bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fighting COVID-19 in the United States with Federalism and Other Constitutional and Statutory Authority
Authors: Cigler Beverly A 
Published: May 2021

Abstract
The COVID-19 pandemic challenges a workable American federalism. The Tenth Amendment to the U.S. Constitution reserves plenary responsibilities to states for promoting health and well-being; but states and their local governments suffer from a significant lack of resources and interjurisdictional competition during major emergencies. In this article, I argue that a president has significant constitutional and statutory authority for pandemic preparedness and, by law, is responsible for leading a coordinated national response necessary to a pandemic. The article outlines the constitutional and statutory authorities available to President Trump and assesses how he used those powers to address the pandemic. It is argued that early, decisive national coordinative systems for containing and mitigating the virus; testing, tracing, contacting, and isolation protocols; data collection standardization; procurement and distribution of supplies; and planning vaccine eligibility and distribution could have reduced the state and local government disadvantages early in the pandemic, saving lives and boosting the economy.
Vulnerabilities in ‘local moral worlds’: COVID-19 provincial social work interventions
Authors: Kahambing Jan Gresil S 
Published: May 2021

AbstractIntending to contextualize vulnerabilities at the local level during COVID-19, this article reports an investigation of the social workers’ interventions done in a Philippine province. Social workers as frontliners report on (i) the shift of interventions before and during COVID-19, (ii) the most vulnerable sector in their assigned areas, (iii) the problems in working out their field interventions, (iv) the emergence of creative programs and (v) key information to better improve or to have a more sustainable set of interventions in the long run.
Moral Hazard during the Housing Boom: Evidence from Private Mortgage Insurance
Authors: Bhutta Neil , Keys Benjamin J 
Published: May 2021

AbstractWe provide novel evidence of misaligned incentives fueling a portion of the 2000s mortgage boom. We document that private mortgage insurance (PMI) companies expanded insurance issuance on high-risk mortgages purchased by Fannie Mae and Freddie Mac at the tail end of the housing boom, without changing pricing and despite knowledge of heightened housing risk. The expansion of PMI facilitated an unprecedented increase in Fannie and Freddie’s risky purchases, extending the mortgage boom into 2007 and precipitating their collapse. We argue that this unraveling reflects a general moral hazard problem in insurance, coupled with misaligned incentives in the government-backed mortgage market.
How Did Depositors Respond to COVID-19?
Authors: Levine Ross , Lin Chen , Tai Mingzhu , Xie Wensi 
Published: May 2021

AbstractWhy did banks experience massive deposit inflows during the pandemic? We discover that deposit interest rates at bank branches in counties with higher COVID-19 infection rates fell by more than rates at branches—even branches of the same bank—in counties with lower infection rates. Credit drawdowns, national policies, such as the Payment Protection Program, and a flight-to-safety do not account for these cross-branch changes in deposit rates. Evidence suggests that higher local COVID-19 infection rates are associated with households’ greater anxiety about future job and income losses, anxiety that induces households to reduce spending and increase deposits.
The Effect of Intrapartum Oxygen Supplementation on Category II Fetal Monitoring
Authors: Raghuraman Nandini , López Julia D. , Carter Ebony B. , Stout Molly J. , Macones George A. , Tuuli Methodius G. , Cahill Alison G. 
Published: May 2021

(Abstracted from Am J Obstet Gynecol 2020;223:905.e1–905.e7)
The administration of maternal oxygenation (O2) is a commonly used resuscitation technique for fetuses with category II electronic fetal monitoring (EFM) patterns. In cases of recurrent fetal decelerations, the goal of maternal O2 supplementation is to increase fetal oxygenation.
Lack of Effect of Short-Term DHEA Supplementation on the Perimenopausal Ovary
Authors: Luna Selva L. , Brown Donald I. , Kohama Steven G. , Urbanski Henryk F. 
Published: May 2021

(Abstracted from Biol Reprod 2020;103:1209–1216)
Circulating levels of dehydroepiandrosterone (DHEA) and its sulfated ester (DHEAS) undergo marked age-associated decline and by the time a woman reaches menopause their levels may be less than half that observed in young adulthood. DHEA supplementation has been shown to improve oocyte quality in women with diminished ovarian function and has beneficial effects in individuals responding poorly in infertility clinics and women over the age of 40.
Withdrawing Approval of Makena—A Proposal From the FDA Center for Drug Evaluation and Research
Authors: Chang Christina Y. , Nguyen Christine P. , Wesley Barbara , Guo Jia , Johnson Laura Lee , Joffe Hylton V. 
Published: May 2021

