bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can MoCA and MMSE Be Interchangeable Cognitive Screening Tools? A Systematic Review
Authors: Siqueira Glória S A , Hagemann Paula de M S , Coelho Daniela de S , Santos Flávia Heloísa Dos , Bertolucci Paulo H F 
Published: September 2018

Abstract

Background and Objectives
Cognitive disorders may be an early sign of neuropsychiatric disorders; however, it remains unclear whether the screening measures are interchangeable. The aim of this study was to contrast the most commonly used screening tools—Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)—for early detection of neurocognitive disorder (NCD).

Research Design and Methods
This study presents a descriptive systematic review and informative literature according to the Cochrane Foundation’s guidelines. The keywords “Mini-Mental State Examination” and “Montreal Cognitive Assessment” were searched in the Web of Science, SciELO, and LILACS databases.

Results
Fifty-one studies were selected including a total sample of 11,870 participants (8,360 clinical patients and 3,510 healthy controls). Most studies were published in the past 5 years using a cross-sectional design, carried out across the world. They were organized by age ranges (18–69 years and 20–89 years), years of schooling, and mental status (with and without mental and behavior disorders). Sixteen of 18 studies had participants aged 18–69 years, and 21 out of 33 studies within the older set suggested that the MoCA is a more sensitive tool for detecting NCD.

Discussion and Implications
Thirty-seven studies suggested that the MoCA is a more sensitive tool for NCD detection because it assesses executive function and visuospatial abilities. Some individuals who demonstrated normal cognitive function on the MMSE had lower performance on the MoCA. However, it seems necessary to establish different cutoffs based on years of schooling to avoid false positives. Future studies should contrast MoCA with other screening tools designed for NCD assessment.
Remodeling Ancestral Phenotypic Plasticity in Local Adaptation: A New Framework to Explore the Role of Genetic Compensation in the Evolution of Homeostasis
Authors: Velotta Jonathan P , Cheviron Zachary A 
Published: September 2018

AbstractPhenotypic plasticity is not universally adaptive. In certain cases, plasticity can result in phenotypic shifts that reduce fitness relative to the un-induced state. A common cause of such maladaptive plasticity is the co-option of ancestral developmental and physiological response systems to meet novel challenges. Because these systems evolved to meet specific challenges in an ancestral environment (e.g., localized and transient hypoxia), their co-option to meet a similar, but novel, stressor (e.g., reductions in ambient pO2 at high elevation) can lead to misdirected responses that reduce fitness. In such cases, natural selection should act to remodel phenotypic plasticity to suppress the expression of these maladaptive responses. Because these maladaptive responses reduce the fitness of colonizers in new environments, this remodeling of ancestral plasticity may be among the earliest steps in adaptive walks toward new local optima. Genetic compensation has been proposed as a general form of adaptive evolution that leads to the suppression of maladaptive plasticity to restore the ancestral trait value in the face of novel stimuli. Given their central role in the regulation of basic physiological functions, we argue that genetic compensation may often be achieved by modifications of homeostatic regulatory systems. We further suggest that genetic compensation to modify homeostatic systems can be achieved by two alternative strategies that differ in their mechanistic underpinnings; to our knowledge, these strategies have not been formally recognized by previous workers. We then consider how the mechanistic details of these alternative strategies may constrain their evolution. These considerations lead us to argue that genetic compensation is most likely to evolve by compensatory physiological changes that safeguard internal homeostatic conditions to prevent the expression of maladaptive portions of conserved reaction norms, rather than direct evolution of plasticity itself. Finally, we outline a simple experimental framework to test this hypothesis. Our goal is to stimulate research aimed at providing a deeper mechanistic understanding of whether and how phenotypic plasticity can be remodeled following environmental shifts that render ancestral responses maladaptive, an issue with increasing importance in our current era of rapid environmental change.
The evolving response of mesopelagic fishes to declining midwater oxygen concentrations in the southern and central California Current
Authors: Koslow J Anthony , Davison Pete , Ferrer Erica , Jiménez Rosenberg S Patricia A , Aceves-Medina Gerardo , Watson William 
Published: September 2018

