bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Psychometric Properties of EuroQoL 5-Dimension 5-Level and Short-Form 6-Dimension Utility Measures in Low Back Pain
Authors: Cheung Prudence Wing Hang , Wong Carlos King Ho , Cheung Jason Pui Yin 
Published: November 2018

Study Design.
Prospective study.

Objective.
To examine the acceptability and validity of EuroQoL 5-dimension 5-level (EQ-5D-5L) and Short-Form 6-Dimension (SF-6D) health utility measures in patients with low back pain (LBP).

Summary of Background Data.
LBP requires multiple diagnostic tests and treatment that can incur high medical costs. It is thus desirable to have an appropriate measure for cost-utility analysis of various LBP-related interventions.

Methods.
Health-related quality of life (HRQoL) questionnaires including generic 12-item Short Form Health Survey (SF-12), EQ-5D-5L, and low back/back-related questionnaires were administered at a specialty clinic. SF-12 items responses were transformed to SF-6D utility scores using the Hong Kong population scoring algorithm whereas EQ-5D-5L responses were mapped onto EQ-5D-3L response, then converted to EQ-5D-5L utility scores using the Chinese-specific value set. Construct validity was determined by evaluating Spearman correlation between SF-12 and EQ-5D-5L scores. Correlation between back-specific questionnaires and HRQoL scores were assessed.

Results.
A total of 100 patients were recruited. No significant (>15%) floor and ceiling effects were observed for EQ-5D-5L and SF-6D scores. Detailed proportion of respondents for each EQ-5D-5L domain indicated that Pain/Discomfort domain was the most prevalent problem. SF-6D utility score and EQ-5D-5L had respective strong (0.600–0.855) and moderate-to-strong (0.455–0.700) correlations with SF-12 domain and summary scores. EQ-5D-5L and SF-6D scores were correlated (0.625), with adequate construct validity as both utility scores conceptually measure the similar construct. Patients with no previous spine surgery nor disc degeneration had significantly higher EQ-5D-5L scores. Both EQ-5D-5L and SF-6D significantly correlated with back-specific questionnaires.

Conclusion.
Both EQ-5D-5L and SF-6D appeared as applicable and valid measures in assessing HRQoL of LBP patients. Being the first study examining the differential psychometric properties and validation of the use of EQ-5D-5L and SF-6D in Chinese LBP population, this allows future exploration of the impact of utility score selection on assessing effectiveness of clinical intervention for LBP.

Level of Evidence: 2
Clinical Impact of Ossification of the Posterior Longitudinal Ligament Progression After Cervical Laminoplasty
Authors: Kawaguchi Yoshiharu , Nakano Masato , Yasuda Taketoshi , Seki Shoji , Suzuki Kayo , Yahara Yasuhito , Makino Hiroto , Kobayashi Kenji , Kanamori Masahiko , Kimura Tomoatsu 
Published: November 2018

Study Design:
This is a retrospective study.

Objectives:
(1) To analyze the incidence of second surgery after initial laminoplasty for ossification of the posterior longitudinal ligament (OPLL) due to disease progression, (2) to examine factors associated with poor surgical outcome.

Summary of Background Data:
Neurological deterioration after laminoplasty is frequently encountered due to OPLL progression.

Patients and Methods:
Of 201 OPLL patients treated by laminoplasty at a single-institution, the 153 monitored for >3 years postsurgery were included in this analysis. Neurological findings were graded by the Japanese Orthopaedic Association (JOA) score. We retrospectively examined the incidence of second surgery due to OPLL progression. We also evaluated the clinical characteristics and the surgical outcomes after second operation to identify potential risk factors for poor outcome.

Results:
Eight patients required a second surgery due to OPLL progression. Neurological recovery was achieved in 5 of these patients, whereas 3 exhibited continued dysfunction. Patients with poor recovery showed kyphotic changes of spinal alignment and high-intensity regions in the spinal cord on T2-weighted magnetic resonance images (T2-MRI).

Conclusions:
Only a small fraction of OPLL patients required a second surgery due to OPLL progression. Recovery was poor in those with clear high-intensity T2-MRI signals in the spinal cord.
Safety of 2-level Anterior Cervical Discectomy and Fusion (ACDF) Performed in an Ambulatory Surgery Setting With Same-day Discharge
Authors: Vaishnav Avani , Hill Patrick , McAnany Steven , Gang Catherine H. , Qureshi Sheeraz 
Published: November 2018

Study Design:
This was a retrospective review of prospectively collected data.

