bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gen Z GSAs: Trans-Affirming and Racially Inclusive Gender-Sexuality Alliances in Secondary Schools
Authors: Adelman Madelaine , Nonnenmacher Sean , Borman Bailey , Kosciw Joseph G. 
Published: September 2022

Background: Within the context of high school student clubs, the acronym “GSA” originally stood for “Gay-Straight Alliance.” It described gay and straight youth working as allies to learn about themselves and each other’s lives and to navigate and address interpersonal and institutional anti-LGBTQ school policies and practices. Today, the acronym is commonly parsed by Gen Z members as “Gender-Sexuality Alliance” to better represent the presence and needs of transgender, nonbinary, and gender-nonconforming students, and their cisgender allies. Purpose of Study: We inquire how students learn about themselves and others—partially, unevenly, and, at times, uneasily—as they incorporate socially resistant gender and race identity work within their GSA school clubs. Participants: Participants were cisgender ( n = 10) and transgender and nonbinary ( n = 10), racially diverse high school students in GSAs between 14 and 18 years of age. Research Design: Our analysis is grounded in critical pragmatism, a methodological integration of critical theory and pragmatism, which stems from reflexive immersion in the research context and use of empirical inquiry as a tool to acknowledge and guide transformation of entrenched anti-trans oppression in schools, noting that racism, among other forms of structural inequality, is built into schools. We analyzed the interview component of a larger mixed-methods research study conducted by the GLSEN Research Institute, which was intended to generate insight about student and advisor experiences of GSAs. Findings: Our study reveals that while GSAs can be a space for marginalized LGBTQ students to create a collective empowering identity, they can also be a space where some differences may be flattened or left out. We explore how students make visible racial and gender identity groups during GSA activities that are often erased in secondary schools. This implicitly and explicitly entails deploying identity as a challenge to a school’s heteronormative, cisnormative, and white-dominant official curriculum, although the depth or complexity of a GSA’s visibility-based education and critique may be inadequate, given available resources. Our findings demonstrate how GSA students leverage their identity as a goal when mobilizing themselves and their peers to alter a school’s norms and practices. Conclusions: Gen Z GSA students have begun to reimagine their clubs as if they were built from the ground up, with the needs of transgender students and students of color placed at their center. GSAs remain a critical but underdeveloped resource for learning how to recognize and challenge intersectional forms of interpersonal and institutional marginalization.
Orbital myositis and scleritis after anti-SARS-CoV-2 mRNA vaccines: A report of three cases
Authors: Savino Gustavo , Gambini Gloria , Scorcia Giovanni , Comi Nicolino , Fossataro Claudia , Stanislao Rizzo  
Published: September 2022

Purpose To report three cases of ocular myositis and scleritis, bilateral scleritis and unilateral single muscle myositis after mRNA COVID-19 vaccination. Methods Case series of three patients who presented to the Orbit Outpatient Service of Fondazione Policlinico Universitario A. Gemelli with a history of unilateral proptosis, diplopia and pain, bilateral red eye and pain during eye movements and unilateral proptosis and inconstant diplopia respectively with onset 5–10 days after m-RNA COVID-19 vaccine. A thorough hematologic work up and orbital contrast enhanced magnetic resonance imaging (MRI) in patients with proptosis was performed. Results Patients were females, 64, 58 and 45 years old respectively. MRI showed enlargement of all right rectus muscles, with both muscle belly and insertion involvement in the first case associated to right scleritis. A bilateral scleritis was diagnosed in the second patient and a single muscle myositis in the third patient. Serological tests excluded thyroid diseases. The first and second patient were treated respectively with oral and topical glucorticoids with a complete clinical response. Two 2 cycles of oral non-steroidal anti-inflammatory drugs were administered to the third patient with a partial response. Conclusion As far as we know these are the first report of orbital myositis and scleritis presenting after mRNA BNT162b2 vaccine (Pfizer/BioNTech) and mRNA-1273-(Moderna) vaccine, an uncommon effect of a likely autoimmune reaction triggered by the virus antigen.
Acute macular neuroretinopathy in a patient with birdshot chorioretinopathy after intravitreal triamcinolone suspension injection
Authors: Maleki Arash , Fernandez Carla C , Philip Andrew M , Manhapra Ambika , Chang Peter Y , Foster C Stephen 
Published: September 2022

