bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated Shear Fracture of the Metatarsal Head in Lesser Toes Treated With ORIF: Case Series
Authors: Li Ying , Li Wenjing , Li Shaoliang , Wang Yan , Guan Shengsheng , Wu Yong 
Published: September 2020

Background: Isolated shear fractures of a metatarsal head in the lesser toes are rare in clinical practice. We report the clinical and imaging characteristics, and treatment results, of these fractures. Methods: A retrospective consecutive case-series study was performed on 7 patients with symptomatic isolated shear fracture of a metatarsal head in the lesser toes who were operatively treated using open reduction and internal fixation (ORIF). Radiographs and computed tomographic (CT) scans of the patients were analyzed. The American Orthopaedic Foot & Ankle Society–lesser metatarsophalangeal-interphalangeal (AOFAS-LMI) score, visual analog scale (VAS) score, and passive dorsiflexion range of motion (ROM) of the metatarsophalangeal (MTP) joint were determined preoperatively and at final follow-up. Postoperative complications were also recorded. Results: There were 5 males and 2 females, with a mean age of 21 years (range, 16-36) at the time of surgery. Four fractures occurred at the fourth metatarsal. There were 3 chronic cases, 1 was not diagnosed initially; the other 2 failed conservative treatment. The main symptom of the chronic fractures was limited dorsiflexion at the MTP joint. Preoperative radiographs and CT scans revealed dorsal displacement of the fragment without dislocation of the MTP joint. At the final follow-up (mean, 17.4 months; range 9-27), the AOFAS-LMI scores had improved from 70.6 (range, 59-79) preoperatively to 93.3 (range, 92-100) ( P = .001). VAS scores showed a decrease in pain from 4.0 to 0.0 ( P = .016). Mean passive dorsiflexion ROM of the MTP joint improved significantly from 8.6 degrees preoperatively to 35.7 degrees at final follow-up ( P < .001). All patients returned to their respective preinjury activity levels. Conclusion: Patients with an acute or chronic isolated shear fracture of a metatarsal head in the lesser toes treated by ORIF achieved good short-term clinical and radiologic outcomes. Level of Evidence: Level IV, retrospective case series.
Biomechanical Comparison of Hook Plate vs Headless Compression Screw Fixation of Large Fifth Metatarsal Base Avulsion Fractures
Authors: Bean Bryan A. , Smyth Niall A. , Abbasi Pooyan , Parks Brent G. , Hembree Walter C. 
Published: September 2020

Background: Debate exists on the optimum fixation construct for large avulsion fractures of the fifth metatarsal base. We compared the biomechanical strength of 2 headless compression screws vs a hook plate for fixation of these fractures. Methods: Large avulsion fractures were simulated on 10 matched pairs of fresh-frozen cadaveric specimens. Specimens were assigned to receive two 2.5-mm headless compression screws or an anatomic fifth metatarsal hook plate, then cyclically loaded through the plantar fascia and metatarsal base. Specimens underwent 100 cycles at 50%, 75%, and 100% physiological load for a total of 300 cycles. Results: The hook plate group demonstrated a significantly higher number of cycles to failure compared with the screw group (270.7 ± 66.0 [range 100-300] cycles vs 178.6 ± 95.7 [range 24-300] cycles, respectively; P = .039). Seven of 10 hook plate specimens remained intact at the maximum 300 cycles compared with 2 of 10 screw specimens. Nine of 10 plate specimens survived at least 1 cycle at 100% physiologic load compared with 5 of 10 screw specimens. Conclusion: A hook plate construct was biomechanically superior to a headless compression screw construct for fixation of large avulsion fractures of the fifth metatarsal base. Clinical Relevance: Whether using hook plates or headless compression screws, surgeons should consider protecting patient weight-bearing after fixation of fifth metatarsal base large avulsion fracture until bony union has occurred.
The effect of religious fasting and dehydration at Ramadan on choroidal thickness and Retinal vessel densities, measured with optical coherence tomography angiography
Authors: Gokmen Onur , Ozgur Gokhan 
Published: September 2020

