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R-Nb2O5 has minimal structure changes with cycling and symmetric cycling profiles. With Wadsley–Roth ‘slabs’ and an ‘idealized’ V2O5 structure, metastable R-Nb2O5 bridges understanding of two well-studied families of Li-ion battery electrodes.

Variations in the management of pediatric patients at children's hospitals (CHs) and non-CHs (NCHs) have been well described, especially within the trauma literature. However, little is known about the outcomes and costs of common general surgical procedures at NCHs. The purpose of this study was to evaluate the effect of CH designation on the outcomes and costs of appendectomy and cholecystectomy.The Kids' Inpatient Database (2003-2012) was queried for patients aged under 18 y who underwent appendectomy or cholecystectomy at CHs and NCHs. Outcomes analyzed included disease severity, complications, laparoscopy, length of stay (LOS), and cost.Most of appendectomies and cholecystectomies were performed at NCHs. Overall, CHs cared for younger children were more likely to be teaching hospitals, had higher costs, and longer LOS. On multivariate analysis for appendectomies, CHs were associated with higher rates of perforated appendicitis (OR = 1.53, 95% CI = 1.42-1.66, P 0.001), less complications (OR = 0.68, 95% CI = 0.61-0.75, P 0.001), increased laparoscopy (OR = 2.93, 95% CI = 2.36-3.64, P 0.001), longer LOS (RR = 1.13, 95% CI = 1.09-1.17, P 0.001), and higher costs (exponentiated log $ = 1.19, 95% CI = 1.13-1.24, P 0.001). Multivariate analysis for cholecystectomies revealed that CHs were associated with less laparoscopy (OR = 0.58, 95% CI = 0.50-0.67, P 0.001), longer LOS (RR = 1.26, 95% CI = 1.19-1.34, P 0.001), and higher costs (exponentiated log $ = 1.29, 95% CI = 1.22-1.37, P 0.001) with similar complications. Independent predictors of LOS and cost included CH designation, negative appendectomy, perforated appendicitis, complications, younger age, black patients, and public insurance.Variations in surgical management, outcomes, and costs after appendectomy and cholecystectomy exist between CHs and NCHs. CHs excelled in treating complicated appendicitis. NCHs effectively performed cholecystectomies. These differences in outcomes require further investigation to identify modifiable factors to optimize care across all hospitals for these common surgical diseases.

Background Approximately 50% of patients who receive spinal manipulative therapy (SMT) experience some kind of adverse event (AE), typically benign and transient in nature. Regardless of their severity, mitigating benign AEs is important to improve patient experience and quality of care. The aim of this study was to identify beliefs, perceptions and practices of chiropractors and patients regarding benign AEs post-SMT and potential strategies to mitigate them. Methods Clinicians and patients from two chiropractic teaching clinics were invited to respond to an 11-question survey exploring their beliefs, perceptions and practices regarding benign AEs post-SMT and strategies to mitigate them. Responses were analyzed using descriptive statistics. Results A total of 39 clinicians (67% response rate) and 203 patients (82.9% response rate) completed the survey. Most clinicians (97%) believed benign AEs occur, and 82% reported their own patients have experienced one. For patients, 55% reported experiencing benign AEs post-SMT, with the most common symptoms being pain/soreness, headache and stiffness. While most clinicians (61.5%) reported trying a mitigation strategy with their patients, only 21.2% of patients perceived their clinicians had tried any mitigation strategy. Clinicians perceived that patient education is most likely to mitigate benign AEs, followed by soft tissue therapy and/or icing after SMT. Patients perceived stretching was most likely to mitigate benign AEs, followed by education and/or massage. Conclusions This is the first study comparing beliefs, perceptions and practices from clinicians and patients regarding benign AEs post-SMT and strategies to mitigate them. This study provides an important step towards identifying the best strategies to improve patient safety and improve quality of care.

There is a well-established relationship between surgical volume and outcomes after complex pediatric operations. However, this relationship remains unclear for common pediatric procedures. The aim of our study was to investigate the effect of hospital volume on outcomes after hypertrophic pyloric stenosis (HPS).The Kid's Inpatient Database (2003-2012) was queried for patients with congenital HPS, who underwent pyloromyotomy. Hospitals were stratified based on case volume. Low-volume hospitals performed the lowest quartile of pyloromyotomies per year and high-volume hospitals managed the highest quartile. Outcomes included complications, mortality, length of stay (LOS), and cost.Overall, 2137 hospitals performed 51,792 pyloromyotomies. The majority were low-volume hospitals (n = 1806). High-volume hospitals comprised mostly children's hospitals (68%) and teaching hospitals (96.1%). The overall mortality rate was 0.1% and median LOS was 2 d. High-volume hospitals had lower overall complications (1.8% versus 2.5%, P 0.01) and fewer patients with prolonged LOS (17.0% versus 23.5%, P 0.01) but had similar rates of individual complications, similar mortality, and equivalent median LOS as low-volume hospitals. High-volume hospitals also had higher costs by $1132 per patient ($5494 versus $4362, P 0.01). Regional variations in outcomes and costs exist with higher complication rates in the West and lower costs in the South. There was no association between mortality or LOS with hospital volume or region.Patients with pyloric stenosis treated at high-volume hospitals had no clinically significant difference in outcomes despite having higher costs. Although high-volume hospitals offer improved outcomes after complex pediatric surgeries, they may not provide a significant advantage over low-volume hospitals in managing common pediatric procedures, such as pyloromyotomy for congenital HPS.

