bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hybrid-Flexible Classroom Design in the Physical Therapist Classroom
Authors: Jordon Max K , Tudini Frank , Liuzzo Derek 
Published: March 2023

Introduction.
Doctor of Physical Therapy (DPT) education has traditionally been delivered in a face-to-face format. However, alternative educational models are on the rise with the proliferation of hybrid programs. Although hybrid education may benefit students in unique ways, many students prefer the personal interaction afforded by a face-to-face format. An alternative model, Hybrid-Flexible (HyFlex), allows students to have the benefits of a hybrid education while allowing for face-to-face interactions. Therefore, the purpose of this study was to describe the application of an alternative educational method—HyFlex—in the DPT classroom.

Review of Literature.
In a HyFlex model, students can choose to attend each class period in person, synchronously online, or asynchronously. Although previous research has found that hybrid programs have equivalent performance compared with traditional style, there is a paucity of published research on the effectiveness of HyFlex in the DPT classroom.

Subjects.
Thirty-six students (n = 26 female students) enrolled in a first-year DPT kinesiology course participated in this study.

Methods.
Students chose which method of engagement they preferred, and attendance choice was recorded. Students were categorized into synchronous engagement, partial asynchronous engagement, or asynchronous engagement groups. Quantitatively, grades for quizzes, tests, and the final examination were recorded and compared across the groups. Qualitatively, the students filled out a survey asking about their experience, and answers were assessed using a qualitative descriptive approach.

Results.
Quantitative data analysis revealed no differences between the groups in academic performance. Qualitative data revealed that students felt the HyFlex model allowed for better organization, flexibility, and reduced stress. However, there were concerns about the social impact, academic loss, decreased motivation, and technological issues.

Discussion and Conclusion.
This study describes how a HyFlex model can be implemented in a DPT classroom that allows for greater flexibility and reports of improved stress reduction with no academic loss.
Catch-Up Growth in Infants and Young Children With Faltering Growth: Expert Opinion to Guide General Clinicians
Authors: Cooke Richard , Goulet Olivier , Huysentruyt Koen , Joosten Koen , Khadilkar Anuradha Vaman , Mao Meng , Meyer Rosan , Prentice Andrew M. , Singhal Atul 
Published: March 2023

Faltering growth (FG) is a problem regularly seen by clinicians in infants and young children (<2 years of age). It can occur due to non-disease-related and disease-related causes and is associated with a wide range of adverse outcomes, including shorter-term effects such as impaired immune responses and increased length of hospital stay, and longer-term consequences, including an impact on schooling and cognitive achievements, short stature, and socioeconomic outcomes. It is essential to detect FG, address underlying causes and support catch-up growth where this is indicated. However, anecdotal reports suggest misplaced fear of promoting accelerated (too rapid) growth may deter some clinicians from adequately addressing FG.
An invited international group of experts in pediatric nutrition and growth reviewed the available evidence and guidelines on FG resulting from disease-related and non-disease-related effects on nutritional status in healthy term and small for gestational age infants and children up to the age of 2 years in low-, middle-, and high-income countries. Using a modified Delphi process, we developed practical consensus recommendations to provide clarity and practical recommendations for general clinicians on how FG should be defined in different young child populations at risk, how FG should be assessed and managed, and the role of catch-up growth after a period of FG. We also suggested areas where further research is needed to answer remaining questions on this important issue.
Evaluation and treatment of postoperative periprosthetic humeral fragility fractures
Authors: Kobayashi Evangeline F. , Namdari Surena , Schenker Mara , Athwal George S. , Ahn Jaimo 
Published: March 2023

Summary:
Postoperative periprosthetic humeral shaft fractures represent a growing and difficult complication to treat given the aging patient population and associated bone loss. Determining the best treatment option is multifactorial, including patient characteristics, fracture pattern, remaining bone stock, and implant stability. Possible treatment options include nonoperative management with bracing or surgical intervention. Nonoperative treatment has been shown to have higher nonunion rates, thus should only be selected for a specific patient population with minimally displaced fractures or those that are unfit for surgery. Surgical management is recommended with prosthetic loosening, fracture nonunion, or failure of nonoperative treatment. Surgical options include open reduction and internal fixation, revision arthroplasty, or hybrid fixation. Careful evaluation, decision making, and planning is required in the treatment of these fractures.
Periprosthetic fracture management: global approaches
Authors: Miclau Theodore 
Published: March 2023

