bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of a Primary Support Program: family physicians and mental health professionals’ perspective
Authors: Gil-Girbau Montserrat , Peñarrubia-Maria Maria-Teresa , Carbonell-Simeón Davinia , Rodríguez-Ferraz Brenda , Contaldo Salvatore-Fabrizio , Iglesias-González Maria , Fernández-Vergel Rita , Blanco-García Elena , Baladon-Higuera Luisa , Serrano-Blanco Antoni , Rubio-Valera Maria
Published: February 2022

Background

Mental health (MH) disorders are increasingly prevalent in primary care (PC) and this has generated, in recent years, the development of strategies based on the collaborative model and the stepped care model. The Primary Support Program (PSP) was implemented in the community of Catalonia (Spain) during 2006 to improve, from the first level of care, treatment of the population with mild–moderate complexity MH problems along with identification and referral of severe cases to specialized care. The aim of the present study was to identify the strengths and limitations of the PSP from the perspective of health professionals involved in the programme.

Methods

An explanatory qualitative study based on Grounded Theory. We conducted group semistructured interviews with 37 family physicians and 34 MH professionals. A constant comparative method of analysis was performed.

Results

Operation of the PSP is influenced by internal factors, such as the programme framework, MH liaison, management of service supply and demand, and the professional team involved. Additionally, external factors which had an impact were related to the patient, the professionals, the Health System, and community resources.

Conclusions

The operation of the PSP could benefit from a review of the programme framework and optimization of MH liaison. Improvements are also proposed for MH training in PC, intraprofessional coordination, use of community resources, and creation of efficient continuous assessment systems.
A New Gene Family Diagnostic for Intracellular Biomineralization of Amorphous Ca Carbonates by Cyanobacteria
Authors: Benzerara Karim , Duprat Elodie , Bitard-Feildel Tristan , Caumes Géraldine , Cassier-Chauvat Corinne , Chauvat Franck , Dezi Manuela , Diop Seydina Issa , Gaschignard Geoffroy , Görgen Sigrid , Gugger Muriel , López-García Purificación , Millet Maxime , Skouri-Panet Fériel , Moreira David , Callebaut Isabelle
Published: February 2022

Cyanobacteria have massively contributed to carbonate deposition over the geological history. They are traditionally thought to biomineralize CaCO3 extracellularly as an indirect byproduct of photosynthesis. However, the recent discovery of freshwater cyanobacteria-forming intracellular amorphous calcium carbonates (iACC) challenges this view. Despite the geochemical interest of such a biomineralization process, its molecular mechanisms and evolutionary history remain elusive. Here, using comparative genomics, we identify a new gene (ccyA) and protein family (calcyanin) possibly associated with cyanobacterial iACC biomineralization. Proteins of the calcyanin family are composed of a conserved C-terminal domain, which likely adopts an original fold, and a variable N-terminal domain whose structure allows differentiating four major types among the 35 known calcyanin homologs. Calcyanin lacks detectable full-length homologs with known function. The overexpression of ccyA in iACC-lacking cyanobacteria resulted in an increased intracellular Ca content. Moreover, ccyA presence was correlated and/or colocalized with genes involved in Ca or HCO3− transport and homeostasis, supporting the hypothesis of a functional role of calcyanin in iACC biomineralization. Whatever its function, ccyA appears as diagnostic of intracellular calcification in cyanobacteria. By searching for ccyA in publicly available genomes, we identified 13 additional cyanobacterial strains forming iACC, as confirmed by microscopy. This extends our knowledge about the phylogenetic and environmental distribution of cyanobacterial iACC biomineralization, especially with the detection of multicellular genera as well as a marine species. Moreover, ccyA was probably present in ancient cyanobacteria, with independent losses in various lineages that resulted in a broad but patchy distribution across modern cyanobacteria.
Differential Trends in Disability Among Rich and Poor Adults in the United States and England From 2002 to 2016
Authors: Choi HwaJung , Schoeni Robert F , Steptoe Andrew , Cho Tsai-Chin , Langa Kenneth M
Published: February 2022

Objectives

Disability in the United States has not improved in recent decades. Comparing temporal trends in disability prevalence across different income groups, both within and between the United States and England, would inform public policy aimed at reducing disparities in disability.

Methods

Using the Health and Retirement Study and the English Longitudinal Study of Ageing, we estimated annual percent change from 2002 to 2016 in disability among community-dwelling adults (197,021 person-years of observations). Disability was defined based on self-report of limitations with 5 instrumental activities of daily living and 6 activities of daily living. We examined the trends by age and income quintile and adjusted for individual-level sociodemographic status and survey design.

Results

The adjusted annual percent change (AAPC) in disability prevalence declined significantly in both countries for ages 75 and older during 2002–2016. For ages 55–64 and 65–74, disability prevalence was unchanged in the United States but declined in England. Both countries experienced a widening gap in disability between low- and high-income adults among the younger age groups. For example, for those ages 55–64 in each country, there was no significant improvement in disability for the low-income group but a significant improvement for the high-income group (AAPC = −3.60; 95% confidence interval [CI; −6.57, −0.63] for the United States; AAPC = −6.06; 95% CI [−8.77, −3.35] for England).

