bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-level Posterolateral Fusion (PLF) Alone and Posterior Interbody Fusion (PLIF/TLIF) Alone Lead to a Decreased Risk of Short-term Complications Compared to Combined PLF With PLIF/TLIF Procedures
Authors: Plantz Mark A. , Hsu Wellington K. 
Published: August 2020

Study Design.
Retrospective review of a database cohort.

Objective.
To compare short-term outcome measures and complications between single-level posterolateral fusion (PLF), single-level posterior interbody fusion (PLIF/TLIF), and combined single-level PLF+PLIF/TLIF.

Summary of Background Data.
Both PLF and interbody fusion are well-established procedures for degenerative spinal disease. However, there is lack of consensus as to the ideal surgical approach for specific applications. Additionally, the difference in risk of complications with traditional PLF, interbody fusion with posterior approach, and circumferential fusion is still contested.

Methods.
The ACS NSQIP database was used to identify 24,228 patients who underwent either a single-level PLF, single-level PLIF/TLIF, or combined single-level PLF+PLIF/TLIF between 2014 and 2017. To control for potential confounding variables, exact matching was used to pair individuals from each treatment group based on several factors, including sex, age, body mass index, various comorbidities, and American Society of Anesthesiologists classification. After appropriate matching, the rate of various short-term outcome measures and complications were compared between the three treatment groups.

Results.
After exact matching, 13,251 patients were included in the final analysis. The rates of non-home discharge, overall surgical complications, and bleeding requiring transfusion were significantly lower in the PLF group and PLIF/TLIF group relative to the PLF+PLIF/TLIF group (P < 0.001 for all comparisons). The rate of deep venous thrombosis was lower in the PLIF/TLIF group relative to the PLF group (P = 0.006). There were no significant differences in other medical complications, unplanned readmission, reoperation, or return to the OR between any of the treatment groups.

Conclusions.
The combination of single-level PLF+PLIF/TLIF is associated with higher rates of short-term complications relative to either single-level PLF or PLIF/TLIF alone. The associated risks of this therapy should be considered when considering surgical management for lumbar disease.

Level of Evidence: 3.
Hedgehog Pathway Alterations Downstream of Patched-1 Are Common in Infundibulocystic Basal Cell Carcinoma
Authors: Russell-Goldman Eleanor , MacConaill Laura , Hanna John 
Published: August 2020

Abstract:
The infundibulocystic variant of basal cell carcinoma (BCC) is characterized histologically by anastamosing strands of basaloid epithelium with associated small infundibular-type cysts. Since its first description in 1987, this rare entity has generated considerable controversy with some authors classifying it as a benign follicular neoplasm rather than a BCC subtype. Prior studies aiming to settle this issue using immunohistochemical analysis reached opposite conclusions. The defining feature of BCC is activation of the Hedgehog signaling pathway, and mutations in Patched-1 (PTCH1) are the most common molecular finding in both sporadic and inherited forms of BCC. Mutations in other downstream components including Smoothened (SMO) and Suppressor of Fused (SUFU) also occur, but are much less common. Here, we report a molecular genetic analysis of a small series of infundibulocystic BCC using a next-generation DNA sequencing platform. All 4 cases harbored mutations or other genetic alterations in components of the Hedgehog pathway, supporting the classification of this entity as a BCC variant. Interestingly, these tumors were enriched for genetic alterations downstream of PTCH1, involving SUFU, SMO, GLI1, and GLI2. This observation was of particular interest given that rare kindreds of the Multiple Hereditary Infundibulocystic BCC syndrome (MHIBCC), which is related, but possibly distinct from the nevoid BCC syndrome, harbored mutations in SUFU. Our results support the classification of the infundibulocystic variant as a subtype of BCC, and suggest that the level at which genetic alterations occur within the Hedgehog pathway may be an important determinant of the morphologic features in BCC.
Aging Changes of the Superficial Fat Compartments of the Midface Over Time: A Magnetic Resonance Imaging Study
Authors: Cevik Cenkeri Halime , Sarigul Guduk Sukran , Derin Cicek Esin 
Published: August 2020

BACKGROUND
Studies involving superficial facial fat compartments are few in number with conflicting results. Most of them involved small study groups and compared measurements between different populations of young and old subjects either on cadavers or living subjects.

