bluuebunny/crossref_metadata_2025_split huggingface dataset:
The promise of artificial intelligence for kidney pathophysiology
Authors: Jiang Joy , Chan Lili , Nadkarni Girish N. 
Published: June 2022

Purpose of review
We seek to determine recent advances in kidney pathophysiology that have been enabled or enhanced by artificial intelligence. We describe some of the challenges in the field as well as future directions.

Recent findings
We first provide an overview of artificial intelligence terminologies and methodologies. We then describe the use of artificial intelligence in kidney diseases to discover risk factors from clinical data for disease progression, annotate whole slide imaging and decipher multiomics data. We delineate key examples of risk stratification and prognostication in acute kidney injury (AKI) and chronic kidney disease (CKD). We contextualize these applications in kidney disease oncology, one of the subfields to benefit demonstrably from artificial intelligence using all if these approaches. We conclude by elucidating technical challenges and ethical considerations and briefly considering future directions.

Summary
The integration of clinical data, patient derived data, histology and proteomics and genomics can enhance the work of clinicians in providing more accurate diagnoses and elevating understanding of disease progression. Implementation research needs to be performed to translate these algorithms to the clinical setting.
Functional outcomes more than 5 years following acetabulum fracture
Authors: Heimke Isabella M. , Pothireddy Sahini , Krebs J. Collin , Breslin Mary A. , Vallier Heather A. 
Published: June 2022

Abstract

Objectives:
The purposes of this project were to evaluate functional outcomes more than 5 years after acetabulum fracture and to determine factors related to function.

Methods:
This retrospective study consisted of 205 adult patients treated for acetabulum fracture who completed the Musculoskeletal Function Assessment (MFA) a minimum of 5 years following injury. The MFA includes survey of daily activities, gross and fine mobility, social and work function, sleeping, and mood. Higher scores indicate worse function.

Results:
Two hundred five patients with 210 fractures, 69.3% of whom were male, with mean age of 45.7 and mean body mass index 30.1 were included after mean 128 months follow-up. Fracture patterns included OTA/AO 62A (37.1%), 62B (40.5%), or 62C (22.4%), and 80.0% were treated surgically. Late complications were noted in 35.2%, including posttraumatic arthrosis (PTA: 19.5%), osteonecrosis and/or heterotopic ossification. Mean MFA of all patients was 31.4, indicating substantial residual dysfunction. Worse MFA scores were associated with morbid obesity (body mass index >40: 42.3, P>.09), and current tobacco smoking history vs former smoker vs nonsmoker (45.2 vs 36.1 vs 23.0, P < .002). Patients with late complications had worse mean MFA scores (38.7 vs 27.7, P = .001); PTA was the most common late complication, occurring in 19.5%.

Conclusions:
More than 5 years following acetabulum fracture, substantial residual dysfunction was noted, as demonstrated by mean MFA. Worse outcomes were associated with late complications and tobacco smoking. While fracture pattern was not associated with outcome, those patients who had late complications, mostly PTA, had worse outcomes.
First-Year Enrollment and Utilization of New York State Paid Family Leave: 2018
Authors: Dennison Barbara A. , Ncube Butho , Nguyen Trang 
Published: June 2022

Context:
The New York Paid Family Leave (NYPFL) law was passed in April 2016 and took effect January 1, 2018. Expanding paid family leave (PFL) coverage has been proposed as a public health strategy to improve population health and reduce disparities.

Objective:
To describe first-year enrollment in NYPFL and to evaluate utilization of NYPFL benefits.

Design:
Observational study.

Setting:
New York State.

Participants:
Employees enrolled in the NYPFL program (N = 8 528 580).

Methods:
We merged NYPFL enrollment and claim data sets for 2018. Descriptive analysis and multiple logistic regression models were used to assess utilization by demographic variables and business size.

Main Outcome Measure(s):
Utilization and duration of NYPFL to bond with a newborn or care for a family member differed by employees' age, sex, race and ethnicity, residence, income, and business size.