Discussion

Improvements in disability were more widespread in England than in the United States between 2002 and 2016. In both countries, the disparity in disability between low- and high-income adults widened for middle-aged adults. Policies targeted at preventing disability among low-income adults should be a priority in both countries.
Displacements and stress associated with localized and distributed inelastic deformation with piecewise-constant elastic variations
Authors: Sato Dye S K , Moore James D P
Published: February 2022

We present a semi-analytical method and expressions for computing the displacements, strains and stress due to localized (e.g. faulting) and distributed (volumetric) inelastic deformation in heterogeneous elastic full- and half-spaces. Variations in elastic properties are treated as piecewise-constant homogeneous subregions as in orthodox multiregion approaches. The deformation in the subregions is solved by matching the interface traction and displacement conditions for contrasting elastic parameters. We show equivalence between the integral equation convolving boundary traction and those convolving displacement discontinuities and volumetric inelastic strain in the representation theorem for a bounded volume. This equivalence allows us to express the deformation fields in the half-/full-space which comprises those subregions by using virtual fault displacement elements or volumetric eigenstrain elements, the integral kernels of which have known analytic forms for finite sources in homogeneous volumes. We include computer programs that implement our method with known analytic solutions of homogeneous volumes free of major singular points. We provide an extension to the existing toolkit available for the observational and theoretical analyses of deformation fields allowing users to model heterogeneous geological structures, with a number of primary geophysical applications, including earthquake and volcano deformation, where variations in elastic parameters may present a substantial contribution to the observed deformation.
Deleterious variants inCRLS1lead to cardiolipin deficiency and cause an autosomal recessive multi-system mitochondrial disease
Authors: Lee Richard G , Balasubramaniam Shanti , Stentenbach Maike , Kralj Tom , McCubbin Tim , Padman Benjamin , Smith Janine , Riley Lisa G , Priyadarshi Archana , Peng Liuyu , Nuske Madison R , Webster Richard , Peacock Ken , Roberts Philip , Stark Zornitza , Lemire Gabrielle , Ito Yoko A ,   Care4Rare Canada Consortium, Boycott Kym M , Geraghty Michael T , van Klinken Jan Bert , Ferdinandusse Sacha , Zhou Ying , Walsh Rebecca , Marcellin Esteban , Thorburn David R , Rosciolli Tony , Fletcher Janice , Rackham Oliver , Vaz Frédéric M , Reid Gavin E , Filipovska Aleksandra
Published: February 2022

Mitochondrial diseases are a group of inherited diseases with highly varied and complex clinical presentations. Here, we report four individuals, including two siblings, affected by a progressive mitochondrial encephalopathy with biallelic variants in the cardiolipin biosynthesis gene CRLS1. Three affected individuals had a similar infantile presentation comprising progressive encephalopathy, bull’s eye maculopathy, auditory neuropathy, diabetes insipidus, autonomic instability, cardiac defects and early death. The fourth affected individual presented with chronic encephalopathy with neurodevelopmental regression, congenital nystagmus with decreased vision, sensorineural hearing loss, failure to thrive and acquired microcephaly. Using patient-derived fibroblasts, we characterized cardiolipin synthase 1 (CRLS1) dysfunction that impaired mitochondrial morphology and biogenesis, providing functional evidence that the CRLS1 variants cause mitochondrial disease. Lipid profiling in fibroblasts from two patients further confirmed the functional defect demonstrating reduced cardiolipin levels, altered acyl-chain composition and significantly increased levels of phosphatidylglycerol, the substrate of CRLS1. Proteomic profiling of patient cells and mouse Crls1 knockout cell lines identified both endoplasmic reticular and mitochondrial stress responses, and key features that distinguish between varying degrees of cardiolipin insufficiency. These findings support that deleterious variants in CRLS1 cause an autosomal recessive mitochondrial disease, presenting as a severe encephalopathy with multi-systemic involvement. Furthermore, we identify key signatures in cardiolipin and proteome profiles across various degrees of cardiolipin loss, facilitating the use of omics technologies to guide future diagnosis of mitochondrial diseases.
Using guideline-based clinical decision support in oncological multidisciplinary team meetings: A prospective, multicenter concordance study
Authors: Ebben Kees C W J , Hendriks Mathijs P , Markus Lieke , Kos Milan , De Hingh Ignace H J T , Oddens Jorg R , Rothbarth Joost , De wilt Hans , Strobbe Luc J A , Bessems Maud , Mellema Carsten T , Siesling Sabine , Verbeek Xander A A M
Published: February 2022

Background

Multidisciplinary team meetings formulate guideline-based individual treatment plans based on patient and disease characteristics and motivate reasons for deviation. Clinical decision trees could support multidisciplinary teams to adhere more accurately to guidelines. Every clinical decision tree is tailored to a specific decision moment in a care pathway and is composed of patient and disease characteristics leading to a guideline recommendation.

Objective

This study investigated (1) the concordance between multidisciplinary team and clinical decision tree recommendations and (2) the completeness of patient and disease characteristics available during multidisciplinary team meetings to apply clinical decision trees such that it results in a guideline recommendation.

Methods

This prospective, multicenter, observational concordance study evaluated 17 selected clinical decision trees, based on the prevailing Dutch guidelines for breast, colorectal and prostate cancers. In cases with sufficient data, concordance between multidisciplinary team and clinical decision tree recommendations was classified as concordant, conditional concordant (multidisciplinary team specified a prerequisite for the recommendation) and non-concordant.

