bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expansion of 1 mL of Solution by Ultrasound-Guided Injection Between the Trapezius and Rhomboid Muscles: A Cadaver Study
Authors: Kimura Hiroaki , Kobayashi Tadashi , Zenita Yoshihiro , Kurosawa Ayato , Aizawa Shin 
Published: June 2019

Abstract

Objective
An ultrasound-guided interfascial injection, which targets the space between the epimysia, is often performed for myofascial neck and shoulder pain. However, the relationship between the injection volume and clinical effectiveness has been controversial. We conducted an anatomical study with cadavers to measure the distribution of a small amount of pigment solution injected into the interfascial space.

Design
An experimental cadaveric study.

Setting
An institutional clinical anatomy laboratory.

Methods
We performed 20 ultrasound-guided injections with pigment solutions of 1.0 mL each into the space between the trapezius muscle and rhomboid muscle bilaterally on 10 cadaver specimens. Cadavers were then dissected and macroscopically evaluated for pigment distribution on the fascia of the muscular surfaces. The pigment distribution area of each injection site was visually confirmed and calculated using automatic area calculation software.

Results
Pigment solution exclusively within the interfascial space was visually confirmed in 95% (19/20) of injection sites. The median pigmented surface area (interquartile range) was 24.50 (16.17–30.76) cm2 on the deep side of the trapezius muscle and 18.82 (13.04–24.79) cm2 on the superficial side of rhomboid muscle; these measurements were statistically significantly different (P = 0.033).

Conclusions
A pigment solution comprising as little as 1.0 mL injected under ultrasound guidance separated two adjacent muscles and spread to the wide area within the interfascial space. The difference in the pigment distribution area between the two adjacent muscles can be explained by the path made by the injection needle and several layers of fascia between the epimysium.
Reid's Regress
Authors: Cuneo Terence , Harp Randall 
Published: June 2019

AbstractThomas Reid's Essays on the Active Powers presents what is probably the most thoroughly developed version of agent-causal libertarianism in the modern canon. While commentators today often acknowledge Reid's contribution, they typically focus on what appears to be a serious problem for the view: Reid appears to commit himself to a position according to which acting freely would require an agent to engage in an infinite number of exertions of active power. In this essay, we maintain that, properly understood, Reid's version of agent-causal libertarianism generates no regress of exertion. Our discussion begins by presenting Reid's account of free action and why it appears vulnerable to a worrisome regress. We then consider three attempts to address the regress in the contemporary literature offered by William Rowe, Gideon Yaffe, and James Van Cleve, which we find unsatisfactory. We then develop a solution to the worry—one that takes very seriously both what Reid means by an ‘efficient’ cause and his appeal to normative features when explaining action. We call it the ‘networked capacity’ view.
Total-evidence phylogeny of the Rhinomirini, taxonomic review of its subgroupings (Insecta: Heteroptera: Miridae: Cylapinae) and description of new Australian taxa
Authors: Namyatova Anna A , Cassis Gerasimos 
Published: June 2019

AbstractRhinomirini (Insecta: Heteroptera: Miridae: Cylapinae) is a heterogeneous tribe of uncertain systematic position. We provide a phylogenetic analysis of this tribe based on morphological characters and molecular markers. Monophyly of the tribe was not supported by our findings. The Rhinocylapus complex and Rhinomiriella complex are transferred to Fulviini. Rhinomirini are restricted to the Rhinomiris complex. The record of Rhinomirini in Australia is considered dubious. The genera Punctifulvius and Yamatofulvus are transferred to the Rhinocylapus complex. The Rhinocylapus complex is recorded from Australia for the first time, with four new species: Mycetocylapus alexeyi sp. nov., Punctifulvius austellus sp. nov., Punctifulvius aquilonius sp. nov. and Rhinocylapoides valentinae sp. nov. The Philippine species Mycetocylapus major is synonymized with Mycetocylapus minor. The Australian species Rhinomiriella tuberculata is redescribed, and females of this species are described for the first time. Rhinomiriella aidani sp. nov. is described as new to science. The female genitalia of Proamblia elongata, Rhinocylapidius velocipidoides and Rhinomiris conspersus and the male genitalia of Rhinomiris conspersus and Rhinomiridius aethiopicus are illustrated and discussed. Sexual dimorphism in the Rhinocylapus complex and wing modifications in Cylapinae are discussed.
Reflections From the Rearview Mirror: Internal Medicine Physicians’ Reactions to Clinical Feedback After Transitions of Responsibility
Authors: Bowen Judith L. , Ilgen Jonathan S. , Regehr Glenn , Cate Olle ten , Irby David M. , O’Brien Bridget C. 
Published: June 2019

