bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Impact of Failing to Achieve Ideal Proportional Realignment in Adult Spinal Deformity Patients
Authors: Passias Peter G. , Passfall Lara , Williamson Tyler K. , Schoenfeld Andrew J. , Owusu-Sarpong Stephane , Dhillon Ekamjeet , Krol Oscar , Kummer Nicholas A. , Tretiakov Peter , Imbo Bailey , Joujon-Roche Rachel , Moattari Kevin , Lebovic Jordan , Vira Shaleen , Diebo Bassel , Smith Justin S. , Park Paul , Mummaneni Praveen , Shabani Saman , Chou Dean , Lafage Renaud , Lafage Virginie 
Published: February 2022

Summary of Background Data.
The impact of not achieving ideal realignment in the global alignment and proportion (GAP) score in adult spinal deformity (ASD) correction on clinical outcomes is understudied at present.

Objective.
To identify the clinical impact of failing to achieve GAP proportionality in ASD surgery.

Study Design.
Retrospective cohort.

Methods.
Operative ASD patients with fusion to S1/pelvis and with pre-(BL) and 2-year (2Y) data were included. Patients were assessed for matching their 6-week (6W) age-adjusted alignment goals.1 Patients were stratified by age-adjusted match at 6W postoperatively (Matched) and 6W GAP proportionality (proportioned: GAP-P; moderately disproportioned: GAP-MD; severely disproportioned: GAP-SD). Groups were assessed for differences in demographics, surgical factors, radiographic parameters, and complications occurring by 2Y. Multivariable logistic regression was used to assess independent effects of not achieving GAP proportionality on postoperative outcomes for Matched and Unmatched patients.

Results.
Included: One hundred twenty three ASD patients. At baseline, 39.8% were GAP-SD, and 12.2% GAP-SD at 6W. Of 123 patients, 51.2% (n =63) had more than or equal to one match at 6W. GAP-SD rates did not differ by being Matched or Unmatched (P = 0.945). GAP-SD/Unmatched patients had higher rates of reoperation, implant failure, and PJF by 2Y postop (all P <0.05). Regressions controlling for age at BL, levels fused, and CCI, revealed 6W GAP-SD/Unmatched patients had higher odds of reoperation (OR: 54 [3.2–899.9]; P =0.005), implant failure (OR: 6.9 [1.1–46.1]; P =0.045), and PJF (OR: 30.1 [1.4–662.6]; P =0.031). Compared to GAP-P or GAP-MD patients, GAP-SD/ Matched patients did not have higher rates of reoperation, implant failure, or junctional failure (all P >0.05). The regression results for both Matched and Unmatched cohorts were consistent when proportionality was substituted by the continuous GAP score.

Conclusion.
In ASD patients who meet age-adjusted realignment goals, GAP proportionality does not significantly alter complication rates. However, GAP proportionality remains an important consideration in patients with sub-optimal age- adjusted alignment. In these cases, severe global disproportion is associated with higher rates of reoperation, implant failure, rod fracture, and junctional failure.
Performance of the Modified Adult Spinal Deformity Frailty Index in Preoperative Risk Assessment
Authors: Passias Peter G. , Moattari Kevin , Pierce Katherine E. , Passfall Lara , Krol Oscar , Naessig Sara , Ahmad Waleed , Schoenfeld Andrew J. , Ahmad Salman , Singh Vivek , Joujon-Roche Rachel , Williamson Tyler K. , Imbo Bailey , Tretiakov Peter , Vira Shaleen , Diebo Bassel , Lafage Renaud , Lafage Virginie 
Published: February 2022

Study Design.
Retrospective single-center, consecutively enrolled database of adult spinal deformity (ASD) patients.

Objective.
The aim of this study was to assess the performance of the mASD-FI in predicting clinical and patient-reported outcomes after ASD-corrective surgery.

Summary of Background Data.
The recently described modified Adult Spinal Deformity frailty index (mASD-FI) quantifies frailty of ASD patients, but the utility of this clinical prediction tool as a means of prognosticating postoperative outcomes has not been investigated.

