bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration and Magnitude of Opioid Use After Minimally Invasive Sacroiliac Joint Fusion
Authors: Benson Dillon , Litvak Audrey , Zhang Douglas , Johnson Christopher , El Dafrawy Mostafa , Lee Michael 
Published: December 2023

Study Design.
Retrospective cohort study performed in a nationwide insurance claims database.

Objective.
To evaluate the duration and magnitude of post-operative opioid prescriptions after minimally invasive surgical sacroiliac joint fusion (MIS SIJF) as compared to other common spine surgeries.

Summary of Background Data.
MIS SIJF has been reported to significantly improve quality of life and reduce pain. However, there is a paucity of reported data on post-operative opioid use in patients undergoing MIS SIJF for sacroiliac joint dysfunction.

Methods.
A nationwide insurance claims database was queried to identify 4,666 patients who underwent MIS SIJF. Patients were stratified by pre-operative opioid use: Opioid naïve, sporadic use, or chronic use were respectively defined as 0,1, or≥2 opioid prescriptions filled within 6 months prior to surgery. Duration of opioid use was defined by the time between MIS SIJF and last opioid prescription filled while magnitude of opioid use was determined by milligram morphine equivalents filled by 30 days post-operation. This opioid use data was compared to that of other common spine surgeries.

Results.
Patients undergoing MIS SIJF continued to fill opioid prescriptions 1-year post-operatively at significantly higher proportions than those undergoing other common spine procedures assessed by prior literature within each of the pre-operative opioid use cohorts (chronic: 73% vs. 49-62%; P<0.0001, sporadic: 39% vs. 23-28%; P<0.0001, opioid naïve: 22% vs. 15-18%; P<0.0001). Chronic users filled the highest opiate dosages during the 30-day post-operative period, filling on average 64.75 MME/d compared to 19.75 MME/d and 24.25 MME/d by the opioid naïve and sporadic users, respectively.

Conclusion.
After MIS SIJF, opioid naïve patients use fewer opioids and for a shorter period of time compared to patients with sporadic or chronic pre-operative opioid use. MIS SIJF may result in less effective pain reduction when compared to other common spine surgeries evaluated via identical methodology.

Level of Evidence:
3
Low-Density Lipoprotein Cholesterol and Statin Usage Are Associated With Rates of Pseudarthrosis Following Single-Level Posterior Lumbar Interbody Fusion
Authors: Lavu Monish S. , Eghrari Nafis B. , Makineni Pratheek S. , Kaelber David C. , Savage Jason W. , Pelle Dominic W. 
Published: December 2023

Study design.
Retrospective cohort study.

Objective.
To investigate the relationships of low-density lipoprotein cholesterol and statin usage with pseudarthrosis following single-level posterior or transforaminal lumbar interbody fusion (PLIF/TLIF).

Summary of background data.
Hypercholesterolemia can lead to atherosclerosis of the segmental arteries, which branch into vertebral bone through intervertebral foramina. According to the vascular hypothesis of disc disease, this can lead to ischemia of the lumbar discs and contribute to lumbar degenerative disease. Yet, little has been reported regarding the effects of cholesterol and statins on the outcomes of lumbar fusion surgery.

Materials and Methods.
TriNetX, a global federated research network, was retrospectively queried to identify 52,140 PLIF/TLIF patients between 2002 and 2021. Of these patients, 2137 had high cholesterol (≥130 mg/dL) and 906 had low cholesterol (≤55 mg/dL). Perioperatively, 18,275 patients used statins, while 33,415 patients did not. One-to-one propensity score matching for age, sex, race, and comorbidities was conducted to balance the analyzed cohorts. The incidence of pseudarthrosis was then assessed in the matched cohorts within the six-month, one-year, and two-year postoperative periods.

