bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonunion and Calcaneocuboid Subluxation Are Minimal After Evans Osteotomy Without Fixation
Authors: Rodriguez-Materon Solangel , Miles Megan , Hsu Nigel , Gallagher Brian , Guyton Gregory 
Published: November 2024

Background Fixation of the Evans osteotomy for flatfoot correction has been advocated without supporting data to facilitate union and avoid calcaneocuboid subluxation. We examined these issues in the largest reported series of Evans procedures to date. Methods A total of 118 cases from a consecutive series of 137 patients who underwent Evans osteotomy without fixation by a single surgeon were available for review. Average follow-up was 62.5 weeks. Bony union and radiographic measurements including calcaneocuboid subluxation were evaluated. Results Union occurred in 117/118 cases (99.2%). Calcaneocuboid subluxation increased minimally compared to preoperative values (1.5 ± 2.3 mm). The mean wedge size was 7.1 ± 1.4 mm. All radiographic measurements of the longitudinal arch improved. Conclusion The Evans osteotomy without fixation demonstrated near-universal union and minimal calcaneocuboid subluxation. The frequent use of additional osteotomies in our series might have allowed the use of smaller wedges and contributed to our favorable results. Level of Evidence: 4
A Narrative Review of Softball Pitching Workload and Pitch Counts in Relationship to Injury
Authors: Zaremski Jason L. , A. Holtz Kaila , L. Downs Talmage Jessica , Ulman Sophia , Oliver Gretchen D. 
Published: November 2024

Context: Fastpitch softball is a popular women’s sport in the United States, and participation rates are increasing. There is growing concern about the prevalence of overuse injuries in softball pitchers at all competitive levels. Pitching workload in softball may be a modifiable risk factor and will be discussed in this narrative review. Evidence Acquisition: A review of softball injury research related to workload available in electronic databases, including PubMed, Medline, and EBSCO. Study Design: Clinical review. Level of Evidence: Level 4. Results: There is a paucity of research evaluating workload (inclusive of internal and external risk factors) including pitch counts in women’s softball. In particular, research has shown that pitchers report increasing fatigue and pain over a game and weekend tournament, and that the number of pitches thrown by pitchers varies widely. One study showed that pitchers throwing >85 pitches per game had an increased risk of injury over the season. As of 2023, no established pitch count restrictions exist in the United States or Canada. Further research, particularly at high school and collegiate levels, is needed. Conclusion: Softball pitchers are at an increased risk of overuse injury and further research is needed to recommend specific workload interventions such as pitch counts. Strength-of-Recommendation Taxonomy (SORT): B.
Subarachnoid hemorrhage in patients with SARS-CoV-2 infection: A scoping review
Authors: Rosca Elena Cecilia , Al-Qiami Almonzer , Cornea Amalia , Simu Mihaela 
Published: November 2024

Objective: Subarachnoid hemorrhage has high mortality and substantial long-term morbidity. Although SARS-CoV-2 infection is associated with hypercoagulopathy, patients may also present subarachnoid hemorrhage. We aimed to synthesize the clinical and paraclinical characteristics, treatment responses, and outcomes of this neurologic complication. Methods: The population included adults and children, and studies investigated patients with subarachnoid hemorrhagein the context of SARS-CoV-2 infection. We included prospective, retrospective, observational, or interventional studies. We systematically reviewed LitCOVID and the COVID-19 WHO database until February 2023, following a published protocol. Results are presented in tabular form to provide a descriptive summary of the findings. Results: We included 107 patients (30 aneurysmal SAH—aSAH, 52 non-aSAH confirmed by vascular imaging, and 25 without vascular imaging). Subarachnoid hemorrhage was concomitant or developed a few weeks after infection. Severity of COVID-19 ranged from asymptomatic (27.8% aSAH, 5.5% non-aSAH) to severe (50% aSAH, 75% non-aSAH). Patients presented inflammatory markers (25% aSAH, 81%non-aSAH), thrombocytopenia (12.5% aSAH, 28.6% non-aSAH), and impaired coagulation (0% aSAH, 28.6% non-aSAH). SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) in the cerebrospinal fluid was negative in seven patients. Brain samples were positive for SARS-CoV-2 in one case. Conclusions: An inadequate infection response may change aneurysmal size and morphology, with rupture tendency. Renine–angiotensine–aldosteron system disruption with hypertension and cough increases pressure on aneurysmal walls. Furthermore, mycotic and dissecting aneurysms were reported. Non-aSAH accompanies infection-related complications such as cerebral venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, or intracerebral hemorrhage. Cytokine release syndrome, endothelial dysfunction, and SARS-CoV-2 affinity for angiotensin-converting enzyme 2 receptors may induce vasculitic processes. Cough precipitates arterial dissection. Hypoxic brain injury, immune thrombocytopenia, and some COVID-19 medications increase bleeding risks.
Efficacy of the cigarette-burning application combined with medication intervention for smoking cessation in China: A randomized controlled trial
Authors: Wei Xiao-Wen , Qin Rui , Liu Yong-Zhuang , Liu Zhao , Cheng An-Qi , Zhou Xin-Mei , Su Zheng , Cui Zi-Yang , Li Jin-Xuan , Zhao Liang , Xiao Dan , Wang Chen 
Published: November 2024

