bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulating microRNAs in breast cancer: novel diagnostic and prognostic biomarkers
Authors: Hamam Rimi , Hamam Dana , Alsaleh Khalid A , Kassem Moustapha , Zaher Waleed , Alfayez Musaad , Aldahmash Abdullah , Alajez Nehad M 
Published: September 2017

AbstractEffective management of breast cancer depends on early diagnosis and proper monitoring of patients’ response to therapy. However, these goals are difficult to achieve because of the lack of sensitive and specific biomarkers for early detection and for disease monitoring. Accumulating evidence in the past several years has highlighted the potential use of peripheral blood circulating nucleic acids such as DNA, mRNA and micro (mi)RNA in breast cancer diagnosis, prognosis and for monitoring response to anticancer therapy. Among these, circulating miRNA is increasingly recognized as a promising biomarker, given the ease with which miRNAs can be isolated and their structural stability under different conditions of sample processing and isolation. In this review, we provide current state-of-the-art of miRNA biogenesis, function and discuss the advantages, limitations, as well as pitfalls of using circulating miRNAs as diagnostic, prognostic or predictive biomarkers in breast cancer management.
Sensorik Inventar (SI) – Selbstbeurteilung der sensorischen
Sensitivität für Erwachsene und Jugendliche
Authors: Zamoscik Vera , Niemeyer Christine , Gerchen Martin Fungisai , Fenske Sabrina Christina , Witthöft Michael , Kirsch Peter 
Published: September 2017

ZusammenfassungEine adäquate Wahrnehmung der Umwelt repräsentiert eine der Grundvoraussetzungen
adaptiven Verhaltens. Gleichzeitig existieren individuelle Unterschiede in der
sensorischen Sensitivität, die wiederum eine zentrale Rolle bei der Entstehung
und Aufrechterhaltung diverser psychischer Störungen spielen können. Die
Fragestellung war die Entwicklung eines Fragebogens zur multidimensionalen
Erfassung von sensorischer Sensitivität. Das Sensorik Inventar (SI) wurde von
1417 Personen ausgefüllt. Die faktorielle Validität wurde mit Hilfe explorativer
Faktorenanalysen sowie mit Exploratory-Structural-Equation-Modeling überprüft.
Es ergab sich eine 6-faktorielle Struktur und eine hohe interne Konsistenz sowie
Retestreliabilität. Probanden mit psychischen Störungen zeigten überwiegend
verstärkte sensorische Sensitivitäten und eine geringere Körperwahrnehmung. Das
SI stellt ein kurzes und im Forschungs- und Klinikalltag leicht zu
integrierendes Instrument mit guten psychometrischen Eigenschaften dar.
Creating Flexible and Sustainable Work Models for Academic Obstetrician–Gynecologists Engaged in Global Health Work
Authors: Molina Rose , Boatin Adeline , Farid Huma , Luckett Rebecca , Neo Dayna , Ricciotti Hope , Scott Jennifer 
Published: September 2017

OBJECTIVE:
To describe various work models for obstetrics and gynecology global health faculty affiliated with academic medical centers and to identify barriers and opportunities for pursuing global health work.

METHODS:
A mixed-methods study was conducted in 2016 among obstetrics and gynecology faculty and leaders from seven academic medical institutions in Boston, Massachusetts. Global health faculty members were invited to complete an online survey about their work models and to participate in semistructured interviews about barriers and facilitators of these models. Department chairs and residency directors were asked to participate in interviews.

RESULTS:
The survey response rate among faculty was 65.6% (21/32), of which 76.2% (16/21) completed an interview. Five department leaders (45.5% [5/11]) participated in an interview. Faculty described a range of work models with varied time and compensation, but only one third reported contracted time for global health work. The most common barriers to global health work were financial constraints, time limitations, lack of mentorship, need for specialized training, and maintenance of clinical skills. Career satisfaction, creating value for the obstetrics and gynecology department, and work model flexibility were the most important facilitators of sustainable global health careers.

CONCLUSION:
The study identified challenges and opportunities to creating flexible and sustainable work models for academic obstetrics and gynecology clinicians engaged in global health work. Additional research and innovation are needed to identify work models that allow for sustainable careers in global women's health. There are opportunities to create professional standards and models for academic global health work in the obstetrics and gynecology specialty.
Evidence-Based Bundles and Cesarean Delivery Surgical Site Infections
Authors: Carter Ebony B. , Temming Lorene A. , Fowler Susan , Eppes Catherine , Gross Gilad , Srinivas Sindhu K. , Macones George A. , Colditz Graham A. , Tuuli Methodius G. 
Published: September 2017

OBJECTIVE:
To estimate the association of implementation of evidence-based bundles with surgical site infection rates after cesarean delivery.

