bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemedicine in rheumatology: a mixed methods study exploring acceptability, preferences and experiences among patients and clinicians
Authors: Sloan Melanie , Lever Elliott , Harwood Rupert , Gordon Caroline , Wincup Chris , Blane Moira , Brimicombe James , Lanyon Peter , Howard Paul , Sutton Stephen , D’Cruz David , Naughton Felix 
Published: October 2021

Abstract

Objectives
The Covid-19 pandemic necessitated a rapid global transition towards telemedicine; yet much remains unknown about telemedicine’s acceptability and safety in rheumatology. To help address this gap and inform practice, this study investigated rheumatology patient and clinician experiences and views of telemedicine.

Methods
Sequential mixed methodology combined analysis of surveys and in-depth interviews. Between and within-group differences in views of telemedicine were examined for patients and clinicians using t-tests.

Results
Surveys (patients n = 1340, clinicians n = 111) and interviews (patients n = 31, clinicians n = 29) were completed between April 2021 and July 2021. The majority of patients were from the UK (96%) and had inflammatory arthritis (32%) or lupus (32%). Patients and clinicians rated telemedicine as worse than face-to-face consultations in almost all categories, although &gt;60% found it more convenient. Building trusting medical relationships and assessment accuracy were great concerns (93% of clinicians and 86% of patients rated telemedicine as worse than face-to-face for assessment accuracy). Telemedicine was perceived to have increased misdiagnoses, inequalities and barriers to accessing care. Participants reported highly disparate telemedicine delivery and responsiveness from primary and secondary care. Although rheumatology clinicians highlighted the importance of a quick response to flaring patients, only 55% of patients were confident that their rheumatology department would respond within 48 hours.

Conclusion
Findings indicate a preference for face-to-face consultations. Some negative experiences may be due to the pandemic rather than telemedicine specifically, although the risk of greater diagnostic inaccuracies using telemedicine is unlikely to be fully resolved. Training, choice, careful patient selection, and further consultation with clinicians and patients is required to increase telemedicine’s acceptability and safety.

Trial registration
This telemedicine study is part of a pre-registered longitudinal multi-stage trial, the LISTEN study (ISRCTN-14966097), with later Covid-related additions registered in March 2021, including a pre-registered statistical analysis plan.
Lung ultrasound B-lines in systemic sclerosis: cut-off values and methodological indications for interstitial lung disease screening
Authors: Gargani Luna , Romei Chiara , Bruni Cosimo , Lepri Gemma , El-Aoufy Khadija , Orlandi Martina , D’Errico Luigia , Bandini Giulia , D’Angelo Gennaro , Guiducci Serena , Dagna Lorenzo , Falaschi Fabio , Matucci-Cerinic Marco , Moggi-Pignone Alberto 
Published: October 2021

Abstract

Objectives
Lung ultrasound (LUS), through assessment of B-lines and pleural line alterations, is able to evaluate interstitial lung disease (ILD), a frequent complication of SSc. Different scanning schemes and counting methods have been proposed but no clear cut-off values have been indicated for screening. We aimed to evaluate the accuracy of different LUS methodological approaches to detect ILD compared with high-resolution CT (HRCT) as the gold standard.

Methods
Sixty-nine SSc patients underwent LUS and chest HRCT on the same day. Both exams were scored by expert readers. The accuracy of different scanning schemes and counting methods was assessed and clinical and functional data were compared with imaging findings.

Results
B-lines were more numerous in patients with the diffuse skin subset and Scl70 autoantibody positivity. The number of B-lines correlated with the Scleroderma Lung Study (SLS) I HRCT score (R = 0.754, P &lt; 0.0001). A total of &gt;10 B-lines on the whole chest or &gt;1 B-line on the postero-basal chest showed 97% sensitivity for detecting even very early ILD signs (corresponding to an SLS I score of 1). Sensitivity increased to 100% when pleural line alterations were included in the analysis.

Conclusions
LUS has a very high sensitivity in detecting SSc-related ILD. A cut-off value of &gt;10 B-lines on the whole chest or &gt;1 B-line on the postero-basal chest can be used for the screening of SSc-ILD. Assessing only the postero-basal chest seems to be mostly effective, combining high sensitivity with a less time-consuming approach.
Timing of Total Hip Arthroplasty Affects Lumbar Spinal Fusion Outcomes
Authors: Mills Emily S. , Bouz Gabriel J. , Formanek Blake G. , Chung Brian C. , Wang Jeffrey C. , Heckmann Nathanael D. , Hah Raymond J. 
Published: October 2021

Study Design:
This is a retrospective cohort study of consecutive patients undergoing lumbar spinal fusion (LSF) within the PearlDiver Humana research database from 2010 to 2018.