Results:
Approximately 90% of working New Yorkers (N = 8 528 580) were enrolled in NYPFL. First-year utilization of PFL for newborn bonding and family care (9.4 and 4.0 per 1000 employees, respectively) was higher than comparable state PFL programs in California, New Jersey, or Rhode Island. An estimated 38.5% of employed women in New York utilized PFL for newborn bonding. Employees who worked at small businesses (1-49 employees) had lower utilization of PFL. Employees with lower incomes were more likely to claim PFL and employees of color or with lower incomes were more likely to take the maximum 8 weeks of PFL.

Conclusions:
These findings suggest that state PFL programs increase equity in employment benefits. Wider adoption of state/federal PFL programs could help reduce health disparities and improve maternal and infant health outcomes.
Association of Peripheral Serum MicroRNAs With Persistent Phantom Limb Pain in Individuals With Amputation
Authors: Bhomia Manish , Balakathiresan Nagaraja , Zhai Min , Alphonso-Morrison Aimee , Tung Monica , Finn Sacha , Perry Briana , Hill Wendy , O’Connell Colleen , Hanling Steven , Hunt Morgan , Pasquina Paul , Tsao Jack , Knollmann-Ritschel Barbara 
Published: June 2022

Objective
Individuals with major limb amputation(s) frequently experience phantom limb sensations, which are described as vivid impressions of either parts or entire missing limb(s). Despite the high incidence and prevalence of phantom limb pain, the underlying pathophysiology of phantom limb pain remains poorly understood. The objective of this study was to evaluate a possible role of microRNAs in the pathophysiology of phantom limb pain.

Design
Adults with acquired limb amputation and varying degrees of phantom limb pain consented to provide clinical data and blood samples. One hundred forty participants with single or multiple limb amputation(s) were enrolled. The Visual analog scale and neuropathic pain symptom inventory were administered to evaluate the pain. Serum samples were analyzed for microRNA expression and bioinformatic analysis was performed.

Results
Sixty-seven participants did not experience phantom limb pain, whereas 73 participants experienced varying severities of phantom limb pain measured on a pain scale. Linear regression analysis suggested that the time since amputation is inversely related to severity of the pain. A significantly increased expression of 16 microRNAs was observed in participants experiencing phantom limb pain. Bioinformatic analysis shows a possible role of these microRNAs in regulating genes expressed in peripheral neuropathy.

Conclusions
This study provides the first evidence of association of microRNA in phantom limb pain.
Novel testing system to determine shoe mechanical properties
Authors: Anderson Kirsten M. , Martens Ellyson , Powers Olivia , Wilken Jason M. 
Published: June 2022

Background:
Shoes play an important role in ankle foot orthosis (AFO) function and alignment. Despite this, shoe mechanical testing systems are rarely colocated with gait analysis systems, limiting their availability and use during AFO-related studies.

Objective:
The purpose of this study was to evaluate a novel mechanical testing system used to measure shoe heel stiffness and change in height with loading using equipment available in most gait analysis laboratories. The novel testing system will allow for shoe assessment during AFO studies at little additional cost.

Study design:
Shoes were tested to determine initial stiffness, terminal stiffness, and total stiffness, and whether these measures changed with repeated compressions (early vs. late).

Technique:
The novel testing system consists of a baseplate for counterweights, uprights that support a low-friction hinge, and a lever arm with a heel-shaped indenter to apply force to the shoe. Minimal detectable change values were calculated using the standard error of measurement. Intraclass correlation coefficients were calculated in SPSS using a (2, k) model.

Results:
No significant differences in mean values, or interactions, were observed between rounds of testing and early and late compressions (P > .05). Intraclass correlation coefficient values were greater than 0.98, and minimal detectable change values were less than 20% of the average for each measure.