Methods.
ASD patients with available mASD-FI scores and HRQL data at presentation and 2-years postop were included.
Patients were stratified by mASD-FI score using published cutoffs: not frail (NF <7), frail (F, 7–12), severely frail (SF, >12). Analysis of vaiance assessed differences in patient factors across frailty groups. Linear regression assessed the relationship of mASD-FI with length of stay (LOS) and HRQLs. Multivariable logistic regression revealed how frailty category predicted odds of complications, infections and reoperation.

Results.
A total of 509 patients included (59 years, 79%F, 27.7 kg/m2). The cohort presented with moderate baseline deformity: sagittal vertical axis (83.7 mm ± 71), PT (12.7° ± 10.8°), PI-LL (43.1° ± 21.1°). Mean preoperative mASD-FI score was 7.2, frailty category: NF (50.3%), F (34.0%), SF (15.7%).
Age, BMI, and Charlson Comorbidity Index increased with frailty categories (all P < 0.001); however, fusion length (P = 0.247) and osteotomy rate (P = 0.731) did not. At baseline, increasing frailty was associated with inferior Oswestry Disability Index (ODI), EuroQol 5-Dimension Questionnaire (EQ-5D), SRS-22r, Pain Catastrophizing Scale, and NRS Back and Leg (all P < 0.001). Greater frailty was associated with increased LOS and reduced postoperative HRQL. Controlling for complication incidence, baseline mASD-FI predicted 2 year postop scores for year ODI (b = 0.7, 0.58–0.8, P < 0.001) SRS (b = −0.023, −0.03 to −0.02, P < 0.001), EQ-5D (b = −0.003, −0.004 to −0.002, P < 0.001). F and SF were associated with greater odds of unplanned revision surgery and complications.

Conclusion.
Higher preoperative mASD-FI score was associated with significantly greater complications, higher rate of unplanned reoperations and lower postoperative HRQL in this investigation. The mASD-FI provides similar prognostic utility while reducing burden for surgeons and patients.
Breast and Cervical Cancer Screening Disparities in Transgender People
Authors: Oladeru Oluwadamilola T. , Ma Sung Jun , Miccio Joseph A. , Wang Katy , Attwood Kristopher , Singh Anurag K. , Haas-Kogan Daphne A. , Neira Paula M. 
Published: February 2022

Objectives:
The population of individuals who identify as transgender (TG) is increasing in the United States, yet disparities in cancer screening services are widening. It is imperative that interpersonal and systemic barriers to cancer care are identified and removed for this vulnerable population. Our study sought to examine the difference in self-reported breast and cervical cancer screening rates between TG and cisgender (CG) people.

Materials and Methods:
Cross-sectional data from the 2014 to 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) was obtained on individuals who identified as CG or TG (male-to-female [MTF] and female-to-male [FTM]), including their responses to questions regarding breast and cervical screening history and their primary care access and associated barriers.

Results:
Compared with the CG population, TG participants were less likely to adhere to or have undergone breast (FTM: odds ratio [OR] 0.47 and 0.32; MTF: OR 0.04 and 0.02, respectively; all P<0.001) and cervical cancer (FTM: OR 0.42 and 0.26, respectively; all P<0.001) screening. They were also less likely to have a primary care physician (FTM: OR 0.79; MTF: OR 0.58; all P<0.001) and less likely to seek primary care within a year owing to medical costs (FTM: OR 1.44; MTF: OR 1.36; all P<0.001).

Conclusions:
Disparities exist in the uptake of routine cancer screening in the TG population despite their increased risk for breast and cervical cancer. Interventions are urgently needed to mitigate delays to cancer screening, close gaps in provider and patient knowledge about cancer screening, and improve health care experiences of gender minorities in the United States.
The Use of Person-Centered Language in Scientific Research Articles Focused on Autism
Authors: Arnhart Chelsea , Neale Monika , Collins Claire , Chesher Tessa , Coffey Sara , Rogers T. Calli , Ottwell Ryan , Hartwell Micah 
Published: February 2022

ABSTRACT:

Objective:
Individuals with developmental conditions, such as autism, experience stigma, which is reflected in derogatory language and labels. To limit stigma associated with disabilities, government agencies and medical organizations have adopted the use of person-centered language (PCL). This study investigated adherence to PCL guidelines among peer-reviewed research publications focused on autism. In addition, we investigated the co-occurrence of stigmatizing language in articles using person-first language (PFL) and identity-first language (IFL) styles.

