bluuebunny/crossref_metadata_2025_split huggingface dataset:
Restrained Differential Growth
Authors: Crijns Tom Joris , Stadhouder Agnita , Smit Theodoor Henri 
Published: October 2016

Study Design.
An experimental model study and a short review of literature.

Objective.
The purpose of this study was to explore a new hypothesis suggesting that the curvatures seen in adolescent idiopathic scoliosis (AIS) originate from restrained differential growth between the vertebral column and the surrounding musculo-ligamentary structures.

Summary of Background Data.
Despite decades of research, there is no generally accepted theory on the physical origin of the severe spinal deformations seen in AIS. The prevailing theories tend to focus on left-right asymmetry, rotational instability, or the sagittal spinal profile in idiopathic scoliosis.

Methods.
We test our hypothesis with a physical model of the spine that simulates growth, counteracted by ligaments and muscles, modeled by tethers and springs. Growth of the spine is further restrained by an anterior band representing the thorax, the linea alba, and abdominal musculature. We also explore literature in search of molecular mechanisms that may induce differential growth.

Results.
Differential growth in the restrained spine model first induces hypokyphosis and mild lateral bending of the thoracic spine, but then suddenly escalates into a scoliotic deformity, consistent with clinical observations of AIS. The band simulating the ventral structures of the body had a pivotal effect on sagittal curvature and the initiation of lateral bending and rotation. In literature, several molecular mechanisms were found that may explain the occurrence of differential growth between the spine and the musculo-ligamentary structures.

Conclusion.
While AIS is a three-dimensional deformation of the spine, it appears that restrained differential growth in the sagittal plane can result in lateral bending and rotation without a pre-existing left-right asymmetry. This supports the concept that AIS may result from a growth imbalance rather than a local anatomical defect.

Level of Evidence: N/A
Minimum Clinically Important Difference and Substantial Clinical Benefit in Pain, Functional, and Quality of Life Scales in Failed Back Surgery Syndrome Patients
Authors: Park Ki Byung , Shin Joon-Shik , Lee Jinho , Lee Yoon Jae , Kim Me-riong , Lee Jun-Hwan , Shin Kyung-Min , Shin Byung-Cheul , Cho Jae-Heung , Ha In-Hyuk 
Published: October 2016

Study Design..
Prospective observational 1-year study.

Objective..
To determine minimum clinically important difference (MCID) and substantial clinical benefit (SCB) of outcome measures in failed back surgery syndrome (FBSS) patients, as these metrics enable assessment of whether and when an intervention produces clinically meaningful effects in a patient.

Summary of Background Data..
Several methods have been devised to quantify clinically important difference, but MCID and SCB for FBSS patients has yet to be determined.

Methods..
Patients with persisting/recurrent low back pain (LBP) and/or leg pain after lumbar surgery who completed 16 weeks of treatment (n = 105) at two hospitals in Korea from November 2011 to September 2014 were analyzed. Global perceived effect was used to determine receiver operating characteristic curves in visual analogue scale (VAS), Oswestry disability index (ODI), and short form-36 (SF-36) in an anchor-based approach.

Results..
MCIDs for ODI, LBP and leg pain VAS, physical component summary, mental health component summary (MCS), and overall health scores of SF-36 were 9.0, 22.5, 27.5, 10.2, 4.0, and 8.9, and SCBs were 15.0, 32.5, 37.0, 19.7, 19.3, and 21.1, respectively. MCID and SCB area under the curve was ≥0.8, and ≥0.7, respectively.

Conclusion..
LBP and leg pain VAS, ODI, and physical component summary of SF-36 may be used to measure responsiveness in FBSS patients.

Level of Evidence: 3
Comparison of Three Surgical Approaches for Thoracic Spinal Tuberculosis in Adult
Authors: Wang Long-jie , Zhang Hong-qi , Tang Ming-xing , Gao Qi-le , Zhou Zhen-hai , Yin Xin-hua 
Published: October 2016

Study Design.
Retrospective study.

Objective.
To assess the minimum 5-year follow up outcomes of the surgical management of adults with thoracic tuberculosis by comparing posterior only (PO), anterior only (AO), and combined posterior and anterior (AP) surgical approaches.

Summary of Background Data.
Surgeons use multiple methods to treat spinal tuberculosis, including an anterior, posterior, and combined anterior and posterior approach. However, there are a few reports comparing the mid- and long-term outcomes of these surgical methods.

