bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Satisfaction With, and Outcomes of, Ultrasound-Guided Regional Anesthesia at a Referral Hospital in Tanzania: A Cross-Sectional Study
Authors: Mohamed Shuweikha Salim , Temu Rogers , Komba Leticia F. , Kaino Mwemezi M. , Olotu Frank I. , Ndebea Ansbert S. , Vaughan Brian N. 
Published: February 2023

BACKGROUND:
Regional anesthesia techniques are increasingly used in high-income countries (HICs) for both surgical anesthesia and postoperative analgesia. However, regional anesthesia has not been utilized to the same degree in low- to middle-income countries (LMICs) due to a lack of resources and trained personnel. This study evaluates patient satisfaction with, and outcomes of, ultrasound-guided regional anesthesia for extremity surgery at Kilimanjaro Christian Medical Center (KCMC) in the Northeastern zone of Tanzania.

METHODS:
Study patients were ≥18 years of age; American Society of Anesthesiologists (ASA) physical status I, II, or III; and underwent extremity surgery under peripheral nerve block with ultrasound guidance at KCMC. After placement, blocks were assessed for effectiveness intraoperatively, as demonstrated by the need for supplemental analgesic or sedative medication or conversion to a general anesthetic. Postoperatively, patients were assessed for satisfaction with their nerve block and pain at 12 and 24 hours. Adverse events related to regional anesthesia were assessed immediately, 45 minutes after block placement, and at 12 and 24 hours postoperatively. The primary outcome was patient satisfaction at 12 hours. Secondary outcomes were block success rate and analgesia at 12 and 24 hours postoperatively.

RESULTS:
A convenience sample of 170 patients was included in the study, of whom 156 (95% confidence interval [CI], 87–95) were either satisfied or very satisfied with their block. Block placement was highly successful with only 8 of 170 participants (95% CI, 2.4–8.3), requiring conversion to a general anesthetic. Analgesia continued in the postoperative period, with 164 of 170 (95% CI, 93–98) patients and 145 of 170 (95% CI, 80–90) patients reporting acceptable analgesia at 12 and 24 hours, respectively. No major adverse events, such as local anesthetic toxicity, infection, bleeding, nerve injury, or pneumothorax, were observed.

CONCLUSIONS:
Our study found that ultrasound-guided regional anesthesia in a resource-constrained setting was effective for extremity surgery and resulted in high patient satisfaction. No complications occurred. The use of ultrasound-guided regional anesthesia shows promise for the safe and effective care of patients undergoing extremity surgery in LMICs.
Metastatic Breast Cancer to the Spine: Incidence of Somatic Gene Alterations and Association of Targeted Therapies With Overall Survival
Authors: Rabah Nicholas M. , Jarmula Jakub , Hamza Omar , Khan Hammad A. , Chakravarthy Vikram , Habboub Ghaith , Wright James M. , Steinmetz Michael P. , Wright Christina H. , Krishnaney Ajit A. 
Published: February 2023

BACKGROUND:
The increase in use of targeted systemic therapies in cancer treatments has catalyzed the importance of identifying patient- and tumor-specific somatic mutations, especially regarding metastatic disease. Mutations found to be most prevalent in patients with metastatic breast cancer include TP53, PI3K, and CDH1.

OBJECTIVE:
To determine the incidence of somatic mutations in patients with metastatic breast cancer to the spine (MBCS). To determine if a difference exists in overall survival (OS), progression-free survival, and progression of motor symptoms between patients who do or do not undergo targeted systemic therapy after treatment for MBCS.

METHODS:
This is a retrospective study of patients with MBCS. Review of gene sequencing reports was conducted to calculate the prevalence of various somatic gene mutations within this population. Those patients who then underwent treatment (surgery/radiation) for their diagnosis of MBCS between 2010 and 2020 were subcategorized. The use of targeted systemic therapy in the post-treatment period was identified, and post-treatment OS, progression-free survival, and progression of motor deficits were calculated for this subpopulation.

RESULTS:
A total of 131 patients were included in the final analysis with 56% of patients found to have a PI3K mutation. Patients who received targeted systemic therapies were found to have a significantly longer OS compared with those who did not receive targeted systemic therapies.

