bluuebunny/crossref_metadata_2025_split huggingface dataset:
Independent Predictors of Revision Lumbar Fusion Outcomes and the Impact of Spine Surgeon Variability: Does It Matter Whether the Primary Surgeon Revises?
Authors: Montenegro Thiago Scharth , Singh Akash , Elia Christopher , Matias Caio M , Gonzalez Glenn A , Saiegh Fadi Al , Philipp Lucas , Hattar Ellina , Hines Kevin , Fatema Umma , Thalheimer Sara , Wu Chengyuan , Prasad Srinivas K , Jallo Jack , Heller Joshua E , Sharan Ashwini , Harrop James 
Published: July 2021

Abstract

BACKGROUND
There is a paucity of information regarding treatment strategies and variables affecting outcomes of revision lumbar fusions.

OBJECTIVE
To evaluate the influence of primary vs different surgeon on functional outcomes of revisions.

METHODS
All elective lumbar fusion revisions, March 2018 to August 2019, were retrospectively categorized as performed by the same or different surgeon who performed the primary surgery. Oswestry Disability Index (ODI) and clinical variables were collected. Multiple logistic regression identified multivariable-adjusted odds ratio (OR) of independent variables analyzed.

RESULTS
Of the 130 cases, 117 (90%) had complete data. There was a slight difference in age in the same (median: 59; interquartile range [IQR], 54-66) and different surgeon (median: 67; IQR, 56-72) groups (P = .02); all other demographic variables were not significantly different (P > .05). Revision surgery with a different surgeon had an ODI improvement (median: 8; IQR, 2-14) greater than revisions performed by the same surgeon (median: 1.5; IQR, −3 to 10) (P < .01). Revisions who achieved minimum clinically important difference (MCID) performed by different surgeon (59.7%) were also significantly greater than the ones performed by the same surgeon (40%) (P = .042). Multivariate analysis demonstrated that a different surgeon revising (OR, 2.37; [CI]: 1.007-5.575, P = .04) was an independent predictor of MCID achievement, each additional 2 years beyond the last surgery conferred a 2.38 ([CI]: 1.36-4.14, P < .01) times greater odds of MCID achievement, and the anterior lumbar interbody fusion approach decreased the chance of achieving MCID (OR, 0.19; [CI]: 0.04-0.861, P = .03).

CONCLUSION
All revision lumbar spinal fusion approaches may not achieve the same outcomes. This analysis suggests that revision surgeries may have better outcomes when performed by a different surgeon.
Missing repeated measures data in clinical trials
Authors: Pugh Stephanie L , Brown Paul D , Enserro Danielle 
Published: July 2021

Abstract
Clinical trials typically collect longitudinal data, data that are collected repeated over time, such as laboratories, scans, or patient-reported outcomes. Due to a variety of reasons, this data can be missing, whether a patient stops attending clinical visits (ie, dropout) or misses assessments intermittently. Understanding the reasons for missing data as well as predictors of missing data can aid in determination of the missing data mechanism. The analysis methods used are dependent on the missing data mechanism and may make certain assumptions about the missing data itself. Methods for nonignorable missing data, which assumes that the missing data depend on the missing data itself, make stronger assumptions and include pattern-mixture models and shared parameter models. Missing data that are ignorable after adjusting for other covariates can be analyzed using methods that adjust for covariates, such as mixed-effects models or multiple imputation. Missing data that are ignorable can be analyzed using standard approaches that require complete case data, such as change from baseline or proportion of patients who declined at a specified time point. In clinical trials, truly ignorable data are rare, resulting in additional analysis methods required for proper interpretation of the results. Conducting several analyses under different assumptions, called sensitivity analyses, can determine the extent of the impact of the missing data.
Microsurgical Resection of Giant Thoraco-Lumbo-Sacral Ependymoma With Hybrid Spinal Reconstruction Using Multilevel Laminoplasty and Up-Front Thoracolumbar Posterior Fixation: 2-Dimensional Operative Video
Authors: Donoho Daniel A , Lazaro Tyler , Snyder Rita , Guerrero Jaime , Bauer David F 
Published: July 2021

