bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Pediatric Orthopaedic Fellowship Interviews During the Pandemic: What Did the Applicants and Programs Think?
Authors: Inclan Paul M. , Woiczik Marcella R. , Cummings Jason , Goodwin Ryan , Hosseinzadeh Pooya 
Published: June 2022

Background:
The COVID-19 pandemic precluded in-person interviews for the 2020-2021 fellowship application cycle and may impact future interview cycles. No information is available detailing the implications of a virtual format on either the interviewee or the fellowship program.

Methods:
Two surveys regarding the 2020-2021 virtual interview season were developed and distributed by the Pediatric Orthopaedic Society of North America (POSNA) Fellowship Training and Practice Qualifications Committee: one survey for fellowship applicants and one survey for fellowship program directors.

Results:
Surveys were completed by 45 pediatric orthopaedic fellowship applicants and 34 fellowship program directors. Nineteen (42.2%) applicants applied to more programs because of the virtual format and 30 (66.7%) applicants accepted more interviews because of the virtual format. Thirty-one (67%) applicants did not feel the virtual interview format negatively affected their match process. Thirty-eight (84.4%) applicants indicated that they saved >$2000 with the virtual format. Approximately half (22/45, 48.5%) of the applicants would keep the fellowship-interview process virtual—even if in-person interviews were possible—whereas 8 (17.8%) applicants would transition back toward in-person interviews.
Most program directors utilized online interviews for the first time (n=28, 82.3%) during the 2020-2021 application cycle. Programs interviewed more applicants for the 2020-2021 cycle than in the prior 5 years (19.3 vs. 15.7 applicants, P<0.01), with programs interviewing 10.1 applicants per fellowship position. The majority (n=22, 64.7%) of programs utilized Zoom for the interview platform. Program directors indicated that the applicants were either more accomplished (n=14, 41.2%) or similar in accomplishment (n=20, 58.8%) when compared with the applicants from prior years. Half of the program directors (n=17, 50%) surveyed would utilize virtual interviews next year, even if in-person interviews are possible.

Conclusions:
During the 2020-2021 fellowship application process, interviewees applied to and were interviewed at more programs because of the virtual format, while saving >$2000. In a similar manner, fellowship programs were able to interview a greater number of applicants without adversely impacting the applicant quality. Approximately half of the interviewees and program directors would continue to perform virtual interviews, even if in-person interviews are possible.

Level of Evidence:
Level V.
Comparison of Adjacent Segment Degeneration After Minimally Invasive or Open Transforaminal Lumbar Interbody Fusion
Authors: Jia Jun , Chen Cong , Wang Peng , Wang Lianlei , Liu Xinyu 
Published: June 2022

Study Design:
This was a retrospective case series.

Objective:
The purpose of this study was to compare radiologic and clinical outcomes in patients with L4–L5 lumbar spinal stenosis (LSS) who had undergone either minimally invasive (MIS-) or open (O-) transforaminal lumbar interbody fusion (TLIF), especially with regard to the development of adjacent segment degeneration (ASDeg).

Summary of Background Data:
ASDeg is defined as the degenerative changes at adjacent segments of a fused segment, with no obvious clinical symptoms.

Materials and Methods:
A total of 121 LSS patients with a minimum 5-year follow-up were included. Patients were divided into 2 groups according to the surgery performed (MIS-TLIF: 57 patients, O-TLIF: 64 patients). Preoperative and final follow-up radiologic parameters were determined. The incidence of ASDeg was evaluated and compared between the 2 groups. Visual Analog Scale score, Japanese Orthopaedic Association score, and Oswestry Disability Index were used to assess clinical outcomes.

Results:
Before surgery, no significant difference was found between MIS-TLIF and O-TLIF groups regarding demographic, radiologic, and clinical data. After a 5-year follow-up, the incidence of ASDeg in LSS patients was 47.1% (57/121). ASDeg was mostly located at the cranial segment of the fused level in each group. The most common type of ASDeg in both groups was intervertebral space collapse. There was a lower chance of ASDeg in MIS-TLIF group than that in O-TLIF group (33.3% vs. 59.4%, P<0.01). Postoperatively, both groups had significant improvement in clinical outcomes, and there were no statistically significant intergroup differences assessed by Visual Analog Scale, Japanese Orthopaedic Association, and Oswestry Disability Index scores.