Abstract
The incidence of periprosthetic fractures (PPFs) continues to increase worldwide. The goal of management is to restore mobility early while minimizing potential treatment complications. The general medical frailty of patients sustaining PPFs complicates the management of these conditions, with many of those affected being highly susceptible to the consequences of impaired mobilization. Outcomes depend on patient-related (eg, age, physiological condition, medical comorbidities, quality of bone, presence of osteolysis, previous procedures, sex) and surgeon-related (eg, diagnosis, choice of procedure, selected implant, and surgical technique) factors, and preventative measures to decrease the risk of PPFs should be pursued whenever possible. The articles in this supplement address the treatment of the most commonly encountered PPFs, specifically those in the proximal humerus, acetabulum, proximal femur, distal femur, and proximal tibia. This work represents a collaborative effort of the member societies of the International Orthopaedic Trauma Association, an international association of orthopaedic organizations dedicated to the promotion of musculoskeletal trauma care through advancements in patient care, research, and education. The expectation is that the information provided in this supplement will improve the care of patients with PPFs.
The Epidemiology and Costs of Disease Intervention Specialist Retention
Authors: Becher Julie , Salmon Melinda E. , Gift Thomas L. 
Published: March 2023

Abstract

Introduction
The COVID-19 pandemic changed the environment in which disease intervention specialists (DIS) operate, as their skills were in demand beyond STD control programs. Workforce conditions generally have changed in the last 2 years, imposing additional challenges. Retaining STD DIS has become more difficult in the changed environment.

Materials and Methods
We conducted a landscape scan and obtained data from literature and personal observations to characterize current DIS workforce issues. We used published employment data to characterize current labor market conditions and described how cost-effectiveness analysis could be used to assess potential DIS retention interventions. An example illustrating cost-effectiveness concepts was developed.

Results
Many STD control programs faced difficulties in retaining STD DIS, because competing positions often could be done without field work. Economic and crime issues posed additional challenges. General workforce turnover has increased 33% since 2016. Turnover varies by age, gender, and education. Cost-effectiveness analysis can be used to assess DIS retention interventions, but data on costs and outcomes are needed on an ongoing basis. Changes in the workforce environment could impact both retention and the effectiveness of retention interventions.

Conclusions
Workforce changes have impacted employee retention. Increased federal funding makes expansion of the DIS workforce possible, but the labor market environment will continue to pose challenges to recruitment and retention.
Safety and Efficacy of 68Ga- or 177Lu-Labeled DOTA-IBA as a Novel Theranostic Radiopharmaceutical for Bone Metastases
Authors: Qiu Lin , Wang Yingwei , Liu Hanxiang , Wang Qixin , Chen Lin , Liu Lin , Wang Li , Feng Yue , Chen Yue 
Published: March 2023

Purpose
We designed and synthesized a novel theranostic bisphosphonate radiopharmaceutical (68Ga- or 177Lu-labeled DOTA-ibandronic acid [68Ga/177Lu-DOTA-IBA]) for bone metastasis. In this study, the dosimetry, safety, and efficacy of 68Ga/177Lu-DOTA-IBA as a theranostic radiopharmaceutical for bone metastases were evaluated in patients with malignancy based on 68Ga- and 177Lu-DOTA-IBA images, blood samples, and dosimetric analysis.

Patients and Methods
Eighteen patients with bone metastasis and progression under conventional therapies were included in this study. Baseline 99mTc-MDP SPECT and 68Ga-DOTA-IBA PET/CT were performed for comparative purposes within 3 days. After receiving 891.5 ± 301.3 MBq 177Lu-DOTA-IBA, serial 177Lu-DOTA-IBA SPECT bone scan was performed over 14 days. Dosimetric evaluation was performed for main organs and tumor lesions. Safety was assessed by blood biomarkers. Karnofsky Performance Status, pain score, and follow-up 68Ga-DOTA-IBA PET/CT were performed for response evaluation.

