bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting the Occurrence of Postoperative Distal Junctional Kyphosis in Cervical Deformity Patients
Authors: Passias Peter G , Horn Samantha R , Oh Cheongeun , Lafage Renaud , Lafage Virginie , Smith Justin S , Line Breton , Protopsaltis Themistocles S , Yagi Mitsuru , Bortz Cole A , Segreto Frank A , Alas Haddy , Diebo Bassel G , Sciubba Daniel M , Kelly Michael P , Daniels Alan H , Klineberg Eric O , Burton Douglas C , Hart Robert A , Schwab Frank J , Bess Shay , Shaffrey Christopher I , Ames Christopher P ,   On behalf of The International Spine Study Group
Published: August 2019

ABSTRACT

BACKGROUND
Distal junctional kyphosis (DJK) development after cervical deformity (CD)-corrective surgery is a growing concern for surgeons and patients. Few studies have investigated risk factors that predict the occurrence of DJK.

OBJECTIVE
To predict DJK development after CD surgery using predictive modeling.

METHODS
CD criteria was at least one of the following: C2-C7 Coronal/Cobb > 10°, C2-7 sagittal vertical axis (cSVA) > 4 cm, chin-brow vertical angle > 25°. DJK was defined as the development of an angle <−10° from the end of fusion construct to the second distal vertebra, and change in this angle by <−10° from baseline to postoperative. Baseline demographic, clinical, and surgical information were used to predict the occurrence of DJK using generalized linear modeling both as one overall model and as submodels using baseline demographic and clinical predictors or surgical predictors.

RESULTS
One hundred seventeen CD patients were included. At any postoperative visit up to 1 yr, 23.1% of CD patients developed DJK. DJK was predicted with high accuracy using a combination of baseline demographic, clinical, and surgical factors by the following factors: preoperative neurological deficit, use of transition rod, C2-C7 lordosis (CL)<−12°, T1 slope minus CL > 31°, and cSVA > 54 mm. In the model using only baseline demographic/clinical predictors of DJK, presence of comorbidities, presence of baseline neurological deficit, and high preoperative C2-T3 angle were included in the final model (area under the curve = 87%). The final model using only surgical predictors for DJK included combined approach, posterior upper instrumented vertebrae below C4, use of transition rod, lack of anterior corpectomy, more than 3 posterior osteotomies, and performance of a 3-column osteotomy.

CONCLUSION
Preoperative assessment and consideration should be given to these factors that are predictive of DJK to mitigate poor outcomes.
Practice Patterns of Infectious Diseases Physicians in Transitioning From Intravenous to Oral Therapy in Patients With Bacteremia
Authors: Hospenthal Duane R , Waters C Dustin , Beekmann Susan E , Polgreen Philip M 
Published: August 2019

AbstractBackgroundBacteremia in adult patients has traditionally been treated with extended courses of intravenous antibiotics. Data on the use of (or rapid transition to) oral therapy are limited.MethodsAdult infectious disease physicians participating in the Infectious Diseases Society of America Emerging Infections Network (EIN) were surveyed regarding their use of oral antibiotics in patients with bacteremia. Respondents were asked to assume that patients were hemodynamically stable, recovered bacteria were susceptible to potential antibiotics, adequate source control had been achieved, and patients had adequate gastrointestinal absorption. Variables of specific bacteria, oral agent, and associated infection were included.ResultsA total of 655 (50%) of 1321 EIN participants responded. Under certain conditions, 88% would transition patients with Gram-negative bacteremia to complete a course of therapy with oral antibiotics; 71% would transition patients with Gram-positive bacteremia to oral agents. Only 78 (12%) respondents would not treat any bacteremic patient with oral agents. Most respondents (≥75%) were comfortable treating infections secondary to Enterobacteriaceae, Salmonella, Pseudomonas, Stenotrophomonas, Streptococcus pneumoniae, and β-hemolytic streptococci with oral agents. Fewer than 20% endorsed use of oral antibiotics for Staphylococcus aureus or in cases of endocarditis. Fluoroquinolones and trimethoprim-sulfamethoxazole were the preferred agents in Gram-negative bacteremia; linezolid and β-lactams were the preferred agents in Gram-positive bacteremia.ConclusionsIn select circumstances, the majority of respondents would transition patients to oral antibiotics, in both Gram-negative and Gram-positive bacteremia. Most agreed with the use of oral agents in Gram-negative bacteremia caused by Enterobacteriaceae, but they would not use oral agents for Gram-positive bacteremia caused by S aureus or in endocarditis.
Revenge of the Steamroller: ABCP as a Window on Risk Choices*
Authors: Arteta Carlos , Carey Mark , Correa Ricardo , Kotter Jason 
Published: August 2019

