bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Symptoms From C6 and C7 Radiculopathy
Authors: Rainville James , Joyce Andrew A. , Laxer Eric , Pena Enrique , Kim David , Milam R. Alden , Carkner Eric 
Published: August 2017

Study Design.
Case series.

Objective.
This study compared the locations of arm pain, sensory symptoms, and subjective complaints of arm weakness in patients with cervical radiculopathy from MRI confirmed C6 and C7 nerve root compression.

Summary of Background Data.
Cervical radiculopathy is defined as arm pain, sensory and motor symptoms caused by irritation of a cervical nerve root. The C6 and C7 roots are most commonly involved, and differentiating symptoms associated with each root has proven difficult. Cervical MRI allows accurate identification of nerve root compression and therefore makes it possible to explore symptom patterns that may differentiate C6 from C7 radiculopathy.

Methods.
A total of 122 patients with symptoms suggestive of cervical radiculopathy were recruited. Of these, 30 patients had MRI confirmed C6 and 39 patients C7 nerve root compression. By completing a study questionnaire, patients reported specific arm weakness, and marked the location of arm pain and tingling/numbness on graphic representations of the arm. Marked areas were interpreted by superimposing a grid that divided the arm into 54 distinct areas. The frequencies of reported symptoms with C6 and C7 were totaled and then compared with likelihood rations. Power analysis calculated that 27 patients would be needed in each group based on the assumption that a 30 percentage point difference in frequency of specific symptom would be clinically useful for differentiating C6 from C7 radiculopathy.

Results.
Arm pain and sensory symptoms were diffuse, and were not distinctly different for C6 or C7 radiculopathy. Some weakness was reported by 41 percent of patients, with specific descriptions of weakness having limited value for differentiating between radiculopathies.

Conclusion.
The location of pain and sensory symptoms, and specific weakness complaints associated with symptomatic C6 and C7 nerve root compression overlap to the extent that caution should be exercised when predicting root involvement based on symptoms.

Level of Evidence: 3
Predictive Findings of the Presence of Stooping in Patients With Lumbar Degenerative Kyphosis by Upright Whole Spine Lateral Radiography
Authors: Son Seung Min , Shin Jong Ki , Goh Tae Sik , Suh Kuen Tak , Lee Jung Sub 
Published: August 2017

Study Design.
A retrospective study.

Objective.
The aim of this study was to identify the relationships between radiological findings and the presence of stooping in lumbar degenerative kyphosis (LDK).

Summary of Background Data.
Many studies have addressed fixed sagittal imbalances and surgical treatments. However, information regarding the relationship between radiological findings and stooping in LDK is sparse.

Methods.
The study included 73 patients with LDK and 44 with normal lumbar lordosis. Of those with LDK, 63 patients exhibited stooping (group 1) and 10 did not (group 2). Of those with 44 normal lumbar lordosis, 13 patients exhibited stooping (group 3) and 31 patients did not (group 4). Radiographic parameters such as sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), horizontal distance between C7 plumb line and the posterosuperior corner of the sacrum (C7PL), sacrofemoral distance (SFD), C7PL/SFD ratio (C7/SFD), spinosacral angle (SSA), spinopelvic angle (SPA), C2-C7 lordosis (CL), C2-C7 sagittal vertical axis (C2-C7 SVA), T1 slope, and T1 slope minus C2-C7 lordosis (TS-CL) were analyzed.

Results.
Significant differences were observed in TK, LL, C7PL, SFD, C7/SFD, PT, SS, SSA, SPA, C2-C7 SVA, and TS-CL between LDK and normal lumbar lordosis, but no significant intergroup difference was observed in PI, CL, or T1 slope. These results showed that groups 1 and 3 had higher C7PL, C7/SFD, PT, and CL values than groups 2 and 4. Logistic regression analysis revealed that C7/SFD and CL could significantly predict stooping in LDK.

Conclusion.
C7/SFD and CL predict the presence of stooping in LDK. Furthermore, patients with LDK with compensatory mechanisms to maintain sagittal balance have low C7PL values, that is, C7/SFD < 0.5 and high PT and CL on upright whole spine lateral radiography.

