bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Care Costs Following Anterior Cervical Discectomy and Fusion or Cervical Disc Arthroplasty
Authors: Nin Darren Z. , Chen Ya-Wen , Kim David H. , Niu Ruijia , Powers Andrew , Chang David C. , Hwang Raymond W. 
Published: January 2024

Study Design.
Observational cohort study.

Objective.
To describe the postoperative costs associated with both anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) in the two-year period following surgery.

Summary of Background Data.
CDA has become an increasingly common alternative to ACDF for the treatment of cervical disc disorders. Although a number of studies have compared clinical outcomes between both procedures, much less is known about the postoperative economic burden of each procedure.

Materials and Methods.
By analyzing a commercial insurance claims database (Marketscan, Merative), patients who underwent one-level or two-level ACDF and CDA procedures between January 1, 2017 and December 31, 2017 were identified and included in the study. The primary outcome was the cost of payments for postoperative management in the two-year period following ACDF or CDA. Identified postoperative interventions included in the study were: (i) physical therapy, (ii) pain medication, (iii) injections, (iv) psychological treatment, and (iv) subsequent spine surgeries.

Results.
Totally, 2304 patients (age: 49.0±9.4 yr; male, 50.1%) were included in the study. In all, 1723 (74.8%) patients underwent ACDF, while 581 (25.2%) underwent CDA. The cost of surgery was similar between both groups (ACDF: $26,819±23,449; CDA: $25,954±20,620; P=0.429). Thirty-day, 90-day, and two-year global costs were all lower for patients who underwent CDA compared with ACDF ($31,024 vs. $34,411, $33,064 vs. $37,517, and $55,723 vs. $68,113, respectively).

Conclusion.
Lower two-year health care costs were found for patients undergoing CDA compared with ACDF. Further work is necessary to determine the drivers of these findings and the associated longer-term outcomes.
Minimally Invasive Scarf Calcaneal Osteotomy is an Alternative Technique for the Correction of Progressive Collapsing Foot Deformity
Authors: Trojner Teodor , Cvetko Tomaž , Merc Matjaž 
Published: January 2024

Scarf calcaneal osteotomy is an extra-articular procedure to correct progressive collapsing foot deformity (PCFD). As an open approach may display wound healing problems, we herein report a novel method of percutaneously performed minimally invasive scarf calcaneal osteotomy. Twenty patients aged 56.75 ± 7.13 with grade 1AB of PCFD were included. A radiologic assessment was performed before the procedure and after 3 months. Clinical evaluation was done before the procedure, after 3 months, and after 12 months. The Manchester-Oxford Foot Questionnaire and Functional Foot Index score improved from 77.63 ± 11.67 preoperatively to 33.29 ± 18.55 at the follow-up (P < 0.001) and from 69.26 ± 16.32 preoperatively to 32.00 ± 20.35 at the follow-up (P < 0.001), respectively. There was a statistically significant improvement in all radiologic measurements, namely, talonavicular coverage angle from 20.03 ± 5.51 to 14.18 ± 6.49 (P < 0.001), the distance between medial cuneiform and fifth metatarsal from 0.53 ± 3.31 to 6.95 ± 4.01 (P < 0.001), anteroposterior talo-first metatarsal angle from 22.13 ± 7.28 to 17.09 ± 6.87 (P < 0.005), Meary angle from 25.12 ± 2.73 to 15.17 ± 7.06 (P < 0.001), calcaneal inclination angle from 12.23 ± 4.01 to 16.82 ± 5.53 (P < 0.001), navicular height from 15.57 ± 4.10 to 20.57 ± 6.87 (P < 0.005), and tibio-calcaneal angle from −3.79 ± 5.15 to 6.71 ± 4.41 (P < 0.001). In experienced hands, minimally invasive scarf calcaneal osteotomy seems to be an effective and reproducible subtalar preserving surgical technique for PCFD cases with mild midfoot abduction severity.

