bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Neuromonitoring in Surgical Cervical Spondylosis Patients With the Presence or Absence of Myelopathy. Is it Standard?
Authors: Gonzalez Glenn A. , Corso Katherine , Porto Guilherme , Ruppenkamp Jill , Miao Jingya , Franco Daniel , Hines Kevin , O’Leary Matthew , Thalheimer Sara , Harrop James 
Published: November 2024

Study Design:
Cross-sectional, observational study.

Objective:
Investigate the frequency of intraoperative neuromonitoring (IONM) utilization among Medicare patients diagnosed with cervical spondylosis (CS), both with and without myelopathy.

Background:
IONM is widely used as a tool in spine surgery. However, the overall prevalence of neuromonitoring utilization among CS undergoing surgical intervention is not well characterized.

Methods:
This study observed neuromonitoring usage in CS patients who had cervical spinal procedures from 2012 to 2020, using a 5% random sample of Medicare data. Logistic regression compared patient characteristics between those who received neuromonitoring and those who did not. The model included age, sex, region, Elixhauser Comorbidity Index score, year of surgery, elective status, and procedure type. Odds ratios with a 95% CI were generated for each covariate.

Results:
Of the 6224 patients who underwent cervical procedures for CS, 4053 were included in the study, with 2845 having myelopathy and 1208 without. Myelopathy patients had a higher number of hospitalizations (2884) compared with non-myelopathy patients (1229). Among myelopathy patients, the prevalence of neuromonitoring increased from 49.2% in 2012 to 56.5% in 2020. The range of utilization for each type of monitoring was: 96.4%–100% for somatosensory evoked potential, 73.2%–86.1% for electromyography, 70.0%–86.1% for motor evoked potential, and 17.6%–33.6% for other modalities. For non-myelopathy patients, neuromonitoring prevalence increased from 33.1% in 2012 to 43.3% in 2020. The range of utilization for each type of monitoring was: 93.0%–100% for somatosensory evoked potential, 68.9%–89.7% for electromyography, 55.8%–77.4% for motor evoked potential, and 17.8%–36.4% for other modalities.

Conclusions:
This study investigates the utilization of IONM during cervical spinal surgeries in Medicare patients with cervical spondylotic myelopathy or CS between 2012 and 2020. Although IONM is employed in cervical spine procedures, its adoption and standardization appear to vary across the country and different health care settings.
Granulomatous Reactions From Microneedling: A Systematic Review of the Literature
Authors: Friedmann Daniel P. , Mehta Eshani , Verma Kritin K. , Harris Ryan 
Published: November 2024

BACKGROUND
Microneedling is a common minimally invasive procedure for skin rejuvenation. Granulomatous reactions after microneedling have been rarely reported.

OBJECTIVE
To systematically review the literature for granulomatous reactions from microneedling.

MATERIALS AND METHODS
A systematic review of the Medline, Scopus, Google Scholar, and Cochrane databases was performed for articles describing granulomatous reactions to microneedling.

RESULTS
Thirteen studies were selected for inclusion after full-text review, which described 15 patients (26–74 years old) with non-necrotizing granulomatous inflammation postmicroneedling. Motorized microneedling pen use and topical Vitamin C application were implicated in a majority of cases. Although delayed-type hypersensitivity was commonly proposed as the underlying etiology, patch testing or further workup was rarely performed. Improvement or clearance occurred inconsistently with myriad treatment options, including topical steroids, oral antibiotics, and systemic anti-inflammatory medications.

CONCLUSION
Granulomatous reactions to microneedling and microneedling-mediated transepidermal drug delivery can rarely occur and may be treatment-resistant.
Correlation of Hyaluronic Acid (HA), Syndecan-1 (SDC-1), Heparan Sulfate (HS) With Early Stage End Organ Dysfunction in Sepsis Patients
Authors: Li Zhengchao , Jiang Xingpeng , Li Jinghui , Wang Yuzhu 
Published: November 2024