DATA SOURCES:
We searched MEDLINE through PubMed, EMBASE, Scopus, the Cochrane Database of Systematic Reviews, Google Scholar, and ClinicalTrials.gov.

METHODS OF STUDY SELECTION:
We searched electronic databases for randomized controlled trials and observational studies comparing evidence-based infection prevention bundles for cesarean delivery, defined as implementation of three or more processes proven to prevent surgical site infection such as chlorhexidine skin preparation, antibiotic prophylaxis, and hair clipping, with usual care. The primary outcome was overall surgical site infection, defined using Centers for Disease Control and Prevention's National Healthcare Safety Network criteria. Secondary outcomes were superficial or deep surgical site infection and endometritis. Quality of studies and heterogeneity were assessed using validated measures. Pooled relative risks (RRs) with 95% CIs were calculated using random-effects models. Numbers needed to treat were estimated for outcomes with significant reduction.

TABULATIONS, INTEGRATION, AND RESULTS:
We found no randomized controlled trials. Fourteen preintervention and postintervention studies met inclusion criteria. Eight were full-text articles, and six were published abstracts. Quality of most of the primary studies was adequate with regard to the intervention, but modest in terms of implementation. The rate of surgical site infection was significantly lower after implementing an evidence-based bundle (14 studies: pooled rates 6.2% baseline compared with 2.0% intervention, pooled RR 0.33, 95% CI 0.25–0.43, number needed to treat=24). Evidence-based bundles were also associated with a lower rate of superficial or deep surgical site infection (six studies: pooled rate 5.9% baseline compared with 1.1% intervention, pooled RR 0.19, 95% CI 0.12–0.32, number needed to treat=21). The rate of endometritis was low at baseline and not significantly different after intervention (six studies: pooled rate 1.3% baseline compared with 0.9% intervention, pooled RR 0.57, 95% CI 0.31–1.06).

CONCLUSION:
Evidence-based bundles are associated with a significant reduction in surgical site infection after cesarean delivery.
A Missed Opportunity for U.S. Perinatal Human Immunodeficiency Virus Elimination
Authors: Fruhauf Timothee , Coleman Jenell S. 
Published: September 2017

OBJECTIVE:
To estimate the proportion of women at increased risk of sexual human immunodeficiency virus (HIV) acquisition during pregnancy in a high HIV incidence urban setting to identify those who may be eligible for pre-exposure prophylaxis.

METHODS:
We conducted a retrospective cohort study of women who received prenatal care at a large academic center in 2012. Univariable analyses and multiple logistic regression models were built to identify correlates for pre-exposure prophylaxis eligibility.

RESULTS:
Among 1,637 pregnant women, mean age was 27.6 years (SD 6.3), 59.7% were African American, and 56.0% were single. Based on the Centers for Disease Control and Prevention's guidelines, more than 10% of women were at increased risk for HIV acquisition during pregnancy and eligible for pre-exposure prophylaxis. Younger [adjusted odds ratio (OR) 0.9/1-year increase, 95% CI 0.8–0.9], single (adjusted OR 2.4, 95% CI 1.2–4.8), African American women (adjusted OR 3.3, 95% CI 1.6–6.7) with higher parity (adjusted OR 1.3/one-child increase, 95% CI 1.1–1.5), and who smoked regularly during pregnancy (adjusted OR 1.8, 95% CI 1.0–3.0) had greater odds of being eligible for pre-exposure prophylaxis at any time during pregnancy.

CONCLUSIONS:
Pregnancy is a vulnerable period during which some heterosexual women in urban settings have a high risk for HIV acquisition and stand to benefit from pre-exposure prophylaxis.
Spinal Surgeons’ Opinions on Pre- and Postoperative Rehabilitation in Patients Undergoing Lumbar Spinal Fusion Surgery
Authors: van Erp Reni M.A. , Jelsma Jetse , Huijnen Ivan P.J. , Lundberg Mari , Willems Paul C. , Smeets Rob. J.E.M. 
Published: September 2017

Study Design.
A cross-sectional survey in the Netherlands and Sweden.

Objective.
To investigate Dutch and Swedish spinal surgeons’ opinions on spinal fusion pre- and postoperative rehabilitation.

Summary of Background Data.
Lumbar spinal fusion surgery is increasingly provided in patients with chronic low back pain. No guidelines however exist for pre- and postoperative rehabilitation and it is unknown what opinions spinal surgeons currently have about pre- and postoperative rehabilitation.

