bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility and Outcomes of Tubular Decompression in Extreme Stenosis: [RETRACTED]
Authors: Kulkarni Arvind G. , Das Swaroop 
Published: December 2019

Study Design.
Retrospective cohort study.

Objectives.
To report the feasibility, nuances, technical tips as well as outcomes of managing single-level grade D (extreme stenosis) and to compare the outcomes with nonextreme stenosis using the tubular retractor system.

Summary of Background Data.
Minimally invasive decompression in extreme stenosis is a challenge due to technical difficulty, feasibility of adequate decompression, and a steep learning curve.

Methods.
Consecutive patients from January 2007 to January 2017 presenting with neurogenic claudication secondary to single-level spinal stenosis operated using tubular retractors were included in the study. The patients were divided into two groups; extreme-stenosis and nonextreme stenosis. The outcomes of surgery were evaluated and compared using visual analogue score (VAS) for leg and back pain, Oswestry disability index (ODI), and MacNab's criteria.

Results.
A total of 325 patients (out of 446 patients after excluding the multilevel cases) fulfilled the inclusion criteria. One hundred forty patients were cases of extreme stenosis and 185 were nonextreme stenosis. The mean VAS for back and leg pain for extreme stenosis improved from 3.23 ± 1.30 to 2.15 ± 0.91 and 7.33 ± 0.78 to 1.66 ± 1.03 respectively as compared with nonextreme stenosis where the mean VAS for back and leg pain improved from 3.01 ± 1.15 to 1.86 ± 1.10 and 6.57 ± 1.00 to 1.54 ± 1.12 respectively. The mean ODI changed from 66.47 ± 7.53 to 19.95 ± 2.90 in extreme stenosis as compared with nonextreme stenosis where mean ODI changed from 59.05 ± 5.08 to 19.88 ± 2.67. As per MacNab's criteria 102 (of 120 patients) and 139 (of 157 patients) reported excellent and good outcomes in extreme and nonextreme stenosis respectively.

Conclusion.
Tubular decompression is feasible in patients with extreme-stenosis with no difference in the outcomes as well as complication rates when compared with a cohort of nonextreme stenosis.

Level of Evidence: 3
Validity of Patient Health Questionnaire-9 in Minimally Invasive Lumbar Interbody Fusion
Authors: Jenkins Nathaniel W. , Parrish James M. , Brundage Thomas S. , Hrynewycz Nadia M. , Yoo Joon S. , Singh Kern 
Published: December 2019

Study Design.
Retrospective.

Objective.
The aim of this study was to evaluate the validity of Patient Health Questionnaire-9 (PHQ-9) among patients undergoing minimally invasive (MIS) lumbar interbody fusion.

Summary of Background Data.
Few studies have evaluated the utility and concurrent validity of the PHQ-9 survey in patients undergoing spinal procedures.

Methods.
Patients undergoing a one- or two-level MIS lumbar interbody fusion were retrospectively reviewed. Patient-reported outcome surveys were completed preoperatively and at 6-week, 12-week, 6-month, and 1-year timepoints. Postoperative survey scores were compared to preoperative values using paired t tests. PHQ-9 scores were compared with the Mental Component Summary (MCS) scores of the Short Form-12 (SF-12) and the Veterans RAND-12 (VR-12) surveys at each timepoint using the Pearson correlation coefficient.

Results.
A total of 215 patients were included in the analysis. The mean preoperative scores for the PHQ-9, SF-12 MCS, and VR-12 MCS were 6.78, 49.55, and 50.39, respectively. Significant improvements in each survey outcome measure were observed at all postoperative timepoints. Strong correlations with PHQ-9 scores were identified for SF-12 MCS scores and VR-12 MCS scores at preoperative and postoperative timepoints (|r| ≥ 0.5 and P < 0.05 for each).

Conclusion.
This study demonstrated that mental health, as measured by the PHQ-9, SF-12 MCS, and VR-12 MCS surveys, improves significantly after MIS lumbar fusion. In addition, PHQ-9 scores were strongly correlated with SF-12 and VR-12 scores. These results suggest that PHQ-9 can be a valid assessment of baseline mental health and postoperative improvement after MIS lumbar fusion. Concordant results among PHQ-9, SF-12 MCS, and VR-12 indicate that the simultaneous utilization of multiple survey instruments may not be necessary. Limiting the number of questionnaires that are administered in the evaluation of mental health could also help reduce survey burden placed on patients.

