bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Outcomes After Surgical Decompression for Mild Degenerative Cervical Myelopathy: Moving Beyond the mJOA to Identify Surgical Candidates
Authors: Badhiwala Jetan H , Hachem Laureen D , Merali Zamir , Witiw Christopher D , Nassiri Farshad , Akbar Muhammad A , Almenawer Saleh A , Schomacher Markus , Wilson Jefferson R , Fehlings Michael G 
Published: April 2019

Abstract

BACKGROUND
Patients with mild degenerative cervical myelopathy (DCM) represent a heterogeneous population, and indications for surgical decompression remain controversial.

OBJECTIVE
To dissociate patient phenotypes within the broader population of mild DCM associated with degree of impairment in baseline quality of life (QOL) and surgical outcomes.

METHODS
This was a post hoc analysis of patients with mild DCM (modified Japanese Orthopedic Association [mJOA] 15-17) enrolled in the AOSpine CSM-NA/CSM-I studies. A k-means clustering algorithm was applied to baseline QOL (Short Form-36 [SF-36]) scores to separate patients into 2 clusters. Baseline variables and surgical outcomes (change in SF-36 scores at 1 yr) were compared between clusters. A k-nearest neighbors (kNN) algorithm was used to evaluate the ability to classify patients into the 2 clusters by significant baseline clinical variables.

RESULTS
One hundred eighty-five patients were eligible. Two groups were generated by k-means clustering. Cluster 1 had a greater proportion of females (44% vs 28%, P = .029) and symptoms of neck pain (32% vs 11%, P = .001), gait difficulty (57% vs 40%, P = .025), or weakness (75% vs 59%, P = .041). Although baseline mJOA correlated with neither baseline QOL nor outcomes, cluster 1 was associated with significantly greater improvement in disability (P = .003) and QOL (P < .001) scores following surgery. A kNN algorithm could predict cluster classification with 71% accuracy by neck pain, motor symptoms, and gender alone.

CONCLUSION
We have dissociated a distinct patient phenotype of mild DCM, characterized by neck pain, motor symptoms, and female gender associated with greater impairment in QOL and greater response to surgery.
Does Coffee Intake Reduce Postoperative Ileus After Laparoscopic Elective Colorectal Surgery? A Prospective, Randomized Controlled Study: The Coffee Study
Authors: Hasler-Gehrer Simone , Linecker Michael , Keerl Andreas , Slieker Juliette , Descloux Alexandre , Rosenberg Robert , Seifert Burkhardt , Nocito Antonio 
Published: April 2019

BACKGROUND:
Postoperative ileus after colorectal surgery is a frequent problem that significantly prolongs hospital stay and increases perioperative costs.

OBJECTIVE:
The aim was to evaluate the effect of standardized coffee intake on postoperative bowel movement after elective laparoscopic colorectal resection.

DESIGN:
This is a prospective randomized controlled trial that was conducted between September 2014 and December 2016.

SETTINGS:
This study was performed in a public cantonal hospital in Switzerland with accreditation for colon and rectum cancer surgery.

PATIENTS:
Patients who underwent elective colorectal surgery were included.

INTERVENTIONS:
Patients were randomly assigned either to the intervention group receiving coffee or the control group receiving tea. A total of 150 mL of the respective beverage was drunk 3 times per day every postoperative day until discharge.

MAIN OUTCOME MEASURES:
The primary end point was time to first bowel movement. Secondary end points included the use of laxative, insertion of a nasogastric tube, length of hospital stay, and postoperative complications.

RESULTS:
A total of 115 patients were randomly assigned: 56 were allocated to the coffee group and 59 to the tea group. After coffee intake, the first bowel movement occurred after a median of 65.2 hours versus 74.1 hours in the control group (intention-to-treat analysis; p = 0.008). The HR for earlier first bowel movement after coffee intake was 1.67 (p = 0.009). In the per-protocol analysis, hospital stay was shorter in the coffee group (6 d in the coffee group vs 7 d in the tea group; p = 0.043).

LIMITATIONS:
The rate of protocol violation, mostly coffee consumption in the tea arm, was relatively high, even if patients were clearly instructed not to consume coffee if they were in the tea arm.

CONCLUSIONS:
Coffee intake after elective laparoscopic colorectal resection leads to faster recovery of bowel function. Therefore, coffee intake represents a simple and effective strategy to prevent postoperative ileus. See Video Abstract at http://links.lww.com/DCR/A955.

