bluuebunny/crossref_metadata_2025_split huggingface dataset:
Superior-segment Bilateral Facet Violation in Lumbar Transpedicular Fixation, Part III
Authors: Xu Yunfeng , Le Xiaofeng , Zhang Qi , Kuai Shengzheng , Leng Huijie , Duan Fangfang , Shi Zhan , Liu Bo , He Da , Lang Zhao , Wu Jingye , Wang Ling , Tian Wei 
Published: November 2019

Mini
In controls, adjacent-level range of motion (ROM) did not change relative to noninstrumented spine at each moment. In severe violation, flexion-extension and rotation ROM of adjacent vertebrae decreased at each moment (7.5, 6.0, 4.5 Nm); lateral bending ROM decreased at 4.5 Nm. Significant differences in movements were found except lateral bending (7.5 Nm).

Study Design.
This is an in vitro biomechanical study.

Objectives.
This study aimed to investigate the biomechanical variations of lumbar spine motor units after bilateral facet joint severe violation in cadaver specimens and analyze the biomechanics under different moments.

Summary of Background Data.
The incidence of facet joint violation (FJV) is highly variable, and one of the most important factors is the lack of awareness of protection. Until now, the biomechanical effects of FJV remain unclear.

Methods.
Biomechanical testing was performed on 12 human cadaveric spines under flexion-extension, lateral bending, and axial rotation loading. After intact analysis, pedicle screws were inserted at L5, and the biomechanical testing was repeated. Full range of motion (ROM) at the proximal adjacent levels under different moments was recorded and normalized to the intact (100%) noninstrumented spine. The relative ROM changes were compared between the control and severe violation groups.

Results.
The adjacent-level ROM (flexion-extension, lateral bending, axial rotation) did not change significantly in the control group at each moment (7.5, 6.0, 4.5 Nm) compared with the intact noninstrumented spine. In the severe violation group, the supradjacent-level ROM decreased significantly under all moments relative to the intact noninstrumented spine (P < 0.05) except for the ROM of lateral bending at moments of 7.5 and 6.0 Nm. When comparing the ROM between the two groups, there were significant differences in all movements except lateral bending at 7.5 Nm.

Conclusion.
When superior-segment bilateral facet joints are severely violated by screws, the flexion-extension and axial rotation ROM of adjacent vertebrae decreases at each moment (7.5, 6.0, 4.5 Nm), and the lateral bending ROM decreases at 4.5 Nm.

Level of Evidence: N/A
Validation of the Korean Version of the Body Image Disturbance Questionnaire-Scoliosis
Authors: Bae Seong Ho , Son Seung Min , Shin Won Chul , Goh Tae Sik , Lee Jung Sub 
Published: November 2019

Study Design.
Cross-cultural adaptation and validation of the Body Image Disturbance Questionnaire-Scoliosis

Objective.
The purpose of this study was to evaluate the reliability and validity of an adapted Korean version of the Body Image Disturbance Questionnaire-Scoliosis version (BIDQ-S).

Summary of Background Data.
A modified version of the BIDQ instrument has been validated in adolescent idiopathic scoliosis (AIS) to assess the perception of spinal appearance and psychological disturbance. However, there is no culturally adapted, reliable, and validated BIDQ-S for the Korean population.

Methods.
Translation/retranslation of the English version of the BIDQ-S was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the BIDQ-S (K-BIDQ-S) and the previously validated appearance domain of the Korean version of the Scoliosis Research Society-22 Outcomes questionnaire (K-SRS-22) and Spinal Appearance Questionnaire (K-SAQ) were mailed to 152 patients with AIS. Reliability assessments were conducted using κ statistics to assess item agreements, and intraclass correlation coefficients (ICCs) and Cronbach α values were calculated. Convergent validity was evaluated by comparing the scores of the K-BIDQ-S, K-SAQ, and K-SRS-22 appearance domain and discriminant validity by analyzing relationships between K-BIDQ-S score and patient characteristics.

Results.
All items of the K-BIDQ-S had κ values of agreement >0.6. The K-BIDQ-S showed excellent test/retest reliability with an ICC of 0.912. Internal consistency of the K-BIDQ-S was found to be very good (α = 0.880). Convergent validity testing demonstrated good correlations between the K-BIDQ-S and K-SAQ (r = 0.617), and between the K-BIDQ-S and K-SRS-22 (r = −651). The correlation between the K-BIDQ-S and major curve magnitude was significant (r = 0.688). Discriminant validity was confirmed by significant differences in K-BIDQ-S scores among patients requiring observation, bracing, or surgery.

