bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacotherapy, Resource Needs, and Physician Recruitment Practices in Substance Use Disorder Treatment Programs
Authors: Knudsen Hannah K. , Brown Randy , Jacobson Nora , Horst Julie , Kim Jee-Seon , Collier Elizabeth , Starr Sanford , Madden Lynn M. , Haram Eric , Molfenter Todd 
Published: August 2018

Objectives:
Effective pharmacological treatments for opioid use disorder (OUD) continue to be underutilized, particularly within specialty substance use disorder (SUD) treatment organizations. Few studies have examined whether specific practices to recruit prescribers, financial needs, and human resource needs facilitate or impede the implementation of pharmacotherapy.

Methods:
Surveys were completed by administrators from 160 treatment programs in Florida, Ohio, and Wisconsin. Respondents described availability of five pharmacotherapies for treating OUD, organizational resource needs, current use of physician recruitment practices, and buprenorphine treatment slots.

Results:
The mostly commonly available medications were injectable naltrexone (65.4%; n = 102), buprenorphine-naloxone (55.7%; n = 88), and tablet naltrexone (50.0%; n = 78). Adopters of each of the 5 pharmacotherapies reported significantly greater physician outreach than organizations that did not provide these medications. The mean number of buprenorphine slots was 94.1 (SD 205.9). There were unique correlates of adoption (ie, any slots) and availability (number of slots) of buprenorphine. Physician outreach activities were correlated with the likelihood of nonadoption, whereas medical resource needs (ie, needing more physicians to prescribe pharmacotherapy) and dedicated resources for physician recruitment were associated with the number of slots.

Conclusions:
Physician recruitment activities differentiated those organizations that had existing pharmacotherapy treatment capacity (ie, any slots) from those that had no capacity. Efforts to address the medical resource needs of treatment organizations, and also strategies that encourage organizations to devote resources to recruiting prescribers may hold promise for increasing access to these lifesaving treatments.
Nonmedical Use of Stimulants Is Associated With Riskier Sexual Practices and Other Forms of Impulsivity
Authors: Grant Jon E. , Redden Sarah A. , Lust Katherine , Chamberlain Samuel R. 
Published: August 2018

Background:
This study sought to examine the occurrence of the nonmedical use of prescription stimulants (amphetamines and methylphenidate) in a university sample and their associated physical and mental health correlates, including potential relationships with risky sexual practices.

Methods:
A 156-item anonymous online survey was distributed via e-mail to a sample of 9449 university students. Current use of alcohol and drugs, psychological and physical status, and academic performance were assessed, along with questionnaire-based measures of impulsivity and compulsivity.

Results:
A total of 3421 participants (59.7% female) were included in the analysis. 6.7% of the sample reported current/recent nonmedical use of prescription stimulants, while an additional 5.8% reported misuse in the past. Nonmedical use of prescription stimulants was associated with lower grade point averages, and with taking a broad range of other drugs (including alcohol, nicotine, illicit substances, and consumption of caffeinated soft drinks). Nonmedical use of stimulants was also significantly associated with impulsivity (Barratt scale), prior treatment for substance use problems, and elevated occurrence of disordered gambling, post-traumatic stress disorder, and anxiety; but not depression symptoms or binge-eating disorder (though it was associated with using drugs to lose weight). The relationship with probable attention-deficit/hyperactivity disorder (ADHD) on screening was not significant but was numerically elevated. Finally, those using nonmedical prescribed stimulants were significantly more sexually active (including at a younger age), and were less likely to use barrier contraception.

