bluuebunny/crossref_metadata_2025_split huggingface dataset:
Put Down the Tin
Authors: Cole Matthew W. , Collins Lacee K. , Waters Timothy L. , Salas Zachary , Sherman William F. , Cyriac Mathew 
Published: April 2023

Study Design:
Retrospective study.

Objective:
This study evaluated the impact of chewing tobacco on both medical and spine-related complication rates after spinal lumbar fusions in comparison to both a control cohort and a smoking cohort.

Summary of Background Data:
Smoking is a prevalent modifiable risk factor that has been demonstrated to be associated with increased complications after lumbar fusion. Although smoking rates have decreased in the United States, chewing tobacco use has not similarly reduced. Despite chewing tobacco delivering up to 4 times the dose of smoking, the impact of chewing tobacco is incompletely understood.

Methods:
A retrospective cohort study was conducted using the PearlDiver database. Patients who underwent lumbar spine fusion and used chewing tobacco were matched with a control cohort and a smoking cohort. Medical complications within 90 days after primary lumbar fusion were evaluated, including deep venous thrombosis, acute kidney injury, pulmonary embolism, transfusion, acute myocardial infarction, and inpatient readmission. Spine-related complications were evaluated at 2 years postoperatively, including pseudoarthrosis, incision and drainage (I&D), instrument failure, revision, and infection.

Results:
After primary lumbar fusion, the chewing tobacco cohort demonstrated significantly higher rates of pseudoarthrosis [odds ratio (OR): 1.41], revision (OR: 1.57), and any spine-related complication (OR: 1.32) compared with controls. The smoking cohort demonstrated significantly higher rates of pseudoarthrosis (OR: 1.88), I&D (OR: 1.27), instrument failure (OR: 1.39), revision (OR: 1.54), infection (OR: 1.34), and any spine-related complication (OR: 1.77) compared with controls. The chewing tobacco cohort demonstrated significantly lower rates of pseudoarthrosis (OR: 0.84), I&D (OR: 0.49), infection (OR: 0.70), and any spine-related complication (OR: 0.81) compared with the smoking cohort.

Conclusions:
This study demonstrated that chewing tobacco is associated with higher rates of both spine-related and medical complications after primary lumbar fusion. However, chewing tobacco use is associated with less risk of complications compared with smoking.

Level of Evidence:
Level III.
A Portfolio Coach–Informed Professional Development Framework
Authors: Bose-Brill Seuli , Bardales Cheryl , Anjum Phillip , Prater Laura , Otsubo Masami , Walker Curtis , Miles Laura , Kreger Cynthia , Childerhose Janet E. , Kopechek Jack 
Published: April 2023

Introduction:
A majority of US medical schools have incorporated faculty coach–supported educational portfolios into the curriculum. Existing research describes coach professional development, competencies, and program perceptions. However, limited research exists on how programs address coach professional development needs. Our sequential objectives were to (1) explore faculty coach professional development experiences within medical student coaching programs and (2) develop a preliminary framework for medical faculty coach professional development.

Methods:
Faculty portfolio coaches who completed 4 years of a longitudinal coaching program were recruited to complete a semi-structured exit interview. Interviews were transcribed using detailed transcription. Two analysts inductively generated a codebook of parent and child codes to identify themes. They compared themes to the professional development model proposed by O'Sullivan and Irby.

Results:
Of the 25 eligible coaches, 15 completed the interview. Our team organized themes into two broad domains paralleling the established model: program-specific professional development and career-relevant professional development. Four program-specific professional development themes emerged: doing; modeling; relating; and hosting. Three career-relevant professional development themes emerged: advancement; meaning; and understanding. We then applied themes within each domain to propose strategies to optimize coach professional development and develop a framework modeled after O'Sullivan and Irby.

Discussion:
To our knowledge, we propose the first portfolio coach–informed framework for professional development. Our work builds on established standards, expert opinion, and research responsible for portfolio coach professional development and competencies. Allied health institutions with portfolio coaching programs can apply the framework for professional development innovation.
Using “Big Data” to Provide Insights into Early Adopters of Continuing Professional Development: An Example from Project ECHO
Authors: Crawford Allison , Sockalingam Sanjeev , Serhal Eva , Zhou Carrol , Gambin Amanda , de Oliveira Claire , Iwajomo Tomisin , Kurdyak Paul 
Published: April 2023

Introduction:
Mental health care is often managed in primary care with limited specialist support, particularly in rural and remote communities. Continuing professional development programs (CPD) can offer a potential solution to further mental health training; however, engaging primary care organizations (PCOs) can be challenging. The use of “big data” to identify factors influencing engagement in CPD programs has not been well studied. Therefore, the aim of this project was to use administrative health data from Ontario, Canada to identify characteristics of PCOs associated with early engagement in a virtual CPD program, Project Extension for Community Healthcare Outcomes (ECHO) Ontario Mental Health (ECHO ONMH).

