bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secreted Factors From Intervertebral Disc Cells and Infiltrating Macrophages Promote Degenerated Intervertebral Disc Catabolism
Authors: Yang Hao , Liu Bo , Liu Yajun , He Da , Xing Yonggang , An Yan , Tian Wei 
Published: December 2018

Study Design.
Rat nucleus pulposus (NP) cells or annulus fibrosus (AF) cells were stimulated with conditioned media of RAW 264.7 macrophages and vice versa under healthy culture conditions and in the presence of pro-inflammatory mediators. The gene expression of pro-inflammatory mediators, extracellular matrix (ECM)-modifying enzymes, and chemokines, which play important roles in intervertebral disc degeneration (IDD), was determined.

Objective.
To test whether the interaction between native disc cells and infiltrating macrophages accelerates inflammation state, disrupts matrix homeostasis, and promotes inflammatory cells infiltration.

Summary of Background Data.
With macrophages infiltration, the disc resident cells would be inevitably exposed to macrophages. Macrophages have been shown to play pro-inflammatory role in the cellular interactions with disc cells under healthy culture conditions. However, the biologic interactions between macrophages and disc cells under degenerated disc inflammatory environment remain unknown.

Methods.
Murine Macrophages RAW 264.7 were cultured in the conditioned media of Rat AF or NP cells culture in the presence or absence of IL-1β stimulation. Similarly, Rat AF or NP cells were also cultured in the conditioned media of Murine Macrophages RAW 264.7 culture in the presence or absence of IFN-γ stimulation. The mRNA levels difference of pro-inflammatory genes, catabolic genes and chemokines genes for AF cells, NP cells and Macrophages RAW 264.7 were analyzed by qRT-PCR, respectively.

Results.
Compared with serum-free media exposure, RAW 264.7 macrophages exposed to AF or NP cells conditioned media selectively modestly upregulated mRNA levels of the aforementioned cytokines. Exposure of RAW 264.7 macrophages to conditioned media from AF or NP cells with IL-1β stimulation dramatically increased mRNA levels of all the investigated cytokines. Similarly, compared with serum-free media exposure, AF or NP cells exposed to RAW 264.7 macrophages conditioned media selectively modestly upregulated mRNA levels of the aforementioned cytokines. Exposure of AF or NP cells to conditioned media from RAW 264.7 macrophages with IFN-γ stimulation dramatically increased mRNA levels of all the investigated cytokines.

Conclusion.
The biologic interactions between infiltrating macrophages and native disc cells under degenerated disc inflammatory environment lead to an increasingly severe inflammatory conditions, which may be a self-stimulated process from the macrophages infiltration occurrence

Level of Evidence: 5
Vertebral Growth Around Distal Instrumented Vertebra in Patients With Early-Onset Scoliosis Who Underwent Traditional Dual Growing Rod Treatment
Authors: Rong Tianhua , Shen Jianxiong , Kwan Kenny , Zhang Jianguo , Wang Yahan , Li Shugang , Li Zheng , Chen Chong , Lin Youxi , Tan Haining 
Published: December 2018

Study Design.
Retrospective radiographic study.

Objective.
To investigate the growth of the vertebrae around distal instrumented vertebra (DIV) in patients with early-onset scoliosis (EOS) who underwent dual growing rod (DGR) treatment.

Summary of Background Data.
Previous studies indicated that DGR was likely to preserve or even stimulate the spinal growth. However, report pertaining to the effect of growing rod on the growth of individual vertebral body is rare.

Methods.
The EOS patients treated with DGR who had at least four lengthenings and 5-year follow-up were enrolled. Spine radiographs at index surgery and final follow-up were reviewed. The height, width, and depth of vertebral body from DIV–2 to DIV+2, and the height of the adjacent intervertebral space (IVS) were measured. The percentage of growth was calculated.

Results.
Thirty-one patients (mean age, 6.2 ± 2.5 years old) met the inclusion criteria, 74.2% (23/31) of whom were female. The average follow-up was 6.2 years (range, 5.0–10.4 yr). The measured vertebrae were divided into DIV group (n = 65), DIV- group (DIV-1 and DIV-2, n = 60), and DIV+ group (DIV+1 and DIV+2, n = 47). There were 33, 90, and 78 measured IVSs in DIV, DIV–, and DIV+ group, respectively. The total percentage growth of vertebral height was significantly higher in DIV– group than that in DIV and DIV+ groups (56.6 ± 20.3% vs. 45.6 ± 18.0% and 42.7 ± 16.2%, respectively, P ≤ 0.001). The vertebrae in DIV– group also had the highest annual height growth rate (8.7 ± 2.6% vs. 7.0 ± 2.4% and 6.6 ± 2.0%, respectively, P ≤ 0.001). A significant decrease of IVS height was observed in DIV– and DIV groups (P ≤ 0.001).

