bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Blood Loss Prediction Formulas in Burn Surgeries: A Review
Authors: Wardhana Aditya , Aurino Leorca , Menna Clara 
Published: August 2022

AbstractExtensive burn surgeries lead to a considerable amount of blood loss. Predicting preoperative blood loss is essential for blood ordering and cross-matching. Accurate amount of ordered blood units ensures patients’ safety and minimizes cost. However, blood loss estimation is complicated due to a variety of factors influencing blood loss, including patient and operative-related variables. Currently, no standard method to predict blood loss exists prior to surgery. Our goal is to review factors influencing blood loss and formulas that can predict blood loss. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE databases for studies investigating blood loss in burn surgeries with a clear quantitative outcome. Fifteen studies were included, comprising 1613 subjects. All studies calculated blood loss and assessed possible related factors, and four studies proposed preoperative blood loss prediction formulas. Larger areas of tissue excised and grafted, younger age, and delayed surgery were correlated with increased blood loss. Varying decrease in blood loss was observed with tumescent usage and other bleeding control methods. Other variables produced inconsistent results. From four prediction formulas, only one formula, Dye’s Formula, had been applied and proven effective in reducing unused blood units clinically by up to 40% of cross-matched blood. Various confounding factors and dissimilarities between studies make reliable prediction method construction challenging. With consideration of diverse patient characteristics, some study develops formulas to achieve optimal patient care and avoid unnecessary hospital expenditure. Further research with consistent variables should be done to construct a standardized blood loss estimation formula.
Targeting senescent cells for a healthier longevity: the roadmap for an era of global aging
Authors: Sun Yu , Li Qingfeng , Kirkland James L 
Published: August 2022

Abstract
Aging is a natural but relentless process of physiological decline, leading to physical frailty, reduced ability to respond to physical stresses (resilience) and, ultimately, organismal death. Cellular senescence, a self-defensive mechanism activated in response to intrinsic stimuli and/or exogenous stress, is one of the central hallmarks of aging. Senescent cells cease to proliferate, while remaining metabolically active and secreting numerous extracellular factors, a feature known as the senescence-associated secretory phenotype. Senescence is physiologically important for embryonic development, tissue repair, and wound healing, and prevents carcinogenesis. However, chronic accumulation of persisting senescent cells contributes to a host of pathologies including age-related morbidities. By paracrine and endocrine mechanisms, senescent cells can induce inflammation locally and systemically, thereby causing tissue dysfunction, and organ degeneration. Agents including those targeting damaging components of the senescence-associated secretory phenotype or inducing apoptosis of senescent cells exhibit remarkable benefits in both preclinical models and early clinical trials for geriatric conditions. Here we summarize features of senescent cells and outline strategies holding the potential to be developed as clinical interventions. In the long run, there is an increasing demand for safe, effective, and clinically translatable senotherapeutics to address healthcare needs in current settings of global aging.
Barriers and Potential Solutions to Implementing Evidence-Based PTSD Treatment in Military Treatment Facilities
Authors: McLean Carmen P , Cook Jeffrey , Riggs David S , Peterson Alan L , Young-McCaughan Stacey , Borah Elisa V , Comtois Katherine Anne , Dondanville Katherine A , Frick Erin , Haddock Christopher K , Mann Jeffrey , Reynolds David , Mistretta Melissa , Neitzer Andrea , Brzuchalski Amy , Clayton Spencer P , Conforte Allison M , DuMars Tyler D , Ekundayo Kendra , Flores Araceli , Hein Jessica , Jinkerson Jeremy , Keith Felicia , Kim Hana J , Link Jared S , Nofziger Debra , Pollick Kirsten , Ringdahl Erik N , Waggoner John , Woodworth Craig , Rosen Craig S 
Published: August 2022

ABSTRACT

Introduction
Prolonged exposure therapy is an effective treatment for posttraumatic stress disorder that is underutilized in health systems, including the military health system. Organizational barriers to prolonged exposure implementation have been hypothesized but not systematically examined. This multisite project sought to identify barriers to increasing the use of prolonged exposure across eight military treatment facilities and describe potential solutions to addressing these barriers.

