bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Proximal Anchor Choice During Distraction-based Surgeries for Patients With Nonidiopathic Early-onset Scoliosis: A Retrospective Multicenter Study
Authors: El-Bromboly Yehia , Hurry Jennifer , Padhye Kedar , Johnston Charles , McClung Anna , Samdani Amer , Glotzbecker Michael , Salah Hossam , St. Hilaire Tricia , Flynn Tara , El-Hawary Ron 
Published: March 2021

Background:
It is unclear whether the type of proximal anchor affects the spine length achieved with distraction-based surgeries in patients with nonidiopathic early-onset scoliosis (EOS). Since distraction may produce kyphosis, spine length should be assessed in the sagittal plane using the sagittal spine length (SSL—curved arc length of the spine in the sagittal plane). Our purpose was to determine if the type of proximal anchor in distraction-based surgeries will affect final spine length.

Methods:
Patients with nonidiopathic EOS treated with distraction-based systems (minimum 5 y follow-up, 5 lengthenings) were identified from 2 EOS registries. Radiographic analysis preoperative, postimplant (L1), and after each lengthening (L2-L5, L6-L10, L11-L15) was performed with the primary outcome of T1-S1 SSL.

Results:
We identified 126 patients—70 had rib-based implants (52 congenital, 9 syndromic, 9 neuromuscular) and 56 had spine-based implants (15 congenital, 29 syndromic, 12 neuromuscular) with preoperative age 4.6 years, scoliosis 75 degrees, and kyphosis 48 degrees. After initial correction (P<0.05), scoliosis remained constant [58 degrees (13 to 104 degrees) at L11-L15] and kyphosis increased over time [38 degrees (9 to 108 degrees) at L1 to 60 degrees (17 to 134 degrees) at L11-L15] (P<0.05). Preoperative SSL was higher in the spine-based group (29.6 cm) when compared with the rib-based group (25.2 cm) (P<0.05). This difference was maintained after initial implantation (spine-based: 32.2 cm vs. rib-based: 26.7 cm, P<0.05) and at final follow-up (spine-based: 37.0 cm vs. rib-based: 34.4 cm, P<0.05). As preoperative SSL differed between groups, maximum SSL gains per interval were also normalized to preoperative SSL. There was no statistically significant difference between groups at L1, L2-L5, and L6-L10. However, at L11-L15, the rib-based group achieved a more relative increase in spine length compared with the spine-based group (45% vs. 31%, P<0.05).

Conclusion:
At minimum 5 year follow-up, distraction-based surgeries increased spine length for patients with nonidiopathic EOS; regardless of proximal anchor type.
Maternal exposure to PM2.5 during pregnancy and asthma risk in early childhood
Authors: Hazlehurst Marnie F. , Carroll Kecia N. , Loftus Christine T. , Szpiro Adam A. , Moore Paul E. , Kaufman Joel D. , Kirwa Kipruto , LeWinn Kaja Z. , Bush Nicole R. , Sathyanarayana Sheela , Tylavsky Frances A. , Barrett Emily S. , Nguyen Ruby H. N. , Karr Catherine J. 
Published: March 2021

Background:
Increasingly studies suggest prenatal exposure to air pollution may increase risk of childhood asthma. Few studies have investigated exposure during specific fetal pulmonary developmental windows.

Objective:
To assess associations between prenatal fine particulate matter exposure and asthma at age 4.

Methods:
This study included mother–child dyads from two pregnancy cohorts—CANDLE and TIDES—within the ECHO-PATHWAYS consortium (births in 2007–2013). Three child asthma outcomes were parent-reported: ever asthma, current asthma, and current wheeze. Fine particulate matter (PM2.5) exposures during the pseudoglandular (5–16 weeks gestation), canalicular (16–24 weeks gestation), saccular (24–36 weeks gestation), and alveolar (36+ weeks gestation) phases of fetal lung development were estimated using a national spatiotemporal model. We estimated associations with Poisson regression with robust standard errors, and adjusted for child, maternal, and neighborhood factors.

Results:
Children (n = 1,469) were on average 4.3 (SD 0.5) years old, 49% were male, and 11.7% had ever asthma; 46% of women identified as black and 53% had at least a college/technical school degree. A 2 μg/m3 higher PM2.5 exposure during the saccular phase was associated with 1.29 times higher risk of ever asthma [95% confidence interval (CI): 1.06, 1.58]. A similar association was observed with current asthma (risk ratio 1.27, 95% CI: 1.04, 1.54), but not current wheeze (risk ratio 1.11, 95% CI: 0.92, 1.33). Effect estimates for associations during other developmental windows had CIs that included the null.

