bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-Based Review of Vaginal Native Tissue Hysteropexy for Uterovaginal Prolapse
Authors: Hoke Tanya P. , Tan-Kim Jasmine , Richter Holly E. 
Published: July 2019

Importance
As surgical techniques evolve in the treatment of pelvic organ prolapse and patient preferences are better understood, more studies are investigating uterine-sparing procedures for efficacy, safety, and potentially improved quality of life. Much of the literature reflects the use of mesh material in uterine-sparing procedures, and there is a paucity of data regarding the safety and efficacy of native tissue uterine-sparing procedures for the treatment of pelvic organ prolapse.

Objective
To summarize existing evidence regarding objective and subjective outcomes of uterine-preserving procedures including the Manchester procedure (MP) as well as native tissue uterovaginal hysteropexy with repairs, namely, uterosacral hysteropexy (USH) and sacrospinous hysteropexy (SSH), compared with outcomes of total vaginal hysterectomy (TVH) with repairs for the management of uterovaginal prolapse.

Evidence Acquisition
A review of the literature included MEDLINE, Cochrane, and clinicaltrials.gov databases.

Results
Few level 1 data exist comparing outcomes of native tissue hysteropexy to vaginal hysterectomy for management of uterovaginal prolapse. In general, outcomes of the MP for the management of uterovaginal prolapse revealed that compared with TVH it is associated with shorter operative times, lower estimated blood loss and risk of blood transfusion with no difference in hospital stay, and similar quality of life and sexual function outcomes. Retrospective data suggest no difference with respect to recurrent prolapse of any compartment between USH and TVH with repairs. Level 1 data reveal that SSH has been shown to have similar 1-year outcomes and safety compared with TVH with native tissue suspension. Women with stage 4 prolapse who undergo an SSH may be at higher risk of recurrence and may benefit from an alternative method of apical prolapse repair.

Conclusions and Relevance
More level 1 data are needed in order to robustly understand long-term differences in outcomes between native tissue uterine-conserving versus vaginal hysterectomy surgical approaches in women with uterovaginal prolapse.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to explain why uterine-sparing procedures for uterovaginal prolapse are becoming more popular in the United States; compare similarities and differences in subjective and objective outcomes between the MP and TVH; describe subjective and objective outcomes between vaginal native tissue USH and SSH to TVH; and analyze if uterine-sparing surgical procedures impact pregnancy outcomes.
Cystoscopy at the Time of Benign Hysterectomy: A Decision Analysis
Authors: Cadish Lauren A. , Ridgeway Beri M. , Shepherd Jonathan P. 
Published: July 2019

(Abstracted from Am J Obstet Gynecol 2019;220:369.e1–369.e7)
Urinary tract injury (bladder or ureter) occurs in up to 4.3% of all hysterectomies. The risk of morbidity is significantly decreased when a urinary tract injury is detected intraoperatively.
Guidelines for Perioperative Care in Gynecologic/Oncology: Enhanced Recovery After Surgery (ERAS) Society Recommendations—2019 Update
Authors: Nelson Gregg , Bakkum-Gamez Jamie , Kalogera Eleftheria , Glaser Gretchen , Altman Alon , Meyer Larissa A. , Taylor Jolyn S. , Iniesta Maria , Lasala Javier , Mena Gabriel , Scott Michael , Gillis Chelsia , Elias Kevin , Wijk Lena , Huang Jeffrey , Nygren Jonas , Ljungqvist Olle , Ramirez Pedro T. , Dowdy Sean C. 
Published: July 2019

(Abstracted from Int J Gynecol Cancer 2019; doi: 10.1136/ijgc-2019-000356)
Enhanced Recovery After Surgery (ERAS) is a global initiative dedicated to improving gynecologic/oncology surgical quality with attention to both clinical outcomes and economic impact. The ERAS guidelines, first published in February 2016, require updates on a regular basis in order to keep up with contemporary literature and evidence.
Uterosacral Ligament Suspension Versus Robotic Sacrocolpopexy for Treatment of Apical Pelvic Organ Prolapse
Authors: Smith Benjamin C. , Crisp Catrina C. , Kleeman Steven D. , Yook Eunsun , Pauls Rachel N. 
Published: July 2019

