bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transmission of SARS-CoV-2 among recruits in a US Army training environment: a brief report
Authors: Hakre Shilpa , Maljkovic-Berry Irina , Hang Jun , Conte Matthew A , Pollio Adam R , Fung Christian K , Gandhi Jaykumar , Peel Sheila A , Lidl Grace M , Huhtanen Mark E , Hall Tara L , Modjarrad Kayvon , Friberg Heather L , O’Connell Robert J , Scott Paul T 
Published: May 2023

Abstract

Background
In 2020, preventive measures were implemented to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among 600–700 recruits arriving weekly at a basic combat training (BCT) facility in the southern United States. Trainees were sorted into companies and platoons (cocoons) at arrival, tested, quarantined for 14 days with daily temperature and respiratory-symptom monitoring and retested before release into larger groups for training where symptomatic testing was conducted. Nonpharmaceutical measures, such as masking, and social distancing, were maintained throughout quarantine and BCT. We assessed for SARS-CoV-2 transmission in the quarantine milieu.

Methods
Nasopharyngeal (NP) swabs were collected at arrival and at the end of quarantine and blood specimens at both timepoints and at the end of BCT. Epidemiological characteristics were analyzed for transmission clusters identified from whole-genome sequencing of NP samples.

Results
Among 1403 trainees enrolled from 25 August to 7 October 2020, epidemiological analysis identified three transmission clusters (n = 20 SARS-CoV-2 genomes) during quarantine, which spanned five different cocoons. However, SARS-CoV-2 incidence decreased from 2.7% during quarantine to 1.5% at the end of BCT; prevalence at arrival was 3.3%.

Conclusions
These findings suggest layered SARS-CoV-2 mitigation measures implemented during quarantine minimized the risk of further transmission in BCT.
“Blue balls” and sexual coercion: a survey study of genitopelvic pain after sexual arousal without orgasm and its implications for sexual advances
Authors: Levang Samantha , Henkelman Megan , Neish Robin , Zukerman Wendy , Terrell Blythe , Jackman Victoria , Coyle Shannon , Brahmbhatt Jamin , Pukall Caroline 
Published: May 2023

Abstract

Background
Blue balls/vulva has received increasing interest from the public in recent years, sparking debate about genital physiology, controversy around “sexual release” as a treatment for this type of pain, and sexual consent.

Aim
This cross-sectional, mixed-methods online study aimed to evaluate the general understanding and frequency of blue balls/vulva and whether individuals have ever been pressured to continue sexual activity because of a partner’s fears of experiencing pain without orgasm.

Methods
A total of 2621 individuals with a penis (n = 1483) or vagina (n = 1138) were recruited for an online survey on the experience of “blue balls/vulva.” Quantitative analyses consisted primarily of descriptive statistics and chi-square analyses. Between-group differences were analyzed (based on whether respondents reported having a penis or vagina), and responses to open-ended questions were examined via thematic analysis.

Outcomes
The primary outcomes of interest were reports of the belief in blue balls/vulva, the frequency and pain characteristics of blue balls/vulva, and the incidence of being pressured to continue sexual activity due to a partner’s fears of experiencing pain without orgasm.

Results
Results indicated that significantly more individuals with a penis than a vagina reported believing that blue balls are real, endorsed experiencing pain when they approached orgasm but did not ejaculate, and reported moderate and severe pain. Significantly more individuals with a vagina than a penis reported being pressured into a sexual act due to a partner’s fear of experiencing pain without orgasm. Results from the thematic analysis indicated that participants recognized that those with a vagina are expected to act sexually to prevent their partners’ experience of blue balls, despite agreement that this phenomenon should not be used to coerce or manipulate partners into engaging sexually.

Clinical Implications
Education on the frequency of this phenomenon and methods to relieve pain alternative to partnered sexual activity should be addressed in patients who present with this condition.

Strengths and Limitations
Although the survey was brief, it provided information from a relatively large sample about whether people believe that this phenomenon exists, how many experience it, how painful it is, and how often it has been used as an excuse for a partner to continue sexual activity.