Results
Baseline 68Ga-DOTA-IBA PET demonstrated a higher efficacy for detecting bone metastases compared with 99mTc-MDP SPECT. The time-activity curves showed fast uptake and high retention of 177Lu-DOTA-IBA in bone metastases (24 hours: 9.43 ± 2.75 %IA; 14 days: 5.45 ± 2.52 %IA). Liver, kidneys, and red marrow time-activity curves revealed a low uptake and fast clearance. The radiation-absorbed dose in bone metastasis lesions (6.40 ± 2.13 Gy/GBq) was significantly higher than that in red marrow (0.47 ± 0.19 Gy/GBq), kidneys (0.56 ± 0.19 Gy/GBq), or liver (0.28 ± 0.07 Gy/GBq), with all P’s < 0.001. Compared with baseline level, only one patient developed new grade 1 leukopenia (toxicity rate, 6%). The 177Lu-DOTA-IBA therapy had no statistically significant effect on bone marrow hematopoietic function, liver function, and kidney function at any follow-up visit. Bone pain palliation was achieved in 82% (14/17) of patients. The 8-week follow-up 68Ga-DOTA-IBA PET/CT demonstrated partial response in 3 patients, disease progression in 1 patient, and stable disease in 14 patients.

Conclusions

68Ga/177Lu-DOTA-IBA provides a set of potential theranostic radiopharmaceuticals and may have a good prospect for the management of bone metastasis.
Orbital Foraminal Morphometrics in Nonsyndromic Unilateral Coronal Craniosynostosis
Authors: Liu Helen , Katz Abigail , Janssen Pierce , Rajasekaran Vignesh , Stanton Eloise , Oleru Olachi O. , Bellaire Christopher P. , Devarajan Alex , Napoli James G. , Rutland John W. , Lacoste Joshua , Frempong Tamiesha , Delman Bradley N. , Urata Mark M. , Taub Peter J. 
Published: March 2023

Abstract
Nonsyndromic unilateral coronal craniosynostosis (UCS) is a rare congenital disorder that results from premature fusion of either coronal suture. The result is growth restriction across the suture, between the ipsilateral frontal and parietal bones, leading to bony dysmorphogenesis affecting the calvarium, orbit, and skull base. Prior studies have reported associations between UCS and visual abnormalities. The present study utilizes a novel geometric morphometric analysis to compare dimensions of orbital foramina on synostotic versus nonsynostotic sides in patients with UCS. Computed tomography head scans of pediatric UCS patients were converted into 3-dimensional mesh models. Anatomical borders of left and right orbital structures were plotted by a single trained team member. Dimensions between synostotic and nonsynostotic sides were measured and compared. Medical records were examined to determine prevalence of visual abnormalities in this patient cohort. Visual abnormalities were reported in 22 of the 27 UCS patients (77.8%). Astigmatism (66.7%), anisometropic amblyopia (44.4%), and motor nerve palsies (33.3%) represented the 3 most prevalent ophthalmologic abnormalities. Orbits on synostotic sides were 11.3% narrower (P < 0.001) with 21.2% less volume (P = 0.028) than orbits on nonsynostotic sides. However, average widths, circumferences, and areas were similar between synostotic and nonsynostotic sides upon comparison of supraorbital foramina, infraorbital foramina, optic foramina, and foramina ovalia. Therefore, previously proposed compression or distortion of vital neurovascular structures within bony orbital foramina does not seem to be a likely etiology of visual abnormalities in UCS patients. Future studies will examine the role of ocular and/or neuro-ophthalmologic pathology in this disease process.
Comparison of Tumescent Anesthesia Versus Pectoral Nerve Block in Bilateral Reduction Mammaplasty
Authors: McLaughlin Caroline M. , Hughes Alexa J. , Lee Charles C. , Perez Holguin Rolfy A. , Warfield Dennis J. , Henry Cathy R. , Johnson Timothy S. , Potochny John D. 
Published: March 2023

