bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Vertebral Fracture and Diffuse Idiopathic Skeletal Hyperostosis
Authors: Murakami Yusuke , Mashima Naohiko , Morino Tadao , Fukuda Takahiko , Iwase Miho , Hino Masayuki , Misaki Hiroshi , Miura Hiromasa 
Published: July 2019

Study Design.
Retrospective case-control study.

Objective.
To investigate the prevalence and characteristics of diffuse idiopathic skeletal hyperostosis (DISH) in vertebral fracture patients admitted to our hospital.

Summary of Background Data.
Although vertebral fracture is generally treated conservatively with rest and use of a corset, surgery with rigid internal fixation is recommended for vertebral fractures in patients with DISH. Thus, treatment strategies for vertebral fracture differ according to the presence or absence of DISH. However, only a few studies have investigated the prevalence of DISH in vertebral fracture patients.

Methods.
A total of 159 patients (49 men and 110 women, with a mean age of 82.9 years) who were diagnosed with fresh vertebral fracture and required admission to HITO Hospital. The diagnosis of fresh vertebral fracture was made using x-ray imaging, computed tomography, and magnetic resonance imaging, and the presence or absence of DISH was assessed. In addition, age, sex, bone mineral density ( % young adult mean), blood test results, treatment, and length of hospital stay were compared between patients with and without DISH.

Results.
The proportion of patients with DISH among the patients with vertebral fracture was 33.9% (54 of 159 patients). The proportions in men and women were 38.8% and 31.8%, respectively, with no significant difference between sexes (P = 0.39). The patients in the DISH group were older than those in the non-DISH group (83.6 vs. 79.4 years, P = 0.009), and the DISH group had higher glycated hemoglobin A1c (P = 0.005), higher bone mineral density (P = 0.042), and longer length of hospital stay (P = 0.0001) compared with those in the non-DISH group.

Conclusion.
The proportion of patients with DISH among the vertebral fracture patients was 33.9%. Given that patients with DISH may require different treatment approaches, careful observation is needed.

Level of Evidence: 3
National Trends in the Surgical Management of Lumbar Spinal Stenosis in Adult Spinal Deformity Patients
Authors: Al Jammal Omar M. , Delavar Arash , Maguire Kathleen R. , Hirshman Brian R. , Wali Arvin R. , Kazzaz Majd , Pham Martin H. 
Published: July 2019

Study Design.
This is a retrospective analysis of national administrative hospital data.

Objective.
This study examines national trends in the surgical management of lumbar spinal stenosis (LSS) in patients with and without coexisting scoliosis between 2010 and 2014. The study also examines revision rates for LSS procedures.

Summary of Background Data.
There is wide variability in the surgical management of patients with LSS, with and without coexisting spinal deformity.

Methods.
Data were obtained from the Healthcare Cost and Utilization Project's National Inpatient Sample Database. International Classification of Diseases 9th revision- Clinical Modification codes were used to identify all patients with a primary diagnosis of lumbar spinal stenosis. These patients were divided into two groups: 1) LSS alone and 2) LSS with coexisting scoliosis. The two groups were examined for one of three surgical outcomes: 1) decompression alone (discectomy, laminectomy), 2) simple fusion, and 3) complex fusion (>three vertebrae or 360° fusion). The groups were then further examined for revision operations. National Inpatient Sample discharge weights were applied where relevant.

Results.
In 2014 national estimates of discharged patients indicated 76,275 patients with a primary diagnosis of LSS (population rate, 23.9; in the elderly (65+) the age-adjusted population rate was 95.4). Of these patients, 88.5% were managed through primary surgery (34.6% decompression, 47.2% simple fusion, 5.7% complex fusion). Between 2010 and 2014, the percentage of decompression decreased from 47.5% to 34.6%, the percent of simple fusion increased from 35.3% to 47.2%, and the percent of complex fusion increased from 5.7% to 7.1% (P < 0.01). In patients with coexisting scoliosis, lumbar spinal stenosis was predominantly managed by simple fusion and complex fusion (15.5% decompression, 51.9% simple fusion, 27.3% complex fusion, in 2014). Revision rates were highest among patients without scoliosis managed with complex fusion (15.8% in 2014) compared with patients with scoliosis (8.8% in 2014). Patients with scoliosis who underwent decompression only had revision rates of 1.7% and 0.62% in 2010 and 2014, respectively.

Conclusion.
We observed a leveling-off of the rate of operation for patients with a primary diagnosis of LSS at around 88%. There was an increase in the rate of fusion and a decrease in the rate of decompression across all patient groups. We report no difference in revision rates between patients with and without scoliosis, except in those undergoing a complex fusion.

