bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of the acromion index as a reference of severity of stratified supraspinatus tendon injury: a secondary analysis
Authors: Kim Hyoung Seop , Joo Seung Ho , Lim Hyun Sun , Kim Hye Won 
Published: March 2020

Background The acromion index (AI) is the acromial lateral extension above the head of the humerus. Some researchers have advocated that the AI indicates the severity of the tear size of the full-thickness supraspinatus tendon. Purpose To validate the reproducibility of the AI between shoulder magnetic resonance imaging (MRI) and standard X-ray and to verify whether the AI is a useful index for stratifying the severity of supraspinatus tendon injuries, as well as full-thickness tears. Material and Methods We enrolled 200 patients with impingement syndrome who were subsequently evaluated with standard X-ray of the shoulder in the anteroposterior view, as well as an MRI. We performed a pilot study to validate the reproducibility of the AI using standard X-ray and MRI, and to compare the AI between these imaging modalities. The severity of supraspinatus tendon injury was classified into four groups (0 = no evidence of injury, 1 = partial tear, 2 = full-thickness tear, and 3 = complete rupture) based on an official reading of the shoulder MRI. We compared the AIs of both modalities between the groups. Results Intraclass correlation coefficients of the AIs between the two examiners were 0.819 for MRI and 0.808 for plain X-ray. The mean AI from standard X-ray was greater than that from MRI ( P<0.0001). There was no statistical correlation between the AI and the severity of supraspinatus tendon injury. Conclusion Our findings indicate that the AI cannot be generally used as a predictive reference for the stratified severities of supraspinatus tendon injury.
Cytoplasmic mislocalization and mitochondrial colocalization of TDP-43 are common features between normal aged and young mice
Authors: Termsarasab Pichet , Thammongkolchai Thananan , Gao Ju , Wang Luwen , Liang Jingjing , Wang Xinglong 
Published: March 2020

Transactive response DNA binding protein 43 (TDP-43) pathologies have been well recognized in various neurodegenerative disorders including frontotemporal lobar degeneration (FTLD), amyotrophic lateral sclerosis (ALS), and Alzheimer’s disease (AD). However, there have been limited studies on whether there are any TDP-43 alterations in normal aging. We investigated TDP-43 distribution in different brain regions in normal aged ( n =  3 for 26- or 36-month-old) compared to young ( n =  3 for 6- or 12-month-old) mice. In both normal aged and young mice, TDP-43 and phosphorylated TDP-43 (pTDP-43) demonstrated a unique pattern of distribution in neurons in some specific brain regions including the pontine nuclei, thalamus, CA3 region of the hippocampus, and orbital cortex. This pattern was demonstrated on higher magnification of high-resolution double fluorescence images and confocal microscopy as mislocalization of TDP-43 and pTDP-43, characterized by neuronal nuclear depletion and cytoplasmic accumulation in these brain regions, as well as colocalization between TDP-43 or pTDP-43 and mitochondria, similar to what has been described previously in neurodegenerative disorders. All these findings were identical in both normal aged and young mice. In summary, TDP-43 and pTDP-43 mislocalization from nucleus to cytoplasm and their colocalization with mitochondria in the specific brain regions are present not only in aging, but also in young healthy states. Our findings provide a new insight for the role of TDP-43 proteinopathy in health and diseases, and that aging may not be a critical factor for the development of TDP-43 proteinopathy in subpopulations of neurons. Impact statement Despite increasing evidence implicating the important role of TDP-43 in the pathogenesis of a wide range of age-related neurodegenerative diseases, there is limited study of TDP-43 proteinopathy and its association with mitochondria during normal aging. Our findings of cytoplasmic accumulation of TDP-43 that is highly colocalized with mitochondria in neurons in selective brain regions in young animals in the absence of neuronal loss provide a novel insight into the development of TDP-43 proteinopathy and its contribution to neuronal loss.
Are cardiovascular function and habitual physical activity levels similar in patients with classic and atypical claudication symptoms? A cross-sectional study
Authors: Longano Paulo , Kanegusuku Hélcio , Correia Marilia A. , Puech-Leao Pedro , Wolosker Nelson , Cucato Gabriel G , Ritti-Dias Raphael M. 
Published: March 2020