Level of Evidence: 3
Adiponectin Downregulates TNF-α Expression in Degenerated Intervertebral Discs
Authors: Yuan Bin , Huang Liangliang , Yan Ming , Zhang Shilei , Zhang Yongfeng , Jin Boquan , Ma Ying , Luo Zhuojing 
Published: August 2017

Study Design.
Given the results of previous in vitro investigations of the expression patterns of adiponectin and its receptors in healthy and degenerated intervertebral discs (IVDs), we studied the effects of adiponectin on tumor necrosis factor-alpha (TNF-α) production in degenerated nucleus pulposus (NP) cells and analyzed the association between adiponectin levels in IVD tissues and IVD Pfirrmann grades.

Objective.
The aim of this study was to investigate the potential role of adiponectin in the pathogenesis of IVD degeneration.

Summary of Background Data.
Adiponectin has been reported to be involved in physiologic and pathologic processes associated with bone and cartilage diseases. However, the expression profiles of adiponectin and its receptors in human IVD tissues and the function of adiponectin in the pathogenesis of IVD degeneration remain unknown.

Methods.
Real-time polymerase chain reaction, immunohistochemistry, and western blotting were performed to examine the expression levels of adiponectin, adiponectin receptors, and TNF-α in IVD tissues and isolated NP cells. The effects of adiponectin on TNF-α production in degenerated NP cells were detected by enzyme linked immunosorbent assay.

Results.
Adiponectin expression levels were downregulated, while adiponectin receptor 1 (adipoR1) and adipoR2 expression levels were upregulated in degenerated IVD tissues and degenerated NP cells compared with those in healthy IVD tissues and healthy NP cells. Moreover, we confirmed that TNF-α production by degenerated NP cells was downregulated by adiponectin administration in a dose- and time-dependent manner. Furthermore, our data showed that adiponectin levels in degenerated IVD tissues were inversely correlated with IVD Pfirrmann grades.

Conclusion.
These results indicated that adiponectin may play an anti-inflammatory role with respect to the maintenance of IVD homeostasis by downregulating TNF-α production.

Level of Evidence: N/A
Can C7 Slope Substitute the T1 slope?
Authors: Tamai Koji , Buser Zorica , Paholpak Permsak , Sessumpun Kittipong , Nakamura Hiroaki , Wang Jeffrey C. 
Published: August 2017

Study Design.
Retrospective analysis of consecutive 45 radiographs and 120 kinematic magnetic resonance images (kMRI)

Objective.
The aim was to assess the visibility of C7 and T1 endplates on radiographs, and to verify the correlation between C7 or T1 slope and cervical balance parameters using kMRI.

Summary of Background Data.
Because the T1 slope is not always visible due to the anatomical interference, several studies have used C7 slope instead of T1. However, it is still unclear whether the C7 endplate is more visible on radiographs than T1, and if C7 slope has similarity with T1 slope.

Methods.
The endplate visibility was determined using weight-bearing radiography. Subsequently, using weight-bearing MR images, the C7 slope of upper and lower endplate, T1 slope, C1 inclination, C2 slope, atlas-dens interval (ADI), C2–C7 lordotic angle, cervical sagittal vertical axis (cSVA), cervical tilt, cranial tilt, neck tilt, thoracic inlet angle (TIA) were measured, for the analysis of correlation between three types of slopes and cervical balance parameters.

Results.
82% of the upper C7, and 18% of T1 endplate were clearly visible. The upper C7 endplate was significantly visible, whereas T1 endplate was significantly invisible (residual analysis, P < 0.01). Linear regression analysis showed correlation between the upper C7 slope and T1 slope (R
2 = 0.818, P < 0.01) and, lower C7 slope and T1 slope (R
2 = 0.840, P < 0.01). T1 slope significantly correlated with neck tilt, TIA, C2–C7 angle, cSVA, cervical and cranial tilt, but not with the C1 inclination, C2 slope, and ADI. Upper and lower C7 slopes showed the close resemblance with T1 slope in terms of correlation with those parameters.

Conclusion.
Both, upper and lower C7 slope correlated strongly with T1 slope and showed similar relationship with cervical balance parameters as T1 slope. Therefore, C7 slope could potentially substitute T1 slope, especially upper C7 slope due to the good visibility.

