bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Brief Screening and Assessment Tool for Opioid Use in Adults: Results from a Validation Study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool
Authors: Bunting Amanda M. , Schwartz Robert P. , Wu Li-Tzy , Wahle Aimee , Kline Margaret , Subramaniam Geetha , McNeely Jennifer 
Published: February 2023

Objectives
This secondary analysis evaluated opioid-specific validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substances (TAPS) tool for screening in primary care.

Methods
This study is a secondary data analysis of the TAPS validation study. Performance of the TAPS tool for screening for unhealthy opioid use (with a score of 1+ for heroin and/or prescription opioids representing a positive screen) was evaluated. Discriminative ability was examined in comparison with reference standard measures across the spectrum of unhealthy opioid use: timeline follow-back with and without oral fluid testing identifying past-month use and the modified Composite International Diagnostic Interview for past-year problem use, opioid use disorder (OUD), and moderate-severe OUD.

Results
In a sample of 2000 primary care patients, 114 screened positive for opioids on the TAPS tool. With a TAPS cutoff equal to 1+, the TAPS accurately identified past-month use, problem use, any OUD, and moderate-severe OUD (sensitivities = 68%–85%, specificities = 97%–98%, area under the curve = 0.80–0.91). When past-month use was expanded to include timeline follow-back with oral fluid testing, accuracy declined (52% sensitivity [95% confidence interval, 43%–60%], 98% specific [95% confidence interval, 97%–98%]).

Conclusions
While further testing in a larger population sample may be warranted, given their brevity, simplicity, and accuracy when self-administered, the TAPS opioid items can be used in primary care settings for a spectrum of unhealthy opioid use; however, self-disclosure remains an issue in primary care settings.
Hooks Versus Pedicle Screws at the Upper Instrumented Level
Authors: Colantonio Donald F. , Le Anthony H. , Pisano Alfred J. , Chung Joon M. , Wagner Scott C. , Fredericks Donald R. , Roach William B. , Schlaff Cody , Dill Andrew , Mauntel Timothy C. , Hendershot Brad D. , Helgeson Melvin D. 
Published: February 2023

Study Design.
Controlled laboratory study.

Objective.
The aim was to compare motions at the upper instrumented vertebra (UIV) and supra-adjacent level (UIV+1) between two fixation techniques in thoracic posterior spinal fusion constructs. We hypothesized there would be greater motion at UIV+1 after cyclic loading across all constructs and bilateral pedicle screws (BPSs) with posterior ligamentous compromise would demonstrate the greatest UIV+1 range of motion.

Summary of Background Data.
Proximal junctional kyphosis is a well-recognized complication following long thoracolumbar posterior spinal fusion, however, its mechanism is poorly understood.

Materials and Methods.
Twenty-seven thoracic functional spine units were randomly divided into three UIV fixation groups (n=9): (1) BPS, (2) bilateral transverse process hooks (TPHs), and (3) BPS with compromise of the posterior elements between UIV and UIV+1 (BPS-C). Specimens were tested on a servohydraulic materials testing system in native state, following instrumentation, and after cyclic loading. functional spine units were loaded in flexion-extension (FE), lateral bending, and axial rotation.

Results.
After cyclic testing, the TPH group had a mean 29.4% increase in FE range of motion at UIV+1 versus 76.6% in the BPS group (P<0.05). The BPS-C group showed an increased FE of 49.9% and 62.19% with sectioning of the facet joints and interspinous ligament respectively prior to cyclic testing.

Conclusion.
BPSs at the UIV led to greater motion at UIV+1 compared to bilateral TPH after cyclic loading. This is likely due to the increased rigidity of BPS compared to TPH leading to a “softer” transition between the TPH construct and native anatomy at the supra-adjacent level. Facet capsule compromise led to a 49.9% increase in UIV+1 motion, underscoring the importance of preserving the posterior ligamentous complex. Clinical studies that account for fusion rates are warranted to determine if constructs with a “soft transition” result in less proximal junctional kyphosis in vivo.
Thoracolumbar Sagittal Shape Varies with Pelvic Morphology and Aging
Authors: Prost Solène , Charles Yann-Philippe , Ilharreborde Brice , Riouallon Guillaume , Pesenti Sébastien , Blondel Benjamin ,   On behalf of the French Spine Surgery Society (SFCR)
Published: February 2023

Study Design.
Retrospective study of a multicenter prospective database.

