bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poor Fusion Rates Following Cervical Corpectomy Reconstructed With an Expandable Cage: Minimum 2-Year Radiographic and Clinical Outcomes
Authors: Byvaltsev Vadim A , Kalinin Andrei A , Aliyev Marat A , Azhibekov Nurzhan O , Shepelev Valerii V , Riew K Daniel 
Published: June 2021

Abstract

BACKGROUND
Expandable cages are often used to reconstruct cervical corpectomies but there are few long-term follow-up studies with large numbers.

OBJECTIVE
To analyze the clinical and radiographic results of cervical corpectomy reconstructed with expandable cages for degenerative stenosis.

METHODS
We performed a retrospective analysis of 78 patients with degenerative cervical stenosis treated with a corpectomy reconstructed with an expandable cage. We evaluated the clinical and radiographic outcomes, as well as complications of the procedure at a minimum 2-yr follow-up.

RESULTS
There was a decrease in the visual analog scale pain average from 75 mm to 8.5 mm (P = .02); a decrease in the Neck Disability Index average from 55% to 12% (P = .009); and improvement in the Japanese Orthopaedic Association average from 12 to 14 points (P = .01). There was a change in cervical lordosis (Cobb method) average from −9.3° to −15.1° (P = .002), without significant loss of lordosis (P = .63). The fusion rate, by criteria of the Cervical Spine Research Society (CSRS), was low: using dynamic X-rays – 50% (n = 39/78) and using computed tomography (CT) – 47.4% (n = 37/78). A total of 11 patients (14.1%) suffered complications.

CONCLUSION
To our knowledge, this is the largest series (78) with a minimum 2-yr follow-up in the literature and the first using the dynamic radiographic and CT criteria endorsed by the CSRS. Using these criteria, our fusion rates were much lower than all previous reports in the literature. Despite this, patient-reported outcomes were reasonable. There was a relatively low incidence of perioperative complications, most of which were likely not implant-specific and there was only 1 case of implant failure.
Nicotine and Tobacco Product Use and Dependence Symptoms Among US Adolescents and Adults: Differences by Age, Sex, and Sexual Identity
Authors: Evans-Polce Rebecca J , Veliz Philip , Kcomt Luisa , Boyd Carol J , McCabe Sean Esteban 
Published: June 2021

Abstract

Introduction
Sexual minorities are at increased risk for tobacco use; however, there is heterogeneity in this risk by sociodemographic factors.

Aims and Methods
This study sought to understand if vulnerability to tobacco use among US sexual minorities varies by age group. For this study we used data from wave 4 of the Population Assessment of Tobacco and Health adolescent and adult surveys (n = 37 959), a nationally representative survey. We examined five nicotine/tobacco use outcomes by sex and sexual identity across four age groups. The five outcomes included past 30-day e-cigarette use, past 30-day cigarette use, past 30-day other tobacco use, the number of tobacco products used, and nicotine dependence symptoms.

Results
For males, sexual identity differences were greatest in middle adulthood, particularly for bisexual males; adjusted odds ratios and adjusted incident rate ratios ranged from 2.08 to 5.59 in middle adulthood compared to 0.83–1.62 in adolescence. For females, sexual identity differences were persistent from adolescence through middle adulthood. We found significant differences most consistently for nicotine dependence symptoms when comparing gay/lesbian and bisexual females across multiple age groups; adjusted incident rate ratios ranged from 1.90 in middle adulthood to 3.26 in adolescence.

Conclusions
Risk among sexual minorities varied considerably across age groups and by nicotine/tobacco product and severity of symptoms. Our findings underscore the importance of looking beyond single tobacco products when examining nicotine/tobacco differences related to sexual identity and in examining differences by age group. Our results demonstrating age-varying risk among sexual minorities have important implications for tobacco prevention and cessation efforts.