(Abstracted from N Engl J Med 2020;383:e131(1)–e131(4))
Makena (hydroxyprogesterone caproate injection) is currently the only drug on the market for the prevention of recurrent preterm birth (PTB). The Food and Drug Administration (FDA) granted accelerated approval for this drug in 2011.
Static and Dynamic Pain Sensitivity in Adults With Persistent Low Back Pain
Authors: Simon Corey B. , Lentz Trevor A. , Ellis Lindsay , Bishop Mark D. , Fillingim Roger B. , Riley Joseph L. , George Steven Z. 
Published: May 2021

Objectives:
Despite its impact, individual factors associated with persistent low back pain (LBP) remain poorly understood. This study investigated static and dynamic pain sensitivity in adults with persistent LBP versus pain-free controls; and investigated associations between pain sensitivity and 3 clinical pain measures: recalled, resting, and movement-evoked pain (MEP).

Materials and Methods:
A lifespan sample of 60 adults with persistent LBP and 30 age-matched/sex-matched controls completed 4 laboratory sessions. Static pain sensitivity (pressure pain threshold [PPT], heat pain threshold) and dynamic pain sensitivity (heat pain aftersensations [AS], temporal summation [TS] of second heat pain) were measured. Demographic and clinical factors collected were education, global cognition, and perceived health. Resting and recalled pain were measured via questionnaire, and MEP via the Back Performance Scale.

Results:
LBP participants demonstrated lower PPT remotely (hand; F
1,84=5.34, P=0.024) and locally (low back; F
1,84=9.55, P=0.003) and also had higher AS (F
1,84=6.01, P=0.016). Neither static nor dynamic pain sensitivity were associated with recalled pain (P>0.05). However, static pain sensitivity (local PPT) explained an additional 9% variance in resting pain, while dynamic pain sensitivity (AS, TS) explained an additional 10% to 12% variance in MEP.

Discussion:
This study characterized pain sensitivity measures among individuals with persistent LBP and suggests static pain sensitivity plays a larger role in resting pain while dynamic pain sensitivity plays a larger role in MEP. Future studies will confirm these relationships and elucidate the extent to which changes in static or dynamic pain sensitivity predict or mediate clinical pain among adults with persistent LBP.
Sickle Cell Disease and Pain
Authors: Ramsay Zachary , Bartlett Rachel , Ali Amza , Grant Justin , Gordon-Strachan Georgiana , Asnani Monika 
Published: May 2021

Objectives:Acute pain is the main complication of sickle cell disease. Chronic pain (CP) and neuropathic pain (NP) may also be experienced, but have not been formally described in Jamaican patients. A cross-sectional study was conducted to determine their prevalence and characteristics, and to determine the common pain locations and modalities of management.Materials and Methods:All well individuals with sickle cell disease patients 14 years and older, not pregnant and without a history of clinical stroke were consecutively recruited. Anthropometric measurements, hematology studies, an analgesia checklist, and the Adult Sickle Cell Quality of Life Measurement Information System questionnaire were completed. The painDETECT questionnaire was completed to describe NP and pain patterns—from which CP was defined.Results:There were 257 patients in total, with 55.6% being females; the mean age of the patients was 31.7±12 years, and 75% had the SS genotype. Almost all patients (92.6%) had had an acute pain crisis in their lifetime and 72.4% in the last year. The mean severity at last attack was 6.8±3.1 on a scale of 0 to 10. The prevalences of CP and NP were 21.5% and 17.9%, respectively. Female sex, the presence of current leg ulcers, and the use of a strong opioid in the last 4 weeks produced higher odds of NP, whereas older age, milder genotypes, and daily analgesic use had the highest odds of CP. Opioids were used by 40.1% of the patients in the previous 4 weeks, whereas nonpharmacological treatments such as physiotherapy was less used, but reported to be very effective.Discussion:CP and NP should be assessed during routine care of sickle cell pain so that targeted therapies can be applied.
Occupational Hearing Loss Associated With Non-Gaussian Noise: A Systematic Review and Meta-analysis
Authors: Shi Zhihao , Zhou Jiena , Huang Yuwen , Hu Yong , Zhou Lifang , Shao Yongqiang , Zhang Meibian 
Published: May 2021

Objectives:
Epidemiological characteristics of occupational noise-induced hearing loss (NIHL) associated with non-Gaussian noise are still unclear and have been rarely reported in the literature.

