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Objective: To evaluate the reliability and validity of the Thai version of the modified Japanese Orthopaedic Association scale. Methods: The modified Japanese Orthopaedic Association scale was translated into Thai language to create the Thai version of the Modified Japanese Orthopaedic Association (Thai-mJOA) scale. Translation was performed according to international standards using a forward-backward translation protocol. Translation was performed by 2 expert translators and 1 physician, and the final version was approved by an expert committee. Thai patients with cervical spondylosis with myelopathy were enrolled and evaluated using the Thai-mJOA scale, Nurick Grading, the Thai version of the Neck Disability Index (Thai-NDI), and the Thai version of the Short Form-36 (Thai-SF-36). Reliability and validity of the Thai-mJOA were assessed via comparison with the Nurick Grading and the Thai-NDI. Results: Ninety-two patients were included. The most common compression level was C5-C6 vertebral disc. Cronbach’s alpha of the total Thai-mJOA showed excellent internal consistency (0.991). The intraclass correlation coefficient (ICC) for test-retest reliability was 0.981 (95% confidence interval [CI]: 0.972-0.988). Regarding concurrent validity, the motor dysfunction score of the lower extremities and the total score of the Thai-mJOA were strongly correlated with Nurick Grading (r=0.825, r=0.712, respectively). The total score of the Thai-mJOA was moderately correlated with the Thai-NDI (r=0.670). Conclusion: The Thai-mJOA was found to be a valid and reliable tool for evaluating symptom severity in Thai patients with cervical spondylosis with myelopathy.

Inappropriate intervertebral height restoration caused by nonoptimal choice of cage size is common in anterior cervical discectomy and fusion. The purpose of this study was to evaluate the radiological and clinical outcomes of cervical intervertebral distraction performed in prediscectomy under the strain limitation of the intact disc in a procedure defined as disc-limited intervertebral distraction.A total of 61 patients were enrolled. Japanese Orthopaedic Association score, Neck Disability Index, and visual analog scale score for neck pain were evaluated. The parameters of the degenerative intervertebral space height, mean value of the adjacent intervertebral space heights, preoperative and postoperative day 3 segmental height, regional sagittal alignment and global sagittal alignment were measured on plain radiographs. The change in the degenerative intervertebral space height, postoperative day 3 degenerative intervertebral space height, and intervertebral distraction ratio were calculated according to the parameters measured on radiographs.The change in the degenerative intervertebral space height and distraction ratio in the study group were both significantly lower than those in the control group (both P0.001). In the study group, there was no significant difference between postoperative day 3 degenerative intervertebral space height and mean value of the adjacent intervertebral space heights (P = 0.752). The Japanese Orthopaedic Association score improved significantly in both groups, with similar recovery rates. There were significant differences in neck pain score and Neck Disability Index between the groups at the 3 days and 1 month follow-ups (P0.001).Disc-limited intervertebral distraction is beneficial in avoiding overestimation of the cage size when performing anterior cervical discectomy and fusion and physiologically restoring intervertebral space height.

We sought to compare the clinical and radiologic outcomes after anterior cervical surgery between zero-profile (Zero-P) cage and plate-cage construct (PCC).One-hundred and sixteen patients with single-level cervical disk herniation who underwent anterior cervical diskectomy and fusion between May 2015 and March 2017 were enrolled. They were divided into a Zero-P group (61 cases) and a PCC group (55 cases). At 1, 6, 12, and 24 months after the operation, routine follow-up evaluation was recommended including visual analog scale score and Japanese Orthopaedic Association score. The lateral x-ray film was performed at 1 and 24 months postoperatively.All 116 patients successfully completed the operation and achieved bone fusion. While there was no significant difference in the amount of bleeding between the 2 groups, the operation time of the Zero-P group was significantly shorter than that of the PCC group with statistically difference. The visual analog scale score and Japanese Orthopaedic Association score of the 2 groups at each follow-up interval postoperatively were significantly improved compared with that before operation; the difference was statistically significant (P0.05, respectively). While all the C2-7 cervical curvature, segmental Cobb angle, and height of adjacent vertebral body were lost at the 24-month follow-up, the significant difference was observed in the Zero-P group (P0.05, respectively).Compared with the Zero-P system, the PCC system provides a comparable clinical outcome. Although it showed the disadvantages in controlling the operation time and surgical bleeding, the radiologic outcome was better at the 2-year follow-up.

Purpose Degenerative cervical myelopathy (DCM) is the most common non-traumatic cause of spinal cord dysfunction. Prediction of the neurological outcome after surgery is important. The aim of this study was to analyze the relationship between first symptoms of DCM and the neurological outcome after surgery. Methods A retrospective analysis over a period of 10 years was performed. First symptoms such as cervicobrachial neuralgia, sensory and motor deficits and gait disturbances were evaluated regarding the postoperative neurological outcome. The modified Japanese Orthopedic Association Score (mJOA Score) was used to evaluate neurological outcome. Results In total, 411 patients (263 males, 64%) with a median age of 62.6 ± 12.1 years were included. Cervicobrachial neuralgia was described in 40.2%, gait disturbance in 31.6%, sensory deficits in 19% and motor deficits in 9.2% as first symptom. Patients with cervicobrachial neuralgia were significantly younger (median age of 58 years, p = 0.0005) than patients with gait disturbances (median age of 68 years, p = 0.0005). Patients with gait disturbances and motor deficits as first symptom showed significantly lower mJOA Scores than other patients (p = 0.0005). Additionally, motor deficits and gait disturbance were negative predictors for postoperative outcome according to the mJOA Score. Conclusion Motor deficits and gait disturbances as the first symptom of DCM are negative predictors for postoperative neurological outcome. Nevertheless, patients with motor deficits and gait disturbance significantly profit from the surgical treatment despite poor preoperative mJOA Score.

