 edition of National Health Interview Survey, we found that 50.2 million adults (20.5%) reported pain on most days or every day. The most common pain locations were back pain and hip, knee, or foot pain. The most commonly used management strategies for chronic pain were physical therapy and massage. Respondents with chronic pain reported limitations in daily functioning, including social activities and activities of daily living. Respondents with chronic pain reported significantly more workdays missed compared with those without chronic pain (10.3 vs 2.8, P < 0.001). Overall, these findings indicate that more than 1 in 5 adults in America experiences chronic pain; additional attention to managing the burden of this disease is warranted.
Reciprocal interaction between depression and pain: results from a comprehensive bidirectional Mendelian randomization study and functional annotation analysis
Authors: Tang Bowen , Meng Weihua , Hägg Sara , Burgess Stephen , Jiang Xia 
Published: April 2021

Abstract
To understand a putative causal link for depression and pain, we retrieved summary statistics from genome-wide association studies conducted for pain at 7 different body sites (N = 151,922-226,683) and major depression disorder (MDD, Ncase/control = 246,363/561,190). We conducted a bidirectional Mendelian randomization analysis using distinct genome-wide association studies-identified single nucleotide polymorphisms for each trait as instrumental variables and performed several sensitivity analyses to verify Mendelian randomization assumptions. We also conducted functional annotation analysis using 396 tissue-specific annotations from the roadmap project. Across 7 different body sites, genetic predisposition to depression was associated with pain at the neck/shoulder (odds ratio [OR] = 1.08 per one log-unit increase in depression risk, 95% confidence interval [CI]: 1.06-1.10), back (OR = 1.05, 95% CI: 1.04-1.07), abdominal/stomach (OR = 1.03, 95% CI: 1.02-1.04), as well as headache (OR = 1.10, 95% CI: 1.07-1.12), but not with pain on the face, hip, and knee. In the reverse direction, genetically instrumented multisite chronic pain (OR = 1.78 per one increment in the number of pain site, 95% CI: 1.51-2.11) and headache (OR = 1.55 per one log-unit increase in headache risk, 95% CI = 1.13-2.10) were associated with MDD. Functional annotation analysis showed differential clustering patterns where depression clustered closely with headache and neck/shoulder pain, exhibiting substantial brain tissue enrichment. Our study indicates that depression is a causal risk factor for headache and pain localized at neck/shoulder, back, and abdominal/stomach, rather than pain at face, hip, and knee, and suggests common neurological pathologies underlying the development of depression, headache, and neck/shoulder pain.
Pain response to cannabidiol in induced acute nociceptive pain, allodynia, and hyperalgesia by using a model mimicking acute pain in healthy adults in a randomized trial (CANAB I)
Authors: Schneider Tobias , Zurbriggen Laura , Dieterle Markus , Mauermann Eckhard , Frei Priska , Mercer-Chalmers-Bender Katja , Ruppen Wilhelm 
Published: April 2021

Abstract
Preclinical studies have demonstrated the analgesic potential of cannabidiol (CBD). Those suggesting an effect on pain-processing receptors have brought CBD back into focus. This study assessed the effect of CBD on acute pain, hyperalgesia, and allodynia compared with placebo. Twenty healthy volunteers were included in this randomized, placebo-controlled, double-blinded, crossover study assessing pain intensities (using numeric rating scale), secondary hyperalgesia (von Frey filament), and allodynia (dry cotton swab) in a well-established acute pain model with intradermal electrical stimulation. The authors compared the effect of 800-mg orally administered CBD on pain compared with placebo. They further examined the effect on hyperalgesia and allodynia. Cannabidiol whole blood levels were also measured. Pain ratings (mean ± SD) did not differ significantly after CBD application compared with placebo (5.2 ± 0.7 vs 5.3 ± 0.7, P-value 0.928), neither did the areas of hyperalgesia and allodynia differ significantly after CBD application compared with placebo (hyperalgesia 23.9 ± 19.2 cm2 vs 27.4 ± 17.0 cm2, P-value 0.597; allodynia 16.6 ± 13.1 cm2 vs 17.3 ± 14.1 cm2, P-value 0.884). The CBD whole blood level (median, first to third quartile) was 2.0 µg/L (1.5-5.1) 60 minutes and 5.0 µg/L (4.0-10.4) 130 minutes after CBD application. Although the oral application of 800-mg CBD failed to show a significant effect, it is important to focus future research on different dosing, routes of administration, and CBD as a part of multimodal treatment strategies before negating its effects on acute pain.
Heart Health in Teachers—Do We Need to Know More?
Authors: Barron Keri A. , Ford Cassandra D. , Wang Hui 
Published: April 2021

Objectives:
To evaluate the relationship between the prevalence and risk factors for cardiovascular disease and hypertension, physical activity, and mental health in teachers.