TRIAL REGISTRATION:
clinicaltrials.gov identifier: NCT02469441.
Utilization of Laser Therapy During Pregnancy: A Systematic Review of the Maternal and Fetal Effects Reported From 1960 to 2017
Authors: Wilkerson Eric C. , Van Acker Monica M. , Bloom Bradley S. , Goldberg David J. 
Published: April 2019

BACKGROUND
Due to concerns regarding maternal and fetal safety and the absence of evidence to the contrary, laser treatment during pregnancy has traditionally been limited to situations of absolute necessity.

OBJECTIVE
This review seeks to examine the available evidence to determine the safety of laser therapy during pregnancy.

METHODS
Medical databases were searched for relevant reports from all specialties regarding the use of lasers during pregnancy from 1960 to 2017. A legal case review was also performed.

RESULTS
Twenty-two publications in the literature reported the use of various laser wavelengths in 380 pregnant women during all trimesters. Other than 1 case of premature rupture of membranes questionably related to the laser treatment, there were no cases of maternal or fetal morbidity or mortality, premature labor, or identifiable fetal stress.

CONCLUSION
The available evidence, limited to low evidence level case reports and series, indicates cutaneous laser treatment during pregnancy is safe for both mother and fetus. Furthermore, laser physics and optics dictate there should theoretically be no risk of fetal laser exposure from commonly used cutaneous lasers.
Purging of malignant cell contamination prior to spermatogonia stem cell autotransplantation to preserve fertility: progress & prospects
Authors: Abdelaal Omar , Barber Heather , Atala Anthony , Sadri-Ardekani Hooman 
Published: April 2019

Purpose of review
This systematic review evaluates the state of the art in terms of strategies used to detect and remove contaminated malignant cells from testicular biopsy prior to spermatogonia stem cells (SSCs) autotransplantation to restore fertility.

Recent findings
Several trials have been done in past two decades to determine the reliable methods of detecting and purging cancer cells prior to SSCs autotransplantation.

Summary
The success in treating childhood cancer has dramatically increased over the past few decades. This leads to increasing demand for a method of fertility preservation for patients with pediatric cancer, as many cancer therapies can be gonadotoxic. Storing the SSCs prior to chemo- or radiation therapies and transplanting them back has been tested as a method of restoring fertility in rodents and nonhuman primate models. This has promise for restoring fertility in childhood cancer survivors. One of the major concerns is the possibility of malignant cell presence in testicular tissue biopsies that could re-introduce cancer to the patient after SSCs autotransplantation. Non-solid cancers – especially hematologic malignancies – have the risk of being transplanted back into patients after SSCs cryopreservation even if they were only present in small number in the stored testicular tissue biopsy.
Psychological Symptoms and Stress Are Associated With Decrements in Attentional Function in Cancer Patients Undergoing Chemotherapy
Authors: Atallah Marie , Cooper Bruce , Muñoz Ricardo F. , Paul Steven M. , Anguera Joaquin , Levine Jon D. , Hammer Marilyn , Wright Fay , Chen Lee-May , Melisko Michelle , Conley Yvette P. , Miaskowski Christine , Dunn Laura B. 
Published: April 2019

Background
Decrements in attentional function—perceived effectiveness in everyday functioning related to cognitive dysfunction—are frequently reported by cancer patients during treatment. However, patients vary widely in their experiences of changes in attentional function.

Objective
The aim of this study was to understand differences in attentional function among cancer patients during chemotherapy.

Methods
Patients (n = 1329) undergoing chemotherapy were assessed at 6 time points during 2 rounds of chemotherapy. Latent profile analysis was used to identify subgroups of patients based on patterns in changes on the Attentional Function Index. Differences among the subgroups in demographic and clinical characteristics, psychological symptoms, and stress were evaluated.

Results
Three latent classes (ie, high, moderate, and low attentional function) were identified. Patients in the low and moderate classes were younger, more likely to be female, and less likely to be employed compared with those in the high class. Patients in the low class had higher levels of depressive and anxiety symptoms, cancer-related distress, and perceived stress compared with those in the moderate class, who, in turn, reported higher levels of these symptoms compared with those in the high class.

Conclusions
Different experiences of changes in self-perceived attentional function are associated with psychological symptoms in cancer patients.