Results

Fifty-nine multidisciplinary team meetings were attended in 8 different hospitals, and 355 cases were included. For 296 cases (83.4%), all patient data were available for providing an unconditional clinical decision tree recommendation. In 59 cases (16.6%), insufficient data were available resulting in provisional clinical decision tree recommendations. From the 296 successfully generated clinical decision tree recommendations, the multidisciplinary team recommendations were concordant in 249 (84.1%) cases, conditional concordant in 24 (8.1%) cases and non-concordant in 23 (7.8%) cases of which in 7 (2.4%) cases the reason for deviation from the clinical decision tree generated guideline recommendation was not motivated.

Conclusion

The observed concordance of recommendations between multidisciplinary teams and clinical decision trees and data completeness during multidisciplinary team meetings in this study indicate a potential role for implementation of clinical decision trees to support multidisciplinary team decision-making.
Development of a framework to assess the quality of data sources in healthcare settings
Authors: Hooshafza Sepideh , Mc Quaid Louise , Stephens Gaye , Flynn Rachel , O’Connor Laura
Published: February 2022

Objective

The purpose of this study was to develop a framework to assess the quality of healthcare data sources.

Materials and Methods

First, a systematic review was performed and a thematic analysis of included literature conducted to identify items relating to the quality of healthcare data sources. Second, expert advisory group meetings were held to explore experts’ perception of the results of the review and identify gaps in the findings. Third, a framework was developed based on the findings.

Results

Synthesis of the review results and expert advisory group meetings resulted in 8 parent themes and 22 subthemes. The parent themes were: Governance, leadership, and management; Data; Trust; Context; Monitoring; Use of information; Standardization; Learning and training. The 22 subthemes were: governance, finance, organization, characteristics, time, data management, data quality, ethics, access, security, quality improvement, monitoring and feedback, dissemination, analysis, research, standards, linkage, infrastructure, documentation, definitions and classification, learning, and training.

Discussion

The herein presented framework was developed using a robust methodology which included reviewing literature and extracting data source quality items, filtering, and matching items, developing a list of themes, and revising them based on expert opinion. To the best of our knowledge, this study is the first to apply a systematic approach to identify aspects related to the quality of healthcare data sources.

Conclusions

The framework, can assist those using healthcare data sources to identify and assess the quality of a data source and inform whether the data sources used are fit for their intended use.
A novel long-term intravenous combined with local treatment with human amnion-derived mesenchymal stem cells for a multidisciplinary rescued uremic calciphylaxis patient and the underlying mechanism
Authors: Qin Lianju , Zhang Jing , Xiao Yujie , Liu Kang , Cui Yugui , Xu Fangyan , Ren Wenkai , Yuan Yanggang , Jiang Chunyan , Ning Song , Ye Xiaoxue , Zeng Ming , Qian Hanyang , Bian Anning , Li Fan , Yang Guang , Tang Shaowen , Zhang Zhihong , Dai Juncheng , Guo Jing , Wang Qiang , Sun Bin , Ge Yifei , Ouyang Chun , Xu Xueqiang , Wang Jing , Huang Yaoyu , Cui Hongqing , Zhou Jing , Wang Meilian , Su Zhonglan , Lu Yan , Wu Di , Shi Jingping , Liu Wei , Dong Li , Pan Yinbing , Zhao Baiqiao , Cui Ying , Gao Xueyan , Gao Zhanhui , Ma Xiang , Chen Aiqin , Wang Jie , Cao Meng , Cui Qian , Chen Li , Chen Feng , Yu Youjia , Ji Qiang , Zhang Zhiwei , Gu Mufeng , Zhuang Xiaojun , Lv Xiaolin , Wang Hui , Pan Yanyan , Wang Ling , Xu Xianrong , Zhao Jing , Wang Xiuqin , Liu Cuiping , Liang Ningxia , Xing Changying , Liu Jiayin , Wang Ningning
Published: February 2022

Calciphylaxis is a rare disease characterized histologically by microvessel calcification and microthrombosis, with high mortality and no proven therapy. Here, we reported a severe uremic calciphylaxis patient with progressive skin ischemia, large areas of painful malodorous ulcers, and mummified legs. Because of the worsening symptoms and signs refractory to conventional therapies, treatment with human amnion-derived mesenchymal stem cells (hAMSCs) was approved. Preclinical release inspections of hAMSCs, efficacy, and safety assessment, including cytokine secretory ability, immunocompetence, tumorigenicity, and genetics analysis in vitro, were introduced. We further performed acute and long-term hAMSC toxicity evaluations in C57BL/6 mice and rats, abnormal immune response tests in C57BL/6 mice, and tumorigenicity tests in neonatal Balbc-nu nude mice. After the preclinical research, the patient was treated with hAMSCs by intravenous and local intramuscular injection and external supernatant application to the ulcers. When followed up to 15 months, the blood-based markers of bone and mineral metabolism improved, with skin soft tissue regeneration and a more favorable profile of peripheral blood mononuclear cells. Skin biopsy after 1-month treatment showed vascular regeneration with mature noncalcified vessels within the dermis, and 20 months later, the re-epithelialization restored the integrity of the damaged site. No infusion or local treatment-related adverse events occurred. Thus, this novel long-term intravenous combined with local treatment with hAMSCs warrants further investigation as a potential regenerative treatment for uremic calciphylaxis due to effects of inhibiting vascular calcification, stimulating angiogenesis and myogenesis, anti-inflammatory and immune modulation, multidifferentiation, re-epithelialization, and restoration of integrity.
The merging galaxy cluster Abell 3266 at low radio frequencies
Authors: Duchesne S W , Johnston-Hollitt M , Riseley C J , Bartalucci I , Keel S R
Published: February 2022

