bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gait Variability and Relationships With Fear, Avoidance, and Pain in Adolescents With Chronic Pain
Authors: Beebe Justin A , Kronman Corey , Mahmud Farah , Basch Molly , Hogan Melinda , Li Eileen , Ploski Chris , Simons Laura E 
Published: January 2021

Abstract

Objective
Some children with chronic pain struggle with fear of pain, avoidance behaviors, and associated disability; however, movement adaptations in the context of chronic pain in childhood is virtually unknown. Variability in adaptive movement responses previously observed between individuals might be largely explained by the presence of problematic psychological drivers (eg, fear, avoidance). The goals of this study were to quantify the variability of gait and examine relationships among pain, fear, avoidance, function (perceived and objective), and gait variability.

Methods
This study used a cross-sectional design. Eligible patients were between 8 and 17 years of age and had musculoskeletal, neuropathic, or headache pain that was not due to acute trauma (eg, active sprain) or any specific or systemic disease. Participants completed the Numeric Pain Rating Scale, Fear of Pain Questionnaire (FOPQ), Functional Disability Inventory, and 6-Minute Walk Test and received kinematic gait analysis. Relationships were analyzed among these measures, and the self-report and functional measures were examined to determine whether they predicted gait variability (GaitSD).

Results
The 16 participants who were evaluated (13.8 [SD = 2.2] years of age; 13 female) had high Numeric Pain Rating Scale scores (6.2 [SD = 2.1]), FOPQ-Fear scores (25.9 [SD = 12.1]), FOPQ-Avoidance scores (22.8 [SD = 10.2]), and Functional Disability Inventory scores (28.6 [SD = 9.4]) and low 6-Minute Walk Test distance (437.1 m [SD = 144.6]). Participants had greater GaitSD than age-predicted norms. Fear was related to self-selected GaitSD, and avoidance was related to both self-selected and standardized GaitSD. Avoidance predicted 43% and 47% of the variability in self-selected and standardized GaitSD, respectively.

Conclusion
GaitSD was significantly related to both fear of pain and avoidance behaviors, suggesting the interplay of these psychological drivers with movement. FOPQ-Avoidance was robust in accounting for GaitSD.

Impact
This study offers preliminary evidence in understanding movement adaptations associated with adolescents with chronic pain. They may lend to more directed interventions.
Custom Dynamic Orthoses and Physical Therapist Intervention for Bilateral Midfoot Amputation: A Case Report
Authors: Anderson Kirsten M , Evans Richard E , Connerly Charles E , Pacha Molly , Wilken Jason M 
Published: January 2021

Abstract

Objective
Partial foot amputation is often associated with decreased mobility and function. Recent advances in custom carbon-fiber dynamic ankle-foot orthoses (CDOs) have improved gait, pain, and function following musculoskeletal trauma and can benefit individuals with partial foot amputation. However, limited information is available related to CDO use outside the military. The purpose of this case report is to describe the course of care and outcomes of a civilian provided with CDOs after bilateral transmetatarsal amputation.

Case Description
A 72-year-old man had a blood-borne bacterial infection (septicemia) of unknown origin at 68 years of age, developed limb-threatening necrosis of the hands and feet, and received bilateral transmetatarsal amputations with skin grafting. The patient initially used foam toe fillers and cushioned shoes but was functionally limited and experienced recurrent ulceration. He was fitted with bilateral CDOs 39 months after amputation and completed device-specific training with a physical therapist.

Results
After 1 week with the CDOs, ankle range of motion during gait was reduced, but greater than 40% increases were observed in bilateral ankle plantarflexor moments and ankle plantarflexion push-off power compared with the toe fillers. With additional therapist-directed training focused on gait and activity performance, ankle plantarflexor moments and plantarflexion push-off power further increased when compared with results after 1 week of CDO use. The patient reported marked improvement in quality of life with the CDOs due to improved walking ability on level and uneven terrain, marked improvement in confidence, and reduced pain.

Conclusion
This case reflects the lessons learned and outcomes of a civilian using bilateral CDOs after bilateral transmetatarsal amputation and with poor skin quality. The results from this case study suggest that carbon-fiber CDOs and focused training by a physical therapist can result in improved gait biomechanics, mobility, and quality of life.
Predictors of the intention to receive a SARS-CoV-2 vaccine
Authors: Meier Brian P , Dillard Amanda J , Lappas Courtney M 
Published: January 2021

Abstract

Background
It is imperative to understand the predictors of vaccine hesitancy for current and future pandemics.