For two decades, many scores, questionnaires, and rating systems have been used to evaluate the functional outcome of children with an upper extremity fracture (UEF). However, only a few of these were created specifically for children, and many assess only elbow function. In the absence of any published review on this topic, we set out to identify and categorize different scores used to evaluate the clinical and functional outcomes of surgically treated pediatric UEFs. A literature search was performed, and 38 studies were identified. The scores used more often were the shortened version of the Disability of the Arm, Shoulder and Hand questionnaire and the Mayo Elbow Performance Score/Index. In a lower number of studies, authors used other scoring systems, including the Mayo Wrist Score, the Patient-Rated Wrist Evaluation, the Patient-Rated Elbow Evaluation, the Metaizeau functional scoring system, the Oxford Elbow Score, the Price and Flynn criteria, the Hardacre Functional Score, the Neer Shoulder Score, the Constant-Murley Shoulder Score, the Modified Orthopedic Trauma Association Score, the Medical Outcomes Study Short Form-36, and the Pediatric Outcomes Data Collection Instrument. Some specific pediatric scoring systems to evaluate the functional outcome of children with a UEF have been suggested, but a single tool that is valid and reliable for skeletally immature patients of all ages is not yet available. Further studies are needed to identify specific pediatric measurements to increase validity, responsiveness, sensitivity, and interpretability of upper limb functional outcome scores in common clinical practice.

INTRODUCTION AND OBJECTIVE:Accurate prediction of competing risks of mortality is a key component of prostate cancer treatment decision-making. We sought to compare the Prostate Cancer Comorbidity ...

Hanahan and Weinberg introduced the “hallmarks of cancer” and typified essential biological abilities acquired by human cancer. Since then, a growing understanding of hallmark principles associated with breast cancer has assisted knowledge-based therapeutics development; however, despite the rapidly increasing number of targeted therapeutics, enduring disease-free responses for most forms of breast cancer is rare. Invasion and metastasis are the most defining feature of breast cancer malignancy and the leading cause of patient mortality. Hence, we propose a modified hallmarks model adapted to breast cancer, in which invasion and metastasis are shifted to the center of attention, thereby emphasizing it as a potentially superior therapeutic target. Although the scientific community highly appreciates the importance of the invasion and metastasis hallmark, as can be demonstrated by the growing number of publications on breast cancer metastasis, very few clinical trials concentrate on testing anti-metastasis inhibitors and even fewer trials focus on inhibitors for breast cancer metastasis. Here, we discuss the obstacles of applying research on invasion and metastasis therapeutics into the clinic and present current developments that could provide a potential solution to this dilemma.

Background: Ultrasound-guided regional anesthesia has gained popularity over the last decade. This study aimed to assess whether YouTube videos sufficiently serve as an adjunctive tool for learning how to perform an ultrasound-guided brachial plexus block (BPB). Methods: All YouTube videos were classified, based on their sources, as either academic, manufacturer, educational, or individual videos. The metrics, accuracy, utility, reliability (using the Journal of American Medical Association Score benchmark criteria (JAMAS)), and educational quality (using the Global Quality Score (GQS) and Brachial Plexus Block Specific Quality Score (BSQS)) were validated. Results: Here, 175 videos were included. Academic (1.19 ± 0.62, mean ± standard deviation), manufacturer (1.17 ± 0.71), and educational videos (1.15 ± 0.76) had better JAMAS accuracy and reliability than individual videos (0.26 ± 0.67) (p &lt, 0.001). Manufacturer (11.22 ± 1.63) and educational videos (10.33 ± 3.34) had a higher BSQS than individual videos (7.32 ± 4.20) (p &lt, 0.001). All sources weakly addressed the equipment preparation and post-procedure questions after BSQS analysis. Conclusions: The reliability and quality of ultrasound-guided BPB videos differ depending on their source. As YouTube is a useful educational platform for learners and teachers, global societies of regional anesthesiologists should set a standard for videos.

Background Biological experiments have confirmed the association between miRNAs and various diseases. However, such experiments are costly and time consuming. Computational methods help select potential disease-related miRNAs to improve the efficiency of biological experiments. Methods In this work, we develop a novel method using multiple types of data to calculate miRNA and disease similarity based on mutual information, and add miRNA family and cluster information to predict human disease-related miRNAs (FCMDAP). This method not only depends on known miRNA-diseases associations but also accurately measures miRNA and disease similarity and resolves the problem of overestimation. FCMDAP uses the k most similar neighbor recommendation algorithm to predict the association score between miRNA and disease. Information about miRNA cluster is also used to improve prediction accuracy. Result FCMDAP achieves an average AUC of 0.9165 based on leave-one-out cross validation. Results confirm the 100, 98 and 96% of the top 50 predicted miRNAs reported in case studies on colorectal, lung, and pancreatic neoplasms. FCMDAP also exhibits satisfactory performance in predicting diseases without any related miRNAs and miRNAs without any related diseases. Conclusions In this study, we present a computational method FCMDAP to improve the prediction accuracy of disease related miRNAs. FCMDAP could be an effective tool for further biological experiments. Electronic supplementary material The online version of this article (10.1186/s12918-019-0696-9) contains supplementary material, which is available to authorized users.