Level of Evidence: 3
Comparative and Predictor Analysis of 30-day Readmission, Reoperation, and Morbidity in Patients Undergoing Multilevel ACDF Versus Single and Multilevel ACCF Using the ACS-NSQIP Dataset
Authors: Katz Austen David , Mancini Nickolas , Karukonda Teja , Cote Mark , Moss Isaac L. 
Published: July 2019

Study Design.
Retrospective cohort study.

Objective.
The aim of this study was to determine the differences in 30-day readmission, reoperation, and morbidity for patients undergoing multilevel anterior cervical discectomy and fusion (ACDF) or single and multilevel anterior cervical corpectomy and fusion (ACCF).

Summary of Background Data.
Despite increasing rates of surgical treatment of cervical spine disease, few studies have compared outcomes by surgical technique. To the best of our knowledge, this is the only large-scale administrative database study that directly evaluates early outcomes between multilevel ACDF and single and multilevel ACCF.

Methods.
Patients who underwent ACDF and ACCF were identified using the NSQIP database. Multivariate regression was utilized to compare rates of readmission, reoperation, morbidity, and specific complications between surgical techniques, and to evaluate for predictors of primary outcomes.

Results.
We identified 15,600 patients. ACCF independently predicted (P < 0.001) greater reoperation (odds ratio [OR] = 1.876) and morbidity (OR = 1.700), but not readmission, on multivariate analysis. ACCF was also associated with greater rates of transfusion (OR = 3.273, P < 0.001) and DVT/thrombophlebitis (OR = 2.852, P = 0.001). ACCF had significantly (P < 0.001) greater operative time and length of stay. In the cohort, increasing age (P < 0.001), diabetes (P = 0.025), chronic obstructive pulmonary disease (P = 0.027), disseminated cancer (P = 0.009), and American Society of Anesthesiologists (ASA) class ≥3 (P < 0.001) predicted readmission. Age (P = 0.011), female sex (P = 0.001), heart failure (P = 0.002), ASA class ≥3 (P < 0.001), and increased creatinine (P = 0.044), white cell count (P = 0.033), and length of stay (P < 0.001) predicted reoperation. Age (P < 0.001), female sex (P = 0.002), disseminated cancer (P = 0.010), ASA class ≥3 (P < 0.001), increased white cell count (P = 0.036) and length of stay (P < 0.001), and decreased hematocrit (P < 0.001) predicted morbidity. Within ACDF, three or more levels treated compared to two levels did not predict poorer 30-day outcomes.

Conclusion.
Compared to multilevel ACDF, ACCF was associated with an 88% increased odds of reoperation and 70% increased odds of morbidity; readmission was similar between techniques. Older age, higher ASA class, and specific comorbidities predicted poorer 30-day outcomes. These findings can guide surgical solution given specific factors.

Level of Evidence: 3
Prospective Observational Cohort Study of Health-related Quality of Life
Authors: Ryu Dal-Sung , Shinn James Ki , Kim Byeong-Woo , Moon Bong-Ju , Ha Yoon , Lee Jung-Kil , Kim Keung-Nyun , Chin Dong-Kyu , Yoon Seung-Hwan 
Published: July 2019

Study Design.
Retrospective analysis of prospective observational cohort

Objective.
This study assessed the difference in health-related quality of life (HRQOL) between participants with a mild to moderate adult sagittal deformity (ASD) (sagittal vertical axis [SVA] ≤9.5 cm) and those with a marked deformity (SVA >9.5 cm). We also evaluated predisposing factors for a marked deformity.

Summary of Background Data.
Sagittal imbalance is closely associated with HRQOL for the patient. However, how the effect changes depending on the degree of imbalance has not been fully evaluated. The understanding of the predisposing factor associated with marked deformity also lacks.

Methods.
A total of 124 elderly persons with a stooping posture were enrolled. Questionnaires related to HRQOL were administered. Sagittal alignment parameters and pelvic parameters were measured with a whole spine x-ray. Lumbar spine magnetic resonance imaging was used to assess the presence of pathologic conditions, muscle quality and quantity. Multivariate logistic regression analysis was conducted to analyze potential risk factors.