Level of Evidence:
Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.
Pharmacotherapy for opioid use disorder in pregnancy
Authors: Trammel Cassandra J. , Whitley Julia , Kelly Jeannie C. 
Published: January 2024

Purpose of reviewOpioid use disorder (OUD) in pregnancy has significantly increased in the last decade, impacting 8.2 per 1000 deliveries. OUD carries significant risk of morbidity and mortality for both the birthing person and neonate, but outcomes for both are improved with opioid agonist treatment (OAT). Here, we describe the recommended forms of OAT in pregnancy, updates to the literature, and alternate OAT strategies, and share practical peripartum considerations for patients on OAT.Recent findingsRecent studies comparing buprenorphine and methadone have reaffirmed previous findings that buprenorphine is associated with superior outcomes for the neonate, without clear differences in morbidity or mortality for the birthing person. Optimal initiation and dosing of OAT remains unclear, with several recent studies evaluating methods of initiation, as well as a potential role for higher and more rapid dosing in the fentanyl era. Alternative products such as buprenorphine-naloxone and extended-release buprenorphine are of significant research interest, though randomized prospective data are not yet available.SummaryBuprenorphine and methadone are standard of care for treatment of OUD during pregnancy, and multiple patient factors impact the optimal choice. Insufficient data exist to recommend alternative agents as a primary strategy currently. All patients with OUD in pregnancy should be counseled regarding OAT.Videohttp://links.lww.com/COOG/A94
Treatment Outcomes of Primary Combined Trabeculotomy With Trabeculectomy in Early Onset Glaucoma With Sturge-Weber Syndrome
Authors: Senthil Sirisha , Durgam Shravya Sri , Ali Hasnat , Pratinya Kolipaka Gowri , Krishnamurthy Rashmi , Mandal Anil K. 
Published: January 2024

Précis:
In eyes with Sturge-Weber syndrome (SWS) with early onset glaucoma, primary combined trabeculotomy with trabeculectomy (CTT) had a good intermediate-term success rate and minimal postoperative complications.

Design:
Retrospective cohort study.

Objective:
To report the intermediate-term outcomes of primary CTT in early onset glaucoma with SWS.

Patients and Methods:
This study included 49 eyes of 49 children (1997–2020) with SWS and early onset glaucoma who underwent primary CTT with at least 1-year postoperative follow-up. Success was defined as complete when intraocular pressure was >5 mm Hg and ≤16 mm Hg under general anesthesia or ≤21 mm Hg in the clinic without antiglaucoma medications (AGMs) and as qualified with AGM.

Results:
The median age (interquartile range) at CTT was 0.58 (0.19, 8.3) years. The median postoperative follow-up was 4.7 years (2.5, 9). The majority were male children (31/49, 63%). Epilepsy was noted in 7 (14.3%) and diffuse choroidal hemangioma in 17 children (35%). At diagnosis, 37 eyes(75%), had corneal edema, and the mean (±SD) horizontal corneal diameter was 12.8 ± 0.7 mm. Postoperatively, the median intraocular pressure decreased from 26 (22, 30) mm Hg to 16 (12, 20) mm Hg (P < 0.0001) and the median number of AGM reduced from 1 (0,1) to 0 (0,1; P < 0.01). Complete success probability of CTT was 86% (76, 96) at 1 year and 64% (49, 84) at 5 years. Qualified success was 98% (94, 100) at 1 year and 89% (78, 100) at 5 years. A larger cup-to-disk ratio (P < 0.005) was associated with a higher risk of surgical failure. Postoperative complications were noted in 9 eyes (18%), all resolved with conservative management except one eye with a retinal detachment that ended in phthisis bulbi.

Conclusion:
CTT as a primary procedure showed good long-term efficacy and safety in SWS with early onset glaucoma.
Opioid trends and risk factors for sustained use among children and adolescents in Israel: a retrospective cohort study
Authors: Tuttnauer Aviv , Atias Dor , Reznik Orly , Shomron Noam , Obolski Uri 
Published: January 2024