Conclusion:
The clinical effect of MIS-TLIF and O-TLIF were similar, but the incidence of ASDeg was significantly lower after MIS-TLIF at 5-year follow-up.
Lung Ultrasound to Assist ICU Admission Decision-Making Process of COVID-19 Patients With Acute Respiratory Failure
Authors: Aguersif Amazigh , Sarton Benjamine , Bouharaoua Sihem , Gaillard Lucien , Standarovski Denis , Faucoz Orphée , Martin Blondel Guillaume , Khallel Hatem , Thalamas Claire , Sommet Agnes , Riu Béatrice , Morand Eric , Bataille Benoit , Silva Stein 
Published: June 2022

OBJECTIVES:
There is only low-certainty evidence on the use of predictive models to assist COVID-19 patient’s ICU admission decision-making process. Accumulative evidence suggests that lung ultrasound (LUS) assessment of COVID-19 patients allows accurate bedside evaluation of lung integrity, with the added advantage of repeatability, absence of radiation exposure, reduced risk of virus dissemination, and low cost. Our goal is to assess the performance of a quantified indicator resulting from LUS data compared with standard clinical practice model to predict critical respiratory illness in the 24 hours following hospital admission.

DESIGN:
Prospective cohort study.

SETTING:
Critical Care Unit from University Hospital Purpan (Toulouse, France) between July 2020 and March 2021.

PATIENTS:
Adult patients for COVID-19 who were in acute respiratory failure (ARF), defined as blood oxygen saturation as measured by pulse oximetry less than 90% while breathing room air or respiratory rate greater than or equal to 30 breaths/min at hospital admission. Linear multivariate models were used to identify factors associated with critical respiratory illness, defined as death or mild/severe acute respiratory distress syndrome (Pao
2/Fio
2 < 200) in the 24 hours after patient’s hospital admission.

INTERVENTION:
LUS assessment.

MEASUREMENTS AND MAIN RESULTS:
One hundred and forty COVID-19 patients with ARF were studied. This cohort was split into two independent groups: learning sample (first 70 patients) and validation sample (last 70 patients). Interstitial lung water, thickening of the pleural line, and alveolar consolidation detection were strongly associated with patient’s outcome. The LUS model predicted more accurately patient’s outcomes than the standard clinical practice model (DeLong test: Testing: z score = 2.50, p value = 0.01; Validation: z score = 2.11, p value = 0.03).

CONCLUSIONS:
LUS assessment of COVID-19 patients with ARF at hospital admission allows a more accurate prediction of the risk of critical respiratory illness than standard clinical practice. These results hold the promise of improving ICU resource allocation process, particularly in the case of massive influx of patients or limited resources, both now and in future anticipated pandemics.
Sudden deaths due to accidental leakage of Lindane from a storage tank in a village, Sitapur, Uttar Pradesh, India, 2020
Authors: Jain Piyush , Kapoor Amit , Rubeshkumar Polani , Raju Mohankumar , Joseph Bency , Bhat Prashant , Ganeshkumar Parasuraman , Kesavachandran Chandrasekharan Nair , Patel Devendra Kumar , Manickam Natesan , Kaur Prabhdeep 
Published: June 2022

Background:
Chemical leakages cause devastating health effects on humans. On 6 February 2020, seven deaths were reported following a hazardous chemical leakage in a village in Uttar Pradesh, India. We investigated the event to identify the cause and propose recommendations.

Methods:
We defined a case as sudden onset of breathlessness, headache, or death in the village, 6–7 February 2020. We conducted a house-to-house case search and calculated attack rate (AR) and case-fatality rate (CFR) by age and gender. We conducted an environmental investigation at the leakage site and sent the chemicals for forensic analysis. We obtained the cause of death through autopsy reports.

Results:
Out of 2,942 residents, we identified 23 cases (AR = 8/1,000) and seven deaths (CFR = 30%). The median age of the case was 42 years (range, 2–64 years). The AR was higher among males (14/1,000 [19/1,402]). All the 23 case-patients who were sleeping at the chemical leakage site or visited to witness the event developed symptoms, and all seven cases who were sleeping within 150 meters of the leakage site died. The environmental investigation revealed leakage of hazardous substances from the storage tank. Toxicology analysis confirmed the leaked chemical as Lindane (gamma-hexachlorocyclohexane), and autopsy reports confirmed the cause of death as asphyxia.

