bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanics of Transforaminal Endoscopic Approaches
Authors: Farshad Mazda , Hagel Vincent , Spirig José Miguel , Fasser Marie-Rosa , Burkhard Marco Dimitri , Widmer Jonas , Calek Anna-Katharina 
Published: September 2022

Study Design.
Biomechanical cadaveric study.

Objective.
The aim of this study was to compare the effect of transforaminal endoscopic approaches with open decompression procedures.

Summary.of Background Data.
Clinical studies have repeatedly highlighted the benefits of endoscopic decompression, however, the biomechanical effects of endoscopic approaches (with and without injury to the disc) have not been studied up to now.

Methods.
Twelve spinal segments originating from four fresh frozen cadavers were biomechanically tested in a load-controlled endoscopic transforaminal approach study. Segmental range of motion (ROM) after endoscopic approach was compared with segmental ROM after (1) microsurgical decompression with unilateral laminotomy and (2) midline decompression with bilateral laminotomy. In the intact state and after decompression, the segments were loaded in flexion-extension (FE), lateral shear (LS), lateral bending (LB), anterior shear (AS) and axial rotation (AR).

Results.
Vertebral segment ROM was comparable between the two endoscopic transforaminal approaches. However, there was a – statistically non-significant – trend for a larger ROM after accessing via the inside-out technique: FE:+3% versus+7%, P=0.484; LS:+1% versus+12%, P=0.18; LB:+0.6% versus+9%, P=0.18; AS:+2% versus+11%, P=0.31; AR: −4% versus+5%, P=0.18. No significant difference in vertebral segment ROM was seen between the transforaminal endoscopic approaches and open unilateral decompression. Vertebral segment ROM was significantly smaller with the transforaminal endoscopic approaches compared to midline decompression for almost all loading scenarios: FE:+4% versus+17%, P=0.005; AS:+6% versus 21%, P=0.007; AR: 0% versus+24%, P=0.002.

Conclusion.
Biomechanically, the transforaminal endoscopic intracanal technique preserves the native range of motion of lumbar vertebral segments and shows a trend towards biomechanically superiority to the inside-out technique and open decompression procedures.
Effectiveness of Lumbosacral Orthosis after Discectomy for Lumbar Disc Herniation: A Prospective Comparative Study
Authors: Sakaki Kyohei , Yoshii Toshitaka , Arai Yoshiyasu , Torigoe Ichiro , Tomori Masaki , Onuma Hiroaki , Ogawa Takahisa , Hirakawa Akihiro , Sakai Kenichiro , Okawa Atsushi 
Published: September 2022

Study Design.
Prospective comparative study.

Objective.
To investigate the benefits of postoperative application of lumbosacral orthosis after single-level discectomy for lumbar disc herniation (LDH).

Summary of Background Data.
Although many surgeons use postoperative lumbosacral orthosis for patients with LDH, there is no clear evidence to support or deny its effectiveness.

Methods.
Ninety-nine consecutive patients who underwent the microscopic discectomy were included. They were divided into two groups: Orthosis group and Non-orthosis group, before surgery. The recurrence rate and reoperation rate were compared between the two groups at 4-week, 6-month and 1-year follow-up. Japanese Orthopaedic Association Score for lumbar spine (L-JOA score) at 2-week and 1-year follow-up, lower extremities and low back pain’s visual analog scale (VAS) and Oswestry Disability Index (ODI) at 6-month and 1-year follow-up were compared.

Results.
Forty-two patients in the Orthosis group and 39patients in the Non-orthosis group were followed up for at least 1-year after surgery. Recurrence occurred in 3 patients (7.1%) in the Orthosis group and 6 (15.4%) in the Non-orthosis group within 1-year. Two patients (4.8%) in the Orthosis group and 2 patients (5.1%) in the Non-orthosis group underwent reoperation. There were no significant intergroup differences in the recurrence rate and in the reoperation rate. No significant difference was also observed between the two groups in L-JOA score, ODI, VAS of low back pain, and leg pain at 1-year after surgery. Furthermore, at any other follow-up period, no significant differences were observed between the two groups in recurrence rate, reoperation rate, L-JOA score, VAS of low back/leg pain, or ODI.

