bluuebunny/crossref_metadata_2025_split huggingface dataset:
Homelessness and Veteran Status in Relation to Nonfatal and Fatal Opioid Overdose in Massachusetts
Authors: Jasuja Guneet K. , Bettano Amy , Smelson David , Bernson Dana , Rose Adam J. , Byrne Thomas , Berlowitz Dan R. , McCullough Megan B. , Miller Donald R. 
Published: March 2021

Background:
Compared with non-Veterans, Veterans are at higher risk of experiencing homelessness, which is associated with opioid overdose.

Objective:
To understand how homelessness and Veteran status are related to risks of nonfatal and fatal opioid overdose in Massachusetts.

Design:
A cross-sectional study.

Participants:
All residents aged 18 years and older during 2011–2015 in the Massachusetts Department of Public Health’s Data Warehouse (Veterans: n=144,263; non-Veterans: n=6,112,340). A total of 40,036 individuals had a record of homelessness, including 1307 Veterans and 38,729 non-Veterans.

Main Measures:
The main independent variables were homelessness and Veteran status. Outcomes included nonfatal and fatal opioid overdose.

Results:
A higher proportion of Veterans with a record of homelessness were older than 45 years (77% vs. 48%), male (80% vs. 62%), or receiving high-dose opioid therapy (23% vs. 15%) compared with non-Veterans. The rates of nonfatal and fatal opioid overdose in Massachusetts were 85 and 16 per 100,000 residents, respectively. Among individuals with a record of homelessness, these rates increased 31-fold to 2609 and 19-fold to 300 per 100,000 residents. Homelessness and Veteran status were independently associated with higher odds of nonfatal and fatal opioid overdose. There was a significant interaction between homelessness and Veteran status in their effects on risk of fatal overdose.

Conclusions:
Both homelessness and Veteran status were associated with a higher risk of fatal opioid overdoses. An understanding of health care utilization patterns can help identify treatment access points to improve patient safety among vulnerable individuals both in the Veteran population and among those experiencing homelessness.
Predictors of Nursing Home Admission Among a Cohort of Homeless Older Adults Entering Emergency Shelter
Authors: Byrne Thomas , Roncarati Jill S. , Miller Daniel P. 
Published: March 2021

Objective:
This study examined the extent and timing of nursing home admissions among older adults who had their first visit at an emergency shelter or re-entered after an extended absence. We assessed the relationships between demographic characteristics, health and behavioral health conditions, and health services utilization measures and the risk of nursing home admission.

Methods:
We linked administrative data from the emergency shelter system in Boston, MA to claims data from the Massachusetts Medicaid program. Using the linked data, we identified a cohort of 432 adults aged 55 and above who entered the shelter for the first time (or re-entered after an extended absence) between 2012 and 2015. We estimated Kaplan-Meier survival curves and hazard functions to describe the extent and timing of nursing home admissions in this population following the date of their initial shelter entry and Cox proportional hazards regression models to identify predictors of the risk of nursing home admission.

Results:
Roughly 12% of the study cohort had a nursing home admission within 4 years of their initial shelter entry and risk of shelter admission was highest in the first few months following shelter entry. Older age, diagnoses indicating alcohol use disorder, greater overall disease burden, and a prior history of nursing home admission were all associated with a higher risk of nursing home admission following shelter entry.

Conclusions:
Amidst ongoing growth in the number of older homeless adults, our study findings have important implications for efforts to meet the housing and health needs of this population.
Telehealth and chronic pain management from rapid adaptation to long-term implementation in pain medicine: A narrative review
Authors: Perez Jordi , Niburski Kacper , Stoopler Michelle , Ingelmo Pablo 
Published: March 2021

