bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Body Weight–Supported Exercise on Symptoms of Knee Osteoarthritis: A Follow-up Investigation
Authors: Peeler Jason , Leiter Jeffrey , MacDonald Peter 
Published: October 2018

Objective:
To examine the long-term effect of participation in a 12-week lower-body positive pressure (LBPP)–supported low-load treadmill exercise regime on knee joint pain, physical function, and thigh muscle strength in patients with knee osteoarthritis (OA).

Design:
Prospective, observational, repeated measures.

Setting:
Clinical orthopedic setting.

Patients:
Nineteen overweight patients with knee OA.

Intervention:
Participants exercised under low-load treadmill walking conditions 2×/week for 12 weeks using an amount of LBPP support that minimized knee pain while walking for a period of 30 minutes at a set speed of 3.1 mph at 0-degree incline.

Main Outcome Measures:
Knee pain, function, thigh muscle strength, and body anthropometry were reassessed a minimum of 6 months after completion of the initial exercise regime and compared with results from baseline and postexercise evaluation.

Results:
Data suggested that: (1) patients were able to maintain improvements in knee joint pain and symptoms; (2) patients continued to report enhanced joint function and improved quality of life; and (3) patients maintained thigh muscle strength gains. Finally, a majority of patients continued to experience significant reductions in acute knee pain during full weight-bearing treadmill walking.

Conclusions:
Data suggest that improvements in knee pain, joint function, and thigh muscle strength associated with participation in a 12-week LBPP-supported low-load exercise regime were maintained well after cessation of the program. These findings have important implications for the development and refinement of exercise strategies and interventions used in the long-term management of joint symptoms associated with knee OA in overweight patients.
A noninvasive indicator for the diagnosis of early hepatitis B virus-related liver fibrosis
Authors: Li BinBin , Zhang LiFen , Zhang ZhanQing , Yan GangLi , Zhu Liang , Lu Wei , Yu HongYu 
Published: October 2018

Background and aims
Liver stiffness measurement (LSM) detected by FibroScan, combined with biochemical indexes, has shown potential values for assessment of liver fibrosis pathological degrees. Here we aimed to investigate a noninvasive method for hepatitis B virus-related liver fibrosis.

Patients and methods
In all, 307 patients who underwent liver biopsy and LSM measurement were included. Inflammation grades and fibrosis stages were evaluated according to METAVIR scoring system. Spearman’s rank correlation analysis, logistic regression analysis, and receiver operating characteristic (ROC) curves analysis were performed to assess the factors’ role in inflammation grades/fibrosis stages.

Results
Spearman’s rank correlation analysis showed that LSM, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and AST-to-platelet ratio index were positively correlated with inflammation grades and histologic fibrosis stages; platelets showed negative correlation, and AST-to-ALT ratio was not related. Logistic regression analysis indicated that LSM and APRI were risk factors for inflammation grades; LSM was the independent risk factor for fibrosis stages, P<0.0001, odds ratio>1. ROC curve analysis found LSM cutoff values and areas under the curve for the diagnosis of fibrosis scores: 6.95 and 0.804, respectively, for the diagnosis of significant fibrosis (F≥F2); 10.35 and 0.856, respectively, for severe fibrosis (F≥F3); 11.35 and 0.897, respectively, for cirrhosis (F=F4). Considering ALT as a confounding factor, ROC analysis was repeated in patients with normal and elevated ALT separately; the results indicated that when ALT was up to 40 U/l, LSM cutoff value and areas under the curve for the diagnosis of significant fibrosis (F≥F2) were 6.55 and 0.748, respectively.

Conclusion
This study provided a noninvasive treatment and prevention indicator for early hepatitis B virus-related liver fibrosis.
A Glutathione Precursor Reduces Oxidative Injury to Cultured Embryonic Cardiomyocytes
Authors: Peterson Darryl R. , Huang Huiya , Peresada Dmitriy , Sukowski Ernest J. , White Carl , Stefanov Gospodin , Schweig Lorene , Vazzalwar Ramesh 
Published: October 2018

Background:
Newborn infants are highly vulnerable to oxidative stress. Following birth asphyxia, oxidative injury due to ischemia–reperfusion can result in significant brain and heart damage, leading to death or long-term disability.

