bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Tibiotalar Joint Space and Ankle Function Following Ankle Surgery
Authors: Mullens Jess , Stake Ingrid K. , Matheny Lauren M. , Daney Blake , Clanton Thomas O. 
Published: October 2020

Background: Joint-preserving procedures of the ankle may postpone the need for ankle arthrodesis (AA) or total ankle replacement (TAR). The challenge for the surgeon is to determine which patients may benefit from these joint-preserving procedures. We hypothesized that patents with less than 2 mm of ankle joint space on preoperative radiographs would report inferior outcomes following joint-preserving surgery compared with those with 2 mm or greater joint space. Methods: Patients 18 years of age or older treated with joint-preserving ankle surgery with a minimum of 2 years of follow-up were considered for study inclusion. The ankle joint space was measured on standardized weightbearing preoperative radiographs. At follow-up, patients completed questionnaires including the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales, the Short Form-12 (SF-12) Physical Component Summary and Mental Component Summary, the Tegner Activity Scale, and satisfaction with outcome. Results: A total of 251 patients were included in the study. Forty-three patients had an ankle joint space of less than 2 mm. Compared with the 208 patients with an ankle joint space of 2 mm or greater, they had inferior FAAM ADL, FAAM Sports, and SF-12 Physical Component Summary scores ( P = .001, P = .001, and P = .006, respectively). Additionally, a statistically significant positive correlation between joint space distance and the FAAM ADL ( P = .012, r = 0.158), FAAM Sports ( P < .001, r = 0.301), and SF-12 Physical Component Summary ( P < .010, r = 0.163) scores was found. Conclusion: Patients with a preoperatively narrowed ankle joint space of less than 2 mm had significantly lower outcome scores following joint-preserving ankle surgery compared with patients with preserved ankle joint space. These results may assist clinicians in selecting patients who may benefit from ankle joint–preserving procedures, as well as counseling patients with a narrowed ankle joint space regarding expected outcome after joint-preserving ankle surgery. Level of Evidence: Level II, prognostic comparative study.
Autistic traits are related to worse performance in a volatile reward learning task despite adaptive learning rates
Authors: Goris Judith , Silvetti Massimo , Verguts Tom , Wiersema Jan R , Brass Marcel , Braem Senne 
Published: October 2020

Recent theories propose that autism is characterized by an impairment in determining when to learn and when not. We investigated this by estimating learning rate in environments varying in volatility and uncertainty. Specifically, we correlated autistic traits (in 163 neurotypical participants) with modelled learning behaviour during probabilistic reward learning under the following three conditions: a Stationary Low Noise condition with stable reward contingencies, a Volatile condition with changing reward contingencies and a Stationary High Noise condition where reward probabilities for all options were 60%, resulting in an uncertain, noisy environment. Consistent with earlier findings, we found less optimal decision-making in the Volatile condition for participants with more autistic traits. However, we observed no correlations between underlying adjustments in learning rates and autistic traits, suggesting no impairment in updating learning rates in response to volatile versus noisy environments. Exploratory analyses indicated that impaired performance in the Volatile condition in participants with more autistic traits, was specific to trials with reward contingencies opposite to those initially learned, suggesting a primacy bias. We conclude that performance in volatile environments is lower in participants with more autistic traits, but this cannot be unambiguously attributed to difficulties with adjusting learning rates. Lay abstract Recent theories propose that autism is characterized by an impairment in determining when to learn and when not. Here, we investigated this hypothesis by estimating learning rates (i.e. the speed with which one learns) in three different environments that differed in rule stability and uncertainty. We found that neurotypical participants with more autistic traits performed worse in a volatile environment (with unstable rules), as they chose less often for the most rewarding option. Exploratory analyses indicated that performance was specifically worse when reward rules were opposite to those initially learned for participants with more autistic traits. However, there were no differences in the adjustment of learning rates between participants with more versus less autistic traits. Together, these results suggest that performance in volatile environments is lower in participants with more autistic traits, but that this performance difference cannot be unambiguously explained by an impairment in adjusting learning rates.
Dignity Rights for a Pandemic
Authors: May James R. , Daly Erin 
Published: October 2020