Purpose To report a case of acute macular neuroretinopathy (AMN) after intravitreal triamcinolone acetonide (TRIESENCE®) injection for cystoid macular edema secondary to birdshot chorioretinopathy. Method A case report. Patient A 62-year-old female. Results The patient presented with acutely decreased vision and a ring scotoma around her central vision three days after intravitreal triamcinolone acetonide (TRIESENCE®) injection for cystoid macular edema in her right eye (OD) secondary to birdshot chorioretinopathy. She had undergone pars plana vitrectomy, cataract extraction, and secondary intraocular lens implantation OD three months prior to the recent injection. Best-corrected visual acuity (BCVA) was 20/1000 OD and 20/50 OS. Intraocular pressure was 21 mmHg OD and 12 mmHg OS. Fluorescein angiography demonstrated a hypofluorescent area in the perifoveal zone OD. Optical coherence tomography OD depicted hyperreflective areas in the outer nuclear layer, outer plexiform layer, and retinal pigment epithelium. We diagnosed her with AMN OD and started her on brimonidine three times a day OD. She came back a week later with resolved scotoma and her vision improved to 20/60 OD. Five weeks later, BCVA was 20/40 and Intraocular pressures (IOP) was 12 mmHg OD. Conclusions and importance Intravitreal triamcinolone injection may be a cause of AMN with cystoid macular edema (CME) and borderline-high intraocular pressure. Brimonidine may be an effective treatment for these patients in the early course of the disease.
Influence of inflammatory plasma biomarkers on choroidal thickness in type 2 diabetes mellitus
Authors: Bartol-Puyal Francisco de Asís , Isanta Carlos , Verdes Guayente , Ruiz-Moreno Óscar , Calvo Pilar , Pablo Luis 
Published: September 2022

Purpose To assess the influence of inflammatory plasma biomarkers on choroidal thickness (CT) in patients with type 2 diabetes (T2D). Methods Cross-sectional study enrolling T2D patients and age-matched healthy controls (>55 years of age, Caucasian, axial length <26 mm, no macular edema, and naïve). Patients were examined with swept-source OCT Triton, obtaining automatic measurements. CT was analyzed using the ETDRS grid and the recently proposed choroidal division. A blood analysis was commanded: general biochemical profile, liver status, T2D status, thyroid and parathyroid activity, coagulation, general immunological profile, and inflammatory biomarkers. Results 124 eyes of 124 patients with a mean age between 66 and 68 years were examined. The new choroidal division showed differences between groups (p < 0.05) in more sectors than the ETDRS grid, and more biomarkers influenced these new sectors. T2D patients had higher levels of IL-8, TNF-α, MCP1, adiponectin and L-selectin. CT was influenced by TNF-α, IL-17, leukocytes and erythrocyte sedimentation rate, as well as by HDL cholesterol, albumin, liver function biomarkers, and TSH. HbA1c showed little influence on CT. Conclusions T2D patients present increased plasma inflammatory biomarkers, exhibiting an influence on CT. IL-17 is related to a thicker choroid but TNF-α is related to a thinner choroid. HbA1c has little influence on CT. The recently proposed choroidal division is more sensitive to CT changes than the ETDRS grid. Some sectors are more sensitive to plasma biomarkers.
CAD/CAM nitinol bonded retainer versus a chairside rectangular-chain bonded retainer: A multicentre randomised controlled trial
Authors: Jowett Adam C , Littlewood Simon J , Hodge Trevor M , Dhaliwal Harmeet K , Wu Jianhua 
Published: September 2022