IntroductionWith an increasing focus on multimodal pain control to reduce opioid requirements, regional and local anesthesia techniques have been investigated in bilateral reduction mammaplasty with variable results. The purpose of this study is to compare tumescent anesthesia with pectoral nerve block II (PECS II) in patients undergoing bilateral reduction mammaplasty with respect to postoperative pain and nausea, opioid consumption, length of stay, and cost.MethodsA retrospective review of patients undergoing bilateral reduction mammaplasty for macromastia between November 2020 and December 2021 was performed. Demographic information, operative and anesthesia times, antiemetic and morphine equivalent requirements, postoperative numeric pain rating scales, and time until hospital discharge were compared between groups.χ2and Fisher exact tests examined subgroup differences in categorical variables. Two-samplettest and Wilcoxon rank-sum test evaluated differences in continuous parametric and nonparametric variables, respectively.ResultsFifty-three patients underwent bilateral reduction mammaplasty by 3 surgeons, 71.7% (n = 38) with tumescent anesthesia infiltrated by the operating surgeon before the start of the procedure and 28.3% (n = 15) with bilateral PECS II blocks performed by anesthesia before the start of the procedure. There was no difference in age, body mass index, weight resected, intraoperative medication, or immediate postoperative complications. Postoperative pain scores and opioid requirements were similar between the 2 groups. Twenty-one percent (n = 8) of tumescent patients compared with 66.7% (n = 10) of block patients required 1 or more doses of postoperative antiemetics (P= 0.002). Patients who received blocks spent longer in the postoperative recovery area (5.3 vs 7.1 hours,P< 0.01). However, this did not translate to a significant increase in overnight stays. The block group had significantly higher hospitalization cost by an average of $4000, driven by pharmacy and procedural cost (P< 0.01).ConclusionIn this cohort of multimodal perioperative pain-controlled reduction mammaplasty patients, tumescent anesthesia was associated with decreased antiemetic requirements, less time in recovery before discharge, and lower cost compared with PECS II blocks. Therefore, tumescent anesthesia may be favored over PECS II blocks when considering multimodal pain control strategies in reduction mammaplasty patients.
Examination of Outcome Disparities in Reports of Prepectoral and Subpectoral Direct-to-Implant Reconstruction
Authors: Montorfano Lisandro , Hung Ya-Ching , Chaker Sara , Saad Mariam , Kalmar Christopher L. , Ferri Francisco , Higdon Kent K. , Perdikis Galen 
Published: March 2023

Background
There are mixed results in surgical complications regarding the usage of prepectoral versus subpectoral implant placement in direct-to-implant breast reconstruction. This study aimed to provide a comprehensive synthesis of surgical complications between the subpectoral and prepectoral reconstructive method.

Methods
PubMed, Embase, and Cochrane were searched for literature published up until December 2022. Studies that compared subpectoral and prepectoral breast reconstruction and reported at least one postoperative complication were included. The following 8 major outcomes were included: revision and reoperation, capsular contracture, explantation, seroma, hematoma, infection, skin necrosis, and animation deformity. Systematic review and meta-analysis were performed to compare outcomes of the 2 techniques. Subgroup analysis was performed to compare whether practice differences in different countries may have an impact on outcomes.

Results
A total of 18 studies were identified in our literature search. Two thousand three hundred sixty patients were included, representing a total of 3135 breasts. Our analysis demonstrated that prepectoral reconstruction had significantly lower odds of developing postoperative hematoma [odds ratio (OR), 0.62; P = 0.05], seroma (OR, 0.67; P = 0.01), infection (OR, 0.64; P = 0.03), revision and reoperation (OR, 0.44; P < 0.00001), and animation deformity (OR, 0.01; P < 0.00001), compared with the subpectoral method. Subgroup analysis showed that differences between 3 countries (United States, Korea, Italy) are low (all subgroup heterogeneity test P > 0.1).

Conclusions
While both subpectoral and prepectoral are safe methods for breast reconstruction, the prepectoral technique may lead to lower odds of developing multiple major postoperative complications.
Multi-omics analysis reveals drivers of loss of β-cell function after newly diagnosed autoimmune type 1 diabetes: An INNODIA‡multicenter study
Authors: Armenteros Jose Juan Almagro , Brorsson Caroline , Johansen Christian Holm , Banasik Karina , Mazzoni Gianluca , Moulder Robert , Hirvonen Karoliina , Suomi Tomi , Rasool Omid , Bruggraber Sylvaine FA , Marcovecchio M Loredana , Hendricks Emile , Al-Sari Naba , Mattila Ismo , Legido-Quigley Cristina , Suvitaival Tommi , Chmura Piotr J , Knip Mikael , Schulte Anke M , Lee Jeong Heon , Sebastiani Guido , Grieco Giuseppina Emanuela , Elo Laura L , Kaur Simranjeet , Pociot Flemming , Dotta Francesco , Tree Tim , Lahesmaa Riitta , Overbergh Lut , Mathieu Chantal , Peakman Mark , Brunak Søren 
Published: March 2023