Conclusion
Results indicated that severe pain exists in a minority of individuals, that solitary sexual and nonsexual activities can help to alleviate the discomfort, and that this pain is not a valid reason to continue unwanted sexual activity.
Early and late implications of COVID-19 on male reproductive health: 3 years of data
Authors: Pellegrino Christopher J , Ye Nancy Y , Chen Irene K , Abdelsayed George A 
Published: May 2023

AbstractIntroductionCOVID-19 (coronavirus disease 2019), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has significantly affected global health. Research has shown that the virus can be found at high concentrations in male gonadal tissue. Yet, the virus’s long-term implications on male reproductive health remains relatively unclear.ObjectiveA comprehensive narrative review of published literature regarding COVID-19’s short- and long-term implications on male reproductive health.MethodsA literature search of the PubMed and EMBASE databases was performed for articles ranging from November 2019 to August 2022. Studies that focused on the impact of COVID-19 on male reproductive health were selected for review. Studies were included if they were written in English and reported semen analyses, pathologic gonadal tissue analyses, serum androgen assays, or a combination of these in patients with COVID-19. Moreover, literature was included on COVID-19 vaccinations’ impacts on male reproductive health. Case reports and other narrative reviews were excluded from this review.ResultsSARS-CoV-2 has been detected in cadaveric testicular tissue during the initial stages of infection in fatal cases of the disease, demonstrating marked inflammatory changes and decreased spermatogenesis in patients with COVID-19. Several studies have revealed a negative impact on androgens during acute illness and in the ensuing months, but data on the recovery of androgen levels are confounding and limited in scope. COVID-19 does have significant negative impacts on bulk semen parameters, as confirmed in studies comparing pre- and post–COVID-19 semen samples. Vaccination is a valuable tool for protecting patients from the negative impacts of the virus and has been shown to have no negative impact on male reproductive potential.ConclusionGiven the virus’s impacts on testicular tissue, androgens, and spermatogenesis, COVID-19 can negatively affect male reproductive health for an extended period. Therefore, vaccinations should continue to be recommended to all eligible patients.
Controlled Ankle Movement (CAM) Boot Provides Improved Outcomes With Lower Complications Than Short Leg Walking Cast in Low-energy Pediatric Lateral Ankle Injuries: A Prospective, Randomized Study
Authors: Beck Jennifer J. , Kang Victoria , Bennett Abbie , Bloom Summer , Jackson Nicholas J. 
Published: May 2023

Background:Low-energy lateral ankle injuries (Salter-Harris 1 distal fibula, distal fibula avulsion fractures, and radiograph-negative lateral ankle injuries) are common in pediatric patients. Patient-based outcomes for the 2 treatment options, short leg walking cast (CAST) and controlled ankle motion (CAM) boot, are unknown. This study aims to determine differences between 2 treatments of low-energy lateral ankle injuries in pediatric patients.Methods:A prospective, randomized controlled trial comparing the acute outcomes of CAST and CAM treatment for low-energy lateral ankle injuries in pediatric patients was completed. Patients were evaluated in-person at presentation and 4 weeks for ankle range of motion and Oxford foot and ankle score. A novel survey defining patient and parent satisfaction and time away from school/work was also completed. Treatment complications were documented. Patients were called at 8 weeks postinjury to determine other complications and the final time of return to sport. Mixed effects linear regression models evaluated change over time between the 2 treatment groups.Results:After 60 patients were enrolled, 28 patients in the CAST group and 27 patients in the CAM group completed the study. Males comprised 51% (28), with 38 (69%) patients identifying as Hispanic. The patient’s average age was 11.3±2.9 years and the average body mass index was 23.At the 4-week evaluation, the CAM group had improved range of motion, higher satisfaction scores (5.26 CAM vs. 4.25 CAST,P<0.05), similar pain scores (0.32 CAST vs. 0.41 CAM,P=0.75), and lower complications (0.54/patient CAST vs. 0.04/patient CAM,P<0.0001) than the CAST group. Female patients had improved inversion with CAM treatment than males (P<0.05). Patients over age 12 in the CAST group had significantly decreased plantarflexion at week 4 (P=0.002). Improvement in Oxford scores was similar between the CAST and CAM groups between the initial presentation and 4 weeks, except for increased improvement in CAM group Oxford scores for difficulty running and symptoms with walking/walking. At the 8-week evaluation, patients in the CAST group had a higher rate of continued symptoms than the CAM group (15.4% vs. 0%)Conclusions:CAM boot treatment of low-energy lateral ankle injuries in pediatric patients results in improved results and lower complications than CAST treatment.Level of Evidence:Level I —randomized, controlled trial with a statistically significant difference.
A Genetic Variant of FAM46A is Associated With the Development of Adolescent Idiopathic Scoliosis in the Chinese Population
Authors: Min Kaixing , Li Yang , Wu Zhichong , Dai Zhicheng , Feng Zhenhua , Qian Zhuang , Sun Xu , Qiu Yong , Xu LeiLei , Zhu Zezhang 
Published: May 2023