Background: Bonded retainers are widely used to maintain the positions of anterior teeth after orthodontic treatment. Various types of bonded retainer exist however, there is a lack of evidence to indicate which type is superior. Aim: To compare upper and lower CAD/CAM nitinol bonded retainers (Memotain®) with upper and lower chairside rectangular-chain bonded retainers (Ortho-FlexTech™), in terms of stability, retainer failures and patient satisfaction. Trial design: Multi-centre, two-arm, parallel-group, randomised controlled clinical trial with 1:1 allocation. Setting: Three trial centres: University Teaching Hospital; District General Hospital; and Specialist Orthodontic Practice. All treatment was provided free as part of a state-funded healthcare system. Materials and methods: A total of 68 patients were randomly allocated to receive either upper and lower Memotain® bonded retainers or upper and lower Ortho-FlexTech™ bonded retainers. Ten trained operators placed and reviewed the bonded retainers. Measurements were carried out on study models taken at debond and after six months. Patient satisfaction questionnaires were completed at six months following debond. Results: The trial was terminated due to the high number of failures (50%) of the upper Memotain® retainers within six months. Memotain® retainers were three times more likely to fail (unadjusted hazard ratio = 2.82, 95% confidence interval = 1.00-7.99) than Ortho-FlexTech™ retainers at six months in the upper arch. Patients were satisfied with both types of retainer. Limitations: Early termination of the trial means that the a priori sample size was not reached, so outcomes should be interpreted with caution. Conclusion: The trial was terminated early due to the high failure rate of upper Memotain® bonded retainers. They had a higher risk of failure in the maxillary arch when compared to upper Ortho-FlexTech™ bonded retainers after six months.
Work difficulties in people with multiple sclerosis: The role of anxiety, depression and coping
Authors: van Egmond EEA , van der Hiele K , van Gorp DAM , Jongen PJ , van der Klink JJL , Reneman MF , Beenakker EAC , van Eijk JJJ , Frequin STFM , de Gans K , van Geel BM , Gerlach OHH , Hengstman GJD , Mostert JP , Verhagen WIM , Middelkoop HAM , Visser LH 
Published: September 2022

Background Symptoms of anxiety and depression affect the daily life of people with multiple sclerosis (MS). This study examined work difficulties and their relationship with anxiety, depression and coping style in people with MS. Methods 219 employed people with MS (median age  =  43 years, 79% female) completed questionnaires on anxiety, depression, coping style, demographics and work difficulties, and underwent a neurological examination. Two regression analyses were performed with work difficulties as the dependent variable and either anxiety or depression as continuous independent variables. Coping style, age, gender, educational level, MS-related disability and disease duration were added as additional predictors, as well as interaction terms between coping style and either symptoms of depression or anxiety. Results A significant model was found ( F(10,205)  =  13.14, p < 0.001, R2  =  0.39) in which anxiety, emotion- and avoidance-oriented coping and MS-related disability were positively related to work difficulties. The analysis of depression resulted in a significant model ( F(10,205)  =  14.98, p < 0.001, R2  =  0.42) in which depression, emotion- and avoidance-oriented coping and MS-related disability were positively related to work difficulties. None of the interaction effects were significant. Conclusions Work difficulties were positively related to anxiety, depression, emotion- and avoidance-oriented coping and MS-related disability in workers with MS.
Cycling and activated CD8+ T lymphocytes and their association with disease severity in influenza patients
Authors: Liu Shuai , Huang Zhisheng , Fan Ruyue , Jia Ju , Deng Xiaoyan , Zou Xiaohui , Li Hui , Cao Bin 
Published: September 2022

Abstract
Background
T cell lymphopenia was a significant characteristic of severe influenza infection and it was associated with the functional changes of T cells. It is necessary to clarify the T cells characteristics of kinetic changes and their correlation with disease severity.

Methods
In a cohort of hospitalized influenza patients with varying degrees of severity, we characterized lymphocyte populations using flow cytometry.

Results
The numbers of cycling (Ki67+) T cells at the acute phase of severe influenza were higher, especially in the memory (CD45RO+) T cell subsets. T cells from hospitalized influenza patients also had significantly higher levels of the exhausted marker PD-1. Cycling status of T cells was associated with T cell activation during the acute phase of influenza infection. The recruitment of cycling and activated (CD38+HLA-DR+) CD8+ T cells subset is delayed in severe influenza patients.