Aim: To investigate the effect of religious fasting and dehydration at Ramadan on choroidal thickness and vessel density in the superficial and deep vascular plexuses with OCTA. Methods: The choroidal thickness, and superficial and deep vessel density indices of fasting healthy subjects were measured with an OCTA device, and compared with non-fasting measurements. Results: The study included 70 eyes of 35 healthy subjects with a mean age of 42.86 ± 8.3 years. The measured choroidal thickness, superficial vessel density index and deep vessel density index were 288.89 ± 67 µm, 40.56% and 41.43%, respectively when measured in the fasting period, compared to 284.62 ± 65 µm, 40.41% and 41.41%, respectively when measured in the non-fasting period. The choroidal thickness under the fovea center was found to be significantly higher in the fasting period than in the non-fasting period ( p = 0.014). The mean total choroidal thickness was found to be reduced in the non-fasting period, although not to a statistically significant degree ( p > 0.05). An analysis of the mean total superficial and deep vascular plexuses revealed no statistically significant difference ( p = 0.368, p = 0.938 respectively). Conclusion: Although a significant increase was noted in central choroidal thickness in the fasting period, no significant change due to fasting was observed in the superficial and deep capillary plexuses. The choroidal layer may vary in thickness due to fasting-related metabolic factors, while retinal vessels are more stable against such effects.
A gateway to complexity: A cross-linguistic comparison of child bilingual speech
Authors: Quick Antje Endesfelder , Gaskins Dorota , Bailleul Oksana , Frick Maria , Palola Elina 
Published: September 2020

Objectives: This study investigates monolingual and code-mixed utterances in four bilingual children with different language combinations (German–English, English–Polish, Finnish–English, and French–Russian) in terms of utterance lengths (MLUs) and complexities offering a usage-based (UB) explanation based on cognitive mechanisms. Methodology: Utterances from four different child bilingual corpora were extracted and coded for individual monolingual languages and bilingual utterances. Data and analysis: 35.441 utterances between the age of 2–4 were analyzed in terms of MLU and syntactic complexity. Findings/conclusions: Results showed that for all children monolingual MLUs and complexities reflect their input situations: the more input in one language, the longer and more complex those utterances were. However, in all four children code-mixed utterances were longer and more complex from the beginning of the recordings. Implications: This is the first study that systematically compares MLU scores and complexities of monolingual and bilingual utterances taking diverse language combinations into account and offering a UB explanation based on chunking and entrenchment processes as a new alternative for further research in bilingualism.
Coronary flow impairment in asymptomatic patients with early stage type-2 diabetes: Detection by FFRCT
Authors: Mrgan Monija , Nørgaard Bjarne Linde , Dey Damini , Gram Jørgen , Olsen Michael Hecht , Gram Jeppe , Sand Niels Peter Rønnow 
Published: September 2020

Purpose: To determine the occurrence of physiological significant coronary artery disease (CAD) by coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) in asymptomatic patients with a new diagnosis (<1 year) of type-2 diabetes mellitus (T2DM). Methods: FFRCT-analysis was performed from standard acquired coronary CTA data sets. The per-patient minimum distal FFRCT-value (d-FFRCT) in coronary vessels (diameter ⩾1.8 mm) was registered. The threshold for categorizing FFRCT-analysis as abnormal was a d-FFRCT ⩽0.75. Total plaque volume and volumes of calcified plaque, non-calcified plaque, and low-density non-calcified plaque (LD-NCP) were assessed by quantitative plaque analysis. Results: Overall, 76 patients; age, mean (SD): 56 (11) years; males, n (%): 49(65), were studied. A total of 57% of patients had plaques. The d-FFRCT was ⩽0.75 in 12 (16%) patients. The d-FFRCT, median (IQR), was 0.84 (0.79–0.87). Median (range) d-FFRCT in patients with d-FFRCT ⩽0.75 was 0.70 (0.6–0.74). Patients with d-FFRCT⩽0.75 versus d-FFRCT >0.75 had numerically higher plaque volumes for all plaques components, although only significant for the LD-NCP component. Conclusion: Every sixth asymptomatic patient with a new diagnosis of T2DM has hemodynamic significant CAD as evaluated by FFRCT. Flow impairment by FFRCT was associated with coronary plaque characteristics.
An optical coherence tomography comparison of coronary arterial plaque calcification in patients with end-stage renal disease and diabetes mellitus
Authors: Weber Joseph R , Martin Brendan , Kassis Nicholas , Shah Kunal , Kovarnik Tomas , Mattix-Kramer Holly , Lopez John J 
Published: September 2020