Study Design.
A genetic case-control study.

Objective.
To replicate recently reported genetic loci associated with adolescent idiopathic scoliosis (AIS) in the Chinese Han population, and to determine the relationship between gene expression and the clinical features of the patients.

Summary of Background Data.
A recent study conducted in the Japanese population identified several novel susceptible loci, which might provide new insights into the etiology of AIS. However, the association of these genes with AIS in other populations remains unclear.

Materials and Methods.
A total of 1210 AIS and 2500 healthy controls were recruited for the genotyping of 12 susceptibility loci. Paraspinal muscles used for gene expression analysis were obtained from 36 AIS and 36 patients with congenital scoliosis. The difference regarding genotype and allele frequency between patients and controls was analyzed by χ2 analysis. The t test was performed to compare the target gene expression level between controls and AIS patients. Correlation analysis was performed between gene expression and phenotypic data, including Cobb angle, bone mineral density, lean mass, height, and body mass index.

Results.
Four SNPs, including rs141903557, rs2467146, rs658839, and rs482012, were successfully validated. Allele C of rs141903557, allele A of rs2467146, allele G of rs658839, and allele T of single nucleotide polymorphism rs482012 showed significantly higher frequency in patients. Allele C of rs141903557, allele A of rs2467146, allele G of rs658839, and allele T of rs482012 could notably increase the risk of AIS patients, with an odds ratio of 1.49, 1.16, 1.11, and 1.25, respectively. Moreover, tissue expression of FAM46A was significantly lower in AIS patients as compared with controls. Moreover, FAM46A expression was remarkably correlated with bone mineral density of patients.

Conclusion.
Four SNPs were successfully validated as novel susceptibility loci associated with AIS in the Chinese population. Moreover, FAM46A expression was associated with the phenotype of AIS patients.
Assessing Treatment of Floating Lateral Mass (FLM) Fractures of the Subaxial Cervical Spine
Authors: Prezelski Kayla , Simon Karissa N. , Nwadike Benjamin A. , Place Howard M. 
Published: May 2023

Study design.
Retrospective cohort.

Objective.
The purpose of the study was to evaluate differences across surgical approaches (anterior, posterior, or combined anterior-posterior) in terms of outcomes following treatment for floating lateral mass (FLM) fractures. Furthermore, we sought to determine whether operative approach to FLM fracture treatment remains superior to nonoperative treatment in terms of clinical outcomes.

Background Data.
FLM fractures of the subaxial cervical spine involves separation of the lateral mass from the vertebrae via a disruption of both the lamina and pedicle, resulting in a disconnection of the superior and inferior articular processes. This subset of cervical spine fractures is highly unstable, making proper treatment selection of great importance.

Methods.
In this single-center, retrospective study, we identified patients meeting the definition of an FLM fracture. Radiological imaging from the date of injury was reviewed to ensure presence this injury pattern. Treatment course was assessed to determine nonoperative versus operative treatment. Operative treatment was divided into patients who underwent anterior, posterior, or combined anterior-posterior spinal fusion. We then reviewed postoperative complications among each of the subgroups.