We present new low-frequency (ν = 88–216 MHz) observations of the complex merging galaxy cluster Abell 3266. These new observations are taken with the Murchison Widefield Array (MWA) in its Phase II ‘extended’, long-baseline configuration, offering the highest resolution low-frequency view of the cluster to date. We report on the detection of four steep spectrum (α ≲ −1 for Sν ∝ να) extended radio sources within the cluster. We confirm the detection of a ∼570 kpc radio relic to the south of the cluster, and a possible bridge of emission connecting the relic to the cluster core. We also detect two new ultra-steep-spectrum (α ≲ −1.7) fossil plasma sources to the north and west of the cluster centre without associated compact radio emission. A previously detected radio galaxy in the cluster is also found to have a spectrally steepening tail with steep-spectrum components highlighted by the MWA. The timeline of the merger and the overall mass of the system are consistent with clusters hosting giant radio haloes, yet we do not detect a radio halo in Abell 3266. After simulating a range of radio haloes at 216 MHz, we place upper limits on the radio luminosity corresponding to ∼7.2 × 1024 W Hz−1 at 150 MHz assuming the expected 500 kpc radius – up to a factor of 5 lower than expected from scaling relations.
Weak gravitational lensing shear measurement with FPFS: analytical mitigation of noise bias and selection bias
Authors: Li Xiangchong , Li Yin , Massey Richard
Published: February 2022

Dedicated ‘Stage IV’ observatories will soon observe the entire extragalactic sky, to measure the ‘cosmic shear’ distortion of galaxy shapes by weak gravitational lensing. To measure the apparent shapes of those galaxies, we present an improved version of the Fourier Power Function Shapelets (FPFS) shear measurement method. This now includes analytic corrections for sources of bias that plague all shape measurement algorithms: Including noise bias (due to noise in non-linear combinations of observable quantities) and selection bias (due to sheared galaxies being more or less likely to be detected). Crucially, these analytic solutions do not rely on calibration from external image simulations. For isolated galaxies, the small residual ${\sim}10^{-3}$ multiplicative bias and ${\lesssim}10^{-4}$ additive bias now meet science requirements for Stage IV experiments. FPFS also works accurately for faint galaxies and robustly against stellar contamination. Future work will focus on deblending overlapping galaxies. The code used for this paper can process ${\gt}1000$ galaxy images per CPU second and is available from https://github.com/mr-superonion/FPFS.
Distances of galactic radio pulsars; first quadrant: −2° < ℓ < 90° and −2° < b < 2°
Authors: Kütükcü Pinar , Ankay Askin , Yazgan Efe , Bozkurt Kutsal
Published: February 2022

Distance versus dispersion measure relations are constructed for Galactic radio pulsars in small solid angle intervals. The calculations are based on some basic criteria, as well as using the independent distance measurements of well examined pulsars for the first Galactic quadrant, including Galactic central directions. Values of average free electron density for these regions are derived from the fits to distance versus dispersion measure relations and checked for consistency and smoothness. The effects of plasma in the Galactic arms and within the central parts of the Galactic bulge region are also compared and discussed. Our adopted distances for the radio pulsars are compared with the ones given in some other models. Some basic results on distributions of the radio pulsars and the plasma are presented.
CsIVP Modulates Low Nitrogen and High-Temperature Resistance in Cucumber
Authors: Yan Shuangshuang , Yu Bingwei , Ming Fangyan , Liang Yonggui , Zhong Yanting , Wang Zhongyi , Zhang Xiaolan , Li Xuexian , Qiu Zhengkun , Cao Bihao
Published: February 2022

Crop plants experience various abiotic stresses that reduce yield and quality. Although several adaptative physiological and defense responses to single stress have been identified, the behavior and mechanisms of plant response to multiple stresses remain underexamined. Herein, we determined that the leaf and vascular changes in Cucumis sativus Irregular Vasculature Patterning (CsIVP)-RNAi cucumber plants can enhance resistance to nitrogen deficiency and high-temperature stress. CsIVP negatively regulated high nitrate affinity transporters (NRT2.1, NRT2.5) and reallocation transporters (NRT1.7, NRT1.9, NRT1.12) under low nitrogen stress. Furthermore, CsIVP-RNAi plants have high survival rate with low heat injury level under high-temperature condition. Several key high-temperature regulators, including Hsfs, Hsps, DREB2C, MBF1b and WRKY33 have significant expression in CsIVP-RNAi plants. CsIVP negatively mediated high-temperature responses by physically interacting with CsDREB2C. Altogether, these results indicated that CsIVP integrates innate programming of plant development, nutrient transport and high-temperature resistance, providing a potentially valuable target for breeding nutrient-efficient and heat-resistant crops.
Pulmonary function testing for the diagnosis of asthma in preschool children
Authors: Chawes Bo , Elenius Varpu
Published: February 2022

Purpose of review

To highlight the recent evidence of the lung function techniques used in preschool children to diagnose asthma.