Objective:
The aim of this study was to determine if timing of total hip arthroplasty (THA) affects LSF outcomes.

Summary of Background Data:
In patients with both spine and hip pathology, outcomes of THA have been shown to be affected by the timing of THA relative to LSF. However, few studies have assessed postoperative outcomes following LSF in this clinical scenario.

Materials and Methods:
A national database was queried for patients undergoing lumbar fusion and divided into 4 groups: (1) those who underwent LSF without THA (No THA); (2) those who underwent THA at least 2 years before LSF (>2 Prior THA); (3) those who underwent THA in the 2 years before LSF (0–2 Prior THA); and (4) those who underwent THA after LSF (THA After). We assessed lumbar-specific outcomes, including pseudarthrosis, revision, mechanical failure, and adjacent segment disease (ASD); as well as systemic complications. Controlling for age, sex, and Charlson comorbidity index, complication rates between all groups were assessed using univariate and multivariate logistic regression analysis. Post hoc comparisons were performed using the Fisher exact test with Bonferroni correction to account for multiple pairwise comparisons, resulting in an adjusted threshold for statistical significance of P<0.007.

Results:
When compared with the no THA group, those in the THA After group had a higher rate of ASD on multivariate analysis [adjusted odds ratio: 1.53, 95% confidence interval: 1.20–1.94, P<0.001]. When compared with all patients who underwent THA before LSF, patients who underwent THA after LSF had an increased risk of ASD (adjusted odds ratio: 3.80, 95% confidence interval: 2.21–6.98, P<0.001).

Conclusions:
Patients who undergo THA after LSF have an increased rate of lumbar-related complications both when compared with patients who do not undergo THA and when compared with patients who undergo THA before LSF.
Laser corneal enhancement after trifocal intraocular lens implantation in eyes that previously had photoablative corneal refractive surgery
Authors: Mayordomo-Cerdá Fernando , Ortega-Usobiaga Julio , Bilbao-Calabuig Rafael , González-López Félix , Llovet-Osuna Fernando , Fernández-García Javier L , Cobo-Soriano Rosario 
Published: October 2021

Purpose:
To evaluate the visual and refractive outcomes of laser corneal enhancement after trifocal intraocular lens (IOL) implantation in eyes previously treated with myopic/hyperopic laser corneal refractive surgery (LCRS).

Setting:
Clinica Baviera-AIER-Eye Group, Spain.

Design:
Retrospective comparative case series.

Methods:
Patients were divided by primary LCRS into myopic and hyperopic groups. The outcomes evaluated were uncorrected distance (UDVA), corrected distance (CDVA), uncorrected intermediate (UIVA), and uncorrected near visual acuity (UNVA), and predictability, safety, efficacy, and satisfaction after implantation of 2 trifocal IOL models (Physiol-FineVision and Zeiss-ATLisa 839) and subsequent laser enhancement.

Results:
186 eyes (89 myopic and 97 hyperopic eyes) from 146 patients were assessed. At the last visit, refractive outcomes were better in myopic than those in hyperopic eyes, with statistically significant differences for sphere (P < .001), cylinder (P < .001), manifest refraction spherical equivalent (MRSE) (P = .003), CDVA (P = .005), UDVA (P = .047), and UNVA (P = .003) but not for UIVA (P = .580), binocular UIVA (P = .660), or binocular UNVA (P = .836). Predictability differences were nonsignificant between groups for a final MRSE of ±0.5 diopters (D) and ±1.0 D (P = .167 and .502, respectively). Efficacy and safety were similar in both groups (P = .235 and P = .080). A greater myopic MRSE was present after trifocal implantation in myopic than in hyperopic eyes (MRSE = −0.93 vs −0.69 D, P = .013), and the statistically significant differences were maintained after enhancement between both groups (MRSE −0.00 vs 0.00 D, P = .003). Overall satisfaction was similar in both groups (P > .05 all items).

