bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Characteristics and Surgical Outcomes of Congenital Ulnar-deviated Thumbs: Delta Triphalangeal Thumbs and Irregular Epiphyses
Authors: Han Bingqiang , Shen Kaiying , Wang Zhigang , Xu Yunlan 
Published: October 2020

Background:
Delta triphalangeal thumbs (DTPT) and irregular epiphysis thumbs (IET) had different anatomic deformities. Our primary purpose was to evaluate the clinical and radiographic outcomes of surgical treatment in DTPT and IET.

Methods:
In total, 43 ulnar-deviated thumbs were included and categorized into 2 types according to x-ray and exploration during surgery, DTPT and IET. Surgical excision of the delta phalanx in DTPT and intraepiphysis osteotomy in IET was conducted.

Results:
In total, 23 ulnar-deviated thumbs were classified as DTPT and 20 as IET. Ten thumbs that could not be classified initially were followed-up until they could be categorized at the mean age of 24 months. The preoperative mean degrees of ulnar deviation at the interphalangeal joints were 40 and 33 degrees, in DTPT and IET, respectively. The mean degrees were 2 and 5 degrees in final follow-up, showing significant improvement (DTPT, P<0.05; IET, P<0.05). Complications during the study included residual ulnar deviation, overcorrection, and nonunion. The stability and range of movement at the interphalangeal joint were good overall. According to the Japanese Society for Surgery of the Hand scoring system, results were excellent in 29 cases, good in 13, and fair in 1.

Conclusions:
Ulnar clinodactyly of the thumb occurs because of different anatomic features such as DTPT or IET. We recommend surgical treatment be postponed until the anatomic abnormality can be ascertained. Furthermore, almost all patients with ulnar-deviated thumbs had significant improvement in clinical and radiographic outcomes after surgery.
Negative correlation of high serum bilirubin with cancer development in adults without hepatobiliary disease
Authors: Yamamoto Kazuki , Ikeya Takashi , Okuyama Shuhei , Okamoto Takeshi , Fukuda Katsuyuki , Kobayashi Daiki 
Published: October 2020

Background and aims
This study aimed to evaluate whether serum bilirubin levels were associated with cancer development in a population without liver disease.

Methods
A retrospective longitudinal study was performed by including participants who underwent a health checkup at St. Luke’s International Hospital in Tokyo from 2005 to 2019. We excluded those with liver diseases or prior history of cancer at baseline. All participants were classified into four groups according to their total bilirubin (T-Bil) level: very low (<0.5 mg/dl), low (≥0.5 mg/dl, <1.0 mg/dl), intermediate (≥1.0 mg/dl, <1.5 mg/dl), and high (≥1.5 mg/dl). Our primary outcome was to observe cancer development. This study received IRB approval (19-R041).

Results
A total of 77 855 patients were included. During a median follow-up of 1751 days, 5110 participants developed some type of cancer during the study period. Compared to the very-low group, odds ratio (OR) for developing any type of cancer in a concentration-dependent manner decreased as the T-Bil category shifted to higher groups: OR 0.89, 95% confidence interval (CI) 0.79–1.01 for low group; OR 0.81, 95% CI 0.71–0.94 for intermediate group, and OR 0.80, 95% CI 0.65–0.99 for high group. In terms of secondary outcome, neoplasms of the female genital organs showed the same trend; OR 0.69, 95% CI 0.51–0.93 for low group; OR 0.63, 95% CI 0.44–0.92 for intermediate group, and OR 0.52, 95% CI 0.24–1.09 for high group.

Conclusion
Increased serum bilirubin negatively correlated with cancer development in a concentration-dependent manner, especially for neoplasms of the female genital organs.
Keep Them in the Game: Screening for Cardiovascular Disease and Diabetes in Aging Athletes
Authors: Jordre Becca D. , Brisk Brody W. , Schweinle William E. 
Published: October 2020

Purpose:
This observational cross-sectional study of aging athletes aims to (1) compare the prevalence of cardiovascular disease (CVD) and diabetes in aging athletes to the general population, (2) describe anthropometric values of aging athletes, (3) investigate the influence of cardiovascular sport competition on these measures, and (4) address any predictive value of evaluated measures.

Methods:
Health and sport history, blood pressure, waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) were collected on 2351 aging athletes.