Results.
After propensity score matching, high-cholesterol patients had greater odds of developing pseudarthrosis six months [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.28–2.33], one year (OR: 1.59, 95% confidence interval (CI): 1.20–2.10), and two years (OR: 1.57, 95% CI: 1.20–2.05) following a PLIF/TLIF procedure. Patients with statin usage had significantly lower odds of developing pseudarthrosis six months (OR: 0.74, 95% CI: 0.69–0.79), one year (OR: 0.76, 95% CI: 0.71–0.81), and two years (OR: 0.77, 95% CI: 0.72–0.81) following single-level PLIF/TLIF.

Conclusions.
The findings suggest that patients with hypercholesterolemia have an increased risk of developing pseudarthrosis following PLIF/TLIF while statin use is associated with a decreased risk. The data presented may underscore an overlooked opportunity for perioperative optimization in lumbar fusion patients, warranting further investigation in this area.
Anterior Chest Wall Reconstruction After Separation of Thoraco-Omphalopagus Conjoined Twins With Cadaveric Rib Grafts and Omental Flap
Authors: Hashemi Ammar S.A. , Gimenez Alejandro , Yim Nicholas , Bay Caroline , Grush Andrew E. , Heinle Jeffrey S. , Buchanan Edward P. 
Published: December 2023

Background
Anterior chest wall defects have a wide range of etiologies in the pediatric population, ranging from infection, tumor, and trauma to congenital diseases. The reconstructive goals include restoring skeletal stability, obliterating dead space, preserving cardiopulmonary mechanics, and protecting vital underlying mediastinal organs. Although various reconstructive methods have been described in the literature, selecting the optimal method is challenging for the growing pediatric skeleton. Here, we report a case of previously thoraco-omphalopagus twins who underwent successful separation and reconstruction and presented for definitive anterior chest wall reconstruction.

Methods
A pair of previously thoraco-omphalopagus conjoined twins underwent definitive anterior chest wall defect reconstruction using cadaveric ribs and omental flap. Twin A received 2 cadaveric ribs, whereas twin B had a much larger sternal defect that required 3 cadaveric ribs combined with an omental flap for soft tissue chest coverage. Both twins were followed up for 8 months.

Results
Twin A's postoperative course was uneventful, and she was discharged on postoperative day 6. Twin B's course was complicated, and she was discharged on supported ventilation on postoperative day 10. At 8 months postoperatively, both twins healed well, and chest radiographs confirmed the stability of the chest reconstructions. The rib grafts in the twin with a tracheostomy were not mobile, and the patient had a solid sternum with adequate pulmonary expansion. The construct initially did not facilitate pulmonary functioning, but after a healing process, it eventually allowed for the twin with the tracheostomy who required pulmonary assistance to no longer need this device.

Conclusions
Cryopreserved cadaveric ribs and omental flaps offer safe and reliable reconstructive methods to successfully reconstruct congenital anterior chest wall skeletal defects in the growing pediatric population. The involvement of multidisciplinary team care is key to optimizing the outcomes.
Use of Questionnaire-Based Research in Hand Surgery
Authors: Wu-Fienberg Yuewei , Rousseau Morgan Ansley , Mitchell Scott 
Published: December 2023

Introduction
Questionnaire-based research is ubiquitous, and careful survey design is paramount to obtaining meaningful results. This study characterizes the use of questionnaire-based studies in the current hand surgery literature.

Methods
We conducted a systematic review of questionnaire-based studies published between 2010 and 2020 in 4 major American journals. We included studies in which questionnaire results represented a primary outcome. Validation status of the survey instruments was assessed, and topics of study were categorized. Nonvalidated instruments were assessed for reporting of parameters to limit bias.

Results
Three hundred fifty-four studies were identified, including 186 (52.5%) using validated instruments, 98 (27.7%) using nonvalidated instruments, 64 (18.1%) using a combination, and 6 (1.7%) that sought to validate an instrument. Of the studies that used validated instruments, 84.9% focused on patient-reported outcomes and 15.1% focused on other patient-centered topics. In contrast, of studies that used nonvalidated instruments, 44.9% focused on physician practice, 30.6% were patient centered, and 13.3% focused on education. Among nonvalidated questionnaires, 74.5% did not report predistribution testing, 49.0% did not publish full survey questions, and 33.3% did not report response rates.