Abstract
We use credit-arbitrage asset-backed commercial paper vehicles as a laboratory to empirically examine financial institutions’ motivations to take bad-tail systematic risk. By comparing the characteristics of global banks that sponsored credit-arbitrage vehicles prior to the global financial crisis to those that did not, we show that owner–manager agency problems, government safety nets, and government ownership of banks are associated with bad-tail systematic risk-taking. Although good governance is associated with less risk-taking on average, well-governed banks that also have a high ex ante expectation of being bailed out by the government take more risk. Lastly, we find mixed evidence that tougher bank capital regulation deters bad-tail risk-taking.
Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial
Authors: Thompson Jeffrey , Long Mitchell , Rogers Eloise , Pesso Raymond , Galos David , Dengenis Rhyne Champ , Ruotolo Charles 
Published: August 2019

Objectives:
To determine the efficacy of a preoperative fascia iliaca compartment block in decreasing postoperative pain and improving functional recovery after hip fracture surgery.

Design:
Randomized prospective Level 1 therapeutic.

Setting:
Academic Level 1 trauma center.

Patients:
Geriatric patients with fractures of the proximal femur (neck, intertrochanteric, or subtrochanteric regions) were prospectively randomized into an experimental (A) or control (B) groups. Forty-seven patients met inclusion criteria, 23 randomized to the experimental group and 24 to the control group.

Intervention:
Patients randomized to the experimental group received an ultrasound-guided fascia iliaca compartment block administered by a board-certified anesthesiologist immediately before the initiation of anesthesia.

Main Outcome Measurements:
Primary outcome measure was postoperative pain medication consumption until postoperative day 3. Secondary outcomes included functional recovery and a study-specific patient-reported satisfaction survey assessed on postoperative day 3.

Results:
There was no significant difference in consumption of acetaminophen for mild pain, tramadol for moderate pain, or functional recovery between the 2 groups. There was a statistically significant decrease in morphine consumption (0.4 mg vs. 19.4 mg, P = 0.05) and increase in patient-reported satisfaction (31%, P = 0.01).

Conclusions:
Preoperative fascia iliaca compartment block significantly decreases postoperative opioid consumption while improving patient satisfaction. We recommend the integration of this safe and efficacious modality into institutional geriatric hip fracture protocols as an adjunctive pain control strategy.

Level of Evidence:
Therapeutic Level II See Instructions for Authors for a complete description of levels of evidence.
The Effects of Diabetes and Diabetic Medications on Bone Health
Authors: Elamir Yasmine , Gianakos Arianna L. , Lane Joseph M. , Sharma Anupa , Grist William P. , Liporace Frank A. , Yoon Richard S. 
Published: August 2019

Summary:
The incidence and prevalence of diabetes continues to increase, and proper understanding of the adverse effects on bone metabolism is important. This review attempts to discuss the pathophysiology of the effects of diabetes and diabetic medications on bone metabolism and bone health. In addition, this review will address the mechanisms resulting in increased fracture risk and delayed bone healing to better treat and manage diabetic patients in the orthopedic clinical setting.
Source-Apportioned PM2.5 and Cardiorespiratory Emergency Department Visits
Authors: Pennington Audrey Flak , Strickland Matthew J. , Gass Katherine , Klein Mitchel , Sarnat Stefanie Ebelt , Tolbert Paige E. , Balachandran Sivaraman , Chang Howard H. , Russell Armistead G. , Mulholland James A. , Darrow Lyndsey A. 
Published: August 2019

Background:
Despite evidence suggesting that air pollution-related health effects differ by emissions source, epidemiologic studies on fine particulate matter (PM2.5) infrequently differentiate between particles from different sources. Those that do rarely account for the uncertainty of source apportionment methods.

Methods:
For each day in a 12-year period (1998–2010) in Atlanta, GA, we estimated daily PM2.5 source contributions from a Bayesian ensemble model that combined four source apportionment methods including chemical transport and receptor-based models. We fit Poisson generalized linear models to estimate associations between source-specific PM2.5 concentrations and cardiorespiratory emergency department visits (n = 1,598,117). We propagated uncertainty in the source contribution estimates through analyses using multiple imputation.

