bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative Evolution of Sagittal Parameters Over Time Does Not Differ by Upper Instrumented Vertebra
Authors: Steinhaus Michael E. , Lafage Renaud , Alluri Ram K. , Lovecchio Francis , Clark Nicholas J. , Sivaganesan Ahilan , Schwab Frank , Lafage Virginie , Kim Han Jo 
Published: October 2021

Study Design.
Retrospective cohort study.

Objectives.
The aim of this study was to examine sagittal alignment over time in adult spinal deformity (ASD) and to understand whether these changes vary by choice of upper instrumented vertebra (UIV).

Summary of Background Data.
Recent ASD literature has focused on specific alignment goals. Less is known about how sagittal parameters evolve over time after surgical correction and whether these changes differ by choice of UIV.

Methods.
This was a retrospective review of ASD patients from a single institution. Routine 36″ sagittal x-rays were obtained preoperatively, before hospital discharge, and at 6 months, 1 year, and 2 years and sagittal parameters were measured. Patients with UIV T6 and above were classified as upper thoracic (UT) and T7 and below as lower thoracic (LT).

Results.
A total of 102 patients with mean age 66.0 years (±7.7) were included in the analysis (49 UT, 53 LT). All sagittal and coronal alignment parameters demonstrated significant improvement from preoperatively to any postoperative time point. Although multiple parameters maintained correction over time, others (TK, TPA, and PT) demonstrated significant increase from discharge to 2 years postoperatively, with changes occurring relatively early after surgery, whereas overall global alignment was maintained. Both UT/LT groups demonstrated significantly greater TK from preoperatively to discharge to 6 months (P
< 0.05), stabilizing at that time point out to 2 years, whereas TLK preferentially increased in the LT group. There was significant improvement in sagittal vertical axis after surgery, which was maintained out to 2years of follow-up (P > 0.05).

Conclusions.
Our data suggest that although several key parameters are maintained over time out to 2years postopera- tively, TK tends to worsen over time for all patients, whereas TLK preferentially increases in the LT group. Nevertheless, despite these trends, compensatory changes are seen in PT such that global alignment is relatively maintained.

Level of Evidence: 3
Ultrastructural alterations of megakaryocytes in thrombocytopenia: A review of 43 cases
Authors: Eyden Brian , Ru Yong-Xin , Dong Shu-Xu , Liu Jing , Liu Xiao-Fan 
Published: October 2021

Abstract
Thrombocytopenia is a frequent occurrence in a variety of hematopoietic diseases; however, the details of the mechanism leading to low platelet count remain elusive. Megakaryocytes are a series of progenitor cells responsible for the production of platelets. Alterations in megakaryocytes in the bone marrow are a causative factor resulting in thrombocytopenia in varied diseases. Based on ultrastructural analysis of incidentally encountered megakaryocytes in 43 patients with blood diseases marked by low platelet counts, electron micrographs demonstrated that aberrant megakaryocytes predominated in idiopathic thrombocytopenic purpura, aplastic anemia, and myelodysplastic syndrome; autophagy, apoptosis, and cellular damage in megakaryocytes were a prominent feature in aplastic anemia. On the other hand, poorly differentiated megakaryocytes predominated in acute megakaryoblastic leukemia (AMKL) although damaged megakaryocytes were seen in non-AMKL acute leukemia. This paper documents the ultrastructural alterations of megakaryocytes associated with thrombocytopenia and reveals distinctive features for particular blood diseases. A comment is made on future avenues of research emphasizing membrane fusion proteins.
State of the art and future directions in the systemic treatment of medullary thyroid cancer
Authors: Jager Eline C. , Broekman K. Esther , Kruijff Schelto , Links Thera P. 
Published: October 2021

Purpose of review
Systemic treatment is the only therapeutic option for patients with progressive, metastatic medullary thyroid cancer (MTC). Since the discovery of the rearranged during transfection (RET) proto-oncogene (100% hereditary, 60–90% sporadic MTC), research has focused on finding effective systemic therapies to target this mutation. This review surveys recent findings.