Objective.
To determine the organization and correlations between different spinal segments according to pelvic incidence and age.

Summary of Background Data.
When planning surgery for correction of adult spinal deformities, considering lumbar lordosis (LL) as a uniform segment is an approximation that can lead to planning errors.

Methods.
Radiographs of 1540 subjects were analyzed and divided into 3 pelvic incidence (PI) groups: low <45 , intermediate 45-60, high > 60 and stratified by age (<45 y, 45-70, and >70). The different segments of L1-L4 proximal lumbar lordosis (PLL), L4-S1 distal lumbar lordosis (DLL), and T10-L1 thoracolumbar junction (TLJ) were analyzed.

Results.
The mean age was 53.5 years (SD=17, min=20, max=93). There was a significant correlation between thoracic kyphosis T5-T12 and TLJ segment T10-L1 (R =0.581, P<0.001). Only the L1-L4 PLL segment correlated with PI (R =0.47, P<0.001).The T10-L1 TLJ segment was constant regardless of age or PI groups considered (mean =−8, SD=9). PLL did not vary with aging but differed according to PI. The DLL showed significant differences between age and PI groups but without significant correlation between PI and DLL.

Conclusion.
Pelvic morphology is known to determine the curvatures of the spine, however, the distribution of lumbar lordosis is not homogeneous. Our study provided a normative value reference and showed that T10-L1 is constant regardless of the age or the pelvic incidence.

Level of Evidence.
3
The effects of leadership for self-worth, inclusion, trust, and psychological safety on medical error reporting
Authors: Brimhall Kim C. , Tsai Chou-Yu , Eckardt Rory , Dionne Shelley , Yang Biying , Sharp Adam 
Published: February 2023

Background
Although trust and psychological safety (PS) are critical for improving patient safety and medical error reporting, little is known about how they work together and how health care systems promote PS.

Purpose
This study examined how leadership for self-worth, inclusion, and trust may work together to foster PS and how this influences medical error reporting.

Approach
Data were collected in 2019 from 373 employees (24% response rate) in 85 hospital departments (54% response rate) in a nonprofit health care system in the eastern United States. Constructs were operationalized at the department level.

Results
Negative binomial path model results found several direct effects. Leadership for self-worth was positively associated with inclusion, inclusion was positively associated with trust and PS, trust was positively associated with reported medical errors, and PS was negatively associated with reported medical errors. Indirect effects uncovered leadership for self-worth was positively associated with PS by enhancing inclusion. In addition, leadership for self-worth increased inclusion, which increased trust and ultimately encouraged PS. Leadership for self-worth was associated with fewer reported medical errors through increasing inclusion, trust, and PS.

Practical Implications
Trust encourages the formal reporting of medical errors whereas PS encourages learning from mistakes and improving care to reduce future errors (and consequently the number of reported errors). Leaders who understand employees’ unique needs, express confidence in employees’ abilities, and encourage employees to share their ideas, create inclusive and trusting work environments that encourage PS and ultimately help reduce reported medical errors.
Managing safety in perioperative settings
Authors: Brooks Joanna Veazey , Nelson-Brantley Heather 
Published: February 2023

Background
Perioperative nursing units are described as one of the most challenging practice environments, characterized by a distinct hierarchal culture and rapid pace. These dynamics create challenges for creating a culture of safety, where meso-level nurse leaders (MLNLs) must operate in the space between the micro level of direct patient care and the macro-level administrative priorities.

Purpose
Guided by complexity leadership theory, we sought to understand the strategies MLNLs used to facilitate a culture of safety in perioperative settings.

Methodology
A qualitative descriptive study with semistructured interviews was conducted. Inductive thematic analysis was used to analyze content from the interviews, and several techniques (audit trail, reflexivity, peer debriefing) were used to ensure rigor.

Results
Seventeen MLNLs completed an interview, and analysis identified four strategies that MLNLs reported to foster safety as meso-leaders in perioperative environments: (a) recognizing the unique perioperative management environment, (b) learning not to take interactions personally, (c) developing “super meso-level nurse leader” skills, and (d) appealing to policies and patient safety.

Conclusion
Perioperative environments require MLNLs to use multifaceted strategies to keep the peace among many stakeholders and foster patient safety.

