bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological Risk Factors for Neurological Deficits After Traumatic Mid and Low Lumbar Fractures
Authors: Lee Han-Dong , Jeon Chang-Hoon , Moon Sung-Won , Chung Hee-Woong , Park Ki-Hoon , Chung Nam-Su 
Published: August 2020

Study Design.
Retrospective study.

Objective.
We identified radiological risk factors for neurological deficits in mid and low lumbar spinal fractures.

Summary of Background Data.
Although numerous studies have focused on radiological risk factors for neurological deficits in spinal cord injury or thoracolumbar junction area fractures, few have examined mid and low lumbar fractures at the cauda equina level.

Methods.
We retrospectively reviewed 71 consecutive patients who suffered acute traumatic mid and low lumbar fractures (L2–L5) corresponding to the cauda equina level, as confirmed on magnetic resonance imaging. We defined a neurological deficit as present if the patient had any sensory or motor deficit in the lower extremity or autonomic system at the initial assessment. Various computed tomography parameters of canal stenosis, vertebral body compression, sagittal alignment, interpedicular distance, and presence of vertical laminar fractures were analyzed as independent risk factors to predict neurological deficits using multivariate logistic regression analyses.

Results.
At the initial assessment, 31 patients had neurological deficits. Fracture level, AO fracture type, canal encroachment ratio, vertebral compression ratio, interpedicular distance ratio, and presence of a vertical laminar fracture were significantly associated with the presence of neurological deficits (all P < 0.05). Multivariate logistic regression identified fracture level, canal encroachment ratio (adjusted odds ratio [aOR] 1.072, 95% confidence interval [CI] 1.018–1.129), and vertebral compression ratio (aOR 0.884, 95% CI 0.788–0.992) as independent predictors of a neurological deficit. Receiver operating characteristic curve analyses revealed that only the canal encroachment ratio had good discriminatory ability (area under the curve 0.874, 95% CI 0.791–0.957), and the optimal cutoff was 47% (canal diameter 6.6 mm) with 90.3% sensitivity and 80% specificity.

Conclusion.
The canal encroachment ratio was most strongly associated with neurological deficits in traumatic mid and low lumbar fractures, with an optimal cutoff of 47%.

Level of Evidence: 4
A Screening Tool for Patients With Lumbar Instability
Authors: Chatprem Thiwaphon , Puntumetakul Rungthip , Boucaut Rose , Wanpen Sawitri , Chatchawan Uraiwan 
Published: August 2020

Study Design.
The study is a cross-sectional, diagnostic validity study.

Objective.
The aim of this study was to examine the performance characteristics and validity of an existing lumbar instability questionnaire as a screening tool for lumbar instability among chronic low back pain (CLBP) patients.

Summary of Background Data.
Lumbar instability is an initial stage of more severe spinal pathology. Early screening for this condition should help prevent more structural damage. To meet this need, the present study developed numerical cutoff scores for the lumbar instability screening tool.

Methods.
Lumbar instability screening tool responses and x-ray assessments were reviewed from a sample of 110 patients with CLBP (aged 20–59 years). Receiver operator curves were constructed to optimize sensitivity and specificity of the tool.

Results.
Fourteen (12.73%) patients had radiological lumbar instability. These patients reported a higher mean lumbar instability questionnaire score than those without radiological lumbar instability. A questionnaire score of at least 7 had a sensitivity of 100% (95% CI, 100–100) and a specificity of 26.04% (95% CI = 17.84–34.24) for detecting lumbar instability when compared with x-ray examination. Receiver operator curve analysis revealed the lumbar instability screening had an area under the curve of 0.62 (95% CI, 0.47–0.77).

Conclusion.
A lumbar instability screening tool total score of at least 7 was ruled out lumbar instability in CLBP patients. This cutoff score may be used as a marker of conservative treatment response. The sample size of patients with lumbar instability in this study was small, which may hinder the reliability of the data. Further studies are needed.

Level of Evidence: 4
Postoperative Distal Coronal Decompensation After Fusion to L3 for Adolescent Idiopathic Scoliosis Is Affected by Sagittal Pelvic Parameters
Authors: Kato So , Zeller Reinhard D. , Magana Sofia P. , Ganau Mario , Oshima Yasushi , Tanaka Sakae , Lewis Stephen J. 
Published: August 2020

Study Design.
Retrospective study.

