bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Odontoid and Orbital–Coronal Vertical Axis Lines in Evaluating Coronal Alignment and Outcomes in Adult Spinal Deformity Surgery
Authors: Shen Yong , Sardar Zeeshan M. , Katiyar Prerana , Malka Matan , Greisberg Gabriella , Hassan Fthimnir , Reyes Justin L. , Zuckerman Scott L. , Lombardi Joseph M. , Lehman Ronald A. , Lenke Lawrence G. ,   Multi-Ethnic Alignment Normative Study Group
Published: November 2023

Study Design.
Asymptomatic Multi-Ethnic Alignment Normative Study (MEANS) cohort: cross-sectional, multicenter. Symptomatic cohort: retrospective, multisurgeon, single-center.

Objective.
To assess the association of odontoid–coronal vertical axis (OD-CVA) and orbital–coronal vertical axis (ORB-CVA) with radiographic parameters, patient-reported outcomes, and clinical outcomes.

Summary of Background Data.
Previous literature studied the OD-CVA in an asymptomatic cohort and ORB-CVA in a symptomatic cohort, demonstrating their correlations with radiographic parameters and ORB-CVA with outcomes.

Materials and Methods.
A total of 468 asymptomatic adult participants were prospectively enrolled in the MEANS cohort. 174 symptomatic patients with adult spinal deformity with ≥6 fused levels and 2-year follow-ups were retrospectively enrolled in the symptomatic cohort. The association between OD-CVA and ORB-CVA, and radiographic parameters, perioperative variables, PROs, and outcomes were analyzed. Pearson correlation was used to assess correlation and logistic regression odds of outcomes.

Results.
In the MEANS cohort, the ORB-CVA correlated with C7-CVA (r = 0.58) and OD-CVA (r= 0.74). In the symptomatic cohort, preoperative ORB-CVA correlated better with leg length discrepancy; r = 0.17, P= 0.029), whereas preoperative OD-CVA correlated better with C7-CVA (r = 0.90, P< 0.001). Postoperative ORB-CVA correlated with postoperative C7-CVA (r = 0.66, P< 0.001), and postoperative OD-CVA correlated strongly with postoperative C7-CVA (r= 0.81, P< 0.001). Both preoperative OD-CVA (r= 0.199) and ORB-CVA (r = 0.208) correlated with the preoperative Oswestry Disability Index. ORB-CVA correlated better than OD-CVA in the preoperative Scoliosis Research Society-22r pain category but worse in total and other subcategories. Preoperative ORB-CVA was associated with increased odds of intraoperative complication (odds ratio = 1.28, 1.01–1.22), like OD-CVA (odds ratio = 1.30, 1.12–1.53). Neither preoperative ORB-CVA nor OD-CVA was associated with reoperations and readmissions after multivariate analysis. Preoperative OD-ORB mismatch >1.5 cm was not associated with increased odds of intraoperative and postoperative complications, reoperations, or readmissions.

Conclusion.
ORB-CVA and OD-CVA correlated with radiographic parameters, patient-reported outcomes, and intraoperative complications. ORB-CVA and OD-CVA can be used interchangeably as cranial coronal parameters in adult spinal deformity surgery.
Anti-Factor-Xa and Activated Partial Thromboplastin Time Concordance and Outcomes in Adults Undergoing Extracorporeal Membrane Oxygenation: A Secondary Analysis of the Pilot Low-Dose Heparin in Critically Ill Patients Undergoing Extracorporeal Membrane Oxygenation Randomized Trial
Authors: Aubron Cécile , Chapalain Xavier , Bailey Michael , Board Jasmin , Buhr Heidi , Cartwright Bruce , Dennis Mark , Hodgson Carol , Forrest Paul , McIlroy David , Murphy Deirdre , Murray Lynne , Pellegrino Vincent , Pilcher David , Sheldrake Jayne , Tran Huyen , Vallance Shirley , Cooper D. James , McQuilten Zoe 
Published: November 2023

OBJECTIVES:
To determine the concordance between activated partial thromboplastin time (aPTT) and anti-factor-Xa (anti-Xa) in adults undergoing extracorporeal membrane oxygenation (ECMO) and to identify the factors associated with discordant paired aPTT/anti-Xa.

DESIGN:
Pre-planned secondary analysis of the Low-Dose Heparin in Critically Ill Patients Undergoing Extracorporeal Membrane Oxygenation pilot randomized unblinded, parallel-group controlled trial.

SETTING:
Two ICUs in two university hospitals.