Background Although smartphone application for smoking cessation was considered a promising strategy, there were scarce studies on the combination of usual interventions and apps for smoking cessation in China. Our study aimed to evaluate the efficacy of the Cigarette-Burning application combined with medication intervention for smoking cessation. Methods A parallel, open-label randomized clinical trial was conducted with a ratio of 1:1 allocation into the bupropion plus app group and bupropion group. All participants received bupropion intervention. Besides, participants in the bupropion plus app group were required to download and use the Cigarette-Burning app. Follow-up visits were conducted at weeks 1, 2, 4, 9, 12, and 24 after initiation of treatment. Results Four hundred participants were eventually included and analyzed from July 2019 to June 2021. The continuous abstinence rate at 9–12 weeks was significantly higher in the bupropion plus app group (39.5%) than in the bupropion group (27.5%) (OR = 1.64, 95% CI: 1.04–2.60, p < .05). The similar result was found for the 24-week sustained abstinence rate. The results of subgroup analysis expressed that the 9–12 weeks continuous abstinence rate in the bupropion plus app group was significantly higher than the bupropion group when the age of participants ≥ 50, the education level was college and above, FTND scores > 5, age at starting smoking ≤ 18 ( p < .05). Conclusions Our study found that the intervention combined with the Cigarette-Burning smartphone application is more effective than medication alone, and the application for smoking cessation could be an accessible complement to smoking cessation medication treatment.
Feasibility and acceptability of design and conduct of a registry-based randomised clinical trial evaluating eVIS as a digital support for physical activity in interdisciplinary pain rehabilitation programs: A randomised pilot study
Authors: Sjöberg Veronica , Monnier Andreas , Tseli Elena , LoMartire Riccardo , Hagströmer Maria , Björk Mathilda , Äng Björn , Vixner Linda 
Published: November 2024

Background Patients with chronic pain often struggle to engage in physical activity despite its health benefits. The eVISualisation of physical activity and pain intervention (eVIS) was developed to support adherence to physical activity plans in Interdisciplinary Pain Rehabilitation Programs (IPRPs) by visualising activity, pain levels, pain interference, and pharmacological use. This pilot study assesses the feasibility and acceptability of trial design and trial conduct of a registry-based randomised clinical trial (R-RCT). Method This randomised clinical pilot study included the first 10% (n = 39, mean age 43.5, 74.4% females) of the R-RCT sample (n≈400). Participants with non-cancer chronic pain from six IPRP units were randomly assigned to either the intervention group (IPRP + eVIS, n = 19) or the control group (IPRP, n = 20). Feasibility and acceptability were evaluated using pre-defined criteria on recruitment- and data collection procedures (e.g., inclusion rates, representativeness, adverse events), physiotherapists’ ratings of trial design and conduct (e.g., acceptability, feasibility), and outcome data characteristics and completeness (e.g., adherence, data accessibility). Results Recruitment was largely feasible, though attrition differences and the need for refined eligibility screening were noted. Physiotherapists cited time and implementation challenges. Both groups had satisfactory data completeness, but the control group showed lower adherence to daily reporting in the final third of the study. The intervention group had greater improvements in physical health, with 19.5% more participants achieving the minimum clinically important difference (≥3) on the physical component summary scale (PCS). No adverse events occurred. Conclusion With minor adjustments, the R-RCT design is mostly feasible, though some challenges to feasibility were identified and addressed.
Digitisation and health: Second nationwide survey of internet users in Germany
Authors: De Santis Karina Karolina , Muellmann Saskia , Pan Chen-Chia , Hoffmann Stephanie , Spallek Jacob , Haug Ulrike , Zeeb Hajo 
Published: November 2024