Objective:
To evaluate differences in patient factors, procedural factors, outcomes and safety in 2-level anterior cervical discectomy and fusion (ACDF) performed in ambulatory surgery centers (ASCs) versus the hospital setting.

Background:
Emphasis on reducing health care costs has led to numerous surgeries across specialties being performed in ASCs. Because of short operative times and moderate postoperative pain, 1-level ACDF is one of the most common spine surgeries successfully performed in ASCs. Despite the success of single-level ACDF, concerns over postoperative complications, including respiratory compromise have curtailed the performance of 2-level ACDF in ASCs.

Materials and Methods:
Patient demographics, operative factors and outcomes [blood loss, operative time, length of stay, complications and patient-reported outcomes (PROs)] of patients undergoing 2-level ACDF in an ASC and a hospital were compared using the Fisher exact test for categorical and the Student t test for continuous variables.

Results:
Of the 83 patients included, 25 underwent 2-level ACDF in an ASC, and 58 in a hospital. Mean age for the ASC group was 51.7±7.6 and 53.2±7.9 years for the hospital group (P=0.44). Body mass index was lower in the ASC group, at 27.3 kg/m2 versus 30.4 in the hospital group (P=0.03). Likewise, the ASC group had a lower ASA grade, favoring ASA 1 and 2 (P<0.001). There were no differences in blood loss (P=0.72) or complication rates, (P=0.16) with urinary retention being most common, and only 1 patient in the hospital setting requiring reintubation. In addition, no patients in the ASC setting required hospitalization. There were no differences in preoperative, 6-week and 6-month PROs.

Conclusions:
The results of our study suggest that 2-level ACDF can be performed safely in the ASC setting without increased risk of complications compared with the hospital setting in an appropriately selected patient. Specifically, body mass index, and ASA class should be taken into consideration. Importantly, the setting of the surgery does not impact early PROs.

Level of Evidence:
Level 3.
Utility of Skin Biopsy and Culture in the Diagnosis and Classification of Chronic Ulcers: A Single-Institution, Retrospective Study
Authors: Khoobyari Shiva , Miller Timothy I. , Shinohara Michi M. 
Published: November 2018

Abstract:
In the United States, chronic ulcers affect 6.5 million people, with a cost of ≈$20 million annually. The most common etiology of chronic ulcers in the United States is venous stasis, followed by arterial insufficiency and neuropathic ulcers. Less common causes of chronic ulcers include infection, inflammatory etiologies such as vasculitis and pyoderma gangrenosum, and neoplastic causes. Obtaining skin biopsy and tissue culture can be helpful in diagnosing unusual causes of chronic ulcers; however, there are little data on the diagnostic utility of skin biopsy in rendering a definitive diagnosis of the etiology of chronic ulcers. A retrospective study of all skin ulcers biopsied during a 10-year period at the University of Washington was undertaken. Re-excisions and surgical wounds were excluded. A total of 270 ulcer biopsy specimens were included. In 48% of cases, no specific diagnosis could be rendered histologically. 44.8% of chronic ulcers biopsied were due to atypical causes, with neoplasms (basal cell carcinoma, squamous cell carcinoma, melanoma, and cutaneous T-cell lymphoma) being the most common. Vasculitis and pyoderma gangrenosum each represented 1.5% of rendered diagnoses. Concomitant skin culture was performed in 28.9% of cases, and special stains [acid-fast bacilli, Brown and Brenn (B&B), Grocott's methenamine silver, and periodic acid-Schiff stains] were performed in 34.0%. Although more than half (49 of 78) of tissue cultures were positive, only 6.8% (12 of 175) of special stains on tissue sections were positive. We conclude that although the etiology of many ulcers cannot be determined by routine histology alone, skin biopsy of ulcers remains a critical part of the workup given that when a specific cause can be determined, atypical etiologies, including neoplasms, represent a significant proportion of chronic ulcers. Limitations of our study include referral bias. Our results also confirm the higher diagnostic yield of conventional tissue culture compared with special tissue stain biopsies of skin ulcers.
Linear IgA Bullous Dermatosis Preceding the Diagnosis of Primary Sclerosing Cholangitis and Ulcerative Colitis: A Case Report
Authors: Humphrey Victoria S. , Lee Jonathan J. , Supakorndej Teerawit , Malik Shahid M. , Huen Arthur C. , Jaroslaw Jedrych 
Published: November 2018

