bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical efficacy of percutaneous transforaminal endoscopic discectomy in treating adolescent lumbar disc herniation
Authors: Liu Wei , Li Qingning , Li Ziyu , Chen Lei , Tian Dasheng , Jing Juehua 
Published: February 2019

Abstract
Ten years ago, endoscopic techniques began to prevail in clinical treatment of lumbar disc herniation (LDH), but to date, few studies have reported the clinical efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in treating adolescent LDH. This study aimed to evaluate the surgical outcomes of PTED in treating adolescent patients with LDH.
Between June 2012 and June 2016, retrospective analysis of 43 adolescent patients diagnosed with single-segment LDH at spine surgery at the Second Affiliated Hospital of Anhui Medical University. The patients’ lower limb pain was evaluated using visual analogue scale (VAS) scores and the Oswestry Disability Index (ODI). The VAS is the most commonly-used quantitative method for assessing the degree of pain in clinical practice. The measurement method is to draw a 10 cm horizontal line on a piece of paper, 1 end of which is 0, indicating no pain, while the other end is 10, which means severe pain, and the middle part indicates different degrees of pain. The clinician then asks the patient to make a mark on the line to indicate the degree of pain based on how he or she feels. The ODI is the most widely-used assessment method internationally for lumbar or leg pain at present. The ODI questionnaire is composed of 10 questions, covering pain intensity, independent living, carrying, walking, sitting, standing, sleep, travel, sex, and social life. Every category comprises 6 options, with the highest score for each question being 5 points. Thus the 1st option is worth 0 points, the last option scores 5 points, and higher scores represent more serious dysfunction. Patient satisfaction was evaluated using the modified MacNab score. Clinical outcomes were measured preoperatively, and at 3 days, 6 months, and 12 months postoperatively.
All 43 patients were followed up for 12 to 24 months. The average follow-up time was 18.33 months. The VAS scores and ODI scores at 3 days, 6 months, and 12 months postoperatively were significantly lower than before surgery. The difference was statistically significant (P < .001). The differences in VAS scores and ODI scores at 3 days, 6 months, and 12 months after surgery were also statistically significant (P < .001). According to the modified MacNab criteria, 26 cases were rated excellent, 14 cases were good, and 3 cases were acceptable at the final follow-up, and 93.02% of these patients had excellent outcomes.
The PTED is an effective and safe surgical method for the treatment of adolescent patients with LDH, but high-quality randomized controlled trials are still required to further verify these findings.
Normal body mass index (BMI) can rule out metabolic syndrome
Authors: Kobo Ofer , Leiba Ronit , Avizohar Ophir , Karban Amir 
Published: February 2019

Abstract
The aim of the study was to assess whether body mass index (BMI) can be used as a simple and reliable survey test for metabolic syndrome.
The study is an observational cohort study among patients who visited the Rambam Periodic Examinations Institute (RPEI). We analyzed the correlation between obesity indices and presence of metabolic syndrome. We identified the ideal value of BMI for identification of patients at risk for metabolic syndrome. We also described the correlation between different BMI values and its negative predictive value (NPV) for metabolic syndrome.
During the study years, 23,993 patients visited the RPEI, and 12.5% of them fulfilled the criteria for metabolic syndrome. Women with metabolic syndrome had higher proportion of obesity, when compared with men (89.9% vs 52.6%; P < .0001). Normal BMI had very high NPV to rule out metabolic syndrome among men and women (98% and 96%, respectively). Using receiver-operating characteristic curve, we found BMI 27 to be the ideal value for identification of metabolic syndrome for the entire cohort (area under the curve [AUC] 0.767, 95% confidence interval [CI] 0.758–0.775, P < .0001), for men (AUC 0.726, 95% CI 0.715–0.738, P < .0001), and for women (AUC 0.843, 95% CI 0.831–0.855, P < .0001). BMI below 30 provided NPV of 91.1% to rule out metabolic syndrome.
The BMI as single survey measurement of obesity offers high NPV for metabolic syndrome and can be used by physician and patients for this purpose.
Effectiveness of vitamin D for irritable bowel syndrome
Authors: Shi Sheng-Mei , Wen Yan-Li , Hou Hai-Bin , Liu Hai-Xia 
Published: February 2019

Abstract

Background:
Irritable bowel syndrome (IBS) is a prevalent and debilitating condition for patients who experience this disorder. Clinical researches indicate that vitamin D (VD) can help relief the symptoms of IBS. However, no systematic review has addressed this issue yet. Thus, this systematic review aims to investigate the effectiveness and safety of VD for patients with IBS.