Objective Rapid digitisation of health occurred during the COVID-19 pandemic worldwide. In October 2020, we conducted a survey on digital health technology use in Germany. This study aimed to conduct a second survey to investigate in more detail the internet use in health context and digital technology use for health promotion and disease prevention in Germany. Methods A cross-sectional, nationwide telephone survey was conducted in November 2022. Anonymous data on internet and digital technology use, digital health literacy, and sociodemographic characteristics were analysed using descriptive statistics and binary logistic regressions. Results The 1020 participants were aged 18–92 years, 53% were male, 62% completed primary or secondary education, 71% resided in large cities, and 45% reported a country-average net household income. Overall, 61% reported internet use in health context via 1–4 devices. Among those, more than 50% used the internet and apps to obtain general health information and less than 50% used digital technologies for physical activity promotion or cancer prevention. Overall, 34% were confident in using the internet for health decisions and 71% preferred to receive health information non-digitally (e.g. on paper). Internet, app, and digital technology use were associated with higher digital health literacy and income, and residence in larger cities. Digital technologies were used for physical activity promotion by younger and for cancer prevention by older participants. Conclusion The internet and digital technologies were predominantly used to obtain health information, but less often for health promotion and disease prevention in 2022 in Germany. While health app and digital technology use for physical activity promotion increased, the confidence in using online information for health decisions decreased in 2022 relative to 2020. Factors that promote confidence in online health information and digital technology use for health promotion and disease prevention need to be investigated in future studies.
An Initial Exploratory Examination of the Sensitivity and Specificity of MyCog Mobile Using the Mini-Cog as a Proxy for Suspected Cognitive Impairment
Authors: Young Stephanie Ruth , Dworak Elizabeth , Byrne Greg , Shono Yusuke , Zhang Manrui , Yoshino Benavente Julia , Yao Lihua , Bass Mike , Curtis Laura , Varela Diaz Maria , Jones Callie , Gershon Richard , Wolf Michael , Nowinski Cindy 
Published: November 2024

Objectives: To help promote early detection of cognitive impairment in primary care, MyCog Mobile was designed as a cognitive screener that can be self-administered remotely on a personal smartphone. We explore the potential utility of MyCog Mobile in primary care by comparing MyCog Mobile to a commonly used screener, Mini-Cog. Methods: A sample of 200 older adults 65+ years (mean age = 72.56 years), completed the Mini-Cog and MyCog Mobile, which includes 2 memory measures and 2 executive functioning measures. A logistic regression model was conducted to predict failing Mini-Cog scores (≤2) based on MyCog Mobile measures. Results: A total of 20 participants earned a Mini-Cog score ≤2. MyCog Mobile demonstrated an AUC of 0.83 (95% bootstrap CI [0.75, 0.95]), sensitivity of 0.76 (95% bootstrap CI [0.63, 0.97]), and specificity of .88 (95% bootstrap CI [0.63, 0.10]). The subtest Name Matching from MyFaces and MySorting were the only significant predictors of failed Mini-Cogs. Conclusions: MyCog Mobile demonstrated sensitivity and specificity to identify participants who failed the Mini-Cog, and may show promise as a screening tool for cognitive impairment in older adults. Further research is necessary to establish the clinical utility of MyCog Mobile in a larger sample using documented clinical diagnoses.
Outcomes of One Versus Two Level MIS Decompression With Adjacent Level Stenosis
Authors: Subramanian Tejas , Shahi Pratyush , Hirase Takashi , Kazarian Gregory S. , Boddapati Venkat , Kaidi Austin C. , Asada Tomoyuki , Singh Sumedha , Mai Eric , Simon Chad Z. , Akosman Izzet , Zhao Eric R. , Song Junho , Amen Troy B. , Araghi Kasra , Korsun Maximilian K. , Zhang Joshua , Kwas Cole T. , Vaishnav Avani S. , Tuma Olivia , Kim Eric T. , Singh Nishtha , Allen Myles R. J. , Bay Annika , Sheha Evan D. , Lovecchio Francis C. , Dowdell James E. , Qureshi Sheeraz A. , Iyer Sravisht 
Published: November 2024