Practice Implications
Our study shows how clear organizational policies and procedures can serve as a vital tool—moving attention away from a feeling of individual “policing” and toward joint discussion about shared patient safety goals—and ultimately support MLNLs in challenging perioperative work environments. Perioperative environments create unique challenges, and organizations should consider perioperative-specific leadership training to prepare MLNLs for these roles.
Descemet Membrane Endothelial Patching: Selective Endothelial Replacement in Eyes With Localized Endothelial Dysfunction
Authors: García-Onrubia Luis , Stanojcic Nick , Bhogal Maninder 
Published: February 2023

Abstract:
Descemet membrane (DM) endothelial keratoplasty is considered the gold standard for treating corneal endothelial decompensation and is a true like-for-like replacement. Not all causes of endothelial dysfunction are global, with conditions such as viral endotheliitis affecting discrete populations of endothelial cells. In this study, endothelial grafts matching the area of dysfunction were produced to preserve healthy host cells and limit the immunological burden of new grafts. We have termed this modified DM endothelial keratoplasty procedure DM endothelial patching.
Rotational stability of a new toric intraocular lens with an advanced optical profile
Authors: Zeilinger Johannes , Hienert Julius , Ruiss Manuel , Pilwachs Caroline , Findl Oliver 
Published: February 2023

Purpose:
To examine the rotational stability of a new toric intraocular lens (IOL), the TECNIS Eyhance Toric II, over a course of 3 months.

Setting:
Vienna Institute for Research in Ocular Surgery, Hanusch Hospital, Vienna, Austria.

Design:
Prospective unmasked single-center study.

Methods:
50 eyes of 50 patients with cataract and regular corneal astigmatism ≥0.75 diopters (D) were included. The TECNIS Eyhance Toric II IOL was implanted in 1 eye of each study patient. Images of the alignment axis of the IOL were taken intraoperatively, as well as at 1 hour, 1 week, and 3 months postoperatively. For the measurement of toric IOL rotation, images were superimposed on the basis of ocular landmarks. Uncorrected and corrected distance (4 m) and intermediate (66 cm) visual acuities were assessed at the 3-month visit.

Results:
There was no significant difference in the rotational position between the intraoperative and 3 month timepoints, with a mean rotation of 1.34 ± 1.46 degrees, in 27 examined eyes. (P = 0.313). No patients had to undergo repositioning of the toric IOL. A significant reduction of refractive cylinder occurred from preoperatively 1.8 ± 1.1 to 0.40 ± 0.42 D at the 3-month visit (P = .001; n = 43). The corrected distance visual acuity improved significantly from 0.28 ± 0.16 logMAR preoperatively to −0.01 ± 0.13 logMAR at 3 months postoperatively (P = .001; n = 43).

Conclusions:
The TECNIS Eyhance Toric II showed a good visual performance with no significant rotation over a course of 3 months and, therefore, an excellent rotational stability. The intraocular lens showed a good safety profile with no adverse events.
The safety and cost-analysis of simultaneous versus staged bilateral total knee arthroplasty in a Taiwan population
Authors: Chou Te-Feng Arthur , Ma Hsuan-Hsiao , Tsai Chi-Wu , Tsai Shang-Wen , Chen Cheng-Fong , Chiu Fang-Yao , Wu Po-Kuei , Chen Wei-Ming 
Published: February 2023

Background:
In patients with advanced osteoarthritis (OA) of the bilateral knees, uncertainty remains as to whether simultaneous bilateral total knee arthroplasty (SiTKA) or staged TKA (StTKA) is the treatment of choice. The purpose of this study was to investigate the safety and relative cost of SiTKA vs StTKA in Taiwan patients.

Methods:
Using the Big Data Center of Taipei Veterans General Hospital, we retrospectively reviewed all patients who underwent SiTKA or StTKA due to OA or spontaneous osteonecrosis of the knee from January 2011 to December 2016. We assessed length of stay, transfusion rate, early postoperative complications, 30- and 90-day readmission rate, 1-year reoperation rate, and the indication for reoperation. Furthermore, we analyzed the total cost of the two groups, including reimbursement from the national health insurance (NHI), cost of the procedures, and net income from each case.

Results:
A total of 2016 patients (1565 SiTKA and 451 StTKA) were included in this study. The two groups had no significant differences in rates of complications, 30- and 90-day readmission, or 1-year reoperation. The length of stay was on average 5.0 days longer for StTKA (p < 0.01). In terms of cost, all categories of medical costs were significantly lower for SiTKA, while the net hospital income was significantly higher for StTKA.

