bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sit-to-Stand Weight-Bearing Symmetry Performance in Total Knee Arthroplasty
Authors: Pua Yong-Hao , Tan John Wei-Ming , Poon Cheryl Lian-Li , Chew Eleanor Shu-Xian , Seah Felicia Jie-Ting , Thumboo Julian , Yeo Seng-Jin , Woon Ee-Lin , Clark Ross Allan 
Published: October 2021

Objective
After total knee arthroplasty, the ability to weight bear symmetrically during the sit-to-stand task provides important information regarding altered movement patterns. Despite this, comprehensive recovery curves and validity data for sit-to-stand weight-bearing symmetry are lacking in the total knee arthroplasty population. Our study aimed to (1) develop recovery curves with reference ranges, (2) identify the correlates of standard and constrained sit-to-stand weight-bearing symmetry, and (3) evaluate their predictive validity with gait speed.

Design
We performed a retrospective longitudinal study of 706 patients with primary unilateral total knee arthroplasty. Monthly, for 4 mos after surgery, sit-to-stand weight-bearing symmetry, knee pain, knee range of motion, quadriceps strength, and gait speed were quantified.

Results
Standard and constrained sit-to-stand weight-bearing symmetry measures improved nonlinearly over time. Standard sit-to-stand weight-bearing symmetry was most strongly associated with bilateral quadriceps strength, whereas constrained sit-to-stand weight-bearing symmetry was most strongly associated with ipsilateral quadriceps strength. Knee range of motion and contralateral knee pain were additional correlates. Both standard sit-to-stand and constrained sit-to-stand weight-bearing symmetry were independently and nonlinearly associated with gait speed in multivariable models.

Conclusions
Our study provided recovery curves and validity data to support routine clinical measurement of sit-to-stand weight-bearing symmetry in total knee arthroplasty. Our results also indicate that constrained sit-to-stand may promote greater use of the operated limb than standard sit-to-stand.
Insurance and Employment Status Are Correlated With the Presence of Waddell Signs
Authors: Radoslovich Stephanie S. , Smith Spencer , Haag Carter , Carlson Hans , Carlson Nels , Ensrud Erik , Yoo Jung U. 
Published: October 2021

Objective
The aim of the study was to determine whether employment or insurance status is associated with the presence and number of Waddell signs.

Design
In this cross-sectional study, adult low back pain patients were seen at a tertiary academic center for thoracic or lumbar back pain, due to a degenerative condition. Frequency data were compared with contingency table analysis, including χ2 and logistic regression.

Results
Of 462 patients, 26% had any Waddell signs and 10% had clinically significant Waddell signs. Nonemployed patients had a higher prevalence of Waddell signs than employed and retired patients (P = 0.0004 and P = 0.001, respectively). Subgroups of Medicaid participants as well as patients with secondary gain issues, including worker’s compensation and motor vehicle accident, had a higher prevalence of 1+ Waddell signs than patients of other insurances (P < 0.0001 and P = 0.01, respectively). Medicaid participants had a higher prevalence of 3+ Waddell signs than other insurances (P = 0.002).

Conclusions
The presence of Waddell signs is associated with employment and insurance status. This suggests that social factors may affect patients’ perceptions of their thoracic or low back pain. Clinicians aware of these factors can provide individualized care to their patients prone to poor outcomes.
A pilot study of microbial signatures of liver disease in those with HIV mono-infection in Rio de Janeiro, Brazil
Authors: Yanavich Carolyn , Perazzo Hugo , Li Fan , Tobin Nicole , Lee David , Zabih Sara , Morata Michelle , Almeida Cristiane , Veloso Valdilea G. , Grinsztejn Beatriz , Aldrovandi Grace M. 
Published: October 2021

Objective:
The rectal microbiome was examined to assess the relationship between the microbiome and liver disease in HIV-infection.

Design:
Eighty-two HIV-1 mono-infected individuals from the PROSPEC-HIV-study (NCT02542020) were grouped into three liver health categories based on results of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) of transient elastography: normal (n = 30), steatosis (n = 30), or fibrosis (n = 22).

Methods:
Liver steatosis and fibrosis were defined by CAP at least 248 dB/m and LSM at least 8.0 kPa, respectively. 16S rRNA gene and whole genome shotgun metagenomic sequencing were performed on rectal swabs. Bacterial differences were assessed using zero-inflated negative binomial regression and random forests modeling; taxonomic drivers of functional shifts were identified using FishTaco.