AbstractDeclining oxygen concentrations in the deep ocean, particularly in areas with pronounced oxygen minimum zones (OMZs), are a growing global concern related to global climate change. Its potential impacts on marine life remain poorly understood. A previous study suggested that the abundance of a diverse suite of mesopelagic fishes off southern California was closely linked to trends in midwater oxygen concentration. This study expands the spatial and temporal scale of that analysis to examine how mesopelagic fishes are responding to declining oxygen levels in the California Current (CC) off central, southern, and Baja California. Several warm-water mesopelagic species, apparently adapted to the shallower, more intense OMZ off Baja California, are shown to be increasing despite declining midwater oxygen concentrations and becoming increasingly dominant, initially off Baja California and subsequently in the CC region to the north. Their increased abundance is associated with warming near-surface ocean temperature, the warm phase of the Pacific Decadal oscillation and Multivariate El Niño-Southern Oscillation Index, and the increased flux of Pacific Equatorial Water into the southern CC.
Mapping of HIE CT terms to LOINC®: analysis of content-dependent coverage and coverage improvement through new term creation
Authors: Peng Paul , Beitia Anton Oscar , Vreeman Daniel J , Loo George T , Delman Bradley N , Thum Frederick , Lowry Tina , Shapiro Jason S 
Published: September 2018

AbstractObjectiveWe describe and evaluate the mapping of computerized tomography (CT) terms from 40 hospitals participating in a health information exchange (HIE) to a standard terminology.MethodsProprietary CT exam terms and corresponding exam frequency data were obtained from 40 participant HIE sites that transmitted radiology data to the HIE from January 2013 through October 2015. These terms were mapped to the Logical Observations Identifiers Names and Codes (LOINC®) terminology using the Regenstrief LOINC mapping assistant (RELMA) beginning in January 2016. Terms without initial LOINC match were submitted to LOINC as new term requests on an ongoing basis. After new LOINC terms were created, proprietary terms without an initial match were reviewed and mapped to these new LOINC terms where appropriate. Content type and token coverage were calculated for the LOINC version at the time of initial mapping (v2.54) and for the most recently released version at the time of our analysis (v2.63). Descriptive analysis was performed to assess for significant differences in content-dependent coverage between the 2 versions.ResultsLOINC’s content type and token coverages of HIE CT exam terms for version 2.54 were 83% and 95%, respectively. Two-hundred-fifteen new LOINC CT terms were created in the interval between the releases of version 2.54 and 2.63, and content type and token coverages, respectively, increased to 93% and 99% (P &lt; .001).ConclusionLOINC’s content type coverage of proprietary CT terms across 40 HIE sites was 83% but improved significantly to 93% following new term creation.
Stereoscopic Surgical Video of Combined Petrosectomy With Virtual Reality Headset: 3-Dimensional Operative Video
Authors: Bernard Florian , Troude Lucas , Laccourreye Laurent , Roche Pierre-Hugues , Fournier Henri-Dominique 
Published: September 2018

Abstract
The use of 3-dimensional (3D) videos allows students to visualize surgical procedures from the perspective of the surgeon without missing the essential parts.
1
This 3D commented video demonstrates the operative technique and surgical nuances of the combined petrosectomy, visualize using virtual reality headsets.
Historically, traditional intradural cisternal routes using suboccipital and pterional approaches have been proposed to remove petroclival tumors.
2-5
It allows rapid identification of neurovascular structures and a short exposure time. However, access to the petroclival region is far, not direct, and requires intradural cerebral retraction.
6

In order to improve the access for tumoral dissection, lateral transpetrosal approaches have been proposed.
7-12
The extradural route shortened the distance to the petroclival region, allows to better preserve the veins, to decrease the cerebral retraction, to interrupt early the tumor vascular supply, and a larger extent of resection.
6
Transpetrosal approaches includes middle fossa approach
8,10
(removing the petrous apex), posterior petrosal approach
9,13,14
(removing of presigmoid retrolabyrinthine bone), and translabyrinthine petrosectomy.
12

A combined petrosectomy may be used to approach larger tumor extending across the clival midline, upward to the tentorium or downward to the lower cranial nerves.
6,10,15,16
Alternatively, according to Nanda, a retro-sigmoid approach may need to be performed to avoid critical draining veins injury.
10,17
Good resection and outcomes are obtained when experienced surgeons use familiar approaches and microsurgical techniques.
10
Recurrent Rathke's Cleft Cysts: Incidence and Surgical Management in a Tertiary Pituitary Center over 2 Decades
Authors: Wedemeyer Michelle A , Lin Michelle , Fredrickson Vance L , Arakelyan Anush , Bradley Daniel , Donoho Daniel A , Hurth Kyle M , Weiss Martin H , Carmichael John D , Zada Gabriel 
Published: September 2018

Abstract

Background
Limited data exist pertaining to outcomes following surgery for recurrent Rathke's cleft cysts (RCC).