Conclusions
Survey research is common in the hand surgery literature. Forty-six percent of examined studies included at least some nonvalidated elements. Techniques to limit bias in the design and reporting of studies based on nonvalidated surveys were not uniformly disclosed. Identified areas for improvement include (1) pilot testing to assess for question clarity; (2) publication of full texts to improve transparency; and (3) better reporting on sample selection, respondents, and nonrespondents.
Acromiothoracic Venous Supercharge for Abdominal-Based Free Flaps in Breast and Chest Wall Reconstruction
Authors: Alsharkawy Kareem , Youssif Sherif , Malahias Marco , Filobbos George , Kalkat Maninder , Khalil Haitham 
Published: December 2023

Background
Supercharging the venous drainage of free abdominal flaps in breast reconstruction has been well described in the literature, with diverse options used to augment venous drainage. In this study, we present our experience in using the acromiothoracic vein (ATV)/thoracoacromial vein (TAV) as a secondary recipient vein for the superficial inferior epigastric vein (SIEV) of free, muscle-sparing transverse rectus abdominis myocutaneous flaps in breast and chest wall reconstruction.

Patients and Methods
We retrospectively reviewed 523 free, muscle-sparing transverse rectus abdominis myocutaneous flaps the senior author (H.H.K.) performed between 2009 and 2022 for breast and chest wall reconstruction; 46 cases required venous super drainage. Seventeen patients had ipsilateral SIEV anastomosed into the second internal mammary vein, 5 had ipsilateral SIEV anastomosed into flap second deep inferior epigastric vein, and 24 required the use of the (ATV)/(TAV), which will be the focus of this study.

Results
The study included 24 female (20 breast and 4 chest wall reconstruction) patients ranging in ages between 39 and 72 years. They had a median follow-up of 26 months. Combined muscle splitting and cutting techniques were used to expose the ATV/TAV. Increase in operative time ranged between 10 and 20 minutes (median, 12 minutes). Vein coupler sizes were 1.5 to 3 mm. The mean weight of the flap was 740 g (range, 460–1300 g). There was 1 flap failure (salvage with latissimus dorsi flap performed), whereas 23 flaps wholly survived.

Conclusions
The ATV/TAV is a suitable recipient for venous supercharging free flaps used to reconstruct breast and chest wall defects.
Endothelial Cell Calcium Influx Mediates Trauma-induced Endothelial Permeability
Authors: Schaid Terry R. , Mitra Sanchayita , Stafford Preston , DeBot Margot , Thielen Otto , Hallas William , Cralley Alexis , Gallagher Lauren , Jeffrey Danielle , Hansen Kirk C. , D’Alessandro Angelo , Silliman Christopher C. , Dabertrand Fabrice , Cohen Mitchell J. 
Published: December 2023

Objective:
We aimed to investigate if ex vivo plasma from injured patients causes endothelial calcium (Ca2+) influx as a mechanism of trauma-induced endothelial permeability.

Summary Background Data:
Endothelial permeability after trauma contributes to post-injury organ dysfunction. While the mechanisms remain unclear, emerging evidence suggests intracellular Ca2+ signaling may play a role.

Methods:

Ex vivo plasma from injured patients with “Low Injury/Low Shock” (injury severity score [ISS]<15, base excess [BE])≥-6mEq/L) and “High Injury/High Shock” (ISS≥15, BE<-6mEq/L) were used to treat endothelial cells. Experimental conditions included Ca2+ removal from the extracellular buffer, cyclopiazonic acid pre-treatment to deplete intracellular Ca2+ stores, and GSK2193874 pre-treatment to block the TRPV4 Ca2+ channel. Live cell fluorescence microscopy and ECIS were used to assess cytosolic Ca2+ increases and permeability, respectively. Western blot and live cell actin staining were used to assess myosin light chain (MLC) phosphorylation and actomyosin contraction.

