bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency and Implications of Concurrent Complications Following Adult Spinal Deformity Corrective Surgery
Authors: Bortz Cole , Pierce Katherine E. , Brown Avery , Alas Haddy , Passfall Lara , Krol Oscar , Kummer Nicholas A. , Wang Erik , O’Connell Brooke , Wang Charles , Vasquez-Montes Dennis , Diebo Bassel G. , Neuman Brian J. , Gerling Michael C. , Passias Peter G. 
Published: October 2021

Study Design.
Retrospective review.

Objective.
Identify co-occurring perioperative complications and associated predictors in a population of patients undergoing surgery for adult spinal deformity (ASD).

Summary of Background Data.
Few studies have investigated the development of multiple, co-occurring complications following ASD-corrective surgery. Preoperative risk stratification may benefit from identification of factors associated with multiple, co-occurring complications.

Methods.
Elective ASD patients in National Surgical Quality Improvement Program (NSQIP) 2005 to 2016 were isolated; rates of co-occurring complications and affected body systems were assessed via cross tabulation. Random forest analysis identified top patient and surgical factors associated with complication co-occurrence, using conditional inference trees to identify significant cutoff points. Binary logistic regression indicated effect size of top influential factors associated with complication co-occurrence at each factor's respective cutoff point.

Results.
Included: 6486 ASD patients. The overall perioperative complication rate was 34.8%; 28.5% of patients experienced one complication, 4.5% experienced two, and 1.8% experienced 3+. Overall, 11% of complication co-occurrences were pulmonary/cardiovascular, 9% pulmonary/renal, and 4% integumentary/renal. By complication type, the most common co-occurrences were transfusion/urinary tract infection (UTI) (24.3%) and transfusion/pneumonia (17.7%). Surgical factors of operative time ≥400 minutes and fusion ≥9 levels were the strongest factors associated with the incidence of co-occurring complications, followed by patient-specific variables like American Society of Anesthesiologists (ASA) physical status classification grade ≥2 and age ≥65 years. Regression analysis further showed associations between increasing complication number and longer length of stay (LOS), (R
2 = 0.202, P < 0.001), non-home discharge (R
2 = 0.111, P = 0.001), and readmission (R
2 = 0.010, P < 0.001).

Conclusion.
For surgical ASD patients, the overall rate of co-occurring perioperative complications was 6.3%. Body systems most commonly affected by complication co-occurrences were pulmonary and cardiovascular, and common co-occurrences included transfusion/UTI (24.3%) and transfusion/pneumonia (17.7%). Increasing number of perioperative complications was associated with greater LOS, non-home discharge, and readmission, highlighting the importance of identifying risk factors for complication co-occurrences.

Level of Evidence: 3
The Relationship of Kinesiophobia with Pain and Quality of Life in Idiopathic Scoliosis
Authors: Figueras Clara , Matamalas Antonia , Pizones Javier , Moreno-Manzanaro Lucia , Betegón Jesús , Bagó Juan 
Published: October 2021

Study Design.
Prospective, multi-centric, cross-sectional study.

Objective.
To analyze the construct validity of the Tampa Scale of Kinesiophobia (TSK) in a cohort of patients with adolescent idiopathic scoliosis (AIS).

Summary of the Background Data.
Back pain is not uncommon in AIS. The fear of movement (kinesiophobia) in response to pain is related to back pain. TSK psychometric properties in AIS patients have not been properly analyzed.

Methods.
Patients with AIS and no prior spine surgery were prospectively included. They fulfilled the Spanish version of the TSK-11 questionnaire, a pain intensity numerical rating scale (NRS), refined SRS-22 (SRS-22r), the Hospital Anxiety and Depression Scale (HADS), and item 7 of the Core Outcome Measurement Index (COMI). The sample was split into two groups for the statistical analysis: adolescents and young adults. Cronbach alpha was used to assess internal consistency. Discriminant and concurrent validity were obtained by computing Pearson correlation coefficients between the TSK score and several criterion measures.

Results.
A total of 275 patients were included—198 adolescents (mean age of 14.6 yrs) and 77 young adults (mean age of 26.9 yrs). The Cobb of largest curve means were 44.9° and 48.9°, respectively. In the adolescent group, the TSK mean (±SD) was 21.5 (±5.93), with a floor effect of 2.5%. In the adult group, the TSK mean was 24.2 (±6.63), with a floor effect of 3.9%. The ceiling effect was 0% in both groups. Cronbach alphas for the adolescent and adult groups were 0.76 and 0.79, respectively. No correlation was found in any group between the TSK score and the curve magnitude or pattern (Lenke classification). The TSK was significantly correlated with HAD depression and SRS-22r in both groups. However, these correlations were weaker in adolescents. In adults, the TSK also significantly correlates with NRS and work/school absenteeism.