Study Question:
The study objective was to evaluate the effectiveness of antioxidant gamma-l-glutamyl-l-cysteine (γGlu-Cys) in inhibiting oxidative injury to cultured embryonic cardiomyocytes (H9c2 cells).

Study Design:
Control and γGlu-Cys–treated (0.5 mM) H9c2 cells were incubated under 6-hour ischemic conditions followed by 2-hour simulated reperfusion.

Measures and Outcomes:
To quantify oxidative stress-induced apoptosis sustained by cardiomyocytes, lactate dehydrogenase (LDH) release and the presence of cytosolic cytochrome c were measured, as well as the number of secondary lysosomes visualized under electron microscopy.

Results:
Compared to controls, H9c2 cells coincubated with γGlu-Cys during ischemia–reperfusion exhibited a significant reduction in both LDH release into the incubation medium [23.88 ± 4.08 (SE) vs. 9.95 ± 1.86% of total; P = 0.02] and the number of secondary lysosomes [0.070 ± 0.009 (SD) vs. 0.043 ± 0.004 per μm2; P = 0.01]. Inhibition of LDH release with γGlu-Cys was the same (P = 0.67) as that of a caspase inhibitor. The significant increase in cytosolic cytochrome c (P = 0.01) after ischemia–reperfusion simulation further supports γGlu-Cys's role in apoptosis prevention.

Conclusions:
It is concluded that the glutathione precursor γGlu-Cys protects cultured embryonic cardiomyocytes from apoptosis-associated oxidative injury.
Development of a Sexually Transmitted Disease Client-friendly Unit at a Primary Care Clinic in Malaysia: Lessons Learnt
Authors: Pannir Selvam Sheela Bai , Khoo Ee Ming , Chow Suet Yin , Wong Ping Foo , Mohsin Siti Shafiatun , Abdullah Adina , Choo Wan Yuen 
Published: October 2018

Abstract
Management of sexually transmitted diseases and human immunodeficiency virus is challenging due to the social stigma attached. We describe the development of a client-friendly sexually transmitted disease service in a primary care clinic in Malaysia with a special focus on key populations. Challenges and key lessons learnt from its development and implementation are discussed.
Individual and Neighborhood Factors Associated With Sexual Behavior Classes in an Urban Longitudinal Sample
Authors: Green Kerry M. , Matson Pamela A. , Reboussin Beth A. , Milam Adam J. , Furr-Holden C. Debra M. , Rabinowitz Jill A. , Powell Terrinieka W. , Ialongo Nicholas S. 
Published: October 2018

Background
This study aimed to increase understanding of the clustering of sexual behaviors in an urban sample of emerging adults, and the individual and neighborhood factors associated with sexual behavior patterns to provide insight into reducing the disproportionate burden of poor sexual outcomes among urban African Americans.

Methods
We draw on 2 cohorts of urban, predominantly African American youth first assessed at age 6 years and follow-up to emerging adulthood (mean age, 20 years; n = 1618). Latent class analyses by gender identified co-occurrence of sexual behavior.

Results
We found 3 classes for both males and females: high-risk (13% of males, 15% of females), low-risk (54% of males, 56% of females) and no-risk (33% of males, 29% of females). Membership in the high-risk class was associated with school dropout, a substance use disorder diagnosis, having a criminal arrest, pregnancy, and sexually transmitted diseases for both males and females. High-risk females also had higher rates of depression. Low-risk males and females also had elevated risk of pregnancy and parenthood. Neighborhood factors distinguished the high- and no-risk classes for males and females, including the neighborhood environment scale, which assessed poverty, safety, drug activity, and crime/violence in the neighborhood. Neighborhood religiosity was inversely associated with membership in the high-risk class compared with the no-risk class for females only. Neighborhood racism distinguished those in the high-risk class compared with the no-risk class for males.