Conclusions:
Asphyxia following the leakage of Lindane from the storage tank possibly led to sudden deaths. We recommend using leak-proof tanks to ensure safe storage and disposal, law enforcement, and regulations to prevent people from staying close to chemical storage sites.
Metabolic evaluation: is there really a future?
Authors: Traxer Olivier , Corrales Mariela , Sierra Alba 
Published: June 2022

Purpose of review
To confirm the need for a metabolic evaluation in stone formers based on the latest information published in the last 24 months and in the current 2022 American and European urological guidelines.

Recent findings
Recent studies suggest that urolithiasis prevalence has been increasing since 1990. Along with it, metabolic abnormalities that contribute to the development of kidney stones are also increasing, such as hyperuricosuria, hyperoxaluria, hypocitraturia, hypomagnesuria, hypocalciuria, hypophosphaturia, and hyperuricemia. Those abnormalities can only be detected through a metabolic evaluation in patients with stone disease.

Summary
It is important for us, urologists, to have in mind the actual stone prevalence worldwide. As part of our initial evaluation of the patient with urolithiasis, we must not forget to perform the basic metabolic analysis and, according to the patient's risk classification, continue with a deep metabolic analysis. This extensive analysis includes blood and urine tests. The urinalysis covers 24-h urinalysis, and it would be accurate to also have an early fresh urine analysis. Moreover, identifying the stone type is intimately correlated with the search for other metabolic parameters.
The First Successful Combined Full Face and Bilateral Hand Transplant
Authors: Ramly Elie P. , Alfonso Allyson R. , Berman Zoe P. , Diep Gustave K. , Bass Jonathan L. , Catalano Louis W. , Ceradini Daniel J. , Choi Mihye , Cohen Oriana D. , Flores Roberto L. , Golas Alyssa R. , Hacquebord Jacques H. , Levine Jamie P. , Saadeh Pierre B. , Sharma Sheel , Staffenberg David A. , Thanik Vishal D. , Rojas Allison , Bernstein G. Leslie , Gelb Bruce E. , Rodriguez Eduardo D. 
Published: June 2022

Background:
Vascularized composite allotransplantation has redefined the frontiers of plastic and reconstructive surgery. At the cutting edge of this evolving paradigm, the authors present the first successful combined full face and bilateral hand transplant.

Methods:
A 21-year-old man presented for evaluation with sequelae of an 80 percent total body surface area burn injury sustained after a motor vehicle accident. The injury included full face and bilateral upper extremity composite tissue defects, resulting in reduced quality of life and loss of independence. Multidisciplinary evaluation confirmed eligibility for combined face and bilateral hand transplantation. The operative approach was validated through 11 cadaveric rehearsals utilizing computerized surgical planning. Institutional review board and organ procurement organization approvals were obtained. The recipient, his caregiver, and the donor family consented to the procedure.

Results:
Combined full face (i.e., eyelids, ears, nose, lips, and skeletal subunits) and bilateral hand transplantation (i.e., forearm level) was performed over 23 hours on August 12 to 13, 2020. Triple induction and maintenance immunosuppressive therapy and infection prophylaxis were administered. Plasmapheresis was necessary postoperatively. Minor revisions were performed over seven subsequent operations, including five left upper extremity, seven right upper extremity, and seven facial secondary procedures. At 8 months, the patient was approaching functional independence and remained free of acute rejection. He had significantly improved range of motion, motor power, and sensation of the face and hand allografts.

Conclusions:
Combined face and bilateral hand transplantation is feasible. This was the most comprehensive vascularized composite allotransplantation procedure successfully performed to date, marking a new milestone in plastic and reconstructive surgery for patients with otherwise irremediable injuries.
Medical Students' Learning Process During Simulated Patient Consultations in Psychiatry: A Grounded Theory Study
Authors: Piot Marie-Aude , Pham-Scottez Alexandra , Bazziconi Pierre-François , Lebailly Thibaut , Le Moal Valérie , Kalindjian Nina , Sulimovic Leslie , Duriez Philibert , Lombardi Laura , Barbotin Bénédicte , Vinckier Fabien , Burn Carine Layat , Rethans Jan-Joost , Tesnière Antoine , Falissard Bruno 
Published: June 2022

Introduction
Recent changes in psychiatric care and teaching, which limit patient contact for medical students, can be partially overcome by simulation-based education in psychiatry. The authors explored the learning processes of medical students during meetings with simulated patients to inform efforts to improve this teaching.