Methods.
The medical records for 184 patients treated for thoracic tuberculosis between January 2003 and November 2010 were retrospectively reviewed. Among them, 62 patients were treated with a single-stage posterior debridement and interbody fusion with instrumentation (Group A), 65 patients with posterior instrumentation, anterior debridement, and bone graft in a single or two-stage procedure (Group B), and 57 patients with anterior debridement and strut grafting with instrumentation (Group C). Operative time, blood loss, Visual Analog Scale for pain, complications, recovery of neurological function, Cobb angle, correction rate, and loss angle were compared among all groups.

Results.
Groups A, B, and C were followed for 72.7 ± 3.8 months, 74.3 ± 4.2 months, and 73.6 ± 4.5 months, respectively. The operative time, blood loss, and rate of complications for Group A were significantly less than Groups B and C (P < 0.05). The correction rate and loss angle were superior in Groups A and B compared with C, whereas the Visual Analog Scale for pain and fusion time showed no statistically significant difference among the groups (P > 0.05).

Conclusion.
For patients with thoracic tuberculosis, use of the AO approach should be limited. Although the AP approach produced satisfactory outcomes, it remains more traumatic. Therefore, the PO approach is recommended, not only because it achieves good results, but because it has reduced complications, operative time, and blood loss.

Level of Evidence: 3
Family planning and the Zika era
Authors: Goldthwaite Lisa M. , Velasquez Griselda 
Published: October 2016

Purpose of review
To review the current evidence regarding the impact of the Zika virus epidemic on pregnancy and the implications for family planning and reproductive health services for women in affected countries.

Recent findings
In the past 2 years, over the course of the Zika epidemic, much has been learned about the virus. Specifically in regard to pregnancy, a causative relationship has been established between the Zika virus and adverse fetal outcomes, and sexual transmission of the virus has been documented. Broad recommendations by government agencies and public health officials regarding avoidance of pregnancy for women at risk of acquiring the Zika virus have theoretical and documented implications for abortion and contraception demand and access.

Summary
Additional research is needed to better understand the impact of Zika virus health recommendations and advisories on women's decision making around pregnancy, as well as their impact on demand, access and safety of family planning services.
Injectable contraception: updates and innovation
Authors: Schivone Gillian , Dorflinger Laneta , Halpern Vera 
Published: October 2016

Purpose of review
Injectable contraception is a highly effective form of birth control that is globally popular. Recent research has focused on ways to make injectables such as depot medroxyprogesterone acetate (DMPA) more accessible and to improve the side-effect profile of injectables. This review will focus on new directions and approaches to the use of injectable contraception.

Recent findings
Research in the area of injectable contraception has focused on improving access for women through home or self-injection, and also task-shifting and community-based distribution in low-resource areas. Specific to DMPA, studies have focused on lowering the overall dose of medication while maintaining efficacy, and improving drug-delivery systems. More research into the association between DMPA and HIV is needed, and also the effects of administration of DMPA at the time of medication abortion.

Summary
Injectable contraceptives are an important part of the global method mix of highly effective birth control. Improving the accessibility and side effect profile of commodities such as DMPA will make injectables even more valuable for women seeking effective contraception.
Secondary Cleft Lip Reconstruction and the Use of Pedicled, Deepithelialized Scar Tissue
Authors: Nadjmi Nasser , Amadori Sara , Van de Casteele Elke 
Published: October 2016

Background:
The optimal time to create symmetry in a cleft lip is during primary repair; a secondary effort later is more difficult due to potential scarring and possible tissue deficiency of the repaired cleft lip. A plethora of methods for secondary correction have been described that have the goal of constructing the philtral column, ameliorating bad scar results, and augmenting lip volume, for example. Nevertheless, there is no single procedure that yields completely satisfactory results. In addition, the appropriate timing for secondary surgical corrections of the cleft lip is still under debate.

Methods:
We present a new technique for secondary lip reconstruction of unilateral and bilateral cleft patients using pedicled, de-epithelialized cleft scar tissue as an autologous graft to obtain sustainable lip volume. Our results were evaluated by physicians and patient-parent satisfaction surveys.

Results:
The esthetic outcomes of 29 patients were assessed using a patient satisfaction questionnaire and a physician survey based on the preoperative and postoperative clinical images. The success of the procedure was evaluated using a 5-point scale. The total scores of both the physician and patient assessments were high, although no correlation was found between the scores.