PATIENTS:
Thirty-two critically ill patients who underwent ECMO and who had at least one paired aPTT and anti-Xa assay performed at the same time.

INTERVENTIONS:
We analyzed the concordance between aPTT and anti-Xa and identified factors associated with discordant paired aPTT/anti-Xa based on their respective therapeutic ranges. We also compared biological parameters between heparin resistance episode and no heparin resistance.

MEASUREMENTS AND MAIN RESULTS:
Of the 32 patients who were included in this study, 24 (75%) had at least one discordant paired aPTT/anti-Xa. Of the 581 paired aPTT/anti-Xa that were analyzed, 202 were discordant. The aPTT was relatively lower than anti-Xa in 66 cases (32.7%) or relatively higher than anti-Xa in 136 cases (67.3%). Thirty-three heparin resistance episodes were identified in six patients (19%).

CONCLUSIONS:
In these critically ill patients undergoing ECMO, one third of paired aPTT/anti-Xa measures was discordant. Coagulopathy and heparin resistance might be the reasons for discordance. Our results support the potential importance of routinely monitoring both tests in this setting.
Higher Survival With the Use of Extracorporeal Cardiopulmonary Resuscitation Compared With Conventional Cardiopulmonary Resuscitation in Children Following Cardiac Surgery: Results of an Analysis of the Get With The Guidelines-Resuscitation Registry*
Authors: Kobayashi Ryan L. , Gauvreau Kimberlee , Alexander Peta M. A. , Teele Sarah A. , Fynn-Thompson Francis , Lasa Javier J. , Bembea Melania , Thiagarajan Ravi R. ,   for the American Heart Association’s (AHA) Get With The Guidelines-Resuscitation (GWTG-R) Investigators
Published: November 2023

OBJECTIVES:
Extracorporeal membrane oxygenation to support cardiopulmonary resuscitation (CPR) is increasingly used in children suffering cardiac arrest after cardiac surgery. However, its efficacy in promoting survival has not been evaluated. We compared survival of pediatric cardiac surgery patients suffering in-hospital cardiac arrest who were resuscitated with extracorporeal CPR (E-CPR) to those resuscitated with conventional CPR (C-CPR) using propensity matching.

DESIGN:
Retrospective study using multicenter data from the American Heart Association Get With The Guidelines-Resuscitation registry (2008–2020).

SETTING:
Multicenter cardiac arrest database containing cardiac arrest and CPR data from U.S. hospitals.

PATIENTS:
Cardiac surgical patients younger than 18 years old who suffered in-hospital cardiac arrest and received greater than or equal to 10 minutes of CPR.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Among 1223 patients, 741 (60.6%) received C-CPR and 482 (39.4%) received E-CPR. E-CPR utilization increased over the study period (p < 0.001). Duration of CPR was longer in E-CPR compared with C-CPR recipients (42 vs. 26 min; p < 0.001). In a propensity score matched cohort (382 E-CPR recipients, 382 C-CPR recipients), E-CPR recipients had survival to discharge (odds ratio [OR], 2.22; 95% CI, 1.7–2.9; p < 0.001). E-CPR survival was only higher when CPR duration was greater than 18 minutes. Propensity matched analysis using patients from institutions contributing at least one E-CPR case (n = 35 centers; 353 E-CPR recipients, 353 C-CPR recipients) similarly demonstrated improved survival in E-CPR recipients compared with those who received C-CPR alone (OR, 2.08; 95% CI, 1.6–2.8; p < 0.001).

CONCLUSIONS:
E-CPR compared with C-CPR improved survival in children suffering cardiac arrest after cardiac surgery requiring CPR greater than or equal to 10 minutes.
Rate and durability of the clearance of HBsAg in Alaska Native persons with long-term HBV infection: 1982–2019
Authors: Bruden Dana , McMahon Brian J. , Snowball Mary , Towshend-Bulson Lisa , Homan Chriss , Johnston Janet M. , Simons Brenna C. , Bruce Michael G. , Cooley Laura , Spradling Philip R. , Harris Aaron M. 
Published: November 2023

Background and Aims:
A functional cure and therapeutic end point of chronic HBV infection is defined as the clearance of HBsAg from serum. Little is known about the long-term durability of HBsAg loss in the Alaskan Native population.