Conclusions:
Later phases of prenatal lung development may be particularly sensitive to the developmental toxicity of PM2.5.
Racial disparities in Coronavirus Disease 2019 (COVID-19) outcomes
Authors: Aleligne Yeabsra Kefyalew , Appiah Duke , Ebong Imo A. 
Published: March 2021

Purpose of review
The Coronavirus Disease 2019 (COVID-19) pandemic has exposed preexisting racial disparities in the healthcare system. This review discusses racial-ethnic differences in COVID-19 related outcomes with an emphasis on the social determinants of health that are responsible for these disparities.

Recent findings
Higher hospitalizations and deaths have been reported amongst minority individuals after a COVID-19 infection. Cardiovascular disease and its risk factors are also more common in minority populations and negatively impact clinical outcomes after a COVID-19 illness. The racial disparities seen after COVID-19 infections appear to be driven by multiple preexisting comorbidities, adverse socioeconomic conditions, and lack of access to healthcare. These disadvantages were present before the COVID-19 pandemic. To effectively reduce disparities in outcomes of COVID-19 and the impact of the virus on minority communities, a multifaceted approach will be needed.

Summary
Government-backed policies that foster health equity and promote easily accessible testing and fair distribution of COVID-19 therapies and vaccines are necessary to successfully combat racial disparities in COVID-19 outcomes.
Red blood cells from patients with pre-eclampsia induce endothelial dysfunction
Authors: McCann Haworth Sarah M. , Zhuge Zhengbing , Nihlén Carina , Von Rosen Matilda Fornell , Weitzberg Eddie , Lundberg Jon O. , Krmar Rafael T. , Nasiell Josefine , Carlström Mattias 
Published: March 2021

Rationale:
Pre-eclampsia is a multisystem disorder associated with systemic vascular dysfunction and decreased nitric oxide (NO) bioactivity. Arginase competes with NO synthase (NOS) for l-arginine, and its upregulation may reduce NOS-derived NO formation or induce production of reactive oxygen species (ROS) via uncoupling of NOS, resulting in endothelial dysfunction. Red blood cells (RBCs) have emerged as key players in NO homeostasis via their interactions with the endothelium. Studies have demonstrated that abnormal RBC arginase function in patients with diabetes contributes to oxidative stress and endothelial dysfunction.

Aim:
The aim of the study was to investigate if reduced NO bioavailability and increased ROS in pre-eclampsia is mediated via RBC-dependent mechanisms.

Methods:
In this translational study, plasma and RBCs were isolated from gestationally matched pre-eclamptic and healthy pregnant women and co-incubated overnight with mouse aortas for vascular reactivity studies. NO bioactivity, that is, nitrate, nitrite and cGMP, was assessed in plasma. Arginase activity and expression were analysed in RBCs.

Results:
Plasma markers of NO homeostasis and signalling were decreased in pre-eclamptic women vs. healthy pregnant women. Co-incubation of aorta with pre-eclamptic RBCs, but not healthy pregnant RBCs, induced endothelial dysfunction, which was ameliorated by pharmacological inhibition of arginase, scavenging of ROS, and by nitrite treatment. This pathological vascular phenotype was not observed following incubation with pre-eclamptic plasma. Arginase expression and activity in RBCs were increased in pre-eclamptic vs. healthy pregnant women and was associated with pre-eclampsia severity. Pre-eclamptic RBC-induced endothelial dysfunction was not because of increased haemolysis/cell-free haemoglobin.

Conclusion:
This study demonstrates a novel role of the RBC in mediating the endothelial dysfunction associated with pre-eclampsia through arginase-dependent and oxidative stress-dependent mechanisms. Targeting of RBC arginase may provide a novel treatment modality for pre-eclampsia.
Feasibility and Acceptability of a Telephone-Based Intervention for Hispanic Children to Promote Treatment Adherence After Traumatic Brain Injury: A Pilot Study
Authors: Jimenez Nathalia , Fuentes Molly , Virtue Alyssa , Alonso-Gonzalez Laura , Lopez Edgar , Zhou Chuan , Crawley Deborah , Apkon Susan , Johnston Brian , Rivara Frederick 
Published: March 2021

Objective:
To assess the feasibility and acceptability of a telephone-based education and navigation program for Hispanic parents of children hospitalized with traumatic brain injury (TBI).