Summary Purpose To assess the quality of YouTube™ videos on keratoconus as an information resource for patients. Methods The words “Keratoconus”, “Crosslinking”, and “Keratoconus treatment for patients” were used as search terms on the official YouTube™ website ( http://www.youtube.com ). All cookies were disabled, the search history of the web browser was deleted just prior to the search, and no additional changes were made to the standard YouTube™ search preferences. The first 180 videos were downloaded. A total of 116 videos were evaluated according to DISCERN score, Journal of the American Medical Association score, and Global Quality Score. Videos were also assessed based on the presence or absence of 10 criteria proposed by two ophthalmologists. Results One hundred and sixteen videos were analyzed after the exclusion of 54 videos that were either duplicates, irrelevant, or in languages other than English. The mean DISCERN, Journal of the American Medical Association and Global Quality scores were 43.25 ± 11.52, 1.30 ± 0.90, 3.05 ± 0.96 respectively. Fifty-six (48.3%) videos had been uploaded by physicians, 23 (19.8%) by healthcare organizations, 23 (19.8%) by patients, and 14 (12.1%) by other entities such as independent organizations and YouTube™ health channels. The most commonly satisfied criterion was information on treatment modalities (82.7%). Conclusion Keratoconus is a disease of youth, therefore YouTube™ videos would seem to be an easily accessible, informative and educational source, especially for younger patients. However, these videos are not useful as information resources and overall do not offer any additional benefit to patients.

To study pattern and rate of neurological functional recovery after surgery for cervical spondylotic myelopathy (CSM).This prospective study comprised 25 patients with CSM who underwent surgical decompression at our institution. Upper limb, lower limb, and sphincter functions were assessed using the modified Japanese Orthopaedic Association score (mJOA). Assessment was done before the operation and at 1 month, 3 months, and 1 year after surgery.The mJOA score did not significantly increase at 1 month after surgery (P = 0.051); however, increase in mJOA score was statistically significant at 3 and 1 year after surgery (P0.001 and P0.001, respectively). Upper limb motor dysfunction improved in 65% of patients, lower limb motor dysfunction improved in 52% of patients, upper limb sensory dysfunction improved in 48% of patients, and sphincter dysfunction improved in 14.2% of patients. There was a significant positive correlation between preoperative and postoperative mJOA score at 1 month, 3 months, and 1 year after surgery.Minimal improvement occurred in the first month after CSM surgery to reach a peak at 3 months after surgery and steady improvement up to 1 year after surgery. Upper limbs recovered better and earlier than lower limbs and sphincter function. Preoperative severity of CSM is one of the main predictors of postoperative neurological outcome.

Introduction: The modified Japanese Orthopaedic Association (mJOA) score is considered to be among the most comprehensive scores in the assessment of patients with cervical myelopathy. Hence, providing reliable, translated, and cross-culturally adapted versions in different languages is required to standardize the evaluation of patients. This study aimed to translate a reliable Arabic version of the mJOA score. Methods: A total of 65 patients of variable age and with etiologies for compressive cervical myelopathy were recruited. Both forward and backward translations were performed. Then, intraobserver and interobserver reliabilities were measured using the intraclass correlation coefficient and Cronbach's alpha coefficient. Results: The mean age of the patients was 58.08 years, and most of them were male (69.2%). The intraobserver and interobserver reliabilities were almost in perfect agreement for the different sections and the total score, which were 96.8% and 97.4%, respectively. Conclusions: In this study, a reliable, cross-culturally adapted Arabic version of the mJOA score for patients with cervical myelopathy is provided. Although the study was conducted on Egyptian patients, we believe that it could be implemented in majority of the Arabic-speaking population.

This paper presents a novel framework for fraud detection in healthcare systems which self-learns from the historical medical data. Historical medical records are required for training and testing of machine learning models. The main problem being faced by both private and government health supported schemes is a rapid rise in the amount of claims by beneficiaries mostly based on fraudulent billing. Detection of fraudulent transactions in healthcare systems is a strenuous task due to intricate relationships among dynamic elements including doctors, patients, service. In light of aforementioned challenges in health support programs, there is a need to develop intelligent fraud detection models for tracing the loopholes in procedures which may lead to successful reimbursement of fraudulent medical bills. In order to address the issue of fraud in healthcare programs our solution proposes a framework based on three entities (patient, doctor, service). Firstly, the framework computes association scores for three elements of the healthcare ecosystem namely patients, doctors or services. The framework filters out identified cases using association scores. The Confidence values, after G-means clustering of transactional data, are computed for each service in each specialty. Rules are generated based on the confidence values of services for each specialty. Then, an evaluation of identified cases is done using rule engine. The framework classifies cases into fraudulent activities based on the similarity bit&rsquo, s value. The validation of framework is performed on local hospital employees transactional data which includes many reported cases of fraudulent activities in addition to some introduced anomalies.

