bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Safety and Efficacy in the Surgical Management of Low-tone Neuromuscular Scoliosis: Integrated Approach With a 2-attending Surgeon Operative Team and Modified Anesthesia Protocol
Authors: Ozhan Mehmet O. , Bakircioglu Sancar , Bekmez Senol , Olgun Zeynep D. , Süzer Anil , Demirkiran Halil G. , Yazici Muharrem 
Published: August 2020

Background:
Substantially increased operative time and amount of bleeding may complicate the course of surgical treatment in neuromuscular scoliosis. A well-organized team approach is required to reduce morbidity. The aim of this study is to review our early, short-term surgical outcomes with our new integrated approach that includes a 2-attending surgeon team and modifications in the anesthesia protocol in low-tone neuromuscular scoliosis and compare with a matched cohort of our historic patients.

Methods:
We retrospectively reviewed our patients with (1) neuromuscular scoliosis with collapsing spine deformity, (2) low-tone neuromuscular etiology, (3) multilevel posterior column osteotomies with posterior all pedicle screw spinal fusion, and (4) more than 1-year follow-up. Patients were grouped into 2: group 1 consisted of patients managed with the integrated surgical team approach, group 2 included the matched historic patients.

Results:
There were 16 patients in group 1 and 17 patients in group 2. There was no significant difference between the groups regarding age, sex, body mass index, number of levels fused, major coronal deformity magnitude, pelvic obliquity, number of posterior column osteotomies, or amount of deformity correction. However, significantly shorter operative time (241 vs. 297 min, P=0.006), less intraoperative bleeding (1082 vs. 1852 mL, P=0.001), less intraoperative blood transfusion (2.1 vs. 3.1 U, P=0.028), less postoperative intensive care unit admission (23% vs. 100%, P=0.001), and shorter hospital stay (4.7 vs. 5.9 d, P=0.013) were observed in group 1.

Conclusions:
Our results indicate that spinal deformity surgery in patients with underlying low-tone neuromuscular disease may not be as intimidating as previously thought. Our surgical team approach integrating a 2-attending surgeon operative team, a new anesthetic protocol that includes a modification of perioperative blood management is effective in reducing operative times, blood loss, transfusion rates, intensive care unit admission, and length of hospital stay.

Levels of Evidence:
Level III—retrospective comparative study.
The Majority of Patient-reported Outcome Measures in Pediatric Orthopaedic Research Are Used Without Validation
Authors: Arguelles Gabriel R. , Shin Max , Lebrun Drake G. , Kocher Mininder S. , Baldwin Keith D. , Patel Neeraj M. 
Published: August 2020

Background:
Given that patient-reported outcome measures (PROMs) are increasingly used to inform clinical decision-making, it is vital that they are validated, reliable, responsive, and appropriate for the population under study. The purpose of this systematic review was to assess the rate of PROM use in the pediatric orthopaedic literature, characterize whether each use was in the PROM-validated demographic, and analyze the association between bibliometric factors and the use of PROMs with incomplete validation.

Methods:
The Institute for Scientific Information (ISI) Web of Science database was queried for all clinical pediatric orthopaedic studies from 2014 to 2017. All PROMs were recorded for each study independently by 2 reviewers and cross-referenced with the published orthopaedic literature as of 2017 to determine if the PROM had been validated for the study population. PROMs that had not been validated, had been shown to be invalid, or had conflicting validity studies for use in the population of interest were designated as incompletely validated or used without complete validation. The following covariates were recorded for each study: subspecialty, inclusion of a statistician coauthor, sample size, journal, and the journal impact factor. χ2 analysis was used to evaluate the association between categorical variables and the use of at least 1 incompletely validated PROM.

Results:
In total, 1000 articles were screened, yielding 653 studies that met our inclusion criteria. A total of 104/653 (16%) publications-reported PROMs. PROMs were used without complete validation 120/165 (73%) times, and 77/104 (74%) studies used at least 1 PROM without complete validation. The most frequent reasons for incomplete validation were (1) using PROMs that had been validated in adults, but not pediatrics (n=47; 28.5%), and (2) using PROMs that had been designated in the literature as invalid for pediatrics (n=27; 16.4%). The incomplete validation of at least 1 PROM was associated with smaller sample size (P=0.01) and subspecialty (P<0.01). Overall rates of PROM use and the proportion of PROMs used without complete validation were both found to be higher than those previously reported.

