bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use and Cost of Orthosis in Conservative Treatment of Acute Thoracolumbar Fractures
Authors: Linhares Daniela , Sousa-Pinto Bernardo , Ribeiro da Silva Mnuel , Fonseca João A. , Neves Nuno 
Published: November 2020

Study Design.
Survey study.

Objective.
Assess practices and opinions of spine specialists from Europe and North America on orthosis use in adult patients with acute thoracolumbar (TL) fractures. Evaluate cost of the devices.

Summary of Background Data.
Although orthosis are traditionally used in conservative treatment of TL fractures, recent systematic reviews showed no benefit in patient's outcomes.

Methods.
A search for contact authors with publications on spine fractures from all European and North American countries was performed. An online questionnaire was sent on demographic data, practice setting, mean number of fractures treated, use of orthosis upon choice for conservative treatment, and average orthosis cost. Data was analyzed based in world regions, economic rank of the country, and health expenditure.

Results.
We received 130 answers, from 28 European and five North American countries. Most responders had more than 9 years of practice and worked at a public hospital. 6.2% did not prescribe a brace in any patient with acute TL fractures conservatively treated and 11.5% brace all patients. In a scale from 1 to 5, 21 considered that there is no/low benefit (1) and 14 that bracing is essential (5), with a mean of 3.18. Europeans use orthosis less commonly than North Americans (P < 0.05). Orthosis mean cost was $611.4 ± 716.0, significantly higher in North America compared with Europe and in high income, when compared with upper middle income countries (both P < 0.05). Although hospital costs were not evaluated, orthosis is costlier when it involves admission of the patient (P < 0.05). An increase in orthosis cost associated with higher gross domestic product (GDP) per capita and higher health expenditure was found.

Conclusion.
More than 90% of spine specialists still use orthosis in conservative treatment of adult patients with acute TL fractures. Orthosis cost vary significantly between continents, and it is influenced by the country's economy.

Level of Evidence: 4
Decreasing Incidence of Lumbar Discectomy Surgery in Finland in 1997–2018
Authors: Ponkilainen Ville T. , Mäntymäki Heikki , Huttunen Tuomas T. , Mattila Ville M. 
Published: November 2020

Study Design.
Retrospective register study.

Objective.
The aim of this study was to assess the incidence and trends of lumbar disc surgeries in Finland from 1997 through 2018.

Summary of Background Data.
The evidence on lumbar spine discectomy has shifted from supporting surgical treatment toward nonoperative treatment. Still, the incidence of lumbar discectomy operations increased until the 1990 s. In the United States, the incidence began to decline after a downward turn in 2008, yet recent trends from countries with public and practically free health care are not widely known.

Methods.
Data for this study were obtained from the Finnish nationwide National Hospital Discharge Register. The study population covered all patients 18 years of age or older in Finland during a 22-year period from January 1, 1997, to December 31, 2018.

Results.
A total of 65,912 lumbar discectomy operations were performed in Finland from 1997 through 2018. The annual population-based incidence of lumbar discectomy decreased 29% during the 22-year period, from 83 per 100,000 person-years in 1997 to 58 per 100,000 person-years in 2018. In addition, the incidence of microdiscectomy increased 12%, from 41 per 100,000 person-years in 1997 to 47 per 100,000 person-years in 2018, whereas the incidence of open discectomy decreased 71%, from 41 per 100,000 person-years in 1997 to 12 per 100,000 person-years in 2018. The total reoperation rate for microendoscopic, microscopic, and open discectomy surgeries was 16.3%, 15.3%, and 14.9%, respectively.

Conclusion.
The nationwide incidence of lumbar discectomy decreased in Finland from 1997 through 2018. Additionally, the incidence of open discectomy is decreasing rapidly, whereas the incidence of microsurgical techniques is increasing.