Level of Evidence: 3
T-type and L-type Calcium Channel Blockers for the Treatment of Cardiac Iron Overload: An Update
Authors: Kumfu Sirinart , Chattipakorn Siriporn C. , Chattipakorn Nipon 
Published: August 2017

Abstract:
In patients with thalassemia, iron overload cardiomyopathy is a major cause of cardiac dysfunction and mortality. Despite many advances in the development of new iron chelating agents, heart failure still occurs in some patients and can lead to an increase in mortality rate. Recently, potential novel therapeutic strategies in the treatment of these patients have focused on L-type and T-type calcium channel blockers. These 2 channels have been reported as being the main routes for cardiac iron uptake under conditions of iron overload. In this review, the effects of these calcium channel blockers on both cardiac iron uptake and cardiac function under conditions of iron overload are discussed, and both consistent and inconsistent findings published in various studies are summarized and reviewed. Through this we hope to provide a greater insight into how future studies can most effectively use these drugs at the clinical trial stage.
Endometriosis in adolescents
Authors: Dowlut-McElroy Tazim , Strickland Julie L. 
Published: August 2017

Purpose of review
The current article addresses recent literature regarding the diagnosis and management of endometriosis in adolescents.

Recent findings
An increasing body of literature suggests that advanced-stage endometriosis (revised scoring system of the American Society for Reproductive Medicine Stage III or IV) and deeply invasive endometriosis are relatively common in adolescents. There remains limited data on the efficacy of postoperative hormonal management of endometriosis in the adolescent population.

Summary
Strong consideration should be made for surgical diagnosis of endometriosis in adolescents with pelvic pain, including noncyclic pain, with a concurrent family history of endometriosis and personal history of atopic disease. More research is needed regarding the benefits of the routine use of hypoestrogenic and other hormonal agents in the prevention of disease progression and long-term sequela in adolescents with endometriosis.
Is the Optic Nerve Head Structure Impacted by a Diagnostic Lumbar Puncture in Humans?
Authors: Poli Muriel , Denis Philippe , Sellem Eric , Aho-Glélé Ludwig-Serge , Bron Alain M. 
Published: August 2017

Purpose:
The purpose of this study is to assess in vivo whether diagnostic lumbar puncture (LP) is followed by optic nerve head (ONH) and parapapillary anatomic changes in normal human eyes.

Materials and Methods:
Prospective, single-center, observational case series. ONH structures (prelaminar tissue surface, anterior surface of the lamina cribrosa, central retinal vessels) and parapapillary structures (internal limiting membrane, posterior surfaces of retinal nerve fiber layer and Bruch membrane/retinal pigment epithelium complex, Bruch membrane opening, posterior surface of the choroid) were quantitatively evaluated by means of swept-source optical coherence tomography (Triton Ver.10.05, Topcon, Tokyo, Japan) before and after LP (5, 60, and 360 min). Each of these structures was manually delineated for measurement before being superimposed to detect any displacement, using peripheral margins of parapapillary structures as a reference plane.

Results:
A total of 16 eyes of 8 nonglaucomatous patients were evaluated. The CSF volume was median (IQR), 1.65 mL (1.16 to 2.00) and none of the ONH structures showed any anatomic changes at any time point after LP.

Conclusions:
According to the design of this study, diagnostic LP is a safe procedure regarding deep ONH structures in nonglaucomatous subjects.
Risk Markers for Pertussis Among Infants <4 Months of Age
Authors: Winter Kathleen , Harriman Kathleen 
Published: August 2017

Objectives:
Hispanic infants are at greater risk of pertussis compared with other racial/ethnic groups. Studies have shown that the source of Bordetella pertussis infection for most infants is household members. Using a case-control study, we examined risk markers for pertussis among Hispanic and non-Hispanic infants and evaluated whether maternal parity, a proxy for household size, contributes to the ethnic disparity.

Methods:
We evaluated infants born in California during 2013–2014; cases were infants reported to California Department of Public Health with pertussis occurring before 4 months of age, and controls were infants who survived to at least 4 months of age without pertussis. Bivariate comparisons and multivariate logistic regression models were used to identify risk markers for pertussis in Hispanic and non-Hispanic infants.

Results:
Increased maternal parity was associated with greater risk of pertussis, with a clear dose response observed with increasing risk for additional prior births. Teenage mothers were more likely to have infants with pertussis. These were both independent risk factors across all racial/ethnic groups, even when adjusting for important covariates. Preterm birth and Medicaid insurance were also identified as independent risk markers among Hispanic infants only.