Abstract
The COVID-19 pandemic called for drastic changes to expand and rapidly implement telehealth to prevent breach of care for chronic patients. Responding to the challenge of implementing remote care in chronic pain services, a specialty highly dependent on doctor–patient rapport, physical examination, and frequent follow-up visits requires extensive adaptation involving administrative processes and clinical routines. We present our experience of a successful rapid adaptation to telemedicine paradigm as a response to the COVID-19 pandemic during a time of marked restriction of access to ambulatory hospital services for pediatric and adult chronic pain patients. This narrative review covers current scientific evidence for the use of telehealth for chronic pain management and describes in detail the challenges to implement telemedicine in ambulatory clinics from different perspectives. Best practices for telehealth use are recommended. A proposal for remote physical examination of pain patients is made, based on available evidence in the fields of musculoskeletal medicine and neurology comparing in-person vs remote physical examination. As an internal quality control process, an informal online survey was conducted to assess thoughts and experiences among patients and caregivers using telemedicine consultation services at the pediatric pain clinic. Providing chronic pain management services through telehealth is a viable option for many patients and health care professionals. This is reliant on the availability of appropriate materials and training, with guidelines for both patients and health care workers. With the rapid pace of technological advancements, even further integration of telehealth into routine health care is possible.
Plasma biomarker factors associated with neurodevelopmental outcomes in children with perinatal HIV infection and controlled viremia
Authors: Kapetanovic Suad , Giganti Mark J. , Abzug Mark J. , Lindsey Jane C. , Sirois Patricia A. , Montepiedra Grace , Canniff Jennifer , Agwu Allison , Boivin Michael J. , Weinberg Adriana 
Published: March 2021

Objective:
We examined relationships between plasma biomarkers and neurodevelopment in children from sub-Saharan Africa with perinatal HIV (PHIV) with controlled viremia on antiretroviral therapy (ART).

Design:
Longitudinal retrospective cohort study of children with controlled blood HIV replication.

Methods:
Children (N = 213; 57% girls) started ART at less than 3 years of age, had neurodevelopmental assessments (cognition, attention/impulsivity, motor proficiency, global executive functions) at 5–11 years, and achieved controlled viremia (HIV-1 RNA <400 copies/ml for ≥9 months before initial assessment). Twenty-three plasma biomarkers were measured at onset of controlled viremia, week 0 (first neurodevelopmental assessment), and week 48 (second neurodevelopmental assessment). Factor analysis was conducted at each time point. Multivariable linear regressions assessed associations between factors and neurodevelopmental scores.

Results:
Median age at week 0 was 7.0 years. Eighteen biomarkers loaded on six factors: a (L-10, IFNγ, IFNα2, IL-1β, IL-6, IP-10, TNFα); B (sCD163, sICAM-1, sVCAM-1, CRP); C (sE-selectin, sP-selectin); D [MIP-1β, vascular endothelial growth factor (VEGF)-A]; E (sCD14, CRP); and F (CX3CL1, MCP-1). Higher factor B scores were consistently associated with worse cognition and attention/impulsivity, and higher factor D scores with better attention/impulsivity.

Conclusion:
These results suggest a detrimental effect of increased endothelial cell activation (sICAM-1, sVCAM-1) and monocyte/macrophage scavenger function (sCD163) and a beneficial effect of increased CCR5 ligand and HIV entry blocker MIP-1β and angiogenesis stimulant-VEGF concentrations on the neurodevelopment of children with PHIV. The model that emerges is of vascular inflammation leading to neurodevelopmental deficits. The role of persistent HIV replication in the central nervous system also needs to be further explored.
Redistribution of brain glucose metabolism in people with HIV after antiretroviral therapy initiation
Authors: Wang Zeping , Manion Maura M. , Laidlaw Elizabeth , Rupert Adam , Lau Chuen-Yen , Smith Bryan R. , Nath Avindra , Sereti Irini , Hammoud Dima A. 
Published: March 2021

Objective:
We evaluated brain glucose metabolism in people living with HIV (PWH) with [18F]-Fluoro-Deoxyglucose (FDG) PET/computed tomography (CT) before and after antiretroviral therapy (ART) initiation.

Design:
We conducted a longitudinal study wherein ART-naive late-presenting untreated PWH with CD4+ cell counts less than 100 cells/μl were prospectively assessed for FDG uptake at baseline and at 4–8 weeks (n = 22) and 19–26 months (n = 11) following ART initiation.

Methods:
Relative uptake in the subcortical regions (caudate, putamen and thalamus) and cortical regions (frontal, parietal, temporal and occipital cortices) were compared across time and correlated with biomarkers of disease activity and inflammation, in addition to being compared with a group of uninfected individuals (n = 10).