Background: Coronary arterial plaques in patients with end-stage renal disease (ESRD) are assumed to have increased calcification due to underlying renal disease or initiation of dialysis. This relationship may be confounded by comorbid type 2 diabetes mellitus (DM). Methods: From a single-center OCT registry, 60 patients were analyzed. Twenty patients with ESRD and diabetes (ESRD-DM) were compared to 2 groups of non-ESRD patients: 20 with and 20 without diabetes. In each patient, one 20 mm segment within the culprit vessel was analyzed. Results: ESRD-DM patients exhibited similar calcium burden, arc, and area compared to patients with diabetes alone. When compared to patients without diabetes, patients with diabetes exhibited a greater summed area of calcium (DM: Median 9.0, IQR [5.3–28] mm2 vs Non-DM: 3.5 [0.1–14] mm2, p = 0.04) and larger calcium deposits by arc (DM: Mean 45 ± SE 6.2° vs Non-DM: 21 ± 6.2°, p = 0.01) and area (DM: 0.58 ± 0.10 mm2 vs Non-DM: 0.26 ± 0.10 mm2, p = 0.03). Calcification deposits in ESRD-DM patients (0.14 ± 0.02 mm) and patients with diabetes (0.14 ± 0.02 mm) were more superficially located relative to patients without diabetes (0.21 ± 0.02 mm), p = 0.01 for both. Conclusions: Coronary calcification in DM and ESRD-DM groups exhibited similar burden, deposit size, and depth within the arterial wall. The increase in coronary calcification and cardiovascular disease events seen in ESRD-DM patients may not be secondary to ESRD and dialysis, but instead due to a combination of declining renal function and diabetes.
Evaluation of the relationship between cardiac autonomic function and glucose variability and HOMA-IR in prediabetes
Authors: Dimova Rumyana , Chakarova Nevena , Grozeva Greta , Tankova Tsvetalina 
Published: September 2020

Aims: The present study aims to investigate the relationship between cardiac autonomic function (CAF) and glucose variability (GV) and HOMA-IR in subjects with prediabetes and normal glucose tolerance (NGT). Material and methods: Ninety-two subjects (59 with prediabetes and 33 with NGT), of mean age 50.3 ± 11.5 years, mean BMI 30.4 ± 6.0 kg/m2, were included in this cross-sectional study. Glucose tolerance was assessed by OGTT according to WHO 2006 criteria. Glucose, HbA1c, insulin, oxLDL, and 3-Nitrotyrosine were measured. CGM was performed with a blinded sensor (FreeStyle Libre Pro). CAF was assessed by ANX-3.0 technology. Results: GV indices were increased in prediabetes. CAF was suppressed in subjects with any stage of dysglycemia. The prevalence of cardiac autonomic dysfunction was higher in prediabetes −20.3% as compared to NGT −3.0%, p = 0.028. HOMA-IR [OR 1.5 (95% CI: 1.1–2.1), p = 0.010] and time in target range [OR 0.8 (95% CI: 0.67–0.97), p = 0.021] were found to be predictive variables for impaired CAF. Sympathetic and parasympathetic activity negatively correlated with mean glycemia and GV indices and were independently related to JINDEX in prediabetes ( F[1, 47] = 5.76, p = 0.021 and F[1, 47] = 5.94, p = 0.019, respectively); and to time above target range in NGT ( F[1, 18] = 4.48, p = 0.049 and F[1, 18] = 4.65, p = 0.046, respectively). Conclusion: CAF is declined in prediabetes and seems to be related to GV and HOMA-IR at early stages of dysglycemia.
High hemoglobin glycation index is associated with increased systemic arterial stiffness independent of hyperglycemia in real-world Japanese population: A cross-sectional study
Authors: Nagayama Daiji , Watanabe Yasuhiro , Yamaguchi Takashi , Saiki Atsuhito , Shirai Kohji , Tatsuno Ichiro 
Published: September 2020