Materials and Methods
As part of a larger project to increase the use of prolonged exposure therapy in the military health system, we conducted a needs assessment at eight military treatment facilities. The needs assessment included analysis of clinic administrative data and a series of stakeholder interviews with behavioral health clinic providers, leadership, and support staff. Key barriers were matched with potential solutions using a rubric developed for this project. Identified facilitators, barriers, and potential solutions were summarized in a collaboratively developed implementation plan for increasing prolonged exposure therapy tailored to each site.

Results
There was a greater than anticipated consistency in the barriers reported by the sites, despite variation in the size and type of facility. The identified barriers were grouped into four categories: time-related barriers, provider-related barriers, barriers related to patient education and matching patients to providers, and scheduling-related barriers. Potential solutions to each barrier are described.

Conclusions
The findings highlight the numerous organizational-level barriers to implementing evidence-based psychotherapy in the military health system and offer potential solutions that may be helpful in addressing the barriers.
Vein and Wehrlite Formation in the Lithospheric Mantle Below the West Eifel Volcanic Field: Modelling the Effects of Pressure, Temperature and Peridotite/Melt Ratio on Magma-Peridotite Interaction Using pMELTS and a Melt Infiltration Experiment
Authors: Ma Shuai , Shaw Cliff S J 
Published: August 2022

AbstractThe mantle peridotite xenoliths of the West Eifel Volcanic Field in Germany preserve evidence of multiple phases of metasomatism. The most recent metasomatic episode produced a variety of veins in the peridotite: high temperature (&gt;1150°C), phlogopite–clinopyroxenite intermediate temperature (~1150°C), olivine clinopyroxenite and relatively low temperature (&lt;1100°C) hornblendite together with marginal reaction zones of wehrlite and dunite. The veins and associated reaction zones have been interpreted as products of crystallization of magmas similar to those that transported the xenoliths to surface. We describe a high temperature melt infiltration experiment and thermodynamic (pMELTS) models that examine the origin of high temperature phlogopite–clinopyroxenite veins and the evolution of the wall rock adjacent to the veins and compare the result to the major and trace element signatures of the minerals in the veins. The infiltration experiment replicates the common reaction textures such as partially dissolved orthopyroxene and sieved secondary clinopyroxene that are found associated with veins. In the thermodynamic model, we calculated the equilibrium assemblages and mineral compositions for peridotite–melt mixtures ranging from peridotite only to melt only over the range of 1150 to 1350°C and 1 GPa to 2 GPa. The models reproduce the composition of vein minerals at a small peridotite/melt ratio, whereas at larger peridotite/melt ratios they produce wehrlite/dunite assemblages that are similar both in modal mineralogy and composition to the natural samples. The models show that olivine clinopyroxenite veins may have been produced at a higher pressure than the phlogopite–clinopyroxenite veins. Our models show that interaction of magma with a trace element signature indicative of a garnet-bearing source with spinel facies mantle will result in a dilution of the trace element garnet signature with little to no variation in the major oxide composition.
Formulation, design and strategies for efficient nanotechnology-based nasal delivery systems
Authors: de Barros Cecilia , Portugal Isabella , Batain Fernando , Portella Décio , Severino Patrícia , Cardoso Juliana , Arcuri Plinio , Chaud Marco , Alves Thais 
Published: August 2022

Abstract

Objectives
Nanotechnology-based nasal delivery systems have gained interest as a way of overcoming low drug bioavailability, limited brain exposure, fast metabolism and elimination, high doses and unwanted side effects. The main benefits of intranasal (IN) administration include the non-invasive method, easy accessibility, porous epithelial barrier and highly vascularized tissue. However, it is imperative to identify interactions between the materials used and the nasal biological environment to ensure proper release.

Key findings
We have examined principal factors in nasal administration, such as physiological aspects of the nose, drug and biopharmaceutical properties, formulation properties and nasal devices for drug delivery.

