bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Cervical Alignment after Multilevel Schwab Grade II Thoracolumbar Osteotomies for Adult Spinal Deformity
Authors: Ghobrial George M. , Lebwohl Nathan H. , Green Barth A. , Gjolaj Joseph P. 
Published: May 2017

Study Design.
A retrospective cohort.

Objective.
The aim of this study was to describe changes in cervical alignment (CA) and cervical deformity (CD) after multilevel Schwab Grade II Osteotomies for adult spinal deformity (ASD).

Summary of Background Data.
Reciprocal cervical and global changes after ASD surgery have not been previously described in the setting of multilevel osteotomy.

Methods.
Patients with long-segment (> five levels) fusion and osteotomy for ASD were radiographically evaluated. Pre- and postoperative cervical parameters evaluated included cervical lordosis (CL), C2-C7 sagittal vertical axis (C2-C7 SVA), and the T1 slope (T1S) minus the CL (T1S-CL). CD was defined as C2-C7 SVA >4 cm, CL < 0°, or T1S-CL ≥15°.

Results.
Eighty-five patients (mean age 64 ± 11.1) were identified. Preoperative lumbar lordosis (LL) was 28.7° ± 13.8°, thoracic kyphosis (TK) was 28.2° ± 17.0°, C7 plumbline (C7 SVA) was 7.54 ± 6.7 cm, pelvic tilt (PT) was 30.0° ± 8.96°, lumbopelvic mismatch was 32° ± 17.1°, and the T1 pelvic angle (TPA) was 26.8° ± 12.9°. The C7 SVA and TPA corrected to 3.90 cm (P < 0.0001) and 17.5°, respectively (P < 0.0001). CD increased from 41 (48%) to 47 (55%) patients. The mean CL changed from 16.5° to 11.9° (P < 0.013), C2 SVA from 10.1 to 6.37 cm (P < 0.0001), T1S-CL from 10.2° to 14.3° (P = 0.021), and TK from 28° to 39° (P < 0.0001). A correlation was observed between T1S and CL (ρ = 0.435, P < 0.0001) and C2-C7 SVA (ρ = 0.624, P < 0.0001). T1S was the only independent predictor of both the postoperative C2-C7 SVA and CL.
In this study, the presence of any single preoperative CD criterion was noted to be a risk for persistent global deformity on postoperative radiograph [odds ratio (OR) = 2.5] and the development of PJK (OR = 2.1). The T1-CL < 15° may indicate an even greater risk for persistent global deformity (OR = 3.5).

Conclusion.
Thoracolumbar fusion with multilevel Schwab Grade II Osteotomies was associated with a decreased CL and reciprocal increases in TK and T1S-CL.

Level of Evidence: 3
Congenital Infantile Fibrosarcoma Associated With a Lipofibromatosis-Like Component: One Train May Be Hiding Another
Authors: Swiadkiewicz Romain , Galmiche Louise , Belhous Kahina , Boccara Olivia , Fraitag Sylvie , Pedeutour Florence , Dadone Bérangère , Buis Jacques , Picard Arnaud , Orbach Daniel , Kadlub Natacha 
Published: May 2017

Abstract:
Congenital infantile fibrosarcoma (CIFS) is a soft tissue sarcoma of infants mainly involving lower extremities and usually developing during the first year of life. At another end of the spectrum of pediatric fibroblastic lesions, lipofibromatosis is a rare benign infiltrative soft tissue tumor that affects children. The authors report in this study a particular presentation with a CIFS surrounded by lipofibromatosis-like areas. The presence of a surrounding benign tumor confused and delayed CIFS diagnosis.
Counterbalanced Comparison of the BSID-II and Bayley-III at Eighteen to Twenty-two Months Corrected Age
Authors: Sharp Meghan , DeMauro Sara B. 
Published: May 2017

ABSTRACT:

Objective:
To evaluate differences in developmental assessments using the current version of the Bayley Scales of Infant Development (Bayley-III) as compared to the older BSID-II. Previous studies suggest that average scores on the Bayley-III may be significantly higher than scores on the previous version, but the magnitude and potential impact of differences between these 2 assessments are uncertain.

