bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of Methadone and BUP/NX Dose Titration Patterns With Retention in Treatment and Opioid Use in Individuals With Prescription-Type Opioid Use Disorder: Secondary Analysis of the OPTIMA Study
Authors: Bakouni Hamzah , Haquet Lexie , Socias M. Eugenia , Le Foll Bernard , Lim Ron , Ahamad Keith , Jutras-Aswad Didier ,   for the OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse
Published: January 2024

Introduction
Methadone and buprenorphine/naloxone (BUP/NX) titration parameters (eg, range, duration, and rate) can vary during opioid use disorder (OUD) treatment. We describe methadone and BUP/NX titration patterns and their associations with treatment outcomes among individuals with a prescription-type OUD.

Methods
We used data from a 24-week open-label, multicenter randomized controlled trial, including N = 167 participants aged 18–64 years old with prescription-type OUD who received at least a first dose of treatment. Descriptive analyses of methadone and BUP/NX titration patterns were conducted, that is, range and duration from first to maximum dose, and rate (range/duration ratio). Outcomes included percentage of opioid-positive urine drug screens (UDS) and treatment retention. Adjusted linear and logistic regressions were used to study associations between titration patterns and percentage of opioid-positive UDS and treatment retention.

Results
Methadone doses were increased by a mean dose range of 42.4 mg over a mean duration of 42.2 days. BUP/NX doses were increased by a mean dose range of 8.4 mg over a mean duration of 28.7 days. Only methadone dose titration range (odds ratio: 1.03; 95% CI, 1.01 to 1.05) and duration (odds ratio: 1.03; 95% CI, 1.01 to 1.05) were associated with higher retention. Only methadone dose titration rate was associated with lower percentage of opioid-positive UDS at weeks 12–24 (B: −2.77; 95% CI, −4.72 to −0.81).

Conclusions
Specific parameters of methadone titration were associated with treatment outcomes and may help in personalizing treatment schedules. Sustained methadone dose titration, when indicated, may help increase retention, whereas faster dose titration for methadone may help decrease opioid use.
The Activity Management Inventory for Pain (AMI-P)
Authors: Racine Mélanie , Jensen Mark P. , Cane Douglas , Moulin Dwight E. , Vlaeyen Johan W.S. , Nielson Warren R. 
Published: January 2024

Objectives:
Activity management is an important treatment component in chronic pain programs. However, there are shortcomings in measures of this construct, leading to inconsistencies in research findings. Here, we describe the development of the Activity Management Inventory for Pain (AMI-P).

Methods:
The AMI-P was developed by a group of international researchers with extensive expertise both in chronic pain and activity management. The initial evaluation of the AMI-P items included two studies that were both conducted in Canadian tertiary pain care centers.

Results:
The resulting 20-item measure has three behavior scales (Rest, Alternating Activity, Planned Activity), and four goal scales (Feel Less Pain, Get More Done, Complete the Task, Save Energy). The behavior scales evidenced marginal to good internal consistency and test-retest reliability, and a moderate positive association with an existing pacing measure. The Rest and Alternating Activity scales were associated with greater pain interference, the Alternating Activity and Planned Activity scales were associated with less satisfaction with social roles, and the Planned Activity scale was associated with fewer depressive symptoms. The Alternating Activity scale increased significantly from pre- to post-treatment. All goal scales were positively associated with all behavior scales. The Feel Less Pain goal scale was positively associated with measures of avoidance and pain interference, while the Get More Done goal scale was negatively associated with measures of depressive symptoms and overdoing.

Discussion:
The findings support the reliability and validity of the AMI-P scales, while also highlighting the complexity and multidimensional aspects of activity management.
Comparison of Short-term Results: Robotic-assisted vs. Conventional Bilateral Total Knee Arthroplasty
Authors: Kang Louis , Lee Ji Won , Mistretta Katherine , Pianka Mark , Chou Jiling , Macaraeg Crisanto , Boucher Henry R. 
Published: January 2024

Introduction:
Robotic-assisted total knee arthroplasty is becoming widely accepted as a method to improve intra-operative measures and post-operative functional outcomes. While there is a large body of evidence supporting robotic-assisted unilateral total knee arthroplasty (TKA), few studies have examined the outcomes of this technology in simultaneous bilateral TKA procedures. Thus, the purpose of the study is to compare the clinical outcomes between patients undergoing simultaneous robot-assisted bilateral total knee arthroplasty (raTKA) versus conventional bilateral total knee arthroplasty (convTKA).