Results.
Forty-five patients were determined to have a FLM fracture over a 10-year span. The nonoperative group had n=25, and evidently, there were no patients that crossed over to surgery due to subluxation of the cervical spine after nonoperative treatment. The operative treatment group had n=20, and consisted of 6 anterior, 12 posterior, and 2 combined approaches. Complications appeared in posterior and combined groups. Two hardware failures were noted in the posterior group, along with two postoperative respiratory complications in the combined group. No complications were observed for the anterior group.

Conclusions.
None of the nonoperative patients in this study required further operation or management of their injury, indicating nonoperative treatment as a potentially satisfactory management for appropriately selected FLM fractures.
Biomechanical Effects of Facet Joint Violation After Single-Level Lumbar Fusion With Transpedicular Screw and Rod Instrumentation
Authors: Wangsawatwong Piyanat , de Andrada Pereira Bernardo , Lehrman Jennifer N. , Sawa Anna G.U. , O’Neill Luke K. , Turner Jay D. , Uribe Juan S. , Kelly Brian P. 
Published: May 2023

Study Design.
In vitro biomechanical study.

Objective.
This study aimed to investigate the biomechanical effects of facet joint violation (FV) on mobility and optically tracked intervertebral disc (IVD) surface strains at the upper level adjacent to L4-5 pedicle screw-rod fixation.

Summary of Background Data.
FV is a complication that can occur when placing lumbar pedicle screws; the reported incidence is as high as 50%. However, little is known about how FV affects superior adjacent-level spinal stability, and especially IVD strain, after lumbar fusion.

Methods.
Fourteen cadaveric L3-S1 specimens underwent L4-5 pedicle-rod fixation, 7 in the facet joint preservation (FP) group and 7 in the FV group. Specimens were tested multidirectionally under pure moment loading (7.5 Nm). Colored maps of maximum (ε1) and minimum (ε2) principal surface strain changes on the lateral L3-4 disc were generated, with the surface divided into 4 quarters anterior to posterior (Q1, Q2, Q3, and Q4, respectively) for subregional analyses. Range of motion (ROM) and IVD strain were normalized to intact upper adjacent-level and compared between the groups using analysis of variance. Statistical significance was set at P<0.05.

Results.
Normalized ROM was significantly greater with FV vs. FP in flexion (11% greater; P=0.04), right lateral bending (16% greater; P=0.03), and right axial rotation (23% greater; P=0.04). Normalized L3-4 IVD ε1 during right lateral bending was greater on average for the FV group than the FP group: Q1, 18% greater; Q2, 12% greater; Q3, 40% greater (P<0.001); Q4, 9% greater. Normalized ε2 values during left axial rotation were greater in the FV group, the highest increase being 25% in Q3 (P=0.02).

Conclusions.
Facet joint violation during single-level pedicle screw-rod fixation was associated with increased superior adjacent level mobility and alteration of disc surface strains, with significant increases in selected regions and directions of loading.
Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion
Authors: Buckland Aaron J. , Proctor Dylan , Thomas J. Alex , Protopsaltis Themistocles S. , Ashayeri Kimberly , Braly Brett A. 
Published: May 2023

Study Design.
Multi-centre retrospective cohort study.

Objective.
To evaluate the feasibility and safety of the single-position prone lateral lumbar interbody fusion (LLIF) technique for revision lumbar fusion surgery.

Background Context.
Prone LLIF (P-LLIF) is a novel technique allowing for placement of a lateral interbody in the prone position and allowing posterior decompression and revision of posterior instrumentation without patient repositioning. This study examines perioperative outcomes and complications of single position P-LLIF against traditional Lateral LLIF (L-LLIF) technique with patient repositioning.

Method.
A multi-centre retrospective cohort study involving patients undergoing 1-4 level LLIF surgery was performed at 4 institutions in the USA and Australia. Patients were included if their surgery was performed via either: P-LLIF with revision posterior fusion; or L-LLIF with repositioning to prone. Demographics, perioperative outcomes, complications, and radiological outcomes were compared using independent samples t-tests and chi-squared analyses as appropriate with significance set at P<0.05.