Abstract:
Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering disorder seen in the pediatric and adult populations that is often linked to a medication, infection, or underlying gastrointestinal, hepatobiliary, or autoimmune disease. In this study, we describe the case of a 23-year-old white man whose presentation and diagnosis of LABD ultimately led to the discovery of underlying primary sclerosing cholangitis (PSC) and ulcerative colitis (UC). His dermatitis resolved with topical steroids and dapsone, and he is undergoing systemic treatment for his UC and PSC. This exceptional case further validates the association between LABD with UC, strengthens that with PSC, and underscores the importance of alerting clinicians to consider conducting a systemic workup in addition to thorough medication history on making the diagnosis of LABD.
Concurrent Metastatic Merkel Cell Carcinoma and Cutaneous Squamous Cell Carcinoma in the Same Lymph Node
Authors: Suaiti Lubna , Onajin Oluwakemi , Sangueza Omar 
Published: November 2018

Abstract:The coexistence of Merkel cell carcinoma (MCC) and squamous cell carcinoma (SCC) in the same cutaneous lesion is well known. The pathogenesis is believed to be distinct from conventional polyomavirus-related MCC, and it has a more aggressive course. Metastasis of MCC and SCC to the same lymph node is exceedingly rare with only one previously reported case in the English literature. To the best of our knowledge, this is the second case of MCC and SCC with metastasis to the same lymph node. Our case demonstrates the aggressive nature of the combined MCC and SCC in the setting of immunosuppression.
Proliferating Neurocristic Hamartoma Arising in a Giant Congenital Nevus: Comparative Genomic Hybridization Findings
Authors: Garrido Maria Concepcion , Maroñas-Jiménez Lidia , Ruano Yolanda , Rodriguez-Peralto Jose Luis 
Published: November 2018

Abstract:
Neurocristic cutaneous hamartomas (NCHs) are rarely reported tumors with divergent differentiation derived from persistently active pluripotent cells from the neural crest. They result from aberrant development of the neuromesenchyme, and they can express fibrogenic, melanocytic, and/or neurosustentacular differentiation. Thus, congenital melanocytic nevus also represents a neurocristic dysplasia of the skin in which cells are melanogenic cells arrested in development located in the reticular dermis, and nodular proliferative neurocristic hamartoma may arise within a congenital melanocytic nevus. The real importance of NCHs is that, although few cases have been reported in the literature, some cases have shown development of melanoma. Moreover, the only previously reported case of a similar “proliferative neurocristic nodule” analyzed with comparative genomic hybridization showed an aberration pattern similar to melanoma. We present a rare case of NCH associated with a congenital nevus in a 7-year-old boy, with classical histological and immunohistochemical features suggesting a “proliferative neurocristic hamartoma”. Comparative genomic hybridization assay showed that chromosomal aberrations were absent in the congenital nevus, whereas, interestingly, the proliferative neurocristic proliferation had an aberration pattern similar to proliferative nodules with gains or losses of entire chromosomes only, similar to typical proliferative nodules and supporting the benign behavior of this lesion.
Comparison of Methods for Algorithmic Classification of Dementia Status in the Health and Retirement Study
Authors: Gianattasio Kan Z. , Wu Qiong , Glymour M. Maria , Power Melinda C. 
Published: November 2018

Background:
Dementia ascertainment is time-consuming and costly. Several algorithms use existing data from the US-representative Health and Retirement Study (HRS) to algorithmically identify dementia. However, relative performance of these algorithms remains unknown.

Methods:
We compared performance across five algorithms (Herzog–Wallace, Langa–Kabeto–Weir, Crimmins, Hurd, Wu) overall and within sociodemographic subgroups in participants in HRS and Wave A of the Aging, Demographics, and Memory Study (ADAMS, 2000–2002), an HRS substudy including in-person dementia ascertainment. We then compared algorithmic performance in an internal (time-split) validation dataset including participants of HRS and ADAMS Waves B, C, and/or D (2002–2009).