Objective
To determine treatment outcomes in patients undergoing reoperation for recurrent or residual RCCs.

Methods
A retrospective analysis of 112 consecutive RCC operations in 109 patients between 1995 and 2017 was conducted.

Results
Eighteen patients underwent 21 RCC reoperations with a mean follow-up of 58 mo. Patient symptoms prior to reoperation included headaches (14, 66.7%) and vision loss (12, 57.1%). Thirteen of 18 patients (72.2%) required hormone supplementation prior to reoperation including 5 with diabetes insipidus (DI). Mean RCC diameter was 16 mm and 76% had suprasellar extension. Compared to index RCC cases, intraoperative cerebrospinal fluid leak repair was more common in reoperation cases (15/21, 71% vs 43/91, 47%, P = .05). There was 1 carotid artery injury without neurological sequelae, and 2 postoperative cerebrospinal fluid (CSF) leaks (9.5%). Rates of transient hyponatremia (3/10, 30% vs 4/91, 4.4%, P = .04) and transient DI (5/10, 50% vs 17/91, 18.7%, P = .04) were higher in the reoperation vs index group. Improved headaches and vision were reported in 4/12 (33%) and 8/12 (61.5%) of RCC reoperation patients, respectively. Two patients developed new permanent DI. A higher proportion of reoperation patients had RCC squamous metaplasia (24% vs 5.4%, P = .02) or wall inflammation (42.9% vs 2.2%, P < .001) on pathological examination.

CONCLUSION
Reoperation for RCCs is generally safe at tertiary pituitary centers and often results in improved vision. Hypopituitarism is less likely to improve following reoperation for recurrent RCCs. Several histopathological features may help characterize “atypical RCCs” with a higher likelihood of recurrence/progression.
Next-Generation Robotic Spine Surgery: First Report on Feasibility, Safety, and Learning Curve
Authors: Khan Asham , Meyers Joshua E , Siasios Ioannis , Pollina John 
Published: September 2018

Abstract

Background
Pedicle screw placement is a commonly performed procedure. Robot-guided screw placement is a recent technological advance that has shown accuracy and reliability with first-generation platforms.

Objective
To report our initial experience with the safety, feasibility, and learning curve associated with pedicle screw placement utilizing next-generation robotic guidance.

Methods
A retrospective chart review was conducted to obtain data for 20 patients who underwent lumbar pedicle screw placement under robotic guidance after undergoing interbody fusion for lumbar spinal stabilization for degenerative disc disease with or without spondylolisthesis. The newest generation Mazor X (Mazor Robotics Ltd, Caesarea, Israel) was used. Accuracy of screw placement was determined to be grade I to IV. Grade I was in the pedicle (no breach/deviation), grade II was breach < 2 mm, grade III was breach 2 to 4 mm, and grade IV was breach >4 mm; breach direction (superior, lateral, inferior, or medial) was also recorded.

Results
Twenty patients underwent robotically assisted pedicle screw placement of 75 screws at 24 levels. Seventy-four screw placements (98.7%) were grade I; 1 (1.3%) was grade II (medial). No complications occurred. Mean time for screw insertion was 3.6 min. Mean fluoroscopy time was 13.1 s and mean radiation dose was 29.9 mGy.

CONCLUSION
We found that next-generation robotic spine surgery was safe and feasible with reliable and precise accuracy and a minimal learning curve. As this technology improves, further novel applications are expected to develop. Further research is needed to determine long-term efficacy.
Increased Osteoblastic Activity Suppressed Proliferation of Multiple Myeloma Plasma Cells
Authors: Cho Yoo-Kyung , Kim Sang-Il , Ha Kee-Yong , Kim Young-Hoon , Park Hyung-Youl , Min Chang-Ki 
Published: September 2018

Study Design.

In vitro experimental study.