Objective.
To identify on early postoperative radiographs the risk factors for late distal decompensation in adolescent idiopathic scoliosis (AIS) patients undergoing posterior fusion surgery to L3.

Summary of Background Data.
Sparing distal fusion levels in AIS surgery is considered beneficial for postoperative mobility and outcomes; nonetheless, late distal decompensation is of concern. L3 is often advocated as lower instrumented vertebra in posterior fusion, but progressive angulation of the L3/4 disc is commonly observed.

Methods.
A retrospective analysis was conducted on 78 AIS patients who underwent posterior fusion to L3 from 2007 to 2014. Patients’ demographic data, early and 2-year postoperative standing radiographs by biplanar imaging system were investigated. Late decompensation was defined as progressive increase of L3–4 disc wedging angle at 2-year follow-up. Coronal, sagittal, and rotational radiographic parameters were compared between those with and without decompensation. SRS-30 scores were reviewed.

Results.
Mean age was 14.5-year, and fusion levels averaged 12.0 (range: 6–15); 43 out of 78 patients (55%) experienced progressive L3-4 disc wedging, with 6 showing wedging >5°. L3 translation from the central sacral vertical line (13.9 vs. 11.1 mm, P = 0.13) and increased pelvic tilt (13.3° vs. 8.6°, P = 0.06) on the early postoperative radiograph were associated with increased L3-4 disc wedging. Multivariate analysis revealed that larger pelvic tilt was a significant risk factor for decompensation (odds ratio = 1.1 per 1°, 95% confidence interval: 1.0–1.1, P = 0.04). SRS-30 scores did not differ significantly between the two groups (4.0 vs. 4.1, P = 0.44).

Conclusions.
Pelvic retroversion and increased translation of L3 from the central sacral line on the early postoperative radiograph were associated with late L3-4 disc wedging in AIS fusions to L3. Careful surgical planning and correction of sagittal alignment are imperative to ensure the long-term outcomes.

Level of Evidence: 4
Frameless Patient Tracking With Adhesive Optical Skin Markers for Augmented Reality Surgical Navigation in Spine Surgery
Authors: Burström Gustav , Nachabe Rami , Homan Robert , Hoppenbrouwers Jurgen , Holthuizen Ronald , Persson Oscar , Edström Erik , Elmi-Terander Adrian 
Published: August 2020

Study Design.
Observational study.

Objective.
The aim of this study was to evaluate the accuracy of a new frameless reference marker system for patient tracking by analyzing the effect of vertebral position within the surgical field.

Summary of Background Data.
Most modern navigation systems for spine surgery rely on a dynamic reference frame attached to a vertebra for tracking the patient. This solution has the drawback of being bulky and obstructing the surgical field, while requiring that the dynamic reference frame is moved between vertebras to maintain accuracy.

Methods.
An augmented reality surgical navigation (ARSN) system with intraoperative cone beam computed tomography (CBCT) capability was installed in a hybrid operating room. The ARSN system used input from four video cameras for tracking adhesive skin markers placed around the surgical field. The frameless reference marker system was evaluated first in four human cadavers, and then in 20 patients undergoing navigated spine surgery. In each CBCT, the impact of vertebral position in the surgical field on technical accuracy was analyzed. The technical accuracy of the inserted pedicle devices was determined by measuring the distance between the planned position and the placed pedicle device, at the bone entry point.

Results.
The overall mean technical accuracy was 1.65 ± 1.24 mm at the bone entry point (n = 366). There was no statistically significant difference in technical accuracy between levels within CBCTs (P ≥ 0.12 for all comparisons). Linear regressions showed that null- to negligible parts of the effect on technical accuracy could be explained by the number of absolute levels away from the index vertebrae (r
2 ≤ 0.007 for all, β ≤ 0.071 for all).

Conclusion.
The frameless reference marker system based on adhesive skin markers is unobtrusive and affords the ARSN system a high accuracy throughout the navigated surgical field, independent of vertebral position.

Level of Evidence: 3
Comparison of Cranial Facet Joint Violation Rate and Four Other Clinical Indexes Between Robot-assisted and Freehand Pedicle Screw Placement in Spine Surgery
Authors: Zhou Lu-Ping , Zhang Ren-Jie , Li Hui-Min , Shen Cai-Liang 
Published: August 2020

Study Design.
A meta-analysis.

