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The surgical management of adult spinal deformities (ASDs) involves a wide variety of complex and technically challenging operative techniques. Despite numerous publications examining the relationship between surgeon experience and outcomes in ASD, no systematic review or meta-analysis exists. This first-time systematic review and meta-analysis examines the impact of surgeon experience on the surgical parameters and complication rates for the surgical management of ASD. Four databases were used for the initial search of this study from database inception until 22 September 2023. The inclusion criteria required articles that examined the outcomes for surgery for ASD, stratified outcomes by surgeon experience and/or the learning curve as a proxy for surgeon experience, and utilized adult patients (>18 years of age). Seven articles met the criteria for final inclusion. Patients in the Experienced Surgeon group had statistically significantly lower levels of EBL with no significant difference in operative time after surgery for ASD compared to patients in the Inexperienced Surgeon group via a meta-analysis of three articles. Patients in the Experienced Surgeon group had a statistically significantly lower total complication rate compared to patients in the Inexperienced Surgeon group via a meta-analysis. Increased surgeon experience resulted in lower levels of EBL, without a significant difference in the operative time after surgery for ASD.

Cervical disc degenerative disease (CDDD) is a common spinal pathology that is often treated with anterior cervical discectomy and fusion (ACDF), cervical disc arthroplasty (CDA), and/or hybrid cervical surgery (HCS). The purpose of this first-time systematic review is to examine the biomechanical outcomes associated with three types of non-contiguous cervical surgeries—ACDF, CDA, and HCS—to provide a greater understanding of non-contiguous cervical surgical biomechanics. A systematic review was performed using PubMed, Cumulated Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, and Web of Science from database inception until June 6th, 2023. The inclusion criteria was any article that reported biomechanical or kinematic outcomes, outcomes for any of the three non-contiguous cervical surgeries, and human-derived and/or human cadaver subjects. A total of 5 biomechanical articles were included from a total of 523 articles. Non-contiguous two-level HCS experienced less drastic range-of-motion (ROM) changes throughout the cervical spine and decreased intervertebral disc pressure (IDP) compared to non-contiguous two-level ACDF. Non-contiguous two-level CDA resulted in more cervical ROM and less non-operative segment facet contact force compared to non-contiguous two level ACDF. There was less cephalad and caudal non-operative segment ROM in non-contiguous two-level ACDF compared to contiguous three-level ACDF.

Little evidence exists concerning the proportion of US college students meeting collective recommendations for the behaviors of sleep, sedentary behavior, and physical activity, together known as 24-hour movement guidelines. As these behaviors are known to be related to mental health, the association between meeting these guidelines and mental health outcomes is of particular importance. Additionally, disparities by socio-demographic characteristics may also exist and need to be explored. To examine the following among US college students, (a) the proportion meeting 24-hour movement guidelines, (b) inequities based on socio-demographic characteristics, and (c) associations between meeting guidelines and mental health outcomes. A quantitative survey design was used with US college students (N = 515). Reported socio-demographic characteristics, physical activity, sedentary behavior, sleep, perceived stress, and depressive symptoms were assessed. Movement guidelines were met by 22.1% of students. No differences in the proportion meeting all guidelines were evident based on gender (p = 0.143) or sexual orientation (p = 0.135), but more White students met all movement guidelines than nonwhite students (p = 0.022). Meeting all movement guidelines was not associated with lower perceived stress (p = 0.090), but was associated with lower depressive symptoms (p < 0.001). Most students do not meet 24-hour movement guidelines, and not meeting these guidelines appears to be associated with less favorable mental health. Given a plausible bi-directional association between movement behaviors and mental health, a dual-pronged approach simultaneously promoting healthier movement behaviors and mental wellbeing whilst considering student characteristics should be assessed by colleges.

College years are a formative life stage; however, students who identify as a sexual minority participate in insufficient physical activity. This study examined differences in level of comfort 1) with/in campus recreation facilities overall, and 2) using specific amenities, by sexual orientation. Students at four public universities completed online surveys assessing perceived comfort using their campus recreation facility. Among participants (n = 160), Kruskal-Wallis analyses showed comfort using campus recreation facilities, free weights, non-intramural sports,and intramural sports was significantly higher among heterosexual students compared to sexual minority students (all p < 0.005). These findings highlight inequities in comfort using campus recreation facilities and provide evidence of the need for inclusive recreation spaces for all students regardless of sexual orientation. Future research is needed to assess LBGTQ+ student's health disparities related to campus recreation facility use and how to increase perceived comfort for all students. [ABSTRACT FROM AUTHOR]