Results:
Liver health status explained four percentage of the overall variation (r
2 = 0.04, P = 0.003) in bacterial composition. Participants with steatosis had depletions of Akkermansia muciniphila and Bacteroides dorei and enrichment of Prevotella copri, Finegoldia magna, and Ruminococcus bromii. Participants with fibrosis had depletions of Bacteroides stercoris and Parabacteroides distasonis and enrichment of Sneathia sanguinegens. In steatosis, functional analysis revealed increases in primary and secondary bile acid synthesis encoded by increased Eubacterium rectale, F. magna, and Faecalibacterium prausnitzii and decreased A. muciniphila, Bacteroides fragilis and B. dorei. Decreased folate biosynthesis was driven by similar changes in microbial composition.

Conclusion:
HIV mono-infection with steatosis or fibrosis had distinct microbial profiles. Some taxa are similar to those associated with non-alcoholic fatty liver disease in HIV-negative populations. Further studies are needed to define the role of the gut microbiota in the pathogenesis of liver disease in HIV-infected persons.
Cytomegalovirus in primary immunodeficiency
Authors: Godsell Jack , Chan Samantha , Slade Charlotte , Bryant Vanessa , Douglass Jo Anne , Sasadeusz Joe , Yong Michelle K. 
Published: October 2021

Purpose of review
Cytomegalovirus (CMV) infection and disease are well described in the setting of secondary immunodeficiency. Less is known about CMV in the context of primary immunodeficiencies (PIDs), where inborn errors in one or more arms of the immune system result in variable degrees of CMV susceptibility.

Recent findings
PID presents unique challenges in the diagnosis and management of CMV disease. The clinical presentation of CMV in PID is often severe, accelerated by underlying immune dysregulation and iatrogenic immunosuppression. Here we describe the clinical significance of CMV infection in PID, the key components of immune defence against CMV and how these are affected in specific PIDs. CMV disease is under-recognized as a complication of common variable immunodeficiency (CVID). High rates of CMV end-organ disease, mortality, development of CMV resistance and prolonged antiviral use have been observed in individuals with CVID.

Summary
We recommend that clinicians tailor their approach to the individual based on their underlying immune deficit and maintain a high index of suspicion and low threshold for treatment. More research is required to improve stratification of CMV risk in PID, develop new diagnostic tools and manage end-organ disease in this cohort.
A Medical Records Review Study Assessing Safety of Zoster Vaccine Recombinant, Adjuvanted in Patients With Rheumatic Disease
Authors: Gupta Surbhi , Arasaratnam Reuben J. , Solow E. Blair , Bajaj Puneet 
Published: October 2021

Objective
Patients with rheumatic disease are at increased risk for herpes zoster infection. Because of limited safety data in this population and concerns over vaccine-precipitated flares, there are no guidelines for vaccination with the zoster vaccine recombinant, adjuvanted (ZRA). We evaluated self-reported adverse events (AEs) and disease activity after ZRA administration in adults with rheumatic disease.

Methods
In this medical records review study at our large academic center, patients who had received at least 1 dose of ZRA from January 1, 2018 to March 11, 2020 were assessed. Self-reported AEs and disease activity were monitored 3 months after each ZRA administration. Measures of disease activity were reviewed 6 months before ZRA in those who received both doses, or 3 months before ZRA in those who received 1 dose.

Results
We identified 65 patients, of whom 34 (52.3%) received both doses of ZRA. Four patients (6.2%) self-reported AEs after receiving ZRA, all of which were minor and systemic. Three patients (9.2%) developed a flare after receiving ZRA, compared with 8 (12.3%) who experienced a flare in the baseline period. There was no significant change in flare incidence or disease activity after vaccination. Subgroup analysis of those on biologic and nonbiologic disease-modifying antirheumatic drugs revealed no differences in frequency of postvaccination AEs, flares, or disease activity.