Objective.
Through meta-analysis, whether RA techniques are superior to conventional freehand (FH) techniques was determined in terms of cranial facet joint protection and four other clinical indexes, namely, the accuracy of pedicle screw placement, the number of surgical revision due to malposition, intraoperative radiation dose, and operative time.

Summary of Background Data.
Cranial facet joint violation (FJV) is an important risk factor for adjacent segment degeneration. Some studies recommended the use of robot-assisted (RA) pedicle screw placement in reducing the rate of cranial FJV instead of conventional FH pedicle screw placement. However, the superiority of RA techniques to FH techniques remains controversial.

Methods.
A comprehensive search on PubMed, EMBASE, Cochrane, Web of Science, CNKI, and WanFang was conducted for the selection of potential eligible literature. The outcomes were evaluated in terms of odds ratio (OR) or standardized mean difference and corresponding 95% confidence interval (CI). The meta-analysis was conducted using RevMan 5.3. The subgroup analyses of the violation of the cranial facet joint and the accuracy of pedicle screw placement were performed on the basis of robot type.

Result.
Three randomized controlled trials, two prospective cohort study, and one retrospective cohort study consisting of 783 patients and 2694 cranial pedicle screws were included in the meta-analysis. RA pedicle screw placement was associated with significantly fewer cranial FJVs than FH screw placement. Subgroup analyses showed that the Renaissance (OR = 0.19, 95% CI = 0.07–0.56) and TINAVI (OR = 0.19, 95% CI = 0.09–0.38) robots under RA techniques were associated with significantly fewer cranial FJVs than FH techniques. Furthermore, the RA techniques showed more accurate pedicle screw placement and lower intraoperative radiation dose, equivalent number of surgical revision due to malposition, but longer operative time than the FH techniques.

Conclusion.
The RA (Renaissance and TINAVI) techniques are superior to conventional FH techniques in terms of protecting the cranial facet joint. RA techniques are accurate and safe in clinical application.

Level of Evidence: 2
TOSO interacts with SYK and enhances BCR pathway activation in chronic lymphocytic leukemia
Authors: Zhang Yan-Ru , Yu Zhen , Xiong Wen-Jie , Liu Xu-Xiang , Liu Hui-Min , Cui Rui , Wang Qi , Chen Wen-Ming , Qiu Lu-Gui , Yi Shu-Hua 
Published: August 2020

Abstract

Background
TOSO, also named Fas inhibitory molecule 3 (FAIM3), has recently been identified as an immunoglobulin M (IgM) Fc receptor (FcμR). Previous studies have shown that TOSO is specifically over-expressed in chronic lymphocytic leukemia (CLL). However, the functions of TOSO in CLL remain unknown. The B-cell receptor (BCR) signaling pathway has been reported to be constitutively activated in CLL. Here, we aimed to investigate the functions of TOSO in the BCR signaling pathway and the pathogenesis of CLL.

Methods
We over-expressed TOSO in B-cell lymphoma cell lines (Granta-519 and Z138) by lentiviral transduction and knocked down TOSO by siRNA in primary CLL cells. The over-expression and knockdown of TOSO were confirmed at the RNA level by polymerase chain reaction and protein level by Western blotting. Co-immunoprecipitation with TOSO antibody followed by liquid chromatography coupled with tandem mass spectrometry (IP/LCMS) was used to identify TOSO interacting proteins. Western blotting was performed to detect the activation status of BCR signaling pathways as well as B-cell lymphoma 2 (BCL-2). Flow cytometry was used to examine the apoptosis of TOSO-over-expressing B lymphoma cell lines and TOSO-down-regulated CLL cells via the staining of Annexin V and 7-AAD. One-way analyses of variance were used for intergroup comparisons, while independent samples t tests were used for two-sample comparisons.

Results
From IP/LCMS, we identified spleen tyrosine kinase (SYK) as a crucial candidate of TOSO-interacting protein and confirmed it by co-immunoprecipitation. After stimulation with anti-IgM, TOSO over-expression increased the phosphorylation of SYK, and subsequently activated the BCR signaling pathway, which could be reversed by a SYK inhibitor. TOSO knockdown in primary CLL cells resulted in reduced SYK phosphorylation as well as attenuated BCR signaling pathway. The apoptosis rates of the Granta-519 and Z138 cells expressing TOSO were (8.46 ± 2.90)% and (4.20 ± 1.21)%, respectively, significantly lower than the rates of the control groups, which were (25.20 ± 4.60)% and (19.72 ± 1.10)%, respectively (P < 0.05 for both). The apoptosis rate was reduced after knocking down TOSO in the primary CLL cells. In addition, we also found that TOSO down-regulation in primary cells from CLL patients led to decreased expression of BCL-2 as well as lower apoptosis, and vice versa in the cell line.

