bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players
Authors: Bezuglov Eduard , Lazarev Artemii , Petrov Arseniy , Brodskaia Alesia , Lyubushkina Anastasiya , Kubacheva Kamila , Achkasov Evgeny , Nikolenko Vladimir 
Published: October 2020

Study Design.
Cross-sectional study

Objective.
The aim of this study was to evaluate the actual prevalence of degenerative spinal changes and their association with age in a cohort of professional soccer players.

Summary of Background Data.
Presently, there are data that athletes have more degenerative changes than nonathletes; however, the research examining the prevalence of degenerative spinal conditions among professional elite soccer players is scarce.

Methods.
Professional male soccer players were included in the study (n = 40, average age 26,6 ± 4,5 years, average height 18 ± 0.07 m, weight 76.7 ± 7.1 kg). Lumbosacral spine MRI scanning at the L1-S1 level has been performed. Two radiologists with at least 7 years of experience of working with athletes evaluated all images independently of each other

Results.
92.5% (n = 37) of soccer players had ≥1 spinal degenerative condition. Thirty-five percent (n = 14) of players had three to five, and 50% (n = 20) had six or more conditions. The average age of players who had six or more conditions was significantly higher than those who had zero to five or three to five conditions—28.1 ± 4.8 years versus 25.1 ± 3.6 years (P = 0.029), and 24.8 ± 3.6 years, respectively.
Kruskal-Wallis test has shown no association between the number of degenerative conditions and weight (P = 0.98) as well as body mass index (P = 0.99). The age was associated with degenerative changes (P = 0.008).
Disc desiccation was the most common pathologic condition, which was found in 82.5% of athletes. Facet joint arthropathy and spondylosis were present in 70, and 50% of the studied lumbar spine MRI scans, respectively. The spondylolysis prevalence of 20% was noted.

Conclusion.
Elite professional soccer players demonstrate a high prevalence of asymptomatic degenerative lumbar spinal degenerative changes, which are significantly associated with age. These conditions might lead to the development of symptomatic lower back pain, given the high-intensity exercise required in professional soccer. It is presently unclear what measures might be applied for the primary prevention of these degenerative spinal conditions.

Level of Evidence: 4
Predictive Probability of the Global Alignment and Proportion Score for the Development of Mechanical Failure Following Adult Spinal Deformity Surgery in Asian Patients
Authors: Yagi Mitsuru , Daimon Kenshi , Hosogane Naobumi , Okada Eijiro , Suzuki Satoshi , Tsuji Osahiko , Nagoshi Narihito , Fujita Nobuyuji , Nakamura Masaya , Matsumoto Morio , Watanabe Kota 
Published: October 2020

Study Design.
This is a multicenter retrospective review of 257 surgically treated consecutive ASD patients who had a minimum of five fused segments, completed a 2-year follow-up (53 ± 19 yrs, females: 236 [92%]).

Objective.
This study aimed to validate the predictive probability of the GAP score in an Asian ASD patient cohort.

Summary of Background Data.
The GAP score is a recently established risk stratification model for MF following ASD surgery. However, the predictive ability of the GAP score is not well studied. This study aimed to validate the predictive probability of the GAP score in an Asian ASD patient cohort.

Methods.
Comparisons of the immediate postoperative GAP scores between MF the and MF-free groups were performed. We evaluated the discriminative ability of the GAP score based on the area under the receiver operating characteristic curve (AUROC). The Cuzick test was performed to determine whether there is a trend between the GAP score and the incidence of MF or revision surgery. Univariate logistic regression analyses were performed to explore the associations between the GAP score and the incidence of MF or revision surgery.

Results.
No difference was observed in the GAP score between the MF and MF-free groups (MF vs. MF-free; GAP: 5.9 ± 3.3 vs. 5.2 ± 2.7, P = 0.07). The Cuzick analysis showed no trend between the GAP score and the risk for MF or revision surgery. Likewise, the MF rate was not correlated with the GAP score, as shown by the ROC curve (AUC of 0.56 [95% CI 0.48–0.63], P = 0.124). Univariate logistic regression confirmed no associations between the GAP score and the incidence of MF or revision surgery (MF; moderately disproportioned [MD]: OR: 0.6 [95% CI: 0.3–1.2], P = 0.17, severely disproportioned [SD]: OR: 1.2 [95% CI: 0.6–2.3], P = 0.69, revision surgery; MD: OR: 0.8 [95% CI: 0.2–2.8], P = 0.71, SD: OR: 1.2 [95% CI: 0.9–8.7], P = 0.08).

