bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pilot Randomized Controlled Trial of a Phone-based Intervention for Smoking Cessation and Relapse Prevention in the Postpartum Period
Authors: Coleman-Cowger Victoria H. , Mark Katrina S. , Rosenberry Zachary R. , Koszowski Bartosz , Terplan Mishka 
Published: January 2018

Objectives:
To pilot-test a Phone-based Postpartum Continuing Care (PPCC) protocol developed from existing evidence-based approaches to address both postpartum smoking relapse among low-income women who quit smoking during pregnancy and postpartum smoking increase among those who had cut down.

Methods:
One hundred thirty low-income pregnant women who were current or recently quit tobacco smokers were recruited at their first prenatal appointment and randomized to either a Control (standard care) or Experimental (standard care + PPCC) group. An intent-to-treat analysis was conducted on biochemically verified data from 6 in-person interviews during pregnancy and postpartum. Feasibility with regard to recruitment, randomization, assessment, and implementation of PPCC were assessed, along with acceptability among the target population.

Results:
PPCC was found to be feasible and acceptable to some participants, but not all. There were no significant differences in tobacco products per day at 6 months postpartum between groups; however, effect sizes differed at 6 weeks compared with 6 months postpartum. Similarly, there were no significant differences between groups in cessation rate (24% in each group) and past 90-day tobacco use (59 vs 55 days, for Control and Experimental groups, respectively).

Conclusions:
The PPCC intervention did not differentially reduce tobacco use postpartum compared with a controlled comparison group, though it was found to be acceptable among a subpopulation of low-income pregnant women and feasible with regard to recruitment, randomization, assessment procedures, and implementation. Further research is needed to identify an intervention that significantly improves smoking relapse rates postpartum.
The Effect of Melatonin Upon Postacute Withdrawal Among Males in a Residential Treatment Program (M-PAWS): A Randomized, Double-blind, Placebo-controlled Trial
Authors: Bondi Corry D. , Kamal Khalid M. , Johnson David A. , Witt-Enderby Paula A. , Giannetti Vincent J. 
Published: January 2018

Objective:
Assess the effect of melatonin (5 mg) compared with placebo as an adjuvant treatment along with current behavioral and pharmacotherapy for 28 days on weekly self-reported severity of anxiety, depression, stress, and sleep complaints, and also how sleep is affecting daily life in males 18 years of age and older in recovery from substance use at a residential program in south-western Pennsylvania.

Background:
Individuals in recovery experience a variety of symptoms including, but are not limited to, anxiety, depression, sleep difficulties, and stress. In the U.S., melatonin is a readily available nutraceutical that is used to alleviate sleep difficulties. Studies also suggest that melatonin may also have anxiolytic and antidepressive actions alone, as well as in those with co-morbid insomnia. Observation of clinicians treating individuals during and/or post drug cessation indicated that melatonin is commonly provided specifically to alleviate sleep difficulties with little evidence regarding efficacy in this population. The paucity of evidence as well as observation of clinical practices provided the rationale for this randomized clinical trial.

Methods:
A single-center, randomized, double-blind, placebo-controlled, parallel-group trial was conducted. Seventy individuals were enrolled, block-randomized with an allocation ratio of 1:1. Intention-to-treat analysis was performed for all primary outcome measures. Primary outcome measures were assessed with the Generalized Anxiety Disorder Scale (GAD-7), Personal Health Questionnaire Depression Scale (PHQ-8), Perceived Stress Scale (PSS-14), and Pittsburgh Sleep Symptom Questionnaire—Insomnia (PSSQ-1). Secondary outcome measures were to acquire participant characteristics, determine adherence, and document adverse events.

Results:
No statistically significant between-group differences were detected for baseline characteristics. Even though the proportion of individuals reporting an adverse event between groups was not significantly different, the frequency of reported adverse events was greater in the melatonin group. Intention-to-treat analysis for all the measured outcomes revealed no statistically significant between-group differences for same day comparisons.