Setting:
Level I trauma hospital and pediatric inpatient rehabilitation unit in the Northwestern United States.

Participants:
Fourteen Hispanic parent-child dyads. Parents were 85% female, with a mean age of 35 years. Children were 58% male, with a mean age of 9.7 years, and had been hospitalized for complicated mild/moderate (n = 5) or severe (n = 9) TBI.

Design:
Pilot prospective cohort design.

Main Measures:
Feasibility measures include recruitment, retention, and intervention adherence rates. Acceptability of intervention was measured by parents' use of educational materials and satisfaction with navigation program. We also evaluated study processes, including completion of baseline, 3, 6, and 12 months functional assessments of the child; assessment of parental health literacy and self-efficacy; and adherence to follow-up rehabilitation appointments.

Results:
Eighty-two percent of approached potential participants were recruited into the study. One hundred percent of participants completed the intervention, and 85% had 1-year follow-up. Intervention acceptability was high: 90% reported satisfaction with navigator, and 92% used the educational manual. Assessments demonstrated significant improvement in parents' TBI caregiving and community self-efficacy; 92% attendance to follow-up rehabilitation appointments; and improvement in the child's functional measures, except communication skills.

Conclusions:
Findings support feasibility and acceptability of a culturally relevant program to facilitate transitions of care for Hispanic children with TBI. A future randomized trial is warranted to determine the efficacy of the intervention on long-term treatment adherence and the child's post-TBI function.
Associations Among PTSD and Postconcussive Symptoms in the Long-Term Impact of Military-Relevant Brain Injury Consortium–Chronic Effects of Neurotrauma Consortium Prospective, Longitudinal Study Cohort
Authors: O'Neil Maya E. , Klyce Daniel W. , Pogoda Terri K. , Cifu David X. , Eggleston Barry E. , Cameron David C. , Wilde Elisabeth A. , Walker William C. , Carlson Kathleen F. 
Published: March 2021

Objective:
To describe rates of mild traumatic brain injury (mTBI) with and without concurrent posttraumatic stress disorder a sample of former and current military personnel, and to compare the factor structure of the Neurobehavioral Symptom Inventory (NSI) based on whether participants sustained mTBI with and without a positive posttraumatic stress disorder (PTSD) screen.

Setting:
Participants recruited and tested at 7 Veterans Affairs (VA) sites and 1 military training facility as part of a national, longitudinal study of mental health, physical, and cognitive outcomes among veterans and service members. Participants: Total of 1540 former and current military personnel with a history of combat exposure.

Design:
Cross-sectional analysis of observational data, including confirmatory factor analysis. Main Measures: NSI and PTSD Checklist for DSM-5 (PCL-5).

Results:
Most participants (81.5%) had a history of mTBI and almost half of these screened positive for PTSD (40.5%); only 23.9% of participants without a history of mTBI screened positive for PTSD. Participants with a history of mTBI reported higher elevations of NSI and PCL-5 symptoms compared with those without a history of mTBI. Confirmatory factor analyses of the NSI demonstrated good model fit using a 4-factor structure (somatosensory, affective, cognitive, and vestibular symptoms) among groups of participants both with and without a history of mTBI.

Conclusion:
Symptoms of mTBI and PTSD are strongly associated with each other among veterans and service members with a history of combat exposure. The 4-factor NSI structure is supported among participants with and without a history of mTBI. These findings suggest the potential benefit of a holistic approach to evaluation and treatment of veterans and service members with concurrent and elevated postconcussive and posttraumatic stress symptoms.
Effects of Recurrent Mild Traumatic Brain Injuries on Incidence, Severity, and Recovery of Concussion in Young Student-Athletes
Authors: Hannah Theodore C. , Spiera Zachary , Li Adam Y. , Durbin John , Dreher Nickolas , Ali Muhammad , Marayati Naoum Fares , Gometz Alex , Lovell Mark , Choudhri Tanvir 
Published: March 2021

Objective:
To examine the effects of recurrent concussions on the incidence, severity, and recovery of significant neurocognitive dysfunction (SND) in young athletes.

Setting:
Various US youth sports organizations that utilize Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) for baseline and postinjury concussion testing.