Study Design Retrospective cohort study. Objective Decompression for the treatment of lumbar spinal stenosis (LSS) has shown excellent clinical outcomes. In patients with symptomatic single level stenosis and asymptomatic adjacent level disease, it is unknown whether decompressing only the symptomatic level is sufficient. The objective of this study is to compare outcomes between single level and dual level minimally invasive (MIS) decompression in patients with adjacent level stenosis. Methods The current study is a retrospective review of patients undergoing primary single or dual level MIS decompression for LSS. Radiographic stenosis severity was graded using the Schizas grading. Patients undergoing single level decompression (SLD) with moderate stenosis at the adjacent level were compared with patients undergoing dual level decompression (DLD) for multi-level LSS. Clinical outcomes, complications, and reoperations were compared. Subgroup analysis was performed on patients with the same Schizas grade at the adjacent level in the SLD group and the second surgical level in the DLD group. Results 148 patients were included (126 SLD, 76 DLD). There were no significant differences in patient reported outcomes between the two groups at any timepoint up to 2 years postoperatively, including in the matched stenosis severity subgroups. Operative time was longer in the DLD cohort ( P < 0.001). There were no significant differences in complications or reoperation rates. Conclusion In patients with single level symptomatic LSS and adjacent level stenosis, decompression of only the symptomatic level provided equivalent clinical outcomes compared to dual level decompression. The additional operative time and potential incremental risk of dual level surgery may not be justified.
Therapeutic drug monitoring for dose optimization in Alzheimer's disease and in dementia with Lewy bodies: A randomized single-blinded clinical trial
Authors: Fischer Michael Hén Forbord , Zibrandtsen Ivan Chrilles , Johannsen Peter , Siersma Volkert , Rasmussen Jan Borg , Larsen Jens Borggaard , Høgh Peter 
Published: November 2024

Background Previous evidence suggests serum concentrations of donepezil varies in clinical populations and that a dose higher than standard may have additional positive effect on cognition. Therapeutic drug monitoring (TDM) is a tool for dose optimization (DO) whereby treatment is adjusted based on previous quantification of the prescribed drug. Objective Investigate whether TDM-based DO of donepezil or memantine improves clinical outcomes and/or reduce the frequency of adverse reactions (ARs) in neurodegenerative conditions commonly treated with these two study drugs. Methods Single-blinded 1:1 randomized controlled study in an outpatient memory clinic. Eligible participants either newly diagnosed with Alzheimer's disease dementia (AD), dementia with Lewy bodies (DLB), or Parkinson's disease dementia (PDD) scheduled for treatment with donepezil or memantine. The intervention group received TDM based DO. The control group received DO solely based on clinical assessment. Clinical outcomes were change in Mini-Mental State Examination, Addenbrooke's Cognitive Examination, Neuropsychiatric Inventory, and Disability Assessment in Dementia from baseline to 12 months. Additionally, data on incidence and severity of ARs and proportion of participants with a serum concentration within the therapeutic reference range were collected. Results 132 participants recruited (125 AD, 7 DLB, none with PDD) of whom 107 completed the study (101 AD and 6 DLB), fewer in the control group than planned. Statistical analysis did not reveal significant differences between groups neither for clinical outcomes nor for frequency of ARs. Conclusions TDM based DO did not significantly improve clinical outcomes nor reduce the frequency of ARs albeit important caveats to the results apply. ClincialTrials.gov identifier NCT04117178 (first posted October 7, 2019).
Intravenous thrombolysis therapy and dementia risk in acute ischemic stroke patients: A retrospective cohort study in Taiwan
Authors: Huang Yan-Siang , Kung Te-Jung , Chuang Yi-Fang 
Published: November 2024