Conclusion:
The majority of pediatric orthopaedic studies reporting PROMs used at least 1 PROM without complete validation for their study population.

Level of Evidence:
Level IV—systematic review of level I, II, III, and IV studies.
Helal Metatarsal Osteotomy in Apert Foot
Authors: Casula Ilaria , Guero Stéphane 
Published: August 2020

Background:
Apert syndrome is a rare condition characterized by a craniosynostosis associated with complex bilateral malformations of the hands and feet. Although correction of syndactyly of the extremities is largely described, just a few authors have focused their attention on the gradual subluxation of the second metatarsal head during child growth, with hyper pressure, hyperkeratosis on the plantar surface and acute pain leading to walking impairment. The aim of this study is to describe our experience with the Helal metatarsal osteotomy technique on this group of patients. An oblique osteotomy performed dorsal to plantar, proximal to distal on the subluxed metatarsal bone is carried out. No internal bone fixation is needed, but a fundamental hypercorrective bandage is placed under the plantar surface. Immediate full weight-bearing, 24 hours after surgery, is highly recommended.

Methods:
Seventeen feet of 12 patients were treated between 2003 and 2018. Corrective osteotomy was performed on a single bone in 13 patients, on 2 bones in 3 patients, and on 3 bones on 1 patient. The mean follow-up was 5 years, with a physical examination once a year.

Results:
No complication such as infection or delayed wound healing was registered. X-rays taken 3 weeks after surgery showed complete bone consolidation and a correction of the previous plantarflexed position of the metatarsal with consistent reduction of pressure and pain for every patient who was able to wear normal shoes again after surgery.

Conclusion:
The Helal metatarsal osteotomy is a safe, reproducible, and feasible technique that should be considered in cases of painful metatarsal head plantar subluxation in Apert feet.

Level of Evidence:
Level IV.
Comparison of Iliac and Femoral Autograft Practices in Pemberton Pelvic Osteotomy
Authors: Bulut Mehmet , Azboy Ibrahim , Ozkul Emin , Karakurt Lokman 
Published: August 2020

Background:
There is no consensus in regard to grafts used after pelvic osteotomy in developmental dysplasia of the hip in the literature. The aim of this study was to compare iliac and femoral autografts used after Pemberton pelvic osteotomy (PPO).

Methods:
In this prospective, randomized study, 60 hips with dysplasia of the hip were included. All patients underwent open reduction, PPO, and femoral shortening osteotomy. Iliac autograft (group I; n=30 hips; mean age, 39.07; range, 18 to 72 mo) and femoral autograft (group II; n=30 hips; mean age, 42.53; range, 19 to 70 mo) were used to fill the iliac osteotomy. The height and width of the iliac and femoral autografts were measured intraoperatively. Anteroposterior pelvic radiographs were obtained on the 45th day, and in the 2nd, 3rd, 6th, and 12th months postoperatively. Acetabular index angle, height of the graft, loss of graft position, graft resorption, operative time, blood loss, and union time were compared between the groups.

Results:
There was a significant difference in each group in terms of loss of graft height between the intraoperative measurement and the postoperative measurement at the 6th week and 3rd month. The intraoperative width of the grafts was significantly greater, loss of graft height was significantly less, and the amount of bleeding was significantly lower in group II (P<0.001 for all 3). However, time to union was significantly shorter in group I (P<0.001). There was no significant difference between the groups in terms of acetabular index angle at the last controls. There were loss of graft position in 2 cases and graft resorption in 1 case for group I, but no such cases occurred for group II.

Conclusions:
Graft height and position loss, donor site morbidity, and graft resorption were less in the femoral autografts group compared with the iliac autografts group in the treatment PPO with femoral shortening osteotomy.

