bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of early-onset scoliosis: techniques, indications, and complications
Authors: Zhang Yan-Bin , Zhang Jian-Guo 
Published: January 2020

Abstract
The treatments for early-onset scoliosis (EOS) remain great challenges for spine surgeons. This study aimed to comprehensively review the treatments for EOS, especially the advancements made in the last decade. Current studies on EOS were retrieved through a search on PubMed, UpToDate, the Web of Science Core Collection and Scopus were reviewed. The most pertinent information related to the current treatments for EOS was collected. The foci of treatments for EOS have included creating a well-developed thoracic cavity, improving lung volume, and improving pulmonary function. Conservative treatments include bracing, casting, halo-gravity traction, and physiotherapy. Serial casting is the most effective conservative treatment for EOS. Surgical treatments mainly include growth-friendly techniques, which are generally classified into three types according to the amount of correction force applied: distraction-based, compression-based, and growth-guided. The distraction-based systems include traditional or conventional growing rods, magnetically controlled growing rods, and vertical expandable prosthesis titanium ribs. The compression-based systems include vertebral body stapling and tethering. The growth-guided systems include the Shilla system and modern Luque trolley. In addition, some newer techniques have emerged in recent years, such as posterior dynamic deformity correction (ApiFix). For EOS patients presenting with sharp deformities in a long, congenital spinal deformity, a hybrid technique, one-stage posterior osteotomy with short segmental fusion and dual growing rods, may be a good choice. Hemivertebra resection is the gold standard for congenital scoliosis caused by single hemivertebra. Although the patient's growth potential is preserved in growth-friendly surgeries, a high complication rate should be expected, as well as a prolonged treatment duration and additional costs. Knowledge about EOS and its treatment options is rapidly expanding. Conservative treatments have specific limitations. For curves requiring a surgical intervention, surgical techniques may vary depending on the patients’ characteristics, the surgeon's experience, and the actual state of the country.
Vision 2020: where are we?
Authors: Bourne Rupert R.A. 
Published: January 2020

Purpose of review
To describe the VISION 2020: The Right to Sight, global initiative for the elimination of avoidable blindness, the contribution of glaucoma to the magnitude of global blindness and priorities going forward.

Recent findings
Although the target of the World Health Organization's Global Action Plan (2014–2019) has not been met in terms of 25% reduction in avoidable blindness, there is evidence that the contribution of glaucoma to blindness and vision impairment is reducing. Yet this focus on a threshold of visual acuity by which to measure prevalence underestimates the true burden of glaucoma. Recent population-based studies demonstrate the scale of the unmet need.

Summary
Scaling up of integrated people-centered eye care, by embedding glaucoma detection and care pathways in health systems with a strong focus on primary healthcare, is necessary. Solutions include reinforcing existing pathways while emphasizing high-quality glaucoma care, in addition to novel solutions such as self-testing, digital portable technology, artificial intelligence, and multilevel care pathways that extend to the most underserved parts of the global community.
Dynamic analysis of variations in postoperative pain trajectories over time in patients receiving epidural analgesia using latent curve models
Authors: Lee Ming-Ying , Chang Wen-Kuei , Wu Hsiang-Ling , Lin Shih-Pin , Tsou Mei-Yung , Chang Kuang-Yi 
Published: January 2020

Background:
Although epidural analgesia (EA) provides reliable pain relief after major operations, few studies have explored how postoperative pain trajectories change over time in patients receiving EA and the associated factors. This study aimed to model the dynamic features of pain trajectories after surgery and investigate factors associated with their variations using latent curve analysis.

Methods:
This retrospective study was conducted at a single medical center in Taiwan, and data were obtained from patients receiving perioperative EA by electronic chart review. Mean numeric rating pain scores were recorded daily in the first five postoperative days. Patient demographics, surgical sites, and infusion pump settings were also collected. Latent curve models using two latent variables, intercept and slope, were developed to explain the variations in postoperative pain scores over time. The influences of potential predictors of postoperative pain trajectories were further evaluated for the final model determination.

