bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated Custom Composite Polyetheretherketone/Carbon fiber (PEEK/CF) Vertebral Body Replacement (VBR) in the Treatment of Bone Tumors of the Spine
Authors: Shen Francis H. , Gasbarrini Alessandro , Lui Darren F. , Reynolds Jeremy , Capua John , Boriani Stefano 
Published: July 2021

Study Design.
Retrospective, multicenter chart, and radiologic review.

Objective.
To present the first case series of bone tumors of the spine surgically reconstructed with a new custom, fully radiolucent, polyetheretherketone/carbon fiber (PEEK/CF) vertebral body replacement (VBR) integrated system.

Summary of Background Data.
Surgical resections of spinal tumors result in large defects and local recurrence remains a concern. Current titanium-based implants adversely affects postoperative imaging, directly affects ability to identify tumor recurrence, and for delivery of radiotherapy treatments. PEEK/CF spinal implants allows for improved tumor surveillance, precise pre-radiation Computed Tomography planning, and reduces interference with post-reconstructive adjuvant radiotherapy.

Method.
Thirteen patients with spinal tumors underwent vertebral body resection and reconstruction with an integrated, fully radiolucent, custom PEEK/CF vertebral body replacement, and radiolucent posterior PEEK/CF screw-rod system and/or radiolucent anterior PEEK/CF plate system. Clinical and radiographic data were tabulated. Need for adjuvant radiotherapy determined based on final tissue histology and extent of surgical margins. Postoperative surveillance imaging were reviewed for local tumor recurrence.

Results.
The ability to integrate the PEEK/CF VBR connected to either the posterior screw-rod system, or anterior plate system provided immediate stability. The VBR was placed directly on cancellous vertebral body surface in 46.2% of cases. Loosening of the distal, or proximal, aspect of posterior system was seen in 15.4% of cases. There was no clinical or radiographic evidence of VBR migration and subsidence at latest follow up. Local recurrence occurred in one (7.7%) patient.

Conclusion.
This is the first series to describe the use of a fully-radiolucent, integrated, PEEK/CF implant system for spinal tumor reconstruction. The use of a PEEK/CF VBR system integrated to either the anterior plate, or posterior screw-rod system is feasible and allows for superior postoperative surveillance imaging and effective delivery of postoperative adjuvant radiotherapy.

Level of Evidence: 4
Mapping of Venous Sinus Anatomy and Occipital Bone Thickness for Safe Screw Placement in 100 Patients with 46,200 Standardized Measurements Using Computed Tomography Angiography
Authors: Reisener Marie-Jacqueline , Arzani Artine , Okano Ichiro , Salzmann Stephan N. , Rentenberger Colleen , Carrino John A. , Shue Jennifer , Pumberger Matthias , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Hughes Alexander P. 
Published: July 2021

Study Design.
Retrospective descriptive study.

Objective.
The aim of this study was to create topographical maps of occipital bone thickness and venous sinus (VS) presence to assess the risks of screw insertion in four commercially available occipital plates.

Summary of Background Data.
Craniocervical junction instability and deformity are serious pathological conditions that require posterior fixation of the occipital bone to the cervical vertebrae. Insertion of occipital bone screws requires evaluation of both occipital bone thickness for effective internal fixation and intracranial VS presence for vascular injury prevention. Despite the surgical risks, there is a paucity of research on safe screw placement.

Methods.
We created a matrix of 231 standardized measurement points to analyze the occipital bone thickness and VS presence in cervical spine CT angiograms. These measurements were used to create topographical maps of occipital bone thickness and likelihood of VS presence, which we then compared to the screw hole configurations of four occipital plates.

Results.
Hundred patients were assessed. Maximum occipital bone thickness of 13.9 ± 3.3 mm was midline in the occipital bone, 45 mm from the foramen magnum, around the external occipital protuberance (EOP). Regions with thicknesses >8 mm were 2 cm lateral to the EOP at the level of the superior nuchal line and 2.5 cm inferior to the EOP. The area with the highest VS presence rate was around the EOP and the superior nuchal line. The right transverse VS was more prominent in both sexes.

