bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural History of Cervical Degenerative Spondylolisthesis
Authors: Park Moon Soo , Moon Seong-Hwan , Oh Jae Keun , Lee Ho Won , Riew K. Daniel 
Published: June 2018

Study Design.
Retrospective observational and case-control study.

Objective.
To determine the risk factors for progression of degenerative listhesis by comparing patients with and without progression at greater than 5-year follow-up.

Summary of Background Data.
The previous study with 2- to 7-year follow-up showed that degenerative spondylolisthesis of the cervical spine did not progress. Longer-term follow-up may reveal that these patients actually do progress over time.

Methods.
We identified 218 patients with greater than 5-year follow-up without surgery. They were categorized as either having or not having cervical spondylolisthesis. We defined spondylolisthesis as the presence of greater than 2 mm of translation in standing neutral lateral radiographs of the cervical spine at the initial evaluation. The control group at baseline was those without spondylolisthesis. Progression of translation was defined as greater than 2 mm of additional translation on the final standing neutral radiograph.

Results.
The mean follow-up duration was 6.4 ± 1.0 years (range: 5–9.4 yr). Progression of translation was found in 20 patients (9.2%), including 4 patients in the spondylolisthesis group and 16 patients in the control group. Progression of translation was not related to the presence of spondylolisthesis or the severity of translation at the initial evaluation, but was more common in the elderly and in the patients with anterior translation than those with posterior translation at the initial evaluation. In addition, progression of spondylolisthesis was not correlated with any change of symptoms.

Conclusion.
Progression of cervical spondylolisthesis is not related to the presence of spondylolisthesis at baseline.

Level of Evidence: 4
A Technique for Dynamic Cervical Magnetic Resonance Imaging Applied to Cervical Spondylotic Myelopathy
Authors: Pratali Raphael R. , Smith Justin S. , Ancheschi Bruno C. , Maranho Daniel A. , Savarese Aniello , Nogueira-Barbosa Marcello H. , Herrero Carlos Fernando P.S. 
Published: June 2018

Study Design.
Cross-sectional study.

Objective.
To evaluate morphometric variations of the cervical spine in patients with cervical spondylotic myelopathy (CSM) using a standard technique of dynamic magnetic resonance imaging (MRI), to assess the inter- and intraobserver reliability of measurements of morphometric parameters based on this imaging, and to compare the resulting measurements with those previously published.

Summary of Background Data.
Because dynamic factors may contribute to the etiology and severity of CSM, dynamic (flexion-extension) MRI may be useful to better evaluate for spinal stenosis and cord compromise.

Methods.
Dynamic cervical MRI was obtained using a standard protocol with the neck in neutral, flexion, and extension positions. The morphometric parameters considered were anterior length of the spinal cord (ALSC), posterior length of the spinal cord (PLSC), spinal canal diameter, and spinal cord width. Two observers analyzed the parameters independently, and the inter- and intraobserver reliabilities were assessed by the intraclass correlation coefficient (ICC).

Results.
A total of 18 patients were included in the study and all completed the dynamic MRI acquisition protocol. The inter- and intraobserver reliabilities demonstrated “almost perfect agreement” (ICC >0.9, P < 0.001) for ALSC and PLSC in all positions. The spinal canal diameter had inter- and intraobserver reliability classified as “almost perfect agreement” (ICC: 0.83–0.98, P < 0.001 and ICC: 0.90–0.99, P < 0.001, respectively) in all positions. The spinal cord width had inter- and intraobserver reliability classified as “substantial agreement” (ICC: 0.73–0.94, P < 0.001 and ICC: 0.79–0.96, P < 0.001, respectively) in all positions. ALSC and PLSC in neutral, flexion, and extension positions from the present study were significantly greater compared to the measurements previously published (P < 0.001).

Conclusion.
The dynamic MRI protocol presented was safe and may allow a more complete evaluation of variations in the cervical spine in patients with CSM than traditional MRI protocols. The morphometric parameters based on this protocol demonstrated excellent inter- and intraobserver reliabilities.

Level of Evidence: 4
Effects of Childhood Life Events on Adjustment Problems in Adolescence: A Longitudinal Study
Authors: Koechlin Helen , Donado Carolina , Berde Charles B. , Kossowsky Joe 
Published: June 2018

ABSTRACT:

Objectives:
Stressful life events (SLEs) have been associated with adjustment problems in adolescence (APA) in cross-sectional studies. Using a longitudinal cohort, we examined the influence of these events and predefined covariates on APA and compared internalizing and externalizing trajectories among children with many versus few SLEs.

