Publications by authors named "Erich Berg"

8 Publications

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Evaluating for a correlation between osteopathic examination and ultrasonography on thoracic spine asymmetry.

J Osteopath Med 2021 Oct 13;122(1):31-43. Epub 2021 Oct 13.

Department of Anatomy, Midwesetern University, Arizona College of Osteopathic Medicine, Glendale, AZ, USA.

Context: The thoracic spine is a common area of focus in osteopathic manipulative medicine (OMM) for a variety of conditions. Thoracic spine somatic dysfunction diagnosis is achieved by palpating for asymmetry at the tips of the transverse processes (TPs). Previous studies reveal that instead of following the rule of threes, the TPs of a given thoracic vertebra generally align with the spinous process (SP) of the vertebra above. Ultrasonography has been widely utilized as a diagnostic tool to monitor musculoskeletal conditions; it does not utilize ionizing radiation, and it has comparable results to gold-standard modalities. In the case of thoracic somatic dysfunction, ultrasound (US) can be utilized to determine the location of each vertebral TP and its relationship with the SP. Previous studies have investigated the correlation between OMM and ultrasonography of the cervical, lumbar, and sacral regions. However, there has been no study yet that has compared osteopathic structural examination with ultrasonographic examination of the thoracic vertebral region.

Objectives: To examine the relationship between osteopathic palpation and ultrasonographic measurements of the thoracic spine by creating a study design that utilizes interexaminer agreement and correlation.

Methods: The ClinicalTrials.gov study identifier is NCT04823637. Subjects were student volunteers recruited from the Midwestern University (MWU)-Glendale campus. A nontoxic, nonpermanent marker was utilized to mark bony landmarks on the skin. Two neuromusculoskeletal board-certified physicians (OMM1, OMM2) separately performed structural exams by palpating T2-T5 TPs to determine vertebral rotation. Two sonographers (US1, US2) separately scanned and measured the distance from the tip of the SP to the adjacent TPs of the vertebral segment below. Demographic variables were summarized with mean and standard deviation. Interexaminer agreement was assessed with percent agreement, Cohen's Kappa, and Fleiss' Kappa. Correlation was measured by Spearman's rank correlation coefficient. Recruitment and protocols were approved by the MWU Institutional Review Board (IRB).

Results: US had fair interexaminer agreement for the overall most prominent segmental rotation of the T3-T5 thoracic spine, with Cohen's Kappa at 0.27 (0.09, 0.45), and a total agreement percentage at 51.5%. Osteopathic palpation revealed low interexaminer agreement for the overall most prominent vertebral rotation, with Cohen's Kappa at 0.05 (0.0, 0.27), and 31.8%. Segment-specific vertebral analysis revealed slight agreement between US examiners, with a correlation coefficient of 0.23, whereas all other pairwise comparisons showed low agreement and correlation. At T4, US had slight interexaminer agreement with 0.24 correlation coefficient, and osteopathic palpation showed low interexaminer (OMM1 vs. OMM2) agreement (0.17 correlation coefficient). At T5, there was moderate agreement between the two sonographers with 0.44 (0.27, 0.60) and 63.6%, with a correlation coefficient of 0.57, and slight agreement between OMM1 and OMM2 with 0.12 (0.0, 0.28) and 42.4%, with 0.23 correlation coefficient.

Conclusions: This preliminary study of an asymptomatic population revealed that there is a low-to-moderate interexaminer reliability between sonographers, low-to-slight interexaminer reliability between osteopathic physicians, and low interexaminer reliability between OMM palpatory examination and ultrasonographic evaluation of the thoracic spine.
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http://dx.doi.org/10.1515/jom-2021-0020DOI Listing
October 2021

National Institutes of Health Funding in Internal Medicine: Analysis of Physicians Receiving an R01 Grant Between 2008 and 2017.

Cureus 2021 Jan 21;13(1):e12842. Epub 2021 Jan 21.

Emergency Medicine, Kingman Regional Medical Center, Kingman, USA.

Introduction As the world's largest funding source for biomedical research, the National Institutes of Health (NIH) supports physician-scientists with a discipline-specific R01 grant. Recently, scholarly activity disparities regarding investigator degree and gender have been highlighted in the medical literature among allopathic and osteopathic investigators of various medical backgrounds. We aimed to assess trends in internal medicine NIH R01 grants over the past decade. Methodology Internal medicine R01 funding was retrospectively obtained from a centralized online NIH database encompassing 2008 through 2017. Principal investigators (PIs) were then categorized by gender and academic degree(s). Two-way analysis of variance was used to analyze NIH grant funding trends over the time period studied. Results A total of 5,089 NIH R01s were awarded to internal medicine PIs, with an average value per grant of $469,270. Awardees were predominantly male (71.5%, 3,639/5,089). Most awards were issued to PIs with an MD degree (62.4%, 3,173/5,089), followed by PhD degree (36.3%, 1,845/5,089). DOs accounted for five awards over the time period studied (0.15%). MDs were awarded higher funding than PhDs ($466,494 and $421,576, p < 0.001), and females were awarded higher amounts than males ($462,771 and $444,868, p < 0.001). Investigators who held a second degree received more funding than PIs with a single degree ($476,693 and $439,693, p < 0.001). Conclusion In the decade under investigation, both gender and degree disparities existed within NIH R01 funding for PIs in the field of internal medicine, and osteopathic representation accounted for a paucity of R01 funding.
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http://dx.doi.org/10.7759/cureus.12842DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899272PMC
January 2021