Summary
This review highlights new insights into different nanotechnology-based approaches for IN use and focuses on recent developments in topical nasal DDS, outlining the advantages and limitations of each system. This article confines itself to research and novel concepts and the different strategies developed to increase bioavailability, safety and a route to brain delivery.
A modern roadmap for the use of simulation in regional anesthesiology training
Authors: Kumar Amanda H. , Sultan Ellile , Mariano Edward R. , Udani Ankeet D. 
Published: August 2022

Purpose of review
A variety of educational modalities are used to teach regional anesthesia. Simulation is an educational tool that facilitates hands-on learning in a well tolerated, reproducible environment, eliminating potential harm to patients during the process of learning. Available literature and expert consensus statements support customizing simulation programs according to the level of training and experience of the learners.

Recent findings
Simulation is useful for learners of all levels of expertise, though the application and frequency of simulation must be adapted to meet the learners’ objectives.

Summary
This review presents recommendations for the use of simulation for residents, fellows, practicing anesthesiologists without formal training in regional anesthesia, and practicing anesthesiologists with regional anesthesia expertise. Passports and portfolio programs that include simulation can be used to verify training. Virtual applications of simulation are growing, expanding the scope of regional anesthesia simulation and increasing access to lower resource areas.
Ultrasound-guided fascial plane blocks for spine surgery
Authors: McCracken Stephen , Lauzadis Justas , Soffin Ellen M. 
Published: August 2022

Purpose of review
The development of truncal and fascial plane blocks has created novel opportunities to apply regional analgesic techniques to patients undergoing spine surgery. This review will summarize recent literature devoted to evaluating candidate blocks for spine surgery, including erector spinae plane block, thoracolumbar interfascial plane block, midpoint transverse process to pleura block, and transversus abdominis plane block. Procedure-specific effects of blocks on patient and healthcare system outcomes will be presented and gaps in care and knowledge will be highlighted.

Recent findings
The most studied paradigm was bilateral erector spinae plane block for lumbar spine surgery. The most common outcomes assessed were early postoperative pain scores, opioid consumption and related side effects, and length of hospital stay. All candidate blocks were associated with mixed evidence for analgesic and opioid-sparing benefits, and/or reductions in length of hospital stay. The magnitude of these effects was overall small, with many studies showing statistically but not clinically significant differences on outcomes of interest. This may reflect, at least in part, the current state of the (emerging) evidence base on this topic.

Summary
Our understanding of the risks, benefits, and value of truncal and fascial plane blocks for spine surgery cohorts is evolving. Although the results derived from this body of literature are encouraging, further research is required before the widespread adoption of specified blocks into spine care can be recommended.
Cerebral metabolic derangements following traumatic brain injury
Authors: Demers-Marcil Simon , Coles Jonathan P. 
Published: August 2022

Purpose of review
Outcome following traumatic brain injury (TBI) remains variable, and derangements in cerebral metabolism are a common finding in patients with poor outcome. This review compares our understanding of cerebral metabolism in health with derangements seen following TBI.

Recent findings
Ischemia is common within the first 24 h of injury and inconsistently detected by bedside monitoring. Metabolic derangements can also result from tissue hypoxia in the absence of ischemic reductions in blood flow due to microvascular ischemia and mitochondrial dysfunction. Glucose delivery across the injured brain is dependent on blood glucose and regional cerebral blood flow, and is an important contributor to derangements in glucose metabolism. Alternative energy substrates such as lactate, ketone bodies and succinate that may support mitochondrial function, and can be utilized when glucose availability is low, have been studied following TBI but require further investigation.

Summary
Mitochondrial dysfunction and the use of alternative energy substrates are potential therapeutic targets, but improved understanding of the causes, impact and significance of metabolic derangements in clinical TBI are needed. Maintaining adequate oxygen and glucose delivery across the injured brain may accelerate the recovery of mitochondrial function and cerebral energy metabolism and remain important management targets.
Utility of 45S5 Bioactive Glass As Bone Graft Substitute for Cavitary Defects in Pediatric Bone Tumors: A Preliminary Study
Authors: Samade Richard , Jonard Brandon , Scharschmidt Thomas J. 
Published: August 2022

Background:
Bioactive glass has become an increasingly used treatment of cavitary bone defects in a number of orthopaedic applications. The purpose of this study was to evaluate the clinical and radiographic outcomes of bioactive glass used for benign cavitary pediatric bone tumors. A specific focus was on radiographic filling of defects and occurrence of complications by tumor class.

