bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative imaging of traumatic anterior shoulder instability: Diagnostic effectiveness of magnetic resonance arthrography and comparison with conventional magnetic resonance imaging and arthroscopy
Authors: Haroun Haitham , Abd rabu Ahmed , Kotb Ahmed , Awad Fath Allah 
Published: August 2019

Background:
Associated injuries of traumatic anterior shoulder dislocations play an important role in predicting recurrent instability. MRI has proved popular for imaging of suspected abnormalities. MR arthrography (MRA) has been suggested to be more sensitive than MRI in the detection of labral tears and other capsular lesions. In this study, we aimed to assess prospectively the diagnostic effectiveness of MRA in the preoperative planning of traumatic anterior shoulder instability compared with conventional MRI and arthroscopy.

Methods:
Shoulder MRI and MRA in 100 patients (73 men and 27 women; mean age, 27 yr) with shoulder dislocations were evaluated by two musculoskeletal radiologists who were blinded to arthroscopic findings, which represented the reference standard. An arthroscopic surgeon blinded to the imaging findings evaluated the osseous abnormalities involving the humeral head and glenoid, anterior labroligamentous lesions, and capsular lesions. Sensitivity, specificity, accuracy, and positive and negative predictive values of each imaging study were calculated for each elemental lesion and compared using a paired McNemar test.

Results:
When comparing the sensitivity and accuracy values of the MRA and MRI for the detection of these elemental lesions, all values of MRA were higher than those of MRI (P<0.01). However, when comparing the specificity values, both MRI and MRA were highly specific (100%) in diagnosing bony Bankart lesions and anterior labroligamentous periosteal sleeve avulsions. MRI missed Perthes lesions, humeral avulsions of the anterior glenohumeral ligament, and glenoid avulsions of the anterior glenohumeral ligament.

Conclusions:
Despite being invasive, MRA is considerably more useful in the identification and categorization of different elemental lesions of traumatic chronic anterior shoulder instability.
The Influence of Conflicts of Interest on Outcomes in the Lumbar Disc Arthroplasty Literature
Authors: Guntin Jordan A. , Patel Dil V. , Cardinal Kaitlyn L. , Haws Brittany E. , Khechen Benjamin , Yoo Joon S. , Block Andrew M. , Lalehzarian Simon P. , Singh Kern 
Published: August 2019

Study Design.
A systematic review.

Objective.
The aim of this study was to determine the association between study outcomes and the presence of a conflict of interest (COI) in the lumbar disc arthroplasty (LDA) literature.

Summary of Background Data.
Previous studies have evaluated the efficacy of LDA as a surgical alternative to arthrodesis. As investigators may have financial relationships with LDA device companies, it is important to consider the role of COI on study outcomes.

Methods.
A systematic review was performed to identify articles reporting clinical outcomes of LDA. Any financial COIs disclosed were recorded and confirmed through Open Payments and ProPublica databases. Study outcomes were graded as favorable, unfavorable, or equivocal. Pearson Chi-squared analysis was used to determine an association between COI and study outcomes. Favorable outcomes were tested for an association with study characteristics using Poisson regression with robust error variance.

Results.
Fifty-seven articles were included, 30 had a financial COI, while 27 did not. Ninety percent of the conflicted studies disclosed their COI in the article. Studies with United States authors were more likely to be conflicted (P = 0.019). A majority of studies reported favorable outcomes for LDA (n = 39). Conflicted studies were more likely to report favorable outcomes than nonconflicted studies (P = 0.020). Articles with COIs related to consultant fees (P = 0.003), research funding (P = 0.002), and stock ownership (P < 0.001) were more likely to report favorable outcomes.

Conclusion.
This study highlights the importance for authors to accurately report conflicting relationships with industry. As such, orthopedic surgeons should critically evaluate study outcomes with regard to potential conflicts before recommending LDA as a surgical option to their patients.

Level of Evidence: 3
Long-Term Results of the Surgical Management of the Upper Eyelids in “Ablepharon”-Macrostomia Syndrome
Authors: Cruz Antonio Augusto V. , Quiroz Doris , Boza Tatiana , Wambier Sarah P. F. , Akaishi Patricia S. 
Published: August 2019

The upper eyelids in ablepharon-macrostomia syndrome can be permanently lengthened with full thickness skin grafts over Müller muscle.