Methods
A representative sample (age, race & gender) of 1054 US adults was collected in October 2020 to examine the predictors of vaccine hesitancy. Participants were asked several questions including their intention to receive a vaccine for the novel coronavirus.

Results
Predictors significantly associated with a greater intention to receive a COVID-19 vaccine included greater perceived feelings of vulnerability to COVID-19, having received a flu vaccination at the time the question was asked, more liberal political orientation, non-Black race, male gender, and a lower naturalness bias.

Conclusions
Vaccines are essential for mitigating current and future pandemics. Multiple strategies are important in encouraging people to be vaccinated and the predictors highlighted here and elsewhere are likely to be useful targets.
EQ-5D-3L full health state discriminates between drug and placebo in clinical trials of systemic lupus erythematosus
Authors: Lindblom Julius , Gomez Alvaro , Borg Alexander , Emamikia Sharzad , Ladakis Dimitris  , Matilla Joaquin , Pehr Martin , Cobar Flordelyn , Enman Yvonne , Heintz Emelie  , Regardt Malin , Parodis Ioannis 
Published: January 2021

Abstract

Objectives
The objectives of this study were to investigate the discriminative ability of EQ-5D-3L full health state (FHS) in clinical trials of SLE, and to identify factors associated with FHS after treatment.

Methods
Data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials of belimumab (N = 1684) were utilized. FHS was defined as a response of no problems in all five EQ-5D-3L dimensions, yielding an index score of 1. The Pearson’s χ2 or Fisher’s exact test was employed for comparisons, and logistic regression for adjustments and assessment of independence.

Results
We demonstrated higher EQ-5D-3L FHS frequencies among patients given standard therapy (ST) plus the licensed belimumab dose vs ST alone (26.1% vs 19.4%; P = 0.001; week 52), and within SRI-4 responders vs non-responders (27.0% vs 19.8%; P &lt; 0.001; week 52) from weeks 36 to 52. In multivariable regression analysis, SLEDAI-2K (OR: 0.90; 95% CI: 0.87, 0.94; P &lt; 0.001) and SLICC/ACR Damage Index (OR: 0.79; 95% CI: 0.69, 0.91; P = 0.001) scores were independently associated with lower FHS frequencies at week 52, while adding monthly infusions of belimumab 10 mg/kg to ST favoured FHS perception (OR: 1.60; 95% CI: 1.15, 2.24; P = 0.006). Add-on belimumab 10 mg/kg yielded higher FHS frequencies in antimalarial users vs non-users (29.9% vs 20.1%; P = 0.011), and in anti-dsDNA- and anti-Sm- positive vs negative patients (31.4% vs 13.4%; P &lt; 0.001 and 33.0% vs 22.6%; P = 0.010, respectively), whereas no significant differences were observed in patients given ST alone.

Conclusion
EQ-5D-3L FHS distinguished belimumab from placebo and responders from non-responders, and exhibited known-group validity in subgroup analysis. FHS may prove a useful patient-reported outcome in SLE studies.
Hidden in Plain Sight—Reconsidering the Use of Race Correction in Clinical Algorithms
Authors: Vyas Darshali A. , Eisenstein Leo G. , Jones David S. 
Published: January 2021

(Abstracted from N Engl J Med 2020;383(9):874–882)
The role of race and ethnicity in medicine continues to be debated. On one side, categories of race and ethnicity are seen as clinically useful because they reflect population genetics.
Identification of Factors Associated With Delayed Treatment of Obstetric Hypertensive Emergencies
Authors: Kantorowska Agata , Heiselman Cassandra J. , Halpern Tara A. , Akerman Meredith B. , Elsayad Ashley , Muscat Jolene C. , Sicuranza Genevieve B. , Vintzileos Anthony M. , Heo Hye J. 
Published: January 2021

(Abstracted from Am J Obstet Gynecol 2020;223:250.e1–250.e11)
Obstetric hypertensive emergency is a serious hypertensive disorder that can complicate pregnancy and lead to maternal death. It is defined as acute-onset and severe high blood pressure (BP) that lasts for 15 minutes or longer.
Neurodevelopmental Outcome of Prenatally Diagnosed Boys With 47,XXY (Klinefelter Syndrome) and the Potential Influence of Early Hormonal Therapy
Authors: Samango-Sprouse Carole A. , Tran Selena L. , Lasutschinkow Patricia C. , Sadeghin Teresa , Powell Sherida , Mitchell Francie L. , Gropman Andrea 
Published: January 2021

