bluuebunny/crossref_metadata_2025_split huggingface dataset:
Musculoskeletal Pain Management and Patient Mental Health and Well-being
Authors: Wally Meghan K. , Hsu Joseph R. , Seymour Rachel B. 
Published: September 2022

Summary:
Orthopaedic trauma patients have high rates of psychiatric disorders, which put them at risk for worse outcomes after injury and surgery, including worse pain. Mental health conditions, such as depression and anxiety, can affect the perception of pain. Pain can also exacerbate or contribute to the development of mental illness after injury. Interventions to address both mental health and pain among orthopaedic trauma patients are critical. Balancing safety and comfort amid a drug overdose epidemic is challenging, and many clinicians do not feel comfortable addressing mental health or have the resources necessary. We reviewed the literature on the complex relationship between pain and mental health and presented examples of scalable and accessible interventions that can be implemented to promote the health and recovery of our patients. Interventions described include screening for depression in the orthopaedic trauma clinic and the emergency department or inpatient setting during injury and using a comprehensive and evidence-based multimodal pain management regimen that blends pharmacologic alternatives to opioids and physical and cognitive strategies to manage pain.
Return to Work after Surgery for Cervical Radiculopathy: A Nationwide Registry-based Observational Study
Authors: Hara Sozaburo , Lønne Vetle Vangen , Aasdahl Lene , Salvesen Øyvind , Solberg Tore , Gulati Sasha , Hara Karen Walseth 
Published: September 2022

Study Design.
Observational multicenter study.

Summary of Background Data.
Return to work (RTW) is increasingly used to assess the standard, benefit, and quality of health care.

Objective.
The aim of this study was to evaluate sick leave patterns among patients undergoing surgery for cervical radiculopathy and identify predictors of successful RTW using two nationwide databases.

Methods.
Data from the Norwegian Registry for Spine Surgery (NORspine) and the Norwegian Labour and Welfare Administration were linked on an individual level. We included patients between 18 and 60 years of age registered in NORspine from June 2012 through December 2019 that were temporarily out of the labor force for medical reasons at the time of surgery. We assessed types and grades of sickness benefits before and after surgery and conducted logistic regression analyses.

Results.
Among 3387 patients included in the study, 851 (25.1%) received temporary benefits one year before surgery. The proportion of recipients increased steadily towards surgery. Postoperatively the medical benefit payment decreased rapidly, and half of the patients had already returned to work by four months. The rate of RTW reached a plateau at one year. By the end of the third year, 2429 patients (71.7%) had returned to work. The number of sick days, categorized as 90 or less, during the year before surgery had the most powerful association with RTW at two years (OR 4.54, 95%CI 3.42-6.03, P<0.001). Improvement in neck-related disability was the second strongest predictor (OR 2.17, 95%CI 1.69-2.78, P<0.001).

Conclusion.
RTW after cervical radiculopathy surgery occurs primarily during the first year. The strongest predictor of RTW was fewer sick days before surgery. The clinical improvement after surgery had a lesser impact.

Level of Evidence.
2
Instability Missed by Flexion-Extension Radiographs Subsequently Identified by Alternate Imaging in L4-5 Lumbar Degenerative Spondylolisthesis
Authors: Fong Alex M. , Duculan Roland , Endo Yoshimi , Carrino John A. , Cammisa Frank P. , Sama Andrew A. , Hughes Alexander P. , Lebl Darren R. , Farmer James C. , Huang Russel C. , Sandhu Harvinder S. , Mancuso Carol A. , Girardi Federico P. 
Published: September 2022

Study Design.
Cross-sectional preoperative and intraoperative imaging study of L4-5 lumbar degenerative spondylolisthesis (LDS).

Objective.
To determine if alternate imaging modalities would identify LDS instability that did not meet criteria for instability based on comparison of flexion and extension radiographs.

Summary of Background Data.
Pain may limit full flexion and extension maneuvers and thereby lead to underreporting of true dynamic translation and angulation in LDS. Alternate imaging pairs may identify instability missed by flexion-extension.