Conclusion.
In this multicenter study, in an Asian ASD patient cohort, the GAP score was not associated with the incidence of MF or revision surgery. Additional studies on the predictive ability of the GAP score in different patient cohorts are warranted.

Level of Evidence: 3
Presurgical Short-Term Halo-Pelvic Traction for Severe Rigid Scoliosis (Cobb Angle >120°)
Authors: Wang Yu , Li Chunde , Liu Long , Li Hong , Yi Xiaodong 
Published: October 2020

Study Design.
A 2-year follow-up review of 62 patients with severe rigid scoliosis (>120°).

Objective.
To evaluate the effectiveness and safety of halo-pelvic traction (HPT) for treating severe rigid scoliosis (>120°).

Summary of Background Data.
Severe rigid scoliosis (>120°) is still a challenge for spine surgeons. A combination of presurgical HPT traction, osteotomy, and internal fixation could be a safe and effective solution for these cases.

Methods.
We reviewed the records of all the patients with severe rigid scoliosis (>120°) treated with presurgical HPT from 2013 through 2017. Radiographic measurements were performed. The period of traction, estimated blood loss, operation time, complications, and bed rest period were recorded.

Results.
A total of 62 patients who had 2-year radiological follow-up were included in the study. In 30 patients, vertebral column resection (VCR) was performed aiming to achieve a better correction rate. In patients who received a VCR, the average preoperative Cobb angle was 133.6°, and the average correction rate at 2 years after surgery was 65.4%. Compared with the average height before treatment, at 2 years after surgery the average height was 12.5 cm greater. In patients who did NOT received VCR, the average preoperative Cobb angle was 131.5°, and the average correction rate at 2 years after surgery was 64.1%. Compared with the average height before treatment, at 2 years after surgery the average height was 14.0 cm greater. Common complications during HPT included infected pelvic pins, brachial plexus palsy, and weakness of the lower extremities. No patients experienced permanent neurological deficits or death.

Conclusion.
For severe rigid scoliosis with a Cobb angle greater than 120°, a combination of short-term presurgical HPT and posterior surgery is an effective and safe solution. After 4 to 6 weeks of presurgical HPT the Cobb angle can be decreased by approximately 50%, providing a favorable condition for spine corrective surgery.

Level of Evidence: 3
Online educational curriculum in pediatric epilepsy: A pilot study
Authors: Winesett Steven. Parrish , Amankwah Ernest K. , Nguyen Anh Thy H. , Sibinga Erica 
Published: October 2020

ABSTRACT
Recent projections suggest that increasing numbers of nurse practitioners (NPs) and physician assistants (PAs) will be needed to meet the increasing need for pediatric neurology expertise. This pilot study assessed feasibility and preliminary effectiveness of an online curriculum designed to impact knowledge, skills, attitudes, and behaviors of NPs/PAs treating patients with pediatric epilepsy. Ten-session online curriculum was developed using previous experience and published recommendations to improve knowledge, electroencephalogram (EEG) skills, attitudes, and behaviors related to treating patients with pediatric epilepsy. Participants were NPs and PAs recruited from regional pediatric neurology practices. Three successive 10-week courses were provided. Attendance and completion were used to assess feasibility. Knowledge, EEG skills, attitudes, and behaviors were evaluated using pretest versus posttest questionnaires and compared analytically using a paired t-test and McNemar test. Twenty-nine NPs/PAs started the course, with typical attendance ∼85%. Twenty-two participants (76%) completed the course. Completers showed significant improvements in medication knowledge (premedication: mean = 74.6, SD = 16.4; postmedication: mean: 88.3, SD = 14.0; p = .001), EEG skills (premedication: mean = 44.8, SD = 24.4; postmedication: mean: 77.3, SD = 19.8; p < .001), and several measures of attitude and behavior. This pilot study shows feasibility and potential educational benefit of a 10-hour online course on pediatric epilepsy and may provide a convenient and effective option for continuing education for hard-to-reach students.
Introducing telehealth skills into the Doctor of Nursing Practice curriculum
Authors: Love Rene , Carrington Jane M. 
Published: October 2020