Conclusion:
SiTKA is a safe and cost-effective surgery. Both SiTKA and StTKA have similar rates of postoperative complications, readmission and reoperation, but SiTKA significantly reduces medical expenses for both the patient and the NHI.
Effects of Meditation Intervention on Self-management in Adult Patients With Type 2 Diabetes
Authors: Heo Seongkum , Kang JungHee , Umeakunne Erica , Lee Sohye , Bertulfo Tara F. , Barbé Tammy , Kim JinShil , Black Vicki , An Minjeong , Randolph Justus 
Published: February 2023

Background
Diabetes complications are prevalent and cause adverse effects on the physical, psychological, and economic status of adult patients with type 2 diabetes. Meditation may positively affect self-management and, in turn, reduce diabetes complications. However, the systematic examination of the effects of meditation without additional components on self-management in this population have been rarely examined.

Purpose
The aim of this study was to examine the effects of meditation interventions on self-management (ie, control of glucose, blood pressure, cholesterol, and obesity and self-management) among adult patients with type 2 diabetes in randomized controlled trials.

Methods
In this systematic review and meta-analysis, 6 electronic databases were searched using major keywords of meditation, diabetes, and self-management during March 2022.

Results
Eight studies (9 articles) using mindfulness-based meditation were included. The meta-analysis showed that meditation improved hemoglobin A1c (effect size = −0.75; 95% confidence interval, −1.30 to −0.21; P = .007) but not fasting blood glucose. Only a few studies examined meditation effects on other types of self-management (eg, blood pressure, body mass index, cholesterol, diet, exercise, foot care, and monitoring of blood glucose), and the effects were inconsistent. In 1 study, meditation improved diabetes self-management.

Conclusions
Mindfulness-based meditation reduced hemoglobin A1c levels in adult patients with type 2 diabetes but did not consistently improve other types of self-management in a few studies examined. This may imply the need for additional intervention components to improve different types of self-management. Further studies are needed to examine the effects of different types of meditations with additional components on different types of self-management.
Dyadic Associations Between Burden and Depressive Symptoms Among Patients With Heart Failure and Their Caregivers
Authors: Dong Xiaoyu , He Dengxin , Zhang Yilin , Zhao Qiuge , Zhang Xiuting , Fan Xiuzhen 
Published: February 2023

Background
Depressive symptoms are prevalent in patients with heart failure and their family caregivers. Given the interpersonal interactions between dyadic individuals with intimate relationship, it is essential to consider the dyads as a unit when exploring the factors associated with depressive symptoms in heart failure patient–caregiver dyads.

Objective
The aims of this study were to explore the dyadic effects of burden on depressive symptoms in heart failure patient–caregiver dyads and investigate whether perceived stress acts as a mediator in these relationships.

Methods
In this cross-sectional study, 237 heart failure patient–caregiver dyads were recruited from 3 hospitals in China between November 2018 and June 2019. Symptom burden, caregiving burden, perceived stress, and depressive symptoms were assessed using self-report questionnaires. The actor-partner interdependence model and actor-partner interdependence mediation model were used to analyze the data.

Results
Patients' symptom burden had an actor effect on their own depressive symptoms and a partner effect on their caregivers' depressive symptoms. Similarly, caregivers' caregiving burden had an actor effect on their own depressive symptoms and a partner effect on patients' depressive symptoms. The actor effects between burden and depressive symptoms were partially mediated by their own perceived stress in heart failure patient–caregiver dyads. Furthermore, the partner effect between caregivers' caregiving burden and patients' depressive symptoms was completely mediated by patients' perceived stress.