Conclusions:
The diversity of medication regimens, and also the services provided by the residential treatment site add to the complexity of assessing the efficacy of melatonin on the measured outcomes. Given these limitations, there exists insufficient evidence to suggest that the effect of melatonin and placebo on the outcomes were significantly different.
Preferential peroneal nerve injury after acetabular fracture and reconstruction
Authors: Goyal Kanu S. , Hill Michael , O’Malley Michael , Mehta Manish , Moossy John , Tarkin Ivan 
Published: January 2018

Background:
Sciatic nerve dysfunction typically involving the peroneal division infamously plagues acetabular reconstruction through a posterior exposure. Competing explanations include mechanical compression from retractor placement at the hip versus overstretch. In an effort to improve the current care paradigm, we asked what underlying mechanisms of injury lead to preferential injury to the peroneal division of the sciatic nerve.

Methods:
A cadaver model was established to measure both sciatic nerve strain and intraneural pressure generated during simulated retraction performed during acetabular reconstruction. The tibial and peroneal divisions were studied independently using a micro differential variable reluctance transducer (DVRT) to quantify strain and an angiocatheter to measure intraneural pressure. Measurements were recorded at both the hip and knee.

Results:
Both divisions of the sciatic nerve experienced significantly more pressure at the hip than at the knee. Knee flexion reduced intraneural pressure of the peroneal division at the hip by approximately 30%. Intraneural pressure at the knee was significantly greater in the peroneal versus tibial nerve during knee extension, yet was reduced with knee flexion.

Conclusions:
Our results suggest that direct compression of the peroneal nerve during hip retraction has the most potential to cause iatrogenic sciatic nerve injury. Knee flexion was beneficial for decreasing nerve stretch and pressure. The peroneal division, however, is vulnerable to dysfunction because of the higher intraneural pressures experienced by the tethering effect of the fibular tunnel at the knee.
MRI Is Better Than CT Scan for Detection of Structural Pathologies After Traumatic Posterior Hip Dislocations in Children and Adolescents
Authors: Thanacharoenpanich Songkiat , Bixby Sarah , Breen Michael A. , Kim Young-Jo 
Published: January 2018

Background:
Traumatic posterior hip dislocations in children and adolescents requires emergent closed reduction. Postreduction imaging is necessary to assess the concentricity of reduction and structural injuries to the hip. There is no a consensus for which imaging is a modality of choice in such condition. The purposes of this study are to describe magnetic resonance imaging (MRI) findings of traumatic posterior hip dislocations and to compare the effectiveness of MRI with computerized tomography (CT) in detecting structural abnormalities of the hip that impact patient management.

Methods:
This study is a retrospective review of imaging in traumatically dislocated hips in patients who were treated at our institution. All CT and MRI imaging were reviewed and specific osseous and soft tissue injuries documented by consensus among 2 musculoskeletal pediatric radiologists who interpreted the MRI and CT scans of each patient in a blinded manner.

Results:
In total, 27 patients (23 males, 4 females) with mean age of 12.5 years (range, 2 to 19 y) with postreduction MRI were evaluated. MRI findings revealed femoral head injuries in 17 (62.9%), posterior labral entrapments in 6 (22.2%), posterior labral tears in 17 (62.9%), posterior wall fractures in 15 (55.5%), fracture of the posterior unossified part of acetabulum in 4 (14.8%), and ligamentum teres injuries in 8 (29.6%). Of 16 patients who had postreduction CT scans, 6 (37.5%) had femoral head fractures, 9 (56.3%) had posterior wall fractures, and 8 (50%) had intra-articular osseous entrapments. All bony fractures and intra-articular entrapment could be seen on MRI imaging. In 16 patients with both CT and MRI, posterior acetabular injury was detected in 10/16 (62.5%) on MRI and 9/16 (56.3%) on CT. Three patients with entrapment of labrums identified on MRI could not be seen on CT scan. One patient with persistently unstable hip after reduction had an entrapped unossified portion of acetabular fracture which was seen on MRI but not on CT.

Conclusions:
MRI is superior to CT scan for detection of structural injuries in children and adolescents with traumatic hip dislocation. The unique structural injuries included entrapment of posterior labrum and posterior unossified acetabular fractures could be seen only at MRI. These findings will impact surgical decision making of these injuries.

Level of evidence:
Level IV.
Fracture Patterns Differ Between Osteogenesis Imperfecta and Routine Pediatric Fractures
Authors: Peddada Kranti V. , Sullivan Brian T. , Margalit Adam , Sponseller Paul D. 
Published: January 2018

Background:
It is important to estimate the likelihood that a pediatric fracture is caused by osteogenesis imperfecta (OI), especially the least severe type of OI (type 1).