Conclusions
TOSO might be involved in the pathogenesis of CLL by interacting with SYK, enhancing the BCR signaling pathway, and inducing apoptosis resistance.
Comparison of various intraocular lens formulas using a new high-resolution swept-source optical coherence tomographer
Authors: Szalai Eszter , Toth Noemi , Kolkedi Zsofia , Varga Csaba , Csutak Adrienne 
Published: August 2020

Purpose:
To compare vergence, artificial intelligence, and combined intraocular lens (IOL) calculation formulas using a new swept-source optical coherence tomographer (SS-OCT) and to analyze their performance based on manifest and estimated refractive outcomes of cataract surgery.

Setting:
Department of Ophthalmology, University of Pécs Medical School, Pécs, Hungary.

Design:
Retrospective data analysis.

Methods:
Optical biometry readings of patients who underwent uneventful cataract removal and implantation of a monofocal acrylic IOL were used to predict IOL power with Barrett Universal II (BUII), Haigis, Hoffer Q, Holladay 1, Radial Basis Function (RBF) 2.0, Kane, Ladas Super Formula, and SRK/T. All the implanted IOLs were calculated by using the Haigis formula. The arithmetic prediction error and median and mean absolute refractive errors for all formulas were computed. The percentage of eyes within ±0.25 diopters (D), ±0.50 D, and ±1.0 D of prediction error was calculated.

Results:
A total of 95 eyes of 95 patients with a mean age of 68.80 ± 7.57 years were included. There was a statistically significant difference in absolute prediction error across the 8 IOL calculation formulas (P < .0001). Haigis showed the lowest mean absolute error, and it differed significantly from the BUII, Hoffer Q, Holladay 1, Ladas, RBF 2.0, and SRK/T formulas (P < .05). In terms of eyes within ±0.25 D, ±0.50 D, and ±1.0 D of prediction error, the Haigis formula showed the overall best performance.

Conclusions:
The results indicated that a recently developed SS-OCT provided accurate ocular biometry measurements before cataract surgery, and the Haigis formula incorporated in its software enabled precise calculation of IOL refractive power.
Home-Based Telework and Presenteeism Across Europe
Authors: Steidelmüller Corinna , Meyer Sophie-Charlotte , Müller Grit 
Published: August 2020

Objective:
Flexible work arrangements such as telework are gaining importance. Although telework is accompanied by advantages for employees such as increased flexibility, current research reveals associations between home-based telework and self-endangering behavior such as sickness presenteeism. As empirical evidence is still scarce, we explore the relationship between home-based telework and sickness presenteeism across Europe.

Methods:
We perform multilevel analyses including 25,465 individuals who responded to the 6th wave of the European Working Conditions Survey 2015.

Results:
Home-based telework is positively related to sickness presenteeism. The results are quite robust across different measures of sickness presenteeism and to several sensitivity analyses.

Conclusion:
Although sickness presenteeism can be functional for specific illnesses, organizations should be aware of possible risks related to home-based telework. They should design telework in a way that it reduces triggers for self-endangering behavior.
Congenital Prepapillary Arterial Convolutions: A Requiem for William F. Hoyt
Authors: Brodsky Michael C. 
Published: August 2020

Abstract:
This vignette describes a diagnostic telephone consultation with Bill Hoyt regarding a 65-year-old man who was found to have an unusual vascular pattern overlying the left optic disc. Bill recognized and characterized this condition as prepapillary arterial convolutions, a congenital vascular anomaly that has never entered the scientific literature. Close inspection disclosed evidence of mild vascular derangement in the contralateral eye as well. The cause of this condition remains unknown.
The Retinal Nerve Fiber Layer: How William F. Hoyt Opened Our Eyes to It
Authors: Monteiro Mário L. R. 
Published: August 2020

