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Background And Objectives: This study evaluates the effectiveness of a transitional care program (TCP) implemented for spinal neurosurgery patients, focusing on the reduction of length of stay (LOS).
Methods: We conducted a retrospective analysis of patients treated by 5 primary surgeons at our institution from January 2023 to December 2023. The analysis included 2 distinct parts: a multivariable ordinary least squares regression to determine factors affecting LOS for all spine surgery patients and a subset analysis using multivariable logistic regression to identify factors contributing to extended LOS in extended recovery unit (ERU)-admitted patients.
Results: The study encompassed 986 patients, highlighting a significant reduction in LOS for those with planned ERU stays. Key findings from the ordinary least squares regression revealed factors such as chronic obstructive pulmonary disorder history and postoperative complications significantly increased LOS, whereas planned ERU admission decreased LOS. The logistic regression focused on ERU patients indicated that chronic obstructive pulmonary disorder markedly increased the odds of an extended LOS. However, receiving an educational visit from a TCP nurse significantly decreased the likelihood of extended LOS, underlining the importance of in-hospital education. In addition, complex surgeries indicated by the number of levels fused showed a correlation with prolonged LOS.
Conclusion: Our findings underscore the significance of targeted educational interventions and preoperative planning in achieving these outcomes. Future efforts should aim to further refine the TCP and explore digital innovations for patient engagement and education.
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http://dx.doi.org/10.1227/ons.0000000000001650 | DOI Listing |
JAMA Intern Med
September 2025
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Importance: Hospitals have reported growing difficulty in discharging patients in a timely manner, often citing bottlenecks in postacute care. Medicare Advantage plans, now the dominant form of Medicare coverage, may contribute to these delays due to administrative and network constraints, yet national evidence is lacking.
Objective: To quantify changes in hospital length of stay for Medicare Advantage vs traditional Medicare beneficiaries.
ACS Chem Neurosci
September 2025
Chemical and Biomolecular Engineering Dept, University of California, Los Angeles, Los Angeles, California 90095, United States.
Simulations in three dimensions and time provide guidance on implantable, electroenzymatic glutamate sensor design; relative placement in planar sensor arrays; feasibility of sensing synaptic release events; and interpretation of sensor data. Electroenzymatic sensors based on the immobilization of oxidases on microelectrodes have proven valuable for the monitoring of neurotransmitter signaling in deep brain structures; however, the complex extracellular milieu featuring slow diffusive mass transport makes rational sensor design and data interpretation challenging. Simulations show that miniaturization of the disk-shaped device size below a radius of ∼25 μm improves sensitivity, spatial resolution, and the accuracy of glutamate concentration measurements based on calibration factors determined .
View Article and Find Full Text PDFOphthalmic Plast Reconstr Surg
September 2025
Division of Orbital and Ophthalmic Plastic Surgery.
Purpose: To objectively quantify, in East Asians and Caucasians, the width and distribution of the retro-orbicularis oculi and frontalis fat (ROOF) pad, subcutaneous fat, and orbicularis oculi muscle (OOM) at the superior orbital rim margin as well as 5 mm superior and inferior to this point.
Methods: Thirty adults were studied by high-resolution, surface coil MRI. In the quasi-sagittal image through the globe center, the ROOF, subcutaneous fat, and OOM thickness were measured anterior to the orbital septum, at 3 points: at the superior orbital rim, and 5 mm superior, and 5 mm inferior to the rim.
Perspect Behav Sci
September 2025
University of Southern California and FirstSteps for Kids, Los Angeles, CA USA.
Feelings have long run high between many autistic advocates and behavior analysts. The former often experience and perceive ABA as harmful and traumatic in its methods, and prejudicial and stigmatizing in its objectives, with some of the latter retorting that criticisms reflect misunderstandings of the science rather than areas of true concern. The result? A deep and contentious conceptual divide, leaving little room for dialogue or progress.
View Article and Find Full Text PDFRes Pract Thromb Haemost
July 2025
Division of Cardiology, Ahmanson-UCLA Cardiomyopathy Center, University of California Los Angeles, Los Angeles, California, USA.
Background: Venous thromboembolism (VTE) is a major cause of cardiovascular morbidity and mortality globally. Although direct oral anticoagulants (DOACs) have improved extended VTE treatment, the optimal dose for balancing efficacy and safety remains unclear.
Objectives: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of reduced-dose DOACs vs full-dose regimens during extended anticoagulation for VTE.