Methods:
We retrospectively reviewed 140 simultaneous bilateral TKA cases (61 conventional, 79 robot-assisted) performed by a single surgeon in a single institution from January 1, 2015 to December 11, 2020. The institution’s electronic medical records were reviewed for patient demographic information, operative data, and post-operative complications. Outcomes Based Electronic Research Database (OBERD) records were reviewed for patient-reported outcomes (Oxford Knee Score and SF-12 Version 1) preoperatively and postoperatively at 6 months, 1 year, and 2 years.

Results:
Both raTKA and convTKA groups exhibited clinically relevant improvements beyond the minimally clinically important difference (MCID) in SF-12 physical and Oxford Knee Scores at 6 months, 1 year, and 2 years post-surgery. There were no statistically significant differences found between the two groups in terms of postoperative SF-12 scores, Oxford Knee Scores, complications, or revision rates. The raTKA group had a longer length of stay (2.6 versus 2.2 days, P=0.001) and a significantly different discharge disposition with more patients entering acute rehab compared to the convTKA group (20 versus 7 patients respectively, P=0.031).

Conclusion:
Robotic-assisted total knee arthroplasty has a non-inferior impact on short-term patient outcomes compared to conventional methods in patients undergoing simultaneous bilateral total knee arthroplasty.

Level of evidence:
III
Corticosteroids in Sepsis and Septic Shock: A Systematic Review, Pairwise, and Dose-Response Meta-Analysis
Authors: Pitre Tyler , Drover Katherine , Chaudhuri Dipayan , Zeraaktkar Dena , Menon Kusum , Gershengorn Hayley B. , Jayaprakash Namita , Spencer-Segal Joanna L. , Pastores Stephen M. , Nei Andrea M. , Annane Djillali , Rochwerg Bram 
Published: January 2024

OBJECTIVES:
To perform a systematic review and meta-analysis to assess the efficacy and safety of corticosteroids in patients with sepsis.

DATA SOURCES:
We searched PubMed, Embase, and the Cochrane Library, up to January 10, 2023.

STUDY SELECTION:
We included randomized controlled trials (RCTs) comparing corticosteroids with placebo or standard care with sepsis.

DATA EXTRACTION:
The critical outcomes of interest included mortality, shock reversal, length of stay in the ICU, and adverse events.

DATA ANALYSIS:
We performed both a pairwise and dose-response meta-analysis to evaluate the effect of different corticosteroid doses on outcomes. We used Grading of Recommendations Assessment, Development and Evaluation to assess certainty in pooled estimates.

DATA SYNTHESIS:
We included 45 RCTs involving 9563 patients. Corticosteroids probably reduce short-term mortality (risk ratio [RR], 0.93; 95% CI, 0.88–0.99; moderate certainty) and increase shock reversal at 7 days (RR, 1.24; 95% CI, 1.11–1.38; high certainty). Corticosteroids may have no important effect on duration of ICU stay (mean difference, –0.6 fewer days; 95% CI, 1.48 fewer to 0.27 more; low certainty); however, probably increase the risk of hyperglycemia (RR, 1.13; 95% CI, 1.08–1.18; moderate certainty) and hypernatremia (RR, 1.64; 95% CI, 1.32–2.03; moderate certainty) and may increase the risk of neuromuscular weakness (RR, 1.21; 95% CI, 1.01–1.45; low certainty). The dose-response analysis showed a reduction in mortality with corticosteroids with optimal dosing of approximately 260 mg/d of hydrocortisone (RR, 0.90; 95% CI, 0.83–0.98) or equivalent.