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25:93–98)
More than 10% of women with pelvic organ prolapse (POP) will undergo reconstructive pelvic surgery during their lifetime. There are many surgical options available to patients undergoing reconstruction for POP.
Does Maternal Age at Retrieval Influence the Implantation Potential of Euploid Blastocysts?
Authors: Irani Mohamad , Zaninovic Nikica , Rosenwaks Zev , Xu Kangpu 
Published: July 2019

(Abstracted from Am J Obstet Gynecol 2019;220:379.e1–379.e7)
The average age of first-time mothers continues to rise steadily on a global scale. Concerningly, maternal age is a critical factor when determining the probability of conception either naturally or through in vitro fertilization.
The Impact of Extending the Second Stage of Labor to Prevent Primary Cesarean Delivery on Maternal and Neonatal Outcomes
Authors: Zipori Yaniv , Grunwald Oren , Ginsberg Yuval , Beloosesky Ron , Weiner Zeev 
Published: July 2019

(Abstracted from Am J Obstet Gynecol 2019;220(2):191.e1–191.e7)
Cesarean delivery (CD) is associated with higher morbidity and mortality than vaginal birth. More than one-third of all indications for primary CD are due to labor dystocia (abnormal progression of labor defined as abnormal descent of the fetal head) in the second stage of labor.
Chronic Hypertension: Effect of Blood Pressure Control on Pregnancy Outcome
Authors: Panaitescu Anca M. , Roberge Stephanie , Nicolaides Kypros H. 
Published: July 2019

(Abstracted from J Matern Fetal Neonatal Med 2019;32(5):857–863)
Chronic hypertension (cHTN) complicates 1% to 2% of pregnancies. In these pregnancies, there is a 10-fold increase in the risk of preeclampsia (PE) and 2-fold increase in risk of small for gestational age (SGA) neonates.
Sleep disturbances in orthopaedic trauma patients
Authors: Lu Keyin , Barron John O. , Israel Heidi , Cannada Lisa K. 
Published: July 2019

Abstract

Objectives:
To determine the prevalence of sleep disturbances in orthopaedic trauma patients 3 months following surgery and to identify any subset(s) of patients at high risk for prolonged sleep disturbance.

Design:
Prospective cohort.

Setting:
Level 1 Trauma Center.

Patient/Participants:
All patients at an orthopaedic trauma clinic from May 3, 2016 to Feb 23, 2017.

Main outcome measurements:
Baseline patient Pittsburgh Sleep Questionnaire (PSQI) and Insomnia Severity Index (ISI) scores compared to PSQI and ISI scores 3-months postoperatively. Both gender and age stratified data analyses were performed.

Results:
Sixty-six patients met our inclusion criteria and completed both baseline and 3-month surveys. There were 44 males and 22 females. There was a significant increase in PSQI and ISI scores from baseline to 3 months across all patients. Further analysis revealed significant increases from baseline to 3 months in both PSQI and ISI scores for female patients but not male patients. There was a significant difference from baseline to 3 months in patients 50 years old and under but not for patients above 50 years old. No patients required revision surgery in the first 3 months.

Conclusions:
More than half of all patients reported continued sleep disturbance 3 months postoperatively. Females are at particularly increased risk for sleep disturbance. These findings demonstrate that sleep disturbances merit attention in the early stages of the postoperative recovery process.

Level of evidence:
Therapeutic Level II.
An Uncommon Diagnosis in a Child Presenting With Double Vision and Imbalance
Authors: Sharp Audrey , Santiago Lucia , Dam Aaron , Pereyra Charles , Mihailos Athena 
Published: July 2019

Abstract
Acute disseminated encephalomyelitis (ADEM) is exceptionally uncommon, with approximately 3 pediatric cases reported in the United States each year. Given the uncommon nature of ADEM, most of the current data rely heavily on case reports. The overwhelming majority of cases have been reported after an acute viral infection or vaccination. Although up to 90% of cases exhibit full remission after intravenous steroids, those in which treatment is delayed can display debilitating sequelae. Here, we present a case of ADEM in a 7-year-old boy who presented with double vision and imbalance with no recent history of acute viral infections or vaccinations.
A Call to Restore Your Calling
Authors: Mull Colette C. , Thompson Amy D. , Rappaport David I. , Gartner J. Carlton , Bowman Wesley R. 
Published: July 2019

