bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between small intestinal bacterial overgrowth and beta-cell function of type 2 diabetes
Authors: Yan Li-hui , Mu Biao , Pan Da , Shi Ya-nan , Yuan Ji-hong , Guan Yue , Li Wang , Zhu Xiao-yi , Guo Lei 
Published: July 2020

Aims Previous studies suggest that small intestinal bacterial overgrowth (SIBO) is associated with type 2 diabetes. However, few studies have evaluated the association between SIBO and beta-cell function in type 2 diabetes. The aim of this study was to evaluate whether beta-cell function was associated with SIBO. Materials and methods One hundred four patients with type 2 diabetes were included in this study. Based on the presence of SIBO, the patients were divided into SIBO-positive and SIBO-negative groups. Oral glucose tolerance tests were performed. Insulin sensitivity was measured using 1/homeostasis model assessment of insulin resistance (1/HOMA-IR) and the insulin sensitivity index (ISIM). Insulin release was calculated by HOMA-β, early-phase insulin secretion index InsAUC30/GluAUC30, and total-phase insulin secretion index InsAUC120/GluAUC120. Results Compared with the SIBO-negative group, patients in the SIBO-positive group showed a higher glucose level at 120 minutes, HbA1c, 1/HOMA-IR, and ISIM and a lower HOMA-β level, early-phase InsAUC30/GluAUC30, and total-phase InsAUC120/GluAUC120. Multiple linear regression analysis showed that body mass index, glucose at 0 minutes, and SIBO were independently associated with the early-phase and total-phase insulin secretion. Conclusion SIBO may be involved in lower levels of insulin release and worse glycemic control.
Non-tropical fibrocalculous pancreatic diabetes: case reports and review of recent literature
Authors: Xia Fang , Zhou Weibin , Wang Bin , Hu Yongmei 
Published: July 2020

Background Fibrocalculous pancreatic diabetes (FCPD), an uncommon form of secondary diabetes, is caused by chronic nonalcoholic calcific pancreatitis and primarily occurs in tropical countries. Objective To present our first-hand experiences in the diagnosis and management of FCPD in two patients from a non-tropical location. Case report Two male Chinese patients (29 and 32 years old) presented with poor insulin function, negative islet cell and glutamate decarboxylase antibodies, and no spontaneous ketosis or abdominal pain. A careful clinical assessment was made and the results were correlated with laboratory findings. Abdominal ultrasound and computed tomography scans further revealed pancreatic calcification, calculi, and pancreatic duct dilation. Differential diagnosis confirmed FCPD and excluded the potential misdiagnosis of type 2 diabetes mellitus. FCPD in these patients was managed with insulin and symptomatic treatment with close monitoring. At the time of submission of this report, the first patient was stable at his last follow-up, but the second had been re-hospitalized for worsening symptoms. Conclusion Early differential diagnosis of FCPD based on clinical examination and biochemical and radiological investigations, in tandem with insulin therapy, can help manage FCPD effectively.
Animal geographies II: Killing and caring (in times of crisis)
Authors: Gibbs Leah 
Published: July 2020

Humans kill and care for animals in a multitude of contexts. These themes – killing and caring – form the focus of this second report on animal geographies research. Most notably, killing and caring take place through conservation and the production and consumption of food. Other realms of recent research include killing through climate change, formal arrangements of care, how animals are made killable, and the significance of the individual and collective. Further to these two major themes, the review identifies other approaches to animal geographies research in recent years; namely, political and relational. Finally, the propensity for humans to kill and care for animals is highlighted by crisis. I open and close the review by considering connections between animals and two contemporary emergencies: the fires that burned south-eastern Australia over summer 2019–20 and the COVID-19 pandemic.
Concussion Symptom Cutoffs for Identification and Prognosis of Sports-Related Concussion: Role of Time Since Injury
Authors: Eagle Shawn R. , Womble Melissa N. , Elbin R.J. , Pan Raymond , Collins Michael W. , Kontos Anthony P. 
Published: July 2020

