bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Patients Undergoing an Anterior Cervical Discectomy and Fusion Treated Differently at a Physician-owned Hospital?
Authors: Schroeder Gregory D. , Kurd Mark F. , Kepler Christopher K. , Radcliff Kris E. , Maltenfort Mitchell G. , Murphy Hamadi , Rihn Jeffery A. , Anderson D. Greg , Hilibrand Alan S. , Vaccaro Alexander R. 
Published: May 2018

Study Design:
Retrospective case-control study.

Background:
Physician-owned specialty hospitals focus on taking care of patients with a select group of conditions. In some instances, they may also create a potential conflict of interest for the surgeon. The effect this has on the surgical algorithm for patients with degenerative cervical spine conditions has not been determined.

Methods:
A retrospective review of all patients who underwent a 1- or 2-level anterior cervical discectomy and fusion between October 2009 and December 2014 at either a physician-owned specialty hospital or an independently owned community hospital were identified. Demographic information, the time course for treatment and the nonoperative treatment regimen were evaluated.

Results:
In total, 115 patients undergoing surgery at a physician-owned specialty hospital and 149 patients undergoing surgery at an independent community hospital were identified. Demographic data between the groups including the presence of 12 medical comorbidities and insurance status was similar between the groups. The only difference that was identified was that patients at the surgeon-owned hospital were marginally younger than patients who had surgery at the independent hospital (49.7 vs. 50.0, P=0.048). No difference in the median number of months from the onset of symptoms to surgery (6.51 vs. 7.53 mo, respectively; P=0.55), from the onset of symptoms to the preoperative visit (6.02 vs. 6.02, P=0.64), or from the initial surgical consultation to surgery (0.99 vs. 1.02, P=0.31) was identified. No difference in the number of patients who underwent formal physical therapy (72.2% vs. 67.1%, P=0.42) or who had a cervical steroid injection (55.6% vs. 50.3%, P=0.25%) was identified between patients who had surgery at a physician-owned or independent hospital; however, patients who underwent surgery at the physician-owned hospital were more likely to have taken oral anti-inflammatories (93.0% vs. 83.9%, P=0.04).

Conclusions:
When comparing hospitals with similar resources, surgeons do not preferentially select younger, healthier patients with higher paying insurance to be treated at the physician-owned hospital. Furthermore, both the time from the onset of symptoms to surgery and the nonoperative treatment regimen were similar between patients treated at the 2 facilities.
Pharmacokinetics Evaluation of Mycophenolic Acid and Its Glucuronide Metabolite in Chinese Renal Transplant Recipients Receiving Enteric-Coated Mycophenolate Sodium and Tacrolimus
Authors: Xu Lu-yang , Jiao Zheng , Liu Fei-yan , Qiu Xiao-yan , Ji Li , Zhang Ming 
Published: May 2018

Background:
The aim of this study was to characterize the pharmacokinetics of mycophenolic acid (MPA) and MPA glucuronide (MPAG) in Chinese renal transplant patients taking enteric-coated mycophenolate sodium (EC-MPS). Limited sampling strategies (LSSs) were developed to estimate the area under the concentration curve from 0 to 12 hours (AUC0–12h) of total and free MPA. Another objective was to investigate the correlation between high-performance liquid chromatography (HPLC) and enzyme-multiplied immunoassay technology (EMIT) for total MPA determination.

Methods:
Serial blood samples were collected over 12 hours from 15 patients who were administered multiple doses of EC-MPS. LSS was developed by multiple stepwise regression analysis. Measurement by HPLC and EMIT was compared using Passing–Bablok regression and Bland–Altman analysis.

Results:
Normalized to 720 mg twice daily, the AUC0–12h of total MPA and MPAG was 43.0 ± 17.4 and 653 ± 329 mg·h/L, respectively, whereas the free MPA AUC0–12h was 1.368 ± 0.988 mg·h/L. The free fraction of MPA was 3.01% ± 3.15%. The combination of C2h–C4h–C6h and C2h–C4h–C6h–C8h was found to be superior to estimate total and free MPA simultaneously. The EMIT showed an acceptable correlation with HPLC, with an AUC0–12h overestimation of 11.32% ± 15.77%.