Conclusions
Future work should take into account the clustering of sexual risk behaviors. Specific neighborhood factors could be addressed to reduce sexual health disparities.
Lymphogranuloma Venereum: An Increasingly Common Anorectal Infection Among Men Who Have Sex With Men Attending New York City Sexual Health Clinics
Authors: Pathela Preeti , Jamison Kelly , Kornblum John , Quinlan Tammy , Halse Tanya A. , Schillinger Julia A. 
Published: October 2018

Abstract
Using Chlamydia trachomatis anorectal specimens routinely tested for lymphogranuloma venereum (LGV) (2008–2011) and samples of archived specimens tested for LGV (2012–2015), we observed increased LGV positivity among men who have sex with men attending NYC Sexual Health Clinics. Using clinical data, we determined predictors of anorectal LGV that may guide clinical management.
Variability in Pediatric Ideal Body Weight Calculation: Implications for Lung-Protective Mechanical Ventilation Strategies in Pediatric Acute Respiratory Distress Syndrome*
Authors: Ward Shan L. , Quinn Carson M. , Steurer Martina A. , Liu Kathleen D. , Flori Heidi R. , Matthay Michael A. 
Published: October 2018

Objectives:
No gold standard for ideal body weight determination in children exists. We aimed to compare four methods of ideal body weight calculation and determine level of agreement between methods and impact of measurement variance on tidal volumes prescribed in mechanically ventilated pediatric acute respiratory distress syndrome.

Design:
Post hoc analysis of four multicenter pediatric acute respiratory distress syndrome studies.

Setting:
Twenty-six academic PICUs.

Patients:
Five hundred eighty-nine patients.

Interventions:
None.

Measurements and Main Results:
Ideal body weight was calculated by four common methods: National Center for Health Statistics, McLaren, Moore, and body mass index, and compared in three ways: 1) determine the proportion of the cohort for which each method could successfully calculate ideal body weight; 2) compare the level of agreement between the ideal body weight methods by Bland-Altman analysis; and 3) evaluate the difference in tidal volume when 6 mL/kg ideal body weight was prescribed. We a priori defined the better method to be one that could calculate ideal body weight in most subjects, had good agreement with other methods, and led to a lower tidal volume. Only 55% could have ideal body weight measured by all four methods. National Center for Health Statistics, McLaren, and Moore methods could calculate ideal body weight in greater than or equal to 90%, whereas body mass index method was successful in only 61% because of no body mass index validation in less than 2-year-olds. In comparing each method to the others, there was great variance, particularly in greater than or equal to 10-year-olds. This variance was greatest between Moore and body mass index methods with greater than or equal to 10 kg difference in ideal body weight in some subjects. The McLaren method had the best agreement with all other methods, and yielded similar prescribed tidal volume in 2- to 10-year-olds and lower tidal volume in greater than or equal to 10 years old.

Conclusions:
There is substantial variation in calculated ideal body weight among four commonly used methods, particularly in adolescents. Since varying ideal body weight may lead to discrepancies in pediatric acute respiratory distress syndrome care, a standard approach to ideal body weight measurement is needed. We recommend the McLaren method to calculate ideal body weight in children with pediatric acute respiratory distress syndrome until a gold standard method is validated.
A Quality Improvement Bundle Including Pay for Performance for the Standardization of Order Set Use in Moderate Asthma
Authors: Conners Gregory P. , Fowler Milton A. , Lee Brian R. , Schroeder Lisa L. 
Published: October 2018

Objective
In order to standardize use of our hospital's computerized asthma order set, which was developed based on an asthma clinical practice guideline, for moderately ill children presenting for care of asthma, we developed a quality improvement bundle, including a time-limited pay-for-performance component, for pediatric emergency department and pediatric urgent care faculty members.

Methods
Following baseline measurement, we used a run-in period for education, feedback, and improvement of the asthma order set. Then, faculty members earned 0.1% of salary during each of 10 successive months (evaluation period) in which the asthma order set was used in managing 90% or more of eligible patients.