Conclusion.
Traditional DGR with periodical distraction stimulated the longitudinal growth of the two segments immediately above DIV in patients with EOS. DGR technique had a negative effect on the development of intervertebral discs within distracted levels.

Level of Evidence: 3
Poor Baseline Mental Health Does Not Influence Improvement in Patient-reported Outcomes, Satisfaction, and Return to Work Two Years After Single-level Anterior Cervical Discectomy and Fusion
Authors: Goh Graham Seow-Hng , Liow Ming Han Lincoln , Yeo William , Ling Zhixing Marcus , Guo Chang Ming , Yue Wai Mun , Tan Seang Beng , Chen Li Tat John 
Published: December 2018

Study Design.
Retrospective study using prospectively collected registry data.

Objective.
The authors examine the influence of preoperative mental health on outcomes after anterior cervical discectomy and fusion (ACDF) and determine the impact of ACDF on postoperative mental health.

Summary of Background Data.
While studies have reported a negative correlation between preoperative mental health and outcomes following lumbar spine surgery, the influence on outcomes following cervical spine surgery remains relatively understudied.

Methods.
Prospectively collected registry data of 104 patients who underwent single-level ACDF for cervical spondylotic myelopathy were reviewed. Patients were dichotomized into top and bottom halves based on preoperative SF-36 MCS (Mental Component Summary) using a cutoff of 48. Outcomes assessed were visual analogue scale for neck pain, arm pain, AAOS Neck Pain and Disability, Neurogenic Symptoms, Neck Disability Index, Short-Form 36, Japanese Orthopaedic Association myelopathy score, return to work, return to function, satisfaction and expectation fulfilment up to 2 years postoperatively.

Results.
The preoperative MCS was 37.5 ± 8.1 and 57.4 ± 6.3 in the Low and High MCS groups respectively (P < 0.001). The Low MCS group had poorer preoperative scores (P < 0.05). There was no significant difference in length of stay or comorbidities (P > 0.05). The High MCS group had less neck pain (P = 0.002) and showed a trend towards lower Neck Disability Index (P = 0.062) at 2 years. The Low MCS group demonstrated greater improvement in Japanese Orthopaedic Association (P = 0.007) and similar improvement in other scores (P > 0.05). There was no significant difference in proportion that achieved minimal clinically important difference for each score (P > 0.05). Both groups had similar rates of return to work, return to function, expectation fulfilment, and satisfaction (P > 0.05). Lower preoperative MCS was predictive of greater improvement in MCS (r = −0.477, P < 0.001).

Conclusion.
Despite relatively greater pain and disability at 2 years, patients with poor baseline mental health experienced similar improvement in clinical outcomes, return to work, and satisfaction rates.

Level of Evidence: 3
Titration and Tolerability of Sacubitril/Valsartan for Patients With Heart Failure in Clinical Practice
Authors: Du Amy X. , Westerhout Cynthia M. , McAlister Finlay A. , Shanks Miriam , Oudit Gavin Y. , Paterson David Ian , Hanninen Mikael , Thomas Jissy , Ezekowitz Justin A. 
Published: December 2018

Abstract:
Little is known about the dosing and tolerability of sacubitril/valsartan (LCZ696; Entresto, Quebec, Canada) in a nonclinical trial population. This study was conducted to evaluate the use and tolerability of sacubitril/valsartan in patients followed at a multidisciplinary heart failure (HF) clinic. We performed a retrospective chart review of 126 patients with HF, initiated on sacubitril/valsartan, and seen at a specialty HF clinic between August 1, 2015, and August 1, 2017. We defined the target dose of sacubitril/valsartan as 200 mg twice a day. At baseline, median age was 67 years, 77% were men, median ejection fraction was 29%, and 86.5% of patients had symptoms of New York Heart Association class ≥II. Within 6 months of being transitioned onto sacubitril/valsartan therapy, 27.2% achieved the target dose of 200 mg twice a day, 40.8% achieved the target dose of 100 mg twice a day, and 32.0% achieved the target dose of 50 mg twice a day. The main reasons for not achieving target dose within 6 months included slower uptitration of therapy than in the trial (n = 41, 54.7%), a decrease in systolic blood pressure (n = 19, 25.3%), not completing blood work (n = 3, 4%), and patient noncompliance (n = 3, 4%). Overall, achievement of sacubitril/valsartan target doses was modest in a tertiary HF clinic, limited by various factors such as side effects and patients' medication noncompliance. Implementation of patient and clinician support pathways may improve uptake, uptitration, and maintenance of evidence-based doses in clinical practice.
Circulating tumor cells in metastatic breast cancer: clinical relevance and biological potential
Authors: Arkadius Polasik , Volkmar Müller , Jens Huober , Wolfgang Janni , Tanja Fehm 
Published: December 2018