Recent findings

Several techniques are available to measure lung function and airway inflammation in preschool children, including spirometry (from age 5 years), impulse oscillometry (>3 years), whole-body plethysmography (>3 years), fractional exhaled nitric oxide (FeNO) (>5 years), multiple breath washout (>3 years), structured light plethysmography (>1–2 years) and impedance pneumography (>1 years). If applicable, measuring forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) ratio using spirometry is useful (cut-off < 80% predicted or below lower limit of normal [LLN] defined as z-score < −1.64) for diagnosing preschool asthma. For those unable to perform spirometry, whole-body plethysmography (sRaw > 1.6 kPa/s) and impulse oscillometry (Rrs and Xrs at 5 Hz z-score > 2) may be useful. Adding a bronchodilator reversibility test (FEV1 increase > 12%, sRaw decrease > 25–30%, Rrs at 5 Hz decrease > 40%) or a bronchial challenge test, for example, exercise test (FEV1 decrease > 10%), may improve the sensitivity of these tests. Elevated FeNO (>25–35 ppb) is a promising adjunctive test for diagnosing preschool asthma.

With trained personnel, lung function testing can be done with high reliability even in children between 2 and 4 years of age. To avoid over and undertreatment of asthma, objective measurement of lung function is clinically important in preschool children.
Intravenous Fluid Supplementation for Preterm Infants With Hyperbilirubinemia
Authors: Al-Wassia Heidi , Garrada Shadi
Published: February 2022

Background:

Hyperbilirubinemia is one of the most frequently occurring problems in the neonatal period, and phototherapy has remained the primary treatment of choice. Fluid supplementation has been proposed to reduce serum bilirubin levels.

Purpose:

To assess the risks and benefits of fluid supplementation compared with standard fluid management in preterm infants with unconjugated hyperbilirubinemia under conventional phototherapy.

Methods:

A retrospective cohort study of preterm infants (gestational ages ≥28 to ≤32 weeks) admitted to the neonatal intensive care unit at the Maternity and Children Hospital in Jeddah, Saudi Arabia, from January 1, 2017, to December 31, 2017, and required the initiation of phototherapy in the first week of life.

Results:

One hundred and fifteen infants were included; 51 received fluid supplementation, and 64 received standard fluid management. There were no significant differences in demographic characteristics between groups. The infants who received fluid supplementation had a significantly larger decline in the total serum bilirubin level per day and a shorter phototherapy duration (P < .01). There were no significant differences in weight (P = .14), or sodium (P = .79) change per day or the need for exchange transfusion between groups. The prematurity-related inhospital morbidities were similar between groups.

Implications for Practice and Research:

Fluid supplementation in preterm infants receiving conventional phototherapy resulted in a faster decline in the bilirubin level and a shorter duration of phototherapy, without increasing prematurity-related morbidities. Future randomized controlled trials to assess the benefits and risks of fluid supplementation during conventional phototherapy in preterm infants are needed.
Abbreviated Outpatient Upper Extremity Fracture Care to Avoid Clinic and Hospital Environmental Encounters During the COVID-19 Pandemic: A New Approach to Fracture Care?
Authors: Anderson Kathryn G. , Bompadre Viviana , Parker Cheryl , Varakitsomboon Shing , Krengel Walter F. , Lockhart John , Tremonti Christopher , Schmale Gregory A.
Published: February 2022

Background:

To minimize in-person visits during the COVID-19 pandemic, a new fracture care protocol for children with complete and stable, nondisplaced or minimally displaced upper extremity (UE) fractures has been implemented. This protocol involves immobilization with a bivalved cast, which allows for home cast removal during a telemedicine visit, and no follow-up radiographs, thus eliminating the requirement for a return to clinic. The purpose of this study is to evaluate the outcomes and parent satisfaction of this new abbreviated fracture care protocol.

Methods:

Between May 2020 and April 2021, during the COVID-19 pandemic, children with complete and stable, nondisplaced or minimally displaced UE fractures were treated with a bivalved cast and 1 follow-up telemedicine visit for home cast removal. A prospective longitudinal study of these patients was performed. The PROMIS Upper Extremity questionnaire was administered at enrollment and 3 months follow-up. Parents completed a satisfaction survey after home cast removal. Demographic data and information regarding complications were collected. A historical cohort of controls treated with standard cast in 2019 was used for comparison.

Results:

A total of 56 patients with a mean age of 8±3 years (range 2 to 15) were prospectively enrolled in this study. Parent-reported PROMIS Upper Extremity scores showed a significant increase from 24.9 (95% confidence interval=20.8-29.1) at enrollment to 51.6 (95% confidence interval=50.8-52.5) at 3 months follow-up (P<0.001). Results of the satisfaction survey (n=39) showed all parents were either very satisfied (85%) or satisfied (15%). In addition, 10% of parents would have initially preferred to come into clinic for cast removal and 90% of parents would prefer this new treatment plan in the future. Patients in the abbreviated care cohort returned to clinic for a median 1 in-person visits, compared with 2 for historical controls (n=183, P<0.001). Abbreviated care patients received fewer (1.0) radiographs than controls (2.0, P<0.001). Complication rate did not differ between the groups (P=0.77).

Conclusions:

Complete and stable, nonminimally or minimally displaced UE fractures can be cared for safely and effectively in a single in-person visit, with a telemedicine cast removal visit. Parents are satisfied with this abbreviated protocol and prefer it to additional in-person visits.

Level of Evidence:

Level III.
The Clinical Impact of Failing to Achieve Ideal Proportional Realignment in Adult Spinal Deformity Patients
Authors: Passias Peter G. , Passfall Lara , Williamson Tyler K. , Schoenfeld Andrew J. , Owusu-Sarpong Stephane , Dhillon Ekamjeet , Krol Oscar , Kummer Nicholas A. , Tretiakov Peter , Imbo Bailey , Joujon-Roche Rachel , Moattari Kevin , Lebovic Jordan , Vira Shaleen , Diebo Bassel , Smith Justin S. , Park Paul , Mummaneni Praveen , Shabani Saman , Chou Dean , Lafage Renaud , Lafage Virginie
Published: February 2022

Summary of Background Data.