The concept of human dignity means, quite simply, that every person has inherent equal worth. This incontrovertible but profound concept is derived from the body of dignity law that has developed since the end of World War II at the international, regional, national, and subnational levels, where dignity has become the central axis around which law rotates. Both the UN Charter and the Universal Declaration of Human Rights confirm the foundational place of the recognition of human dignity in the building of the new postwar world order. Advancing human dignity also is a central premise of the binding International Covenant on Civil and Political Rights and International Covenant on Economic, Social and Cultural Rights, and virtually all subsequent instruments addressing human well-being. The right to dignity is guaranteed by the national constitutions of more than 160 countries. Further, courts around the globe have applied the right to dignity thousands of times in cases involving issues that matter everyday to everyday people, including involving poverty, employment, marriage, adoption, incarceration, education, safety, health, discrimination, immigration, and police brutality, and many more. The pandemic wrought by Covid-19 has tested the boundaries of dignity’s role under the of law. Millions are infected. Hundreds of thousands have died. Nations have closed their borders. People are quarantined, desparate, and desparing, leading to social and economic dislocation not seen since the Great Depression. This article highlights the normative and legal dimensions of dignity, and how taking account of dignity under law can improve outcomes during the pandemic. It theorizes that, while not a cure, recognizing dignity under law can be therapeutic in these troubling times.
Quality-of-life issues and symptoms reported by patients living with haematological malignancy: a qualitative study
Authors: Goswami Pushpendra , Oliva Esther N. , Ionova Tatyana , Else Roger , Kell Jonathan , Fielding Adele K. , Jennings Daniel M. , Karakantza Marina , Al-Ismail Saad , Collins Graham P. , McConnell Stewart , Langton Catherine , Salek Sam 
Published: October 2020

Background: Our aim was to identify health-related quality-of-life (HRQoL) issues and symptoms in patients with haematological malignancies (HMs) and develop a conceptual framework to reflect the inter-relation between them. Methods: A total of 129 patients with HMs were interviewed in a UK multicentre qualitative study. All interviews were audio recorded, transcribed and analysed using NVivo-11. Results: Overall, 34 issues were reported by patients and were grouped into two parts: quality of life (QoL) and symptoms. The most prevalent HRQoL issues were: eating and drinking habits; social life; physical activity; sleep; and psychological well-being. Furthermore, most prevalent disease-related symptoms were: tiredness; feeling unwell; breathlessness; lack of energy; and back pain. The most prevalent treatment side effects were: tiredness; feeling sick; disturbance in sense of taste; and breathlessness. Conclusions: Both HMs and their treatments have a significant impact on patients’ HRQoL, in particular on issues such as job-role change, body image and impact on finances.
Treatment strategy for elderly patients with the isolated greater trochanteric fracture
Authors: Oc Yunus , Varol Ali , Yazar Ethem Aytac , Ak Semih , Akpolat Ahmet Onur , Kilinc Bekir Eray 
Published: October 2020