Abstract:
The aim of this study was to explore the relationship between the changes in early degradation products of polysaccharide coatings [such as hyaluronic acid (HA), syndecan-1 (SDC-1), and heparan sulfate (HS)] and the development of organ dysfunction in sepsis patients. We conducted a retrospective analysis on 140 sepsis patients admitted from January 2021 to June 2022, who formed the study group; 100 healthy individuals who underwent health checks during the same period were included as the control group. The study found that the expression levels of HA, SDC-1, and HS on admission and within 24 hours of admission in sepsis patients, as well as the early change rates, were positively correlated with organ dysfunction (P < 0.05). Through receiver operating characteristic curve analysis, we discovered that the early change rates of HA, SDC-1, and HS have high predictive value for organ dysfunction in sepsis patients, with the combined predictive value being the most significant. The study conclusion points out that the increased levels of HA, SDC-1, HS, and other degradation products of polysaccharide coatings in the early stage of sepsis are positively associated with the occurrence of organ dysfunction. Clinicians can use the early expression changes of these biomarkers to predict the risk of organ dysfunction in sepsis patients, enabling timely implementation of preventive measures that may improve patient outcomes.
Planned Y-shaped Muscle Wrapping for Salvaging Aortic Graft Infection: Latissimus Dorsi and Reverse Serratus Anterior Muscles
Authors: Tsuge Itaru , Saito Susumu , Takatoku Kazuhiro , Matsuo Takehiko , Minatoya Kenji , Morimoto Naoki 
Published: November 2024

Summary:
Aorta-related infections are life threatening. Aggressive replacement surgery using artificial aortic grafts should be performed using well-vascularized tissue wrapping to avoid reinfection. An omental flap is the first choice; however, a history of abdominal surgery necessitates other methods. In a cadaveric study in 2021, we verified the distal tight attachment area between the latissimus dorsi (LD) muscle and serratus anterior (SA) muscle to apply a Y-shaped combined flap consisting of the LD and reverse SA. We used this procedure to treat a 79-year-old man who underwent stent-graft insertion in the descending thoracic aorta. Descending aortic graft replacement was performed with a left anterior lateral thoracotomy. Then, we elevated the LD and SA combined flap by “posterior-to-anterior elevation” based on the previous cadaveric study. After blocking blood flow from the SA branch with a microvascular clip, blood flow from the LD branch of the thoracodorsal artery to the distal part of the SA muscle across the distal attachment area was evaluated using indocyanine green fluorescence. Fluorescence had spread throughout the distal part of the SA muscle. Postoperative computed tomography and the clinical course indicated successful regulation of infection. We established a novel surgical technique for the complete muscle wrapping of the descending thoracic aorta, including the aortic arch. The accumulation of further cases is needed to determine whether the blood flow of the distal connection area from the LD to the SA has individual variations; however, we hope this technique improves the mortality and morbidity associated with aorta-related infections.
INCIDENCE OF CENTRAL SEROUS CHORIORETINOPATHY AND ITS ASSOCIATION WITH GYNECOLOGICAL DISEASES IN WOMEN
Authors: Lee Ju-Yeun , Noe Eunbee , Yoon Chang Ki , Lee Eun Kyoung , Park Un Chul , Bae Kunho 
Published: November 2024

Purpose:
Although the exact pathogenesis of central serous chorioretinopathy (CSC) remains unclear, some factors are known to be sex-specific. We aimed to investigate the incidence and systemic associations for CSC in women.

Methods:
This population-based nested case–control study included East Asian women whose medical claims data were obtained from the Korean National Health Insurance Service database. Patients newly diagnosed with CSC between 2017 and 2019 were assigned to the CSC group and matched to healthy controls in a 1:4 ratio by age, gender, and index date. The incidence of CSC in women and its association with gynecologic comorbidities and corticosteroid use before the index date (2008–2017) were analyzed.

Results:
The study matched 3,789 patients with CSC with 15,156 controls. The 3-year cumulative incidence of CSC in women was 27.13 (95% confidence interval [CI], 27.06–27.19) per 100,000 people. Multivariate logistic analysis showed a significantly increased association of CSC in patients with pre-eclampsia (adjusted odds ratio, 2.66; 95% CI, 1.86–3.81) (P < 0.001), endometriosis (adjusted odds ratio, 1.19; 95% CI, 1.03–1.38) (P < 0.001), steroid injections alone (adjusted odds ratio, 1.29; 95% CI, 1.16–1.43) (P < 0.001), and combination use of oral and injected steroid (adjusted odds ratio, 1.34; 95% CI, 1.23–1.47) (P < 0.001) compared with the controls.