Implications for Practice
Relationships between changes in attentional function and psychological symptoms and stress suggest that clinicians should attend to the potential that patients’ cognitive and psychological experiences may be closely linked and may need to be addressed as related phenomena. Clinical trials are needed that evaluate treatments for both attentional and psychological symptoms.
The Influence of Four Different Treatment Protocols on Maxillofacial Growth in Patients with Unilateral Complete Cleft Lip, Palate, and Alveolus
Authors: Xu Xue , Cao Congcong , Zheng Qian , Shi Bing 
Published: April 2019

Background:
The purpose of this study was to evaluate the effect of four different treatment protocols on maxillofacial growth in patients aged 7 to 8 years with unilateral complete cleft lip, palate, and alveolus.

Methods:
Sixty-one patients with nonsyndromic unilateral complete cleft lip, palate, and alveolus were entered into this study and grouped as follows: group 1 patients had a repaired lip and an unrepaired palate; group 2 patients underwent one-stage palatoplasty; group 3 patients underwent two-stage palatoplasty; and group 4 patients underwent lip adhesion and two-stage palatoplasty. The control group was composed of 16 patients with unilateral incomplete cleft lip. The Kolmogorov-Smirnov test was used to test the nature of data distribution. The Bonferroni test and the Kruskal-Wallis H test were used for multiple comparisons.

Results:
Group 5 showed a more protruding maxilla (basion-nasion-A point, basion-nasion-anterior nasal spine, sella-nasion-anterior nasal spine; p < 0.05), longer maxillary sagittal length (anterior nasal spine-posterior maxillary point; p < 0.05) and maxillary basal sagittal length (A point-posterior maxillary point; p < 0.05), and a better jaw relationship (A point-nasion-B point angle; p < 0.05) than groups 2, 3, and 4. Group 2 had higher anterior facial height (anterior nasal spine-nasion, anterior nasal spine-menton, nasion-menton; p < 0.05) and posterior facial height (registration point-posterior maxillary point; p < 0.05) than groups 3 and 4. Groups 2 and 3 had better maxillary position (sella-pterygomaxillary fissure; p < 0.05) and deeper bony pharynx (basion-posterior maxillary point; p < 0.05) than group 4.

Conclusions:
In patients aged 7 to 8 years with unilateral complete cleft lip, palate, and alveolus, both one- and two-stage palatoplasty inhibited maxillary sagittal growth. Vomer flap repair with denuded bone inhibited maxillary vertical growth. Lip adhesion did adversely affect maxilla position.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
String Fat/Dermis Graft for Correction of Wrinkles and Scars
Authors: Guyuron Bahman , Son Ji H. 
Published: April 2019

Summary:
Established creases and wrinkles do not predictably respond to the fat injection technique. The authors describe a minimally invasive yet simple technique to address recalcitrant facial rhytides and minor depressed scars. This technique optimally requires a concomitant procedure whereby suitable fat or dermis graft could be available for grafting without having to make another incision. However, if needed, the graft can be harvested from an easily concealed area such as postauricular sulcus. Preferably, dermis or a combination of fat and dermis is harvested in the form of strings using a pair of straight iris scissors. The sharp end of an 18-gauge needle is then used to create a tunnel in the subcutaneous plane beneath each line while releasing any fibrous bands. The string of dermis/fat is then engaged at the end of the 18-gauge needle and delivered into the subcutaneous tunnel with rotation and advancement of the needle. The authors have used this graft on 49 sites on 39 patients. The mean age of the patients was 57.6 years, with eight male and 31 female patients. The sites included rhytides in upper and lower lips, oral commissure, labial mental groove, and frown lines, and scars in the forehead, nasal dorsum, nasal tip, and eyebrows. String fat grafting is a simple and reliable method to address limited rhytides or depressed scars.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations
Authors: Li Wei , Ren Yi-peng , Shi Yue-yi , Zhang Lei , Bu Rong-fa 
Published: April 2019