ABSTRACT
Telehealth training was important for nurse practitioner (NP) students prior to the COVID-19 pandemic, but now it is essential. Training in telehealth allows access to health care for vulnerable populations in rural health areas and beyond. As the future of health care delivery changes, providers will be required to use this technology. Therefore, it is imperative that such training become part of NP education to prepare students to be technologically competent providers in the 21st century. The objective of this educational pilot project was to educate Doctor of Nursing Practice nurse practitioner students to conduct patient interviews and provide interprofessional collaboration using telehealth. The project addressed a gap in the literature on planning for simulations from varying NP specialties and provided feedback from standardized patients on their experiences. A total of 83 students from four specialty tracks received telehealth education. Students then interviewed simulated patients and provided a collaborating report. The students and patients were asked to complete questionnaires to assess the modules and the experience itself. Quantitative descriptive data were gathered, and qualitative themes were obtained from open-ended questions. Both the students and simulated patients indicated that they appreciated the ease and convenience of interviewing patients through technology. Both struggled with issues related to the technology and the need to have backup systems available. The students demonstrated that they were very capable of using telehealth and were generally very positive about the experience.
Advancing the health of homeless populations through vaccinations
Authors: Washington-Brown Linda , Cirilo Rose Wimbish 
Published: October 2020

ABSTRACT

Background:
Homeless individuals and families are at an increased risk for contracting and transmitting communicable infections and diseases. Due to poor living conditions and limited access to health care resources, homeless people of all ages are vulnerable to acquiring communicable infections, such as pneumococcal pneumonia.

Local problem:
Less than 40% of sheltered and unsheltered homeless people in South Florida, who were interviewed for this project, knew their immunization status and/or were up-to-date with their recommended vaccine histories.

Methods:
The immunization project implemented a five-step process to provide pneumococcus (pneumococcal polysaccharide vaccine 23) and Prevnar 13 vaccinations to a convenience sample of adult homeless men and women (N = 209) participants, who completed the financial eligibility form (J11) during their intake process to admission, for sheltered services from two local clinics.

Interventions:
To promote herd immunity, the five-step process was followed. As per the Centers for Disease Control and Prevention guidelines, initial training was provided to homeless shelter health care providers on vaccine storage, handling, and vaccination. A subsequent 1-week follow-up was completed with participants to determine if any delayed vaccination adverse reactions occurred.

Results:
Descriptive statistics was used to examine data from the initial project implementation. Findings indicated that more African Americans (n = 117) participated in the project than Whites (n = 50), Hispanics (n = 35), or Haitians (n = 7).

Conclusions:
Homeless individuals experience illnesses that are preventable through involvement with a structured immunization program. Collectively, nurse practitioners can reduce barriers to immunization by increasing vaccine coverage and introducing incremental policy changes that enhance the health status among homeless populations.
Bone Marrow Reconversion With Reambulation
Authors: Liu Tammy , Melkus Gerd , Ramsay Tim , Sheikh Adnan , Laneuville Odette , Trudel Guy 
Published: October 2020

Objectives
Marrow adipose tissue may be modulated by physical activity and reambulation after inactivity. The aim of this study was to measure the effect of reambulation for up to 2 years after 60 days of bed rest on the lumbar bone marrow composition.

Methods
In a prospective clinical trial, 20 healthy men participated in a 60-day, 6-degree head-down tilt bed rest study. Serial 3-T magnetic resonance (MR) imaging measures of the lumbar spine were performed at baseline, after 57 days of bed rest, and at 30, 360, and 720 days of reambulation (100 MR imaging scans). Proton density with and without fat saturation, 2-point Dixon, and single-voxel MR spectroscopy techniques were used to assess bone marrow composition (300 measures). Erythropoiesis was measured using hematocrit, reticulocyte, and ferritin. Also, participants randomly received either a nutritional intervention composed of polyphenols, omega-3, vitamin E, and selenium or a normal diet.

