bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatal and Nonfatal Overdose Among Pregnant and Postpartum Women in Massachusetts
Authors: Schiff Davida M. , Nielsen Timothy , Terplan Mishka , Hood Malena , Bernson Dana , Diop Hafsatou , Bharel Monica , Wilens Timothy E. , LaRochelle Marc , Walley Alexander Y. , Land Thomas 
Published: July 2018

OBJECTIVE:
To estimate fatal and nonfatal opioid overdose events in pregnant and postpartum women in Massachusetts, comparing rates in individuals receiving and not receiving pharmacotherapy for opioid use disorder (OUD).

METHODS:
We conducted a population-based retrospective cohort study using linked administrative and vital statistics databases in Massachusetts to identify women with evidence of OUD who delivered a liveborn neonate in 2012–2014. We described maternal sociodemographic, medical, and substance use characteristics, computed rates of opioid overdose events in the year before and after delivery, and compared overdose rates by receipt of pharmacotherapy with methadone or buprenorphine in the prenatal and postpartum periods.

RESULTS:
Among 177,876 unique deliveries, 4,154 (2.3%) were to women with evidence of OUD in the year before delivery, who experienced 242 total opioid-related overdose events (231 nonfatal, 11 fatal) in the year before or after delivery. The overall overdose rate was 8.0 per 100,000 person-days. Overdoses were lowest in the third trimester (3.3/100,000 person-days in the third trimester) and then increased in the postpartum period with the highest overdose rate 7–12 months after delivery (12.3/100,000 person-days). Overall, 64.3% of women with evidence of OUD in the year before delivery received any pharmacotherapy in the year before delivery. Women receiving pharmacotherapy had reduced overdose rates in the early postpartum period.

CONCLUSION:
Pregnant women in Massachusetts have high rates of OUD. The year after delivery is a vulnerable period for women with OUD. Additional longitudinal supports and interventions tailored to women in the first year postpartum are needed to prevent and reduce overdose events.
Frequency of Opioid Dispensing After Vaginal Delivery
Authors: Prabhu Malavika , Garry Elizabeth M. , Hernandez-Diaz Sonia , MacDonald Sarah C. , Huybrechts Krista F. , Bateman Brian T. 
Published: July 2018

OBJECTIVE:
To describe nationwide patterns in outpatient opioid dispensing after vaginal delivery.

METHODS:
Using the Truven Health Analytics MarketScan database, we performed a large, nationwide retrospective cohort study of commercially insured beneficiaries who underwent vaginal delivery between 2003 and 2015 and who were opioid-naive for 12 weeks before the delivery admission. We assessed the proportion of women dispensed an oral opioid within 1 week of discharge, the associated median oral morphine milligram equivalent dose dispensed, and the frequency of opioid refills during the 6 weeks after discharge. We evaluated predictors of opioid dispensing using multivariable logistic regression.

RESULTS:
Among 1,345,244 women undergoing vaginal delivery, 28.5% were dispensed an opioid within 1 week of discharge. The most commonly dispensed opioids were hydrocodone (44.7%), oxycodone (34.6%), and codeine (13.1%). The odds of filling an opioid were higher among those using benzodiazepines (adjusted odds ratio [OR] 1.87, 95% CI 1.73–2.02) and antidepressants (adjusted OR 1.63, 95% CI 1.59–1.66), smokers (adjusted OR 1.44, 95% CI 1.38–1.51), and among those undergoing tubal ligation (adjusted OR 3.77, 95% CI 3.67–3.87), operative vaginal delivery (adjusted OR 1.52, 95% CI 1.49–1.54), and higher order perineal laceration (adjusted OR 2.15, 95% CI 2.11–2.18). The median (interquartile range, 10th–90th percentile) dose of opioids dispensed was 150 (113–225, 80–345) morphine milligram equivalents, equivalent to 20 tablets (interquartile range 15–30, 10th–90th percentile 11–46) of 5 mg oxycodone. Six weeks after discharge, 8.5% of women filled one or more additional opioid prescriptions.

CONCLUSION:
Opioid dispensing after vaginal delivery is common and often occurs at high doses. Given the frequency of vaginal delivery, this may represent an important source of overprescription of opioids in the United States.
Improving Patient Knowledge of Aneuploidy Testing Using an Educational Video
Authors: Mulla Bethany M. , Chang Olivia H. , Modest Anna M. , Hacker Michele R. , Marchand Karen F. , O’Brien Karen E. 
Published: July 2018

OBJECTIVE:
To evaluate the effectiveness of an educational video explaining aneuploidy testing.