Conclusions.
Postoperative orthosis did not reduce the recurrence/ reoperation rates, nor improve postoperative clinical symptoms. Routine use of orthosis may not be necessary after single-level lumbar discectomy.
Risk of Bleeding Among Individuals on Direct-Acting Oral Anticoagulants: An Academic Medical Center Cohort Study
Authors: Gomez Lumbreras Ainhoa , Tan Malinda S. , Moorman-Bishir Krystal , Ilham Sabrina , Malone Daniel C. 
Published: September 2022

Abstract:
Previous research has identified risk factors that may affect the risk of bleeding when individuals are exposed to oral anticoagulants. It is unclear if the risk continues to exist with the direct oral anticoagulants (DOACs). The purpose of this study was to assess the risk of bleeding in patients on DOACs (apixaban, rivaroxaban, dabigatran, edoxaban, and betrixaban) based on known risk factors including demographics, medical conditions, and concomitant medications. This study was a retrospective analysis using electronic health record data from the University of Utah Hospital (Division of Cardiovascular Medicine) of individuals receiving a DOAC from 2015 to 2020. The primary outcome of interest was bleeding events [gastrointestinal (GI) bleeding, other anatomical site bleeding (excluding GI), and any bleeding] recorded in the electronic health record that codes using International Classification of Diseases 9th and 10th codes. Known risk factors were used to predict bleeding using multivariate logistic regression. A total of 5492 patients received a DOAC during the study period. Less than half the study population were female (2287, 41.6%). During the follow-up, there were 988 patients (18.0%) experiencing a bleeding event. Of them, 351 patients (35.5%) had a GI bleeding event. Significant risk factors of GI bleeding included clopidogrel [odds ratio (OR) 1.71; 95% confidence interval (95% CI), 1.16–2.52] and previous GI bleeding episodes (OR 7.73; 95% CI, 5.36–11.16). Exposure to corticosteroids (OR 1.50; 95% CI, 1.20–1.87) and previous GI bleeding (OR 1.61; 95% CI, 1.10–2.35) were associated with an increase in bleeding at other anatomical sites (not GI included).
Effects of Recombinant Human Brain Natriuretic Peptide on Atrial Fibrillation After Coronary Artery Bypass Grafting
Authors: Wei Yangyan , Zhang Qian , Chi Honghui , Wang Ziyao , Chang Qing 
Published: September 2022

Abstract:
Previous studies reported that the use of natriuretic peptides (NPs) can effectively decrease arrhythmias. However, there is a lack of clinical evidence that recombinant human brain natriuretic peptide (rh-BNP) inhibits postoperative atrial fibrillation (POAF). This cohort aims to assess the effect of rh-BNP on POAF. This study retrospectively reviewed patients who underwent isolated coronary artery bypass grafting from January 2018 to January 2021. Patients were divided into 2 groups according to whether they received rh-BNP therapy within 5 days after surgery. A total of 1153 patients met the inclusion and exclusion criteria, of which 54 received rh-BNP therapy within 5 days. After propensity score matching, 53 patients were treated with rh-BNP, and 148 patients were not treated with rh-BNP. The incidence of POAF was lower in rh-BNP group than non-rh-BNP group (18.9% vs. 37.2%, odds ratio = 0.393, 95% confidence interval, 0.183–0.845, P = 0.017). There was no significant difference in the occurrence of ventricular arrhythmia (P = 0.4), hypotension (P = 0.763), and the risk of death (P = 0.14). rh-BNP could significantly reduce the occurrence of POAF after coronary artery bypass grafting, and rh-BNP did not increase the risk of ventricular arrhythmia, hypotension, and death. Accordingly, rh-BNP could be a potential safe medicine for preventing POAF.
Intraoperative optical coherence tomography observation with perfluorocarbon tamponade for subretinal membranes in proliferative vitreous retinopathy
Authors: Shiraki Akihiko , Sakimoto Susumu , Nishida Kohji 
Published: September 2022

Abstract

Purpose:
To report the efficacy of intraoperative optical coherence tomography (iOCT) in locating proliferative membranes or strands subretinally or preretinally during pars plana vitrectomy for proliferative vitreoretinopathy (PVR) or old rhegmatogenous retinal detachment.

Methods:
After removing the vitreous and apparent epiretinal membranes, vitreous fluid was exchanged for perfluorocarbon. Lesions of the retinal folds or persistently detached retinas, suspected to be subretinal membrane lesions, were examined using iOCT in three eyes with PVR.