Objective To analyze the impact of the different types of exertional leg pain on cardiovascular function, functional capacity, and habitual physical activity levels in patients with peripheral arterial disease. Methods In this cross-sectional study, 124 patients with symptomatic peripheral arterial disease were included. Exertional leg pain was evaluated using the San Diego Claudication Questionnaire. Subsequently, patients were categorized into two groups according to their exertional leg pain: atypical leg pain (non-calf pain and atypical calf pain, n = 31) and intermittent claudication (classic intermittent claudication symptoms, n = 93). Cardiovascular function (blood pressure, heart rate, arterial stiffness, and heart rate variability), functional capacity (6-min walk distance, handgrip strength, and short physical performance battery), and habitual physical activity levels were measured. Results Functional capacity and physical activity levels were similar between patients with atypical leg pain and symptoms of intermittent claudication. However, patients with classic intermittent claudication symptoms presented higher central systolic blood pressure ( P = 0.028) and arterial stiffness (augmentation index and pulse pressure; P ≤ 0.001 and 0.019, respectively) compared to patients with atypical leg pain. Conclusion The type of exertional leg pain does not influence functional capacity and habitual physical activity levels in patients with peripheral arterial disease. However, patients with classic intermittent claudication symptoms present impaired cardiovascular function compared to patients with atypical leg pain.
Comparison of Maxillofacial Trauma Patterns in the Urban Versus Suburban Environment: A Pilot Study
Authors: Cohn Jason E. , Licata Jordan J. , Othman Sammy , Shokri Tom , Zwillenberg Seth 
Published: March 2020

Introduction: Assault appears to be the most frequent cause of facial fractures in certain urban trauma centers, possibly due to the ease of acquiring weapons and increasingly aggressive behavior. The objectives of this study were to identify specific demographic, socioeconomic, maxillofacial fracture, and assault patterns in urban versus suburban communities. Methods: A retrospective chart review of patients who sustained maxillofacial fractures from August 2014 through August 2016 at one urban campus, Einstein Medical Center, Philadelphia, and two suburban campuses, Einstein Medical Center Montgomery and Elkins Park. The χ2 testing was used to compare the categorical variables between the 2 groups. Results: A total of 259 maxillofacial trauma patients were identified, with 204 (79%) in the urban and 55 (21%) in the suburban environment. Patients in the urban population were more likely to be African American (70% vs 33%) and Hispanic (15% vs 6%) but less likely to be Caucasian (12% vs 55%, P < .0001). Urban patients were more likely to be single (70% vs 47%, P < .01), unemployed (64% vs 44%, P < .001), and receive Medicaid coverage (58% vs 26%, P < .001). Urban patients were more likely to be victims of assault (63% vs 44%), whereas suburban patients were more likely to sustain accidental injuries (16% vs 2%, P < .0001). Urban victims were more likely to be assaulted with an object (30% vs 12%) or gun (7% vs 0%, P = .05). Conclusion: Maxillofacial trauma patterns were shown to be significantly different in the urban versus suburban environment.
Socioeconomic disparities in the management of coronary heart disease in 438 general practices in Australia
Authors: Mnatzaganian George , Lee Crystal Man Ying , Robinson Suzanne , Sitas Freddy , Chow Clara K , Woodward Mark , Huxley Rachel R 
Published: March 2020

Abstract

Background
This population-based cross-stional and panel study investigated disparities in the management of coronary heart disease (CHD) by level of socioeconomic status.

Methods
CHD patients (aged ≥18 years), treated in 438 general practices in Australia, with ≥3 recent encounters with their general practitioners, with last encounter being during 2016–2018, were included. Secondary prevention prescriptions and number of treatment targets achieved were each modelled using a Poisson regression adjusting for demographics, socioeconomic indicators, remoteness of patient’s residence, comorbidities, lifetime follow-up, number of patient–general practitioner encounters and cluster effect within the general practices. The latter model was constructed using the Generalised Estimating Equations approach. Sensitivity analysis was run by comorbidity.

