bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chain‐loaded variable resistance warm‐up improves free‐weight maximal back squat performance
Authors: Mina Minas A. , Blazevich Anthony J. , Giakas Giannis , Seitz Laurent B. , Kay Anthony D. 
Published: July 2016

AbstractThe acute influence of chain‐loaded variable resistance exercise on subsequent free‐weight one‐repetition maximum (1‐RM) back squat performance was examined in 16 recreationally active men. The participants performed either a free‐weight resistance (FWR) or chain‐loaded resistance (CLR) back squat warm‐up at 85% 1‐RM on two separate occasions. After a 5‐min rest, the participants attempted a free‐weight 1‐RM back squat; if successful, subsequent 5% load additions were made until participants failed to complete the lift. During the 1‐RM trials, 3D knee joint kinematics and knee extensor and flexor electromyograms (EMG) were recorded simultaneously. Significantly greater 1‐RM (6.2 ± 5.0%; p < .01) and mean eccentric knee extensor EMG (32.2 ± 6.7%; p < .01) were found after the CLR warm‐up compared to the FWR condition. However, no difference (p > .05) was found in concentric EMG, eccentric or concentric knee angular velocity, or peak knee flexion angle. Performing a CLR warm‐up enhanced subsequent free‐weight 1‐RM performance without changes in knee flexion angle or eccentric and concentric knee angular velocities; thus a real 1‐RM increase was achieved as the mechanics of the lift were not altered. These results are indicative of a potentiating effect of CLR in a warm‐up, which may benefit athletes in tasks where high‐level strength is required.
A Qualitative Study of the Experiences and Factors That Led Physicians to Be Lifelong Health Advocates
Authors: Law Marcus , Leung Pearl , Veinot Paula , Miller Daniel , Mylopoulos Maria 
Published: July 2016

Purpose
Given the public’s trust and the opportunities to observe and address social determinants of health, physicians are well suited to be health advocates, a key role in the CanMEDS physician competency framework. As some physicians find it difficult to fulfill this role, the authors explored the experiences and influences that led established physicians to be health advocates.

Method
The authors used a phenomenological approach to explore this topic. From March to August 2014, they interviewed 15 established physician health advocates, using a broad definition of health advocacy—that it extends beyond individual patient advocacy to address the root causes of systemic differences in health. Interviews were audio recorded and transcribed verbatim. The transcripts were coded and the data categorized into clusters of meaning, then into themes. Data analysis was conducted iteratively, with data collection continuing until no new information was gathered.

Results
Participants described the factors that contributed to the development of their health advocate identity (i.e., exposure to social injustice, upbringing, schooling, specific formative experiences) and those that facilitated their engagement in health advocacy work (i.e., mentors, training, systemic and organizational supports). They also highlighted how they continue in their role as lifelong advocates (i.e., continuous learning and improvement, self-reflection and self-reflexivity, collaboration, intrinsic satisfaction in the work).

Conclusions
Many factors allow physician health advocates to establish and sustain a commitment to improve the health of their patients and the broader population. Medical schools could use these findings to guide curriculum development related to teaching this physician competency.
Assessment of Spectral and Temporal Resolution in Cochlear Implant Users Using Psychoacoustic Discrimination and Speech Cue Categorization
Authors: Winn Matthew B. , Won Jong Ho , Moon Il Joon 
Published: July 2016

Objectives:
This study was conducted to measure auditory perception by cochlear implant users in the spectral and temporal domains, using tests of either categorization (using speech-based cues) or discrimination (using conventional psychoacoustic tests). The authors hypothesized that traditional nonlinguistic tests assessing spectral and temporal auditory resolution would correspond to speech-based measures assessing specific aspects of phonetic categorization assumed to depend on spectral and temporal auditory resolution. The authors further hypothesized that speech-based categorization performance would ultimately be a superior predictor of speech recognition performance, because of the fundamental nature of speech recognition as categorization.