Conclusions:
Infants of all races/ethnicities with older siblings or born to younger mothers are at increased risk of pertussis. Among Hispanic infants, prematurity and Medicaid insurance were independent risk markers for pertussis. These factors highlight the need to ensure prompt immunization of pregnant women with Tdap at the earliest opportunity starting at 27 weeks gestation.
Patient-Reported Outcomes From the United States Clinical Trial for a Hybrid Cochlear Implant
Authors: Kelsall David C. , Arnold Renée J. G. , Lionnet Leonard 
Published: August 2017

Objective:
To assess patient-reported outcomes (PROs) in individuals with significant residual low-frequency hearing and severe-to-profound high-frequency sensorineural hearing loss (SNHL) who received the hybrid cochlear implant (CI).

Study Design:
Prospective, multicenter, nonrandomized, single-arm repeated measures, single-subject design.

Setting:
Tertiary centers, ambulatory care.

Patients:
Fifty adults with severe-to-profound high-frequency SNHL and residual low-frequency hearing with aided word recognition scores between 10 and 60% in the ear to be implanted, and in the contralateral ear greater than or equal to implant ear less than or equal to 80%.

Intervention:
Therapeutic; hybrid CI.

Main Outcome Measures:
Speech, spatial and qualities of hearing scale (SSQ), device use questionnaire (DUQ), University of Washington Clinical Assessment of Music Perception (UW-CAMP) assessed preoperatively and after 6 and 12 (SSQ and DUQ only) months of hybrid CI use.

Results:
Significant improvements in mean SSQ ratings were demonstrated at 6 and 12 months postactivation overall and for domains related to speech hearing, spatial hearing, and sound quality. Significant improvement was also found for overall satisfaction on the DUQ and across a number of specific listening situations in addition to aspects related to social engagement. UW-CAMP pitch discrimination and melody and timbre recognition abilities were not compromised postoperatively, allowing hybrid subjects to maintain superior music perception abilities than typically observed with standard CIs.

Conclusions:
Patients who received the hybrid CI demonstrated significant PRO benefits on the SSQ and the DUQ after 6 and 12 months of CI use. In addition, given the opportunity to maintain useful low-frequency acoustic hearing, patients retained music listening abilities, as assessed by the UW-CAMP.
The Disputed Discovery of Facial and Trigeminal Nerve Function: Revisiting the Contributions of Herbert Mayo and Charles Bell
Authors: Carlson Matthew L. , Bradley James , Van Gompel Jamie J. , Tubbs R. Shane 
Published: August 2017

Background:
The first description of the voluntary motor function of the facial nerve and separate sensory-motor contributions of the trigeminal nerve is most commonly attributed to Charles Bell. However, a review of the original scientific accounts and subsequent historical publications question the validity of this credit. The objective of the present historical analysis is to clarify the contributions of Herbert Mayo toward discovering the functions of the fifth and seventh cranial nerves and to raise awareness of this historical controversy within the medical literature.

Methods:
Review of Charles Bell's and Herbert Mayo's original dissertations published between 1821 and 1823, and subsequent reports relevant to these primary works.

Results:
Bell's submissions to the Royal Society of London in 1821 and 1822 describe the seventh nerve as the “respiratory nerve of the face” responsible for involuntary coordination of facial movement with the organs of respiration. Separately, Bell states that the fifth nerve is responsible for sensibility and voluntary movement of the facial muscles. In these accounts, Bell only peripherally alludes to the motor function of the seventh nerve and often comments inaccurately on fifth and seventh cranial nerve innervation. In contrast, in 1822 and 1823, Herbert Mayo first accurately and unequivocally defined the voluntary motor function of the facial nerve and sensory-motor function of the trigeminal nerve on the basis of his detailed experiments. The ultimate transfer of acknowledgment to Bell was rooted in surreptitious reworking of Bell's original dissertations and personal attacks against Mayo rather than arguments of scientific merit.

Conclusion:
Several notable clinicians and anatomists have contributed to our current understanding of the anatomy and physiology of the facial and trigeminal nerves, including Charles Bell; however, Herbert Mayo should be remembered for first providing a more accurate and clear description of their separate functions.
Provider Opinions and Experiences Regarding Development of a Social Support Assessment to Inform Hospital Discharge
Authors: Wallace Andrea , Papke Todd , Davisson Erica , Spooner Kara , Gassman Laura 
Published: August 2017

Purpose of Study:
Despite over three decades of research linking social support and optimal health outcomes, social support is not systematically assessed or addressed during clinical care. This study sought input from health care providers to inform the design of an intervention intended to facilitate assessment of social support in a way that could aid in anticipatory planning during the process of hospital discharge.