Methods:
Ontario health administrative data for fiscal year 2014 was used to compare the characteristics of ECHO ONMH-adopting PCOs, and their patients, to nonadopter organizations (N = 280 vs. N = 273 physicians).

Results:
ECHO-adopting PCOs did not differ with respect to physician age or years of practice, although PCOs with more female physicians were somewhat more likely to participate. ECHO ONMH adoption was more likely in regions with lower psychiatrist supply, among PCOs using partial salary payment models, and those with a greater interprofessional complement. Patients of ECHO-adopters did not differ on the basis of gender or health care utilization (physical or mental health); however, ECHO-adopting PCOs tended to have patients with less psychiatric comorbidity.

Discussion:
Models such as Project ECHO, which deliver CPD to primary care, are advanced to address lack of access to specialist health care. These findings support the use of administrative health data to assess the implementation, spread, and impact of CPD.
Mobile Bony Cap (Meysem Yorgun Technique): An Innovative Technique in Preservation Rhinoplasty for Crooked Nose Deformity
Authors: Yorgun Meysem , Çekiç Erdinç , Evlice Ali 
Published: April 2023

Background:
Crooked nose deformity is a vertical axis deviation of the nasal pyramid; despite all advancements, it remains a significant problem to resolve. In this study, we present our I- and C-shaped crooked nose rhinoplasty results with this new osteotomy technique.

Methods:
This study included 25 patients with I- or C-shaped crooked nose deformities who underwent correction with a closed-approach let-down procedure. In this technique, the middle vault is preserved, the bony cap is mobilized and preserved, and the lateral nasal bones are equalized by a piezo device or classical osteotomes. By the mobilization of the bony cap, tension on the dorsal septum is released, and slight asymmetries are hidden behind this mobile bony cap.

Results:
The postoperative angles for both type I and C deformities were closer to the ideal angle, and the difference was statistically significant. All patients were satisfied with their aesthetic and functional results.

Conclusions:
In this procedure, we correct asymmetries at the lower maxillary nasal junction, such as in the let-down approach, as well as asymmetries at the K-point, such as in the structural approach. Thus, we combine the advantages of both techniques. Additionally, the mobile-bony cap left on the patient is very useful for releasing the tension of the septal dorsum and hiding slight asymmetries that remain below in the patients.
Intramedullary Insetting of Silicone Implant for Lateral Stability in Distal Interphalangeal Joint Arthroplasty
Authors: Usami Satoshi , Minamikawa Yoshitaka , Kinoshita Yukiko , Ohira Kenji , Hamada Yoshitaka 
Published: April 2023

Summary:
Silicone implant arthroplasty is an alternative surgical intervention for painful and deformed osteoarthritis of the distal interphalangeal (DIP) joints. DIP joint stability is essential for hand function; however, it carries a potential risk of postoperative joint instability. To address this concern, an intramedullary implant insetting method was used to maintain joint stability by minimum resection of the head of the middle phalanx and preserving the collateral ligament. In the new method, the length of the bone excision was limited to maintain the lateral cortical bone with the insertion of the collateral ligament, and the medullary cavity of the middle phalanx was partially removed to intentionally set the hinge part of the silicone implant in the medullary canal. Between 20 digits of the conventional approach and 23 digits of the intramedullary insetting method, there were no significant differences in patient demographics (ie, age, affected hand, and finger), and clinical characteristics (ie, active DIP joint arc, DIP joint extension loss, grip strength, visual analog scale, and Quick Disabilities of the Arms, Shoulder and Hand questionnaire score) before and over 6 months after surgery. However, postoperative joint instability was significantly lower with the intramedullary insetting method, with a significantly shorter length of bone excision of the middle phalanx. This new approach is more beneficial than the conventional approach for preventing postoperative joint instability.
Targeted Muscle Reinnervation for Limb Amputation to Avoid Neuroma and Phantom Limb Pain in Patients Treated at a Pediatric Hospital
Authors: Bjorklund Kim A. , Alexander John , Tulchin-Francis Kirsten , Yanes Natasha S. , Singh Satbir , Valerio Ian , Klingele Kevin , Scharschmidt Thomas 
Published: April 2023