Background: While most renal cell carcinomas (RCC) are of the clear cell subtype, other histologic subtypes are well described and have distinct clinical behavior. This study seeks to evaluate survival of clear and non-clear cell RCC retrospectively from a large, population-based cancer registry. Objectives: The key objectives of this study were to determine cancer-specific survival (CSS) and overall survival (OS) of RCC by histologic subtype and to examine survival by histologic subtype since the advent of anti-angiogenesis therapy in 2006. Methods: Within the California Cancer Registry (CCR), we used multivariable Cox proportional hazards models to assess the association of histologic subtype with CSS and OS, adjusted for sociodemographic and clinical factors. Results: In the CCR, 33,539 RCC patients were diagnosed between 2004 and 2014. The most common subtype, clear cell RCC, comprised 82.6% (n=27,717) of cases. The next most common subtypes were papillary (8.8%, 2,948) and chromophobe (5.2%, 1,759). RCC was more common in men (62.9%, 21,097) compared to women (37.1%, 12,442). Across histologic subtypes, patients with low neighborhood socioeconomic status had lower CSS (HR=1.07, 95% CI 1.02-1.13, p=0.011) and OS (HR=1.14, 95% CI: 1.10-1.19, p

Sexual minority (e.g. non-heterosexual) individuals are at greater risk for negative health outcomes, often linked to inadequate physical activity (PA). The purpose of this study was to assess PA levels and PA enjoyment among college students, by sexual orientation. Data were collected from a volunteer sample of college students enrolled in general health and wellness courses offered at a large, Northeastern U.S. university via an online survey. Participants self-reported demographic information, PA levels using the Global Physical Activity Questionnaire (GPAQ), and PA enjoyment using a 7-item Physical Activity Enjoyment scale (PACES). Among participants (n = 1471), independent sample t-tests showed that sexual minority (SM) students reported significantly lower mean MET-mins/week of MPA (MHeterosexual = 568.09 ± 488.12 vs. MSexual minority = 469.95 ± 471.51; p = .006) and VPA (MHeterosexual = 1089.54 ± 1110.64 vs. MSexual Minority = 628.93 ± 942.78; p < .001), ST days/week (MHeterosexual = 1.93 ± 1.90 vs. MSexual Minority = 1.00 ± 1.60; p < .001), and reported lower total PACES score (MHeterosexual = 7.80 ± 1.92 vs. MSexual Minority = 6.87 ± 2.14; p < .001) compared to heterosexual students. Bootstrap mediation analyses with 5000 samples revealed that PACES has direct and indirect mediation effects on the association between sexual orientation status and MET-mins/week of MPA and VPA, and ST days/week. The current findings provide evidence of the underlying mechanisms linked to the physical activity disparities experienced by SM college students compared to heterosexual students. Additionally, PACES can serve as a facilitator to promote PA engagement among SM students. These findings can inform future intervention work to target PA enjoyment for meaningful behavior change. [ABSTRACT FROM AUTHOR]

In this study of North American campus recreation staff, we examined staff perceptions of transgender and nonbinary student inclusivity, and explored differences in perceived inclusivity based on institutional characteristics, policies, amenities, and staff characteristics. Staff were recruited to participate in an online survey that assessed: institutional characteristics, amenities, and policies; personal characteristics; and, their perception of their campus recreation facilities' inclusivity of transgender and nonbinary students. Perceived inclusivity was greater at nonreligiously affiliated institutions, and at institutions that had antidiscrimination/antiharassment policies and/or all-gender locker/restrooms within the campus recreation department. Men and heterosexual staff reported greater perceived inclusivity than women and sexual minority staff. In summary, antidiscrimination and antiharassment policies and all-gender locker/rest rooms appear to contribute to creating the perception of a more inclusive campus recreation environment. Continued work on staff awareness/knowledge relating to inclusion of transgender and nonbinary students appears to be necessary, and application of policies that support inclusivity should be a priority. [ABSTRACT FROM AUTHOR]

Adequate participation in physical activity (PA) is effective in reducing negative health outcomes, including cardiovascular disease, stroke, type 2 diabetes, as well as stress, anxiety, and depression. However, 1 in 4 adults meet the PA guidelines, with lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons reporting increased rates of inactivity and higher rates of negative health outcomes. Limited research can be conducted on best methods to promote PA among LGBTQ+ adults as there is a lack of standardized measurements for both sexual orientation status and PA used in US national data set methodologies. A call to action is warranted to highlight the lack of uniform methodologies for collecting both sexual orientation and PA data in national data sets, with an overall goal of promoting inclusion and transparency of sexual orientation as a primary, secondary, and tertiary influence on PA. The current societal disconnect of national data sets collecting sexual orientation does not allow for proper extrapolation within the LGBTQ+ classifications. LGBTQ+ identities each report differing PA and health outcomes, promoting the need for proper sexual orientation measures. Without this inclusion, we will continue to see larger health disparities among LGBTQ+ persons due to outdated measurements in current US national data sets. This commentary provides sexual orientation status on health outcomes linked to physical inactivity, the need to include uniform sexual orientation measures in national data sets, and implications of the inclusion of this measure to conduct PA research as it relates to health outcomes. [ABSTRACT FROM AUTHOR]