Methods:
Data were obtained from the Study of Early Child Care and Youth Development. One thousand three hundred sixty-four children and their families were followed from child's birth until age 15 years. Adjustment problems at age 15 years were defined as high (>60 T-score) internalizing and/or externalizing problems on the Youth Self-Report and Child Behavior Checklist. Stressful life events were evaluated at 54 months, and third and fifth grade. Categories created by mixture model analyses for covariates were used in logistic regressions to predict adjustment problems.

Results:
Mothers reported higher rates of adjustment problems than adolescents (21.1% vs 16.3%; p < 0.0001). Adjustment problems were associated with more SLEs (odds ratio [OR] = 1.7; p = 0.0042), male sex (OR = 1.9; p = 0.001), child's high emotional reactivity (OR = 1.6; p = 0.01), and paternal depression (OR = 2.1; p = 0.0165). Analysis using the mother's report of adjustment problems showed the same predictors, as well as lower maternal education level (OR = 3.5; p = 0.0003), and child's friendship quality (OR = 0.4; p = 0.005). Higher internalizing and externalizing T-scores were apparent in children with more SLEs from 2 years of age onward (ps < 0.0001).

Conclusion:
After adjusting for multiple covariates, SLEs during childhood predicted adjustment problems. Our results suggest that emotional reactivity and paternal depression play a role in the development of APA.
Revisional and Reconstructive Surgery for Failing IPAA is Associated with Good Function and Pouch Salvage in Highly Selected Patients
Authors: Lightner Amy L. , Shogan Benjamin D. , Mathis Kellie L. , Larson David W. , Duchalais Emilie , Pemberton John H. , Dozois Eric J. 
Published: June 2018

BACKGROUND:
Revisional and reconstructive surgery for IPAA is rare given the high success of pouch surgery for chronic ulcerative colitis. Limited data exist on both surgical and functional outcomes in patients with chronic ulcerative colitis who undergo IPAA revision or reconstruction.

OBJECTIVE:
This study aimed to determine the surgical and functional outcome in patients with chronic ulcerative colitis who undergo IPAA revision or reconstruction.

DESIGN:
A prospectively collected surgical database was accessed for this study.

SETTING:
This study was conducted at an IBD referral center.

PATIENTS:
Patients with chronic ulcerative colitis who underwent IPAA revision or reconstruction were selected.

MAIN OUTCOME MEASURES:
The primary outcomes measured were 30-day postoperative outcomes and long-term pouch function.

RESULTS:
Eighty-one patients were identified. Original IPAA was performed for chronic ulcerative colitis (n = 71; 88%) and indeterminate colitis (n = 11; 12.%), and the most common configuration was a J-pouch (n = 69; 86%) with handsewn anastomosis (n = 41;68%). No independent predictors of 30-day postoperative complications following reconstructive/revisional surgery were identified. Pelvic abscesses and Crohn’s disease of the pouch were independently associated with ultimate pouch excision. Median follow-up following revision/reconstruction was 40 months (range, 1–292 months) during which 15 patients (23%) had pouch failure. The 5- and 10-year pouch survival rates following revision were 85 ± 5% and 65 ± 9% by Kaplan-Meier estimation; age <30 years was significantly associated with pouch survival. Long-term function (n = 30; 35%) compared with a matched control cohort of primary IPAA was characterized by significantly increased daytime bowel incontinence (p = 0.0119), liquid stool (p = 0.0062), and medication to thicken stools (p = 0.0452).

LIMITATIONS:
This was a single-center series, and response rate for functional data was 35%.

CONCLUSIONS:
In properly selected patients with a failing pouch, originally made for chronic ulcerative colitis or indeterminate colitis, revisional and reconstructive surgery is associated with low complication rates, high pouch salvage, and acceptable long-term pouch function. See Video Abstract at http://links.lww.com/DCR/A640.
The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women
Authors: Moral Eloy , Delgado Juan L. , Carmona Francisco , Caballero Borja , Guillán Cristina , González Paula M. , Suárez-Almarza Javier , Velasco-Ortega Syra , Nieto Magro Concepción 
Published: June 2018

Abstract

Objective:
Symptoms of genitourinary syndrome of menopause (GSM) are bothersome to middle-aged and older women, and affect their quality of life (QoL), sexuality, and daily activities. The objective of the study was to evaluate the impact of vaginal symptoms and GSM on the well-being, functioning, and QoL of postmenopausal women from Spain.