Abstract
Despite growing global concern over opioids, little is known about the epidemiology of opioid use in children and adolescents. This retrospective study investigated opioid use trends and identified risk factors associated with sustained opioid use among outpatient children and adolescents in Israel. Electronic health records of 110,955 children and adolescents were used to establish opioid purchase trends in outpatient settings between 2003 and 2021. Of these, data from 2012 to 2021, n = 32,956, were included in a Cox proportional hazards analysis to identify demographic, clinical, and pharmacological risk factors for sustained opioid use. An increase in opioid use was observed, with a notable rise among strong opioids, peripheral areas, and noncancer patients. Prevalence of sustained opioid users was approximately 2.5%. Risk factors with significant adjusted hazard ratios for sustained use included history of frequent doctor visits 1.82 (95% CI [1.50-2.22]) and drug purchases 1.30 (95% CI [1.07-1.58]), malignancy 1.50 (95% CI [1.07-2.09]), history of cardiovascular (1.44 (95% CI [1.04-1.98]) and pain-related conditions 1.34 (95% CI [1.14-1.58]), and different opioid substances (relative to codeine use): tramadol 2.38 (95% CI [1.73-3.27]), oxycodone 4.29 (95% CI [3.00-6.16]), and “other strong opioids” 6.05 (95% CI [3.59-10.2]). Awareness of observed increase in opioid purchases is crucial for doctors and public health practitioners. Additional monitoring and secondary prevention of children and adolescents possessing the identified risk factors should facilitate where appropriate reducing sustained opioid use when it is unnecessary.
Perceiving and Mentally Rotating Real and Artificial Hands
Authors: Duncan-Cross Isaac , Kyberd Peter , Poliakoff Ellen 
Published: January 2024

ABSTRACT

Introduction
In a hand laterality judgment task, participants determine whether rotated images depict a left or a right hand. It is believed that people use motor imagery (imagining their own body moving) to complete this task. This is evidenced by a biomechanical constraints effect (BCE), whereby people take longer to respond to hands shown at biologically awkward angles. It is unknown whether this extends to artificial hands. This study investigated whether prosthetic hands are processed differently when mentally manipulated, potentially due to their perceived eeriness.

Materials and Methods
In two online studies, participants completed a hand laterality judgment task containing real and artificial hands (realistic and mechanical prosthetics).

Results
All three hand types produced a BCE, evidencing motor imagery, although this was weaker in mechanical hands. Reaction time and slope (effect of angular rotation on reaction time) also varied between the hand types.

Conclusions
Our findings indicate that people use motor imagery to process artificial hands, although possible differences in processing between the hands should be followed up.

Clinical Relevance
Hand laterality judgment tasks could be used to further explore differences in how people process real and artificial hands. Future research might incorporate these tasks with users of prosthetic hands.
Different nursing interventions on sleep quality among critically ill patients: A systematic review and network meta-analysis
Authors: Huang Daijin , Li Yumei , Ye Jing , Liu Chang , Shen Dongyan , Lv Yunhui 
Published: January 2024

Background:
Critically ill patients in intensive care often struggle with disrupted sleep, a prevalent issue in this population. However, the question of which non-pharmacological intervention is most effective in enhancing sleep quality remains unanswered. This study was conducted to comprehensively evaluate and compare the efficacy of various non-pharmacological interventions aimed at improving sleep quality among critically ill individuals.

Methods:
We conducted a search of PubMed, Embase, and the Cochrane Library (Cochrane Central Register of Controlled Trials) without language restrictions to identify articles published until July 15, 2023. Randomized controlled trials (RCTs) that investigated various nursing interventions designed to improve sleep quality in critically ill patients were included in this network meta-analysis. All analyses were performed using R software (version 3.4.3) with the “gemtc” package.

Results:
A total of 2036 patients from 31 RCTs were included in the network meta-analysis, involving 11 different nursing interventions (routine care, relaxation combined with imagery (RI), nursel, music + earplugs + eye masks, music, eye masks, earplugs + eye masks, earplugs, aromatherapy, Warm footbath combined with acupoint exercise (WFA), Virtual reality meditation (VR)). Eye masks and earplugs + eye masks were associated with improved sleep quality compared to routine care intervention (P < .05).

Conclusions:
In summary, eye masks and earplugs + eye masks stand out as the most effective interventions for enhancing sleep quality in critically ill patients. Therefore, critical care nurses should consider incorporating the use of eye masks alone or combining music with eye masks into the sleep care regimen for critically ill patients.
Extracorporeal shock wave therapy for low back pain: A systematic review and meta-analysis
Authors: Wu Zhuorao , Zhou Tianqi , Ai Shuangchun 
Published: January 2024

Background:
To provide high-quality evidence for extracorporeal shock wave therapy (ESWT) for low back pain (LBP).