CONCLUSIONS:
We found that corticosteroids may reduce mortality and increase shock reversal but they may also increase the risk of hyperglycemia, hypernatremia, and neuromuscular weakness. The dose-response analysis indicates optimal dosing is around 260 mg/d of hydrocortisone or equivalent.
Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
Authors: Barone Mirko , Frontera Regina , Liouras Rita Vaia , Ippoliti Massimo , Serano Luca , Iovino Carmine Giovanni , Dell’Atti Ivan , Vetrugno Luigi , Mucilli Felice , Maggiore Salvatore Maurizio 
Published: January 2024

Abstract
Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of typical abdominal signs and symptoms due to sedation, poor reactivity, need for ventilation, and confounding comorbidities. Moreover, imaging has poor specificity with findings often inconclusive. A bedside exploratory laparoscopy, as a complementary strategy, would allow for early and prompt diagnosis. Limits of a minimally invasive surgical rationale lie upon the effects of pneumoperitoneum induction, surgical stress, logistical resources, expertise, and costs.
Routine screening for gestational diabetes: a review
Authors: Sarker Minhazur R. , Ramos Gladys A. 
Published: January 2024

Purpose of Review
Rates of gestational diabetes mellitus (GDM) throughout the world continue to increase associated with the increasing rates of obesity. Given this epidemiologic burden, the importance of proper screening, diagnosis, and management cannot be understated. This review focuses on the current screening guidelines utilized throughout the world and new data recently published regarding the most optimal screening techniques and future directions for research.

Recent Findings
Despite unanimous opinion that GDM warrants screening, the optimal screening regimen remains controversial. Notably, in the United States per the consensus recommendation by the American College of Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine, a 2-step screening approach is often used. Recently, there have been multiple studies published that have compared the 1-step and 2-step screening process with respect to GDM incidence and perinatal outcomes. These new findings are summarized below.

Summary
Utilization of the 1-step screening as opposed to the 2-step screening results in an increased diagnosis of GDM without significant population level benefit in outcomes. However, these studies remain underpowered to allow for meaningful comparison of outcomes in those diagnosed with GDM.
Tranexamic Acid in Tumescence for Cervicofacial Rhytidectomies
Authors: Trimas Gracen E. , Frost Morgan D.T. , Trimas Scott J. 
Published: January 2024

Background:
Cervicofacial rhytidectomies are one of the most common procedures in the United States. There are many different methods and techniques involved, but all aim to minimize blood loss and procedure time. In our study, we investigated the addition of tranexamic acid (TXA) to tumescent anesthesia during rhytidectomy procedures. Our objective was to analyze the difference in mean procedure time and estimated blood loss in patients undergoing both general and other anesthesia types, with and without the addition of TXA, while maintaining patient safety.

Methods:
Seventy-four patients underwent a standard superficial musculoaponeurotic system plication technique rhytidectomy, with 60 patients undergoing general anesthesia and the remaining 14 undergoing other anesthesia types. Forty patients were treated without TXA, whereas the remaining 34 were treated with TXA.

Results:
Although the difference was not statistically significant, the addition of TXA resulted in a lower procedure time and estimated blood loss. Within anesthesia type, there was also a slight difference that TXA decreased blood loss and procedure time. We did find that general anesthesia type does significantly impact procedure time and estimated blood loss, when compared with other anesthesia types, independent of TXA use.

Conclusion:
The use of tumescent TXA may allow for a faster procedure with less blood loss, although further studies with a larger sample size are needed.
A Rare Case of Dermatofibrosarcoma in a Pediatric Patient
Authors: Martinez Paul F. , Richardson Skyler , Bakovic Melanie , Manrique Monica , Mantilla-Rivas Esperanza , Oh Albert K. , Rogers Gary F. 
Published: January 2024

Summary:
Dermatofibrosarcoma protuberans (DFSP) is a rare malignant fibroblastic tumor. DFSP has an insidious onset, slow growth, and heterogeneous presentation that can create a delay in diagnosis and increase morbidity. In this case report, we present a child with DFSP that presented as a large, slow-growing mass over the dorsum of the left foot. She underwent successful surgical excision with no functional sequelae.
Compression Dressing versus Noncompressive Transparent Eye Shield after Ptosis Surgery
Authors: Schuh Anna , Reischmann Lilian , Hintschich Christoph R. 
Published: January 2024

Background:
We aimed to investigate the effect of compression dressing on edema, ecchymosis, pain, and ocular surface irritation after ptosis surgery.

