bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of HIV Diagnosis Following Bacterial Sexually Transmitted Infections in Tennessee, 2013–2017
Authors: Grome Heather N. , Rebeiro Peter F. , Brantley Meredith , Herrera-Vasquez Dyanne , Mathieson Samantha A. , Pettit April C. 
Published: April 2021

Background
Data on associations between sexually transmitted infections (STIs) and incident human immunodeficiency virus (HIV) diagnoses beyond men who have sex with men (MSM) are lacking. Identifying STIs associated with greatest risk of incident HIV diagnosis could help better target HIV testing and prevention interventions.

Methods
The STI and HIV surveillance data from individuals 13 years or older in Tennessee from January 2013 to December 2017 were cross-matched. Individuals without diagnosed HIV, but with reportable STIs (chlamydia, gonorrhea, syphilis) were followed up from first STI diagnosis until HIV diagnosis or end of study. Cox regression with time-varying STI exposure was used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CI) for subsequent HIV diagnosis; results were stratified by self-reported MSM.

Results
We included 148,465 individuals without HIV (3831 MSM; 144,634 non-MSM, including heterosexual men and women) diagnosed with reportable STIs; 473 had incident HIV diagnoses over 377,823 person-years (p-y) of follow-up (median, 2.6 p-y). Controlling for demographic and behavioral factors, diagnoses of gonorrhea, early syphilis, late syphilis, and STI coinfection were independently associated with incident HIV diagnosis compared with chlamydia. Early syphilis was associated with highest HIV diagnosis risk overall (aHR, 5.5; 95% CI, 3.5–5.8); this risk was higher for non-MSM (aHR, 12.3; 95% CI, 6.8–22.3) versus MSM (aHR, 2.9; 95% CI, 1.7–4.7).

Conclusions
While public health efforts often focus on MSM, non-MSM with STIs is also a subgroup at high risk of incident HIV diagnosis. Non-MSM and MSM with any STI, particularly syphilis, should be prioritized for HIV testing and prevention interventions.
Measuring the Impact of the COVID-19 Pandemic on Sexually Transmitted Diseases Public Health Surveillance and Program Operations in the State of California
Authors: Johnson Kelly A. , Burghardt Nicole O. , Tang Eric C. , Long Pike , Plotzker Rosalyn , Gilson Denise , Murphy Ryan , Jacobson Kathleen 
Published: April 2021

Background
As public health personnel and resources are redirected to COVID-19, sexually transmitted diseases (STD) programs have been unable to sustain pre–COVID-19 activities.

Methods
We used California (CA) surveillance data to describe trends in case reporting for gonorrhea, chlamydia, and syphilis of any stage in the pre– versus post–COVID-19 eras (January–June 2019 and January–June 2020). We also analyzed data from an electronic survey administered by the CA STD Control Branch to local health jurisdictions in April, June, and September of 2020, assessing the impact of COVID-19 on STD programs.

Results
There were sharp declines in cases of all reportable bacterial STDs occurring in conjunction with the March 19, 2020 CA stay-at-home order, most of which did not return to baseline by July. Comparing January–June 2020 to January–June of 2019, there were decreases in reported cases of chlamydia (31%), late syphilis (19%), primary/secondary syphilis (15%), early nonprimary nonsecondary syphilis (14%), and gonorrhea (13%). The largest percentage declines in STD case reporting were among Hispanic, Asian/Pacific Islander, and Black persons. Seventy-eight percent of local health jurisdiction respondents indicated that half or more of their workforce had been redeployed to COVID-19 by September 2020.

Conclusions
During the COVID-19 era, STD case reporting and programmatic functions have diminished throughout CA. Because this may contribute to decreases or delays in STD diagnosis and treatment—with resultant increases in STD transmission—providers and public health officials should prepare for potential increases in STD-related morbidity in the months and years to come.
Evaluation of Online Information on Complementary and Alternative Treatments for Dry Eye Disease
Authors: Rapata Micah E. J. , Meyer Jay J. 
Published: April 2021

SIGNIFICANCE
Dry eye disease is a common condition with many complementary and alternative therapies promoted online. Patients may inquire about these therapies, and clinicians should be aware of the existence, safety, and efficacy of these therapies, as well as the quality of available online information.