Conclusion.
There is a limited area of the occipital bone with thicknesses for enough screw purchase. Previous studies have shown 8 mm as the minimum screw length to reduce the risk of implant failure. In our analysis, only “T”-shaped plates had configurations with thicknesses >8 mm for each screw hole. For every screw hole in the analyzed occipital plates, there was a possibility of VS presence ranging from 8% to 33%.

Level of Evidence: 5
Prevalence of Self-Reported Prescription Opioid Use and Illicit Drug Use Among U.S. Adults
Authors: Gu Ja K. , Allison Penelope , Grimes Trotter Alexis , Charles Luenda E. , Ma Claudia C. , Groenewold Matthew , Andrew Michael E. , Luckhaupt Sara E. 
Published: July 2021

Objective:
To estimate the self-reported prevalence of prescription opioid use and illicit drug use in the United States.

Methods:
Self-reported prescription opioid use and illicit drug use (mostly nonopioid) were obtained for adults and adult workers (NHANES 2005–2016).

Results:
Prevalence (95% CI) of prescription opioid use was 6.5% (6.0–7.0) (adults) and 4.1% (3.7–4.5) (workers). Prevalence of illicit drug use was 9.5% (8.8–10.1) (adults) and 10.2% (9.4–11.1) (workers). Among occupations, prevalence of prescription opioid use was highest in personal care (6.5%; 4.1–10.4) and healthcare practitioners (5.9%; 3.8–9.0); for illicit drug use, construction/extraction (18.0%; 15.1–21.3) and food preparation (15.8%; 12.5–19.7).

Conclusion:
The prevalence of prescription opioid use was elevated among some occupations. Judicious prescription strategies and targeted interventions are both needed. The prevalence of illicit drug use among certain occupational groups suggests the need to ensure access to therapy.
Risk Factors for Complications Following Lateral Skull Base Surgery and the Utility of ICU Monitoring
Authors: Sioshansi Pedrom C. , Conway Robert M. , Anderson Brian , Minutello Katrina , Bojrab Dennis I. , Hong Robert S. , Sargent Eric W. , Schutt Christopher A. , Zappia John J. , Babu Seilesh C. 
Published: July 2021

Objective:
To examine the role of intensive care unit (ICU) management following lateral skull base surgery for vestibular schwannoma and identify risk factors for complications warranting admission to the ICU.

Study Design:
Retrospective review.

Setting:
Tertiary referral center.

Patients:
Two hundred consecutive patients undergoing lateral skull base surgery for vestibular schwannomas.

Intervention:
Lateral skull base approach for resection of vestibular schwannoma and postoperative monitoring.

Main Outcome Measures:
Patients were grouped if they sustained an ICU complication, a non-ICU complication, or no complication. Analysis was performed to determine patient or treatment factors that may be associated with ICU complications. Multivariate and three-way analysis of variance compared groups, and multivariate logistic regression determined adjusted odds ratios (aOR) for analyzed factors.

Results:
Seventeen of 200 patients sustained ICU complications (8.5%), most commonly hypertensive urgency (n = 15). Forty-six (23%) sustained non-ICU complications, and 137 (68.5%) had no complications. When controlling for age, sex, obesity, and other comorbidities, only hypertension (aOR 5.43, 95% confidence interval (CI) 1.35–21.73, p = 0.017) and tumor volume (aOR 3.29, 95% CI 1.09–9.96, p = 0.035) were independently associated with increased risk of ICU complications.

Conclusions:
The necessity of intensive care following lateral skull base surgery is rare, with the primary ICU complication being hypertensive urgency. Preoperative hypertension and large tumor volume (>4500 mm3) were independently associated with increased risk for ICU complications. These findings may allow for risk stratification of patients appropriate for admission to stepdown units following resection of vestibular schwannomas. Further prospective, multi-center, randomized studies are necessary to validate these findings before systematic changes to current postoperative care practices.
Trends and Healthcare Use Following Different Cholesteatoma Surgery Types in a National Cohort, 2003–2019
Authors: Qian Zhen Jason , Tran Emma D. , Alyono Jennifer C. , Cheng Alan G. , Ahmad Iram N. , Chang Kay W. 
Published: July 2021

Objective:
To describe national trends in cholesteatoma management.

Study Design and Setting:
Retrospective analysis Optum Clinformatics® Database from 2003 to 2019.

Patients:
16,179 unique adult and pediatric patients who received cholesteatoma surgery.