Results:
Aging athletes showed a significantly lower prevalence of CVD and diabetes than the general population. Athletes demonstrated BMI in the overweight range, WC in a healthy range, and waist-to-hip ratio in a healthy range for women but just over risk thresholds for men. Average blood pressure was near stage 1 hypertension. Waist circumference and waist-to-hip ratio were superior predictors of disease in the population. Cardiovascular athletes showed a lower disease risk and overall superior anthropometric values than other aging athletes.

Conclusion:
Aging athletes demonstrate a relatively low prevalence of CVD and diabetes despite demonstrating some anthropometric measurements over risk thresholds. Measures of central adiposity seem best for predicting disease in this population.
High-Intensity Interval Training for Adults With Chronic Stroke: A Pilot Feasibility Study
Authors: Bosch Pamela Rogers , Holzapfel Simon D. , Nordin Kali , Ojameruaye Ochuko , Zubriski Mark , Angadi Siddhartha S. 
Published: October 2020

Purpose:
This study was conducted to assess the feasibility of twice weekly treadmill high-intensity interval training (HIIT) after stroke; to measure cardiorespiratory (CR) changes and assess predictors of CR change and the validity of existing age-predicted maximal heart rate (AP-HRmax) equations to dose HIIT; and to determine the effect of HIIT on functional measures.

Methods:
Seventeen adults ≥6 months poststroke participated in twice-weekly, supervised HIIT plus 30-minute home walking sessions for 10 weeks (n = 10) or served as control participants (CON, n = 7). Feasibility was measured by HIIT attendance (≥90%) and attaining targeted HIIT parameters with no adverse events. Cardiorespiratory response, peak HR, and function were measured before and after intervention. Validity of AP-HRmax equations was assessed.

Results:
Feasibility was supported (99% of training sessions completed, no adverse events, and targeted intensity achieved). V̇o
2peak increased significantly for HIIT, P = .019 and decreased for CON, P = .044. Functional outcomes did not improve for either group. Age-predicted maximal heart rate equations were valid, with poor absolute agreement at baseline and post-test for HIIT (P = .024; P = .003) and CON (P = .012; P = .005).

Conclusions:
Ten weeks of twice-weekly HIIT is feasible post-stroke and increased aerobic capacity, but functional outcomes did not improve. Some existing AP-HRmax equations can be used to formulate HIIT exercise prescription.
Childhood Glaucoma Profile in a Brazilian Tertiary Care Center Using Childhood Glaucoma Research Network Classification
Authors: Lopes Nara L. , Gracitelli Carolina P.B. , Rolim-de-Moura Christiane 
Published: October 2020

Purpose:
To apply the Childhood Glaucoma Research Network (CGRN) classification in children from a pediatric glaucoma outpatient clinic in a tertiary Brazilian care center to better understand the prevalence and the demographic and clinical characteristics of each subtype of childhood glaucoma.

Methods:
This was a retrospective study in which medical records were collected from patients assisted in childhood glaucoma’s clinic at the Department of Ophthalmology and Visual Sciences, Federal University of São Paulo from January 2010 to January 2018. The initial diagnosis and new diagnosis according to CGRN classification were collected. In addition, age, sex, visual acuity, and affected eye were recorded.

Results:
From 624 ophthalmic consultations in the clinic, 496 had confirmed diagnosis of childhood glaucoma or glaucoma suspect. Mean age at diagnosis of the entire group was 3.62±4.23 years (range, 0 to 17 y). Two hundred eight-one (56.65%) of all patients were male and 349 patients (81.16%) had bilateral disease. All patients fit 1 of the 7 categories of the new classification. In all, 48.59% of diagnoses were changed upon reclassification. According to CGRN classification, 220 patients (44.35%) had primary glaucoma (juvenile open-angle glaucoma and primary congenital glaucoma); 210 patients (42.34%) had secondary glaucoma (glaucoma associated with nonacquired ocular anomalies; glaucoma associated with nonacquired systemic disease or syndrome; glaucoma associated with acquired condition; and glaucoma following cataract surgery); and 66 patients (13.31%) were glaucoma suspect. The most common diagnoses found were primary congenital glaucoma with 218 cases (43.95%) and the last common diagnosis was juvenile open-angle glaucoma with 2 cases (0.40%).