Background: Symptom reporting with scales such as the Post-Concussion Symptom Scale (PCSS) is one of the most sensitive markers of concussed status and/or recovery time, It is known that time from injury until initial clinic visit affects symptom presentation and recovery outcomes, but no study to date has evaluated changes in clinical cutoff scores for the PCSS based on earlier versus later clinical presentation postconcussion. Purpose: To evaluate if time since injury after sports-related concussion (SRC) affects clinical cutoff scores for total PCSS and PCSS factors in differentiating athletes with SRC from healthy controls and predicting prolonged recovery (>30 days) after SRC. Study Design: Cohort study; Level of evidence, 3. Methods: A chart review was conducted of clinical data from patients with SRC (age, 13-25 years; n = 588; female, n = 299) who presented to concussion specialty clinics. Participants were categorized on the basis of time from injury: early (≤7 days; n = 348) and late (8-21 days; n = 240). Outcomes were total symptom severity (ie, total PCSS score) and total score for each of 4 symptom factors (cognitive/migraine/fatigue [CMF], affective, sleep, and somatic). Area under the curve (AUC) analyses were conducted using the Youden index to optimize sensitivity and specificity cutoffs. Results: In the early group, the CMF factor (cutoff, ≥7; AUC = 0.944), affective factor (cutoff, ≥1; AUC = 0.614), and total PCSS (cutoff, ≥7; AUC = 0.889) differentiated athletes with SRC from controls. In the late group, the CMF factor cutoff was reduced (cutoff, ≥4; AUC = 0.945), while the total PCSS score (cutoff, ≥7; AUC = 0.892), affective factor (cutoff, ≥1; AUC = 0.603), and sleep factor (cutoff, ≥1; AUC = 0.609) remained the same. In the early cohort, the CMF factor was the strongest predictor of protracted recovery (cutoff, ≥23; AUC = 0.717), followed by the total PCSS (cutoff, ≥39; AUC = 0.695) and affective factor (cutoff, ≥2; AUC = 0.614). The affective factor (cutoff, ≥1; AUC = 0.642) and total PCSS (cutoff, ≥35; AUC = 0.592) were significant predictors in the late cohort, but the cutoff threshold was reduced. Conclusion: The findings indicate that PCSS symptom clinical cutoffs for identifying injury and recovery prognosis change on the basis of time since injury. Specifically, the combination of CMF, affective, and sleep factors is the best differentiator of athletes with SRC from controls regardless of time since injury. Furthermore, the CMF factor is the most robust predictor of prolonged recovery if the patient is within 1 week of SRC, whereas the affective factor is the most robust predictor of prolonged recovery if the patient is within 2 to 3 weeks of SRC.
Gastrocnemius Injuries in Professional Baseball Players: An Epidemiological Study
Authors: Hultman Kristi , Szukics Patrick F. , Grzenda Adrienne , Curriero Frank C. , Cohen Steven B. 
Published: July 2020

Background: Gastrocnemius injuries are a common lower extremity injury in elite baseball players. There are no current epidemiological studies focused on gastrocnemius injuries in professional baseball players that provide information on the timing, distribution, and characteristics of such injuries. Hypothesis: Gastrocnemius injury in professional baseball players is a common injury that is influenced by factors such as age, player position, and time of season. Study Design: Descriptive epidemiological study. Methods: Based on Major League Baseball’s (MLB’s) Health and Injury Tracking System (HITS) database, gastrocnemius injuries that caused time out of play for MLB and Minor League Baseball (MiLB) players during the 2011-2016 seasons were identified. Player characteristics, including age, level of play, and position at time of injury, were collected. Injury-specific factors analyzed included date of injury, time of season, days missed, and activity leading to injury. Results: A total of 402 gastrocnemius injuries (n = 145, MLB; n = 257, MiLB) occurred during the 2011-2016 seasons. MLB players were significantly older at the time of injury (30.1 years, MLB; 23.9 years, MiLB; P < .001). Base running (36.1%) was the most common activity causing the injury, followed by fielding (23.6%), with 50.3% of base-running injuries sustained on the way to first base. In MLB players, gastrocnemius injuries were most common in infielders (48.3%), followed by pitchers (27.6%) and then outfielders (17.9%), while for MiLB players the injuries were more evenly distributed (33.5%, 28.8%, and 30.7%, respectively). The frequency of injuries in MLB players dropped off after the start of the regular season, whereas MiLB players had a consistent injury rate throughout the year. Conclusion: Gastrocnemius injuries are a common cause of lower extremity injury in professional baseball players, resulting in significant time out of play. Base running, particularly to first base, was the most common activity during injury. Outfielders had the fewest injuries; however, they required the longest time to recover. This study provides the first investigation to date with the HITS database to examine the characteristics and distribution of gastrocnemius injuries in professional baseball players, offering insight into risk factors, injury prevention, and recovery expectations.
Meniscal Allograft Transplantation After Anterior Cruciate Ligament Reconstruction Can Improve Knee Stability: A Comparison of Medial and Lateral Procedures
Authors: Yoon Kyoung Ho , Lee Hyun Woo , Park Soo Yeon , Yeak Raymond D.K. , Kim Jung-Suk , Park Jae-Young 
Published: July 2020

