bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Intraosseous Basivertebral Nerve Radiofrequency Neurotomy for the Treatment of Chronic Low Back Pain in Patients with Modic Changes: A Systematic Review
Authors: Conger Aaron , Schuster Nathaniel M , Cheng David S , Sperry Beau P , Joshi Anand B , Haring R Sterling , Duszynski Belinda , McCormick Zachary L 
Published: February 2021

AbstractObjectiveDetermine the effectiveness of intraosseous basivertebral nerve radiofrequency neurotomy for the treatment of chronic low back pain with type 1 or 2 Modic changes.DesignSystematic review.PopulationPersons aged ≥18 years with chronic low back pain with type 1 or 2 Modic changes.InterventionIntraosseous basivertebral nerve radiofrequency neurotomyComparisonSham, placebo procedure, active standard care treatment, or none.OutcomesThe primary outcome of interest was the proportion of individuals with ≥50% pain reduction. Secondary outcomes included ≥10-point improvement in function as measured by Oswestry Disability Index as well as ≥2-point reduction in pain score on the Visual Analog Scale or Numeric Rating Scale, and decreased use of pain medication.MethodsThree reviewers independently assessed publications before May 15, 2020, in MEDLINE and Embase and the quality of evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation framework.ResultsOf the 725 publications screened, seven publications with 321 participants were ultimately included. The reported 3-month success rate for ≥50% pain reduction ranged from 45% to 63%. Rates of functional improvement (≥10-point Oswestry Disability Index improvement threshold) ranged from 75% to 93%. For comparison to sham treatment, the relative risk of treatment success defined by ≥50% pain reduction and ≥10-point Oswestry Disability Index improvement was 1.25 (95% confidence interval [CI]: .88—1.77) and 1.38 (95% CI: 1.10—1.73), respectively. For comparison to continued standard care treatment the relative risk of treatment success defined by ≥50% pain reduction and ≥10-point Oswestry Disability Index improvement was 4.16 (95% CI: 2.12–8.14) and 2.32 (95% CI: 1.52–3.55), respectively.ConclusionsThere is moderate-quality evidence that suggests this procedure is effective in reducing pain and disability in patients with chronic low back pain who are selected based on type 1 or 2 Modic changes, among other inclusion and exclusion criteria used in the published literature to date. Success of the procedure appears to be dependent on effective targeting of the BVN. Non-industry funded high-quality, large prospective studies are needed to confirm these findings.
Opioid Prescribing Among Outpatients with Rheumatoid Arthritis
Authors: Huang Yinan , Rege Sanika , Chatterjee Satabdi , Aparasu Rajender R 
Published: February 2021

Abstract

Study Objectives
To examine the outpatient opioid prescribing practices and the factors associated with opioid prescriptions in patient visits with rheumatoid arthritis (RA).

Design
This cross-sectional study used the 2011–2016 National Ambulatory Medical Care Survey. Descriptive weighted analyses were used to examine the trends in opioid prescribing practices for RA. Multivariable logistic regression was used to examine the factors associated with opioid prescriptions among RA visits.

Subjects
Adult patients (&gt;18 years of age) with a primary diagnosis of RA based on the International Classification of Diseases.

Results
According to the national surveys, an average of 4.45 (95% confidence interval [CI], 2.30–6.60) million office visits were made annually for RA. Approximately 24.28% of these visits involved opioid prescriptions. The RA visits involving opioid prescriptions increased from 1.43 million in 2011–2012 to 3.69 million in 2015–2016 (P &lt; .0001). Being in the age group of 50–64 years (odds ratio [OR] = 3.40; 95% CI, 1.29–9.00), being Hispanic or Latino (OR = 2.92, 95% CI, 1.10–7.74), visiting primary physician (OR = 4.67; 95% CI, 1.86–11.75), prescribing of muscle relaxants (OR = 64.32; 95% CI, 9.71–426.09), acetaminophen (OR = 93.40; 95% CI, 26.19–333.04), antidepressants (OR = 6.10; 95% CI, 2.63–14.14), and glucocorticoids (OR = 3.20; 95% CI, 1.61–6.38), were associated with an increased likelihood of receiving opioid prescriptions in RA.