Methods
After recruiting 81 undergraduate medical students from 3 universities to participate in 6 simulation sessions in psychiatry, the authors purposively sampled 21 students to participate in face-to-face individual semistructured interviews analyzed with constructivist grounded theory. Integration of this analysis with those of the simulation consultation videotapes and the debriefing audiotapes improved the triangulation process.

Results
Three organizational themes were identified: developing and structuring representations of psychiatry; integrating subjectivity into learning; and refining and developing psychiatric praxis. Given the broad and in-depth learning that occurs, simulation in psychiatry should respect content validity of SP portrayals to ensure appropriate learning. However, psychological fidelity seems to provide adequate realism while retaining feasibility. Psychiatric simulation also requires the encouragement of student self-confidence and well-being. Within a reflective framework, simulation triggers cognitive reframing, which can alleviate fears and prejudice toward people with mental disorders.

Conclusions
The holistic interactive learning process involved in simulation can address the complexity of the personal and interpersonal features needed in psychiatry.
Secondary Prophylaxis With Inhaled Colistin to Prevent Recurrence of Pseudomonas aeruginosa and Extended-spectrum β-lactamase-producing Enterobacterales Pneumonia in ICU After Lung Transplantation: A Before-and-after Retrospective Cohort Analysis
Authors: Tran-Dinh Alexy , Slassi Lina , De Tymowski Christian , Assadi Maksud , Tanaka Sébastien , Zappella Nathalie , Lortat Jacob Brice , Jean-Baptiste Sylvain , Atchade Enora , Castier Yves , Mal Hervé , Mordant Pierre , Armand-Lefèvre Laurence , Messika Jonathan , Grall Nathalie , Montravers Philippe 
Published: June 2022

Background.
Early pneumonia is an independent risk factor for 1-y mortality after lung transplantation (LTx). Pseudomonas aeruginosa is the most common isolate in early pneumonia and is also associated with an increased risk of chronic lung allograft dysfunction. The aim of our study was to evaluate the efficacy of secondary prophylaxis with inhaled colistin (IC) in preventing the recurrence of P aeruginosa or extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) pneumonia in the postoperative period in the intensive care unit after LTx.

Methods.
We conducted a before-and-after retrospective cohort study by including all patients who underwent LTx between January 2015 and December 2020 in our center. Secondary prophylaxis with IC was instituted in January 2018 (observation period from January 2015 to December 2017, intervention period from January 2018 to December 2020).

Results.
A total of 271 lung transplants were included (125 in the observation period and 146 in the intervention period). The patients were predominately male (64.2%) with a median age of 57 y and received double LTx (67.9%) for chronic obstructive pulmonary disease/emphysema (36.2%) or interstitial lung disease (48.3%). The proportion of patients who experienced at least 1 recurrence of P aeruginosa or ESBL-PE pneumonia was significantly lower in the intervention period than in the observation period (0.7% versus 7.2%, P = 0.007).

Conclusions.
Our study suggests a potential benefit of secondary prophylaxis with IC to prevent the recurrence of P aeruginosa or ESBL-PE pneumonia in the intensive care unit after LTx.
Progression in multiple sclerosis – a long-term problem
Authors: Bittner Stefan , Zipp Frauke 
Published: June 2022

Purpose of review
Disability progression in multiple sclerosis (MS) is strongly linked to central nervous system (CNS)-specific pathological processes that occur throughout all disease stages, but that become clinically evident in later phases of the disease. We here discuss current views and concepts for targeting progressive MS.

Recent findings
Detailed clinical assessment of MS patients has identified an even closer entanglement of relapse-remitting and progressive disease, leading to novel concepts such as ‘progression independent of relapse activity’. Evolving clinical concepts together with a focus on molecular (neurofilament light chain) and imaging (paramagnetic rim lesions) biomarkers might specifically identify patients at risk of developing progressive MS considerably earlier than before. A multitude of novel treatment approaches focus either on direct neuroaxonal protection or myelin regeneration or on beneficially modulating CNS-intrinsic or innate immune inflammation. Although some long-awaited trials have recently been unsuccessful, important lessons could still be drawn from novel trial designs providing frameworks for future clinical studies.