Results
Of 137,408 patients (47% women), approximately 48% were prescribed ≥3 secondary prevention medications. However, only 44% were screened for CHD-associated risk factors. Of the latter, 45% achieved ≥5 treatment targets. Compared with patients from the highest socioeconomic status fifth, those from the lowest socioeconomic status fifth were 8% more likely to be prescribed more medications for secondary prevention (incidence rate ratio (95% confidence interval): 1.08 (1.04–1.12)) but 4% less likely to achieve treatment targets (incidence rate ratio: 0.96 (0.95–0.98)). These disparities were also observed when stratified by comorbidities.

Conclusion
Despite being more likely to be prescribed medications for secondary prevention, those who are most socioeconomically disadvantaged are less likely to achieve treatment targets. It remains to be determined whether barriers such as low adherence to treatment, failure to fill prescriptions, low income, low level of education or other barriers may explain these findings.
Training With Lighter Baseballs Increases Velocity Without Increasing the Injury Risk
Authors: Erickson Brandon J. , Atlee Thomas R. , Chalmers Peter N. , Bassora Rocco , Inzerillo Christopher , Beharrie Andrew , Romeo Anthony A. 
Published: March 2020

Background: Pitch velocity has become an increasingly popular metric by which pitchers are graded and compared. Training programs that utilize weighted balls have been effective in increasing velocity but at the cost of an increased injury risk. No studies have evaluated training with lighter baseballs with regard to increasing pitch velocity and the injury risk. Purpose/Hypothesis: The purpose of this study was to determine whether a training program utilizing lighter baseballs could increase fastball velocity without increasing the injury risk to participants. We hypothesized that a training program with lighter baseballs would increase fastball velocity but not increase the injury risk. Study Design: Case series; Level of evidence, 4. Methods: All baseball pitchers who participated in a 15-week program at a single location, with the same coaches, and aimed to improve pitching mechanics and increase velocity were included. The training program was broken down into 3 phases, and each participant went through the same program. Lighter baseballs (3 and 4 oz) and standard baseballs (5 oz) were utilized as part of the training program. Weighted (heavier) balls were not used. Velocity was measured at 4 time points throughout the program with the pitcher throwing 5 fastballs using a standard 5-oz ball at maximum velocity (sessions 3, 10, 17, and 25). Injuries for all players were recorded throughout the entire program. Results: A total of 44 male pitchers aged 10 to 17 years (mean age, 14.7 ± 1.8 years) completed the training program and were available for analysis. No pitcher sustained a shoulder or elbow injury during the course of the training program. Fastball velocity increased by a mean of 4.8 mph (95% CI, 4.0-5.6 mph) ( P < .001). Overall, 43 of 44 players (98%) had an increase in fastball velocity over the course of the program. Conclusion: A 15-week pitching training program with lighter baseballs significantly improved pitching velocity without causing any injuries, specifically to the shoulder or elbow. Lighter baseballs should be considered as an alternative to weighted baseballs when attempting to increase a pitcher’s velocity.
The safety of isoniazid tuberculosis preventive treatment in pregnant and postpartum women: systematic review and meta-analysis
Authors: Hamada Yohhei , Figueroa Carmen , Martín-Sánchez Mario , Falzon Dennis , Kanchar Avinash 
Published: March 2020