Implications
This study identifies important age variation in sexual minority differences in tobacco use, particularly among males. This study also shows that many sexual minorities not only have higher risk for tobacco and nicotine product use but also use significantly more tobacco products and have higher nicotine dependence symptom scores. These results have important implications for implementation of nicotine and tobacco prevention and cessation strategies for sexual minority adolescents and adults.
A Group-Based Modeling Approach to Identify Developmental Trajectories of Nicotine Dependence Among Lebanese Adolescents Waterpipe Smokers
Authors: Ebrahimi Kalan Mohammad , Bahelah Raed , Bursac Zoran , Ward Kenneth D , Ben Taleb Ziyad , Tleis Malak , Jebai Rime , Asfar Taghrid , Eissenberg Thomas , Maziak Wasim 
Published: June 2021

AbstractIntroductionAdolescence represents a critical period in which nicotine dependence (ND) symptoms are developing. Little is known about waterpipe (WP) smoking and developmental trajectories of ND criteria across adolescence.Aims and MethodsHere, we aimed to identify ND trajectories from early- to late-adolescence in current (past 30 days) WP smokers and examine baseline correlates of each identified trajectory, using the International Classification of Diseases, 10th Revision (ICD-10). The analytical sample consisted of 278 current WP smokers from eight waves of an ongoing longitudinal cohort of eighth to ninth graders in Lebanon. Group-based trajectory modeling was estimated to identify trajectory classes for ICD-10-ND criteria over ages 11–18.ResultsA group-based modeling approach yielded a four-class solution that best fit the data and reflected differences in the timing of ND onset during adolescence: no-onset of ND (43.9%), early-onset (16.2%), mid-onset (26.6%), and late-onset (13.3%) of ND criteria. Having a less-educated mother (adjusted odds ratio [aOR] = 4.08, 95% confidence interval [95% CI] = 1.01% to 16.53%) and siblings who smoke WP (aOR = 3.95, 95% CI = 1.08% to 14.42%), exposure to favorite WP-specific advertisements (aOR = 3.33, 95% CI = 1.03% to 10.85%), and being a novelty seeker (aOR = 1.12, 95% CI = 1.02% to 1.23%) were associated with early-onset of ND. Daily (aOR = 3.48, 95% CI = 1.08% to 11.23%) or weekly (aOR = 2.20, 95% CI = 1.05% to 4.62%) WP smokers (vs. monthly) and having higher stress level (aOR = 1.07, 95% CI = 1.00% to 1.14%) were associated with mid-onset trajectory. Believing that WP smoking is not harmful to health (aOR = 0.11, 95% CI = 0.02% to 0.82%) and spending less than 60 minutes on a WP smoking session (aOR = 5.62, 95% CI = 1.20% to 26.44%) were associated with late-onset ND trajectory class.ConclusionsMonitoring the development of ND trajectories among WP smokers may identify an individual as belonging to one of these four groups with distinct individual and socioenvironmental factors and allow the individual and health care providers opportunities to inform initiate on-time WP-specific tailored prevention and cessation interventions.ImplicationsThe results from this study showed a four-class trajectory of ICD-10-ND criteria and suggested that every ND trajectory class during adolescence could have distinctive characteristics and therefore provides new insights into the process of ND in terms of when and what specific interventions are needed to curb the development of ND and long-term WP smoking among youth.
Climate Crisis
Authors: Graham Erin R. 
Published: June 2021

Abstract
International relations scholarship on climate change exists primarily in the field of Global Environmental Politics (GEP) and outside the substantive purview of mainstream International Political Economy (IPE). This chapter argues that the climate crisis is fundamentally an IPE problem, and it requires attention from IPE scholars as a primary subject of interest. To facilitate engagement, the chapter reviews a diverse literature at the intersection of IPE and climate across three substantive areas: the global climate regime, trade, and renewable energy transitions. Each section offers avenues for research, and provides ideas on how to put concepts and ideas from IPE to work in climate crisis scholarship.
From Silos to Barns?
Authors: Solingen Etel 
Published: June 2021

Abstract
The explosion of research on regional economic institutions (REI) over the last two decades has led to a richer understanding of why they emerge, what form they take, and what effects they have. This chapter argues that research on REI is not a monopoly of any particular theoretical, methodological, or epistemological approach. Ongoing work leans not merely on standard political science and economics but on sociology, psychology, and critical theory. Yet, REI studies cluster in silos more often than barns, although this chapter highlights some research programs with potential for fostering barns. Exclusive attention to power, economic efficiency, transaction costs, and transnational normative diffusion—the common analytical currency in standard accounts of REI—may conceal deeper domestic drivers underlying REI dynamics.
Conceptualizing Organizational Change Through the Lens of Complexity Science
Authors: Dooley Kevin J. 
Published: June 2021