Methods:
The relationships between non-Gaussian noise exposure and occupational NIHL were analyzed based on the published papers. Systematic review and meta-analysis of epidemiological studies were performed.

Results:
Of 78 epidemiological studies (47,814 workers) selected, there were seven cohort studies and 71 cross-sectional studies. The incidence of high-frequency NIHL (HFNIHL) and speech-frequency NIHL (SFNIHL) in the seven cohort studies was 10.9 and 2.9%, respectively. In 71 cross-sectional studies, the prevalence of HFNIHL and SFNIHL was 34.2 and 18.9%, respectively. The average hearing threshold level at the high frequencies was 42.1 ± 17.4 dB HL. Workers exposed to non-Gaussian noise had a higher risk of developing HFNIHL than those not exposed to noise (overall-weighted odds ratio [OR] = 4.46) or those exposed to Gaussian noise (overall-weighted OR = 2.20). The Chi-square trend test demonstrated that the prevalence of HFNIHL was positively correlated with age, cumulative noise exposure, and exposure duration (p < 0.001).

Conclusions:
Workers exposed to non-Gaussian noise suffered from greater NIHL than those exposed to Gaussian noise or not exposed to noise. Age, exposure duration, noise level, and noise temporal structure were the main risk factors for occupational NIHL. The A-weighted equivalent continuous sound pressure level (LAeq) is not a sufficient measurement metric for quantifying non-Gaussian noise exposure, and a combination of kurtosis and noise energy metrics (e.g., LAeq) should be used. It is necessary to reduce the exposure of non-Gaussian noise to protect the hearing health of workers.
Variability in Postoperative Immobilization and Rehabilitation Following Reconstructive Hip Surgery in Nonambulatory Children With Cerebral Palsy
Authors: Miller Stacey D. , Juricic Maria , Fajardo Nandy , So Judy , Shore Benjamin J. , Narayanan Unni G. , Mulpuri Kishore 
Published: May 2021

Background:
Despite being a common procedure, there are no standard protocols for postoperative immobilization and rehabilitation following reconstructive hip surgery in children with cerebral palsy (CP). The purpose of this study was to investigate variability in postoperative management and physical therapy (PT) recommendations among orthopaedic surgeons treating hip displacement in children with CP.

Methods:
An invitation to participate in an anonymous, online survey was sent to 44 pediatric orthopaedic surgeons. The case of a child undergoing bilateral femoral varus derotation osteotomies and adductor tenotomies was presented. Surgeons were asked to consider their typical practice and the case scenario when answering questions related to immobilization, weight-bearing, and rehabilitation. Recommendations with increasingly complex surgical interventions and different age or level of motor function were also assessed.

Results:
Twenty-eight orthopaedic surgeons from 9 countries with a mean 21.3 years (range: 5 to 40 y) of experience completed the survey. Postoperative immobilization was recommended by 86% (24/28) of respondents with 7 different methods of immobilization identified. All but 1 (23/24) reported immobilizing full time. Most (20/23) reported using immobilization for 4 to 6 weeks. Return to weight-bearing varied from 0 to 6 weeks for partial weight-bearing and 0 to 12 weeks for full weight-bearing. PT in the first 1 to 2 weeks postoperatively was reported as unnecessary by 29% (8/28) of surgeons. PT for range of motion, strengthening, and return to function was recommended by 96% (27/28) of surgeons, starting at a mean of 2.6 weeks postoperatively (range: 0 to 16 wk). Only 48% (13/27) reported all of their patients would receive PT for these goals in their practice setting. Inpatient rehabilitation was available for 75% (21/28) but most surgeons (17/21) reported this was accessed by 20% or fewer of their patients.

Conclusions:
Postoperative immobilization and PT recommendations were highly variable among surgeons. This variability may influence surgical outcomes and complication rates and should be considered when evaluating procedures. Further study into the impact of postoperative immobilization and rehabilitation is warranted.
Diversity and Inclusion in an Orthopaedic Surgical Society: A Longitudinal Study
Authors: Singleton Ian M. , Poon Selina C. , Bisht Roy U. , Vij Neeraj , Lucio Francisco , Belthur Mohan V. 
Published: May 2021

Background:
Diversity and inclusion are critical to providing the best possible health care. Previous studies have shown that diversity among physicians increases cultural competency, which in turn enhances the quality of care provided and increases minoritized patients’ participation in decisions regarding their health care. However, physician diversity in both race and sex is lacking in orthopaedic surgery. This study seeks to determine the sex and racial diversity in the membership and leadership of the Pediatric Orthopaedic Society of North America (POSNA).