Approach and Results:
We performed a retrospective cohort study of Alaska Native patients with chronic HBV-monoinfection from January 1982 through December 2019. The original group in this cohort was identified during a 1982 to 1987 population-based screening for 3 HBV serologic markers in 53,000 Alaska Native persons. With close to 32,000 years of follow-up, we assessed the frequency and duration of HBsAg seroclearance (HBsAg-negative for > 6 mo). We examined factors associated with HBsAg clearance and followed persons for a median of 13.1 years afterward to assess the durability of HBsAg clearance. Among 1079 persons with an average length of follow-up of 33 years, 260 (24%) cleared HBsAg at a constant rate of 0.82% per person/per year. Of the 260 persons who cleared, 249 (96%) remained HBsAg-negative, while 11 persons had ≥ 2 transient HBsAg-positive results in subsequent follow-up.

Conclusions:
Of the patients with chronic HBV monoinfection, 0.82% of people per year achieved a functional cure. HBsAg seroclearance was durable for treated and nontreated patients and lasted, on average, over 13 years without seroreversion.
Prosthetic Stimulation of the Vestibular Nerve Can Evoke Robust Eye and Head Movements Despite Prior Labyrinthectomy
Authors: Wiboonsaksakul Kantapon Pum , Della Santina Charles C. , Cullen Kathleen E. 
Published: November 2023

Hypothesis
Prosthetic electrical stimulation can evoke compensatory eye and head movement despite vestibular implant electrode insertion occurring years after prior labyrinthectomy.

Background
Vestibular implants sense head rotation and directly stimulate the vestibular nerve, bypassing damaged end organs. Animal research and current clinical trials have demonstrated the efficacy of this approach. However, candidacy criteria for vestibular implants currently require presence of a patent labyrinth in the candidate ear and at least aidable hearing in the opposite ear, thus excluding patients who have undergone prior labyrinthectomy for unilateral Menière's disease that later progressed to bilateral vestibular hypofunction.

Methods
Eight years after right unilateral labyrinthectomy, we implanted stimulating electrodes in the previously exenterated right ear ampullae of a rhesus macaque monkey. The left labyrinth had long-standing hypofunction due to intratympanic gentamicin injection and surgical disruption. We used three-dimensional video-oculography to measure eye movement responses to prosthetic electrical stimulation. We also measured head-movement responses to prosthetic stimulation with the head unrestrained.

Results
Bilateral vestibular hypofunction was confirmed by absence of vestibuloocular reflex responses to whole-body rotation without prosthetic stimulation. For a subset of the implanted electrodes, prosthetic vestibular stimulation evoked robust compensatory eye and head movements. One electrode reliably elicited responses aligned with the implanted ear's anterior canal nerve regardless of the return electrode used. Similarly, a second electrode also elicited responses consistent with excitation of the horizontal canal nerve. Responses grew quasilinearly with stimulation rate and current amplitude.

Conclusion
Prosthetic electrical stimulation targeting the vestibular nerve can be effective years after labyrinthectomy, if at least some parts of the vestibular nerve's ampullary branches remain despite destruction or removal of the membranous labyrinth.
Exoscope-Assisted Stapedotomy: Evaluation of Safety and Efficacy
Authors: Conway Robert M. , Fan Caleb J. , Choi Jonathan S. , Babu Kavan , Mallany Hugh P. , Babu Seilesh C. 
Published: November 2023

Objective
Evaluate the safety and efficacy of exoscope-assisted stapedotomy.

Study Design
Retrospective chart review.

Setting
Tertiary care neurotology clinic.

Patients
Adult patients with otosclerosis undergoing stapedotomy.

Intervention(s)
Primary stapedotomy.

Main Outcome Measure(s)
Evaluation of audiologic outcomes, including pure-tone average, bone-conduction thresholds, word recognition score, and air-bone gap. Complications, need for scutum removal, and length of surgery were also evaluated.

Results
A total of 47 patients were identified, and 24 patients underwent surgery with the microscope and 22 with the exoscope. There were significant improvements in pure-tone average, mean bone-conduction thresholds, and air-bone gap for both groups. There was no difference in preoperative or postoperative audiologic status for either group. There was no difference in rates of dysgeusia, chorda tympani nerve damage, dizziness, or facial paresis in either group.

Conclusions
This study indicates similar audiologic outcomes, complication profiles, and visualization when comparing exoscopic and microscopic stapedotomy. Demonstrated here, exoscopic stapedotomy can be safely performed in a transcanal manner.
Advancements in airway stents: a comprehensive update
Authors: Aravena Carlos , Gildea Thomas R. 
Published: November 2023

Purpose of review
This review provides an overview of the evolving field of airway stenting (AS), highlighting its relevance in the management of central airway obstruction (CAO). It discusses recent advancements, including 3D-printed silicone stents (3DPSS), metallic stents, biodegradable stents (BS), and drug-eluting stents (DES), which are transforming clinical practice. The review underscores the ongoing challenges in patient selection, stent choice, and long-term management in the context of an evolving landscape.