Results:
In the unweighted training data, sensitivity ranged from 53% to 90%, specificity ranged from 79% to 97%, and overall accuracy ranged from 81% to 87%. Though sensitivity was lower in the unweighted validation data (range: 18%–62%), overall accuracy was similar (range: 79%–88%) due to higher specificities (range: 82%–98%). In analyses weighted to represent the age-eligible US population, accuracy ranged from 91% to 94% in the training data and 87% to 94% in the validation data. Using a 0.5 probability cutoff, Crimmins maximized sensitivity, Herzog–Wallace maximized specificity, and Wu and Hurd maximized accuracy. Accuracy was higher among younger, highly-educated, and non-Hispanic white participants versus their complements in both weighted and unweighted analyses.

Conclusion:
Algorithmic diagnoses provide a cost-effective way to conduct dementia research. However, naïve use of existing algorithms in disparities or risk factor research may induce nonconservative bias. Algorithms with more comparable performance across relevant subgroups are needed.
Long-term weight loss maintenance, sex steroid hormones, and sex hormone-binding globulin
Authors: Duggan Catherine , Tapsoba Jean de Dieu , Stanczyk Frank , Wang Ching-Yun , Schubert Karen Foster , McTiernan Anne 
Published: November 2018

Abstract

Objective:
We tested the effects of weight loss on serum estradiol, estrone, testosterone, and sex hormone-binding globulin (SHBG) in overweight/obese women 18 months after completing a year-long, 4-arm, randomized-controlled dietary weight loss and/or exercise trial.

Methods:
From 2005 to 2008, 439 overweight/obese, postmenopausal women (BMI >25 kg/m2), 50 to 75 years, were randomized to a year-long intervention: diet (reduced calorie, 10% weight loss, N = 118), exercise (225 min/wk moderate-to-vigorous activity, N = 117), combined diet + exercise (N = 117), or control (N = 87). At 12 months, 399 women provided blood; of these, 156 returned at 30 months and gave a blood sample. Hormones and SHBG were measured by immunoassay. Changes were compared using generalized estimating equations, adjusting for confounders.

Results:
At 30 months, participants randomized to the diet + exercise intervention had statistically significant increases in SHBG levels versus controls (P = 0.001). There was no statistically significant change in SHBG in the exercise or diet intervention arms. Hormone levels did not vary by intervention arm from baseline to 30 months. Participants who maintained weight loss at 30 months had statistically significantly greater decreases in free estradiol and free testosterone (P
trend = 0.02 and P
trend = 0.04, respectively) and increases in SHBG (P
trend < 0.0001) versus those who did not have sustained weight loss. Levels of other analytes did not vary by weight loss at 30 months.

Conclusions:
Sustained weight loss results in reductions in free estradiol and testosterone and increases in SHBG 18-month post-intervention.
An Atypical Presentation of Pacinian Corpuscles on Bilateral Guyon’s Tunnel
Authors: Shturman Sirota Isaac , Olivares Ronces Andrés 
Published: November 2018

Summary:
Guyon’s syndrome results from a lesion of the ulnar nerve at the wrist caused by several conditions. The most common causes are ganglion, lipomas, fractures of the radius or pisiform bone, occupational trauma, neuritis, musculotendinous arch, and diseases of the ulnar artery. The clinical presentation varies with the site of lesion, as described by Sean and McClain in 1969, and can involve combined sensory and motor deficits, motor deficit alone, or sensory deficit alone. We present a case of bilateral Guyon’s canal syndrome caused by a lipoma with Pacinian corpuscles on both wrists. Patient presented with sensory deficit as it is described by Shea and McClain with a negative electroneuromyography for ulnar compression. Articles correlating clinical presentation, etiology, and electrophysiological findings relating to ulnar nerve compression on the wrist are still uncommon in the literature.
Patient Perception of How Smoking Status Influences Cardiac Rehabilitation Attendance After an Acute Cardiac Hospitalization
Authors: Riley Hayden , Headley Samuel , Lindenauer Peter K. , Goff Sarah , Szalai Heidi , Gaalema Diann E. , Pack Quinn R. 
Published: November 2018

Purpose:
Patients hospitalized with a cardiac condition are less likely to attend cardiac rehabilitation (CR) if they are smokers despite the benefits of doing so. The present study sought to investigate how, if at all, a patient's decision to attend CR was influenced by his or her tobacco use post-discharge.

Methods:
We surveyed smokers during their hospitalization for a cardiac condition. Four to 8 wk after discharge, a follow-up survey assessed self-reported CR attendance, smoking cessation (SC), and patient opinion of how their smoking status influenced CR attendance.