PURPOSE
Complementary and alternative medicine is a multibillion-dollar industry with increasing popularity. Dry eye disease is a chronic condition with many complementary and alternative therapies described online. Patients may inquire about and elect to forgo conventional treatments in favor of these therapies. This study identified alternative treatments for dry eye disease described online and evaluated the Web sites that described them.

METHODS
An Internet search algorithm identified Web sites describing complementary and alternative therapies for dry eye disease. Web site quality was assessed using the Sandvik score to evaluate Web site ownership, authorship, source, currency, interactivity, navigability, and balance. The potential risk of Web sites to patients was assessed using a risk scoring system. A list of described therapies was compiled.

RESULTS
Eight Web sites describing complementary and alternative therapies for dry eye disease were assessed. The Sandvik score classified more than half of the Web sites as “satisfactory” and none as “poor.” The overall mean risk score was low at 0.9. One Web site displayed information that discouraged the use of conventional medicine, whereas no Web sites discouraged adhering to clinicians' advice. The Web sites listed 12 therapies with a further 32 found in Web site comments. The most common therapies were acupuncture, vitamin supplements, homeopathic eye drops, castor oil, coconut oil, and chamomile eye wash.

CONCLUSIONS
The majority of analyzed Web sites were of satisfactory quality with a low potential risk to patients. However, some Web sites were biased toward their own therapies, lacked proper referencing, and/or did not identify authorship. Further research is required to ascertain the efficacy and safety of these therapies.
An Autopsy Case of Spontaneous Coronary Artery Dissection With Eosinophilic Coronary Periarteritis and Degeneration of Medial Smooth Muscles
Authors: Fukuta Mamiko , Kurose Akira , Horita Tetsuya , Otaki Jun , Nakamura Yoshimi , Kanno Sanae , Kato Hideaki , Aoki Yasuhiro 
Published: April 2021

Abstract
A 45-year-old woman with no known medical history died suddenly shortly after complaining of anterior chest discomfort. The autopsy revealed a dissection at the anterior descending branch of the left coronary artery, and eosinophilic adventitial inflammation was observed both in the right coronary artery and in the vicinity of the dissection. Furthermore, there was degeneration of the tunica media in the right coronary artery, and this was thought to be a predissection lesion. In the degenerated area of the tunica media, probable apoptosis of smooth muscle cells was noted, suggesting that the degeneration was not due only to the effect of eosinophilic lytic enzymes. These findings also indicated that eosinophilic infiltration preceded the dissection. Eosinophilic infiltration around the coronary arteries is occasionally observed in cases of sudden death, but although it might be associated with the death, the pathological mechanism is yet to be elucidated. Eosinophilic periarteritis has also been observed around the site of spontaneous coronary artery dissection, although a causal relationship is unproven. The histopathology of this case indicated that the eosinophilic infiltration preceded the dissection. Detailed pathological findings are presented, together with a review of the literature.
Understanding parents' use of a knowledge translation tool to manage children's vaccination pain
Authors: MacKenzie Nicole E. , Tutelman Perri R. , Chambers Christine T. , Parker Jennifer A. , MacDonald Noni E. , McMurtry C. Meghan , Pluye Pierre , Granikov Vera , Taddio Anna , Barwick Melanie , Birnie Kathryn A. , Boerner Katelynn E. 
Published: April 2021

Abstract

Introduction:
Although several evidence-based strategies for managing children's vaccination pain exist, many parents report being unaware of them. Knowledge translation (KT) tools present evidence-based information in plain language.

Objectives:
This two-phase study assessed parents/caregivers' uptake of evidence-based pain management strategies via a KT tool and considered factors related to parents' planned, actual, and future use of these strategies.