Abstract
Lingual thyroglossal duct cysts (LTDCs) are rare congenital anomalies of the neck. The authors described the presentation, management, and outcome of LTDC in pediatric and adult cases through a retrospective observational analysis between 2008 and 2018. Data included patients’ demographics, main complaint, preoperative investigations, surgical management, and recurrences. Seventeen patients were included: 8 pediatric and 9 adult patients. The most common presenting symptom was foreign body sensation (35.3%). In all, 50% (4/8) of the children had respiratory problems, while the most common symptom in adults was difficulty swallowing (8/9). Five patients were of recurrent LTDC; 3 referred patients were suspected of having recurrent epiglottic cysts. The total misdiagnosis rate was 35.3% (6/17): 14.3% (1/7) in children and 55.6% (5/9) in adults. Fiber optic laryngoscopic examination revealed that LTDCs mostly occurred at the base of the tongue (53.3%) and vallecula epiglottica (33.3%). Ultrasound examination revealed low to anechoic masses on the root of the tongue; 50% were regular in shape and 50% were irregular. All pediatric patients had regular masses (100%), but most adults had irregular masses (85.7%). In total, 76.5% of the patients underwent the Sistrunk procedure, and 23.5% underwent marsupialization alone. The mean follow-up length was 37.5 ± 32.8 months. All patients were well at follow-up. In conclusion, direct laryngoscopy and ultrasound examination are essential for diagnosis as LTDCs can be confused with vallecular cysts. Surgical treatment such as marsupialization or the Sistrunk operation must be performed thoroughly.
Prehospital Blood Product and Crystalloid Resuscitation in the Severely Injured Patient
Authors: Guyette Francis X. , Sperry Jason L. , Peitzman Andrew B. , Billiar Timothy R. , Daley Brian J. , Miller Richard S. , Harbrecht Brian G. , Claridge Jeffrey A. , Putnam Tyler , Duane Therese M. , Phelan Herb A. , Brown Joshua B. 
Published: April 2019

Objective:
The aim of this study was to determine whether prehospital blood products reduce 30-day mortality in patients at risk for hemorrhagic shock compared with crystalloid only resuscitation.

Summary of Background Data:
Hemorrhage is the primary cause of preventable death after injury. Large volume crystalloid resuscitation can be deleterious. The benefits of prehospital packed red blood cells (PRBCs), plasma, or transfusion of both products among trauma patients is unknown compared with crystalloid.

Methods:
Secondary analysis of the multicenter PAMPer trial was performed on hypotensive injured patients from the scene. The trial randomized 27 helicopter bases to prehospital plasma or standard resuscitation. Standard resuscitation at the sites was equally divided between crystalloid and crystalloid + PRBC. This led to 4 prehospital resuscitation groups: crystalloid only; PRBC; plasma; and PRBC+plasma. Cox regression determined the association between resuscitation groups and risk-adjusted 30-day mortality. The dose effect of resuscitation fluids was also explored.

Results:
Four hundred seven patients were included. PRBC+plasma had the greatest benefit [hazard ratio (HR) 0.38; 95% confidence interval (95% CI) 0.26–0.55, P < 0.001], followed by plasma (HR 0.57; 95% CI 0.36–0.91, P = 0.017) and PRBC (HR 0.68; 95% CI 0.49–0.95, P = 0.025) versus crystalloid only. Mortality was lower per-unit of PRBC (HR 0.69; 95% CI 0.52–0.92, p = 0.009) and plasma (HR 0.68; 95% CI 0.54–0.88, P = 0.003). Crystalloid volume was associated with increased mortality among patients receiving blood products (HR 1.65; 95% CI 1.17–2.32, P = 0.004).

Conclusion:
Patients receiving prehospital PRBC+plasma had the greatest mortality benefit. Crystalloid only had the worst survival. Patients with hemorrhagic shock should receive prehospital blood products when available, preferably PRBC+plasma. Prehospital whole blood may be ideal in this population.
Long noncoding RNAs sustain high expression of exogenous Oct4 by sponging miRNA during reprogramming
Authors: Kong Qingran , Zhang Xiaolei , Zhang Jiaming , Zheng Kailun , Zhang Heng , Pei Xixiang , Yin Zhi , Wen Duancheng , Liu Zhonghua 
Published: April 2019

