bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lumbar 3–Lumbar 5 Robotic-Assisted Endoscopic Transforaminal Lumbar Interbody Fusion: 2-Dimensional Operative Video
Authors: Liounakos Jason I , Wang Michael Y 
Published: December 2019

Abstract
Minimally invasive spine surgery has the potential to reduce soft tissue destruction, blood loss, postoperative pain, and overall perioperative morbidity while accelerating recovery. Robotic guidance systems are relatively new tools in the minimally invasive surgeon's armamentarium, striving to increase accuracy of instrumentation placement, decrease complications, reduce radiation burden, and enhance surgical ergonomics in order to improve efficiency and maximize patient outcomes. We present the case of a 78-yr-old male with intractable lower back and bilateral lower extremity pain with multilevel degenerative spondylosis. The procedure performed was a L3-5 robotic-assisted endoscopic transforaminal lumbar interbody fusion (TLIF) utilizing the Mazor X robotic guidance system (Medtronic) for both percutaneous pedicle screw placement, as well as trajectory localization for endoscopic discectomy and percutaneous interbody delivery. Previously, clinical and radiographic success has been published regarding the awake, endoscopic TLIF.
1
We document the first use of robotic guidance for disc space localization and its combination with endoscopy to achieve interbody fusion, utilizing an expandable, allograft-filled mesh interbody device.
2
This video demonstrates appropriate patient positioning, work flow for this unique technique, and the benefits of using robotic guidance to plan and execute percutaneous trajectories through Kambin's triangle. This procedure involves the off-label use of recombinant human bone morphogenetic protein-2 (Infuse™, Medtronic), OptiMesh® graft containment device (Spineology), and liposomal bupivacaine (Exparel®, Pacira).
Patients’ Experiences with Telecare for Chronic Pain and Mood Symptoms: A Qualitative Study
Authors: Matthias Marianne S , Evans Erica , Porter Brian , McCalley Stephanie , Kroenke Kurt 
Published: December 2019

Abstract

Objective
Pain, anxiety, and depression commonly co-occur, can have reciprocal effects, and are associated with substantial disability and health care costs. However, few interventions target treatment of pain and mood disorders as a whole. The Comprehensive vs. Assisted Management of Mood and Pain Symptoms (CAMMPS) trial was a randomized trial comparing two pragmatic telecare interventions, a high- vs low-resource approach to pain and anxiety/depression treatment. The purpose of the current study is to better understand patients’ perspectives on both intervention approaches, including intervention components, delivery, patient experiences, and patient outcomes.

Design
Qualitative, semistructured interviews.

Setting
A Veterans Affairs Medical Center.

Subjects
Twenty-five patients were purposefully sampled from both study arms.

Methods
Patients were interviewed about their experiences with pain and mood treatment, perceived benefits and changes, and experiences with the intervention model to which they were randomized. The constant comparison method guided analysis.

Results
Pain was more important than mood for most participants. Participants described developing increased awareness of their symptoms, including connecting pain and mood, which enabled better management. Participants in the high-resource intervention described the added value of the study nurse in their symptom management.

Conclusions
Patients in a telecare intervention for chronic pain and mood symptoms learned to connect pain and mood and be more aware of their symptoms, enabling more effective symptom management. Patients in the high-resource intervention described the added benefits of a nurse who provided informational and motivational support. Implications for tradeoffs between resource intensity and patient outcomes are discussed.
NUMBER OF PRIME FACTORS OVER ARITHMETIC PROGRESSIONS
Authors: Meng Xianchang 
Published: December 2019

Abstract
Numerical experiments suggest that there are more prime factors in certain arithmetic progressions than others. Greg Martin conjectured that the function $\sum _{n\leq x, n\equiv 1 \bmod 4} \omega (n)-\sum _{n\leq x, n\equiv 3 \bmod 4} \omega (n)$ will attain a constant sign as $x\rightarrow \infty $, where $\omega (n)$ is the number of distinct prime factors of $n$. In this paper, we prove explicit formulas for both $\sum _{n\leq x}\chi (n)\Omega (n)$ and $\sum _{n\leq x}\chi (n)\omega (n)$ under some reasonable assumptions, where $\chi (n)$ is a Dirichlet character and $\Omega (n)$ is the number of prime factors of $n$ counted with multiplicity. Our results give strong evidence for Martin’s conjecture.
A LESSON FROM AUTOMATIC TUBE VOLTAGE SELECTION: FEASIBILITY OF 100 kVp IN PORTAL VENOUS PHASE ABDOMINAL CT
Authors: Choi Moon Hyung , Lee Young Joon , Jung Seung Eun 
Published: December 2019