Level of Evidence: 3
Arginine metabolism: a potential target in pancreatic cancer therapy
Authors: Yang Jin-Shou , Wang Cheng-Cheng , Qiu Jiang-Dong , Ren Bo , You Lei 
Published: November 2020

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an extremely malignant disease, which has an extremely low survival rate of <9% in the United States. As a new hallmark of cancer, metabolism reprogramming exerts crucial impacts on PDAC development and progression. Notably, arginine metabolism is altered in PDAC cells and participates in vital signaling pathways. In addition, arginine and its metabolites including polyamine, creatine, agmatine, and nitric oxide regulate the proliferation, growth, autophagy, apoptosis, and metastasis of cancer cells. Due to the loss of argininosuccinate synthetase 1 (ASS1) expression, the key enzyme in arginine biosynthesis, arginine deprivation is regarded as a potential strategy for PDAC therapy. However, drug resistance develops during arginine depletion treatment, along with the re-expression of ASS1, metabolic dysfunction, and the appearance of anti-drug antibody. Additionally, arginase 1 exerts crucial roles in myeloid-derived suppressor cells, indicating its potential targeting by cancer immunotherapy. In this review, we introduce arginine metabolism and its impacts on PDAC cells. Also, we discuss the role of arginine metabolism in arginine deprivation therapy and immunotherapy for cancer.
The Challenge of Contact Lens Visual Rehabilitation for Open Globe Injuries in Children Under 5 Years of Age
Authors: Itoi Motohiro , Higashihara Hisayo , Yamagishi Keiko , Hyakutake Yoko , Sotozono Chie 
Published: November 2020

Purpose:
To investigate the clinical course of children younger than 5 years old who underwent rigid gas-permeable (RGP) contact lens (CL) wearing as visual rehabilitation of open globe injuries (OGIs) in Japan.

Methods:
This retrospective case series involved six eyes of six children (four boys and two girls) with OGIs. The mean patient age at injury was 4.0±0.83 SD (range: 2.5–5 years), and the mean follow-up period was 42.9 months (range: 31.6–52.8 months). In each child, data regarding injury type, ocular surgery performed, outcomes of amblyopia management (including best-corrected visual acuity [BCVA] with RGP CL or spectacles), the RGP CL-wear training period, and rate of continuous RGP CL-wear were analyzed.

Results:
Trauma type was penetrating injury (four eyes) and globe rupture (two eyes). All six cases showed lens penetration, and underwent corneal suture, lensectomy, and pars plana vitrectomy under general anesthesia. The mean RGP CL-wear training period was 3.5 months, and only one of the six cases discontinued RGP CL use. The mean BCVA with spectacles and with RGP CL was LogMAR: 1.52±0.41 (range 1.00–2.00) and 0.73±0.41 (range: 0.30–1.15), respectively. In all patients, except in one case in which strabismus developed, BCVA improved with RGP CL wear more than 0.2 logMAR compared with that with spectacles.

Conclusion:
Although the training period for RGP CL-wear is long in pediatric patients with OGIs, the treatment can be effective for refractive problems and for preventing the development of strabismus.
Double-Organ Bias in Controlled Trials on Eyelid Ptosis
Authors: Mangan Mehmet Serhat , Esen Fehim 
Published: November 2020

Purpose:
Proper statistical analysis is an essential element in the evaluation of clinical trial outcomes. We had the informal observation that double-organ bias was a neglected issue during the statistical analyses of clinical trials on eyelid ptosis. The aim of this study was to formally document the prevalence of this bias in these studies.

Methods:
Clinical trials on eyelid ptosis, published in the last 20 years, were searched in PubMed with the terms; “((blepharoptosis) OR upper eyelid ptosis) OR eyelid ptosis” and with the filters “Randomized Controlled Trial (RCT), Clinical Trial, Humans.” Two independent observers evaluated the articles for eligibility, field of the journal, field of the authors, presence of randomization, type of the study (surgical, medical), and statistical approach to double organ bias.

Results:
The PubMed search yielded 101 articles and 23 of them met the above-mentioned criteria. In 3 articles, primary outcome measure was not related with the eyes. Among the remaining 20 articles, 14 (70%) had double-organ bias in the statistics. The bias was slightly less common in randomized trials (60% vs. 80%), but the difference was not statistically significant. Its prevalence was similar between ophthalmology journals and the rest (p = 0.64). Interestingly, the bias tended to be more in Q1 journals (87.5%) compared to Q2 and Q3 journals (58.3%) and median impact factor was higher in biased articles (1.82 vs. 1.29), but the differences weren’t statistically significant (p = 0.32, p = 0.24). There was no difference between the last 2 decades (66.6% vs. 75%, p = 0.64).