Methods:
This study involved 423 postmenopausal women participating in the GENISSE study (a multicenter, cross-sectional, descriptive, observational study) who presented at least 1 vaginal symptom. All women completed the “day-to-day impact of vaginal aging” (DIVA) questionnaire. Analysis of total scores and subdomains of the questionnaire were performed in women diagnosed with GSM and those without the condition.

Results:
In these women, the highest mean scores on the DIVA questionnaire were found in the sexual functioning domain long version (mean 1.8; SD 1.0), followed by the sexual functioning domain short version (mean 1.7; SD 1.1), self-perception and body image (mean 1.4; SD 1.1), activities of daily living (mean 0.7; SD 0.8), and emotional well-being (mean 0.7; SD 0.8) scales. A total of 299 women (70.7%) had vaginal symptoms with a diagnosis of GSM, whereas 124 (29.3%) had no GSM diagnosis. Scores on the DIVA questionnaire were significantly higher in women with a diagnosis of GSM than in those without this condition.

Conclusions:
Vaginal symptoms impact the well-being, functioning, and QoL of postmenopausal women, especially sexual function, self-perception, and body image. This impact is significantly higher in women with GSM. Identifying and treating patients affected by vaginal symptoms and GSM may be beneficial for improving their QoL.
Zumba Fitness and Women's Cardiovascular Health
Authors: Cugusi Lucia , Manca Andrea , Bergamin Marco , Di Blasio Andrea , Yeo Tee Joo , Crisafulli Antonio , Mercuro Giuseppe 
Published: June 2018

Purpose:
Zumba fitness (ZF) is a well-known exercise program involving dance and fitness. Despite its increasing popularity, no analysis has been conducted on studies focusing on the cardiovascular (CV) profile of women who performed this activity. The aim of this systematic review is to provide insights into the impact of ZF on women's CV health.

Methods:
Five clinical databases were searched. To be included, the articles had to include (1) women with or without CV risk factors (CVRF) and (2) CV-related outcomes resulting from a ZF program.

Results:
Ten studies (322 women; 181 healthy, 141 with CVRF) were included. In healthy women, low absolute effect sizes for maximal oxygen uptake (

JOURNAL/jcprh/04.03/01273116-201905000-00004/4FSM1/v/2023-09-11T074705Z/r/image-gif

o
2max), anthropometric and body composition profile after 8 and 12 wk of ZF were found compared with nonparticipants. Moderate to large absolute effect sizes were recorded for

JOURNAL/jcprh/04.03/01273116-201905000-00004/4FSM1/v/2023-09-11T074705Z/r/image-gif

o
2max and body composition following 40 wk of ZF. Findings proved promising but less consistent for ZF studies involving women with CVRF due to the absence of control groups.

Conclusions:
Data describe ZF as feasible for healthy women and a promising fitness option for those with CVRF. Because of the low quality of the studies on women with CVRF and the overall small sample size along with discrepancies such as the average length of the studies on healthy women, cautious interpretation of the findings is recommended. Further investigations with a standardized design are needed to verify whether ZF may be considered as an alternative fitness option in primary prevention of CV disease in women.
Exertional Oxygen Requirements During Exercise Training in Advanced Interstitial Lung Disease
Authors: Wickerson Lisa , Brooks Dina , Reid W. Darlene , Singer Lianne G. , Granton John , Mathur Sunita 
Published: June 2018

Purpose:
Little is known about the oxygen requirements during physical exertion or exercise in individuals with interstitial lung disease (ILD). This study examined exertional oxygen requirements, the relationships between exertional oxygen use, exercise capacity and aerobic training parameters, and predictors of change in exertional oxygen requirements during pulmonary rehabilitation (PR).

Methods:
A retrospective study of lung transplant candidates with advanced ILD who underwent at least 4 wk of outpatient PR between 2004 and 2014 was undertaken. Data were extracted at baseline, 4 wk, and 6 mo. Exertional oxygen was prescribed during PR to support continuous, moderate-intensity aerobic training.

Results:
The study cohort (n = 375) had a median age of 61 y (55-66 y), were 57% male, and most were diagnosed with idiopathic pulmonary fibrosis (n = 214). A variety of oxygen delivery systems were used and exertional oxygen requirements increased after 4 wk (0.5 [0.4-0.6] vs 0.5 [0.4-0.73], P < .001, n = 375) and 6 mo (0.44 [0.36-0.5] vs 0.5 [0.4-0.55], P < .001, n = 196) of PR. A higher exertional oxygen requirement was associated with lower 6-min walk distance and lower aerobic training intensity at all time points. There were no identified predictors of the change in exertional oxygen requirements.