Methods:
We enrolled 77 former preterm infants (born <32 wk gestation and ≤2000 g) at 18 to 22 months corrected age in this randomized crossover study. The Bayley-III was administered in follow-up clinic per standard of care. The BSID-II was administered during a separate study visit. The order of testing was randomly assigned. The assessments were performed 4 to 8 weeks apart by masked personnel. The main outcomes were mean difference between BSID-II Mental Development Index (MDI) and Bayley-III Cognitive Composite score, mean difference between BSID-II Psychomotor Development Index (PDI) and Bayley-III Motor Composite score, and difference in the proportion of infants classified as having “developmental delay.”

Results:
Bayley-III scores were significantly higher across the range of scores and in all domains. Mean Cognitive Composite scores were almost 1 SD higher than MDI scores (14.1 ± 12.9 points, p < .001). Mean Motor Composite scores were 9.0 ± 11.9 points higher than PDI scores (p < .001). When severity of delay was classified using standardized cut-points for moderate and severe developmental delay (1 and 2 SDs below reference norm), 40% of children (n = 31/77) were classified as less severely delayed with the Bayley-III Cognitive Composite score than with the BSID-II MDI, whereas only 1 (<2%) was classified as more severely delayed with the Bayley-III (p < .001).

Conclusion:
These findings have critical implications for both the interpretation of clinical research studies and determination of eligibility for services in high-risk children.
Current techniques and outcomes in hysteroscopic sterilization: current evidence, considerations, and complications with hysteroscopic sterilization micro inserts
Authors: Casey James , Cedo-Cintron Laura , Pearce Jessica , Yunker Amanda 
Published: May 2017

Purpose of review
To describe the current data regarding effectiveness, complications, postoperative evaluation, and surgical interventions associated with Essure hysteroscopic sterilization.

Recent findings
Hysteroscopic sterilization is a commonly performed procedure that is offered as a well tolerated, effective, outpatient method of permanent sterilization. Over the past several years, concerns have been raised regarding correct placement and postoperative complications. This has led to statements by both the Food and Drug Administration (FDA) in October, 2016 and American Association of Gynecologic Laparoscopists in February, 2017, as a significant portion of women seek removal of these devices. A current black-box warning issued by the FDA in 2016 recommends discussion of ‘the probabilities of rates or events’ of adverse outcomes associated with Essure placement.

Summary
Although hysteroscopic sterilization is usually a safe, effective option for permanent contraception, new evidence regarding complications has emphasized the need for proper education and counseling. Appropriate patient selection and knowledge of potential complications is paramount to ensuring patients, and medical providers are well informed and have realistic expectations regarding potential placement and postoperative issues.
Vibroplasty in Severe Congenital or Acquired Meatal Stenosis by Coupling an Active Middle Ear Implant to the Short Process of the Incus
Authors: Thomas Jan Peter , Voelter Christiane , Neumann Katrin , Dazert Stefan 
Published: May 2017

Objective:
To evaluate the safety and effectiveness of coupling an active middle ear implant to the short process of the incus in subjects with meatal pathologies.

Study Design:
Retrospective study.

Setting:
Tertiary referral center.

Patients:
Twelve patients suffering from either congenital aural atresia or acquired meatal fibrosis.

Intervention:
Implantation of an active middle ear implant with coupling of the actuator to the short process of the incus.

Main Outcome Measures:
Evaluation of the air conduction and bone conduction hearing thresholds pre- and postoperatively, aided warble-tone hearing thresholds, unaided and aided speech recognition in quiet and noise. Questionnaires on subjective benefit and quality of life.

Results:
Mean unaided postoperative air conduction and bone conduction thresholds did not vary significantly from preoperative values (p = 0.55 and 0.082, respectively). The mean functional gain amounted to 42.1 ± 8.8 dB, the mean aided sound field threshold of the implanted ear was 28.6 ± 8.6 dB. No significant difference in functional gain but a close to significant difference in postoperative aided thresholds (p = 0.053) were found between subjects with congenital atresia and acquired fibrosis. Subjective benefit assessed by the global score of the Abbreviated Profile of Hearing Aid Benefit questionnaire revealed an improvement of 31 to 42%.