Purpose
Learning from practice is important for continuous improvement of practice. Yet little is known about how physicians assimilate clinical feedback and use it to refine their diagnostic approaches. This study described physicians’ reactions to learning that their provisional diagnosis was either consistent or inconsistent with the subsequent diagnosis, identified emotional responses to those findings, and explored potential consequences for future practices.

Method
In 2016–2017, 22 internal medicine hospitalist and resident physicians at Oregon Health & Science University completed semistructured interviews. Critical incident prompts elicited cases of patient care transitions before the diagnosis was known. Interview questions explored participants’ subsequent follow-up. Matrix analysis of case elements, emotional reactions, and perceived practice changes was used to compare patterns of responses between cases of confirming versus disconfirming clinical feedback.

Results
Participants described 51 cases. When clinical feedback confirmed provisional diagnoses (17 cases), participants recalled positive emotions, judged their performance as sufficient, and generally reinforced current approaches. When clinical feedback was disconfirming (34 cases), participants’ emotional reactions were mostly negative, frequently tempered with rationalizations, and often associated with perceptions of having made a mistake. Perceived changes in practice mostly involved nonspecific strategies such as “trusting my intuition” and “broadening the differential,” although some described case-specific strategies that could be applied in similar contexts in the future.

Conclusions
Internists’ experiences with posttransition clinical feedback are emotionally charged. Internists’ reflections on clinical feedback experiences suggest they are primed to adapt practices for the future, although the usefulness of those adaptations for improving practice is less clear.
Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice
Authors: Coutinho Anastasia J. , Levin Zachary , Petterson Stephen , Phillips Robert L. , Peterson Lars E. 
Published: June 2019

Purpose
A family physician’s ability to provide continuous, comprehensive care begins in residency. Previous studies show that patterns developed during residency may be imprinted upon physicians, guiding future practice. The objective was to determine family medicine residency characteristics associated with graduates’ scope of practice (SCoP).

Method
The authors used (1) residency program data from the 2012 Accreditation Council for Graduate Medicine Education Accreditation Data System and (2) self-reported data supplied by family physicians when they registered for the first recertification examination with the American Board of Family Medicine (2013–2016)—7 to 10 years after completing residency. The authors used linear regression analyses to examine the relationship between individual physician SCoP (measured by the SCoP for primary care [SP4PC] score [scale of 0–30; low = small scope]) and individual, practice, and residency program characteristics.

Results
The authors sampled 8,261 physicians from 423 residencies. The average SP4PC score was 15.4 (standard deviation, 3.2). Models showed that SCoP broadened with increasing rurality. Physicians from unopposed (single) programs had higher SCoP (0.26 increase in SP4PC); those from major teaching hospitals had lower SCoP (0.18 decrease in SP4PC).

Conclusions
Residency program characteristics may influence family physicians’ SCoP, although less than individual characteristics do. Broad SCoP may imply more comprehensive care, which is the foundation of a strong primary care system to increase quality, decrease cost, and reduce physician burnout. Some residency program characteristics can be altered so that programs graduate physicians with broader SCoP, thereby meeting patient needs and improving the health system.
Hip Arthroscopy Successfully Treats Femoroacetabular Impingement in Adolescent Athletes
Authors: Litrenta Jody , Mu Brian H. , Ortiz-Declet Victor , Chen Austin W. , Perets Itay , Wojnowski Natalia M. , Domb Benjamin G. 
Published: June 2019

Background:
There is evidence that femoroacetabular impingement (FAI) is increasingly prevalent among adolescent athletes. Abnormal contact forces across the hip and alterations in bony morphology characteristic of FAI may be especially detrimental in this group, given their young age and active lifestyle.

Purpose:
The purpose of this study was to report the findings, outcomes, and return to sport percentage among adolescent athletes with FAI treated with hip arthroscopy.

