bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia: A mixed-methods program evaluation
Authors: M Ezzat Allison , Kemp Joanne L , J Heerey Joshua , F Pazzinatto Marcella , De Oliveira Silva Danilo , Dundules Karen , Francis Matthew , J Barton Christian 
Published: April 2023

Introduction We aimed to evaluate the implementation of the Good Life with osteoArthritis in Denmark (GLA:D®) program via telehealth in Australia using Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation framework. Methods Using a convergent mixed-methods design, semi-structured one-on-one interviews with physiotherapist adopters and nonadopters of GLA:D® via telehealth were analyzed thematically alongside the examination of registry data (1 March 2020–10 February 2022) from patients with hip or knee osteoarthritis completing GLA:D® via telehealth (telehealth-only) or combined with in-person care (hybrid). Effectiveness was determined as changes from baseline to 3-month follow-up (mean differences, 95% confidence intervals, effect size) for Knee injury and Osteoarthritis Outcome Score (KOOS-12)/Hip disability and Osteoarthritis Outcome Score-12 (HOOS-12), and chair stand test. Group- and individual-level changes were compared to published minimally clinically important change scores. Results Twenty-three interviews (12 adopters, 11 nonadopters) found key barriers/facilitators to reach and adoption, high perceived effectiveness, and strategies to support sustainability. Of 2612 registered patients, 85 (3%) and 115 (4%) completed GLA:D® via telehealth-only or hybrid model, respectively. Most effectiveness outcomes were associated with moderate-large improvements. Group-level changes exceeded minimally clinically important change values for KOOS/HOOS-quality of life and chair stand test. Nearly two out of three patients reached a minimally clinically important change for KOOS/HOOS-quality of life. With telehealth-only and hybrid delivery, 99% ( n = 82) and 85% ( n = 97) were satisfied/very satisfied. Physiotherapist adoption was limited ( n = 128, 6%). Discussion GLA:D® delivered via telehealth is effective, had high patient satisfaction, and was perceived positively by physiotherapist adopters. Addressing low reach and adoption requires further implementation strategies to facilitate greater telehealth opportunities for patients and physiotherapists.
Left Inferior Vena Cava With Infrahepatic Disruption, Azygos Continuation, and Retroaortic Left Renal Vein – A Complex, Symptomatic Caval Anomaly Managed With Endovascular Intervention
Authors: Samoyedny Andrew , Cobb Ryan 
Published: April 2023

Background: Complex congenital anomalies of the inferior vena cava (IVC) are rare sequelae of inappropriate persistence or regression of embryological precursor veins. These anomalies are typically asymptomatic and generally do not warrant intervention. Case Presentation: Here we present a case of severely symptomatic left IVC with infrahepatic disruption, azygos continuation, and retroaortic left renal vein causing symptoms of severe pelvic congestion and recurrent miscarriages (8 total) in a 41 year old female. The patient was treated with stenting of the compressed retroaortic portion of the IVC/left renal vein. Four months post-procedure, the stent remained patent and the patient reported considerable improvement in their venous congestion symptoms. Most notably, as of the writing of this report, the patient is 38 weeks pregnant. Conclusions: The case is notable for its severe symptomatology of pelvic venous disease including recurrent miscarriage. More importantly, it represents the first documented case of successful retroaortic endovascular management of such a venous anomaly, in which the entirety of the typical IVC drainage occurred via a compressed left-to-right retroaortic crossover.
Fascia Lata: Another Workhorse for Complex Skull Base Reconstruction
Authors: Godse Neal R. , Sreenath Satyan B. , Sbeih Firas , Woodard Troy D. , Kshettry Varun R. , Recinos Pablo F. , Sindwani Raj 
Published: April 2023