Results:
Of the 81 patients who completed the baseline survey (68% male, 57 ± 10 y), 62 (77%) completed the follow-up survey. Consistent with prior findings, there was a substantial correlation between SC and CR attendance (OR: 16.0, P < .001) with 36 (44%) patients attending CR overall and 38 (47%) abstaining from smoking. Patients reported a wide variety of reasons for not attending CR, but most patients (n = 39, 63%) reported that their smoking status did not influence their decision to attend CR. However, 5 patients (8%) reported attending CR because they successfully quit smoking, and 5 (8%) attended CR anticipating support with SC.

Conclusion:
A strong relationship exists between SC and CR attendance following a cardiac hospitalization; however, most patients did not feel that their smoking status was a factor in their decision to attend CR. Regardless of the reason, it appears that success with one behavior may be related to the other and that both SC and CR attendance should be encouraged.
Examining the role of value congruence, professional identity, and managerial job engagement in the budgetary participation–performance link
Authors: Macinati Manuela S. , Nieddu Luciano , Rizzo Marco Giovanni 
Published: November 2018

Background:
In health care, important phenomena of perceived incompatibility between professional and managerial values have emerged as consequences of New Public Management reforms. Although there is a growing evidence on the variation in the enactment of hybrid roles by medical managers, existing research in health care management is mostly descriptive with little emphasis on the conditions under which hybrid roles are enacted and, importantly, on the effects of this variation on performance.

Purpose:
In this article, we seek to fill this research gap by empirically examining (a) whether budgetary participation aligns professional and organizational values, (b) the impact of this alignment on employees’ work-related feelings and managerial performance, and (c) the effect of professional identity on value congruence.

Methodology:
Data were collected by a survey conducted in an Italian hospital, and partial least square was used to test the relationships among variables.

Results:
Overall, results show that (a) high involvement in budgeting is instrumental in facilitating medical managers’ value congruence, and this, in turn, positively effects managerial job engagement; (b) the effect of budgetary participation on value congruence depends on the extent of professional identity; and (c) as a result of enhanced value congruence and managerial job engagement, employees tend to deliver superior role performance.

Practice implication:
Findings of this study provide some guidance for managers on how organizations can take steps to guarantee effective support to hybrid professionals.
Cigarette Smoking on Severity of Primary Angle Closure Glaucoma in Malay Patients
Authors: Niven Teh Chong Seong , Azhany Yaakub , Rohana Abdul J. , Karunakar Tirmandas V.N. , Thayanithi Sandragasu , Jelinar Noor Mohd N. , Norhalwani Husain , Zuraidah Mustari , Siti Azrin Ab H. , Ahmad Mt S. , Aung Tin , Liza-Sharmini Ahmad T. 
Published: November 2018

Purpose:
The purpose of this study was to determine the association between cigarette smoking and the severity of primary angle closure glaucoma (PACG) in Malay patients residing in Malaysia.

Methods:
A cross-sectional study was conducted involving 150 Malay PACG patients between April 2014 and August 2016. Ocular examination was performed including Humphrey visual field (HVF) 24-2 analysis assessment. On the basis of the 2 consecutive reliable HVFs, the severity of glaucoma was scored according to modified Advanced Glaucoma Intervention Study (AGIS) by 2 masked investigators and classified as mild, moderate, and severe. Those with retinal diseases, neurological diseases, memory problem, and myopia ≥4 diopters were excluded. Their smoking status and details were obtained by validated questionnaire from Singapore Malay Eye Study (SiMES). The duration of smoking, number of cigarettes per day, and pack/year was also documented. Multiple linear regression analysis was conducted.

Results:
There was a significant association between education level and severity of PACG (P=0.001). However, there was no significant association between cigarette smoking and severity of glaucoma (P=0.080). On the basis of multivariate analysis, a linear association was identified between cigarette smoked per day (adjusted b=0.73; 95% CI: 0.54, 1.45; P<0.001) and body mass index (adjusted b=0.32; 95% CI: 0.07, 1.35; P=0.032) with AGIS score.

Conclusions:
There was no significant association between cigarette smoking and severity of PACG. Cigarette smoked per day among the smokers was associated with severity of PACG. However, because of the detrimental effect of smoking, cessation of smoking should be advocated to PACG patients.