bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertebral Augmentation
Authors: Francio Vinicius Tieppo , Kalia Hemant , Escobar Alexander 
Published: September 2024

Abstract
The treatment options available for vertebral fractures (VFs) range from nonsurgical treatment (NST) to minimally invasive interventions, such as vertebral augmentation, which includes percutaneous balloon kyphoplasty (BKP) and titanium implantable vertebral augmentation devices (TIVAD). Although most VFs can be managed with NST, a subset with significant vertebral height loss, mechanical disruption, and uncontrollable pain may warrant vertebral augmentation. Vertebral augmentation using specific FDA approved devices are considered medically necessary for the treatment of symptomatic thoracolumbar osteoporotic VFs that have failed to respond to at least 6 weeks of conservative NST, and for the treatment of severe pain due to osteolytic lesions of the spine, related to malignancy. Overall, current guidelines and multiple reviews suggest that BKP is a safe and effective procedure with level I evidence recommending its use when proper criteria are met. Additionally, level I TIVAD related studies have demonstrated non-inferiority, when compared to BKP, with similar safety, efficacy, and interestingly less incidence of adjacent fractures. A poor prognostic factor is found if vertebral augmentation is not performed earlier than 6 months after injury, advocating a strategy for intervention early on. Hence, vertebral augmentation has a life changing impact in morbidity and mortality in patients with VFs, with a low NNT to save one life at 1 and 5 years. Both vertebral augmentation modalities conferred a prominent mortality benefit over NST with a low NNT, demonstrating a relative mortality advantage of BKP over NST. Since VFs have been associated with increased morbidity and mortality, and considering the abundance of high-quality information, multiple medical societies favor and confidently advocate the use of vertebral augmentation in the treatment of VFs. In summary, there is no consensus about which vertebral augmentation device is best for treating VFs. The decision to choose one vertebral augmentation system over another is physician dependent, however clinical guidelines, society recommendations and level I studies favor BKP and TIVAD, which have demonstrated similar outcomes of improved quality of life, functionality and pain relief in patients with VFs.
Basivertebral Nerve Ablation
Authors: Giuffrida Anthony , Westerhaus Benjamin D. 
Published: September 2024

Abstract
This chapter focuses on chronic low back pain caused by degenerative endplate disease. Animal and cadaver studies have shown this pain is transmitted from the vertebral endplate through the basivertebral nerve (BVN). In the setting of vertebral endplate disruption, there is an upregulation in the nerve endings of the BVN, and thus an increase in pain at this location. MRI in patients with degenerative endplate disease shows edema, which is characterized as Modic type I and type II change. Patients with chronic low back pain who have failed 6 months of conservative care and who have active Modic changes on MRI can be treated with a BVN ablation. The BVN is accessed with a cannula via a transpedicular approach. The target for the ablation is near the center of the lumbar and sacral vertebral bodies before the BVN arborizes to each endplate. Once proper access is obtained, ablation is performed at a constant 85°C for 15 minutes. The procedure takes approximately 30 minutes per level treated, and the patient returns home the same day. The evidence for BVN ablation is supported by two Level l randomized clinical trials. At this time, BVN ablation is approved for vertebral levels L3 to S1. Given the robust evidence and its relatively low risk profile, BVN ablation should be considered in patients who present with chronic low back pain.
Sacroiliac Joint Fusion—Posterior Approach
Authors: Buchanan Patrick , Diep Jack 
Published: September 2024

Abstract
Sacroiliac joint pain is one of the most common causes of low back pain, accounting for 15% to 30% of all cases. The incidence of sacroiliac joint degeneration in patients who have undergone lumbar fusion surgery is 75% at 5 years after surgery. Minimally invasive posterior sacroiliac joint fusion is a treatment option for patients who have failed conservative management, including intra-articular steroid injections, and it is an alternative to radiofrequency ablation.
Percutaneous Spinal Cord Stimulator Implantation (Cervical/Lumbar)
Authors: Francio Vinicius Tieppo , Abd-Elsayed Alaa , Deer Timothy , Westerhaus Benjamin D. 
Published: September 2024

Abstract
The use of electrical stimulation for pain relief has been described since 15 AD, with the earliest documentation for gout treatment by contact with a torpedo fish (electric fish), discovered by the Roman physician Scribonius Largus.1 Since, many other scientists and physicians have experimented with electrical stimulation and pain relief, but it wasn't until 1967 that Dr. Norman Shealy, the pioneer of contemporary neuromodulation, decided to stimulate large fibers in the dorsal column of the spinal cord2, based on a new theory of pain mechanisms called the "gate-control" theory proposed a few years earlier.
Neuropsychological Evaluation
Authors: Hromas Gabrielle A. , Davis Jeremy J. 
Published: September 2024