Abstract
Extensive multifocal intradural lesions in children present a formidable challenge. This surgical video illustrates our management of a 14-yr=old boy with two intradural mass lesions on magnetic resonance imaging (MRI): one at T2-5 and the other from T12 through the sacral cul-de-sac. In a single procedure, we performed a T2-5 laminectomy and laminoplasty and T12-sacrum laminectomy for tumor resection. For reconstruction, we performed complete laminoplasty at all levels with supplementation at the thoracolumbar junction via T11-L2 posterior spinal fixation and allograft placement for fusion. In this video, we illustrate the microsurgical challenges of intradural tumor resection in both the thoracic cord and amidst the cauda equina. In young patients, prevention of postsurgical spinal deformity is of paramount concern. We discuss considerations for long-segment spinal stabilization in an adolescent and describe our decision-making to perform stabilization at the thoracolumbar junction to supplement laminoplasty while preserving function. The patient and their family consented to the procedure.
Image of the article at 0:51 is from McGirt et al, Short-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 239 patients, Neurosurgery, 2010, 66(5), 1005-1012, by permission of the Congress of Neurological Surgeons.
COVID-19 diplomacy: analysis of Serbia COVID-19 vaccine strategy in the western Balkans
Authors: Barovic Alek , Cardenas Nicky C 
Published: July 2021

Abstract
Serbia’s regional influence in the western Balkans enhanced strategic geopolitical partnership with Russia and China during COVID-19 pandemic. This paper critically analyzes Serbia COVID-19 vaccine strategy to the public health in the western Balkans. Importantly, this paper proposes strategic policy by enhancing ‘joint coordinated EU–US-western Balkans COVID-19 vaccine manufacturing production’ to accelerate inoculation, address gaps on vaccine hesitancy and promote long-term post-pandemic recovery plan to build back together and achieve herd immunity.
OBSIDIAN – real-world evidence of originator to biosimilar drug switch in juvenile idiopathic arthritis
Authors: Maccora Ilaria , Lombardi Niccolò , Crescioli Giada , Bettiol Alessandra , Bonaiuti Roberto , Pagnini Ilaria , Maniscalco Valerio , Marrani Edoardo , Mastrolia Maria Vincenza , Ravaldi Claudia , Consolini Rita , Cattalini Marco , Vannacci Alfredo , Simonini Gabriele 
Published: July 2021

Abstract

Objectives
Limited data about use of biosimilars (BIOs) are available in children with JIA. This study therefore aimed to evaluate long-term efficacy and safety of switching from etanercept (ETA) and adalimumab (ADA) originators to their biosimilars (BIOs), in children with JIA, in a real-world setting.

Methods
This is a retro-prospective non-interventional multicentre Italian comparative cohort study. Medical charts of JIA children treated with biosimilars of ETA or ADA were included. Efficacy and safety of TNF-inhibitors therapy was evaluated at last follow-up during originator and at 3, 6 and 12 months following the switch to biosimilar.

Results
A total of 59 children (42 female, median age at onset 88 months) were treated with biosimilar of ETA (21) and ADA (38). Forty-five switched from the originator to the BIO (17 ETA, 28 ADA). At time of switch, 12/17 patients on ETA and 18/28 on ADA were in remission. No significant difference has been found at 3, 6 and 12 months after the switch. Ten patients discontinued biosimilars due to disease remission (4 ETA, 3 ADA), family willing (1 ETA), occurrence of burning at injection site (1 ETA) and persistent activity (1 ADA). No statistically significant difference was observed between originator and BIOs, nor between originator and BIOs, and between ADA and ETA in time to disease remission achievement, time to relapse and number of patients who experienced adverse event (AE).

Conclusion
Our real-life results seem to confirm the efficacy and safety profile of switching from originator of ADA and ETA to their respective BIOs, also in paediatric patients with JIA.
Clinical significance of anti-NOR90 antibodies in systemic sclerosis and idiopathic interstitial pneumonia
Authors: Yamashita Yuta , Yamano Yasuhiko , Muro Yoshinao , Ogawa-Momohara Mariko , Takeichi Takuya , Kondoh Yasuhiro , Akiyama Masashi 
Published: July 2021