Methods:
After ptosis correction [anterior levator reinsertion (and resection) (ALR), if necessary additional blepharoplasty], the eye was randomized for compression dressing or transparent eye shield. Edema and ecchymosis were scored on a four-point rating scale by a blinded observer 1 day (D1), 1 week (D7), and 8 weeks (D56) after surgery; the same was done for scar formation regarding redness and bulging at D7 and D56. Aesthetic outcome was ranked by patient and blinded observer using the Global Aesthetic Improvement Score at D1, D7, and D56. Postoperative pain was scored using a visual analogue scale (0 to 10) at D1. Impairment after surgery by dressing or eye shield was evaluated at D1.

Results:
Ecchymosis, edema, scar formation, and aesthetic outcome ranked by the patient and blinded observer did not differ between the groups with compression dressing and eye shield at any day of follow-up (P > 0.05). Postoperative pain and impairment were the same in both groups (P > 0.05). One case of corneal erosion occurred in the group with compression dressing at D1 (P = 0.342). At D7, corneal staining was increased in the group without compression dressing (P = 0.930).

Conclusions:
Compression dressing after ALR does not reduce ecchymosis, edema, or postoperative pain and has no effect on early scar formation or aesthetic results. To prevent corneal erosion caused by the dressing, it can be omitted after ALR without inferiority for the early postoperative results.
A Retrospective Review of Patient-reported Outcomes after Postaxial Polydactyly Ligation and Surgical Excision
Authors: Ganju Nakul , Mantilla-Rivas Esperanza , Martinez Paul F. , Manrique Monica , Escandón Joseph M. , Shah Samay , Rogers Ashley E. , Boyajian Michael J. , Oh Albert K. , Rogers Gary F. 
Published: January 2024

Background:
Interventions for type B postaxial polydactyly include suture ligation and surgical excision, yet there is a paucity of literature comparing the outcomes of these procedures. This study sought to compare patient-reported long-term outcomes of postaxial digit excision.

Methods:
A six-question survey was distributed from January 2021 to March 2022 to patients who underwent treatment for type B postaxial polydactyly at a single pediatric institution from 2010 to 2016. Patients were queried about the incidence of pain sensitivity, keloid healing, and/or persistent presence of bump (“nubbin”) at the treatment site.

Results:
A total of 158 responses accounting for 258 digits were attained for a 53% response rate. The majority of digits (67.4%, n = 174) were surgically excised. Median age at procedure was 49 days: 13.0 days for ligation, 63.0 days for surgical excision. Median age at survey was 8 [IQR 5.4–10.2] years. Short-term (<30 days after procedure) complications rate was 1.6%. The rate of a raised or sensitive scar was 39.5% (ligation 51.5% versus surgery 35.4%, P < 0.05). The likelihood of postoperative sensitivity (P = 0.80) was similar among groups. However, the odds of a residual bump or raised scar at the surgical site was significantly higher in the ligation group (P = 0.001). These findings remained significant in the adjusted analysis.

Conclusion:
This study suggests that suture ligation can be used in select cases without increasing the prevalence of long-term pain or sensitivity, albeit with greater risk of a bump or raised scar at the excision site compared with surgical excision.
Greater use of antihypertensive medications explains lower blood pressures and better control in statin-treated than statin-eligible untreated adults
Authors: Egan Brent M. , Li Jiexiang , Sutherland Susan E. , Rakotz Michael K. 
Published: January 2024

Objective:
Statins appear to have greater antihypertensive effects in observational studies than in randomized controlled trials. This study assessed whether more frequent treatment of hypertension contributed to better blood pressure (BP, mmHg) control in statin-treated than statin-eligible untreated adults in observational studies.

Methods:
National Health and Nutrition Examination Surveys 2009–2020 data were analyzed for adults 21–75 years (N = 3814) with hypertension (BP ≥140/≥90 or treatment). The 2013 American College of Cardiology/American Heart Association Cholesterol Guideline defined statin eligibility. The main analysis compared BP values and hypertension awareness, treatment, and control in statin-treated and statin-eligible but untreated adults. Multivariable logistic regression was used to assess the association of statin therapy to hypertension control and the contribution of antihypertensive therapy to that relationship.