Purpose:
To describe the late results of the placement of skin graft over conjunctiva-Müller muscle complex in 3 patients with ablepharon-macrostomia syndrome (AMS) and to review the procedures used to manage the upper eyelids in AMS.

Methods:
The authors searched the Pubmed database for all articles that used the term “ablepharon-macrostomia syndrome” in any field. Data collection included description of eyelid changes, age at surgery, status of the cornea before surgery, type of eyelid repair, and final outcome. Two previously reported siblings were reevaluated 10 and 15 years after a single reconstructive operation. A new case from Peru is also described.

Results:
Only 15 patients with AMS have been described in 12 articles. In 60% of the cases, the lids were described as absent. The surgical modalities employed to reconstruct the upper eyelids were quite variable, including local flaps, lid sharing procedures, and even a masquerade flap. At long-term follow-up, all 3 cases who underwent upper eyelid lengthening with full thickness skin grafts placed over Müller muscle had clear corneas with a small amount of lagophthalmos.

Conclusions:
The lids in AMS are not absent and should not be managed with complex reconstructive techniques. Full thickness skin grafts placed over the inner aspect of the palpebral conjunctiva allow permanent eye protection.
Screen Time and Cardiovascular Risks Among Middle-Aged Women
Authors: Ham Ok Kyung , Lee Bo Gyeong 
Published: August 2019

Background
Screen time is a marker of sedentary behavior that threatens the health of women. Extended screen time is associated with depression, insomnia, cardiovascular disease, and decreased quality of life.

Objective
In this study, we examined the factors associated with screen time and whether screen time is associated with the physiological and psychosocial health of middle-aged women. We applied a psycho-socioeconomic biobehavioral model of health and studied the outcomes of cardiometabolic biomarkers, insomnia, and quality of life.

Methods
Secondary data analysis was performed using data from a cross-sectional study conducted with 423 women between 40 and 65 years of age. Socioeconomic, physiological, psychosocial, and behavioral characteristics were measured. Self-reported screen time during the past week was measured using an ordinal scale. The data were analyzed using multivariate analysis of covariance, analysis of covariance, and logistic regression analysis.

Results
Twenty-four percent of subjects had at least 3 hours per day of screen time on weekdays, whereas 30.7% had at least 3 hours per day on weekends. Older women, unemployed women, and those who do not perform regular exercise were more likely to have at least 3 hours per day of screen time (P < .05). Screen time was associated with total cholesterol and low-density lipoprotein cholesterol levels, insomnia, and menopause-specific quality of life (P < .05).

Conclusions
Based on a psycho-socioeconomic biobehavioral framework, we found that screen time is associated with the physiological and psychosocial health of women independent of socioeconomic and biobehavioral variables. Efforts to reduce the amount of screen time targeting middle-aged women will help improve cardiometabolic biomarkers and quality of life.
Distinct Factors Associated With Better Self-care in Heart Failure Patients With and Without Mild Cognitive Impairment
Authors: Lee Kyoung Suk , Choi Jin-Oh , Jeon Eun-Seok , Park Jae-Hyeong , Jung Mi Sook , Lee Zian , Lee Hyeong Suk , Yoo Hye Jin 
Published: August 2019

Background
A decline in cognition may limit patients' ability to effectively engage in self-care in those with heart failure (HF). However, several studies have shown no difference in self-care between HF patients with and without cognitive impairment. This may indicate that there are more salient factors associated with self-care in HF patients with cognitive impairment compared with those without cognitive impairment.

Objective
The aim of this study was to explore which factors are related to self-care based on the presence and absence of mild cognitive impairment (MCI) among patients with HF.

Methods
Patients with HF were recruited from outpatient settings. The Montreal Cognitive Assessment was used to screen for MCI. Self-care was measured with the Self-care of HF Index v.6.2. Two separate stepwise linear regressions were performed to identify which factors (HF knowledge, perceived control, functional status, multimorbidity, executive function, and social support) predicted self-care in HF patients with and without MCI.

Results
Of the 132 patients in this study, 36 (27.3%) had MCI. Self-care maintenance and management were associated with social support (β = 0.489) and executive function (β = 0.484), respectively, in patients with MCI. Perceived control was associated with both self-care maintenance and management in patients without MCI (βs = 0.404 and 0.262, respectively).