Conclusions:
The pharmacokinetic profile of total and free MPA and its main metabolite MPAG was examined in Chinese adult renal transplant patients receiving EC-MPS. The use of LSS to estimate individual free and total MPA exposure could be useful in optimizing patient care.
COMBINING EN FACE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY WITH STRUCTURAL OPTICAL COHERENCE TOMOGRAPHY AND BLOOD FLOW ANALYSIS FOR DETECTING CHOROIDAL NEOVASCULAR COMPLEXES IN PIGMENT EPITHELIAL DETACHMENTS
Authors: Kang Hyunseung , Byeon Suk Ho , Kim Sung Soo , Koh Hyoung Jun , Lee Sung Chul , Kim Min 
Published: June 2018

Purpose:
This work aimed to describe the morphology of pigment epithelial detachment (PED) using optical coherence tomography angiography and to investigate its potential to detect choroidal neovascularization in various types of PEDs.

Methods:
In this retrospective study, 53 patients diagnosed with PED after undergoing both optical coherence tomography angiography (AngioPlex, CIRRUS HD-OCT) and spectral domain optical coherence tomography (Spectralis SD-OCT) were included.

Results:
Among the 53 eyes, flat vascularized PED (vPED) affected 21 eyes (40%), peaked vPED affected 10 eyes (19%), serous PED affected 12 eyes (23%), drusenoid PED affected 6 eyes (11%), and 4 eyes (7%) had multiple PED subtypes. The main underlying etiologies were pachychoroid spectrum disorder (30.2%), wet age-related macular degeneration (28.3%), central serous chorioretinopathy (18.9%), dry age-related macular degeneration (11.3%), and polypoidal choroidal vasculopathy (11.3%). Optical coherence tomography angiography identified neovascularization in 29 (94%) of the vPED eyes, 2 (17%) of the serous PED eyes, and all 4 (100%) mixed PED eyes.

Conclusion:
Optical coherence tomography angiography successfully identified neovascularization in both vPEDs and PEDs previously considered to be nonneovascular. However, structural OCT and blood flow analysis should be combined to interpret PED-associated neovascularization accurately in the clinic.
SPONTANEOUS CLOSURE OF SIMULTANEOUS IDIOPATHIC MACULAR HOLES DOCUMENTED BY SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY
Authors: Gonzalez-Cortes Jesus H. , Toledo-Negrete Juan J. , Bages-Rousselon Yunuen , de Alba-Castilla Manuel A. , Mohamed-Hamsho Jesus 
Published: May 2018

Purpose:
To report a case of spontaneous closure of simultaneous full-thickness macular hole.

Methods:
Case report and literature review.

Results:
A 67-year-old woman with small-diameter simultaneous macular holes was observed for a period of 5 months, and progression was documented with spectral-domain optical coherence tomography. Closure of right full-thickness macular hole was evidenced by 1 month and left full-thickness macular hole by 5 months.

Conclusion:
This case demonstrates possible spontaneous resolution of a condition that is usually treated surgically. A period of observation with serial imaging studies may be advised in cases of small macular holes.
Topography-Based Removal of Corneal Epithelium for Keratoconus: A Novel and Customized Technique
Authors: Shetty Rohit , Vunnava KrishnaPoojita , Khamar Pooja , Choudhary Urvija , Sinha Roy Abhijit 
Published: May 2018

Purpose:
To report 3 cases of management of keratoconus with a novel topography-based removal of corneal epithelium in keratoconic eyes combined with corneal crosslinking.

Methods:
Case report and technique description.