Results:
Of the 1294 collected patients, the daily pain scores averaged 2.0 to 2.9 for different surgical sites. Among the nine significant factors influencing pain trajectories, chest and lower extremity surgery tended to induce less and more baseline pain, respectively, than those with abdomen surgery (both p < 0.001). In addition, male patients and those with a shorter anesthesia time had less baseline pain (p < 0.001 and p = 0.016, respectively). The older and lighter patients and those with chest surgery or American Society of Anesthesiologists class ≥ 3 tended to have milder decreasing trends in pain trajectories. A higher infusion rate was associated with an elevated baseline level and smoother decreasing trend in pain trajectory. The final model fit our data acceptably (root mean square error of approximation = 0.05, comparative fit index = 0.97).

Conclusion:
Latent curve analysis provided insights into the dynamic nature of variations in postoperative pain trajectories. Further studies investigating more factors associated with pain trajectories are warranted to elucidate the mechanisms behind the transitions of pain scores over time after surgery.
European Group for Blood and Marrow Transplantation score correlates with outcomes of older patients undergoing allogeneic hematopoietic stem cell transplantation
Authors: Chien Sheng-Hsuan , Liu Yao-Chung , Liu Chia-Jen , Ko Po-Shen , Wang Hao-Yuan , Hsiao Liang-Tsai , Lin Jeong-Shi , Chiou Tzeon-Jye , Liu Chun-Yu , Gau Jyh-Pyng 
Published: January 2020

Background:
Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are hematological diseases predominantly occurring in older patients. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the curative therapy for refractory AML or high-risk MDS, old age is often a hurdle to the procedure. We conducted a retrospective study to analyze the prognostic factors predicting outcomes of older patients undergoing allo-HSCT for acute leukemia and MDS.

Methods:
We collected data from patients diagnosed with acute leukemia or MDS, who underwent allo-HSCT at >50 years of age and reviewed clinical characteristics, including age, sex, underlying disease, European Group for Blood and Bone Marrow Transplantation (EBMT) risk score, and presence of acute graft-versus-host disease (aGVHD) or chronic GVHD (cGVHD). The Cox proportional hazard model was adopted to explore the independent prognostic factors for overall survival (OS), progression-free survival (PFS), and non-relapse mortality (NRM).

Results:
A total of 85 older patients were included, with the median age at allo-HSCT being 55 years. The significant prognostic factors for worse OS or PFS were an EBMT risk score > 3 and grade III–IV aGVHD, while patients with moderate to severe cGVHD would have better OS or PFS. Interestingly, it is not cGVHD but grade III–IV aGVHD that significantly correlated with NRM.

Conclusion:
This cohort study suggests that an EBMT risk score >3 and grade III–IV aGVHD predict poor outcomes, and careful management of GVHD may allow better survival for older patients undergoing allo-HSCT.
Depression and Anxiety Moderate the Relationship Between Body Image and Personal Well-being Among Patients With an Implanted Left Ventricular Assist Device
Authors: Melnikov Semyon , Abuhazira Miri , Golobov Dimitry , Yaari Victoria , Jaarsma Tiny , Ben Gal Tuvia 
Published: January 2020

Background
Left ventricular assist devices (LVADs) support the diseased heart of patients with advanced heart failure and are used as a bridge to heart transplantation or as destination therapy for patients ineligible for heart transplantation. Body image changes, as well as anxiety and depression, are prevalent among patients with an implanted LVAD.

Objective
The aim of this study was to investigate whether a relationship exists between body image and personal well-being among patients with an implanted LVAD and, if it does, whether it is moderated by anxiety and depression.

Methods
In this cross-sectional correlational study, a convenience sample of 30 adult patients with an implanted LVAD (mean age, 63 ± 10; 90% male) from the outpatient facility of a tertiary medical center completed validated instruments including the Body Image Scale, Cosmetic Scale, Hospital Anxiety and Depression Scale, and Personal Well-being Index, from October 2017 to February 2018. Results were subjected to multivariate linear regression and bootstrap moderation analyses.

Results
Eleven patients (37%) had below-average personal well-being scores, and 14 patients (47%) had below-average body image scores. Seven (23%) had either anxiety or depression, and 11 (37%) had both anxiety and depression. Body image was found to be a significant predictor of personal well-being (t = 2.16, P = .04). When anxiety and depression were present, body image (t = 2.08, P = .049), depression (t = 2.53, P = .018), and the interaction between body image and depression (t = −2.1, P = .047) were significantly associated with personal well-being.