Design:
Nineteen cochlear implant listeners and 10 listeners with normal hearing participated in a suite of tasks that included spectral ripple discrimination, temporal modulation detection, and syllable categorization, which was split into a spectral cue-based task (targeting the /ba/–/da/ contrast) and a timing cue-based task (targeting the /b/–/p/ and /d/–/t/ contrasts). Speech sounds were manipulated to contain specific spectral or temporal modulations (formant transitions or voice onset time, respectively) that could be categorized. Categorization responses were quantified using logistic regression to assess perceptual sensitivity to acoustic phonetic cues. Word recognition testing was also conducted for cochlear implant listeners.

Results:
Cochlear implant users were generally less successful at utilizing both spectral and temporal cues for categorization compared with listeners with normal hearing. For the cochlear implant listener group, spectral ripple discrimination was significantly correlated with the categorization of formant transitions; both were correlated with better word recognition. Temporal modulation detection using 100- and 10-Hz-modulated noise was not correlated either with the cochlear implant subjects’ categorization of voice onset time or with word recognition. Word recognition was correlated more closely with categorization of the controlled speech cues than with performance on the psychophysical discrimination tasks.

Conclusions:
When evaluating people with cochlear implants, controlled speech-based stimuli are feasible to use in tests of auditory cue categorization, to complement traditional measures of auditory discrimination. Stimuli based on specific speech cues correspond to counterpart nonlinguistic measures of discrimination, but potentially show better correspondence with speech perception more generally. The ubiquity of the spectral (formant transition) and temporal (voice onset time) stimulus dimensions across languages highlights the potential to use this testing approach even in cases where English is not the native language.
Hearing and Vestibular Function After Preoperative Intratympanic Gentamicin Therapy for Vestibular Schwanomma as Part of Vestibular Prehab
Authors: Tjernström Fredrik , Fransson Per-Anders , Kahlon Babar , Karlberg Mikael , Lindberg Sven , Siesjö Peter , Magnusson Måns 
Published: July 2016

Objective:
To evaluate auditory and vestibular function after presurgical treatment with gentamicin in schwannoma patients.

Background:
The vestibular PREHAB protocol aims at diminishing the remaining vestibular function before vestibular schwannoma surgery, to ensure less acute symptoms from surgery, and initiate a more efficient vestibular rehabilitation already before surgery. However, the potential cochleotoxicity of gentamicin is a concern, since modern schwannoma surgery strives to preserve hearing.

Study design:
Retrospective study.

Setting:
University hospital.

Patients:
Seventeen patients diagnosed with vestibular schwannoma between 2004 and 2011, and took part in vestibular PREHAB program. The patients were of age 21 to 66 years (mean 48.8), 9 females and 8 males.

Intervention:
Intratympanic gentamicin installations before surgery as part of the vestibular PREHAB.

Main outcome measures:
Hearing thresholds, word recognition score, caloric response, subjective visual vertical and horizontal, cVEMP, and vestibular impulse tests.

Results:
Combined analysis of frequency and hearing threshold showed a significant decrease after gentamicin therapy (p < 0.001). Pure-tone average decreased with 7.1 ± 8.5 dB (p = 0.004), and speech recognition with 10%. The treatment resulted in unilateral vestibular deafferentation with no notable reaction to bithermal caloric irrigation (reduction 64%, p < 0.001), loss of the vestibulo-ocular response measured by the head-impulse test, and deviation of subjective horizontal/vertical to the side of the lesion (+2.2 degrees, p = 0.010).

Conclusions:
Intratympanic installations of gentamicin, as part of the vestibular PREHAB, result in unilateral vestibular deafferentation, but constitute a definite risk for high-frequency hearing loss. The hearing results are in line with those reported upon when treating Menière’s disease.
Cervical Sagittal Alignment in Extensive Fusions for Lenke 3C and 6C Scoliosis
Authors: Yanik Hakan Serhat , Ketenci Ismail Emre , Erdem Sevki 
Published: July 2016

Study Design.
A retrospective analysis of cervical sagittal alignment (CSA) in Lenke 3C and 6C adolescent idiopathic scoliosis (AIS).