Results.
101 patients undergoing revision LLIF surgery were included, of which 43 had P-LLIF and 58 had L-LLIF. Age, BMI and CCI were similar between groups. The number of posterior levels fused (2.21 P-LLIF vs. 2.66 L-LLIF, P=0.469) and number of LLIF levels (1.35 vs. 1.39, P=0.668) was similar between groups. Operative time was significantly less in the P-LLIF group (151 vs. 206 min, P=0.004). EBL was similar between groups (150 mL P-LLIF vs. 182 mL L-LLIF, P=0.31) and there was a trend toward reduced length of stay in the P-LLIF group (2.7 vs. 3.3 d, P=0.09). No significant difference was demonstrated in complications between groups. Radiographic analysis demonstrated no significant differences in preoperative or postoperative sagittal alignment measurements.

Conclusion.
P-LLIF significantly improves operative efficiency when compared to L-LLIF for revision lumbar fusion. No increase in complications was demonstrated by P-LLIF or trade-offs in sagittal alignment restoration.

Level of Evidence.
Level IV
Evaluating Public Perceptions of Cosmetic Procedures in the Medical Spa and Physician's Office Settings: A Large-scale Survey
Authors: Gibson Juliet , Greif Charlotte , Nijhawan Rajiv I. 
Published: May 2023

BACKGROUND
Medical spa and cosmetic procedure markets have grown substantially in recent years. The lack of consistent medical oversight at medical spas raises safety concerns.

OBJECTIVE
To understand how the public views medical spas compared with physician's offices as places to receive cosmetic procedures with a focus on safety.

METHODS
1,108 people were surveyed on an internet platform about their perceptions of the safety of receiving cosmetic procedures at medical spas and physician's offices. Respondents were grouped by their past experiences. Chi-squared and analysis of variance models were used to determine statistically significant differences between groups at the 0.05 level.

RESULTS
Respondents who had only received cosmetic procedures at physician's offices or had never received a cosmetic procedure cared more about being treated by a physician (p < .001) and rated safety as more important (p = .03). Total complication rates were numerically higher at medical spas compared with physician's offices (p = .41). Minimally invasive skin tightening (0.77 vs 0.0, p < .001) and nonsurgical fat reduction (0.80 vs 0.36, p = .04) had higher complication rates at medical spas.

CONCLUSION
There were concerns among the public about the safety of cosmetic procedures at medical spas, and some procedures demonstrated higher complication rates in this setting.
A New Powder Dressing for Management of Chronic Venous Ulcers
Authors: Mahmood Barakat Abdelreheem , ElSayed Emad Hussein , Abd Elghany Salah M. , Elnaggar Dina Farouk , Youssef Hoda A. A. , Abdelmaksoud Saber M. 
Published: May 2023

BACKGROUND
A new powder dressing (TPD) is a methacrylate-based powder formulation that transforms in situ into a shape-retentive matrix upon hydration to create optimum moist wound healing conditions. The following randomized, controlled, clinical study aimed to evaluate the role of TPD in the management of chronic venous ulcers (CVU).

METHODS
The randomized controlled prospective study enrolled 60 CVU patients. After randomization, patients in the treatment group (n = 30) were treated with TPD, whereas those in the control group (n = 30) received conventional compression dressing therapy.

RESULTS
After treatment, patients in the TPD group had significantly higher rates of complete ulcer healing at 12 weeks (43.3% vs 10.0%, p = .004) and 24 weeks (86.7% vs 40.0%, p = .001) when compared with conventional dressing group. Moreover, patients in the TP dressing group had significantly shorter time to complete ulcer healing [mean (95% CI): 16.7 (14.1–19.3) versus 37.0 (30.8–43.2) weeks, p = .001]. In addition, patients in the TPD group had significantly fewer number of dressings, less severe pain after dressing, and lower need for systemic analgesics.

CONCLUSION
Use of TPD in management of CVUs was associated with significantly higher healing rates, shorter duration to healing, and lower pain.