Background Multiple methods exist for skull base reconstruction of defects created by expanded endonasal approaches. While the nasoseptal flap (NSF) has been well established as the workhorse of mucosal reconstruction in complex skull base defects in multi-layered closures, a variety of options exist for the inner layer of multilayer reconstruction, including fascia lata (FL). Objective To present our experience and outcomes in utilizing FL in multiple ways to reconstruct a wide variety of complex skull base defects. Methods Retrospective review was performed from May 2017 to February 2022 to identify 50 consecutive patients who underwent endoscopic skull base reconstruction using FL. Results FL was employed for reconstruction in 50 patients included in the study: 37 undergoing primary expanded endonasal skull base surgery and 13 revision cases. A wide range of complex pathology was treated, with meningioma and craniopharyngioma being the two most common. FL was utilized as a “button” graft (34/50, 68.0%), free graft inlay/onlay (13/50, 26.0%), and as a button graft combined with onlay (3/50, 6.0%). Expanded surgery defects addressed included tuberculum sella/sphenoid planum (36/50, 72.0%), clivus (6/50, 12.0%), and cribriform/planum (8/50, 16.0%). Successful reconstruction with fascia lata was accomplished in 46/50 cases (92%), with only 4 cases (8%) requiring revision for post-op CSF leak. Donor-site complications were rare with only 1 case (2.0%) of post-op seroma. Conclusion FL, usually with NSF, offers a versatile option for the reconstruction of challenging defects with excellent outcomes and minimal morbidity. FL is emerging as a workhorse for reconstruction of the inner layer of complex skull base defects.
Improving adherence and health outcomes in testicular cancer survivors using a mobile health-based intervention: A mixed-methods pilot study
Authors: Deleemans Julie M , Samnani Sunil , Lloyd Chris , Alimohamed Nimira 
Published: April 2023

Objective Testicular cancer (TC) is one of the most common cancers among young men, with survival rates exceeding 97% due to effective treatments. Post-treatment follow-up care is important for long-term survival and monitoring psychosocial symptoms, yet TC survivors (TCS) show poor adherence to post-treatment care. Mobile-health-based interventions show high acceptability in men with cancer. This study will examine the feasibility of using the Zamplo health app to improve adherence to post-treatment care and support psychosocial outcomes in TCS. Methods This mixed-methods, longitudinal, single-arm pilot study will recruit N = 30 patients with a diagnosis of TC who finished treatment within ≤ 6 months and are currently aged ≥18 years old. Adherence to follow-up appointments (e.g. blood work, scans) will be assessed (primary outcome), and measures for fatigue, depression, anxiety, sexual satisfaction and function, social roles satisfaction, general mental and physical health and body image (secondary outcomes) will be completed at four-time points: baseline, 3, 6 and 12 months. One-on-one semi-structured interviews will be conducted post-intervention (month 12). Results Improvements in post-treatment follow-up appointment adherence and psychosocial outcomes will be analyzed using descriptive statistics, paired samples t-tests to determine changes across time points 1 through 4, and correlation analysis. Qualitative data will be analyzed using thematic analysis. Conclusion Findings will inform future, larger trials that incorporate evaluation of sustainability and economic implications to improve adherence to TC follow-up guidelines. Findings will be disseminated via infographics, social media, publications and presentations conducted in partnership with TC support organizations and at conferences.
An Analysis of COVID-19 Mortality During the Dominancy of Alpha, Delta, and Omicron in the USA
Authors: Tabatabai Mohammad , Juarez Paul D. , Matthews-Juarez Patricia , Wilus Derek M. , Ramesh Aramandla , Alcendor Donald J. , Tabatabai Niki , Singh Karan P. 
Published: April 2023

Background: The objective of the study was to measure the risk of death due to COVID-19 in relation to individuals’ characteristics, and severity of their disease during the dominant periods of Alpha, Delta, and Omicron variants have influenced mortality rates. Methods: This study was conducted using COVID-19 Centers for Disease Control and Prevention (CDC) Case Surveillance Public Data Taskforce for 57 states, and United States territories between January 1, 2020 and March 20, 2022. Multivariable binary Hyperbolastic regression of type I was used to analyzes the data. Results: Seniors and ICU-admitted patients had the highest risk of death. For each additional percent increase in fully vaccinated individuals, the odds of death deceased by 1%. The odds of death prior to vaccine availability, compared to post vaccine availability, was 1.27. When comparing the time periods each variant was dominant, the odds of death was 3.45-fold higher during Delta compared to Alpha. All predictor variables had P-values ≤.001. Conclusion: There was a noticeable difference in the odds of death among subcategories of age, race/ethnicity, sex, PMCs, hospitalization, ICU, vaccine availability, variant, and percent of fully vaccinated individuals.
Spondylodiscitis in Geriatric Patients: What Are the Issues?
Authors: Herren Christian , von der Hoeh Nicolas Heinz , Zwingenberger Stefan , Sauer Daniel , Jung Norma , Pieroh Philipp , Drange Steffen , Pumberger Matthias , Scheyerer Max J. ,   and Spine Section of the German Society for Orthopaedics and Trauma
Published: April 2023