Conclusions
In our cohort, disease activity seemed stable when comparing disease markers before and after ZRA administration. In addition, ZRA was well-tolerated with minor AEs. Further studies are needed to guide formal vaccination recommendations.
Treatment of Benign Lesion of Levels I or II of the Parotid Gland: Long Term Results of Partial Superficial Parotidectomy
Authors: Visconti Irene Claudia , lannella Giannicola , Meccariello Giuseppe , Cammaroto Giovanni , Gulotta Giampiero , Greco Antonio , de Vincentiis Marco , Magliulo Giuseppe , Pelucchi Stefano , Maniaci Antonino , Cocuzza Salvatore , La Mantia Ignazio , Brevi Bruno , Vicini Claudio 
Published: October 2021

Abstract
The correct surgical approach to benign parotid gland tumors is still matter of debate, it should be chosen considering the possibility of local recurrence or facial nerve complications in case of “not necessary” facial nerve dissection. In the era of minimally invasive surgery, more sparing approaches such as extracapsular dissection or partial superficial parotidectomy (PSP) are gaining popularity. The aim of the study is to present surgical results and long-term outcomes of PSP (level i or ii) in a large group of patients. Six hundred fifty-one patients who underwent parotid surgery between 2004 and 2020 were initially considered. Five hundred forty patients with benign lesions treated with PSP, enucleation, ECD were enrolled. Clinical features, surgical data, postoperative scarring, seroma, dehiscence, neuroma, outcomes as Frey syndrome, and delayed facial nerve dysfunction have been evaluated. 65.5% PSP, 25.2% enucleation, and 9.2% extracapsular dissection. No statistical difference in surgical time has been found (P 0.16). P
> 0.05 for seroma, neuroma, Frey syndrome, and facial palsy between different type of surgery. Frey syndrome in PSP: 6/135 (4.4%) in 2004 to 2012 and 2/219 (0.9%) in 2013 to 2020. The reduction between periods is significant (P < 0.04). Recurrence: 0.8% (3/354) for PSP patients, 3.4% (5/ 136) in enucleation and 10% (5/50) in ECD (P = 0.02). Partial superficial parotidectomy can be considered a minimally invasive and quick procedure with low complication rate. Our data seem to support this statement (large case series and long-term follow-up).
Characteristic of Cleft Lip and Palate Cases Attended to Khoula Hospital Cleft Center
Authors: Balushi Taimoor Al , Sahib Meera , Abduwani Zahra Al , Viswapurna P. S. , Zeinalddin Mohammad 
Published: October 2021

Cleft lip and/or palate are one of the most common birth defects around the world. This cross sectional study aimed to study characteristic of cleft lip and plate cases attended Khaula Hospital Cleft Center.

Methods:
The data were collected from Plastic Surgery Department of Khaula Hospital Muscat, Oman, between years 2010 and 2019. Data was collected using a form that included demographic distribution of patients, gender, age, birth weight, region, age when first attended hospital, associated congenital anomalies and syndromes, type of delivery, mother consumption of Folic Acid, types of cleft lip/palate, and surgeries done.

Results:
During 9 years period the total number of recorded patients having cleft Lip/Palate was 1899. 43.7% of cases had CLP, 36% had CP, 20.3% had complete fissuring of the lip. Sixty-eight percent of the children were between 0 and 3 months of age when they first attended Hospital. 6.2% of children had siblings with orofacial clefts. Congenital malformations associated with CL/P or syndromic cleft were seen in 31.1% of cases. 86.8% of children got operated at Hospital and most common types of surgeries were lip and palate repair. Twenty-three percent of patients had undergone orthodontic treatment, 49.3% of patients had speech therapy, 32.5% referred for ENT consultation, and 20.5% of patients got grommet inserted.

Conclusion:
Prevalence of CL/P in Oman is 2.6 in 1000 live births. Two main possible reasons contributing to the increase seen in this prevalence can be increase in the number of live births in Oman and parent's education toward cleft treatment that led more patients attending hospital for treatment.
Anxiety and Performance in Prehospital Emergency Care Simulation Assessments
Authors: Stein Christopher 
Published: October 2021

Introduction
Anxiety experienced by students participating in simulations may impede their learning and performance. The added anxiety brought about by the socioevaluative nature of simulation assessments may accentuate this effect. This study aimed to assess the relationship between anxiety experienced by emergency care students and performance in an authentic prehospital emergency care simulation assessment.

Methods
The State-Trait Anxiety Inventory (STAI) was completed before and after a simulation assessment by 58 emergency care students across all academic years of study of a 4-year degree program in prehospital emergency care. The state anxiety component of the STAI was plotted together with marks obtained by each student using a standardized assessment tool, and curve estimation was used to determine the nature of the relationship between state anxiety scores and marks.