Methods:
We performed a systematic search of PubMed for autism-focused articles from January 2019 to May 2020. Articles from journals with more than 20 search returns were included, and a random sample of 700 publications were screened and examined for inclusion of prespecified, non-PCL terminology.

Results:
Of the 315 publications, 156 (49.5%) were PCL compliant. Articles frequently used PCL and non-PCL terminology concomitantly, and 10% of publications included obsolete nomenclature. A logistic regression model showed the odds were more likely that publications using IFL were more likely to include other stigmatizing terminology than publications using PFL (odds ratio = 2.03, 95% confidence interval: 1.15–3.58).

Conclusion:
Within medical research, the language to describe individuals and populations needs to be used with intentionality and acknowledges that individuals are more than the diagnosis under study. This may reduce the structural stigma that may be implied otherwise. Our study showed that when PFL is used when addressing individuals with autism, other more stigmatizing language is often avoided and is in line with medical education and clinical practice.
Investigation of Radionuclide Migration at Sites Adjacent to the 30-km Exclusion Zone of the Chernobyl Nuclear Power Plant
Authors: Zheltonozhskyi V. A. , Zheltonozhskaya M. V. , Myznikov D. E. , Bondarkov M. D. , Farfán E. B. 
Published: February 2022

Abstract
This paper reports the study of the vertical migration of radionuclides in soils at test sites adjacent to the 30-km Chernobyl Exclusion Zone. The results of this effort demonstrate that the migration processes for studied pollution occur similarly to the fuel fallout behavior at the vicinity of the Chernobyl Nuclear Power Plant (ChNPP) Unit 4. It was also observed that the main fallout component, 137Cs, originated from aerosol fallout and was bound in the surface layer. The authors determined a significant increase of 60Co, 94Nb, and 241Am radionuclide concentrations in soils near the ChNPP Unit 4 and suggested their appearance due to the installation of the New Safe Confinement. Niobium-94 activity is proposed as a marker for monitoring the “fresh” fallout in the Chernobyl Exclusion Zone.
UTILIZATION OF PREOPERATIVE MIDPERIPHERAL OPTICAL COHERENCE TOMOGRAPHY FOR TAILORED SURGICAL MANAGEMENT OF PROLIFERATIVE VITREORETINOPATHY
Authors: Pollmann André S. , Mishra Amit V. , Choudhry Netan , Gupta R. Rishi 
Published: February 2022

Purpose:
The purpose of this study was to report on the use of preoperative spectral domain optical coherence tomography to assess retinal pathology and guide the surgical approach to proliferative vitreoretinopathy.

Methods:
A case report was discussed.

Results:
A 70-year-old man developed proliferative vitreoretinopathy after surgical repair of a macula-off rhegmatogenous retinal detachment. In preparation for further surgery, inferior preretinal fibrosis and membranes were identified on preoperative optical coherence tomography. The patient underwent successful vitrectomy with peeling of the membranes resulting in markedly improved visual acuity.

Conclusion:
Widely available spectral domain optical coherence tomography can be used preoperatively to image the midperipheral retina and guide surgical decision-making in the management of proliferative vitreoretinopathy.
Cervical Cancer Among Women With HIV in South Carolina During the Era of Effective Antiretroviral Therapy
Authors: Nissim Oriel , Dees Aariel , Cooper S. Lewis , Patel Khilen , Lazenby Gweneth B. 
Published: February 2022

Objectives
We aimed to determine whether women with HIV (WWH) and cervical cancer were more likely to experience cancer-related death and to be diagnosed with cervical cancer at a younger age and in more advanced stages.

Materials and Methods
This is a retrospective cohort study of all women diagnosed with cervical cancer in South Carolina from 1998 to 2018. Deidentified data were obtained from 2 statewide databases. A survival analysis was performed to evaluate differences in cancer survival between women with and without HIV. Wilcoxon rank sum test was used to determine differences in the median age at cancer diagnosis. χ2 test was used to assess differences in cancer stage according to HIV status.