Results:
iOCT showed subretinal or preretinal structures in all three patients. A subretinal structure with underlying fluid was removed through an intentional hole in a patient. In another patient, a subretinal structure without underlying fluid was not removed. In the remaining patient, the preretinal membranes detected with iOCT could be peeled successfully.

Conclusion:
iOCT examination with perfluorocarbon tamponade effectively identified the correct location of proliferative membranes or strands, namely preretinal or subretinal. This imaging technique helps surgeons determine whether an intentional hole should be made to remove the subretinal structure during vitrectomy. iOCT, combined with perfluorocarbon tamponade, leads to safer and more effective surgery for PVR.
Consistent pattern between physical activity measures and chronic pain levels: the Tromsø Study 2015 to 2016
Authors: Fjeld Mats Kirkeby , Årnes Anders Pedersen , Engdahl Bo , Morseth Bente , Hopstock Laila Arnesdatter , Horsch Alexander , Stubhaug Audun , Strand Bjørn Heine , Nielsen Christopher Sivert , Steingrímsdóttir Ólöf Anna 
Published: September 2022

Abstract
Epidemiological literature on the relationship between physical activity and chronic pain is scarce and inconsistent. Hence, our aim was to assess the relationship applying comprehensive methodology, including self-reported and accelerometer measures of physical activity and different severity levels of chronic pain. We used data from the Tromsø Study (2015-2016). All residents in the municipality, aged 40 years and older were invited to participate (n = 32,591, 51% women). A total of 21,083 (53%) women reported on questionnaires. Additionally, 6778 participants (54% women) were invited to wear accelerometers (6125 with complete measurements). Our exposure measures were self-reported leisure time physical activity, exercise frequency, duration, and intensity and 2 accelerometer measures (steps per day and minutes of moderate to vigorous physical activity per day). Outcome measurements were chronic pain and moderate-to-severe chronic pain. We used Poisson regression to estimate chronic pain prevalence and prevalence ratios for each physical activity measure, with adjustments for sex, age, education level, smoking history, and occupational physical activity. Our main analyses showed an inverse dose–response relationship between all physical activity measures and both severity measures of chronic pain, except that the dose–response relationship with exercise duration was only found for moderate-to-severe pain. All findings were stronger for the moderate-to-severe pain outcomes than for chronic pain. Robustness analyses gave similar results as the main analyses. We conclude that an inverse dose-response association between physical activity and chronic pain is consistent across measures. To summarize, higher levels of physical activity is associated with less chronic pain and moderate-to-severe chronic pain.
The timing of intravenous oxytocin administration is crucial to minimize perioperative blood loss during first-trimester suction curettage for missed abortion
Authors: Yang Szu-Ting , Chang Wen-Hsun , Chao Wei-Ting , Lai Ting-Jung , Lin Wei-Lin , Lim Hong-Ci , Liu Chia-Hao , Wang Peng-Hui 
Published: September 2022

Background:
Oxytocin is commonly used to reduce blood loss during suction curettage for missed abortion. However, the potential of oxytocin to mitigate blood loss in early pregnancy remains controversial. Based on the hypothesis that the “timing” of oxytocin administration may be a critical factor, we investigated whether the timing of intravenous (IV) administration is associated with reduced perioperative blood loss during first-trimester suction curettage for missed abortion.

Methods:
The medical charts of 146 patients with ultrasound-confirmed first-trimester missed abortion who underwent suction curettage with IV oxytocin administration were retrospectively reviewed.

Results:
Among the patients, 67 received 10 IU of IV oxytocin before suction curettage (early-oxytocin administration group), while 79 patients received 10 IU of IV oxytocin after suction curettage (late-oxytocin administration group). The demographic features between the two groups did not significantly differ. However, there was a lower proportion of nulliparous patients in the early-oxytocin administration group than in the late-oxytocin administration group (38.8% vs 60.8%, p = 0.006). The perioperative blood loss amount was significantly lower in the early-oxytocin administration group than in the late-oxytocin administration group (60 [range: 50–100] vs 100 [range: 30–250] mL, p = 0.001). Moreover, the multivariate logistic regression analysis showed that the early-oxytocin administration group had a lower risk for a perioperative blood loss amount of ≥100 mL than the late-oxytocin administration group (0.23 [range: 0.10–0.55], p = 0.001); a gestational age of 9–12 weeks (p = 0.009) was found to be associated with an increased risk for a perioperative blood loss amount of ≥100 mL.