Level of Evidence:
Level II.
Core Outcomes Set for Trials in People With Coronavirus Disease 2019
Authors: Tong Allison , Elliott Julian H. , Azevedo Luciano Cesar , Baumgart Amanda , Bersten Andrew , Cervantes Lilia , Chew Derek P. , Cho Yeoungjee , Cooper Tess , Crowe Sally , Douglas Ivor S. , Evangelidis Nicole , Flemyng Ella , Hannan Elyssa , Horby Peter , Howell Martin , Lee Jaehee , Liu Emma , Lorca Eduardo , Lynch Deena , Marshall John C. , Gonzalez Andrea Matus , McKenzie Anne , Manera Karine E. , McLeod Charlie , Mehta Sangeeta , Mer Mervyn , Morris Andrew Conway , Nseir Saad , Povoa Pedro , Reid Mark , Sakr Yasser , Shen Ning , Smyth Alan R. , Snelling Tom , Strippoli Giovanni FM , Teixeira-Pinto Armando , Torres Antoni , Turner Tari , Viecelli Andrea K. , Webb Steve , Williamson Paula R. , Woc-Colburn Laila , Zhang Junhua , Craig Jonathan C. 
Published: August 2020

Objectives:
The outcomes reported in trials in coronavirus disease 2019 are extremely heterogeneous and of uncertain patient relevance, limiting their applicability for clinical decision-making. The aim of this workshop was to establish a core outcomes set for trials in people with suspected or confirmed coronavirus disease 2019.

Design:
Four international online multistakeholder consensus workshops were convened to discuss proposed core outcomes for trials in people with suspected or confirmed coronavirus disease 2019, informed by a survey involving 9,289 respondents from 111 countries. The transcripts were analyzed thematically. The workshop recommendations were used to finalize the core outcomes set.

Setting:
International.

Subjects:
Adults 18 years old and over with confirmed or suspected coronavirus disease 2019, their family members, members of the general public and health professionals (including clinicians, policy makers, regulators, funders, researchers).

Interventions:
None.

Measurements:
None.

Main Results:
Six themes were identified. “Responding to the critical and acute health crisis” reflected the immediate focus on saving lives and preventing life-threatening complications that underpinned the high prioritization of mortality, respiratory failure, and multiple organ failure. “Capturing different settings of care” highlighted the need to minimize the burden on hospitals and to acknowledge outcomes in community settings. “Encompassing the full trajectory and severity of disease” was addressing longer term impacts and the full spectrum of illness (e.g. shortness of breath and recovery). “Distinguishing overlap, correlation and collinearity” meant recognizing that symptoms such as shortness of breath had distinct value and minimizing overlap (e.g. lung function and pneumonia were on the continuum toward respiratory failure). “Recognizing adverse events” refers to the potential harms of new and evolving interventions. “Being cognizant of family and psychosocial wellbeing” reflected the pervasive impacts of coronavirus disease 2019.

Conclusions:
Mortality, respiratory failure, multiple organ failure, shortness of breath, and recovery are critically important outcomes to be consistently reported in coronavirus disease 2019 trials.
Up-regulation of circular RNA hsa_circ_01844 induces apoptosis and suppresses proliferation and migration of glioblastoma cells
Authors: Zhou Jin-Xu , Chen Ke-Fei , Hu Shuai , Dong Ji-Rong , Wang Hong-Xiang , Su Xin , Wang Yu-Hai , Chu Jun-Sheng 
Published: August 2020

Abstract

Background
Previous studies have demonstrated that various circular RNAs are involved in the malignant proliferation of cancers, such as liver cancer, lung cancer, breast cancer, and others. The potential role of circular RNAs in glioblastoma, however, is still uncertain. In this study, we aimed to study the potential role of hsa_circ_01844 in glioblastoma.

Methods
Using reverse transcription-polymerase chain reaction (RT-PCR) method, hsa_circ_01844 expression was measured in five glioblastoma samples and five normal brain samples. To evaluate the potential function of hsa_circ_01844 in glioblastoma, hsa_circ_01844 was overexpressed in glioblastoma cell lines (U251 and U87 cells). Using these two cell lines, in vitro experiments including the flow cytometry assay, 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay, Transwell assay, and cell apoptosis assay were performed to investigate the role of hsa_circ_01844 in glioblastoma. Student t test and one-way analysis of variance were used for statistical analysis.