Abstract
Purpose: To evaluate the relationship between ATVS-recommended tube voltage and patient body habitus and to compare radiation dose and diagnostic performance between fixed 120-kVp and ATVS protocols in portal venous phase abdomen CT. Methods: A total of 907 portal venous phase abdominal CTs were evaluated. Radiation dose in the ATVS protocol was compared according to tube voltage (80, 100 or 120 kVp). Quantitative image analysis and diagnostic performance were compared between 81 pairs of CT using ATVS and fixed 120-kVp protocols. Results: Most CT examinations with ATVS were performed with 80 or 100 kVp. The average reduction rate of radiation dose in the ATVS protocol was 15.4%. There was no significant difference in diagnostic performance (p = 0.388) between ATVS and fixed 120-kVp protocols. Conclusions: In conclusion, ATVS frequently selected 80 or 100 kVp for portal venous phase abdominal CT without impairing the diagnostic performance, even with filtered back projection.
Variability in Discharge Disposition Across US Trauma Centers After Treatment for High-Energy Lower Extremity Injuries
Authors: Gitajn Ida L. , Reider Lisa , Scharfstein Daniel O. , O'Toole Robert V. , Bosse Michael J. , Castillo Renan C. , Jevsevar David S. , Pollak Andrew N. ,   on behalf of METRC
Published: December 2019

Objective:
To evaluate the association between patient- and center-level characteristics and discharge to an inpatient facility versus home after treatment for lower extremity trauma, as well as examine the variability in discharge disposition across clinical centers after controlling for these factors.

Design:
This is an analysis of data collected prospectively across 5 multicenter studies of extremity trauma.

Setting:
US Trauma Centers.

Participants:
Patients 18–80 years with lower extremity trauma treated at 1 of 55 participating centers.

Main Outcome Measure:
Discharge disposition.

Results:
Among 2365 patients treated at 1 of 55 centers across 13 states, 673 (28.5%) were discharged to an inpatient facility, and 1692 (71.5%) were discharged home. Individuals who were older, female, unmarried, insured, higher body mass index, history of severe alcohol abuse, Gustilo type IIIB or IIIC open injuries, bilateral, spine and upper extremity injuries, higher injury severity score scores, or intensive care unit stay were more likely to be discharged to an inpatient facility. Even after accounting for patient- and center-level characteristics, there was substantial variation in discharge disposition across centers (likelihood ratio test: P < 0.001).

Conclusion:
Variation in discharge disposition may represent a potential for improvement in resource utilization and cost savings. Further studies are needed to examine the relationship between utilization of postdischarge inpatient facility after trauma and outcomes.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Dual Mini-Fragment Plating Is Comparable With Precontoured Small Fragment Plating for Operative Diaphyseal Clavicle Fractures: A Retrospective Cohort Study
Authors: DeBaun Malcolm R. , Chen Michael J. , Campbell Sean T. , Goodnough L. Henry , Lai Cara , Salazar Brett P. , Bishop Julius A. , Gardner Michael J. 
Published: December 2019

Objectives:
To compare precontoured (Pc) small fragment plating to dual mini-fragment plating (DmF) for open reduction and internal fixation of diaphyseal clavicle fractures.

Design:
Retrospective cohort.

Setting:
Level 1 trauma center.

Patients/Participants:
A total of 133 patients with displaced fractures of the diaphyseal clavicle (OTA/AO 15-B1, -2, and -3) treated with open reduction and internal fixation with a minimum of 1 year follow-up or until radiographic and clinical union.