Purpose of review
The possibility of tumor dissemination through the blood system has been known for years. Circulating tumor cells (CTCs) are detectable in the peripheral blood of patients with early as well as metastatic breast cancer. The prognostic relevance of this biomarker has already been described. By the use of repeated blood sampling along the course of disease, CTCs can be monitored in terms of a regular ‘liquid biopsy’. This review aims to summarize recent research findings and actual ongoing clinical studies to demonstrate the actual and future relevance of CTCs in daily clinical routine.

Recent findings
Recent research results show that additional molecular analysis of CTCs might be helpful in gaining information about tumor characteristics, tumor heterogeneity and possible therapy resistance. Repetitive invasive core biopsies might be avoided.

Summary
The assessment of molecular attributes may be indispensable for obtaining an optimized and personalized therapy aiming at extended survival and/or improved quality of life.
Effect of Mannitol on Intraocular Pressure in Vitrectomized and Nonvitrectomized Eyes: A Prospective Comparative Study
Authors: Ramachandra Varsha , Chandran Premanand , Philip Reji , Arunaachalam Vinoth , Raman Ganesh V. 
Published: December 2018

Purpose:
To compare the effect of mannitol in reducing intraocular pressure (IOP) in vitrectomized and nonvitrectomized eyes.

Materials and Methods:
Prospective comparative case study. Eyes with IOP≥40 mm Hg were included. Eyes which are vitrectomized and silicon oil filled were classified as group 1, and nonvitrectomized open-angle eyes were classified as group 2. Mannitol (20%, 1 g/kg) was administered intravenously over 30 minutes, and IOP was recorded at 30 minutes interval till 2 hours and at the third and fourth hour from the start of mannitol.

Results:
Thirty eyes (patients) were recruited in each group. Mean (SD) IOP reduced from 48.5±5.2 to 43.7±8 at 30 minutes, 40.7±8.4 at 60 minutes, 37.3±9.6 at 90 minutes, 35.6±10.4 at 2 hours, 34±10.7 at 3 hours, and 33±11.2 mm Hg at 4 hours in group 1, and from 48.9±6.5 to 43.2±8.6 at 30 minutes, 40.2±7.8 at 60 minutes, 36.7±7.3 at 90 minutes, 35.1±7.7 at 2 hours, 34.2±8.8 at 3 hours, and 35.7±9.4 mm Hg at 4 hours in group 2. There was a significant reduction in IOP at each time point compared with baseline in both the groups (P<0.001). There was no significant difference in IOP between the 2 groups at each time point.

Conclusion:
Mannitol reduces IOP significantly in both vitrectomized and nonvitrectomized eyes.
Refractory Mycobacterium avium Complex Pneumonia and Anti-Interferon-γ Autoantibodies
Authors: Saba Marian , Greene John N. 
Published: December 2018

Abstract
There has been increasing evidence in recent literature of the link between acquired antibodies to cytokines and manifestations of immune deficiency, for example, the emerging association between acquired interferon gamma autoantibody and susceptibility to intracellular organisms, in particular, nontuberculous mycobacterium (NTM). Although the presence of these autoantibodies does not always reflect pathology, their presence in high titers in a healthy individual in the setting of an opportunistic infection necessitates greater research with regard to their role. We report a case of refractory NTM with herpes zoster reactivation in an adult South Asian woman developing in association with acquired interferon gamma autoantibody. Consider testing for this rare adult onset immunodeficiency and similar ones in the setting of severe refractory or disseminated NTM and other opportunistic pathogens in patients without human immunodeficiency virus infection or acquired immunodeficiency syndrome.
Personality traits and styles may affect the reporting of chronic pruritus: a cross-sectional study
Authors: Kini Seema , Chen Kuang-Ho , Chen Suephy C. 
Published: December 2018

Introduction:
Chronic pruritus (CP) is a common symptom, but can be a diagnostic and therapeutic challenge. Our objective was to determine how personality traits, and more specifically personality styles, influence quality of life (QoL) impact of CP.