Results:
Before treatment initiation, putaminal and caudate relative FDG uptake values in PWH were significantly higher than in uninfected controls. Relative putaminal and thalamic uptake significantly decreased shortly following ART initiation, while frontal cortex values significantly increased. FDG uptake changes correlated with changes in CD4+ cell counts and viral load, and, in the thalamus, with IL-6R and sCD14. Approximately 2 years following ART initiation, there was further decrease in subcortical relative uptake values, reaching levels below those of uninfected controls.

Conclusion:
Our findings support pretreatment basal ganglia and thalamic neuroinflammatory changes in PWH, which decrease after treatment with eventual unmasking of long-term irreversible neuronal damage. Meanwhile, increased frontal cortex metabolism following ART initiation suggests reversible cortical dysfunction which improves with virologic control and increased CD4+ cell counts. Early initiation of treatment after HIV diagnosis and secondary control of inflammation are thus necessary to halt neurological damage in PWH.
Transfacial Exposures of the Anterior Skull Base and Cervical Spine: Straightforward “Line-of-Sight” Algorithm for Selection of Approach
Authors: Powers Jeremy M. , Sachanandani Neil , Chaiyasate Kongkrit 
Published: March 2021

Abstract
Surgical treatment for tumors of the skull base remains gross total resection with microscopic negative margins. Sufficient surgical access is paramount to adequate treatment but must be balanced with patient morbidity and protection of vital neurovascular structures. While endoscopic surgery has made transfacial access less common, there are still indications for open transfacial exposure including tumors that involve facial soft tissues, the palate, anterolateral frontal sinus, dural involvement lateral to the mid-pupillary line, tumor recurrence/repeat resection, and/or lack of access to endoscopic equipment or expertise. The authors present a “line-of-sight” algorithm for selection of approach, discuss pre-operative planning, review selected clinical experiences, and discuss the role of microsurgery and prevention of complications.
Analysis of Sagittal Position Changes of the Condyle After Mandibular Setback Surgery Across the Four Different Types of Plating Systems
Authors: Ku Jeong-Kui , Choi Sun-Kyu , Lee Jung-Gon , Yu Han-Chang , Kim Sang-Yun , Kim Young-Kyun , Shin Yonsoo , Lee Nam-Ki 
Published: March 2021

Abstract
The authors analyzed the three-dimensional postoperative condylar position change across the plating systems. This retrospective study was conducted with the patients who underwent bilateral sagittal split ramus osteotomy with setback surgery. The condylar change was analyzed from preoperative cone-beam computed tomography to postoperative 1 month (T1) and postoperative 6 months (T2) using superimposition software, automatically merging based on the anterior cranial base. The condylar changes during T1 and T2 were analyzed across the four types of plates (4-hole sliding, heart-shaped, 3-hole sliding, and 4-hole conventional) Mean intraclass correlation coefficient values were consistently high for each measurement (>0.850). During T1, the conventional plate had a decreased condylar anterior distance when compared with the 3-hole sliding plate (P = 0.032). During T2, the conventional plate had an increased condylar posterior distance when compared with the 3-hole sliding plate (P = 0.031). Superimposition software based on the anterior cranial base could be available for measurement of condylar position with highly reproducible results. After bilateral sagittal split ramus osteotomy, the 3-hole sliding plate could effectively compensate for the anterior displacement of the condyle compared to other plates.
Skating on Thin Ice: Craniofacial Injuries in Amateur Ice Hockey
Authors: Pierrot Randall G. , Weber Lee E. , Wolfe Erin M. , Slavin Benjamin R. , Eidelson Sarah A. , Plotsker Ethan , Mathew Prakash J. , Thaller Seth R. 
Published: March 2021

Introduction:
Hockey is a sport of high speeds, projectiles, and slick surfaces. A scenario is ripe for craniofacial injuries. Annually, over 1 million Americans, with many more abroad participate in organized hockey. This number continues to grow at youth, amateur and professional levels. Following the characterization of groups with the highest incidence of hockey-related craniofacial injuries, our goal is to propose guidelines for the acute management of hockey-related craniofacial injuries in amateur settings.

Methods:
This study follows a 10-year retrospective cohort design, examining hockey-related craniofacial injury data derived from the National Electronic Injury Surveillance System database. Within the NEISS data, patients were stratified by age, gender, and ethnicity to allow for analysis and comparison between groups.