Methods:
We reviewed records of 29,101 pediatric patients with fractures from 2003 through 2015. We included patients with closed fractures not resulting from motor vehicle accidents, gunshot wounds, nonaccidental trauma, or bone lesions. Patients with OI of any type were identified through International Classification of Diseases-9 code. We randomly sampled 500 pediatric patients in whom OI was not diagnosed to obtain a control (non-OI) group. We reviewed age at time of fracture, sex, fracture type, laterality, and bone and bone region fractured. Bisphosphonate use and OI type were documented for OI patients. Subanalysis of patients with type-1 OI was performed. The Fisher exact and χ2 tests were used to compare fracture rates between groups. P<0.05 was considered significant. Positive likelihood ratios for OI were calculated by fracture pattern.

Results:
The non-OI group consisted of 500 patients with 652 fractures. The OI group consisted of 52 patients with 209 fractures. Non-OI patients were older at the time of fracture (mean, 9.0±5.0 y) than OI patients (mean, 5.5±4.4 y) (P<0.001). OI patients had more oblique, transverse, diaphyseal, and bilateral long-bone fractures than non-OI patients (all P<0.001). Non-OI patients had more buckle (P=0.013), metaphyseal (P<0.001), and physeal (P<0.001) fractures than OI patients. For patients with type-1 OI and long-bone fractures (n=18), rates of transverse and buckle fractures were similar compared with controls. Transverse humerus (15.2), olecranon (13.8), and diaphyseal humerus (13.0) fractures had the highest positive likelihood ratios for OI, and physeal (0.09) and supracondylar humerus (0.1) fractures had the lowest.

Conclusions:
Transverse and diaphyseal humerus and olecranon fractures were most likely to indicate OI. Physeal and supracondylar humerus fractures were least likely to indicate OI. Radiographic fracture pattern is useful for estimating likelihood of OI.

Level of Evidence:
Level III.
Structural and Mechanical Comparison of Human Ear, Alar, and Septal Cartilage
Authors: Bos Ernst Jan , Pluemeekers Mieke , Helder Marco , Kuzmin Nikolay , van der Laan Koen , Groot Marie-Louise , van Osch Gerjo , van Zuijlen Paul 
Published: January 2018

Background:
In the human ear and nose, cartilage plays a key role in establishing its form and function. Interestingly, there is a noticeable paucity on biochemical, structural, and mechanical studies focused on facial cartilage. Such studies are needed to provide elementary knowledge that is fundamental to tissue engineering of cartilage. Therefore, in this study, a comparison is made of the biochemical, structural, and mechanical differences between ear, ala nasi, and septum on the extracellular matrix (ECM) level.

Methods:
Cartilage samples were harvested from 10 cadaveric donors. Each sample was indented 10 times with a nanoindenter to determine the effective Young’s modulus. Structural information of the cartilage was obtained by multiple-photon laser scanning microscopy capable of revealing matrix components at subcellular resolution. Biochemistry was performed to measure glycosaminoglycan (GAG), DNA, elastin, and collagen content.

Results:
Significant differences were seen in stiffness between ear and septal cartilage (P = 0.011) and between ala nasi and septal cartilage (P = 0.005). Elastin content was significantly higher in ear cartilage. Per cartilage subtype, effective Young’s modulus was not significantly correlated with cell density, GAG, or collagen content. However, in septal cartilage, low elastin content was associated with higher stiffness. Laser microscopy showed a distinct difference between ear cartilage and cartilage of nasal origin.

Conclusion:
Proposed methods to investigate cartilage on the ECM level provided good results. Significant differences were seen not only between ear and nasal cartilage but also between the ala nasi and septal cartilage. Albeit its structural similarity to septal cartilage, the ala nasi has a matrix stiffness comparable to ear cartilage.
Impact of Pulmonary Rehabilitation on Exercise Tolerance and Quality of Life in Patients With Idiopathic Pulmonary Fibrosis
Authors: Gomes-Neto Mansueto , Silva Cassio Magalhães , Ezequiel Diego , Conceição Cristiano Sena , Saquetto Micheli , Machado Adelmir Souza 
Published: January 2018

Background:
Patients with pulmonary fibrosis are living longer and present with an increasing number of comorbidities over time. Pulmonary rehabilitation, as a nonpharmacological approach, may be promising in these patients, although there is limited information on the impact of pulmonary rehabilitation on exercise tolerance and quality of life. Thus, conducting a systematic review and meta-analysis, the purpose of this study was to determine the effects of pulmonary rehabilitation on exercise tolerance and quality of life in patients with idiopathic pulmonary fibrosis.