Participants:
Data from 11 563 ImPACT baseline evaluations of US student-athletes aged 12 to 22 years were separated into 2 cohorts: subjects reporting 2 or more previous concussions (PC; n = 976 baseline evaluations) at baseline and a control group reporting zero previous concussions (CT; n = 7743 baseline evaluations). Subjects reporting 1 prior concussion were excluded.

Design:
Retrospective cohort.

Main Measures:
Differences in SND incidence, severity, and recovery between the 2 cohorts were assessed using chi-squared tests, t tests, survival analyses, and multivariate regressions.

Results:
The PC cohort had a higher incidence of head injury leading to ImPACT (436.7 per 1000 person-years vs 194.4 per 1000 person-years, P < .0001) and a higher incidence of SND (140.4 vs 71.8, P < .0001) than controls. However, the Severity Index (SI) demonstrated that SND severity was lower in the PC group (7.55 vs 8.59, P = .04). Adjusted analyses similarly demonstrated that the PC cohort had increased SND incidence (odds ratio = 1.93; 95% CI, 1.61 to 2.31; P < .0001), decreased SI (β = −1.37; 95% CI, −2.40 to −0.34; P = .009), and equivalent recovery (hazard ratio = 0.98; 95% CI, 0.76 to 1.72; P = .90).

Conclusion:
Participants with a history of concussion have a higher incidence of SND but present with lower severity SND, which may be a result of increased concussion education or symptom awareness. Recurrent concussion has no significant impact on acute neurocognitive recovery. Together, these results provide evidence against the supposition that a history of concussion increases the severity of future SND.
COMPARISON OF SPECTRALIS AND CIRRUS OPTICAL COHERENCE TOMOGRAPHY FOR THE DETECTION OF INCOMPLETE AND COMPLETE RETINAL PIGMENT EPITHELIUM AND OUTER RETINAL ATROPHY
Authors: Corvi Federico , Corradetti Giulia , Nittala Muneeswar Gupta , Velaga Swetha Bindu , Haines Jonathan L. , Pericak-Vance Margaret Ann , Stambolian Dwight , Sadda SriniVas R. 
Published: March 2021

Purpose:
To evaluate and compare the detection of incomplete and complete retinal pigment epithelial and outer retinal atrophy (iRORA and cRORA) using Spectralis and Cirrus optical coherence tomography (OCT) devices.

Methods:
Subjects with late age-related macular degeneration were imaged on the same day with Spectralis and Cirrus OCT. Two, masked, independent, and experienced retina specialist graders evaluated each case for the presence of cRORA and iRORA lesions.

Results:
A significantly higher number of lesions were observed using Spectralis compared with Cirrus (239 vs. 226 and 223 vs. 209). Higher number of iRORA lesions were identified with Spectralis (105 vs. 90 and 96 vs. 82), and no significant difference was observed between devices for cRORA lesions (134 vs. 136 and 128 vs. 126). When considering the presence or absence of iRORA or cRORA, the agreement between devices for both graders was excellent for cRORA and good for iRORA.

Conclusion:
Spectralis and Cirrus OCT identified a similar number of cRORA lesions, although more iRORA lesions could be detected with Spectralis OCT. These findings may have implications for developing acquisition protocols for trials based on the intended atrophy targets and highlight the importance of using a consistent OCT instrument across a study.
Factors Associated With Myocardial Infarction Reoccurrence
Authors: Abel Willie M. , Scanlan Lauren N. , Horne Carolyn E. , Crane Patricia B. 
Published: March 2021

Background
As recurrent myocardial infarctions (MIRs) constitute almost a third of the annual incidence of myocardial infarction, identifying the traditional and novel variables related to MIR is important.

Objective
The aim of this study was to examine modifiable cardiac risks, adiposity, symptoms associated with inflammation (fatigue, depression, sleep) and inflammatory cytokines, and MIR by sex and race.

Methods
Using a cross-sectional descriptive design, we recruited a convenience sample of adults (N = 156) discharged with first myocardial infarction or had MIR in the last 3 to 7 years. Surveys measured demographics, cardiac risk factors, depression, sleep, and fatigue. Anthropometric measures and cytokines tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein (hsCRP) were obtained. A maximum likelihood regression was calculated to predict MIR.