OBJECTIVE
To clarify volumetric and dimensional changes in midfacial superficial fat compartment retrospectively in patients who underwent a repeat magnetic resonance imaging (MRI) without gross pathology.

MATERIALS AND METHODS
A total of 70 patients with a mean age of 60 years (range: 33–82 years) and a median elapsed time of 44.5 months (range: 32–64 months) between 2 MRIs were included. Magnetic resonance imaging scans were analyzed in the axial and sagittal planes to obtain measurements of the medial part of the superficial cheek fat. Superficial cheek fat was divided into 3 compartments. Thickness, width, and height were measured, and volumes were calculated for each compartment on both hemifaces.

RESULTS
Volume and thickness were decreased significantly in all compartments (p < .05). The width was decreased in superior and middle compartments, whereas increased in lower compartment indicating dislocation of the fat tissue (p < .05). Height was also significantly increased (p < .05). A subgroup analysis has shown that there was no significant difference between men and women.

CONCLUSION
This study clarifies that aging is associated with a significant decrease in superficial midfacial fat tissue volume and thickness both in women and men. The decrease in width in upper and middle compartments, but increase in lower compartment suggests a volume shift within superficial fat tissue.
A Prospective, Split-Face, Comparative Study of Combined Treatment With Fractional Microneedle Radiofrequency and Nonablative 1927-nm Fractional Thulium Fiber Laser for Wrinkle Treatment
Authors: Park Min-Young , Hwang Shinwon , Chun Soo Il , Kim Su Min , Almurayshid Abdurrahman , Oh Sang Ho 
Published: August 2020

BACKGROUND
Fractional microneedle radiofrequency (FMR) and nonablative 1927-nm fractional thulium fiber laser (TFL) are widely used for skin rejuvenation treatment.

OBJECTIVES
To investigate the efficacy and safety of combined treatment with both devices for wrinkles.

PATIENTS AND METHODS
Twenty-five patients with wrinkles were enrolled. One side of the face was treated with FMR alone, while the other side was treated with a combination of FMR and TFL. Each treatment consisted of 3 sessions at four-week intervals and patients were followed up 12 weeks after the last treatment. Overall improvement was assessed by patient global assessment (PGA) and investigator global assessment (IGA). Depression scores for the evaluation of wrinkles were objectively assessed by Antera 3D system.

RESULTS
Both sides of the face led to clinical improvement in both mean PGA and IGA. Combination treatment demonstrated a greater improvement in both mean PGA and IGA compared with FMR alone. In addition, wrinkle grading scales and depression scores showed greater improvement in the combination group than in FMR alone.

CONCLUSION
This study demonstrated that FMR and TFL comprise a good combination treatment for the treatment of wrinkles because both treatments have a synergistic effect on wrinkle improvement.
Systematic Review of Digital Phenotyping and Machine Learning in Psychosis Spectrum Illnesses
Authors: Benoit James , Onyeaka Henry , Keshavan Matcheri , Torous John 
Published: August 2020

Abstract

Background
Digital phenotyping is the use of data from smartphones and wearables collected in situ for capturing a digital expression of human behaviors. Digital phenotyping techniques can be used to analyze both passively (e.g., sensor) and actively (e.g., survey) collected data. Machine learning offers a possible predictive bridge between digital phenotyping and future clinical state. This review examines passive digital phenotyping across the schizophrenia spectrum and bipolar disorders, with a focus on machine-learning studies.

Methods
A systematic review of passive digital phenotyping literature was conducted using keywords related to severe mental illnesses, data-collection devices (e.g., smartphones, wearables, actigraphy devices), and streams of data collected. Searches of five databases initially yielded 3312 unique publications. Fifty-one studies were selected for inclusion, with 16 using machine-learning techniques.

Results
All studies differed in features used, data pre-processing, analytical techniques, algorithms tested, and performance metrics reported. Across all studies, the data streams and other study factors reported also varied widely. Machine-learning studies focused on random forest, support vector, and neural net approaches, and almost exclusively on bipolar disorder.