Conclusions:
Cleft lip reconstruction using pedicled, deepithelialized scar tissue leads to excellent physician and patient satisfaction scores; this technique can be executed at any patient age and as a secondary repair for any given primary type of cleft disorder.
RESOLUTION OF A MACULAR HOLE COMPLICATING A PSEUDOPHAKIC MACULAR EDEMA WITH NONSURGICAL TREATMENT
Authors: Lam Delphine , Srour Mayer , Semoun Oudy , Tilleul Julien , Souied Eric H. 
Published: October 2016

Background:
Pseudophakic cystoid macular edema (PCME) is a common complication of cataract surgery. We report the management of a case presenting with PCME in his left eye complicated by a full-thickness macular hole (MH). Four weeks after a cataract surgery on his left eye, a 75-year-old man presented with a vision loss on the same eye (best-corrected visual acuity: 20/64). A PCME complicated by a full-thickness MH was diagnosed. After oral acetazolamide treatment, the PCME completely regressed and the full-thickness MH closed after medical treatment.

Conclusion:
Macular edema may rarely lead to MHs, by inducing mechanical changes and probable inflammatory mechanisms as well as a thinning of the fovea. We report a case of spontaneous closure of MH complicating a PCME, with medical treatment.
Mid-term Clinical Results of CO2 Laser-assisted Sclerectomy Surgery (CLASS) for Open-Angle Glaucoma Treatment
Authors: Geffen Noa , Mimouni Michael , Sherwood Mark , Assia Ehud I. 
Published: October 2016

Purpose:
To evaluate the efficacy and safety of CO2 Laser-assisted Sclerectomy Surgery (CLASS) in primary and pseudoexfoliative open-angle glaucoma.

Materials and Methods:
Single-arm, open-label study included data from 9 medical centers located in 7 countries. Subjects underwent nonpenetrating CLASS procedure with a CO2 laser system (IOPtiMate). Intraocular pressure (IOP) and number of medications were measured at baseline, 1, 2, 4, and 6 weeks, and 3, 6, 12, 24, and 36 months. Complete success was defined as 5≤IOP≤18 mm Hg and at least 20% IOP reduction with no medications, and qualified success as the same with or without medications at 12, 24, and 36 months.

Results:
A total of 111 consecutive eyes were enrolled in the study, 14 were excluded from the study due to protocol deviation or operator error. The mean age was 69.3±12.8 and 73.9% were whites. Percent change in IOP from baseline at 1, 2, and 3 years was, respectively, 45.1%, 46.8%, and 42.5% (P<0.001). Complete success rates after 12, 24, and 36 months were 60.2%, 57.9%, and 47.8%, respectively. Qualified success rates after 12, 24, and 36 months were 79.6%, 91.2%, and 84.8%, respectively. Number of medications dropped from 2.39±1.24 to 0.47±0.84, 0.53±0.75, and 0.71±0.89 at 12, 24, and 36 months, respectively (P<0.001).

Conclusions:
The CLASS procedure may be a simple and effective treatment for open-angle glaucoma providing extended relief of elevated IOP.
Predictive Value of HRT Stereometric Parameters and Blue-on-Yellow Perimetry Global Indices in Glaucoma-suspected Subjects
Authors: Rallis Konstantinos , Kymionis George D. , Georgalas Ilias , Moschos Marilita M. , Koutsandrea Chryssanthi , Grentzelos Michael A. , Papaconstantinou Dimitris 
Published: October 2016

Objective:
To determine subtle changes of Heidelberg retina tomography (HRT) stereometric parameters and blue-on-yellow (B/Y) perimetry global indices for the early diagnosis of glaucoma in suspected subjects.

Patients and Methods:
Cross-sectional data on 174 eyes of 87 subjects from a larger cohort, attending the Glaucoma Department of the “G. Gennimatas” General Hospital of Athens from January 2004 to February 2014, were used in the study. Subjects were assigned to 3 groups: (a) “normals” not requiring treatment throughout the study (group 1), (b) suspects who developed glaucoma and required treatment during the study (group 2), and (c) patients with incipient glaucoma (group 3). Specific HRT and B/Y perimetry variables were compared among the 3 groups.

Results:
Significant differences were established for the following HRT parameters: “reference height” differed significantly between groups 1 and 2 and groups 1 and 3; “cup shape measure” differed significantly between groups 1 and 2 and groups 2 and 3. B/Y perimetry global index “mean deviation” significantly distinguished group 2 from groups 1 and 3.