Results
The sample included 57% male and 30% Black participants, and the mean (SD) age was 65 (12) years. The hsCRP was the only cytokine related to symptoms: fatigue (r = 0.309, P < .001) and depression (r = 0.255, P = .002). An MIR was not associated with race despite White participants reporting better sleep (t
146 = −3.25, P = .002), lower body mass index (t
154 = −3.49, P = .001), and fewer modifiable risk factors (t
152 = −2.05, P = .04). An MIR was associated with being male, higher hsCRP and tumor necrosis factor-α levels (P < .001), and higher inflammatory symptoms of fatigue (P = .04), depression (P = .01), and poor sleep (P < .001).

Conclusion
Further examination of biomarkers to understand the mechanisms associated with inflammatory symptoms of fatigue, depression, and poor sleep and MIR is needed.
Fleshy Papules on Left Upper Body
Authors: Vassantachart Janna M. 
Published: March 2021

ABSTRACT
Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In this modality, there is a transfer of medical information electronically (including history and visual data) on a patient in one location to a provider who is in another location (Roman & Jacob, 2015). The construct of this column is such that cases are presented in a standardized teledermatology reader format. This is a case of asymptomatic fleshy papules on the left upper trunk and shoulder.
Blaschkolinear Keratotic Spines With Erythronychia and V-Shaped Nicking of the Fingernails
Authors: Rosenfeld Adam H. , Alghalith Yazan , Martin Kari 
Published: March 2021

ABSTRACT
This case describes a man in his late 30s who presented with a 25-year history of malodorous keratotic papules on the face, neck, chest, and back, as well as thick, painful linear spines along the lines of Blaschko on the lower extremities. His father had similar diffuse skin findings. A Type II mosaicism of Darier disease was likely because of the focal linear keratotic spines with a background of classic Darier lesions.
Skin Cancer: Back to Basics—Merkel Cell Carcinoma
Authors: Brickley Sylvana A. , Franco Abigail , Somers Kathryn 
Published: March 2021

ABSTRACT
Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer. Advanced disease portends a poor prognosis in most patients. We review the pathogenesis, clinical features, dermoscopic findings, differential diagnosis, workup, treatment modalities, and follow-up of MCC for dermatology nurses. It is important for nurses to be familiar with MCC to prevent delayed diagnosis.
Impact of Ergonomics on Cardiometabolic Risk in Office Workers
Authors: Jindo Takashi , Kai Yuko , Kitano Naruki , Makishima Mitsuru , Takeda Koji , Arao Takashi 
Published: March 2021

Objective:
Ergonomic office redesigning possibly improves physical activity (PA) and sedentary behavior (SB); however, its impact on cardiometabolic risk has not yet been determined. This study aimed to examine the effect of office relocation on cardiometabolic risk factors.

Methods:
Annual health check-up data of 95 office workers from four offices in Tokyo, Japan, who relocated to an office with activity-based working (ABW) and height-adjustable desk (HAD) and a propensity-score matched control-cohort were analyzed. PA and SB on weekdays were measured only in the relocation group before and 10 months after relocation.

Results:
Significant interactions were observed for waist circumference, high-density lipoprotein cholesterol, and glycosylated hemoglobin (HbA1c). HbA1c changes showed a significant negative association with moderate-to-vigorous-intensity PA.

Conclusion:
An ABW office with HAD improves cardiometabolic risk factors in office workers, possibly through changes in PA and SB.
Molecular targets and the use of biologics in the management of small bowel fibrosis in inflammatory bowel disease
Authors: Abdulla Muaad , Chew Thean Soon 
Published: March 2021

Purpose of review
Small bowel fibrosis is a significant burden on Crohn's disease patients with limited effective medical treatments that then requires surgery. A better understanding of the molecular mechanisms causing fibrosis and the evidence of benefit of available biologics will potentially lighten this burden and avoid the need for surgery.

Recent findings
Transforming growth factor-beta and it's associated pathways remain the central cog in the wheel of fibrosis formation. Various new enzymes, cellular pathways, interleukins and molecules have been associated with beneficial modification of the fibrotic process. Licensed biologics such as antitumour necrosis factors continue to show evidence of efficacy in the treatment of fibrostenotic small bowel disease as well as the newer biologics ustekinumab and vedolizumab.

Summary
Fibrostenotic disease of the small bowel is a significant and common debilitating complication in Crohn's disease patients. Multiple new molecular targets have been identified that may prove to become effective therapies in future. Antitumour necrosis factors remain the treatment with the best available evidence to date in fibrostenotic Crohn's disease.