Cumulative experimental studies have demonstrated the critical roles of microRNAs (miRNAs) in the diverse fundamental and important biological processes, and in the development of numerous complex human diseases. Thus, exploring the relationships between miRNAs and diseases is helpful with understanding the mechanisms, the detection, diagnosis, and treatment of complex diseases. As the identification of miRNA-disease associations via traditional biological experiments is time-consuming and expensive, an effective computational prediction method is appealing. In this study, we present a deep learning framework with variational graph auto-encoder for miRNA-disease association prediction (VGAE-MDA). VGAE-MDA first gets the representations of miRNAs and diseases from the heterogeneous networks constructed by miRNA-miRNA similarity, disease-disease similarity, and known miRNA-disease associations. Then, VGAE-MDA constructs two sub-networks: miRNA-based network and disease-based network. Combining the representations based on the heterogeneous network, two variational graph auto-encoders (VGAE) are deployed for calculating the miRNA-disease association scores from two sub-networks, respectively. Lastly, VGAE-MDA obtains the final predicted association score for a miRNA-disease pair by integrating the scores from these two trained networks. Unlike the previous model, the VGAE-MDA can mitigate the effect of noises from random selection of negative samples. Besides, the use of graph convolutional neural (GCN) network can naturally incorporate the node features from the graph structure while the variational autoencoder (VAE) makes use of latent variables to predict associations from the perspective of data distribution. The experimental results show that VGAE-MDA outperforms the state-of-the-art approaches in miRNA-disease association prediction. Besides, the effectiveness of our model has been further demonstrated by case studies.

Background: The purpose of this study is to investigate the quality and reliability of YouTube videos regarding developmental dysplasia of the hip (DDH).YouTube is one of the most popular websites used as a source of information, but the variety in authorship and lack of a peer-review process are problems.Methods: The search string “developmental dysplasia of the hip” was inputted to the YouTube search engine, and the first 52 videos returned as a response were assessed. The Video Power Index (VPI) (like ratio*view ratio/100) was used to assess the popularity of the videos. Global Quality Score (GQS) and developmental dysplasia of the hip scores (DDHS) were used to evaluate the quality and educational quality of the videos, and The Journal of the American Medical Association Score (JAMAS) was used to evaluate the accuracy of the source of information.Results: According to our research, the mean duration time of the videos was 526 s (SD: 813), and the average view count of the videos was 34,644. The mean time since upload was 1907 days (SD: 1137). On average, the videos received 10.9 comments, 210.3 likes, and 6.8 dislikes. The mean like ratio and VPI were 92.9 (SD: 19.57) and 25.8 (SD: 53.43), respectively. The mean JAMAS, GQS, and DDHS of all videos evaluated were 1.37 (SD: 0.7), 2.46 (SD: 1.09), and 4.63 (SD: 5.00), respectively. The DDHS and GQS were positively correlated (p:0.001 r: 65.8%). The GQS and the DDHS were higher in the academic group than in the commercial group (p:0.01). (p:0.037).Conclusions: The videos regarding DDH on YouTube generally had poor quality. As a result, to maintain an optimal parent–physician or patient–physician relationship, we suggest that international health societies make their own educational videos for parents, patients, and fellow physicians.

Background Spondylotic cervical myelopathy (SCM) is a common cause of spinal-related disability in elderly patients. The assessment of this disability is a challenging task and depends on the subjective evaluation of the investigator. As a widespread-used scale, the modified version of the Japanese Orthopaedic Association score (mJOA) should be translated and culturally adapted in the Brazilian Portuguese language (i.e., mJOA-Br) to provide its clinical and research use. This study aimed to perform translation, transcultural adaptation, and validation of the mJOA into Brazilian Portuguese. Methods Following the transcultural adaptation model described by Guillemin et al., the scale as translated into Brazilian Portuguese and back-translated to English. Afterwards, questionnaires were applied in consecutive patients with SCM and compared with a control group (without SCM). The final scale was compared with the Brazilian version of Neck Disability Index for validation. Results Sixty patients were submitted to the translated version of mJOA. There was a strong correlation between mJOA-Br scores and Neck Disability Index scores to evaluate SCM symptoms (R = −0.75). Conclusions mJOA-Br was considered a valid and reliable tool to evaluate patients with SCM.

Objective: The purpose of this study was to evaluate the clinical results of arthroscopic rotator cuff repair with a tape-attached anchor: The HEALICOILRG with ULTRATAPE. We hypothesised that performing arthroscopic rotator cuff repair with tape-attached anchors would result in better clinical outcomes and reduce the retear rate compared with conventional suture anchors. Methods: We included 83 patients treated by arthroscopic rotator cuff repair with a minimum 1-year follow-up. We divided them into two groups: Use of the HEALICOILRG with ULTRATAPE (group T: 41 shoulders; mean patient age, 64.3 years) and use of the conventional suture anchor (group S: 42 shoulders; mean patient age, 68.9 years). We compared the University of California Los Angeles scores, Japanese Orthopaedic Association scores, range of motion, and retear rate between the two groups. The Student t test and chi-square test were used in statistical analyses. Results: At the 1-year postoperative follow-up, both groups showed improvement in the average University of California Los Angeles score, Japanese Orthopaedic Association score, and range of motion, although no significant difference was found in the retear rate between the two groups. Conclusions: Results of arthroscopic rotator cuff repair with the HEALICOILRG with ULTRATAPE were generally good. However, our results could not demonstrate efficacy of the HEALICOILRG with ULTRATAPE. Further detailed studies are needed to determine its treatment result.