Recent findings
Multikinase inhibitors are systemic agents targeting angiogenesis, inhibiting growth of tumor cells and cells in the tumor environment and healthy endothelium. In the phase III EXAM and ZETA trials, cabozantinib and vandetanib showed progression-free survival benefit, without evidence of prolonged overall survival. Selpercatinib and pralsetinib are kinase inhibitors with high specificity for RET; phase I and II studies showed overall response rates of 73% and 71% in first line, and 69% and 60% in second line treatment, respectively. Although resistance mechanisms to mutation-driven therapy will be a challenge in the future, phase III studies are ongoing and neo-adjuvant therapy with selpercatinib is being studied.

Summary
The development of selective RET-inhibitors has expanded the therapeutic arsenal to control tumor growth in progressive MTC, with fewer adverse effects than multikinase inhibitors. Future studies should confirm their effectiveness, study neo-adjuvant strategies, and tackle resistance to these inhibitors, ultimately to improve patient outcomes.
Emergency Medicine and COVID-19: now and next year
Authors: Christopher Theodore A. , Christopher Adrienne N. 
Published: October 2021

Abstract
The COVID-19 pandemic is responsible for infecting to date more than 93 million people worldwide and causing more than 2 million deaths. That the vast majority of deaths have occurred in the United States (U.S.) can be attributed to nonadherence by Americans to basic public health mitigation strategies that are known to curtail coronavirus spread. Emergency Departments (ED's) throughout the U.S. experienced a dramatic decrease in patient visits during the first surge of COVID-19, followed by an ED patient visit rebound to approximately 80% of pre-COVID-19 numbers, which have remained relatively stable through the current second COVID-19 surge. The pandemic highlighted the significant role that hospital ED's and emergency physicians played in combatting COVID-19 “on the front lines.” Wearing extensive and escalating personal protective equipment (PPE) layers became the norm in seeing emergency patients, and many infrastructure and process changes occurred included evaluating and treating patients in outdoor tents, cohorting confirmed and suspected COVID-19 patients in designated ED and hospital sections, and repeatedly amending COVID-19 evaluation and treatment guidelines as more information became available on a sometimes daily basis. Regarding other clinical venues in which emergency physicians were working during COVID-19 surges, Observation Unit patient visits decreased, although patient acuity increased; urgent care (UC) patient visits decreased dramatically, whereas Telehealth (TH) patient visits to our 24/7 available platform, JeffCONNECT, saw a dramatic increase in activity. Remdesivir, Dexamethazone and more recently, the monoclonal antibody Bamlanivimab, have formed the mainstay of treatment offered to our patients with COVID-19; all these agents are offered to patients in our ED's and Observation Unit. The current second COVID-19 surge, with our ED and hospital patient visits remaining essentially stable, has intensified the public health crisis as record numbers of U.S. patients continue to acquire COVID-19 and die. With ED patient care processes being optimized to treat the influx of COVID-19 patients, and ED geography being adjusted within ED's and expanding maximally to areas outside the ED's but still within the confines of hospital walls, emergency physicians have taken the lead in caring for patients remotely via on demand TH Virtual ED visits. Rather than continuing to request the patients to come to us, emergency physicians are evolving to assess patients remotely and are embracing health care delivery models that bring acute unscheduled medical care to patients at home. This will include also prioritizing health wellness, health care disparities, and health equity, as Emergency Medicine (EM) and emergency physicians begin to collectively address community and patient social determinants of health, especially in vulnerable populations and communities.
Self-report Versus Measured Physical Activity Levels During Outpatient Cardiac Rehabilitation
Authors: Groothuis Rutger J. , van Keeken Helco G. , de Vries Arjen E. , Dijkstra Pieter U. 
Published: October 2021

Purpose:
Many patients with coronary artery disease (CAD) do not achieve the recommended physical activity (PA) levels during and after cardiac rehabilitation (CR). The aim of this study was to analyze moderate to vigorous physical activity (MVPA) levels and the differences between perceived (self-reported) and measured (activity monitor) MVPA in CAD patients during CR. The second aim was to analyze which patient characteristics were associated with this difference.

Methods:
A two-center observational-sectional study was conducted within the Department of Rehabilitation Medicine of the University Medical Center Groningen between January and April 2018. Adults with CAD, following an outpatient CR program, were included. Perceived MVPA was assessed with the Short Questionnaire to Assess Health-enhancing Physical Activity and compared with ActivPAL3 activity monitor outcomes over a period of 7 d.