Methods:
Data were drawn from the 2011–2012 National Health and Nutrition Examination Survey. A series of analyses were conducted utilizing exploratory data analysis, nominal logistic regression, and multivariate regression analysis.

Results:
The study sample included 148 participants. The results showed that an increase in age and BMI contributed to an increase in high blood pressure. Significance was not seen between physical activity, anxiety, and mental well-being as they related to cardiovascular disease and teaching.

Conclusions:
Our results showed that the prevalence of cardiovascular disease and hypertension could be related to the occupation of teaching; however, additional research should be done to assess the relationship between the occupation of teaching and cardiovascular disease.
The diagnostic dilemma and the treatment approach of COVID-19 pneumonia in a kidney transplant patient
Authors: Elfanish Amin , Tuschen Katharina , Anders Johanna , Neumann Lars , Wendel Andreas F. , Lüsebrink Jessica , Schildgen Verena , Schildgen Oliver , Brockmann Michael , Karagiannidis Christian , Weidemann Alexander 
Published: April 2021

Abstract

Introduction:
Coronavirus disease 2019 (COVID-19) pneumonia is a disease caused by the newly discovered coronavirus severe acute respiratory syndrome coronavirus-2. There is no effective treatment and the global pandemic is likely to continue for a certain time until sufficient herd immunity has been reached through the recently released vaccines. As transplant patients are presumably at a higher risk for infection and for a more severe course of disease, diagnostic validity is especially crucial. Polymerase chain reaction testing sometimes yields false-negative results, and especially in areas where medical resources are limited, diagnostic tests have to be safe and feasible yet cost effective to facilitate broad implementation.

Patient concerns:
A 46-year-old kidney transplant recipient with severe COVID-19 pneumonia requiring intubation and mechanical ventilation.

Diagnoses:
Albeit she presented with typical symptoms for at least 2 weeks, two nasopharyngeal swabs and 1 throat gargle sample were negative. Ultimately, positive stool samples confirmed the diagnosis before bronchoalveolar lavage tested positive.

Interventions:
Therapy consisted of reduction of immunosuppression and mechanical ventilation without experimental treatments.

Outcomes:
The patient recovered completely and was discharged after 60 days from the hospital.

Conclusion:
Our findings suggest that stool testing for severe acute respiratory syndrome coronavirus-2 might be a fast and cost effective way to identify and isolate COVID-19 patients, especially in areas where complex medical procedures such as bronchoscopy cannot be performed. Furthermore, the reduction of the immunosuppression and a therapy with intravenous immunoglobulin could be sufficient in kidney transplant patients without further experimental therapy.
The Development of iManage-PC, an Online Symptom Monitoring and Self-management Tool for Men With Clinically Localized Prostate Cancer
Authors: Murphy Karly M. , Sauer Christina , Yang Dershung , Hass Niina , Novakovic Kristian , Helfand Brian , Nadler Robert , Schalet Benjamin D. , Victorson David 
Published: April 2021

Background
Prostate cancer (PC) often impacts 4 major aspects of health-related quality of life (HRQL): urinary, sexual, and bowel dysfunction, and anxiety. Online tools may be helpful in supporting the development of self-management skills that can improve HRQL.

Objective
The aim of this study was to develop and pilot-test an online symptom monitoring and self-management program, iManage-PC.

Methods
A literature search, input from experts, and feedback from patients were used to develop iManage-PC. A 4-week, single-arm pilot study was conducted with 96 men with prostate cancer. We evaluated system usability, acceptance, and satisfaction and examined preliminary effects on patient-reported outcomes.

Results
Rates of retention (94.8%) and adherence to symptom monitoring (95.0%-97.0%) were high. Most participants rated the tool as satisfactory and acceptable (81.2%-94.3%). Related-samples Wilcoxon signed rank tests revealed that participants reported increased self-efficacy related to their ability to manage their adverse effects (T = 1772.0, P < .001, r = 0.39), physical discomfort (T = 1259.0, P < .001, r = 0.40), and stress and worry (T = 1108.5, P = .001, r = 0.34). Global mental and physical health also improved (T = 1322.0, P = .032, r = 0.23, and T = 1409.0, P = .001, r = 0.35, respectively).