Methods.
Consecutive patients scheduled for surgery for single level L4-5 LDS had preoperative standing radiographs in the lateral, flexion and extension positions, supine CT scans, and intraoperative fluoroscopic images in the supine and prone positions after anesthesia but before incision. Instability was defined as translation ≥3.5 mm or angulation ≥11° between the following pairs of images: 1) flexion-extension; 2) CT-lateral; 2) lateral-intraoperative supine; 3) lateral-intraoperative prone; and 4) intraoperative supine-prone.

Results.
Of 240 patients (mean age 68 y, 54% women) 15 (6%) met criteria for instability by flexion-extension and 225 were classified as stable. Of these 225, another 84 patients (35% of total enrollment) were re-classified as unstable by comparison of CT-lateral images (21 patients) and by lateral-intraoperative images (63 patients). Nine of the 15 patients diagnosed with instability by flexion-extension had fusion (60%), and 68 the 84 patients re-classified as unstable by other imaging pairs had fusion (81%) (P=0.07). The 84 re-classified patients were more likely to undergo fusion compared to the 141 patients who persistently remained classified as stable (OR 2.6, 95% CI 1.4-4.9, P=0.004).

Conclusions.
Our study provides evidence that flexion and extension radiographs underreport the dynamic extent of LDS and therefore should not be solely relied upon to ascertain instability. These findings have implications for how instability should be established and the extent of surgery that is indicated.
Usage of augmented reality for interventional neuraxial procedures
Authors: Reinacher Peter Christoph , Cimniak Anina , Demerath Theo , Schallner Nils 
Published: September 2022

BACKGROUND
Neuraxial access is necessary for an array of procedures in anaesthesia, interventional pain medicine and neurosurgery. The commonly used anatomical landmark technique is challenging and requires practical experience.

OBJECTIVE
We aimed to evaluate the technical feasibility of an augmented reality-guided approach for neuraxial access and tested the hypothesis that its use would improve success as the primary outcome. As secondary outcomes, we measured accuracy and the procedural duration compared with the classical landmark approach.

DESIGN
A randomised phantom-based study.

SETTING
The three-dimensional image of a thoracolumbar phantom spine model with the surrounding soft tissue was created with a neurosurgical planning workstation and ideal trajectories to the epidural space on the levels T10-L1 were planned using a paramedian approach. Both the three-dimensional holographic image of the spine and the trajectories were transferred to an augmented reality-headset. Four probands (two anaesthesiologists, one neuroradiologist and one stereotactic neurosurgeon) performed 20 attempts, 10 each of either conventional landmark or augmented reality-guided epidural punctures, where anatomical level, side and sequence of modality were all randomised.

OUTCOME MEASURES
Accuracy was assessed by measuring Euclidean distance and lateral deviation from the predefined target point. Success of epidural puncture on the first attempt was compared between the conventional and the augmented reality-guided approaches.

RESULTS
Success was achieved in 82.5% of the attempts using augmented reality technique, compared with 40% with the conventional approach [P = 0.0002, odds ratio (OR) for success: 7.07]. Euclidean distance (6.1 vs. 12 mm, P < 0.0001) and lateral deviation (3.7 vs. 9.2 mm, P < 0.0001) were significantly smaller using augmented reality. Augmented reality-guided puncture was significantly faster than with the conventional landmark approach (52.5 vs. 67.5 s, P = 0.0015).

CONCLUSION
Augmented reality guidance significantly improved the accuracy and success in an experimental phantom model of epidural puncture. With further technical development, augmented reality guidance might prove helpful in anatomically challenging neuraxial procedures.
A 48-year-old Caucasian man with unilateral “smudge” in inferior visual field
Authors: Pasricha Malini V. , Johnson Robert N. , Agarwal Anita , Jumper J. Michael , McDonald H. Richard , Cunningham Emmett T. 
Published: September 2022

Abstract

PURPOSE:
To report an increasingly prevalent fundoscopic manifestation of syphilitic uveitis.