Conclusions:
The results of the present study suggest the predictive value of the HRT stereometric parameters “reference height” and “cup shape measure” and of the B/Y perimetry global index “mean deviation” in glaucoma-suspected subjects; further corroboration through longitudinal studies is warranted.
Patterns of Diagnosis and Misdiagnosis in Pediatric Cancer and Relationship to Survival
Authors: Chen Jing , Mullen Craig A. 
Published: October 2016

Background:Pediatric cancer is rare and its symptoms are often ambiguous. The aims of this study were to investigate the time needed to make a diagnosis, assess the frequency of misdiagnosis, and to determine whether these factors affected survival.Methods:A review of records of 364 pediatric patients diagnosed with cancer at the University of Rochester Golisano Children’s Hospital between 2004 and 2012 was conducted. Data were extracted on patient and health care system–related factors and clinical outcomes.Results:The median time from symptom onset to diagnosis was shortest for leukemia (18.5 d) and longest for bone tumors (86.5 d). Tumor type was the only factor associated with time to diagnosis. In 52% of cases an incorrect nononcological diagnosis was initially made. Soft tissue sarcomas and brain tumors were misdiagnosed most often. Neither prolonged time to diagnosis nor initial misdiagnosis was associated with reduced survival. Tumor type and presence of metastatic disease at diagnosis were significantly associated with survival.Conclusions:There is significant variation in the time from symptom onset to diagnosis of pediatric cancers, and incorrect initial diagnostic impressions are common. Despite this there is no impact of prolonged time to diagnosis on survival.
Relationship of Self-reported Attentional Fatigue to Perceived Work Ability in Breast Cancer Survivors
Authors: Von Ah Diane , Storey Susan , Crouch Adele , Johns Shelley A. , Dodson Jill , Dutkevitch Sarah 
Published: October 2016

Background:
Breast cancer survivors (BCSs) have identified attentional fatigue, a decrease in the ability to focus, as a persistent daily challenge; however, little is known regarding its impact on work ability.

Objective:
The purpose of this study was to examine the relationship between attentional fatigue and perceived work ability in BCSs controlling for the known covariates of age, education, household income, and time posttreatment.

Methods:
A cross-sectional, descriptive design was used. Breast cancer survivors who were currently employed and at least 1 year post–adjuvant treatment participated. Breast cancer survivors completed the Attentional Function Index and Work Ability Index questionnaires. Descriptive statistics, linear regression, and Fisher exact test were used for analysis.

Results:
Sixty-eight female BCSs, ranging from 29 to 68 years of age (mean, 52.1 [SD, 8.6]) and on average 4.97 (SD, 3.36) years posttreatment, participated. More than one-fourth of BCSs (26.5%) reported poor to moderate perceived work ability, indicating substantial concerns regarding work performance. Attentional fatigue was found to significantly predict perceived work ability (P < .001), explaining 40% of the variance of perceived work ability.

Conclusions:
Attentional fatigue is a prevalent symptom posttreatment that is negatively related to perceived work ability in BCSs.

Implications for Practice:
Nurses are in a prime position to assess and intervene to alleviate attentional fatigue to improve work ability. Findings suggest a need for individual, comprehensive survivorship care plans to effectively address symptoms that impact work ability and, ultimately, the quality of life of cancer survivors.
Budgetary Impact of Compliance With STI Screening Guidelines in Persons Living With HIV
Authors: Eaton Ellen F. , Hudak Kathryn , Muzny Christina A. 
Published: October 2016

Introduction:
The 2015 Centers for Disease Control Sexually Transmitted Diseases Treatment Guidelines recommend annual screening of all people living with HIV (PLWH) for Neisseria gonorrhoeae, Chlamydia trachomatis, and syphilis; annual Trichomonas vaginalis screening is recommended for HIV-infected women. The study objective was to evaluate the budgetary impact of sexually transmitted infection (STI) screening. We hypothesized that recommended STI screening is costly and would not be covered in full by insurers.

Methods:
This cost analysis evaluates charges and reimbursement for recommended screening for the above 4 STIs. This study projects the net yield (reimbursement minus expenditures) of providing tests to eligible PLWH receiving care at an urban HIV clinic in Birmingham, AL. Four scenarios evaluated the net yield when different laboratory providers, rates of compliance, and Ryan White Program fund availability were examined.

Results:
The number of patients receiving care at our HIV clinic from August 2014 to August 2015 was 3163 (768 female and 2395 male patients). Annual screening for N. gonorrhoeae, C. trachomatis, syphilis, and T. vaginalis would lead to a mean net loss of $129,416, $118,304, $72,625, and $13,523, respectively. Most costly scenarios for a health system include the use of a regional laboratory (−$1,241,101) and lack of Ryan White HIV/AIDS Program funding (−$85,148).