Methods:
We searched MEDLINE, Cochrane Library, Embase, Scielo, PEDro, and CINAHL (from the earliest date available to June 2016) for trials. Study selection included randomized controlled trials (RCTs) that examined the effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis. Two reviewers selected studies independently. Data were extracted from published RCTs. Study quality was evaluated using the PEDro scale. Weighted mean differences, standard mean differences, and 95% CIs were calculated.

Results:
We analyzed data from 5 RCTs comparing a pulmonary rehabilitation group with a control group. Pulmonary rehabilitation improved exercise tolerance weighted mean differences (44 m; 95% CI, 5.3-82.8) compared with no exercise. The meta-analyses also showed significant improvement in symptoms, impact, and total score from the St George's Respiratory Questionnaire for participants in pulmonary rehabilitation compared with control. No serious adverse events were reported.

Conclusion:
Pulmonary rehabilitation is effective in increasing exercise tolerance and improving quality of life in patients with idiopathic pulmonary fibrosis.
Coregulation of endoplasmic reticulum stress and oxidative stress in neuropathic pain and disinhibition of the spinal nociceptive circuitry
Authors: Ge Yanhu , Jiao Yingfu , Li Peiying , Xiang Zhenghua , li Zhi , Wang Long , Li Wenqian , Gao Hao , Shao Jiayun , Wen Daxiang , Yu Weifeng 
Published: January 2018

Abstract
The accumulation of unfolded or misfolded proteins in the endoplasmic reticulum (ER) lumen leads to ER stress, which is related to cellular reactive oxygen species production. Neuropathic pain may result from spinal dorsal horn (SDH) ER stress. In this study, we examined the cause–effect relationship between ER stress and neuropathic pain using the spinal nerve ligation (SNL) rat model. We showed that ER stress was mutually promotive with oxidative stress during the process. We also tested the hypothesis that spinal sensitization arose from reduced activities of GABA-ergic interneurons and that spinal sensitization was mediated by SDH ER stress. Other important findings in this study including the following: (1) nociceptive behavior was alleviated in SNL rat as long as tauroursodeoxycholic acid injections were repeated to inhibit ER stress; (2) inducing SDH ER stress in healthy rat resulted in mechanical hyperalgesia; (3) blocking protein disulfide isomerase pharmacologically reduced ER stress and nociceptive behavior in SNL rat; (4) cells in the dorsal horn with elevated ER stress were mainly neurons; and (5) whole-cell recordings made in slide preparations revealed significant inhibition of GABA-ergic interneuron activity in the dorsal horn with ER stress vs in the healthy dorsal horn. Taken together, results of the current study demonstrate that coregulation of ER stress and oxidative stress played an important role in neuropathic pain process. Inhibiting SDH ER stress could be a potential novel strategy to manage neuropathic pain.
Professionals underestimate patients' pain: a comprehensive review
Authors: Seers Tim , Derry Sheena , Seers Kate , Moore R. Andrew 
Published: January 2018

Abstract
Pain assessment by patients is the rule in clinical trials but may not be in clinical practice. We examined studies comparing assessment of pain by patients and professionals in clinical practice using published studies (1990-2016; ≥20 patients), in English, in an institutional setting, comparing pain assessment within 24 hours by patients and health care professionals. A difference of at least 10% of the maximum score was considered significant. We judged quality on sampling method, blinding, and study size. Eighty studies (20,496 patients) provided data from a range of settings and locations; most (51%) used unbiased sampling, and most (68%) were blind or probably blind. Nine studies with ≥500 patients involved 58% of patients; 60 with <200 patients involved 25%. Large studies were more likely to use comprehensive or random sampling and blinding of patients and professionals. Underestimation of pain by professionals compared with patients was reported by 62/80 studies (78%); there was no difference in 17 (21%) and overestimation in 1 (1%). Underestimation was reported in 75% of large studies (>500 patients), 91% of mid-sized studies (200-400), and 78% of small studies (<200). High-quality studies (blind, comprehensive, or random sampling, >200 patients) consistently reported underestimation (10/11; 91%). The extent of underestimation tended to increase with pain severity. Professionals consistently tend to underestimate pain compared with assessment by patients. This tendency is more pronounced with more severe pain, and the extent of underestimation can be large. It is likely that this contributes to undertreatment of pain.
Functional Outcomes with Externally Powered Partial Hand Prostheses
Authors: Whelan Lynsay R. , Farley Jeremy 
Published: January 2018

ABSTRACT

Introduction
Despite the large number of individuals experiencing partial hand limb loss or deficiency, and the impact of this level of loss on hand function, there is minimal research available regarding the benefit of partial hand externally powered prostheses. The purpose of this research was to explore how using an externally powered partial hand prosthesis contributes to the completion of functional tasks.

