bluuebunny/crossref_metadata_2025_split huggingface dataset:
An updated audit of the patient selection process for pain management programmes in a speciality care service before and during the COVID-19 pandemic
Authors: Buscemi Valentina , Chicken Joe , Mahy Tim , Knight Lucie , Scott Whitney 
Published: December 2022

Background The provision of pain management programmes (PMPs) changed substantially in response to the COVID-19 pandemic with virtual delivery implemented in many services. Little is known about patient selection processes for virtual PMPs and how this might differ from in-person programmes. The aim of this audit was to document the patient selection process for PMPs at a speciality pain service prior to and during the pandemic. Methods This retrospective audit used data from consecutive patients attending a multidisciplinary assessment to determine the suitability of a PMP. Anonymized data were extracted from assessment letters and hospital records in the months prior to the pandemic (n =168) and during the start of the pandemic once the service began delivering virtual PMPs (n =171). Results For the standard pain management pathway, most patients were offered a PMP option within the service before and during the pandemic, although a greater proportion of patients were offered treatment during the pandemic. For the neuromodulation pathway, most patients were offered a pre-neuromodulation PMP option, and this was similar before and during the pandemic. Psychosocial complexities and unwillingness to engage in a pain management approach that does not principally focus on pain reduction were the most common reasons that patients were not offered a programme. Discussion This audit points to a pattern of more inclusive assessment outcomes within our service over time and particularly during the pandemic. Offering a range of in-person and virtual PMPs can meet a wider range of patient need. Research is needed to understand how to best assess and match patients with the breadth of treatment delivery formats now available.
General vs Local Anesthesia for Percutaneous Endoscopic Lumbar Discectomy (PELD): A Systematic Review and Meta-Analysis
Authors: Mooney James , Laskay Nicholas , Erickson Nicholas , Salehani Arsalaan , Mahavadi Anil , Ilyas Adeel , Mainali Bipul , Nowak Błażej , Godzik Jake 
Published: December 2022

Study Design Systematic review Objectives It remains unknown whether general anesthesia (GA) or local ± epidural anesthesia (LA) results in superior outcomes with percutaneous endoscopic lumbar discectomy (PELD). The present study sought to examine the impact of anesthesia type on patient-reported outcomes (PROs) and complications with PELD. Methods Systematic review and meta-analysis examining PELD performed under GA or LA was conducted. Patient-reported outcomes including Visual Analog Scale (VAS)-leg/back, and Oswestry Disability Index (ODI) scores were collected. Complication, recurrent disc herniation, durotomy, and reoperation rates as well as surgical data were recorded. All outcomes were compared between pooled studies examining GA or LA. Results Sixty-eight studies consisting of 5269 patients (724 GA, 4465 LA) were included in the meta-analysis. Overall complication rate was significantly higher in the GA group (9% vs 4%, P = .003). Durotomy rates, length of stay, recurrent disc herniation and reoperation rates were similar between groups. At the first follow-up timepoint, the LA group demonstrated significant improvements in VAS back and ODI scores ( P < .05) while the GA group did not ( P > .05). At the final follow-up (> 6 months), the percent of patients achieving an excellent McNab score was significantly higher in the GA vs LA group ( P < .001). Conclusions Percutaneous endoscopic lumbar discectomy with LA may be associated with greater short-term improvement in VAS back pain and ODI scores. General anesthesia may be associated with more durable pain relief but a higher complication rate. Further systematic investigation is necessary to determine what short and long term benefits are associated with PELD performed under LA and GA.
Epidemiology of Work-Related Neck Pain Among Spine Surgeons
Authors: Abolfotouh Sameh M. , Alnori Omar , Choma Theodore , Moore Don , Abolfotouh Mostafa A. 
Published: December 2022