Conclusions
Patients' symptom burden and caregivers' caregiving burden aggravated their depressive symptoms by increasing their own perceived stress. Moreover, patients' symptom burden led to caregivers' depressive symptoms, and caregivers' caregiving burden contributed to patients' depressive symptoms through patients' perceived stress. These interdependent relationships suggest that dyadic interventions focused on reducing burden and perceived stress may be beneficial for relieving depressive symptoms in heart failure patient–caregiver dyads.
Combined heart-liver transplantation practices survey in North America: Evaluation and organ listing practices
Authors: Shingina Alexandra , Chadha Ryan , Lim Nicholas , Pillai Anjana , Vodkin Irene , Montenovo Martin , Heller Theo , Yardeni David , Ganger Daniel 
Published: February 2023

We conducted a web-based survey to characterize liver transplant (LT) evaluation and listing practices for patients being evaluated for combined heart-liver transplantation (CHLT), with a specific emphasis on patients with congenital heart disease (CHD), around transplant centers in North America. Very few protocols for liver evaluation and listing in patients undergoing combined heart-liver transplantation are published, and no guidelines currently exist on this topic. A subject of intense debate in the transplant community is the decision of which patients with CHD and liver disease benefit from CHLT compared with heart transplantation. A focus group from the American Society of Transplantation Liver-Intestine Community of Practice Education Subcommittee developed a web-based survey that included questions (1) respondee demographic information; (2) LT evaluation practices in CHLT; (3) liver organ listing practices in CHLT, and (4) 4 clinical vignettes with case-based scenarios in CHLT liver listings among CHD patients who underwent Fontan palliation. The survey was distributed to medical and surgical LT program directors of 47 centers that had completed at least 1 CHLT up to July 2021 in the US and the University of Toronto, Canada. The survey had an excellent 83% response rate (87% for centers that completed at least 1 CHLT in the past 5 y). Total 66.7% used transjugular liver biopsy with HVPG measurements, 30% used percutaneous liver biopsy with no consensus on the use of a fibrosis staging system, 95% mandated contrasted cross-sectional imaging, and 65% upper endoscopy. The following isolated findings evaluation mandated CHLT listing: isolated elevated HVPG (61.5%); the presence of portosystemic collaterals on imaging (67.5%); the endoscopic presence of esophageal or gastric varices (75%), and the presence of HCC (80%), whereas the majority of centers did not feel that the presence of isolated splenomegaly (100%), thrombocytopenia (81.6%), endoscopic findings of portal hypertensive gastropathy (66.7%), or highly sensitized patients (84.6%) justified CHLT. In our survey of North American centers that had performed at least 1 CHLT in the past 5 years, we observed heterogeneity in practices for both evaluation and listing protocols in these patients.
Effects of 20% albumin infusion therapy during liver transplantation on plasma neutrophil gelatinase-associated lipocalin level: A randomized controlled trial
Authors: Kim Doyeon , Kim Jeayoun , Han Sangbin , Jung Hyunjoo , Park Hyung-Doo , Ko Justin S. , Gwak Mi Sook , Kim Gaab Soo 
Published: February 2023

The risk of acute kidney injury (AKI) after liver transplantation was lower in patients with serum albumin levels ≥3.0 mg/dL during surgery. We tested whether intraoperative infusion of 20% albumin affects neutrophil gelatinase-associated lipocalin (NGAL) level, a reliable indicator of AKI. We randomly assigned 134 patients undergoing liver transplantation into albumin group (n=70, 20% albumin 200 mL) and the control group (n=66, crystalloid solution 200 mL). The 2 study fluids were infused at 100 mL/h from the start of the anhepatic phase. The primary outcome was plasma NGAL level at 1 hour after graft reperfusion. Albumin level at the start of graft reperfusion was significantly greater in albumin group than in the control group [2.9 (2.4–3.3) g/dL vs. 2.3 (2.0–2.7) g/dL, p<0.001]. The NGAL level at 1 hour after graft reperfusion was not significantly different between the 2 groups [100.2 (66.7–138.8) ng/mL vs. 92.9 (70.8–120.6) ng/mL, p=0.46], and the AKI risk was not either (63.9% vs. 67.8%, adjusted p=0.73). There were no significant differences between the 2 groups regarding hospital readmission within 30 days/90 days after transplantation (32.6% vs. 41.5%, adjusted p=0.19 and 55.0% vs. 55.7%, adjusted p=0.87). Graft survival probability at 30 days/90 days/1 year after transplantation was 90.0%/84.3%/78.6% in albumin group and 97.0%/90.9%/89.4% in the control group [HR=1.6 (0.6–4.0), adjusted p=0.31]. In conclusion, intraoperative infusion of 20% albumin 200 mL increased the albumin level but failed to maintain serum albumin ≥3.0 mg/dL during surgery. The hypertonic albumin therapy did not significantly affect plasma NGAL level and clinical outcomes including AKI.