CONCLUSION:
The results of this study demonstrate that there is an increased prevalence of PI3K mutations in patients with MBCS and there are a significant survival benefit and delay in progression of motor symptoms associated with using targeted systemic therapies for adjuvant treatment.
Trends in Online Patient Perspectives of Neurosurgeons: A Sentiment Analysis
Authors: Quinones Addison , Tang Justin E. , Vasan Vikram , Li Troy , Schupper Alexander J. , Ali Muhammad , White Christopher A. , Hannah Theodore C. , Asfaw Zerubabbel , Li Adam Y. , Durbin John , Arvind Varun , Kim Jun S. , Choudhri Tanvir F. 
Published: February 2023

BACKGROUND:
Patients increasingly rely on readily available physician reviews to inform their provider choices. Sentiment analysis and machine learning techniques quantitatively analyze written prose to understand patient desires from physician encounters. Patient perspectives on their medical care have been understudied in neurosurgery.

OBJECTIVE:
To analyze patient reviews of neurosurgeons to uncover trends between patient ratings of their encounters and content in their reviews.

METHODS:
Identification of neurosurgeons and demographic data were collected from 115 Accreditation Council for Graduate Medical Education–accredited programs using public data. Healthgrades.com was used to obtain online written and star rating reviews which were analyzed using a machine learning sentiment analysis package to generate a sentiment score. Student t tests compared differences between demographics and outcomes from the sentiment analysis. Multivariate regression was performed to examine associations between sentiment rating and word/word pair frequency.

RESULTS:
One thousand two hundred eighty-four neurosurgeons were found to have review profiles which consisted of 6815 reviews. Analysis revealed a direct correlation between sentiment score and star rating (r2 = 0.554, P < .0001). There were no differences in the sentiment score based on neurosurgeons' sex; however, younger surgeons had more positive reviews (P = .022). Word frequency analysis showed that reviews were less likely to be positive if they included “pain” (odds ratio [OR]: 0.28, CI: 0.24-0.32, P < .0001) or “rude” (OR: 0.03, CI: 0.01-0.06, P < .0001). Reviews were more likely to be positive when they included “kind” (OR: 3.7, CI: 2.6-5.3, P < .0001) or “pain-free” (OR: 3.1, CI: 2.1-4.7, P < .0001).

CONCLUSION:
Top-rated reviews demonstrate the importance of compassion in patient satisfaction. The word “pain” arose for both negative and positive reviews. Pain management seems to be a salient component of patients' evaluation of their neurosurgical care, thereby underscoring the importance of guiding patient pain expectations.
Weanling gut microbiota composition of a mouse model selectively bred for high voluntary wheel-running behavior
Authors: McNamara Monica P. , Venable Emily M. , Cadney Marcell D. , Castro Alberto A. , Schmill Margaret P. , Kazzazi Lawrence , Carmody Rachel N. , Garland, Jr Theodore 
Published: February 2023

ABSTRACTWe compared the fecal microbial community composition and diversity of four replicate lines of mice selectively bred for high wheel-running activity over 81 generations (HR lines) and four non-selected control lines. We performed 16S rRNA gene sequencing on fecal samples taken 24 h after weaning, identifying a total of 2074 bacterial operational taxonomic units. HR and control mice did not significantly differ for measures of alpha diversity, but HR mice had a higher relative abundance of the family Clostridiaceae. These results differ from a study of rats, where a line bred for high forced-treadmill endurance and that also ran more on wheels had lower relative abundance of Clostridiaceae, as compared with a line bred for low endurance that ran less on wheels. Within the HR and control groups, replicate lines had unique microbiomes based on unweighted UniFrac beta diversity, indicating random genetic drift and/or multiple adaptive responses to selection.
Taurine depletion impairs cardiac function and affects tolerance to hypoxia and high temperatures in brook char (Salvelinus fontinalis)
Authors: Dixon Toni-Anne M. , Rhyno Emma-Lee M. , El Nir , McGaw Samuel P. , Otley Nathan A. , Parker Katya S. , Buldo Elena C. , Pabody Claire M. , Savoie Mireille , Cockshutt Amanda , Morash Andrea J. , Lamarre Simon G. , MacCormack Tyson J. 
Published: February 2023