Objective.
The aim of this study was to evaluate CSA according to upper instrumented vertebra (UIV) level.

Summary of Background Data.
Hypokyphotic effect of extensive fusions of Lenke 3C and 6C curves on thoracic spine leads to kyphotic changes in cervical region. No study has evaluated the CSA in these patients according to UIV level.

Methods.
A total of 55 Lenke 3C and 6C AIS patients who underwent posterior fusion with pedicle screw instrumentation were recruited in this study. Patients were divided into three groups according to UIV level, which was determined preoperatively on the basis of shoulder balance. There were 22, 19, and 14 patients in T2, T3, and T4 groups, respectively. Three groups were similar according to demographic and preoperative coronal and sagittal alignment parameters. Patients were compared at two-year follow-up according to radiographic changes in coronal and sagittal planes. Main sagittal parameters were C2-C7 cervical lordosis (CL), T1 slope, T1-T5, and T5-T12 kyphosis. Clinical outcomes were assessed using scoliosis research society (SRS)-22 and short form (SF)-36 questionnaires.

Results.
In all patients, C2-C7 CL, T5-T12 kyphosis, and T1 slope significantly decreased postoperatively (P < 0.05). The amount of decrease was similar between groups. T1-T5 kyphosis did not change significantly in all groups. Twenty-seven patients had postoperative cervical kyphosis (CK). Thirteen of them had preoperative CL and 14 had CK. Twenty-eight of 41 patients with preoperative CL remained in lordotic CSA postoperatively. SRS-22 and SF-36 scores did not change significantly after the surgery.

Conclusion.
In Lenke 3C and 6C AIS, postoperative CSA is independent from UIV level. Decreased CL is mainly caused by T5-T12 and T1 slope decrease. In order to achieve level shoulders, fusion can be extended to appropriate upper level, without increased risk of CK.

Level of Evidence: 4
Assessment of Cardiac Device Position on Supine Chest Radiograph in the ICU: Introduction and Applicability of the Aortic Valve Location Ratio
Authors: Ouweneel Dagmar M. , Sjauw Krischan D. , Wiegerinck Esther M. A. , Hirsch Alexander , Baan Jan , de Mol Bas A. J. M. , Lagrand Wim K. , Planken R. Nils , Henriques José P. S. 
Published: July 2016

Objectives:
The use of intracardiac assist devices is expanding, and correct position of these devices is required for optimal functioning. The aortic valve is an important landmark for positioning of those devices. It would be of great value if the device position could be easily monitored on plain supine chest radiograph in the ICU. We introduce a ratio-based tool for determination of the aortic valve location on plain supine chest radiograph images, which can be used to evaluate intracardiac device position.

Design:
Retrospective observational study.

Setting:
Large academic medical center.

Patients:
Patients admitted to the ICU and supported by an intracardiac assist device.

Interventions:
We developed a ratio to determine the aortic valve location on supine chest radiograph images. This ratio is used to assess the position of a cardiac assist device and is compared with echocardiographic findings.

Measurements and Main Results:
Supine anterior-posterior chest radiographs of patients with an aortic valve prosthesis (n = 473) were analyzed to determine the location of the aortic valve. We calculated several ratios with the potential to determine the position of the aortic valve. The aortic valve location ratio, defined as the distance between the carina and the aortic valve, divided by the thoracic width, was found to be the best performing ratio. The aortic valve location ratio determines the location of the aortic valve caudal to the carina, at a distance of 0.25 ± 0.05 times the thoracic width for male patients and 0.28 ± 0.05 times the thoracic width for female patients. The aortic valve location ratio was validated using CT images of patients with angina pectoris without known valvular disease (n = 95). There was a good correlation between cardiac device position (Impella) assessed with the aortic valve location ratio and with echocardiography (n = 53).