METHODS:
Case report of a patient with acute retinal necrosis secondary to syphilis.

RESULTS:
A 48-year-old man presented with decreased vision, anterior segment inflammation, and a wedge-shaped retinal lesion in the superior periphery, with a diaphanous leading edge extending down towards the superior arcade. The patient was HIV+ and poorly compliant with therapy. The top three differential diagnoses were herpetic necrotizing retinitis, syphilis, and lymphoma. An extensive lab workup was positive for syphilis. The patient was treated with IV penicillin G and demonstrated improvement in visual acuity and exam.

CONCLUSION:
There have been an increasing number of reports of syphilis patients, especially in the population of men who have sex with men, who present with fundus findings similar to acute retinal necrosis. These findings include a characteristic ground glass, translucent appearance of unifocal or multifocal lesions, primarily affecting the inner retina and sometimes associated with co-localizing occlusive vasculitis. Treatment with IV penicillin G is warranted and has demonstrated good visual recovery.
Efficacy of Robots-Assisted Therapy in Patients With Stroke
Authors: Saragih Ita Daryanti , Everard Gauthier , Tzeng Huey-Ming , Saragih Ice Septriani , Lee Bih-O 
Published: September 2022

Background
Robot-assisted therapy (RAT) could address an unmet need to relieve the strain on healthcare providers and intensify treatment in the context of an increasing stroke incidence. A comprehensive meta-analysis could provide firmer data about the topic by considering methodology limitations discovered in previous reviews and providing more rigorous evidence.

Objective
This meta-analysis study identifies RAT's efficacy for patients with stroke.

Methods
A systematic search of the 7 databases from January 10 to February 1, 2022, located relevant publications. We used the updated Cochrane risk-of-bias checklist for 52 trials to assess the methodologic quality of the included studies. The efficacy of RAT for patients with stroke was estimated using a pooled random-effects model in the Stata 16 software application.

Results
The final analysis included 2774 patients with stroke from 52 trials. In those patients, RAT was proven to improve quality of movement (mean difference, 0.15; 95% confidence interval, 0.03–0.28) and to reduce balance disturbances (mean difference, −1.28; 95% confidence interval, −2.48 to −0.09) and pain (standardized mean difference, −0.34; 95% confidence interval, −0.58 to −0.09).

Conclusions
Robot-assisted therapy seems to improve the quality of mobility and reduce balance disturbances and pain for patients with stroke. These findings will help develop advanced rehabilitation robots and could improve health outcomes by facilitating health services for healthcare providers and patients with stroke.
Lived Experience of Breast Cancer Survivors: A Phenomenological Study
Authors: CHIARANAI Chantira , CHULAREE Saranya , WHITE Jeranut Somchock 
Published: September 2022

ABSTRACT

Background
Breast cancer (BrCa) is the most common cancer worldwide. Five-year survival rates among individuals with BrCa are the highest of all types of cancer, yet there is a paucity of knowledge about the experiences of survivors regarding living through their diagnosis and treatment. In-depth interviews and the systematic analysis of self-reported experiences may provide in-depth information about the BrCa survivorship experience.

Purpose
This qualitative study was designed to identify and elucidate the lived experiences of Thai women with BrCa who successfully completed their treatment program for BrCa and/or treatment with chemotherapy for over 5 years and are currently cancer-free.

Methods
A phenomenological method was employed. Survivors of BrCa who met the inclusion criteria were purposively selected and invited to take part in the study. Study data were collected between January and March 2019. An open-ended, in-depth interview guide was used to direct the conversation concerning the participants' experiences and perceptions. Thematic analysis was used for data analysis.

Results
Data saturation was reached after 12 interviews. The five themes derived from the data include (a) being distressed, (b) accepting treatments and seeking alternative treatments, (c) going through difficult times, (d) becoming a stronger person, and (e) becoming thankful.