Results:
Fifty-one patients with CAD (age 59.4 ± 7.1 yr, eight females) were recruited. Four patients (8%) did not achieve the recommended guideline level of ≥150 min/wk of MVPA. Patients spent ≥80% of the week in sedentary activities. Patients overestimated MVPA with a median of 805 (218, 1363) min/wk (P< .001). The selected patient characteristics (age, body mass index, type of CAD, type of CR, social support, and self-efficacy) were not associated with this overestimation.

Conclusions:
Most patients with CAD, participating in an outpatient CR program, do achieve MVPA exercise recommendations but spend simultaneously too much time in sedentary activities.
Development and Validity Testing of the Workplace Parent Index
Authors: Yun Young Ho , Choi Yeani , Chae Minjin 
Published: October 2021

Objective:
We aimed to develop the Workplace Parent Index (WPI) as an assessment tool of family-friendly practice in the workplace and validate its psychometric properties.

Methods:
The development of the WPI included three phases: item generation, scale construction, and field testing. Participants were 1000 parents, aged 18 or more years old, who completed the WPI online and measures of competency of parentship, life satisfaction, and positive growth after experiencing a traumatic event.

Results:
The WPI comprised 80 items and five domains: Governance and Infrastructure, Planning and Communications, Action-Pregnancy and Childbirth, Action-Childrearing, and Monitoring and Feedback. All subscales of the WPI demonstrated high internal consistency reliability and correlated with other scales as expected in support of concurrent and predictive validity.

Conclusions:
The WPI demonstrated excellent psychometric properties that can be used to assess comprehensive family-friendly practices in the workplace when addressing the need and prioritizing the allocation of resources for workplace parentship program initiatives.
18F-Choline PET Detected the Third Ventricle Craniopharyngioma
Authors: Zhu Yunqi , Zhao Kui , Wang Zhen , Zhang Yafei , Lu Xiaoya 
Published: October 2021

Abstract
Craniopharyngiomas are rare tumors of low histological malignancy (World Health Organization grade I) in the sellar and suprasellar region of the brain. We report a case of the third ventricular craniopharyngioma detected using 18F-choline PET/CT in a 43-year-old man. MRI of the brain revealed an intense gadolinium enhancement focus in the same area. Histology revealed characteristics of papillary craniopharyngioma. Our findings suggest that craniopharyngioma should be included in the differential diagnosis of 18F-choline–avid brain lesions.
Accuracy of emergency medical service telephone triage of need for an ambulance response in suspected COVID-19: An observational cohort study
Authors: Marincowitz Carl , Stone Tony , Hasan Madina , Campbell Richard , Bath Peter A. , Turner Janette , Pilbery Richard , Thomas Benjamin , Sutton Laura , Bell Fiona , Biggs Katie , Hopfgartner Frank , Mazumdar Suvodeep , Petrie Jennifer , Goodacre Steve 
Published: October 2021

AbstractBackgroundEmergency Medical Services (EMS) have experienced surges in demand as the COVID-19 pandemic has progressed with ambulances services in the UK declaring major incidents due to the risk of care being compromised. COVID-19 specific EMS telephone triage tools have been introduced to help manage demand. There has been no previous evaluation of the accuracy of EMS telephone triage in identifying patients with suspected COVID-19 at risk of serious adverse outcome.We aimed to assess accuracy of EMS telephone triage in identifying patients who need an EMS response and identify factors which affect triage accuracy.MethodPatients who made an emergency call to Yorkshire Ambulance Service between 2ndApril and 29thJune 2020 and were assessed using an AMPDS pandemic pathway for suspected COVID-19 were linked to Office for National Statistics death registration data, hospital and general practice electronic health care data collected by NHS Digital.Accuracy of decision to dispatch an ambulance was assessed in terms of death or need for organ support at 30 days from the first 999 call. Multivariable logistic regression was used to identify factors associated with false negative and false positive triage.ResultsOf 12, 653 callers included in the study population, 11.1% experienced the primary composite adverse outcome. Using the triage pathway, 16% of callers did not receive an emergency response and they had a lower risk (3.5%) of the primary outcome. Ambulances were dispatched to 4, 230 callers (33.4%) who were not subsequently conveyed to hospital and did not experience the primary outcome (false positive triage). Multivariable modelling found older age and presence of pre-existing respiratory disease were significant predictors of false positive triage.ConclusionEMS telephone triage avoided 16% of calls receiving an emergency ambulance, of whom 3.5% died or needed organ support by 30 days. Telephone triage can therefore reduce the burden of EMS responses but with the cost of a small proportion of patients who do not receive an initial emergency response deteriorating. Research is needed to identify the appropriate balance between over- and under-triage
SARS-COV-2 δ variant drives the pandemic in India and Europe via two subvariants
Authors: Yang Xiang-Jiao 
Published: October 2021