Conclusion.
The Spanish version of TSK-11 is a reliable and valid instrument to analyze kinesiophobia in AIS. However, the weak correlation between kinesiophobia and pain intensity, disability, and emotional condition in adolescents requires further study.

Level of Evidence: 4
Safety of Prolonged Inhalation of Hydrogen Gas in Air in Healthy Adults
Authors: Cole Alexis R. , Sperotto Francesca , DiNardo James A. , Carlisle Stephanie , Rivkin Michael J. , Sleeper Lynn A. , Kheir John N. 
Published: October 2021

BACKGROUND:
Ischemia-reperfusion injury is common in critically ill patients, and directed therapies are lacking. Inhaled hydrogen gas diminishes ischemia-reperfusion injury in models of shock, stroke, and cardiac arrest. The purpose of this study was to investigate the safety of inhaled hydrogen gas at doses required for a clinical efficacy study.

DESIGN:
Prospective, single-arm study.

SETTING:
Tertiary care hospital.

PATIENTS/SUBJECTS:
Eight healthy adult participants.

INTERVENTIONS:
Subjects underwent hospitalized exposure to 2.4% hydrogen gas in medical air via high-flow nasal cannula (15 L/min) for 24 (n = 2), 48 (n = 2), or 72 (n = 4) hours.

MEASUREMENTS AND MAIN RESULTS:
Endpoints included vital signs, patient- and nurse-reported signs and symptoms (stratified according to clinical significance), pulmonary function testing, 12-lead electrocardiogram, mini-mental state examinations, neurologic examination, and serologic testing prior to and following exposure. All adverse events were verified by two clinicians external to the study team and an external Data and Safety Monitoring Board. All eight participants (18–30 yr; 50% female; 62% non-Caucasian) completed the study without early termination. No clinically significant adverse events occurred in any patient. Compared with baseline measures, there were no clinically significant changes over time in vital signs, pulmonary function testing results, Mini-Mental State Examination scores, neurologic examination findings, electrocardiogram measurements, or serologic tests for hematologic (except for clinically insignificant increases in hematocrit and platelet counts), renal, hepatic, pancreatic, or cardiac injury associated with hydrogen gas inhalation.

CONCLUSIONS:
Inhalation of 2.4% hydrogen gas does not appear to cause clinically significant adverse effects in healthy adults. Although these data suggest that inhaled hydrogen gas may be well tolerated, future studies need to be powered to further evaluate safety. These data will be foundational to future interventional studies of inhaled hydrogen gas in injury states, including following cardiac arrest.
ICU Mortality in Patients With Coronavirus Disease 2019 Infection: Highlighting Healthcare Disparities in Rural Appalachia
Authors: Sharma Sunil , Badami Varun , Rojas Edward , Mittal Abhinav , Stansbury Robert , Rana Bilal , Wilson Alison , Wen Sijin 
Published: October 2021

OBJECTIVES:
To assess 30-day mortality in coronavirus disease 2019 acute respiratory distress syndrome patients transferred from rural Appalachian hospitals.

DESIGN:
Retrospective case controlled, based on consecutive patients transferred and admitted from rural hospitals to a tertiary-care ICU. The primary outcome was all-cause 30-day mortality. Kaplan-Meier method and log-rank test were used in the survival data analysis.

SETTING:
Medical ICU, West Virginia University Hospital, Morgantown, WV.

PATIENTS:
All adult patients admitted to the ICU for coronavirus disease 2019 disease between September 30, 2020, and December 2, 2020.

INTERVENTION:
Not applicable.

MEASUREMENTS AND MAIN RESULTS:
Seventy-nine consecutive coronavirus disease 2019 patients were admitted to the ICU during the defined period. Overall mortality of the cohort was 54%. Of the 79 patients, 50 were transferred from critical access hospitals/rural facilities with coronavirus disease 2019–induced acute respiratory distress syndrome. A control group consisted of 39 patients admitted to the ICU with noncoronavirus disease 2019 acute respiratory distress syndrome who were intubated and mechanically ventilated. Thirty-day mortality in patients with coronavirus disease 2019 admitted to the ICU was significantly higher than the control group (68% vs 42%) (p = 0.034). Mean Sequential Organ Failure Assessment scores were similar in both coronavirus disease 2019 acute respiratory distress syndrome group and controls. Intubation in patients 70 years or older and mechanical ventilation for over 5 days was associated with significantly higher mortality.