Background: The objective of this study was to evaluate the risk of femur intertrochanteric fracture associated with femur trochanter major fractures in patients over 65 years of age with magnetic resonance examination for better diagnosis and treatment. Methods: Thirty-one patients who had incomplete femur intertrochanteric fracture diagnosed were included in the study. Patients were classified according to the length of the fracture line crossing the intertrochanteric border. Fracture patterns were described on magnetic resonance imaging coronal views. Group A, pattern 1, greater trochanteric fracture extends to intertrochanteric region with both cortices; Group B, pattern 2, fracture has characteristics of pattern 1 fracture including diametaphysis fracture line; Group C, pattern 3, greater trochanteric fracture only has extending superolateral cortex fracture line of intertrochanteric region; and Group D, pattern 4, fracture has characteristics of pattern 1 fracture and including superior extension to the baso-cervical line. Surgical treatment with dynamic hip screw was applied to all patients with intertrochanteric extension after magnetic resonance examination. Results: This study included 16 women (80.3 ± 6.7 years) and 15 men (76.9 ± 10.94 years). Group A had 11 patients, group B had 8 patients, group C had 6 patients, and group D had 6 patients. Ambulation was initially prescribed for these patients 1 day after the surgery. The average surgery durations of the A, B, C, and D patterns were 44.54 ± 7.56, 49.37 ± 12.65, 49.16 ± 3.76, and 44.16 ± 5.84 min, respectively. No statistically significant differences were observed among the four patterns (P = 0.404). Conclusion: Surgical treatment of the greater trochanteric fracture which is considered an indicator of occult intertrochanteric fracture is a good choice for the treatment because of the procedure safety and early mobilization after the surgery
Use of 0.014-in. pushable bare platinum coils in super-selective embolization through the 1.6-Fr. microcatheter of the triaxial system
Authors: Tsukahara Satoshi , Shimohira Masashi , Nagai Keiichi , Ohta Kengo , Sawada Yusuke , Hashizume Takuya , Goto Taeko , Shibamoto Yuta 
Published: October 2020

Background A triple-coaxial (triaxial) system, which consists of a small microcatheter, a large microcatheter, and a 4-Fr. catheter, has been reported to allow super-selective catheterization. A 1.6-Fr. microcatheter has recently become available as the small microcatheter for the triaxial system, in addition to 0.014-in. pushable bare platinum coils that may be introduced into the 1.6-Fr. microcatheter. Purpose The purpose of the present study was to evaluate the feasibility of 0.014-in. pushable bare platinum coils in embolization through the 1.6-Fr. microcatheter of the triaxial system. Material and Methods Between November 2015 and October 2019, 19 embolizations were performed on 18 patients, 9 males and 9 females with a median age of 77 years (range, 41–88 years), using 0.014-in. pushable bare platinum coils through the 1.6-Fr. microcatheter of the triaxial system. The technical success rate, clinical success rate, and complications associated with the procedure were assessed. Technical success was defined as the successful delivery and placement of 0.014-in. pushable bare platinum coils, and clinical success as the immediate postembolic complete cessation of blood flow confirmed by digital subtraction angiography. Results Eighty-four 0.014-in. pushable bare platinum coils were delivered and 19 arteries were successfully embolized. The median number of 0.014-in. pushable bare platinum coils was 4 (range, 1–12). The technical success rate was 100% (84/84) and the clinical success rate was also 100% (19/19). There were no complications associated with the procedures. Conclusion The use of 0.014-in. pushable bare platinum coils in super-selective embolization through the 1.6-Fr. microcatheter of the triaxial system appears to be feasible and safe.
Variations of Sagittal Alignment in Standing Versus Sitting Positions Under the Roussouly Classification in Asymptomatic Subjects
Authors: Sun Zhuoran , Zhou Siyu , Jiang Shuai , Zou Da , Yu Miao , Li Weishi 
Published: October 2020

Study Design: Prospective radiological analysis. Objective: To investigate the characteristics of the sagittal spinopelvic alignment in the standing and sitting positions under the Roussouly classification in a healthy population. Methods: This study using standing and sitting lateral radiographs included 143 volunteers whose spinopelvic parameters were measured. The parameters were compared in the standing and sitting positions. The lumbo-pelvic profile was identified according to the Roussouly classification. The differences in the values of the parameters between the standing and sitting positions were analyzed. The different frequencies of the unchanged apex were assessed. Results: All parameter values except the thoracolumbar angle (TLK) were significantly altered. With regard to the classification of the lumbopelvic profile, 15 (10.5%) subjects were excluded because they were evaluated as not belonging to any of the Roussouly types. The remaining 128 subjects were evaluated and classified as follows: 19 (14.8%), type 1; 53 (41.4%), type 2; 9 (7.0%), type 3 + anteverted pelvis (AP); 33 (25.8%), type 3; and 14 (10.9%), type 4. The differences in the pelvic tilt (PT), sacral slope (SS), and thoracic pelvic angle (TPA) values were significantly lower in types 1 and 2 than in other Roussouly types. Corresponding variations in the apical vertebra for the sagittal lumbar curves in the sitting position were observed. Conclusions: Subjects with Roussouly type 1 and type 2 sagittal alignments were found to be less capable of performing changes in alignment when changing to the sitting position. The characteristics of the apical movement were also different.
Epicrania fugax: Report of eight cases with some novel features
Authors: Chowdhury Debashish , Chawla Tanushree , Duggal Ashish 
Published: October 2020