Discussion
Many machine-learning techniques have been applied to passively collected digital phenotyping data in schizophrenia and bipolar disorder. Larger studies, and with improved data quality, are needed, as is further research on the application of machine learning to passive digital phenotyping data in early diagnosis and treatment of psychosis. In order to achieve greater comparability of studies, common data elements are identified for inclusion in future studies.
The Feasibility and Validity of a Wearable Sensor System to Assess the Stability of High-Functioning Lower-Limb Prosthesis Users
Authors: Miller Kyle T. , Russell Molly , Jenks Terese , Surratt Kaddie , Poretti Kelly , Eigenbrot Samantha S. , Akins Jonathan S. , Major Matthew J. 
Published: August 2020

ABSTRACT

Introduction
Lower-limb prosthesis users (LLPUs) experience increased fall risk due to gait and balance impairments. Clinical outcome measures are useful for measuring balance impairment and fall risk screening but experience limited resolution and ceiling effects. Recent advances in wearable sensors that can measure different components of gait stability may address these limitations. This study assessed feasibility and construct validity of a wearable sensor system (APDM Mobility Lab) to measure postural control and gait stability.

Materials and Methods
Lower-limb prosthesis users (n = 22) and able-bodied controls (n = 24) completed an Instrumented Stand-and-Walk Test (ISAW) while wearing the wearable sensors. Known-groups analysis (prosthesis versus controls) and convergence analysis (Prosthetic Limb Users Survey of Mobility [PLUS-M] and Activities-Specific Balance Confidence [ABC] scale) were performed on 20 stability-related measures.

Results
The system was applied without complications; however, missing anticipatory postural adjustment data points for nine subjects affected the analysis. Of the 20 analyzed measures output by the sensors, only three significantly differed (P < 0.05) between two cohorts, and two demonstrated statistically significant correlations with the self-report measures.

Conclusions
The results of this study suggest the clinical feasibility but only partial construct validity of the wearable sensor system in conjunction with the ISAW test to measure LLPU stability and balance. The sample consisted of high-functioning LLPUs, so further research should evaluate a more representative sample with additional outcome measures and tasks.
Comparison of surgical outcomes of lumbar disc herniation using local anesthesia and epidural anesthesia
Authors: Wang Wei , Ni Bin-bin , Shen Hao , Lu Hua 
Published: August 2020

Abstract
We performed this meta-analysis to evaluate the effects of epidural anesthesia and local anesthesia on the surgical outcomes of lumbar disc herniation (DH).
Electronic databases including PubMed, EMBASE, Cochrane Library, and the Chinese Academic Journal Full-text Database were searched to identify randomized controlled trials (RCTs) that reported on the effects of local anesthesia and epidural anesthesia in lumbar DH surgical management. Evaluation indicators included: onset time of anesthesia, patient satisfaction, and the rate of adverse effects. There were 6 RCTs with a total of 606 patients in this meta-analysis: 274 cases in the local anesthesia group and 332 in the epidural anesthesia group.
This meta-analysis demonstrated that the epidural anesthesia group had a better analgesic effect, a lower adverse effect rate (mean difference [MD] = 0.21, 95% confidence interval [CI] [0.08, 0.54], P = .001) and a better satisfaction rate: (MD = 6.54, 95% CI [2.77, 15.45], P < .0001). The duration of anesthesia was not statistically significant.
Epidural anesthesia is a better choice for lumbar DH surgery compared to local anesthesia.
Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery
Authors: Zheng Xiangrong , Wang Yunpeng , Chen Guocang , Ma Chuanyong , Yan Weiming , Chen Meizhu 
Published: August 2020

Abstract

Rationale:
Ischemic optic neuropathy (ION), due to diseases of the arteries supplying the optic nerve, is an ischemic damage of the optic nerve. This report highlights a case with monocular decreasing visual acuity caused by dissection of the internal carotid artery (ICA), which is a relatively rare cause for ION.