Results:
Respiratory emergency department visits were positively associated with biomass burning and secondary organic carbon. For a 1 µg/m3 increase in PM2.5 from biomass burning during the past 3 days, the rate of visits for all respiratory outcomes increased by 0.4% (95% CI 0.0%, 0.7%). There was less evidence for associations between PM2.5 sources and cardiovascular outcomes, with the exception of ischemic stroke, which was positively associated with most PM2.5 sources. Accounting for the uncertainty of source apportionment estimates resulted, on average, in an 18% increase in the standard error for rate ratio estimates for all respiratory and cardiovascular emergency department visits, but inflation varied across specific sources and outcomes, ranging from 2% to 39%.

Conclusions:
This study provides evidence of associations between PM2.5 sources and some cardiorespiratory outcomes and quantifies the impact of accounting for variability in source apportionment approaches.
Cardiac Rehabilitation in a Rural Setting
Authors: Frechette Kristen M. , Conley Sheila M. , Tang Austin , Welch Terrence D. 
Published: August 2019

Purpose:
The cardiac rehabilitation (CR) program at Dartmouth-Hitchcock Medical Center (DHMC) devotes a nurse to the inpatient units in an attempt to optimize the referral process. This report defines the rates of referral and participation at DHMC and explores potential factors that affect participation.

Methods:
Seven hundred ten consecutive patients who underwent percutaneous coronary intervention, coronary artery bypass grafting, or valve surgery from January 1, 2015 to June 30, 2015 were reviewed to determine whether the patient was referred for CR. Participation rates and the effect of time delay and patient-specific factors on participation were examined.

Results:
Six hundred ninety-eight (98%) of the 710 post-procedural patients were evaluated by the inpatient rehabilitation nurse. One hundred sixty-seven patients were ineligible for outpatient therapy on the basis of established criteria; the remaining 543 patients were referred to DHMC or regional rehabilitation programs. Of those referred to the on-site program at DHMC, 84% participated. Of those referred to regional programs, 60% participated. There was an inverse correlation (r = −0.82; P = .003) between wait times and participation rates for the various programs.

Conclusions:
Despite its rural location with a large geographic catchment area, DHMC achieves high rates of CR referral and participation. The approach used at DHMC, which includes a CR nurse working with the inpatient cardiac services, a strong level of integration with the physician community, and well-developed relationships with regional rehabilitation programs, may be helpful for those programs wishing to improve referral and participation rates. Shorter wait times between hospital discharge and initiation of rehabilitation may improve participation rates.
Expression and function of lncRNA ANRIL in a mouse model of acute myocardial infarction combined with type 2 diabetes mellitus
Authors: Zhang Lin , Wang Yan-Min 
Published: August 2019

Background:
This study intends to explore whether lncRNA ANRIL has an influence on type 2 diabetes mellitus (T2DM) complicated with acute myocardial infarction (MI) and to further investigate the underlying mechanism.

Methods:
The ANRIL level in peripheral blood from patients was detected by qRT-PCR. A T2DM mouse model was established by intraperitoneal injection of streptozocin (STZ). MI was induced by ligation of the left anterior descending coronary artery. Cardiac function parameters were measured using echocardiography. Triphenyltetrazolium chloride (TTC) staining was performed to determine the infarct size, and Masson staining was conducted to delineate the area of fibrosis in the myocardium. TUNEL staining was used to detect myocardial cell apoptosis. The expression of the myocardial fibrosis-related proteins TGF-β1, collagen I and collagen III was analysed using Western blot.

Results:
ANRIL was upregulated in peripheral venous blood from patients with T2DM-MI and in myocardial tissues from the established T2DM-MI model mice. Furthermore, ANRIL overexpression caused cardiac dysfunction and increased the heart/body weight rate and infarct size in the T2DM-MI mice. Moreover, ANRIL overexpression caused myocardial fibrosis and myocardial cell apoptosis, and it increased the expression of the myocardial fibrosis-related proteins TGF-β1, collagen I and collagen III in the T2DM-MI mice. However, ANRIL knockdown exerted the opposite effects.