Conclusions/Implications for Practice
The experiences and themes identified enhance scholarly understanding regarding the experience of survivors of BrCa. A true understanding of this experience enables healthcare providers to craft and deliver appropriate interventions that provide quality care and improve women's health, thereby enhancing their quality of life. The results of this study may contribute to the development of new theories by using different qualitative approaches such as grounded theory.
The effects of nutrition supplement on rehabilitation for patients with stroke: Analysis based on 16 randomized controlled trials
Authors: Liu Jianhua , Dong Jige , Guo Jiangzhou 
Published: September 2022

Background:
Malnutrition is a relatively common and often unrecognized condition in stroke survivors, which may negatively affect functional recovery and survival. Though previous studies have indicated significant role of nutrition supplement for rehabilitation of patients with stroke, the results still remain controversy.

Objective:
The present analysis was designed to systematically review effective evidence of nutrition supplement on rehabilitation for patients with stroke.

Methods:
A systematic search of PubMed, EMBASE, the Cochrane Library, and Web of Science up to August 1, 2021 was performed to find relevant studies that analyzed the effect of nutrition supplement on rehabilitation of patients with stroke. The primary outcome was functional outcomes and activities of daily living (ADL). The secondary outcomes included disability, all-cause mortality, infections, pneumonia, walking ability, stroke recurrence, and laboratory results indicating nutrition status of patients. All statistical analyses were performed using standard statistical procedures with Review Manager 5.2.

Results:
Ultimately, 16 studies including 7547 patients were identified. Our pooled results found no significant difference in total, cognitive and motor FIM score between nutrition supplement and placebo groups, with pooled MDs of 7.64 (95% CI − 1.67 to 16.94; P = .11), 0.74 (95% CI − 1.33 to 2.81; P = .48), 1.11 (95% CI − 1.68 to 3.90; P = .44), respectively. However, our result showed that nutritional interventions had significant effect on ADL for patients with stroke (MD 3.26; 95% CI 0.59 to 5.93; P = .02). In addition, nutrition supplement reduced the incidence of infections for patients with stroke, with a pooled RR of 0.65 (95% CI 0.51 to 0.84; P = .0008). No significant results were found in disabilities, complication and laboratory outcomes.

Conclusions:
The present meta-analysis indicated no statistically significant effect of nutrition supplement on functional outcomes as well as disabilities, complication and laboratory outcomes for patients with stroke. However, it increased ADL and reduced the incidence of infections.
ATRX status in patients with gliomas: Radiomics analysis
Authors: Meng Linlin , Zhang Ran , Fa Liangguo , Zhang Lulu , Wang Linlin , Shao Guangrui 
Published: September 2022

The aim of this study was to develop a noninvasive radiomics analysis model based on preoperative multiparameter MRI to predict the status of the biomarker alpha thalassemia/mental retardation X-linked syndrome (ATRX) in glioma noninvasively.

Material and methods:
A cohort of 123 patients diagnosed with gliomas (World Health Organization grades II–IV) who underwent surgery and was treated at our center between January 2016 and July 2020, was enrolled in this retrospective study. Radiomics features were extracted from MR T1WI, T2WI, T2FLAIR, CE-T1WI, and ADC images. Patients were randomly split into training and validation sets at a ratio of 4:1. A radiomics signature was constructed using the least absolute shrinkage and selection operator (LASSO) to train the SVM model using the training set. The prediction accuracy and area under curve and other evaluation indexes were used to explore the performance of the model established in this study for predicting the ATRX mutation state.

Results:
Fifteen radiomic features were selected to generate an ATRX-associated radiomic signature using the LASSO logistic regression model. The area under curve for ATRX mutation (ATRX(−)) on training set was 0.93 (95% confidence interval [CI]: 0.87–1.0), with the sensitivity, specificity and accuracy being 0.91, 0.82 and 0.88, while on the validation set were 0.84 (95% CI: 0.63–0.91), with the sensitivity, specificity and accuracy of 0.73, 0.86, and 0.79, respectively.