Abstract
Organizational scholars interested in organizational change and learning have been inspired by the mathematics, concepts, models, and metaphors of complexity science since the 1990s. Time is a fundamental variable in all complexity science models, so descriptions of change follow naturally. Complexity science builds upon systems theory to provide a more nuanced and thick causal narrative of change. Researchers in the organizational sciences have used four different types of complexity science based models to conceptualize organizational change: agent-based, computational, dynamical, and far-from-equilibrium. These different approaches hold the common assumptions that change is both continuous and discontinuous, and nonlinear dynamics arising from complex interactions can make organizational change difficult to predict or control. Studies of organizational change using complexity science models may be deductive or inductive and may engage quantitative or qualitative data. This chapter reviews these models and their application to the study of organizational change and assesses what influence complexity science has had on organizational studies since its own emergence.
Adrenal suppression from exogenous glucocorticoids: Recognizing risk factors and preventing morbidity
Authors: Ahmet Alexandra , Rowan-Legg Anne , Pancer Larry 
Published: June 2021

Abstract
Adrenal suppression (AS), a potential side effect of glucocorticoid therapy (including inhaled corticosteroids), can be associated with significant morbidity and even death. In Canada, adrenal crisis secondary to AS continues to be reported in children. Being aware of symptoms associated with AS, understanding the risk factors for developing this condition, and familiarity with potential strategies to reduce risks associated with AS, are essential starting points for any clinician prescribing glucocorticoids.
La suppression surrénalienne causée par les glucocorticoïdes exogènes : en reconnaître les facteurs de risque et en prévenir les effets
Authors: Ahmet Alexandra , Rowan-Legg Anne , Pancer Larry 
Published: June 2021

Résumé
La suppression surrénalienne, un effet secondaire potentiel du traitement aux glucocorticoïdes (y compris les corticostéroïdes inhalés), peut avoir des conséquences graves et même fatales. Au Canada, on continue de déclarer des poussées d’insuffisance corticosurrénalienne consécutives à une suppression surrénalienne chez les enfants. Avant de prescrire des glucocorticoïdes, le clinicien doit absolument connaître les symptômes de suppression surrénalienne, comprendre les facteurs de risque de cette affection et être au courant des stratégies susceptibles d’en réduire les risques.
ASSESSMENT OF THE AWARENESS LEVEL OF RADIATION PROTECTION AMONG RADIOGRAPHERS WORKING IN THE MEDICAL IMAGING WARDS OF THE HOSPITALS IN ZANJAN, IRAN
Authors: Moghimi Parastoo , Hajimiri Khadijeh , Saghatchi Franak , Rezaeejam Hamed 
Published: June 2021

Abstract
X-ray usage in medical diagnosis could have hurtful effects for both patient and medical imaging wards’ personnel as a result of failure to follow radiation protection (RP) principles (shielding, distance and time) by radiographers. This cross-sectional descriptive–analytical study was carried out by valid and reliable online questionnaire, which was completed by 103 radiographers. Data were analyzed by using descriptive statistics (mean, standard deviation and frequency) and analytical statistics (Pearson’s correlation coefficient test, Student’s independent t-test and analysis of variance test) in the Statistical Package for Social Sciences version 20 (sig: P &lt; 0.05). The study’s response rate was 67.32%. The mean scores of participants’ total, RP and device knowledge were 42.76, 42.86 and 42.72 out of 100, respectively. Work experience and age of participants were significantly related to device and total knowledge (P &lt; 0.01). Results revealed an undesirable level of participants’ awareness, indicating the necessity of holding training courses, especially for less experienced radiographers.
Color Polymorphism is a Driver of Diversification in the Lizard Family Lacertidae
Authors: Brock Kinsey M , McTavish Emily Jane , Edwards Danielle L 
Published: June 2021