Primary Practice Setting(s):
Using a purposive sampling strategy, data were collected from providers in two acute care settings serving rural patients, one academic and one community based. Opinions about what an assessment of social support would seek to accomplish, what is currently done and by whom, and the preferred format for delivery were elicited during a series of individual and group interviews. During phase two, feasibility was assessed with three inpatient nurses over 3 clinical days. Field notes were analyzed throughout the project using rapid data analysis techniques.

Results:
Health care providers endorsed the creation of an assessment and stated that target users would include all members of the discharge team (e.g., clinical nurses, case managers, discharge coordinators, hospitalists, and specialty care). They identified the need for a patient–family resource (vs. a traditional provider-facing assessment). Participants stated that, although both the information collected and the interview process would meet a need to increase patient engagement in inpatient settings, competing clinical demands would require a tool that was easily completed by patients and family and seen as directly informing clinical activities. To this end, although focusing on the eventual development of an electronic tool seemed valuable, a hard-copy resource was considered more feasible for patient use at the present time. The preliminary test of the resulting hard-copy “Going Home Toolkit” demonstrated potential feasibility and usefulness during clinical practice.

Implications for Case Management Practice:
There is need for not only assessing patients' supportive networks during discharge planning, but to do so in a way that would facilitate directed communication between, and engagement with, team members, patients, and families. Especially in light of new legislation focusing on involvement of caregivers, a tool such as the “Going Home Toolkit” may facilitate important conversations about, and planning around, patients' supportive resources at home.
Point-of-Care Ultrasound in Acute Neonatal Ascites
Authors: Ramgopal Sriram , Scholz Stefan , Marin Jennifer R. 
Published: August 2017

Abstract
We present a 4-week-old neonate with acute onset of bloody stools and abdominal distention. Point-of-care ultrasound performed in the emergency department allowed for rapid diagnosis of a large amount of free intra-abdominal fluid, which together with the physical findings, prompted emergent operative exploration revealing chylous ascites. Although no areas of active volvulus were identified intraoperatively, findings in the case were suggestive of small bowel volvulus and deemed as the most likely etiology for this patient's presentation. In this report, we review the relevant aspects of ultrasonography for ascites and discuss the diagnosis of chylous ascites.
“I Did Not Want to Give Birth to a Child Who has HIV”: Experiences Using PrEP During Pregnancy Among HIV-Uninfected Kenyan Women in HIV-Serodiscordant Couples
Authors: Pintye Jillian , Beima-Sofie Kristin M. , Kimemia Grace , Ngure Kenneth , Trinidad Susan Brown , Heffron Renee A. , Baeten Jared M. , Odoyo Josephine , Mugo Nelly , Bukusi Elizabeth A. , Kelley Maureen C. , John-Stewart Grace C. 
Published: August 2017

Objectives:
The perceptions, motivations, and beliefs of HIV-uninfected women about pre-exposure prophylaxis (PrEP) use during pregnancy can influence its uptake and adherence. This study elicited the views of HIV-uninfected women with personal experience taking PrEP during pregnancy.

Design:
Qualitative interviews were conducted with HIV-uninfected women who had personal experience taking PrEP while pregnant.

Methods:
Semistructured interviews were conducted with 21 HIV-uninfected Kenyan women in HIV-serodiscordant couples enrolled in an open-label PrEP demonstration project who became pregnant while using PrEP and continued PrEP through their pregnancy. Interviews were audio-recorded and transcribed into English. A qualitative descriptive analysis was performed, using a constant comparison approach to identify key themes related to PrEP use in pregnancy.

Results:
Desire to remain HIV uninfected and have an HIV-free infant were strong motivators influencing continued use of PrEP during pregnancy. Supporting HIV-infected partners and childbearing within an HIV-serodiscordant relationship were also motivators. Women had challenges distinguishing normal pregnancy symptoms from PrEP side effects and were concerned that observed side effects could be signs of danger for the infant related to PrEP exposure. Health care providers were important conduits of knowledge about PrEP, and continuity of PrEP providers throughout pregnancy facilitated adherence.

Conclusions:
HIV-uninfected women in HIV-serodiscordant couples were motivated to use PrEP during pregnancy to remain HIV uninfected and to have an HIV-free child but had concerns about side effects. Health care providers will be important for PrEP messaging and adherence support in this unique population.