BackgroundThe World Health Organization (WHO) recommends tuberculosis (TB) preventive treatment for high-risk groups. Isoniazid preventive therapy (IPT) has been used globally for this purpose for many years, including in pregnancy. This review assessed current knowledge about the safety of IPT in pregnancy.MethodsWe searched PubMed, Embase, CENTRAL, Global Health Library and HIV and TB-related conference abstracts, until May 15, 2019, for randomised controlled trials (RCTs) and non-randomised studies (NRS) where IPT was administered to pregnant women. Outcomes of interest were: 1) maternal outcomes, including permanent drug discontinuation due to adverse drug reactions, any grade 3 or 4 drug-related toxic effects, death from any cause and hepatotoxicity; and 2) pregnancy outcomes, includingin uterofetal death, neonatal death or stillbirth, preterm delivery/prematurity, intrauterine growth restriction, low birth weight and congenital anomalies. Meta-analyses were conducted using a random-effects model.ResultsAfter screening 1342 citations, nine studies (of 34 to 51 942 participants) met inclusion criteria. We found an increased likelihood of hepatotoxicity among pregnant women given IPT (risk ratio 1.64, 95% CI 0.78–3.44) compared with no IPT exposure in one RCT. Four studies reported on pregnancy outcomes comparing IPT exposure to no exposure among pregnant women with HIV. In one RCT, adverse pregnancy outcomes were associated with IPT exposure during pregnancy (odds ratio (OR) 1.51, 95% CI 1.09–2.10), but three NRS showed a protective effect.ConclusionsWe found inconsistent associations between IPT and adverse pregnancy outcomes. Considering the grave consequences of active TB in pregnancy, current evidence does not support systematic deferral of IPT until postpartum. Research on safety is needed.
Effects of aging on the quality of roasted sesame-like flavor Daqu
Authors: Fan Guangsen , Fu Zhilei , Teng Chao , Liu Pengxiao , Wu Qiuhua , Rahman Md Khondakar Raziur , Li Xiuting 
Published: March 2020

Abstract
Background
Daqu, the saccharification, fermentation, and aroma-producing agents for Baijiu brewing, is prepared using a complex process. Aging is important for improving the quality of Daqu, but its impact has rarely been studied. This study investigated changes in the physicochemical properties, flavor compounds, and microbial communities during aging of Daqu with a roasted sesame-like flavor.

Results
The physicochemical properties changed continuously during aging to provide a high esterifying activity. Aging removed unpleasant flavor compounds and helped to stabilize the flavor compounds in mature Daqu. A high-throughput sequencing approach was used to analyze the changing composition of the microbial communities during aging. Aging helped to modify the microbial population to produce better Baijiu by eliminating low-abundance microbial communities and optimizing the proportion of predominant microbial communities. Nine genera of prokaryotic microbes formed the core microbiota in Daqu after aging. Regarding eukaryotic microbes, Zygomycota, the predominant community, increased in the first 2 months, then decreased in the third month of aging, while Ascomycota, the subdominant community, showed the opposite behavior. Absidia, Trichocomaceae_norank and Rhizopus were the predominant genera in the mature Daqu.

Conclusions
Significant correlations between microbiota and physicochemical properties or flavor compounds were observed, indicating that optimizing microbial communities is essential for aging Daqu. This study provides detailed information on aging during Daqu preparation.
On estimating the time to statistical cure
Authors: Jakobsen Lasse H. , Andersson Therese M.-L. , Biccler Jorne L. , Poulsen Laurids Ø. , Severinsen Marianne T. , El-Galaly Tarec C. , Bøgsted Martin 
Published: March 2020

Abstract
Background
The mortality risk among cancer patients measured from the time of diagnosis is often elevated in comparison to the general population. However, for some cancer types, the patient mortality risk will over time reach the same level as the general population mortality risk. The time point at which the mortality risk reaches the same level as the general population is called the cure point and is of great interest to patients, clinicians, and health care planners. In previous studies, estimation of the cure point has been handled in an ad hoc fashion, often without considerations about margins of clinical relevance.

Methods
We review existing methods for estimating the cure point and discuss new clinically relevant measures for quantifying the mortality difference between cancer patients and the general population, which can be used for cure point estimation. The performance of the methods is assessed in a simulation study and the methods are illustrated on survival data from Danish colon cancer patients.