Conclusions
Body image significantly predicted personal well-being among patients with an implanted LVAD. Depression alone, or depression combined with anxiety, moderated the relationships between body image and personal well-being. The current results may help to heighten healthcare providers' awareness of body image perception among patients with an implanted LVAD.
Mindfulness, Anxiety Symptoms, and Quality of Life in Heart Failure
Authors: Rechenberg Kaitlyn , Cousin Lakeshia , Redwine Laura 
Published: January 2020

Background
An estimated 6.5 million American adults live with heart failure (HF). Elevated anxiety symptoms may worsen HF symptoms and contribute to decreases in overall quality of life (QOL). Mindfulness has been associated with better psychological health with lower levels of anxiety symptoms. Mindfulness may be a modifiable target for reducing anxiety symptoms and increasing QOL in patients with HF.

Objective
The objective of this study is to examine the relationships among anxiety symptoms, dispositional mindfulness, and QOL in patients with symptomatic HF.

Methods
In this cross-sectional study, we conducted a secondary analysis of baseline data from 70 participants. We performed descriptive statistics, bivariate Pearson correlations, and multiple linear regression.

Results
The sample included 70 individuals with a mean age of 65 ± 10.5 years, 89% male, mean left ejection fraction of 45.7 ± 13.6, mean total QOL of 36.9 ± 21.7, mean total mindfulness of 82.2 ± 12.8, and mean anxiety of 4.8 ± 2.9. In multiple regression analyses, total mindfulness was significantly associated with lower anxiety (β = −0.491, P < .01), greater observational mindfulness was significantly associated with lower anxiety (β = −0.377, P < .01), and greater nonreactivity to inner experience was significantly associated with lower anxiety (β = −0.320, P < .05). Lower anxiety was associated with greater total QOL (β = 0.488, P < .01), greater physical QOL (β = 0.381, P < .01), and greater emotional QOL (β = 0.639, P < .01).

Conclusions
Mindfulness may be a way of improving both anxiety symptoms and QOL in this population.
Effects of a Comprehensive Reminder System Based on the Health Belief Model for Patients Who Have Had a Stroke on Health Behaviors, Blood Pressure, Disability, and Recurrence From Baseline to 6 Months
Authors: Wang Meng-Yao , Shen Meng-Jie , Wan Li-Hong , Mo Miao-Miao , Wu Zhen , Li Li-Li , Neidlinger Susan H. 
Published: January 2020

Background
The health behaviors and blood pressure control of patients with hypertension who have had a stroke are unsatisfactory. A protocol of a comprehensive reminder system has been published, and the results of 3 months of implementation have demonstrated improved patient health behaviors and blood pressure control. The continuity of the intervention effect on these variables after 3 months was not clear.

Objective
The aim of this study was to determine the impact of a comprehensive reminder system intervention on health behaviors, medication adherence, blood pressure, disability, and stroke recurrence in patients with hypertension who have had a stroke from baseline to 6 months after discharge.

Method
A multicenter, assessor-blinded, randomized controlled trial was conducted with 174 patients with hypertension who have had a stroke. The intervention consisted of health belief education, a calendar handbook, weekly short message services, and telephone interviews. Data were collected at baseline and at 3 and 6 months after discharge.

Results
Repeated-measures analysis of variance and single-effect analysis revealed that, compared with the control group, improvements of health behaviors, medication adherence, blood pressure, and disability of participants in the intervention group were superior. From 3 to 6 months after discharge, these trends remained or continually improved, whereas a downward trend was observed in the control group. There were only 2 stroke recurrences within 6 months, and no statistically significant difference between groups was found.

Conclusion
The comprehensive reminder system improved patients' health behaviors and medication adherence and reduced blood pressure and disability; the effect extended to 6 months after discharge.
Gender Differences in Hypertension Treatment and Control in Young Adults
Authors: KIM Ji-Soo , KIM Chul-Gyu 
Published: January 2020

ABSTRACT

Background
Compared with older adults, young adults exhibit poor treatment and control of hypertension. However, little is known about the factors affecting the treatment and control of hypertension in young adults.