Methods:
A single institution retrospective study was performed, which entailed review of the clinical and radiographic data of 21 patients who underwent surgical curettage and grafting of benign or low-grade malignant bone tumors from 2018 to 2020. In all the cases, 45S5 bioactive glass (Fibergraft; Prosidyan, New Providence, NJ) was used to fill the bone defects. For each patient, data on demographic, preoperative diagnosis, defect size, time to mobilization, radiographic filling grade, pain, and complications were obtained. The Wilcoxon-Mann-Whitney test and Kaplan-Meier survival analysis were used for comparisons between tumor classes.

Results:
In the 21 patients, 11 bone tumors were latent or active (class 1) and 10 were aggressive (class 2). The mean age was 13.0±3.7 years, 6 (28.6%) were female, and the median and interquartile range for initial tumor size were 18.8 (5.8 to 50.6) cm3. Tumors that were class 2 had significantly more complications with bioactive glass use compared with class 1 tumors [0 vs. 1 (0 to 1), P=0.040]. The time of persistent fill grade 1 or 2 defects up to final follow-up was less in class 1 versus class 2 lesions (P=0.048).

Conclusions:
Bioactive glass agents have utility for treating a broad variety of pediatric bone tumors after curettage. However, focusing these agents’ use in treating latent or active subtypes of bone tumors may be ideal in minimizing complications and time to higher fill grade.

Level of Evidence:
Level III—Therapeutic.
Lower Prevalence and Severity of Degenerative Changes in the Lumbar Spine in Elderly Hong Kong Chinese Compared with Age-matched Italian Caucasian Women
Authors: So Tiffany Y. , Diacinti Davide , Leung Jason C.S. , Iannacone Antonio , Kripa Endi , Kwok Timothy C.Y. , Diacinti Daniele , Wang Yi Xiang J. 
Published: August 2022

Study Design.
Cross sectional observational study.

Objective.
To compare the prevalence and severity of radiographic lumbar spine degeneration between elderly Hong Kong Chinese and elderly Italian Caucasian women.

Summary of Background Data.
Rates of symptomatic low back pain and osteoporotic vertebral fracture have been shown to be lower in Asian and Chinese populations compared to Caucasians, but ethnic differences in spinal degeneration are less established.

Methods.
Lumbar spine lateral radiographs of 566 age-matched (mean: 73.6 y; range: 65-87 y) female subjects from two population-based epidemiological studies from Hong Kong (n=283) and Rome, Italy (n=283) were reviewed. Grading of degeneration categories: disc height loss (none, <30%, 30-60%, >60%), osteophyte formation (not present, minimal, small, large), endplate sclerosis (none, mild, moderate, severe), and antero/retrolisthesis (none, <25%, 25-50%, >50%) was performed for vertebral levels from L1/2-L5/S1 (5 levels). Each category was assigned a score (0, 1, 2, 3) at individual vertebral level according to severity. The total degeneration score was obtained by adding scores for all categories across the vertebral levels.

Results.
Italian subjects (total score [mean±SD], 7.0±5.5) had a higher severity of overall degenerative changes compared to Hong Kong subjects (5.7±4.4), P<0.01. Italian subjects had higher scores for individual findings of disc height loss (Italian, 3.6±2.8 vs. Hong Kong 2.5±2.1, P<0.01); antero/retrolisthesis (Italian 0.3±0.7 vs. Hong Kong 0.2±0.4, P=0.01); and end plate sclerosis (Italian 1.0±1.2 vs. Hong Kong 0.6±1.0, P<0.01). At each individual level from L1/2 to L5/S1, total degeneration scores were higher in Italian than Hong Kong subjects (P<0.01 to 0.04)

Conclusion.
Degenerative changes in the lumbar spine are less prevalent and less severe in elderly Hong Kong Chinese women than in age-matched Italian Caucasian women. The observed differences may reflect a foundational background influence of genetic predisposition that requires further studies.
Abaloparatide Enhances Fusion and Bone Formation in a Rabbit Spinal Arthrodesis Model
Authors: Morse Kyle W. , Moore Harold , Kumagai Hiroshi , Hahn William , Koo Alexander , Meyers Kathleen N. , Bouxsein Mary L. , Brooks Daniel J. , Lanske Beate , Iyer Sravisht , Cunningham Matthew 
Published: August 2022

Study Design.
Prospective Randomized Placebo Controlled Animal Trial

Objective.
Determine the effect of daily subcutaneous abaloparatide injection on the intervertebral fusion rate in rabbits undergoing posterolateral fusion.