Abstract
This chapter provides an introduction to neuropsychological assessment, commonly used tests, and guidance on referrals. Neuropsychological evaluation involves systematic assessment of brain-behavior relationships in individuals with a history of cerebral insult, neurodevelopmental disorders, and/or neurologic or psychiatric conditions. The evaluation process is multidimensional, with collection and interpretation of data from sources including medical records, interviews, observations, and standardized tests of cognitive and emotional status. Comprehensive neuropsychological evaluation typically covers multiple cognitive domains including attention, language, visuospatial ability, memory, and executive function, in addition to examining the validity of obtained data and estimating premorbid and current general cognitive ability. Test raw scores are converted to standardized scores based on normative comparison groups. The goals of neuropsychological evaluation may include comprehensive description of cognitive ability, diagnosis, treatment planning, identification of needed work or school accommodations, assessment of safety concerns, and determining cognitive capacity (e.g., for healthcare decisions, financial management, and legal matters).
Differential Diagnosis
Authors: MacKillop Emily J. , McNeely Heather E. 
Published: September 2024

Abstract
Diagnostic accuracy is the first step to proper treatment, management, and future planning in dementia. Diagnostic challenges arise due to the co-occurrence of a multitude of conditions that contribute to cognitive changes in aging. Improving differential diagnostic skills is critical for detection, intervention, and treatment, in addition to the reduction of harm associated with missed and misdiagnoses. This chapter reviews differential diagnosis between the three main categories of conditions known to promote cognitive impairment in older adults and mimic neurodegenerative conditions: delirium; medical conditions; and psychiatric conditions. In addition, a framework is provided to assist the clinician broadly in making a differential diagnosis.
Vascular Dementia
Authors: Chandrasekhara Seetha , Zevy Danna L. 
Published: September 2024

Abstract
Vascular dementia (VaD) is one of the four major dementias. It is associated with white matter lesions in the brain from direct injury to the blood vessels, leading to multiple subtypes based on injury type and location. Risk factors are understandably similar to that of a stroke, as stroke can be a cause of VaD. These risk factors include smoking, hypertension, diabetes mellitus, hyperlipidemia, and other cardiac factors. Neuropsychiatric symptoms may be present, along with cognitive and motor changes, with depression being the most common. Management strategies often are based on controlling modifiable risk factors as pharmacologic interventions have limited benefit.
Lewy Body Disease and Atypical Parkinsonian Conditions
Authors: Scott Bonnie M. , Benge Jared F. 
Published: September 2024

Abstract
Parkinsonian conditions impact more than movement. A host of cognitive and behavioral features can occur with or even precede the onset of motor dysfunction, and the myriad symptoms can make classification challenging. This chapter reviews these conditions through the lens of neuropsychiatric features, while orienting students and providers to the cognitive background of the characteristic motor and imaging findings that co-occur with these diseases. It begins by reviewing conditions caused by abnormal accumulation of alpha-synuclein, including Parkinson’s disease, dementia with Lewy bodies, and multiple system atrophy. Characteristic cognitive, motoric, and other symptom presentations are reviewed, along with case examples to help differentiate these conditions. Next, the authors discuss the characteristic cognitive and behavioral features of the atypical parkinsonian conditions known as progressive supranuclear palsy and corticobasal ganglionic degeneration, and conclude with a discussion of the continued diagnostic uncertainties and heterogeneities in the presentation of these types of movement disorders.
Nonpharmacological Interventions for Symptoms and Related Contextual Difficulties in Dementia
Authors: Serrano Yesenia , Weil Marie C. , Tuncel Stephanie A. 
Published: September 2024

Abstract
Age-related neurocognitive disorders (NCDs) present with complex, heterogeneous, and inter-dynamic sets of symptoms across multiple domains of functioning (e.g., motor, affective, cognitive, behavioral), which are often influenced by medical, personal, contextual, sociocultural, and time factors. Assessment and interventions should therefore be person-centered and holistic, and involve the person, their families, and an interdisciplinary team. Treatment should respond to interacting medical and non-medical systems and emphasize nonpharmacological interventions (NPIs) to manage symptoms, improve function, promote independence, maintain quality of life (QoL), and prevent secondary complications such as pressure ulcers, contractures, pneumonia, and depression. This chapter provides a framework for the biopsychosocial evaluation of symptoms of NCDs postdiagnosis and a conceptualization model to aid in selecting interventions. It includes an introduction to commonly used NPIs for NCDs, and two illustrative cases.
Attending to the Caregiver
Authors: Reilly Shannon , Daranciang Brianna , Fuchs Kathleen 
Published: September 2024