Results
The expression of circular RNA hsa_circ_01844 was lower in glioblastoma tissues when compared with the normal brain tissues by RT-PCR method (0.034 ± 0.036 vs. 1.630 ± 0.891, P < 0.001). Using two glioblastoma cell lines, we found that overexpression of hsa_circ_01844 in glioblastoma cells suppressed their proliferation, colony formation, migration, and increased the apoptotic rate compared with empty vector group and blank control group (all P < 0.05).

Conclusion
Hsa_circ_01844 shows decreased expression in glioblastoma and its overexpression induces apoptosis and inhibits proliferation, migration, and invasion of glioblastoma cells.
The Influence of Intrinsic Motivation on Pay Satisfaction Among Caregivers in Residential Home for the Elderly in China: The Mediating Role of Job Burnout
Authors: WANG Enjian , HU Hongwei , LIU Hongting , MAO Shan , CHANG Ruihua , JIANG Wei 
Published: August 2020

ABSTRACT

Background
According to the theory of compensating differentials, caregivers with high levels of intrinsic motivation should exhibit a higher-than-average satisfaction with their pay. Whereas studies conducted in Western countries have provided empirical evidence for the theory of compensating differentials in various care settings, few studies have been conducted in China that focus on caregivers employed in residential homes for the elderly (RHE). The sociodemographic characteristics of caregivers in China different significantly from their counterparts in Western countries.

Purpose
This study was developed to analyze the mediating role of job burnout to assess the influence of intrinsic motivation on pay satisfaction among caregivers in RHE.

Methods
Structural equation modeling was used to examine the influences of intrinsic motivation on pay satisfaction in a sample of 1,212 caregivers employed in RHE in China by analyzing the mediating role of job burnout.

Results
Intrinsic motivation was found to relate positively to pay satisfaction (β = .11, p < .05). Negative relationships were identified between intrinsic motivation and job burnout (β = −.46, p < .01) and between job burnout and pay satisfaction (β = −.13, p < .01). Job burnout was found to have a significant mediating effect on the relationship between intrinsic motivation and pay satisfaction (β = .06, p < .01).

Conclusions/Implications for Practice
A significant relationship was found between intrinsic motivation and pay satisfaction, with job burnout playing a mediating role in caregivers employed in RHE in China. This research has profound implications for nursing education, practice, and research. First, greater efforts should be focused on instilling nursing values in nursing students to foster intrinsic motivation. Second, nonpecuniary rewards may be offered to caregivers to acknowledge the values of care work and strengthen intrinsic motivation. Third, a supportive working climate should be fostered to reduce job burnout. Fourth, caregivers should be informed of their rights to decent pay and their right to bargain collectively through unions. Fifth, appropriate public policies should be implemented to provide pay for caregivers at levels that recognize and appreciate their intrinsic motivation.
Appropriate use of multimodality stress testing for chest pain in new patient referrals to cardiologists
Authors: Lam David H. , Tiwana Jasleen , Li Song , Kirkpatrick James N. , Cheng Richard K. 
Published: August 2020

Objective
In response to the growing use of imaging-based cardiac stress tests in the evaluation of stable ischemic heart disease, professional societies have developed appropriate use criteria (AUC). AUC will soon be linked to reimbursement of advanced diagnostic imaging for Medicare beneficiaries via Clinical Decision Support Mechanisms (CDSMs). We sought to characterize the frequency and type of stress test utilization for chest pain referrals evaluated by cardiologists and determine appropriateness.

Methods
We conducted a retrospective review of new patient referrals seen by general cardiologists at an academic medical center between 2016 and 2017 for a diagnosis of chest pain or angina. Type of stress test ordered, if any, and its appropriateness (Appropriate, May be appropriate, and Rarely appropriate) were ascertained based on the 2013 multimodality AUC guideline document.

Results
There were 535 total outpatients. After applying exclusion criteria, there were 349 patients in the sample; the average age was 52 ± 15 years and 53% were female. Most chest pain was nonanginal (65%). Pretest probability of CAD was most commonly intermediate (54%). A total of 183 patients (52%) were referred for stress testing. The majority of stress tests were considered appropriate (82%) by AUC.