Study Design Review article. Objectives A review of literature on the treatment of pyogenic spondylodiscitis in geriatric patients was performed with the aim to give an overview about these special patients and a recommendation on necessary diagnostics as well as conservative and operative treatment options. Methods A systematic computerized literature search was done by the spondylodiscitis working group of the German Society for Orthopedics and Trauma Surgery. Results Spondylodiscitis has an increasing incidence by age with a peak at 75 years or older. The 1-year mortality without an appropriate treatment is with 15 to 20% extremely high. Pathogen detection is the essential diagnostic step and the basis for a sufficient antibiotic treatment. Geriatric patients have initially less elevated inflammatory parameters. Compared to younger patients. They have a longer length of hospital stay and take longer for CRP normalization. Even the outcome between conservative and operative treatment is comparable after one year. Patients with spinal instability, immobilizing pain, epidural abscess, and newly emerged neurological deficits should be considered for operative treatment. Conclusions The treatment of geriatric patients with pyogenic spondylodiscitis must take into account that these patients usually have multiple comorbidities. The main goals are resistance-based antibiotics and the shortest possible time of immobilization of the patient.
Combined Odontoid (C2) and Atlas (C1) Fractures in Geriatric Patients: A Systematic Review and Treatment Recommendation
Authors: Spiegl Ulrich J. A. , Keil Holger , Krause Johannes , Osterhoff Georg , Scheyerer Max J. , Schnake Klaus John , Perl Mario 
Published: April 2023

Study Design Systematic review. Objective The aim of this study was to conduct a systematic overview of the pathogenesis and the treatment options of combined odontoid and atlas fractures in geriatric patients. Methods This review is based on articles retrieved by a systematic search in the PubMed and Web of Science databases for articles published until February 2021 dealing with combination fractures of C1 and C2 in geriatric patients. Results Altogether, 438 articles were retrieved from the literature search. A total of 430 articles were excluded. The remaining eight original articles were included in this systematic review depicting the topics pathogenesis, non-operative treatment, posterior approach, and anterior approach. The overall level of evidence of the studies is low. Conclusion Combined odontoid and atlas fractures in the geriatric population are commonly caused by simple falls and seem to be associated with atlanto-odontoid osteoarthritis. Non-operative treatment with a cervical orthosis is a feasible treatment option in the majority of patients with stable C2 fractures. In case of surgery posterior C1 and C 2 stabilization and anterior triple or quadruple screw fixation are possible techniques. Some patients may also deserve an occipito-cervical fusion. A possible treatment algorithm is proposed.
Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Fractures With Anterior or Posterior Tension Band Failure (OF 5): Short-Term Results From the Prospective EOFTT Multicenter Study
Authors: Osterhoff Georg , Schenk Philipp , Katscher Sebastian , Schnake Klaus John , Bäumlein Martin , Zimmermann Volker , Schmeiser Gregor , Scherer Michael A. , Müller Michael , Sprengel Kai , Liepold Katja , Schramm Simon , Baron Christopher , Siekmann Holger , Schwarz Falko , Franck Alexander , Scheyerer Max J. , Spiegl Ulrich J. A. , Ullrich Bernhard W. ,   Working Group Osteoporotic Fractures of the Spine Section of the German Society of Orthopaedics and Trauma
Published: April 2023