The impact of not achieving ideal realignment in the global alignment and proportion (GAP) score in adult spinal deformity (ASD) correction on clinical outcomes is understudied at present.

Objective.

To identify the clinical impact of failing to achieve GAP proportionality in ASD surgery.

Study Design.

Retrospective cohort.

Methods.

Operative ASD patients with fusion to S1/pelvis and with pre-(BL) and 2-year (2Y) data were included. Patients were assessed for matching their 6-week (6W) age-adjusted alignment goals.1 Patients were stratified by age-adjusted match at 6W postoperatively (Matched) and 6W GAP proportionality (proportioned: GAP-P; moderately disproportioned: GAP-MD; severely disproportioned: GAP-SD). Groups were assessed for differences in demographics, surgical factors, radiographic parameters, and complications occurring by 2Y. Multivariable logistic regression was used to assess independent effects of not achieving GAP proportionality on postoperative outcomes for Matched and Unmatched patients.

Results.

Included: One hundred twenty three ASD patients. At baseline, 39.8% were GAP-SD, and 12.2% GAP-SD at 6W. Of 123 patients, 51.2% (n =63) had more than or equal to one match at 6W. GAP-SD rates did not differ by being Matched or Unmatched (P = 0.945). GAP-SD/Unmatched patients had higher rates of reoperation, implant failure, and PJF by 2Y postop (all P <0.05). Regressions controlling for age at BL, levels fused, and CCI, revealed 6W GAP-SD/Unmatched patients had higher odds of reoperation (OR: 54 [3.2–899.9]; P =0.005), implant failure (OR: 6.9 [1.1–46.1]; P =0.045), and PJF (OR: 30.1 [1.4–662.6]; P =0.031). Compared to GAP-P or GAP-MD patients, GAP-SD/ Matched patients did not have higher rates of reoperation, implant failure, or junctional failure (all P >0.05). The regression results for both Matched and Unmatched cohorts were consistent when proportionality was substituted by the continuous GAP score.

Conclusion.

In ASD patients who meet age-adjusted realignment goals, GAP proportionality does not significantly alter complication rates. However, GAP proportionality remains an important consideration in patients with sub-optimal age- adjusted alignment. In these cases, severe global disproportion is associated with higher rates of reoperation, implant failure, rod fracture, and junctional failure.
Performance of the Modified Adult Spinal Deformity Frailty Index in Preoperative Risk Assessment
Authors: Passias Peter G. , Moattari Kevin , Pierce Katherine E. , Passfall Lara , Krol Oscar , Naessig Sara , Ahmad Waleed , Schoenfeld Andrew J. , Ahmad Salman , Singh Vivek , Joujon-Roche Rachel , Williamson Tyler K. , Imbo Bailey , Tretiakov Peter , Vira Shaleen , Diebo Bassel , Lafage Renaud , Lafage Virginie
Published: February 2022

Study Design.

Retrospective single-center, consecutively enrolled database of adult spinal deformity (ASD) patients.

Objective.

The aim of this study was to assess the performance of the mASD-FI in predicting clinical and patient-reported outcomes after ASD-corrective surgery.

Summary of Background Data.

The recently described modified Adult Spinal Deformity frailty index (mASD-FI) quantifies frailty of ASD patients, but the utility of this clinical prediction tool as a means of prognosticating postoperative outcomes has not been investigated.

Methods.

ASD patients with available mASD-FI scores and HRQL data at presentation and 2-years postop were included.

Patients were stratified by mASD-FI score using published cutoffs: not frail (NF <7), frail (F, 7–12), severely frail (SF, >12). Analysis of vaiance assessed differences in patient factors across frailty groups. Linear regression assessed the relationship of mASD-FI with length of stay (LOS) and HRQLs. Multivariable logistic regression revealed how frailty category predicted odds of complications, infections and reoperation.

Results.

A total of 509 patients included (59 years, 79%F, 27.7 kg/m2). The cohort presented with moderate baseline deformity: sagittal vertical axis (83.7 mm ± 71), PT (12.7° ± 10.8°), PI-LL (43.1° ± 21.1°). Mean preoperative mASD-FI score was 7.2, frailty category: NF (50.3%), F (34.0%), SF (15.7%).

Age, BMI, and Charlson Comorbidity Index increased with frailty categories (all P < 0.001); however, fusion length (P = 0.247) and osteotomy rate (P = 0.731) did not. At baseline, increasing frailty was associated with inferior Oswestry Disability Index (ODI), EuroQol 5-Dimension Questionnaire (EQ-5D), SRS-22r, Pain Catastrophizing Scale, and NRS Back and Leg (all P < 0.001). Greater frailty was associated with increased LOS and reduced postoperative HRQL. Controlling for complication incidence, baseline mASD-FI predicted 2 year postop scores for year ODI (b = 0.7, 0.58–0.8, P < 0.001) SRS (b = −0.023, −0.03 to −0.02, P < 0.001), EQ-5D (b = −0.003, −0.004 to −0.002, P < 0.001). F and SF were associated with greater odds of unplanned revision surgery and complications.

Conclusion.