Level of Evidence: 3
An epidemiology study of fecal incontinence in adult Chinese women living in urban areas
Authors: Yuan Yuan , Qiu Lin , Li Zhi-Yi , Zhang Lei , Xu Tao , Lang Jing-He , Li Zhao-Ai , Gong Jian , Liu Qing , Liu Xiao-Chun , Wang Jun-Tao , Xia Zhi-Jun , Zhu Lan 
Published: December 2019

Abstract

Background:
Fecal incontinence (FI) has been shown to be a common symptom in Western countries; however, there is few researches focusing on its epidemic condition in Chinese women. We conducted this national population-based epidemiology study to estimate the prevalence and risk factors of FI among adult Chinese women living in urban regions.

Methods:
This is a subgroup analysis of a national population-based epidemiology study of FI. Total 28,196 adult women from urban regions of six provinces and municipalities participated in this research from 2014 to 2015. They finished the questionnaire under the direction of trained interviewers. FI was defined as accidental leakage of flatus and/or liquid or solid stool at least once in the past. The FI prevalence trend and risk factors were identified by the Cochran-Armitage test, Chi-square test, and multivariable logistic regression.

Results:
The prevalence of FI in adult females in urban China was 0.43% (95% confidence interval: 0.35%–0.51%). Among women with FI, 42.96%, 82.96%, and 42.22% reported having leakage of solid, liquid stool, and gas, respectively. The overall FI prevalence and the incidence rate of solid stool/liquid stool/gas leakage increased with age. The mean Wexner score was 4.0% and 12.0% FI patients reported Wexner score ≥9. Body mass index ≥24 kg/m2, pelvic organ prolapses, chronic constipation, chronic cough, alcohol consumption, physical diseases including chronic bronchitis and cancer, gynecological diseases like gynecological inflammation are risk factors for FI. Vaginal delivery was the risk factor for FI in females with labor history.

Conclusions:
FI was not a common symptom in adult Chinese women living in urban areas and there were some potential modifiable risk factors.

Trial Registration:
Chinses Clinical Trial Registry: ChiCTR-OCS-14004675; http://www.chictr.org.cn/showproj.aspx?proj=4898
Age-specific differences in non-cardiac comorbidities among elderly patients hospitalized with heart failure: a special focus on young-old, old-old, and oldest-old
Authors: Yang Meng-Xi , An Hui , Fan Xue-Qiang , Tao Li-Yuan , Tu Qiang , Qin Li , Zhang Li-Fang , Feng Dong-Ping , Wang Yu , Sun Li , Gao Si , Guan Wen-Zhuo , Zheng Jin-Gang , Ren Jing-Yi 
Published: December 2019

Abstract

Background
Despite the growing epidemic of heart failure (HF), there is limited data available to systematically compare non-cardiac comorbidities in the young-old, old-old, and oldest-old patients hospitalized for HF. The precise differences will add valuable information for better management of HF in elderly patients.

Methods
A total of 1053 patients aged 65 years or older hospitalized with HF were included in this study. Patients were compared among three age groups: (1) young-old: 65 to 74 years, (2) old-old: 75 to 84 years, and (3) oldest-old: ≥85 years. Clinical details of presentation, comorbidities, and prescribed medications were recorded.

Results
The mean age was 76.7 years and 12.7% were 85 years or older. Most elderly patients with HF (97.5%) had at least one of the non-cardiac comorbidities. The patterns of common non-cardiac comorbidities were different between the young-old and oldest-old group. The three most common non-cardiac comorbidities were anemia (53.6%), hyperlipidemia (45.9%), and diabetes (42.4%) in the young-old group, while anemia (73.1%), infection (58.2%), and chronic kidney disease (44.0%) in the oldest-old group. Polypharmacy was observed in 93.0% elderly patients with HF. Additionally, 29.2% patients were diagnosed with infection, and 67.0% patients were prescribed antibiotics. However, 60.4% patients were diagnosed with anemia with only 8.9% of them receiving iron repletion.

