bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Analysis of Eating Disorders in Adolescent Idiopathic Scoliosis: A Prospective Cross-sectional Study in a Female Population
Authors: Cantele Francesca , Maghini Irene , Tonellato Michele , Meneguzzo Paolo , Favaro Angela , Masiero Stefano 
Published: December 2020

Study Design.
Prospective cross-sectional study.

Objective.
We designed this study to investigate whether adolescent girls with idiopathic scoliosis show a predisposition for eating disorders (EDs) and alterations of the quality of life and body image self-perception, compared to same-age healthy females.

Summary of Background Data.
Idiopathic scoliosis is the most common spinal deformity of adolescence. Recent findings about the impairment of the self-body image in adolescents with idiopathic scoliosis provide a common trait of scoliosis and EDs and could lead to the suspicion of an association between these two pathological conditions. Despite this, current literature shows the lack of evident results about the impact of adolescent idiopathic scoliosis (AIS) on the possibility to develop of EDs.

Methods.
One hundred forty-four females with diagnosis of AIS (aged 10–18 years) formed the scoliosis group. One hundred forty-six same-age healthy girls were enrolled in the control group. For all subjects, we considered sport practice. Only for Scoliosis Group, we also considered the severity of scoliosis, the use of brace and the practice of physiotherapy scoliosis-specific exercises. The participants were asked to answer to the Scoliosis Research Society-22 revised Patient Questionnaire (SRS-22r) and the Eating Disorders Inventory (EDI).

Results.
In the scoliosis group, significantly lower scores on the SRS-22r total and in the self-image domain were detected. The two groups showed differences in the total EDI score and in the body dissatisfaction EDI's domain. Severity of scoliosis was correlated with worse SRS-22r total score and SRS-22r self-image domain score. There were no differences in the scores of the SRS-22r and EDI between braced and nonbraced subjects. Lower scores in SRS-22r total and self-image domain were found in girls who practiced physiotherapy exercises. Subjects who practiced a sport showed higher SRS-22r total scores.

Conclusion.
The AIS cohort in our study demonstrated lower levels of eating psychopathology than healthy controls. Surprisingly, eating behavior does not seem to be affected by orthotic management. However, quality of life and self-body image could be impaired in scoliotic girls, especially when they practice physiotherapy exercises, whereas those who practice sport seem to be preserved in this regard.

Level of Evidence: 4
Characteristics and Trends of the Most Cited Spine Publications
Authors: Donnally Chester J. , Lugo-Pico Julian G. , Bondar Kevin J. , Chen Clark J. , McCormick Johnathon R. , Errico Thomas J. 
Published: December 2020

Study Design.
Bibliometric literature review.

Objective.
The aim of this study was to recognize and analyze the most frequently cited manuscripts published in the journal Spine.

Summary of Background Data.
Although the journal Spine is considered a premiere location for distributing influential spine research, no previous study has evaluated which of their publications have had the most impact. Knowledge and appreciation of the most influential Spine publications can guide and inspire future research endeavors.

Methods.
Using the Scopus database, the 100 most cited articles published in Spine were accessed. The frequency of citations, year of publication, country of origin, level-of-evidence (LOE), article type, and contributing authors/institutions were recorded. The 10 most cited articles (per year) from the past decade were also determined.

Results.
“Guidelines For The Process Of Cross-Cultural Adaptation Of Self-Report Measures” by Beaton DE was the most cited article with 2960 citations. 2000 to 2009 (n = 46) was the most productive period. A LOE of III (n = 35) followed by II (n = 34) were the most common. Deyo RA (n = 8), Bombardier C (n = 6), and Waddell G (n = 6) produced the most articles. University of Washington (n = 8) and University of Toronto (n = 8) ranked first for institutional output. Clinical Outcome (n = 28) was the most recurring article topic. The United States (n = 51) ranked first for country of origin.

Conclusion.
Using citation analysis as an objective proxy for influence, certain publications can be distinguished from others due to their lasting impact and recognition from peers. Of the top cited Spine publications, many pertained to clinical outcomes (28%) and had a LOE of I, II, or III (60%). Although older publications have had longer time to accrue citations, those in the most recent decade comprise this list almost 2:1. Knowledge of these “classic” publications allows for a better overall understanding of the diagnosis, management, and future direction of spine health care.

Level of Evidence: 3
Improvement in SRS-22R Self-Image Correlate Most with Patient Satisfaction after 3-Column Osteotomy
Authors: Gum Jeffrey L. , Shasti Mark , Yeramaneni Samrat , Carreon Leah Y. , Hostin Richard A. , Kelly Michael P. , Lafage Virginie , Smith Justin S. , Passias Peter G. , Kebaish Khaled , Shaffrey Christopher I. , Burton Douglas L. , Ames Christopher P. , Schwab Frank J. , Protopsaltis Themistocles , Bess R. Shay 
Published: December 2020

Study Design.
Longitudinal cohort.