Results
Four thousand three hundred fourteen women were diagnosed with cervical cancer, and 53 (1.2%) had HIV infection. Survival time in months was similar between WWH and HIV-negative women (86 months [interquartile range {IQR} = 32–146] and 62 months [IQR = 18–153], p = .37; log-rank p = .26). Compared with HIV-negative women, WWH were less likely to experience cervical cancer–related death (36% vs. 19%, p = .005). Women with HIV were diagnosed with cervical cancer at a younger age (44 [IQR = 37–54] vs. 49 [IQR = 39–61], p = .02). Cervical cancer stage was similar at diagnosis between groups (tumor node metastasis stage, p = .97, and Surveillance, Epidemiology, and End Results summary stage, p = .41).

Conclusions
Women with HIV were younger at diagnosis than HIV-negative women, but they were no more likely to die from or have more advanced cervical cancer. Women with HIV were not more likely to develop cervical cancer before the age of 21 years and earlier screening is likely unnecessary.
Influenza: clinical aspects, diagnosis, and treatment
Authors: Sukhdeo Sharon , Lee Nelson 
Published: February 2022

Purpose of review
To review the clinico-epidemiological aspects of influenza in the context of the Coronavirus Disease 2019 (COVID-19) pandemic; the recent advances in point-of-care molecular diagnostics and co-detection of influenza and coronaviruses, and the development of new influenza therapeutics.

Recent findings
Rates of influenza have declined globally since the 2020–2021 season; waning population immunity and uncertainty in vaccine strains could pose a risk in its significant resurgence, especially where pandemic public health interventions start being lifted. As symptoms are similar for influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, accurate, rapid diagnostics are needed to guide management. In addition to neuraminidase inhibitors, newer class of antivirals including polymerase inhibitors show promise in treating influenza infections in adults, children, and high-risk individuals.

Summary
This review summarizes the most recent data on rapid molecular diagnostics, including point-of-care tests and co-detection of influenza and SARS-CoV-2 viruses. The implications to inform clinical and infection control practices, and detection of antiviral resistance are discussed. The latest clinical trial data on neuraminidase inhibitors and polymerase inhibitors, their efficacy, limitations, and resistance concerns are reviewed.
The role of social media in promoting vaccine hesitancy
Authors: Clark Shannon E. , Bledsoe Megan C. , Harrison Christopher J. 
Published: February 2022

Purpose of review
To offer: (1) Insight into the antivaccine movement's use of social media negatively impacting vaccine hesitancy and disease outbreaks, (2) Examples via case observations, and (3) Selected resources to combat vaccine hesitancy.

Recent findings
For the past 25 years, daily social media usage has risen continually, allowing information to spread widely to a reading/listening/viewing audience via mostly unvetted social media sites. During a pandemic/epidemic (e.g., coronavirus disease 2019 pandemic), an overabundance of information from many sources, including social media, has led to what is now termed as an ’infodemic’. Infodemics arise from overwhelming amounts of both correct and incorrect information from experts and nonexperts alike. Differentiating correct from incorrect information is difficult for social media users who can be swayed by nonscientific ’influencers’ or fear-mongering more than by vetted expert scientific information. Consequently, vaccine misinformation is steadily increasing via social media, the use of which is often believed to be associated with vaccine hesitancy. Stopping the spread of misinformation has been a difficult task.

Summary
Vaccine misinformation on social media has been detrimental to public health. Vaccine advocates must increase the use of social media to the advantage of public health in the persistent struggle against vaccine hesitancy/refusal.
Toward greater nuance in delayed cord clamping
Authors: Marrs Laura , Niermeyer Susan 
Published: February 2022

Purpose of review
For over a decade, the International Liaison Committee on Resuscitation has recommended delayed cord clamping (DCC), but implementation has been variable due to lack of consensus on details of technique and concerns for risks in certain patient populations. This review summarizes recent literature on the benefits and risks of DCC in term and preterm infants and examines alternative approaches such as physiologic-based cord clamping or intact cord resuscitation (ICR) and umbilical cord milking (UCM).

Recent findings
DCC improves hemoglobin/hematocrit among term infants and may promote improved neurodevelopment. In preterms, DCC improves survival compared to early cord clamping; however, UCM has been associated with severe intraventricular hemorrhage in extremely preterm infants. Infants of COVID-19 positive mothers, growth-restricted babies, multiples, and some infants with cardiopulmonary anomalies can also benefit from DCC. Large randomized trials of ICR will clarify safety and benefits in nonvigorous neonates. These have the potential to dramatically change the sequence of events during neonatal resuscitation.