Results:
Three eyes were imaged with the Sirius topographer (Schwind Eye-Tech-Solutions, Germany). Single-step transphototherapeutic keratectomy was performed. After removal of epithelium with laser, 4-mm diameter ablation was performed centered at the location of the maximum anterior tangential curvature point. An ellipsoid ablation pattern was used for all eyes. The stromal ablation depth did not exceed 25 μm. Next, epithelium over the remaining central 8-mm cornea was manually scraped. Accelerated crosslinking (9 mW/cm2 for 10 min) of the central 8-mm cornea was performed. After 3 months, spherical equivalent, maximal anterior curvature, and root mean square of higher-order aberrations decreased by 1.75 D, 2.0 D, and 0.15 μm, respectively, in the first eye. The spherical equivalent, maximal anterior curvature, and root mean square decreased by 2.75 D, ∼4.0 D, and 0.36 μm, respectively, in the second eye. In the third eye, the decrease was 0.75 D, 8.3 D, and 1.0 μm, respectively. After 3 months, improvement in visual acuity was significant in 2 of the 3 eyes. In 1 eye, there was a slight reduction in corrected distance visual acuity mostly because of ongoing remodeling of the cornea and delayed vision stabilization.

Conclusions:
A novel technique named topography-based removal of corneal epithelium in keratoconic eyes was described. This combined technique ablated less stroma and achieved outcomes comparable to those of existing techniques.
Serum Bile Acids in Patients With Primary Open-angle Glaucoma
Authors: Jacob Mridula M. , Pai H. Vijaya , Gnanaharan John , Kamath Shobha 
Published: May 2018

Purpose:To measure the serum bile acids (SBA) in patients with primary open-angle glaucoma (POAG) and to compare with nonglaucomatous controls.Patients and Methods:A hospital-based case control study of 90 patients above the age of 40 years was conducted. Patients with POAG formed the study group and individuals without glaucoma in the same age group formed the control group. SBA estimation was done using ELISA kit enzymatic assay technique and the median value was compared between the 2 groups.Results:The median of SBA level was found to be more in POAG patients when compared with the control group. The difference was statistically significant (P<0.001). Median SBA level was not affected by the age or sex of the participants in the study.Conclusions:“Bile acids” may have a role in the oxidative stress and apoptosis involved in the pathophysiology of POAG.
Do Depressive Symptoms Moderate the Effects of Exercise Self-efficacy on Physical Activity Among Patients With Coronary Heart Disease?
Authors: Siow Elaine , Leung Doris Yin Ping , Wong Eliza Mi Ling , Lam Wai Han , Lo Shuk Man 
Published: May 2018

Background:
Exercise self-efficacy is an important predictor of physical activity. Patients with coronary heart disease are at risk of developing depressive symptoms that could further weaken their self-efficacy and interfere with their ability to engage in physical activity.

Objective:
The aim of this study was to examine the relationship between depressive symptoms, exercise self-efficacy, and physical activity among patients with coronary heart disease and how the efficacy-activity relationship is affected by the patient's level of depression.

Methods:
A survey was conducted on 149 participants at the time of discharge from the emergency and in-patient medical wards at 2 regional hospitals.

Results:
The sample was mostly male, married, living with families, and of lower socioeconomic status. The mean exercise self-efficacy was 4.26 ± 2.73, and the median physical activity was 12 (interquartile range, 6–21). Approximately 26% of participants had high depressive symptoms. Those with more depressive symptoms reported lower self-efficacy scores and lower physical activity. In multivariate regressions, self-efficacy was an independent predictor of physical activity (b = 1.48, P < .001). After including depressive symptoms as the interaction term, exercise self-efficacy had a significantly stronger and positive relationship with physical activity (b = 0.14, P = .043).

Conclusion:
Exercise self-efficacy had a positive association with physical activity, and this relationship was stronger among coronary heart disease patients with depressive symptoms. This finding suggests that self-efficacy might be important in encouraging individuals with depressive symptoms to participate in physical activity. More efforts should target the development of effective strategies to improve exercise self-efficacy as a way of promoting physical activity among depressed coronary heart disease patients.
Trends and Patterns of Antidepressant Use in French Children and Adolescents From 2009 to 2016
Authors: Revet Alexis , Montastruc François , Raynaud Jean-Philippe , Baricault Bérangère , Montastruc Jean-Louis , Lapeyre-Mestre Maryse 
Published: May 2018

Abstract

Purpose/Background
Over the last decade, the use of antidepressants (ATDs) in children and adolescents has markedly increased in several occidental countries, but recent data in French children are missing. This study aimed to assess trends of ATD use in French children (6–11 years) and adolescents (12–17 years) and to characterize changes in ATD prescribing patterns from 2009 to 2016.