ABSTRACTPhysiological and environmental stressors can cause osmotic stress in fish hearts, leading to a reduction in intracellular taurine concentration. Taurine is a β-amino acid known to regulate cardiac function in other animal models but its role in fish has not been well characterized. We generated a model of cardiac taurine deficiency (TD) by feeding brook char (Salvelinus fontinalis) a diet enriched in β-alanine, which inhibits cardiomyocyte taurine uptake. Cardiac taurine levels were reduced by 21% and stress-induced changes in normal taurine handling were observed in TD brook char. Responses to exhaustive exercise and acute thermal and hypoxia tolerance were then assessed using a combination of in vivo, in vitro and biochemical approaches. Critical thermal maximum was higher in TD brook char despite significant reductions in maximum heart rate. In vivo, TD brook char exhibited a lower resting heart rate, blunted hypoxic bradycardia and a severe reduction in time to loss of equilibrium under hypoxia. In vitro function was similar between control and TD hearts under oxygenated conditions, but stroke volume and cardiac output were severely compromised in TD hearts under severe hypoxia. Aspects of mitochondrial structure and function were also impacted in TD permeabilized cardiomyocytes, but overall effects were modest. High levels of intracellular taurine are required to achieve maximum cardiac function in brook char and cardiac taurine efflux may be necessary to support heart function under stress. Taurine appears to play a vital, previously unrecognized role in supporting cardiovascular function and stress tolerance in fish.
Myofibrillar Protein Synthesis and Acute Intracellular Signaling with Elastic Band Resistance Exercise in Young and Older Men
Authors: MARSHALL RYAN N. , MORGAN PAUL T. , SMEUNINX BENOIT , QUINLAN JONATHAN I. , BROOK MATTHEW S. , ATHERTON PHILIP J. , SMITH KENNETH , WILKINSON DANIEL J. , BREEN LEIGH 
Published: February 2023

ABSTRACT

Purpose
Resistance exercise training (RET) attenuates age-related muscle and strength loss (“sarcopenia”). However, compared with machine-based RET, the efficacy of cost-effective, accessible elastic band RET (EB-RET) for muscle adaptive remodeling lacks supporting mechanistic evidence.

Methods
Eight young (YM; 24 ± 4 yr) and eight older (OM; 68 ± 6 yr) untrained males consumed an oral stable isotope tracer (D2O) combined with serial vastus lateralis muscle biopsies to measure integrated myofibrillar protein synthesis (iMyoPS) and regulatory signaling over ~48 h before (habitual) and after an acute bout of EB-RET (6 × 12 repetitions at ~70% of one-repetition maximum). iMyoPS was determined via gas chromatography–pyrolysis–isotope ratio mass spectroscopy and regulatory signaling expression by immunoblot.

Results
Habitual iMyoPS did not differ between YM and OM (1.62% ± 0.21% vs 1.43% ± 0.47%·d−1, respectively, P = 0.128). There was a significant increase in iMyoPS after EB-RET in YM (2.23% ± 0.69%·d−1, P = 0.02), but not OM (1.75% ± 0.54%·d−1, P = 0.30). EB-RET increased the phosphorylation of key anabolic signaling proteins similarly in YM and OM at 1 h postexercise, including p-IRS-1Ser636/639, p-AktSer473, p-4EBP-1Thr37/46, p-P70S6KThr389, and p-RPS6Ser240/244, whereas p-TSC2Thr1462 and p-mTORSer2448 increased only in YM (all P < 0.05). There were no differences in the expression of amino acid transporters/sensors or proteolytic markers after EB-RET.

Conclusions
iMyoPS was elevated after EB-RET in YM but not OM. However, the increase in acute anabolic signaling with EB-RET was largely similar between groups. In conclusion, the capacity for EB-RET to stimulate iMyoPS may be impaired in older age. Further work may be necessary to optimize prescriptive programming in YM and OM.
Immunomodulatory Function of Interleukin-15 and Its Role in Exercise, Immunotherapy, and Cancer Outcomes
Authors: FARLEY MORGAN J. , BARTLETT DAVID B. , SKINNER TINA L. , SCHAUMBERG MIA A. , JENKINS DAVID G. 
Published: February 2023

ABSTRACT

Exercise has been shown to improve physical and psychosocial outcomes for people across the cancer care continuum. A proposed mechanism underpinning the relationship between exercise and cancer outcomes is exercise-induced immunomodulation via secretion of anti-inflammatory myokines from skeletal muscle tissue. Myokines have the potential to impair cancer growth through modulation of natural killer (NK) cells and CD8+ T cells while improving the effectiveness of cancer therapies. Interleukin-15 (IL-15), one of the most abundant myokines found in skeletal muscle, has a key immunoregulatory role in supporting the proliferation and maturation of T cells and NK cells, which have a key role in the host’s immune response to cancer. Furthermore, IL-15 is being explored clinically as an immunotherapy agent with doses similar to the IL-15 concentrations released by skeletal muscle during exercise. Here we review the role of IL-15 within the immune system, examine how IL-15 is produced as a myokine during exercise, and how it may improve outcomes for people with cancer, specifically as an adjuvant or neoadjuvant to immunotherapy. We summarize the available evidence showing changes in IL-15 in response to both acute exercise and training, and the results are inconsistent; higher quality research is needed to advance the understanding of how exercise-mediated increases in IL-15 potentially benefit those who are being treated for, or who have had, cancer.
Kinesiophobia Is Associated with Peak Knee Abduction Angle during Jump Landing after ACL Reconstruction
Authors: BAEZ SHELBY , COLLINS KATHERINE , HARKEY MATTHEW , BIRCHMEIER THOMAS , TRIPLETT ASHLEY , PIETROSIMONE BRIAN , KUENZE CHRISTOPHER 
Published: February 2023