Results.
Marked ASD was associated with female sex, lower height and weight, and osteoporosis (P
< 0.05). Back pain (assessed by a visual analogue scale) and the Oswestry Disability Index were significantly higher in the marked deformity group (P = 0.012, 0.002, respectively). Multivariate logistic regression analysis showed significant relationships between the following parameters and marked deformity: preexisting compression fracture (odds ratio [OR] = 7.793; 95% confidence interval [CI], 1.527–39.768), severe L5/S1 Pfirrmann disc degeneration grade (OR = 1.916; 95% CI, 1.086–3.382), and lower quantities of multifidus and psoas muscles (OR = 0.994, 0.997; 95% CI, 0.991–0.998, 0.994–0.999, respectively).

Conclusion.
Participants with a marked ASD showed different features from those with a mild to moderate ASD. This study also implies that anatomical factors, including the vertebrae, intervertebral discs, and paraspinal muscles, synergistically contribute to progression into marked deformity.

Level of Evidence: 3
The Relationship Between Physical Activity and Cardiorespiratory Fitness Among People Living With Human Immunodeficiency Virus Throughout the Life Span
Authors: Webel Allison R. , Perazzo Joseph , Phillips J. Craig , Nokes Kathleen M. , Rentrope Cynthia , Schnall Rebecca , Musanti Rita , Adams Tufts Kimberly , Sefcik Elizabeth , Hamilton Mary Jane , Portillo Carmen , Chaiphibalsarisdi Puangtip , Orton Penelope , Davis Liana , Rose Carol Dawson 
Published: July 2019

Background:
People living with human immunodeficiency virus (PLHIV) are at an increased risk for developing cardiovascular disease (CVD). Physical activity and cardiorespiratory fitness in PLHIV are poorly understood.

Objective:
The aims of this study were to describe physical activity and cardiorespiratory fitness by sex and age and to examine the association between physical activity and cardiorespiratory fitness in PLHIV, controlling for covariates.

Methods:
Seven hundred two PLHIV participated in a cross-sectional study and completed validated measures of self-reported physical activity (7-day Physical Activity Recall) and cardiorespiratory fitness (6-minute walk test). Participants were recruited from 7 diverse sites in the United States and Thailand, and data were analyzed using descriptive statistics and multiple regression to examine the relationship between physical activity and cardiorespiratory fitness.

Results:
On average, participants self-reported engaging in 115 minutes of, mostly light (75%), physical activity. Men reported twice the amount of physical activity as women (155 vs 73 minutes, P = .01). Participants' ability to achieve their predicted 6-minute walk test distances was similar between men (68%) and women (69%) (P > .01). For women, vigorous physical activity was associated with a 6.6% increase in cardiorespiratory fitness and being temporarily unemployed was associated with an 18% decline in cardiorespiratory fitness. Cardiorespiratory fitness increased with age (P < .01).

Conclusions:
Weekly physical activity of people living with human immunodeficiency virus averaged 85 minutes of mostly light activity, well below the recommended 150 minutes of moderate activity. Vigorous physical activity was associated with improved cardiorespiratory fitness in women, but not men. Although PLHIV would benefit from interventions to increase physical activity, our data suggest a need to develop sex-specific physical activity strategies.
Smoking Is Associated With Lower Dose–Corrected Serum Concentrations of Escitalopram
Authors: Scherf-Clavel Maike , Deckert Jürgen , Menke Andreas , Unterecker Stefan 
Published: July 2019

AbstractBackgroundTobacco smoking rates in depressive patients are higher compared with the general population. Smoking was demonstrated to accelerate the metabolism of different drugs metabolized by CYP1A2, but possibly also by CYP2C19 and CYP3A4. The principle aim of the present investigation from 2015 to 2018 was to determine the differences in the pharmacokinetics of escitalopram between smokers and nonsmokers.MethodsA group of nonsmokers (n = 88) was compared with smokers (n = 36), both receiving escitalopram, using the Mann-WhitneyUtest. Linear regression analysis was used to account for the impact of escitalopram dose, age, and sex in addition to smoking on the steady-state serum concentration of escitalopram.ResultsSmokers received by mean 17.6% higher doses of escitalopram (P= 0.026) but showed 31.9% lower serum concentrations (P= 0.031). To control for confounders, linear regression analysis showed that dose (P< 0.001), sex (P= 0.03), and smoking tobacco (P= 0.027) did significantly influence serum concentrations of escitalopram with higher levels in women and nonsmokers.ConclusionsNotwithstanding higher daily doses, smokers had significantly lower serum concentrations of escitalopram. In concordance with previous results, besides CYP1A2, a possible induction of CYP2C19 and CYP3A4 by tobacco smoke, resulting in lower serum concentrations of escitalopram in smokers than in nonsmokers, is suggested. Therefore, to provide personalized therapy, clinicians should consider smoking status and inform patients on the interactions of smoking and escitalopram metabolism.
A note on error bars as a graphical representation of the variability of data in biomedical research: choosing between standard deviation and standard error of the mean
Authors: Tang Li , Zhang Hui , Zhang Bo 
Published: July 2019