Results:
Sample data consisted of 2,544 hockey-related craniofacial injuries treated in US emergency departments between 2010 and 2019. Majority of the injuries included in this analysis involved patients within the 12–18-year-old age group (53.8%). Of the diagnoses, concussion was the most frequent hockey-related craniofacial injury (39.9%). Dental injuries represented the least (1%). In the 12 to 18 age group, the diagnoses concussion, fracture, and laceration differed significantly from the null hypothesis of equality of proportions across all injury types (P < 0.05). Similarly, within the 19 to 34 age group, the diagnoses of concussion, fracture, laceration, and internal injury differed significantly from the null hypothesis of assumed equality of proportion (P < 0.05).

Conclusions:
High incidence of hockey-related craniofacial injury among patients 12 to 18 years of age signals a need for continued interventions targeted towards this age group. Increased sideline personnel training and education, as well as promoting a stricter adherence to established guidelines are integral parts of a greater strategy towards reducing injury incidence. Working towards reducing injuries and making participation in hockey safer, should be a goal as the sport continues to experience a historic rise in interest and participation.
Prospective validation of smartphone-based heart rate and respiratory rate measurement algorithms
Authors: Bae Sean , Borac Silviu , Emre Yunus , Wang Jonathan , Wu Jiang , Kashyap Mehr , Kang Si-Hyuck , Chen Liwen , Moran Melissa , Cannon John , Teasley Eric S. , Chai Allen , Liu Yun , Wadhwa Neal , Krainin Mike , Rubinstein Michael , Maciel Alejandra , McConnell Michael V. , Patel Shwetak , Corrado Greg S. , Taylor James A. , Zhan Jiening , Po Ming Jack 
Published: March 2021

AbstractMeasuring vital signs plays a key role in both patient care and wellness, but can be challenging outside of medical settings due to the lack of specialized equipment. In this study, we prospectively evaluated smartphone camera-based techniques for measuring heart rate (HR) and respiratory rate (RR) for consumer wellness use. HR was measured by placing the finger over the rear-facing camera, while RR was measured via a video of the participants sitting still in front of the front-facing camera. In the HR study of 95 participants (with a protocol that included both measurements at rest and post exercise), the mean absolute percent error (MAPE) ± standard deviation of the measurement was 1.6% ± 4.3%, which was significantly lower than the pre-specified goal of 5%. No significant differences in the MAPE were present across colorimeter-measured skin-tone subgroups: 1.8% ± 4.5% for very light to intermediate, 1.3% ± 3.3% for tan and brown, and 1.8% ± 4.9% for dark. In the RR study of 50 participants, the mean absolute error (MAE) was 0.78 ± 0.61 breaths/min, which was significantly lower than the pre-specified goal of 3 breath/min. The MAE was low in both healthy participants (0.70 ± 0.67 breaths/min), and participants with chronic respiratory conditions (0.80 ± 0.60 breaths/min). Our results validate that smartphone camera-based techniques can accurately measure HR and RR across a range of pre-defined subgroups.
SARS-CoV-2 seroassay optimization and performance in a population with high background reactivity in Mali
Authors: Sagara Issaka , Woodford John , Dicko Alassane , Zeguime Amatigue , Doucoure M’Bouye , Kwan Jennifer , Zaidi Irfan , Doritchamou Justin , Snow-Smith Maryonne , Alani Nada , Renn Jonathan , Kosik Ivan , Holly Jaroslav , Yewdell Jonathan , Esposito Dominic , Sadtler Kaitlyn , Duffy Patrick 
Published: March 2021