Study of Background Data.
Despite the wide utilization of spine fusion, pseudarthrosis remains prevalent and results in increased morbidity. Abaloparatide is a novel analog of parathyroid hormone-related peptide (1-34) and has shown efficacy in a rat posterolateral spine fusion model to increase fusion rates. The effect of abaloparatide on the fusion rate in a larger animal model remains unknown.

Methods.
24 skeletally mature New Zealand White male rabbits underwent bilateral posterolateral spine fusion. Following surgery, the rabbits were randomized to receive either saline as control or abaloparatide subcutaneous injection daily. Specimens underwent manual assessment of fusion, radiographic analysis with both x-ray and high-resolution peripheral quantitative computed tomography, and biomechanical assessment.

Results.
Rabbits that received abaloparatide had a 100% (10/10) fusion rate compared to 45% (5/11) for controls (P<0.02) as assessed by manual palpation. Radiographic analysis determined an overall mean fusion score of 4.17±1.03 in the abaloparatide group versus 3.39±1.21 for controls (P<0.001). The abaloparatide group also had a greater volume of bone formed with a BV of 1209±543 mm3 compared to 551±152 mm3 (P<0.001) for controls. The abaloparatide group had significantly greater trabecular bone volume fraction and trabecular thickness and lower specific bone surface and connectivity density in the adjacent levels when compared to controls. Abaloparatide treatment did not impact trabecular number or separation. There were no differences in biomechanical testing in flexion, extension, or lateral bending (P>0.05) between groups.

Conclusion.
Abaloparatide significantly increased the fusion rate in a rabbit posterolateral fusion model as assessed by manual palpation. Additionally, there were marked increases in the radiographic evaluation of fusion.
The Variability and Contributions to Cost of Anterior Cervical Discectomy and Fusion Constructs
Authors: Lindsey Matthew H. , Xiong Grace X. , Karhade Aditya V. , Lightsey Harry M. , Crawford Alexander M. , Schoenfeld Andrew J. , Simpson Andrew K. 
Published: August 2022

Study Design:
This was a retrospective cohort study.

Objective:
To characterize the variability in cost for anterior cervical discectomy and fusion (ACDF) constructs and to identify key predictors of procedural cost.

Summary of Background Data:
ACDF is commonly performed for surgical treatment of cervical radiculopathy and myelopathy. Numerous biomechanical constructs and graft/biological options are available, with most demonstrating relatively equivalent clinical results. Despite the substantial focus on value in spine care, the differences and contributions to procedural cost in ACDF have not been well defined.

Materials and Methods:
We evaluated the records of patients who underwent a single level ACDF from 2016 to 2020 at 4 hospitals in a major metropolitan area. We abstracted demographics, insurance status, operative time, diagnosis, surgeon, institution, and components of procedural costs. Costs based on construct were compared using multivariable adjusted analyses using negative binomial regression. The primary outcome measures were cost differences between ACDF techniques.

Results:
Two hundred sixty-four patients were included, with procedures by 13 surgeons across 4 institutions. The total procedural cost for ACDF had a mean of US$2317 with wide variation (range, US$967–US$7370). Multivariable analysis revealed body mass index and use of polyether ether ketone to be correlated with increased cost while carbon fiber and autograft correlated with decreased cost. When comparing standalone device constructs to cases with anterior instrumentation (plate/screws), the total cost was significantly higher in the plate/screw group (US$2686±US$921 vs. US$1466±US$878, P<0.001).

Conclusions:
We encountered wide variation in procedural costs associated with ACDF, including as much as an 8-fold difference in the cost of constructs. The most important drivers included instrumentation type and implant materials. Here, we identify potential targets of opportunity for health care organizations that are looking to reduce variance in procedural expenditures to improve health care savings associated with the performance of ACDF.