CONCLUSIONS:
Our data on critically ill and mechanically ventilated coronavirus disease 2019 acute respiratory distress syndrome patients transferred from critical access hospitals/rural facilities have increased mortality compared with noncoronavirus disease 2019 acute respiratory distress syndrome controls. These data suggest that lack or delay in access to tertiary care may impact coronavirus disease 2019 outcome in rural areas. Intubated patients 70 years old or more and mechanical ventilation for over 5 days may be a risk factor for increased mortality. These data may help physicians and hospital administrators in rural areas for optimal utilization of limited resources.
Allogeneic Hematopoietic Stem Cell Transplant Infusion During Venovenous Extracorporeal Membrane Oxygenation Support
Authors: Qutob Rayan , Ji Xinyu , Assanangkornchai Nawaporn , Sapon-Cousineau Vladimir , Tam May , Larotonda Rita , Routy Jean-Pierre , Popradi Gizelle , Samoukovic Gordan 
Published: October 2021

BACKGROUND:
Management of hematopoietic stem cell transplant complicated by respiratory failure has been facilitated by the use of extracorporeal membrane oxygenation as a bridge to curative chemotherapeutic options. This is the first report of hematopoietic stem cell transplantation on extracorporeal membrane oxygenation in the adult population.

CASE SUMMARY:
A 28-year-old woman diagnosed with idiopathic aplastic anemia complicated by acute respiratory distress syndrome secondary to pneumonia required venovenous extracorporeal membrane oxygenation to supplement oxygenation and ventilation. She received hematopoietic stem cell transplantation while she was on extracorporeal membrane oxygenation support.

MAIN RESULTS AND CONCLUSION:
Delivery of the stem cell through extracorporeal membrane oxygenation circuit was successful in the described patient. There was no sequestered stem cell in extracorporeal membrane oxygenation circuit, and she was found to have 90% donor chimerism suggesting successful engraftment. This report showed that infusion of stem cell through extracorporeal membrane oxygenation circuit is safe and feasible, and our results suggest that successful engraftment is possible.
Induced pluripotent stem cell-derived motor neurons from amyotrophic lateral sclerosis (ALS) patients carrying different superoxide dismutase 1 mutations recapitulate pathological features of ALS
Authors: Liu Wen-Chao , Liu Na , Wang Yan , Huang Chen , Li Yan-Fang , Wang Hao , Li Xiao-Gang , Deng Min 
Published: October 2021

Abstract

Background:
Investigations of the pathogenic mechanisms in motor neurons (MNs) derived from amyotrophic lateral sclerosis (ALS) disease-specific induced pluripotent stem (iPS) cell lines could improve understanding of the issues affecting MNs. Therefore, in this study we explored mutant superoxide dismutase 1 (SOD1) protein expression in MNs derived from the iPS cell lines of ALS patients carrying different SOD1 mutations.

Methods:
We generated induced pluripotent stem cell (iPSC) lines from two familial ALS (FALS) patients with SOD1-V14M and SOD1-C111Y mutations, and then differentiated them into MNs. We investigated levels of the SOD1 protein in iPSCs and MNs, the intracellular Ca2+ levels in MNs, and the lactate dehydrogenase (LDH) activity in the process of differentiation into the MNs derived from the controls and ALS patients’ iPSCs.

Results:
The iPSCs from the two FALS patients were capable of differentiation into MNs carrying different SOD1 mutations and differentially expressed MN markers. We detected high SOD1 protein expression and high intracellular calcium levels in both the MN and iPSCs that were derived from the two SOD1 mutant patients. However, at no time did we observe stronger LDH activity in the patient lines compared with the control lines.

Conclusions:
MNs derived from patient-specific iPSC lines can recapitulate key aspects of ALS pathogenesis, providing a cell-based disease model to further elucidate disease pathogenesis and explore gene repair coupled with cell-replacement therapy. Incremental mutant expressions of SOD1 in MNs may have disrupted MN function, either causing or contributing to the intracellular calcium disturbances, which could lead to the occurrence and development of the disease.
Selective elimination of host cells harboring replication-competent human immunodeficiency virus reservoirs: a promising therapeutic strategy for HIV cure
Authors: Zaongo Silvere D. , Wang Yue , Ma Ping , Song Fang-Zhou , Chen Yao-Kai 
Published: October 2021

