bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There Equivalence Between the Electronic and Paper Version of the Questionnaires for Assessment of Patients With Chronic Low Back Pain?
Authors: Azevedo Bruna Rabelo , Oliveira Crystian B. , Araujo Giulia Marcondes D. , Silva Fernanda G. , Damato Tatiana M. , Pinto Rafael Z. , Christofaro Diego G.D. 
Published: October 2019

Study Design.
Cross-sectional study.

Objective.
To investigate the equivalence of electronic and paper version of self-report questionnaires for the assessment of disability, pain, fear of movement, depression, and physical activity of patients with chronic low back pain (LBP).

Summary of Background Data.
Paper and electronic versions of self-report questionnaires are commonly used for assessment of patients with LBP. However, the equivalence of self-report questionnaires commonly used for assessment of patients with chronic LBP remains unclear.

Methods.
Seventy-nine individuals with chronic LBP seeking physiotherapy care were recruited. Participants attended the clinic twice with an interval of 1 week and completed the self-reported questionnaires in a random order. The following questionnaires were administered: Roland Morris Disability Questionnaire (RMDQ); 11-point numerical rating scale (NRS); Tampa Scale for Kinesiophobia (TSK); Center for Epidemiological Studies-Depression (CES-D), and Baecke Habitual Physical Activity Questionnaire (BPAQ). To investigate the equivalence between the two questionnaire versions, intraclass correlation coefficient with 95% confidence interval and Bland-Altman plotting was used.

Results.
The paper and electronic versions of the RMDQ, TSK, and CES-D showed good reliability and the showed moderate reliability. In contrast, the NRS showed poor reliability between the electronic and paper versions.

Conclusion.
Our findings support that the electronic version of the RMDQ, TSK, CES-D, and BPAQ can be administered in clinical and research settings for assessment of patients with chronic LBP. Nevertheless, electronic version of the NRS for assessment of pain intensity should not be used interchangeably in clinical practice in patients with chronic LBP.

Level of Evidence: 3
Papillary Hemangioma: An Under-Recognized Entity Not to Be Confused With Glomeruloid Hemangioma
Authors: Maloney Nolan , Miller Patricia , Linos Konstantinos 
Published: October 2019

Abstract:
Papillary hemangioma is a recently described benign hemangioma that typically presents on the head and neck of otherwise healthy individuals. It comprises branching papillary structures that protrude into the lumen of ectatic thin-walled vessels. Glomeruloid hemangioma (GH) is a similar, but unique, entity that occurs in patients with POEMS syndrome. The additional clinical implications of GH make distinction from papillary hemangioma critical. An additional case is herein presented and the literature on the subject reviewed. Potential differential diagnoses are discussed, with particular emphasis on the distinction from GH.
Should Margin Status of Biopsies Be Included in Dermatopathology Reports? Clinician Preferences and the Importance of Unambiguous Language
Authors: Jacobsen Emilie , Hippe Daniel S. , Lachance Kristina , Perrone Marie E. , Chang Oliver H. , Shinohara Michi M. 
Published: October 2019

Abstract:
Significant communication occurs between pathologists and clinicians through the dermatopathology report. Our objective was to describe clinician preference about reporting of the margin status of skin biopsies of nonmelanoma skin cancers. An anonymous survey was sent to 243 medical providers who submitted specimens to a single institution university medical center; 50 complete responses from attending-level providers and advance practice providers were received. The majority (96%) of those surveyed indicated margins should be reported on skin biopsies of neoplasms, particularly nonmelanoma skin cancers (basal cell carcinoma 96% and squamous cell carcinoma 92%) and atypical nevi (96%). When asked about particular language used to describe the margin status, some phrasing led to more variance in respondents' clinical management decisions, with 96%–98% of respondents making the same decision when presented with “unambiguous” terms and 58%–84% of respondents making the same decision when presented with “ambiguous” language (P < 0.001). Respondents generally preferred “unambiguous” margin descriptions when shown an involved margin (70% vs. 30%, P < 0.001) but accepted “ambiguous” language when the margin was clearly uninvolved (68% vs. 32%, P = 0.015). Most respondents (88%) desire inclusion of treatment recommendations in dermatopathology reports. Microscopic descriptions were highly utilized, particularly by nondermatology trained clinicians (97% vs. 80%, P = 0.09). Clinicians desire inclusion of margins for skin biopsies in dermatopathology reports, at least in some circumstances. The choice of language used to describe the margin status in dermatopathology reports has important implications for patient care. Margin descriptors that are unclear or ambiguous may lead to more variance in clinical management.
Sarcoid Orbital Myopathy: Clinical Presentation and Outcomes
Authors: Vahdani Kaveh , Rose Geoffrey E. 
Published: October 2019

Sarcoid orbital myopathy is rare and mainly affects the superior rectus/levator complex and lateral rectus, possibly due to neighboring dacryoadenitis. Most settle with systemic corticosteroids, a quarter need second-line immunosuppressants, and one-third will have relapse.