Conclusions
One in four adult RA visits resulted in opioid prescriptions, and the opioid visits more than doubled during the study period. Several patient and provider factors were associated with the opioid prescribing among RA visits. Understanding these prescribing practices can help to devise strategies for safe opioid prescribing practices in RA.
Paresthesia Predicts Increased Risk of Distal Neuropathic Pain in Older People with HIV-Associated Sensory Polyneuropathy
Authors: Diaz Monica M , Keltner John R , Simmons Alan N , Franklin Donald , Moore Raeanne C , Clifford David , Collier Ann C , Gelman Benjamin B , Marra Ph D , Christina , McCutchan J Allen , Morgello Susan , Sacktor Ned , Best Brookie , Notestine Christine Fennema , Weibel Sara Gianella , Grant Igor , Marcotte Thomas D , Vaida Florin , Letendre Scott , Heaton Robert , Ellis Ronald J 
Published: February 2021

Abstract

Objective
Distal sensory polyneuropathy (DSP) is a disabling consequence of human immunodeficiency virus (HIV), leading to poor quality of life and more frequent falls in older age. Neuropathic pain and paresthesia are prevalent symptoms; however, there are currently no known curative treatments and the longitudinal course of pain in HIV-associated DSP is poorly characterized.

Methods
This was a prospective longitudinal study of 265 people with HIV (PWH) enrolled in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study with baseline and 12-year follow-up evaluations. Since pain and paresthesia are highly correlated, statistical decomposition was used to separate the two symptoms at baseline. Multivariable logistic regression analyses of decomposed variables were used to determine the effects of neuropathy symptoms at baseline on presence and worsening of distal neuropathic pain at 12-year follow-up, adjusted for covariates.

Results
Mean age was 56 ± 8 years, and 21% were female at follow-up. Nearly the entire cohort (96%) was on antiretroviral therapy (ART), and 82% had suppressed (≤50 copies/mL) plasma viral loads at follow-up. Of those with pain at follow-up (n = 100), 23% had paresthesia at the initial visit. Decomposed paresthesia at baseline increased the risk of pain at follow-up (odds ratio [OR] 1.56; 95% confidence interval [CI] 1.18, 2.07), and decomposed pain at baseline predicted a higher frequency of pain at follow-up (OR 1.96 [95% CI 1.51, 2.58]).

Conclusions
Paresthesias are a clinically significant predictor of incident pain at follow-up among aging PWH with DSP. Development of new therapies to encourage neuroregeneration might take advantage of this finding to choose individuals likely to benefit from treatment preventing incident pain.
Specialized, Pro-Resolving Mediators as Potential Therapeutic Agents for Alleviating Fibromyalgia Symptomatology
Authors: Livshits Gregory , Kalinkovich Alexander 
Published: February 2021

Abstract

Objective
To present a hypothesis on a novel strategy in the treatment of fibromyalgia (FM).

Design
A narrative review.

Setting
FM as a disease remains a challenging concept for numerous reasons, including undefined etiopathogenesis, unclear triggers, and unsuccessful treatment modalities. We hypothesize that the inflammatome, the entire set of molecules involved in inflammation, acting as a common pathophysiological instrument of gut dysbiosis, sarcopenia, and neuroinflammation, is one of the major mechanisms underlying FM pathogenesis. In this setup, dysbiosis is proposed as the primary trigger of the inflammatome, sarcopenia as the peripheral nociceptive source, and neuroinflammation as the central mechanism of pain sensitization, transmission, and symptomatology of FM. Whereas neuroinflammation is highly considered as a critical deleterious element in FM pathogenesis, the presumed pathogenic roles of sarcopenia and systemic inflammation remain controversial. Nevertheless, sarcopenia-associated processes and dysbiosis have been recently detected in individuals with FM. The prevalence of pro-inflammatory factors in the cerebrospinal fluid and blood has been repeatedly observed in individuals with FM, which supports the idea of a role of the inflammatome in FM pathogenesis. As such, failed inflammation resolution might be one of the underlying pathogenic mechanisms. Accordingly, the application of specialized, inflammation pro-resolving mediators (SPMs) seems most suitable for this goal.