(Abstracted from Am J Med Genet 2020;182A:1881–1889)
47,XXY (Klinefelter syndrome) is characterized by disruption in neurodevelopment, the endocrine and musculoskeletal systems, and brain morphology. It is also associated with an increased risk of asthma, infertility, decreased muscle tone, emotional lability, and decreased libido.
Implementation of Population-Based Newborn Screening Reveals Low Incidence of Spinal Muscular Atrophy
Authors: Kay Denise M. , Stevens Colleen F. , Parker April , Saavedra-Matiz Carlos A. , Sack Virginia , Chung Wendy K. , Chiriboga Claudia A. , Engelstad Kristin , Laureta Emma , Farooq Osman , Ciafaloni Emma , Lee Bo Hoon , Malek Sohail , Treidler Simona , Anziska Yaacov , Delfiner Leslie , Sakonju Ai , Caggana Michele 
Published: January 2021

(Abstracted from Genet Med 2020;22:1296–1302)
Spinal muscular atrophy (SMA) is a neurodevelopmental disorder that is associated with muscle weakness and atrophy. There are several subtypes that are categorized as SMA type 1 (presenting in early infancy), where infants are unable to sit unassisted; SMA type 2 (presenting between 6 and 18 months of age), where patients are unable to walk independently; SMA type 3 (presenting after 18 months of age), where some patients were able to walk independently, but others lose this ability; and SMA type 4 (presenting in adulthood), which is rare and less severe.
Safety of anti-inflammatory drugs in children with asthma
Authors: de Benedictis Fernando Maria , Carloni Ines , Guidi Roberto 
Published: January 2021

Purpose of review
Inhaled corticosteroids (ICS) are widely used as the first-line treatment of asthma. When the disease is not controlled by standard doses of ICS, other anti-inflammatory drugs should be considered. The aim of this report is to review the main adverse events induced by anti-inflammatory drugs in children with asthma and discuss possible actions to prevent or mitigate these effects.

Recent findings
Proper interpretation of ICS safety studies requires knowledge of the pharmaceutical properties and delivery device systems of the different ICS available. Genetic variants affecting susceptibility to corticosteroid-induced adrenal suppression were found in children and adults who use ICS to treat their asthma. There is evidence of the association between montelukast use and neuropsychiatric events.

Summary
Benefits of ICS, properly prescribed and used, outweigh their potential adverse effects. There is substantial evidence that the combination of ICS with long-acting beta2 agonists is safe for asthmatic children. Awareness of the potential risks of neuropsychiatric events in children taking montelukast should inform the clinicians’ prescribing practices. Omalizumab is generally well-tolerated, but the evidence on the safety of other biologic agents in children is scanty. The risk of systemic adverse events with anti-inflammatory drugs must be balanced against the risks of uncontrolled asthma and/or frequent oral steroid use.
Inadvertent Burst Suppression During Total Intravenous Anesthesia in 112 Consecutive Patients Undergoing Spinal Instrumentation Surgery: A Retrospective Observational Quality Improvement Project
Authors: Lele Abhijit V. , Furman Michele , Myers Jonathan , Kinney Greg , Sharma Deepak , Hecker James 
Published: January 2021

Introduction:
The incidence and quantification of inadvertent electroencephalographic burst suppression during total intravenous anesthesia (TIVA) for spine instrumentation surgery has not previously been reported.

Methods:
The primary aim of this retrospective observational quality improvement project was to establish the prevalence of burst suppression during spine instrumentation surgery with TIVA. The secondary outcome was the incidence of postoperative delirium.

Results:
One hundred twelve consecutive patients, aged between 20 and 88 years, underwent spinal instrumentation surgery. Seventy-eight (69.6%) patients experienced inadvertent burst suppression; the maximal degree of burst suppression ratio was 20% to 100%. Median (interquartile range [IQR]) time spent in burst suppression was 44 (77) minutes, and burst suppression was present for 22% (range: 2% to 93%) of the monitoring period. Average (±SD) propofol dose was lower in patients with burst suppression (87±19 vs. 93±15 µg/kg/min, P=0.04). Ten (8.9%) patients experienced postoperative delirium. Intraoperative burst suppression was more prevalent in those that experienced delirium (100% vs. 66.7%, P=0.03, relative risk: 1.5, 95% confidence interval: 1.3-1.7). The proportion of the monitoring period spent in maximal burst suppression (15.3 [25.9]% vs.11.7 [21.7]%) was similar between those that did, and did not, experience delirium.