Methods:
Cross-sectional study of patients with CP from 2 main groups: (1) National Eczema Association and (2) US Veterans Health Administration (VHA) National Patient Care Database. Participants (N=483) answered questions regarding demographics, characteristics of CP, personality traits (NEO Five-Factor Model) and pruritus impact (ItchyQoL). A multivariate linear regression was performed to determine which of 15 covariates (age, race, marital status, itch duration, itch frequency, and each of the 10 personality styles) were significantly associated with greater total mean ItchyQoL score (ie, greater burden of CP). Secondary outcome measures included the 3 ItchyQoL subscale scores (symptom, emotion, function).

Results:
The Lethargic personality style (low extraversion, low conscientiousness) was significantly associated with greater total mean ItchyQoL score (β=11.65, P=0.04) while the Overcontrolled (high neuroticism, high conscientiousness) and Undercontrolled (high neuroticism, low conscientiousness) styles were significantly associated with greater symptomatic impact from CP (β=2.76, P=0.01 and β=2.34, P=0.03), respectively. African American race was significantly associated with greater mean ItchyQoL score (β=8.14, P=0.002), ItchyQoL emotional score (β=2.98, P=0.02) and trended to significance for ItchyQoL symptom score (β=1.23, P=0.06). Curiously, white race was associated with higher ItchyQoL scores for the function construct (β=1.2, P=0.04). “Single” marital status trended to significance for higher mean ItchyQoL score (β=3.79, P=0.06).

Discussion:
Our results highlight certain personality styles (Lethargic, Overcontrolled, Undercontrolled) and important demographics (ie, African American race, single marital status) that may influence itch-related QoL impact. In the clinical setting these findings may suggest a role for support structures and other integrative measures (eg, support groups, cognitive and mindfulness based therapies) to augment traditional therapeutics for CP.
Reliability of the Functional Reach Test Using a Mobile Pole Versus the Traditional Fixed Ruler
Authors: Olson Lee , Zareh Ali 
Published: December 2018

Background:
The Functional Reach Test (FRT), which uses a ruler fixed to a wall, has been shown to be a reliable and valid method of evaluating fall risk in seniors and persons with various neurological conditions. However, because of various logistical reasons, the FRT may be underused by therapists in some settings. A novel method of performing the FRT has been proposed using a measuring tape attached to the end of a mobile pole.

Purpose:
The purpose was to evaluate and compare the interrater reliability of the FRT using both the traditional ruler and the mobile pole method.

Research Design:
Repeated measures.

Method:
Twenty-one persons ranging from 77 to 92 years of age from an independent living seniors complex completed both the traditional FRT and the mobile pole FRT. Tests were repeated on the same day by 2 different physical therapists.

Result:
The FRT using the mobile pole was shown to have moderate-to-excellent intertester reliability (intraclass correlation coefficient = 0.827; 95% confidence interval, lower bound 0.561, upper bound 0.931). No significant difference was found between scores obtained by the traditional and the mobile pole versions.

Conclusion:
Taking into account a relatively small sample, this study suggests that the mobile pole version is a reliable modification of the FRT. Its portability may make it useful to therapists in settings where a ruler fixed to a wall is unavailable or inconvenient.
Preinjury and Postinjury Factors That Predict Sports-Related Concussion and Clinical Recovery Time
Authors: Putukian Margot , Riegler Kaitlin , Amalfe Stephanie , Bruce Jared , Echemendia Ruben 
Published: December 2018

Objectives:
To evaluate the relationship between preinjury risk factors (RFs) and subsequent occurrence of concussion and examine whether preinjury RFs or postinjury assessments predict clinical recovery in collegiate athletes.

Methods:
Risk factors (sex, sport, and self-report history of concussion, migraine, attention-deficit disorder, learning disability, depression, and anxiety) and Sport Concussion Assessment Tool (SCAT), depression/anxiety screenings, and neuropsychological testing were obtained before the season. For athletes who sustained concussion, RFs, postinjury SCAT, neuropsychological assessment, and clinical recovery were assessed.