Intervention:
Two patient cohorts were identified: (1) patients treated with orthogonal DmF plate constructs and (2) patients treated with Pc clavicle-specific plates.

Outcome Measurements:
Union rate and implant removal were assessed using standard descriptive statistics. Odds ratios, 95% confidence intervals, and P values (P) were calculated.

Results:
There were 60 DmF and 74 Pc patients. There were no significant differences between groups with respect to age, sex, surgeon, body mass index, or mode of fixation. There was no significant difference in union (98.3% DmF; 100% Pc, P = 0.45) or maintenance of reduction (98.3% DmF; 100% Pc, P = 0.45). A total of 8% of DmF patients had symptomatic implant removal compared with 20% of Pc patients (odds ratio 0.36, confidence interval 0.12–1.05, P = 0.061).

Conclusions:
This retrospective comparative study found no difference in union or maintenance of reduction for diaphyseal clavicle fractures fixed with DmF compared with Pc plating. Patients treated with DmF plates may have lower rates of symptomatic implant removal.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Protocol on transcranial alternating current stimulation for the treatment of major depressive disorder: a randomized controlled trial
Authors: Wang Hong-Xing , Wang Kun , Zhang Wen-Rui , Zhao Wen-Feng , Yang Xiao-Tong , Wang Li , Peng Mao , Sun Zhi-Chao , Xue Qing , Jia Yu , Li Ning , Dong Kai , Zhang Qian , Zhan Shu-Qin , Min Bao-Quan , Fan Chun-Qiu , Zhou Ai-Hong , Song Hai-Qing , Yin Lu , Si Tian-Mei , Huang Jing , Lu Jie , Leng Hai-Xia , Ding Wei-Jun , Liu Yuan , Yan Tian-Yi , Wang Yu-Ping 
Published: December 2019

AbstractBackground:Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD). The study is to evaluate the efficacy and safety of tACS treating MDD.Methods:This is an 8-week, double-blind, randomized, placebo-controlled study. Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4), following a 4-week observation period (week 8). The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8. Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17, the proportion of participants having improvement in the clinical global impression-improvement, the change in HDRS-17 score (range, 0–52, with higher scores indicating more depression) over the study, and variations of brain imaging and neurocognition from baseline to week 4. Safety will be assessed by vital signs at weeks 4 and 8, and adverse events will be collected during the entire study.Discussion:The tACS applied in this trial may have treatment effects on MDD with minimal side effects.Trial registration:Chinese Clinical Trial Registry, ChiCTR1800016479; http://www.chictr.org.cn/showproj.aspx?proj=22048.
Role of NFATc1 in the Bone-Vascular Axis Calcification Paradox
Authors: Gu Wen , Wang Zhongqun , Sun Zhen , Bao Zhengyang , Zhang Lili , Geng Yue , Jing Lele , Mao Xiang , Li Lihua 
Published: December 2019

Abstract:
Nuclear factor of activated T cell cytoplasmic 1 (NFATc1), a crucial member of the transcription factor NFAT family, is indispensable in the immune system and the morphogenesis of cardiac valves and septa and is also vital in osteoclasts and atherosclerotic calcification. Currently, osteoporosis and vascular diseases are severely hazardous to health and quality of life, and the 2 conditions always coincide with each other. The bone-vascular axis calcification paradox serves as a bridge between bone and vascular diseases, linking these 2 seemingly separate diseases, and the receptor activator of NF-κB (RANK)/receptor activator of nuclear factor kappa-B ligand (RANKL)/osteoprotegerin (OPG) system may be the common mechanism of the bone-vascular axis calcification paradox. NFATc1 provides a new therapeutic target for bone and vascular diseases. However, the specific mechanism by which NFATc1 acts on the bone-vascular axis calcification paradox, whether NFATc1 is related to the RANK/RANKL/OPG system, and how to use NFATc1 as a therapeutic target to avoid its side effects in other systems requires further study.
Restoration of Adiponectin-Connexin43 Signaling Mitigates Myocardial Inflammation and Dysfunction in Diabetic Female Rats
Authors: Leffler Korin E. , Abdel-Rahman Abdel A. 
Published: December 2019