Discussion:
Compliance with STI screening practices is costly. Sustainability will require critical analysis of true costs and cost-effectiveness of STI screening tests in PLWH. Providers, policy makers, and insurers each have a role in ensuring the provision of these evidence-based services to PLWH.
Association of HIV and Opportunistic Infections With Incident Stroke: A Nationwide Population-Based Cohort Study in Taiwan
Authors: Yen Yung-Feng , Chen Marcelo , Jen Ian , Lan Yu-Ching , Chuang Pei-Hung , Liu Yen-Ling , Lee Yun , Chen Yi-Ming Arthur 
Published: October 2016

Background:
HIV-associated vasculopathy and opportunistic infections (OIs) might cause vascular atherosclerosis and aneurysmal arteriopathy, which could increase the risk of incident stroke. However, few longitudinal studies have investigated the link between HIV and incident stroke. This cohort study evaluated the association of HIV and OIs with incident stroke.

Methods:
We identified adults with HIV infection in 2000–2012, using the Taiwan National Health Insurance Research Database. A control cohort without HIV infection, matched for age and sex, was selected for comparison. Stroke incidence until December 31, 2012 was then ascertained for all patients. A time-dependent Cox regression model was used to determine the association between OIs and incident stroke among patients with HIV.

Results:
Among a total of 106,875 patients (21,375 patients with HIV and 85,500 matched controls), stroke occurred in 927 patients (0.87%) during a mean follow-up period of 5.44 years, including 672 (0.63%) ischemic strokes and 255 (0.24%) hemorrhagic strokes. After adjusting for other covariates, HIV infection was an independent risk factor for incident all-cause stroke [adjusted hazard ratio (AHR) 1.83; 95% confidence interval (CI): 1.58 to 2.13]. When the type of stroke was considered, HIV infection increased the risks of ischemic (AHR 1.33; 95% CI: 1.09 to 1.63) and hemorrhagic stroke (AHR 2.01; 95% CI: 1.51 to 2.69). The risk of incident stroke was significantly higher in patients with HIV with cryptococcal meningitis (AHR 4.40; 95% CI: 1.38 to 14.02), cytomegalovirus disease (AHR 2.79; 95% CI: 1.37 to 5.67), and Penicillium marneffei infection (AHR 2.90; 95% CI: 1.16 to 7.28).

Conclusions:
Patients with HIV had an increased risk of stroke, particularly those with cryptococcal meningitis, cytomegalovirus, or P. marneffei infection.
ERAS Protocol Reduces IL-6 Secretion in Colorectal Laparoscopic Surgery: Results From a Randomized Clinical Trial
Authors: Mari Giulio , Crippa Jacopo , Costanzi Andrea , Mazzola Michele , Rossi Michele , Maggioni Dario 
Published: October 2016

Background:
Enhanced Recovery After Surgery (ERAS) program applied to colorectal laparoscopic surgery is well known to reduce hospitalization improving short-terms outcomes. Its goal is to minimize the surgical stress response in order to maintain the physiological homeostasis altered by surgery. However, there is little knowledge about the involved dynamics in the reduction of the surgical stress that these programs allow. The primary aim of this study was to compare the level of immune and nutritional serum investigators across surgery in patients undergoing elective colorectal laparoscopic surgery within an ERAS protocol or according to a standard care program.

Materials and Methods:
One hundred forty patients undergoing major colorectal laparoscopic surgery were enrolled and randomized in 2 groups (70 per arm).
Cortisol, C-reactive protein (CRP), white blood cell count, prolactin, interleukin (IL)-6 levels were collected preoperatively, 1, 3, and 5 days after surgery. Transferrin, prealbumin, albumin, and triglyceride level were collected preoperatively, 1 and 5 days after surgery. Short-term outcomes were also prospectively assessed.

Results:
IL-6 levels were lower in the ERAS group on 1, 3, and 5 days postoperatively (P<0.05). IL-6 levels in the enhanced group, differently from control group, returned to preoperative level 3 days after surgery. CRP level was lower in the enhanced group on day 1, 3, and 5 (P<0.05). There was no difference in cortisol and prolactin levels between groups. Prealbumin serum level was higher on day 5 (P<0.05) compared to standard group.

Conclusions:
ERAS protocol applied to colorectal laparoscopic surgery affects surgical stress response, decreasing IL-6 and CRP levels postoperatively and improving prealbumin postoperative synthesis.