Objectives.
The aim of this study was to examine the relationship between patient satisfaction, patient-reported outcome measures (PROMs) and radiographic parameters in adult spine deformity (ASD) patients undergoing three-column osteotomies (3CO).

Summary of Background Data.
Identifying factors that influence patient satisfaction in ASD is important. Evidence suggests Scoliosis Research Society-22R (SRS-22R) Self-Image domain correlates with patient satisfaction in patients with ASD.

Methods.
This is a retrospective review of ASD patients enrolled in a prospective, multicenter database undergoing a 3CO with complete SRS-22R pre-op and minimum 2-years postop. Spearman correlations were used to evaluate associations between the 2-year SRS Satisfaction score and changes in SRS-22R domain scores, Oswestry Disability Index (ODI), and radiographic parameters.

Results.
Of 135 patients eligible for 2-year follow-up, 98 patients (73%) had complete pre- and 2-year postop data. The cohort was mostly female (69%) with mean BMI of 29.7 kg/m2 and age of 61.0 years. Mean levels fused was 12.9 with estimated blood loss of 2695 cc and OR time of 407 minutes; 27% were revision surgeries. There was a statistically significant improvement between pre- and 2-year post-op PROMs and all radiographic parameters except Coronal Vertical Axis. The majority of patients had an SRS Satisfaction score of ≥3.0 (90%) or ≥4.0 (68%), consistent with a moderate ceiling effect. Correlations of patient satisfaction was significant for Pain (0.43, P < 0.001), Activity (0.39, P < 0.001), Mental (0.38, P = 0.001) Self-Image (0.52, P < 0.001). ODI and Short-Form-36 Physical component summary had a moderate correlation as well, with mental component summary being weak. There was no statistically significant correlation between any radiographic or operative parameters and patient satisfaction.

Conclusion.
There was statistically significant improvement in all PROMs and radiographic parameters, except coronal vertical axis at 2 years in ASD patients undergoing 3CO. Improvement in SRS Self-Image domain has the strongest correlation with patient satisfaction.

Level of Evidence: 3
Efficacy of Early Prophylaxis Against Catheter-Associated Thrombosis in Critically Ill Children: A Bayesian Phase 2b Randomized Clinical Trial*
Authors: Faustino E. Vincent S. , Shabanova Veronika , Raffini Leslie J. , Kandil Sarah B. , Li Simon , Pinto Matthew G. , Cholette Jill M. , Hanson Sheila J. , Nellis Marianne E. , Silva Cicero T. , Chima Ranjit , Sharathkumar Anjali , Thomas Kimberly A. , McPartland Tara , Tala Joana A. , Spinella Philip C. 
Published: December 2020

OBJECTIVES:
We obtained preliminary evidence on the efficacy of early prophylaxis on the risk of central venous catheter-associated deep venous thrombosis and its effect on thrombin generation in critically ill children.

DESIGN:
Bayesian phase 2b randomized clinical trial.

SETTING:
Seven PICUs.

PATIENTS:
Children less than 18 years old with a newly inserted central venous catheter and at low risk of bleeding.

Intervention:
Enoxaparin adjusted to anti-Xa level of 0.2–0.5 international units/mL started at less than 24 hours after insertion of central venous catheter (enoxaparin arm) versus usual care without placebo (usual care arm).

MEASUREMENTS AND MAIN RESULTS:
At the interim analysis, the proportion of central venous catheter-associated deep venous thrombosis on ultrasonography in the usual care arm, which was 54.2% of 24 children, was significantly higher than that previously reported. This resulted in misspecification of the preapproved Bayesian analysis, reversal of direction of treatment effect, and early termination of the randomized clinical trial. Nevertheless, with 30.4% of 23 children with central venous catheter-associated deep venous thrombosis on ultrasonography in the enoxaparin arm, risk ratio of central venous catheter-associated deep venous thrombosis was 0.55 (95% credible interval, 0.24–1.11). Including children without ultrasonography, clinically relevant central venous catheter-associated deep venous thrombosis developed in one of 27 children (3.7%) in the enoxaparin arm and seven of 24 (29.2%) in the usual care arm (p = 0.02). Clinically relevant bleeding developed in one child randomized to the enoxaparin arm. Response profile of endogenous thrombin potential, a measure of thrombin generation, was not statistically different between trial arms.