Methods:
POSNA membership and leadership were reviewed for the years 2010, 2015, and 2020. This data was gathered from membership directories and committee reference books. All North American Active Members’ race/ethnicity and sex were recorded for each year. The categories for race/ethnicity are Caucasian, East/South/Middle Eastern Asian American (Asian), Hispanic/Latin/South American (HLSA), and African American.

Results:
From 2010 to 2020, Active Members of POSNA increased from 608 to 818, and the percentage of female (14.6% to 23.7%), Asian (7.4% to 11.2%), HLSA (2.5% to 2.9%), and African American membership (1.6% to 1.8%) increased. Male (85.4% to 76.3%) and Caucasian (88.5% to 84.0%) membership decreased. From 2010 to 2020, male leadership decreased on both the Board of Directors and Committee Chairs (89.5% to 81.8% and 86.4% to 64.7%, respectively), as did Caucasians (94.7% to 81.8% and 90.9% to 88.2%, respectively). The number of Asian members holding positions on both the Board of Directors and Committee Chairs increased (0% to 18.2% and 4.5% to 11.8%, respectively) as did the number of females (10.5% to 18.2% and 13.6% to 35.3%, respectively). HLSA and African American members were proportionally represented in leadership for the years 2010 and 2015.

Conclusions:
Membership in POSNA has increased between 2010 to 2020 for every diversity category examined and POSNA membership exhibits significantly more diversity than the orthopaedic specialty as a whole. Leadership as a whole is more diverse in 2020 than it was in 2010.

Level of Evidence:
Level II—retrospective.
Traumatic Glenohumeral Dislocation in Pediatric Patients Is Associated With a High Risk of Recurrent Instability
Authors: Yapp Liam Z. , Baxendale-Smith Leo , Nicholson Jamie A. , Gaston Mark S. , Robinson Christopher M. 
Published: May 2021

Background:The natural history of traumatic glenohumeral dislocation is well-established in young adults, but it is less clear in pediatric patients. We aimed to determine the rate of recurrent instability and medium-term functional outcome following shoulder dislocation in patients aged 14 years or younger.Methods:All patients aged 14 years or younger who sustained a glenohumeral dislocation from 2008 to 2019 presenting to our regional health-board were identified. Patients who had subluxations associated with generalized laxity were excluded. Data was collected regarding further dislocations, stabilization surgery, sporting activity and patient-reported outcomes using the Western Ontario Shoulder Instability (WOSI) Index and Quick Disabilities of the Arm, Shoulder, and Hand score.Results:Forty-one patients with a radiologically confirmed traumatic glenohumeral dislocation were suitable for study inclusion [mean age at injury 12.3 y (range: 7.2 to 14.0 y), male sex 29 (70.7%), median 7.9 y follow-up]. The incidence rate of pediatric glenohumeral dislocation was 2.5 cases per 100,000 population (aged 0 to 14 y) per year. Recurrent dislocation occurred in 43.9% (n=18/41) at a median time of 14.7 months postinjury (range: 1 to 54 mo). Skeletal maturity was associated with significantly higher proportion of recurrent instability (immature 6/24 vs. mature 12/17,P=0.01). One in 5 patients required surgical intervention for recurrent instability [mean 8 (range: 1 to 14) dislocations before surgery]. Twenty-eight patients had completed outcome questionnaires. The median modified WOSI score was 87.1% [270 (interquartile range: 65 to 795)] and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 3.4 (interquartile range: 0 to 9.7). Recurrent shoulder instability was significantly associated with poorer WOSI score (unstable 71.4% vs. stable 94.3%, 95% confidence interval of the difference 6.2-36.9,P=0.04).Conclusions:Traumatic glenohumeral dislocation in patients aged 14 years or younger occurs rarely but is not a benign event. One in 2 patients experienced recurrent dislocation and 1 in 5 ultimately underwent surgical stabilization.Level of Evidence:Level IV.
Factors Affecting Operation Duration in Posterior Spinal Fusion (PSF) Using Dual Attending Surgeon Strategy Among Lenke 1 and 2 Adolescent Idiopathic Scoliosis (AIS) Patients
Authors: Chung Weng Hong , Mihara Yuki , Chiu Chee Kidd , Hasan Mohd Shahnaz , Chan Chris Yin Wei , Kwan Mun Keong 
Published: May 2021

Study Design:
This was a retrospective study.