We conducted an in silico analysis to search for important genes in the pathogenesis of Caseous Lymphadenitis (CL), with prospects for use in formulating effective vaccines against this disease. For this, we performed a survey of proteins expressed by Corynebacterium pseudotuberculosis, using protein sequences collected from the NCBI GenPept database and the keywords "caseous lymphadenitis" and "Corynebacterium pseudotuberculosis" and "goats". A network was developed using the STRING 10 database, with a confidence score of 0.900. For every gene interaction identified, we summed the interaction score of each gene, generating a combined association score to obtain a single score named weighted number of links (WNL). Genes with the highest WNL were named "leader genes". Ontological analysis was extracted from the STRING database through Kyoto Encyclopedia of Genes and Genomes (KEGG) database. A search in the GenPept database revealed 2,124 proteins. By using and plotting with STRING 10, we then developed an in silico network model comprised of 1,243 genes/proteins interconnecting through 3,330 interactions. The highest WNL values were identified in the rplB gene, which was named the leader gene. Our ontological analysis shows that this protein acts effectively mainly on Metabolic pathways and Biosynthesis of secondary metabolites. In conclusion, the in silico analyses showed that rplB has good potential for vaccine development. However, functional assays are needed to make sure that this protein can potentially induce both humoral and cellular immune responses against C. pseudotuberculosis in goats.

While variants of noncoding RNAs (ncRNAs) have been experimentally validated as a new class of biomarkers and drug targets, the discovery and interpretation of relationships between ncRNA variants and human diseases become important and challenging. Here we present ncRNAVar (http://www.liwzlab.cn/ncrnavar/), the first database that provides association data between validated ncRNA variants and human diseases through manual curation on 2650 publications and computational annotation. ncRNAVar contains 4565 associations between 711 human disease phenotypes and 3112 variants from 2597 ncRNAs. Each association was reviewed by professional curators, incorporated with valuable annotation and cross references, and designated with an association score by our refined score model. ncRNAVar offers web applications including association prioritization, network visualization, and relationship mapping. ncRNAVar, presenting a landscape of ncRNA variants in human diseases and a useful resource for subsequent software development, will improve our insight of relationships between ncRNA variants and human health.

A growing body of evidence indicates that circular RNAs (circRNAs) play a pivotal role in various biological processes and have a close association with the initiation and progression of diseases. Moreover, circRNAs are considered as promising biomarkers for disease diagnosis owing to their characteristics of conservation, stability and universality. Inferring disease–circRNA relationships will contribute to the understanding of disease pathology. However, it is costly and laborious to discover novel disease–circRNA interactions by wet-lab experiments, and few computational methods have been devoted to predicting potential circRNAs for diseases. Here, we advance a computational method (NCPCDA) to identify novel circRNA–disease associations based on network consistency projection. For starters, we make use of multi-view similarity data, including circRNA functional similarity, disease semantic similarity, and association profile similarity, to construct the integrated circRNA similarity and disease similarity. Then, we project circRNA space and disease space on the circRNA–disease interaction network, respectively. Finally, we can obtain the predicted circRNA–disease association score matrix by combining the above two space projection scores. Simulation results show that NCPCDA can efficiently infer disease–circRNA relationships with high accuracy, obtaining AUCs of 0.9541 and 0.9201 in leave-one-out cross validation and five-fold cross validation, respectively. Furthermore, case studies also suggest that NCPCDA is promising for discovering new disease–circRNA interactions. The NCPCDA dataset and code, as well as the detailed readme file for our code, can be downloaded from Github (https://github.com/ghli16/NNCPCD).

Objective Patients are increasingly referring to the Internet after a diagnosis of vascular disease. This study was performed to quantitatively define the accuracy and reliability of information on YouTube regarding abdominal aortic aneurysms (AAA). Methods A systematic search of YouTube was conducted using multiple AAA-specific keywords. The default YouTube search setting of “relevance” was used to replicate an average search attempt, and the first 50 results from each keyword search were reviewed and analyzed by two independent reviewers. Descriptive characteristics, Journal of the American Medical Association Score, modified DISCERN score, Video Power Index, and a novel scoring system for the management of AAAs, the AAA-Specific Score (AAASS), were used to record data. Inter-rater agreement was analyzed using intraclass correlation coefficient estimates and the Kruskal-Wallis test was used for intergroup comparisons. Results Fifty-one videos were included for analysis. The mean Journal of the American Medical Association Score, DISCERN, and AAASS values among videos were 1.74/4.00 (standard deviation [SD], 0.84), 2.37/5.00 (SD, 0.97), and 6.63/20.00 (SD, 3.23), respectively. Of all the included videos, 78% were educational in nature, 14% were patient testimonials, and 8% were news programs. Based on the AAASS, the majority of analyzed videos fell into the poor category (41%), followed next by the very poor (31%), moderately useful (25%), very useful (2%), and exceptional (0%) categories. Videos by nonphysicians were significantly more popular (P Conclusions Although variable in source and content, the completeness and reliability of information offered on YouTube for AAA diagnosis and treatment is poor. Patients watching YouTube for information on their AAA diagnosis are receiving an incomplete and perhaps misleading picture of available diagnostic and treatment options. Given that vascular surgeons are likely to be affected by unrealistic treatment expectations from patients accessing online materials regarding AAA, it is important to acknowledge the nature of content on these platforms.