Introduction: Epicrania fugax (EF) is an epicranial headache syndrome characterized by short lasting headache paroxysms which spread in a typical linear/zigzag pattern. The definition of EF has evolved over time, and new phenotypes have been observed in various studies. Aim: We present eight cases diagnosed as EF according to the International Classification of Headaches Disorders, 3rd edition criteria and highlight certain novel characteristics which will help in the further categorization of this disorder. Methods: We prospectively studied eight cases of EF who presented to our headache clinic from January 2016 to September 2020. Demographic and detailed clinical data were collected and analyzed. Results: The mean age of onset of the cohort was 42 ± 10.47 years with a median duration of symptoms being 1 year. There were 5 male and 3 female patients. The mean visual analog scale score was 5.25 ± 1.83. Headache frequency had high intra and interindividual variability. Four patients had a typical spread of pain along the distribution of greater occipital, and supraorbital, nerves. Four patients had an atypical presentation with midline headache, transverse occipital, and bilateral simultaneous hemicranium involvement. Headache paroxysm was followed by a prolonged fixed pain in the same linear distribution in three patients. One patient had ipsilateral redness in the eye. All eight patients required medical intervention with amitriptyline or neuromodulators, five of whom reported a significant reduction in their headache symptoms. Conclusion: Our case series highlights a few interesting features which need further exploration with larger studies. Firstly, the atypical distribution of the pain trajectory forces us to dig deeper into the pathogenesis of the disorder. Secondly, our data also suggest a possibility of EF triggered “linear headaches.” EF is a relatively uncommon headache disorder that can be managed easily with neuromodulators but the lack of awareness of the condition often leads to delayed diagnosis.
Reduced-intensity therapy for pediatric lymphoblastic leukemia: impact of residual disease early in remission induction
Authors: Sidhom Iman , Shaaban Khaled , Youssef Sarah H. , Ali Nesreen , Gohar Seham , Rashed Wafaa M. , Mehanna Mai , Salem Sherine , Soliman Sonya , Yassin Dina , Mansour Emad , Coustan-Smith Elaine , Ribeiro Raul C. , Rivera Gaston K. 
Published: October 2020

Abstract
Legacy data show that ∼40% of children with acute lymphoblastic leukemia (ALL) were cured with limited antimetabolite-based chemotherapy regimens. However, identifying patients with very-low-risk (VLR) ALL remains imprecise. Patients selected based on a combination of presenting features and a minimal residual disease (MRD) level &lt;0.01% on day 19 of induction therapy had excellent outcomes with low-intensity treatment. We investigated the impact of MRD levels between 0.001% and &lt;0.01% early in remission induction on the outcome of VLR ALL treated with a low-intensity regimen. Between October of 2011 and September of 2015, 200 consecutive patients with B-precursor ALL with favorable clinicopathologic features and MRD levels &lt;0.01%, as assessed by flow cytometry in the bone marrow on day 19 and at the end of induction therapy, received reduced-intensity therapy. The 5-year event-free survival was 89.5% (± 2.2% standard error [SE]), and the overall survival was 95.5% (± 1.5% SE). The 5-year cumulative incidence of relapse (CIR) was 7% (95% confidence interval, 4-11%). MRD levels were between 0.001% and &lt;0.01% on day 19 in 29 patients. These patients had a 5-year CIR that was significantly higher than that of patients with undetectable residual leukemia (17.2% ± 7.2% vs 5.3% ± 1.7%, respectively; P = .02). Our study shows that children with VLR ALL can be treated successfully with decreased-intensity therapy, and it suggests that the classification criteria for VLR can be further refined by using a more sensitive MRD assay.
Safety of venetoclax rapid dose escalation in CLL patients previously treated with B-cell receptor signaling antagonists
Authors: Koenig Kristin L. , Huang Ying , Dotson Emily K. , Sheredy Shane , Bhat Seema A. , Byrd John C. , Desmond Emily , Ford Jill , Iarocci Shauna , Jones Jeffrey A. , Lucas Margaret S. , Moran Mollie E. , Wiczer Tracy E. , Woyach Jennifer A. , Awan Farrukh T. , Rogers Kerry A. 
Published: October 2020