Conclusions:
The prevalence of the double-organ bias was very high in published clinical trials on eyelid ptosis (70%) and even among RCTs (60%). The prevalence of the bias didn’t prevent publication in higher impact factor journals and didn’t change between journals from different disciplines or over time.
Relationships Between Job Satisfaction and Job Demand, Job Control, Social Support, and Depression in Iranian Nurses
Authors: BAGHERI HOSSEIN ABADI Majid , TABAN Ebrahim , KHANJANI Narges , NAGHAVI KONJIN Zahra , KHAJEHNASIRI Farahnaz , SAMAEI Seyed Ehsan 
Published: November 2020

ABSTRACT

Background
Nurses often experience a wide variety of stressful situations. Excessive work stress influences the physical and mental health of nurses and decreases their life quality and professional efficacy. In addition, high levels of psychological stress may cause job dissatisfaction and job strain.

Purpose
The objective of this study was to explore the relationship between several work-related risk factors and job satisfaction in Iranian nurses.

Methods
A cross-sectional study was conducted on 730 nurses from four public hospitals in, respectively, northern, southern, eastern, and western Iran. Variables in the job demand–control–support (JDCS) model were measured using the Job Content Questionnaire, and job satisfaction was measured using the Minnesota Satisfaction Questionnaire.

Results
The mean score for job satisfaction was 62.94 ± 14.24, which is considered moderate. Nurses with a low level of job satisfaction had significantly higher psychological and physical job demands (p < .05). Significant relationships were found between job satisfaction and several dimensions of the JDCS model, including psychological job demands (β = −0.11, p < .001), physical job demands (β = −0.86, p = .004), skill discretion (β = 0.48, p = .033), decision authority (β = 0.43, p = .028), and supervisor support (β = 1.85, p = .004). The sociodemographic and JDCS model variables used in this study explained 42% of the variation in job satisfaction (R
2 = .42).

Conclusions/Implications for Practice
Enhancing the job satisfaction of nurses is possible by creating a balance between job demands, job control, and social support.
Burnout Among Hospital Non-Healthcare Staff
Authors: Clinchamps Maëlys , Auclair Candy , Prunet Denis , Pfabigan Daniela , Lesage Francois-Xavier , Baker Julien S. , Parreira Lenise , Mermillod Martial , Gerbaud Laurent , Dutheil Frédéric 
Published: November 2020

Objectives:
To study the prevalence of burnout among non-health care workers (NHCW), the risk and protective factors and to quantify the risk of burnout.

Method:
We conducted a cross-sectional study on the 3142 NHCW of the University Hospital of Clermont-Ferrand. They received a self-assessment questionnaire.

Results:
Four hundred thirty seven (13.9%) NHCW completed the questionnaires. More than three quarter (75.4%) of NHCW was in burnout, with one in five (18.7%) having a severe burnout. Job demand was the main factor explaining the increase in exhaustion and overinvestment was the main factor explaining the increase in cynicism. Effort-reward imbalance (ERI) multiplied the risk of severe burnout by 11.2, job strain by 3.32 and isostrain by 3.74.

Conclusion:
NHCW from hospital staff are at high risk of burnout. The two major models of stress at work, the job demand-control-support and the ERI, were highly predictive of burnout, with strong dose-response relationships.
The Short-Term Effects of Ambient Air Pollutants are Associated With Daily Mortality in Northeast China From 2014 to 2018
Authors: Liu Xiao-Bo , Wen Xi-Mei , Sun Xiao-Hong , Hong Qian-Qi , Wang Qian , Kang Zhen , Xia Su-Jian , Yang Chao , Zhu Sui 
Published: November 2020

Objective:
We aimed to examine the associations between ambient air pollutants and daily mortality in Northeast China from 2014 to 2018.

Methods:
A two-stage approach was used to estimate particulate matter with an aerodynamic diameter of 10 μm (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2) exposure and daily mortality.

Results:
An increase of 10 μg/m3 of PM10 exposure and NO2 at lag of 0 to16 days was associated with the cumulative relative risk of 1.011 (95% confidence interval [CI]: 1.004, 1.019) and 1.026 (95% CI: 1.004, 1.049), respectively, in non-accident mortality. Meanwhile, significant association was observed in people aged under 60 years between SO2 exposure and respiratory mortality at lag of 0 to 9 days.