Conclusion.
The K-BIDQ-S showed satisfactory reliability and validity, and thus, is considered suitable for the evaluation of spinal deformity appearance in Korean-speaking patients with AIS.

Level of Evidence: 3
A 10-Year Radiographic Study Comparing Anterior Versus Posterior Instrumented Spinal Fusion in Patients With Lenke Type 5 Adolescent Idiopathic Scoliosis
Authors: Lim Joel Louis , Hey Hwee Weng Dennis , Kumar Nishant , Teo Alex Quok An , Lau Leok Lim , Hee Hwan Tak , Ruiz John Nathaniel , Kumar Naresh Satyanarayan , Thambiah Joseph Shanthakumar , Liu Gabriel Ka-Po , Wong Hee-Kit 
Published: November 2019

Mini
This is a long-term prospective cohort study comparing the radiographic outcomes of anterior versus posterior instrumentation for Lenke 5 adolescent idiopathic scoliosis. Both approaches were comparable in terms of radiographic outcomes up to 10 years. The posterior approach is more prone to developing proximal junctional kyphosis.

Study Design.
Prospective cohort study.

Objective.
To compare the long-term, radiographic coronal and sagittal outcomes of these two approaches at 10-year follow-up.

Summary of Background Data.
Both anterior and posterior instrumented fusions have been found to be safe and effective treatments for Lenke 5 adolescent idiopathic scoliosis with up to 2 to 5 years of follow-up. Few studies follow patients beyond this duration.

Methods.
36 patients who underwent anterior (n = 25) or posterior instrumented spinal fusion (n = 11) for Lenke 5 adolescent idiopathic scoliosis over a 4-year period were recruited and followed for 10 years. Preoperative clinical data include patient's age and age of menarche. Operative data included instrumented levels, duration of surgery, and surgical blood loss. Postoperative data included duration of hospital stay, duration of intensive care unit stay, and complications. Pre- and postoperative radiographic data collected include coronal Cobb angles for structural thoracolumbar/lumbar curves, and sagittal angles—sagittal vertical axis, thoracic kyphosis, global lumbar angle, pelvic incidence, pelvic tilt, sacral slope, and upper and lower end vertebrae.

Results.
Posterior surgery had a shorter operative time (P < 0.010) and hospital stay (P < 0.010). Coronal plane deformity improved by a mean of 74% in the anterior group and 71% in the posterior group. There was no significant change at 10 years in both groups (anterior P = 0.455 and posterior P = 0.325). Sagittal parameters remained unchanged. There was a higher incidence of proximal junctional kyphosis in the posterior (45%) compared to the anterior (16%) group (P < 0.010).

Conclusion.
Both anterior and posterior instrumentation and fusion are successful surgeries after 10 years of follow-up. They are comparable with regards to their ability to achieve and maintain good correction of scoliotic deformities and have a low rate of pseudoarthrosis and instrument failure. Ideal sagittal parameters are maintained up to 10 years of follow-up.

Level of Evidence: 3
Vascular Endothelial Growth Factor-Transfected Bone Marrow Mesenchymal Stem Cells Improve the Recovery of Motor and Sensory Functions of Rats With Spinal Cord Injury
Authors: Liu Xiao , Xu Wenqi , Zhang Zhengzheng , Liu He , Lv Lanxin , Han Dong , Liu Lin , Yao Aimin , Xu Tie 
Published: November 2019

Study Design.
Basic science.

Objective.
The aim of this study was to examine the effect of vascular endothelial growth factor (VEGF)-transfected bone marrow mesenchymal stem cells (BMSCs) on the recovery of motor and sensory functions of rats with spinal cord injury (SCI).

Summary of Background Data.
There is no effective treatment to protect against SCI. BMSCs have been widely applied to the treatment of nervous system damage due to the function of prompt neurite growth and inhibition of demyelination following injury.

Methods.
VEGF-transfected BMSCs were injected to rats with SCI and the recovery of motor and sensory functions was observed. The Basso, Beattie, and Bresnahan, mechanical withdrawal threshold and thermal withdraw latency grading was conducted to assess the recovery status of motor and sensory functions of the SCI rats. The expression of VEGF, CD31, and NF200 was detected by immunofluorescence.