Objective.
To investigate the impact of increased osteoblastic activity on the proliferation and survival of multiple myeloma (MM) plasma cells in vitro

Summary of Background Data.
MM is one of representative hematologic malignancies that cause skeletal-related events (SREs) and dysregulation of bone remodeling is known as a key pathomechanism of disease progression and skeletal-related events. However, decreased proliferation of MM at fracture sites is frequently noted in clinical situations regardless of systemic disease activity.

Methods.
Co-culture under various conditions was used to investigate effects of increased osteoblastic activity on survival and proliferation of MM plasma cells. MM plasma cells were cultured in culture media (control) and co-cultured with human mesenchymal stem cells (hMSCs, group I), osteoblasts (OBs) induced from hMSCs (group II) or bone morphogenic protein-2 (BMP-2, group III). Proliferation measured as extracellular signal-regulated kinase (ERK) and immunoglobulin G (Ig G) expression and apoptosis measured as fluorescence-activated cell sorting (FACS) with annexin V method, caspase-3, and stat-3 expression were assessed for cultured MM plasma cells, along with expression of sclerostin.

Results.
After 72 hours of co-culture, group II and III showed decreased ERK expression compared with controls. Lower Ig G expression was also noted for groups II and III compared with controls. Group I did not show significantly decreased Ig G and ERK expression compared with controls. Expressions of caspase-3 in groups II and III were higher than controls. Co-culture with hMSCs showed decreased caspase-3 expression compared with control. FACS with annexin V showed higher apoptosis in groups II and III. Sclerostin expression was also decreased in osteoblastic conditions compared with the control and hMSCs co-culture condition.

Conclusion.
Collectively, our data suggest that increased osteoblastic conditions may provide not only prevention of SREs but also anti-tumor effects on MM cells in the bone marrow environment.

Level of Evidence: N/A
Does Extension Dysfunction Affect Postoperative Loss of Cervical Lordosis in Patients Who Undergo Laminoplasty?
Authors: Lee Su Hun , Son Dong Wuk , Lee Jun Seok , Sung Soon Ki , Lee Sang Weon , Song Geun Sung 
Published: September 2018

Study Design.
Retrospective study.

Objective.
To investigate whether loss of cervical lordosis (LCL) after laminoplasty can be predicted from specific preoperative dynamic radiograph measurements.

Summary of Background Data.
Recent studies have focused on the correlation between LCL after laminoplasty and T1 slope. These studies explain this correlation through the injury of the posterior neck muscular-ligament complex (PMLC); however, this muscle injury model could not explain the less kyphotic change in high T1s patients, as reported in some studies as controversy. We have focused on the PMLC constriction reservoir which was represented by extension function (EF).

Methods.
We retrospectively analyzed 50 consecutive patients who underwent open-door laminoplasty (>1-year follow-up). EF is defined as extension C2–7 Cobb angle (CA) minus neutral C2–7 CA (Ext CA – CA). LCL is defined as follow-up CA minus preoperative CA (CA [FU] – CA [PRE]), and significant kyphotic change was defined as LCL smaller than –10°.

Results.
The distribution of LCL was –3.70 ± 7.98 and the significant kyphotic change occurred in 20% of the patients (10/50). EF, C2–7 sagittal vertical axis (PRE), and C2 slope (PRE) were found to be risk factors for LCL by multiple linear regression analysis. The receiver operating characteristic curve analysis revealed that EF could predict the significant kyphotic change well than previously known risk factors. The cutoff value of EF was 14°. No significant kyphotic change occurred at EF greater than or equal to 14°. Upon limiting the number of patients with preoperative straight curvature (n = 28), there is also no significant kyphotic change occurred in any patient whose EF was greater than or equal to 14°.

Conclusion.
In our study sample, we found that there is no relation between T1 slope and LCL. We have identified a new factor, EF, that could predict LCL after laminoplasty. No significant kyphotic changes after laminoplasty occurred particularly when the EF was greater than or equal to 14°.

Level of Evidence: 3
What are the Demographics and Epidemiology of Legg-Calvé-Perthes Disease in a Large Southern California Integrated Health System?
Authors: Kessler Jeffrey I. , Cannamela Peter C. 
Published: September 2018

Abstract

Background
Although many authors have reported the incidence of Legg-Calvé-Perthes disease (LCPD), there have been few incidence studies in the United States on large, self-contained populations such as those within an integrated health system. Understanding the epidemiology and demographics of LCPD in this setting may help clinicians identify patients at the greatest risk and aid in diagnosis and subsequent treatment.