Methods
Using data from the French Health Insurance Database, annual prevalence and incidence of ATD use and changes in ATD prescribing patterns were analyzed.

Results
Overall ATD prevalence of use rose slightly from 0.51% in 2009 to 0.53% in 2016 (+3.9%), with a decrease in children (0.18%–0.11%; −38.9%) and an increase in adolescents (0.86%–0.98%; +14.0%) and an overall female preponderance (56.7% in 2009; 58.7% in 2016). Serotonin reuptake inhibitor prevalence of use increased from 0.24% to 0.34%, whereas tricyclic ATD use decreased (from 0.20% to 0.16%). Similar trends were obtained with overall incidence of use, from 0.39% in 2009 to 0.36% in 2016 (−7.7%). Sertraline was the most frequently prescribed in adolescents (2009: 22.2% of all ATD prescriptions; 2016: 32.9%), whereas amitriptyline was the most prescribed in children (2009: 42.7% and 2016: 41.2%). Off-label use decreased in adolescents (from 48.4% to 34.8%) but increased in children (from 10.0% to 26.5%).

Implications/Conclusions
Antidepressant level of use in French children and adolescents was stable in recent years and lower than that observed in other European countries and the United States.
Sustained Impairment of Lurasidone Clearance After Discontinuation of Posaconazole
Authors: Greenblatt David J. , Harmatz Jerold S. , Ryan Michael J. , Chow Christina R. 
Published: May 2018

AbstractPurpose/BackgroundThe antipsychotic agent lurasidone (Latuda®) is metabolized by Cytochrome P450-3A (CYP3A) enzymes. Coadministration with strong CYP3A inhibitors (such as ketoconazole, posaconazole, and ritonavir) is contraindicated due to the risk of sedation and movement disorders from high levels of lurasidone. This study evaluated the time-course of recovery from the posaconazole drug interaction, and the effect of obesity on the recovery process.Methods/ProceduresHealthy normal-weight volunteers (n = 11, mean body mass index, BMI, = 23.1 kg/m2) and otherwise healthy obese subjects (n = 13, mean BMI = 49.3 kg/m2) received single doses of lurasidone in the baseline control condition, again during coadministration of posaconazole, and at 4 additional time points during the 2 weeks after posaconazole discontinuation.Findings/ResultsWith posaconazole coadministration, lurasidone area under the concentration curve (AUC) increased by an arithmetic mean factor of 6.2 in normals, and by 4.9 in obese subjects. Post-treatment washout of posaconazole was slow in normals (mean half-life 31 hours), and further prolonged in obese subjects (53 hours). Recovery of lurasidone AUC toward baseline was correspondingly slow, and was incomplete. AUC remained significantly elevated above baseline both in normals (factor of 2.1) and obese subjects (factor of 3.4) even at 2 weeks after stopping posaconazole.Implications/ConclusionsProduct labeling does not address the necessary delay after discontinuation of a strong CYP3A inhibitor before lurasidone can be safely administered. We recommend requiring normal-weight and obese patients to limit the dosage of lurasidone, or undergo a washout period, for two and three weeks, respectively, after discontinuation of posaconazole.
Analgesic Management of Pain in Elite Athletes: A Systematic Review
Authors: Harle Christopher A. , Danielson Elizabeth C. , Derman Wayne , Stuart Mark , Dvorak Jiri , Smith Lisa , Hainline Brian 
Published: May 2018

Objective:To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes.Design:Systematic literature review.Data Sources:Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus.Eligibility Criteria for Selecting Studies:Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded.Main Results:Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared.Conclusions:Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations.
The Relationship Between Prescription Copayments and Contraceptive Adherence in a New-user Cohort
Authors: Marshall Cassondra , Schmittdiel Julie , Chandra Malini , Calhoun Amanda , Raine-Bennett Tina 
Published: May 2018

Background:
Contraceptive nonadherence is an important contributor to unintended pregnancy in the United States. While the elimination of patient cost sharing has been cited as means to improve contraceptive access, little is known about the relationship between cost sharing and ongoing adherence and continuation of chosen methods. The purpose of this study was to examine the relationship between copayment amount and adherence to pharmacy-dispensed contraception in young women.