Abstract
Individuals who are incapable of caring for themselves due to a neurocognitive disorder rely upon caregivers (CGs) for support with basic and/or complex activities of daily living (ADLs). CGs are often family members, who may struggle to meet their own needs given the health risks associated with caregiving. This chapter offers healthcare providers guidance in assessing the changing needs of CGs over time, along with practical tips about obtaining information and supporting their well-being. Information is provided about evidence-based interventions and brief therapeutic strategies that providers can employ or recommend. The authors describe how caregiving tasks may change with disease progression, as well as special CG circumstances for providers to consider. This chapter highlights that healthcare providers play an important, consistent role in helping CGs to navigate the unpredictable challenges of disease progression and offers guidance about individualizing support and resources.
Bioethics
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
This book discusses ethical and moral issues facing practitioners and provides the reader with the steps to identify the best pathway for maximizing the patient’s best interest. It contains 60 healthcare education topics and includes references for clinical practice and academic writings. Each topic addresses specific high-yield content for healthcare licensing exams and provides a framework for the healthcare profession’s behavioral expectations. The approach used in this book is the tripartite process—think, assess, and conclude—in which the practitioner considers the ethical issue, specifies and balances the four principles of bioethics—autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair)—and determines answers that are consistent with the standards of care. This approach also emphasizes the importance of effective communication and empathy in establishing a patient–practitioner relationship that maximizes the patient’s best interests.
Abuse
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract: Practitioners are required by law to report any suspected child or elder abuse to protective services. This is to protect vulnerable populations who cannot give informed consent or make treatment decisions. This reporting is part of the patient–practitioner social contract and is not considered a breach of confidentiality. Intimate partners with decisional capacity are not considered vulnerable populations, and the practitioner must get their expressed consent before reporting abuse. If the victim is being coerced, the practitioner can make an exception based on professional principles of doing good and not causing harm. The government’s role in healthcare is to implement justice by protecting vulnerable populations and reducing healthcare disparities. In 1974, Congress passed the Child Abuse Prevention and Treatment Act, which requires all states to prevent, identify, and treat child abuse and neglect.
Euthanasia
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract: Euthanasia, meaning “good death” in Greek, is administering a lethal agent by another person to relieve a patient’s incurable and intolerable suffering. The American Medical Association’s Code of Medical Ethics considers euthanasia incompatible with the role of a practitioner as a healer and states it would cause more harm than good. The American College of Physicians does not support practitioner-assisted suicide or euthanasia. Although some states have legalized practitioner-assisted death, also known as “death with dignity,” the healthcare profession has made it clear that euthanasia is never permissible for a practitioner to engage in. The healthcare profession recommends palliative care and a supportive patient environment to control a patient’s pain and suffering instead of euthanasia.
Genetic Information Nondiscrimination Act
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract: The requirement of genetic testing for insurance and employment in the 1970s violated the principles of autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair). Congress responded by enacting the 1972 National Sickle Cell Anemia Control Act and Title II of the 2008 Genetic Information Nondiscrimination Act (GINA) to prevent discrimination in health insurance and employment, making it illegal for insurance companies to use genetic information for adjusting premiums, denying coverage, or for companies with 15 or more employees to use genetic information for hiring, firing, job placement, or promotion decisions. The implementation of GINA ensures that individuals are protected from discrimination based on their genetic information.
Immunization—Vaccine Hesitancy
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract: There is a professional and social obligation of practitioners toward their patients that they take reasonable measures to reduce and prevent the spread of infectious diseases, including being vaccinated. The American Medical Association states that in the context of a highly transmissible disease, practitioners should accept immunization if a safe and effective vaccine is available. The justification for this is based on the principles of patient autonomy (informed consent), professional beneficence (do good), nonmaleficence (do no harm), and social justice (be fair) and how they apply in the patient–practitioner relationship. It is concluded that vaccine hesitancy based on the individual liberty of the practitioner is a violation of the patient–practitioner social contract and, therefore, a violation of all four principles of bioethics. Practitioners must stay up-to-date on vaccinations; not doing so is professional misconduct. Patient-centered healthcare for the patient’s best interest is the ultimate goal.
Media Communications
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract:Practitioners interacting with the media must navigate the delicate balance of promoting public health awareness and maintaining patient confidentiality. Ensuring compliance with professional and institutional media policies, obtaining informed consent from patients before disclosing any protected health information, and prioritizing patient autonomy and privacy are all critical aspects of this interaction. The practitioner’s primary allegiance lies within the patient–practitioner relationship and their pursuit of the patient’s best interests. As ambassadors of the healthcare profession, practitioners bear the social responsibility of informing the media about evidence-based care and existing healthcare disparities while protecting the patient’s right to confidentiality. Understanding the sanctity of the patient–practitioner relationship and the severe consequences of privacy breaches is essential for ethically sound media communications.
Organ Donations
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract: Informed consent for organ and tissue donation emphasizes the autonomy and rights of the individual. The sale of nonrenewable vital organs and tissues is prohibited, thus preventing the exploitation of vulnerable individuals. Renewable tissues, such as blood, sperm, and unfertilized ova, can be reimbursed for donor costs and compensation for services, with specific financial prospects for each. The U.S. Food and Drug Administration sets guidelines for plasma donations, allowing potential earnings of $260–$650 per year. Sperm donations may yield up to $18,000 annually, whereas egg donations can result in payments ranging from $5,000 to $35,000 per cycle. Minors can donate nonvital organs, but it requires the minor’s informed assent and the parent or guardian’s informed consent. Legally, practitioners cannot pursue organ donation consent from their own patients. Federal law stipulates that families must be presented with the option to donate a deceased relative’s organs.
Pregnant Patients
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Abstract: The right of a pregnant patient to refuse or withdraw from healthcare treatment has been a matter of controversy, as state laws differ. The American College of Obstetricians and Gynecologists (ACOG) states that a pregnant woman’s decision to refuse treatment should be respected, and any fetal intervention must have explicit informed consent from the pregnant woman. ACOG argues that the patient–practitioner relationship is with the pregnant woman and not with the fetus to ensure the woman’s autonomy (informed consent) and prevent her from being viewed as a “fetal container.” The practitioner must obtain informed consent from the pregnant patient and prioritize the patient’s best interests, informed by principles of beneficence (do good) and nonmaleficence (do no harm). State laws on the status of the fetus as a person vary, but once the fetus is born, it becomes a child and has all the protective rights.
Sexually Transmitted Infections
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Because the term “venereal disease” carries social stigma, the term “sexually transmitted infection” (STI) has been adopted for use instead. STIs are usually transmitted through sexual contact and can be caused by various bacteria, viruses, or protozoa. Mandatory reporting laws require practitioners to report STIs to the health department, which is not a breach of confidentiality. The professional principles of beneficence (do good) and nonmaleficence (do no harm) apply in treating STIs, emphasizing the need to treat both the patient’s and the partner’s infection to break the cycle of reinfection. The concept of expedited partner therapy (EPT), wherein a practitioner treats the patient’s partner without a direct consultation, is also discussed in this chapter. The practitioner should utilize alternative methods such as telemedicine to mitigate EPT concerns about informed consent, continuity of care, privacy, and other potential issues.
Strikes—Unionization
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
The issue of practitioners unionizing and engaging in collective bargaining has become a subject of renewed interest as the number of salaried practitioners increases and the number of private practices decreases. It is argued that such actions are justifiable only if they strengthen the patient–practitioner relationship, prioritize the patient’s best interests, and decrease healthcare disparities. It is important to assess the impact of practitioner unionization and strikes on patient autonomy (informed consent), practitioners’ duty of beneficence (do good) and nonmaleficence (do no harm), and public policy’s principle of justice (be fair). The conclusion is that unionization and strikes can only be justified if they are not motivated by self-interested reasons, do not violate the patient–practitioner relationship, do not increase the risk of harm to patients, and prioritize the patient’s best interests while decreasing healthcare disparities.
Terminal and Palliative Sedation
Authors: Bulger Jeffrey W. 
Published: September 2024