Abstract
Many seminal advances have been made in human immunodeficiency virus (HIV)/AIDS research over the past four decades. Treatment strategies, such as gene therapy and immunotherapy, are yielding promising results to effectively control HIV infection. Despite this, a cure for HIV/AIDS is not envisioned in the near future. A recently published academic study has raised awareness regarding a promising alternative therapeutic option for HIV/AIDS, referred to as “selective elimination of host cells capable of producing HIV” (SECH). Similar to the “shock and kill strategy,” the SECH approach requires the simultaneous administration of drugs targeting key mechanisms in specific cells to efficiently eliminate HIV replication-competent cellular reservoirs. Herein, we comprehensively review the specific mechanisms targeted by the SECH strategy. Briefly, the suggested cocktail of drugs should contain (i) latency reversal agents to promote the latency reversal process in replication-competent reservoir cells, (ii) pro-apoptotic and anti-autophagy drugs to induce death of infected cells through various pathways, and finally (iii) drugs that eliminate new cycles of infection by prevention of HIV attachment to host cells, and by HIV integrase inhibitor drugs. Finally, we discuss three major challenges that are likely to restrict the application of the SECH strategy in HIV/AIDS patients.
Direct comparison of the reproducibility of in-office and self-measured home blood pressures
Authors: Asayama Kei , Ohkubo Takayoshi , Rakugi Hiromi , Miyakawa Masaaki , Mori Hisao , Katsuya Tomohiro , Ikehara Yumi , Ueda Shinichiro , Ohya Yusuke , Tsuchihashi Takuya , Kario Kazuomi , Miura Katsuyuki , Ito Sadayoshi , Umemura Satoshi 
Published: October 2021

Objective:
The aim was to compare short-term and long-term reproducibilities of in-office unattended blood pressure (BP), namely automated office blood pressure (AOBP), conventionally measured attended office BP, and self-measured home BP.

Methods:
A multicentre, clinical study was conducted in Japan, and 287 Japanese outpatients on antihypertensive drug medication were followed-up for 1 year.

Results:
The intensity of drug treatment was sustained consistently throughout the study period (defined daily doses, 1.62–1.68; P = 0.12). The mean SBP differences between baseline and 1 month later, as well as baseline and 1 year later, were less than 1.5 mmHg, whereas the standard deviations of the differences for home, AOBP, and attended office measurements for the 1-year interval were 7.7, 14.5, and 15.3 mmHg, respectively. The coefficients of variation were significantly smaller for home BP than for AOBP among all patients at both 1-month and 1-year intervals (P < 0.0001). In the 1-month interval, partial correlation coefficients of home BP (r, 0.73/0.88 for systolic/diastolic measures) were significantly higher than of conventional BP (r, 0.47/0.69). However, the correlations converged to the modest level regardless of BP information (r, 0.49–0.54/0.63–0.73) when the 1-year interval was assessed. Results were confirmatory when patients on the same drug regimen (n = 167) were analysed.

Conclusion:
A higher reproducibility of home BP was demonstrated compared with in-office BP, including AOBP. However, the modest correlations for the 1-year interval support the importance of regular assessment of BP, regardless of in-office or home measurements for treatment of hypertension.
PARACENTRAL ACUTE MIDDLE MACULOPATHY IN BEHCET DISEASE
Authors: Song Delu , Choi Daniel J. , Bhatt Nirali 
Published: October 2021

Purpose:
To report a novel presentation of bilateral paracentral acute middle maculopathy and peripheral vascular occlusions in Behcet disease.

Methods:
A retrospective case report with multimodal imaging studies of a patient with Behcet's disease.

Results:
A 58-year-old Chinese man presented with a paracentral scotoma, fever, arthralgias, and skin rash. Human leukocyte antigen (HLA) typing revealed HLA-B51 positivity. Ophthalmic examination showed peripheral retinal hemorrhages and fluorescein angiography (FA) demonstrated vascular occlusions in the peripheral retina bilaterally. Optical coherence tomography showed classic acute paracentral acute middle maculopathy lesions in both eyes.

Conclusions:
Paracentral acute middle maculopathy and peripheral vascular occlusion are infrequent and unconventional presentations of Behcet disease. To the best of our knowledge, this is the first report in the ophthalmic literature of paracentral acute middle maculopathy and peripheral vascular occlusion in Behcet disease.
Long-Term Outcomes of Bowman Layer Inlay Transplantation for the Treatment of Progressive Keratoconus
Authors: van der Star Lydia , van Dijk Korine , Vasiliauskaitė Indrė , Dapena Isabel , Oellerich Silke , Melles Gerrit R. J. 
Published: October 2021

Purpose:
To report long-term clinical outcomes and estimated success rates after Bowman layer (BL) inlay transplantation in eyes treated for progressive keratoconus (KC).