Conclusions:
Corneal laser enhancement after implantation of a trifocal IOL in eyes previously treated for myopia or hyperopia with LCRS was safe, effective, predictable, and highly satisfactory.
Use of a Novel, Shortened, Indwelling Pleural Catheter (PleurX) for the Ambulatory Management of Malignant Pleural Effusion
Authors: Rajchgot Jason , Amjadi Kayvan 
Published: October 2021

Background:
Indwelling pleural catheters are frequently used for the treatment of malignant pleural effusion. The PleurX catheter (Becton, Dickinson and Company) is a commonly used indwelling pleural catheter across Canada. The traditional PleurX catheter is designed with a long segment of tubing outside of the patient’s chest, making insertion, drainage, and dressing changes awkward. Our clinic developed a novel, shortened, PleurX catheter that is easier to handle.

Methods:
We conducted retrospective chart review for all patients treated with a shortened PleurX catheter at our center from December 2015 to May 2019 and demographics, clinical information, and complications were recorded retrospectively. A survey was designed and distributed to nurses experienced with the use of both catheters to elicit a preference between the short and long catheter.

Results:
We analyzed data from 503 catheters placed in 491 patients. The most frequently encountered complications were loculation requiring fibrinolytic (2.4%), catheter dislodgement (1.2%), and pleural infection (0.6%). Of nurses surveyed, 74% preferred using the shortened PleurX catheter.

Conclusion:
Complication rates of the novel, shortened PleurX catheter are low. Further research is needed to better determine the optimal catheter length for ambulatory management of malignant pleural effusion.
New primary immunodeficiencies 2021 context and future
Authors: Demirdag Yesim , Fuleihan Ramsay , Orange Jordan S. , Yu Joyce E. 
Published: October 2021

Purpose of review
Primary immunodeficiency diseases (PIDs), also called inborn errors of immunity (IEI), are genetic disorders classically characterized by an increased susceptibility to infection and/or disruption in the regulation of an immunologic pathway. This review summarizes and highlights the new IEI disorders in the IUIS 2019 report and 2020 interim report and discusses the directions for the future management of PIDs.

Recent findings
Since 2017, the International Union of Immunologic Societies (IUIS) IEI committee has updated the IUIS classification of IEIs with 88 new gene defects and 75 new immune disorders. The increased utilization of genetic testing and advances in the strategic evaluation of genetic variants have identified, not only novel IEI disorders, but additional genetic causes for known IEI disorders. Investigation of potential immune susceptibilities during the ongoing COVID-19 pandemic suggests that defects in Type I interferon signalling may underlie more severe disease.

Summary
The rapid discovery of new IEIs reflects the growing trend of applying genetic testing modalities as part of medical diagnosis and management.
In turn, elucidating the pathophysiology of these novel IEIs have enhanced our understanding of how genetic mutations can modulate the immune system and their consequential effect on human health and disease.
Syphilis in Greenland, 2015 to 2019
Authors: Andersen Marianne Welzel , Johansen Mila Broby , Bjorn-Mortensen Karen , Pedersen Michael Lynge , Jensen Jørgen Skov , Koch Anders 
Published: October 2021

Background
An increase in the incidence of syphilis was reported in Greenland from 2011 to 2014, and notification rates kept rising in the following years in spite of focused efforts. To better understand the syphilis epidemic, this study was conducted to describe the syphilis epidemic in Greenland from 2015 to 2019.

Methods
Syphilis cases and their characteristics were identified through reviews of electronic medical records and laboratory results in 3 different data sets: notifications to the National Board of Health, electronic prescriptions for benzathine penicillin, and the national laboratory database. Annual incidences were calculated stratified by sex, age, and region.

Results
The incidence of syphilis in Greenland increased from 107.4 to 246.8 cases per 100,000 inhabitants from 2015 to 2019. The incidence increased in both sexes and in nearly all regions, although with large regional differences. Especially the age group 15 to 29 years showed a substantial increase in incidence in 2018 and 2019. More females than males were infected (245 female cases vs. 178 male cases).

Conclusions
The burden of syphilis in Greenland is high, primarily among the age group 15 to 29 years. A higher incidence among females than among males was found, suggesting mainly heterosexual transmission, as seen for other sexually transmitted infections in Greenland.
Factors Associated With Partner Notification, Testing, and Positivity in HIV Partner Services Programs in the United States, 2013 to 2017
Authors: Song Wei , Mulatu Mesfin S. , Rao Shubha , Mendoza Maria C.B. , Kudon Hui Zhang , Rorie Michele 
Published: October 2021

Background
Human immunodeficiency virus (HIV) partner services are an essential component of comprehensive HIV prevention and care. We examined factors associated with partner notification, HIV testing, and HIV positivity among partners of HIV-diagnosed persons (index persons) contacted by Centers for Disease Control and Prevention (CDC)–funded state and local health departments.