Methods:
We will retrieve the following databases for randomized controlled trials to assess the effectiveness and safety of VD for patients with IBS: Cochrane Library, EMBASE, MEDICINE, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Each database will be retrieved from its inception to January 31, 2019. Two researchers will independently selection studies, extract data and assess methodological quality. RevMan 5.3 software will be used to pool the data, and carry out the meta-analysis if it is possible.

Results:
This systematic review will evaluate the effectiveness and safety of VD for patients with IBS. The primary outcomes include stool frequency and abdominal pain. The secondary outcomes consist of stool status, quality of life, and adverse effects.

Conclusions:
The findings of this systematic review may provide the existing evidence on the effectiveness and safety of VD for patients with IBS.

Ethics and dissemination:
This systematic review will not require ethical approval, because all data will be extracted from the published literature. The findings of this study will be disseminated at peer-reviewed journals.

PROSPERO registration number: PROSPERO CRD42019122641.
Two-stage posterior spinal fusion for early-onset scoliosis
Authors: Uehara Masashi , Takahashi Jun , Kuraishi Shugo , Ikegami Shota , Futatsugi Toshimasa , Oba Hiroki , Takizawa Takashi , Munakata Ryo , Koseki Michihiko , Kato Hiroyuki 
Published: February 2019

Abstract

Rationale:
Fusionless techniques for early-onset scoliosis (EOS) have evolved to allow near-normal growth while maintaining the correction achieved during the initial surgery. However, such procedures require repeated surgeries and have increased complication rates. We have developed a 2-stage fusion technique using pedicle screws for EOS to reduce patient burden and complication risk. This series describes the clinical and radiological features of 2 patients with EOS who received 2-stage posterior spinal fusion. This surgical method for EOS represents the first of its kind.

Patient concerns:
Case 1 was a 10-year-old girl who was diagnosed as having scoliosis with Prader Willi syndrome at the age of 2 years. Her preoperative major curve Cobb angle was 100 degrees at age 10 years. Case 2 was an 11-year-old boy who was found to have scoliosis with 22q11.2 deletion syndrome at the age of 4 years. His preoperative major curve Cobb angle was 77 degrees at age 11 years.

Diagnosis:
Whole-spine radiographs were performed to diagnose scoliosis.

Interventions:
Both patients received 2-stage posterior spinal fusion.

Outcomes:
Postoperative Cobb angle of the major curve improved to 46 and 48 degrees, respectively. Thoracic height respectively improved from 160 and 148 mm before surgery to 206 and 211 mm at final follow-up. Surgical outcome as evaluated by Scoliosis Research Society-22 patient questionnaires revealed acceptable results without any severe complications.

Lessons:
Based on the present case report, 2-stage posterior spinal fusion for EOS achieves good radiological and clinical outcomes without severe complications.
Non-Robertsonian translocations involving chromosomes 13, 14, or 15 in male infertility
Authors: Zhang Hongguo , Wang Ruixue , Yu Yang , Zhu Haibo , Li Leilei , Yang Xiao , Hu Xiaonan , Liu Ruizhi 
Published: February 2019