Results
Thirty days of reambulation after 60 days of bed rest caused a marked decrease of the mean lumbar vertebral fat fraction (VFF) (−9.2 ± 1.6 percentage points, −8.0 ± 1.3 percentage points, and −12.7 ± 1.2 percentage points compared with baseline using proton density, Dixon, MR spectroscopy, respectively; all 3, P < 0.05). Reambulation also decreased the fat saturation index (−5.3 ± 1.1 percentage points compared with baseline; P < 0.05). These coincided with lower hematocrit and ferritin and with increased reticulocytes at reambulation day 13 compared with baseline (all 3, P < 0.05). After 57 days of bed rest, the VFF was unchanged from baseline (all 3 MR techniques, P > 0.05); reambulation for 2 years returned the lumbar VFF to baseline values.

Interpretation
This longitudinal trial established that 30 days of reambulation after 60 days of bed rest constituted a powerful stimulus for bone marrow reconversion. In this model, the enhanced erythropoiesis coupled with preferential consumption of fatty acids from regulated marrow adipose tissue to supply energy for erythropoiesis and bone anabolism may explain the lumbar vertebrae reconversion. These results will help interpreting bone marrow signal in ambulatory patients after long periods of bed rest.
Deformation Assessment of the Manually Pre-Bent Titanium Miniplates in Orthognathic Surgery With Finite Element Analysis
Authors: Liu Li-Nan , Li Jia-Yang , Li Ke-Han , Wu Qiong-Hui , Liu Yao , Luo En 
Published: October 2020

Abstract
This study summarized the literature regarding the application of pre-bent titanium miniplates in orthognathic surgery and evaluated the extra deformation of the manually pre-bent titanium miniplates via finite element analysis for acquiring higher surgical accuracy. The literature was reviewed with a chart. Three models of titanium miniplates with different thicknesses (1.0 mm, 0.8 mm, 0.6 mm) were created using COMSOL Multiphysics software for biomechanical behavior analysis. The 3 models were virtually bent into 5 angles (15 degree, 30 degree, 45 degree, 60 degree, 80 degree). respectively to simulate the preoperative virtual bending, then to simulate the practical manual bending via finite element analysis. The stresses and displacements of these models were recorded. The models from virtual bending simulation and manual bending simulation were registered to analyze the deviations. The results showed that the maximum stress and the displacement deviations between the virtual bending models and the manual bending models increased with the thickness and bending angle of the pre-bent miniplate models. To improve the surgical accuracy, measures should be applied to the manually pre-bent titanium miniplates to reduce the extra deformation when the plate being thicker and the bending angle being larger.
Carotid Sacrifice via Endonasal Clipping to Treat Carotid Injury in Extended Endoscopic Endonasal Surgery
Authors: Liu Bin , Tian Hailong , Wang Zhigang 
Published: October 2020

Abstract
Internal carotid artery (ICA) injury is a rare but disastrous complication during extended endoscopic endonasal surgery. The method of ICA sacrifice via endonasal clipping has only been reported in a few cases to treat ICA injury. To provide some technical experience of this method, here the authors present 2 cases of ICA injury during extended endoscopic endonasal surgery with 2-year follow-up. The 2-nostrils/4-hands technique was used to control the active bleeding. Based on the good collateral circulation status and the normal results of intraoperative electrophysiological monitoring, we sacrificed the injured ICAs via endonasal clipping. Both cases had a satisfying tumor resection rate and a good clinical outcome.
Evaluation of diastolic function in newly diagnosed hyperthyroid patients with preserved left ventricular systolic function
Authors: Shojaeifard Maryam , Davoudi Zahra , Erfanifar Azam , Fattahi Neisiani Hamed , Erami Sajad , Bakhshandeh Hooman , Mohammadi Khadije 
Published: October 2020

Background
Diastolic dysfunction has been reported as a cardiovascular effect of hyperthyroidism, and is also supposed to be a cause of heart failure manifestations in the patients with preserved ejection fraction (EF).

Methods
For evaluation of diastolic function in hyperthyroid patients and also diastolic function during performing exercise stress echocardiography, we conducted this study on 25 newly diagnosed hyperthyroid patients compared to 26 healthy subjects as control group. Diastolic function of the patients at rest was assessed using these parameters as follows: left atrium volume index, tricuspid regurgitation (TR) velocity, mitral inflow early diastolic flow (E wave), tissue Doppler of mitral annular velocity (e′), E/e′ ratio, and isovolumic relaxation time (IVRT); and during exercise stress echocardiography, we judged diastolic response by measuring E/e′ ratio and TR velocity at the peak of stress.