Results
At baseline, the asthma order set was used in managing 60.5% of eligible patients. Order set use rose sharply during the run-in period. During the 10-month evaluation period, use of the asthma order set was significantly above baseline, with a mean of 91.6%; faculty earned pay-for-performance bonuses during 8 of 10 possible months. Following completion of the evaluation period, asthma order set use remained high.

Conclusions
A quality improvement bundle, including a time-limited pay-for-performance component, was associated with a sustained increase in the use of a computerized asthma order set for managing moderately ill asthmatic children.
A Case of Intracardiac Invasion of Hepatoblastoma Diagnosed With Point-of-Care Ultrasound
Authors: Fukuhara Shinichi , Yamaguchi Yoshimichi 
Published: October 2018

Abstract
Ultrasonography can be useful in the evaluation of children with abdominal complaints and may be the initial imaging modality in patients presenting with a newly recognized abdominal mass. Hepatoblastoma is an uncommon cause of acute abdominal pain in children and can rarely metastasize to the heart through vascular invasion. We report a case in which a 4-year-old girl who presented to the emergency department with abdominal pain promptly underwent point-of-care ultrasound and was subsequently diagnosed with intracardiac invasion of an abdominal tumor.
Development and Pilot Testing of a Computerized Asthma Kiosk to Initiate Chronic Asthma Care in a Pediatric Emergency Department
Authors: Kwok Maria Y. , Bakken Suzanne R. , Pusic Martin V. , York Deborah , Pahalyants Vartan , Ye Choong , Javed Kainaat , Dayan Peter S. 
Published: October 2018

Objectives
Emergency department (ED) visits are an opportunity to initiate chronic asthma care. Ideally, this care should be implemented in a fashion that limits utilization of scarce ED resources. We developed, iteratively refined, and pilot tested the feasibility of a computerized asthma kiosk to (1) capture asthma information, (2) deliver asthma education, and (3) facilitate guideline-based chronic asthma management.

Methods
The following are the 4 phases of this study: (1) developing the content and structure of a computerized asthma kiosk, (2) iterative refinement through heuristic testing by human-computer interface experts, (3) usability testing with ED providers (n = 4) and caregivers of children with asthma (n = 4), and (4) pilot testing the kiosk with caregivers (n = 31) and providers in the ED (n = 18). Outcome measures for the pilot-testing phase were the proportion of ED providers who prescribed long-term controller medication (LTCM) and asthma action plans (AsAPs) and the proportion of children who took LTCMs and attended primary care providers follow-up.

Results
After kiosk development and refinement, pilot implementation resulted in LTCMs prescribing and AsAP provision for 19 (61%) of 31 and 17 (55%) of 31 patients, respectively. Before kiosk use, the proportion of the 18 ED providers who reported prescribing LTCM was 1 (5%) of 18, and providing AsAPs was 0 (0%) of 18. Eighteen (58%) of the 31 caregivers reported that their children used LTCMs after kiosk use and 13 (42%) of 31 reported following up with the primary care provider within 1 month of the ED visits.

Conclusions
A rigorously developed asthma kiosk showed promise for initiating chronic asthma care in the ED.
Physical Therapists' Use and Alteration of Standardized Assessments of Motor Function in Children
Authors: Fay Deanne , Brock Elizabeth , Peneton Samantha , Simon Rebecca , Splan Madison , Sullivan Laura , Weiler Alyce 
Published: October 2018

Purpose:
This study presents survey responses of pediatric physical therapists' use and alteration of standardized assessments of motor function in children aged 2 to 10 years.

Methods:
Electronic and paper surveys were distributed to practicing physical therapists through the APTA Academy of Pediatric Physical Therapy electronic newsletter and 2 national conferences. Data were analyzed by response frequencies, qualitative responses, and χ2analyses for demographic characteristics.

Results:
A total of 497 pediatric physical therapists responded. Most (93%) reported using standardized assessments, with the majority (84%) reporting the normative scores. Almost all respondents (94%) also reported that they at least occasionally modify assessments.