Background:
Amputees frequently experience chronic neuroma-related residual limb and phantom limb pain (PLP). Targeted muscle reinnervation (TMR) transfers transected nerves to nearby motor nerves to promote healing and prevent neuroma formation and PLP. The purpose of this study was to report outcomes of TMR in a series of children and young adults treated at a pediatric hospital.

Methods:
Patients undergoing major limb amputation with TMR were included with minimum one year follow-up and completed questionnaires. Primary clinical outcomes included incidence of symptomatic neuromas, PLP, residual limb pain, narcotic use, and neuromodulator use. A follow-up phone survey was conducted assessing five pediatric Patient Reported Outcomes Measurement Information System (PROMIS) metrics adapted to assess residual limb and PLP.

Results:
Nine patients (seven male and two female patients, avg. age = 16.83 ± 7.16 years) were eligible. Average time between surgery and phone follow-up was 21.3 ± 9.8 months. Average PROMIS Pediatric t-scores for measures of pain behavior, interference, quality—affective, and quality—sensory for both PLP and residual limb pain were nearly 1 standard deviation lower than the United States general pediatric population. One patient developed a symptomatic neuroma 1 year after surgery.

Conclusions:
Compared with an adult patient sample reported by Valerio et al, our TMR patients at Nationwide Children’s Hospital (NCH) showed similar PLP PROMIS t-scores in pain behavior (50.1 versus 43.9) and pain interference (40.7 versus 45.6). Both pediatric and adult populations had similar residual limb pain including PROMIS pain behavior (36.7 adult versus 38.6 pediatric) and pain interference (40.7 adult versus 42.7 pediatric). TMR at the time of amputation is feasible, safe, and should be considered in the pediatric population.
Long-Term Benefits of Tear Exchangeable Limbal-Rigid Contact Lens Wear Therapy in Stevens–Johnson Syndrome Cases
Authors: Yoshikawa Yamato , Ueta Mayumi , Kinoshita Shigeru , Kida Teruyo , Sotozono Chie 
Published: April 2023

Objectives:
To evaluate the long-term benefits of tear-exchangeable, limbal-rigid contact lens (CL) wear therapy in patients with Stevens–Johnson syndrome (SJS)–associated ocular sequelae.

Methods:
This retrospective study evaluated 50 eyes of 41 SJS patients (15 men and 26 women) who underwent limbal-rigid CL wear therapy for more than 2 years post fitting. Ocular sequelae (i.e., conjunctival hyperemia, corneal neovascularization, and upper tarsus scarring) before fitting and at 3 months, 6 months, 12 months, and annually after initiating CL wear therapy were evaluated and then graded on a severity score (range: 0–3, maximum score: 3). Moreover, visual acuity (VA) at immediately post initiating CL wear therapy was evaluated.

Results:
The mean follow-up period was 4.3±1.1 years. Compared with before fitting, the mean conjunctival hyperemia score improved from 1.14 to 0.86 at 3 months of CL wear therapy (P<0.01) and was maintained thereafter; the mean corneal neovascularization score improved from 2.10 to 1.98 at 3 months of CL wear therapy, with no deterioration of the score observed in all cases at the final follow-up examination, and mean VA (log of minimum angle of resolution) improved from 1.60 to 1.04 at immediately post initiating CL wear therapy (P<0.01).

Conclusions:
Limbal-rigid CL wear therapy can provide long-term ocular surface stabilization and improved VA in SJS patients.
Frequency of Visual Fields Needed to Detect Glaucoma Progression: A Computer Simulation Using Linear Mixed Effects Model
Authors: Sabouri Samaneh , Haem Elham , Masoumpour Masoumeh , Vermeer Koenraad A. , Lemij Hans G. , Yousefi Siamak , Pourahmad Saeedeh 
Published: April 2023

Précis:
Irregular visual field test frequency at relatively short intervals initially and longer intervals later on in the disease provided acceptable results in detecting glaucoma progression.