Study Design Cross-sectional survey. Objectives This study aimed to investigate work-related neck pain among AO spine surgeons in different regions by estimating its prevalence, predictors, consequences, and management methods. Methods A cross-sectional survey of 411 spine surgeon members of AO spine was conducted during March–May 2021, using the Modified Nordic Questionnaire and the Neck Disability Index. Data on neck pain experience during the last 12 months and its consequences and risk factors were collected. Logistic regression analysis was done to identify significant predictors of neck pain. Significance was set at P < .05. Results The 1-year neck pain was experienced by 66.7% of surgeons. According to the Neck Disability Index, more than one-half (52.8%) experienced disability due to neck pain of mild (45.5%), moderate (6.5%), and severe (.8%) grades. Neck pain was responsible for stopping work in 17.5% of surgeons, with a median of 3.5 (IQR, 2-7.8) days off work. One-half of the participants (56.3%) were treated by medical care, 31.5% by physiotherapy, and 16.5% requested rest days and sick leave. Physical stress (P < .001) and non-exercising (P = .04) were the significant predictors of neck pain. Conclusion The 12-month prevalence of neck pain was high among spine surgeons, with an impact on activities of daily living, mainly of a mild degree, reported by one-half of surgeons. Physical stress was the only significant predictor, while sports practice was a protective factor against neck pain. Medication was the primary management adopted—an increased focus on pain prevention through improved workplace ergonomics and sports activity programs is recommended.
Use of Lung Sonography in the Assessment and Confirmation of Pulmonary Complications in the Pediatric Patient
Authors: Shonk Andrew , Sergakis Georgianna , Varekojis Sarah M. 
Published: December 2022

Objective: To determine if lung sonography is accurate in assessing and confirming pulmonary compromise and thereby reduce the risk of x-ray exposure, for pediatric patients. Materials and Methods: This study was a systematic review of individual published studies. PubMed was the only database used for the article search. A review by a committee of contributors determined whether studies met the specific inclusion criteria. Studies reviewed had participants between the ages 0 and 18 years, with lung compromise of varying pathophysiological diagnoses. Each intervention was coded by levels of evidence; grading of recommendations, assessment, development, and evaluation (GRADE); the evidence alert traffic light grading system; and risk of bias in nonrandomized studies of interventions. Each article was evaluated using the Cochrane assessment of bias and GRADE evidence tables. Results: Thirty-seven articles were retrieved. Of those, 21 articles were removed following title and abstract screening. With 16 articles remaining, only one duplicate was removed. Based on the 15 articles extracted, in full-text versions, only two articles were noted to be irrelevant, and one article was not provided in English. Only 12 articles met the eligibility criteria, but two articles had to be removed because they were systematic reviews and not individual studies. The final analysis was based on 10 articles that met the inclusion criteria. Conclusion: Once reviewed, all 10 articles indicated that lung sonography had high accuracy and confirmation of lung compromise, which spanned multiple pulmonary diagnoses, in pediatric patients. When used by a trained clinician, lung sonography was as highly effective in comparison to other diagnostic tools, such as a chest radiograph and computed tomography.
The global progress on the non-point source pollution research from 2012 to 2021: a bibliometric analysis
Authors: Xie Zi-jian , Ye Chun , Li Chun-hua , Shi Xiao-gang , Shao Ying , Qi Wei 
Published: December 2022

Abstract
Background
With effective control of point source pollution, non-point source (NPS) pollution has been widely concerned as the primary reason for the improvement of global water environmental quality. Some bibliometric analysis related to NPS pollution has been carried out before the mid-2010s. Analyzing the research status and hot issues of NPS pollution in the past decade is important for guiding the control and management of NPS pollution in the future.

Results
A bibliometric analysis was conducted based on 3407 publications retrieved from the Web of Science during 2012–2021. China, USA and UK were the most productive countries. Sci. Total Environ, Environ. Sci. Pollut. Res, and Water were the most productive journals. The NPS pollutant, pollution types, driving forces, technology and the research object were retrieved from the keywords analysis. The common NPS pollutants of nitrogen, phosphorus, and heavy metals grabbed the highest attention, while the emerging contaminants have attracted increased attention. The migration and transformation of agricultural NPS pollution and urban NPS pollution driven by climate change and land use change were hot issues related to NPS pollution studies. Technologies related to the combination of 3S technology (RS, GIS, and GPS) and NPS pollution models, the sustainable control technologies, the technology of accurate traceability and automatic monitoring, and the comprehensive management plan were the important research areas related to NPS pollution. Although the research locations were mostly concentrated in the surface water and groundwater, the ocean and drinking water have great potential for future research.