Methods:
We conducted a retrospective cohort study of 39,142 women ages 19–29 with a new prescription for the contraceptive pill, patch, or ring at Kaiser Permanente Northern California during 2011–2014. We examined 12-month nonadherence as measured by timely prescription refills and used multivariable Cox proportional hazards models to assess the association between copayment amount and the risk of nonadherence.

Results:
Ninety-four percent of women used the pill, and 6% used the patch or ring. Forty percent of patients had no copayment and 25% had a copayment of ≥$30. Nearly 75% of women were nonadherent during the study period. In 2013 and 2014, women with a copayment had a 9% increased risk of nonadherence (adjusted hazard ratio, 1.09; 95% confidence interval, 1.04, 1.14) compared with women with no copayment.

Conclusions:
Prescription copayments may serve as a barrier to adherence of pharmacy-dispensed contraception. Given recent changes to Affordable Care Act contraceptive coverage requirement, these findings can be used to support state-level and health system-level policies for no-cost contraception, and to determine the potential public health impact of this policy change.
Academic Stress May Contribute to the Onset of Pediatric Inflammatory Bowel Diseases
Authors: Krishna Mahesh Z. , Barton Keisha R. , Perez Carla M. , Walsh Seema M. , Assa Amit , Kellermayer Richard 
Published: May 2018

ABSTRACTIt is currently unclear whether seasonality affects the onset of inflammatory bowel diseases (IBDs: Crohn disease and ulcerative colitis) in children. Here, we examined the records of pediatric patients with IBD diagnosed between 2009 and 2015 in a discovery cohort of 169 cases and a validation cohort of 122 subjects, where the month of symptoms onset could be determined. No seasonal patterns could be identified in respect to conception, birth, and disease onset. An annual rhythm of symptomatic onset, however, correlating with academic semesters was identified. IBD symptoms in the discovery cohort presented significantly more (P = 0.0218) during 5 months including the initiation (August, September, January) and the termination of academic semesters (December, May) compared to any other 5 months of the year. This observation was validated in the independent cohort (P < 0.0001). Our findings imply that academic stress may contribute to disease onset in pediatric IBD, which may improve timely diagnosis.
Management of Paediatric Ulcerative Colitis, Part 2
Authors: Turner Dan , Ruemmele Frank M. , Orlanski‐Meyer Esther , Griffiths Anne M. , de Carpi Javier Martin , Bronsky Jiri , Veres Gabor , Aloi Marina , Strisciuglio Caterina , Braegger Christian P. , Assa Amit , Romano Claudio , Hussey Séamus , Stanton Michael , Pakarinen Mikko , de Ridder Lissy , Katsanos Konstantinos H. , Croft Nick , Navas‐López Víctor Manuel , Wilson David C. , Lawrence Sally , Russell Richard K. 
Published: May 2018

ABSTRACTBackground and aim:Acute severe colitis (ASC) is one of the few emergencies in pediatric gastroenterology. Tight monitoring and timely medical and surgical interventions may improve outcomes and minimize morbidity and mortality. We aimed to standardize daily treatment of ASC in children through detailed recommendations and practice points which are based on a systematic review of the literature and consensus of experts.Methods:These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Fifteen predefined questions were addressed by working subgroups. An iterative consensus process, including 2 face‐to‐face meetings, was followed by voting of the national representatives of ECCO and all members of the Paediatric Inflammatory Bowel Disease (IBD) Porto group of ESPGHAN (43 voting experts).Results:A total of 24 recommendations and 43 practice points were endorsed with a consensus rate of at least 91% regarding diagnosis, monitoring, and management of ASC in children. A summary flowchart is presented based on daily scoring of the Paediatric Ulcerative Colitis Activity Index. Several topics have been altered since the previous 2011 guidelines and from those published in adults.Discussion:These guidelines standardize the management of ASC in children in an attempt to optimize outcomes of this intensive clinical scenario.