ABSTRACT

Introduction
This study aimed to investigate the associations between kinesiophobia, knee abduction angle (KAA) during the first 100 ms of landing, and knee flexion excursion (KFE) in individuals 5–12 months after anterior cruciate ligament reconstruction (ACLR). We hypothesized that greater kinesiophobia would be associated with greater peak KAA and lesser KFE during landing on the ACLR limb, but not on the contralateral limb.

Methods
Thirty-six participants between 14 and 35 yr old (females = 19, age = 19.9 ± 5.1 yr, height = 172.5 ± 9.4 cm, weight = 76.7 ± 20.0 kg, time since surgery =7.2 ± 1.7 months) were recruited from a sports medicine clinic at 5–12 months after primary unilateral ACLR. Participants completed the Tampa Scale of Kinesiophobia-11 (TSK-11) to measure kinesiophobia and three successful trials of a standard drop vertical jump task. A 10-camera three-dimensional motion capture system synchronized with two embedded force plate platforms was used to capture jump-landing kinematics. Separate stepwise linear regression models were used to examine the associations between kinesiophobia, peak KAA, and KFE on the ACLR and contralateral limbs after accounting for time since surgery and biological sex.

Results
When accounting for time since surgery and biological sex, every 1-point increase on the TSK-11 (i.e., increase in kinesiophobia) associated with a 0.37° increase (i.e., a 7.1% increase) in ACLR limb KAA (P = 0.02). Kinesiophobia was not associated with contralateral limb KAA, ACLR limb KFE, or contralateral limb KFE.

Conclusions
Higher kinesiophobia was related to greater amounts of peak KAA during landing in individuals 5–12 months post-ACLR. Modifying kinesiophobia may help to decrease KAA and lead to reduced secondary ACL injury risk. Future research should investigate feasible psychological interventions to reduce kinesiophobia and improve KAA in patients post-ACLR.
Effects of Eccentric Resistance Training on Lower-Limb Passive Joint Range of Motion: A Systematic Review and Meta-analysis
Authors: KAY ANTHONY D. , BAXTER BRETT A. , HILL MATHEW W. , BLAZEVICH ANTHONY J. 
Published: February 2023

ABSTRACT

Introduction
Substantial increases in joint range of motion (ROM) have been reported after eccentric resistance training; however, between-study variability and sample size issues complicate the interpretation of the magnitude of effect.

Methods
PubMed, Medline, and SPORTDiscus databases were searched for studies examining the effects of eccentric training on lower-limb passive joint ROM in healthy human participants. Meta-analysis used an inverse-variance random-effects model to calculate the pooled standardized difference (Hedge’s g) with 95% confidence intervals.

Results
Meta-analysis of 22 ROM outcomes (17 studies, 376 participants) revealed a large increase in lower-limb passive joint ROM (g = 0.86 (95% confidence intervals, 0.65–1.08)). Subgroup analyses revealed a moderate increase after 4–5 wk (g = 0.63 (0.27–0.98)), large increase after 6–8 wk (g = 0.98 (0.73–1.24)), and moderate increase after 9–14 wk (g = 0.75 (0.03, 1.46)) of training. Large increases were found in dorsiflexion (g = 1.12 (0.78–1.47)) and knee extension (g = 0.82 (0.48–1.17)), but a small increase in knee flexion was observed (g = 0.41 (0.05–0.77)). A large increase was found after isokinetic (g = 1.07 (0.59–1.54)) and moderate increase after isotonic (g = 0.77 (0.56–0.99)) training.