Summary of Background Data:
Prolonged operation duration in adolescent idiopathic scoliosis (AIS) surgery was associated with increased perioperative complications. However, the factors affecting operation duration in AIS surgery were unknown.

Objective:
The aim of the study was to investigate the factors affecting operation duration in posterior spinal fusion (PSF) surgery using a dual attending surgeon strategy among Lenke 1 and 2 AIS patients.

Methods:
In all, 260 AIS patients with Lenke 1 and 2 curves who underwent PSF were retrospectively reviewed. Preoperative and intraoperative factors affecting operation duration such as age, sex, height, weight, body mass index, Risser grade, Lenke subtypes, number of fusion level, number of screws, screw density, wound length, upper and lowest instrumented vertebrae level, preoperative Cobb angle, and flexibility of the major curve were assessed using univariate and multivariate linear regression analyses. Independent factors were determined when P-value <0.05.

Results:
The mean operation duration was 122.2±28.6 minutes. Significant independent factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 subtypes (β=8.86, P=0.008), number of screws (β=7.01, P<0.001), wound length (β=1.14, P=0.009), and flexibility of the major curve (β=−0.25, P=0.005). The overall model fit was R
2=0.525. Operation duration can be predicted using the formula: (8.86×Lenke subtypes)+(7.01×number of screws)+(1.14×wound length)−(0.25×flexibility)−0.54, where Lenke 2=1 and Lenke 1=0.

Conclusion:
The factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 curves, number of screws, wound length, and curve flexibility. The knowledge of these factors enables the spinal deformity surgeons to plan and estimate the operation duration before AIS surgery.
Safety and Effectiveness of Modified Expansive Open-door Laminoplasty Using a Ultrasonic Bone Scalpel Compared With a High-speed Drill
Authors: Lin Qin , Lin Taotao , Wang Zhenyu , Chen Gang , Liu Wenge 
Published: May 2021

Study Design:
This was a retrospective study.

Objective:
Our study aimed to compare the effectiveness and safety of ultrasonic bone scalpel (UBS) and high-speed drill (HSD) in modified expansive open-door laminoplasty.

Summary of Background Data:
The traditional methods of decompression mostly use HSD and laminectomy forceps to lift the lamina. As a new type of bone cutting instrument, UBS has the advantages of good tissue selectivity, bone cutting accuracy, good hemostasis, cold cutting, and easy operation, leading to its popular use in surgery.

Materials and Methods:
Forty-two patients who underwent modified expansive open-door laminoplasty for multilevel cervical spondylotic myelopathy were included in this study. They were divided into HSD and UBS groups (n=18 and 24, respectively). Data on demographics, operation duration, blood loss, postoperative drainage, extubation time, length of stay, cost of hospitalization, and complications were collected and compared. Modified Japanese Orthopedic Association score, visual analog scale, Neck Disability Index, and axial symptoms were also recorded and analyzed.

Results:
The blood loss in the UBS group was 255.4±217.5 mL, which was lower than that in the HSD group (490.6±389.4 mL, P=0.030). The cost of hospitalization was similar between the 2 groups. The operative time and postoperative drainage did not significantly differ (P>0.05). The modified Japanese Orthopedic Association score, visual analog scale score, and Neck Disability Index score after surgery were better than those before surgery (P<0.05), but no significant difference existed between the 2 groups in each period (P>0.05). No significant difference existed in the incidence of axial symptoms and other complications (P>0.05).

Conclusion:
The application of the UBS to modified open-door laminoplasty resulted in a safe and effective decompression effect and reduced blood loss without increasing cost benefit.
Fructose and metabolic diseases: too much to be good
Authors: Shi Ya-Nan , Liu Ya-Jin , Xie Zhifang , Zhang Weiping J. 
Published: May 2021

Abstract
Excessive consumption of fructose, the sweetest of all naturally occurring carbohydrates, has been linked to worldwide epidemics of metabolic diseases in humans, and it is considered an independent risk factor for cardiovascular diseases. We provide an overview about the features of fructose metabolism, as well as potential mechanisms by which excessive fructose intake is associated with the pathogenesis of metabolic diseases both in humans and rodents. To accomplish this aim, we focus on illuminating the cellular and molecular mechanisms of fructose metabolism as well as its signaling effects on metabolic and cardiovascular homeostasis in health and disease, highlighting the role of carbohydrate-responsive element–binding protein in regulating fructose metabolism.