Results
The simulations revealed that the bias of the estimated cure point depends on the measure chosen for quantifying the excess mortality, the chosen margin of clinical relevance, and the applied estimation procedure. These choices are interdependent as the choice of mortality measure depends both on the ability to define a margin of clinical relevance and the ability to accurately compute the mortality measure. The analysis of cancer survival data demonstrates the importance of considering the confidence interval of the estimated cure point, as these may be wide in some scenarios limiting the applicability of the estimated cure point.

Conclusions
Although cure points are appealing in a clinical context and has widespread applicability, estimation remains a difficult task. The estimation relies on a number of choices, each associated with pitfalls that the practitioner should be aware of.
Oral cavity swabbing for diagnosis of group a Streptococcus: a prospective study
Authors: Adler Limor , Parizade Miriam , Koren Gideon , Yehoshua Ilan 
Published: March 2020

Abstract
Background
Throat pain is a common complaint in the ambulatory setting. Diagnosis of group A Streptococcus is made with a culture, molecular test or a rapid antigen detection test from the tonsils or the posterior pharyngeal wall, while other areas of the oral cavity are considered unacceptable. The purpose of the study is to compare cultures from the tonsils or posterior pharyngeal wall (throat) with cultures from the oral cavity (mouth).

Methods
A prospective study conducted in ambulatory care. Eleven family physicians collected 2 swabs (throat and mouth) from 200 consecutive patients who complaint about throat pain. Inclusion criteria were throat pain and Centor Criteria > 2. Exclusion criteria were tonsillectomy and age (< 3 or > 65 years old). Participants were later divided into two groups – pediatrics (3–18 years old) and adults (19–65 year old). Sensitivity and specificity of mouth culture were calculated, with throat culture considered the reference gold standard.

Results
Between November 2017 and March 2019, 200 swabs were collected (101 adults and 99 children). In the adult group sensitivity of mouth culture was 72.1% (95% Confidence Interval [CI] 59.9–82.3%) and specificity was 100% (95% CI 92.7–89.4%-100%). In the pediatric group sensitivity of mouth culture was 78.3% (95% CI 65.8–87.9%) and specificity was 100% (95% CI 92.5–100%).

Conclusion
Our study demonstrated higher sensitivity of mouth culture for GAS than previously published. This finding suggests that areas of the oral cavity that were considered as unacceptable sites for culture of GAS pharyngitis may be considered as acceptable swabbing sites.

Trial registration
Trial registration: ClinicalTrials.gov, ID NCT03137823. Registered 3 May 2017.
Knowledge and skills required to perform point-of-care ultrasonography in family practice – a modified Delphi study among family physicians in Slovenia
Authors: Homar Vesna , Gale Zala Kumse , Lainscak Mitja , Svab Igor 
Published: March 2020

Abstract
Background
More and more family physicians (FPs) are using point-of-care ultrasonography (POCUS) in Europe. Still, there is no general consensus about the specific knowledge and skills that a FP should acquire in order to effectively perform POCUS. The objective of this study was to identify indications for the use of POCUS among FPs, explore the barriers of its use and provide an expert opinion of FPs on knowledge and skills required to effectively implement POCUS in family practice.

Methods
A modified two-round Delphi study was carried out among FPs using POCUS in Slovenia.

Results
21 FPs were invited to participate in the study. A total of 13 FPs (62%) responded the round-one questionnaire and 10 (48%) completed the round-two questionnaire. Results show a large variability of indications for the use of POCUS in family practice, the most common being acute abdominal conditions, lung ultrasonography and eyeballing echocardiography. In contrast, the results show little variability in barriers for the use of POCUS, the most common being lack of time, inaccessibility of specific training programmes and financial issues. There is a strong consensus on the knowledge and skills needed to perform POCUS. Panellists agreed on a learning medical knowledge, technical skills and expressed a need for individual consultations and tutorship options.

Conclusion
This study proves that although POCUS is used in family practice for a wide variety of indications with a significant number of barriers, there is a strong consensus on what a FP needs to know to effectively perform POCUS.