Climatic and Environmental Correlates of Dry Eye Disease Severity: A Report From the Dry Eye Assessment and Management (DREAM) Study.

Transl Vis Sci Technol 2020 04 29;9(5):25. Epub 2020 Apr 29.

Department of Ophthalmology, Mayo Clinic, Scottsdale, AZ, USA.

Purpose: Correlate climate, weather parameters, and environmental exposures with the severity of symptoms and signs of dry eye disease (DED) in Dry Eye Assessment and Management (DREAM) study participants.

Methods: Participants from five distinct climates completed the Ocular Surface Disease Index (OSDI) and were examined for corneal and conjunctival staining, tear breakup time (TBUT), and Schirmer's testing at baseline, 3, 6, and 12 months. Climate, weather parameters, and pollutants including ozone (O), carbon monoxide (CO), nitrous oxides (NO, NO, NO), sulfur dioxide (SO), particulate matter, and optical depth were obtained from governmental databases. Multivariate analysis and partial correlation coefficients (ρ) were used to assess associations, adjusted for age, sex, and the presence of Sjögren disease.

Results: Among 535 participants, 81% were female and mean age was 58 years. Participants from the Mediterranean climate demonstrated better corneal fluorescein staining, better TBUT, and higher Schirmer's test scores throughout the calendar year (each < 0.0001). Greater corneal fluorescein staining was associated with lower humidity ( < 0.0038). TBUT measurements positively correlated with temperature, humidity, and dewpoint and inversely correlated with NO levels ( < 0.0038). Paradoxically, some airborne pollutants were associated with less severe signs of dry eye ( < 0.0038). Windspeed was not correlated with signs of DED, and OSDI scores did not correlate with individual environmental exposures.

Conclusions: Dry eye signs differed between climates and local humidity levels. With the exception of NO, airborne pollutants were not associated with detrimental dry eye features.

Translational Relevance: These results support limiting dry air exposure for patients with DED.
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http://dx.doi.org/10.1167/tvst.9.5.25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401914PMC
April 2020

National Institutes of Health Funding in Obstetrics and Gynecology: Analysis of R01 Grants by Degree and Gender.

Cureus 2020 May 17;12(5):e8170. Epub 2020 May 17.

Emergency Medicine, Kingman Regional Medical Center, Kingman, USA.

Introduction: Limited data currently exist regarding the demographics of principal investigators (PIs) in obstetrics and gynecology (OBGYN), who have received an R01 grant from the National Institutes of Health (NIH).

Objective: This study investigated funding differences among gender and advanced degree for PIs in the disciplines of OBGYN.

Methods: Retrospective data were collected from the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) tool to identify OBGYN PIs who received an R01 grant between 2008 and 2017.  Results: Between 2008 and 2017, the NIH awarded 263 R01 grants totaling $113,326,883 in funding to investigators in OBGYN. Male PIs and PIs holding a non-medical degree were awarded the majority of R01 grants (52.47% and 55.51%, respectively). Zero osteopathic (Doctor of Osteopathic Medicine [DO]) physicians were awarded an R01 grant in OBGYN during this time period. Females were awarded larger dollar amounts than males ($449,556 vs $414,003, p=0.04). Allopathic (Doctor of Medicine [MD]) physicians were awarded larger grants than scientists holding a non-medical degree ($467,849 vs $401,291, p<0.01). Both male and female MD physicians were awarded more dollars per grant as compared with PIs holding a non-medical degree (p=0.01 and p<0.01, respectively).

Conclusions: Between 2008 and 2017, a degree disparity was found to exist for investigators who received an NIH R01 grant in OBGYN. Females and investigators holding an MD degree were awarded larger total grants than their male and non-physician counterparts. Further research needs to be undertaken to understand the degree disparity and recent funding trends by the NIH.
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http://dx.doi.org/10.7759/cureus.8170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296887PMC
May 2020

Patterns of Recent National Institutes of Health Funding in Family Medicine: Analysis Using the NIH Research Portfolio Online Reporting Tools Expenditures and Results System.