Abstract
Terminal sedation, also referred to as palliative sedation, is a healthcare practice in which medication is used to relieve refractory symptoms and decrease a patient’s consciousness in the final stages of life. The aim is to improve the quality of life by reducing suffering and not hastening death. It is considered morally acceptable by many professional associations, including the American Medical Association and the American College of Physicians. Informed consent is essential for the practice of terminal sedation, and the decision to undergo continuous sedation to unconsciousness is considered permanent and irrevocable. It is the responsibility of both the practitioner and the surrogate to act in the patient’s best interests, in accordance with the patient’s reasonable goals, values, and priorities, while following the principles of beneficence (do good) and nonmaleficence (do no harm).
Epidemiological aspects of suicide and suicidality
Authors: Rössler Wulf , Schreiter Stefanie , Gutwinski Stefan 
Published: September 2024

Abstract
Epidemiological research on suicide can be traced back almost 100 years. Despite a large number of empirical findings, our theoretical understanding of suicide is still limited. One of the best known conceptualizations of suicide is found in the monograph by Emile Durkheim, who described suicide not from an individual, but from a psychosocial perspective. To this date, we still try to find a common denominator for the causes of suicide. But as suicidal acts obviously represent a very complex behaviour, similarly the number of factors involved are large, with each factor contributing a small effect. This chapter looks at some of those effects, and the epidemiological aspects of suicide and suicidality.