Conclusions
The capability of various SPMs to prevent and attenuate pain has been repeatedly demonstrated in laboratory animal experiments. As SPMs suppress inflammation in a manner that does not compromise host defense, they could be attractive and safe candidates for the alleviation of FM symptomatology, probably in combination with anti-dysbiotic medicine.
Sensory Innervation of the Hip Joint and Referred Pain: A Systematic Review of the Literature
Authors: Laumonerie Pierre , Dalmas Yoann , Tibbo Meagan E , Robert Suzanne , Durant Thibault , Caste Thomas , Vialla Tristan , Tiercelin Joris , Gracia Gauthier , Chaynes Patrick 
Published: February 2021

Abstract

Objectives
The aim of this literature review was to establish consensus with respect to the anatomic features of the articular branches innervating the hip joint and the distribution of sensory receptors within its capsule.

Methods
Five electronic databases were queried, with the search encompassing articles published between January 1945 and June 2019. Twenty-one original articles providing a detailed description of sensory receptors around the hip joint capsule (n=13) and its articular branches (n=8) were reviewed.

Results
The superior portions of the anterior capsule and the labrum were found to be the area of densest nociceptive innervation. Similar to the distribution of nociceptors, mechanoreceptor density was found to be higher anteriorly than posteriorly. Hip joint capsular innervation was found to consistently involve the femoral and obturator nerves, which supply the anterior capsule, and the nerve to the quadratus femoris, which supplies the posterior capsule. The femoral, obturator, and superior gluteal nerves supply articular branches to the most nociceptor-rich region of the hip capsule.

Conclusions
The femoral and obturator nerves and the nerve to the quadratus femoris were found to consistently supply articular branches to both the anterior and posterior capsule of the hip joint. The anterior capsule, primarily supplied by the femoral and obturator nerves, and the superior labrum appear to be the primary pain generators of the hip joint, given their higher density of nociceptors and mechanoreceptors.

Level of Evidence
Anatomy study, literature review.
Does Falls Efficacy Influence the Relationship Between Forward and Backward Walking Speed After Stroke?
Authors: Bansal Kanika , Clark David J , Fox Emily J , Rose Dorian K 
Published: February 2021

Abstract

Objective
Forward walking speed (FWS) is known to be an important predictor of mobility, falls, and falls-related efficacy poststroke. However, backward walking speed (BWS) is emerging as an assessment tool to reveal mobility deficits in people poststroke that may not be apparent with FWS alone. Since backward walking is more challenging than forward walking, falls efficacy may play a role in the relationship between one’s preferred FWS and BWS. We tested the hypothesis that people with lower falls efficacy would have a stronger positive relationship between FWS and BWS than those with higher falls efficacy.

Methods
Forty-five individuals (12.9 ± 5.6 months poststroke) participated in this observational study. We assessed FWS with the 10-meter walk test and BWS with the 3-meter backward walk test. The modified Falls-Efficacy Scale (mFES) quantified falls efficacy. A moderated regression analysis examined the hypothesis.

Results
FWS was positively associated with BWS (R2 = 0.26). The addition of the interaction term FWS × mFES explained 7.6% additional variance in BWS. As hypothesized, analysis of the interaction revealed that people with lower falls efficacy (mFES ≤ 6.6) had a significantly positive relationship between their preferred FWS and BWS, whereas people with higher falls efficacy (mFES &gt; 6.6) had no relationship between their walking speed in the 2 directions.

Conclusions
FWS is positively related to BWS poststroke, but this relationship is influenced by one’s perceived falls efficacy. Our results suggest that BWS can be predicted from FWS in people with lower falls efficacy, but as falls efficacy increases, BWS becomes a separate and unassociated construct from FWS.

Impact
This study provides unique evidence that the degree of falls efficacy significantly influences the relationship between FWS and BWS poststroke. Physical therapists should examine both FWS and BWS in people with higher falls efficacy, but further investigation is warranted for those with lower falls efficacy.
Specific Contribution of Quadriceps Muscle Strength, Endurance, and Power to Functional Exercise Capacity in People With Chronic Obstructive Pulmonary Disease: A Multicenter Study
Authors: Gephine Sarah , Frykholm Erik , Nyberg Andre , Mucci Patrick , Van Hees Hieronymus W H , Lemson Arthur , Klijn Peter , Maltais François , Saey Didier 
Published: February 2021

Abstract

Objective
Various functional muscle properties affect different aspects of functional exercise capacity in people with chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate the contribution of quadriceps muscle strength, endurance, and power to 6-Minute Walking Distance (6MWD) and 1-minute sit-to-stand test (1STS) performance in people with COPD.