Methods.
A survey was circulated to Dutch and Swedish spinal surgeons. Reminders were sent after 4 and 8/9 weeks. Data of completed questionnaires of orthopedic- and neurosurgeons currently performing lumbar spinal fusion were included for analysis. Analysis comprised a range of descriptive summaries (numerical, graphical, and tabular).

Results.
Surveys of 34 Dutch and 48 Swedish surgeons were analyzed. Surgeons provided preoperative information on postoperative mobilization. Spinal fusion techniques varied, but technique did not influence postoperative treatment. Swedish surgeons recommended slightly faster mobilization than Dutch (direct vs. 1-day postoperative), and more activities the first day (sitting, standing, walking). Stair climbing was the most reported discharge criterion; however, time point to start varied. More Swedish surgeons referred to postoperative physiotherapy than Dutch (88% vs. 44%). Time-point to start home activities varied from 1 week to more than 6 months. Pain increase was allowed for less than 24 hours (The Netherlands 81%, Sweden 92%).

Conclusion.
Findings reflect variability in lumbar spinal fusion rehabilitation in two European countries, especially in postoperative phase. The study proposes many new research topics and acts as starting point for future research valuable for the spinal community.

Level of Evidence: 3
Morphometric Analysis of Rat Spinal Cord Angioarchitecture by Phase Contrast Radiography
Authors: Wu Tianding , Cao Yong , Ni Shuangfei , Luo Zixiang , Jiang Liyuan , Lu Hongbin , Hu Jianzhong 
Published: September 2017

Study Design.
An advanced imaging of vasculature with synchrotron radiation X-ray in a rat model.

Objective.
To develop the potential for quantitative assessment of vessel network from two-dimensional (2D) to 3D visualization by synchrotron radiation X-ray phase contrast tomography (XPCT) in rat spinal cord model.

Summary of Background Data.
Investigation of microvasculature contributes to the understanding of pathological development of spinal cord injury. A few of X-ray imaging is available to visualize vascular architecture without usage of angiography or invasive casting preparation.

Methods.
A rat spinal cord injury model was produced by modified Allen method. Histomorphometric detection was simultaneously analyzed by both histology and XPCT from 2D to 3D visualization. The parameters including tissue lesion area, microvessel density, vessel diameter, and frequency distribution of vessel diameter were evaluated.

Results.
XPCT rendered the microvessels as small as capillary scale with a pixel size of 3.7 μm. It presented a high linear concordance for characterizing the 2D vascular morphometry compared with the histological staining (r2 = 0.8438). In the presence of spinal cord injury model, 3D construction quantified the significant angioarchitectural deficiency in the injury epicenter of cord lesion (P<0.01).

Conclusion.
XPCT has a great potential to detect the smallest vascular network with pixel size up to micron dimension. It is inferred that the loss of abundant microvessels (≤40 μm) is responsible for local ischemia and neural dysfunction. XPCT holds a promise for morphometric analysis from 2D to 3D imaging in experimental model of neurovascular disorders.

Level of Evidence: N/A
Predicting Perioperative Complications in Adult Spinal Deformity Surgery Using a Simple Sliding Scale
Authors: Yoshida Go , Hasegawa Tomohiko , Yamato Yu , Kobayashi Sho , Oe Shin , Banno Tomohiro , Mihara Yuuki , Arima Hideyuki , Ushirozako Hiroki , Yasuda Tatsuya , Togawa Daisuke , Matsuyama Yukihiro 
Published: September 2017

Study Design.
A retrospective database study.

Objective.
The aim of this study was to develop and validate a sliding scale for predicting perioperative complications associated with adult spinal deformity (ASD) surgery.

Summary of Background Data.
ASD surgery can have high perioperative complication rates, which is associated with increased morbidity and mortality.

Methods.
Data on consecutive ASD patients undergoing posterior corrective surgery over a 6-year interval were collected from a prospective database. The patients’ preoperative general condition, surgical status, and perioperative complications occurring within 30 days of surgery were analyzed and independent predictors were determined using multivariable logistic regression analysis. We made the sliding scale using cut-off values from receiver operating curve analysis and validated the performance of this model.