Results.
The recovery of the rat motor and sensory functions in the VEGF-transfected BMSC (BMSC-VEGF) group was higher than those of the other groups with the exception of the Sham group (P < 0.05). The expression of the CD31 and NF200 proteins in the rat SCI regions was the highest in the BMSC-VEGF group, whereas the survival of BMSC in the BMSC-VEGF group was increased compared with that in the BMSC-Ad group. In addition, the injection of VEGF-transfected BMSCs can improve the angiogenesis of the injured area and retain the survival of injected cells and neurons.

Conclusion.
The injection of BMSC-VEGF improved the recovery of motor function in SCI rats.

Level of Evidence: N/A
Can the American College of Surgeons Risk Calculator Predict 30-day Complications After Spine Surgery?
Authors: McCarthy Michael H. , Singh Partik , Nayak Rusheel , Maslak Joseph P. , Jenkins Tyler J. , Patel Alpesh A. , Hsu Wellington K. 
Published: November 2019

Mini
It is unclear whether the ACS NSQIP Surgical Risk Calculator can predict 30-day complications after lumbar and cervical spinal fusions. This study shows that the Risk Calculator is only of marginal benefit in predicting outcomes in cervical fusion and unlikely to be of benefit in lumbar fusions.

Study Design.
Retrospective cohort study.

Objective.
The aim of this study was to assess the American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) Risk Calculator's ability to predict 30-day complications after spine surgery.

Summary of Background Data.
Surgical risk calculators may identify patients at increased risk for complications, improve outcomes, enhance the informed consent process, and help modify risk factors. The ACS NSQIP Risk Calculator was developed from a cohort of >1.4 million patients, using 2805 unique CPT codes. It uses 21 patient predictors and the planned procedure to predict the risk of 12 different outcomes within 30 days following surgery.

Methods.
A retrospective chart review was performed on patients who underwent primary lumbar and cervical fusions with at least 30-day postoperative follow-up between 2009 and 2015 at a single-institution. Descriptive statistics were calculated for the overall sample, anterior versus posterior fusion (cervical only), and single versus multilevel fusion. Logistic regression models were fit with actual complication occurrence as the dependent variable in each model and ACS estimated risk as the independent variable. The c-statistic was used as the measure of concordance for each model. Receiver-operating charateristic curves depicted the predictive ability of the estimated risks. Acceptable concordance was set at c >0.80.

Results.
A total of 237 lumbar and 404 cervical patients were included in the study. The Risk Calculator risk estimates significantly predicted (P < 0.001) “any complication” and “discharge to skilled nursing facility” among the cervical cohort and demonstrated no significant outcome prediction the lumbar cohort.

Conclusion.
The ACS Risk-Calculator accurately predicted complications in the categories of “any complication” and “discharge to skilled nursing facility” for our cervical cohort and failed to demonstrate benefit for our lumbar cohort. Although the ACS Risk-Calculator may be useful in general surgery, our findings demonstrate that it does not necessarily provide accurate information for patients undergoing spinal surgery.

Level of Evidence: 3
Trends in Leadership at Spine Surgery Fellowships
Authors: Donnally Chester J. , Schiller Nicholas C. , Butler Alexander J. , Sama Andrew J. , Bondar Kevin J. , Goz Vadim , Shenoy Kartik , Vaccaro Alexander R. , Hilibrand Alan S. 
Published: November 2019

Study Design.
Cross-sectional study.

Objective.
To illustrate demographic trends among spine fellowship leaders (FLs).

Summary of Background Data.
No previous study in the orthopedic literature has analyzed the demographic characteristics or past surgical training of FL in an orthopedic sub-specialty. We attempt to illustrate demographic trends among spine fellowship leadership including fellowship directors (FDs) and co-fellowship directors (co-FDs). We also highlight the institutions that have trained these leaders at various levels.

Methods.
Our search for FDs was constructed from the 2018 to 2019 North American Spine Surgery (NASS) Fellowship Directory. Datapoints gathered included: age, sex, residency/fellowship training location, time since training completion until FD appointment, length in FD role, and personal research H-index.

Results.
We identified 103 FLs consisting of 67 FDs, 19 co-FDs, and another 16 individuals with a synonymous leadership title. 96.1% (99) of the leadership consisted of males while 3.9% (4) were female. The mean age was 52.9 years old and the mean h-index of the FLs was 23.8. FLs were trained in orthopedic surgery (n = 89), neurosurgery (n = 13), or combined orthopedic surgery and neurosurgery training (n = 1). The top fellowships programs producing future FLs were: Case Western Reserve University, Cleveland (n = 10), Washington University, St. Louis (n = 9), and Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia (n = 7).