Conclusions:
Nonmedical use of prescription stimulants is common in young adults and has profound public health associations including with a profundity of other drug use (licit and illicit), certain mental health diagnoses (especially gambling, anxiety, and post-traumatic stress disorder ), worse scholastic performance, and riskier sexual practices. The majority of people with nonmedical use of prescription stimulants do not have ADHD, and its link with current ADHD symptoms was less marked than for certain other disorders. Clinicians should screen for the misuse of prescription stimulants as they may be associated with a range of problematic behaviors. Risk of diversion (which may be higher for those living in shared accommodation and those with substance use disorder history) merits careful assessment before prescribing stimulant medication.
The Impact of Comorbidity Burden on Complications, Length of Stay, and Direct Hospital Costs After Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Khechen Benjamin , Haws Brittany E. , Bawa Mundeep S. , Patel Dil V. , Cardinal Kaitlyn L. , Guntin Jordan A. , Lalehzarian Simon P. , Singh Kern 
Published: August 2018

Study Design.
A retrospective cohort.

Objective.
The aim of this study was to determine whether comorbidity as determined by Charlson Comorbidity Index (CCI) is associated with inpatient complication rate, length of stay (LOS), or direct hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

Summary of Background Data.
In the spine literature, comorbidity burden has been associated with an increased risk for complications, prolonged LOS, and greater hospital costs. Few studies have investigated the influence of comorbidity burden on these outcomes in minimally invasive spine surgery populations.

Methods.
A prospectively maintained surgical registry of patients undergoing primary, single-level MIS-TLIF was retrospectively reviewed. Patients were stratified by CCI and tested for association with preoperative demographics and perioperative characteristics using Chi-squared analysis or one-way analysis of variance for categorical and continuous variables, respectively. Complication rates, LOS, and direct hospital costs were compared between groups using a one-way analysis of variance.

Results.
Two hundred ninety-eight patients were included. About 19.8% had a CCI of 0, 41.3% had a CCI of 1 to 2, 27.2% had a CCI of 3 to 4, and 11.7% had a CCI ≥ 5. Elevated CCI was associated with older age, smoking, and insurance status. Elevated CCI was significantly associated with a greater total inpatient complication rate. Regarding LOS and total direct hospital costs, there were no associations identified. However, elevated CCI was associated with greater costs accrued in the intensive care unit, laboratory costs, and cardiology-related costs.

Conclusion.
Greater comorbidity burden as reflected by higher CCI was associated with increased postoperative complication rates following primary, single-level MIS-TLIF. However, this did not lead to prolongations in hospital stay or increased total direct hospital costs. This lack of association may suggest that the limited tissue trauma and operative exposure utilized in minimally invasive approaches may limit the utility of CCI as a predictor of surgical outcomes and costs.

Level of Evidence: 4
Postdischarge Major Adverse Cardiovascular Events of ICU Survivors Who Received Acute Renal Replacement Therapy
Authors: Park Sehoon , Lee Soojin , Kang Min Woo , Han Kyungdo , Kim Yaerim , An Jung Nam , Joo Kwon Wook , Lim Chun Soo , Kim Yon Su , Yoo Hai-Won , Kim Hyeongsu , Kim Dong Ki 
Published: August 2018

Objectives:
Long-term risk of a major adverse cardiovascular events in ICU survivors who underwent acute renal replacement therapy requires further investigation.

Design:
Nationwide population-based study using the claims database of Korea.

Setting:
Index admission cases of ICU survivors in government-designated tertiary hospitals

Patients:
The study group consisted of ICU survivors who underwent acute renal replacement therapy, and the control group consisted of those without acute renal replacement therapy. Patients were excluded if they 1) were under age 20, 2) expired within 30 days after discharge, 3) received ICU care for less than 24 hours, 4) had a previous ICU admission, 5) had a history of major adverse cardiovascular event, or 6) had a major adverse cardiovascular event–related cardio/cerebrovascular diseases. The outcomes of the patients who received continuous renal replacement therapy were compared with those of patients who received only intermittent renal replacement therapy.

Interventions:
None.