Conclusion:
The CGRN classification provides a useful method for classifying childhood glaucoma. A single, standardized classification system is important for diagnosis and management these patients, in addition, may improve physician communication, and future research.
Expanded Scope of Bacillus Calmette-Guerin (BCG) Vaccine Applicability in Disease Prophylaxis, Diagnostics, and Immunotherapeutics
Authors: Adesanya Oluwafolajimi A. , Uche-Orji Christabel I. , Adedeji Yeshua A. , Joshua John I. , Adesola Adeniyi A. , Chukwudike Chibuike J. 
Published: October 2020

Abstract
Following the discovery of the Bacillus Calmette-Guerin (BCG) vaccine, its efficacy against Mycobacterium tuberculosis was soon established, with several countries adopting universal BCG vaccination schemes for their populations. Soon, however, studies aimed to further establish the efficacy of the vaccine in different populations discovered that the vaccine has a larger effect in reducing mortality rate than could be explained by its effect on tuberculosis alone, which sparked suggestions that the BCG vaccine could have effects on other unrelated or non-mycobacterial pathogens causing diseases in humans. These effects were termed heterologous, non-specific or off-target effects and have been shown to be due to both innate and adaptive immune system responses. Experiments carried out in a bid to further understand these effects led to many more discoveries about the applicability of the BCG vaccine for the prevention, diagnosis, and treatment of certain disease conditions. As we approach the second century since the discovery of the vaccine, we believe it is timely to review these interesting applications of the BCG vaccine, such as in the prevention of diabetes, atherosclerosis, and leukemia; the diagnosis of Kawasaki disease; and the treatment of multiple sclerosis, non-muscle invading bladder cancer, and stage III melanoma. Furthermore, complications associated with the administration of the BCG vaccine to certain groups of patients, including those with severe combined immunodeficiency and HIV, have been well described in literature, and we conclude by describing the mechanisms behind these complications and discuss their implications on vaccination strategies, especially in low-resource settings.
Good Sleep Quality and Progressive Increments in Vigilance During Extended Night Shifts
Authors: Lavigne Andrée-Anne , Hébert Marc , Auclair Julie , Laberge Luc 
Published: October 2020

Objective:
Assess the change in sleep and vigilance of underground miners during long periods of extended shifts.

Methods:
Seventy miners worked 14 consecutive 12-hour day and/or night shifts. Also, they wore an actigraph and completed a visual analog scale for vigilance four times per shift. Linear regression models with mixed effects were used.

Results:
Sleep efficiency was higher during day shifts than during night shifts (86,5 vs 85.5, P < 0.05) but sleep duration did not differ (6:34 vs 6:44, n.s.). Mean vigilance level at Time 3 (02h00) was significantly lower than that at Time 1 (19h00) during the first 10 night shifts whereas mean vigilance level at Time 4 (05h30) remained significantly lower for the 14 night shifts.

Conclusions:
Underground miners exhibit good sleep quality despite evidence of limited circadian adaptation in terms of nighttime vigilance.
The Safety of Drivers
Authors: Kao Feng-Hsia , Kuo Chien-Chih 
Published: October 2020

Objectives:
The aim of this study was to understand the relationship between employees’ perception of work load, group interactional quality, and their effects on employee's psychological strain (need for recovery after work and fatigue) and job accidents.

Methods:
Questionnaire was used to collect data form 401 employees in the transport service industry in Taiwan.

Results:
(1) Workload was positively related with need for recovery after work; (2) group interaction quality was negatively related with need for recovery after work; (3) need for recovery after work was positively related with fatigue; (4) fatigue was positively related with job accidents.

Conclusions:
The findings highlight the importance for organizations to provide adequate work design and build a supportive working environment, which may ultimately contribute to decreased psychological strain and fewer job accidents.
Spring-Loaded Dynamic Foot: An Act of Product Development in Economically Developing Country
Authors: Divya Dharshni M. , Rout Bapina Kumar 
Published: October 2020

ABSTRACT

Introduction
There is a need for a new prosthetic foot in economically developing countries that is technically simple yet functionally more equivalent to the dynamic response foot.

Objectives
The aim of this study is to develop and clinically evaluate a new prosthetic foot with a simple technical design that is as energy efficient as a dynamic response foot.

Study Design
This study is a crossover repeated measures study design comparing the new prosthetic foot to the participant's conventional high-end or low-end prosthetic foot.