To evaluate surgical outcomes of homogeneous spinal-shortening axial decompression (HSAD) for reoperation in pediatric patients with tethered cord syndrome.Twenty consecutive pediatric patients (≤18 years old, 7 boys, 13 girls) who underwent HSAD after untethering surgery between June 2012 and May 2015 were included. The Japanese Orthopaedic Association score and visual analog scale were used to evaluate preoperative and postoperative neurologic function and pain. The International Consultation on Incontinence Questionnaire-Short Form and urodynamics were used to evaluate urinary function. The Rintala score was used to evaluate stool function.Mean age of patients was 13.4 ± 3.6 years (range, 7-18 years). The mean duration of follow-up was 31.2 ± 12.7 months (range, 12-48 months). The Japanese Orthopaedic Association score was increased from 13.31 ± 4.03 preoperatively to 19.15 ± 4.17 at final follow-up (P0.01). The visual analog scale score was decreased from 5.25 ± 1.78 preoperatively to 2.21 ± 1.63 at final follow-up (P0.01). The International Consultation on Incontinence Questionnaire-Short Form score was decreased from 14.94 ± 4.15 preoperatively to 7.63 ± 4.40 at final follow-up (P0.01). All urodynamics parameters improved compared with before the operation. The Rintala score improved from 5.26 ± 3.45 preoperatively to 12.32 ± 3.43 at final follow-up (P0.01).Outcomes of HSAD for revision surgery of tethered cord syndrome were satisfactory. HSAD improved neurologic function of patients significantly. HSAD could become an alternative surgical treatment of reoperation for tethered cord syndrome.

A retrospective analysis.The aim of this study was to elucidate the psychometric properties of the original Japanese Orthopaedic Association (JOA) score, including the minimum detectable change (MDC), minimum clinically important difference (MCID), and patient-accepted symptom state (PASS).Despite the worldwide popularity of modified JOA score (mJOA), the original JOA score is still commonly used in East Asian countries, including Japan. However, unlike mJOA score, the psychometric properties of JOA score remain poorly understood.We retrospectively reviewed a consecutive series of laminoplasty for degenerative cervical myelopathy patients in a single academic institution. Pre- and postoperative JOA scores were collected, and the recovery rate was calculated. Anchor-based methods were used to determine the cut-off values by a receiver operating characteristic (ROC) curve analysis. The patients were also asked to answer an anchor question analyzing their postoperative health transition used for the MDC and another question assessing the patient satisfaction used for the MCID and PASS.A total of 101 patients were included in the analysis. The mean preoperative JOA score was 10.3 [standard deviation (SD): 2.4), and the mean postoperative JOA score was 13.4 (SD: 2.5). The mean recovery rate was 44%. A total of 68% of the patients admitted that their health condition was at least "somewhat better" than their preoperative condition, and 66% were at least "somewhat satisfied" with the treatment results. On the basis of ROC curve analyses, the MDC and MCID for JOA score in degenerative cervical myelopathy patients were calculated to be 2.5. The PASS was estimated to be 14.5, and the MCID for JOA recovery rate was 52.8%.The MDC, MCID, and PASS for JOA score for degenerative cervical myelopathy patients were reported by anchor-based ROC curve analyses.4.

Posterior atlantoaxial pedicle screw fixation is an effective technique for atlantoaxial instability (AAI). However, because of the complex anatomy of the cranio-cervical junction, it remains challenging to insert atlantoaxial pedicle screw precisely and safely. A novel drill guide template was designed for atlantoaxial pedicle screw placement in this study. The purpose of this study is to quantitatively evaluate the accuracy of atlantoaxial pedicle screw placement using the novel drill guide template. Between June 2014 and September 2015, 32 consecutive patients with AAI were included. Using the Mimics v17.0 and 3-matic v9.0 softwares, a novel drill guide template with two location holes and guide rods was designed. All patients underwent posterior atlantoaxial pedicle screw fixation assisted by the novel drill guide template. After surgery, the entry point and directions of actual and ideal screw trajectories were measured and compared. All patients underwent surgery successfully assisted by the novel drill guide template. A total of 128 atlantoaxial pedicle screws were placed for 32 AAI patients. Postoperative CT scans showed two screws in atlas deviated medially from the pedicle cortex and entered the spinal canal about 1 mm but without symptoms. For both atlas and axis, there were no significant differences in entry point or directions between the ideal and actual screw trajectories (P > 0.05). Significant differences were found in preoperative and postoperative Japanese Orthopaedic Association score and Visual Analogue Score (P

There is increasing interest in scoring systems to prioritize patients for hip and knee arthroplasty. The purpose of this study was to determine the effectiveness of the New Zealand Orthopaedic Association (NZOA) score and compare it with patient-reported scores of patients listed for hip and knee arthroplasty.Over a 1-year period, all patients listed for primary hip and knee arthroplasty were scored by a prioritization nurse. The NZOA score, outcome, preoperative Oxford hip or knee score (OHKS) and reduced Western Ontario McMaster osteoarthritis index (WOMAC) score (RWS) were collected.Overall, 608 patients were listed for hip (319) or knee (289) arthroplasty. The mean scores for knees were all better than hips (P.001). On initial scoring, 324 patients (53%) were given certainty (mean NZOA, 80.5; OHKS, 10.0; RWS, 35.1), 90 (15%) given clinical over-ride (NZOA, 69.6; OHKS, 12.0; RWS, 33.2), and 194 (32%) returned to general practitioner (NZOA, 64; OHKS, 14.2; RWS, 30.8). Knees (38%) were more likely to be returned than hips (26%; P = .002). Fifty (26%) were re-referred during the study period (mean, 5 months) and given certainty or over-ride. The difference at final outcome between patients with certainty and clinical over-ride was NZOA, 10.3 points; Oxford, 1.6 points; and RWS, 1.4 points. The difference between clinical over-ride and returned to general practitioner was NZOA, 7.2; Oxford, 4.4; RWS, 5.3.The NZOA score is an effective tool for rationing for joint arthroplasty. Patients around the threshold score of 70 may not have a clinically important difference compared with those above threshold.