A Canadian sports chiropractic research agenda has yet to be defined. The Delphi method can be utilized to achieve this purpose; however, the sample of experts who participate can influence the results. To better inform sample selection for future research agenda development, we set out to determine if differences in opinions about research priorities exist between chiropractors who have their sports specialty designation and those who do not.Fifteen sports clinical practice chiropractors who have their sports fellowship designation and fifteen without, were interviewed with a set of standardized questions about sports chiropractic research priorities. A centering resonance analysis and cluster analysis were conducted on the interview responses.The two practitioner groups differed in their opinions about the type of research that they would like to see conducted, the research that would impact their clinical practice the most, and where they believed research was lacking. However, both groups were similar in their opinions about research collaborations.Sports clinical practice chiropractors, with their sports specialty designation and those without, differed in their opinions about sports chiropractic research priorities; however, they had similar opinions about research collaborations. These results suggest that it may be important to sample from both practitioner groups in future studies aimed at developing research agendas for chiropractic research in sport.Un programme canadien de recherche en chiropratique sportive n’a pas encore été établi. La méthode Delphi peut être utilisée pour atteindre cet objectif; cependant, l’échantillon d’experts qui participent peut influencer les résultats. Afin de mieux informer la sélection d’échantillons pour le développement futur du programme de recherche, nous avons entrepris de déterminer si des différences d’opinions sur les priorités de recherche existent entre les chiropraticiens qui sont spécialisés dans les disciplines sportives et ceux qui ne le sont pas.Quinze chiropraticiens spécialisés en sport ayant une désignation de spécialiste dans le domaine et quinze autres sans cette désignation ont répondu à un ensemble de questions normalisées sur les priorités de la recherche en chiropractie sportive. Les réponses données durant les entretiens ont fait l’objet d’une analyse par recoupement et d’une analyse qui représente les termes dans un réseau qui met en évidence leur fréquence, leur importance et leur influence (centering resonance analysis).Les deux groupes de praticiens ont exprimé des opinions divergentes quant au type de recherche qu’ils souhaitaient voir menée, à la recherche qui aurait le plus d’impact sur leur pratique clinique et aux domaines qui devaient faire l’objet de recherche. Cependant, les deux groupes avaient des réponses similaires sur les collaborations en recherche.Les chiropraticiens spécialisés en sport ayant une désignation de spécialiste dans le domaine et ceux sans cette désignation ont des points de vue différents sur les priorités de la recherche en chiropractie sportive; cependant, ils avaient des opinions similaires sur les collaborations en recherche. Ces résultats suggèrent qu’il peut être important d’inclure des représentants des deux groupes dans les futures études visant à développer des programmes de recherche pour la recherche en chiropratique sportive.

Omohyoid muscle syndrome is a rare cause of an X-shaped bulging lateral neck mass that occurs on swallowing. This is a diagnostic case report of a 22-year-old mixed martial arts athlete who acquired this condition.

Purpose: To describe and discuss the processes used to write scholarly book reviews for publication in peer-reviewed journals and to provide a recommended strategy and book appraisal worksheet to use when conducting book reviews. Methods: A literature search of MEDLINE, EMBASE, CINAHL, and the Index to Chiropractic Literature was conducted in June 2009 using a combination of controlled vocabulary and truncated text words to capture articles relevant to writing scholarly book reviews for publication in peer-reviewed journals. Results: The initial search identified 839 citations. Following the removal of duplicates and the application of selection criteria, a total of 78 articles were included in this review including narrative commentaries (n = 26), editorials or journal announcements (n = 25), original research (n = 18), and journal correspondence pieces (n D 9). Discussion: Recommendations for planning and writing an objective and quality book review are presented based on the evidence gleaned from the articles reviewed and from the authors' experiences. A worksheet for conducting a book review is provided. Conclusions: The scholarly book review serves many purposes and has the potential to be an influential literary form. The process of publishing a successful scholarly book review requires the reviewer to appreciate the book review publication process and to be aware of the skills and strategies involved in writing a successful review.

Stress fractures are troublesome injuries. Sites of occurrence are activity-related and specific anatomical sites are endemic to certain sports. Little is known about stress fracture patterns in golf.A structured review of the literature was conducted to identify the occurrence and injury sites of golf-related stress fractures.A literature search of MEDLINE, CINAHL, and SPORTDiscus was conducted using a combination of controlled vocabulary and truncated text words to capture all articles relevant to golf-related stress fractures. Articles meeting inclusion criteria were descriptively analyzed.The search resulted in 164 articles, of which 13 met the inclusion, and reported 44 cases of golf-related stress fractures. Seven anatomical injury sites were identified with rib stress fracture being the most commonly reported. Stress fractures occurred on the golfer's lead-side in 80% of cases.Golf-related stress fractures are infrequent injuries. The ribs were the most common stress fracture site, and a predilection for lead-side involvement was reported.