Methods:
In phase 1, parents were exposed to an online KT tool on physical, psychological, and pharmacological vaccination pain management strategies, and their impressions were assessed by questionnaires including the Information Assessment Method for Parents. In phase 2, after vaccination, parents completed a follow-up survey on their uptake and experiences using the information.

Results:
A total of 312 participants reported their plans for KT tool use. Parents who found the KT tool relevant were more likely to plan to use it at their child's upcoming vaccination. A total of 128 parents (93% mothers) completed both surveys. Nearly all parents who planned to use the information did so during their child's subsequent vaccination (90%). When the KT tool was relevant to their needs, parents were more likely to use the information during their child's vaccination. Parents who felt confident using the tool were significantly more likely to report plans for future tool use.

Discussion:
This study demonstrates the effectiveness of a KT tool that was relevant to parents' needs and built confidence to increase parent-reported uptake of evidence-based strategies. Proper pain management could positively impact parents' uptake of vaccinations for children.
Development of a physical mobility prediction model to guide prosthetic rehabilitation
Authors: Anderson Chelsey B. , Wurdeman Shane R. , Miller Matthew J. , Christiansen Cory L. , Kittelson Andrew J. 
Published: April 2021

Background:
Prosthetic rehabilitation decisions depend on estimating a patient's mobility potential. However, no validated prediction models of mobility outcomes exist for people with lower-limb amputation (LLA).

Objectives:
To develop and test predictions for self-reported mobility after LLA, using the Prosthetic Limb Users Survey of Mobility (PLUS-M).

Study Design:
This is a retrospective cohort analysis.

Methods:
Eight hundred thirty-one patient records (1,860 PLUS-M observations) were used to develop and test a neighbors-based prediction model, using previous patient data to predict the 6-month PLUS-M T-score trajectory for a new patient (based on matching characteristics). The prediction model was developed in a training data set (n = 552 patients) and tested in an out-of-sample data set of 279 patients with later visit dates. Prediction performance was assessed using bias, coverage, and precision. Prediction calibration was also assessed.

Results:
The average prediction bias for the model was 0.01 SDs, average coverage was 0.498 (ideal proportion within the 50% prediction interval = 0.5), and prediction interval was 8.4 PLUS-M T-score points (40% improvement over population-level estimates). Predictions were well calibrated, with the median predicted scores falling within the standard error of the median of observed scores, across all deciles of the data.

Conclusions:
This neighbors-based prediction approach allows for accurate estimates of PLUS-M T-score trajectories for people with LLA.
A systematic review of health economic evaluation in orthotics and prosthetics: Part 2—orthotics
Authors: Clarke Leigh , Dillon Michael P , Shiell Alan 
Published: April 2021

Background:
Health economic evaluations (HEEs) in orthotics are in their infancy. Identification of evidence gaps and method design issues will inform the design of future HEEs that advance knowledge and contributes to policy and investment decisions.

Objectives:
The aim of this systematic review was to critically appraise the existing orthotic/prosthetic health economic evaluation literature and therefore determine evidence gaps, critical method design issues, and the extent to which the literature informs orthotic policy and investment decisions.

Study Design:
Systematic review.

Methods:
A range of databases were searched using intervention- and HEE-related terms. The Consolidated Health Economic Checklist—Extended and the Checklist for Health Economic Evaluation Reporting Standards were used to identify issues with method design and reporting.

Results:
Nine orthotic HEEs were narrowly focused on the cost-effectiveness of low-cost orthotic devices (eg, ankle orthoses for ankle sprains). Method design (eg, cost identification and valuation) and reporting issues (eg, lack of detail about the study population) limited the extent to which this literature can inform policy and investment decisions.

Conclusions:
HEEs comparing a wider variety of interventions are required, particularly for commonly used orthoses (eg, ankle-foot orthoses) and clinical presentations (eg, post-stroke). There are opportunities to strengthen future orthotic HEEs by adopting method design features (eg, microcosting and sensitivity analyses) as recommended by HEE appraisal and reporting tools.
Functional performance differences between carbon fiber and fiberglass prosthetic feet
Authors: Kaufman Kenton R. , Bernhardt Kathie 
Published: April 2021

Background:
Persons with lower limb amputation require increased functionality. The largest category of feet for active individuals with a transtibial amputation is energy storage and return (ESR) feet. These feet are typically constructed of carbon fiber composite materials. Recently, a prosthetic foot composed of a fiberglass composite has emerged in the market. However, there are no comparative studies of these devices.