Patient concerns:
A 44-year-old woman presented with a decreasing visual acuity and defected visual field in the right eye for 1 week. The best corrected visual acuity (BCVA) was 20/400 in the right eye, and 20/20 in the left eye. In the right eye, the pupil showed little reaction to light with a relative afferent pupillary defect. The visual field test disclosed a defect in the inferior field connecting to the blind spot. Electroretinogram recording showed no obviously declined retinal function. No recognizable waveforms were presented in pattern visual–evoked potential (PVEP) examination, whereas the flash visual–evoked potential result revealed a delayed peak time and a reduced amplitude of P2-wave.

Diagnosis:
The patient was diagnosed as ION with the aid of computed tomographic angiography of the brain and neck, which revealed a stenosis in the right ICA and an occlusion in the right cerebral middle artery. The stenosis was verified as dissection of the ICA by digital subtraction angiography.

Interventions:
Based on the clinical findings, stent implantation inside the right ICA was performed.

Outcomes:
The ICA was recanalized soon and the BCVA of the right eye was improved to be 20/25 five months later. A second PVEP examination revealed a recognizable waveform in the right eye, although the peak time and amplitude of the P100-wave was a bit abnormal compared to that of the left eye.

Lessons:
ION with the sign of decreasing monocular visual acuity could occur due to dissection of the ICA, with no obvious neurologic symptom at the beginning. The present case emphasizes the importance of suspicion of ICA problems as the underlying cause for ION, which could help to take in-time measure to save the vision and avoid further complications.
Prognostic value of serum calprotectin level in elderly diabetic patients with acute coronary syndrome undergoing percutaneous coronary intervention
Authors: Zhang Wutang , Kong Yongmei , Wang Lizhi , Song Lizhong , Tan Lijuan , Xue Xiaobo 
Published: August 2020

Abstract
Patients with acute coronary syndrome (ACS) have an increased serum level of calprotectin. The purpose of present study was to analyze the prognostic significance of serum calprotectin levels in elderly diabetic patients underwent percutaneous coronary intervention (PCI) due to ACS.
A total of 273 consecutive elderly diabetic patients underwent PCI for primary ACS were enrolled. Serum calprotectin levels were measured before PCI, and baseline clinical characteristics of all patients were collected. All patients were followed up at regular interval for major adverse cardiovascular events (MACEs) during 1 year after PCI. MACEs include cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization (TVR). The predicting value of serum calprotectin for MACEs was analyzed by using univariate and multivariate analysis and receiver-operating characteristic curve (ROC).
At the endpoint of this study, 47 patients of all 273 patients had MACEs. According to optimal cutoff value of calprotectin for predicting MACEs by ROC analysis, all patients were stratified into a high calprotectin group and a low calprotectin group. The incidence rate of MACEs and TVR in high calprotectin group was prominently higher than that in low calprotectin group (21.9% vs 11.5%, P = .02). In multivariable COX regression analysis adjusting for potential confounders, serum calprotectin level remains as an independent risk predictor of MACE (hazard ratio, 1.56; 95% confidence interval [CI]: 1.08–4.62; P = .01).
In diabetic patients with a comorbidity of ACS, a high serum level of calprotectin is associated to a higher MACE rate after PCI.
Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes
Authors: Han Eugene , Cho Yongin , Kim Kyung-won , Lee Yong-ho , Kang Eun Seok , Cha Bong-Soo , Lee Byung-wan 
Published: August 2020