Results
Mean preassessment STAI scores were lower than mean postassessment scores (48.74 vs. 57.74), but mean scores from both groups were greater than normal mean scores for college students. The relationship of both preassessment and postassessment STAI scores with assessment marks was best described by a quadratic curve suggesting that performance was better at both the lower and higher ends of the range of STAI scores compared with the middle. Postassessment STAI scores provided a better fit with simulation assessment marks.

Conclusions
This study did not confirm the expected decrease in performance associated with increasing anxiety but rather suggests that some students may have the ability to respond positively to the highest levels of anxiety during simulation assessments.
Evaluation of Uroflowmetry Curve Patterns and Nomogram Construct in Healthy Nulliparous Female Adults
Authors: Taylor Danielle Lynn , Dueñas-Garcia Omar F. , Maheshwari Deepali , Sierra Tania , Leung Katherine , Hall Cynthia , Flynn Michael 
Published: October 2021

Objective
The aims of the study were to construct uroflowmetry nomograms, evaluate uroflowmetry flow rate patterns, and graphically illustrate overlaid uroflowmetry curves in nulliparous female adult volunteers.

Methods
We performed a prospective cross-sectional study evaluating uroflowmetry curve and flow rate patterns on a cohort of nulliparous female adult volunteers. Primary outcome was construction of uroflowmetry maximum and average flow rate nomograms. Secondary outcomes included evaluation of uroflowmetry flow rate patterns and graphical illustrations of overlaid uroflowmetry curves. Uroflowmetry printouts were overlaid and used to create a model of uroflow patterns, and nomogram curves were analyzed in 5 groups based on voided volumes.

Results
We enrolled 164 participants and 158 had voided volumes between 50 mL and 800 mL. Participants' mean age and body mass index were 25 years and 23, respectively. Maximum and average flow rate nomograms were created, and analysis of uroflow parameters was performed. Median voided volume was 241 mL (149–431 mL), the median maximum flow was 29 mL/s (20–38 mL/s), and the median average flow was 15 mL/s (10–19 mL/s). Participants were divided into 5 groups based on voided volumes. The nomogram patterns for each voided volume group were visually different from typical nomogram patterns.

Conclusions
Uroflowmetry curves and flow rates vary significantly according to voided volume. Our study suggests that in normal healthy nulliparous female adults there is likely a broader range of normal flow rates and uroflowmetry curves than what has been previously reported. Further research is needed to investigate the accuracy of these finding.
International Travel for Liver Transplantation: A Comprehensive Assessment of the Impact on the United States Transplant System
Authors: Braun Hillary J. , Amara Dominic , Shui Amy M. , Stock Peter G. , Hirose Ryutaro , Delmonico Francis L. , Ascher Nancy L. 
Published: October 2021

Background.
International travel for transplantation remains a global issue as countries continue to struggle in establishing self-sufficiency. In the United States, the United Network for Organ Sharing (UNOS) requires citizenship classification at time of waitlisting to remain transparent and understand to whom our organs are allocated. This study provides an assessment of patients who travel internationally for liver transplantation and their outcomes using the current citizenship classification used by UNOS.

Methods.
Adult liver UNOS data from 2003 to 2019 were used. Patients were identified as citizens, noncitizen, nonresidents (NCNR), or noncitizen residents (NC-R) according to citizenship status. Descriptive statistics compared demographics among the waitlisted patients and demographics and donor characteristics among transplant recipients. A competing risks model was used to examine waitlist outcomes. The Kaplan-Meier method and Cox proportional hazards were used for posttransplant outcomes.

Results.
There were significant demographic differences according to citizenship group among waitlisted (n = 125 652) and transplanted (n = 71 536) patients. Compared with US citizens, NCNR was associated with a 9% increase in transplant (subdistribution hazard ratio [SHR], 1.09; 95% confidence interval [CI], 1.00-1.18; P = 0.04), and NC-R was associated with a 24% decrease in transplant (SHR, 0.76; 95% CI, 0.72-0.79; P < 0.0001) and a 23% increase in death or removal for being too sick (SHR, 1.23; 95% CI, 1.14-1.33; P < 0.0001). US citizens had significantly inferior graft and patient survival (P < 0.001).