Conclusions:
High rates and prolonged periods of inadvertent burst suppression may be prevalent during spine instrumentation surgery with TIVA. Our findings suggest that usage of electroencephalography alone is incomplete without prompt interpretation and intervention, mandating close communication between neuromonitoring and anesthesia teams. The dose-response relationship between burst suppression, total time spent in maximal burst suppression, and their association with delirium warrants further evaluation.
First Metatarsophalangeal Joint Polyvinyl Alcohol Hydrogel Implant Hemiarthroplasty: Current Operative Technique
Authors: Younger Alastair S.E. , Glazebrook Mark A. , Daniels Timothy R. , Wapner Keith L. , DiGiovanni Christopher W. , Baumhauer Judith F. 
Published: January 2021

Polyvinyl alcohol hydrogel implant hemiarthroplasty for the first metatarsophalangeal joint has been shown to be an effective, safe, motion-preserving, surgical treatment alternative to fusion for hallux rigidus in a level I, randomized controlled trial. To obtain optimal results, however, surgeons must be sure to perform the appropriate surgical technique as well as educate patients regarding pertinent risks, benefits, and the associated recovery process. Achievement of results commensurate with those published in the randomized controlled trial is predicated on an understanding of the various technical aspects of the surgical procedure, such as avoiding excessive heat during reaming, ensuring appropriate implant positioning, and appreciating the need for performing associated procedures when anatomically appropriate, as well as their potential effect on clinical outcome. This paper will review the initial technique described in 2013 and provide key clinical care suggestions resulting from the 10 years of experience with polyvinyl alcohol hydrogel implant hemiarthroplasty for the surgical treatment of hallux rigidus.
Levels of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.
Functional Effects of Intervening Illnesses and Injuries After Critical Illness in Older Persons
Authors: Gill Thomas M. , Han Ling , Gahbauer Evelyne A. , Leo-Summers Linda , Murphy Terrence E. , Ferrante Lauren E. 
Published: January 2021

OBJECTIVES:
Intervening illnesses and injuries have pronounced deleterious effects on functional status in older persons, but have not been carefully evaluated after critical illness. We set out to evaluate the functional effects of intervening illnesses and injuries in the year after critical illness.

DESIGN:
Prospective longitudinal study of 754 nondisabled community-living persons, 70 years old or older.

SETTING:
Greater New Haven, CT, from March 1998 to December 2018.

PATIENTS:
The analytic sample included 250 ICU admissions from 209 community-living participants who were discharged from the hospital.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Functional status (13 activities) and exposure to intervening illnesses and injuries leading to hospitalization, emergency department visit, or restricted activity were assessed each month. Comprehensive assessments (for covariates) were completed every 18 months. In the year after critical illness, recovery of premorbid function was observed for 169 of the ICU admissions (67.6%), and the mean (sd) number of episodes of functional decline (from 1 mo to the next) was 2.2 (1.6). The adjusted hazard ratios (95% CI) for recovery were 0.18 (0.09–0.39), 0.46 (0.17–1.26), and 0.75 (0.48–1.18) for intervening hospitalizations, emergency department visits, and restricted activity, respectively. For functional decline, the corresponding odds ratios (95% CI) were 2.06 (1.56–2.73), 1.78 (1.12–2.83), and 1.25 (0.92–1.69). The effect sizes for hospitalization and emergency department visit were larger than those for any of the covariates.

CONCLUSIONS:
In the year after critical illness, intervening illnesses and injuries leading to hospitalization and emergency department visit are strongly associated with adverse functional outcomes, with effect sizes larger than those of traditional risk factors. To improve functional outcomes, more aggressive efforts will be needed to prevent and manage intervening illnesses and injuries after critical illness.
A Perfect Match? A Scoping Review of the Influence of Personality Matching on Adult Mentoring Relationships—Implications for Academic Medicine
Authors: Huggett Kathryn N. , Borges Nicole J. , Blanco Maria A. , Wulf Karyn , Hurtubise Larry 
Published: January 2021

Introduction:
Mentoring is a widely regarded faculty development strategy in academic medicine. However, the lack of understanding about mentoring relationship dynamics limits effective recruitment, implementation, and evaluation. Despite decades of publications describing adult mentoring initiatives, few studies examine personality influence in mentoring relationships. This scoping review examined the extent, range, and nature of the research on personality matching in mentoring relationships, and identified research gaps in the literature.