Purpose:
It is challenging to maintain a balance between the frequency of visual field testing and the long-term costs that may result from insufficient treatment of glaucoma patients. This study aims to simulate real-world circumstances of visual field data to determine the optimum follow-up scheme for the timely detection of glaucoma progression using a linear mixed effects model (LMM).

Materials and Methods:
An LMM with random intercept and slope was used to simulate the series of mean deviation sensitivities over time. A cohort study including 277 glaucoma eyes that were followed for 9.0±1.2 years was used to derive residuals. Data were generated from patients with early-stage glaucoma having various regular and irregular follow-up scenarios and different rates of visual field loss. For each condition, 10,000 series of eyes were simulated, and one confirmatory test was conducted to identify progression.

Results:
By doing one confirmatory test, the percentage of incorrect progression detection decreased considerably. The time to detect progression was shorter for eyes with an evenly spaced 4-monthly schedule, particularly in the first 2 years. From then onward, results from twice-a-year testing were similar to results from examinations scheduled 3 times per year.

Conclusions:
Irregular visual field test frequency at relatively short intervals initially and longer intervals later on in the disease provided acceptable results in detecting glaucoma progression. This approach could be considered for improving glaucoma monitoring. Moreover, simulating data using LMM may provide a better estimate of the disease progression time.
Eye Drop Adherence With an Eye Drop Bottle Cap Monitor
Authors: Kinast Robert M. , Sanchez Facundo G. , Rees Jack P. , Yeh Kaileen , Gardiner Stuart K. , Dawes Jacob , Johnston Matthew L. , Porter J. David , Klei Viridian , Mansberger Steven L. 
Published: April 2023

Précis:
An eye drop bottle cap monitor with audio and visual alarms measured eye drop adherence in 50 subjects with glaucoma. Baseline adherence rates were too high to test if the alarms could improve adherence.

Purpose:
To determine if an eye drop bottle cap monitor can measure and improve adherence.

Materials and Methods:
The Devers Drop Device (D3, Universal Adherence LLC) was designed to measure eye drop adherence by detecting bottle cap removal and replacement, and it can provide text, visual and audio alerts when a medication is due. In Stage 1, we determined baseline adherence for 50 subjects using a nightly eye drop over a 25-day period. Subjects with less than 90% baseline adherence were eligible for Stage 2. In Stage 2, we randomized subjects to receive either no reminder or automated D3 alerts for their nightly eye drop over a subsequent 25-day period. We defined adherence as the proportion of drops administered within 3 hours of the subjects’ scheduled dosing time. Subjects completed 3 questions regarding satisfaction with the device and willingness to pay.

Results:
The D3 monitor remained attached to the eye drop bottle cap for the duration of the study and collected adherence data in all 50 patients. In Stage 1, the mean adherence rate was 90 ± 18% (range 32–100%). Forty (80%) subjects had an adherence rate greater than 90%. Adherence rates were too high in Stage 1 to adequately test the effects of reminders in Stage 2. Ninety-eight percent (49/50) and 96% (48/50) of subjects agreed “the device always stayed attached to the bottle cap” and “I was able to use the device to take the drops”, respectively. Patients would pay $61±83 (range $0-400) for a similar device to improve adherence.

Conclusions:
The D3 can measure eye drop adherence. Research subjects reported high satisfaction and willingness to pay for an eye drop bottle cap monitor. Glaucoma patients have high adherence when they are being monitored, and future studies with research subjects screened for poor adherence may further determine the benefit of electronic monitoring of adherence with and without electronic reminders.
Acute Necrotizing Retinopathy After Xen Gel Stent Implantation
Authors: Lo Wen-Jung , Kuang Tung-Mei , Chen Shih-Jen , Hwang De-Kuang 
Published: April 2023

Précis:
We report a case of a 45-year-old woman who developed serous retinal detachment, hypotony, and retinal necrosis after Xen gel stent implantation.

