bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Incidence of Adverse Childhood Experiences (ACEs) and Their Association With Pain-related and Psychosocial Impairment in Youth With Chronic Pain
Authors: Nelson Sarah , Simons Laura E. , Logan Deirdre 
Published: September 2017

Objectives:
Adverse childhood experiences (ACEs) in youth have been found to be frequently associated with several chronic illnesses, including chronic pain. However, this relationship remains poorly understood. Previous research has examined the association between ACEs and chronic pain, but these have primarily been examined in the context of adults with limited assessment of ACEs and individual pain conditions. The primary objectives of this study were to examine the incidence and psychological/pain-related correlates of ACEs in a sample of youth with chronic pain. Exploratory analyses were also examined using primary pain diagnosis and number of pain locations.

Methods:
Data were gathered using retrospective data from a clinical databank. Participants were 141 youth aged 9 to 19 with chronic pain who presented for evaluation at a multidisciplinary pain clinic. Information on ACEs exposure, pain diagnostic information, pain-related impairment, and psychosocial functioning were gathered via self-report and retrospective review of the medical record.

Results:
Results revealed that over 80% of youth with chronic pain reported at least 1 ACE in their lifetime. Further, multiple and univariate analyses of variance revealed that ACEs exposure is significantly associated with greater symptoms of anxiety, depression, and fear of pain, with ≥3 ACEs associated with greatest impairment in functioning. No relationships were found between ACEs and increased pain-related disability or pain intensity.

Discussion:
ACEs exposure in youth with chronic pain occurs frequently and can be associated with increased psychosocial but not functional impairment. Future research is needed to further examine the relationship between ACEs and chronic pain in youth in a prospective manner.
Analgesic Effects of Locally Administered Ketorolac-based Analgesics After Breast Surgery
Authors: Chen Jen-Yin , Feng I-Jung , Loh El-Wui , Wang Li-Kai , Lin Chao-Chun , Tam Ka-Wai 
Published: September 2017

Objective:
Reducing postoperative pain following breast surgery is crucial for rapid recovery and shortening hospital stay. Ketorolac, a nonsteroidal anti-inflammatory drug, has been used as a postoperative analgesic in many surgical procedures. We conducted a systemic review and meta-analysis on the efficacy of locally administered ketorolac-based analgesics in managing pain after breast surgery.

Methods:
We searched the PubMed, Embase, Cochrane Library, Scopus, and ClinicalTrials.gov registry for randomized control trials (RCTs) published up to September 2016. The primary outcome was pain level assessed using a visual analog scale (VAS) at 1 and 6 hours following breast surgery.

Results:
We reviewed 4 RCTs with 255 patients. For meta-analysis, VAS at 1 and 6 hours of 3 similar RCTs were compared. At 1 hour, VAS scores were significantly lower in patients administered a ketorolac solution [weighted mean difference (WMD)=−2.04; 95% confidence interval (CI): −3.08 to −1.00] or ketorolac-bupivacaine solution (WMD=−2.30; 95% CI, −4.07 to −0.54) than in controls. At 6 hours, the ketorolac-bupivacaine solution reduced VAS scores significantly (WMD=−1.40; 95% CI, −2.48 to −0.32) compared with controls. However, at 1 hour, the ketorolac solution was significantly more effective than the bupivacaine solution was (WMD=−1.70; 95% CI, −2.81 to −0.59).

Discussion:
The effects of ketorolac-based analgesics vary as per the surgery and disease type. Locally administered ketorolac-based analgesics decreased postoperative pain in breast surgery patients, and the effect of local ketorolac was better than local bupivacaine. Therefore, ketorolac-based analgesics demonstrate considerable local infiltration during pain management after breast surgery.
Translation, Cross-cultural Adaptation and Validation of the Farsi Version of NIH Task Force's Recommended Multidimensional Minimal Dataset for Research on Chronic Low Back Pain
Authors: Noormohammadpour Pardis , Tavana Bahareh , Mansournia Mohammad Ali , Zeinalizadeh Mehdi , Mirzashahi Babak , Rostami Mohsen , Kordi Ramin 
Published: September 2017

Study Design.
Translation and cultural adaptation of the National Institutes of Health (NIH) Task Force's minimal dataset.

Objective.
The purpose of this study was to evaluate validity and reliability of the Farsi version of NIH Task Force's recommended multidimensional minimal dataset for research on chronic low back pain (CLBP).