Aims: To investigate the association of metabolic parameters including hemoglobin glycation index (HGI, observed HbA1c – predicted HbA1c) with systemic arterial stiffness assessed by cardio-ankle vascular index (CAVI). Subjects: We analyzed the cross-sectional data from 22,696 subjects (mean age 48.0 years, mean FPG 88 mg/dL, mean HbA1c 5.5%) with or without past history of metabolic disorders including diabetes. Results: Men had higher body mass index (BMI), CAVI, blood pressure (BP), FPG, HbA1c, total cholesterol and triglyceride; and lower age, HGI and HDL-cholesterol. After stratifying subjects into HGI quartiles, the highest quartile (Q4) group showed higher age, female ratio, and frequencies of obesity, hypertension, diabetes, and dyslipidemia. Furthermore, bivariate logistic regression model revealed that the Q4 of HGI was a significant predictor of high CAVI (⩾9.0) independent of the presence of diabetes. Conclusion: High HGI is associated with systemic arterial stiffening independent of hyperglycemia. This index is therefore expected to be not only a predictor of hypoglycemia, but also a therapeutic guide for atherosclerosis.
Association of vitamin D3 and its metabolites in patients with and without type 2 diabetes and their relationship to diabetes complications
Authors: Butler Alexandra E. , Dargham Soha R. , Latif Aishah , Mokhtar Haira R. , Robay Amal , Chidiac Omar M. , Jayyousi Amin , Al Suwaidi Jassim , Crystal Ronald G. , Abi Khalil Charbel , Atkin Stephen L. 
Published: September 2020

Background: Epidemiological studies have suggested that vitamin D deficiency is associated with the development of type 2 diabetes (T2DM) and is related to diabetes complications. This study was undertaken to determine the relationship between diabetes complications and cardiovascular risk factors with vitamin D3 and its metabolites: 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), 25-hydroxyvitamin D3 (25(OH)D3), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3); and 25-hydroxy-3epi-vitamin D3 (3epi25(OH)D3). Methods: 750 Qatari subjects, 460 (61.3%) with and 290 (38.7%) without T2DM, who were not taking vitamin D3 supplements, participated in this cross-sectional, observational study. Plasma concentrations of vitamin D3 and its metabolites were measured by liquid chromatography tandem mass spectrometry analysis. Results: T2DM subjects had lower concentrations of all vitamin D3 metabolites ( p < 0.001) except 3epi25(OH)D3 ( p < 0.071). Males had higher concentrations of all vitamin D3 metabolites ( p < 0.001). In the T2DM subjects, lower 25(OH)D3 was associated with retinopathy ( p < 0.03) and dyslipidemia ( p < 0.04), but not neuropathy or vascular complications; lower 1,25(OH)2D3 was associated with hypertension ( p < 0.009), dyslipidemia ( p < 0.003) and retinopathy ( p < 0.006), and coronary artery disease ( p < 0.012), but not neuropathy; lower 24,25(OH)2D3 concentrations were associated with dyslipidemia alone ( p < 0.019); 3epi25(OH)D3 associated with diabetic neuropathy alone ( p < 0.029). In nondiabetics, 25(OH)D3, 1,25(OH)2D3 and 24,25(OH)2D3 were associated with dyslipidemia ( p < 0.001, p < 0.001, p < 0.015, respectively) and lower 1,25(OH)2D3 was associated with hypertension ( p < 0.001). Spearman’s correlation showed 1,25(OH)2D3 to be negatively correlated to age and diabetes duration. Conclusions: Different diabetes complications were associated with differing vitamin D parameters, with diabetic retinopathy related to lower 25(OH)D3 and 1,25(OH)2D3 levels, hypertension significantly associated with lower 1,25(OH)2D3, while dyslipidemia was associated with lower 25(OH)D3, 1,25(OH)2D3 and 24,25(OH)2D3. While 25(OH)D metabolites were lower in females, there was not an exaggeration in complications.
Internet addiction belief, but not Internet use time, is independently associated with menstrual pain severity and interference to social life among adolescents: a cross-sectional study
Authors: Yamada Keiko , Kubota Yasuhiko , Paré Catherine , Takeda Takashi 
Published: September 2020