Abstract
Venetoclax has efficacy in patients relapsing after B-cell receptor pathway inhibitors (BCRis); however, because of the risk of tumor lysis syndrome (TLS), a 5-week dose ramp-up is required to attain the target dose. Patients relapsing after BCRis frequently have proliferative disease, requiring a faster time to target dose than this scheme allows. This limitation can potentially be overcome with rapid dose escalation (RDE). We analyzed 33 chronic lymphocytic leukemia patients who underwent venetoclax RDE after prior BTKi treatment. Median time to target dose was 9 days. Seventeen patients (52%) developed laboratory TLS, and 5 (15%) developed clinical TLS, all as a result of renal injury. TLS was seen in more patients with a higher initial tumor burden. TLS occurred at all dose levels, with most episodes occurring at the 50- and 100-mg doses. Most interestingly, a decrease in absolute lymphocyte count (ALC) from pre–venetoclax dose to 24 hours post–venetoclax dose of 10 × 103/μL was associated with an increased risk of TLS (hazard ratio, 1.32; P = .02), after controlling for venetoclax dose level. Venetoclax RDE with close in-hospital monitoring at experienced centers and in select patients is feasible. The rapidity with which ALC drops helps predict TLS and could help guide dose-escalation decisions.
Long-term prognosis of new adult-onset asthma in obese patients
Authors: Ilmarinen Pinja , Pardo Adrienn , Tuomisto Leena E. , Vähätalo Iida , Niemelä Onni , Nieminen Pentti , Kankaanranta Hannu 
Published: October 2020

BackgroundObesity has been associated with poor outcomes of asthma in cross-sectional studies, but long-term effect of obesity on asthma remains unknown.AimsTo study the effects of obesity, found at the time of diagnosis of adult-onset asthma, on 12-year prognosis by focusing on oral corticosteroid (OCS) use and respiratory-related hospital admissions.MethodsPatients diagnosed with adult-onset asthma (n=203) were divided into three categories based on diagnostic body mass index (BMI) (<25 kg·m−2, 25–29.9 kg·m−2, ≥30 kg·m−2) and followed for 12 years as part of the Seinäjoki Adult Asthma Study. Self-reported and dispensed OCS were assessed for the 12-year period. Data on hospital admissions were analysed based on medical records.Results12 years after diagnosis, 86% of the patients who were obese (BMI ≥30 kg·m−2) at diagnosis remained obese. During the follow-up, no difference was found in weight gain between the BMI categories. During the 12-year follow-up, patients obese at diagnosis reported more frequent use of OCS courses (46.9%versus23.1%, p=0.028), were dispensed OCS more often (81.6%versus56.9%, p=0.014) and at higher doses (median 1350 (interquartile range 280–3180) mgversus600 (0–1650) mg prednisolone, p=0.010) compared to normal-weight patients. Furthermore, patients who were obese had more often one or more respiratory-related hospitalisations compared to normal-weight patients (38.8%versus16.9%, p=0.033). In multivariate logistic regression analyses, obesity predicted OCS use and hospital admissions.ConclusionsIn adult-onset asthma, patients obese at diagnosis mostly remained obese at long-term and had more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. Weight loss should be a priority in their treatment to prevent this outcome.