METHODS:
This was a randomized controlled trial of women with singleton pregnancies having aneuploidy testing at less than 14 weeks of gestation from September 2016 to March 2017 at our prenatal ultrasound center. We developed an educational video on aneuploidy testing. Participants, stratified by age younger than or 35 years or older at estimated delivery date, were randomized to either view or not view the video before their ultrasonogram. Participants 35 years or older also met with a genetic counselor at the ultrasound appointment. All participants completed a survey assessing knowledge of genetic testing (score of 0–15) at baseline and after the appointment. The primary outcome was change in knowledge score after the intervention. A sample size of 23 per group (n=92) was planned for a total of 46 women younger than 35 years of age and 46 women aged 35 years or older. Data are presented as median (interquartile range).

RESULTS:
Of 104 eligible women who were approached, 92 were randomized. Forty women aged younger than 35 years and 41 women aged 35 years or older completed the study. Baseline characteristics were similar across groups. In women younger than 35 years, the video group had a significant improvement in knowledge score (+2.0 [1.0–5.0]) compared with the control group (0 [−1.0 to 1.0]; P=.01) and reported better understanding of the information compared with the control group (P<.001) with no change in patient satisfaction (P=.25). In women 35 years or older, change in knowledge score was similar for the video and control groups (P=.98) with no difference in self-reported understanding (P=.49) or patient satisfaction (P=.30).

CONCLUSION:
A patient-centered educational video explaining aneuploidy testing options improved knowledge and self-reported understanding of the information in women younger than 35 years with no change in patient satisfaction. No difference was seen for women 35 years or older, likely as a result of genetic counseling provided to these women.
Comparison of Mesenteric Lengthening Techniques in IPAA: An Anatomic and Angiographic Study on Fresh Cadavers
Authors: İsmail Erkin , Açar Halil İbrahim , Arslan Murat Nihat , Çoban İsmail , Cömert Ayhan , Aşlar Ahmet Keşşaf , Kuzu Mehmet Ayhan 
Published: July 2018

BACKGROUND:
The IPAA technique restores anal functionality in patients who have had the large intestine and rectum removed; however, 1 of the most important reasons for pouch failure is tension on the anastomosis.

OBJECTIVE:
The aim of this study was to compare technical procedures for mesenteric lengthening used for IPAA to reduce this tension.

DESIGN:
After randomization, 4 different techniques for mesenteric lengthening were performed and compared on fresh cadavers.

SETTING:
This was a cross-sectional cadaveric study.

MAIN OUTCOME MEASURES:
In the first group (n = 5), stepladder incisions were made on the visceral peritoneum of the mesentery of the small intestine. In the second and third groups, the superior mesenteric pedicle was divided, whereas the ileocolic pedicle (n = 7) or marginal vessels (n = 6) were preserved during proctocolectomy. In the fourth group (n = 7), the superior mesenteric pedicle was cut without preserving any colic vessels. Mesenteric lengthening was analyzed. Angiography was performed to visualize the blood supply of the terminal ileum and pouch after mesenteric lengthening.

RESULTS:
Average mesenteric lengthening was 5.72 cm (± 1.68 cm) in group 1, 3.63 cm (± 1.75 cm) in group 2, 7.03 cm (± 3.47 cm) in group 3, and 7.29 cm (± 1.73 cm) in group 4 (p = 0.011 for group 2 when compared with the others).

LIMITATIONS:
The study was limited by nature of being a cadaver study.

CONCLUSIONS:
Stepladder incisions through superior mesenteric pedicle trace are usually sufficient for mesenteric lengthening. In addition, division of the superior mesenteric pedicle with either a preserving marginal artery or without preserving ileocolic and marginal arteries leads to additional mesenteric lengthening.
Bone Resorption after Use of Silicone Chin Implants, Long-term Follow-up Study with Lateral Chin Radiography
Authors: Sciaraffia Carlos E. , Ahumada Macarena F. , Parada Francisco J. , Gonzalez Esteban , Prado Arturo 
Published: July 2018