Summary
Targeting progressive disease biology and repairing established damage is the current central challenge in the field of MS. Especially, the compartmentalized adaptive and innate CNS inflammation is an attractive target for novel approaches, probably as a combinatory approach together with neuroprotective or myelin regenerating strategies.
Microglia in multiple sclerosis – pathogenesis and imaging
Authors: Airas Laura , Yong V. Wee 
Published: June 2022

Purpose of review
Microglia normally protects the central nervous system (CNS) against insults. However, their persistent activation in multiple sclerosis (MS) contributes to injury. Here, we review microglia activation in MS and their detection using positron emission tomography (PET).

Recent findings
During lesion evolution and the progression of MS, microglia activity may contribute to neurotoxicity through the release of pro-inflammatory cytokines, reactive oxidative species, proteases and glutamate. A means to detect and monitor microglia activation in individuals living with MS is provided by positron emission tomography (PET) imaging using the mitochondrial 18-kDa translocator protein (TSPO) ligand. TSPO PET imaging shows increased microglial activation within the normal appearing white matter that precedes radiological signs of neurodegeneration measured by T2 lesion enlargement. PET-detected microglia activation increases with progression of MS. These findings demand the use of CNS penetrant inhibitors that affect microglia. Such therapies may include hydroxychloroquine that is recently reported in a small study to reduce the expected progression in primary progressive MS, and Bruton's tyrosine kinase inhibitors for which there are now eleven Phase 3 registered trials in MS.

Summary
Microglial activation drives injury in MS. PET imaging with microglia-specific ligands offer new insights into progression of MS and as a monitor for treatment responses.
Pathomechanisms in demyelination and astrocytopathy: autoantibodies to AQP4, MOG, GFAP, GRP78 and beyond
Authors: Mader Simone , Kümpfel Tania , Meinl Edgar 
Published: June 2022

Purpose of review
The purpose of this review is to highlight the recently emerging pathomechanisms of diseases associated with autoantibodies to AQP4, MOG, GFAP, GRP78 and further novel targets. We discuss novel biomarkers and therapeutic approaches.

Recent findings
Although complement-mediated cytotoxicity (CDC) is regarded as the major effector mechanism for AQP4-IgG in neuromyelitis optica spectrum disorders (NMOSD), recent studies helped to understand the relevance of complement-independent effector mechanisms. For MOG-IgG mediated diseases the role of CDC is less clear. MOG-IgG may trigger a tightly controlled FcR and BTK-driven microglia proliferative response in MOG-antibody-associated diseases. Differences of antibody-mediated tissue damage may reflect differential response to therapy. In addition, antibodies to GFAP, GRP78 and further novel targets have been implicated in demyelination and astrocytopathy.

Summary
Elucidating the whole spectrum of effector functions in diseases mediated by AQP4-IgG and MOG-IgG and understanding the role of additional novel autoantibodies involved in demyelination and astrocytopathy may guide further novel treatment decisions.
Interrogating large multiple sclerosis registries and databases: what information can be gained?
Authors: Trojano Maria , Kalincik Tomas , Iaffaldano Pietro , Amato Maria P. 
Published: June 2022

Purpose of review
Although substantial progress has been made in understanding the natural history of multiple sclerosis (MS) and the development of new therapies, many questions concerning disease behavior and therapeutics remain to be answered. Data generated from real-world observational studies, based on large MS registries and databases and analyzed with advanced statistical methods, are offering the scientific community answers to some of these questions that are otherwise difficult or impossible to address. This review focuses on observational studies published in the last 2 years designed to compare the effectiveness of escalation vs. induction treatment strategies, to assess the effectiveness of treatment in pediatric-onset and late-onset MS, and to identify the clinical phenotype of secondary progressive (SP)MS.

Recent findings
The main findings originating from real-world studies suggest that MS patients who will qualify for high-efficacy disease-modifying therapies (DMTs) should be offered these as early as possible to prevent irreversible accumulation of neurological disability. Especially pediatric patients derive substantial benefits from early treatment. In patients with late-onset MS, sustained exposure to DMTs may result in more favorable outcomes. Data-driven definitions are more accurate in defining transition to SPMS than diagnosis based solely on neurologists’ judgment.

Summary
Patients, physicians, industry, and policy-makers have all benefited from real-world evidence based on registry data, in answering questions of diagnostics, choice of treatment, and timing of treatment decisions.