Summary of Background Data.
Considering the high treatment cost of CLBP and its increasing prevalence, NIH Pain Consortium developed research standards (including recommendations for definitions, a minimum dataset, and outcomes’ report) for studies regarding CLBP. Application of these recommendations could standardize research and improve comparability of different studies in CLBP.

Methods.
This study has three phases: translation of dataset into Farsi and its cultural adaptation, assessment of pre-final version of dataset's comprehensibility via a pilot study, and investigation of the reliability and validity of final version of translated dataset. Subjects were 250 patients with CLBP. Test-retest reliability, content validity, and convergent validity (correlations among different dimensions of dataset and Farsi versions of Oswestry Disability Index, Roland Morris Disability Questionnaire, Fear-Avoidance Belief Questionnaire, and Beck Depression Inventory-II) were assessed.

Results.
The Farsi version demonstrated good/excellent convergent validity (the correlation coefficient between impact dimension and ODI was r = 0.75 [P < 0.001], between impact dimension and Roland-Morris Disability Questionnaire was r = 0.80 [P < 0.001], and between psychological dimension and BDI was r = 0.62 [P < 0.001]). The test-retest reliability was also strong (intraclass correlation coefficient value ranged between 0.70 and 0.95) and the internal consistency was good/excellent (Chronbach's alpha coefficients’ value for two main dimensions including impact dimension and psychological dimension were 0.91 and 0.82 [P < 0.001], respectively). In addition, its face validity and content validity were acceptable.

Conclusion.
The Farsi version of minimal dataset for research on CLBP is a reliable and valid instrument for data gathering in patients with CLBP. This minimum dataset can be a step toward standardization of research regarding CLBP.

Level of Evidence: 3
Organizational and environmental factors influencing hospital community orientation
Authors: Jennings J'Aime C. , Landry Amy Y. , Hearld Larry R. , Weech-Maldonado Robert , Snyder Scott W. , Patrician Patricia A. 
Published: September 2017

Background:
Community orientation refers to hospitals' efforts to assess and meet the health needs of the local population. Variations in the number of community orientation-related activities offered by hospitals may be attributed to differences in organizational and environmental characteristics. Therefore, hospitals have to strategically respond to these internal and external constraints to improve community health. Understanding the facilitators and barriers of hospital community orientation is important to health care managers facing pressure from the external environment to meet the expectations of the community as well as Affordable Care Act guidelines.

Purpose:
The purpose of this study was to examine the organizational and environmental factors that promote or impede hospital community orientation.

Methodology:
A multivariate regression with random effects was conducted using data from the American Hospital Association Annual Survey from 2007 to 2010 and county level data from the Area Health Resource Files.

Findings:
Not-for-profit, system-affiliated, network-affiliated, and larger hospitals have a higher degree of community orientation. In addition, the percentage of the county residents under the age of 65 years with health insurance and hospitals in states with certificate-of-need laws were also positively related to the degree of community orientation. During the study period, it appears that organizational factors mattered more in determining the degree of community orientation.

Practice Implications:
Overall, a better understanding of the factors that influence community orientation can assist hospital administrators and policymakers in stimulating the hospital's role in improving population health and its responsiveness to community health needs. These efforts may occur by building interorganizational relationships or by incentivizing those hospitals that are least likely to be community oriented.
Descemet Membrane Thickening as a Sign for the Diagnosis of Corneal Graft Rejection: An Ex Vivo Study
Authors: VanDenBerg Ryan , Diakonis Vasilios F. , Bozung Alison , Gameiro Gustavo Rosa , Fischer Oliver , El Dakkak Ahmed , Ulloa-Padilla Jan Paul , Anagnostopoulos Apostolos , Dubovy Sander , Abou Shousha Mohamed 
Published: September 2017

Purpose:
To disclose, using an ex vivo study, the histopathological mechanism behind in vivo thickening of the endothelium/Descemet membrane complex (En/DM) observed in rejected corneal grafts (RCGs).

Methods:
Descemet membrane (DM), endothelium, and retrocorneal membranes make up the total En/DM thickness. These layers are not differentiable by high-definition optical coherence tomography; therefore, the source of thickening is unclear from an in vivo perspective. A retrospective ex vivo study (from September 2015 to December 2015) was conducted to measure the thicknesses of DM, endothelium, and retrocorneal membrane in 54 corneal specimens (31 RCGs and 23 controls) using light microscopy. Controls were globes with posterior melanoma without corneal involvement.