Study Design Subgroup analysis of a multicenter prospective cohort study Objective To analyse surgical strategies applied to osteoporotic thoracolumbar osteoporotic fracture (OF) 5 injuries with anterior or posterior tension band failure and to assess related complications and clinical outcome. Methods A multicenter prospective cohort study (EOFTT) was conducted at 17 spine centers including 518 consecutive patients who were treated for an osteoporotic vertebral fracture (OVF). For the present study, only patients with OF 5 fractures were analysed. Outcome parameters were complications, Visual Analogue Scale (VAS), Oswestry Disability Questionnaire (ODI), Timed Up & Go test (TUG), EQ-5D 5L, and Barthel Index. Results In total, 19 patients (78 ± 7 years, 13 female) were analysed. Operative treatment consisted of long-segment posterior instrumentation in 9 cases and short-segment posterior instrumentation in 10 cases. Pedicle screws were augmented in 68 %, augmentation of the fractured vertebra was performed in 42%, and additional anterior reconstruction was done in 21 %. Two patients (11 %) received short-segment posterior instrumentation without either anterior reconstruction or cement-augmentation of the fractured vertebra. No surgical or major complications occurred, but general postoperative complications were observed in 45%. At a follow-up of mean 20 ± 10 weeks (range, 12 to 48 weeks), patients showed significant improvements in all functional outcome parameters. Conclusions In this analysis of patients with type OF 5 fractures, surgical stabilization was the treatment of choice and lead to significant short-term improvement in terms of functional outcome and quality of life despite a high general complication rate.
Avoiding Spinal Implant Failures in Osteoporotic Patients: A Narrative Review
Authors: Schömig Friederike , Becker Luis , Schönnagel Lukas , Völker Anna , Disch Alexander C. , Schnake Klaus John , Pumberger Matthias 
Published: April 2023

Study design Narrative review. Objectives With an aging population, the prevalence of osteoporosis is continuously rising. As osseous integrity is crucial for bony fusion and implant stability, previous studies have shown osteoporosis to be associated with an increased risk for implant failure and higher reoperation rates after spine surgery. Thus, our review’s purpose was to provide an update of evidence-based solutions in the surgical treatment of osteoporosis patients. Methods We summarize the existing literature regarding changes associated with decreased bone mineral density (BMD) and resulting biomechanical implications for the spine as well as multidisciplinary treatment strategies to avoid implant failures in osteoporotic patients. Results Osteoporosis is caused by an uncoupling of the bone remodeling cycle based on an unbalancing of bone resorption and formation and resulting reduced BMD. The reduction in trabecular structure, increased porosity of cancellous bone and decreased cross-linking between trabeculae cause a higher risk of complications after spinal implant-based surgeries. Thus, patients with osteoporosis require special planning considerations, including adequate preoperative evaluation and optimization. Surgical strategies aim towards maximizing screw pull-out strength, toggle resistance, as well as primary and secondary construct stability. Conclusions As osteoporosis plays a crucial role in the fate of patients undergoing spine surgery, surgeons need to be aware of the specific implications of low BMD. While there still is no consensus on the best course of treatment, multidisciplinary preoperative assessment and adherence to specific surgical principles help reduce the rate of implant-related complications.
An Investigation Into the Relationship Between the Sedimentation Sign and Lumbar Disc Herniation in Upright Magnetic Resonance Images
Authors: Patel Kishan , Son Seung Min , Zhang Qiwen , Wang Jeffrey C. , Buser Zorica 
Published: April 2023

Study Design Retrospective Upright MRI Study. Objectives Determine the relationship between lumbar disc herniation and presence of the nerve root sedimentation sign on upright kinematic MRI patients. Methods T2-weighted axial upright kMRI images of 100 patients with the presence of disc herniation in at least 1 lumbar disc between L1/L2 and L5/S1 were obtained. Sedimentation sign, spinal canal anterior-posterior (AP) diameter, disc height, disc herniation size, type of herniation, and zone of herniation were evaluated. A positive sedimentation sign was defined as having either the majority of nerve roots running ventrally or centrally in the canal or conglomeration of the nerve roots at the mid-disc level. Herniation types were defined as either no herniation, disc bulge, protrusion, extrusion, or sequestration. Zones of herniation were categorized as either central, lateral, or far lateral. Results The kappa value of intra-observer reliability was .915. The kappa value of disc levels with a negative sedimentation sign were seen more frequently (n = 326, 65.2%) than those with a positive sedimentation sign (n = 174, 34.8%). The spinal canal AP diameter was significantly decreased at the L3/L4 and L4/L5 level in patients with a positive sedimentation sign. Discs with a positive sedimentation sign had a larger average size of disc herniation compared to those with a negative sign at all levels. A relationship between positivity of the sedimentation sign and disc herniation type was significant at L2/L3, L3/L4, and L4/L5. Conclusions Patients with a positive sedimentation sign were seen to have larger disc herniations and more severely degenerated discs.
The Corticosteroid Meniscectomy Trial of Extended-Release Triamcinolone Injection After Arthroscopic Partial Meniscectomy: Protocol for a Double-Blind Randomized Controlled Trial
Authors: Sullivan James K. , Gottreich Julia R. , Huston Laura J. , Imrey Peter B. , Winalski Carl S. , Li Xiaojuan , Spindler Kurt P. , Tomko Patrick M. , Cox Charles L. , Wright Rick W. , Jones Morgan H. 
Published: April 2023