Methods:
A retrospective review of all patients younger than 18 years who underwent hip arthroscopy for FAI at a single institution was performed. All athletes who were attempting to return to sport and underwent hip arthroscopy were included. Patients with previous hip surgery and/or hip conditions were excluded. Arthroscopic procedures and an assessment of intra-articular findings were recorded. Patient-reported outcome measures were recorded at 3 months, 1 year, and 2 years postoperatively, and included the modified Harris hip score, the nonarthritic hip score, hip outcome score—sports subscale, visual analogue scale for pain, and patient satisfaction. Return to sport percentage and ability levels were also noted.

Results:
There were 96 eligible cases of adolescent athletes treated with hip arthroscopy; 81 (84.4%) hips in 69 patients had 2-year follow-up. Running/track and field was the most common sport (25), followed by soccer (12), dance (10), baseball/softball (9), and basketball (6). There were 61 females and 20 males, whose average age was 15.9±1.2 y (range: 13.1 to 18.0 y). The most common procedures were labral repair (81.5%), iliopsoas fractional lengthening (72.8%), femoroplasty (69.1%), and acetabuloplasty (66.7%). Capsular repair or plication was performed in most patients (81.5%). Cartilage damage was more common on the acetabulum than the femur, with Outerbridge grade 2 or higher occurring in 23.5% and 4.9% of hips, respectively. Statistically significant improvements were seen in all patient-reported outcomes from preoperative to minimum 2-year follow-up. A total of 84.0% of patients had returned to their sport at latest follow-up. There were 6 (7.4%) patients who underwent revision arthroscopy at a mean of 37.3 months postoperatively.

Conclusion:
Symptomatic FAI in adolescent athletes can be successfully treated with hip arthroscopy, with a higher return to sport rate and low complications and reoperation rate at minimum 2-year follow-up.
Interval Endurance and Resistance Training as Part of a Community-Based Secondary Prevention Program for Patients With Diabetes Mellitus and Coronary Artery Disease
Authors: Christle Jeffrey W. , Knapp Sebastian , Geisberger Marisa , Cervenka Marina , Moneghetti Kegan , Myers Jonathan , Halle Martin , Boscheri Alessandra 
Published: June 2019

Purpose:
High-intensity interval training (HIIT) has been observed to improve health and fitness in patients with cardiovascular disease. High-intensity interval training may not be appropriate in community-based settings. Moderate-intensity interval training (MIIT) and resistance training (RT) are emerging as effective alternatives to HIIT. These have not been well investigated in a community-based cardiac maintenance program.

Methods:
Patients with coronary artery disease and/or diabetes mellitus participated in clinical examinations and a 6-mo exercise program. Center-based MIIT and home-based moderate continuous intensity exercise were performed for 3-5 d/wk for 30-40 min/session. RT, nutritional counseling, coping, and behavioral change strategies were offered to all patients. Within-group changes in clinical metrics and exercise performance were assessed on a per-protocol basis after 6 mo.

Results:
Two hundred ninety-two patients (74%) concluded the 6-mo program. There were no serious adverse events. The peak oxygen uptake and peak workload increased significantly, 21.8 ± 6.1 to 22.8 ± 6.3 mL/kg/min and 128 ± 39 to 138 ± 43 W, respectively (both P < .001). Submaximal exercise performance increased from 68 ± 19 to 73 ± 22 W (P < .001). Glycated hemoglobin decreased from 6.57 ± 0.93% to 6.43 ± 0.12%, (P = .023). Daily injected insulin dosage was reduced from 42 IU (interquartile range: 19.0, 60.0) to 26 IU (interquartile range: 0, 40.3, P < .001).

Conclusions:
MIIT and RT were feasible and effective in a community-based cardiac maintenance program for patients with cardiovascular disease, improving exercise performance, and blood glucose control.
Intratympanic Triamcinolone Acetonide as Treatment Option for Idiopathic Sudden Sensorineural Hearing Loss
Authors: Dahm Valerie , Nieratschker Michael , Riss Dominik , Kaider Alexandra , Auinger Alice , Honeder Clemens , Arnoldner Christoph 
Published: June 2019

Introduction:
Corticosteroids represent the most commonly used treatment option for patients with idiopathic sudden sensorineural hearing loss. In the past, these compounds were mainly formulated and tested for intravenous or oral administration. Intratympanic application is increasingly being used, often as salvage treatment. The most suitable corticosteroid for local application has yet to be identified. Trials have suggested that triamcinolone acetonide has superior molecular properties for this treatment modality.