Conclusions:
The novel mechanical testing system, combined with pre-existing gait analysis equipment, can be used to reliably assess shoe stiffness and change in height.
Profile of the Portfolio of NIH-Funded HIV Implementation Research Projects to Inform Ending the HIV Epidemic Strategies
Authors: Queiroz Artur , Mongrella Melissa , Keiser Brennan , Li Dennis H. , Benbow Nanette , Mustanski Brian 
Published: June 2022

Background:
The US government created an initiative to end the HIV epidemic in the United States by the year 2030 (EHE). This multiagency initiative was structured around four pillars: Prevent, Diagnose, Treat, and Respond to improve HIV programs, resources, and service delivery infrastructure. In support of its research mission, the National Institutes of Health (NIH) has funded implementation research (IR) projects by addressing the four pillars and encouraging investigators to collaborate with local partners and Health and Human Services (HHS) grantees in 57 priority jurisdictions.

Methods:
This paper analyzed data from the NIH funded CFAR/ARC supplement projects from 2019 to 2021. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework was used to characterize projects by stage of implementation.

Results:
The Prevent pillar was most frequently studied, with Pre-Exposure Prophylaxis (PrEP) being the most studied intervention. The most common partners were health departments, community-based organizations (CBOs), and Federally Qualified Health Centers (FQHCs). The Consolidated Framework for Implementation Research (CFIR) framework was the most utilized to investigate implementation determinants, followed by the RE-AIM framework and Proctor model to assess implementation outcomes.

Conclusion:
Monitoring the projects resulting from NIH investments is fundamental to understanding the response to EHE, and achieving these results requires systematic and continuous effort that can support the generalizable implementation knowledge emerging from individual studies. There are some remaining gaps in the project portfolio, including geographical coverage, range of implementation outcomes being measured, and interventions still requiring further research to ensure equitable scale-up of evidence based interventions and achieve EHE goals.
Tailored Motivational Interviewing in Adolescent HIV Clinics: Primary Outcome Analysis of a Stepped Wedge Implementation Trial
Authors: Naar Sylvie , MacDonell Karen , Chapman Jason , Todd Lisa , Wang Yuxia , Sheffler Julia , Fernandez Maria Isabel 
Published: June 2022

Background:
Youth continue to have the poorest outcomes along the HIV prevention and care continua. Motivational Interviewing (MI) may promote behavior change and reduce perceived stigma, but providers often demonstrate inadequate MI competence. This study tested Tailored Motivational Interviewing (TMI), a set of implementation strategies designed to improve MI competence in youth HIV providers.

Setting:
Ten HIV clinics in the Adolescent Trials Network for HIV/AIDS Interventions.

Methods:
In a stepped wedge design, 10 clinics (N = 151 providers) were randomized in 5 clusters every 3 months to receive TMI for a 12-month implementation period. Sites were rerandomized within each cluster to receive communities of practice guidance with or without internal facilitator support in the sustainment period. Standard patient assessments were coded every 3 months for 36 months.

Results:
Nesting was addressed using mixed-effects regression models, with random effects for providers and sites. TMI resulted in significantly improved MI competence over baseline. Despite small reductions in competence in the sustainment window, competence was still significantly improved over baseline, with no difference between the 2 sustainment conditions.

Conclusions:
TMI may be an important tool to capacitate the HIV HealthForce to end the HIV epidemic in young people.
Safe Spaces 4 Sexual Health: A Status-Neutral, Mobile Van, HIV/STI Testing Intervention Using Online Outreach to Reach MSM at High Risk for HIV Acquisition or Transmission
Authors: Fields Errol L. , Thornton Nicole , Huettner Steven , Schumacher Christina , Barrow Genevieve , Greenbaum Adena , Jennings Jacky M. 
Published: June 2022

Background:
Black men who have sex with men (MSM) carry the greatest burden of new HIV diagnoses in the United States. Ending the HIV epidemic requires strategic, culturally specific approaches to target factors contributing to persistent HIV disparities.

Setting:
Safe Spaces 4 Sexual Health (SS4SH), a community-informed HIV/sexually transmitted infection (STI) testing strategy combining mobile van testing with online outreach, was implemented over a 14-month period from 2018 to 2019 in Baltimore, MD.