Measurements and Main Results:
Information regarding patient characteristics and treatment modalities was collected and adjusted. The main outcome was major adverse cardiovascular event, including acute myocardial infarction, revascularization, and acute ischemic stroke. Patient mortality and progression to end-stage renal disease were also evaluated. We included 12,380 acute renal replacement therapy patients and 382,018 patients in the control group. Among the study group, 6,891 patients were included in the continuous renal replacement therapy group, and 5,034 in the intermittent renal replacement therapy group. The risks of major adverse cardiovascular event (adjusted hazard ratio, 1.463 [1.323–1.619]; p < 0.001), all-cause mortality (adjusted hazard ratio, 1.323 [1.256–1.393]; p < 0.001), and end-stage renal disease (adjusted hazard ratio, 18.110 [15.779–20.786]; p < 0.001) were higher in the acute renal replacement therapy patients than the control group. When we compared the continuous renal replacement therapy patients with the intermittent renal replacement therapy patients, the risk of major adverse cardiovascular event was comparable (adjusted hazard ratio, 1.049 [0.888–1.239]; p = 0.575).

Conclusions:
Clinicians should note the increased risk of a long-term major adverse cardiovascular event in acute renal replacement therapy patients and consider appropriate risk factor management. Significant difference in the risk of postdischarge major adverse cardiovascular event was not identified between continuous renal replacement therapy and intermittent renal replacement therapy.
Surgical skills assessment tools in gynecology
Authors: Clark Nisse V. , Pepin Kristen J. , Einarsson Jon I. 
Published: August 2018

Purpose of review
The purpose of this review is to outline surgical skills assessment tools for the purpose of training and competency evaluation, with a focus on recent literature in gynecology.

Recent findings
Objective standardized surgical skills assessment tools are increasingly being explored in multiple surgical disciplines including gynecology. Several small studies in gynecology have validated procedure-specific checklists, global rating scales, and other surgical proficiency examinations in their ability to differentiate trainee skill level or correlate with other standardized tests. Few studies have included gynecologic surgeons in practice, and no studies have investigated their use in credentialing and maintenance of certification.

Summary
Surgical skills assessment tools may be a useful adjunct to gynecology training programs, with promising applications for practicing gynecologists.
How to Make Your Life Easier: Blepharoplasty Markings with Microsurgical Clamps
Authors: Ramella Vittorio , Stocco Chiara , Facchin Federico , Troisi Luigi , Papa Giovanni , Arnez Zoran Marij 
Published: August 2018

Summary:
Preoperative blepharoplasty markings might be challenging, especially for young surgeons. It takes experience to carefully evaluate the amount of skin excess that can be safely removed. In the current study, we explored the use of microsurgical vascular clamps as a novel and useful tool in the preoperative upper blepharoplasty markings; they made it possible to directly visualize the amount of skin to be removed, facilitating the surgeon (especially the young surgeon) preoperative markings process. In our series, 30 patients underwent upper blepharoplasty with preoperative application of microvascular clamps with satisfactory results.
Squid Ring Teeth–coated Mesh Improves Abdominal Wall Repair
Authors: Leberfinger Ashley N. , Hospodiuk Monika , Pena-Francesch Abdon , Ayan Bugra , Ozbolat Veli , Koduru Srinivas V. , Ozbolat Ibrahim T. , Demirel Melik C. , Ravnic Dino J. 
Published: August 2018

Background:
Hernia repair is a common surgical procedure with polypropylene (PP) mesh being the standard material for correction because of its durability. However, complications such as seroma and pain are common, and repair failures still approach 15% secondary to poor tissue integration. In an effort to enhance mesh integration, we evaluated the applicability of a squid ring teeth (SRT) protein coating for soft-tissue repair in an abdominal wall defect model. SRT is a biologically derived high-strength protein with strong mechanical properties. We assessed tissue integration, strength, and biocompatibility of a SRT-coated PP mesh in a first-time pilot animal study.

Methods:
PP mesh was coated with SRT (SRT-PP) and tested for mechanical strength against uncoated PP mesh. Cell proliferation and adhesion studies were performed in vitro using a 3T3 cell line. Rats underwent either PP (n = 3) or SRT-PP (n = 6) bridge mesh implantation in an anterior abdominal wall defect model. Repair was assessed clinically and radiographically, with integration evaluated by histology and mechanical testing at 60 days.