Recent findings
Innovations, particularly 3DPSS, have shown promise in providing patient-specific solutions. These stents offer improved symptom relief, enhanced quality of life, and lower complication rates, especially for complex airway diseases. The use of BS and DES is explored, raising prospects for future applications.

Summary
The evolution of AS reflects a deepening understanding of airway obstructions. Recent innovations, such as 3DPSS, BS, and DES, show considerable promise in addressing the limitations of conventional stents. However, challenges related to complications, patient selection, and long-term management persist, demanding further research. Wide practice variations in the management of AS highlight the need for more clinical data and standardized guidelines. The search for the ideal stent continues, driven by the pursuit of better outcomes for patients with CAO.
Board Leaders' Perspectives of the Impact of Nurses on Boards
Authors: Sundean Lisa J. , Christopher Roberta , Reede Lynn , Mott Jason , Mylott Laura 
Published: November 2023

OBJECTIVE
The purpose of the study was to explore the impact of nurses on boards (NOBs) from the perspectives of board leaders who are not nurses.

BACKGROUND
Research about the impact of NOBs derives from nurses' recall of board experiences. No studies explore the impact of NOBs from perspectives other than nurses.

METHODS
Researchers used an exploratory qualitative design with purposive sampling and interviewed 16 participants.

RESULTS
According to participants, NOBs impact board governance as boundary spanners within the healthcare ecosystem. The overarching pattern is supported by 6 traversing themes.

CONCLUSIONS
Board leaders' perspectives of NOBs as boundary spanners illustrate the far-reaching impact nurses have in the board role and on the direction of healthcare organizations.
Mediators of psychosocial well-being for immigrant women living with breast cancer in Canada: a critical ethnography
Authors: D'Souza Melba Sheila , Fehr Florriann Carissa , Smith Michelle Lynne , Marshall Marie-Claire 
Published: November 2023

Abstract

Background:
Immigrant women living with breast cancer experience a lack of psychosocial and emotional support, which adds to the complexity of navigating and using health care services in Canada.

Aim:
To explore the mediators of psychosocial well-being for immigrant women living with breast cancer in Canada.

Methods:
A critical ethnography was used. The study identified 27 immigrants living with breast cancer, who had been born in a foreign country, migrated to Canada within the past 10 years, and lived in rural communities of British Columbia between August 2021 and March 2022. Institutional research ethics board approval and informed consent were obtained.

Results:
The findings indicated two significant themes: The immigrant women had limited knowledge, information, and communication and experienced physical, psychological, and emotional distress.

Conclusion:
There is a significant need for culturally responsive care services for immigrant women living with breast cancer in rural communities. Recommendations include the development of psychosocial oncology, such as integrated counseling and therapies, to reduce cancer-related post-traumatic stress and improve their psychosocial and emotional well-being. Interdisciplinary approaches to psychosocial oncology are particularly crucial for immigrants and rural communities, where women need access to cancer navigation and ongoing support for a better health-related quality of life.
A Year After Implementation of the Telehealth Waiver: Being Offered and Utilizing Video-Specific Telehealth Among Dual-Eligible Medicare Recipients During the COVID-19 Pandemic
Authors: Choi Jasmin , Kim Grace , Choi Sugy , Chang Ji Eun 
Published: November 2023

Objective:
Telehealth is an essential tool to provide access to care while reducing infection exposure for high-risk populations during the COVID-19 pandemic. Our study aims to examine factors associated with telehealth availability and usage among Medicare and dual-eligible recipients 1 year after implementation of the Medicare's temporary telehealth waiver.

Design, Setting, and Participant:
A cross-sectional, phone survey with a national representative sample of Medicare recipients. We obtained a final study sample from the Winter 2021 COVID-19 Supplement of Medicare Current Beneficiary Survey dataset (N = 10 586). We examined associations for being offered and having had telehealth visits or any video telehealth visits during the pandemic since November 1, 2020.

Main Outcome Measures:
Our primary outcomes were being offered any telehealth, being offered any video telehealth, having had any telehealth visit, and having had any video telehealth.

Results:
Although dual eligibility was not significantly associated with being offered or having had any telehealth services during the pandemic, those who were dual eligible were more likely to have had video telehealth visits (adjusted odds ratio = 1.39, 95% confidence interval 1.04-1.86, P = .03) compared with those with non-dual eligibility. Recipients with disability eligibility, technology access, and severe chronic conditions were more likely to have been offered or have had telehealth. At the same time, those who lived in the nonmetropolitan area were less likely to have been offered or have had telehealth, including video telehealth.