Background: Meniscal tear in older adults often accompanies knee osteoarthritis and is commonly treated with arthroscopic partial meniscectomy (APM) when patients have persistent pain after a trial of physical therapy. Cross-sectional evidence suggests that synovitis is associated with baseline pain in this patient population, but little is known about the relationship between synovitis and postoperative recovery or progression of knee osteoarthritis. Purpose/Hypothesis: Intra-articular extended-release triamcinolone may reduce inflammation and thereby improve outcomes and slow disease progression. This article presents the rationale behind the Corticosteroid Meniscectomy Trial (CoMeT) and describes its study design and implementation strategies. Study Design: Randomized controlled trial. Methods: CoMeT is a 2-arm, 3-center, randomized placebo-controlled trial designed to establish the clinical efficacy of extended-release triamcinolone administered via intra-articular injection immediately after APM. The primary outcome is change in Knee injury and Osteoarthritis Outcome Score Pain subscore at 3-month follow-up. Synovial biopsy, joint fluid aspirate, and urine and blood sample analyses will examine the associations between various objective measures of baseline inflammation and pre- and postoperative outcome measures and clinical responses to triamcinolone intervention. Quantitative 3-T magnetic resonance imaging will evaluate cartilage and meniscal composition and 3-dimensional bone shape to detect early joint degeneration. Results: We discuss methodologic innovations and challenges. Conclusion: To our knowledge, this is the first randomized double-blind clinical trial that will analyze the effect of extended-release triamcinolone acetonide on pain, magnetic resonance imaging measures of structural change and effusion/synovitis, soluble biomarkers, and synovial tissue transcriptomics after APM.
Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States
Authors: Choi S.E. , Mo E. , Sima C. , Wu H. , Thakkar-Samtani M. , Tranby E.P. , Frantsve-Hawley J. , Barrow J.R. 
Published: April 2023

Purpose: We aim to understand the impact of the COVID-19 on health care utilization and oral health conditions of patients at federally qualified health centers (FQHCs), where patients are disproportionately low income, publicly insured, or uninsured. Methods: Using deidentified electronic health records of patients at FQHCs in the United States from January 2019 through December 2020 ( n = 431,509), variations in health care utilization since the COVID-19 outbreak were observed by procedure types and patient characteristics. Changes in dental utilization and oral health conditions were characterized using mixed-effect negative binomial and logistic regression models. Results: Dental utilization decreased more drastically than medical utilization during shelter-in-place periods in 2020 and rebounded more slowly after the reopening. Greater demands for oral surgery and teledentistry and less demands for preventive services were observed in 2020. As compared to 2019, patients experienced more psychological stress–related dental conditions with odds ratios of 1.52 (95% confidence interval [CI], 1.31–1.76) for uninsured, 1.48 (95% CI, 1.07–2.02) for Medicaid enrollees, and 2.38 (95% CI, 1.68–3.40) for private insurance beneficiaries. Conclusion: As a result of COVID-19, patients received more invasive dental procedures due to delayed treatment and experienced a higher risk of psychological stress–related dental conditions. Continued support for statewide policies to expand access to oral health care and oral health promotion strategies for the vulnerable populations would be encouraged. Knowledge Transfer Statement: Our study describes the impact of COVID-19 on dental care use and oral health conditions at Federally Qualified Health Centers, targeted to provide care for some of the most vulnerable populations in the United States. The results of this retrospective cohort study can be used by clinicians and policymakers on understanding the clinical needs of the vulnerable populations after the pandemic. It highlights the need for continued support to expand access to oral health care and oral health promotion to these populations.