Abstract
The association between non-alcoholic fatty liver disease (NAFLD) and diabetic kidney disease assessed using either albuminuria or proteinuria remains controversial. This study aimed to investigate the association between hepatic steatosis or fibrosis and albuminuria or proteinuria in Korean patients with type 2 diabetes mellitus (T2D).
We enrolled 1108 patients with T2D and categorized as 3 groups; non-proteinuria (NP), isolated non-albumin proteinuria (iNAP), and albuminuria. Urinary albumin and protein levels were assessed as urinary albumin-to-creatinine ratio (uACR) and urinary protein-to-creatinine ratio (uPCR), respectively. Hepatic steatosis and fibrotic burden were assessed using the NAFLD liver fat score, Fibrosis-4 calculator (FIB-4) index, and NAFLD fibrosis score (NFS).
The prevalence of significant steatosis was similar among groups (NP: 74.6% vs iNAP: 70.3% vs albuminuria: 79.9%, P = .085). The prevalence of significant fibrosis was significantly higher in the iNAP (18.7%) and albuminuria (16.5%) groups than in the NP group (9.5%, P = .001). Both uPCR and uACR showed a correlation with NFS (uPCR: r = 0.123, P < .001; uACR: r = 0.064, P = .033). In multivariate logistic regression analysis, uPCR ≥150 mg/g was found to have a stronger association with hepatic fibrosis than uACR ≥30 mg/g (adjusted odds ratio 1.55 [95% CI 1.03–2.33] vs adjusted odds ratio 1.16 [95% CI, 0.72–1.87]).
In conclusion, patients with iNAP and albuminuria had a higher prevalence of hepatic fibrosis than those without proteinuria. Total proteinuria was associated with advanced liver fibrosis, whereas albuminuria was related to hepatic steatosis.
Mycophenolate mofetil in the treatment of Chinese patients with lupus nephritis
Authors: Zhang Haitao , Zhou Minlin , Han Xiaoyan , Yang Yang , Yu Xin 
Published: August 2020

AbstractBackgroud:Mycophenolate mofetil (MMF) has been recommended for the treatment of lupus nephritis (LN). Although inter-racial differences exist regarding the appropriate dose and efficacy of MMF in patients with LN, no definitive meta-analysis has yet been conducted in Chinese patients. This analysis investigated the efficacy and safety of MMF in Chinese patients with proliferative LN.Methods:A systematic literature search was conducted to select randomized controlled trials that reported at least one of the following: complete remission (CR), partial remission, total remission (TR; defined as complete remission + partial remission), relapse rate, serum creatinine, creatinine clearance, end-stage renal disease, death, infections, amenorrhea, leukopenia, alopecia, gastrointestinal symptoms, or liver damage.Results:Eighteen trials (927 patients) were included; 14 (750 patients) reported CR, partial remission, and TR. Two trials (58 patients) reported relapse rates during maintenance treatment. MMF induction significantly improved CR and TR vs cyclophosphamide (relative risk 1.34, 95% confidence interval: 1.13–1.58;P < .001; relative risk 1.16, 95% confidence interval: 1.02–1.33;P = .03), and was associated with significantly lower risks of infection (P < .001), amenorrhea (P < .001), leukopenia, and alopecia. No significant difference in relapse rate was evident between the MMF and azathioprine groups (P = .66).Conclusion:According to this meta-analysis of 18 trials, MMF is significantly more effective than cyclophosphamide induction, and is associated with reduced incidences of infections, amenorrhea, leukopenia, and alopecia in Chinese patients with proliferative LN.
Diagnostic value of circulating tumor DNA in molecular characterization of glioma
Authors: Kang Yin , Lin Xiaohua , Kang Dezhi 
Published: August 2020

Abstract

Introduction:
Circulating tumor DNA (ctDNA) has provided a minimally invasive approach for the detection of genetic mutations in glioma. However, the diagnostic value of ctDNA in glioma remains unclear. This meta-analysis was designed to investigate the diagnostic value of ctDNA, compared with the current “criterion standard” tumor tissues.

Materials and methods:
The included studies were collected by searching PubMed, Web of Science, Cochrane Library, and Embase databases. All statistical analyses were performed using the STATA12.0 and Meta-DiSc1.4 software.

Result:
A total of 11 studies comprising 522 glioma patients met our inclusion criteria. The pooled sensitivity and specificity were 0.69 (95% confidence interval [CI] 0.66–0.73) and 0.98 (95% CI 0.96–0.99), respectively. The pooled diagnostic odds ratio was 23.27 (95% CI 13.69–39.53) and the area under the curve of the summary receiver operating characteristics curve was 0.90 (95% CI 0.89–0.92).

Conclusions:
ctDNA analysis is an effective method to detect the genetic mutation status in glioma patients with high specificity and relatively moderate sensitivity. The application of high-throughput technologies, the detection of patients with high-grade glioma, and sampling from cerebrospinal fluid could have higher diagnostic accuracy. The improvement of detection methods and more large-sample case–control studies are required in the future.