Methods:
Scoping review methodology guided a search of six databases representing higher education, health sciences education, and professional contexts where mentoring is used. Consistent with the inclusive approach of a scoping review, authors included academic papers and other article types.

Results:
The scoping review yielded 39 articles. Literature mostly originated in the United States, publication sources represented multiple disciplines, and the context for the majority of articles was the workplace. The most common publication type was a research report. Although all articles addressed personality or mentoring, only three articles examined personality matching and its contribution to the mentoring relationship. Finally, although the Big Five personality traits were cited in multiple studies, other personality frameworks were used.

Discussion:
Academic medicine expends resources developing and supporting mentoring programs but there remains limited understanding of how best to identify and match mentors and protégés. Further understanding of the role of joint and unique personality traits in academic medicine mentoring relationships seems necessary, if the field continues to invest, time, money, and resources for mentoring programs.
A Systematic Review and Narrative Synthesis: Determinants of the Effectiveness and Sustainability of Measurement-Focused Quality Improvement Trainings
Authors: Khurshid Zuneera , De Brún Aoife , Martin Jennifer , McAuliffe Eilish 
Published: January 2021

Introduction:
The ability of health care professionals to measure change is critical for successful quality improvement (QI) efforts. Currently, there are no systematic reviews focusing on continuing education for health care professionals in data skills for QI. The purpose of this systematic review is to define effectiveness and sustainability of QI programs for health care professionals containing a measurement skills component and to identify barriers and facilitators to effectiveness and sustainability.

Methods:
The systematic review involved study identification, screening, full text review, and data extraction. Four electronics databases and grey literature sources were searched to identify studies published between 2009 and 2019 (11 years). A customized data extraction form was developed. Mixed methods appraisal tool was used for quality assessment and a thematic analysis was conducted for narrative synthesis.

Results:
Fifty-three studies from 11 countries were included. Most study designs were quantitative descriptive (17/53) and used a blended learning approach (25/53) combining face-to face and distance learning modes. The programs included basic, intermediate, and advanced data skills concepts. Overall, studies reported positive outcomes for participant reaction, learning, and behavior, but reported variable success in sustainability and spread of QI.

Discussion:
Studies discussed measurement as a key competency for clinical QI. Effectiveness definitions focused on the short-term impact of the programs, whereas sustainability definitions emphasized maintenance of outcomes and skills in the long-term. Factors that influenced effectiveness and sustainability of the included studies were strategic approach to QI, organizational support, intervention design, communication, accountability, leadership support, and learning networks.
Immune-related genes STIM1, ITPKC and PELI1 polymorphisms are associated with risk of colorectal cancer
Authors: Zhu Lei , Zheng Yuqin , Wu Tao , He Jiaxing , Fang Xiongchao , Zhou Shuai , Wang Ke , Wang Nan 
Published: January 2021

Objectives

STIM1, ITPKC and PELI1 are all immune-related genes that take part in the T cell activation, toll-like receptor and IL1 receptor pathways. The goal of this study was to evaluate the associations between STIM1, ITPKC and PELI1 polymorphisms and colorectal cancer (CRC) risk.

Methods
Six single nucleotide polymorphisms (SNPs) in STIM1, ITPKC and PELI1 were genotyped using a MassARRAY platform in a discovery cohort including 480 CRC cases and 480 healthy individuals and validated in a replication cohort including 505 CRC cases and 510 controls.

Results
The minor alleles of rs3794050, rs3750996 and rs2607420 were associated with an increased CRC risk (P < 0.05). In contrast, the minor allele of rs329497 was correlated with reduced disease risk (P = 0.025). Genetic model analysis showed that rs3794050 was related to an increased risk of disease in recessive and log-additive models (P < 0.05); rs3750996 had a strong correlation with CRC risk under all genetic models (P < 0.02); rs2607420 was correlated with an increased risk of disease in dominant and log-additive models (P < 0.01); whereas the protective effect of rs329497 on CRC risk was observed in dominant and log-additive models (P < 0.05). Finally, the association between the above SNPs and CRC risk was validated in a replication cohort (P < 0.05).

Conclusions
Our results could be helpful for the early screening of individuals with high CRC risk.