CONCLUSIONS:
These findings suggest the efficacy and safety of early prophylaxis that should be validated in a pivotal randomized clinical trial.
Dermal Filler Injections in Patients With Autoimmune and Inflammatory Rheumatic Diseases—The Patients' Perspective
Authors: Koren Amir , Sarbagil-Maman Hagit , Litinsky Irina , Furer Victoria , Artzi Ofir 
Published: December 2020

BACKGROUND
Injecting dermal fillers in patients with autoimmune inflammatory rheumatic diseases (AIIRDs) is controversial.

OBJECTIVE
To evaluate the attitudes of patients with AIIRDs regarding the use of dermal fillers and the side effects of those who underwent them.

METHODS
Patients with AIIRDs who attended a rheumatology outpatient clinic between 2016 and 2018 filled in a questionnaire about their attitudes toward dermal filler injections. The questionnaire evaluated information received from professionals and the factors that influenced their decision of whether or not to undergo the procedures.

RESULTS
Overall, 194 patients with AIIRDs (mean age 56.5 ± 14.0, 99% women) responded. Forty-two of them had previously undergone the injections and intended to repeat them (Group A), 37 had not received filler injections but intended to do so (Group B), and 114 who had never undergone them did not intend to undergo them. The major motivation for undergoing filler injections was social. Patients treated with dermal fillers refrained from informing their rheumatologist about their injections. They were, however, highly satisfied with the procedure and reported negligible side effects.

CONCLUSION
The use of dermal fillers was apparently safe and well received by patients with AIIRDs. Physicians' recommendations to refrain from injecting them with dermal fillers should be reconsidered and evaluated in clinical studies.
Safety and Efficacy of Pharmaco-invasive Approach Using Streptokinase Compared With Primary Percutaneous Coronary Angiography
Authors: Sultan El-Zahraa M. , Elberry Ahmed A. , Rabea Hoda , Mahmoud Hesham B. 
Published: December 2020

Background:
Fibrin-specific fibrinolytics are preferred when they used in STEMI patients (pharmaco-invasive approach). However, streptokinase is still the most common used thrombolytic agent in Egypt because of its cheaper cost.

Methods:
266 STEMI patients were randomly assigned to undergo PPCI or pharmacoinvasive (using streptokinase). Primary end point (death, shock, congestive heart failure, or reinfarction up to 30 d) and secondary end point (ischemic stroke, intracranial hemorrhage, or nonintracranial bleeding) were followed for 30 days after reperfusion. In pharmaco-invasive arm, urgent coronary angiography was performed in case of failed reperfusion. Based on the reperfusion time from symptoms onset, patients in both arms were divided into; early (≤3 hrs) and late reperfusion (>3 hrs).

Results:
No statistical significant difference regarding left ventricular ejection fraction, end diastolic and end systolic diameter in both arms. Early PPCI (≤3 hrs) had highest ejection fraction values (56.9 ± 7.5). Myocardial wall preservation was best achieved in early pharmaco-invasive (≤3 hrs).There was no statistical significant difference in TIMI flow results between all subgroups (early and late of both arms) (P = 0.750). Suction devices and IV Eptifibatide were less frequently used in the pharmaco-invasive comparing to PPCI arm; (P = 0.000 and P = 0.006) subsequently. No statistical significant difference regarding complication incidence in both arms (P = 0.518). Radial access was more commonly used in the pharmaco-invasive arm (P = 0.015).

Conclusion:
Utilizing streptokinase in early re-perfused patients by PI approach (≤3 hrs) seems safe and efficient when PPCI delay (>120 min from symptom onset) is the other option.
New Freeware for Image Analysis of Lissamine Green Conjunctival Staining
Authors: Courrier Emilie , Renault Didier , Dib Elian , Urrea Caroline , Kaspi Mathilde , Fournier Corinne , Lépine Thierry , Chiambaretta Frédéric , Hor Guillaume , He Zhiguo , Garcin Thibaud , Thuret Gilles , Gain Philippe 
Published: December 2020

Purpose:
Lissamine green (LG) is often used in addition to fluorescein to assess the severity of conjunctival damage in dry eye syndrome, which is graded manually. Our purpose was to describe an algorithm designed for image analysis of LG conjunctival staining.

Methods:
Twenty pictures of patients suffering from dry eye with visible LG conjunctival staining were selected. The images were taken by 2 different digital slit lamps with a white light source and a red filter transmitting over the wavelengths absorbed by LG. Conjunctival staining appeared in black on a red background. The red channel was extracted from the original image. Stained areas were then detected using a Laplacian of Gaussian filter and applying a threshold whose value was determined manually on a subset of images. The same algorithm parameters remained constant thereafter. LG-stained areas were also drawn manually by 2 experts as a reference.