Results.
Three hundred four patients were included with a mean age of 62.9 years. One hundred eight patients (35.5%) were affected by at least one perioperative complication with a total of 195 perioperative complications, including neurological (12.8%), excessive blood loss (11.2%), delirium (11.2%), and infection (3.6%). Total independent predictors were age [odds ratio (OR): 1.042], operation time (OPT) (OR: 2.015), and estimated blood loss (EBL) (OR: 4.885) with cut-off values of approximately 70 years, 6 hours, and 2000 mL, respectively. Fusion of ≥10 segments (OR: 2.262), three-column osteotomy (OR: 1.860), current use of antihypertensive (OR: 2.595) and anticoagulant (OR: 7.013), and body mass index (OR: 1.160) were risk factors for neurological complications, infection, and deep vein thrombosis/pulmonary thrombosis. Our proposed sliding scale had a sensitivity of 91%, specificity of 58.1%, and the incidence of perioperative complication in the validation dataset was smaller than that without this scale (P ≤ 0.05).

Conclusion.
Patients’ age, current medication, and degenerative pathology might be independent preoperative as well as operative predictors. An age and comorbidities based sliding scale with classifications of OPT and EBL may be useful for risk prediction in ASD surgery.

Level of Evidence: 3
Whether Orthotic Management and Exercise are Equally Effective to the Patients With Adolescent Idiopathic Scoliosis in Mainland China?
Authors: Zheng Yu , Dang Yini , Yang Yan , Li Huabo , Zhang Lijie , Lou Edmond H. M. , He Chengqi , Wong Mansang 
Published: September 2017

Study Design.
A prospective randomized controlled trial.

Objective.
The aim of this study was to investigate the effectiveness of orthotic management versus exercise on spinal curvature, body symmetry, and quality of life.

Summary of Background Data.
A number of well-designed studies comparing conservative treatment of adolescent idiopathic scoliosis (AIS) have been conducted and the evidence becomes stronger. However, there is a lack of the information on the effectiveness of orthotic management versus exercise.

Methods.
The inclusion criteria recommended by the Scoliosis Research Society (SRS) and the international Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORT) were used during enrollment. Eligible patients were randomly assigned to either bracing group or exercise group. Patients in the bracing group were prescribed with a rigid thoracolumbosacral orthosis and requested to wear 23 h/day, while patients in the exercise group were treated with the protocol of the Scientific Exercise Approach to Scoliosis. Data regarding angle of trunk inclination, Cobb angle, shoulder balance, body image, and quality of life (QoL) were collected every 6 months.

Results.
Twenty-four patients in the bracing group and 29 patients in the exercise group participated in this study. For the intergroup comparison, the bracing group showed better results about the correction of spinal curvature (Cobb angle at the first 12 months of intervention, P = 0.039), scores concerning QoL, especially function (P < 0.001), mental health (P < 0.001), and total score (P < 0.001), were higher than that of the exercise group. The results of body symmetry evaluation did not differ significantly between the two groups. For the intragroup comparison, parameters of spinal curvature (baseline vs. 12-month, P < 0.03 in the exercise group and P < 0.001 in the bracing group), QoL (baseline vs. 12-month, P < 0.001), and TAPS (baseline vs. 12-month, P < 0.033) significantly improved over the studied period. Shoulder balance (baseline vs. 12-month, P < 0.005) showed significant improvement only in the bracing group.

Conclusion.
Both interventions of bracing and exercise showed significant treatment effectiveness on the patients with AIS. Bracing was superior to capture corrections in parameters of spinal curvature and body symmetry, while the QoL, especially in aspect of the functional and psychological status, was significantly better in the exercise group.

Level of Evidence: 1
Chronic exposure to insufficient sleep alters processes of pain habituation and sensitization
Authors: Simpson Norah S. , Scott-Sutherland Jennifer , Gautam Shiva , Sethna Navil , Haack Monika 
Published: September 2017

Abstract
Chronic pain conditions are highly comorbid with insufficient sleep. While the mechanistic relationships between the 2 are not understood, chronic insufficient sleep may be 1 pathway through which central pain-modulatory circuits deteriorate, thereby contributing to chronic pain vulnerability over time. To test this hypothesis, an in-laboratory model of 3 weeks of restricted sleep with limited recovery (5 nights of 4-hour sleep per night followed by 2 nights of 8-hour sleep per night) was compared with 3 weeks of 8-hour sleep per night (control protocol). Seventeen healthy adults participated, with 14 completing both 3-week protocols. Measures of spontaneous pain, heat-pain thresholds, cold-pain tolerance (measuring habituation to cold over several weeks), and temporal summation of pain (examining the slope of pain ratings during cold water immersion) were assessed at multiple points during each protocol. Compared with the control protocol, participants in the sleep-restriction protocol experienced mild increases in spontaneous pain (P < 0.05). Heat-pain thresholds decreased after the first week of sleep restriction (P < 0.05) but normalized with longer exposure to sleep restriction. By contrast, chronic exposure to restricted sleep was associated with decreased habituation to, and increased temporal summation in response to cold pain (both P < 0.05), although only in the past 2 weeks of the sleep-restriction protocol. These changes may reflect abnormalities in central pain-modulatory processes. Limited recovery sleep did not completely resolve these alterations in pain-modulatory processes, indicating that more extensive recovery sleep is required. Results suggest that exposure to chronic insufficient sleep may increase vulnerability to chronic pain by altering processes of pain habituation and sensitization.
Comparison of an Electromagnetic Middle Ear Implant and Hearing Aid Word Recognition Performance to Word Recognition Performance Obtained Under Earphones
Authors: Chang C. Y. Joseph , Spearman Michael , Spearman Brian , McCraney Anna , Glasscock Michael E. 
Published: September 2017