Results:
There were 54 corneas examined ex vivo with mean age 58.1 ± 12.2 in controls and 51.7 ± 27.9 years in RCGs. The ex vivo study uncovered the histopathological mechanism of En/DM thickening to be secondary to significant thickening (P < 0.001) of DM (6.5 ± 2.4 μm) in RCGs compared with controls (3.9 ± 1.5 μm).

Conclusions:
Our ex vivo study shows that DM is responsible for thickening of the En/DM in RCGs observed in vivo by high-definition optical coherence tomography and not the endothelium or retrocorneal membrane.
Metabolic regulation of macrophages in tumor microenvironment
Authors: Kim Jaehong , Bae Jong-Sup 
Published: September 2017

Purpose of review
Insight into the metabolic changes in cancer has become so important that cancer is regarded as a disease entity full of metabolic implications. We summarize the recent findings pertaining to cancer cell-derived metabolic changes that regulate the function of macrophages to favor cancer cell survival, and the reported approaches to reverse these changes.

Recent findings
Since the observation and dramatic revitalization of the Warburg effect, metabolic changes were thought to be confined in cancer cells. However, the Warburg effect has recently been proven to exist in various types of immune cells in tumor tissue. A growing number of publications now indicate that cancer cells interact with other cells in the tumor microenvironment, not only through traditional inflammatory mediators, but also through oncometabolites, and that metabolic changes in immune cells by oncometabolites are the key factors favoring the survival of cancer cells and pro-tumoral function of immune cells. Notably, these metabolic changes do not occur uniformly in tumor progression.

Summary
Understanding of the complex metabolic interactions in the tumor microenvironment can not only set a new paradigm for tumor progression, but also provide new breakthroughs to control cancer by modulation of function in tumor-associated macrophages.
New insights into the role of glycosylation in lipoprotein metabolism
Authors: van den Boogert Marjolein A.W. , Rader Daniel J. , Holleboom Adriaan G. 
Published: September 2017

Purpose of review
Human genetics has provided new insights into the role of protein glycosylation in regulating lipoprotein metabolism. Here we review these new developments and discuss the biological insights they provide.

Recent findings
Case descriptions of patients with congenital defects in N-glycosylation (CDG-I) frequently describe a distinct hypocholesterolemia in these rare multisystem clinical syndromes. Two novel CDGs with disturbed Golgi homeostasis and trafficking defects result in mixed glycosylation disorders, hepatic steatosis and hypercholesterolemia. In addition, the presence of particular N-glycans is essential for physiological membrane expression of scavenger receptor B1 and for adequate lipolytic activity of endothelial lipase. GalNAc-T2, a specific O-glycosyl transferase, was found to be a direct modulator of HDL metabolism across mammals, validating its relationship with HDL-c found in genome-wide association studies. Furthermore, genetic variation in ASGR1, the major subunit of the asialoglycoprotein receptor (ASGPR), was found to be associated with a reduction in LDL-c and risk of coronary artery disease.

Summary
Protein glycosylation plays an important regulatory role in lipoprotein metabolism. Greater insight into how protein glycosylation regulates lipoprotein metabolism could provide novel approaches for the treatment of dyslipidemia.
Maximum Step Length Test Performance in People With Parkinson Disease: A Cross-sectional Study
Authors: Duncan Ryan P. , McNeely Marie E. , Earhart Gammon M. 
Published: September 2017

Background and Purpose:
The Maximum Step Length Test (MSLT), a measure of one's capacity to produce a large step, has been studied in older adults, but not in people with Parkinson disease (PD). We characterized performance and construct validity of the MSLT in PD.

Methods:
Forty participants (mean age: 65.12 ± 8.20 years; 45% female) with idiopathic PD completed the MSLT while “OFF” and “ON” anti-PD medication. Construct validity was investigated by examining relationships between MSLT and measures of motor performance. The following measures were collected: Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, gait velocity, 6-minute walk test (6MWT), Movement Disorder Society-Unified Parkinson Disease Rating Scale subsection III (MDS-UPDRS III), and Timed Up and Go (TUG) test. A repeated-measures analysis of variance tested for main effects of medication and stepping direction and the interaction between the 2. Pearson or Spearman correlations were used to assess the relationships between MSLT and motor performance measures (α = 0.05).