Conclusion:
Coupling of the actuator to the short process of the incus is a safe and clinically promising procedure in cases where the standard application to the long process is not feasible. In pure conductive hearing loss the benefit is comparable to long incus process coupling, whereas in mixed hearing loss slightly worse results were observed.
Minimally invasive cardiac output technologies in the ICU: putting it all together
Authors: Clement Ramon P. , Vos Jaap J. , Scheeren Thomas W.L. 
Published: May 2017

Purpose of review
Haemodynamic monitoring is a cornerstone in the diagnosis and evaluation of treatment in critically ill patients in circulatory distress. The interest in using minimally invasive cardiac output monitors is growing. The purpose of this review is to discuss the currently available devices to provide an overview of their validation studies in order to answer the question whether these devices are ready for implementation in clinical practice.

Recent findings
Current evidence shows that minimally invasive cardiac output monitoring devices are not yet interchangeable with (trans)pulmonary thermodilution in measuring cardiac output. However, validation studies are generally single centre, are based on small sample sizes in heterogeneous groups, and differ in the statistical methods used.

Summary
Minimally and noninvasive monitoring devices may not be sufficiently accurate to replace (trans)pulmonary thermodilution in estimating cardiac output. The current paradigm shift to explore trending ability rather than investigating agreement of absolute values alone is to be applauded. Future research should focus on the effectiveness of these devices in the context of (functional) haemodynamic monitoring before adoption into clinical practice can be recommended.
Avoidant/restrictive food intake disorder: a new eating disorder diagnosis in the diagnostic and statistical manual 5
Authors: Mammel Kathleen A. , Ornstein Rollyn M. 
Published: May 2017

Purpose of reviewAvoidant/restrictive food intake disorder (ARFID) is a new eating disorder diagnosis in the 5th edition of the diagnostic and statistical manual (DSM-5), published in 2013. The purpose of this review is to describe the creation of ARFID as a diagnostic category, and to explain the DSM-5 diagnostic criteria; to demonstrate what is known thus far about the prevalence of ARFID and characteristics of patients with this disorder; to provide guidance to the pediatrician and other providers on making a diagnosis of ARFID; and to discuss evolving treatment approaches.Recent findingsSeveral studies have been published recently on the prevalence and characteristics of patients with ARFID. Research has just begun to focus on new assessment measures, approaches to treatment based on established therapies for other eating/psychiatric disorders, and short-term outcomes. Robust treatment studies are in development.SummaryThe addition of ARFID to the DSM-5 has captured a category of patients with clinically significant restrictive eating, but without weight and shape concerns, who were poorly classified in the past. Future research is needed to further elucidate the presentation, characteristics, diagnostic instruments, and effective management.
Translation and Cultural Adaptation of the Scored Patient-Generated Subjective Global Assessment: An Interdisciplinary Nutritional Instrument Appropriate for Dutch Cancer Patients
Authors: Sealy Martine J. , Haß Ulrike , Ottery Faith D. , van der Schans Cees P. , Roodenburg Jan L.N. , Jager-Wittenaar Harriët 
Published: May 2017

Background:Assessment of malnutrition is important in cancer patients. The Scored Patient-Generated Subjective Global Assessment (PG-SGA), an instrument that enables interdisciplinary assessment of malnutrition and its risk factors, was not available in Dutch.Objective:Translation and cultural adaption of the original English PG-SGA to the Dutch setting.Methods:The PG-SGA was translated and culturally adapted, following the International Society for Pharmacoeconomics and Outcomes Research principles. Perceived content validity, comprehensibility, and difficulty were explored among a multidisciplinary sample of healthcare professionals and their cancer patients. Content validity, comprehensibility, and difficulty were operationalized by calculating item and scale indices. On scale level, indices of 0.80 to 0.90 were considered acceptable, and indices of 0.90 or greater were considered excellent.Results:Consensus was reached on 91 and 8 differences in the forward and back translations, respectively. Scale Content Validity Index was 0.89. Scale Comprehensibility Index and Scale Difficulty Index of the patient-generated component of the PG-SGA were 0.99 and 0.96, respectively. Scale Comprehensibility Index and Scale Difficulty Index of the professional component were 0.81 and 0.55, respectively.Conclusions:Translation and cultural adaptation of the PG-SGA according to the International Society for Pharmacoeconomics and Outcomes Research principles resulted in a Dutch version that maintained the purpose, meaning, and format and have acceptable content validity. Now a Dutch version of the PG-SGA is available that is considered comprehensible and easy by patients, and comprehensible and relevant by professionals. However, the professional component was considered difficult by the PG-SGA–naive professionals, which indicates a need for training.Implications for Practice:A similar systematic approach for future translations of the PG-SGA is recommended, to safeguard cultural equivalence.
Physical Activity Patterns in Infants With and Without Down Syndrome
Authors: Ketcheson Leah , Pitchford E. Andrew , Kwon Hyun-Jin , Ulrich Dale A. 
Published: May 2017

Purpose:
Individuals with Down syndrome (DS) are at greater risk for obesity than their peers who are developing typically. One factor contributing to an early onset of obesity is low levels of physical activity (PA). However, there is little known regarding PA patterns during infancy.