Conclusion:
This study provides nationwide population-based data on the incidence of CSC in Asian women and suggests that exposure to specific gynecological comorbidities and intensive corticosteroid use are associated with the development of CSC in women.
CHRONIC RETINAL DETACHMENT
Authors: Dimakopoulou Ioanna , Mylonas Georgios , Kanata Aliki , Reiter Gregor S. , Schranz Markus , Lisy Marcus , Georgopoulos Michael 
Published: November 2024

Purpose:
To elucidate the management of individuals with chronic retinal detachment, considering both surgical intervention and observation. The authors specifically focus on the long-term anatomical and functional outcomes, with a particular emphasis on optical coherence tomography follow-up.

Methods:
Data from 24 consecutive patients presenting with a chronic retinal detachment between 2014 and 2023 at the Department of Ophthalmology and Optometry, Medical University of Vienna, Austria, were retrospectively analyzed. The study used optical coherence tomography scanning with the Heidelberg Spectralis optical coherence tomography device's integrated measurement tool to assess the stability of chronic retinal detachment, potentially introducing optical coherence tomography as a follow-up tool for these patients.

Results:
The study included 27 eyes of 24 patients with an average age of 41.8 ± 13 years, and the mean follow-up time was 34 ± 27 months. Among the cases, 11 (41%) progressed and required surgery. Of these surgeries, 4 (37%) were scleral buckling and 7 (63%) were pars plana vitrectomy. After surgery, 64% experienced improved or stable vision, whereas 36% experienced a decrease in visual acuity. In the subgroup that had pars plana vitrectomy, two eyes (29%) had a redetachment, necessitating a second surgery. Meanwhile, 94% of untreated patients maintained stable 20/20 best-corrected visual acuity throughout the entire follow-up period.

Conclusion:
A cautious observation strategy could lead to superior outcomes when contrasted with more invasive management approaches in patients with chronic retinal detachment. Furthermore, when surgical intervention becomes imperative, the study suggests a preference for the adoption of a scleral buckling procedure in phakic patients without posterior vitreous detachment.
PNEUMATIC DISPLACEMENT AND INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR, WITH OR WITHOUT INTRAVITREAL TISSUE PLASMINOGEN ACTIVATOR, INJECTION FOR SUBMACULAR HEMORRHAGE
Authors: Chotikkakamthorn Patraramon , Bhurayanontachai Patama , Jirarattanasopa Pichai , Tsutsumi Wantanee Dangboon , Tantisarasart Thada , Ratanasukon Mansing 
Published: November 2024

Purpose:
To evaluate the outcomes of intravitreal gas and anti–vascular endothelial growth factor (anti-VEGF), with or without tissue plasminogen activator (tPA), injection for submacular hemorrhage (SMH).

Methods:
The authors retrospectively enrolled patients with SMH treated with intravitreal gas and anti-VEGF, with or without tPA (tPA and non-tPA groups, respectively), injection between 2014 and 2021, and data were collected at the preoperative visit and at 1-, 3-, 6-, and 12-month follow-ups. The primary outcome was the final best-corrected visual acuity, and the secondary outcomes were central subfield thickness, degree of blood displacement, and incidence of vitreous hemorrhage.

Results:
Herein, 38 eyes received intravitreal gas, anti-VEGF, and tPA injections, whereas 89 eyes received intravitreal gas and anti-VEGF injections. At 12 months, no significant intergroup difference was detected (P = 0.94), except the slightly greater central subfield thickness change in the non-tPA group (P = 0.03). Complete SMH displacement occurred in 35 (tPA = 92.1%) and 89 (non-tPA = 89.9%) eyes, with higher vitreous hemorrhage incidence in the non-tPA group (odds ratio 7.03, P = 0.004).