Purpose:
To describe the clinical manifestations, systemic associations, radiological features, and treatment outcome for patients presenting with sarcoid-like granulomatous disease involving the extraocular muscles.

Study design:
Retrospective noncomparative case series and literature review.

Methods:
Patients presenting with presumed sarcoid orbital myopathy between 1990 and 2016 were classified either as having known systemic sarcoidosis at time of orbital presentation (Group I) or as having newly diagnosed sarcoidosis (Group II).

Results:
Twenty patients (15 females; 75%) were identified, 8 having a known systemic sarcoidosis and 12 with a new diagnosis. The average age at presentation was 53.7 years (median 54.5; range 31–78), with the commonest symptoms being swelling, pain, and diplopia. The superior rectus/levator complex was most commonly affected (50%), followed by lateral rectus (40%) and the superior oblique only rarely (2 in Group II), but with no evident bias between the groups. Most patients had additional involvement of lacrimal gland (70%) and orbital fat (95%), and systemic disease was present in 18 of 20 patients. Four patients were on oral corticosteroids prior to orbital presentation (2 in each group) and 16 received oral prednisolone after orbital diagnosis—14 commencing steroids and 2 continued previous steroids. Clinical improvement was noted in 13 of 20 (65%) patients, the results being similar in the 2 groups (p = 1.0). The average follow up was 56 months (median 41; range 1–315), and disease recurrence occurred in 6 patients (30%) at an average interval of 12.5 months after diagnosis.

Conclusions:
This study presents the long-term results of patients with sarcoid-related orbital myopathy and systemic disease may be found in over 80% of newly diagnosed cases. The superior rectus/levator complex and lateral rectus are most commonly involved—possibly due to spill-over inflammation from granulomatous dacryoadenitis. Approximately two-thirds of cases respond well to systemic corticosteroids, while one-third develop recurrent disease.
Orbital Diffuse Large B-Cell Lymphoma Initially Presenting as Neovascular Glaucoma
Authors: Aldaas Khalid M. , Randall Cara , Eftekhari Kian , Zhang Alice Y. 
Published: October 2019

Orbital lymphoma can result in rapid loss of vision if not diagnosed and treated in a timely manner. This patient presented with rapid visual loss and on examination had a rubeosis iridis with a hyphema as well as neovascular glaucoma with vitreous hemorrhage. His medical history included systemic diffuse large B-cell lymphoma and a workup ultimately revealed an orbital mass in the body of the optic nerve. Optic nerve biopsy demonstrated diffuse large B-cell lymphoma. To the authors' knowledge, neovascular glaucoma as the presentation of an extraocular diffuse large B-cell lymphoma has not been reported previously. Lymphomas of the orbit and its adnexa constitute roughly 1% of all non-Hodgkin lymphoma.
1
Most cases are marginal-zone B-cell lymphomas, with the second most common being diffuse large B-cell lymphomas.
2
Orbital lymphomas can rapidly progress to complete visual loss when not diagnosed early. The authors report a patient who presented with rapid visual loss due to hyphema, rubeosis iridis, neovascular glaucoma and vitreous hemorrhage secondary to orbital diffuse large B-cell lymphoma. Research methods were adherent to the ethical principles outlined in the Declaration of Helsinki as amended in 2013. The collection and evaluation of protected patient health information was Health Insurance Portability and Accountability Act compliant.
The authors report a case of lymphoma metastatic to the optic nerve masquerading as neovascular glaucoma with vitreous hemorrhage.
Dynamic Stiffness of Pediatric Prostheses During Rapid Loading
Authors: Agnew Sarah , Geil Mark D. , Gharai Mohammad H. 
Published: October 2019