AbstractBackgroundHeterogeneity in the rate of β-cell loss in newly diagnosed type 1 diabetes patients is poorly understood and creates a barrier to designing and interpreting disease-modifying clinical trials. Integrative analyses of complementary multi-omics data obtained after the diagnosis of T1D may provide mechanistic insight into the diverse rates of disease progression.MethodsWe collected samples in a pan-European consortium that enabled the concerted analysis of five different omics modalities in data from 97 newly diagnosed patients. In this study we used Multi-Omics Factor Analysis to identify molecular signatures correlating with post-diagnosis decline in β-cell mass measured as fasting C-peptide.ResultsTwo molecular signatures were significantly correlated with fasting C-peptide levels. One signature showed a correlation to neutrophil degranulation, cytokine signaling, lymphoid and non-lymphoid cell interactions and G-protein coupled receptor signaling events that were inversely associated with rapid decline in β-cell function. The second signature was related to translation and viral infection were inversely associated with change in β-cell function. In addition, the immunomics data revealed a Natural Killer cell signature associated with rapid β-cell decline.ConclusionFeatures that differ between individuals with slow and rapid decline in β-cell mass could be valuable in staging and prediction of the rate of disease progression and thus enable smarter (shorter and smaller) trial designs for disease modifying therapies, as well as offering biomarkers of therapeutic effect.FundingThis work is funded by the Innovative Medicine Initiative 2 Joint Undertaking (IMI2 JU) under grant agreement N° 115797 (INNODIA) and N° 945268 (INNODIA HARVEST). This Joint Undertaking receives support from the Union’s Horizon 2020 research and innovation program and ‘EFPIA’, ‘JDRF’ and ‘The Leona M. and Harry B. Helmsley Charitable Trust’.
The Mediating Role of Systemic Inflammation and Moderating Role of Race/Ethnicity in Racialized Disparities in Incident Dementia: A Decomposition Analysis
Authors: Higgins Tejera César , Ware Erin B. , Hicken Margaret T. , Kobayashi Lindsay C. , Wang Herong , Adkins-Jackson Paris B. , Blostein Freida , Zawistowski Matthew , Mukherjee Bhramar , Bakulski Kelly M. 
Published: March 2023

Abstract DescriptionBackgroundExposure to systemic racism is linked to increased dementia burden. To assess systemic inflammation as a potential pathway linking exposure to racism and dementia disparities, we investigated the mediating role of C-reactive protein (CRP), a systemic inflammation marker, and the moderating role of race/ethnicity on racialized disparities in incident dementia.MethodsIn the US Health and Retirement Study (n=5,143), serum CRP was measured at baseline (2006, 2008 waves). Incident dementia was classified by cognitive tests over a six-year follow-up. Self-reported racialized categories were a proxy for exposure to the racialization process. We decomposed racialized disparities in dementia incidence (non-Hispanic Black and/or Hispanic vs. non-Hispanic White) into 1) the mediated effect of CRP, 2) the moderated portion attributable to the interaction between racialized group membership and CRP, and 3) the controlled direct effect (other pathways through which racism operates).ResultsThe 6-year cumulative incidence of dementia was 15.5%. Among minoritized participants (i.e., non-Hispanic Black and/or Hispanic), high CRP levels (> 75thpercentile or 4.57μg/mL) was associated with 1.27 (95%CI: 1.01,1.59) times greater risk of incident dementia than low CRP (<4.57μg/mL). Decomposition analysis comparing minoritized versus non-Hispanic White participants showed that the mediating effect of CRP accounted for 2% (95% CI: 0%, 6%) of the racial disparity, while the interaction effect between minoritized group status and high CRP accounted for 12% (95% CI: 2%, 22%) of the disparity. Findings were robust to potential violations of causal mediation assumptions.ConclusionsSystemic inflammation mediates racialized disparities in incident dementia.