Results:
Among adults with hypertension in 2009–2020, 30.3% were not statin-eligible, 36.9% were on statins, and 32.8% were statin-eligible but not on statins. Statin-treated adults were more likely to be aware of (93.4 vs. 80.6%) and treated (91.4 vs. 70.7%) for hypertension than statin-eligible adults not on statins. The statin-treated group had 8.3 mmHg lower SBP (130.3 vs. 138.6), and 22.8% greater control (<140/<90: 69.0 vs. 46.2%; all P values <0.001). The association between statin therapy and hypertension control [odds ratio 1.94 (95% confidence interval 1.53–2.47)] in multivariable logistic regression was not significant after also controlling for antihypertensive therapy [1.29 (0.96–1.73)].

Conclusion:
Among adults with hypertension, statin-treated adults have lower BP and better control than statin-eligible untreated adults, which largely reflects differences in antihypertensive therapy.
Methylation-associated pathways in Macular Telangiectasia Type 2 and ophthalmologic findings in patients with genetic methylation disorders
Authors: Pauleikhoff Laurenz , Wingert Victoria , Grünert Sarah C. , Lange Clemens , Hannibal Luciana , Bucher Felicitas 
Published: January 2024

Purpose:
Serine (Ser) and glycine (Gly) levels were reported to differ between Macular telangiectasia type 2 (MacTel) patients compared to healthy controls. Since they are closely related to methylation metabolism, this report investigates methylation-associated metabolite (MAM) levels in MacTel patients and retinal changes in monogenetic methylation disorders.

Methods:
Prospective, monocentric study on MacTel patients and healthy controls the underwent a standardized protocol including a blood draw. MAM levels in plasma were determined using targeted quantitative metabolomics. Furthermore, patient records of cystathionine beta-synthase (CBS), methylenetetrahydrofolate reductase (MTHFR), and cobalamin C (MMACHC) deficiency were screened for reported retinal changes.

Results:
In total, 29 MacTel patients and 27 healthy controls were included. MacTel patients showed lower plasma Ser (p = 0.02 and p = 0.01) and Gly (p= 0.11 and p = 0.11) levels than controls. Principal component analyses revealed that MAM, especially homocysteine, contributed to a distinct clustering of MacTel patients. No retinal changes were seen in CBS (n=1) and MTHFR (n=2) deficiency, while two patients with MMACHC (n=4) deficiency displayed extensive macular dystrophy.

Conclusions:
MacTel patients show distinct clustering of MAM compared to controls. Of the three homocystinurias, only MMACHC resulted in macular dystrophy, possibly due to distinct compensatory pathways.
Pneumatic Retinopexy: Analysis of Risk Factors and Complications in 850 Cases
Authors: Erdoğdu Erdem , Kayıkçı Gülce , Aksoy Funda Ebru , Uygur Abdulkerim , Artunay Özgür 
Published: January 2024

Background:
To study out types and incidence of the complications and reveal the risk factors that affect anatomical and visual success of pneumatic retinopexy (PR) with a high number of rhegmatogenous retinal detachment (RRD) cases.

Methods:
Eight hundred and fifty eyes of the 837 patients who admitted at a tertiary center, between January 2015 and January 2022 for the diagnosis of RRD, then underwent PR and had at least 6th month follow-up, were included in the study. The multivariate logistic regression model was created to investigate the factors affecting anatomical and visual success.

Results:
The anatomical success rate was 53.4% with the first PR and 99.8% after subsequent procedures. Visual acuity of >0.4 LogMAR (<20/50 Snellen), proliferative vitreoretinopathy (PVR) and macular involvement were determined as significant preoperative risk factors for single operation and visual success in all univariate and multivariate analyses. In addition, pseudophakic/aphakic lens status was associated with single operation failure in all analyses. Besides, in all analyzes for single operation and visual success, new or missed tears, PVR, delayed subretinal fluid, macular hole and subretinal gas were identified as significant postoperative risk factors. Among these, new or missed tears was determined as the most common complication with a rate of 24%.

Conclusion:
There are many risk factors influencing the success of PR. These factors and complications should always be considered, before applying this rapid, effective, inexpensive and minimally invasive method.