Conclusions
This study illustrates the global focuses related to NPS pollution during 2012–2021 according to analyzing the publication outputs, source journals, source country, author, institution and the high-frequency keywords. Results demonstrated that the migration and transformation mechanism and ecological risk assessment for heavy metals and emerging pollutants, accurate traceability techniques, sustainable ecological restoration control techniques, and marine pollution have attracted rising attention. Additionally, developing countries will have a higher interest in NPS pollution in the future, because developed countries have already made great progress in controlling NPS pollution.
Review and future trends of soil microplastics research: visual analysis based on Citespace
Authors: Ya-di Zhu , Tian-jie Shao , Yan-hua Wang , Rui-yuan Wang 
Published: December 2022

AbstractCompared with the research results of water microplastics, soil microplastics have been of concern for a shorter time, and the research started later. As a whole, they are still in the initial stage of development, and the problems of arable land and food security caused by them have attracted close attention from scholars around the world, but have not been effectively solved. To reveal the research status, development and change process and future trend, this paper is based on the data in the Web of Science (WOS) databases from 2016 to November 2021, with the help of Citespace software. The number of articles published, source countries and degree of cooperation, research institutions and teams, keyword clustering and change trend are sorted out. The results showed that: (1) the research results of soil microplastics has experienced a slow-rapid growth stage. In terms of the number of articles published, China occupies the first place in the world, with 55 articles. In terms of the number of publications, Free Univ Berlin ranks first, followed by the Chinese Academy of Sciences, Berlin Brandenburg Inst Adv Biodivers Res, and Wageningen Univ&Res. (2) In terms of content, environmental pollution and exposure, the function and health of soil-associated media, the common shape characteristics of microplastics and their influencing factors, and the combined pollution caused by microplastics are all covered, and can be divided into eight main categories: soil, ingestion, heavy meals, fiber, marine environment, microplastic, metals, and plants. (3) The migration behavior and ecotoxicological effects of microplastics in soil media are still the focus of attention at present. (4) In the future, “regression process and mechanism", “detection method and evaluation standard”, “risk assessment model”, “removal technology and control means” are undoubtedly worthy of attention.
Alfaxalone anaesthesia increases brain derived neurotrophic factor levels and preserves postoperative cognition by activating pregnane-X receptors: an in vitro study and a double blind randomised controlled trial
Authors: Serrao Juliet M. , Goodchild Colin S. 
Published: December 2022

Abstract
Background
Alfaxalone is a fast acting intravenous anaesthetic with high therapeutic index. It is an analogue of the naturally-occurring neurosteroid allopregnanolone responsible for maintenance of cognition and neuroprotection by activation of brain pregnane X receptors and consequent increased production of mature brain-derived neurotrophic factor (m-BDNF). Two studies are reported here: an in vitro study investigated whether alfaxalone activates human pregnane X receptors (h-PXR) as effectively as allopregnanolone; and a clinical study that measured postoperative changes in serum m-BDNF and cognition in patients after alfaxalone anaesthesia compared with propofol and sevoflurane.

Methods
In vitro Activation of h-PXR by allopregnanolone and alfaxalone solutions (206 - 50,000 nM) was measured using human embryonic kidney cells expressing h-PXR hybridised and linked to the firefly luciferase gene. Light emission by luciferase stimulated by each ligand binding with h-PXR was measured.
Clinical A double blind prospective randomised study of patients undergoing hip arthroplasty anaesthetised with alfaxalone TIVA (n = 8) or propofol TIVA (n = 3) or propofol plus sevoflurane inhalational anaesthesia (n = 4). The doses of anaesthetics were titrated to the same depth of anaesthesia (BIS 40-60). Subjects’ cognitive performance was assessed using the Grooved Pegboard Test, Digit Symbol Substitution Test (DSST) and Mini Mental State examination (MMSE) for 7 days postoperatively. Serum m-BDNF concentrations were measured for 7 postoperative days.

Results
In vitro Allopregnanolone and alfaxalone both activated h-PXR, alfaxalone being more efficacious than allopregnanolone: 50,000 nM, p = 0.0019; 16,700 nM, p = 0.0472; 5600 nM, p = 0.0031.
Clinical Alfaxalone treated subjects scored better than propofol and sevoflurane anaesthetised patients in the cognition tests: (MMSE p = 0.0251; Grooved Pegboard test dominant hand pre v post anaesthesia scores p = 0.8438 for alfaxalone and p = 0.0156 for propofol and propofol/sevoflurane combined). The higher cognition scores were accompanied by higher serum m-BDNF levels in the alfaxalone anaesthetised patients (p < 0.0001).