Results:
Compared to Low Injury/Low Shock plasma, High Injury/High Shock induced greater cytosolic Ca2+ increase. Cytosolic Ca2+ increase, MLC phosphorylation, and actin cytoskeletal contraction were lower without extracellular Ca2+ present. High Injury/High Shock plasma did not induce endothelial permeability without extracellular Ca2+ present. TRPV4 inhibition lowered trauma plasma-induced endothelial Ca2+ influx and permeability.

Conclusions:
This study illuminates a novel mechanism of post-injury endotheliopathy involving Ca2+ influx via the TRPV4 channel. TRPV4 inhibition mitigates trauma-induced endothelial permeability. Moreover, widespread endothelial Ca2+ influx may contribute to trauma-induced hypocalcemia. This study provides the mechanistic basis for the development of Ca2+-targeted therapies and interventions in the care of severely injured patients.
Entrepreneurial intentions among university students: the role of mentoring, self-efficacy and motivation
Authors: Al Issa Hussein-Elhakim 
Published: December 2023

PurposeThis research examines whether mentoring is a predictor of entrepreneurial intentions. It also explores how intent translates into action through implementation intentions. The study tests if the mentoring-intentions association is mediated by self-efficacy. The potential moderating effect of achievement motivation on the relationship was also investigated.Design/methodology/approachPLS-SEM was used to test the hypotheses of the 242 valid responses collected from final-year students from Libyan public universities.FindingsResults show that self-efficacy partially mediated the mentoring-intentions association, while motivation negatively moderated the relationship. Entrepreneurial intentions had a significantly strong effect on implementation intentions.Research limitations/implicationsThe results verify mentoring as a practical socializing instructional approach. Therefore, universities should implement structured mentoring programs, offering emotional guidance, counsel and networking opportunities. Also, mentors should undergo training, and progress tracking is essential for improvement.Originality/valueExamining entrepreneurial self-efficacy as a mediator and achievement motivation as a moderator in the mentoring-intentions association is unprecedented. The findings narrow the search for antecedents to entrepreneurial intentions and pinpoint intervention points.
Education networks for deeper learning
Authors: Gatz Erin , Akiva Tom 
Published: December 2023

PurposeThis study focuses on a regional education network in the Mid-Atlantic that aims to facilitate equitable learning practices by providing ongoing teacher/leader support, cross-sector collaboration and professional learning for educators. The authors probe networks as providing core support for systems level change and serving as precursors to the community engagement that is essential for deeper learning. Specifically, this study is driven by the hypotheses that (1) deeper learning may be supported by pathways for students and educators to meaningfully engage with the local community; (2) deeper learning is more likely to happen when educators connect to communities beyond their own school or organization and (3) education networks can help facilitate those functions.Design/methodology/approachThe authors aimed to understand how participation in an education network influenced members (which include school leaders, teachers and leaders of youth programs) and how experiences might differ by level of participation. The authors conducted interviews with individuals across three groups of adults (n = 111 total): core members (n = 16), members with mid-level engagement (n = 30) and peripheral members (n = 65).FindingsEducators who participated most intensely and deeply described the network as a vehicle for learning about and advancing equity through specific practices including individualized learning, increasing access and resource redistribution. Mid-level participants emphasized the professional network building function of the network. For peripheral or new participants, the most salient function of the network was celebration of education and educators. These findings suggest that education networks have a role in strengthening the structures that support leaders to make deeper learning happen.Research limitations/implicationsMore research is needed on how participants move from the periphery to more core involvement in education networks, where they may gain the full benefits of participation. Further research is also needed to explore the link between education network engagement among school leaders and the deeper learning environments in schools.Originality/valueResearch on education networks is limited. To the authors' knowledge, the present study is one of the largest collections and analyses of interviews with education network members to date. The authors present education network engagement as a precursor for community embedded deeper learning in schools.
Deeper learning and leadership development in a school–university partnership with a rural district
Authors: Williams Leslie Ann , Atkinson Linda , Dean Sharon , McCarty Tracy Watts , Mathews Emmett , Jaques-McMillin Shelley 
Published: December 2023