Methods:
The purpose of this study was to examine the daily PA patterns in 22 infants developing typically and 11 infants with Down syndrome (aged 1-12 months) using Actigraph GT3X+ (wrist and ankle).

Results:
No significant differences between groups were identified in PA counts at the ankle. Both groups produced significantly more PA at the wrist than at the ankle and PA counts increased across months in age.

Conclusion:
This study represents an important first step in establishing baseline PA patterns during infancy.
Prevalence of Pulmonary Embolism Among Systemic Lupus Erythematosus Discharges
Authors: Annangi Srinadh , Dammalapati Tirumala Rao , Nutalapati Snigdha , Henriques King Marshaleen N. 
Published: May 2017

Introduction
Pulmonary embolism (PE) is a life threatening preventable medical condition involving sudden occlusion of arteries within the lungs. Systemic lupus erythematosus (SLE) is an inflammatory disorder and therefore independently poses a risk of PE. We aimed to determine the association of SLE and PE using National Hospital Discharge Survey data, a national representative sample of hospital discharges throughout the United States.

Methods
Retrospective population-based analysis was done using National Hospital Discharge Survey data for the period 2001 to 2010. International Classification of Diseases, Ninth Revision (ICD-9) coding was used to identify SLE (ICD-9 code 710.0) and PE (ICD-9 codes 415.11, 415.12, 415.13, and 415.19) mentioned in any of the discharge diagnosis. Patients 15 years or older were included in the study. Regression analysis was done including hyperlipidemia, heart failure, lower-limb injury or surgery, hypertension, diabetes cerebrovascular disease, and cancer.

Results
Our regression analysis demonstrated a significant association between SLE and PE, which was independent of sex, race, age, and associated comorbidities (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.99–2.16). Of included comorbidities, primary hypercoagulable disorder has the highest odds of association with PE (OR, 15.37; 95% CI, 15.22–15.51) followed by African American race compared with whites (OR, 1.08, 95% 1.08–1.09), and presence of at least 1 of the comorbidities (OR, 1.06; 95% CI, 1.06–1.06). African American SLE cases have the higher prevalence of PE in all age groups, with the exception of persons 35 to 44 years old.

Conclusions
Significant association exists between SLE and PE regardless of sex, race, age, and associated comorbidities. Females had an overall higher prevalence of SLE-related PE (1.67%) compared with males (1.29%). Stratified according to sex, race, and age groups, the association is highest for females, blacks, and age group 35 to 44 years, respectively.
Ultrasound Diagnosis of Clinically Unsuspected Ureteral Stone Presenting as Acute Scrotum
Authors: Wachsberg Ronald H. 
Published: May 2017

Abstract
Ureteral colic is not generally included in the differential diagnoses of acute scrotal pain, although ureteral pathology is a recognized cause of pain referred to the scrotum. We report 3 patients presenting with acute scrotal pain who had normal scrotal color Doppler ultrasound scans; subsequent ultrasound of the ipsilateral kidney revealed hydronephrosis, which ultimately led to the clinically unsuspected diagnosis of ureteral colic. We conclude that ureteral colic should be included in the differential diagnosis of acute scrotal pain, and we further suggest that a survey ultrasound of the kidney on the side of the pain should be performed in patients presenting with acute scrotal pain and a normal color Doppler ultrasound examination of the scrotum.
Coaching the Debriefer
Authors: Cheng Adam , Grant Vincent , Huffman James , Burgess Gavin , Szyld Demian , Robinson Traci , Eppich Walter 
Published: May 2017