ABSTRACTIntroductionIndividuals with limb loss rely on the use of prostheses to maintain functional independence and ambulatory capabilities. Because of the relatively higher and more rapid loads imposed by active children upon lower-limb prosthetic components, it is essential to understand the response of pediatric prostheses to dynamic loading. The purpose of this study was to quantify the stiffness characteristics of four pediatric prosthetic feet under different drop heights and contact orientations.Materials and MethodsSingle-leg drop-landing was simulated with four pediatric prosthetic feet (College Park: Truper; Össur: Cheetah Junior, Flex-Foot Junior, Vari-Flex Junior). Each device was dropped from two different heights at two different contact orientations (forefoot, midfoot).ResultsStiffness ranged from 586.3 N/cm to 10,628.4 N/cm. The running-specific Cheetah Junior was the least stiff. All feet were stiffer for flatfoot contact, but the Cheetah was least sensitive to foot angle. The Flex-Foot Junior and Truper had the largest increases in stiffness for flatfoot contact. Stiffness was not significantly different across the two drop heights, although individual feet showed differing responses.ConclusionsForefoot contact mitigates force transmission in landing. Overall, the feet exhibited a large range of force, deformation, and stiffness results, indicating the possibility of activity-specific individualized prescription.
Effect of an Electronic Health Record Decision Support Alert to Decrease Excess Cervical Cancer Screening
Authors: Teoh Deanna , Vogel Rachel I. , Langer Adam , Bharucha Jinai , Geller Melissa A. , Harwood Eileen , Kulasingam Shalini , Melton Genevieve B. 
Published: October 2019

Objective
Cervical cancer screening is often conducted in excess of current screening guidelines. The objective of this study was to evaluate the effect of an electronic health record (EHR) clinical decision support alert to decrease guideline-nonadherent cervical cancer screening beyond the age limits of screening or posthysterectomy.

Materials and Methods
The proportion of guideline-nonadherent Pap tests in women younger than 21 years or older than 65 years or posthysterectomy were compared 4 months before and 3 months after implementation of an EHR clinical decision support alert warning providers that a Pap test is not indicated. Providers could cancel the Pap test or override the alert and place the order. Provider characteristics and Pap test indications were summarized by preintervention/postintervention period using descriptive statistics. The proportions of nonindicated Pap tests were compared by intervention period and provider characteristics using generalized estimating equation models.

Results
In women beyond the screening age limits or posthysterectomy, a total of 388 Pap tests were ordered before intervention, and 313 tests were ordered after intervention. Proportion of guideline-nonadherent tests was similar before (62%) and after intervention (63%); thus, implementation of the clinical decision support alert did not change the proportion of guideline-nonadherent Pap tests ordered (OR = 1.08, 95% CI = 0.77–1.52). It is notable that 52% of guideline-nonadherent tests were ordered by 11 providers. Even when controlling for providers who ordered more than 1 test during the study period, multivariate analysis showed that male providers were more likely to order guideline-nonadherent Pap tests (OR = 2.30, 95% CI = 1.36–3.89); no other differences by provider characteristics were observed.

Conclusions
An EHR clinical decision support alert does not decrease guideline-nonadherent cervical cancer screening. These data suggest efforts to optimize clinical decision support should be focused on other aspects of cervical cancer prevention.
Low-Risk Human Papillomavirus Types in Cervical Intraepithelial Neoplasia 2–3 and in Invasive Cervical Cancer Patients
Authors: Siegler Efraim , Reichman Yael , Kugelman Nir , Mackuli Lena , Lavie Ofer , Ostrovsky Ludmila , Shaked-Mishan Pninint , Segev Yakir 
Published: October 2019

Objectives
A total of 95% to 99% of patients with invasive cervical cancer (CC) are infected with human papillomavirus (HPV). The aim of the study was to evaluate the incidence of low-risk HPV (LR-HPV) types among women with cervical intraepithelial neoplasia (CIN 2–3) and CC.

Materials and Methods
We conducted a nested cohort study of patients diagnosed with CIN 2–3 or CC. Inclusion criteria were diagnosis of CIN 2–3 or CC and HPV-DNA testing from the cervix.

Results
During the study period, we collected clinical data on 608 women of whom 402 were with CIN 2–3 and 206 with diagnosis of CC. When examining 14 high-risk HPV (HR-HPV) types, patients with CIN 2–3, 90.3% were found positive to at least one type of HR-HPV, 89.8% from CC patients were found positive to at least one type of HR-HPV. A total of 4.5% of patients with CIN 2–3 and 3.9% of those with CC were positive to only one LR-HPV or to some of a few LR-HPV types. Among 5.2% with CIN 2–3 and 6.3% of those with CC, no HPV types were detected.