Abstract
Standard deviation (SD) and standard error of the mean (SEM) have been applied widely as error bars in scientific plots. Unfortunately, there is no universally accepted principle addressing which of these 2 measures should be used. Here we seek to fill this gap by outlining the reasoning for choosing SEM over SD and hope to shed light on this unsettled disagreement among the biomedical community. The utility of SEM and SD as error bars is further discussed by examining the figures and plots published in 2 research articles on pancreatic disease.
Prognostic Factors and Treatment Outcome of Pediatric Anaplastic Large Cell Lymphoma Treated at the Children Cancer Hospital Egypt
Authors: Abdel Rahman Hany , El Semary Samah , Sedky Mohamed , Atteya Iman , El Kinaaie Naglaa , El Wakeel Madeha , Hassanein Omneya , Mohy Rana 
Published: July 2019

Introduction:The aim of the current study is to report the epidemiologic data, response rate, treatment outcome, and overall survival of anaplastic large cell lymphoma (ALCL) patients during the 8-year period.Patients and Methods:A retrospective study included all patients with newly diagnosed ALCL from July 2007 till December 2015.Results:A total of 48 patients were enrolled. The majority (66.7%) were male individuals. Twenty-one patients (43.7%) were low stage I or II, whereas 27 (56.2%) had advanced stage III or IV. Two patients (4.2%) died during induction chemotherapy. Disease status at last follow-up showed 35 patients (72.9%) in complete remission, 5 (10.5%) relapse, and 5 disease progression. The median time to relapse was 17.2 months. Four patients (8.4%) were salvaged by high-dose chemotherapy ifosphamide, carboplatine, etoposide followed by autologous hematopoietic stem cell transplantation, whereas 5 (10.5%) died out of disease progression. The 5-year overall survival and event-free survival were 81.2% and 68.6%, respectively. Median FU period was 58.7 month. Multivariate analysis included age, sex, stage, and response to chemotherapy and showed no statistical significance.Conclusion:Treatment of ALCL according to the Children’s Oncology Group ANHL 0131 protocol is well tolerated. The relapsing patient could be salvaged by high-dose chemotherapy and autologous hematopoietic stem cell transplantation.
Spinal Stenosis Patients' Visual and Verbal Description of the Comprehension of Their Surgery
Authors: Kesänen Jukka , Leino-Kilpi Helena , Lund Teija , Montin Liisa , Puukka Pauli , Valkeapää Kirsi 
Published: July 2019

BACKGROUND:
Spine surgery patients have difficulty comprehending the patient education aimed at preparing for surgery.

PURPOSE:
To assess the effect of a specific preoperative education approach (Knowledge Test Feedback Intervention, KTFI) on patients' verbal and visual understanding of their surgery.

METHODS:
In this randomized controlled trial, the intervention group (n = 50) went through the KTFI and routine education, whereas the control group (n = 50) received only routine patient education. Written description of the surgical procedure and drawing of incision were used as outcome measures at baseline, at hospitalization, at discharge, and 3 and 6 months after surgery.

RESULTS:
At baseline, half of the participants showed verbal and visual understanding of their surgery. During follow-up, understanding improved significantly with no statistically significant differences between the groups.

CONCLUSION:
Spinal stenosis patients' understanding of their surgical procedure is imperfect. Patient educators need to ensure patient learning by evaluating comprehension outcomes.
Visual Deficits and Dysfunctions Associated with Traumatic Brain Injury: A Systematic Review and Meta-analysis
Authors: Merezhinskaya Natalya , Mallia Rita K. , Park DoHwan , Bryden Daniel W. , Mathur Karan , Barker Felix M. 
Published: July 2019

SIGNIFICANCE
This study reports prevalence data combined independently for accommodative dysfunction, convergence insufficiency, visual field loss, and visual acuity loss in patients with traumatic brain injury in the absence of eye injury.

OBJECTIVE
The objective of this study was to conduct a systematic review and meta-analysis to determine the prevalence rates of accommodative dysfunction, convergence insufficiency, visual field loss, and visual acuity loss in TBI patients without concomitant eye injury.