Methods:
A computerized search screened trials of ESWT for LBP, and the time range was from the establishment of databases to August 2023, including CNKI, CBMdisc, Wanfang Data, VIP, PubMed, Web of Science, Embase, and Cochrane databases. The outcomes were extracted, including patients’ pain, physical and psychological conditions, and adverse reactions. Meta-analysis was completed using Revman 5.4 and Stata 15 software, and GRADEpro software quantitated rate the evidence and assigned a recommendation strength.

Results:
This meta-analysis included 22 studies involving 1749 patients. After treatment, patients in the ESWT group had lower scores in the visual analog scale (VAS) (mean difference [MD] = −1.14, 95% confidence interval [CI] (−1.47, −0.80), P < .00001), Oswestry disability index (ODI) [MD = −6.01, 95%CI (−7.97, −4.05), P < .00001], and Beck depression inventory [MD = −3.89, 95%CI (−6.59, −1.20), P = .005]; finger-floor distance [MD = −3.71, 95%CI (−5.26, −2.17), P < .00001] was shorter; Japanese orthopedic association scores [MD = 3.20, 95%CI (1.56, 4.85), P = .0001] were higher; at the 3-month follow-up, the VAS [MD = −1.29, 95%CI (−2.39, −0.19), P = .02] and ODI [MD = −5.95, 95%CI (−10.06, −1.84), P = .005] remained lower; adverse reactions [odds ratio = 0.19, 95%CI (0.07, 0.52), P = .001] were less, and the valid cases [odds ratio = 3.84, 95%CI (2.47, 5.96), P < .00001] were more. Sensitivity analyses revealed that the results were stable; Egger test found no publication bias in VAS (P = .270) and valid cases (P = .747); the trim and fill analysis tested the robustness of ODI scores due to the publication bias (P = .029), and the effect sizes before and after the trim and fill were consistent, which means the result was robust.

Conclusion:
ESWT for LBP has efficacy and safety in improving pain, dysfunction, and psychological conditions compared to other therapies. ESWT has shown advantages in terms of long-term efficacy. Randomized controlled trials with larger sample sizes and more objective outcomes are required.
Acquired isolated factor VII deficiency in a patient with myxoid pleomorphic liposarcoma, case report
Authors: Aljabry Mansour , Aleid Manar , Almutairi Shahad , AlSerhani Reema , Alsahil Shahad , Alotaibi Ghazi 
Published: January 2024

Introduction:Acquired factor VII (FVII) deficiency is a rare condition with various causes, including acquired inhibitors to FVII, liver disease, and malignancies. Myxoid pleomorphic liposarcoma is a rare and aggressive form of soft tissue sarcoma that can cause a range of clinical manifestations, including bleeding and clotting disorders.Patient concerns and diagnosis:We present a case report of a 21-year-old man with severe acquired FVII deficiency due to mediastinal myxoid pleomorphic liposarcoma. The patient presented with elevated International normalized ratio (INR) and a severe reduction in FVII coagulant activity, unresponsive to conventional therapy. While an acquired inhibitor to FVII was initially suspected, negative results from laboratory testing, including protein G sepharose adsorption and a Bethesda assay using Immunoglobulin G purified from patient plasma, made the diagnosis of an acquired inhibitor to FVII uncertain.Interventions and outcome:The patient underwent surgical resection of the tumor, supported by recombinant FVII infusion, leading to the normalization of coagulation parameters. However, a relapse of the disease was detected 6 months later when he was noted to have a decline in FVII levels.Conclusion:This case highlights the importance of considering rare causes of bleeding and clotting disorders, particularly in unresponsive or atypical presentations. It also underscores the need for close monitoring and follow-up in patients with acquired FVII deficiency, even after successful treatment.
Neurosurgery for the rhinologist
Authors: Nizzola Mariagrazia , Leonel Luciano C.P.C. , Peris-Celda Maria 
Published: January 2024