AbstractObjectiveAnti-NOR90 antibodies are usually found in patients with SSc; however, their clinical relevance remains obscure. We developed an ELISA for measuring them to investigate the clinical features of patients with anti-NOR90 antibodies.MethodsSerum samples from 1252 patients with various conditions from Nagoya University Hospital and 244 patients with idiopathic interstitial pneumonia (IIP) from Tosei General Hospital were included. Anti-NOR90 antibodies were assayed by an ELISA using the recombinant protein produced by in vitro transcription/translation.ResultsFive (0.4%) patients in the Nagoya University Hospital cohort had anti-NOR90 antibodies. One patient with diffuse cutaneous SSc, three with limited cutaneous SSc, and one with Raynaud’s disease were positive for anti-NOR90 antibodies. Anti-NOR90 antibodies were found more frequently in patients with systemic scleroderma-spectrum disorders (SSDs) than without SSDs (5/316 vs 0/936, P &lt;0.00101) and were found more frequently in patients with SSc than without SSc (4/249 vs 0/528, P &lt;0.0104) in the systemic autoimmune rheumatic diseases cohort. Three of the four anti-NOR90-positive SSc patients had interstitial lung disease (ILD), and two of those four had cancer. Three (1.2%) patients in the Tosei General Hospital cohort had anti-NOR90 antibodies. All three of the anti-NOR90-positive IIP patients had gastrointestinal tract involvement, and two of those three had cancer or skin lesions observed in SSc.ConclusionsAlthough anti-NOR90 antibodies are rarely found in clinics, our ELISA is useful for their detection. Further studies are needed to confirm the association of anti-NOR90 antibodies with ILD and cancer in SSc and IIP patients.
Changing Trends in Corneal Transplantation in Aotearoa/New Zealand, 1991 to 2020: Effects of Population Growth, Cataract Surgery, Endothelial Keratoplasty, and Corneal Cross-Linking for Keratoconus
Authors: Chilibeck Corina M. , Brookes Nigel H. , Gokul Akilesh , Kim Bia Z. , Twohill Helen C. , Moffatt S. Louise , Pendergrast David G. , McGhee Charles N. J. 
Published: July 2021

Purpose:
The purpose of this study was to identify trends in the primary indication for keratoplasty in New Zealand/Aotearoa (NZ) after significant population growth, increase in the number of cataract surgeries per population, widespread adoption of endothelial keratoplasty, and introduction of corneal cross-linking for keratoconus.

Methods:
Statistical analysis of the New Zealand National Eye Bank's prospective database of all keratoplasties was performed between January 1991 and January 2020. Indications for keratoplasty were isolated for the primary diagnosis.

Results:
In total, 6840 corneas were transplanted with mean 236 ± 57.5 transplants/year, increasing from 2.55 to 6.06 per 100,000 NZ population/year. Over the past decade, the number of transplant recipients aged 60 years or older has increased and recipients aged 20 to 39 years have plateaued. In 2019, for the first time, regraft became the most common indication (30.9%), followed by keratoconus (27.9%) and corneal dystrophy (18.8%), with a steady decline in bullous keratopathy. Proportions of the keratoplasty technique changed dramatically: penetrating keratoplasty fell from 91.4% in 2006 to 55.0% in 2019, Descemet’s stripping endothelial keratoplasty increased from 0% to 29.5%, anterior lamellar keratoplasty increased from 2.5% to 5.7%, and Descemet membrane endothelial keratoplasty increased from 0% to 9.1%.

Conclusions:
Keratoplasty trends in Aotearoa/NZ have changed considerably because of the evolution of phacoemulsification and keratoplasty techniques. Unlike proportions observed overseas, NZ still performs penetrating keratoplasties in over half of all transplants. Corneal cross-linking may be having an early effect of reducing keratoplasty rates for keratoconus.
Holistic Review in Doctor of Physical Therapy Admissions Can Lead to Enhanced Diversity in Admitted Students
Authors: Canham Lara E. , Mañago Mark M. , Dannemiller Lisa , Rapport Mary Jane 
Published: July 2021

Background and Purpose.
Despite an increase in the number of physical therapist education programs and applicants, there is limited diversity represented in the physical therapy profession. This case report describes the development and implementation of a holistic review rubric with the goal of increasing diversity in 1 entry-level physical therapist education program.

Case Description.
The University of Colorado Physical Therapy Program developed a holistic review rubric, based on literature review and conversations with other programs, with a focus on the specific mission/values/goals of the program. Admissions decisions for the 2018–19 admissions cycle were based on holistic rubric scores in addition to the traditionally used cognitive measures and interview recommendations.