Methods:
We evaluated the reach of MSM at high risk with high acquisition or transmission risk by SS4SH mobile van combined with online outreach as compared with the Baltimore City Health Department's venue-based mobile van (with no online outreach) operating during the same period based on the following HIV/STI testing outcome measures: (1) number of MSM HIV or STI tested, (2) new HIV diagnosis rate, (3) percent with new syphilis diagnosis, (4) percent at high risk for HIV acquisition, and (5) percent people living with HIV at high risk for transmission.

Results:
Over a 14-month period, SS4SH HIV/STI tested 151 MSM. Of these, 74% were Black and the mean age was 34 (SD = 10, range = 19–68). Seven percent (10/148) were new HIV diagnoses, and 10% (13/130) were diagnosed with syphilis. The Baltimore City Health Department's venue-based mobile van strategy yielded 53% (231) more MSM (71% Black, mean age 38, SD = 14, range = 15–74), but the HIV/syphilis positivity rate was significantly lower: 0.5% new HIV diagnosis rate (P < 0.001) and 0.5% with syphilis diagnosis (P < 0.001).

Conclusions:
Our findings suggest SS4SH combing online outreach with mobile van testing may be more effective at reaching high-risk Black MSM than venue-based mobile testing.
Explorations of the Role of Digital Technology in HIV-Related Implementation Research: Case Comparisons of Five Ending the HIV Epidemic Supplement Awards
Authors: Jones Jeb , Knox Justin , Meanley Steven , Yang Cui , Lounsbury David W. , Huang Terry T. , Bauermeister Jose , Gonzalez-Hernandez Graciela , Frye Victoria , Grov Christian , Patel Viraj , Baral Stefan D. , Sullivan Patrick S. , Schwartz Sheree R. 
Published: June 2022

Introduction:
The use of digital technology in HIV-related interventions and implementation strategies is increasing. Whether the use of technology is to directly improve patient outcomes (ie, part of the intervention) or as part of the strategy to implement interventions has important implications. In this article, we present 5 case studies of projects that feature the use of technology in HIV-related implementation research to identify and describe challenges specific to technology-based implementation research about study design, outcome measurement, implementing in an evolving technology landscape, and equity.

Methods:
For each case study, we identified the technological components, classified the components as intervention or implementation strategy, and identified implications for measuring performance and ensuring equity. The Exploration, Preparation, Implementation, and Sustainment framework was used to identify the research stage of each project.

Results:
Technology is being leveraged across a diverse array of implementation strategies to promote Ending the HIV Epidemic in the United States. The case studies were primarily in the exploration and preparation phases of implementation, yet technology played a different role in each project— developing educational materials, mass media to recruit participants or distribute evidence-based campaigns, providing training, guiding tailoring, and implementing novel methods to democratize intervention development.

Discussion:
Technology can play multiple roles in HIV-related implementation research projects, including serving as the intervention, being leveraged within implementation strategies, or both. We identified multiple considerations across projects that should be taken into account when measuring success and planning for equitable and sustained impact.
Reconstruction of the Fourth Metacarpal Using a Chimeric Medial Femoral Condyle Vascularized Osteochondral Cutaneous Graft
Authors: S. R. G. Jorge Ana Cristina , Estler Arne , Wahler Theodora , Grözinger Gerd , Stahl Stéphane 
Published: June 2022

Background
The medial femoral condyle has become a matter of great interest, thanks to the possibility of harvesting versatile chimeric flaps for reconstruction of metacarpal defects with minimal donor site morbidity. This case stands out because of the complete reconstruction of the metacarpal head, harvesting with a skin paddle for tension-free closure and monitoring, and the use of external fixation for better predictability of the reconstruction and early postoperative mobilization.

Case Presentation
We report the case of a 20-year-old male patient who presented with an aneurysmal bone cyst involving the fourth metacarpal bone. The patient underwent resection en bloc of the metaphysis and distal epiphysis of the fourth metacarpal bone, and the bone defect was reconstructed using a 3.4-cm vascularized osteochondral cutaneous graft from the medial femoral condyle.