Results:
Cell proliferation was enhanced on SRT-PP mesh. This was corroborated in vivo by abdominal wall histology, dramatically diminished craniocaudal mesh contraction, improved strength testing, and higher tissue failure strain. There was no increase in seroma or visceral adhesion formation. No foreign body reactions were noted on liver histology.

Conclusions:
SRT applied as a coating appears to augment mesh–tissue integration and improve abdominal wall stability following bridged repair. Further studies in larger animals will determine its applicability for hernia repair in patients.
Pyoderma Gangrenosum–like Wounds in Leukocyte Adhesion Deficiency: Case Report and Review of Literature
Authors: Simpson Andrew M. , Chen Karin , Bohnsack John F. , Lamont Matthew N. , Siddiqi Faizi A. , Gociman Barbu 
Published: August 2018

Summary:
Leukocyte adhesion deficiency (LAD) is a rare primary immunodeficiency characterized by impairment of leukocyte migration during an inflammatory response. LAD patients can experience recurrent neutrophilic wounds similar to pyoderma gangrenosum (PG), predominantly of the skin and mucosal surfaces. There have been only a few reports addressing the management of extensive, life-threatening wounds in LAD patients. We describe here both the systemic and local management employed to successfully treat a severe PG-like cutaneous lesion in the setting of LAD in a 9-year-old female. A comprehensive literature review was performed to identify previously reported similar cases. Under aggressive systemic and local management, the wound was stabilized and complete epithelialization was achieved in 8 months. Eight studies documenting 11 patients with LAD and PG-like lesions were identified in our review of the literature. The complexity of wounds associated with LAD requires an aggressive, multidisciplinary approach. Involvement of pediatrics, immunology, plastic surgery, infectious disease, and physical therapy is essential to obtaining a positive outcome. In the setting of LAD with PG-like lesions, the only viable option is allowing for closure by secondary epithelialization. This was achieved in our patient once the wound was stabilized with the systemic administration of infliximab and topical administration of tacrolimus.
Fingertip Necrosis due to Intravascular Use of Mephedrone: A Case Report
Authors: Francés Mónica , Fuertes Víctor , Casarrubios José M. , Navarro Carlos , Sánchez Olivia C. , Poza Estefania , Fernández-Palacios Javier 
Published: August 2018

Summary:
Mephedrone is a new synthetic cathinone-derived drug. It is a sympathomimetic drug, and its structure is similar to amphetamines, although its specific pharmacokinetics and metabolism remain unknown. We performed a literature search in PUBMED with the following key words: Mephedrone AND Necrosis AND Hand. No results were found. We performed a second literature search with the following key words: Mephedrone AND Physiopathology AND Side effects, obtaining a total of 7 articles that we read before writing this case report. We will present a case report of a 28-year-old man with distal ischemia in his left hand associated to intra-arterial drug use of mephedrone. The patient ended up having superficial necrosis involving skin and subcutaneous tissue in his thumb, which was treated with wound care. Good quality healing, full range of motion, and normal sensitivity were achieved. There are no previous publications related to any side effects secondary to its intravascular use. The ultimate mechanism producing this distal fingertip necrosis remains undefined.
SURGICAL MANAGEMENT OF FULL-THICKNESS MACULAR HOLE SUPERIMPOSED ON EXUDATIVE AGE-RELATED MACULAR DEGENERATION
Authors: Shif Olga A. , Katz Matthew S. J. 
Published: August 2018

Background/Purpose:
We describe a case of full-thickness macular hole formation in a patient with exudative age-related macular degeneration after an intravitreal ranibizumab injection and its surgical management.

Methods:
This case is a retrospective, interventional case report.

Results:
A 77-year-old woman with bilateral exudative age-related macular degeneration and pre-existing retinal pigment epithelium tear developed a full-thickness macular hole after intravitreal ranibizumab. The macular hole was repaired successfully with pars plana vitrectomy, internal limiting membrane peel, and 16% C3F8 gas fill.