ABSTRACTSerological tests are an indispensable tool to understand the epidemiology of the SARS-CoV-2 pandemic, particularly in areas where molecular diagnostics are limited. Poor assay performance may hinder the utility of these tests, including high rates of false-positivity previously reported in sub-Saharan Africa. From 312 Malian samples collected prior to 2020, we measured antibodies to the commonly tested SARS-CoV-2 antigens and four other betacoronaviruses by ELISA, and assessed functional cross-reactivity in a subset by SARS-CoV-2 pseudovirus neutralization assay. We then evaluated the performance of an ELISA developed in the US, using two-antigen SARS-CoV-2 spike protein and receptor-binding domain. To optimize test performance, we compared single and two-antigen approaches using existing assay cutoffs and population-specific cutoffs for Malian control samples (positive and negative). Background reactivity to SARS-CoV-2 antigens was common in pre-pandemic samples compared to US controls (43.4% (135/311) for spike protein, 22.8% (71/312) for RBD, and 33.9% (79/233) for nucleocapsid protein). SARS-CoV-2 reactivity correlated weakly with other betacoronavirus reactivity, varied between Malian communities, and increased with age. No pre-pandemic samples demonstrated functional activity. Regardless of the cutoffs applied, specificity improved using a two-antigen approach. Test performance was optimal using a two-antigen assay with population-specific cutoffs derived from ROC curve analysis [Sensitivity: 73.9% (51.6-89.8), Specificity: 99.4% (97.7-99.9)]. In the setting of high background reactivity, such as sub-Saharan Africa, SARS-CoV-2 serological assays need careful qualification is to characterize the epidemiology of disease, prevent unnecessary harm, and allocate resources for targeted control measures.
Predicting the Efficacy of COVID-19 Convalescent Plasma Donor Units with the Lumit Dx anti-Receptor Binding Domain Assay
Authors: Janaka Sanath Kumar , Clark Natasha M , Evans David T , Connor Joseph P 
Published: March 2021

AbstractBackgroundThe novel coronavirus SARS-CoV2 that causes COVID-19 has resulted in the death of more than 2.5 million people, but no cure exists. Although passive immunization with COVID-19 convalescent plasma (CCP) provides a safe and viable therapeutic option, the selection of optimal units for therapy in a timely fashion remains a barrier.Study design and methodsSince virus neutralization is a necessary characteristic of plasma that can benefit recipients, the neutralizing titers of plasma samples were measured using a retroviral-pseudotype assay. Binding antibody titers to the spike (S) protein were also determined by a clinically available serological assay (Ortho-Vitros total IG), and an in-house ELISA. The results of these assays were compared to a measurement of antibodies directed to the receptor binding domain (RBD) of the SARS-CoV2 S protein (Promega Lumit Dx).ResultsAll measures of antibodies were highly variable, but correlated, to different degrees, with each other. However, the anti-RBD antibodies correlated with viral neutralizing titers to a greater extent than the other antibody assays.DiscussionOur observations support the use of an anti-RBD assay such as the Lumit Dx assay, as an optimal predictor of the neutralization capability of CCP.
Constitutional thinness and anorexia nervosa differ on a genomic level
Authors: Hübel Christopher , Abdulkadir Mohamed , Herle Moritz , Palmos Alish B. , Loos Ruth J.F. , Breen Gerome , Micali Nadia , Bulik Cynthia M. 
Published: March 2021

AbstractConstitutional thinness and anorexia nervosa are both characterised by persistent, extremely low weight with body mass indices (BMI) below 18.5 kg/m2. Individuals with anorexia nervosa concurrently show distorted perceptions of their own body and engage in weight-loss behaviours, whereas individuals with constitutional thinness typically wish to gain weight. Both are heritable, share genomics with BMI, but have not been shown to be genetically correlated with each other. We aim to differentiate between constitutional thinness and anorexia nervosa on a genomic level.First, we estimated genetic correlations between constitutional thinness and eleven psychiatric disorders and compared them with anorexia nervosa using publicly available data. Second, we identified individuals with constitutional thinness in the Avon Longitudinal Study of Parents and Children (ALSPAC) by latent class growth analysis of measured BMI from 10 to 24 years (n = 8,505) and assigned polygenic scores for eleven psychiatric disorders and a range of anthropometric traits to evaluate associations.In contrast to anorexia nervosa, attention deficit hyperactivity disorder (rgAN = 0.02 vs. rgCT = −0.24) and alcohol dependence (rgAN = 0.07 vs. rgCT = −0.44) showed a statistically significant negative genetic correlation with constitutional thinness. A higher polygenic score for posttraumatic stress disorder was associated with an increased risk of constitutional thinness in the ALSPAC cohort (OR = 1.27; Q = 0.03) whereas posttraumatic stress disorder shows no genetic correlation with anorexia nervosa (rg = −0.02). Overall, results suggest that constitutional thinness is different from anorexia nervosa on the genomic level.