Conclusions
Non-cardiac comorbidities are nearly universal in three groups but obviously differ by age, and inappropriate medications are very common in elderly patients with HF. Further treatment strategies should be focused on providing optimal medications for age-specific non-cardiac conditions.
Not Everyone Should be a Nurse Practitioner
Authors: Nielson Mary Hugo , Halloran Laurel 
Published: December 2019

ABSTRACT:
There has been an increase in student enrollment in advanced practice nurse programs, but limited information regarding attrition and dropout rates in nurse practitioner (NP) programs. Management of NP students includes student evaluations, preceptor guidance and support, student support, and use of reflective practice. Program directors, faculty members, and preceptors must assist NP students with role transitioning and help those who are not meeting the rigors of NP education to leave the program and discover alternative nursing roles.
Safety and Efficacy of Nanosecond Pulsed Electric Field Treatment of Seborrheic Keratoses
Authors: Hruza George J. , Zelickson Brian D. , Selim Mona M. , Rohrer Thomas E. , Newman James , Park Hyoung , Jauregui Lauren , Nuccitelli Richard , Knape William A. , Ebbers Edward , Uecker Darrin 
Published: December 2019

BACKGROUND
Nanosecond pulsed electric field technology (also known as Nano-Pulse Stimulation or NPS) is a nonthermal, drug-free, energy-based technology that has demonstrated effects on cellular structures of the dermis and epidermis in previous clinical studies.

OBJECTIVE
To evaluate the safety and efficacy of a single NPS treatment for clearing seborrheic keratoses (SKs).

MATERIALS AND METHODS
This study was a prospective, randomized, open-label, multisite, nonsignificant risk trial in which each subject served as their own control. Fifty-eight subjects had 3 of 4 confirmed SK lesions treated, resulting in 174 total treated lesions. Subjects returned for 5 to 6 follow-up evaluations and photographs.

RESULTS
At 106 days after NPS treatment, 82% of treated seborrheic keratoses were rated clear or mostly clear by the assessing physician. Seventy-one percent of lesions were rated clear or mostly clear by the 3 independent reviewers based on the 106-day photographs. All treated subjects returned for all study visits, and 78% of the subjects were satisfied or mostly satisfied with the outcome of the treatment. No adverse events were reported.

CONCLUSION
The NPS procedure was well tolerated and effective in the removal of SKs.
Assessment of Bias in Estimates of Sexual Network Degree using Prospective Cohort Data
Authors: Uong Stephen , Rosenberg Eli S. , Goodreau Steven M. , Luisi Nicole , Sullivan Patrick , Jenness Samuel M. 
Published: December 2019

Background:
Sexual network degree, a count of ongoing partnerships, plays a critical role in the transmission dynamics of human immunodeficiency virus and other sexually transmitted infections. Researchers often quantify degree using self-reported cross-sectional data on the day of survey, which may result in bias because of uncertainty about future sexual activity.

Methods:
We evaluated the bias of a cross-sectional degree measure with a prospective cohort study of men who have sex with men (MSM). At baseline, we asked men about whether recent sexual partnerships were ongoing. We confirmed the true, ongoing status of those partnerships at baseline at follow-up. With logistic regression, we estimated the partnership-level predictors of baseline measure accuracy. With Poisson regression, we estimated the longitudinally confirmed degree as a function of baseline predicted degree.

Results:
Across partnership types, the baseline ongoing status measure was 70% accurate, with higher negative predictive value (91%) than positive predictive value (39%). Partnership exclusivity and racial pairing were associated with higher accuracy. Baseline degree generally overestimated confirmed degree. Bias, or number of ongoing partners different than predicted at baseline, was −0.28 overall, ranging from −1.91 to −0.41 for MSM with any ongoing partnerships at baseline. Comparing MSM of the same baseline degree, the level of bias was stronger for black compared with white MSM, and for younger compared with older MSM.

Conclusions:
Research studies may overestimate degree when it is quantified cross-sectionally. Adjustment and structured sensitivity analyses may account for bias in studies of human immunodeficiency virus or sexually transmitted infection prevention interventions.
Proton-pump Inhibitor Use and Myocardial Infarction
Authors: Qian Yiran , Jick Susan 
Published: December 2019

Background:
Use of proton-pump inhibitors (PPIs) is suggested to be associated with adverse cardiovascular (CV) events via. endothelial dysfunction. Studies show that PPIs are associated with increased risk of myocardial infarction (MI) among patients with preexisting CV disease. However, little is known about their risk among people without known CV disease.

Methods:
We conducted a nested case–control study in the UK Clinical Practice Research Datalink (CPRD) GOLD to evaluate the association between PPI use and risk of MI in patients without known CV disease. From among PPIs users age 25 to 65 between 1988 and 2017, we identified 32,793 MI cases and 127,291 controls matched 4:1 on age, sex, general practice setting, and calendar time. Using logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) for MI comparing PPI users to nonusers, adjusting for body mass index, smoking, alcohol abuse, drug abuse, type 2 diabetes, hyperlipidemia, hypertension, and peripheral artery disease. We repeated this analysis in users of histamine 2 receptor antagonists (H2RA), a drug with a similar indication, to assess protopathic bias.