Conclusion:
Compared with late-oxytocin administration, early-oxytocin administration could reduce perioperative blood loss during first-trimester suction curettage for missed abortion. However, the results require further investigation.
Influencing factors associated with lymph node status in patients with cutaneous melanoma: an Asian population study
Authors: Chu Po-Yu , Chen Yi-Fan , Li Cheng-Yuan , Wang Tien-Hsiang , Chiu Yu-Jen , Ma Hsu 
Published: September 2022

Background:
Sentinel lymph node (SLN) status is the predominant prognostic factor in patients diagnosed with clinically localized melanoma. The significance of completion lymph node dissection in patients with SLN metastasis is debatable. Not many studies have been conducted on acral lentiginous melanoma (ALM). This study aimed to characterize the prognostic factors of nodal positive ALM and confirm whether ALM patients can undergo the same treatment strategy as non-ALM patients in the Asian population.

Methods:
This is a retrospective review of patients who underwent surgery for cutaneous melanoma (CM) at Taipei Veterans General Hospital between January, 1993 and December, 2019. We investigated the risk factors for lymph node status. The association between clinicopathological factors and lymph node status of ALM and non-ALM patients was analyzed. Outcomes of completion lymph node dissection (CLND) performed following sentinel lymph node biopsy (SLNB) in the CM and ALM groups were compared.

Results:
A total of 197 patients were included in this study. ALM was the most common histological subtype, accounting for 66.5% of all the cases. Patients in the CM and ALM subgroups with metastatic SLN (p = 0.012) or lymph nodes (p < 0.001 and p = 0.001) exhibited higher mortality rate. Multivariate analysis showed that patients with clinical presentation of T4 category tumor (p = 0.012) and lymphovascular invasion (p = 0.012) had a significantly higher risk of positive lymph nodes. The overall survival of patients with lymph nodes metastasis was not associated with the performance of CLND.

Conclusion:
Patients in the CM or ALM subgroups with metastatic SLNs or lymph nodes exhibited significantly poorer overall survival. Advanced Breslow thickness and lymphovascular invasion were independent predictive factors for CM and ALM patients with positive lymph node status. There was no significant difference in survival between CM and ALM patients following SLNB, regardless of CLND being performed.
Evaluation of Oxidative Stress Parameters and Genotoxic Effects in Patients With Work-Related Asthma and Silicosis
Authors: Kurt Ozlem Kar , Ergun Dilek , Anlar Hatice Gul , Hazar Merve , Aydin Dilsiz Sevtap , Karatas Mevlut , Basaran Nursen 
Published: September 2022

ObjectiveTo determine the mechanistic roles of oxidative stress, inflammation, and genotoxicity parameters in patients with work-related asthma (WRA) and silicosis.MethodsThirty-eight healthy office workers, 27 employees with a history of exposure and no disease, 24 employees with WRA, and 23 employees with silicosis were included in this study. Superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and interleukins (IL) 17, 23, and 27 levels were measured in the serum. Genotoxic damage was evaluated by calculating the frequency of micronuclei in swab samples and 8-hydroxy-2'-deoxyguanosine in serum.ResultsSerum superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, 8-hydroxy-2'-deoxyguanosine, and IL-17, IL-23, and IL-27 levels were found to be statistically significantly higher in the exposure, WRA, and silicosis groups compared with the control group. The frequency of micronuclei in buccal epithelial cells of the patient group was found to be significantly higher than that of the control group.ConclusionThese results may provide information for molecular mechanisms and early diagnosis of WRA and silicosis and will be a guide for taking precautions in the early period.
Telework Conditions, Ergonomic and Psychosocial Risks, and Musculoskeletal Problems in the COVID-19 Pandemic
Authors: El Kadri Filho Fauzi , Lucca Sérgio Roberto de 
Published: September 2022

Objective
To evaluate the association of telework conditions with ergonomic and psychosocial risks and with the occurrence of musculoskeletal problems among employees of the Brazilian Labor Judiciary during the COVID-19 pandemic.

Methods
A cross-sectional study was conducted with 934 workers from August to October 2021. The data were collected via Web using a self-administrated questionnaire survey. Nonparametric tests and generalized linear regression analysis were used.

Results
Previous experience in telework was associated with a better evaluation of the home workstation, a lower increase in workload, a greater increase in productivity, and greater preference to continue teleworking after the pandemic. The lack of a place dedicated to telework was specially related to greater ergonomic and psychosocial risks and to the greater occurrence of musculoskeletal problems.