Materials and Methods
Fifteen individuals being fit with i-digits partial hand prostheses were evaluated using the Southampton Hand Assessment Procedure (SHAP) and Patient-Specific Functional Scale (PSFS). The individuals were each fit during a 1-week condensed fitting and training process and received 10 to 15 hours of therapy between the prefitting and postfitting testing.

Results
Twelve male and three female clients with four- (with thumb remaining) or five-digit partial hand limb loss or deficiency participated. Average age was 42 years, and 87% had acquired amputations an average of 2.44 years before the fitting. All subjects demonstrated clinically significant change scores on both the PSFS and the SHAP. The individuals with five-digit absence demonstrated marked improvement in comparison with those with four-digit absence; however, both were far superior to the minimal detectable change score for the SHAP, with 42.33 and 19.16 average improvement scores, respectively.

Conclusions
Subjects fit with four- or five-digit externally powered partial hand prostheses demonstrated significant functional improvements in objective hand function and individualized goals. The remnant thumbs of users fit with four-digit systems sometimes exhibited limitations on range of motion or strength. Despite this, their evaluation scores still showed significant improvement; in fact, almost 10 times the minimal detectable change score. For those with five-digit absence, the change was 20 times the minimal threshold. These results suggest the benefit of the i-digits partial hand prosthesis as contributing to the function of individuals with partial hand limb loss or deficiency, particularly with the individuals' priority functional goals.
Prolonged Recurrent Abdominal Pain is Associated With Ongoing Underlying Mucosal Inflammation in Patients who had an Episode of Acute Complicated Diverticulitis
Authors: Lahat Adi , Necula Daniela , Yavzori Miri , Picard Orit , Halperin Sharon , Eliakim Rami , Ben-Horin Shomron 
Published: January 2018

Background:
Recent data suggest continuous chronic inflammation in patients after an acute diverticulitis (AD) episode.

Goals:
The aim of this article was to compare clinical parameters, inflammatory cytokine expression, and immune-cell infiltrates between patients after severe versus nonsevere AD, as defined by radiology examination during the acute episode.

Study:
Sixteen patients, after suffering an episode of AD, were included, and, of them, 8 had severe disease. Demographic data, disease characteristics, and inflammatory markers were collected. Tissue samples from diverticular and unaffected tissue were obtained during colonoscopy. Mucosal inflammation was assessed histologically and by measuring inflammatory cytokine mRNA expression.

Results:
Clinically, continued nonspecific abdominal symptoms were significantly more prevalent among patients after severe AD compared with patients after nonsevere AD (P=0.0002). Patients after severe AD also had significantly higher C reactive protein levels (9.85±7.5 vs. 3±2.1 mg/dL; P=0.027) and tendency for higher calprotectin levels (115.7±85 vs. 35±8.7 mg/g; P=0.08). Reverse transcription polymerase chain reaction–determined cytokines levels were 5.4±4.4, 5.14±10, and 0.8±0.82 for tumor necrosis factor alpha, interleukin-6, and interleukin-1β, respectively, in affected mucosa compared with 1.06±1.57, 1.56±2.1, and 0.35±0.5, respectively, in nonaffected mucosa (P=0.01, 0.05, 0.14, respectively). Cytokine expression in patients after nonsevere AD did not differ significantly between affected and nonaffected mucosa. Histologic scores for crypt distortion, lymphoid aggregates, and lymphocyte infiltration were all significantly higher in patients after severe AD compared with patients after nonsevere AD (P<0.05 for all comparisons).

Conclusions:
Patients after severe AD have more prolonged chronic symptoms, higher inflammatory markers, higher tissue inflammatory cytokine levels, and more inflammatory infiltrates in diverticular colonic tissue than patients after nonsevere AD. These results may contribute to patients’ risk stratification and guide therapeutic decisions.