Conclusion
We found that social support and executive function were associated with self-care in HF patients with MCI, whereas perceived control was associated with self-care in HF patients with intact cognition. Clinicians should develop tailored interventions to enhance self-care by considering the distinct factors associated with self-care based on the presence or absence of MCI.
Active Physical Activity Patterns Are Associated With Improved Quality of Life and Depression Status in Taiwanese Women With Metabolic Syndrome
Authors: Chiang Li-Chi , Chiang Shang-Lin , Tzeng Wen-Chii , Lee Meei-Shyuan , Hung Yi-Jen , Lin Chia-Huei 
Published: August 2019

Background:
Metabolic syndrome (MetS), health-related quality of life (HRQL), and depression status are independently associated with cardiac health. Therefore, understanding the associations between MetS, HRQL, and depression status and determining factors related to improved HRQL and depression status in people with MetS may help in cardiovascular disease prevention.

Objective:
The aim of this study was to examine whether there are differences in HRQL and depression status between Taiwanese women with and without MetS and whether physical activity patterns are associated with HRQL and depression status in this population.

Methods:
A cross-sectional study of 326 Taiwanese middle-aged and older women (≥40 years) was conducted. Metabolic syndrome was determined based on the National Cholesterol Education Program Adult Treatment Panel III definition. Health-related quality of life and depression status were collected using the Short Form 36 Health Survey and Beck Depression Inventory. Univariate and multivariate linear regression analyses were conducted.

Results:
Women with MetS had lower HRQL (P < .001) and higher depression status (P = .002) than those without MetS. Participants with active physical activity patterns had higher HRQL (P < .001) and lower depression status (P = .046) than those with sedentary patterns. Among women with MetS, those with active physical activity patterns had higher HRQL (P = .001) and lower depression status (P = .007) than those with sedentary patterns.

Conclusions:
Metabolic syndrome is related to lower HRQL and higher depression status in women 40 years and older. Active physical activity patterns are associated with better HRQL and reduced depression status in middle-aged and older women (≥40 years) with MetS.
Self-management Among Elderly Patients With Hypertension and Its Association With Individual and Social Environmental Factors in China
Authors: Zhang Xiao-Nan , Qiu Chen , Zheng Yu-Zhi , Zang Xiao-Ying , Zhao Yue 
Published: August 2019

Background:
The hypertension control rate in China is much lower than that in developed countries. Self-management among elderly patients with hypertension can improve blood pressure control; thus, it is necessary to explore its association with individual and social environmental factors.

Objective:
Our objective was to investigate self-management among elderly patients with hypertension in China and its association with individual and social environmental factors based on the social ecological model.

Methods:
A total of 301 elderly patients with hypertension were recruited to do a questionnaire survey based on the social ecological model, which included the General Demographic Information Questionnaire, Hypertension Patients Self-Management Behavior Rating Scale, World Health Organization Well-Being Index, Family APGAR Index, and Social Support Rating Scale.

Results:
The lowest level of self-management behaviors was in exercise management, and the highest was in medication management. The results of multiple linear regression analysis showed that well-being, family function, sex, education level, and age were pivotal individual and social environmental factors influencing self-management behaviors among elderly patients with hypertension.

Conclusions:
There is a need to develop and test interventions that improve self-management in elderly patients with hypertension. Specifically, individualized interventions to promote exercise among elderly persons with hypertension who are single and living alone are needed. Male patients with a lower education level, poor well-being, poor family function, and the lowest self-management levels are a key population to target.
Pleural Fluid Cytokine Levels at Baseline and Over Time are Associated With Time to IPC Removal
Authors: Grosu Horiana B. , Lu Wei , Ost David E. , Vial Macarena R. , Hernandez Mike , Ghosh Natasha , Noor Laila , Hasan Arain M. , Bashoura Lara , Faiz Saadia , Balachandran Dave , Casal Roberto , Eapen George , Shannon Vickie , Sheshadri Ajay , Tang Ximing , Rahman Najib , Wistuba Ignacio I. 
Published: August 2019

Background:
The behavior of pleural fluid cytokine (PFCs) levels and their association with pleurodesis after indwelling pleural catheter (IPC) placement is unknown.

Objective:
A prospective exploratory study was conducted to obtain preliminary data on PFC levels after IPC placement.