The modified Japanese orthopaedic association scale (mJOA) is considered one of the most appropriate outcome measures for the assessment of cervical spondylotic myelopathy (CSM). Moreover, mJOA has been recognised among the key predictors of surgical outcome at a global level. To apply the mJOA successfully at an international level, it should be translated and culturally adapted in the native language of the investigators using this scale. A translated version of the mJOA or any other functional scale has never been studied within an Italian population affected by CSM. The aim of this study has been to describe translation, cultural adaptation and psychometric properties of the Italian version of the mJOA (mJOA-IT). The mJOA-IT was developed following a forward–backward translation procedure. Psychometric properties were assessed on a cohort of patients with CSM undergone anterior or posterior decompression associated with stabilisation in lordosis. The mJOA-IT proved to be a reliable outcome measure for CSM (internal consistency 0.60, test–retest stability 0.910, P

MicroRNAs (miRNAs) have been proved to play an indispensable role in many fundamental biological processes, and the dysregulation of miRNAs is closely correlated with human complex diseases. Many studies have focused on the prediction of potential miRNA-disease associations. Considering the insufficient number of known miRNA-disease associations and the poor performance of many existing prediction methods, a novel model combining gradient boosting decision tree with logistic regression (GBDT-LR) is proposed to prioritize miRNA candidates for diseases. To balance positive and negative samples, GBDT-LR firstly adopted k-means clustering to screen negative samples from unknown miRNA-disease associations. Then, the gradient boosting decision tree (GBDT) model, which has an intrinsic advantage in finding many distinguishing features and feature combinations is applied to extract features. Finally, the new features extracted by the GBDT model are input into a logistic regression (LR) model for predicting the final miRNA-disease association score. The experimental results show that the average AUC of GBDT-LR in 5-fold cross-validation (CV) can achieve 0.9274. Besides, in the case studies, 90 %, 94 % and 88 % of the top 50 miRNAs potentially associated with colon cancer, gastric cancer, and pancreatic cancer were confirmed by databases, respectively. Compared with the other three state-of-the-art methods, GBDT-LR can achieve the best prediction performance. The source code and dataset of GBDT-LR are freely available at https://github.com/Pualalala/GBDT-LR.

MicroRNAs (miRNAs) have been proved to be targeted by the small molecules recently, which made using small molecules to target miRNAs become a possible therapy for human diseases. Therefore, it is very meaningful to investigate the relationships between small molecules and miRNAs, which is still yet in the newly-developing stage. In this paper, we presented a prediction model of Graphlet Interaction based inference for Small Molecule-MiRNA Association prediction (GISMMA) by combining small molecule similarity network, miRNA similarity network and known small molecule-miRNA association network. This model described the complex relationship between two small molecules or between two miRNAs using graphlet interaction which consists of 28 isomers. The association score between a small molecule and a miRNA was calculated based on counting the numbers of graphlet interaction throughout the small molecule similarity network and the miRNA similarity network, respectively. Global and two types of local leave-one-out cross validation (LOOCV) as well as five-fold cross validation were implemented in two datasets to evaluate GISMMA. For Dataset 1, the AUCs are 0.9291 for global LOOCV, 0.9505, and 0.7702 for two local LOOCVs, 0.9263 ± 0.0026 for five-fold cross validation; for Dataset 2, the AUCs are 0.8203, 0.8640, 0.6591, and 0.8554 ± 0.0063, in turn. In case study for small molecules, 5-Fluorouracil, 17β-Estradiol and 5-Aza-2'-deoxycytidine, the numbers of top 50 miRNAs predicted by GISMMA and validated to be related to these three small molecules by experimental literatures are in turn 30, 29, and 25. Based on the results from cross validations and case studies, it is easy to realize the excellent performance of GISMMA.

The objective of this study was to validate the efficacy of Takeuchi classification for lateral hinge fractures (LHFs) in open wedge high tibial osteotomy (OWHTO). In all 74 osteoarthritic knees (58 females, 16 males; mean age 62.9 years, standard deviation 7.5, 42 to 77) were treated with OWHTO using a TomoFix plate. The knees were divided into non-fracture (59 knees) and LHF (15 knees) groups, and the LHF group was further divided into Takeuchi types I, II, and III (seven, two, and six knees, respectively). The outcomes were assessed pre-operatively and one year after OWHTO. Pre-operative characteristics (age, gender and body mass index) showed no significant difference between the two groups. The mean Japanese Orthopaedic Association score was significantly improved one year after operation regardless of the presence or absence of LHF (p = 0.0015, p < 0.001, respectively). However, six of seven type I cases had no LHF-related complications; both type II cases had delayed union; and of six type III cases, two had delayed union with correction loss and one had overcorrection. These results suggest that Takeuchi type II and III LHFs are structurally unstable compared with type I.Cite this article: Bone Joint J 2015;97-B:1226–31.

International audience; We propose a method for joint unsu-pervised discovery of multiword expressions (MWEs) and their translations from parallel corpora. First, we apply independent monolingual MWE extraction in source and target languages simultaneously. Then, we calculate translation probability , association score and distributional similarity of co-occurring pairs. Finally, we rank all translations of a given MWE using a linear combination of these features. Preliminary experiments on light verb constructions show promising results.