Higher preoperative mASD-FI score was associated with significantly greater complications, higher rate of unplanned reoperations and lower postoperative HRQL in this investigation. The mASD-FI provides similar prognostic utility while reducing burden for surgeons and patients.
Breast and Cervical Cancer Screening Disparities in Transgender People
Authors: Oladeru Oluwadamilola T. , Ma Sung Jun , Miccio Joseph A. , Wang Katy , Attwood Kristopher , Singh Anurag K. , Haas-Kogan Daphne A. , Neira Paula M.
Published: February 2022

Objectives:

The population of individuals who identify as transgender (TG) is increasing in the United States, yet disparities in cancer screening services are widening. It is imperative that interpersonal and systemic barriers to cancer care are identified and removed for this vulnerable population. Our study sought to examine the difference in self-reported breast and cervical cancer screening rates between TG and cisgender (CG) people.

Materials and Methods:

Cross-sectional data from the 2014 to 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) was obtained on individuals who identified as CG or TG (male-to-female [MTF] and female-to-male [FTM]), including their responses to questions regarding breast and cervical screening history and their primary care access and associated barriers.

Results:

Compared with the CG population, TG participants were less likely to adhere to or have undergone breast (FTM: odds ratio [OR] 0.47 and 0.32; MTF: OR 0.04 and 0.02, respectively; all P<0.001) and cervical cancer (FTM: OR 0.42 and 0.26, respectively; all P<0.001) screening. They were also less likely to have a primary care physician (FTM: OR 0.79; MTF: OR 0.58; all P<0.001) and less likely to seek primary care within a year owing to medical costs (FTM: OR 1.44; MTF: OR 1.36; all P<0.001).

Conclusions:

Disparities exist in the uptake of routine cancer screening in the TG population despite their increased risk for breast and cervical cancer. Interventions are urgently needed to mitigate delays to cancer screening, close gaps in provider and patient knowledge about cancer screening, and improve health care experiences of gender minorities in the United States.
The Use of Person-Centered Language in Scientific Research Articles Focused on Autism
Authors: Arnhart Chelsea , Neale Monika , Collins Claire , Chesher Tessa , Coffey Sara , Rogers T. Calli , Ottwell Ryan , Hartwell Micah
Published: February 2022

Objective:

Individuals with developmental conditions, such as autism, experience stigma, which is reflected in derogatory language and labels. To limit stigma associated with disabilities, government agencies and medical organizations have adopted the use of person-centered language (PCL). This study investigated adherence to PCL guidelines among peer-reviewed research publications focused on autism. In addition, we investigated the co-occurrence of stigmatizing language in articles using person-first language (PFL) and identity-first language (IFL) styles.

Methods:

We performed a systematic search of PubMed for autism-focused articles from January 2019 to May 2020. Articles from journals with more than 20 search returns were included, and a random sample of 700 publications were screened and examined for inclusion of prespecified, non-PCL terminology.

Results:

Of the 315 publications, 156 (49.5%) were PCL compliant. Articles frequently used PCL and non-PCL terminology concomitantly, and 10% of publications included obsolete nomenclature. A logistic regression model showed the odds were more likely that publications using IFL were more likely to include other stigmatizing terminology than publications using PFL (odds ratio = 2.03, 95% confidence interval: 1.15–3.58).

Conclusion:

Within medical research, the language to describe individuals and populations needs to be used with intentionality and acknowledges that individuals are more than the diagnosis under study. This may reduce the structural stigma that may be implied otherwise. Our study showed that when PFL is used when addressing individuals with autism, other more stigmatizing language is often avoided and is in line with medical education and clinical practice.
Inequalities in Life Expectancy Across North Carolina
Authors: Mitchell Jessica H. , Runkle Jennifer D. , Andersen Lauren M. , Shay Elizabeth , Sugg Margaret M.
Published: February 2022

Health inequalities are characterized by spatial patterns of social, economic, and political factors. Life expectancy (LE) is a commonly used indicator of overall population health and health inequalities that allows for comparison across different spatial and temporal regions. The objective of this study was to examine geographic inequalities in LE across North Carolina census tracts by comparing the performance of 2 popular geospatial health indices: Social Determinants of Health (SDoH) and the Index of Concentration at Extremes (ICE). A principal components analysis (PCA) was used to address multicollinearity among variables and aggregate data into components to examine SDoH, while the ICE was constructed using the simple subtraction of geospatial variables. Spatial regression models were employed to compare both indices in relation to LE to evaluate their predictability for population health. For individual SDoH and ICE components, poverty and income had the strongest positive correlation with LE. However, the common spatial techniques of adding PCA components together for a final SDoH aggregate measure resulted in a poor relationship with LE. Results indicated that both metrics can be used to determine spatial patterns of inequities in LE and that the ICE metric has similar success to the more computationally complex SDoH metric. Public health practitioners may find the ICE metric's high predictability matched with lower data requirements to be more feasible to implement in population health monitoring.
Large-Scale Immigration Worksite Raids and Mixed-Status Families
Authors: Lopez William D. , Collins Katherine M. , Cervantes Guadalupe R. , Reynosa Dalila , Salazar Julio C. , Novak Nicole L.
Published: February 2022