Objectives:
Compare the biomechanical performance and prosthesis-related quality of life when using a fiberglass prosthetic foot design compared with traditional carbon fiber ESR designs.

Study Design:
This is a repeated-measures randomized cross-over trial.

Methods:
Gait analysis was performed on 10 experienced male subjects with unilateral transtibial amputations (K-level III) while walking on level ground and a ramp. Patient-reported outcomes were collected using the Prosthesis Evaluation Questionnaire.

Results:
Gait data demonstrated increased ankle dorsiflexion (P < .01), similar ankle moments (P = .07), and increased ankle power generation (P = .01) when using the fiberglass foot. The increased power generation occurred at the correct time in the gait cycle such that the timing and magnitude of peak knee flexion was unaffected (P > .19). The fiberglass foot had greater energy absorption during gait (P = .01) with no difference in energy return (P = .37). The subjects expressed improved prosthesis-related quality of life with the fiberglass foot (P = .01).

Conclusions:
The findings of this study demonstrate that the new ESR foot comprising a fiberglass material had better performance than traditional designs using a carbon fiber material.
Cranial remolding orthosis for postoperative management of bilateral lambdoid and sagittal synostosis: A case report
Authors: Taheri Zahra , Babaee Taher , Hajiaghaei Behnam , Mohammadi Hassan Reza 
Published: April 2021

Case Description:
This is a report of a 2.5-month-old infant with bilateral lambdoid and sagittal synostosis who underwent minimally invasive suturectomy followed by cranial remolding orthosis (CRO).

Objectives:
To evaluate the result of minimally invasive suturectomy followed by CRO treatment in an infant with bilateral lambdoid and sagittal synostosis.

Study Design:
This is a case report.

Treatment:
We fabricated the orthosis based on a computer-aided design and with computer-aided manufacturing technology. Cranial remolding orthosis compliance was measured subjectively. The child's parents were asked to complete a survey using visual analog scales to assess their satisfaction of their child's head appearance, problems with donning/doffing the orthosis, and feedback received from other people.

Outcomes:
At the time of fitting, the posterior skull hemisphere volume was 389.4 cm3. The values of cephalic index and cranial vault asymmetry index (CVAI) were 81% and 5%, respectively. After 6 months of CRO treatment, the cephalic index and CVAI were 83% and 1.5%, respectively. Moreover, the posterior skull hemisphere volume was 589.2 cm3. Average compliance with CRO wear was 88%. According to the parental questionnaire results, pressure sores occurred 0% of the time, displacement occurred 15% of the time, contact dermatitis occurred 10% of the time, problems with donning/doffing of the orthosis occurred 27% of the time, difficulties in breastfeeding occurred 30% of the time, negative feedback from other people upset them 55% of the time, and they were 100% satisfied with treatment.

Conclusions:
After 6 months of using CRO, the CVAI and skull volume improved and reached their normal proportions. Our results may help ongoing research and clinical care regarding the role of postoperative CRO treatment in patients with complex synostosis.
Self-reported socket comfort, mobility, and balance-confidence of individuals with transtibial amputation using pinlock vs suction suspension
Authors: Seth Mayank , Beisheim Emma Haldane , Spencer Maximilian Tobias , Horne John Robert , Sarlo Frank Bernard , Sions Jaclyn Megan 
Published: April 2021

Background:
Improper suspension between the residual limb and prosthesis can result in pistoning, which may compromise skin integrity and reduce overall user comfort. In addition to objective measures of limb pistoning, user perspective may provide insight into suspension system effectiveness.

Objectives:
The primary objective of this analysis was to explore differences in self-reported measures among adults with transtibial amputation (TTA) using pinlock vs suction suspension systems.