Results
At 1-year follow-up, the patient showed no impairment in hand range of motion and had a Disabilities of Arm, Shoulder and Hand score inferior to that of the male healthy population. Almost 5 years after the procedure, the radiographic examination did not reveal signs of arthrosis. This case report shows that the medial femoral condyle is an excellent and versatile source of vascularized osteochondral grafts for reconstruction of metacarpal defects.
Outcomes of Flexor Tendon Repair in Patients With Concurrent Neurovascular Injuries of Multiple Digits in Zone 1
Authors: Cha Soo Min , Shin Hyun Dae , Lee Seung Hoo , Shin Jae Woo 
Published: June 2022

Purpose
We treated several patients with multiple flexor (flexor digitorum profundus; FDP) injuries accompanied by injuries to the digital nerve or vessels around the distal interphalangeal crease (zone 1). Here, we retrospectively report the outcomes and review the literature.

Materials and Methods
Between January 2010 and December 2018, 16 patients who met the study inclusion criteria were investigated. Tendons were repaired using the cross-locked cruciate (Adelaide) technique (6-strand) or modified Becker method (4-strand). The neurovascular structures were repaired under a microscope.

Results
Sixteen patients (47 digits) were treated. According to the criteria of Moiemen and Elliot, the lacerated areas were in zones IA and IB in 7 and 40 digits, respectively. The mean ranges of motion were 149.27 ± 7.78 and 66.43 ± 2.04 degrees according to the Strickland and modified Strickland assessments, respectively. The mean 2-point discrimination was 5.00 ± 0.63 mm. Four patients (group 1) presented with injuries to 2 digits, and 9 (group 2) and 3 (group 3) patients had 3 and 4 injured digits, respectively. The outcomes were satisfactory in terms of the mean range of motion; 2-point discrimination; cold tolerance; visual analog scale pain score; Disabilities of the Arm, Shoulder, and Hand score; and grip strength. There were no differences among the groups.

Conclusions
Open multiple-finger injuries involving flexor digitorum profundus rupture with concurrent neurovascular injuries on one or both sides occasionally occur in industrial environments. Fortunately, each digit exhibits a consistent injury type in a particular anatomical location; appropriate repair yields satisfactory outcomes despite the presence of multiple injuries.
Perforators of the Anteromedial Thigh Skin and Possible Design of the Anteromedial Thigh Flap
Authors: El-Shennawy Habiba Ahmed Tawfik Mahmoud , Elzawawy Ehab Mostafa , Atta-Allah Elsayed Soliman , Omar Sally Mahmoud Mohamed Hussein 
Published: June 2022

Background
Specific perforator-based flaps are a new era in plastic reconstruction. They have replaced many of the traditional paradigms in plastic surgery. The anteromedial thigh flap is a versatile flap that can be used as a primary choice for many reconstructive purposes or as a secondary choice for the anterolateral thigh flap. Mapping the vascular territory of anteromedial thigh is essential for the proper design of the flap.

Aim of the Work
The aim of this work was to study the cutaneous perforators of the anteromedial thigh and explain their significance in flap design.

Material and Methods
The material of this study included 30 fresh cadaveric lower limbs. The external iliac artery was injected with colored latex. Superficial and deep dissections were undertaken under a magnifying lens to locate the perforators and identify their type. The length and diameter of the perforators were measured.

Results
Anteromedial thigh skin was divided into 6 squares. Squares 1 and 4 are the upper squares and comprise the skin over the upper medial thigh. It is primarily based on the superficial external pudendal artery, deep external pudendal artery, and superficial circumflex femoral artery. Squares 2 and 5 are the middle squares and were mainly supplied by perforators of the superficial femoral artery. Squares 3 and 6 are the lower squares and were mainly supplied by the saphenous artery and superficial femoral artery. The possible flap designs are then discussed.

Conclusion
The anteromedial thigh skin is richly supplied by a mixture of perforators from multiple sources. The segmental nature of the perforators arising from the superficial external pudendal artery, deep external pudendal artery, superficial femoral artery, and saphenous artery together with the long course and large diameter of perforators grant the anteromedial thigh flap its versatility.