Mixed-status families—whose members have multiple immigration statuses—are common in US immigrant communities. Large-scale worksite raids, an immigration enforcement tactic used throughout US history, returned during the Trump administration. Yet, little research characterizes the impacts of these raids, especially as related to mixed-status families. The current study (1) describes a working definition of a large-scale worksite raid and (2) considers impacts of these raids on mixed-status families. We conducted semistructured interviews in Spanish and English at 6 communities that experienced the largest worksite raids in 2018. Participants were 77 adults who provided material, emotional, or professional support following raids. Qualitative analysis methods were used to develop a codebook and code all interviews. The unpredictability of worksite raids resulted in chaos and confusion, often stemming from potential family separation. Financial crises followed because of the removal of primary financial providers. In response, families rearranged roles to generate income. Large-scale worksite raids result in similar harms to mixed-status families as other enforcement tactics but on a much larger scale. They also uniquely drain community resources, with long-term impacts. Advocacy and policy efforts are needed to mitigate damage and end this practice.
Trends in Use of Conventional Cigarettes, E-cigarettes, and Marijuana in Pregnancy and Impact of Health Policy
Authors: HAWKINS SUMMER S. , HACKER MICHELE R.
Published: February 2022

The substance use policy context continues to evolve. As tobacco control policies have become more restrictive, marijuana legalization has increased access to marijuana. Data suggest that prenatal conventional cigarette use is declining, while e-cigarette and marijuana use are increasing among persons preconception, prenatally, and postpartum. Policy evaluations have found that increasing cigarette taxes reduces prenatal smoking and improves birth outcomes; however, there have been few studies of e-cigarette policies or marijuana legalization on prenatal use or birth outcomes. It is important for clinicians to screen for prenatal substance use, as recommended by American College of Obstetricians and Gynecologists (ACOG), and understand how policies influence use among their patients.
Investigation of Radionuclide Migration at Sites Adjacent to the 30-km Exclusion Zone of the Chernobyl Nuclear Power Plant
Authors: Zheltonozhskyi V. A. , Zheltonozhskaya M. V. , Myznikov D. E. , Bondarkov M. D. , Farfán E. B.
Published: February 2022

This paper reports the study of the vertical migration of radionuclides in soils at test sites adjacent to the 30-km Chernobyl Exclusion Zone. The results of this effort demonstrate that the migration processes for studied pollution occur similarly to the fuel fallout behavior at the vicinity of the Chernobyl Nuclear Power Plant (ChNPP) Unit 4. It was also observed that the main fallout component, 137Cs, originated from aerosol fallout and was bound in the surface layer. The authors determined a significant increase of 60Co, 94Nb, and 241Am radionuclide concentrations in soils near the ChNPP Unit 4 and suggested their appearance due to the installation of the New Safe Confinement. Niobium-94 activity is proposed as a marker for monitoring the “fresh” fallout in the Chernobyl Exclusion Zone.
UTILIZATION OF PREOPERATIVE MIDPERIPHERAL OPTICAL COHERENCE TOMOGRAPHY FOR TAILORED SURGICAL MANAGEMENT OF PROLIFERATIVE VITREORETINOPATHY
Authors: Pollmann André S. , Mishra Amit V. , Choudhry Netan , Gupta R. Rishi
Published: February 2022

Purpose:

The purpose of this study was to report on the use of preoperative spectral domain optical coherence tomography to assess retinal pathology and guide the surgical approach to proliferative vitreoretinopathy.

Methods:

A case report was discussed.

Results:

A 70-year-old man developed proliferative vitreoretinopathy after surgical repair of a macula-off rhegmatogenous retinal detachment. In preparation for further surgery, inferior preretinal fibrosis and membranes were identified on preoperative optical coherence tomography. The patient underwent successful vitrectomy with peeling of the membranes resulting in markedly improved visual acuity.

Conclusion:

Widely available spectral domain optical coherence tomography can be used preoperatively to image the midperipheral retina and guide surgical decision-making in the management of proliferative vitreoretinopathy.
Cervical Cancer Among Women With HIV in South Carolina During the Era of Effective Antiretroviral Therapy
Authors: Nissim Oriel , Dees Aariel , Cooper S. Lewis , Patel Khilen , Lazenby Gweneth B.
Published: February 2022

Objectives

We aimed to determine whether women with HIV (WWH) and cervical cancer were more likely to experience cancer-related death and to be diagnosed with cervical cancer at a younger age and in more advanced stages.

Materials and Methods

This is a retrospective cohort study of all women diagnosed with cervical cancer in South Carolina from 1998 to 2018. Deidentified data were obtained from 2 statewide databases. A survival analysis was performed to evaluate differences in cancer survival between women with and without HIV. Wilcoxon rank sum test was used to determine differences in the median age at cancer diagnosis. χ2 test was used to assess differences in cancer stage according to HIV status.

Results

Four thousand three hundred fourteen women were diagnosed with cervical cancer, and 53 (1.2%) had HIV infection. Survival time in months was similar between WWH and HIV-negative women (86 months [interquartile range {IQR} = 32–146] and 62 months [IQR = 18–153], p = .37; log-rank p = .26). Compared with HIV-negative women, WWH were less likely to experience cervical cancer–related death (36% vs. 19%, p = .005). Women with HIV were diagnosed with cervical cancer at a younger age (44 [IQR = 37–54] vs. 49 [IQR = 39–61], p = .02). Cervical cancer stage was similar at diagnosis between groups (tumor node metastasis stage, p = .97, and Surveillance, Epidemiology, and End Results summary stage, p = .41).

Conclusions

Women with HIV were younger at diagnosis than HIV-negative women, but they were no more likely to die from or have more advanced cervical cancer. Women with HIV were not more likely to develop cervical cancer before the age of 21 years and earlier screening is likely unnecessary.