Abstract
Physicians suffer from most medical conditions at the same rate as their lay peers. However, physicians' self-care is often sacrificed for patient care. This third article in our series examines physician and trainee illness and impairment. Presenteeism, physician impairment, and substance use disorder (SUD) are defined. We call attention to the potential for harm of dated cultural norms, which often fuel physicians' neglect of their own health and development of ill-advised coping skills.
Although any medical condition may become a functional impairment, the primary cause of physician impairment is SUD. Alcohol and prescription opioids top the list of substances used in excess by physicians. Although SUD is less prevalent in residency, we focus on the rise of marijuana and alcohol use in emergency medicine trainees. A nonpunitive model for the prevention and treatment of SUD in residency is described.
Physicians are ethically and legally mandated to report any concern for impairment to either a state physician health program or a state medical board. However, recognizing physician SUD is challenging. We describe its clinical presentation, voluntary and mandated treatment tracks, provisions for protecting reporters from civil liability, prognosis for return to practice, and prevention efforts. We underscore the need to model healthy coping strategies and assist trainees in adopting them.
In closing, we offer our colleagues and trainees today's to-do list for beginning the journey of reclaiming your health. We also provide resources focused on the practical support of ill and/or impaired physicians.
Implementation of an Innovative, Multiunit, Postevent Debriefing Program in a Children's Hospital
Authors: Zinns Lauren E. , Welch-Horan Thomas B. , Moore Thomas A. , Ades Anne , Wolfe Heather A. , Mullan Paul C. 
Published: July 2019

Background
Postevent debriefing has been associated with improved resuscitation outcomes and is recommended by the American Heart Association and the American Academy of Pediatrics to improve clinical performance.

Objective
Despite the benefits of postevent debriefing, published debriefing programs have focused on single areas within a hospital. We are unaware of any hospital-wide debriefing programs implemented in a pediatric setting.

Methods
We established a multidisciplinary, interprofessional debriefing collaborative at the Children's Hospital of Philadelphia to implement postevent debriefings in multiple areas of the hospital. The collaborative created a standardized debriefing form to capture data about the postevent debriefings.

Results
From July 23, 2015 to December 31, 2017, the emergency department performed 153 debriefings (18%) for 850 resuscitations. The neonatal intensive care unit conducted 10 debriefings (9%) for 107 resuscitations, and the pediatric intensive care unit performed 5 debriefings (7%) for 73 resuscitations.

Conclusions
Several departments at the Children's Hospital of Philadelphia have incorporated hot and cold debriefings into their clinical practice as part of their continuous quality improvement programs. By disseminating the tools and lessons learned from the implementation process, the collaborative hopes that other institutions will benefit from their lessons learned to successfully create their own debriefing programs. Widespread adoption of debriefing programs will enable a more scientific approach to studying the outcomes of debriefing.
Clinical, Radiographic, and Ultrasound Findings Between Simple and Complicated Baker’s Cysts
Authors: Park Gi-Young , Kwon Dong Rak , Kwon Dae Gil 
Published: July 2019

Purpose
The aim of the study was to compare the clinical, radiographic, and ultrasound findings between simple and complicated Baker’s cysts.

Methods
Forty-seven knees with Baker’s cysts in 45 patients with knee pain were identified from a chart review. Baker’s cysts were classified as simple or complicated according to ultrasound findings. Clinical data, including duration of knee pain, visual analog scale score, Kellgren-Lawrence grade, ultrasound findings, including the size and sonomorphology of the BC, severity of osteophytosis, thickness of joint effusion, meniscal tear, and synovial proliferation of the two types of BC, were compared.