Methods
We analyzed partner service data submitted to the CDC by 61 state and local health departments from 2013 to 2017. Using multivariate Poisson regression—adjusted for clustering effects among partners reported by a common index person—we assessed associations between 3 outcomes of interest (partner notification, HIV testing, and HIV positivity) and the demographic characteristics, risk behaviors, geographic region, and service year of index persons and their partners.

Results
A total of 51,368 sexual and/or needle-sharing partners were matched with 33,524 index persons. Of notifiable partners, 97.2% were notified of their potential HIV exposure, and 52.3% were tested for HIV. Among 21,842 notified and tested partners, 23.8% were newly diagnosed with an HIV infection. Partner notification, HIV testing, and HIV positivity were associated with both partner and index person characteristics (individually and interactively), geographic region, and year of service.

Conclusions
Partner service programs provided through CDC-funded health departments were effective in both partner notification and identification of undiagnosed HIV infection among partners. However, HIV testing rate among notified partners remained low. Implementing strategies to address gaps in HIV testing can contribute toward ending the HIV epidemic in the United States.
Takotsubo Syndrome in the Perioperative Period
Authors: Seretis Konstantinos , Bounas Nikos , Vaikos Dimitrios , Athanasiadis Ilias 
Published: October 2021

Abstract
Stress-induced cardiomyopathy or takotsubo syndrome is a rare, nonischemic, heart condition resembling that of an acute coronary syndrome. Its distinctive feature is a transient wall motion abnormality occurring usually at the apical segment of the heart, with the degree of symptom manifestation and severity varying among patients. Although early data were supportive of a benign sequela and outcome, high degree of adverse events, such as acute heart failure and pulmonary edema, are anticipated, and the mortality rate approaches 5%. Hyperactivation of the sympathetic nervous system and adrenergic drugs have been pointed out as possible precipitators of the condition. Surgical procedures are a known cause of emotional and physical stress on patients, acting as an ideal substrate for the presentation of this syndrome. On occasion of a perioperative takotsubo syndrome case in a female patient during second-stage implant-based breast reconstruction, a review of the pertinent literature is presented. The acute onset and severity of the manifestations in this surgically uneventful procedure necessitated a multidisciplinary approach. Consequently, this report should raise awareness of the syndrome among plastic surgeons and anesthesiologists to promptly recognize and manage it effectively.
Wastewater and surface monitoring to detect COVID-19 in elementary school settings: The Safer at School Early Alert project
Authors: Fielding-Miller Rebecca , Karthikeyan Smruthi , Gaines Tommi , Garfein Richard S. , Salido Rodolfo A. , Cantu Victor J. , Kohn Laura , Martin Natasha K , Wynn Adriane , Wijaya Carrissa , Flores Marlene , Omaleki Vinton , Majnoonian Araz , Gonzalez-Zuniga Patricia , Nguyen Megan , Vo Anh V , Le Tina , Duong Dawn , Hassani Ashkan , Tweeten Samantha , Jepsen Kristen , Henson Benjamin , Hakim Abbas , Birmingham Amanda , De Hoff Peter , Mark Adam M. , Nasamran Chanond A , Rosenthal Sara Brin , Moshiri Niema , Fisch Kathleen M. , Humphrey Greg , Farmer Sawyer , Tubb Helena M. , Valles Tommy , Morris Justin , Kang Jaeyoung , Khaleghi Behnam , Young Colin , Akel Ameen D , Eilert Sean , Eno Justin , Curewitz Ken , Laurent Louise C , Rosing Tajana , Knight Rob 
Published: October 2021