Results:
We assessed 1152 athletes (69% male) at baseline and 145 (75% male) after subsequent concussion diagnosis. Only sport type (Wald = 40.29, P = 0.007) and concussion history (Wald = 9.91, P = 0.007) accounted for unique variance in subsequent concussion. Of athletes followed until full recovery, mean days until symptom-free (DUSF) was 9.84 ± 11.11 days (n = 138, median = 5 days, range = 1-86) and mean days until full return to play (DUFRTP) was 20.21 ± 19.17 (n = 98, median = 20.21, range = 4-150). None of the RFs or baseline testing measures were associated with DUSF or DUFRTP (P's > 0.05). After injury, athletes who reported more total symptoms (r

s
= 0.31, P < 0.001) and higher symptom severity (r

s
= 0.33, P < 0.001) exhibited longer DUSF. Days until symptom-free correlated with DUFRTP (r

s
= 0.75, P < 0.001). Among athletes assessed within 2 days after injury, DUSF was associated with Immediate Postconcussion Assessment and Cognitive Test visual motor (r

s
= −0.31, P = 0.004), reaction time (r

s
= 0.40, P < 0.001), and symptom score (r

s
= 0.54, P < 0.001).

Conclusions:
Only sport type and concussion history predicted subsequent occurrence of concussion, and none of the RFs or baseline measures predicted clinical recovery. Immediate postinjury assessments, including symptom number and severity, and select clinical measures predicted longer clinical recovery.
Systematic review addressing nurse practitioner reimbursement policy: Part one of a four-part series on critical topics identified by the 2015 nurse practitioner research agenda
Authors: Harkless Gene , Vece Loretta 
Published: December 2018

ABSTRACT

Background and purpose:
The growth and sustainability of nurse practitioners (NPs) requires transparent, fair and equitable reimbursement policies. Complicating this issue is variation in reimbursement policy within and across federal, state, and other payers. Even with explicit regulations, there remain questions on how reimbursement policies are covertly operationalized in practice. This systematic review aims to identify knowledge gaps related to reimbursement policy issues and outlines recommendations for further research.

Methods:
Eight major databases were searched using terms including “nurse practitioner,” “reimbursement,” “policy,” and “research,” limited to the United States and inclusive of December 2006–September 2017. Articles meeting the inclusion criteria were analyzed for themes and gaps.

Conclusion:
The final review includes 17 articles identifying themes including state-determined Medicaid reimbursement and scope of practice legislation shapes NP clinical practice; NPs as identified primary care providers: credentialing and contracting; reimbursement parity; and “incident to” billing. Moreover, there is evidence of discriminatory policies that disadvantage NPs and limit their access to patients, direct billing, and direct reimbursement.

Implications for practice:
Future research needs to focus on outcomes of discriminatory, as well as supportive, reimbursement policies in organizations, and their influence on patient access and quality care.
Naunton's Masking Dilemma Revisited
Authors: Seneviratne Sheran , McNeill Celene , Greenberg Simon L. , Kong Jonathan 
Published: December 2018

Background:
Pure-tone audiometry is essential in diagnosing clinical hearing loss. Masking of the nontest ear is mandatory for determining accurate hearing thresholds in the presence of asymmetrical levels between the two ears and for ascertaining the presence of a conductive hearing loss. Paradoxically, over masking occurs when the intensity of the required masking noise to the contralateral ear is such that it exceeds interaural cranial attenuation by an amount sufficient to mask the test ear. Ralph F Naunton was the first to describe this phenomenon, which has since been known as “Naunton's masking dilemma.”

Methods:
A formula was derived mathematically to predict when Naunton's masking dilemma might occur in air and bone conduction. Review of Ralph F Naunton's primary works and related publications was performed.

Results:
Our derived mathematical formulae predict when “Naunton's masking dilemma” may occur. During air conduction testing, a masking dilemma may occur when the sum of the air/bone gaps is greater than or equal to twice the interaural attenuation minus 15 dB (Σ ABG

NTE+TE

≥ 2 × IA – 15 dB). During bone conduction testing, a masking dilemma may occur when the air-bone gap of the nontest ear is greater than or equal to the interaural attenuation minus 15 dB (ABG

NTE

≥ IA

AIR

− 15 dB).

Conclusion:
Naunton's masking dilemma imposes a significant limitation to conventional audiometric testing. To the best of our knowledge, we think this is the first time that Naunton's masking dilemma has been represented in a simplified mathematical equation.