Results:
Regardless of medication status, participants stepped further in the forward direction compared with the backward and lateral directions (P < 0.001). Participants increased MSLT performance when ON-medication compared with OFF-medication (P = 0.004). Regardless of medication status, MSLT was moderately to strongly related to Mini-BESTest, TUG, and 6MWT.

Discussion and Conclusions:
People with PD stepped furthest in the forward direction when performing the MSLT. Increased MSLT performance was observed in the ON-medication state compared with OFF-medication; however, the small increase may not be clinically meaningful. Given the relationships between the MSLT and the Mini-BESTest, 6MWT, and TUG, MSLT performance appears to be associated with balance and gait hypokinesia in people with PD.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A186).
Lateral Perturbation-Induced Stepping: Strategies and Predictors in Persons Poststroke
Authors: Gray Vicki L. , Yang Chieh-ling , McCombe Waller Sandy , Rogers Mark W. 
Published: September 2017

Background and Purpose:
Falls commonly occur as weight is transferred laterally, and impaired reactive stepping responses are associated with falls after stroke. The purpose of this study was to examine differences in and the determinants of mediolateral (M-L) protective stepping strategies when pulled off balance toward the paretic and nonparetic sides.

Methods:
Eighteen individuals more than 6 months poststroke were pulled in the M-L direction by a lateral waist-pull perturbation system. Step type (crossover, medial, and lateral) and count were recorded, along with first-step initiation time, length, and clearance. Sensorimotor variables including hip adductor/abductor and ankle plantar flexor/dorsiflexor peak isokinetic torques, paretic foot plantar cutaneous sensation, and motor recovery were used to predict step type by discriminant function analyses (DFAs).

Results:
Regardless of pull direction, nearly 70% of trials required 2 or more recovery steps, with more frequent nonparetic leg first steps, 63.5%. The step type was significantly different for pull direction (P = 0.005), with a greater percentage of lateral steps when pulled toward the nonparetic side (45.1%) compared with the paretic side (17.5%). The M-L step length of the lateral step was increased (P < 0.001), with a reduced step clearance (P = 0.05), when pulled toward the paretic side compared with a pull toward the nonparetic side. DFAs revealed that nonparetic and paretic-side pulls could respectively classify step type 64% and 60% of the time, with foot cutaneous sensation discriminating for pull direction.

Discussion and Conclusions:
Balance recovery initiated with the nonparetic leg occurred more frequently in response to M-L perturbations, and paretic foot cutaneous sensation was an important predictor of the stepping response regardless of the pull direction.

Video Abstract available for more insights from the authors (see Video, Supplementary Digital Content 1, http://links.lww.com/JNPT/A190).
Body Mass Index and Saltwater Drowning
Authors: Byard Roger W. 
Published: September 2017

Abstract
Comparison of body mass index (BMI) was undertaken between 30 cases of salt water drowning and 30 age- and sex-matched controls randomly selected from the autopsy files of Forensic Science SA, Adelaide, Australia, during the period 2000 to 2017. The age range of drowning cases and controls was 18 to 80 (average, 49) years, with a male to female ratio of 19:11. The BMIs of the drowning cases ranged from 15.5 to 37.5 (average, 25.4; median, 23). The control cases had higher BMIs ranging from 22.9 to 44.3 (average, 29.2; median, 25). The number of obese (BMI, ≥30) decedents in the drowning group was 5 (17%) and in the controls was 9 (30%). Individuals who drown in the sea may regularly swim, and thus be fitter and therefore slimmer than more sedentary controls. However, it is also possible that greater amounts of adipose tissue may be protective against drowning, as increased fat stores could improve buoyancy. Thinner individuals with denser body mass may have to struggle more to avoid submersion. It could be that a low BMI is an underappreciated finding that may increase the risk of lethal immersion along with alcohol intoxication and poor swimming skills.
The 1-Year Follow-Up Clinic for Neonates and Children After Respiratory Extracorporeal Membrane Oxygenation Support: A 10-Year Single Institution Experience*
Authors: Kakat Suzan , O’Callaghan Maura , Smith Liz , Hreiche Raymond , Ridout Deborah A. , Wray Jo , Thiruchelvam Timothy , Brown Katherine L. , Hoskote Aparna U. 
Published: September 2017

Objectives:
To establish the effectiveness of a “1-year extracorporeal membrane oxygenation follow-up clinic” and to characterize any neurodevelopmental concerns identified.