Methods
The study was a prospective, multicenter, cross-sectional study. Anthropometrics, Medical Research Council dyspnea scale, lung function, 6MWD, and 1STS number of repetitions were assessed. Isometric quadriceps strength and endurance, isotonic quadriceps endurance, isokinetic quadriceps strength, and power were assessed on a computerized dynamometer while functional quadriceps power was determined during 5 sit-to-stand repetitions. Univariate and multivariate analyses were performed to determine the contribution of functional muscle properties to the 6MWD and the 1STS number of repetitions.

Results
The study included 70 people with COPD (mean % predicted forced expiratory volume in 1 second = 58.9 [SD = 18.2]). The 6MWD correlated with each functional muscle property except the isometric quadriceps endurance. The number of repetitions during the 1STS correlated with each functional muscle property except isometric measurements. Multivariate models explained 60% and 39% of the variance in the 6MWD and 1STS number of repetitions, respectively, with quadriceps power determined during 5 sit-to-stand repetitions being the muscle functional property with the strongest contribution to the models.

Conclusion
Except for isometric endurance, quadriceps strength, endurance, and power were associated with functional exercise capacity in people with moderate COPD. Among these functional muscle properties, muscle power contributed the most to the 6MWD and 1STS number of repetitions, suggesting that muscle power is more relevant to functional exercise capacity than muscle strength or endurance in people with COPD.

Impact
Understanding the individual contribution of muscle properties to functional status is important to designing interventions. This study provides the guidance that muscle power may be more important to functional exercise capacity than muscle strength or endurance in people with COPD.
Sidney and Finch’s Nomotexnia (Art of Law): Religion, Politics, and Patronage?
Authors: Crowley Timothy D 
Published: February 2021

Abstract
This essay brings to light a little-known manuscript on law and religion dedicated to Sir Philip Sidney: the earliest version of Henry Finch’s Nomotexnia (Art of Law). The manuscript’s two-part structure provides ‘Nomotexnia’, a Ramist-style synopsis of certain topics in English common law pertaining to possessions and criminal offences, followed by a supplement entitled ‘A Conference and Reformation of the Same Law by the Law of God’. Later manuscripts and printed witnesses for Finch’s expansion of the ‘Nomotexnia’ section did not include religious commentary. Material evidence alone places the first manuscript’s production after 1583 but leaves unconfirmed whether or not Sidney commissioned either section of its contents. This study reassesses the manuscript text with an eye to Finch’s and Sidney’s legal interests, family concerns, and religious politics in the mid-1580s. Textual and biographical evidence, combined with reasonable conjecture, suggests that Sidney probably commissioned the ‘Nomotexnia’ section, motivated by a desire for legal knowledge on inheritance and land use, and that Finch probably supplied the ‘Conference and Reformation’ section by his own initiative, asserting a polemical stance on the English church that Sidney would not have adopted.
The formation of interlocked grain in African mahogany (Khaya spp.) analysed by X-ray computed microtomography
Authors: Collings David A , Thomas Jimmy , Dijkstra Stephanie M , Harrington Jonathan J 
Published: February 2021

Abstract
Interlocked grain occurs when the orientation of xylem fibres oscillates, alternating between left- and right-handed spirals in successive wood layers. The cellular mechanisms giving rise to interlocked grain, thought to involve the slow rotation of fusiform initials within the vascular cambium, remain unclear. We suggest that observations of wood structure at the cellular level, but over large areas, might reveal these mechanisms. We assayed timber from several commercially important tropical angiosperms from the genus Khaya (African mahogany) that exhibit interlocked grain using X-ray computed microtomography followed by orthogonal slicing and image processing in ImageJ. Reconstructed tangential longitudinal sections were processed with the ImageJ directionality plug-in to directly measure fibre orientation and showed grain deviations of more than 10° from vertical in both left- and right-handed directions. Grain changed at locally constant rates, separated by locations where the direction of grain change sharply reversed. Image thresholding and segmentation conducted on reconstructed cross sections allowed the identification of vessels and measurement of their location, with vessel orientations then calculated in Matlab and, independently, in recalculated tangential longitudinal sections with the directionality plug-in. Vessel orientations varied more than fibre orientations, and on average deviated further from vertical than fibres at the locations where the direction of grain change reversed. Moreover, the reversal location for vessels was shifted ~400 μm towards the pith compared with the fibres, despite both cell types arising from the same fusiform initials within the vascular cambium. We propose a simple model to explain these distinct grain patterns. Were an auxin signal to control both the reorientation of cambial initials, as well as coordinating the end-on-end differentiation and linkage of xylem vessel elements, then it would be possible for fibres and vessels to run at subtly different angles, and to show different grain reversal locations.
Sexually Transmitted and Blood-borne Infections Among Patients Presenting to a Low-barrier Substance Use Disorder Medication Clinic
Authors: Harvey Leah , Taylor Jessica L. , Assoumou Sabrina A. , Kehoe Jessica , Schechter-Perkins Elissa M. , Bernstein Edward , Walley Alexander Y. 
Published: February 2021