ABSTRACTSARS-COV-2 evolution generates different variants and drives the pandemic. As the current main driver, δ variant bears little resemblance to the other three variants of concern, raising the question what features future variants of concern may possess. To address this important question, I compared different variant genomes and specifically analyzed δ genomes in the GISAID database for potential clues. The analysis revealed that δ genomes identified in India by April 2021 form four different groups (referred to as δ1, δ2, δ3 and δ4) with signature spike, nucleocapsid and NSP3 substitutions defining each group. Since May 2021, δ1 has gradually overtaken all other subvariants and become the dominant pandemic driver, whereas δ2 has played a less prominent role and the remaining two (δ3 and δ4) are insignificant. This group composition and variant transition are also apparent across Europe. In the United Kingdom, δ1 has quickly become predominant and is the sole pandemic driver underlying the current wave of COVID-19 cases. Alarmingly, δ1 subvariant has evolved further in the country and yielded a sublineage encoding spike V36F, A222V and V1264L. These substitutions may make the sublineage more virulent than δ1 itself. In the rest of Europe, δ1 is also the main pandemic driver, but δ2 still plays a role. In many European countries, there is a δ1 sublineage encoding spike T29A, T250I and Q613H. This sublineage originated from Morocco and has been a key pandemic driver there. Therefore, δ variant drives the pandemic in India and across Europe mainly through δ1 and δ2, with the former acquiring additional substitutions and yielding sublineages with the potential to drive the pandemic further. These results suggest a continuously branching model by which δ variant evolves and generates more virulent subvariants.
Survey of Direct and Indirect Effects of COVID-19 on Eyes and the Common Ocular Manifestations
Authors: Rabi Dianeh , Rabi Razan , Jarrar Arkan , Mharma Sarah , Jaradat Aya , Bzoor Shatha 
Published: October 2021

AbstractPurposeOcular manifestations were reported in many recent observations that studied either the effect of COVID-19 directly on eyes or of face mask use. Hence, this study aimed to investigate the effect of COVID-19 on the eyes and make a clear comparison of its direct and indirect effect from face mask-wearing.MethodsThis was a cross-sectional study of both written and web-based questionnaires, distributed among a group of COVID-19 patients and a matched control group, the questionnaire consisted of common demographic data, COVID-19 infection history and its symptoms, focusing on ocular symptoms and the presence of conditions related to or cause eye symptoms. As well as the use of face masks that were assessed in terms of the complained ocular manifestationResultsOf 618 participants, 252 had COVID-19 and 366 never had COVID-19. Ocular manifestation among COVID-19 incidence was 44%, significantly higher than non-infected participants’ incidence (35.8%), adjusted odds ratio, 95% confidence interval (AOR, 95%CI); 1.45 (1.02-2.06)). Eye discharges (p-value = 0.033) and photosensitivity (p-value = 0.003) were noted more commonly among COVID-19 participants compared to healthy control. When comparing long periods of face mask use with each ocular symptom; dry eye based on OSDI, forging body sensation, eye pain and eye discharges, were found significantly common among extended periods of face mask use.ConclusionCOVID-19 pandemic affected eyes, both directly from the virus or from its preventive measure of face mask use.
Slower Learning Rates from Negative Outcomes in Substance Use Disorder over a 1-Year Period and their Potential Predictive Utility
Authors: Smith Ryan , Taylor Samuel , Stewart Jennifer L. , Guinjoan Salvador M. , Ironside Maria , Kirlic Namik , Ekhtiari Hamed , White Evan J. , Zheng Haixia , Kuplicki Rayus ,   Tulsa 1000 Investigators, Paulus Martin P. 
Published: October 2021