Methods
Twenty-meter and 2-minute walk tests were performed to measure gait speed, and energy expenditure was estimated using the physiological cost index (PCI) for both the conventional prosthetic foot and the new spring-loaded dynamic (SLD) foot.

Results
The gait speed with the SLD foot was on average 0.27 m/s faster than conventional low-end foot (P < 0.0001), but −0.18 m/s slower than conventional high-end prosthetic foot (P < 0.0001). The PCI was similar across all three prosthetic feet technologies (P = 0.276).

Conclusions
The mobility function of the SLD foot was nearer to the dynamic response foot as compared with the low-end prosthetic foot. Given its technical simplicity and cost-effectiveness, the SLD foot may be considered as a true alternative to the existing dynamic response foot in economically developing countries. This article describes a new design of prosthetic foot that is simple in design, cost-effective, and made from readily available local material, yet shows clinical features that are nearer to the dynamic response foot. With further immaculate clinical and mechanical testing, it can be integrated to prosthetic users in developing countries.
How Do Orthoses Impact Ease of Donning, Handwriting, Typewriting, and Transmission of Manual Torque? A Study of Three Prefabricated Wrist-Hand Orthoses
Authors: Ferrari Ana Lya M. , Medola Fausto O. , Sandnes Frode E. 
Published: October 2020

ABSTRACT

Introduction
Many upper-limb injuries have work-related causes such as continued use of computers, typing activities, mouse manipulation, and repetitive movements performed for long periods. This study evaluated the performance of wrist-hand orthoses in manual tasks and in transmission of torque measurement during canned glass opening.

Methods
Thirty healthy participants performed donning, typing, and handwriting tasks and transmission of manual torque. The procedures were performed in four conditions: with three different orthoses and with no orthosis as a control.

Results
The results showed a significant difference in the time of manual writing (P < 0.001) and in the number of words per minute (P < 0.001) in the typing task with and without orthoses. The perceived difficulty in performing typing (P < 0.001) and manual writing (P < 0.001) was lower with no orthoses and higher for canvas orthosis and the two neoprene orthoses. Transmission of manual torque also decreased with the orthoses compared with using no orthosis (P < 0.001). Among the orthoses, the canvas fabric orthosis yielded a lower performance compared with the two different neoprene fabric orthoses for all the tasks.

Conclusions
There are effects of the materials used and the orthosis design when performing handwriting typing tasks and twisting tasks (transmission of manual torque), as well as the correctness of how users donned the orthosis.
Breastfeeding Monitoring Improves Maternal Self-Efficacy and Satisfaction
Authors: Ahmed Azza H. , Roumani Ali M. 
Published: October 2020

Abstract

Purpose:
The purpose of this study was to determine the effects of an interactive web-based breastfeeding monitoring system on breastfeeding self-efficacy and satisfaction among mothers of full-term infants at 1, 2, and 3 months after hospital discharge.

Study Design:
We conducted a secondary data analysis of our two-arm, repeated-measures randomized controlled trial that took place in three Midwestern hospitals. Participants were assigned to either control or intervention groups using random numbers. Of the 141 mother–baby dyads enrolled and randomized, 35 dropped out of the study, leaving 57 mothers in the control group and 49 in the intervention group. Mothers in both groups received care based on the hospital protocol, but mothers in the intervention group were also given access to an interactive web-based breastfeeding monitoring system prior to discharge. Participants were asked to enter breastfeeding data, receive educational messages for 30 days, and complete the Breastfeeding Self-Efficacy Scale (BFSE) at 1, 2, and 3 months and the Maternal Breastfeeding Evaluation Scale (MBFES) at 3 months. Mothers received feedback in case of breastfeeding problems.

Results:
A significant difference between groups in BFSE at the 2 and 3 months (p = 0.04; p = 0.04) with medium effect size (0.52, 0.53) was found. There was a significant difference between groups in the total score of MBFES (p = 0.02, effect size 0.53). Mean scores were 122.2, SD = 17.68 for intervention and 112.8, SD = 18.03 for control group. The MBFES scores were positively correlated to BFSE scores among intervention group at all time points (r = .714, n = 45, p < .00; r = .611, n = 41, p < .00; r = .637, n = 39, p < .00).