Purpose
This study was aimed to identify the factors affecting the treatment and control of hypertension in early adulthood by gender in South Korea.

Methods
This secondary data analysis study used a data set from the Korean National Health and Nutrition Examination Survey. The inclusion criteria were as follows: (a) 19–44 years old and (b) having an indicator of hypertension (systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking antihypertensive drugs). Seven hundred eighty participants were included in this study. The odds ratios and 95% confidence intervals were derived using composite-sample multiple logistic regression.

Results
In men, age, marital status, family history of hypertension, treatment of hyperlipidemia, abdominal obesity, high-sodium diet, cholesterol, and aerobic exercise were found to be associated with hypertension treatment and control. In women, age, employment status, cardiovascular risk factors, body mass index, high-sodium diet, and drinking were found to be associated with hypertension treatment and control.

Conclusions
The factors affecting the treatment and control of hypertension differed between the two genders. Therefore, healthcare providers should consider the differences in the factors between the two genders in early adulthood. To improve the treatment and control of hypertension, the guidelines for treatment interventions and management should be gender-specific from early adulthood. Nurses should actively suggest health-related behavioral modifications such as performing aerobic exercise for young adult men and reducing alcohol consumption for women.
Water Exchange (WE) and Quality Improvement—Enhanced Advanced Adenoma Detection
Authors: Leung Felix W. , Koo Malcolm , Jia Hui , Leung Joseph W. , Cadoni Sergio , Falt Premysl , Hsieh Yu-Hsi , Hu Chi-Tan , Pan Yanglin , Radaelli Franco 
Published: January 2020

Introduction:
Advanced adenomas (≥10 mm in diameter, >25% villous, or high-grade dysplasia), a marker of colorectal cancer risk, are used to stratify patients for closer surveillance. Modern accessories, endoscopes, and age-adjusted evaluation have variable impacts on the advanced adenoma detection rate (AADR). In 1 randomized controlled trial (RCT) comparing air insufflation (AI) with water exchange (WE), the right colon AADR was significantly increased by WE. Four network meta-analyses reported that WE significantly increased overall adenoma detection rate (ADR), but the impact on AADR was not addressed.

Aim:
The aim of this study was to test the hypothesis that WE significantly increased AADR compared with AI.

Method:
Six Clinicaltrial.gov-registered RCTs were reported by a group of WE investigators. Data including AADR (primary outcome) and overall ADR (secondary outcome) were pooled.

Results:
A total of 5407 patients were randomized to AI (2699) and WE (2708). Compared with AI, WE significantly increased AADR (5.7% vs. 8.3%, P=0.001) and overall ADR (20.9% vs. 27.4%, P=0.001).

Conclusions:
In contrast to published reports, which showed variable impacts on AADR, WE was consistent in increasing AADR in 6 reported RCTs. The pooled data confirm that the impact of WE in increasing AADR was significant. The significantly enhanced overall ADR indicated that WE provided a higher quality outcome than AI. The significant improvement in AADR confirmed WE to be clinically relevant and has finally arrived as a timely addition to colorectal cancer prevention programs.
Metabolic aspects of muscle wasting during critical illness
Authors: van Gassel Robert J.J. , Baggerman Michelle R. , van de Poll Marcel C.G. 
Published: January 2020

Purpose of review
Skeletal muscle wasting during critical illness is the result of disturbed metabolism. No proven effective interventions targeting skeletal muscle mass and function during critical illness currently exist. This review summarizes recent advances regarding the complexity of metabolic factors involved and the challenge of establishing the clinical effects of metabolic interventions targeting the muscle.

Recent findings
Although the catabolic state is limited to the acute phase of critical illness, its subsequent impact on muscle mass and function persists long after ICU discharge. Immobilization, inflammation and disturbed muscle energy and nutrient metabolism are key drivers of muscle protein loss. Current research focuses on the effects of enhanced protein provision, specific substrate delivery and physical exercise. Whilst some interventions have been successful at improving muscle mass, these effects do not always carry over into muscle function or strength.