Results:
The delineation obtained by the algorithm closely matched the actual contours of the punctate dots. In 19 cases of 20 (95%), the algorithm found the same Oxford grade as the experts, even for confluent staining that was detected as a multitude of dots by the algorithm but not by the experts, resulting in a high overestimation of the total number of dots (without mismatching the Oxford grade estimated by the experts). The results were similar for the 2 slit-lamp imaging systems.

Conclusions:
This efficient new image-analysis algorithm yields results consistent with subjective grading and may offer advantages of automation and scalability in clinical trials.
Use of Telepresence Robots in Glaucoma Patient Education
Authors: Ooms Ashley , Shaikh Ibraheem , Patel Nishant , Kardashian-Sieger Thomas , Srinivasan Nivetha , Zhou Benjamin , Wilson Logan , Szirth Bernard , Khouri Albert S. 
Published: December 2020

Précis:
Telepresence robots (TR) present the versatility to effectively provide remote educational sessions for patients affected by glaucoma to improve disease knowledge. Given COVID-19’s effect on clinical practice, TR can maintain social distancing when educating patients.

Purpose:
TR are devices that allow remote users to have a mobile presence anywhere. We compared the effect of an education session given by an in-person educator versus a TR on glaucoma knowledge and identified factors that impact patient education.

Methods:
Eighty-five glaucoma patients were split into control, human, and TR groups. We measured glaucoma knowledge scores (KS) using the National Eye Institute’s Eye-Q Test. Human and TR groups had the education session with a human or TR followed by the questionnaire. The control group was administered the questionnaire without an education session. Treatment regimen recall (RR) >90% was considered a success. We used linear regression and binary logistic regression to determine variables that affect KS and RR, respectively.

Results:
Mean age was 58.3±2.8 years. 49% were female. Mean KS were 5.8±0.7 in the control group (n=31), 7.9±0.5 in the TR group (n=26), and 8.4±0.5 in the human group (n=28). Control participants had a lower mean KS than the human or TR groups (P<0.001). Having the education session (2.5, P<0.001), education greater than high school (0.8, P=0.016), and diabetes (−0.7, P=0.037) affected KS. Having diabetes (odds ratio=0.14, P=0.014) negatively affected RR. Having the education session may affect RR (odds ratio=5.47, P=0.07), warranting additional studies.

Conclusions:
Education sessions with a human and TR improved patients’ glaucoma KS. TRs may serve as an alternative to in-person education sessions and allow educators to safely and effectively educate patients remotely to adhere to COVID-19 social distancing guidelines.
Association between the clinical and demographic characteristics of patients undergoing cataract surgery and their prevalence of conjunctival bacteria
Authors: Fernández-Rubio María-Elisa , Urcelay-Segura José-Luis , Bellón-Cano José-María , Cuesta-Rodríguez Teresa 
Published: December 2020

Purpose:
To identify characteristics of patients undergoing cataract surgery associated with pathogenic and antibiotic-resistant conjunctival bacteria.

Setting:
Spanish tertiary hospital.

Design:
Retrospective cross-sectional study.

Methods:
Records of consecutive patients undergoing cataract surgery between July 2005 and September 2014, contained data on patient characteristics and conjunctival bacteria systematically identified with preoperative tests and anesthetic evaluation. A multivariate logistic regression associated 12 bacterial groups with every category of 17 characteristics. Odds ratio (OR), 95% CIs expressed colonization risk.

Results:
In 14883 patients, categories associated with pathogenic bacteria were age older than 79 years with nonfermentative gram-negative bacilli (NFGNB) (OR 1.74, 1.12-2.71), enterococci (OR 1.90, 1.36-2.65), Enterobacteriaceae (OR 2.17, 1.65-2.87), and Staphylococcus aureus (OR 1.37, 1.16-1.62); obesity with S aureus (OR 1.52, 1.30-1.78), enterococci (OR 1.99, 1.47-2.68), and Enterobacteriaceae (OR 2.17, 1.70-2.77); dacryocystorhinostomy history with S aureus (OR 1.90, 1.48-2.44), Haemophilus spp. (OR 2.06, 1.37-3.11), Streptococcus pneumoniae (OR 3.14, 2.14-4.62), NFGNB (OR 2.23, 1.28-3.88), and enterococci (OR 1.80, 1.16-1.81); diabetes with S aureus (OR 1.27, 1.13-1.44), enterococci (OR 1.49, 1.19-1.87), and Enterobacteriaceae (OR 1.27, 1.04-1.54); smoking habit with Enterobacteriaceae (OR 2.11, 1.56-2.86); autumn with NFGNB (OR 2.0, 1.35-3.0); hot weather with S aureus (OR 1.23, 1.03-1.47); and lung, renal, and some heart insufficiencies with S aureus. Other staphylococci, highly antibiotic-resistant, were associated with old age, obesity, and hot weather.