Conclusions:
Individuals with advanced ILD had high exertional oxygen requirements to participate in moderate-intensity aerobic training, which increased over time. Exertional oxygen needs may affect exercise prescription and response during PR in ILD patients.
Pulmonary Rehabilitation Only Versus With Nutritional Supplementation in Patients With Bronchiectasis
Authors: Doña Esperanza , Olveira Casilda , Palenque Francisco Javier , Porras Nuria , Dorado Antonio , Martín-Valero Rocío , Godoy Ana M. , Espildora Francisco , Olveira Gabriel 
Published: June 2018

Purpose:
Pulmonary rehabilitation (PR) is recommended for bronchiectasis, but there is little evidence of its efficacy in these patients. The aim of this study was to assess the effect of PR in normally nourished patients with noncystic fibrosis bronchiectasis compared with the effect of PR plus an oral nutritional supplement (PRONS).

Methods:
A single-center randomized controlled trial, parallel treatment design in which participants were randomly assigned to receive PR for 12 wk or PR plus a high-protein nutritional supplement enriched with beta-hydroxy-beta-methylbutyrate. Outcome assessments were performed at baseline, 12 and 24 wk including cardiopulmonary exercise testing, health-related quality of life (HRQOL), bronchorrhea, dyspnea, psychological symptoms, spirometry, and exacerbations.

Results:
Thirty patients were randomized into 2 groups of 15 participants. In both groups, cardiopulmonary exercise testing, HRQOL, dyspnea, and spirometry parameters significantly increased from baseline at 3 and/or 6 mo.

Conclusion:
PR improved exercise capacity, HRQOL, and respiratory parameters. The use of PRONS did not have a significant effect on the results.
Characterizing and Comparing Acute Responses of Blood Pressure, Heart Rate, and Forearm Blood Flow to 2 Handgrip Protocols
Authors: Bentley Danielle C. , Thomas Scott G. 
Published: June 2018

Purpose:
Growing evidence supports handgrip exercise training for reducing resting blood pressure (BP), with inconsistent exercise protocols reported throughout the literature. To verify safety of such protocols, real-time cardiovascular responses must be assessed. Consequently, this research sought to evaluate the acute impact of dissimilar handgrip protocols on the cardiovascular responses of BP, heart rate (HR), and forearm blood flow.

Methods:
Using a randomized intraindividual crossover design, 20 post-menopausal women completed 2 distinct handgrip protocols compared with a nonexercise control: 4 × 2-min sustained grips at 30% moderate intensity with 1-min rest between sets (ZONA), and 32 × 5-sec intermittent grips at maximal intensity with 5-sec rest between sets (MINT). Cardiovascular responses were measured throughout exercise and post-exercise recovery.

Results:
Compared to ZONA, the MINT protocol required less time and less exercise effort, yet caused greater average BP perturbations (systolic, MINT: 16.9 ± 12.9 mm Hg, ZONA: 7.9 ± 11.6 mm Hg; diastolic, MINT: 8.7 ± 7.2 mm Hg, ZONA: 4.5 ± 4.9 mm Hg) (P < .05), with peak BP changes far below published safety guidelines. Average HR responses were similarly elevated between protocols (MINT: 5.4 ± 4.9 beats/min, ZONA: 3.4 ± 3.6 beats/min). Post-exercise recovery of BP and HR occurred swiftly following MINT while remaining elevated following ZONA.

Conclusions:
Handgrip exercise protocols with distinct design features (ie, grip intensity, grip strategy, and exercise duration) cause dissimilar acute cardiovascular responses. Careful and controlled attention should be directed toward determining how such acute dissimilarities influence corresponding training outcomes. Given the confirmed safety of acute BP perturbations, future researchers can have confidence in prescribing even the high-intensity MINT protocol for at-home, unsupervised activity.
Advancing theory on the multilevel role of leadership in the implementation of evidence-based health care practices
Authors: Guerrero Erick G. , Frimpong Jemima , Kong Yinfei , Fenwick Karissa , Aarons Gregory A. 
Published: June 2018

Background:
Top managers’ transformational leadership is associated with significant influence on subordinates. Yet little is known about the extent to which top managers’ transformational leadership influences middle managers’ implementation leadership and, ultimately, frontline staff delivery of evidence-based health care practices.