Abstract
For genetic counseling of male carriers of chromosomal translocations, the specific chromosomes and breakpoints involved in the translocation are relevant to know. The structural chromosomal abnormalities may lead to abnormal sperm counts, infertility, and miscarriage. These are related to the specific chromosomes and breakpoints involved in the translocation. To date, over 200 cases of non-Robertsonian translocation in male carriers have been described that involve chromosomes 13, 14, or 15.
This study reports of 28 male carriers from our clinic with balanced reciprocal translocations of chromosome 13, 14, or 15, and a literature review of 201 cases. The 28 male carriers from our clinic were diagnosed by cytogenetic analyses: 19 subjects suffered from pregestational infertility and 9 from gestational infertility. The most common translocations were t(7;13), t(10;14), and t(3;15), observed respectively in 13 (46%), 8 (29%), and 8 (29%) of our subjects. The literature cases (n = 201) involved chromosome 13 (n = 83, 41%), chromosome 14 (n = 56, 28%) or 15 (n = 62, 31%) in which 75 breakpoints were identified, the most common breakpoint, 13q22, was observed in 12 subjects (6%), followed by 14q32 (n = 11), 15q15 (n = 9), and 15q22 (n = 9). Most breakpoints were related to gestational infertility, while breakpoints at 13p13, 13p12, 13p11.2, 13p11, 13q11, 13q15, 14p12, 14p10, 15p13, 15p10, and 15q22.2 were associated with pregestational infertility.
Carriers of non-Robertsonian translocations involving chromosome 13, 14, or 15 and experiencing infertility should receive counseling with regard to chromosomal breakpoints as there seem to be consequences for treatment. Intracytoplasmic sperm injection with preimplantation genetic diagnosis (PGD) for the carriers with oligozoospermia, microscopic testicular sperm extraction or sperm from the sperm bank for the carriers with azoospermia should be considered for pregestational infertility. The carriers with gestational infertility can choose PGD or prenatal diagnosis
Relationship between inflammatory markers and visceral obesity in obese and overweight Korean adults
Authors: Yu Ju-Yeon , Choi Won-Jun , Lee Hye-Sun , Lee Ji-Won 
Published: February 2019

Abstract
Obesity is now considered a state of chronic low-grade inflammation. We investigated the relationship between several inflammatory markers and body composition for identifying patients with an increased risk of visceral obesity and compared the predictive values of inflammatory indices in visceral obesity.
Six hundred individuals who received health checkups for obesity-related risk factors in Severance Hospital between January 2008 and March 2017 were included in our study. Serum inflammatory markers, such as white blood cell (WBC), high-sensitivity C-reactive protein (hsCRP), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) levels were assessed. Intra-abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) areas were measured with computed tomography. We performed analysis of covariance, trend analysis, Steiger's Z tests, and multiple linear regression analysis to investigate associations between abdominal adiposity indices and inflammatory markers.
Pearson's correlation analysis revealed a stronger association of VAT with WBC counts (r = 0.157, P < .001) than with levels of NLR (r = 0.108, P = .11; Steiger's Z test, P
‡ = .04) and PLR (r = 0.036, P = .39; Steiger's Z test, P
‡ = .003). WBC and hsCRP levels linearly increased with VAT area (overall P < .001 and trend P < .001) and VAT/SAT ratio (overall P = .001 and trend P = .002; overall P < .001 and trend P < .001, respectively) but linearly decreased with SAT (overall P = .02 and trend P = .17; overall P = .03 and trend P = .01, respectively). Visceral adipose tissue area was more highly associated with WBC and hsCRP levels than with NLR and PLR. Only VAT area was significantly associated with WBC, hsCRP, and NLR levels after adjusting for confounding variables.
We found that VAT, but not SAT area is independently associated with several inflammatory markers. WBC and hsCRP are more strongly correlated with VAT compared with NLR and PLR. Thus, WBC and hsCRP could be useful parameters for identifying individuals at risk for visceral obesity and cardiometabolic diseases.
Development of Infliximab Target Concentrations During Induction in Pediatric Crohn Disease Patients
Authors: Clarkston Kathryn , Tsai Yi‐Ting , Jackson Kimberly , Rosen Michael J. , Denson Lee A. , Minar Phillip 
Published: February 2019