Questions/purposes
In this study we sought (1) to determine the incidence and demographics of LCPD in a large cohort of children and adolescents in a Southern California integrated healthcare system, and (2) to identify any demographic or clinical factors (such as age, sex, race/ethnicity, or BMI) that are independently associated with LCPD.

Methods
A retrospective chart analysis was done on patients diagnosed with LCPD within our integrated healthcare system in patients aged 2 to 12 years over a 3-year period between 2010-2012. There were nearly 800,000 children in this cohort. Patient demographics were recorded; the incidence of LCPD was determined for the entire group and by sex, age, and race/ethnicity. Odds ratios for an association with LCPD based on age, sex, BMI and race/ethnicity were determined using logistic regression models.

Results
The LCPD incidence per 100,000 for all children was 2.84, with the highest incidence in 2- to 5-year-old children (3.05; 95% CI, 1.51-4.59) and the lowest in 9- to 12-year-old children (1.06; 95% CI, 0.21-1.91). Incidence varied markedly among ethnicities, with the highest incidence in whites (5.69; 95% CI, 3.13-8.24) and the lowest in Asians (0.78; 95% CI, 0.00-2.32). Data analysis revealed a 3.13-times increased odds ratio (OR) of LCPD in 2- to 5-year-old patients versus 9- to 12-year-olds (p = 0.011), and boys had a 12.44 times greater OR of LCPD than girls (p < 0.001). Data analysis showed an increased OR for LCPD (3.41; 95% CI, 1.28-9.09) in patients with extreme obesity (BMI-for-age ≥ 1.2 × 95th percentile or a BMI ≥ 35 kg/m2) compared with patients with a normal BMI.

Conclusions
Our study of a large integrated healthcare system in Southern California revealed an increased association of male sex and young age (2 to 5 years old) with LCPD. The overall incidence was lower overall than previously reported, although the incidence seen in white patients was similar to that in prior studies. The finding that patients with extreme obesity may have an increased association with LCPD merits further study. These findings may increase providers’ awareness of the risk of the disease in younger patients and in extremely obese patients, and it also merits further future investigation as to whether there is a cause or effect relationship between extreme obesity and LCPD.

Level of Evidence
Level IV, prognostic study.
Relevance of Swept-Source Anterior Segment Optical Coherence Tomography for Corneal Imaging in Patients With Flap-Related Complications After LASIK
Authors: Abdelazeem Khaled , Sharaf Mohamed , Saleh Mohamed G. A. , Fathalla Ahmed M. , Soliman Wael 
Published: September 2018

Purpose:
To evaluate the role of swept-source anterior segment optical coherence tomography (AS-OCT) in the diagnosis and management of laser in situ keratomileusis (LASIK) flap-related complications.

Methods:
This prospective study included 25 eyes with LASIK flap-related complications imaged using swept-source AS-OCT between February and August 2016 at Alforsan Eye Centre, Assiut, Egypt. The images were acquired using a 6-mm line scan.

Results:
Imaging of flap-related LASIK complications using AS-OCT revealed specific and nonspecific findings. Of note, epithelial ingrowth appeared as highly reflective lesions below the LASIK flap in the form of islands, nests, or a continuous sheet with or without changes in the overlying flap. Macrostriae manifested as dome-shaped irregularities on the stromal surface with regular overlying epithelium, whereas microstriae appeared as corrugations on the stromal surface with regular overlying epithelium. Less common complications included multiple flap macrostriae accompanied by a traumatic folded flap with a flap edge at the interface. Interface debris appeared as a highly reflective interface lesion with or without a surrounding reaction. One eye with a flap that was torn and lost intraoperatively showed epithelialization over a thin residual stroma underlying a contact lens with no stromal infiltration on the second postoperative day. AS-OCT was useful for the assessment of flap thickness and planning of the new flap thickness in the event of an incomplete cut.

Conclusions:
Swept-source AS-OCT is useful not only for diagnosis but also for management of eyes with LASIK flap-related complications by allowing noninvasive, noncontact, real-time acquisition of cross-sectional AS images.