Conclusions
Future research with such tools should examine the potential role of cut-score–derived management interventions to improve engagement, symptom management self-efficacy, and HRQL.

Implications for Practice
Our findings are consistent with a growing body of literature that supports the feasibility and acceptability of remotely delivered interventions.
Comprehensive Clinical Assessment of Vestibular Function in Multiple Sclerosis
Authors: Cochrane Graham D. , Christy Jennifer B. , Motl Robert W. 
Published: April 2021

Background and Purpose:
Balance disorders and dizziness are common in people with multiple sclerosis (MS), suggesting dysfunction of the vestibular system. Evaluating how people with MS perform on objective clinical vestibular tools will help broaden understanding of vestibular function in MS. This cross-sectional study's goal was to complete a robust battery of vestibular-ocular reflex (VOR), dynamic visual acuity (DVA), subjective visual vertical (SVV), and cervical and ocular vestibular-evoked myogenic potential (c/oVEMP) tests in people with and without MS.

Methods:
Forty people with relapsing-remitting MS (Expanded Disability Status Scale [EDSS] ≤6.5) and 20 controls completed the vestibular testing battery. Results were compared between groups and correlations with EDSS scores were calculated.

Results:
People with MS were less able to visually cancel their VOR and showed a larger variance in response on SVV. EDSS significantly correlated with VOR cancellation, SVV variance, and DVA lines lost; linear regression showed that VOR cancellation and SVV variance significantly predicted EDSS.

Discussion and Conclusion:
Vestibular functions requiring central integration of vestibular information, but not reflexive vestibular functions like VEMP, were impaired in people with MS and correlated with EDSS, suggesting that clinical evaluation of functions requiring central integration best evaluates MS-related vestibular dysfunction. Measures assessing central vestibular integration and not vestibular reflexes may be more sensitive to detecting vestibular deficits in people with mild to moderate MS.

Video Abstract available for more insight from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A344).
Systems Analysis to Increase HIV Testing Delivery and HIV Diagnosis in Primary Care Clinics in South Africa
Authors: Mishra Anant , Mshweshwe-Pakela Nolundi , Kubeka Griffiths , Hansoti Bhakti , Mabuto Tonderai , Hoffmann Christopher J. 
Published: April 2021

Background:
Provider-initiated testing and counseling remains highly underused in many South African health facilities. We implemented a systems analysis to investigate whether simple adjustments to HIV testing services (HTS) delivery can increase HTS provision.

Setting:
Ten primary care facilities in the Ekurhuleni District in South Africa.

Methods:
Following a baseline HTS assessment that showed limited offering of HTS by clinicians, clinic staff had the option to adopt several change approaches to increase HTS delivery using existing human resources. Approaches included adjusting HTS timing, strengthening HTS promotion, counsellor management, and implementing reward systems. Evaluation was conducted identically to the baseline study using patient exit interviews to quantify HTS engagement and value stream mapping to map patient flow through the clinic.

Results:
We conducted 2163 exit interviews and followed 352 patients for value stream mapping. After change implementation, a significantly higher proportion of patients reported being offered HTS (742/2163, 34.3% vs. 231/2206, 10.5% during the baseline period; χ2
P < 0.001) and having undertaken testing (527/2163, 24.4% vs. 197/2206, 8.9% during the baseline period; χ2
P < 0.001) with only a 3-percentage point decrease in HIV-positive yield (14.0% vs. 17.1% during the baseline period). The median time to HTS offer decreased from 77 minutes to 3 minutes after clinic arrival during the intervention (χ2
P = 0.001).

Conclusions:
A systems approach can be an effective and appropriate implementation strategy to augment HTS delivery and increase HIV diagnoses. This low-cost approach may be extended to optimize other aspects of clinic service delivery.
Brief Report: Association Between Pain, Pulmonary Function, and Respiratory Symptoms in People With HIV
Authors: Singhvi Deepti G. , Nouraie Mehdi , Kessinger Cathy , McMahon Deborah K. , Weinman Renee , Crothers Kristina , Huang Laurence , Bon Jessica , Morris Alison , Merlin Jessica 
Published: April 2021

Background:
People with HIV (PWH) experience chronic pain and respiratory symptoms, which are closely related in the general population. Pain may affect the impaired pulmonary function seen in PWH beyond its association with HIV alone. Our objective was to investigate the relationship of pain severity to pulmonary function, respiratory symptoms, and sleep disturbance in PWH.