ABSTRACTObjectives:Subtherapeutic drug concentrations contribute to both primary and secondary nonresponse to infliximab in children with Crohn disease (CD). The aim of this study was to evaluate treatment outcomes and infliximab concentrations at infusions 2 and 3 with an objective to establish infliximab targets during induction for primary responders.Methods:Single‐center, prospective cohort of anti‐ tumor necrosis factor‐alpha naïve CD patients younger than 22 years starting infliximab. Clinical response was defined with the weighted pediatric CD activity index at the fourth infusion. Rates of biological response (>50% improvement in fecal calprotectin) and maintenance concentrations ≥5 μg/mL were secondary outcomes.Results:We enrolled 72 patients with CD with 70 of 72 receiving infliximab monotherapy. Clinical response, biological response, and start of maintenance concentrations ≥5 μg/mL were achieved in 64%, 54%, and 22%, respectively. The median (interquartile range) infliximab concentrations at infusion 2 and 3 in clinical responders were 27.8 μg/mL (19.5–40) and 14 μg/mL (8.3–24) compared to 18.8 μg/mL (9.1–23, P < 0.001) and 7.8 μg/mL (4–13.2, P < 0.01) in nonresponders. Receiver operating characteristic analysis determined that an infliximab concentration ≥15.9 μg/mL at infusion 3 was associated with clinical response (area under the curve [AUC] 0.73), whereas an infusion 3 level ≥18 μg/mL was associated with a start of maintenance concentration >5 μg/mL (AUC 0.85). Independent predictors for infusion 3 levels <18 μg/mL included pretreatment prednisone, low body mass index, elevated erythrocyte sedimentation rate and C‐reactive protein, hypoalbuminemia, and an infusion 2 infliximab level <29 μg/mL.Conclusions:We found that infusion 2 (≥29 μg/mL) and infusion 3 (≥18 μg/mL) infliximab concentrations were strongly associated with improved early outcomes and higher first maintenance dose levels.
Staff's Perception of the Intensive Care Outreach Nurse Role
Authors: Williams Ged , Rotering Loralee , Samuel Asha , Du Plessis Jean , Abdel Khaleq Maher H. A. , Crilly Julia 
Published: February 2019

Background:
Rapid Response Systems are emerging internationally to provide a patient-focused approach to prevent potentially avoidable deaths and serious adverse events.

Local Problem:
This study focused on ward nurses in the United Arab Emirates (UAE) government hospitals who were perceived to lack the confidence and knowledge to detect and/or respond to deteriorating patients.

Method:
A cross-sectional study design was used to evaluate the Intensive Care Outreach Nurse (ICON) role from the perspectives of the ICONs, their managers/educators, and ward-based physicians and nurses. ICONs are intensive care experienced nurses with additional education in the role of rapid responder to the deteriorating patient.

Interventions:
An ICON role was implemented across 4 hospitals to respond to and support clinicians in the recognition and management of the deteriorating patient on general inpatient wards.

Results:
ICON skills perceived as most beneficial by respondents included staff education, respiratory therapy, medication administration, and intravenous access.

Conclusions:
The ICON role is able to support recognition and management of the deteriorating patients.
Academic and Community–Engaged Approach to Integrating Open Educational Resources in Population Health Course
Authors: Nguyen-Truong Connie Kim Yen , Graves Janessa M. , Enslow Electra , Williams-Gilbert Wendy 
Published: February 2019

Background
Open educational resources (OERs) increase access to high-quality academic learning materials and promote affordable education in nursing.

Problem
Integrating OERs into existing nursing courses can be arduous for faculty.

Approach
An academic and community–engaged approach involved faculty, university librarians, and community stakeholders. Community leaders and population health experts helped identify OERs for a population health theory course.

Outcomes
Community stakeholders identified potential OERs, and university librarians assisted faculty in evaluating the OERs for quality.

Conclusions
Findings illustrate the value of faculty engaging with community stakeholders to help identify OERs and with university librarians to evaluate the OERs to ensure that the information presented is relevant and applicable to course objectives.
Ischemic Stroke Incidence in Patients With Microvascular Ocular Motor Palsy Versus Patients With Lacunar Ischemic Stroke
Authors: Beato-Coelho José , Varela Ricardo , Almendra Luciano , Carvalho Mário , Duque Cristina , Patrício Miguel , Sargento-Freitas João , Freire António , Lemos João 
Published: February 2019

Objective:
Presumed microvascular ischemia is the most frequent cause of ocular motor palsy (OMP). Ischemic stroke incidence after an episode of microvascular OMP (mOMP) is not established, contrasting with other common vascular conditions, such as lacunar ischemic stroke (LS). We sought to compare the incidence of subsequent ischemic stroke between mOMP and LS populations.

Methods:
A retrospective observational analysis was conducted on acute patients presenting with either mOMP or LS. A propensity score match was applied to ensure a balance between groups. We compared the incidence of subsequent ischemic stroke during an 80-month follow-up.

Results:
A total of 110 patients were included in the study (57, mOMPs; 53, LS). During follow-up, the annual occurrence rate of ischemic stroke was 2.1% per year in mOMP group and 0.6% per year in the LS group. After performing Cox regression, we found no statistical significance difference between groups in the incidence of subsequent ischemic stroke (P=0.801).