Introduction: Problematic Internet use is a serious health issue for modern adolescents who have developed and matured in a global Internet environment. This study aimed to examine whether Internet use time and Internet addiction beliefs were independently associated with menstrual pain severity and its interference among Japanese adolescents. Methods: We recruited 1166 adolescents at two high schools to complete questionnaires on Internet use and menstrual pain. The explanatory variable was self-reported average Internet use time per day and Internet addiction beliefs (‘none’ (reference) ‘somewhat’, ‘moderate’ and ‘severe’). The outcome variables were moderate-to-severe menstrual pain and interference. A multivariable logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for moderate-to-severe menstrual pain and interference. Adjustment variables were age, body mass index, belonging to a community or school sports club, sleep duration and Internet addiction beliefs/Internet use time. Results: Internet addiction belief, but not Internet use time, was independently associated with menstrual pain severity and interference to social life in a dose–response manner. ORs (95% CIs) of moderate-to-severe menstrual pain for slight, moderate and severe Internet addition beliefs were 1.43 (1.02–1.99), 1.89 (1.31–2.74) and 1.88 (1.10–3.23), respectively. ORs of moderate-to-severe disability due to menstrual pain for slight, moderate and severe Internet addition beliefs were 1.25 (0.75–1.82), 1.72 (1.01–2.92) and 2.21 (1.11–4.40), respectively, after adjusting for average Internet use time. Conclusion: Internet addiction belief was associated with higher prevalence of moderate-to-severe menstrual pain among adolescents, beyond the variance accounted for by Internet use time.
Systematic changes of the static upper body posture with a symmetric occlusion condition
Authors: Maurer-Grubinger C. , Avaniadi I. , Adjami F. , Christian W. , Doerry C. , Fay V. , Fisch V. , Gerez A. , Goecke J. , Kaya U. , Keller J. , Krüger D. , Pflaum J. , Porsch L. , Wischnewski C. , Scharnweber B. , Sosnov P. , Oremek G. , Groneberg D. A. , Ohlendorf D. 
Published: September 2020

Abstract
Background
Temporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range.

Methods
In this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls.

Results
A significant reduction of the trunk length (0.72 mm; p <  0.001), an increase of the lumbar (0.30°; p <  0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p <  0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change.

Discussion
Slight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.
Diabetes as a risk factor for incident peripheral arterial disease in women compared to men: a systematic review and meta-analysis
Authors: Chase-Vilchez Alyssa Z. , Chan Isaac H. Y. , Peters Sanne A. E. , Woodward Mark 
Published: September 2020

AbstractAims/hypothesisPrevious meta-analyses have suggested that diabetes confers a greater excess risk of coronary heart disease, stroke, vascular dementia, and heart failure in women compared to men. While the underlying mechanism that explains such greater excess risk is unknown, in the current meta-analysis we hypothesized that we would find a similar sex difference in the relationship between diabetes and peripheral arterial disease (PAD).MethodsPubMed MEDLINE, the Cochrane Database of Systematic Reviews, and Embase were systematically searched for prospective population-based cohort studies, with no restriction on publication date, language, or country. We included studies that reported the relative risk (RR), and its variability, for incident PAD associated with diabetes in both sexes. We excluded studies that did not adjust at least for age, and in which participants had pre-existing PAD. In cases where sex-specific results were not reported, study authors were contacted. Random-effects meta-analyses with inverse variance weighting were used to obtain summary sex-specific RRs and the women: men ratio of RRs for PAD. The Newcastle–Ottawa scale was used to assess study quality.ResultsData from seven cohorts, totalling 2071,260 participants (49.8% women), were included. The relative risk for incident PAD associated with diabetes compared with no diabetes was 1.96 (95% CI 1.29–2.63) in women and 1.84 (95% CI 1.29–2.86) in men, after adjusting for potential confounders. The multiple-adjusted RR ratio was 1.05 (95% CI 0.90–1.22), with virtually no heterogeneity between studies (I2 = 0%). All studies scored 6–8, on the Newcastle–Ottawa scale of 0–9, indicating good quality. Eleven of the 12 studies that met review inclusion criteria did not report sex-specific relative risk, and these data were collected through direct correspondence with the study authors.Conclusion/interpretationConsistent with other studies, we found evidence that diabetes is an independent risk factor for PAD. However, in contrast to similar studies of other types of cardiovascular disease, we did not find evidence that diabetes confers a greater excess risk in women compared to men for PAD. More research is needed to explain this sex differential between PAD and other forms of CVD, in the sequelae of diabetes. In addition, we found that very few studies reported the sex-specific relative risk for the association between diabetes and PAD, adding to existing evidence for the need for improved reporting of sex-disaggregated results in cardiovascular disease research.