Conclusions.
Though the purpose of the citizenship classification system is transparency, the results of this study highlight significant disparities in the access to and outcomes following liver transplantation according to citizenship status.
Targeting gene fusions in glioma
Authors: Kim Peter L. 
Published: October 2021

Purpose of review
Glioma represents of variety of brain malignancies, the majority of which confer a poor prognosis despite treatment. With the widespread use of next-generation sequencing, gene fusions are being found in greater numbers. Gene fusions in glioma represent an opportunity to deliver targeted therapies to those with limited options for treatment.

Recent findings
Extensive studies on these gene fusions have shown that they can exhibit distinct phenotypes, such as PTPRZ1-MET fusions in secondary glioblastoma or FGFR3-TACC3 fusions in IDH wildtype gliomas. Responses have been observed with the use of targeted therapies but some have been short lived because of the development of treatment resistance.

Summary
Increasing detection of gene fusions in glioma along with basket trials have helped define different fusion phenotypes and paved the way for targeted kinase inhibitor-based therapies. Targeting NTRK fusions has been the most successful fusion-guided therapy to date and evaluating all patients for these fusions may be warranted.
Is there a role for neoadjuvant anti-PD-1 therapies in glioma?
Authors: Sun Lu , Lai Thomas J. , Prins Robert M. 
Published: October 2021

Purpose of review
In this review, we summarized recent findings that highlight the progress for checkpoint blockade immunotherapy in glioblastoma (GBM) patients.

Recent findings
We reviewed new data from our group and others that suggest that the timing of when immunotherapy is applied can impact the antitumor immune response and, potentially, the ultimate clinical benefit of patients.

Summary
The neoadjuvant priming and expansion of exhausted T cells within the GBM microenvironment, followed by the removal of an immune suppressive tumor microenvironment through surgical resection, may lead to enhanced antitumor immune responses that are beneficial clinically. As such, neoadjuvant immunotherapeutic approaches and rational combinations may be helpful scientifically to understand how immunotherapeutic interventions influence the tumor microenvironment, as well benefit the patients.
Peripheral white blood cell responses as emerging biomarkers for patient stratification and prognosis in acute spinal cord injury
Authors: Jogia Trisha , Kopp Marcel A. , Schwab Jan M. , Ruitenberg Marc J. 
Published: October 2021

Purpose of review
To date, prognostication of patients after acute traumatic spinal cord injury (SCI) mostly relies on the neurological assessment of residual function attributed to lesion characteristics. With emerging treatment candidates awaiting to be tested in early clinical trials, there is a need for wholistic high-yield prognostic biomarkers that integrate both neurogenic and nonneurogenic SCI pathophysiology as well as premorbid patient characteristics.

Recent findings
It is becoming clearer that effective prognostication after acute SCI would benefit from integrating an assessment of pathophysiological changes on a systemic level, and with that, extend from a lesion-centric approach. Immunological markers mirror tissue injury as well as host immune function and are easily accessible through routine blood sampling. New studies have highlighted the value of circulating white blood cells, neutrophils and lymphocytes in particular, as prognostic systemic indicators of SCI severity and outcomes.

Summary
We survey recent advances in methods and approaches that may allow for a more refined diagnosis and better prognostication after acute SCI, discuss how these may help deepen our understanding of SCI pathophysiology, and be of use in clinical trials.
The proposed promiscuity value of an HLA can vary significantly depending on the source data used
Authors: Anaya Jordan , Baras Alexander S. 
Published: October 2021

ABSTRACTImmune checkpoint blockade, a form of immunotherapy, mobilizes a patient’s own immune system against cancer cells by releasing some of the natural brakes on T cells. Although our understanding of this process is evolving, it is thought that a patient response to immunotherapy requires tumor presentation of neoantigens to T cells and patients whose tumors present a wider array of neoantigens are more likely to derive benefit from immune checkpoint blockade1–4. Manczinger et al.5 recently reported findings that would appear contrarian to this notion in that they suggested patients with HLA alleles which bind more diverse peptides (higher promiscuity) are less likely to respond to immunotherapy. To estimate HLA promiscuity they looked at the HLA-peptide binding repertoires for class I alleles contained in the IEDB6, and obtained consistent results when performing robustness checks and subsequent analyses. Here we show that the proposed HLA promiscuity values can vary significantly across source data types and individual experiments.