Methods:
The main aim of this study was to retrospectively assess the first audiometric results of patients diagnosed with idiopathic sudden sensorineural hearing loss and treated simultaneously with systemic prednisolone and intratympanic triamcinolone acetonide. This data was then compared to systemic treatment only, as well as to historic cohorts treated intratympanically with widely used corticosteroids, namely dexamethasone or methylprednisolone.

Results:
90 patients received intravenous prednisolone only, and 89 individuals underwent intravenous treatment combined with three to four simultaneous intratympanic applications of triamcinolone. Eight patients received intratympanic triamcinolone as first-line treatment. After adjusting data for sex, time since onset, age, and severity of hearing loss, no statistically significant difference between the two main treatment groups could be identified. No major adverse events were observed, specifically no otitis media or persistent vertigo. Two perforated tympanic membranes healed spontaneously within several days.

Conclusion:
While the exact role of intratympanic injections requires additional trials, triamcinolone resulted in similar outcomes compared to studies using dexamethasone or methylprednisolone. Due to favorable pharmacological properties, triamcinolone represents a safe and efficacious alternative for intratympanic treatment in idiopathic sensorineural hearing loss.
MMP-2 and MMP-9 gene polymorphisms act as biological indicators for ulinastatin efficacy in patients with severe acute pancreatitis
Authors: Ling Lan , Li Yan , Li Hong , Li Wen , Zhang Hong-Bo 
Published: June 2019

Abstract

Background:
Severe acute pancreatitis (SAP) is a severe form of inflammatory disease with a high mortality rate. Ulinastatin, as a urinary trypsin inhibitor (UTI), is a glycoprotein playing a critical role in SAP. Consequently, we identified the hypothesis that both matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) gene polymorphisms might promote the efficacy of ulinastatin in SAP.

Methods:
A total of 235 patients with SAP were treated by intravenous drip of ulinastatin for the duration of 10 days. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed for testing the distribution of genotypes and alleles frequency of MMP-2 and MMP-9 gene polymorphisms, and analyzing association of MMP-2 rs243865, MMP-2 rs2285053, MMP-9 rs3918242, or MMP-9 rs17576 with efficacy of ulinastatin in patients with SAP. Shesis software was adopted for analyzing single genotypes of MMP-2 and MMP-9 gene polymorphisms site A Generalized Multifactor Dimensionality Reduction (GMDR) model and a logistic regression analysis were used for analyzing effect of MMP-2 and MMP-9 gene polymorphisms on the efficacy of ulinastatin in treating patients with SAP.

Results:
CC genotype of MMP-2 gene rs243865 C>T was observed to have a better positive effect in promoting the efficacy of ulinastatin in comparison with CT and TT genotypes. Haplotype CCTG, CCTA, CTTG, and CTTA were combined by MMP-2 and MMP-9 gene polymorphisms which have the ability to increase the efficacy of ulinastatin in treating patients with SAP. MMP-2 gene rs243865 C>T site polymorphism was served as a favorable factor while the MMP-9 gene rs3918242 C>T site polymorphism was noticed as an unfavorable factor for the efficacy of ulinastatin in treating patients with SAP.

Conclusion:
The key findings clearly demonstrated that both the MMP-2 rs243865 and MMP-9 rs3918242 gene polymorphisms served as biological indicators for the efficacy of ulinastatin in treating patients with SAP.
Effects of coenzyme Q10 intervention on diabetic kidney disease
Authors: Zhang Xiaofeng , Shi Zhaofeng , Liu Qian , Quan Haohao , Cheng Xiaohong 
Published: June 2019

Abstract

Background:
The diabetic kidney disease (DKD) has become a seriously kidney disease that commonly caused by diabetes mellitus (DM). Oxidative stress response plays an essential role in the genesis and worsening of DKD and Coenzyme Q10 (CoQ10) has been reported the promising clinical effectiveness on DKD treatment. However, there is lack of relative evidence-based medical evidence currently.

Objective:
The systematic review and meta-analysis was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, which conducted to evaluate the effectiveness of CoQ10 in combination with other western medicine for DKD therapy through the randomized controlled trials (RCTs) and experimental studies.

Methods:
RCTs and experimental studies were searched based on standardized searching rules in 12 medical databases from the inception up to June 2018 and a total of 8 articles (4 RCTs and 4 experimental studies) were enrolled in the meta-analysis.