Interventions and Main Outcome Measures:
Patients were categorized into three groups by initial surgical modality: canal wall down (CWD), canal wall up (CWU), and tympanoplasty without mastoidectomy (TnoM). Three major comparisons between groups were performed: 1) temporal trends, 2) clinical and sociodemographic determinants, and 3) healthcare use in terms of total costs and incidence of postoperative imaging and subsequent surgery.

Results:
Overall, 23.2% received initial CWD surgery, 44.3% CWU, and 32.5% TnoM. 1) The incidence of initial CWD surgery decreased (odds ratios [OR] = 0.98, 95% confidence intervals [CI] [0.97,0.99]), while CWU increased (OR = 1.02, 95% CI [1.01,1.03]), and TnoM remained stable over the study period (OR = 0.99, 95% CI [0.98,1.00]). 2) Relative to CWU, TnoM surgery was less likely in adults, patients with prior complications, and non-White patients, while being more likely in patients with higher household income. CWD was more likely than CWU in adults, patients with prior complications, and non-White patients, while income had no effect. 3) Postoperative costs for CWU and CWD were similar. In 2 years following initial surgery, postoperative imaging and/or subsequent surgery was performed in 45.48% of CWD, 57.42% of CWU, and 41.62% of TnoM patients.

Conclusions:
Incidence of initial CWD surgery decreased and social disparities in cholesteatoma management were observed. Postoperative imaging or second-look surgery were performed in less than 60% of patients with initial CWU surgery and over 40% of patients with initial CWD.
Ectopic parathyroid adenoma with acute pancreatitis in a pediatric patient
Authors: Alghanmi Yasser Yahia , Sindi Haifa Hasan , Bader Doaa Emad , Alraddadi Sarah Mohammed 
Published: July 2021

Abstract

Introduction:
Hypercalcemia due to primary hyperparathyroidism (PHPT) is uncommon in children with an incidence of 2 to 5 in 100,000 children and adolescents. Primary hyperparathyroidism in children has a bimodal distribution that reflects different etiologies in very young and older children. PHPT is typically caused by a single parathyroid adenoma. Ectopic parathyroid adenomas account for 20% to 22% of primary hyperparathyroidism cases and are rare in children but should be considered in cases that present with hypercalcemia.

Patient concerns:
We report the case of a 13-year-old girl with PHPT who presented with an unusual presentation of acute pancreatitis and persistent hypercalcemia.

Diagnosis:
Tc-99m-sestamibi scanning and chest computed tomography scan with contrast showed an anterior mediastinal lesion at the midline embedded into the thymus and was diagnosed as an ectopic anterior mediastinal parathyroid adenoma.

Interventions:
The genetic test results of whole-exome sequencing were negative. After thoracoscopic and thymus excision, the patient's serum calcium level immediately normalized.

Outcomes:
Intact parathyroid hormone, serum calcium, and alkaline phosphatase levels returned to normal within two months.

Conclusion:
PHPT may present with acute pancreatitis, generalized fatigue, and muscle pain as presented in this patient and need a high index of suspicion for early diagnosis. Delayed diagnosis of PHPT can cause end-organ damage; timely diagnosis is especially critical to preserving bone and renal function.
Effectiveness and safety of herbal medicine on children with simple obesity
Authors: Shim Soo Bo , Lee Hyun Hee , Ahn Hye Li , Lee Ju Ah , Lee Hye Lim 
Published: July 2021

Abstract

Introduction:
Simple obesity is a type of obesity that does not involve other diseases or medical factors. Obesity is a serious public health problem in children and has become more serious because of the social distancing caused by the coronavirus disease 2019. This study aims to evaluate the effectiveness and safety of herbal medicine for the treatment of simple childhood obesity.

Methods and analysis:
We will search 11 international databases, namely Medline, the Cochrane Central Register of Controlled Trials, the Allied and Complementary Medicine Database, the Cumulative Index of Nursing and Allied Health Literature, Embase, the Oriental Medicine Advanced Searching Integrated System, the Research Information Service System, DataBase Periodical Information Academic, Wanfang, China National Knowledge Infrastructure, and the Chongqing VIP Chinese Science and Technology Journals Database. We will include randomised controlled trials on the application of herbal medicine on children with simple obesity. We will assess the quality of included studies using the Cochrane Handbook criteria version 5.2.0. We will synthesise and analyse the collected data using RevMan 5.3 software.