Methods:
The PFC panel consisted of 4 cytokines [interleukin -8 (IL-8), vascular endothelial growth factor, total (but not activated) transforming growth factor betas, and basic fibroblast growth factor], measured across 5 time points (T0: insertion; T1: 24 to 48 h; T2: 72 to 96 h; T3: 1 wk; and T4: 2 wk). Profile plots were used to identify patterns of change of PFC levels. Correlation matrices for each PFC over time were computed, and area under the curve (AUC) categories were used to compare the cumulative incidence of IPC removal. Auto pleurodesis was defined as elective catheter removal because of decreased drainage within 90 days of insertion.

Results:
A total of 22 patients provided complete data. Except for IL-8, the majority of PFCs demonstrated strong positive correlations across measurement time points. Patients with high AUCs for IL-8, basic fibroblast growth factor, and vascular endothelial growth factor had a higher cumulative incidence of IPC removal by 90 days than did patients with low AUCs.

Conclusion:
This is the first study to evaluate longitudinal changes of pleural cytokine levels with respect to the likelihood of IPC removal and provide early evidence that the cytokine profile may be associated with the outcome of pleurodesis induced by IPCs. However, this is an exploratory study and further studies are needed to assess if these findings can be validated in further studies.
Efficacy of the Combination of Pinaverium Bromide 100 mg Plus Simethicone 300 mg in Abdominal Pain and Bloating in Irritable Bowel Syndrome: A Randomized, Placebo-controlled Trial
Authors: Schmulson Max J. , Chiu-Ugalde Jazmin , Sáez-Ríos Adolfo , López-Colombo Aurelio , Mateos-Pérez Gualberto J. , Remes-Troche José María , Sobrino-Cossio Sergio , Soto-Pérez Julio C. , Tamayo de la Cuesta José L. , Teramoto-Matsubara Oscar T. , López-Alvarenga Juan C. 
Published: August 2019

Goals:
We aimed to evaluate the efficacy and safety of PB+S (pinaverium bromide 100 mg plus simethicone 300 mg) in patients with irritable bowel syndrome (IBS).

Background:
IBS is a multifactorial disorder; thus, combination therapy with different mechanisms of action is expected to be useful. PB+S has shown effectiveness in an open-label clinical study in IBS. However, there are no placebo-controlled trials.

Materials and Methods:
IBS-Rome III patients with abdominal pain/discomfort for at least 2 days within the week prior to baseline assessment were included in this 12-week, randomized, double-blind, placebo-controlled study of PB+S versus placebo, bid. The primary endpoint was overall symptom improvement, evaluated weekly by the patient (Likert Scale). Secondary endpoints included the weekly improvement in the severity of abdominal pain and bloating assessed both by patients (10-cm Visual Analogue Scale) and investigators (Likert Scale); frequency of Bristol Scale stool types (consistency) evaluated by patients and the IBS Quality of Life scores.

Results:
A total of 285 patients (female: 83%; 36.5±8.9 y old) received at least 1 dose of PB+S (n=140) or placebo (n=145). No difference was observed in overall symptom improvement between the groups (P=0.13). However, PB+S was superior in abdominal pain (effect size: 31%, P=0.038) and bloating (33%, P=0.019). Patients with IBS-C and IBS-M showed the best improvement in the frequency of stool types with PB+S. No differences were observed in IBS Quality of Life scores and adverse events.

Conclusions:
PB+S was superior to placebo in improving abdominal pain and bloating in patients with active IBS. The effect on the frequency of stool consistency was particularly significant in IBS-C and IBS-M.
Obesity and dyslipidemia in patients with psoriasis
Authors: Miao Chaoyang , Li Jing , Li Ying , Zhang Xiaoyan 
Published: August 2019

Abstract
The aim of this study was to conduct a more comprehensive analysis of the association between psoriasis and abnormal lipid metabolism.
The case–control study included 222 psoriatic patients and 445 non-psoriatic control patients matched for age and gender. Clinical parameters included age, gender, and body mass index (BMI). Serum lipid levels were recorded and included cholesterol (CHO), triglycerides (TG), low-density lipoprotein (LDL), high density lipoprotein (HDL), phospholipids (PLIP), free fatty acids (FFA), lipoprotein (a) [Lp(a)], and apolipoproteins (apoA1, apoB, and apoE). Statistical analysis was carried out through the IBM Statistical Package for the Social Studies version 23.0.
Compared with controls, levels of BMI and the prevalence of obesity were significantly higher in psoriatic patients. The results revealed that when compared to controls, significant elevation of serum TG (P <.001) and Lp(a) (P = .022) was observed. Levels of HDL (P <.001) and apoA1 (P <.001) were significantly lower in psoriatic patients. There was no significant difference in CHO (P = .367), LDL (P = .400), apoB (P = .294), apoE (P = .05), PLIP (P = .931) and FFA (P = .554) between patients and controls. The levels of CHO, TG, PLIP, FFA, and apoE were positively correlated with BMI level.
Dyslipidemia was more common in psoriatic patients, compared with non-psoriatic controls.
Delayed closure of macular hole secondary to Terson syndrome after vitrectomy
Authors: Sheng Yan , Sun Wen , Shen Ye 
Published: August 2019