Conclusion:
ANRIL may be involved in the progression and development of T2DM-MI, which might provide novel ideas for the prevention and treatment of cardiovascular diseases.
Perception of Provision of Futile Care Among Clinicians in the Neuroscience Intensive Care Unit
Authors: Amoroso Shanna , Chalela Julio A. 
Published: August 2019

ABSTRACT

BACKGROUND: Futile care in the neuroscience intensive care unit (NSICU) can create moral distress for clinicians who may differ in their interpretation of the value of such care. We sought to compare the perception of provision of futile care in the NSICU among physicians, advanced practice providers, and intensive care unit registered nurses (ICURNs). METHODS: This is a cross-sectional study of 77 patients. A standardized questionnaire was used to ask clinicians whether care being provided to NSICU patients admitted for more than 48 hours was futile and whether they would want that treatment for their loved one. Demographics, diagnosis, and reason for treatment futility were collected. Futility was analyzed independently and in an aggregate manner (yes/probable combined and no/probable combined). RESULTS: The sample median age was 61 (SD, 17.179) years, men comprised 53% of the sample, and 68% were white. Collectively, there were 77 futile responses (33%), 136 nonfutile (59%), and 18 probable futile (8%). Physicians and nurse practitioners deemed futility in 36% of patients; ICURNs, in 27% (P < .05). Age, race, or diagnosis did not impact futility perception. The treatment was acceptable for a loved one in 53% of cases for physicians, 43% for advanced practice providers, and 48% for ICURNs (P < .05). Interobserver agreement for futility was 0.469 (CK), and pairwise agreement was 71%. Interobserver agreement for treatment acceptable for a loved one was 0.568 (CK), and pairwise agreement was 78%. CONCLUSIONS: Clinicians consider NSICU care futile in one-third of patients, but correlation among them is moderate; no specific variable is associated with such perception.
Electrophysiologic Characteristics of Various Degrees of Selective Outer Hair Cell Loss in Rats
Authors: Huang Wenqin , Chen Shulin , Dong Chang , Li Changwu , Sun Liang , Wang Xianren , Jiang Hongyan 
Published: August 2019

Hypothesis:
The characteristics of auditory brainstem response (ABR), electrocochleogram (ECochG), and distortion product otoacoustic emissions (DPOAE) of different degrees of selective outer hair cells (OHCs) loss may be helpful for clinicians to evaluate the pathogeny, diagnosis, and rehabilitation of individuals’ hearing loss.

Background:
How many OHCs are necessary to maintain cochlear amplifier function remains unknown. The electrophysiologic characteristics may indicate different degrees of OHCs loss.

Methods:
Electrophysiological characteristics were tested using 8-kHz pure-tone stimulus and OHCs counted specifically in the region of the cochlea corresponding to 8-kHz. Rat models of selective OHCs loss were established by injecting kanamycin (KM) at various dosages, and the region of 8-kHz was obtained by 8-kHz pure-tone exposure.

Results:
The ABR thresholds were affected slightly with OHCs loss < 30%, and were increased dramatically with OHCs loss ranging from 30 to 70%, but the thresholds did not increase further when OHCs loss exceeded 70%. As OHCs loss increased, the compound action potential (CAP) amplitude decreased. The CAP amplitude and OHCs loss were negatively correlated. Moreover, the summating potential (SP)/action potential (AP) increased as OHCs loss increased. DPOAE and cochlear microphonics (CM) exhibited reduced amplitudes when OHCs loss < 30%.

Conclusions:
Electrophysiologic characteristics may indicate different degrees of OHCs loss. While OHCs loss > 70%, the cochlear amplification may lose completely, but it is difficult to detect OHCs loss < 30%, because the ABR or DPOAE may reveal “normal” at this level. Moreover, the decreased CAP amplitude or increased SP/AP may be indicators for OHCs loss.
A Prospective Evaluation of Postoperative Opioid Use in Otologic Surgery
Authors: Qian Z. Jason , Alyono Jennifer C. , Woods Ong-Dee , Ali Noor , Blevins Nikolas H. 
Published: August 2019

Objective:
To prospectively evaluate opioid consumption following adult outpatient otologic surgery.

Study Design:
Prospective observational.

Setting:
Single-tertiary referral center.

Patients:
Patients scheduled for otologic surgery who did not have a history of chronic opioid use were recruited between February 2018 and February 2019.

Interventions and Main Outcome Measures:
Opioid consumption was queried using telephone or in-person surveys administered between postoperative days 5 and 15. Patient demographics, surgical details, and opioid prescription patterns were abstracted from medical records. Opioid distribution was determined by querying records maintained by the California Department of Justice through a state-wide prescription drug monitoring program mandated since 2016.