Ethics and dissemination:
Ethical approval is not required because there are no privacy concerns. The findings of this systematic review will be disseminated in a peer-reviewed journal.

OSF registration number:
DOI 10.17605/OSF.IO/KCNPX.
Renal function in patients following a low carbohydrate diet for type 2 diabetes: a review of the literature and analysis of routine clinical data from a primary care service over 7 years
Authors: Unwin David , Unwin Jen , Crocombe Dominic , Delon Christine , Guess Nicola , Wong Christopher 
Published: July 2021

Purpose of review
People with T2 Diabetes (T2D) who follow a low carbohydrate diet (LCD) may increase their dietary protein intake. Dietary protein can modulate renal function so there is debate about its role in renal disease. There is concern that higher protein intakes may promote renal damage, and that LCDs themselves may impact on cardiovascular risk. We review the evidence around LCDs, renal and cardiovascular risk factors and compare to results obtained in a real-world, primary care setting.

Recent findings
Chronic kidney disease (CKD) is a well-recognised microvascular complication of T2D caused in part by; chronically increased glomerular pressure, hyperfiltration, increased blood pressure and advanced glycation end products. Hyperglycemia can be seen as central to all of these factors. A LCD is an effective first step in its correction as we demonstrate in our real-world cohort.

Summary
We found evidence that LCDs for people with T2D may improve many renal and cardiovascular risk factors. In our own LCD cohort of 143 patients with normal renal function or only mild CKD, over an average of 30 months the serum creatinine improved by a significant mean of 4.7 (14.9) μmol/L. What remains to be shown is the effect of the approach on people with T2D and moderate/severe CKD.
The Relationship Between Unemployment and Health Insurance Coverage
Authors: Benitez Joseph , Williams Timothy , Goldstein Evan , Seiber Eric E. 
Published: July 2021

Objective:
The objective of this study was to determine whether the Affordable Care Act’s (ACA) major coverage expansions mitigated the impact of unemployment on health insurance coverage status.

Data Source:
A 2011−2019 versions of the American Community Survey developed by the University of Minnesota Integrated Public Use Microdata Series program.

Research Design:
We use difference-in-difference-in-differences (ie, triple difference) regressions to compare changes in the short-run impacts of local unemployment rates before and after the ACA.

Principal Findings:
Before the ACA, rises in local unemployment were associated with uninsurance due to losses in private coverage (ie, both nongroup and employer sponsored).
Following the ACA’s full implementation, the link between employment and coverage was attenuated by access to publicly subsidized qualified health plans on the ACA’s nongroup market, and enhanced access to Medicaid in states that expanded. Our findings suggest protections from unemployment-linked uninsured spells are largest in states that expanded Medicaid.

Conclusions:
Expanded access to coverage under the ACA could mitigate the adverse effects on insurance status and access to care historically linked to job loss. However, should the ACA be repealed, many households stand to lose their ability to turn to Medicaid or subsidized nongroup coverage as safety-net resources to offset the burdens of job loss.
LDL receptor-related protein 1 and its interacting partners in tissue homeostasis
Authors: Jaeschke Anja , Hui David Y. 
Published: July 2021

Purpose of review
LDL receptor-related protein 1 (LRP1) is a multifunctional protein with endocytic and signal transduction properties due to its interaction with numerous extracellular ligands and intracellular proteins. This brief review highlights key developments in identifying novel functions of LRP1 in liver, lung, and the central nervous system in disease pathogenesis.

Recent findings
In hepatocytes, LRP1 complexes with phosphatidylinositol 4-phosphate 5-kinase-1 and its related protein to maintain intracellular levels of phosphatidylinositol (4,5) bisphosphate and preserve lysosome and mitochondria integrity. In contrast, in smooth muscle cells, macrophages, and endothelial cells, LRP1 interacts with various different extracellular ligands and intracellular proteins in a tissue-dependent and microenvironment-dependent manner to either enhance or suppress inflammation, disease progression or resolution. Similarly, LRP1 expression in astrocytes and oligodendrocyte progenitor cells regulates cell differentiation and maturation in a developmental-dependent manner to modulate neurogenesis, gliogenesis, and white matter repair after injury.