Results
There were 22 knees with a simple cyst and 25 knees with a complicated cyst. The thickness of the suprapatellar effusion in complicated Baker’s cysts (5.7 ± 3.0 mm) was significantly greater than that in simple Baker’s cysts (3.8 ± 3.2 mm), and the presence of synovial proliferation in the suprapatellar recess was significantly higher in complicated Baker’s cysts (22 knees, 88.0%) than in the simple Baker’s cysts (12 knees, 54.5%). However, there were no significant differences in demographic, radiographic, and other ultrasound parameters between the two types of BC.

Conclusions
Synovial proliferation with larger effusion in the suprapatellar recess was more associated with complicated BC than simple BC.
Compensation Strategies in Response to Fatiguing Propulsion in Wheelchair Users
Authors: Bossuyt Fransiska M. , Arnet Ursina , Cools Ann , Rigot Stephanie , de Vries Wiebe , Eriks-Hoogland Inge , Boninger Michael L. 
Published: July 2019

Objective
The aims of the study were to examine whether fatigue-inducing wheelchair propulsion changes neuromuscular activation and propulsion biomechanics and to determine predictor variables for susceptibility to fatigue.

Design
This study with a quasi-experimental, one-group, pretest-posttest design investigates a population-based sample of wheelchair users with a spinal cord injury (n = 34, age: 50.8 ± 9.7 yrs, 82% males). Neuromuscular activation and propulsion biomechanics during treadmill propulsion at 25 W and 45 W were assessed before and after a protocol designed to cause fatigue.

Results
With the induced fatigue, wheelchair users propelled with increased neuromuscular activation in the pectoralis major pars sternalis, deltoideus pars acromialis and upper trapezius (45 W, P < 0.05), and a slightly reduced push angle (25 W: 75–74 degrees, P < 0.05, 45 W: 78–76 degrees, P < 0.05). Wheelchair users susceptible to fatigue (47%) were more likely to have a complete lesion, to be injured at an older age, and had less years since injury. This group propelled in general with shorter push angle and greater maximum resultant force, had a greater anaerobic capacity, and had less neuromuscular activation.

Conclusions
Compensation strategies in response to fatiguing propulsion could increase the risk for shoulder injury. Predictor variables for susceptibility to fatigue inform interventions preserving shoulder health and include lesion characteristics, propulsion technique, anaerobic capacity, and neuromuscular activation.

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) Explain a neuromuscular compensation strategy and the corresponding muscles in response to fatiguing wheelchair propulsion; (2) Recommend propulsion biomechanics associated to reduced susceptibly to fatiguing wheelchair propulsion; and (3) List examples of predictor variables of susceptibility to fatigue.

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.
Quantitative Evaluation of Interference Patterns on Electromyography in Neuropathy
Authors: Kobayashi Yukiko , Akaboshi Kazuto , Takahashi Osamu , Liu Meigen 
Published: July 2019

Objective
The aim of this study was to develop a quantitative evaluation method of interference patterns on needle electromyography that is easy to apply in clinical use and to examine its usefulness. Diagnostic electrophysiological assessments are important for physiatrists, and correct diagnosis and assessment are essential for proper rehabilitation.

Design
A total of 112 maximum interference patterns of upper extremity muscles suspected of being affected by neuropathy were quantitatively evaluated based on the parameters of integration values, mean amplitudes, the number of peaks, and activity. “Activity” was defined as the sum of the time during which myoelectric signals were recorded during 1 sec with maximum voluntary contraction, and it was expressed as a percentage. The relationships of the previous parameters with spontaneous pathological potentials and polyphasic motor unit potentials were examined.

Results
The area under the curve of the receiver operating characteristic curve for the diagnosis of neuropathy was the highest using activity (0.917). The integral value and mean amplitude were useful for the diagnosis of cases with chronic neuropathy showing slightly decreased interference patterns.

Conclusions
The quantitative evaluation of the maximal contraction interference pattern in this study was useful for the diagnosis of neuropathy.
Reduction in Thigh Muscle Strength Occurs Concurrently but Does Not Seem to Precede Incident Knee Pain in Women
Authors: Ruhdorfer Anja , Wirth Wolfgang , Culvenor Adam G. , Eckstein Felix 
Published: July 2019

Objective
The aim of the study was to investigate whether muscle strength declines before or concurrent with incident knee pain in subjects with and without radiographic knee osteoarthritis.