Methods:
Thirty-five eyes (29 patients) with progressive KC underwent BL inlay transplantation. Best-corrected spectacle and contact lens visual acuity, Scheimpflug-based corneal tomography [simulated and maximum keratometry (Kmax)], central corneal thickness, thinnest point thickness, complications, and success rate were evaluated up to 8 years postoperatively for the total group and 2 subgroups [group 1: preoperative Kmax > 69 diopter (D) (n = 26); group 2: preoperative Kmax < 69D (n = 9)].

Results:
Mean logarithm of the minimum angle of resolution best contact lens–corrected visual acuity for the total group and the 2 subgroups did not change from preoperative up to the last available follow-up (all P > 0.05), whereas best spectacle–corrected visual acuity improved for group 1 (P = 0.03). Group 1 showed an average Kmax reduction of 7D in the first month (P < 0.001) with no further changes up to 8 years postoperatively (P > 0.05), whereas no significant changes were observed in group 2 (all P > 0.05). Postoperative KC progression occurred in 4 eyes (n = 3 group 1, n = 1 group 2) and 1 eye (group 2) underwent retransplantation for unsatisfactory visual performance. Kaplan–Meier analysis showed an estimated success rate of 85% at the 5 to 8 years follow-up in group 1 and of 75% at the 5 to 7 years follow-up for group 2.

Conclusions:
BL inlay transplantation stabilized KC in most eyes along with preservation of contact lens tolerance up to 8 years postoperatively and may be a successful treatment option, in particular for eyes with progressive advanced KC (Kmax > 69D).
Acute Corneal Transplant Rejection After COVID-19 Vaccination
Authors: Shah Amar P. , Dzhaber Daliya , Kenyon Kenneth R. , Riaz Kamran M. , Ouano Dean P. , Koo Ellen H. 
Published: October 2021

Purpose:
The purpose of this report was to describe 4 cases of acute corneal transplant rejection occurring in association with coronavirus disease 2019 (COVID-19) mRNA vaccination.

Methods:
Four patients with prior keratoplasty developed presumed immunologic rejection after the mRNA-1273 vaccination for coronavirus 2 (SARS-CoV-2). Case 1 had received Descemet membrane endothelial keratoplasty 6 months ago and presented with endothelial graft rejection 3 weeks after the first vaccine dose. Case 2 had undergone penetrating keratoplasty 3 years previously and presented with acute endothelial rejection 9 days after the second vaccine dose. Case 3 had prior Descemet stripping automated endothelial keratoplasty (DSAEK) and began experiencing symptoms of endothelial graft rejection 2 weeks after the second vaccine dose. Case 4 presented with endothelial rejection of the penetrating keratoplasty graft 2 weeks after the second vaccine dose.

Results:
Frequent topical corticosteroids alone were initiated in all 4 cases. In case 1, the endothelial rejection line appeared fainter with improvement in visual acuity and corneal edema 5 weeks after diagnosis. Case 2 experienced complete resolution of corneal stromal edema and rejection line 6 weeks after diagnosis. Cases 3 and 4 have both experienced initial improvement with steroid treatment as well.

Conclusions:
These cases suggest acute corneal endothelial rejection may occur soon after either dose of the COVID-19 mRNA vaccine. Prompt initiation of aggressive topical steroid therapy may result in complete resolution of clinical signs and symptoms. Further studies are needed to elucidate the causal mechanism of corneal graft rejection after COVID-19 vaccination.
Longitudinal Reciprocal Relationships Between the Psychosocial Work Environment and Burnout
Authors: Shahidi Faraz Vahid , Smith Peter M. , Oudyk John , Gignac Monique A.M. 
Published: October 2021

Objective:
To examine longitudinal reciprocal relationships between the psychosocial work environment and burnout.

Methods:
We used two-wave cross-lagged panel models to estimate associations between a wide range of psychosocial work factors (ie, job demands, job control, job insecurity, coworker support, supervisor support, and organizational justice) and burnout in a broadly representative sample of the general working population in Canada (n = 453).

Results:
Bidirectional associations between the psychosocial work environment and burnout were observed. Results supported the causal predominance of psychosocial work factors over burnout. Higher job demands, lower job control, higher job insecurity, and lower organizational justice predicted burnout over time. Burnout only predicted lower supervisor support over time.

Conclusions:
Our findings suggest that stress at work is better understood as a cause rather than a consequence of burnout in the general working population.