Conclusions
The prevalence of the LR-HPV in high-grade squamous intraepithelial lesion cervical lesions is low but is expected to increase in the future because of the expected decrease in CC caused by HPV types that are included in the bi-, quadri-, and nanovalent vaccine. The CIN 2–3 and CC patients with LR-HPV types and with negative HPV, challenge HPV screening sensitivity, which is based on a limited number of HR-HPV types.
Association of rosacea with inflammatory bowel disease
Authors: Wang Fang-Ying , Chi Ching-Chi 
Published: October 2019

Abstract
Rosacea has been reported with several systemic comorbidities, but its relationship with inflammatory bowel disease (IBD) is unclear. Thus, our objective is to conduct a meta-analysis on the association of rosacea with IBD.
We conduct a meta-analysis and searched MEDLINE, CENTRAL, and Embase databases for case-controlled and cohort studies that assessed the association of rosacea with IBD from inception to July 2nd, 2018. Two authors independently selected studies, extracted data, and assessed the risk of bias of included studies. Disagreement was resolved by discussion. We performed random-effects model meta-analysis to obtain the pooled risk estimates for Crohn disease (CD) and ulcerative colitis (UC) in patients with rosacea.
We included three case-control and three cohort studies. The risk of bias of included studies was generally low. The meta-analysis on case-control studies showed marginally increased odds of CD (pooled odds ratio (OR) 1.30, 95% confidence interval (CI) 0.99–1.69) and a significantly increased odds of UC (pooled OR 1.64, 95% CI 1.43–1.89) in patients with rosacea. The meta-analysis on cohort studies demonstrated significant increased risk of CD (pooled hazard ratio (HR) 1.58, 95% CI 1.14–2.20) and UC (pooled HR 1.18, 95% CI 1.01–1.37) in patients with rosacea.
The evidence indicates an association of rosacea with IBD. If patients with rosacea suffer from prolonged abdominal pain, diarrhea, and bloody stool, referral to gastroenterologists may be considered.
Clinicopathological analysis of IgA nephropathy combined with other glomerular diseases
Authors: Jiang Lei , Dong Bao , Yan Yu , Zheng Shuying , Hu Yanan , Zuo Li , Shi Hongxia 
Published: October 2019

Abstract
It is not rare to find Immunoglobulin A (IgA) nephropathy (IgAN) combined with other glomerular diseases, which can be called compound IgAN (cIgAN). Till now, clinical-pathological investigation of cIgAN was lacking, especially the severity of “background IgAN lesions.” This research aimed to investigate the incidence, clinical and pathological characteristics of cIgAN, and thus improve the understanding of the clinical significance of this combination.
Patients with cIgAN diagnosed in Peking University People's Hospital from November 2012 to April 2018 were retrospectively analyzed. Patients with IgAN without compound glomerular diseases (sIgAN) were enrolled as a control group.
Among 1407 patients diagnosed with IgAN, 80 (5.69%) were cIgAN patients. Compared with sIgAN, cIgAN patients had a significantly lower prevalence of microscopic hematuria and more urine protein. There were 10 pathological types of glomerular diseases combined with IgAN, led by diabetic nephropathy 37 (46.25%) and membranous nephropathy 14 (17.5%). Histologically, although the mesangial hypercellularity was comparable in 2 groups, cIgAN patients had a lower prevalence of endocapillary proliferation, segmental glomerulosclerosis, and cellular or fibrocellular crescents formation, as well as weaker immunofluorescence intensity for IgA and C3 (all P < .05). Eight out of 27 (29.63%) cIgAN patients with follow-up data (5–48 months) developed irreversible end-stage renal disease requiring dialysis.
The order of incidence of concomitant diseases was similar to that of the pure diseases. The “background IgAN associated lesions” except mesangial hypercellularity were relatively mild in cIgAN group. Those might suggest that in some cases, IgAN seems to be a chance finding, and the combined diseases may play a more important role in the clinicopathological features of the patients than the nephritis caused by IgA deposition. While diagnosing IgAN, other combined glomerular diseases need to be carefully considered by nephrologists and pathologists.
Evaluation of quality of life in patients with oral cancer after mandibular resection
Authors: Davudov Mahammad M. , Harirchi Iraj , Arabkheradmand Ali , Garajei Ata , Mahmudzadeh Habibollah , Shirkhoda Mohammad , Motiee-Langroudi Maziar , Mirzajani Zoheir , Zebardast Jayran , Montazeri Ali 
Published: October 2019