Summary:
Silicone chin implants are frequently used in cosmetic surgery to enhance a harmonic face. Obtaining an aesthetically pleasing face is increasingly becoming more important for people, and a considerable part of this goal can be achieved through different aesthetic modifications of the chin. The purpose of this study was to analyze the presence of bone resorption after the insertion of silicone chin implants, with lateral chin radiographs. Fifteen patients were studied, all of whom had a chin silicone implant inserted at least 1 year ago using the same surgical technique. The surgery was done intraorally with insertion of the silicone implant under the periosteum of the chin. Fourteen patients presented bone erosion, with the maximum of 2.0 mm erosion. However, none of them manifested any symptoms of this erosion. In conclusion, even though the majority of the patients presented with bone erosion, the results were minimal and completely asymptomatic; thus, this technique produced an excellent final result.
Anti–nerve growth factor does not change physical activity in normal young or aging mice but does increase activity in mice with skeletal pain
Authors: Majuta Lisa A. , Mitchell Stefanie A.T. , Kuskowski Michael A. , Mantyh Patrick W. 
Published: July 2018

AbstractAnti–nerve growth factor (anti-NGF) therapy has shown significant promise in attenuating several types of skeletal pain. However, whether anti-NGF therapy changes the level of physical activity in individuals with or without skeletal pain is largely unknown. Here, automated day/night activity boxes monitored the effects of anti-NGF treatment on physical activity in normal young (3 months old) and aging (18-23 months old) mice and mice with bone fracture pain. Although aging mice were clearly less active and showed loss of bone mass compared with young mice, anti-NGF treatment had no effect on any measure of day/night activity in either the young or aging mice. By contrast, in mice with femoral fracture pain, anti-NGF treatment produced a clear increase (10%-27%) in horizontal activity, vertical rearing, and velocity of travel compared with the Fracture + Vehicle group. These results suggest, just as in humans, mice titrate their level of physical activity to their level of skeletal pain. The level of skeletal pain may in part be determined by the level of free NGF that seems to rise after injury but not normal aging of the skeleton. In terms of bone healing, animals that received anti-NGF showed an increase in the size of calcified callus but no increase in the number of displaced fractures or time to cortical union. As physical activity is the best nondrug treatment for many patients with skeletal pain, anti-NGF may be useful in reducing pain and promoting activity in these patients.
Peripherally administered calcitonin gene–related peptide induces spontaneous pain in mice: implications for migraine
Authors: Rea Brandon J. , Wattiez Anne-Sophie , Waite Jayme S. , Castonguay William C. , Schmidt Chantel M. , Fairbanks Aaron M. , Robertson Bennett R. , Brown Cameron J. , Mason Bianca N. , Moldovan-Loomis Maria-Cristina , Garcia-Martinez Leon F. , Poolman Pieter , Ledolter Johannes , Kardon Randy H. , Sowers Levi P. , Russo Andrew F. 
Published: July 2018

AbstractMigraine is the third most common disease in the world (behind dental caries and tension-type headache) with an estimated global prevalence of 15%, yet its etiology remains poorly understood. Recent clinical trials have heralded the potential of therapeutic antibodies that block the actions of the neuropeptide calcitonin gene–related peptide (CGRP) or its receptor to prevent migraine. Calcitonin gene–related peptide is believed to contribute to trigeminal nerve hypersensitivity and photosensitivity in migraine, but a direct role in pain associated with migraine has not been established. In this study, we report that peripherally administered CGRP can act in a light-independent manner to produce spontaneous pain in mice that is manifested as a facial grimace. As an objective validation of the orbital tightening action unit of the grimace response, we developed a squint assay using a video-based measurement of the eyelid fissure, which confirmed a significant squint response after CGRP injection, both in complete darkness and very bright light. These indicators of discomfort were completely blocked by preadministration of a monoclonal anti-CGRP–blocking antibody. However, the nonsteroidal anti-inflammatory drug meloxicam failed to block the effect of CGRP. Interestingly, an apparent sex-specific response to treatment was observed with the antimigraine drug sumatriptan partially blocking the CGRP response in male, but not female mice. These results demonstrate that CGRP can induce spontaneous pain, even in the absence of light, and that the squint response provides an objective biomarker for CGRP-induced pain that is translatable to humans.
Validity and Reliability of the Korean Version of the Dialysis Symptom Index for Hemodialysis Patients
Authors: CHO Mi-Kyoung , KIM Se Young , SHIM Hye Yeung 
Published: July 2018

ABSTRACT

Background:
Hemodialysis patients experience physical and psychosocial symptoms caused by comorbid illnesses, treatment-related side effects, lifestyle alteration, and the psychosocial impacts of living with end-stage renal disease. The Dialysis Symptom Index (DSI) is the most frequently used instrument to assess symptoms of chronic kidney disease and end-stage renal disease in patients.