Results:
The risk of MI was elevated in new users of PPIs with one to five prescriptions (adjusted OR = 2.8; 95% CI = 2.6, 3.0), but not in any other exposure category. The results among H2RA users were similar across all exposure categories, suggesting that protopathic bias likely explains the results.

Conclusions:
Our study results were not consistent with the hypothesis that PPI use increases MI risk among people without known heart disease.
Electrophysiology in Glaucoma
Authors: Senger Cassia , Moreto Renata , Watanabe Sung E.S. , Matos Alexis G. , Paula Jayter S. 
Published: December 2019

Objectives:
Electrophysiological testing of the visual system has been continuously used in studies involving the evaluation of retinal ganglion cells and the diagnosis of glaucoma. This study aims to review the results of recent studies regarding the clinical applicability of electrophysiological tests to glaucoma.

Methods:
A systematic review of the literature was carried out by 2 independent reviewers using the PubMed and EMBASE electronic databases, searching for articles published in English from January 1, 2014 to July 1, 2019 using a combination of the following keywords: (“glaucoma” OR “ocular hypertension”) AND (“electrophysiolog” OR “electroretinogra” OR “ERG” OR “mfERG” OR “Pattern-reversal electroretinography” OR “PERG” OR “mfPERG” OR “photopic negative response” OR “pattern electroretinogram” OR “visual evoked potential” OR “multifocal electroretinography” OR “multifocal electroretinogram” OR “electro-oculography” OR “multifocal VEP” OR “mf-ERG”). A total of 38 studies were selected and the data of 30 of them were tabulated in this review.

Results:
Among the 30 studies selected, the photopic negative response and the reversal pattern electroretinogram were found to be the major methods used to record the electroretinographic responses generated by the retinal ganglion cell. Their multifocal versions and the multifocal visual evoked potential were also proposed during this period. In general, the results underscored a consistent but general correlation between the amplitude and latency measures and routine tests for glaucoma, such as perimetry and optical coherence tomography.

Discussion:
In agreement with previous reviews, clinical electrophysiological testing of the visual system reasonably matched with both the structural and functional analyses for glaucoma. No definitive indications of these tests have been established either at early detection or during follow-up of the disease, and easier protocols and better topographical correspondence with current glaucoma tests are warranted for their routine use.
Use of Meshed Acellular Dermal Allograft as a Lining Material After Orbital Exenteration
Authors: Young Stephanie Ming , Park Ji Woong , Kim Yoon-Duck , Woo Kyung In 
Published: December 2019

Purpose:
To evaluate the surgical outcome and safety of acellular human dermal allograft as a new lining material to the exposed orbit after exenteration.

Methods:
Retrospective case series of patients who underwent orbital exenteration followed by reconstruction with meshed-type acellular dermal allograft from 2009 to 2018 in a single tertiary institution.

Results:
There were 14 eyes (2 right, 12 left) of 14 patients (6 men, 8 women). Mean age at operation was 69.1 ± 16.5 years. Indication for surgery was malignancy in all patients. One patient underwent subtotal exenteration, while the rest underwent total exenteration. SureDerm Meshed was used in 12 patients, AlloDerm Meshed in 1, and CGDerm Meshed in 1. Mean follow-up period was 12.1 months. Full or nearly full epithelialization occurred in 10 of 14 patients (71.4%) at 1 month and 9 of 12 patients (75.0%) at 3 months. There was delayed epithelialization in 3 patients due to poor wound care (n = 1), adjuvant radiotherapy (n = 1), and adjuvant radiotherapy followed by cerebrospinal fluid leak (n = 1).

Conclusions:
Meshed acellular human dermal allograft showed good success in reconstruction after orbital exenteration and may be considered as an alternative lining material to split-thickness skin graft after orbital exenteration.
Evaluation of Longitudinal Assessment for Use in Maintenance of Certification
Authors: Robinson Lawrence R. , Raddatz Mikaela M. , Kinney Carolyn L. 
Published: December 2019

Objective
The aim of the study was to evaluate a longitudinal assessment program for physical medicine and rehabilitation (LA-PM&R) as a replacement for the American Board of Physical Medicine and Rehabilitation maintenance of certification examination.

Design
In this quality improvement study, randomly selected American Board of Physical Medicine and Rehabilitation diplomates were invited to participate in the LA-PM&R. Participants’ maintenance of certification scaled scores were compared with LA-PM&R nonparticipants. We examined the association between LA-PM&R scores and maintenance of certification scaled scores and performance on clone items placed on both examinations.