Results
The mean age of the patients was 39.64 ± 12.23 years old and 52% of them were female. History of exertional dyspnea was found in 64% of patients. All the patients had normal diastolic function at the time of resting and there was no significant difference in diastolic parameters between the two groups except for IVRT, which was lower in hyperthyroid patients. Interestingly, no patients developed diastolic dysfunction during exercise stress echocardiography.

Conclusion
Our finding did not show diastolic dysfunction in hyperthyroid patients neither at rest nor during exercise echocardiography and did not support the hypothesis that diastolic dysfunction can be a cause of exertional intolerance and dyspnea in the patients with preserved EF.
Predictors of Death in Severe COVID-19 Patients at Millennium COVID-19 Care Center in Ethiopia: A Case-Control Study
Authors: Maru Endalkachew H. , Leulseged Tigist W. , Hassen Ishmael S. , Zewde Wuletaw C. , Chamesew Nigat W. , Abebe Daniel S. , Jagema Tariku B. , Bayisa Abdi B. , Gezahegn Mesfin A. , Tefera Oli S. , Shiferaw Wondmagegn G. , Admasu Teketel T. 
Published: October 2020

ABSTRACTBackgroundAs the number of new cases and death due to COVID-19 is increasing, understanding the characteristics of severe COVID-19 patients and identifying characteristics that lead to death is a key to make an informed decision. In Ethiopia, as of September 27, 2020, a total of 72,700 cases and 1165 deaths were reported.ObjectiveThe study aimed to assess the determinants of death in Severe COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.MethodsA case-control study of 147 Severe COVID-19 patients (49 deaths and 98 discharged alive cases) was conducted from August to September 2020. A comparison of underlying characteristics between cases (death) and controls (alive) was assessed using a chi-square test and an independent t-test with a p-value of <0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the predictor variables and outcome of Severe COVID-19 (Alive Vs Death) where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results.ResultsHaving diabetes mellitus (AOR= 3.257, 95% CI= 1.348, 7.867, p-value=0.00), fever (AOR=0.328, 95% CI: 0.123, 0.878, p-value= 0.027) and Shortness of breath (AOR= 4.034, 95% CI= 1.481, 10.988, p-value=0.006) were found to be significant predictors of death in Severe COVID-19 patients.ConclusionsThe outcome of death in Severe COVID-19 patients is found to be associated with exposures to being diabetic and having SOB at admission. On the other hand, having a fever at admission was associated with a favorable outcome of being discharged alive.
Dry eye disease: A Canadian quality of life and productivity loss survey
Authors: Chan Clara C. , Ziai Setareh , Myageri Varun , Burns James G. , Prokopich C. Lisa 
Published: October 2020

ABSTRACTAimTo capture the direct and indirect cost estimates of dry eye disease (DED), stratified by disease severity, in patients from Canada and to understand the impact of DED on quality of life (QoL) in this group.MethodsA prospective, multi-centre, observational, cross-sectional study was conducted at six optometry and ophthalmology sites across Canada. Eligible patients completed a 20-minute survey on demography, general health, disease severity, QoL, and direct and indirect costs.ResultsA total of 151 patients participated in the study and 146 were included in the analysis. Mean (standard deviation [SD]) age was 49.8 (11.4) years and most patients were female (89.7%). DED was considered moderate or severe by 19.2% and 69.2% of patients, respectively. Sjögren’s syndrome was reported by 8.2% of patients. Total mean annual costs of DED were $24,331 (Canadian dollars [CAD]) per patient and increased with disease severity. Mean (SD) indirect costs for mild, moderate, and severe disease were $5,961 ($6,275), $16,525 ($11,607), and $25,485 ($22,879), respectively. Mean (SD) direct costs were $958 ($1,216), $1,303 ($1,574), and $2,766 ($7,161), respectively. QoL scores were lowest in patients with Sjögren’s syndrome and those with severe DED.ConclusionsThis study provides important insights into the negative impact of DED in a Canadian setting. Patients with severe DED reported higher direct and indirect costs and lower QoL compared with those with mild or moderate disease. Increased costs and poorer QoL were also evident for patients with DED plus Sjögren’s syndrome versus DED alone.