Conclusion:
In pneumatic displacement combined with anti-VEGF therapy in SMH, adjunctive tPA use did not alter the visual and anatomical outcomes, although the vitreous hemorrhage risk in large SMH was reduced.
Impacts of immersive 3D videos on students’ surgical learning compared to 2D videos: a randomized controlled trial
Authors: Favier Amelia , Jaafar Eya , L’Hote Raphael , Gauthier Philippe , Avellino Ignacio , Canlorbe Geoffroy 
Published: November 2024

Background:
Unlike other medical specialties, surgery is primarily learned through apprenticeship, by observing surgeons in action during operations. However, the increasing number of medical students and work-hour restrictions limit opportunities for learning in the operating room (OR). These circumstances call for novel technologies, such as immersive video. The objective of this study is to compare knowledge retention, preparedness, and content engagement for surgical learning when watching a surgical video in 3D through a Head-Mounted Display (HMD) versus in 2D video on a conventional screen.

Materiel and Methods:
This randomized controlled trial includes 231 fourth-year medical students. Participants watched the same 12 min surgical video, narrated by an expert, presented either in immersive 3D form through an HMD, or in 2D form through a conventional screen. The students completed three questionnaires (previewing, postviewing, and 1 month later), which included questions on knowledge retention, expected preparedness, content engagement, tool engagement, and self-assessment. Statistical analyses were adjusted by including the confounding factors.

Results:
Immediately after the video, the 3D immersive video group showed a significantly lower knowledge retention score compared to the classic video group (P<0.01). Nonetheless, the 3D immersive video group demonstrated better-expected preparedness as a future resident (P=0.019), greater satisfaction (P=0.033), better stimulation (P<0.001), higher involvement (P<0.001), and a greater perceived ability to identify anatomical structures (P<0.001). After 1 month, participants in the immersive video group reported feeling more prepared (P=0.016), more self-confident (P=0.020), more at ease (P=0.023), and less overwhelmed (P<0.01) than those in the 2D video group.

Conclusion:
Our results showed that 3D surgical immersive video vs. 2D surgical video, enhances the sense of stimulation, satisfaction, involvement, and the perception of having better identified anatomical structures. For early medical school students where access to the OR is limited, this tool appears to a significant step forward in surgical pedagogy. However, the precise understanding of its pedagogical value required further investigation and refinement.
Educational interventions improve disparities in patient access to kidney transplantation: a network meta-analysis of randomized controlled trials
Authors: Godoi Amanda , Koimtzis Georgios , Felix Nicole , Mora Maria M.R. , Graziani e Sousa Augusto , Soares Giulia A.R. , Carvalho Pedro E.P. , Ilham Mohamed A. , Stephens Michael R. , Khalid Usman 
Published: November 2024

Background:
Transplantation significantly improves the quality of life for patients with chronic kidney disease. Despite various educational strategies being assessed, the optimal approach to overcome barriers to kidney transplantation remains unclear.

Materials and Methods:
The authors conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing educational interventions to improve kidney transplantation access. The authors searched Medline, Embase, Cochrane Central, and Clinicaltrials.gov up until June 2024. Outcomes included rate of transplantation, living donor inquiries, waitlisting, evaluation, and knowledge level. Frequentist random-effects models and p-scores were used to rank strategies. The protocol was registered in PROSPERO.

Results:
The authors included 24 RCTs with a total of 116 054 patients. Of these, 57 996 (49.97%) received educational interventions and 58 058 (50.03%) received standard-care. Educator-guided and home-based strategies were associated with a higher rate of transplantation to multilevel interventions (RR 1.63; 95% CI: 1.07–2.48; P=0.023 | RR 1.85; 95% CI: 1.11–3.08; P=0.019) and standard-care (RR 1.56; 95% CI: 1.00–2.45; P=0.049 | RR 1.78; 95% CI: 1.17–2.70; P=0.007). According to the P-scores ranking, home-based interventions were the most likely strategy to improve transplantation access.

Conclusion:
In this NMA of 24 RCTs, home-based and educator-guided interventions were the most beneficial for improving access to kidney transplantation. Future studies should focus on their applicability for minority populations with challenges in health literacy and transplant access.
Conservative Concussion Management in Youth Athletes Can Avoid Increased Injury Rates After Return to Sport: Initial Evidence
Authors: Adams Sarah N. , Mueske Nicole M. , Katzel Mia J. , Zaslow Tracy , Wren Tishya A. L. 
Published: November 2024

Objective:
To evaluate whether injury rates are elevated after return to sport after concussion clearance in youth athletes and examine differences between concussed athletes who sustain injury after return to play and those who remain uninjured.