Clinical Implications:
Interactive web-based breastfeeding monitoring improved maternal breastfeeding self-efficacy and satisfaction and may be a promising innovation to promote maternal breastfeeding self-efficacy and satisfaction.
Central nervous system disease with JC virus infection in adults with congenital HIV
Authors: McEntire Caleb R.S. , Fong Kathryn T. , Jia Dan Tong , Cooper Ellen R. , Cervantes-Arslanian Anna M. , Mateen Farrah J. , Anand Pria , Thakur Kiran T. 
Published: October 2020

Objective:
The aim of this study was to describe the natural history of individuals with congenital HIV who develop JC virus (JCV) infection of the central nervous system (CNS).

Methods:
We retrospectively evaluated individuals with congenital HIV who met criteria for progressive multifocal leukoencephalopathy (PML) or JCV granule cell neuronopathy (JCV GCN) at three major healthcare centres in the northeast USA. Data on adherence to combined antiretroviral therapy (cART), neurologic symptoms, serum markers of immunity and HIV infection, cerebrospinal fluid (CSF) analyses, radiographic features, modified Rankin Scale (mRS) scores and survival were collected from the electronic medical record up to a censoring date of 1 August 2020.

Results:
Among 10 adults with congenitally acquired HIV, nine were diagnosed with definitive PML and one was diagnosed with probable JCV GCN. Individuals presented at the time of their PML or JCV GCN diagnosis with a mean mRS of 2.0 (standard deviation 1.0). A premorbid mRS was documented for six patients and was zero in all cases. The most common risk factor was confirmed cART nonadherence in nine individuals. Five individuals with PML and one with JCV GCN died, with a latency from symptom onset to death of approximately 3 months for three individuals, and approximately 2 years for the remaining two.

Conclusion:
Youth-adulthood transition is a high-risk point for dropping off from medical care. The study of this timepoint in people living with HIV could help inform effective care in these individuals.
Bone Scintigraphy in Pembrolizumab-Induced Inflammatory Arthritis
Authors: Imai Masamichi , Kosaka Yuki , Tachi Masato , Mori Kazuaki , Maruno Hirotaka 
Published: October 2020

Abstract
We present a novel report on the use of bone scintigraphy in pembrolizumab-induced inflammatory arthritis. A 70-year-old man with lung cancer complained about arthralgia after 7 courses of the pembrolizumab therapy. 99mTc-HMDP bone scintigraphy revealed symmetrically strong uptakes in the major distal joints of the upper and lower extremities, thereby clearly identifying them as the affected joints. The pattern of uptakes was not consistent with that of other pathophysiologies including bone metastases, hypertrophic osteoarthropathy, and rheumatoid arthritis. 99mTc-HMDP bone scintigraphy is more practical and cost-effective compared with PET to reveal the affected joints in pembrolizumab-induced inflammatory arthritis.
Quality and Safety in Health Care, Part LXXXII
Authors: Harolds Jay A. 
Published: October 2020

Abstract
Reports from the Institute of Medicine regarding the number of errors in medicine leading to fatalities prompted a major review of medical practices and a move to make medical systems high reliability organizations. Many of the concepts used today to improve performance in health care are borrowed from what has been learned from successes and accidents in other industries, especially in the aviation, space, and nuclear power programs. An emphasis on excellent leadership and communication, the knowledge that there needs to be an emphasis on system failures rather than human failures, and having a safety culture that encourages everyone to be mindful of potential errors and report errors are critical to achieve high reliability.
Altered FDG Biodistribution in Subcutaneous White Fat on PET/CT Following l-Asparaginase Chemotherapy
Authors: Young Colin R. , Kulon Michal E. , Boustani Anne Marie , Pucar Darko 
Published: October 2020

AbstractA 13-year-old boy with mediastinal T-cell lymphoblastic lymphoma demonstrated an altered biodistribution with diffuse activity in subcutaneous white adipose tissue and decreased visceral activity on interim posttreatment FDG PET/CT. This altered biodistribution was attributed to administration of the chemotherapeutic enzymel-asparaginase 3 hours preceding the PET/CT, altering adipocytes amino acid and glucose metabolism. Treatment response assessment was adversely affected by the altered biodistribution, emphasizing the importance of maximizing the time between chemotherapy and PET/CT during successive oncologic treatment cycles. Because adipocytes protect leukemic cells in culture froml-asparaginase, we hypothesize that white adipose tissue–altered biodistribution may be related tol-asparaginase resistance.