Conclusions
The increased numbers of cycling memory (Ki67+CD45RO+) T cells subsets and delayed kinetics of activated (CD38+HLA-DR+) CD8+ T cells, could serve as possible biological markers for disease severity.
Small-scale spatiotemporal epidemiology of notifiable infectious diseases in China: a systematic review
Authors: Zheng Junyao , Shen Guoquan , Hu Siqi , Han Xinxin , Zhu Siyu , Liu Jinlin , He Rongxin , Zhang Ning , Hsieh Chih-Wei , Xue Hao , Zhang Bo , Shen Yue , Mao Ying , Zhu Bin 
Published: September 2022

Abstract
Background
The prevalence of infectious diseases remains one of the major challenges faced by the Chinese health sector. Policymakers have a tremendous interest in investigating the spatiotemporal epidemiology of infectious diseases. We aimed to review the small-scale (city level, county level, or below) spatiotemporal epidemiology of notifiable infectious diseases in China through a systematic review, thus summarizing the evidence to facilitate more effective prevention and control of the diseases.

Methods
We searched four English language databases (PubMed, EMBASE, Cochrane Library, and Web of Science) and three Chinese databases (CNKI, WanFang, and SinoMed), for studies published between January 1, 2004 (the year in which China’s Internet-based disease reporting system was established) and December 31, 2021. Eligible works were small-scale spatial or spatiotemporal studies focusing on at least one notifiable infectious disease, with the entire territory of mainland China as the study area. Two independent reviewers completed the review process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results
A total of 18,195 articles were identified, with 71 eligible for inclusion, focusing on 22 diseases. Thirty-one studies (43.66%) were analyzed using city-level data, 34 (47.89%) were analyzed using county-level data, and six (8.45%) used community or individual data. Approximately four-fifths (80.28%) of the studies visualized incidence using rate maps. Of these, 76.06% employed various spatial clustering methods to explore the spatial variations in the burden, with Moran’s I statistic being the most common. Of the studies, 40.85% explored risk factors, in which the geographically weighted regression model was the most commonly used method. Climate, socioeconomic factors, and population density were the three most considered factors.

Conclusions
Small-scale spatiotemporal epidemiology has been applied in studies on notifiable infectious diseases in China, involving spatiotemporal distribution and risk factors. Health authorities should improve prevention strategies and clarify the direction of future work in the field of infectious disease research in China.
Improved maternal–fetal outcomes among emergency obstetric referrals following phone call communication at a teaching hospital in south western Uganda: a quasi-experimental study
Authors: Kanyesigye Hamson , Kabakyenga Jerome , Mulogo Edgar , Fajardo Yarine , Atwine Daniel , MacDonald Noni E. , Bortolussi Robert , Migisha Richard , Ngonzi Joseph 
Published: September 2022

Abstract
Background
Emergency obstetric referrals develop adverse maternal–fetal outcomes partly due to delays in offering appropriate care at referral hospitals especially in resource limited settings. Referral hospitals do not get prior communication of incoming referrals leading to inadequate preparedness and delays of care. Phone based innovations may bridge such communication challenges.
We investigated effect of a phone call communication prior to referral of mothers in labour as intervention to reduce preparation delays and improve maternal–fetal outcome at a referral hospital in a resource limited setting.

Methods
This was a quasi-experimental study with non-equivalent control group conducted at Mbarara Regional Referral Hospital (MRRH) in South Western Uganda from September 2020 to March 2021. Adverse maternal–fetal outcomes included: early neonatal death, fresh still birth, obstructed labour, ruptured uterus, maternal sepsis, low Apgar score, admission to neonatal ICU and hysterectomy. Exposure variable for intervention group was a phone call prior maternal referral from a lower health facility. We compared distribution of clinical characteristics and adverse maternal–fetal outcomes between intervention and control groups using Chi square or Fisher’s exact test. We performed logistic regression to assess association between independent variables and adverse maternal–fetal outcomes.

Results
We enrolled 177 participants: 75 in intervention group and 102 in control group. Participants had similar demographic characteristics. Three quarters (75.0%) of participants in control group delayed on admission waiting bench of MRRH compared to (40.0%) in intervention group [p =  < 0.001]. There were significantly more adverse maternal–fetal outcomes in control group than intervention group (obstructed labour [p = 0.026], low Apgar score [p = 0.013] and admission to neonatal high dependency unit [p =  < 0.001]). The phone call intervention was protective against adverse maternal–fetal outcome [aOR = 0.22; 95%CI: 0.09—0.44, p = 0.001].