Summary
Increased understanding of metabolic derangements during critical illness provides new potential targets for treatment. The potential of dietary protein to attenuate the muscle protein catabolic state has yet to be established in clinical trials. Basic research should focus on ways to further improve the anabolic potential of nutrition by unravelling mechanisms that regulate anabolic and catabolic pathways and energy metabolism.
Eosinophils in chronic obstructive pulmonary disease: are they just another biomarker?
Authors: McDonald Christine F. 
Published: January 2020

Purpose of review
Interest in blood eosinophils as a biomarker of responsiveness to therapy in chronic obstructive pulmonary disease (COPD) continues to grow, with recommendations regarding their adjunctive use incorporated into the GOLD 2019 treatment algorithm. The present review summarizes some key recent papers referencing differential treatment effects based on blood eosinophil counts.

Recent findings
Post-hoc analyses of trials of inhaled corticosteroids in COPD have shown greater treatment responses in patients with higher blood eosinophil levels, with some exceptions. Eosinophil-directed treatment with oral corticosteroids showed equivalent benefits to noneosinophil-directed therapy, with reduced corticosteroid exposure. Prespecified analyses of recent prospective trials of therapies incorporating inhaled corticosteroids were generally supportive of previous findings, so evidence for the use of blood eosinophils as biomarkers is gathering. Nonetheless, the anti-interleukin (IL)-5 receptor antagonist benralizumab, which depletes blood eosinophils, showed no treatment benefit in patients with COPD selected for eosinophilic phenotype and treatment of COPD with the IL-5 antagonist, mepolizumab showed inconsistent results.

Summary
The 2019 GOLD COPD Strategy document embraced the use of the blood eosinophil to guide ICS therapy in management of patients with stable COPD and frequent exacerbations. Although post-hoc and several prospective studies with prespecified subgroup analyses have supported this approach, questions still remain about how to incorporate this new assessment tool into real-life management of COPD and more research is required to validate its adoption into clinical practice. There is an absence of data to support the use of biologic therapy in patients with an eosinophilic COPD phenotype at this stage.
Epigenetic alterations of testicular germ cell tumours
Authors: Ilijazi Dafina , Shariat Shahrok F. , Hassler Melanie R. , Lemberger Ursula , Ertl Iris E. 
Published: January 2020

Purpose of review
Testicular germ cell tumours (TGCTs) exhibit, in contrast to other cancer types, a relatively low mutational burden. However, numerous epigenetic alterations have been shown to impact TGCT. In this review, we summarize the most relevant findings of the past 2 years.

Recent findings
Recent studies focused on the functions of microRNAs and the impact of aberrant DNA methylation. Moreover, several epigenetic drugs with antineoplastic effects in TGCTs were identified.

Summary
Aberrant DNA methylation and differentially expressed microRNAs have an important effect on TGCT pathogenesis. Moreover, differential DNA methylation patterns were found to be specific for different TGCT subtypes. Various microRNAs, such as miR-371a-3p, were found to be highly sensitive and specific biomarkers for TGCT. The epigenetic drugs guadecitabine, animacroxam, and JQ1 showed promising effects on TGCT in preclinical in-vivo and in-vitro studies.
Complications after active stone removal
Authors: Mourmouris Panagiotis , Tzelves Lazaros , Skolarikos Andreas 
Published: January 2020

Purpose of review
Active stone removal has been entirely revolutionized in the past decades. Smaller instruments, scope and laser technology advancements and novel lithotripter modalities have entirely changed the way urological surgeons treat stones. Nevertheless novel technologies may lead to different and difficult to manage complications. Accurate knowledge of indications, limitations and technical details of these novel modalities can significantly decrease complication rates. The purpose of this review is to provide the most recently acquired knowledge to decrease patient's morbidity after active stone removal.

Recent findings
Complications of active stone removal are well known for many years, nevertheless novel technologies in stone management can substantially differentiate their rates. Minimal invasive techniques are becoming even more minimal which reflects on the complications.

Summary
Mastering the novel techniques in active stone removal and knowing their inherent limitations, in association with the recognition of predisposing factors and preventing measures have led to a highly acceptable low complication rate. Further refinements and technical improvement will reduce even more the complication incidence in the future.