Outcomes.
The Program received 919 verified applications, 713 met the eligibility requirements and were reviewed using the holistic rubric, 193 were invited to interview, and 71 matriculated. Overall, the Program admitted a greater proportion of diverse students as compared with the total Program applicant pool in the following categories: 1) race/ethnicity, 2) socioeconomic status, and 3) other unique characteristics (first-generation college student, military experience, and rural). Second, compared with the Physical Therapy Centralized Application Service data, the Program admitted an increased proportion of diverse students. Third, the 193 applicants who were interviewed by the Program based on the holistic review compared with the top 193 applicants based on cumulative grade point average had an increased proportion of diverse students.

Discussion and Conclusion.
Although this case report reflects only 1 admission cycle at 1 institution, the initial data suggest that the use of a holistic review may increase diversity in entry-level Doctor of Physical Therapy programs, as compared with using more traditional admissions methods with the goal of leading to increased diversity within the physical therapist profession.
Endoscopic Stapedotomy: A Systematic Review
Authors: Hoskison Emma E. , Harrop Elizabeth , Jufas Nicholas , Kong Jonathan H. K. , Patel Nirmal P. , Saxby Alexander J. 
Published: July 2021

Objectives:
Stapes surgery has evolved from its origins in 1956. Microscopic assisted stapedotomy remains the most common technique but the introduction of endoscopic ear surgery has led to some units using this new approach. The endoscope delivers a wide angled, contextual view of the stapes, and associated pathology. This systematic review provides a critical analysis of the current published endoscopic data, allowing comparison to the established microscopic technique.

Data sources:
Six databases (PubMed, Medline, Cochrane database, AMED, EMBASE, and CINAHL) were searched for studies within the last 10 years.

Study selection and data extraction:
English language articles including 5 or more cases were included. Primary outcomes included audiological results and reported complications. Data was extracted according to PRISMA guidelines.

Results:
Thirteen papers were identified comprising 361 endoscopic stapes surgeries. Postoperative temporary facial nerve weakness was reported in 3 patients (0.8%) which all resolved within 4 weeks. Chorda tympani injury occurred in 21 cases (5.8%) and vertigo in 61 (16.9%). The audiometric outcomes of endoscopic stapes surgery were available for 259 patients and showed air bone gap closure rates of 71.4% (0–10 dB), 25.9% (11–20 dB), 2.3% (21–30 dB), and 0.4% (>30 dB).

Conclusions:
Endoscopic stapes surgery has similar audiometric outcomes compared to the traditional microscopic approach with air bone gap closure values of <20 dB in 97.3% of cases. However, the complication rates of chorda tympani damage, postoperative dysguesia, and tympanic membrane perforation for endoscopic stapes surgery are high. Caution should therefore be taken before undertaking stapes surgery with the endoscopic technique. Further studies are required to prove superiority over well established existing microsurgical methods.
Iatrogenic Third Window After Retrosigmoid Approach to a Vestibular Schwannoma Managed with Cochlear Implantation
Authors: Deep Nicholas L. , Kay-Rivest Emily , Roland J. Thomas 
Published: July 2021

Objective:
To present a case of an iatrogenic inner ear third window after vestibular schwannoma microsurgery.

Patients:
A 42-year-old male presented 9-months after left-sided retrosigmoid approach for an intracanalicular vestibular schwannoma with hearing-preservation attempt performed elsewhere. Immediately postoperatively, he developed the following disabling and persistent symptoms on the ipsilateral side: autophony, pulsatile tinnitus, high-pitched ringing tinnitus, and hearing his footsteps. He denied vertigo. Otoscopy was normal. Tuning fork (512-Hz) lateralized to the left and Rinne was negative on the left. Audiogram demonstrated a severe mixed hearing loss and 10% aided word-recognition score. High-resolution CT demonstrated violation of the common crus and dehiscence of bone along the medial vestibule suggestive of an iatrogenic inner ear third window.

Interventions:
Labyrinthectomy and concurrent cochlear implantation.

Main outcome measures:
Resolution of third window symptoms, open-set speech recognition, tinnitus suppression.

Results:
Patient reported immediate resolution of third window symptoms after labyrinthectomy and cochlear implantation. He demonstrates open-set word recognition of 64% at 1-year postoperatively and tinnitus suppression with his cochlear implant on.