Conclusion
The phone call intervention resulted in reduced delay to patient admission at a tertiary referral hospital in a resource limited setting, and is protective against adverse maternal–fetal outcomes. Incorporating the phone call communication intervention in the routine practice of emergency obstetric referrals from lower health facilities to regional referral hospitals may reduce both maternal and fetal morbidities.

Trial registration
Pan African Clinical Trial Registry PACTR20200686885039.
Integration of clinical and transcriptomics reveals programming of the lipid metabolism in gastric cancer
Authors: Li Yanyan , Zhao Jungang , Chen Renpin , Chen Shengwei , Xu Yilun , Cai Weiyang 
Published: September 2022

AbstractLipid metabolism has a profound impact on gastric cancer (GC) progression and is a newly targetable vulnerability for cancer therapy. Given the importance of lipids in cancer cellular processes, in this study we employed lipidomic clinical and transcriptomic data to connect the variations of lipid metabolism changes of GC. We constructed a clinical nomogram based on the lipid factors and other clinical items. Then by using multi-omics techniques, we established a lipid-related gene signature for individualized prognosis prediction in patients with GC. Moreover, a total of 1357 GC cases were then applied to evaluate the robustness of this model. WGCNA was used to identify co-expression modules and enriched genes associated with GC lipid metabolism. The role of key genes ACLY in GC was further investigated. The prognostic value of the lipgenesis signature was analyzed using Cox regression model, and clinical nomogram was established. Among them, we observed overexpression of ACLY significantly increased the levels of intracellular free fatty acid and triglyceride, and activated AKT/mTOR pathway to promote cancer development. In conclusion, our findings revealed that GC exhibited a reprogramming of lipid metabolism in association with an altered expression of associated genes. Among them, ACLY significantly promoted GC lipid metabolism and increased cancer cell proliferation, suggesting that this pathway can be targetable as a metabolic vulnerability in future GC therapy.
Incidence of invasive pneumococcal disease in children with commercial insurance or Medicaid coverage in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998–2018
Authors: Hu Tianyan , Song Yan , Done Nicolae , Liu Qing , Sarpong Eric M. , Lemus-Wirtz Esteban , Signorovitch James , Mohanty Salini , Weiss Thomas 
Published: September 2022

Abstract
Background
Invasive pneumococcal disease (IPD) is a major cause of pediatric morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) were introduced in the US in 2000 (PCV7) and 2010 (PCV13). This study estimated the annual incidence rates (IRs) and time trends of IPD to quantify the burden of disease in children before and after the introduction of PCV7 and PCV13 in the US.

Methods
IPD episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using claims with International Classification of Diseases 9/10th Revision, Clinical Modification codes. Annual IRs were calculated as the number of IPD episodes/100,000 person-years (PYs) for children < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual IPD IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were conducted to assess immediate and gradual changes in IPD IRs before and after introduction of PCV7 and PCV13.

Results
In commercially insured children, IPD IRs decreased from 9.4 to 2.8 episodes/100,000 PY between the pre-PCV7 (1998–1999) and late PCV13 period (2014–2018) overall, and from 65.6 to 11.6 episodes/100,000 PY in children < 2 years. In the Medicaid population, IPD IRs decreased from 11.3 to 4.2 episodes/100,000 PY between the early PCV7 (2001–2005) and late PCV13 period overall, and from 42.6 to 12.8 episodes/100,000 PY in children < 2 years. The trends of IRs for meningitis, bacteremia, and bacteremic pneumonia followed the patterns of overall IPD episodes. The ITS analyses indicated significant decreases in the early PCV7 period, increases in the late PCV7 and decreases in the early PCV13 period in commercially insured children overall. However, increases were also observed in the late PCV13 period in children < 2 years. The percentage of cases with underlying risk factors increased in both populations.

Conclusions
IRs of IPD decreased from 1998 to 2018, following introduction of PCV7 and PCV13, with larger declines during the early PCV7 and early PCV13 periods, and among younger children. However, the residual burden of IPD remains substantial. The impact of future PCVs on IPD IRs will depend on the proportion of vaccine-type serotypes and vaccine effectiveness in children with underlying conditions.