Purpose:
The aims of this study were to develop the Korean version of the DSI, to verify the reliability and validity of the developed tool, and to use the tool to evaluate the symptoms of hemodialysis patients in Korea.

Methods:
A methodological study was performed on 230 hemodialysis patients from three hospitals who agreed to participate in the study from October 1 to 30, 2015. The Symptom Checklist-90-Revised was used to verify the convergent validity, whereas the total score of Kidney Disease Quality of Life Questionnaire-Short Form, Version 1.3, was used to verify the divergent validity. Data were analyzed using descriptive analysis, Cronbach’s alpha, confirmatory factor analysis, and Pearson’s correlation analysis.

Results:
The internal consistency reliability of the Korean DSI assessed by Cronbach’s alpha was .90. The Korean DSI showed a high positive correlation coefficient of .80 with symptom severity using the Symptom Checklist-90-Revised, which confirmed the convergent validity. Finally, the correlation coefficient with the quality of life of the participants using the Kidney Disease Quality of Life Questionnaire-Short Form, Version 1.3, was −.68, which confirmed the divergent validity.

Conclusions/Implications for Practice:
This study developed the Korean version of the DSI and verified its validity and reliability. The Korean version of the DSI showed good properties and may be used to assess the symptoms of hemodialysis patients. Nurses may use this self-report tool to better understand and help relieve the prevalence and severity of symptoms in hemodialysis patients in Korea.
Prosthetists’ Perceptions of Information Obtained From a Lower-Limb Prosthesis Monitoring System: A Pilot Study
Authors: Balkman Geoffrey S. , Vamos Andrew C. , Sanders Joan E. , Larsen Brian G. , Hafner Brian J. 
Published: July 2018

ABSTRACT

Introduction
Prosthetists have limited knowledge of their patients’ use of a prosthesis outside of the clinical environment. Prosthesis-mounted monitors can be used to directly measure patients’ prosthesis use and activity. Prosthetists’ opinions regarding potential clinical applications for sensor-based information may inform further development of this technology. A pilot study was conducted to assess prosthetists’ perceptions of prosthesis use and activity information obtained by a monitoring system.

Materials and Methods
Three local prosthetists were recruited to participate in the study. One patient with transtibial amputation from each prosthetist volunteered to wear limb presence and activity monitors for 2 weeks. Collected data were used to determine prosthesis use and activity. Each prosthetist completed a survey, examined clinical reports of their patient’s prosthesis use and activity, and participated in a semistructured interview. Survey results and interview transcripts were analyzed to identify and compare prosthetists’ perceptions.

Results
Prosthesis use and activity varied among patients. Prosthetists overestimated and underestimated patient activity relative to measurements recorded by the monitors. All three prosthetists selected multiple clinical applications for the prosthesis use and activity information in the survey, and several additional applications were suggested during the interviews.
When presented with multiple report formats, prosthetists found features of each to be clinically useful.

Conclusions
Prosthesis-mounted monitors may provide prosthetists with a better understanding of their patients’ prosthesis use and activity. Information provided by the monitoring system may inform clinical decisions and promote evidence-based practices.
Revisiting Arthroscopic Partial Meniscectomy for Degenerative Tears in Knees With Mild or No Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Lee Seung Hoon , Lee O-Sung , Kim Sung Taeck , Lee Yong Seuk 
Published: July 2018

Objective:
The purpose of this systematic review and meta-analysis was to evaluate the efficacy of arthroscopic partial meniscectomy (APM) for symptomatic degenerative meniscal tear (DMT) in knees with mild or no osteoarthritis.

Study Design:
A systematic review and meta-analysis.

Methods:
MEDLINE, EMBASE, and Cochrane databases were systematically searched. The inclusion criteria were as follows: (1) English language; (2) randomized controlled trial (RCT); (3) comparison between APM and other treatment modalities as a primary objective; and (4) complete DMT in knees with mild or no osteoarthritis. Mild or no arthritis was defined as Kellgren–Lawrence grade 0 to 2 or Ahlbäck 0 to 1 on radiography. Statistical analysis of functional activity and pain after APM and conservative treatment or sham operation was performed using R version 3.3.1.