Summary
Umbilical cord management has moved beyond simple time-based comparisons to nuances of technique and application in vulnerable sub-populations. Ongoing research highlights the importance of an individualized approach that recognizes the physiologic equilibrium when ventilation is established before cord clamping.
IgA vasculitis nephritis
Authors: Nüsken Eva , Weber Lutz T. 
Published: February 2022

Purpose of review
The purpose of this update is to summarize current knowledge on the pathophysiology of immunglobulin A (IgA) vasculitis nephritis (IgAVN) as well as to critically review evidence for established therapeutic regimes and available biomarkers. An additional purpose is to raise the discussion what could be done to further improve our understanding of IgAVN, identify patients at risk for adverse outcome and increase the evidence for therapy recommendations.

Recent findings
Clinical and experimental studies have established the concept of a multilevel pathogenesis. Toll-like-receptor activation, B cell proliferation, micro-RNAs and complement activation have been identified or confirmed as potential therapeutic targets which can modify the course of the disease. Currently, kidney injury molecule-1, monocyte chemotactic protein-1, N-acetyl-β-glucosaminidase, and angiotensinogen are the most promising urinary biomarkers for early diagnosis of renal involvement in IgA vasculitis.

Summary
Close surveillance of all IgAV patients for renal involvement is recommended. Given the multilevel pathogenesis, early treatment of even mild cases should be initiated. Further therapeutic options should be considered in case first-line therapy (mostly corticosteroids) has no effect. The evidence supporting current therapeutic regimes is predominantly based on expert opinion. Prospective studies are needed and should involve substances inhibiting B cell proliferation and complement activation.
Derivation of the Pediatric Acute Gastroenteritis Risk Score to Predict Moderate‐to‐Severe Acute Gastroenteritis
Authors: Levine Adam C. , O'Connell Karen J. , Schnadower David , VanBuren T. John M. , Mahajan Prashant , Hurley Katrina F. , Tarr Phillip , Olsen Cody S. , Poonai Naveen , Schuh Suzanne , Powell Elizabeth C. , Farion Ken J. , Sapien Robert E. , Roskind Cindy G. , Rogers Alexander J. , Bhatt Seema , Gouin Serge , Vance Cheryl , Freedman Stephen B. ,   Pediatric Emergency Research Canada (PERC) the Pediatric Emergency Care Applied Research Network (PECARN)
Published: February 2022

ABSTRACTObjectives:Although most acute gastroenteritis (AGE) episodes in children rapidly self‐resolve, some children go on to experience more significant and prolonged illness. We sought to develop a prognostic score to identify children at risk of experiencing moderate‐to‐severe disease after an index emergency department (ED) visit.Methods:Data were collected from a cohort of children 3 to 48 months of age diagnosed with AGE in 16 North American pediatric EDs. Moderate‐to‐severe AGE was defined as a Modified Vesikari Scale (MVS) score ≥9 during the 14‐day post‐ED visit. A clinical prognostic model was derived using multivariable logistic regression and converted into a simple risk score. The model's accuracy was assessed for moderate‐to‐severe AGE and several secondary outcomes.Results:After their index ED visit, 19% (336/1770) of participants developed moderate‐to‐severe AGE. Patient age, number of vomiting episodes, dehydration status, prior ED visits, and intravenous rehydration were associated with MVS ≥9 in multivariable regression. Calibration of the prognostic model was strong with a P value of 0.77 by the Hosmer‐Lemenshow goodness‐of‐fit test, and discrimination was moderate with an area under the receiver operator characteristic curve of 0.68 (95% confidence interval [CI] 0.65–0.72). Similarly, the model was shown to have good calibration when fit to the secondary outcomes of subsequent ED revisit, intravenous rehydration, or hospitalization within 72 hours after the index visit.Conclusions:After external validation, this new risk score may provide clinicians with accurate prognostic insight into the likely disease course of children with AGE, informing disposition decisions, anticipatory guidance, and follow‐up care.