Design:
Prospective cohort study.

Setting:
Large metropolitan hospital.

Participants:
Twenty-four youth athletes cleared for return to play after a concussion and 84 pediatric athletes without concussion.

Independent Variables/Interventions:
Concussion (with return to play clearance) versus no concussion; age, sex, hours of sleep, and sports participation.

Main Outcome Measures:
Injury for a 12-week period.

Results:
Injury rates were similar between the concussed (5/24 = 21%) and nonconcussed (15/84 = 18%) athletes (P = 0.77). Within the concussion group, there was no significant difference between the noninjured and injured participants in time to return to play, time from concussion to initial evaluation, age, sex, hours of sleep per night, or hours of sports participation per week (P ≥ 0.19). The median time to clearance for the concussed athletes was 34 (range: 18–61) days.

Conclusions:
This study provides preliminary evidence suggesting that when current guidelines for return to play are followed, concussed pediatric athletes can resume activity without facing an elevated risk of injury. Time to achieve clearance in pediatric and adolescent athletes can be expected to be longer than the 7 to 14 days typical for older athletes.
A Systematic Review of Sports-Related Concussion Education Programs: Design, Outcomes, and Recommendations
Authors: Hussain Abid , Malcolm Dominic , Tausif Muhammad 
Published: November 2024

Objective:
This systematic literature review was undertaken to identify the main design features of sport-related concussion (SRC) education programs, examine their outcomes, and consider the relationship between design and effectiveness.

Design:
Systematic review.

Main Outcome Measures:
Studies which report on educational interventions (a dedicated in-person or online teaching session) that purport to change knowledge, attitudes, and/or behavior toward sports-related concussion. Searches were performed across 5 databases.

Results:
Out of the 9192 records that were initially screened, 28 retrieved studies were identified. The review found considerable diversity in the content, mode of delivery, and aims of SRC education programs. Sport-related concussion programs were largely successful in increasing recipients' knowledge, but these gains were often transitory, and stronger among adults than among children. There was little evidence of a tangible impact on behavior.

Conclusions:
We recommend that future research should (1) seek to clarify what constitutes achievable goals for education programs, (2) move toward better intervention standardization through greater consolidation and coordination of the field, (3) feature explicit attempts to tailor interventions to specific target audiences, and (4) ensure the greater involvement of participants in the creation and design of SRC educational interventions.
Acupotomy therapy for knee osteoarthritis: An overview of systematic reviews
Authors: Zhang Jiangchun , Pang Tingting , Yao Junjie , Li Ailin , Dong Li , Wang Yueting , Wang Yufeng 
Published: November 2024

Background:
This study aimed to evaluate the methodological quality, report quality, and evidence quality of a meta-analysis (MA) and systematic review (SR) of the efficacy of acupotomy in the treatment of knee osteoarthritis (KOA), and provided a reference for clinical decision-making.

Methods:
We searched 8 databases to collect systematic reviews and meta-analyses on the efficacy of acupotomy in the treatment of KOA from January 30, 2018, to January 31, 2023. The methodological quality of the studies was assessed using the assessment of multiple systematic reviews (AMSTAR) 2 scale, the quality of the literature reports was scored using the Preferred Reporting Items for Systems Reviews and Meta-Analyses 2020 Version (PRISMA 2020),and the quality of the evidence was graded using the grading of recommendations assessment, development, and evaluation (GRADE) scale.

Results:
Nine systematic reviews including 35 outcome indicators were included. AMSTAR 2 evaluated the methodological quality of the included studies, and 1 was of low quality, 8 were of very low quality, and the entries with poor scores were 2, 3, 4, 8, 10, 12, and 13. By PRISMA 2020, there were some reporting deficiencies, and quality problems were mainly reflected in the abstract, information sources, search strategy, synthesis methods, reporting bias assessment, certainty assessment, reporting biases, certainly of evidence, registration and protocol. The GRADE classification results showed that there were 2 medium-quality evidences, 7 low-quality evidences, and 26 very low-quality evidences. The main factors of degradation were limitations, imprecision, and publication bias.

Conclusion:
Acupotomy had been a promising complementary treatment for KOA. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples were needed before widespread recommendations could be made.