Background: There are a number of surgical treatment options for cervical spondylotic myelopathy (CSM). In this study, the authors present their clinical results with cervical laminectomy and fusion for the treatment of patients with CSM. Methods: This retrospective study included 58 consecutive patients who underwent cervical laminectomy and fusion for CSM. There were 38 males and 20 females, with a mean age of 64 (range 42-92) years. The Japanese orthopedic association score (mJOA) scale was used as the functional outcome measurement. Both the absolute increase in mJOA and the neurological recovery rate of mJOA were analyzed. The mean clinical follow-up was 17 months (range 5-52 months). Results: There was a statistically significant improvement between mean preoperative (13.2, range 7-17) and postoperative (16.1, range 11-18) mJOA scores following surgery. The average improvement in mJOA score was 2.9 points. The mean neurological recovery rate was 56.6%. Overall 85.5% of patients improved with surgery (n = 51) and the remaining 14.5% of patients had no change in their mJOA score after surgery (n = 7). Fusion was documented in all 58 patients. There was a 10.3% overall complication rate (n = 6). The most common complications were C5 nerve palsies which occurred in 6.9% of the cohort (n = 4); all completely resolved. Conclusion: Cervical laminectomy and fusion is a safe and efficacious procedure for the treatment of CSM. The clinical outcomes appear to be quite reproducible, and this technique is an important part of a spine surgeon's armamentarium.

Purpose: To evaluate the prognostic factors that affect the surgical outcome of laminoplasty in patients with cervical compressive myelopathy. Methods: This is a retrospective review of 43 cases of multi-level cervical compressive myelopathy treated operatively with expansive laminoplasty (Itoh surgical technique), from June 1989 to August 2008. The mean follow-up duration was 7 years. The Japanese Orthopaedic Association score, Hirabayashi recovery rate and improvement of Pavlov's ratio were used to assess the clinical results after laminoplasty. Results: The mean Japanese Orthopaedic Association score improved from 9.7 to 13.7 points after laminoplasty (p

Protein-protein interaction (PPI) database curation requires text-mining systems that can recognize and normalize interactor genes and return a ranked list of PPI pairs for each article. The order of PPI pairs in this list is essential for ease of curation. Most of the current PPI pair ranking approaches rely on association analysis between the two genes in the pair. However, we propose that ranking an extracted PPI pair by considering both the association between the paired genes and each of those genes’ global associations with all other genes mentioned in the paper can provide a more reliable ranked list. In this work, we present a composite interaction score that considers not only the association score between two interactors (pair association score) but also their global association scores. We test three representative data fusion algorithms to estimate this global association score—two Borda-Fuse models and one linear combination model (LCM). The three estimation methods are evaluated using the data set of the BioCreative II.5 Interaction Pair Task (IPT) in terms of area under the interpolated precision/recall curve (AUC iP/R). Our experimental results indicate that using LCM to estimate the global association score can boost the AUC iP/R score from 0.0175 to 0.2396, outperforming the best BioCreative II.5 IPT system.

Reconstructing metabolic and signaling pathways is an effective way of interpreting a genome sequence. A challenge in a pathway reconstruction is that often genes in a pathway cannot be easily found, reflecting current imperfect information of the target organism. In this work, we developed a new method for finding missing genes, which integrates multiple features, including gene expression, phylogenetic profile and function association scores. Particularly, for considering function association between candidate genes and neighboring proteins to the target missing gene in the network, we used Co-occurrence Association Score (CAS) and PubMed Association Score (PAS), which are designed for capturing functional coherence of proteins. We showed that adding CAS and PAS substantially improve the accuracy of identifying missing genes in the yeast enzyme-enzyme network compared to the cases when only the conventional features, gene expression, phylogenetic profile, were used. Finally, it was also demonstrated that the accuracy improves by considering indirect neighbors to the target enzyme position in the network using a proper network-topology-based weighting scheme.

To present the surgical technique, clinical outcomes, and poor prognostic factors of arthroscopic retrograde osteochondral autograft transfer of the tibial plateau.Twelve patients (6 men, 6 women; mean age, 38.7 years) with tibial plateau osteochondral lesions underwent surgery. The primary diseases were osteonecrosis in 4 cases, cartilage injuries in 6, and postfractures of the tibial plateau in 2. Clinical outcomes were evaluated preoperatively and postoperatively according to the International Knee Documentation Committee score and the Japanese Orthopaedic Association score. The International Cartilage Repair Society score was recorded in 7 cases who underwent second-look arthroscopies postoperatively. Statistical analyses were performed to identify prognostic factors associated with the clinical outcomes.The mean International Knee Documentation Committee and Japanese Orthopaedic Association scores were both significantly improved from 39.0 (range, 13.0-57.1) to 72.4 (range, 33.3-100) (P = .0022) and from 65.8 (range, 30.0-85.0) to 85.8 (range, 50.0-100) (P = .0022.05), respectively. In 2 cases, secondary operations were performed because of knee pain (1 varus osteotomy of the femur and 1 total knee replacement). The mean International Cartilage Repair Society scores were significantly worse in the 2 cases who required a secondary operation (3.5; abnormal) than in the 5 cases who did not (10.6; nearly normal). The secondary operation rate was significantly higher in cases with lesion size ≥400 mmMost clinical scores improved significantly postoperatively. The results indicate that arthroscopic retrograde osteochondral autograft transfer is an effective procedure to achieve sufficient cartilage congruity for osteochondral lesions of the tibial plateau400 mmLevel IV, therapeutic case series.