Background: The purpose of this study was to evaluate the clinical score and stability after meniscal allograft transplantation (MAT) after a previous anterior cruciate ligament (ACL) reconstruction. Hypothesis: Medial MAT would improve anteroposterior stability, and lateral MAT would improve rotational stability. Study Design: Cohort study; Level of evidence, 3. Method: We retrospectively investigated 31 cases of MAT after a previous total or nearly total meniscectomy and ACL reconstruction between November 2008 and June 2017. Cases were divided into medial (16 cases) and lateral (15 cases) MAT groups. The patients were assessed preoperatively and at the 2-year follow-up. Results: In the medial MAT group, the International Knee Documentation Committee, Lysholm, Lysholm instability, and Tegner scores improved significantly at the 2-year follow-up, and there were also significant improvements in the anterior drawer, Lachman, and pivot-shift tests. In the lateral MAT group, the Lysholm and Tegner scores improved significantly at the 2-year follow-up, as had the anterior drawer and Lachman tests but not the pivot-shift test. The medial MAT group showed significant improvement in side-to-side difference on Telos stress radiographs, from 6.5 mm (preoperatively) to 3.6 mm (2-year follow-up) ( P = .001), while the lateral MAT group showed no significant change. There was no progression of arthritis in either group. Conclusion: Medial MAT improved not only anteroposterior stability but also rotational stability in the meniscus-deficient ACL-reconstructed knee. Lateral MAT showed improvements in the anterior drawer and Lachman tests but not in the pivot-shift test or side-to-side difference on Telos stress radiographs in meniscus-deficient ACL-reconstructed knees. Instability and pain are indications for MAT in meniscus-deficient ACL-reconstructed knees.
Posterior Rotational and Translational Stability in Acromioclavicular Ligament Complex Reconstruction: A Comparative Biomechanical Analysis in Cadaveric Specimens
Authors: Morikawa Daichi , Huleatt Joel B. , Muench Lukas N. , Kia Cameron , Berthold Daniel P. , Cote Mark P. , Obopilwe Elifho , Kelolli Denis , Scheiderer Bastian , Mazzocca Augustus D. 
Published: July 2020

Background: Persistent posterior instability of the acromioclavicular (AC) joint is a reported complication after isolated coracoclavicular (CC) reconstruction. Thus, multiple techniques have been proposed attempting to restore biomechanics of the AC ligament complex (ACLC). Purpose/Hypothesis: The purpose was to evaluate the posterior translational and rotational stability of an ACLC reconstruction with a dermal allograft (ACLC patch) as compared with 3 suture brace constructs. It was hypothesized that the ACLC patch would better restore AC joint posterior stability. Study Design: Controlled laboratory study. Methods: A total of 28 cadaveric shoulders (mean ± SD age, 57.6 ± 8.3 years) were randomly assigned to 1 of 4 surgical techniques: ACLC patch, oblique brace, anterior brace, and x-frame brace. The force and torque to achieve 10 mm of posterior translation and 20° of posterior rotation of the AC joint were recorded in the following conditions: intact, transected ACLC, ACLC patch/brace repair, ACLC patch/brace repair with dissected CC ligaments, and ACLC patch/brace repair with CC ligament repair. Results: For posterior translation, transection of the ACLC reduced resistance to 16.7% of the native. With the native CC ligaments intact, the ACLC patch (59.1%), oblique brace (54.1%), and anterior brace (60.7%) provided significantly greater stability than the x-frame brace (33.2%; P < .001, P = .008, P < .001, respectively). ACLC patch, oblique brace, and anterior brace continued to have significantly higher posterior translational resistance than the x-frame (35.1%; P < .001, P = .003, P < .001) after transection and subsequent CC ligament repair. For posterior rotation, transection of the ACLC decreased the resistance to 5.4% of the intact state. With the CC ligaments intact, the ACLC patch (77.1%) better restored posterior rotational stability than the oblique (35.3%), anterior (48.5%), and x-frame (23.0%) brace repairs ( P < .001, P = .002, P < .001). CC ligament transection and subsequent repair demonstrated the ACLC patch (41.0%) to have improved stability when compared with the oblique (16.0%), anterior (14.0%), and x-frame (12.7%) repairs ( P = .006, P = .003, P = .002). Conclusion: ACLC reconstruction with a dermal allograft better restored native posterior rotational stability than other brace constructs, with translational stability similar to the oblique and anterior brace technique at the time of surgery. Clinical Relevance: Horizontal stability of the AC joint is primarily controlled by the ACLC. Inability to restore AC joint biomechanics can result in persistent posterior instability and lead to functional impairment.
Up-to-date review of psychotherapy via videoconference: implications and recommendations for the RANZCP Psychotherapy Written Case during the COVID-19 pandemic
Authors: Chherawala Nabil , Gill Shane 
Published: July 2020