Conclusion:
To the best of our knowledge, this is the first reported case of full-thickness macular hole after a retinal pigment epithelium tear repaired successfully with vitrectomy, resulting in improved visual acuity.
Corneal Sensitivity After Ocular Surgery
Authors: Lum Edward , Corbett Melanie C. , Murphy Paul J. 
Published: August 2018

Abstract:
The cornea is densely innervated with free nerve endings to provide a high level of sensitivity to foreign bodies or noxious substances. They also provide trophic support to the tissues of the cornea and facilitate their repair and replacement. Any reduction in the function of the nerve endings through disease, contact lens wear, or surgery may lead to corneal disease, damage, or reduced healing. Assessment of the corneal nerve function can be made by the use of specialized instruments (aesthesiometers) that stimulate the corneal nerves using different modalities—mechanical, chemical, and thermal. Each modality assesses the function of a different cohort of corneal nerve type. Ocular surgery, particularly corneal surgery, can produce significant damage to the corneal innervation. However, for the majority of surgical procedures, corneal sensation eventually returns to preoperative levels, given enough time. The principal exceptions to this are penetrating keratoplasty, epikeratophakia, and cryo-keratomileusis, where sensation rarely returns to normal. For all types of surgery, the pattern of corneal sensation loss and recovery depends on the type, depth, and extent of incision because these influence the number of nerve fibers severed, and on the healing response of the patient.
Research ethics dilemmas in thyroid disease
Authors: Rosenthal M. Sara , Angelos Peter , Schweppe Rebecca E. 
Published: August 2018

Purpose of review
Since research ethics dilemmas frequently fall outside the purview of the Institutional Review Board (IRB), we present three unique recent research ethics cases in thyroidology that demonstrate research ethics dilemmas.

Recent findings
The cases presented raise questions surrounding epistemic/scientific integrity, publication ethics, and professional, and personal integrity.

Summary
Research ethics dilemmas that fall outside the purview of the IRB are appropriate for a Research Ethics Consultation, a common service in many large academic medical centers.
Parent‐child Agreement on Health‐Related Quality of Life in Children With Functional Constipation in Primary Care
Authors: van Summeren Jojanneke J.G.T. , Klunder Jan Willem , Holtman Gea A. , Kollen Boudewijn J. , Berger Marjolein Y. , Dekker Janny H. 
Published: August 2018

ABSTRACTObjective:Functional constipation (FC) has a major impact on the health‐related quality of life (HRQoL) of children. The aim of this study was to evaluate parent‐child agreement on HRQoL in children (8–17 years) with FC in primary care.Methods:Children diagnosed with FC by their clinician were eligible. HRQoL was measured with the Defecation Disorder List (DDL, score 0–100), and the EuroQol‐5‐Dimension‐Youth Visual Analogue Scale (EQ‐5D‐Y‐VAS, scale 0–100). Parent‐child agreement was examined with discrepancy scores, intraclass correlation coefficients and Bland‐Altman plots.Results:Fifty‐six children, median age of 10 years (IQR 8–12) and their parents were included. Parent‐child agreement at a group level was good, with an intraclass correlation coefficient of 0.80 (95% confidence interval 0.67 to 0.88) for the DDL, and 0.78 (95% confidence interval 0.65 to 0.87) for the EQ‐5D‐Y‐VAS. Mean discrepancy scores for the DDL and EQ‐5D‐Y‐VAS were small: −2.6 and −2.9, implying that parents were slightly more positive about the HRQoL than their children. Bland‐Altman plots showed considerable discordance between individual parent‐child pairs. Limits of agreement were −19.7 and 14.6 for the DDL and −27.6 and 21.8 for the EQ‐5D‐Y‐VAS.Conclusions:There is good parent‐child agreement on HRQoL in children with FC at group level. However, a substantial number of parent‐child pairs differed considerably on their rating of the HRQoL of the child. Therefore, we recommend clinicians, if they want to have an impression of the impact of the FC on the HRQoL of the child, to ask both the child and the parent(s).