Purpose of reviewThe purpose of this review is to provide a comprehensive anatomical appraisal of the neurosurgical anatomy exposed through the endonasal and paranasal sinuses routes, focusing on the most common expanded endonasal approaches (EEAs) as well as recent advances in this surgical field.Recent findingsThe EEAs are redefining the management of skull base pathology. Neurovascular structures previously considered a limitation, can be now approached through these surgical corridors. Advances in this field include the development of new surgical techniques and routes that allow better visualization and access to pathologies located in the ventral skull base. Understanding the surgical anatomy related to EEAs is essential not only for neurosurgeons but also for rhinologists.SummaryKnowledge of the surgical anatomy of the most common EEAs that utilize paranasal sinuses as a surgical corridor enables more effective management of complex skull base pathologies. Comprehensive anatomical knowledge of these corridors and the surrounding neurovascular structures is crucial to maximize benefits of EEAs and improve outcomes.
A 50-Year Review of Congressional Membership by Health Care Professionals: Is Surgical Representation Adequate?
Authors: Yau Alice , Lentskevich Marina A. , Yau Irene , Taritsa Iulianna , Ahmed Kaleem S. , Marlowe Teeba , Gosain Arun K. 
Published: January 2024

Summary:
Although 100% of congressional legislators vote on health care policy, only a minority have a background in health care. A review of the participation of health care professionals (HCPs) in Congress, highlighting participation by surgeons, is critical to the future policy-making endeavors in health care. This article seeks to better understand the characteristics of HCPs who engage in advocacy and describe the trends in their representation in Congress, with commentary on participation by surgeons and its impact on current health advocacy efforts.
A search of Congress.gov and the Biographical Directory of the United States Congress was performed to identify professional health care history for each congressperson, followed by review of official campaign websites for health advocacy work. Statistical analysis was performed using IBM SPSS Statistics Software for changes in representation of HCPs, physicians, and surgeons in Congress over time. Although there has been increasing representation of HCPs in Congress in the past 25 years, surgeons have the lowest increase in congressional membership. For health care reform to optimally address high costs, variable insurance coverage and reimbursement rates, and equal access to care, more physicians must make health care advocacy efforts an integral part of their careers. Incorporation of education in areas of health care advocacy and/or reform into undergraduate and graduate medical education curricula may help address deficiencies in knowledge of current health care–related events to further encourage involvement in health care legislation.
Photon-Counting Detector CT for Liver Lesion Detection—Optimal Virtual Monoenergetic Energy for Different Simulated Patient Sizes and Radiation Doses
Authors: Racine Damien , Mergen Victor , Viry Anaïs , Frauenfelder Thomas , Alkadhi Hatem , Vitzthum Veronika , Euler André 
Published: January 2024

ObjectivesThe aim of this study was to evaluate the optimal energy level of virtual monoenergetic images (VMIs) from photon-counting detector computed tomography (CT) for the detection of liver lesions as a function of phantom size and radiation dose.Materials and MethodsAn anthropomorphic abdominal phantom with liver parenchyma and lesions was imaged on a dual-source photon-counting detector CT at 120 kVp. Five hypoattenuating lesions with a lesion-to-background contrast difference of −30 HU and −45 HU and 3 hyperattenuating lesions with +30 HU and +90 HU were used. The lesion diameter was 5–10 mm. Rings of fat-equivalent material were added to emulate medium- or large-sized patients. The medium size was imaged at a volume CT dose index of 5, 2.5, and 1.25 mGy and the large size at 5 and 2.5 mGy, respectively. Each setup was imaged 10 times. For each setup, VMIs from 40 to 80 keV at 5 keV increments were reconstructed with quantum iterative reconstruction at a strength level of 4 (QIR-4). Lesion detectability was measured as area under the receiver operating curve (AUC) using a channelized Hotelling model observer with 10 dense differences of Gaussian channels.ResultsOverall, highest detectability was found at 65 and 70 keV for both hypoattenuating and hyperattenuating lesions in the medium and large phantom independent of radiation dose (AUC range, 0.91–1.0 for the medium and 0.94–0.99 for the large phantom, respectively). The lowest detectability was found at 40 keV irrespective of the radiation dose and phantom size (AUC range, 0.78–0.99). A more pronounced reduction in detectability was apparent at 40–50 keV as compared with 65–75 keV when radiation dose was decreased. At equal radiation dose, detection as a function of VMI energy differed stronger for the large size as compared with the medium-sized phantom (12% vs 6%).ConclusionsDetectability of hypoattenuating and hyperattenuating liver lesions differed between VMI energies for different phantom sizes and radiation doses. Virtual monoenergetic images at 65 and 70 keV yielded highest detectability independent of phantom size and radiation dose.