Design
Osteoarthritis initiative participants with incident knee pain (occurrence of infrequent/frequent knee pain during the past 12 mos at two consecutive follow-up time points (either years Y3 + Y4 or Y4 + Y5) were compared with controls (no incident knee pain) with 2-yr changes in knee extensor strength during BL➔Y2 (before) and Y2➔Y4 (concurrent).

Results
Two hundred two knees (49% women, 40% radiographic knee osteoarthritis) displayed incident pain, and 439 did not (46% women, 23% radiographic knee osteoarthritis). Women with radiographic knee osteoarthritis displayed a significantly greater (P = 0.04) reduction in knee extensor strength concurrent with incident pain compared with controls (mean = −17.6 N vs. +4.5 N), but men did not. A similar trend was observed in women without radiographic knee osteoarthritis, but this was not statistically significant (P = 0.08). There was no significant relationship with change in extensor strength before incident pain (P ≥ 0.43).

Conclusions
These results suggest that in women, incident knee pain is accompanied by a concurrent reduction in knee extensor strength, whereas loss in strength does not precede incident knee pain. The findings encourage interventional studies that attempt to attenuate a decline in extensor strength once knee symptoms occur.
Future Approaches to Precision Oncology–Based Clinical Trials
Authors: Mittra Arjun , Moscow Jeffrey A. 
Published: July 2019

Abstract
The last 2 decades have seen a rapid advance of the precision oncology paradigm—from its early singular successes to becoming the prevailing model of cancer therapy. As the treatment of cancer moves away from traditional chemotherapy, so too will oncology clinical trials have to move away from the traditional model of phase I to phase III progression of drug development. Achieving this goal of individualized care will involve a concerted effort by the entire cancer care community to fundamentally change the design and implementation of oncology clinical trials. We envision that the next 2 decades will be a period of evolution in precision oncology clinical trials through scientific and technologic advances, transformation of clinical trial infrastructure, and changes in the kind of evidence required for regulatory approval.
Biostatistical and Logistical Considerations in the Development of Basket and Umbrella Clinical Trials
Authors: Yee Laura M. , McShane Lisa M. , Freidlin Boris , Mooney Margaret M. , Korn Edward L. 
Published: July 2019

Abstract
Oncology clinical trials are undergoing transformation to evaluate targeted therapies addressing a wider variety of biologically defined cancer subgroups. Multiarm basket and umbrella trials conducted under master protocols have become more prominent mechanisms for the clinical evaluation of promising new biologically driven anticancer therapies that are integral to precision oncology medicine. These new trial designs permit efficient clinical evaluation of multiple therapies in a variety of histologically and biologically defined cancers. These complex trials require extensive planning and attention to many factors, including choice of biomarker assay platform, mechanism for processing clinicopathologic and biomarker data to assign patients to substudies, and statistical design, monitoring, and analysis of substudies. Trial teams have expanded to include expertise in the interface between biology, clinical oncology, bioinformatics, and statistics. Strategies for the design, conduct, and analysis of these complex trials will continue to evolve to meet new challenges and opportunities in precision oncology medicine.
Clinical Applications of Next-Generation Sequencing in Precision Oncology
Authors: Karlovich Chris A. , Williams P. Mickey 
Published: July 2019

Abstract
The ability of next-generation sequencing (NGS) to comprehensively assess the molecular profile of a tumor specimen has transformed the clinical testing landscape in oncology. Accordingly, recent years have seen broad uptake of clinical NGS to inform cancer patient management. However, significant challenges remain. The annotation and clinical interpretation of variants identified by NGS tests often require rigorous review and may vary between laboratories. While a clearer regulatory path has emerged, reimbursement for NGS tests remains a subject of continuing debate. Basket clinical studies such as the National Cancer Institute Molecular Analysis of Therapy Choice are evaluating the degree to which matching of a targeted therapy to tumor molecular profile by NGS can be applied independently of tissue histology. Newer applications of NGS such as for circulating tumor DNA testing and to identify novel RNA fusion driver events continue to expand its clinical utility.