Setting:
Study sites included the University of Pittsburgh, University of California San Francisco, and University of Washington.

Methods:
Pain, dyspnea, and sleep were assessed using the Brief Chronic Pain Questionnaire, St. George's Respiratory Questionnaire, and Pittsburgh Sleep Quality Index. Participants performed prebronchodilator and postbronchodilator spirometry and 6-minute walk test. Associations between pain severity, lung function, dyspnea, and sleep were assessed with bivariate and multiple quantile regression analysis adjusted for age, sex, race, body mass index, and smoking status.

Results:
Of 159 PWH, the median age was 56 years with 30.8% women. Two-thirds experienced pain in the past week, with 40.3% reporting chronic pain. Pain severity was higher with female sex (P = 0.038), non-White race (P = 0.005), current smoking (P = 0.003), and lower CD4+ count (P = 0.035). In adjusted analysis, higher pain severity was correlated with reduced postbronchodilator forced expiratory volume in 1 second %predicted (P = 0.008), reduced postbronchodilator forced vital capacity %predicted (P = 0.019), and chronic obstructive pulmonary disease (P = 0.032). Greater pain severity was strongly associated with a higher St. George's Respiratory Questionnaire score (P < 0.001) and sleep disturbance (P < 0.001).

Conclusions:
In PWH, pain is common and associated with airflow obstruction, dyspnea, and sleep disturbance. Future studies assessing pain severity and pulmonary function over time could clarify the direction of this association and the impact on quality of life.
Patterns of Craniomaxillofacial Trauma After E-Scooter Accidents in Germany
Authors: Thoenissen Philipp , Salewski Deborah , Heselich Anja , Sader Robert , Marzi Ingo , Muehlenfeld Nils , Ghanaati Shahram 
Published: April 2021

Introduction:
E-Scooters are trending as an individual transport vehicle with electric drive in Germany. But there is less data about the frequency, demographic details and possible injuries and therapy needs in context with E-scooter accidents. Therefore, the primary aim of this study was to analyze the frequency and the characteristics of facial trauma as well as the consecutive hospitalization and management after injuries with E-scooters in a German clinic specialized in craniomaxillofacial surgery.

Materials and Methods:
Retrospective data analysis of the hospital information system of patients admitted to central emergency unit driving e-scooters and injuries between June and December 2019.

Results:
A total of 28 consecutive patients were admitted to the emergency care unit of a level one trauma center from June to December 2019. 85% had a minimum of two or more facial injuries. Most common were soft tissue injuries with 64% (n = 18), fractures with 54% (n = 15) and teeth injuries with 39% (n = 11). 82% percent of injuries were related with consumption of alcohol.

Discussion:
The data show a variety of different injuries from teeth injury, wounds and facial fractures in varying degrees in a predominantly young and male cohort (mean age 33.57, 68% male) often associated with alcohol. As accidents happen especially at nighttime and on weekends personnel capacities should be provided. Still bicycle accidents and following injuries stay a major problem.
Bedside testing for precision pain medicine
Authors: Reimer Maren , Sachau Juliane , Forstenpointner Julia , Baron Ralf 
Published: April 2021

Purpose of review
In recent years, the identification of therapy responders has become an increasing focus of pain research. On the basis of laboratory quantitative sensory testing, subgroups of patients were identified, which have been shown to predict treatment response. However, the high cost and time expenditure limits the use of these lab-QST protocols in clinical practice and large clinical trials.

Recent findings
Recently, different bedside testing protocols were developed as easy-to-use alternative for lab-QST. In addition, patients can be subgrouped based on their symptoms by use of patient-reported outcome measures. First results suggest that these approaches can be used to stratify patients into pathophysiological-plausible subgroups predictive for treatment response.

Summary
This review presents recently developed bedside approaches that can be implemented as stratification tools in future clinical trials to realize individualized pain medicine. Being complementary rather than replaceable, future studies should combine questionnaires and sensory testing and apply them prospectively in large clinical trials.