Leaning in and moving forward: a call to action and review of diversity initiatives in SAGES.

Background: Diversity, equity, and inclusion have been an intentional focus for SAGES well before the COVID-19 pandemic and the coincident societal recognition of social injustices and racism. Longstanding inequities within our society, healthcare, and the surgery profession have come to light in the aftermath of events that rose to attention around the time of Covid. In so doing, they have brought into focus disparities, injustices, and inequalities that have long been present in the field of surgery, selectively affecting the most vulnerable.

The Incidence of Torsades de Pointes With Perioperative Triple Antiemetic Administration.

Background: The safety of triple antiemetic therapy consisting of ondansetron, haloperidol, and a steroid, to surgical patients is unknown.

Objective: To determine the incidence of torsade de pointes (TdP) or death following perioperative administration of triple antiemetic therapy.

Methods: A retrospective cohort study identified 19,874 patients who received 22,202 doses of triple antiemetics during the 2.

Multivesicular body and exosome pathway responses to acute exercise.

New Findings: What is the central question of this study? What is the impact of acute aerobic and aerobic + resistance (concurrent) exercise on the regulation of multivesicular body formation in human skeletal muscle? What is the main finding and its importance? Gene expression for proteins associated with multivesicular body biogenesis was increased in response to concurrent exercise, and gene expression of microRNA processing (genetic information) was increased in response to aerobic and concurrent exercise. A greater understanding of the processing of multivesicular bodies in response to acute exercise may lead to novel treatments focused on intercellular communication pathways.

Abstract: Regular aerobic exercise (AEx) and resistance exercise (REx) promote many beneficial adaptations.

[The use of flumazenil for benzodiazepine associated respiratory depression in postanesthesia recovery: risks and outcomes].

Background And Objectives: The primary aim was to determine risk factors for flumazenil administration during postanesthesia recovery. A secondary aim was to describe outcomes among patients who received flumazenil.

Methods: Patients admitted to the postanesthesia recovery room at a large, academic, tertiary care facility after surgery under general anesthesia from January 1, 2010, to April 30, 2015, were identified and matched to 2 controls each, by age, sex, and surgical procedure.

Patient-reported distress and survival among patients receiving definitive radiation therapy.

Objective: Patient-reported distress (PRD) has not been well assessed in association with survival after radiation therapy (RT). The aims of this study were to evaluate the association between PRD level and survival after definitive RT and to identify the main causes of distress in definitive RT patients.

Methods And Materials: A total of 678 consecutive patients receiving definitive RT at our institution from April 2012 through May 2015 were included.

Opioid Use in Patients with Congestive Heart Failure.

Objective: To understand the relationship between opioid use in patients with congestive heart failure and outcomes, we compared length of stay (LOS), 30-day readmission rates, and 30- and 90-day mortality in patients discharged with a primary diagnosis of congestive heart failure (CHF) who were taking opioids.

Design: Retrospective study design.

Setting: Patients were seen at a 320-bed academic hospital.

Impact of foot progression angle modification on plantar loading in individuals with diabetes mellitus and peripheral neuropathy.

Aims: To determine if participants can reduce foot progression angle (FPA), and if FPA reduction decreases regional plantar stresses and forces in individuals with diabetes.

Methods: Three-group cross-sectional design with repeated measures. twenty-eight participants either with diabetes mellitus (DM), diabetes and peripheral neuropathy with (DMPN+NPU) or without a prior history of ulceration (DMPN-NPU) were studied.

Complexity, fractal dynamics and determinism in treadmill ambulation: Implications for clinical biomechanists.

Background: Reduced inter-stride complexity during ambulation may represent a pathologic state. Evidence is emerging that treadmill training for rehabilitative purposes may constrain the locomotor system and alter gait dynamics in a way that mimics pathological states. The purpose of this study was to examine the dynamical system components of gait complexity, fractal dynamics and determinism during treadmill ambulation.