Conclusions
These results suggest that sedation and anaesthesia induced by the synthetic neuroactive steroid alfaxalone may be accompanied by effects normally caused by physiological actions of allopregnanolone at PXR, namely, increased secretion of m-BDNF and consequent neuroprotection and preservation of cognition.

Trial registration
The clinical trial was registered on 17/01/2018 with the Australian New Zealand Clinical Trials Registry: registration number ACTRN12618000064202 [Universal Trial Number U1111-1198-0412].
Emergency department crowding negatively influences outcomes for adults presenting with asthma: a population-based retrospective cohort study
Authors: Huang Yifu , Ortiz Silvia S. , Rowe Brian H. , Rosychuk Rhonda J. 
Published: December 2022

Abstract
Background
Access to emergency department (ED) services is important for patients with acute asthma; however, ED crowding may impact the quality of care and compromise outcomes. We examine the association between ED crowding metrics and individual patient outcomes for adults presenting with asthma.

Methods
This population-based retrospective cohort study extracted all ED presentations made by patients aged 18 to 55 years to 18 high-volume EDs in Alberta from April 2014 to March 2019. Physician initial assessment (PIA) time and ED length of stay (LOS) for discharged and admitted patients were calculated. Other metrics and patient outcomes were also obtained. Linear and generalized linear models were fit for continuous and categorical outcomes. Cox proportional hazards models were used for time-to-event outcomes.

Results
There were 17,724 ED presentations by 12,569 adults. The median age was 33 years, and females (58.7%) made more presentations. ED crowding affected the PIA time for all triage groups. For the high acuity group (Canadian Triage and Acuity Scale [CTAS] 1/2), 1 h increase in median facility-specific PIA was associated with 26 min (95%CI: 24,28) increase; for the moderate acuity (CTAS 3) and low acuity (CTAS 4/5) groups, the individual-level PIA increased by 54 min (95%CI: 53,55) and 61 min (95%CI: 59,63), respectively adjusted by other predictors. Increases in facility PIA resulted in increase in odds of admissions for the high acuity group and increase odds of left without completion of care for the moderate and low acuity groups.

Conclusion
The care provided for patients from all triage groups was impacted when EDs experienced crowding. Effective interventions are needed to mitigate ED crowding and improve care and outcomes for this important patient group.
Automated lung ultrasound image assessment using artificial intelligence to identify fluid overload in dialysis patients
Authors: Tan Grace Feng Ling , Du Tiehua , Liu Justin Shuang , Chai Chung Cheen , Nyein Chan Maung , Liu Allen Yan Lun 
Published: December 2022

Abstract
Background
Fluid assessment is challenging, and fluid overload poses a significant problem among dialysis patients, with pulmonary oedema being the most serious consequence. Our study aims to develop a simple objective fluid assessment strategy using lung ultrasound (LUS) and artificial intelligence (AI) to assess the fluid status of dialysis patients.

Methods
This was a single-centre study of 76 hemodialysis and peritoneal dialysis patients carried out between July 2020 to May 2022. The fluid status of dialysis patients was assessed via a simplified 8-point LUS method using a portable handheld ultrasound device (HHUSD), clinical examination and bioimpedance analysis (BIA).
The primary outcome was the performance of 8-point LUS using a portable HHUSD in diagnosing fluid overload compared to physical examination and BIA. The secondary outcome was to develop and validate a novel AI software program to quantify B-line count and assess the fluid status of dialysis patients.

Results
Our study showed a moderate correlation between LUS B-line count and fluid overload assessed by clinical examination (r = 0.475, p < 0.001) and BIA (r = 0.356. p < 0.001). The use of AI to detect B-lines on LUS in our study for dialysis patients was shown to have good agreement with LUS B lines observed by physicians; (r = 0.825, p < 0.001) for the training dataset and (r = 0.844, p < 0.001) for the validation dataset.