DATA SOURCES
The data sources used in this study were PubMed, EMBASE, EBSCO, and Cochrane Library.

STUDY APPRAISAL AND SYNTHESIS METHODS
Publications reporting the prevalence of diagnosed accommodative dysfunction, convergence insufficiency, visual field loss, or visual acuity loss to the level of legal blindness in TBI patients of any age were included. Univariate metaregression analyses and subgroup analyses were performed to account for statistical heterogeneity.

RESULTS
Twenty-two eligible publications were identified across the four visual conditions. Random-effects models yielded combined prevalence estimates: accommodative dysfunction (42.8; 95% confidence interval [CI], 31.3 to 54.7), convergence insufficiency (36.3%; 95% CI, 28.2 to 44.9%), visual field loss (18.2%; 95% CI, 10.6 to 27.1%), and visual acuity loss (0.0%; 95% CI, 0.0 to 1.1%). Metaregression and subgroup analyses revealed that visual field loss was significantly more prevalent in moderate to severe (39.8%; 95% CI, 29.8 to 50.3%) compared with mild TBI (6.6%; 95% CI, 0 to 19.5%).

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
This study demonstrates that accommodative dysfunction, convergence insufficiency, and visual field loss are common sequelae of TBI. Prospective longitudinal research with rigorous and uniform methodology is needed to better understand short- and long-term effects of TBI on the vision system.
A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control
Authors: Chamberlain Paul , Peixoto-de-Matos Sofia C. , Logan Nicola S. , Ngo Cheryl , Jones Deborah , Young Graeme 
Published: July 2019

SIGNIFICANCE
Results of this randomized, double-masked clinical trial demonstrate the effectiveness of the MiSight soft contact lens in slowing myopia progression over multiple years.

PURPOSE
The purpose of this study was to quantify the effectiveness of MiSight daily disposable soft contact lens in slowing the progression of juvenile-onset myopia.

METHODS
Myopic children (spherical equivalent refraction, −0.75 to −4.00 D; astigmatism, <1.00 D) aged 8 to 12 years with no prior contact lens experience were enrolled in a 3-year, double-masked, randomized clinical trial at four investigational sites in four countries. Subjects in each group were matched for age, sex, and ethnicity and were randomized to either a MiSight 1-day contact lens (test) or Proclear 1-day (control; omafilcon A) and worn on a daily disposable basis. Primary outcome measures were the change in cycloplegic spherical equivalent refraction and axial length.

RESULTS
Of the subjects enrolled, 75.5% (109/144) completed the clinical trial (53 test, 56 control). Unadjusted change in spherical equivalent refraction was −0.73 D (59%) less in the test group than in the control group (−0.51 ± 0.64 vs. –1.24 ± 0.61 D, P < .001). Mean change in axial length was 0.32 mm (52%) less in the test group than in the control group (0.30 ± 0.27 vs. 0.62 ± 0.30 mm, P < .001). Changes in spherical equivalent refraction and axial length were highly correlated (r = −0.90, P < .001). Over the course of the study, there were no cases of serious ocular adverse events reported. Four asymptomatic corneal infiltrative (one test, three control) events were observed at scheduled study visits.

CONCLUSIONS
Results of this clinical trial demonstrate the effectiveness of the MiSight daily disposable soft contact lens in slowing change in spherical equivalent refraction and axial length.
The Impact of One’s Sex and Social Living Situation on Rehabilitation Outcomes After a Stroke
Authors: Hay Catherine Cooper , Graham James E. , Pappadis Monique R. , Sander Angelle M. , Hong Ickpyo , Reistetter Timothy A. 
Published: July 2019

Abstract

Objective
The aim of the study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation.

Design
A retrospective observational study using Medicare fee-for-service beneficiaries (N = 125,548) who were discharged from inpatient rehabilitation facilities in 2013 and 2014 after a stroke. Discharge individual functional independence measure score, dichotomized as ≥5 and <5, was the primary outcome measure. A two-step generalized linear mixed model was used to measure the effect of sex on each functional independence measure item while controlling for many clinical and sociodemographic covariates.

Results
After adjusting for sociodemographic and clinical factors, females had higher odds of reaching a supervision level for 14 of 18 functional independence measure items. Males had higher odds of reaching a supervision level on 2 of 18 functional independence measure items. Individuals who lived alone before their stroke had higher odds of reaching a supervision level than individuals who lived with a caregiver or with family for all functional independence measure items.

Conclusions
When sociodemographic and clinical factors are controlled, females are more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who live alone before their stroke have higher odds of discharging at a supervision level or better.