Summary
LRP1 modulates metabolic disease manifestation, inflammation, and differentiation in a cell-dependent, time-dependent, and tissue-dependent manner. Whether LRP1 expression is protective or pathogenic is dependent on its interaction with specific ligands and intracellular proteins, which in turn is dependent on the cell type and the microenvironment where these cells reside.
Effectiveness of Syphilis Partner Notification After Adjusting for Treatment Dates, 7 Jurisdictions
Authors: Cope Anna Barry , Bernstein Kyle T. , Matthias James , Rahman Mohammad , Diesel Jill C. , Pugsley River A. , Schillinger Julia A. , Chew Ng Rilene A. , Klingler Ellen J. , Mobley Victoria L. , Samoff Erika , Peterman Thomas A. 
Published: July 2021

Background
Disease intervention specialists (DIS) prevent syphilis by ensuring treatment for patients' sex partners through partner notification (PN). Different interpretations of how to measure partners treated due to DIS efforts complicates PN evaluation. We measured PN impact by counting partners treated for syphilis after DIS interviewed the patient.

Methods
We reviewed data from early syphilis cases reported during the 2015–2017 period in 7 jurisdictions. We compared infected partners brought to treatment using the following: (1) DIS-assigned disposition codes or (2) all infected partners treated 0 to 90 days after the patient's interview (adjusted treatment estimate). Stratified analyses assessed patient characteristics associated with the adjusted treatment estimate.

Results
Disease intervention specialists interviewed 23,613 patients who reported 20,890 partners with locating information. Many of the 3569 (17.1%) partners classified by DIS as brought to treatment were treated before the patient was interviewed. There were 2359 (11.3%) partners treated 0 to 90 days after the patient's interview. Treatment estimates were more consistent between programs when measured using our adjusted estimates (range, 6.1%–14.8% per patient interviewed) compared with DIS-assigned disposition (range, 6.1%–28.3%). Treatment for ≥1 partner occurred after 9.0% of interviews and was more likely if the patient was a woman (17.9%), younger than 25 years (12.6%), interviewed ≤7 days from diagnosis (13.9%), HIV negative (12.6%), or had no reported history of syphilis (9.8%).

Conclusions
Counting infected partners treated 0 to 90 days after interview reduced variability in reporting and facilitates quality assurance. Identifying programs and DIS who are particularly good at finding and treating partners could improve program impact.
Check It: A Community-Based Chlamydia Seek, Test, and Treat Program for Young Black Men Who Have Sex With Women in New Orleans, Louisiana
Authors: Schmidt Norine , Gomes Gérard , Scott Glenis , Wise Breon , Craig-Kuhn Megan Clare , Lederer Alyssa M. , Martin David H. , Kissinger Patricia J. 
Published: July 2021

Background

Check It is a novel, bundled, community-based seek, test, and treat Chlamydia trachomatis (Ct) screening program for 15- to 24-year-old Black men in New Orleans who have sex with women. The program design addressed barriers and facilitators to Ct screening/treatment by enlisting trusted community partners, incorporating participant input, providing free index/partner expedited treatment, developing relatable marketing materials and an educational Web site, encouraging peer referral, and providing a modest monetary incentive.

Methods
Areas of high poverty were identified using census data; ethnographic/key informant interviews identified sites in those areas where the target population congregated. Black youth informed Web site design and social marketing. Content was inspirational/educational/amusing and endorsed recruitment and brand awareness. A community advisory board, participant interviews, community partner feedback, and recruitment staff involvement in the process evaluation helped refine the program in an ongoing manner.

Results
During formative stages, 41 key informant/community advisory board members informed program refinement. Community partners provided venue locations (n = 65) and participant referrals. Between May 22, 2017, and February 28, 2020, 1890 men were enrolled (acceptance rate, 96.0%) with Ct infection rate of 10.2%. Overall study treatment was provided to 86.1% (71.4%–90.9%) of participants who tested positive and 28.5% (14.5%–41.5%) of their partners. Findings from in-depth interviews with participants (n = 43) led to increased treatment uptake.

Conclusions

C. trachomatis community screening of young Black men was successful through collaboration with trusted community partners, by tailoring implements/marketing with participant input, reducing barriers to treatment, and providing modest monetary incentives. The Check It program can serve as a roadmap for reducing health disparities in this population.