Conclusion.
Spine surgery fellowship directors are more likely to have graduated from certain residency and fellowship programs. This finding could be a result of the training provided by these centers or the institution's predilection to select applicants that are more likely to later seek academic leadership roles post-training.

Level of Evidence: 4
Hypnosis Influence on the Perfusion in Perforator Flaps in Early Postoperative Period: A Series of 18 Cases
Authors: Badiul Pavlo O. , Sliesarenko Sergii V. , Saliaiev Mykola G. , Kriachkova Lilia V. 
Published: November 2019

Introduction:
In practice worldwide, there are experiences affecting different body functions via central control mechanisms with the help of psychotherapy methods. In plastic and reconstructive surgery, there is the experience of applying hypnosis, with the main goal of eliminating pain. The aim of this research is to study the impact of hypnosis on the perfusion level in perforator flaps in the early postoperative period, which could enhance flap survival.

Patients and Methods:
For studying the impact of hypnosis on blood circulation in perforator flaps, the analysis of a 18 cases has been conducted. All patients had hypnosis sessions on the second day after the reconstruction, and some had additional sessions on the third and fifth days. In the state of trance, the patient was given specially organized instructions aimed at improvement of perforator flap perfusion. Monitoring of microcirculation in the flap during hypnosis sessions was carried out using a Moor VMS-LDF1 Laser Doppler Perfusion and Temperature Monitor.

Results:
When applying hypnosis, the vast majority of patients had significant increases in perfusion as well as flap surface temperature rise. Most of the patients had significant increases in perfusion during the second part of the hypnosis session in synchrony with hypnosis instruction translation aimed at increasing perfusion.

Conclusions:
The results of our research cannot be distributed widely in medical practice, but, despite that, they illustrate the central nervous system influence on perforator flap perfusion. Including hypnosis in a medical protocol can contribute to increasing the effectiveness of flap surgery.
Monitoring Radiation Exposure of Saudi Aramco Pilots
Authors: Shhub Abdu Naser 
Published: November 2019

Abstract
A 1 y study to monitor exposure to cosmic radiation of pilots and aircrew in Saudi Aramco flights has been conducted. In many countries, flight attendants, pilots, and other aircrew are considered to be radiation workers. Five pilots participated in the study, and two methods were used for measuring or estimating the radiation doses received by pilots or aircrew during air flights: the computer program CARI-7 and thermoluminescent dosimeters. It has been concluded that although pilots and aircrew are occupationally exposed to ionizing radiation, they do not receive enough radiation to be included in the company radiation dosimetry program. Although it is not possible, in general, for pilots and aircrew to reach the occupational dose limit, they nonetheless should be monitored (using a computer simulation code) to be in line with international practices. In the case of pregnant aircrew, it is particularly important to monitor their radiation doses, because it is possible for them to reach their radiation dose limits.
Clinical significance of down-regulated HINT2 in hepatocellular carcinoma
Authors: Zhou Dong-Kai , Qian Xiao-Hui , Cheng Jun , Chen Ling-Hui , Wang Wei-Lin 
Published: November 2019

Abstract
To study the clinical significance of HINT2 expression in patients with HCC.
We investigated HINT2 mRNA expression in tumors and adjacent non-tumor hepatic tissues from 106 HCC patients using quantitative real-time PCR. Appropriate statistical methods were then applied to assess the relationships between the HINT2 mRNA level and clinical parameters.

HINT2 was significantly down-regulated in HCC (P < .0001). No significant correlation was found between HINT2 expression and clinicopathological factors in HCC patients. A Kaplan–Meier survival curve showed that HINT2 expression is related to recurrence-free survival (P < .05). Multivariate analyses revealed that tumor size and HINT2 expression are risk factors for HCC recurrence.

HINT2 is down-regulated in HCC, and low HINT2 expression predicts earlier tumor recurrence. HINT2 expression may serve as a prognostic indicator of recurrence in HCC.
Right ventricular dysfunction is associated with the development of chronic thromboembolic pulmonary hypertension but not with mortality post-acute pulmonary embolism
Authors: Hsu Chih-Hsin , Lin Chih-Chan , Li Wei-Ting , Chang Hsien-Yuan , Chang Wei-Ting 
Published: November 2019

Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH), a late complication of pulmonary embolism (PE), is associated with high mortality. However, whether the right ventricular (RV) echocardiographic parameters can predict – in the short- and long-term – the development of CTEPH and mortality after PE remains unknown. Herein, we aim to investigate the incidence of CTEPH after acute PE and to evaluate the risk factors of CTEPH. In this retrospective cohort, patients with PE were followed for 10 years for the onset of CTEPH. The screening was initially conducted through echocardiography and confirmed by right heart catheterization. Also, transient and permanent risk factors were identified. Among 358 patients with PE, 8 patients (4%) were subsequently diagnosed with CTEPH at a median time of 36 months and 47 died during the follow-up period. Notably, both short- and long-term RV dilatation, hypertrophy, and increased pulmonary pressure increased the incidence of CTEPH. However, RV echocardiographic parameters failed to differentiate survivors from non-survivors. Instead, malignancy, respiratory, or chronic heart failure was strongly associated with post PE mortality in the multivariable analysis. According to our findings, post PE screening of CTEPH may facilitate early diagnosis and intervention for patients at high risk of developing CTEPH. Also, RV echocardiographic parameters are associated with subsequent CTEPH, but mortality is mainly dependent on underlying comorbidities.
Risk factor for diabetes mellitus in pediatric chronic pancreatitis patients
Authors: Xie Ting , Hao Lu , Liu Yu , Zhang Di , Bi Ya-Wei , Wang Teng , Zeng Xiang-Peng , Xin Lei , Pan Jun , Wang Dan , Ji Jun-Tao , Du Ting-Ting , Lin Jin-Huan , Zou Wen-Bin , Chen Hui , Guo Hong-Lei , Li Bai-Rong , Cong Zhi-Jie , Liao Zhuan , Wan Rong , Li Zhao-Shen , Hu Liang-Hao 
Published: November 2019

Abstract
Pediatric patients suffer from chronic pancreatitis (CP), especially those with diabetes mellitus (DM). This study aimed to identify the incidence of and risk factors for DM in pediatric CP.
CP patients admitted to our center from January 2000 to December 2013 were assigned to the pediatric (<18 years old) and adult group according to their age at onset of CP. Cumulative rates of DM and risk factors for both groups were calculated and identified.
The median follow-up duration for the whole cohort was 7.6 years. In these 2153 patients, 13.5% of them were pediatrics. The mean age at the onset and the diagnosis of CP in pediatrics were 11.622 and 19.727, respectively. DM was detected in 13.1% patients and 31.0% patients in the pediatric group and adult group, respectively. Age at the onset of CP, smoking history, body mass index (BMI), and etiology of CP were identified risk factors for DM in pediatrics.
DM was detected in 13.1% pediatric patients. Age at the onset of CP, smoking history, BMI, and etiology of CP were identified risk factors for the development of DM in pediatric CP patients. The high-risk populations were suggested to be monitored frequently. They could also benefit from a lifestyle modification.
Effectiveness of continuous adductor canal block versus continuous femoral nerve block in patients with total knee arthroplasty
Authors: Zhang Zhen , Wang Yu , Liu Yuanyuan 
Published: November 2019

AbstractBackground:This study aimed to evaluate the effectiveness of continuous adductor canal block (CACB) versus continuous femoral nerve block (CFNB) in postoperative analgesia and early rehabilitation of patients with total knee arthroplasty (TKA).Methods:The Cochrane Library, PubMed, and EMbase were systematically searched to retrieve literature comparing efficacy of CACB versus CFNB on pain relief and functional recovery in knee replacement patients until December 2018, without language limitation. Meta-analysis was performed using RevMan 5.3 software.Results:A total of 7 clinical randomized controlled trials and 4 retrospective studies were included, involving 484 cases in the CACB group and 491 in the CFNB group. The results of the meta-analysis showed that the visual analogue scores (VAS) at rest were similar between the CACB group and the CFNB group at 8 hours (standard mean difference(SMD) = -0.26, 95% confidence interval(CI): -0.62, 0.11), 12 hours (SMD = -0.02, 95%CI: -0.50, 0.47), 24 hours (SMD = 0.05, 95%CI: -0.22, 0.33), and 48 hours (SMD = -0.10, 95%CI: -0.29, 0.09) after TKA (P > .05 for all). The muscle strength of patients in the CACB group post-operation was significantly improved than those of the CFNB group (SMD = 0.81; 95% CI: 0.35, 1.26;P = .0005). There were no significant differences in the amount of opioids consumption and the incidence of postoperative fall between CACB and CFNB (P > .05).Conclusion:The analgesic effects of CACB versus CFNB are equivalent after TKA. CACB has less effect on the quadriceps muscle strength, which is beneficial to the early postoperative activities and functional rehabilitation.