Objective:
To report the results of patients with the Maxum middle ear implant (MEI) and compare word recognition scores (WRS) and speech perception gap (SP Gap) of Maxum versus optimally fit hearing aids (HA).

Study Design:
Case series with chart review.

Setting:
Single, private otology clinic.

Patients:
Eleven ears, in nine adult patients (two women; average age 62.7 yr).

Interventions:
Twelve consecutive ears with moderate to severe sensorineural hearing loss (SNHL) underwent implantation of the Maxum system. One patient was not included due to inadequate preoperative testing.

Main Outcome Measures:
Primary outcome measures included word recognition score (WRS) and SP Gap (maximum word understanding [PB max] – WRSaided) improvement compared with HAs.

Results:
The average Maxum WRS was 64.7% (range, 28–94%), a 41.6% improvement (range, 10–66%) over HAs (p < 0.001). The average Maxum SP Gap was 6.6% (range, −8 to 24%), a 41.6% improvement (range, 10–66%) over HAs (p < 0.001).

Conclusion:
These data demonstrate that the Maxum provides superior WRS than HAs for patients with significant aided SP Gaps. There is a significant, very strong correlation between Maxum WRS and PB max (r = 0.85, p = 0.001). This implies that PB max may reasonably predict WRS outcomes with Maxum before implantation, and the SP Gap can reasonably predict the degree of additional potential benefit with Maxum. In advising patients who may be candidates for both a CI and MEI, PB max and SP Gap measurements will provide useful predictive information to help clinicians counsel patients on their choice of hearing technology.

LEVEL OF EVIDENCE: 4
A Comparison of Real-Time Polymerase Chain Reaction Assays for the Detection of Antimicrobial Resistance Markers and Sequence Typing From Clinical Nucleic Acid Amplification Test Samples and Matched Neisseria gonorrhoeae Culture
Authors: Peterson Shelley W. , Martin Irene , Demczuk Walter , Hoang Linda , Wylie John , Lefebvre Brigitte , Labbé Annie-Claude , Naidu Prenilla , Haldane David , Mulvey Michael R. 
Published: September 2017

Abstract
Real-time polymerase chain reaction (PCR) assays to detect antimicrobial resistance–associated mutations were tested on Neisseria gonorrhoeae–positive clinical samples with matched isolates. Of the nucleic acid amplification tests/cultures, 87.7% (64/73), 98.6% (72/73), and 98.4% (62/63) predicted cephalosporin, ciprofloxacin, and azithromycin susceptibilities, respectively. N. gonorrhoeae multiantigen sequence type was correctly predicted for 98.7% (79/80), and 13 of 58 N. gonorrhoeae–negative specimens showed false-positive results.
Cellular Angiofibroma of the Nasopharynx
Authors: Erdur Zülküf Burak , Yener Haydar Murat , Yilmaz Mehmet , Karaaltin Ayşegül Batioğlu , Inan Hakki Caner , Alaskarov Elvin , Gozen Emine Deniz 
Published: September 2017

Abstract
Angiofibroma is a common tumor of the nasopharynx region but cellular type is extremely rare in head and neck. A 13-year-old boy presented with frequent epistaxis and nasal obstruction persisting for 6 months. According to the clinical symptoms and imaging studies juvenile angiofibroma was suspected. Following angiographic embolization total excision of the lesion by midfacial degloving approach was performed. Histological examination revealed that the tumor consisted of staghorn blood vessels and irregular fibrous stroma. Stellate fibroblasts with small pyknotic to large vesicular nuclei were seen in a highly cellular stroma. These findings identified cellular angiofibroma mimicking juvenile angiofibroma. This article is about a very rare patient of cellular angiofibroma of nasopharynx.