Objective:
To study the infection-related needs of patients with substance use disorders initiating care at a low-barrier-to-access program (LBAP) by describing the proportion with human immunodeficiency virus (HIV), hepatitis B and C virus (HBV, HCV), syphilis, gonorrhea, and chlamydia and determining rates of treatment and/or linkage to care.

Methods:
We reviewed the records of patients who completed an intake visit at an LBAP in Boston, MA during the first 9 months after implementation of a standardized intake laboratory panel (January 30, 2017–September 30, 2017).

Results:
Among 393 patients initiating care, 84.7% (n = 333) completed at least 1 screening test. Baseline rates of HIV (9/393, 2.3%), current or past HCV (151/393, 38.4%), and chronic HBV (2/393, 0.5%) were high. Sixty-one new, active infections were identified through screening, including 1 HIV, 3 syphilis, 4 gonorrhea, 3 chlamydia, 1 chronic, and 1 acute HBV, and 48 cases of viremic HCV. Many patients were nonimmune to HBV (102/270, 37.8%) and HAV (112/255, 43.9%). Among new diagnoses, treatment was documented in 88% of bacterial infections and linkage occurred in 0/1 HIV, 2/2 HBV (100.0%), and 16/48 HCV (33.3%) cases.

Conclusions:
Patients initiating SUD care at an LBAP have substantial, unmet infection-related needs. Results justify the inclusion of comprehensive infection prevention, screening, and linkage-to-treatment protocols in LBAPs.
Is It Reasonable to Use Indocyanine Green Fluorescence Imaging to Determine the Border of Pedicled TRAM Flap Zone IV?
Authors: Chirappapha Prakasit , Chansoon Tharintorn , Bureewong Siriporn , Phosuwan Songpol , Lertsithichai Panuwat , Sukarayothin Thongchai , Leesombatpaiboon Monchai , Vassanasiri Watoo 
Published: February 2021

Background:
The contralateral lateral section (zone IV) of a pedicled transverse rectus abdominis musculocutaneous (TRAM) flap is generally removed intraoperatively. The border of zone IV is usually identified anatomically using the Hartrampf classification. In this study, we used the indocyanine green (ICG) fluorescence method to determine the border of zone IV and find the correlation with clinical flap outcome.

Methods:
The study recruited breast cancer patients who underwent a pedicled TRAM flap reconstruction. The border of zone IV was identified using the intraoperative ICG fluorescence imaging. The medial border of the removed specimen was sent for a pathological examination of vascular density.

Results:
A total of 29 patients underwent a pedicled TRAM reconstruction. In 16 patients, the border of zone IV identified by ICG fluorescent imaging was identical to the anatomical border. The ICG imaging showed distinct perfusion patterns, which we divided into 4 categories: sequential, simultaneous, low midline scar, and delayed pattern. Overall, there were no patient with total flap loss, 1 patient had a partial flap loss and 4 patients had a fat necrosis. Neither the ICG perfusion time nor the pathological vascular density correlates with the clinical flap outcome. The delayed ICG perfusion pattern (category IV) has the highest fat necrosis rate, although it is not statistically significant.

Conclusions:
In this study, more than half of the patients have ICG perfusion corresponding with the Hartrampf zone, which reflected the conventional practice of zone IV pedicled TRAM flap removal. Some ICG perfusion patterns could be helpful, especially in low midline and delayed pattern.