Conclusion
Our study confirms that 8-point LUS using HHUSD, with AI-based detection of B lines, can provide clinically useful information on the assessment of hydration status and diagnosis of fluid overload for dialysis patients in a user-friendly and time-efficient way.
Smoking cessation in pregnant women using financial incentives: a feasibility study
Authors: Kroder T. A. , Peters L. L. , Roggeveld A. L. , Holtrop M. , Harshagen L. , Klein L. M. , Erwich J. J. H. M. 
Published: December 2022

Abstract
Background
The high prevalence of smoking pregnant women in Dutch areas with lower socioeconomic status and the consecutively harmful exposure to tobacco to both mother and child, depicted a high need for a novel intervention. According to other studies, the utilisation of financial incentives appeared to be a promising method for smoking cessation in pregnant women. Therefore, the aim of this study was to investigate the feasibility of implementing contingent financial incentives as smoking cessation support for pregnant women in the Netherlands.

Methods
Feasibility study consisting of four developmental phases: (1) acceptability of Dutch population regarding financial-incentive-intervention by conducting an online questionnaire, (2) composing a pilot study utilising the financial-incentive-intervention in clinical practice, (3) execution of the composed pilot study and (4) evaluation of the executed pilot study utilising a mixed-methods approach.
A financial-incentive-intervention, given in a contingent financial scheme (during five consequential appointments, respectively €25/€50/€100/€150/€250), if smoking abstinence was proven by the amount of cotinine in the urine of the pregnant women measured utilising a urine dipstick test.
The public acceptability for the financial-incentive-intervention was assessed using 5-Likert scales. The number of pregnant women able to abstain from smoking during the pilot study and utilising the financial-incentive-intervention in clinical practice were used to assess the prosperity and practicality of the pilot study respectively. The pilot study was evaluated using a mixed-methods approach.

Results
In total, 55.1% of the Dutch population sample (n = 328) found a financial incentive inappropriate for smoking cessation in pregnant women, while the healthcare professionals and pilot study participants thought the financial-incentive-intervention to be a helpful approach. Eleven vouchers were given during the pilot study, and one woman completed all test points and tested negative for cotinine at the end of the pilot study.

Conclusion
Although the financial-incentive-intervention appeared to be a promising approach for smoking cessation in pregnant women, the acceptability of the Dutch population and the number of pregnant women able to abstain smoking during this pilot study was low. Despite the limited study population, this study proved the concept of this financial-incentive-intervention to be feasible for implementation in the Netherlands.

Trial registration
Not applicable since this is a feasibility study prior to a trial.
New AMH cutoff values for warning of decreased ovarian response based on MCL characteristics in young women: a retrospective study using a propensity score-matching analysis
Authors: Lv Jia-Bei , Han Ying , Wang Xin-Yan , Yuan Li-Na , Diao Jun-Rong , Fan Ya-Zhen , Luo Hai-Ning 
Published: December 2022

Abstract
Background
Menstrual cycle length (MCL) and ovarian response varies widely among women of childbearing age. They are provided with anti-Mu¨llerian hormone (AMH) cutoffs for “normal” and “weakened” ovarian responses, which give an early warning of the onset of decreased ovarian response.

Methods
This was a retrospective study in women aged 21 to 35 years with MCLs of 21–35 days receiving in vitro fertilization (IVF) treatment at Center for Reproductive Medicine from October 2018 to October 2021. Intergroup variables were balanced using propensity score matching based on age and BMI, and each case patient (patients with MCLs of 21–25 days) was matched with three control patients (patients with MCLs of 26–35 days). A receiver operating characteristic curve was used to calculate the AMH cutoff values.

Results
We included 135 patients with MCLs of 21–25 days and 405 matched control patients with MCLs of 26–35 days who received IVF treatment. The case group had significantly fewer retrieved oocytes, lower AMH values and higher initial and total Gonadotropin (Gn) levels during controlled ovarian hyperstimulation than the control group. The ovarian response began to decrease when AMH was < 3.5 ng/ml in the case group and < 2.7 ng/ml in the control group.

Conclusion
In young women with MCLs of 21–35 days, short MCL was negatively correlated with AMH values and the number of oocytes retrieved. In patients with MCLs of 21–25 days and 26–35 days, the AMH cutoff values corresponding to the onset of decreased ovarian response were 3.5 ng/ml and 2.7 ng/ml, respectively.