Abstract
Color polymorphism—two or more heritable color phenotypes maintained within a single breeding population—is an extreme type of intraspecific diversity widespread across the tree of life. Color polymorphism is hypothesized to be an engine for speciation, where morph loss or divergence between distinct color morphs within a species results in the rapid evolution of new lineages, and thus, color polymorphic lineages are expected to display elevated diversification rates. Multiple species in the lizard family Lacertidae are color polymorphic, making them an ideal group to investigate the evolutionary history of this trait and its influence on macroevolution. Here, we produce a comprehensive species-level phylogeny of the lizard family Lacertidae to reconstruct the evolutionary history of color polymorphism and test if color polymorphism has been a driver of diversification. Accounting for phylogenetic uncertainty with multiple phylogenies and simulation studies, we estimate an ancient origin of color polymorphism (111 Ma) within the Lacertini tribe (subfamily Lacertinae). Color polymorphism most likely evolved few times in the Lacertidae and has been lost at a much faster rate than gained. Evolutionary transitions to color polymorphism are associated with shifts in increased net diversification rate in this family of lizards. Taken together, our empirical results support long-standing theoretical expectations that color polymorphism is a driver of diversification.[Color polymorphism; Lacertidae; state-dependent speciation extinction models; trait-dependent diversification.]
Saddle Pulmonary Embolism: Demographics, Clinical Presentation, and Outcomes
Authors: Wong Kevin J. , Kushnir Margarita , Billett Henny H. 
Published: June 2021

OBJECTIVES:
Saddle pulmonary embolism is an uncommon type of venous thromboembolism that can lead to sudden hemodynamic collapse and death. Saddle pulmonary embolism can be difficult to recognize, and data on its presentation, clinical features, and associated complications are sparse. We sought to characterize patients with saddle pulmonary embolism.

DESIGN:
The Montage software (Nuance, Burlington, MA) was used to identify patients to create a retrospective cohort study.

SETTING:
Montefiore Medical Center from January 1, 2012, to December 31, 2018.

PATIENTS:
All subjects diagnosed with saddle pulmonary embolism in above time period.

INTERVENTIONS:
Charts were reviewed for demographics, diagnostics, laboratory data, presenting vital signs, inhospital mortality, 6-month survival, and prevalence of recurrent venous thromboembolism.

MEASUREMENTS AND MAIN RESULTS:
About 120 patients with saddle pulmonary embolism were identified. Median age was 61 years and 57.5% were women. Events were provoked by a transient risk factor in 43.3%. On presentation, median mean arterial pressures were normal (93 mm Hg). Only five of 120 of patients (4.2%) presented with vitals concerning for massive pulmonary embolism. We found a 9.2% inhospital mortality; an additional 8.6% died within 6 months of discharge. Inhospital mortality was higher in women (11.6%), compared with men (3.9%), but this was not significant (p = 0.28). In 10 patients, both ventilation/perfusion scans and computed tomography pulmonary angiogram were performed. None of the ventilation/perfusion scans diagnosed saddle pulmonary embolism. Thrombus was visualized in the right heart in eight of 105 (7.6%), and this group had a higher inhospital mortality (37.5%). Recurrent venous thromboembolism occurred in 13 of 85 of survivors (15.3%).

CONCLUSIONS:
Despite presenting without the accepted clinical criteria for massive pulmonary embolism, saddle pulmonary embolism has a very high inhospital mortality. Ventilation/perfusion scan is unable to diagnose saddle pulmonary embolism. Visualized right heart thrombi portend an even higher inhospital mortality.
Validation of a Crisis Standards of Care Model for Prioritization of Limited Resources During the Coronavirus Disease 2019 Crisis in an Urban, Safety-Net, Academic Medical Center*
Authors: Nadjarian Albert , LeClair Jessica , Mahoney Taylor F. , Awtry Eric H. , Bhatia Jasvinder S. , Caruso Lisa B. , Clay Alexis , Greer David , Hingorani Karan S. , Horta L. F. B. , Ibrahim Michel , Ieong Michael H. , James Thea , Kulke Matthew H. , Lim Remington , Lowe Robert C. , Moses James M. , Murphy Jaime , Nozari Ala , Patel Anuj D. , Silver Brent , Theodore Arthur C. , Wang Ryan Shufei , Weinstein Ellen , Wilson Stephen A. , Cervantes-Arslanian Anna M. 
Published: June 2021

OBJECTIVES:
The coronavirus disease 2019 pandemic has overwhelmed healthcare resources even in wealthy nations, necessitating rationing of limited resources without previously established crisis standards of care protocols. In Massachusetts, triage guidelines were designed based on acute illness and chronic life-limiting conditions. In this study, we sought to retrospectively validate this protocol to cohorts of critically ill patients from our hospital.

DESIGN:
We applied our hospital-adopted guidelines, which defined severe and major chronic conditions as those associated with a greater than 50% likelihood of 1- and 5-year mortality, respectively, to a critically ill patient population. We investigated mortality for the same intervals.