Abstract:
Retinal nerve fiber layer (RNFL) assessment based on optical coherence tomography has become an essential structural parameter in the evaluation of the visual pathway. Yet, it was the trailblazing efforts of one individual, William F. Hoyt, MD, who in the 1970s published a series of landmark reports, which lay the foundation for evaluating the RNFL. With the aid of a direct ophthalmoscope, red-free photographic techniques, and an inquisitive mind, Hoyt added an entirely new dimension to the importance of careful ophthalmoscopy. This article chronicles the discoveries and publications that allowed Hoyt and his coworkers to establish the importance of analysis of the RNFL.
Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual practices of people living in Australia
Authors: Coombe Jacqueline , Kong Fabian , Bittleston Helen , Williams Hennie , Tomnay Jane , Vaisey Alaina , Malta Sue , Goller Jane , Temple-Smith Meredith , Bourchier Louise , Lau Andrew , Chow Eric P.F. , Hocking Jane S 
Published: August 2020

ABSTRACTIntroductionAustralia recorded its first case of COVID-19 in late January 2020. On 22ndMarch 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help ‘flatten the curve’. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices.MethodsAn online survey was open from the 23rdApril 2020 to the 11thMay 2020. Participants were recruited online via social media and other networks and were asked to report on their sexual practices in 2019 and during lockdown. Logistic regression was used to calculate the difference (including 95% confidence intervals) in the proportion of sex practices between time periods.ResultsOf the 1187 who commenced the survey, 965 (81.3%) completed it. Overall 70% were female and 66.3% were aged 18 to 29 years. Most (53.5%) reported less sex during lockdown than in 2019. Compared with 2019, participants were more likely to report sex with a spouse (35.3% vs 41.7%; difference=6.4%; 95%CI: 3.6, 9.2) and less likely to report sex with a girl/boyfriend (45.1% vs 41.8%; diff=-3.3%; 95%CI: -7.0, -0.4) or with casual hook-up (31.4% vs 7.8%; 95%CI:-26.9, -19.8). Solo sex activities increased, 14.6% (123/840) reported using sex toys more often and 26.0% (218/838) reported masturbating more often. Dating app use decreased during lockdown compared with 2019 (42.1% vs 27.3%; difference= -14.8%; 95%CI: -17.6, -11.9). Using dating apps for chatting/texting (89.8% vs 94.5%; diff=4.7%; 95%CI:1.0, 8.5) and for setting up virtual dates (2.6% vs 17.2%; diff=14.6%; 95%CI:10.1, 19.2) increased during lockdown.ConclusionAlthough significant declines in sexual activity during lockdown were reported, people did not completely stop engaging in sexual activities during the pandemic, highlighting the importance of ensuring availability of normal sexual and reproductive health services during global emergencies.KEY MESSAGESSexual activity declined among our participants during the COVID-19 lockdown restrictions in Australia, with more than half reporting having less sex than in 2019Sexual practices also changed during lockdown, with more people reporting solo sex activities like masturbating alone or using a sex toy.Use of dating apps also declined among our participants. Of those still using apps, we saw increased use for chatting/texting and setting up virtual dates.
Meta-analysis of the gut microbiome of Parkinson’s disease patients suggests alterations linked to intestinal inflammation
Authors: Romano Stefano , Savva George M. , Bedarf Janis R. , Charles Ian G. , Hildebrand Falk , Narbad Arjan 
Published: August 2020

AbstractThe gut microbiota is emerging as an important modulator of neurodegenerative diseases, and accumulating evidence has linked gut microbes to Parkinson’s disease (PD) symptomatology and pathophysiology. PD is often preceded by gastrointestinal symptoms and alterations of the enteric nervous system accompany the disease. Several studies have analyzed the gut microbiome in PD, but a consensus on the features of the PD-specific microbiota is missing. Here, we conduct a meta-analysis re-analyzing 10 currently available 16S microbiome datasets to investigate whether underlying alterations in the gut microbiota of PD patients exist. We found consistent alterations in PD-associated microbiome, which are significant and robust to confounders across studies, although differences in microbiome structure between PD and controls are limited. Enrichment of the generaLactobacillus, Akkermansia, andBifidobacteriumand depletion of bacteria belonging to the families Lachnospiraceae and Ruminococcaceae, which are important short-chain fatty acids producers, emerged as the most consistent PD gut microbiome alterations. This dysbiosis might result in a pro-inflammatory status which could explain the recurrent gastrointestinal symptoms affecting PD patients.