Conclusion
Most patients referred to cardiologists for evaluation of chest pain or angina had nonanginal chest pain and an intermediate pretest probability of CAD. Stress testing was ordered in about half of these patients and the majority were considered appropriate by AUC. These findings suggest that indiscriminate use of CDSMs may not be warranted.
Colectomy Rates Are Increasing Among Inpatients With Concomitant Ulcerative Colitis and Clostridioides difficile
Authors: Shrestha Manish P. , Taleban Sasha 
Published: August 2020

Background:

Clostridioides difficile infection (CDI) is an important cause of inflammatory bowel disease (IBD) exacerbation and is associated with increased risk of hospitalization, colectomy, and mortality. Previous analysis have reported an increasing rate of CDI and associated mortality in IBD patients. We examined the trends in CDI-associated outcomes in hospitalized patients with Crohn’s disease (CD) and ulcerative colitis (UC) over the last decade.

Materials and Methods:
We used data from the National Inpatient Sample to identify patients hospitalized with both CDI and IBD from 2006 to 2014. Outcomes included in-hospital mortality, partial/total colectomy, hospital length of stay, and charges. Analysis included univariate and multivariate regression analysis.

Results:
Between 2006 and 2014, CDI-related hospitalizations increased in both CD (1.6% to 3.2%; P<0.001) and UC (4.9% to 8.6%; P<0.001). CDI-associated mortality in CD and UC patients decreased from 2.4% to 1.2% (P<0.001) and 11.3% to 9.7% (P<0.001), respectively. CDI-associated colectomy rate increased from 4.3% to 8.8% (P<0.001) in UC but decreased from 4.5% to 2.8% (P<0.001) in CD. In multivariable analysis, compared with 2006, there was a nonsignificant decrease in mortality in 2014 in both CD [adjusted odds ratio (AOR) 0.56, 95% confidence interval (CI) 0.25-1.24] and UC (AOR 0.81, 95% CI 0.61-1.07), but a significant increase in colectomy in 2014 only in UC (AOR 2.12, 95% CI 1.46-3.06).

Conclusions:
CDI rates have increased in CD and UC over the last decade. Although there has been a significant increase in colectomies in UC, CDI-associated mortality in CD and UC has not increased over this time.
Noninvasive assessment of liver fibrosis in Crohn’s disease patients exposed to methotrexate
Authors: Llaó Jordina , Masnou Helena , Romero Cristina , Bargalló Anna , Gely Cristina , Mañosa Míriam , Gordillo Jordi , Garcia-Planella Esther , Domènech Eugeni 
Published: August 2020

Background:
Methotrexate is widely used to treat some inflammatory chronic disorders, though it is hampered by the risk of liver fibrosis. Many recommendations have been made to assess methotrexate-related hepatotoxicity, including liver biopsy. However, other noninvasive methods to assess liver fibrosis have been developed and could be implemented for patients treated with methotrexate.

Aim:
The aim of the study was to compare the prevalence of liver fibrosis by means of noninvasive methods [aspartate transaminase-to-platelet ratio index (APRI) Forns index, and transient elastography] in patients with Crohn’s disease exposed or not to methotrexate, and to identify risk factors for liver fibrosis.

Methods:
Prospective, cross-sectional study. All patients with Crohn’s disease exposed to methotrexate were included and compared to an unselected cohort of outpatients with Crohn’s disease never exposed to methotrexate.

Results:
A total of 84 patients with Crohn’s disease, 56 exposed to methotrexate, and 28 controls, were included. Significant liver fibrosis was found in 7% of methotrexate-exposed patients with Crohn’s disease and 10% of controls as measured by transient elastography, and in 7% of controls as measured by the Forns index. No cases of liver fibrosis were detected by APRI. Only alcohol consumption, diabetes mellitus, and age were associated with significant liver fibrosis.

Conclusions:
Significant liver fibrosis is uncommon among patients with Crohn’s disease, even among those exposed to methotrexate. The risk of liver fibrosis in Crohn’s disease seems to depend on common risk factors for liver disease.