Results:
The results revealed that CoQ10 combined with other western medicine show statistical differences in the laboratory parameters of fasting plasma glucose (FPG), Hemoglobin A1c (HbA1c), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), and malondialdehyde (MDA) amelioration after DKD therapy compared with control group. However, LDL-C and Urea level for RCTs and Urine output and Glucose for experimental studies on DKD was not superior to control group.

Conclusion:
We need to make conclusion cautiously for the effectiveness of CoQ10 application on DKD therapy. More standard, multicenter, double-blind RCTs, and formal experimental studies of CoQ10 treatment for DKD were urgent to be conducted for more clinical evidence providing in the future. The underlying pharmacological mechanism of CoQ10 needs to be researched and revealed for its future application on DKD therapy.
Dose optimization strategy of sacrum limitation in cervical cancer intensity modulation radiation therapy planning
Authors: Guo Qi , Cai Shang , Qian Jianjun , Tian Ye 
Published: June 2019

Abstract
The aim of this study was to investigate the dose optimization strategy for the sacrum to reduce the risk of pelvic insufficiency fracture (PIF).
Using a retrospective study design, we analyzed data from 28 patients with cervical cancer who underwent postoperative adjuvant radiotherapy in our department from June 2017 to January 2018. Among these patients, 20 (71.4%) underwent external beam radiation therapy in the pelvic lymphatic drainage area (node-negative patients). Overall, 8 patients (28.6%) underwent radiotherapy in the pelvic lymphatic drainage area with a simultaneous integrated boost (node-positive patients). Furthermore, 20 patients were assigned to 2 groups of plans according to the prescribed doses of 5000 and 4500 cGy/25. Each group had 3 plans according to 3 different dose limit conditions: “pelvic bones and sacrum unlimited,” “pelvic bones limited,” and “pelvic bones + sacrum limited.” The irradiation dose of the sacrum and pelvis was analyzed in three limited optimization models.
The planning target volume conformity index and homogeneity index, based on different optimization modes in the 4500 and 5000 cGy plans, showed no significant differences. The D50% and Dmean of the pelvis + sacrum limited mode were significantly lower than those of the pelvic limited mode (P < .001). The dose of the sacrum and pelvis in the 4500 cGy plan in the lymphatic drainage area was significantly lower than that of the 5000 cGy plan (P < .001). In the lymph node boost group, the irradiation dose of the sacrum and pelvis was significantly increased (P ≤ .001).
Increasing the limitation of the sacrum, on the basis of pelvic bone limitation, in cervical cancer intensity-modulated radiation therapy can significantly reduce the dose to the sacrum. Compared with the dose of 5000 cGy to the lymphatic drainage area, the dose of 4500 cGy was the largest influencing factor to reduce the dose to the sacrum.
Peritoneal sarcoidosis
Authors: Lee Seung Wook , Lee Min Hee , Lee Ji Eun , Choi Seo Youn , Yi Boem Ha , Jung Jung Min 
Published: June 2019

Abstract

Rationale:
Sarcoidosis is an idiopathic granulomatous disease. Although the lungs are most commonly involved, any organ may be affected. To assist with future diagnoses, we describe a rare case of peritoneal sarcoidosis in a young female patient, and present a literature review.

Patient concerns:
A 32-year-old female patient presented to our institution with abdominal discomfort. She was evaluated with contrast-enhanced abdominal computed tomography (CT), and multiple enlarged lymph nodes were detected at the hepatic artery and left gastric artery nodal stations. The patient was lost during follow-up, but returned after 7 months and again underwent abdominal CT. This revealed diffuse nodular thickening of the peritoneum and the appearance of omental cake in her abdomen.

Diagnosis:
Excisional biopsy of a lymph node was performed and extrapulmonary sarcoidosis was confirmed.

Interventions:
The patient was treated with corticosteroid.

Outcomes:
A follow-up abdominal CT scan after two weeks revealed decreases in the numbers and sizes of the previously enlarged lymph nodes, and improvement in the ascites and peritoneal thickening.

Lessions:
Peritoneal sarcoidosis should be considered as an additional differential diagnosis when peritoneal carcinomatosis or tuberculous peritonitis are suspected. In this regard, serum levels of angiotensin-converting enzyme (ACE) may be a valuable diagnostic indicator of unusual sarcoidosis presentations.