PurposeTo meet the needs of under-resourced, rural schools where teacher attrition is high, this case study examined how a school–university partnership strengthened teacher and leader abilities to support deeper learning for students.Design/methodology/approachThis research focused on a 17-year collaborative partnership between one rural school district and a university research and outreach organization to develop deeper learning experiences for students through shared and supportive leadership and learning of teachers and leaders. The researchers utilized documents, field notes and interviews with administrators to validate the data.FindingsThe study’s findings suggest that participation in authentic, researched-based professional development through the partnership improved the skills of leaders and teachers to support deeper learning for students. This partnership heightened teacher and leader capacity to promote and support continued change and sustainability.Originality/valueThis case study explored how one university center collaboratively engaged with a district by sharing research and strategies to support the development of leaders and teachers to create deeper learning for students. Through these experiences, the district evolved its deeper learning system and improved its organizational effectiveness, leadership development and learning for all.
Sugar‐free aerated chocolate: Production, investigation of bubble features using X‐ray computed tomography and image processing
Authors: Sarfarazi Messiah , Mohebbi Mohebbat , Saadatmand‐Tarzjan Mahdi , Mirshahi Ali 
Published: December 2023

AbstractIn contrast to other imaging techniques, X‐ray imaging does not destruct the internal structure of the sample being imaged. Furthermore, this technique is able to capture numerous images of the sample at a low slice thickness, which is almost impossible in other imaging techniques. In this study, sugar was replaced with inulin:maltodextrin mixtures at ratios of 25:75 (i25), 50:50 (i50), and 75:25 (i75). Then, nitrogen (N2) and carbon dioxide (CO2) were injected into the three mixtures as well as the sugar‐containing sample (control) at pressures of 3, 4.5, and 6 bar to produce aerated chocolate. The images of the samples were captured using X‐ray computed tomography (XCT). After processing, they were segmented using the Chan–Vese model. Image segmentation showed that the Chan–Vese method, compared with adaptive thresholding, was more able to segment the images and remove the noise. The bubble total volume (10440 ± 9206 mm3) and average diameter (1.30 ± 0.10 mm) of the control were larger than those of the other samples. The results also demonstrated that the sugar‐free aerated samples had lower hardness than the corresponding unaerated ones. However, it was reversed in the case of the control. This research sheds light on the industrialization of the production of aerated chocolate and the application of XCT and image processing in the analysis of the microstructure of aerated products.
Strategies to improve the postharvest management of flat oyster (Ostrea edulis) from aquaculture using the short‐term storage and package in an innovative closed‐circuit system
Authors: Rusco Giusy , Di Iorio Michele , Felici Alberto , Galosi Livio , Iaffaldano Nicolaia , Roncarati Alessandra 
Published: December 2023

AbstractThis study aimed to improve postharvest management of flat oysters reared in a longline system in the mid Adriatic Sea, using short‐term storage and package in an innovative closed‐circuit system. For the trial, 870 oysters were employed, divided into three experimental groups (A, B, and C), N = 270 oysters each group, whereas the remaining 60 oysters were used for the 2 controls. Each group differed in relation to the time spent in the depuration tank and the time of packaging: group A was packed and immediately transferred to the cell; group B was depurated in a tank for 48 h, then packed and transferred to the cell; group C was depurated in a tank for 48 h and then packed, depurated for another 24 h and transferred to a cell. Samples of each group were sampled at different times of permanence in cell (t0) up until 12 days (t12) for biomorphometric, sensorial, nutritional, and microbiological analysis. Although the nutritional and sensorial quality of the oysters was more pronounced in group A, B and C groups also showed good results. In these two groups, thanks to the use of the modern water recirculation system the quality and safety of oysters was improved by reducing the presence of sludge and eliminating fecal contaminants completely than A treatment and seawater control. These results were also confirmed by the tank control, where a more extended depuration period positively influenced the same parameters emphasizing the importance of the adequate depuration processes in oyster production.