Objective: There has been a surge in videoconferencing technology use in response to the COVID-19 pandemic. RANZCP registrars engaged in the Psychotherapy Written Case are met with new challenges in navigating the psychodynamic processes that can occur when transitioning from in-person to videoconferencing psychotherapy. There is also a myriad of videoconferencing platforms to choose from. Conclusion: It has become necessary to adapt our clinical practice to the current COVID-19 pandemic and physical distancing regulations. The literature recognises videoconferencing psychotherapy as a valid therapeutic medium which can facilitate healthy psychological maturation, but there are theoretical drawbacks. A transition to videoconferencing psychotherapy requires patient agreeability, consistency and reflection upon patient–therapist dynamics; this will aide in the Psychotherapy Written Case submission. Registrars must balance usability, digital security and patient preferences when choosing videoconferencing platforms.
Comparison of Chitosan-Based Liquid Scaffold and Hyaluronic Acid–Based Soft Scaffold for Treatment of Talus Osteochondral Lesions
Authors: Akmeşe Ramazan , Ertan Mehmet Batu , Kocaoğlu Hakan 
Published: July 2020

Background: The aim of this study was to evaluate the clinical and radiologic results of 2 different scaffolds with hyaluronan or chitosan-based structure used in the treatment of talus osteochondral lesions. Methods: Eighty-one patients who underwent chondral lesion repair with hyaluronan (n = 42) or chitosan-based (n = 39) scaffold were included. American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog scale (VAS) scores were evaluated within and between groups preoperatively and at the 3rd, 12th, and 24th month postoperatively. In all patients, magnetic resonance imaging was performed between the 12 and 18th month postoperatively and compared with magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Results: Within-group evaluations revealed significant improvements in AOFAS and VAS scores at postoperative 3 and 12 months. The postoperative 24th-month results of AOFAS scores in any group did not differ significantly from the 12th-month results. There was no significant difference between the groups in comparison of AOFAS, VAS, and MOCART scores at any time period. Conclusion: Both scaffolds were found to be effective in cartilage healing but had no clinical or radiologic superiority to each other. This is the first study to compare the use of different cell-free scaffold types in osteochondral defects of the talus. Level of Evidence: Level III, retrospective comparative study.
Rate of Delayed Union With Early Weightbearing Following Intramedullary Screw Fixation of Jones Fractures
Authors: Looney Austin M. , Renehan John R. , Dean Daniel M. , Murthy Anu , Sanders Thomas H. , Neufeld Steven K. , Cuttica Daniel J. 
Published: July 2020