SETTING:
An urban safety-net hospital ICU.

PATIENTS:
All adults hospitalized during April of 2015 and April 2019 identified through a clinical database search.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Of 365 admitted patients, 15.89% had one or more defined chronic life-limiting conditions. These patients had higher 1-year (46.55% vs 13.68%; p < 0.01) and 5-year (50.00% vs 17.22%; p < 0.01) mortality rates than those without underlying conditions. Irrespective of classification of disease severity, patients with metastatic cancer, congestive heart failure, end-stage renal disease, and neurodegenerative disease had greater than 50% 1-year mortality, whereas patients with chronic lung disease and cirrhosis had less than 50% 1-year mortality. Observed 1- and 5-year mortality for cirrhosis, heart failure, and metastatic cancer were more variable when subdivided into severe and major categories.

CONCLUSIONS:
Patients with major and severe chronic medical conditions overall had 46.55% and 50.00% mortality at 1 and 5 years, respectively. However, mortality varied between conditions. Our findings appear to support a crisis standards protocol which focuses on acute illness severity and only considers underlying conditions carrying a greater than 50% predicted likelihood of 1-year mortality. Modifications to the chronic lung disease, congestive heart failure, and cirrhosis criteria should be refined if they are to be included in future models.
Case–control study about magnitude of exposure to wood smoke and risk of developing lung cancer
Authors: Báez-Saldaña Renata , Canseco-Raymundo Alejandro , Ixcot-Mejía Belizario , Juárez-Verdugo Iván , Escobar-Rojas Araceli , Rumbo-Nava Uriel , Castillo-González Patricia , León-Dueñas Santiago , Arrieta Oscar 
Published: June 2021

Introduction
Exposure to biomass combustion products, particularly firewood, has been considered as a potential carcinogen for developing lung cancer. In this regard, current evidence is widely heterogeneous; besides, in most studies, wood smoke exposure is not appropriately quantified, which further complicates the analysis of wood smoke as a potential carcinogen. The aim of the present study was to estimate the risk of developing lung cancer according to the degree of exposure to wood smoke in patients who use firewood for cooking.

Material and methods
We performed a case-control study that included 482 patients with lung cancer (cases) and 592 hospital controls. Exposure to wood smoke was evaluated as a dichotomous variable (i.e. yes or no); in patients with prior wood smoke exposure, an index of exposure in hours per year was calculated (WSEI). Using bivariate and multivariate logistic regression analyses, the odds ratio (OR) between wood smoke exposure and lung cancer were calculated.

Results
The ORs for developing lung cancer (raw and adjusted) for a WSEI > 100 h/year were OR 1.55 [95% confidence interval (CI), 1.06–2.26) and OR 2.26 (95% CI, 1.50–3.40), respectively; the ORs (raw and adjusted) for WSEI >300 h/year were OR 1.76 (95% CI, 1.06–2.91) and OR 3.19 (95% CI, 1.83–5.55), respectively.

Conclusions
Exposure to wood smoke is a risk factor for lung cancer; furthermore, this effect maintains a dose–response relationship which has a multiplicative effect with smoking.
The development, implementation, and efficacy of a perioperative briefing communication and treatment planning tool and its adaptation to the COVID-19 pandemic
Authors: Rassekh Christopher H. , Atkins Joshua H. , O’Malley Bert W. , Chalian Ara A. , Brody Robert M. , Basu Devraj , Paul Ellen A. , Weinstein Gregory S. 
Published: June 2021

Background:
Effective communication and team alignment are critical elements in overall preparedness for surgery. We sought to assess staff perceptions of a newly implemented perioperative communication mechanism and evaluate its ongoing efficacy.

Methods:
A perioperative email briefing tool was developed as a virtual “huddle” process. A survey of the care team was then done after the first 6 months of its use. Implementation of the briefing for new faculty and a pandemic was observed.

Results:
After 6 months, all 4 head and neck surgeons had adopted this tool and utilized it for nearly 100% of cases, and the instrument was adopted by all other faculty subsequently joining the practice group. In the initial assessment, 98% of all respondents felt the process should continue. In a follow-up survey, over 88% believed the briefings reduced the risk of serious errors, near misses, and complications.

Conclusions:
An email perioperative briefing is feasible and improved workflow and safety.