Abstract
This cross-sectional study aimed to assess and compare quality of life in patients with advanced oral cavity tumors after mandibular resection in 3 groups (no reconstruction, reconstruction with plate, and reconstruction with flap) at the Cancer Institute, affiliated to Tehran University of Medical Sciences. Quality of life was measured using the European Organization for Research and Treatment of Cancer core quality of life questionnaire and European Organization for Research and Treatment of Cancer head and neck cancer-specific quality of life questionnaire-35 items. The comparison was tested using Kurskal–Wallis analysis. All 120 patients were entered into the study. The mean age of patients was 48.5 (standard deviation = 18.1) years. Patients presented with advanced stage of the disease and underwent mandibular resection with no reconstruction (n = 40), reconstruction with plate (n = 41), and reconstruction with flap (n = 39). The findings showed that in general, there were no statistically significant differences in quality of life among 3 groups except for speech problem (P = .4), dry mouth (P = .03), and feeling ill (P = .04). Although there were no significant differences in quality of life among patients in 3 groups, overall patients who received reconstruction with flap reported better functioning and fewer symptoms. Those who did not receive any reconstruction reported the worse conditions.
Differences in corpus callosum injury between cerebral concussion and diffuse axonal injury
Authors: Jang Sung Ho , Kim Oh Lyong , Kim Seong Ho , Lee Han Do 
Published: October 2019

Abstract

Background:
We investigated differences in corpus callosum (CC) injuries between patients with concussion and those with diffuse axonal injury (DAI) by using diffusion tensor tractography (DTT).

Methods:
Twenty-nine patients with concussion, 21 patients with DAI, and 25 control subjects were recruited. We reconstructed the whole CC and 5 regions of the CC after applying Hofer classification (I, II, III, IV, and V). The whole CC and each region of the CC were analyzed to measure DTT parameters (fractional anisotropy [FA], apparent diffusion coefficient [ADC], and fiber number [FN]).

Results:
In the whole CC, significant differences were observed in all DTT parameters between the concussion and control groups and the DAI and control groups (P < .05). Among the 5 regions of the CC, significant differences were observed in FA and ADC between the concussion and control groups and the DAI and control groups (P < .05). Significant differences in FN were observed in CC regions I and II (connected with the prefrontal lobe and secondary motor area) between the concussion and control groups, in CC regions I, II, III, and IV (connected with the frontoparietal lobes) between the DAI and control groups, and in CC regions III, IV (connected with the motor-sensory cortex) between the concussion and DAI groups (P < .05).

Conclusion:
It was observed that both concussion and DAI patients showed diffuse neural injuries in the whole CC and all 5 regions of the CC. Neural FN results revealed that concussion patients appeared to be specifically injured in the anterior part of the CC connected with the frontal lobe, whereas DAI patients were injured in more diffuse regions connected with whole frontoparietal lobes.
Differential proteomic analysis of serum exosomes reveals alterations in progression of Parkinson disease
Authors: Jiang Ruilai , Rong Chunjiao , Ke Ronghu , Meng Shuiyan , Yan Xiumei , Ke Honglin , Wu Shaochang 
Published: October 2019

Abstract
Exosomes are nanometer-sized vesicles with intercellular communication functions, and their encapsulated proteins may participate in the pathological process of neurodegenerative disorders. The aim of this study was to identify the protein changes of serum exosomes in Parkinson disease (PD) patients with different disease progress types, and to identify potential biomarkers. The exosomes of PD patients with different severity and healthy control group were isolated from serum. The exosome proteins were analyzed by mass spectrometry with label-free quantitative proteomics. A total of 429 proteins were identified, of which 14 were significantly different in mild and severe PD patients. The expression levels of 7 proteins, including pigmented epithelium-derived factor, afamin, apolipoprotein D and J, were significantly increased in PD patients. The expression levels of 7 proteins, including complement C1q and protein Immunoglobulin Lambda Variable 1-33 (IGLV1-33)Cluster -33, were decreased in PD patients. These differentially expressed proteins were analyzed by gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis, which confirmed that the interaction between prion diseases and ECM receptors was the most significant pathways of enrichment. The changes of proteins and pathways may be related to the pathophysiological mechanism of PD. Therefore, some of these proteins could be considered as potential biomarkers for early PD diagnosis.