AbstractComputational modelling is a promising approach to parse dysfunctional cognitive processes in substance use disorders (SUDs), but it is unclear how much these processes change during the recovery period. We assessed 1-year follow-up data on a sample of treatment-seeking individuals with one or more SUDs (alcohol, cannabis, sedatives, stimulants, hallucinogens, and/or opioids; N = 83) that were previously assessed at baseline within a prior computational modelling study. Relative to healthy controls (HCs; N = 48), these participants were found at baseline to show altered learning rates and less precise action selection while completing an explore-exploit decision-making task. Here we replicate these analyses when these individuals returned and re-performed the task 1 year later to assess the stability of these baseline differences. We also examine whether baseline modelling measures can predict symptoms at follow-up. Bayesian analyses indicate that: (a) group differences in learning rates were stable over time (posterior probability = 1); (b) intra-class correlations (ICCs) between model parameters at baseline and follow-up were significant and ranged from small to moderate (.25 ≤ ICCs ≤ .54); and (c) learning rates and/or information-seeking values at baseline were associated with substance use severity at 1-year follow-up in stimulant and opioid users (.36 ≤ rs ≤ .43, .002 ≤ ps ≤ .02). These findings suggest that learning dysfunctions are moderately stable during recovery and could correspond to trait-like vulnerability factors. In addition, computational measures at baseline had some predictive value for changes in substance use severity over time and could be clinically informative.
Mod3D: A Low-Cost, Flexible Modular System of Live-Cell Microscopy Chambers and Holders
Authors: Barba Bazan C. , Goss S. , Peng C. , Begeja N. , Suart CE. , Neuman K. , Truant Ray 
Published: October 2021

AbstractLive-cell microscopy imaging typically involves the use of high-quality glass-bottom chambers that allow cell culture, gaseous buffer exchange and optical properties suitable for microscopy applications. However, commercial sources of these chambers can add significant annual costs to cell biology laboratories. Consumer products in three-dimensional printing technology, for both Filament Deposition Modeling (FDM) and Masked Stereo Lithography (MSLA), have resulted in more biomedical research labs adopting the use of these devices for prototyping and manufacturing of lab plastic-based items, but rarely consumables. Here we describe a modular, live-cell chamber with multiple design options that can be mixed per experiment. Single reusable carriers and the use of biodegradable plastics, in a hybrid of FDM and MSLA manufacturing methods, reduce plastic waste. The system is easy to adapt to bespoke designs, with concept-to-prototype in a single day, offers significant cost savings to the users over commercial sources, and no loss in dimensional quality or reliability.
Multi-Functionalized Self-Bonding MXene for Minimal-invasive Jet-injected Neural Interface and Tissue Healing
Authors: Sha Baoning , Zhao Shengzhuo , Gu Minling , Zhao Guannan , Wang Liping , Bi Guo-Qiang , Du Zhanhong 
Published: October 2021

AbstractImplantable central and peripheral neural interfaces have great potential in treating various nerve injuries and diseases. Still, limitations of surgery trauma, handling inconvenience, and biocompatibility issues of available materials and techniques significantly hinder the peripheral nerve interface for research and clinical purposes. MXenes have great potential as bioelectronics materials for excellent hydrophilicity, conductivity, and biocompatibility. However, their application in bioelectronic interface has been limited due to the poor oxidation stability and fast tissue clearance. Here, we developed a minimal-invasive jet-injected neural interface using MXene nanosheets with strong redox stability, tissue adhesion, conductivity, and good self-bonding properties. We also develop a minimal-invasive jet injector to implant the optimized MXene suspension into the damaged sciatic nerve and establish a neural interface through tissue adhesion and self-bonding. We use this neural interface to promote nerve regeneration and perform electrophysiology recording on moving mice. We prove that the nanosheets can mitigate cellular inflammation, promote tissue healing, and record high-quality electrophysiology signals for predicting joint movement. Thus, our material and implantation strategy together form a novel minimal-invasive neural interface, facilitating the collection and analysis of large-scale living body data to solve the challenge of neurological diseases of the peripheral or even the central nervous system.