Life Space Assessment in Spinal Cord Injury.

To examine the Life Space Assessment (LSA) in persons with spinal cord injury (SCI), exploring its psychometric properties, differences between persons with cervical versus thoracolumbar injuries, and cutoff score differentiating a restricted from an unrestricted life space. : We conducted a test-retest reliability study in a community setting involving 50 persons with SCI (25 injured above C7, 25 injured below T1). Data were collected in 2 phone interviews approximately 9 days apart using the LSA.

Influence of Neck Laceration Protectors on Cervical Range of Motion.

Objective: To examine the effect of a hockey neck laceration protector (NLP) on cervical range of motion (ROM) along with the athlete's perception on comfort and restrictiveness. Our hypothesis was that all styles of NLPs would limit cervical ROM compared to no NLP, and that certain designs of NLPs would be perceived as more restrictive and less comfortable.

Design: Cross-sectional observational analytic.

The Relationship Between Serum Neuron-Specific Enolase Levels and Severity of Bleeding and Functional Outcomes in Patients With Nontraumatic Subarachnoid Hemorrhage.

Background: The value of neuron-specific enolase (NSE) in predicting clinical outcomes has been investigated in a variety of neurological disorders.

Objective: To investigate the associations of serum NSE with severity of bleeding and functional outcomes in patients with subarachnoid hemorrhage (SAH).

Methods: We retrospectively reviewed the records of patients with SAH from June 2008 to June 2012.

Impact of fellowship training on robotic-assisted laparoscopic partial nephrectomy: benchmarking perioperative safety and outcomes.

To provide perioperative benchmark data for surgeons entering practice from formal robotic training and performing robotic-assisted laparoscopic partial nephrectomy (RAPN). Perioperative outcomes of the first 100 RAPN from a surgeon entering into practice directly from robotic fellowship training were analyzed. Postoperative complications were categorized by Clavien-Dindo grade.

A comparison of variability in spatiotemporal gait parameters between treadmill and overground walking conditions.

Motorized treadmills are commonly used in biomechanical and clinical studies of human walking. Whether treadmill walking induces identical motor responses to overground walking, however, is equivocal. The purpose of this study was to examine differences in the spatiotemporal gait parameters of the lower extremities and trunk during treadmill and overground walking using comparison of mean and variability values.

Lumbar Traction for Managing Low Back Pain: A Survey of Physical Therapists in the United States.

Study Design: Cross-sectional survey.

Objectives: To examine how many physical therapists use traction, the patients for whom traction is used, the preferred delivery modes/parameters of traction, the supplemental interventions used with traction, and whether professional characteristics influence traction usage.

Background: Several systematic reviews and clinical guidelines have questioned the effectiveness of traction for managing low back pain, yet some patients may benefit from lumbar traction.

Predictors of Delayed Postoperative Respiratory Depression Assessed from Naloxone Administration.

Background: The aim of this study was to identify patient and procedural characteristics associated with postoperative respiratory depression or sedation requiring naloxone intervention.

Methods: We identified patients who received naloxone to reverse opioid-induced respiratory depression or sedation within 48 hours after discharge from anesthetic care (transfer from the postanesthesia care unit or transfer from the operating room to postoperative areas) between July 1, 2008, and June 30, 2010. Patients were matched to 2 control subjects based on age, sex, and exact type of procedure performed during the same year.

Radiographic comparison of cross-sectional lumbar pedicle fill when placing screws with navigation versus free-hand technique.

Background: Pedicle screws are often used for spinal fixation. Increasing the percentage of pedicle that is filled with the screw presumably yields greater fixation. It has not been shown whether spinal navigation helps surgeons more completely fill their instrumented pedicles.

Reliability and accuracy of a goniometer mobile device application for video measurement of the functional movement screen deep squat test.