Summary Statement
Formal faculty development programs for simulation educators are costly and time-consuming. Peer coaching integrated into the teaching flow can enhance an educator's debriefing skills. We provide a practical guide for the who, what, when, where, why, and how of peer coaching for debriefing in simulation-based education. Peer coaching offers advantages such as psychological safety and team building, and it can benefit both the educator who is receiving feedback and the coach who is providing it. A feedback form for effective peer coaching includes the following: (1) psychological safety, (2) framework, (3) method/strategy, (4) content, (5) learner centeredness, (6) co-facilitation, (7) time management, (8) difficult situations, (9) debriefing adjuncts, and (10) individual style and experience. Institutional backing of peer coaching programs can facilitate implementation and sustainability. Program leaders should communicate the need and benefits, establish program goals, and provide assessment tools, training, structure, and evaluation to optimize chances of success.
Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; a 10/66 population-based cohort study
Authors: Prince Martin J , Acosta Daisy , Guerra Mariella , Huang Yueqin , Jimenez-Velazquez Ivonne Z , Rodriguez Juan J Llibre , Salas Aquiles , Sosa Ana Luisa , Chua Kia-Chong , Dewey Michael E , Liu Zhaorui , Mayston Rosie , Valhuerdi Adolfo 
Published: May 2017

AbstractBackgroundExposure to endogenous estrogen may protect against dementia, but evidence remains equivocal. Such effects may be assessed more precisely in settings where exogenous estrogen administration is rare. We aimed to determine whether reproductive period (menarche to menopause), and other indicators of endogenous estrogen exposure are inversely associated with dementia incidenceMethodsPopulation-based cohort studies, of women aged 65 years and over in urban sites in Cuba, Dominican Republic Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, including ages at menarche, birth of first child, and menopause, and parity, with ascertainment of incident 10/66 dementia, and mortality, three to five years later.Results9,428 women participated in the baseline phase, with response rates of 72–98% by site. The ‘at risk’ cohort comprised 8,466 dementia-free women. Mean age at baseline varied from 72.0 to 75.4 years, lower in rural than urban sites and in China than in Latin America. Mean parity was 4.1, generally higher in rural than urban sites and ranging from 2.4-7.2 by site. 6,854 women with baseline reproductive period data were followed up for 26,463 person years. There were 692 cases of incident dementia, and 895 dementia free deaths. Pooled meta-analysed fixed effects, per year, for reproductive period (Adjusted Sub-Hazard Ratio [ASHR] 1.001, 95% CI 0.988-1.015) did not support any association with dementia incidence, with no evidence also for any interaction between APOE genotype and reproductive period (ASHR 0.993, 95% CI 0.947-1.041, I2=39.3%). Similarly no association was observed between incident dementia and; ages at menarche, birth of first child, and menopause: nulliparity; or index of cumulative endogenous estrogen exposure. Greater parity was positively associated with incident dementia (ASHR 1.030, 95% CI 1.002-1.059, I2=0.0%).ConclusionsWe found no evidence to support the theory that natural variation in cumulative exposure to endogenous oestrogens across the reproductive period influences the incidence of dementia in late life.
Community-led research discovers links between elusive symptoms and clinical tests
Authors: Gabashvili Irene S. 
Published: May 2017

AbstractHuman breath and body odors have been used for diagnosis of serious and life-threatening conditions since the dawn of medical practice. More recently, it has been recognized that malodors without accompanying physical symptoms could be a sign of psychologically but not physically debilitating disorders such as Trimethylaminuria (TMAU). Self-reported intermittent odors without apparent cause, are, however, still treated with suspicion by medical professionals. Most cases of socially-disabling idiopathic malodor remain undiagnosed and there are no guidelines for diagnostic tests nor treatment options that extend beyond TMAU. Internationally-recruited volunteers with undiagnosed body odor and halitosis enrolled to participate in our study, registered asNCT02692495at clinicaltrials.gov. Each volunteer underwent several blood and urine tests conducted by Biolab Medical Unit, a medical referral laboratory in London, specializing in nutritional and environmental medicine. Intestinal permeability measurements were strikingly different for subjects that named the nose/mouth as the malodor source(s) versus other, often unidentified, body regions. Furthermore, metabolite levels in blood and urine allowed matching of participants by dietary sensitivities and the type of odor reported, emphasizing the potential of harnessing patients’ olfactory observations. In discussing the anecdotal “People are Allergic to Me” condition (PATM), we show how it fits into the picture.