AbstractLong noncoding RNAs (lncRNAs) modulate gene expression as competing endogenous RNAs (ceRNAs) via sponging microRNAs (miRNAs). However, the extent and functional consequences of ceRNAs in diverse cellular context still need to be proven. Using a doxycycline inducible expression of Yamanaka four factors to generate induced pluripotent stem cells (iPSCs) from mouse embryonic fibroblasts (MEFs), we found the miRNAs from MEFs remained highly expressed from day 0 to day 6 after doxycycline induction; unexpectedly, many genes targeted by these miRNAs were actually up-regulated; meanwhile, long intergenic noncoding RNAs (lincRNAs) and circular RNAs (circRNAs) which have complementary binding sites with the miRNAs were highly expressed, indicating lincRNAs and circRNAs (linc/circRNAs) may serve as sponges for miRNAs to block their activities during reprogramming. Intriguingly, the knockdown of the linc/circRNAs sponging the miRNAs targeting Oct4 mRNA resulted in down-regulation of exogenous Oct4 expression, decrease of reprogramming efficiency, and low-grade chimera forming iPSCs. Our results suggest that the ceRNA network plays an important role in reprogramming somatic cells to pluripotent stem cells.
Qualitative analyses of polishing and pre-coating FIB milled crystals for MicroED
Authors: Martynowycz Michael W. , Zhao Wei , Hattne Johan , Jensen Grant J. , Gonen Tamir 
Published: April 2019

SummaryMicrocrystal electron diffraction (MicroED) leverages the strong interaction between matter and electrons to determine protein structures from vanishingly small crystals. This strong interaction limits the thickness of crystals that can be investigated by MicroED, mainly due to absorption. Recent studies have demonstrated that focused ion beam (FIB) can thin even very large crystals into ideal sized lamellae however it is not clear how to best apply FIB-milling for MicroED. Here, The effects of polishing the lamellae, whereby the last few nanometers are milled away using a low-current gallium beam, are explored in both platinum pre-coated and uncoated samples. Our results suggest that pre-coating samples with a thin layer of platinum followed by polishing the crystal surfaces prior to data collection consistently led to superior results as indicated by higher signal/noise ratio, higher resolution and better refinement statistics. This study lays the foundation for routine and reproducible methodology for sample preparation in MicroED.
The Impact of Informal Financial Groups on Socio‐economic Development in Tanzania
Authors: Kinyondo Abel , Kagaruki Gibson 
Published: April 2019

AbstractFinancial deepening is universally considered to be one of the vital means to trigger inclusive growth, in economies the world over, Tanzania being no exception. However, the lack of traditional collateral among the poor has made it virtually impossible for them to have access to financial services particularly in the formal financial institutions. It is in this context that the informal financial groups (IFGs) are so crucial in filling the financial inclusiveness gap among the poor in Tanzania. It is thus crucial that the efficacy of IFGs in improving the well‐being of the poor is assessed. It is in this context that the present study employs a quasi‐experiment mixed methodology to answer research questions. Findings have categorically shown that membership to IFGs has a positive and significant impact on various socio‐economic variables. Efforts to intensify education and training activities in IFGs, and their access to loans are some of the key recommendations that this paper suggests. It is hoped that the newly promulgated 2017 National Microfinance Policy shall be implemented to that effect.
Effect of high polyphenol extra virgin olive oil on markers of cardiovascular disease risk in healthy Australian adults (OLIVAUS): A protocol for a double‐blind randomised, controlled, cross‐over study
Authors: Marx Wolfgang , George Elena S. , Mayr Hannah L. , Thomas Colleen J. , Sarapis Katerina , Moschonis George , Kennedy Greg , Pipingas Andrew , Willcox Jane C. , Prendergast Luke A. , Itsiopoulos Catherine 
Published: April 2019

BackgroundPrevious clinical studies have suggested that high polyphenol extra virgin olive oil (EVOO) provides a superior cardioprotective effect compared to low polyphenol olive oil. However, further studies are required to replicate these results in non‐Mediterranean populations.AimTo investigate the effect of high polyphenol EVOO versus low polyphenol olive oil with known polyphenol composition on markers of cardiovascular disease risk in a healthy non‐Mediterranean cohort.MethodsIn a double‐blind randomised cross‐over trial, the present study will examine the effect of high polyphenol EVOO versus low polyphenol olive oil in 50 healthy participants. Each intervention phase will be 3 weeks long with a 2‐week washout period between each phase. Outcomes to be assessed include HDL cholesterol efflux, oxidised LDL, blood lipids, C‐reactive protein, arterial stiffness, blood pressure and cognitive function. Dietary intake, physical activity levels and anthropometry will also be collected.DiscussionBecause of the rigorous trial design, novel and clinically relevant outcomes, the use of a well‐characterised EVOO, and, in contrast to the current literature, the non‐Mediterranean study population, the present study will provide a significant contribution to the understanding of the clinical importance of polyphenol intake in the Australian sociocultural context.