Conclusions
These findings demonstrate the potential of eccentric training as an effective flexibility training intervention and provide evidence for “best practice” guidelines. The larger effect after isokinetic training despite <50% training sessions being performed is suggestive of a more effective exercise mode, although further research is needed to determine the influence of contraction intensity and to confirm the efficacy of eccentric training in clinical populations.
Prospective Validation of 2B-Cool: Integrating Wearables and Individualized Predictive Analytics to Reduce Heat Injuries
Authors: LAXMINARAYAN SRINIVAS , HORNBY SAMANTHA , BELVAL LUKE N. , GIERSCH GABRIELLE E. W. , MORRISSEY MARGARET C. , CASA DOUGLAS J. , REIFMAN JAQUES 
Published: February 2023

ABSTRACT

Introduction
An uncontrollably rising core body temperature (TC) is an indicator of an impending exertional heat illness. However, measuring TC invasively in field settings is challenging. By contrast, wearable sensors combined with machine-learning algorithms can continuously monitor TC nonintrusively. Here, we prospectively validated 2B-Cool, a hardware/software system that automatically learns how individuals respond to heat stress and provides individualized estimates of TC, 20-min ahead predictions, and early warning of a rising TC.

Methods
We performed a crossover heat stress study in an environmental chamber, involving 11 men and 11 women (mean ± SD age = 20 ± 2 yr) who performed three bouts of varying physical activities on a treadmill over a 7.5-h trial, each under four different clothing and environmental conditions. Subjects wore the 2B-Cool system, consisting of a smartwatch, which collected vital signs, and a paired smartphone, which housed machine-learning algorithms and used the vital sign data to make individualized real-time forecasts. Subjects also wore a chest strap heart rate sensor and a rectal probe for comparison purposes.

Results
We observed very good agreement between the 2B-Cool forecasts and the measured TC, with a mean bias of 0.16°C for TC estimates and nearly 75% of measurements falling within the 95% prediction intervals of ±0.62°C for the 20-min predictions. The early-warning system results for a 38.50°C threshold yielded a 98% sensitivity, an 81% specificity, a prediction horizon of 35 min, and a false alarm rate of 0.12 events per hour. We observed no sex differences in the measured or predicted peak TC.

Conclusion

2B-Cool provides early warning of a rising TC with a sufficient lead time to enable clinical interventions and to help reduce the risk of exertional heat illness.
Effect of Acute Walking on Endothelial Function and Postprandial Lipemia in South Asians and White Europeans
Authors: ROBERTS MATTHEW J. , THACKRAY ALICE E. , WADLEY ALEX J. , ALOTAIBI TAREQ F. , HUNTER DAVID J. , THOMPSON JULIE , FUJIHIRA KYOKO , MIYASHITA MASASHI , MASTANA SARABJIT , BISHOP NICOLETTE C. , O’DONNELL EMMA , DAVIES MELANIE J. , KING JAMES A. , YATES THOMAS , WEBB DAVID , STENSEL DAVID J. 
Published: February 2023

ABSTRACT

Introduction
South Asians (SAs) have an elevated risk of cardiovascular disease (CVD) compared with White Europeans (WEs). Postprandial endothelial function (flow-mediated dilatation (FMD%)) in SA women and SA men with central obesity has not been investigated. Research in other populations has highlighted that a 1% higher FMD% is associated with a ~13% lower risk of future CVD events. We investigated whether FMD% and lipemia, two markers for CVD risk, were higher in SAs versus WEs, whether walking improved FMD% and lipemia, and if there were ethnic differences in the response.

Methods
Lean premenopausal women (study 1; 12 SA, 12 WE) and men with central obesity (study 2; 15 SA, 15 WE) completed two 2-d trials. On day 1, participants walked for 60 min at 60% of their peak oxygen uptake or rested. On day 2, participants rested and consumed two high-fat meals over 8 h. Repeated ultrasound assessments of endothelial function and venous blood samples for CVD risk markers were taken.

Results
Compared with WEs, SAs had lower postprandial FMD% (study 1, −1.32%; study 2, −0.54%) and higher postprandial triacylglycerol concentrations (study 1, 0.31 mmol·L−1·h−1; study 2, 0.55 mmol·L−1·h−1). Walking improved postprandial FMD% (study 1, 1.12%; study 2, 0.94%) and resulted in no significant change or small reductions in postprandial triacylglycerol concentrations (study 1, −0.01 mmol·L−1·h−1; study 2, −0.25 mmol·L−1·h−1). Exercise-induced changes in FMD% and triacylglycerol were consistent between ethnic groups.

Conclusions
Walking mitigated the adverse postprandial effect of a high-fat diet on FMD% to a similar extent in SA and WE women and men, even with no/small improvements in triacylglycerol. This study highlights the importance of exercise to clinically improve FMD% in SAs and WEs.