Conclusions:
Our findings strengthen the evidence of PM10 and NO2 exposures were independent risk for daily mortality.
Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities
Authors: Meert Kathleen L. , Reeder Ron W. , Maddux Aline B. , Banks Russell , Berg Robert A. , Newth Christopher J. , Hall Mark W. , Quasney Michael , Carcillo Joseph A. , McQuillen Patrick S. , Mourani Peter M. , Chima Ranjit S. , Holubkov Richard , Sorenson Samuel , McGalliard Julie , Dean J. Michael , Zimmerman Jerry J. 
Published: November 2020

OBJECTIVES:
To serially evaluate health-related quality of life during the first year after community-acquired septic shock in children with preexisting severe developmental disabilities and explore factors associated with health-related quality of life changes in these children.

DESIGN:
Secondary analysis of the Life after Pediatric Sepsis Evaluation investigation.

SETTING:
Twelve academic PICU in the United States.

PATIENTS:
Children greater than or equal to 1 month and less than 18 years old identified by their family caregiver (e.g., parent/guardian) as having severe developmental disability prior to septic shock.

INTERVENTIONS:
Family caregivers completed the Stein-Jessop Functional Status II-R Short Form as a measure of their child’s health-related quality of life at baseline (reflecting preadmission status), day 7, and months 1, 3, 6, and 12 following PICU admission. Stein-Jessop Functional Status II-R Short Form scores were linearly transformed to a 0–100 scale, with higher scores indicating better health-related quality of life.

MEASUREMENTS AND MAIN RESULTS:
Of 392 Life after Pediatric Sepsis Evaluation participants, 137 were identified by their caregiver as having a severe developmental disability. Sixteen children (11.6%) with severe disability died during the 12 months following septic shock. Among 121 survivors, Stein-Jessop Functional Status II-R Short Form scores declined from preadmission baseline to day 7 (70.7 ± 16.1 vs 55.6 ± 19.2; p < 0.001). Stein-Jessop Functional Status II-R Short Form scores remained below baseline through month 12 (59.1 ± 21.0, p < 0.001 vs baseline). After adjusting for baseline Stein-Jessop Functional Status II-R Short Form, the caregiver being a single parent/guardian was associated with lower month 3 Stein-Jessop Functional Status II-R Short Form scores (p = 0.041). No other baseline child or caregiver characteristic, or critical illness-related factors were significantly associated with month 3 Stein-Jessop Functional Status II-R Short Form scores.

CONCLUSIONS:
Health-related quality of life among children with severe developmental disability remains, on average, below baseline during the first year following community-acquired septic shock. Children with severe disability and septic shock that are in single parent families are at increased risk. Clinical awareness of the potential for decline in health-related quality of life among disabled children is essential to prevent this adverse outcome from being missed.
Facial Aging: A Quantitative Analysis of Midface Volume Changes over 11 Years
Authors: Boehm Lucas M. , Morgan Aaron , Hettinger Patrick , Matloub Hani S. 
Published: November 2020

Background:
Anatomical studies have identified separate superficial and deep facial fat compartments, leading some to theorize that volume loss from the deep midface causes overlying superficial fat pseudoptosis. Unfortunately, a paucity of evidence exists regarding whether facial fat volume is truly lost with age and, if so, whether it is lost equally or differentially from the superficial and deep compartments. The aim of this study was to quantify volume changes occurring with age within the superficial, deep, and buccal fat compartments of the midface.

Methods:
A retrospective longitudinal study was performed evaluating individuals aged 30 to 65 years who underwent facial computed tomography followed by facial computed tomography greater than or equal to 10 years later. Superficial midface, deep midface, and buccal fat volumes were quantified using Horos radiology software.

Results:
Nineteen subjects met inclusion criteria. Mean total fat volume decreased significantly from 46.47 cc to 40.81 cc (p < 0.01). The mean superficial and deep fat volumes both decreased significantly from 26.10 cc to 23.15 cc (p < 0.01) and from 11.01 cc to 8.98 cc (p < 0.01), respectively. No significant difference was observed in buccal fat volume over time (9.36 cc to 8.68 cc; p = 0.04). Patients lost an average of 11.3 percent of their initial superficial fat volume and 18.4 percent of their initial deep fat volume.