Conclusion:
Standardized assessments are used by most therapists, but the high use of modifications during testing is concerning. Survey reports from therapists indicate a disconnect between standardized assessments and the needs of the child, leaving clinicians working to report required scores while maintaining validity of testing procedures.
Whole-Body Vibration Training Designed to Improve Functional Impairments After Pediatric Inpatient Anticancer Therapy: A Pilot Study
Authors: Rustler Vanessa , Prokop Aram , Baumann Freerk T. , Streckmann Fiona , Bloch Wilhelm , Daeggelmann Julia 
Published: October 2018

Purpose:
To assess a whole-body vibration (WBV) intervention for children after cancer treatment.

Methods:
Eleven children after inpatient anticancer therapy participated in a 12-week supervised WBV intervention, which consisted of one 9- to 13-minute WBV session per week, with 5 to 9 minutes' overall vibration time. Feasibility was defined as the ability to participate in WBV training without reporting adverse events. The number of offered and completed training sessions, program acceptance, and measures of function were assessed.

Results:
Nine participants completed the WBV intervention without any WBV-related adverse events. The adherence rate was 87.96%. Only minor side effects were reported and there was general program acceptance. We found indications that WBV has positive effects on knee extensor strength and active ankle dorsiflexion range of motion.

Conclusions:
WBV was feasible, safe, and well received among children after inpatient anticancer therapy. No health deteriorations were observed. Positive effects need to be confirmed in future trials.
Walking and Fitness Improvements in a Child With Diplegic Cerebral Palsy Following Motor-Assisted Elliptical Intervention
Authors: Burnfield Judith M. , Cesar Guilherme M. , Buster Thad W. , Irons Sonya L. , Pfeifer Chase M. 
Published: October 2018

Purpose:
To quantify effects of motor-assisted elliptical (Intelligently Controlled Assistive Rehabilitation Elliptical [ICARE]) training on walking and fitness of a child with cerebral palsy (CP).

Key Points:
A 12-year-old boy with walking limitations due to spastic diplegic CP (Gross Motor Function Classification System II) participated in 24 sessions of primarily moderate- to vigorous-intensity ICARE exercise. Fitness improvements were evidenced clinically across sessions by the child's capacity to train for longer periods, at faster speeds, and while overriding motor's assistance. Postintervention, the child walked faster with greater stability and endurance and more rapidly completed the modified Time Up and Go test.

Conclusion:
The child's fitness and gait improved following engagement in a moderate- to vigorous-intensity gait-like exercise intervention.

Recommendations for Clinical Practice:
Integration of moderate- to vigorous-intensity motor-assisted elliptical training can promote simultaneous gains in fitness and function for children with CP.
The Struggle for Evidence in Physical and Rehabilitation Medicine
Authors: Negrini Stefano , Levack William , Gimigliano Francesca , Arienti Chiara , Villafañe Jorge Hugo , Kiekens Carlotte 
Published: October 2018

Objective
The aim of the study was to evaluate the rate of publication of randomized controlled trials, systematic reviews, and meta-analysis in physical and rehabilitation medicine and its variation over time.

Design
We performed a bibliometric study and searched PubMed from inception to 2017, using National Library of Medicine 3rd level MeSH terms (“rehabilitation,” “physical therapy modalities,” and “drug therapy”) and filters (“randomized controlled trial,” “systematic reviews,” and “meta-analysis”). We used descriptive statistics, and we calculated the best-fitting regression model for all data considered.

Results
The absolute number of articles is growing in rehabilitation as much as in other treatment fields such as drug therapy. Whereas the rate of growth of publications for all studies relative to PubMed is bigger for drug therapies than for rehabilitation and physical therapy, the rate of growth of randomized controlled trials, systematic reviews, and meta-analysis is significantly greater for rehabilitation and physical therapy (P < 0.001). In 2017, 19.3% and 28.2% of the total production of scientific articles for rehabilitation and physical therapy (respectively) were for randomized controlled trials and systematic reviews versus 11.3% for drug therapy.

Conclusions
Production of the highest form of research evidence (randomized controlled trials, systematic reviews, and meta-analysis) is continuously increasing in physical and rehabilitation medicine at a higher rate than in other treatment fields such as drug therapy. The quality and results of this evidence should be evaluated in future studies.