Cureus 2019 Oct 6;11(10):e5847. Epub 2019 Oct 6.

Emergency Medicine, Kingman Regional Medical Center, Kingman, USA.

Introduction Despite a call for increased research by family-medicine physicians, there is no data on the demographics of those awarded a National Institutes of Health (NIH) R01 grant.  Objective The purpose of the study was to assess recent NIH R01 funding trends over the last decade in family medicine. Methods  A retrospective analysis of NIH R01 grant funding in family medicine was conducted by extracting demographic data from the NIH's Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database from 2008 through 2017. Demographics were reported as percentages, and comparisons of the groups were performed by the t-test.  Results  From 2008 to 2017, the NIH awarded 139 R01 grants to principal investigators (PI) in family medicine. Males comprised 51.80% of all awardees, and those holding a doctorate of medicine (MD) made up 43.88% of the awardees. No one holding a Doctorate of Osteopathic Medicine (DO) degree received an NIH R01 grant during the timeframe studied. A total of 81.97% of all MDs held a dual degree. When gender and degree were considered, no statistical difference was observed for the total amount of dollars awarded.  Conclusion For the years studied, a disparity related to medical degrees was noted for those family-medicine physicians who received an NIH R01 grant. However, no gender disparity was observed.
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http://dx.doi.org/10.7759/cureus.5847DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830844PMC
October 2019

Patterns of Recent National Institutes of Health (NIH) Funding in General Surgery: Analysis Using the NIH RePORTER System.

Cureus 2019 Jun 19;11(6):e4938. Epub 2019 Jun 19.

Emergency Medicine, Kingman Regional Medical Center, Kingman, USA.

Introduction: The National Institutes of Health (NIH) is the world's largest funding source for research, and the R01 grant is seen as a stepping stone to future granting opportunities for the physician-scientist. Recently, both a gender and degree disparity in scholarly activity has been highlighted in the medical literature.  Objective: To assess NIH R01 funding trends in general surgery over the last decade.

Methods: A retrospective review of general surgery funding was extracted from the NIH's Research Portfolio Online Reporting Tools Expenditures and Results database from 2008 through 2017. All principal investigators (PIs) were categorized by gender and academic degree(s). Linear regression analysis assessed NIH grant funding trends over time and comparisons of groups were completed with the t-test.

Results: From 2008 to 2017, the NIH awarded 600 R01 grants and $272,669,397 to PIs in general surgery. The majority of R01 grants were awarded to males (76.33%; p < 0.01) and those holding a Doctorate of Medicine (MD) degree (58.33%; p < 0.01). No Doctorate of Osteopathic Medicine (DO) had received an NIH R01 grant during the time studied. No statistically significant trend could be established for the number of R01 grants awarded over time (p = 0.33), grants awarded to males or females over time (p = 0.73 and p = 0.18), or for those holding an MD or other type of degree over time (p = 0.30 and p = 0.39). Also, no statistically significant trend was established for increased grant funding over time (P = 0.88) but females and those holding an other type of degree (Doctorate in Philosophy (PhD), Doctorate in Science (DSc), Master of Public Health (MPH), etc.) experienced an increase in the total dollar amount of funding over the time studied (p < 0.01 and p < 0.01).  Conclusion: For the years studied, a gender and degree disparity exists for those receiving an NIH R01 grant in general surgery. However, an increase in total grant funding has been seen for both females and non-physician scientists over from 2008 through 2017.
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http://dx.doi.org/10.7759/cureus.4938DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697454PMC
June 2019

Late-onset bleb-associated endophthalmitis and continuous positive airway pressure.

Am J Ophthalmol Case Rep 2018 Jun 8;10:87-90. Epub 2018 Feb 8.

Clinical Research Department, Minnesota Eye Consultants, P.A. 9801 Dupont Avenue S. #200, Bloomington, MN 55431, USA.

Purpose: To raise awareness of a possible association between continuous positive airway pressure (CPAP) devices and postoperative bleb-related infection.

Observations: A 57-year old patient on CPAP presented with unilateral bleb-associated endophthalmitis 32 months after routine ExPress Trabeculectomy with mitomycin C. The offending organism, , is a nonmotile and generally non-virulent pathogen which predominates in the normal human respiratory flora.

Conclusions And Importance: This conceptual report underscores a potential relationship between CPAP use and bleb-associated endophthalmitis. Streptococcal species are the most commonly reported causative organisms in bleb-associated endophthalmitis, and is of particular concern as the most abundant microbe among all human oral flora. A logical risk factor for infection, the CPAP device may inadvertently deliver such organisms to the vulnerable conjunctival filtering bleb.
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http://dx.doi.org/10.1016/j.ajoc.2018.02.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814369PMC
June 2018
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