AbstractBackgroundSchools are high-risk settings for SARS-CoV-2 transmission, but necessary for children’s educational and social-emotional wellbeing. Previous research suggests that wastewater monitoring can detect SARS-CoV-2 infections in controlled residential settings with high levels of accuracy. However, its effective accuracy, cost, and feasibility in non-residential community settings is unknown.MethodsThe objective of this study was to determine the effectiveness and accuracy of community-based passive wastewater and surface (environmental) surveillance to detect SARS-CoV-2 infection in neighborhood schools compared to weekly diagnostic (PCR) testing. We implemented an environmental surveillance system in nine elementary schools with 1700 regularly present staff and students in southern California. The system was validated from November 2020 – March 2021.FindingsIn 447 data collection days across the nine sites 89 individuals tested positive for COVID-19, and SARS-CoV-2 was detected in 374 surface samples and 133 wastewater samples. Ninety-three percent of identified cases were associated with an environmental sample (95% CI: 88% - 98%); 67% were associated with a positive wastewater sample (95% CI: 57% - 77%), and 40% were associated with a positive surface sample (95% CI: 29% - 52%). The techniques we utilized allowed for near-complete genomic sequencing of wastewater and surface samples.InterpretationPassive environmental surveillance can detect the presence of COVID-19 cases in non-residential community school settings with a high degree of accuracy.FundingCounty of San Diego, Health and Human Services Agency, National Institutes of Health, National Science Foundation, Centers for Disease Control
Structural convergence for tubulin binding of CPAP and vinca domain microtubule inhibitors
Authors: Campanacci Valérie , Urvoas Agathe , Khodja Liza Ammar , Aumont-Nicaise Magali , Noiray Magali , Lachkar Sylvie , Curmi Patrick A. , Minard Philippe , Gigant Benoît 
Published: October 2021

AbstractMicrotubule dynamics is regulated by various cellular proteins and perturbed by small molecule compounds. To what extent the mechanism of the former resembles that of the latter is an open question. We report here structures of tubulin bound to the PN2-3 domain of CPAP, a protein controlling the length of the centrioles. We show that an α-helix of the PN2-3 N-terminal region binds and caps the longitudinal surface of the tubulin β subunit. Moreover, a PN2-3 N-terminal stretch lies in a β-tubulin site also targeted by fungal and bacterial peptide-like inhibitors of the vinca domain, sharing a very similar binding mode with these compounds. Therefore, our results identify several characteristic features of cellular partners that bind to this site and highlight a structural convergence of CPAP with small molecule inhibitors of microtubule assembly.
Effect of the third dose of BNT162b2 vaccine in quantitative SARS-CoV-2 spike 1-2 IgG antibody titers in healthcare workers
Authors: Romero-Ibarguengoitia Maria Elena , Rivera-Salinas Diego , Hernández-Ruíz Yodira Guadalupe , Armendariz-Vázquez Ana Gabriela , González-Cantú Arnulfo , Barco-Flores Irene Antonieta , González-Facio Rosalinda , Montelongo-Cruz Laura Patricia , Del Rio-Parra Gerardo Francisco , Garza-Herrera Mauricio René , Leal-Meléndez Jessica Andrea , Sanz-Sánchez Miguel Ángel 
Published: October 2021

AbstractBackgroundVaccination is our main strategy to control SARS-CoV-2 infection. Given a decrease in the quantitative SARS-CoV-2 spike 1-2 IgG antibody titers three months following the second BNT162b2 dose, healthcare workers got a third booster dose after six months of completing the original scheme. This study aimed to analyze quantitative SARS-CoV-2 spike 1-2 IgG antibody titers and safety of the third dose.Material and methodsA prospective longitudinal cohort study included healthcare workers who received a third booster dose after six months of the complete BNT162b2 regimen. We assessed the quantitative SARS-CoV-2 spike 1-2 IgG antibody titers 21-28 days after the first and second dose, three months after the complete scheme, 1-7 days following the third dose, and 21-28 days after the boost.ResultsThe cohort comprised 168 non-immunocompromised participants of 41(10) years old, 67% being women. The third dose was associated with increasing the quantitative antibody titers, regardless of previous SARS-CoV-2 history. In negative SARS-CoV-2 history, the median (IQR) antibody titers increased from 379 (645.4) to 2960 (2010), while in positive SARS-CoV-2 history, from 590 (1262) to 3090 (2080). The third dose had less number of total side effects compared to the other two shots. The most common side effect after the third BNT162b2 shot was pain at the injection site (n=82, 84.5%), followed by tiredness (n=45, 46.4%), with a mild severity (n=36, 37.1%). Tiredness, myalgias, arthralgias, fever, and adenopathy were proportionally higher following the third dose than the two-dose regimen (p<0.05).ConclusionThe third dose applied after six months of the original BNT162b2 regimen provided a good humoral immune response by elevating the quantitative SARS-CoV-2 spike 1-2 IgG antibody titers. The booster dose was well tolerated with no severe side effects after the additional BNT162b2 dose.