Background: Jones fractures of the proximal fifth metatarsal are predisposed to delayed union and nonunion due to a tenuous blood supply. Solid intramedullary (IM) screw fixation is recommended to improve healing, traditionally followed by delayed weightbearing (DWB). However, early weightbearing (EWB) postoperatively may facilitate functional recovery. The purpose of this study was to compare union rates and time to union after solid IM screw fixation of Jones fractures in patients treated with an EWB protocol to those treated with a DWB protocol, as well as to identify any factors that may be predictive of delayed or nonunion. Methods: True Jones (zone 2 fifth metatarsal base) fractures treated from April 2012 through January 2018 with IM screw fixation and 6 months follow-up were identified (41 fractures in 40 patients; mean ± SD age, 45.3 ± 17.9 years). Patients were divided into EWB and DWB cohorts (within or beyond 2 weeks, respectively). Delayed union (12.5 weeks) was statistically derived from established literature. Union times were compared between cohorts. Regression analyses were conducted to investigate possible confounders contributing to delayed union. There were 20 fractures in the EWB cohort and 21 fractures in the DWB cohort. Results: There was no significant difference in healing times (EWB: 25% by 6th week, 55% by the 12th week, 20% delayed; DWB: 33% by 6th week, 43% by 12th week, 24% delayed; P = .819) or delayed unions (EWB, 20% vs DWB, 24%; P > .999). There were no nonunions. No significant confounding risk factors were identified. Conclusion: Postoperative protocols using early weightbearing following solid IM screw fixation of Jones fractures appear to be safe and do not delay fracture healing or increase the risk of delayed union. Older age may be a risk for delayed union, but larger studies are needed to evaluate this with appropriate power in light of possible confounders. EWB protocols may allow better functional recovery without compromising outcomes by increasing the risk of delayed union. Level of Evidence: Therapeutic level III, retrospective comparative study.
Potential voriconazole associated posterior reversible leukoencephalopathy in children with malignancies: Report of two cases
Authors: Amanati Ali , Lotfi Mehrzad , Manen Rob Van , Faghihi Mohammad Ali , Yavarian Majid , Zekavat Omidreza , Badiee Parisa , Mazinani Nazafarin Hatami , Bozorgi Haleh 
Published: July 2020

Introduction The fungal infection has become severe morbidity amongst patients with malignancy. Voriconazole, a new generation of triazole, has shown excellent results in treating invasive fungal infections. Case report Herein, we report two cases of posterior reversible encephalopathy syndrome (PRES), which induced after voriconazole exposure. Management and outcome: Magnetic resonance imaging, and the serum level of voriconazole were investigated in both patients to assess toxicity. The role of methotrexate, as one of the possible causes of PRES, is weakened significantly through precise assessing diffusion-weighted images on magnetic resonance imaging. Discussion These unique cases emphasize that voriconazole can induce PRES even at therapeutic levels. Therefore, in the case of neurotoxicity, PRES must be considered, and voriconazole should discontinue. The prognosis seemed promising when voriconazole stopped immediately after clinical suspicion.
Intracranial venous malformations: Incidence and characterization in a large pediatric cohort
Authors: Chen Karen S , Montaser Alaa , Ashour Ramsey , Orbach Darren B 
Published: July 2020

Background Significant advances have been reported recently in the genetic and mechanistic characterization of extracranial venous malformations. However, intracranial purely venous malformations (icVM) analogous to those outside the CNS have not been systematically described. Purpose We sought to ascertain whether such an entity as icVM could in fact be identified, distinct from previously described CNS venous anomalies and analogous to extracranial venous malformations. Methods Our prospectively collected pediatric cerebrovascular database was reviewed to identify patients with icVM; 1458 consecutive angiograms and/or angiographic interventions performed on 706 children at our institution from October, 2006 through May, 2019 were evaluated, in addition to outside imaging studies on 192 additional patients sent to our Vascular Anomalies Center for cerebrovascular review during the same time period. Thus, the cohort consisted of 898 children. Results Nineteen of 898 patients (2.1%) were found to harbor icVM, including 9 (47.3%) with sinus pericranii, 15 (78.9%) with associated large, complex extracranial venous malformations, and 3 (15.7%) with neurocognitive delay. There was no intracranial hemorrhage or venous hypertension seen in the cohort. Asymptomatic venous thrombosis in the superior sagittal sinus was seen in three patients. Conclusion Venous malformations, both extracranial and icVM, share many characteristics that are distinct from developmental venous anomalies. icVM were not associated with venous hypertension. The underlying genetic mutations involved in the development of icVM, germ-line or somatic, remain to be elucidated, but may very well involve shared mechanisms and pathways with extracranial venous malformations.