Conclusions:
The aortic valve location ratio enables accurate and reproducible localization of the aortic valve on supine chest radiograph. This tool is easily applicable and can be used for assessment of cardiac device position in patients on the ICU.
Effectiveness of a flamenco and sevillanas program to enhance mobility, balance, physical activity, blood pressure, body mass, and quality of life in postmenopausal women living in the community in Spain: a randomized clinical trial
Authors: Serrano-Guzmán Maria , Aguilar-Ferrándiz María Encarnación , Valenza Carmen Marie , Ocaña-Peinado Francisco Manuel , Valenza-Demet Gerald , Villaverde-Gutiérrez Carmen 
Published: July 2016

Abstract

Objective:
This study aimed to test the effectiveness of a dance therapy program in improving mobility, balance, physical activity, blood pressure (BP), body mass, and quality of life in postmenopausal women in Spain.

Methods:
Fifty-two sedentary postmenopausal women (mean age 69.27 ± 3.85 y) were randomly assigned to receive either dance therapy (n = 27) or self-care treatment advice (n = 25). The intervention group participated in 2 months of dance therapy, three sessions weekly, based on Spanish folk dance (flamenco and sevillanas). The control group was provided a booklet containing physical activity recommendations. Mobility, balance, physical activity, BP, body mass, and quality of life were assessed at baseline and posttreatment in both groups. Statistical analysis was performed using a 2 × 2 analysis of variance (ANOVA).

Results:
Women in the intervention group showed significant improvements in mobility and balance (timed up-and-go test [P = 0.022], cognitive timed up-and-go [P = 0.029], and one-leg stance test results [P = 0.001]), physical activity (total time index [P = 0.045], energy expenditure [P = 0.007], vigorous physical activity [P = 0.001], leisure activity [P = 0.001], moving [P < 0.001], and activity dimension summary [P = 0.001]), and fitness (overall fitness [P = 0.039], cardiorespiratory fitness [P < 0.001], speed-agility [P = 0.001], and flexibility [P = 0.007]) compared with those in the control group. No differences were observed in BP, body mass, or quality of life.

Conclusions:
Spanish dance therapy may be effective to improve mobility, balance, and levels of physical activity and fitness in sedentary postmenopausal women.
Characterizing the trajectories of vasomotor symptoms across the menopausal transition
Authors: Tepper Ping G. , Brooks Maria M. , Randolph John F. , Crawford Sybil L. , El Khoudary Samar R. , Gold Ellen B. , Lasley Bill L. , Jones Bobby , Joffe Hadine , Hess Rachel , Avis Nancy E. , Harlow Sioban , McConnell Daniel S. , Bromberger Joyce T. , Zheng Huiyong , Ruppert Kristine , Thurston Rebecca C. 
Published: July 2016

Abstract

Objective:
The aim of the study was to investigate the heterogeneity of temporal patterns of vasomotor symptoms (VMS) over the menopausal transition and identify factors associated with these patterns in a diverse sample of women.

Methods:
The Study of Women's Health Across the Nation is a multisite longitudinal study of women from five racial/ethnic groups transitioning through the menopause. The analytic sample included 1,455 women with nonsurgical menopause and a median follow-up of 15.4 years. Temporal patterns of VMS and associations with serum estradiol and follicle-stimulating hormone, race/ethnicity, body mass index, and demographic and psychosocial factors were examined using group-based trajectory modeling.

Results:
Four distinct trajectories of VMS were found: onset early (11 years before the final menstrual period) with decline after menopause (early onset, 18.4%), onset near the final menstrual period with later decline (late onset, 29.0%), onset early with persistently high frequency (high, 25.6%), and persistently low frequency (low, 27.0%). Relative to women with persistently low frequency of VMS, women with persistently high and early onset VMS had a more adverse psychosocial and health profile. Black women were overrepresented in the late onset and high VMS subgroups relative to white women. Obese women were underrepresented in the late onset subgroup. In multivariable models, the pattern of estradiol over the menopause was significantly associated with the VMS trajectory.