Design:
Single-center retrospective cohort of respiratory extracorporeal membrane oxygenation survivors over 10 years.

Setting:
Nationally commissioned center for neonatal and pediatric (> 28 d of life) respiratory extracorporeal membrane oxygenation.

Patients:
Children attending the follow-up clinic 1 year after receiving respiratory extracorporeal membrane oxygenation between 2003 and 2013.

Interventions:
Standardized follow-up 1 year after extracorporeal membrane oxygenation.

Measurements and Main Results:
In 10 years, 290 children received extracorporeal membrane oxygenation, 194 (67%) survived; all were offered 1-year follow-up, and 98 (51%) attended the clinic. Among these, 51 of 98 (52%) had meconium aspiration syndrome, and 74 of 98 (75%) were on veno-arterial extracorporeal membrane oxygenation with a median (interquartile range) duration of 6 days (4–8 d). Neurodevelopmental problems were identified in 30 of 98 (30%). The specific abnormalities noted included neurologic (seizures, motor, or vision abnormalities) (n = 8), hearing with/without language delay (n = 8), and behavioral problems (as reported by parents) (n = 6), with eight of 30 (27%) having difficulties spanning these domains. An acute neurologic event on extracorporeal membrane oxygenation was found to be the only risk factor for neurodevelopmental concerns (p = 0.006 with odds ratio 5.4 [95% CI, 1.63–17.92]). Despite having neither a cardiac arrest nor an acute neurologic event documented, 18 of 74 (24.3%), 95% CI (15.1–35.7), had neurodevelopmental concerns at 1-year follow-up. Among the nonattenders, 30 (15%) had local follow-up, and 66 (34%) were lost to follow-up.

Conclusions:
All extracorporeal membrane oxygenation survivors need follow-up either at the extracorporeal membrane oxygenation center or in their community, as evidenced by the 1-year follow-up data. Our 1-year extracorporeal membrane oxygenation follow-up clinic provides an opportunity to engage with families, identify neurodevelopmental concerns, and signpost to appropriate services. Of concern, one third of survivors are lost to follow-up, some with an acute neurologic event on extracorporeal membrane oxygenation, a significant risk factor. A consensus-based standardized national follow-up program is vital.
Vectra 3D Imaging for Quantitative Volumetric Analysis of the Upper Limb: A Feasibility Study for Tracking Outcomes of Lymphedema Treatment
Authors: Landau Mark J. , Kim Jennifer S. , Gould Daniel J. , Patel Ketan M. 
Published: September 2017

Background:
Secondary lymphedema of the upper limb is a common sequela following lymphadenectomy during oncologic surgery. The gold standard for evaluating treatment outcomes in upper limb lymphedema is limb volume measurement. However, current techniques lack sensitivity to localized changes. In this study, the Vectra 3D imaging system was used to accurately and precisely obtain volume measurements of the upper limb in patients with lymphedema.

Methods:
A feasibility study was performed in 11 patients with lymphedema and 22 upper extremities; 24 arms were evaluated in total. Three-dimensional images were taken of the upper extremities, and Vectra 3D software was used to calculate the volume of the hand, forearm, and upper arm. These measurements were compared to traditional circumference (tape) and water displacement measurements.

Results:
The 24 arm volumes ranged from 1517 to 4050 cc. The Vectra 3D provided precise and accurate volume measurements (average SD ± 1.0 percent of total volume). Measurements of the forearm and upper arm correlated with circumference measurements (R
2 = 0.991) and were in good agreement, with the mean difference between measurement techniques being 2.8 ± 2.0 percent. Three-dimensional measurements of hand, forearm, and upper arm correlated with water measurements (R
2 = 0.990) and had a mean difference between measurement techniques of 2.6 ± 2.1 percent.

Conclusions:
The Vectra 3D system provides precise and accurate data comparable to those of the most commonly used technique to estimate limb volume (tape measurement) and gold-standard water volume measurement. Three-dimensional imaging also offers several advantages, including time efficiency and obtaining localized measurements with high spatial resolution.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, II.