Conclusions:
Patients with presumed mOCP seem to share similar incidence of subsequent ischemic stroke with patients with LS. Presumed mOCP may be an underrecognized independent risk factor for ischemic stroke.
Next-generation Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors for Leptomeningeal Carcinomatosis
Authors: Grimsrud Kate W. , Mrugala Maciej M. 
Published: February 2019

Introduction:
Epidermal growth factor receptor (EGFR) mutation status is strongly correlated with leptomeningeal carcinomatosis in non–small cell lung cancer. Historically, patients were treated with radiotherapy, intrathecal chemotherapy or first-generation EGFR tyrosine kinase inhibitors (TKIs); however, most would eventually develop resistance and disease progression. Therefore, recent interest has sparked in investigating next-generation EGFR-TKI monotherapy.

Case reports:
We describe 2 patients with non–small cell lung adenocarcinoma who later presented with leptomeningeal disease, treated with next-generation EGFR-TKI monotherapy, independent of whole-brain radiotherapy, with favorable response and outcome.

Conclusions:
The next-generation EGFR-TKIs may have improved success in treatment of leptomeningeal metastases in non–small cell lung adenocarcinoma when compared with the first-generation and second-generation EGFR-TKIs. Next-generation EGFR-TKI monotherapy should be considered in select patients with leptomeningeal metastases from lung adenocarcinoma. More research is needed to review this potential therapeutic option, especially for use as first-line therapy.
Intraocular Pressure as an Indicator of the Level of Induced Anxiety in Basketball
Authors: Vera Jesús , Jiménez Raimundo , Redondo Beatríz , Madinabeitia Iker , Madinabeitia Iñigo , Alarcón López Francisco , Cárdenas David 
Published: February 2019

SIGNIFICANCE
Our data demonstrate that intraocular pressure (IOP) is sensitive to anxiety manipulation in sport scenarios, specifically in a basketball free throw task. The present outcomes may be of special relevance because of its practical advantages for the objective control of athletes' anxiety levels.

PURPOSE
Athletes experience high levels of anxiety during sport competition, and IOP has demonstrated to reflect autonomous nervous system changes during mentally demanding situations. We tested whether different levels of induced anxiety during basketball free throw shooting alter IOP.

METHODS
We followed a repeated-measures design to test the effects of anxiety-induced manipulation during basketball free throw shooting on IOP, shooting performance, and perceived anxiety. Eighteen amateur basketball players performed three experimental sessions consisting of 100 free throws each. However, we gave three different instructions to participants regarding the score assigned to each free throw, allowing us to manipulate the level of induced anxiety (low, medium, and high).

RESULTS
Confirming a successful anxiety manipulation, basketball players reported more perceived anxiety with higher levels of induced anxiety (P < .001, η2 = 0.37). Our data show that higher levels of induced anxiety provoke an acute IOP rise (P < .001, η2 = 0.44), with the low-, medium-, and high-anxiety–induced conditions promoting an average IOP rise of 0.21, 1.63, and 18.46%, respectively. Also, there was a linear IOP rise over time in the high-anxiety–induced condition (r = 0.82). Nevertheless, we found no effect of anxiety-induced manipulation on basketball free throw performance (P = .93).

CONCLUSIONS
Intraocular pressure is sensitive to anxiety-induced manipulation during basketball free throw shooting, showing an increase in parallel with accumulated anxiety. Based on these findings, IOP may be considered a promising tool for the assessment of the level of anxiety in certain sport situations. Future studies are required to explore the generalizability of these results in other scenarios with different physical and mental demands.
Ocular Point-of-Care Ultrasound in the Pediatric Emergency Department
Authors: Seguin Jade , Le Cathie-Kim , Fischer Jason W. , Tessaro Mark Oliver , Berant Ron 
Published: February 2019

Objective
Point-of-care ultrasound has become an important adjunct for diagnostic assessment in pediatric emergency medicine. In this case series, we demonstrate how ocular point-of-care ultrasound is used to correctly diagnose ocular pathologies and to expedite care.

Methods/Results
We present a series of cases in which the point-of-care ultrasound ocular examination proved valuable in the timely diagnosis of pathologies involving the lens, vitreous, retina, and retrobulbar segment of the eye.

Conclusion
Point-of-care ultrasound may facilitate diagnosis in children with ocular complaints, even in young and uncooperative patients, and should be considered in children of all ages.