Abstract:
ur preclinical findings replicated women's hypersensitivity to type-2 diabetes mellitus (T2DM)-evoked cardiac dysfunction along with demonstrating estrogen (E2)-dependent disruption of the cardiac adiponectin (APN)-connexin43 (Cx43) signaling. Whether the latter molecular anomaly underlies this women's cardiovascular health problem remains unknown. We hypothesized that restoration of the disrupted APN-Cx43 signaling alleviates this sex/E2-dependent cardiac dysfunction in diabetic female rats. To test this hypothesis, we administered the adiponectin receptor 1 (AdipoR1) agonist AdipoRon (30 mg/kg/d for 10 days) to female sham operated (SO) and ovariectomized (OVX) rats, which exhibited and lacked the T2DM left ventricular (LV) dysfunction, respectively, when fed high-fat diet and received low dose streptozotocin regimen; nondiabetic control SO and OVX rats received control diet and vehicle for streptozotocin. In T2DM SO rats, LV dysfunction, AdipoRon mitigated: (1) LV hypertrophy, (2) reductions in fractional shortening, LV developed pressure, dP/dtmax, dP/dtmin, and Tau. In LV tissues of the same rats, AdipoRon reversed reduction in Cx43 and elevations in TNFα, heme-oxygenase 1 (HO-1), and circulating cardiovascular risk factor asymmetric dimethylarginine. The findings also revealed ovarian hormones independent effects of AdipoRon, which included dampening of the pro-oxidant enzyme HO-1. These novel findings yield new insight into a causal role for compromised APN-Cx43 signaling in the E2-dependent hypersensitivity to T2DM-evoked cardiac inflammation and dysfunction. Equally important, the findings identify restoration of Cx43 signaling as a viable therapeutic modality for alleviating this women's cardiovascular health-related problem.
Adenocarcinoma Arising in the Conjunctiva With Periparotid Lymph Node Metastases
Authors: Mazzini Cinzia , Pieretti Giulia , Vicini Giulio , Nicolosi Cristina , Spinelli Giuseppe , Maio Vincenza , Portelli Francesca 
Published: December 2019

Purpose:
To report a rare case of adenocarcinoma (ADC) arising in the conjunctiva which locally recurred and metastasized to the periparotid lymph nodes.

Methods:
This is a single observational case report.

Results:
A 79-year-old male patient was referred to us for a suspected recurrence of conjunctival carcinoma of the right eye. At presentation, we observed an elevated conjunctival lesion with corneal involvement. He was treated with neoadjuvant mitomycin C 0.04% eye drops, followed by surgical excision of the lesion, cryotherapy of the excision margins, and reconstruction with amniotic membrane graft. The tumor was histologically diagnosed as ADC. The negative systemic evaluation and the immunoprofile led us to believe the primitive nature of the tumor. The excision margins were positive, and the patient was lost to follow up for 7 months, and when he came back, a new local recurrence was diagnosed. Then, he received rescue treatment with mitomycin C 0.04% eye drops with complete regression of the lesion. No local recurrence was observed until the 14-month follow-up visit, during which the patient complained of swelling in the right parotid region. Subsequently, he underwent total parotidectomy with neck dissection. Metastasis was found in 3 periparotid lymph nodes. The patient did not receive further treatments, and no recurrences were observed over the following 20 months.

Conclusions:
ADC arising in the conjunctiva is a very rare occurrence. Additional observation is required for the management of this rare conjunctival tumor.
Changing in a GIF (Graphics Interchange Format): Innovations in Before and After Photography
Authors: Akella Sruti S. , Goldstein Tova , Kumar Shaina , Patel Parth , Heo Moonseong , Barmettler Anne 
Published: December 2019

Purpose:
Before and after images are an important part of aesthetic counseling, but no studies have examined ways to optimize change detection through the layout of displayed images. This study compares 3 different image layouts to determine which presentation style improves perception of postprocedure changes.