Conclusions
Companies should monitor telework conditions to reduce health risks among their employees.
Apathetic hyperthyroidism in an elderly patient presenting with psychomotor retardation
Authors: Delacroix Romuald , Umberger Julie Marie 
Published: September 2022

ABSTRACT
Hyperthyroidism in the elderly population is often associated with atypical, blunted, or nonspecific signs and symptoms, also known as apathetic hyperthyroidism (AH). The absence of the classical hyperkinetic clinical presentation can be confused with the normal aging process, or other diseases, and often leads to misdiagnosis, delayed treatment, and negative outcomes for elderly patients. We provide a case study of an elderly patient to illustrate the atypical presentation of AH. The vignette also highlights a diagnostic and treatment approach based on geriatric medicine fundamentals and evidence-based research. We then review the multiple factors and pathogenetic mechanisms contributing to endocrine disruptors and the paucity of hyperadrenergic signs and symptoms in the elderly with hyperthyroidism. Additionally, the article contrasts the symptomatology and diagnostic profile between primary hyperthyroidism and AH. Finally, we provide an evidence-based, patient-centered approach to manage AH in the elderly population. We recommend that nurse practitioners cultivate illness script inclusive of atypical presentations to guide their clinical decision making. Psychomotor retardation with or without cardiovascular symptoms warrant a high degree of suspicion and the initiation of laboratory studies, including thyroid functions to confirm or rule out hyperthyroidism.
Molecular Features of Preinvasive and Invasive Vulvar Neoplasms
Authors: Deb Pratik Q. , Heller Debra S. 
Published: September 2022

Objectives
Neoplasms arising from the vulva are uncommon and comprise various subtypes. Given the recent advancements in the molecular aspects of oncologic pathology and how they have impacted cancer treatment, an understanding of recent innovations in the molecular features of vulvar lesions is important.

Materials and Methods
Systematic literature search was performed on PubMed, Google Scholar, and Scopus databases for molecular and genetic characteristics of vulvar neoplasms. Peer-reviewed literature published in English is included.

Results
Squamous cell carcinoma (SCC) and its precursors are the predominant neoplasm at this site. Human papillomavirus (HPV) plays a crucial role in the pathogenesis of some of these lesions. Human papillomavirus–associated SCC follows the carcinogenic pathway driven by viral proteins E6 and E7 while HPV-independent SCC shows a high incidence of mutation of TP53 and CDKN2A genes. Mutations in the genes involving the PI3K-Akt pathway play an important role in the pathogenesis of both types of SCC. Among other vulvar malignancies, melanoma, and vulvar Paget disease (VPD) pose a significant clinical challenge and have unique molecular characteristics. Compared with dermal cutaneous melanoma, vulvar melanoma shows a higher rate of mutation of cKIT and NRAS genes and a lower rate of mutations in BRAF. Less than 20% of VPD shows amplification of ERBB2 and seldom shows mutation in genes involving the PI3K-Akt pathway.

Conclusions
Several potentially targetable molecular pathways have emerged as they have been shown to be involved in the tumorigenesis of SCC, melanoma, and VPD.
Effects of micronutrient and phytochemical supplementation on cardiovascular health in obese and overweight children: a narrative review
Authors: Vrech Massimiliano , Ferruzzi Alessandro , Pietrobelli Angelo 
Published: September 2022

Purpose of review
Cardiovascular damage could begin early in life. Our aim was to examine the current state of the art related to micronutrient supplementation on vascular health in obese and overweight children. We considered only the studies performed over the past few years.

Recent findings
Vitamin D supplementation in the obese pediatric population with vitamin D deficiency could improve the vascular health of these subjects. The evidence is less clear on supplementation with other micronutrients. Zinc supplementation is currently the most supported by the literature.

Summary
As of today, we can only speculate that supplementation with other micronutrients could improve the vascular health of obese and overweight children. Strong limitations are the different instrumental methods used to assess vascular health in obese children and adolescents under micronutrients supplementation. Actually, indirect indicators more reliable to evaluate vascular health seem to be lipid profile and insulin sensitivity. Furthermore, there is a particular lack of studies in this area in recent years, especially in the pediatric population. Additional studies performed in this population should be pursued to clarify significant relationships between micronutrients and vascular health.