Results
There were 2222 American Board of Physical Medicine and Rehabilitation diplomates eligible to take the maintenance of certification examination from February 2018 to February 2019. Invitations were sent to 1050 randomly selected diplomates, of whom 448 initially agreed. Three hundred eighteen individuals completed more than two quarters of LA-PM&R participation and took the maintenance of certification examination. Two hundred sixty-six diplomates took the maintenance of certification examination in the same period who did not participate in LA-PM&R. The LA-PM&R group scored higher on the maintenance of certification examination than the control group (P < 0.05). Performance on the two examinations were highly correlated, r = .50, P < 0.0001. On clone items, LA-PM&R participants had 74% correct on the LA-PM&R but 86% correct on the maintenance of certification examination (P < 0.01).

Conclusions
The LA-PM&R program leads to better learning and retention of information than the 10-yr maintenance of certification examination.
Motivators for and Barriers to Exercise Rehabilitation in Hemodialysis Centers
Authors: Wang Xin-Xin , Lin Ze-Hua , Wang Ying , Xu Ming-Cheng , Kang Zhi-Min , Zeng Wen , Ma Ying-Chun 
Published: December 2019

Objectives
The aim of the study was to explore motivators for and barriers to exercise rehabilitation in hemodialysis patients and the barriers perceived by the hemodialysis center staff.

Design
A cross-sectional study was performed in five hemodialysis centers using patient questionnaires designed for this study to evaluate the motivators for and barriers to exercise rehabilitation. Questionnaires were not yet validated.

Results
Of the 471 recruited patients, 63.3% were willing to participant in exercise rehabilitation. The greatest motivators included improving quality of life (98.0%) and wanting to be healthier (98.0%). Perceived barriers included discomfort (59.0%), concerns regarding safety (36.7%), and disinterest (27.0%). Among these, unwillingness, disinterest, and having peripheral arterial disease were independent risk factors of lack of participation in exercise rehabilitation. The most common perceived barriers among the 90 employees that participated were lack of professional guidance and advice from rehabilitation therapists (93.1%), lack of exercise rehabilitation knowledge (86.2%), and lack of special exercise equipment (86.2%).

Conclusions
Most patients were willing to exercise to improve their health and quality of life. Barriers to exercise rehabilitation included patient and staff factors. It is essential to establish a rehabilitation team within dialysis centers, including general staff and rehabilitation therapists. These centers require improved rehabilitation policies and access to specialized rehabilitation equipment.
Use of HIV Pre-exposure Prophylaxis (PrEP) Associated With Lower HIV Anxiety Among Gay and Bisexual Men in Australia Who Are at High Risk of HIV Infection: Results From the Flux Study
Authors: Keen Phillip , Hammoud Mohamed A. , Bourne Adam , Bavinton Benjamin R. , Holt Martin , Vaccher Stefanie , Haire Bridget , Saxton Peter , Jin Fengyi , Maher Lisa , Grulich Andrew E. , Prestage Garrett 
Published: December 2019

Background:
Many gay and bisexual men (GBM) experience HIV anxiety, particularly around condomless anal intercourse. HIV pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy that may reduce HIV anxiety among GBM.

Methods:
The Following Lives Undergoing Change (Flux) Study is a national, online, open-prospective observational study of licit and illicit drug use among GBM in Australia. In 2018, participants responded to newly included items regarding anxiety about HIV transmission. Stratifying GBM as high or low risk as determined by the Australian PrEP Guidelines, we assess whether PrEP use is associated with lower levels of HIV anxiety. Multivariate logistic regression was used to compare factors associated with PrEP use among GBM at high risk (PrEP-eligible) and low risk (PrEP-ineligible) of HIV infection. Results are reported as adjusted odds ratios and corresponding 95% confidence intervals.

Results:
Among 1547 men, the mean age was 37.1 years (SD 13.1). Men aged 25 years or younger had higher HIV anxiety scores than older men. Among PrEP-eligible men, men who use PrEP reported lower levels of HIV anxiety (adjusted odds ratio = 0.92; 95% confidence interval = 0.87 to 0.99; P < 0.001). No differences were observed on HIV anxiety among PrEP-ineligible men.

Conclusions:
Among PrEP-eligible men, PrEP use was independently associated with lower levels of HIV anxiety. In addition to avoiding HIV infection, PrEP use may help reduce anxiety among men at risk of HIV. This feature of PrEP could be promoted as part of demand creation initiatives to increase PrEP uptake.