Conclusions:
Iatrogenic third window symptoms can occur after hearing-preservation vestibular schwannoma microsurgery. Patients with sufficient hearing preservation who are disabled by third window symptoms yet lack sound clarity and useful hearing may be considered for labyrinthectomy and concurrent cochlear implantation. This intervention effectively extinguishes third window symptoms by destroying residual auditory function and simultaneously provides an opportunity to restore useful hearing and suppress tinnitus, thereby enhancing overall quality of life.
Combination of Direct Oval Window Vibroplasty With Customized Partial Ossicular Replacement Prosthesis (PORP): A Novel Reconstruction Technique to Rehabilitate Mixed Hearing Loss
Authors: Grueninger Ivo , Canis Martin , Spiegel Jennifer L. , Müller Joachim 
Published: July 2021

Objective:
Hearing rehabilitation with an active middle ear implant (AMEI) in patients with mixed hearing loss (MHL) after multiple ear surgeries is surgically challenging and requires individual solutions in some cases. Our objective was to introduce a feasible novel technique for direct oval window vibroplasty (OW vibroplasty) using a partial ossicular replacement prosthesis (PORP) to ensure stability and enable active and passive sound transmission.

Design:
Four patients with MHL following multiple middle ear surgeries and indication for an AMEI received direct OW vibroplasty in combination with a customized PORP between the enwrapped actuator and reconstructed tympanic membrane (TM).

Results:
Postoperative bone conduction was stable in all patients. All patients benefitted from the AMEI in combination with PORP with a mean functional gain of 31.5 ± 17.0 dB. Mean aided postoperative pure tone average was 27.3 ± 2.6 dB. Speech discrimination in quiet at 65 dB with the German Language Freiburg Monosyllabic Test improved for all patients to 68.8 ± 6.3% and in noise with the German Language Oldenburger Sentence Test to –10.4 ± 3.3 dB SNR. No complications were observed.

Conclusions:
This novel technique of direct OW vibroplasty extends the portfolio of reconstructive middle ear procedures by combining an intraoperatively customized “off-the-shelf” PORP as a coupler between floating mass transducer (FMT) and a cartilage TM. We found satisfying functional hearing results. Benefits of the reported technique comprise 1) stabilization and optimized coupling of the reconstruction, 2) possibility of passive sound transmission, 3) general feasibility due to great availability of a regular PORP, and 4) flexibility in bridging of large gaps between TM and actuator.
Cochlear Implant Outcomes in Elderly Recipients During the COVID-19 Pandemic
Authors: Knickerbocker Alissa , Bourn Stephanie , Goldstein Mary Rose , Jacob Abraham 
Published: July 2021

Objective:
To evaluate the potential significance of social distancing and quarantine precautions for COVID-19 on speech outcomes, missed appointments, wear time, and exposure to various sound environments in the first 6 months following activation for elderly cochlear implant (CI) recipients.

Study Design:
Retrospective cohort.

Setting:
Tertiary private practice.

Patients:
Fifty cochlear implant recipients ≥65 years were evaluated. A Control Group consisted of 26 patients implanted between November 2, 2018 and February 18, 2019 while the Pandemic Group included 24 patients implanted between November 1, 2019 and February 17, 2020.

Intervention:
Rehabilitative.

Main Outcome Measures:
Preoperative and 6-month postoperative AzBio sentence scores in quiet were compared between groups along with the number of missed appointments as well as datalogged information regarding average CI wear time and average hours in various sound environments such as quiet, speech, and speech-in-noise.

Results:
The Control Group averaged 36.5% improvement for AzBio in quiet scores while the Pandemic Group averaged only 17.2% improvement, a difference that was both statistically and clinically significant (p = 0.04; g = 0.64). Patients in the Pandemic Group were nearly twice as likely to miss CI programming appointments than the Control Group. The Pandemic Group wore their CI 1.2 less hours per day on average, and while the Pandemic Group spent similar times in quiet and speech environments to the Control Group, the Pandemic Group spent less time in speech with presence of background noise.

Conclusions:
While social distancing and quarantine measures are crucial to limiting spread of COVID-19, these precautions may have negatively impacted early speech performance for elderly cochlear implant recipients. Missed CI programming appointments, decreased sound processor wear time, and reduced exposure to complex listening environments such as speech in the presence of background noise were more common in the Pandemic Group than in the Control Group operated the year prior.