Methods:
In this prospective, randomized study, participants viewed sequential images of patients who either had or had not undergone upper eyelid blepharoptosis repair or blepharoplasty (“change” and “no-change,” respectively). These paired images were randomly presented in 1 of 3 formats: side-by-side, up-and-down, or alternation flicker (in which 2 images are superimposed and alternated in a graphics interchange format). Participants were asked if a procedure had been performed based on the 2 photographs. Paired t tests were used to compare response times and change detection rates between individual-level pairs of presentation modes.

Results:
Of 299 recruited patients, 286 completed the study. Rate of change detection trended toward increased sensitivity for alternation flicker over static images. This became statistically significant for patients less than 45 years old. Detection rates did not differ significantly between the 2 static layouts (side-by-side and up-and down).

Conclusions:
Enhancing and customizing aesthetics counseling for different ages can improve patient understanding, expectations, and advertising. When using static photography, the layout, whether side-by-side or up-and-down, can be chosen to fit the mode of presentation with no statistically significant difference. To optimize detection of changes in before and after photography in a demographic less than 45 years old, the animated, alternation flicker format was statistically significantly more effective.
Repair of a Full-thickness Eyelid Defect With a Bilamellar Full-thickness Autograft in a Porcine Model (Sus scrofa)
Authors: Reed Donovan , Soeken Timothy , Brundridge Wesley , Gallagher Colin , DeMartelaere Sheri , Davies Brett 
Published: December 2019

Purpose:
It has been demonstrated the pedicle of a tarsoconjunctival flap advancement does not appear to supply the flap itself and the vascularization of the remaining eyelid/tear film is thought to offer adequate nourishment for survival of the flap; as such, a swine model was constructed to assess the viability of a bilamellar autograft for repair of large full-thickness eyelid defects.

Methods:
Full-thickness defects of varying sizes were created in each lower eyelid of 4 Yorkshire/Yorkshire crossed swine. The defects were then closed with a full-thickness ipsilateral graft from the upper eyelid. Large full-thickness defects were then created in the upper and lower eyelids of 8 Yorkshire/Yorkshire crossed swine and closed with bilamellar autografts from the contralateral eyelids. The subjects were then monitored postoperatively and assessed clinically for graft viability at postoperative days 1, 7, and 30. At the conclusion of the 30-day postoperative monitoring period, necropsy was performed and histopathologic analysis utilized to assess cell morphology and vessel ingrowth of the graft sites.

Results:
In total, 28 full-thickness bilamellar grafts were constructed and examined. At the conclusion of the postoperative monitoring period, 27 of the grafts were deemed clinically viable and vascular ingrowth was determined to be equivalent to unaffected eyelid sections by histopathologic analysis. One case of postoperative hematoma was noted in the failed graft. One case of postoperative wound dehiscence required subsequent surgical repair. No clinically significant notching of the graft sites was noted. No cases of wound infection, corneal decompensation, or forniceal shortening were identified.

Conclusions:
This analysis demonstrates the viability of a full-thickness bilamellar autograft as a surgical alternative in the repair of large full-thickness eyelid defects in a porcine model. The postoperative outcomes are consistent with the recent literature. Additional studies need to be performed to assess the procedure’s clinical utility in human subjects before incorporation into clinical practice.
Is Higher Work Engagement Associated With Healthy Behaviors? A Longitudinal Study
Authors: Amano Hoichi , Fukuda Yoshiharu , Kawachi Ichiro 
Published: December 2019

Objectives:
We conducted a longitudinal study to examine whether work engagement promotes healthy employee behaviors (smoking cessation, drinking moderation, and regular exercise) among Japanese workers.

Methods:
The study was part of the Japanese Study of Health, Occupation, and Psychosocial Factors Related to Equity (J-HOPE). The survey measured work engagement of 8050 employees from 12 workplaces. A multivariable logistic analysis was used to examine the odds ratio and 95% confidence intervals after adjusting for job stress, psychological distress, and other confounders.

Results:
The mean age of the sample was 40.6 years and 77.4% of the participants were men. The mean work engagement score was 2.9. Higher work engagement was significantly positively associated with drinking moderation and weekly exercise behavior, but not smoking cessation.

Conclusions:
Higher work engagement was associated with healthier employee behaviors after 1 year.