Results:
Five articles were included in the final analysis, and they were all RCTs. Four studies compared clinical results of APM with those for physical therapy, and one study compared APM with sham operation. The functional activity was not better in the APM group (296 cases) than in the conservative treatment or sham operation group (284 cases) (I
2: 0%, small level of heterogeneity). Pain was not reduced significantly in the APM group compared with that in the conservative treatment or sham operation group (I
2: 0∼90%, high level of heterogeneity).

Conclusions:
This systematic review and meta-analysis of high-quality literature provides relatively strong evidence that APM did not improve functional activity or reduce pain compared with the results with conservative treatment or sham operation in knees with mild or no osteoarthritis.
The Early Postoperative Effects of Cochlear Implantation on Horizontal Semicircular Canal Function
Authors: Shute William Graham , McOwan Benjamin , O’Leary Stephen John , Szmulewicz David 
Published: July 2018

Objectives:
To use video head impulse testing to examine the effect of cochlear implantation (CI) on horizontal SCC vestibulo-ocular reflex (VOR) gain early after surgery, and to relate outcomes to subjective imbalance.

Study Design:
Prospective cohort study.

Setting:
Academic tertiary referral center.

Patients:
Thirty-seven (23F:14M) adult cochlear implant recipients (mean age, 55; age range, 20–80).

Intervention:
Cochlear implantation.

Main Outcome Measure:
The VOR of the horizontal semicircular canal of both the operated and non-operated ears was examined using video head impulse testing before surgery and at days 1, 7, and 28 following surgery. VOR gain, VOR gain asymmetry, and the change in VOR gain from preoperative baseline where the primary outcome measures. Subjective imbalance was assessed using a structured questionnaire.

Results:
VOR gain value for the operated ear was 0.88 ± 0.21. Mean VOR gain on day 1 postoperatively was 0.86 ± 0.19; on day 7, 0.87 ± 0.17, and on day 30, 0.91 ± 0.21. Before surgery median asymmery was −5.50%, on day 1 it was –5.30%, at day 7, −6.44%, and at day 30 it was −2.61%. There was no significant difference between these measures for the cohort across the four time points. Thirteen of 37 (35%) of patients experienced imbalance in the follow-up period, but this was not correlated to changes in VOR gain.

Conclusion:
Horizontal semicircular canal function is preserved in the immediate and early postoperative period. This suggests that horizontal semicircular canal impairment is not likely to be responsible for postoperative imbalance.
Round Window Occlusion Affects Bone Conduction in Cadaver Heads
Authors: Chen Keguang , Lyu Huiying , Yin Dongming , Yang Lin , Zhang Tianyu , Dai Peidong 
Published: July 2018

Objective:
To explore the feasibility of ear mold glue in the molding of round window occlusion (RWO) in cadaver heads and to study the effect on bone conduction (BC).

Methods:
Ten cadaver heads were selected to establish RWO model. Ear mold glue was used to immobilize round window niche. The vibration properties of the stapes footplate (VST) in response to the acoustic stimulation, and the vibration properties of the stapes footplate and cochlear promontory (VCP) in response to the B-71 stimulation were assessed by laser Doppler vibrometer in both pre-RWO and post-RWO.

Results:
The mean velocities of the stapes footplate in response to the acoustic stimulation in post-RWO were decreased significantly beyond 14 dB for frequency from 0.5k to 3k Hz and decreased beyond 11 dB for frequency above 4 kHz compared with pre-RWO (p<0.05). The stapes footplate relative velocity (VST/VCP) for pre-RWO and post-RWO conditions showed almost no difference (the difference was around 0.5 dB for 0.5k, 1k, 2k, 5k, 6k, and 7k Hz frequencies), except a slight decrease of around 1.5 dB at 3k and 8k Hz frequencies in post-RWO. However, the VST/VCP was a significant decrease of 1.7 dB at 4k Hz in post-RWO compared with Pre-RWO (p<0.05).

Conclusion:
Ear mold glue was available for the immobilization of round window niche in cadaver heads. The RWO have an impact on the BC hearing threshold. The effect of RWO on the BC was similar to that of otosclerosis, but the feature frequency for the depressed BC threshold at 4k Hz.