Purpose:
To test a multilevel leadership model examining the extent to which top managers’ transformational leadership, as mediated by implementation leadership of middle managers (i.e., those who supervise direct clinical services), affects staff attitudes toward evidence-based practices (EBPs) and their implementation.

Methodology/Approach:
We used data collected in 2013 from 427 employees in 112 addiction health services programs in Los Angeles County, California. We relied on hierarchical linear models with robust standard errors to analyze multilevel data, individuals nested in programs. We conducted two path models to estimate multilevel relationships with two EBPs: contingency management and medication-assisted treatment.

Results:
Findings partially supported our theory-driven multilevel leadership model. Specifically, results demonstrated that middle managers’ implementation leadership mediated the relationship between top managers’ transformational leadership and attitudes toward EBPs. At the same time, they showed the mediated relationship for delivery of contingency management treatment was only marginally significant (standardized indirect effect = .006, bootstrap p = .091). We did not find a mediation effect for medication-assisted treatment.

Discussion:
Findings advance leadership theory in health care, highlighting the importance of middle managers’ implementation leadership in transmitting the influence of top managers’ transformational leadership on staff attitudes toward EBPs. The full path model shows the extent to which transformational leadership may influence staff implementation of innovative practices as mediated through staff attitudes toward EBPs and middle managers’ implementation leadership.

Practice Implications:
Our findings have implications for developing a multilevel leadership approach to implementation in health care. Leadership development should build on different competencies based on managers' level but align managers' priorities on the same implementation goals.
DECREASED RETINAL CAPILLARY DENSITY IS ASSOCIATED WITH A HIGHER RISK OF DIABETIC RETINOPATHY IN PATIENTS WITH DIABETES
Authors: Czakó Cecília , Sándor Gábor , Ecsedy Mónika , Récsán Zsuzsa , Horváth Hajnalka , Szepessy Zsuzsanna , Nagy Zoltán Zsolt , Kovács Illés 
Published: June 2018

Purpose:
To quantify retinal microvascular alterations using optical coherence tomography angiography in diabetic patients, and to evaluate the accuracy of decreased vessel density (VD) in predicting early diabetic retinopathy (DR).

Methods:
One hundred and two eyes of 51 diabetic patients and 92 eyes of 46 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA1C, dyslipidemia, axial length, and the presence of DR were recorded. Retinal VD was measured using optical coherence tomography angiography. The effect of risk factors on VD and on DR was assessed using multivariable regression analyzes.

Results:
Compared with controls, VD was lower in diabetic patients (P < 0.05) and correlated with diabetes duration (P = 0.02). Decreased VD was associated with a higher risk of DR (odds ratio: 1.24, P = 0.009) after controlling for systemic and ocular confounding variables. Eyes with a VD of <50% had an odds ratio of 4.55 (P = 0.003) for DR and an odds ratio of 3.22 (P = 0.03) for decreased visual acuity (<20/25) after controlling for systemic and ocular confounding factors.

Conclusion:
The risk of DR and vision loss is substantially higher in eyes with lower VD, suggesting that optical coherence tomography angiography metrics may serve as prognostic biomarkers for the prediction of early onset DR.
Analysis of SmartPlug Insertion–Related Complications
Authors: Huang Chien-Jung , Lu Chia-Ju , Tu Wen-Hui , Hou Yu-Chih , Wang I-Jong , Hu Fung-Rong , Chen Wei-Li 
Published: June 2018

Purpose:
To evaluate the complications and the treatment results of SmartPlug-related complications.

Methods:
Retrospective review of all patients from a single medical hospital who received SmartPlug (Medennium, Inc., Irvine, CA) insertions from October 2007 to February 2014. All patients who developed SmartPlug-related canaliculitis and pyogenic granuloma were analyzed. Lacrimal irrigation with antibiotics was performed in most patients.

Results:
Six hundred thirty-one eyes received SmartPlug insertion and 18 eyes developed SmartPlug-related complications (14 canaliculitis and 4 pyogenic granuloma). The mean time interval from insertion to development of the complications is 3.0 (0.5–6.9) years. Sixteen eyes received lacrimal irrigation with antibiotics, and all the eyes showed improvement without recurrence. The other two eyes had recurrence of granuloma pyogenica only after surgical excision.

Conclusions:
SmartPlug-related complications, including canaliculitis and granuloma pyogenica, required long-term follow-up. Most of the complications can be cured by lacrimal irrigation of antibiotics.