Conclusions:
Significant volume loss was observed from both superficial and deep facial fat compartments over a mean 11.3 years. Patients lost a greater percentage of deep facial fat volume, providing support for the theory of pseudoptosis caused by deep midface fat loss.
The Role of Magnetic Resonance Imaging in (Future) Cancer Staging
Authors: Scheenen Tom W.J. , Zamecnik Patrik 
Published: November 2020

Abstract
The presence or absence of lymph node metastases is a very important prognostic factor in patients with solid tumors. Current invasive and noninvasive diagnostic methods for N-staging like lymph node dissection, morphologic computed tomography/magnetic resonance imaging (MRI), or positron emission tomography–computed tomography have significant limitations because of technical, biological, or anatomical reasons. Therefore, there is a great clinical need for more precise, reliable, and noninvasive N-staging in patients with solid tumors. Using ultrasmall superparamagnetic particles of ironoxide (USPIO)-enhanced MRI offers noninvasive diagnostic possibilities for N-staging of different types of cancer, including the 4 examples given in this work (head and neck cancer, esophageal cancer, rectal cancer, and prostate cancer). The excellent soft tissue contrast of MRI and an USPIO-based differentiation of metastatic versus nonmetastatic lymph nodes can enable more precise therapy and, therefore, fewer side effects, essentially in cancer patients in oligometastatic disease stage. By discussing 3 important questions in this article, we explain why lymph node staging is so important, why the timing for more accurate N-staging is right, and how it can be done with MRI. We illustrate this with the newest developments in magnetic resonance methodology enabling the use of USPIO-enhanced MRI at ultrahigh magnetic field strength and in moving parts of the body like upper abdomen or mediastinum. For prostate cancer, a comparison with radionuclide tracers connected to prostate specific membrane antigen is made. Under consideration also is the use of MRI for improvement of ex vivo cancer diagnostics. Further scientific and clinical development is needed to assess the accuracy of USPIO-enhanced MRI of detecting small metastatic deposits for different cancer types in different anatomical locations and to broaden the indications for the use of (USPIO-enhanced) MRI in lymph node imaging in clinical practice.
Factors Influencing US Physician and Surgeon Suicide Rates 2003 to 2017
Authors: Elkbuli Adel , Sutherland Mason , Shepherd Aaron , Kinslow Kyle , Liu Huazhi , Ang Darwin , McKenney Mark 
Published: November 2020

Background and Objectives:
With the rate of physician suicide increasing, more research is needed to implement adequate prevention interventions. This study aims to identify trends and patterns in physician/surgeon suicide and the key factors influencing physician suicide. We hope such information can highlight areas for targeted interventions to decrease physician suicide.

Methods:
Review of Centers for Disease Control and Preventions National Violent Death Reporting System (NVDRS) for 2003 to 2017 of physician and dentists dying by suicide. Twenty-eight medical, surgical, and dental specialties were included.

Results:
Nine hundred five reported suicides were reviewed. Physician suicides increased from 2003 to 2017. Majority surgeons’ suicides were middle-aged, White males. Orthopedic surgeons had the highest prevalence of suicide among surgical fields (28.2%). Black/African American surgeons were 56% less likely [odds ratio (OR) = 0.44, 95% confidence interval (CI): 0.06-3.16] and Asian/Pacific Islander were 438% more likely (OR = 5.38, 95% CI: 2.13–13.56) to die by suicide. Surgeons were 362% more likely to have a history of a mental disorder (OR = 4.62, 95% CI: 2.71–7.85), were 139% more likely to use alcohol (OR = 2.39, 95% CI: 1.36–4.21), and were 289% more likely to have experienced civil/legal issues (OR = 3.89, 95% CI: 1.36–11.11).

Conclusions:
The prevalence of physician suicide increased over the 2003 to 2017 time-frame with over a third of deaths occurring from 2015 to 2017. Among surgeons, orthopedics has the highest prevalence of reported suicide.
Risk factors for surgeon suicide include Asian/Pacific Islander race/ethnicity, older age, history of mental disorder, alcohol use, and civil/legal issues.