Abstract
A 45-year-old woman developed sudden blurring of vision 4 days after Xen gel stent replacement surgery. Persistent hypotony, uveitis, and serious retinal detachment rapidly progressed despite medical and surgical treatments. Retinal necrosis, optic atrophy, and total blindness developed within 2 months. Although infectious and autoimmune-related uveitis were ruled out through negative culture and blood test results, acute postoperative infectious endophthalmitis could not be completely excluded in this case. However, toxic retinopathy related to mitomycin-C was suspected eventually.
The Effect of Blue-Light Filtering Intraocular Lenses on the Development and Progression of Glaucoma
Authors: Hecht Idan , Kanclerz Piotr , Achiron Asaf , Elbaz Uri , Tuuminen Raimo 
Published: April 2023

Précis:
Among patients who underwent uneventful cataract surgery, an advantage was seen to blue-light filtering (BLF) intraocular lenses (IOLs) in terms of glaucoma-free survival and glaucoma procedure-free survival. Among patients with preexisting glaucoma, no advantage was seen.

Purpose:
To assess the effect of BLF IOLs on the development and progression of glaucoma after cataract surgery.

Patients and Methods:
A retrospective cohort study of patients who underwent uneventful cataract surgery between 2007 and 2018 at Kymenlaakso Central Hospital, Finland. Survival analyses for the overall risk of developing glaucoma or undergoing glaucoma procedures were assessed between patients who received a BLF IOL (SN60WF) and a non-BLF IOL (ZA9003 and ZCB00). A separate analysis was performed on patients with preexisting glaucoma.

Results:
Included 11,028 eyes of 11,028 patients with a mean age of 75 ± 9 years (62% females). The BLF IOL was used in 5188 eyes (47%) and the non-BLF IOL in 5840 eyes (53%). During the follow-up (mean: 55 ± 34 mo), 316 cases of glaucoma were diagnosed. Glaucoma-free survival rates showed an advantage to the BLF IOL (P = 0.036). In a Cox regression analysis controlling for age and sex the use of a BLF IOL was again associated with a lower ratio of glaucoma development (hazard ratio:0.778; 95% CI: 0.621–0.975). Furthermore, glaucoma procedure-free survival analysis revealed an advantage to the BLF IOL (hazard ratio:0.616; 95% CI: 0.406–0.935). Among 662 cases, which already had glaucoma at the time of surgery, no significant differences were seen in any outcome.

Conclusions:
Among a large cohort of patients who underwent cataract surgery, the use of BLF IOLs was associated with favorable glaucoma outcomes compared with the use of non-BLF IOLs. Among patients with preexisting glaucoma, no significant advantage was seen.
Progressive Macular Vessel Density Loss Observed on Optical Coherence Tomography Angiography in Glaucoma Patients With Single-Hemifield Visual Field Defects
Authors: Lin Sigeng , Zhang Shaodan , Shang Xiao , Gu Juan , Ye Cong , Wang Xiaoyan , Zhou Kun , Kong Yu Xiang George , Liang Yuanbo 
Published: April 2023

Précis:
Faster hemispheric mVD loss was found in the affected hemifield of POAG patients without significant changes in hemispheric thickness. The progression of mVD loss was associated with the severity of VF damage.

Purpose:
To evaluate the changes in macular vessel density (mVD) loss in primary open angle glaucoma (POAG) patients with visual field (VF) defects confined to 1 hemifield.

Materials and Methods:
This longitudinal cohort study used linear mixed models to evaluate the changes in the hemispheric mean total deviation (mTD), mVD, macular ganglion cell complex, macular ganglion cell-inner plexiform layer, and retinal nerve fiber layer between affected hemifields, unaffected hemifields, and healthy controls.

Results:
Twenty-nine POAG eyes and 25 healthy eyes were followed for an average of 29 months. In POAG eyes, the rates of decline in hemispheric mTD and hemispheric mVD in the affected hemifields were significantly faster than those in the unaffected hemifields (−0.42±1.24 vs. 0.02±0.69 dB/year, P=0.018 and −2.16±1.01 vs. −1.77±0.90% / year, P=0.031, respectively). There were no differences in the rate of hemispheric thickness change between the 2 hemifields. The rate of hemispheric mVD decline in both hemifields of POAG eyes was significantly faster than that of the healthy controls (All P<0.05). An association between the reduced mTD of the VF and the rate of hemispheric mVD loss in the affected hemifield was observed (r=0.484, P=0.008). Faster rates of mVD loss (β=−1.72±0.80, P =0.050) were significantly related to reduced hemispheric mTD in the multivariate analysis.

Conclusions:
Faster hemispheric mVD loss was found in the affected hemifield of POAG patients without significant changes in hemispheric thickness. The progression of mVD loss was associated with the severity of VF damage.