Abstract

Rationale:
Macular hole (MH) is a rare complication of Terson syndrome. Delayed closure of persistent MH after pars plana vitrectomy (PPV) is occasionally reported in literature, none of them is MH secondary to Terson syndrome. We describe a case of MH secondary to Terson syndrome and delayed closure occurred after PPV, and we also study the characteristics of delayed closure of persistent MH by reviewing related literatures.

Patient concerns:
A 61-year-old man presented with vitreous hemorrhage in right eye following a subarachnoid hemorrhage due to spontaneous rupture of his right vertebral artery dissecting aneurysm. The visual acuity was hand motion in the right eye and 20/30 in the left eye. Fundus examination showed dense and diffuse vitreous hemorrhage in the right eye.

Diagnoses:
Terson syndrome was diagnosed according to his subarachnoid hemorrhage history and vitreous hemorrhages in right eye.

Interventions:
PPV combined with phacoemulsification and intraocular lens implantation was performed in his right eye, and internal limiting membrane (ILM) peeling was also performed due to a MH noted during the surgery.

Outcomes:
One week after PPV, optical coherence tomography (OCT) showed a persistent MH. Without any intervention, the MH became smaller and flattened, with the best corrected visual acuity (BCVA) improved to 30/200 at 1 month after surgery. Six months later, the MH completely closed with BCVA improved to 20/40. According to our literature review, there are 8 cases of the delayed MH closure, which includes idiopathic MH (4 eyes), traumatic MH (2 eyes), and vitreomacular traction (2 eyes). There is no report about delayed closure of MH secondary to Terson syndrome. The times for these delayed closure occurred following PPV were ranged from 1 to 28 months. Holes even with obviously raised edges after PPV may spontaneously close, just like the case presented here.

Lessons:
Delayed closure of persistent MH after PPV is rarely reported. The significance of this case is to suggest that similar patients should be monitored carefully by OCT, and additional surgery for the MH may be delayed, since delayed closure is possible. The exact mechanisms of delayed closure of persistent MH still need to be clarified.
Risk factors associated with hepatic osteopathy in HBV related cirrhosis measured by liver stiffness
Authors: Zhang Wei , Gong Hui , Su Zengcun , Zhang Xuping , Cao Shujuan 
Published: August 2019

Abstract
To investigate the differences in bone mineral density between patients with liver cirrhosis and healthy control, and to analyze the risk factors of hepatic osteoporosis in patients with HBV related liver cirrhosis.
A total of 189 patients with liver cirrhosis and 207 health controls were enrolled. The bone mineral density of lumbar spine and femoral neck was examined by dual energy X-ray absorptiometry. −2.0 <T value <−1.0 defined as osteopenia, T value ≤−2.0 defined as osteoporosis.
Bone mineral density in the cirrhotic group was significantly lower than that in the control group (lumbar: 1.02 ± 0.16 vs 1.08 ± 0.13, P < .001; femoral neck: 0.86 ± 0.14 vs 0.91 ± 0.14, P < .001). Both 2 groups showed a tendency that decrease bone density correlated with age and decrease body mass index (BMI). Multivariate correlation analysis showed that women (OR = 6.931, P = .002), age (OR = 1.096, P < .001), low BMI (OR = 0.874, P = .037), and high liver stiffness value (OR = 1.125, P = .046) were independent risk factors for osteopenia and low body weight (OR = 0.934, P = .006) and high liver stiffness value (OR = 1.246, P = .034) were independent risk factors for osteoporosis.
Our study shows that bone mineral density in patients with liver cirrhosis decreased significantly, especially in the elderly and low BMI patient. For HBV-related cirrhosis with risk factors, a regular bone density screening should be given, and timely intervention should be taken into consideration.