Study Design:
This is a secondary analysis of cross-sectional data.

Methods:
Participants (n = 48) were included if they (1) were ≥18 years of age, (2) were community-dwelling, (3) had a unilateral TTA of ≥6 months, and (4) were prescribed a prosthesis with either pinlock or suction suspension. Participants completed self-reported measures evaluating socket comfort (Socket Comfort Score [SCS]), prosthesis-enabled mobility (Prosthesis Evaluation Questionnaire—Mobility Section [PEQ-MS]; Locomotor Capabilities Index [LCI]), and balance-confidence (Activities-Specific Balance Confidence Scale [ABC]).

Results:
Participants using suction suspension reported significantly higher SCS as compared with participants using pinlock suspension (P ≤ .001). No differences were observed between groups for PEQ-MS, LCI, and/or ABC.

Conclusions:
Individuals with TTA using suction suspension may report greater socket comfort than peers using pinlock suspension, but prosthesis-enabled mobility and balance-confidence may be similar. Future research is warranted to confirm these preliminary findings using a prospective, crossover study design that controls for all suspected factors that might influence socket comfort.
Locomotor activities of individuals with lower-limb amputation
Authors: Srisuwan Bantoon , Klute Glenn K. 
Published: April 2021

Background:
Ambulatory individuals with lower-limb amputation perform a variety of locomotor activities, but the step count distribution of these activities is unknown.

Objective:
To describe a novel method for activity monitoring and to use it to count steps taken while walking straight ahead on level ground, turning right and left, up and down stairs, and up and down ramps.

Study Design:
This is an observational study.

Methods:
A portable instrument to record leg motion was placed on or inside the prosthetic pylon of 10 individuals with unilateral transtibial amputations. Participants first walked a defined course in a hospital environment to train and validate a machine learning algorithm for classifying locomotor activity. Participants were then free to pursue their usual activities while data were continuously collected over 1-2 d.

Results:
Overall classification accuracy was 97.5% ± 1.5%. When participants were free to walk about their home, work, and community environments, 82.8% of all steps were in a straight line, 9.0% were turning steps, 4.8% were steps on stairs, and 3.6% were steps on ramps.

Conclusion:
A novel activity monitoring method accurately classified the locomotion activities of individuals with lower-limb amputation. Nearly 1 in 5 of all steps taken involved turning or walking on stairs and ramps.
Effect of transfemoral prosthetic socket interface design on gait, balance, mobility, and preference: A randomized clinical trial
Authors: Kahle Jason T. , Miro Rebecca M. , Ho Loi T. , Porter Michael R. , Lura Derek J. , Carey Stephanie L. , Lunseth Paul , Swanson Ann E. , Highsmith M. Jason 
Published: April 2021

Background:
There are alternative transfemoral (TF) socket interface designs that have not been compared with the standard of care, ischial ramus containment (IRC). The interface directly affects performance.

Objectives:
To compare 3 TF interface designs, IRC, dynamic socket (DS), and subischial (Sub-I), regarding gait, balance, mobility, and preference. The authors hypothesized that these more active users may experience gait, mobility, and preference benefits from the less intrusive DS and Sub-I interface designs.

Study Design:
Single-blind, repeated-measures, 3-period randomized controlled crossover clinical trial.

Methods:
People with unilateral TF amputation with 1 year or longer prosthesis use experience, independent community ambulatory status, 18 to 60 years of age, of any race or ethnicity, with a body mass of 45 to 125 kg, and with a self-reported ability to walk for 20 minutes continuously were included in the study. Each participant was fit in all 3 interface designs.

Results:
Thirteen participants completed the clinical trial. Velocity, cadence, mobility, and balance were not statistically different between the 3 socket conditions. The DS demonstrated significantly greater symmetry in swing, stance, single support percentage, and toe angle compared with IRC and Sub-I. Sixty days after study completion, 7 participants changed interfaces, trending away from IRC.

Conclusions:
Large differences were not observed. Small differences in spatiotemporal gait measures combined with patient preference may make a meaningful difference to individual patients and should be considered.