Conclusions:
These data distinctly demonstrate heterogeneous patterns of menopausal symptoms that are associated with race/ethnicity, reproductive hormones, premenopause body mass index, and psychosocial characteristics. Early targeted intervention may have a meaningful impact on long-term VMS.
Long-term oral bisphosphonate use in relation to fracture risk in postmenopausal women with breast cancer: findings from the Women's Health Initiative
Authors: Drieling Rebecca L. , LaCroix Andrea Z. , Beresford Shirley A.A. , Boudreau Denise M. , Kooperberg Charles , Chlebowski Rowan T. , Gass Margery , Crandall Carolyn J. , Womack Catherine R. , Heckbert Susan R. 
Published: July 2016

Abstract

Objective:
The aim of the study was to examine the association of long-term oral bisphosphonate use, compared with short-term use, with fracture risk among postmenopausal women with breast cancer.

Methods:
We studied 887 postmenopausal women who were enrolled to the Women's Health Initiative from 1993 to 1998, diagnosed with breast cancer after enrollment, and reported current oral bisphosphonate use of 2 years or more on a medication inventory administered in 2008 to 2009. The outcome of any clinical fracture was ascertained by self-report on an annual study form; a subset of fractures was confirmed with medical records. Women were followed from completion of the medication inventory until 2014. The association between duration of bisphosphonate use reported on the medication inventory and fracture was estimated using multivariate Cox proportional hazards survival models that compared 4 to 7 years and 8 or more years of bisphosphonate use with 2 to 3 years of use.

Results:
On average, women were 76 years of age and were followed for 3.7 (SD 1.1) years. There were 142 clinical fractures. In the multivariate-adjusted analysis for fracture risk factors, 8 or more years of bisphosphonate use was associated with higher risk of fracture compared with 2 to 3 years of use (hazard ratio, 1.67 [95% CI, 1.06-2.62]). There was no significant association of 4 to 7 years of use with fracture.

Conclusions:
Bisphosphonate use of 8 or more years was associated with higher risk of any clinical fracture compared with 2 to 3 years of use. Our findings raise concern about potential harm or decreased effectiveness of long-term bisphosphonate use on fracture risk. The findings warrant confirmatory studies.
Cost Analysis of an Office-based Surgical Suite
Authors: LaBove Gabrielle , Davison Steven P. 
Published: July 2016

Introduction:
Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead.

Methods:
A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates.

Results:
The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy.

Conclusions:
Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult.
A Meta-Analysis of Early versus Delayed Surgery for Valvular Infective Endocarditis Complicated by Embolic Ischemic Stroke
Authors: Mihos Christos G. , Pineda Andres M. , Santana Orlando 
Published: July 2016

Objective An embolic ischemic stroke occurs in 10% to 40% of patients with valvular infective endocarditis (IE) and confers significant morbidity. The optimal timing of valve surgery in this population is not well defined. Methods With the use of PubMed, EMBASE, Ovid, and Cochrane databases, a systematic review identified 14 studies through October 2015 that compared early versus delayed surgery for valvular IE complicated by an ischemic stroke. Early surgery was defined as 3 days or less in one, 7 days or less in eight, and 14 days or less in five studies. Risk ratios (RRs) were calculated by the Mantel-Haenszel method under a fixed- or random-effects model, for the outcomes of perioperative stroke, operative mortality, and 1-year survival. Results A total of 833 patients (early surgery, 330; delayed surgery, 503) were included. The majority of operations were for aortic and/or mitral valve IE, with prosthetic valve IE present in 0% to 60%. Infection with Staphylococcus aureus ranged from 19% to 66%, and heart failure prevalence at the time of operation was 24% to 66%. Early surgery was associated with an increased risk of operative mortality (RR, 1.72; 95% confidence interval [CI], 1.27–2.34; P = 0.0005), which was significant regardless of surgery within the first 7 days (RR, 2.19; 95% CI, 1.45–3.31; P = 0.0002) or 14 days (RR, 1.72; 95% CI, 1.12–2.64; P = 0.01) after stroke. Surgical timing did not affect the risk of perioperative ischemic or hemorrhagic stroke or 1-year survival. Conclusions In patients with valvular IE complicated by ischemic stroke, early surgery is associated with an increased risk of operative mortality, with no observed benefit in 1-year survival.