Results:
Seventy patients were prescribed an average of 68.9 ± 31.8 mg of morphine equivalents (MME) and consumed 47.3 ± 42.9 MME over 2.4 ± 2.3 days postoperatively. Patients who received a postauricular incision were prescribed significantly more than those who underwent transcanal procedures (86.2 vs 55.9 MME; t test, p < 0.001), consumed significantly more (72.2 vs 28.6 MME; t test, p < 0.001), and for a significantly longer duration (3.4 vs 1.6 days; t test, p = 0.001). In the postauricular group, there was no significant difference in consumption between mastoidectomy and nonmastoidectomy subgroups (64.9 vs 89.2 MME; t test, p = 0.151). Eighty percent of transcanal patients consumed 50 MME (10 pills) or less, while 80% of postauricular patients consumed 80 MME (16 pills) or less.

Conclusions:
Patients in our cohort consumed approximately 3/4 of the prescribed opioids. Those with postauricular incisions used significantly more than those with transcanal incisions. Postoperative opioid prescription recommendations should be tailored according to the extent of surgery.
The Component Structure of the Dizziness Handicap Inventory (DHI): A Reappraisal
Authors: Van De Wyngaerde Kelly M. , Lee Minji K. , Jacobson Gary P. , Pasupathy Kalyan , Romero-Brufau Santiago , McCaslin Devin L. 
Published: August 2019

Objective.:
The Dizziness Handicap Inventory (DHI) is a 25-item self-report questionnaire developed to measure the disabling and handicapping impact of dizziness. The present investigation was conducted in an effort to re-assess the factor structure of the DHI.

Study Design.:
Retrospective study.

Setting.:
Tertiary care center.

Patients.:
Subjects were 1,991 patients who were evaluated in the Mayo Clinic-Rochester Vestibular and Balance Laboratory.

Main Outcome Measures.:
Exploratory factor analysis: an exploratory bifactor analysis (EFA) with bifactor rotation was used to analyze a random sample of 999 patients. Analyses were used to determine the dominance of the general factor (i.e., total score) relative to the group factor (i.e., subscales). Confirmatory factor analysis: a confirmatory bifactor graded response model was fit with appropriate item-to-group relationships that was discovered by our exploratory analyses. To validate the bifactor model that was identified with the exploratory analyses, a bifactor model with three grouping factors (i.e., Physical manifestations, Catastrophic impact of dizziness, and the Emotional impact of dizziness) were fit to a different random sample of 992 patients using the new item-to-group factor specifications.

Results.:
In the confirmatory analyses, all items had a positive factor loading on the general factor. There were 14 items that loaded on the general factor only. The rest of the items (n = 11) loaded on both the general factor and one of three group factors.

Conclusions.:
Conclusions of the study revealed several findings: 1) reporting the result as a total score (i.e., a single general factor) is warranted, and, 2) there is statistical support for the existence of three subscales representing: the Physical manifestations, Catastrophic impact, and Emotional impact of dizziness and vertigo.
Matched Cohort Comparison Indicates Superiority of Precurved Electrode Arrays
Authors: Holder Jourdan T. , Yawn Robert J. , Nassiri Ashley M. , Dwyer Robert T. , Rivas Alejandro , Labadie Robert F. , Gifford René H. 
Published: August 2019

Objective:
Characterize differences in adult cochlear implant outcomes and programming parameters for a straight (CI422/522) and a precurved (CI532) electrode array.

Setting:
Cochlear implant (CI) program at a tertiary otologic center.

Patients:
Fifty-eight adults were included in the study; 29 were implanted with CI422 or CI522 and 29 were implanted with CI532. Each CI532 recipient was matched to a CI422/522 recipient in terms of age and preoperative hearing thresholds for comparison purposes.

Main Outcome Measures:
Consonant-Nucleus-Consonant (CNC) words, AzBio sentences, residual audiometric thresholds, and Speech Spatial Qualities (SSQ) questionnaire collected 6 months postoperatively were used to characterize outcomes. Pulse duration, maxima, impedances, and overall charge measurements were used to characterize programming parameters.

Results:
Postoperative unaided low frequency pure-tone average (LFPTA) was significantly better for the CI532 group. CNC scores were significantly better for the CI532 group. Impedances and pulse duration were significantly lower for the CI532 group, but there was no difference in overall charge between the groups.

Conclusion:
The CI532 group showed either similar or statistically superior results on all measures when compared with the CI422/522 suggesting that the CI532 electrode may be an advantageous substitute for the CI522.