Background/purpose: The squat is a fundamental movement of many athletic and daily activities. Methods to clinically assess the squat maneuver range from simple observation to the use of sophisticated equipment. The purpose of this study was to examine the reliability of Coach's Eye (TechSmith Corp), a 2-dimensional (2D) motion analysis mobile device application (app), for assessing maximal sagittal plane hip, knee, and ankle motion during a functional movement screen deep squat, and to compare range of motion values generated by it to those from a Vicon (Vicon Motion Systems Ltd) 3-dimensional (3D) motion analysis system.

Influence of body mass index and age on functional outcomes in patients with subarachnoid hemorrhage.

Background: Recent studies have highlighted the obesity paradox where patients with obesity have a greater chance of survival than patients with normal weight.

Objective: To investigate the association between body mass index (BMI) and age with severity of subarachnoid hemorrhage (SAH) and functional outcome.

Methods: We retrospectively reviewed the charts of 274 consecutive patients admitted with SAH between June 2008 and June 2012.

The modified gait abnormality rating scale in patients with a conversion disorder: a reliability and responsiveness study.

Individuals with conversion disorder have neurologic symptoms that are not identified by an underlying organic cause. Often the symptoms manifest as gait disturbances. The modified gait abnormality rating scale (GARS-M) may be useful for quantifying gait abnormalities in these individuals.

Assessment of recent graduates preparedness for entry into practice.

To date no studies have been conducted to assess the preparedness of CRNA graduates for entry into practice by asking graduates and their respective employers to assess specific competencies. The purpose of this study was to assess recent graduates' preparation and performance. It was hypothesized recent graduates are prepared for entry into nurse anesthesia practice.

Coordination tests in persons with acute central nervous system pathology: assessment of interrater reliability and known-group validity.

Background And Purpose: Coordination testing is a standard part of the neurologic examination, yet the psychometric properties of many tests used by practitioners are unknown. This study investigated the interrater reliability and known-group validity of limb coordination tests in participants with acute central nervous system (CNS) pathology.

Methods: Twenty-five participants with CNS pathology completed 20 different limb coordination tests administered at bedside by a physical therapist.

Learning of musculoskeletal ligament stress testing in a gross anatomy laboratory.

Human anatomy in physical therapy programs is a basic science course serving as a foundation for subsequent clinical courses. Integration of anatomy with a clinical emphasis throughout a curriculum provides opportunities for reinforcement of previously learned material. Considering the human cadaver laboratory as a fixed cost to our program, we sought opportunities to add value to the resource via vertical integration into a clinical skills course taught later in the curriculum.

Comparison of muscle-activation patterns during the conventional push-up and perfect· pushup™ exercises.

Manufacturers of Perfect·Pushup™ handgrips claim enhanced muscular recruitment when compared with the conventional hand-on-floor push-up exercise. Electromyographic (EMG) data were recorded using surface electrodes from the right-sided triceps brachii, pectoralis major, serratus anterior (SA), and posterior deltoid muscles during push-ups performed from 3 different hand positions: (a) shoulder width, (b) wide base, and (c) narrow base (NB). Push-ups were performed under 2 conditions: (a) standard push-up and (b) Perfect·Pushup™ handgrips.

Number of strides required for reliable measurements of pace, rhythm and variability parameters of gait during normal and dual task walking in older individuals.

The reliability with which spatiotemporal gait parameters are measured has neither been well-established for variability parameters nor during dual task walking. The purpose of this study was to examine test-retest reliability of three gait parameters representing pace, rhythm and variability in healthy older persons during normal and dual task walking and to determine the number of strides necessary to measure the parameters reliably. Twenty-four healthy adults aged 65 or older participated in the study.

A functional model of the digital extensor mechanism: demonstrating biomechanics with hair bands.

The action of muscles about joints can be explained through analysis of their spatial relationship. A functional model of these relationships can be valuable in learning and understanding the muscular action about a joint. A model can be particularly helpful when examining complex actions across multiple joints such as in the digital extensor mechanism of the hand.