Conclusions:
Old age, obesity, diabetes, dacryocystorhinostomy history, smoking habit, and autumn and summer seasons increased the prevalence of enterococci, staphylococci, Enterobacteriaceae, and/or NFGNB. Obesity and humid-warm weather are key for choosing a cataract surgery prophylaxis.
Guideline Adherence of Monitoring Antipsychotic Use for Nonpsychotic Indications in Children and Adolescents
Authors: Dinnissen Mariken , Dietrich Andrea , van der Molen Judith H. , Verhallen Anne M. , Buiteveld Ynske , Jongejan Suzanne , Troost Pieter W. , Buitelaar Jan K. , van den Hoofdakker Barbara J. , Hoekstra Pieter J. 
Published: December 2020

Abstract

Background
Antipsychotics are frequently prescribed to children and adolescents for nonpsychotic indications. Guidelines recommend regularly assessing treatment response and adverse effects and the ongoing need for their use. We aimed to assess adherence to recommendations of available guidelines regarding monitoring antipsychotic use and to test the influence of children's age, sex, intelligence quotient, and diagnosis on adherence.

Methods
We reviewed 426 medical records from 26 centers within 3 large Dutch child and adolescent psychiatry organizations, excluding children with schizophrenia, psychosis, mania, or an intelligence quotient below 70. We investigated whether there was regular assessment of treatment response, adverse events (physical and laboratory), and at least annual discussion of the need of continued use.

Results
On average, treatment response was assessed in 69.3% of the recommended treatment periods, height in 25.6%, weight in 30.6%, blood pressure in 20.6%, evaluation of adverse events in 19.4%, and cardiometabolic measures in 13.7%; discontinuation and/or continued need was discussed at least annually in 36.2%. Extrapyramidal and prolactin-related adverse effects, waist circumference, glucose, and lipids were rarely investigated. Higher age was associated with lower rates of assessment of treatment response. Most antipsychotics were prescribed long-term. In those children with sufficient documentation of the course of treatment, 57.7% was still using an antipsychotic 3 years after initiation.

Conclusions
Our findings indicate insufficient adherence to guideline recommendations for monitoring antipsychotic use in children and adolescents, as well as long duration of use in the majority of children. Especially, older children are at higher risk of receiving suboptimal care.
The Feasibility of Magnetic Resonance Imaging for the Differentiation of Cerebrospinal Fluid Leak From Middle Ear Effusion: A Quantitative Analysis
Authors: Raghavan Arun M. , Breen Joseph T. 
Published: December 2020

Objective:
Assess quantitatively whether magnetic resonance imaging (MRI) signal intensity can be used to distinguish cerebrospinal fluid (CSF) leaks in the temporal bone from middle ear effusions.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Forty-nine patients, 18 with middle ear effusions (MEE), 30 with CSF leaks, and 1 with an MEE on one side and a CSF leak on the other, were evaluated in the study. Primary inclusion criteria for CSF leak patients were operative management of CSF leak with confirmatory diagnosis in follow-up. Primary inclusion criteria for MEE patients were electronic medical record documentation of an effusion with subsequent resolution on follow-up. For all patients, inclusion criteria included MRI imaging with 3D-T2 weighted sequences (3DT2) and fluid-attenuated inversion recovery (FLAIR) sequences performed within 1 year of diagnosis code entry.

Intervention:
Computational analysis of signal intensity of fluid collections in MRI imaging.

Main Outcome Measures:
Sensitivity and specificity of 3DT2 and FLAIR signal intensity in the detection of CSF leak.

Results:
For 3DT2 sequences with a chosen normalized signal intensity threshold (CSF leak if ≥ 0.5), sensitivity was 100% (95% CI: 86.3–100) and specificity was 83.3% (95% CI: 51.6–97.9). For FLAIR sequences with a threshold of 1.0 (CSF leak if < 1.0), sensitivity was 77.4% (95% CI: 58.9–90.4) and specificity was 85.7% (95% CI: 63.6–97.0). For a combined test in which a fluid collection was considered CSF if both 3DT2 ≥ 0.5 and FLAIR < 1.0, sensitivity was 76% (95% CI: 54.9–90.6) and specificity was 100% (95% CI: 73.5–100).