Conclusions:
These results indicate that radiomic features derived from preoperative MRI facilitat efficient prediction of ATRX status in gliomas, thus providing a novel evaluation method for noninvasive imaging biomarkers.
Effects of acupoint herbal patching as an add-on to asthma medication during Sanfu days, as the hottest days in summer, on the acute attack, the immunological response, and the pulmonary function in asthmatic children: A meta-analysis
Authors: Liu Xinsheng , Li Jing 
Published: September 2022

Background:
A meta-analysis was performed to evaluate the effect of acupoint herbal patching as an add-on to asthma medication during Sanfu days, as the hottest days in summer, on the acute attack, immunological response, and the pulmonary function in asthmatic children.

Methods:
A systematic literature search up to July 2021 was performed and 13 studies included 1166 asthmatic children at the start of the study; 587 of them were using acupoint herbal patching as an add-on to asthma medication during Sanfu days and 579 were given asthma medication only.

Results:
Acupoint herbal patching as add-on to asthma medication had significantly lower frequency of acute attack (mean difference [MD], –1.57; 95% confidence interval [CI], –2.28 to –0.85, P < .001), lower asthma relapse (odds ratio, 0.13; 95% CI, 0.04–0.43, P < .001), and higher forced expiratory volume in 1 second (MD, 1.72; 95% CI, 0.89–2.65, P < .001), higher peak expiratory flow rate (MD, 1.15; 95% CI, 0.37–1.93, P = .004), lower immunoglobulin E after treatment (MD, –123.81; 95% CI, –185.60 to –62.02, P < .001), and higher interferon-gamma after treatment (MD, 7.17; 95% CI, 2.42–11.92, P = .003) compared to asthma medication only in asthmatic children.

Conclusions:
Acupoint herbal patching as an add-on to asthma medication during Sanfu days had a significantly lower frequency of acute attack, lower asthma relapse, higher forced expiratory volume in 1 second, higher peak expiratory flow rate, and higher interferon-gamma after treatment in asthmatic children compared to asthma medication only in asthmatic children.
Prognostic factors associated with left ventricular non-compaction: A PRISMA-compliant meta-analysis
Authors: Yang Ze-Guang , Liu Zhi-Jie , Zhang Xiang-Xin , Wang Li 
Published: September 2022

Background:
Left ventricular non-compaction (LVNC) is a rare disease with a poor prognosis. Efforts to improve prognosis are limited by the quality and scope of the available evidence on prognostic factors.

Methods:
Pubmed, Embase, China National Knowledge Infrastructure, Cochrane Library, Wanfang, and Baidu Scholar were searched and all relevant studies that examined factors related to LVNC prognosis, published before January 2021, were retrieved. Study quality evaluation and data extraction were independently completed by two authors. Statistical analyses were performed using STATA 15.0 software.

Results:
A total of 20 cohort studies were included in this study, with a total of 1910 patients. The results of the meta-analysis are as follows: New York Heart Function Association (NYHA) class III/IV (hazard ratio [HR] = 3.93, 95% confidence interval [CI]: 1.66–9.29), (NT-proBNP) increased (HR = 1.98, 95% CI: 1.10–3.58), left ventricular ejection fraction (LVEF) decreased (HR = 1.04, 95% CI: 1.03–1.06), left ventricular end-diastolic diameter (LVEDD) increased (HR = 1.03, 95% CI: 1.01–1.06) was an independent poor prognostic factor, and body mass index (HR = 0.80, 95% CI: 0.64–0.98) was an independent protective factor. Creatinine (CR) level (HR = 1.09, 95% CI: 0.95–1.25) and late gadolinium-enhanced (LGE) imaging (HR = 3.1, 95% CI: 0.85–11.31) has no statistical significance in the prognosis of LVNC.

Conclusion:
In LVNC patients, NYHA class III/IV, elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, decreased LVEF, and increased LVEDD may lead to poor prognosis, and increased body mass index may improve the prognosis of LVNC. Further clinical research with large sample sizes and long-term follow-ups should be conducted.

PROSPERO Registration Number:
42020152706