Conclusions:
Our findings suggest that the federal waivers to expand telehealth services were successful in continuing care for vulnerable Medicare recipients. The providers' specific outreach and intervention efforts to offer telehealth visits are crucial for dual-eligible recipients. To increase video telehealth uptake, technology access and services to rural areas should be prioritized.
Development and Validation of a New Score to Assess the Risk of Posttransplantation Diabetes Mellitus in Kidney Transplant Recipients
Authors: Serna-Higuita Lina Maria , Isaza-López Maria Carolina , Hernández-Herrera Gilma Norela , Serna-Campuzano Angelica Maria , Nieto-Rios John Fredy , Heyne Nils , Guthoff Martina 
Published: November 2023

Background.
Posttransplantation diabetes mellitus (PTDM) is a serious complication of solid organ transplantation. It is associated with major adverse cardiovascular events, which are a leading cause of morbidity and mortality in transplant patients. This study aimed to develop and validate a score to predict the risk of PTDM in kidney transplant recipients.

Methods.
A single-center retrospective cohort study was conducted in a tertiary care hospital in Medellín, Colombia, between 2005 and 2019. Data from 727 kidney transplant recipients were used to develop a risk prediction model. Significant predictors with competing risks were identified using time-dependent Cox proportional hazard regression models. To build the prediction model, the score for each variable was weighted using calculated regression coefficients. External validation was performed using independent data, including 198 kidney transplant recipients from Tübingen, Germany.

Results.
Among the 727 kidney transplant recipients, 122 developed PTDM. The predictive model was based on 5 predictors (age, gender, body mass index, tacrolimus therapy, and transient posttransplantation hyperglycemia) and exhibited good predictive performance (C-index: 0.7 [95% confidence interval, 0.65-0.76]). The risk score, which included 33 patients with PTDM, was used as a validation data set. The results showed good discrimination (C-index: 0.72 [95% confidence interval, 0.62-0.84]). The Brier score and calibration plot demonstrated an acceptable fit capability in external validation.

Conclusions.
We proposed and validated a prognostic model to predict the risk of PTDM, which performed well in discrimination and calibration, and is a simple score for use and implementation by means of a nomogram for routine clinical application.
The Causes of Optic Disc Edema in Patients Presenting With Significantly Compromised Vision
Authors: Pandya Bhadra U. , Jhaveri Aaditeya , Shamshad Farooq , Margolin Edward A. , Micieli Jonathan A. 
Published: November 2023

Background:
To evaluate the most common causes of optic disc edema (ODE) in patients with significantly compromised vision (initial best-corrected visual acuity [BCVA] of 20/400 or worse) at presentation.

Methods:
Retrospective chart review over a 5-year period of consecutive patients presenting to tertiary neuro-ophthalmology clinics at the University of Toronto.

Results:
A total of 656 patients with ODE were included, and 49 patients (7.47%) had an initial BCVA of 20/400 or worse. There were 54 eyes included at baseline and 49 eyes at final follow-up. There were 29 female and 20 male patients. The mean age at first visit across patients was 55.9 years. Female patients (n = 29) were significantly older than male patients (n = 20) (P < 0.05). The causes of ODE were optic neuritis (ON) (n = 22; 40.7%), nonarteritic anterior ischemic optic neuropathy (NAION) (n = 22; 40.7%), arteritic anterior ischemic optic neuropathy (AAION) (n = 5; 9.26%), uveitis-related (n = 3; 5.56%), papilledema from idiopathic intracranial hypertension (IIH) (n = 1; 1.85%), and Vogt–Koyanagi–Harada disease (n = 1; 1.85%). Initial BCVA was not significantly different between ON and NAION groups (P = 0.52); however, final BCVA was significantly better in the ON group (P < 0.0001). The mean initial BCVA was worst in the AAION group (2.62 ± 0.54 logarithm of the minimum angle of resolution). The most common cause of ODE in patients <40 years old was ON (83.3%), whereas the 2 most common causes in patients >80 were NAION (60%) and AAION (40%). In patients between the ages of 60–80, NAION (100%) was the only cause.

Conclusions:
Patients with ODE and poor vision at presentation represent a minority of cases seen in neuro-ophthalmology clinics (<10%). Optic neuritis and NAION are the 2 most common causes of ODE with poor vision at presentation. These findings are limited by a small sample size and potential sampling bias.