Background Intravenous thrombolysis (IVT) is the standard treatment for acute ischemic stroke (AIS) to improve functional outcomes. Furthermore, AIS is an important risk factor for dementia. Limited evidence has shown the long-term benefit of IVT on dementia in Western countries. Objective We aim to investigate the association between IVT and the risk of dementia in acute ischemic stroke patients in Asian population. Methods A retrospective cohort study using medical records from a medical center in Taiwan between 2017 and 2022 was conducted. We included acute ischemic stroke patients aged over 55 years old who had not previously been diagnosed with dementia. The primary outcome was incident dementia ascertained through dementia diagnosis in medical records. The inverse probability of treatment-weighted Cox proportional hazard models were used to estimate the association between IVT and incident dementia. Results A total of 1471 patients with AIS were included. 939 (63.8%) were male, and the mean age was 70.7[Formula: see text]9.6 years. Among them, 19.1% of patients (n = 281) received IVT. The mean follow-up time was 2.6[Formula: see text]1.7 years. Although not statistically significant, the IVT was associated with a decreased risk of dementia (HR: 0.88 [95%CI 0.54–1.41)]). Conclusions The IVT was associated with lower risk of dementia, although not statistically significant, in reducing the incidence of dementia in Asian patients with ischemic stroke. Studies with larger sample sizes will be needed in the future.
Deep brain stimulation of the nucleus basalis of Meynert in severe Alzheimer’s disease
Authors: Xu Junpeng , Liu Bin , Shang Guosong , Liu Shuzhen , Feng Zhebin , Yang Haonan , Liu Di , Chang Qing , Chen Yuhan , Yu Xinguang , Mao Zhiqi 
Published: November 2024

Background Alzheimer's disease (AD) is increasingly prevalent, leading to severe cognitive decline and a diminished quality of life for patients. Nucleus basalis of Meynert deep brain stimulation (NBM-DBS) is a potential treatment approach. Objective This study aims to assess the efficacy and safety of NBM-DBS for AD patients. Methods We conducted a clinical study involving 6 patients with severe AD who received NBM-DBS. The treatment's safety and efficacy were evaluated using cognitive function tests (Mini-Mental State Examination, Montreal Cognitive Assessment, Alzheimer's Disease Rating Scale- cognitive subscale, Clinical Dementia Rating) and assessments of neuropsychiatric symptoms and sleep disorders (Functional Activity Questionnaire, Functional Independence Measure, Zarit Burden Interview, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Neuropsychiatric Inventory, Pittsburgh Sleep Quality Index). Results NBM-DBS was safe, with no severe adverse events. It improved cognitive functions and self-care abilities without altering the disease's progression. Notably, NBM-DBS significantly alleviated neuropsychiatric symptoms and sleep disturbances. Conclusions NBM-DBS could be a promising therapeutic approach for severe AD, particularly for managing neuropsychiatric symptoms and sleep disorders. Further research is warranted to confirm these preliminary findings.
Factors Related to Receipt of Help for Alcohol Use: Extending the Focus of Treatment to the Continuum of Unhealthy Alcohol Use
Authors: Tieu Lina , Pourat Nadereh , Bromley Elizabeth , Simhan Rajat , Bastani Roshan , Glenn Beth 
Published: November 2024

Background: Unhealthy alcohol use is one of the leading preventable causes of mortality in the U.S. Despite evidence of the growing burden of alcohol-associated mortality and disease, treatment is severely underutilized. Prior literature has often focused on assessing treatment among patients with severe alcohol use. Objectives: Assess factors associated with uptake of treatment for alcohol use among a broad population of those regularly exceeding U.S. guidelines for alcohol use. Design: Cross-sectional study. Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions – Wave III (NESARC-III) collected April 2012 to June 2013, weighted descriptive statistics were used to describe the U.S. population who self-reported regularly exceeding U.S. guidelines for moderate alcohol use at least monthly. Weighted multivariable regression was used to assess the association of individual-level factors with receipt of help for unhealthy alcohol use. Results: In weighted analyses of 6467 NESARC-III participants, 17% of the U.S. population reported regular engagement in unhealthy alcohol use (76% use exceeding guidelines, 14% binge drinking, 11% heavy drinking) and were predominantly male (62%), below age 65 (93%), non-Hispanic White (65%), and had lower levels of education and income. Half (53%) met criteria for alcohol use disorder. Only 5% reported receipt of help for their alcohol use. Compared to non-Hispanic White individuals, non-Hispanic Asian/Native Hawaiian or Other Pacific Islander (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.18-0.90) and non-Hispanic Black (OR 0.68, 95% CI 0.48-0.96) individuals were less likely to receive help for alcohol use. Factors associated with greater receipt of help included being older, educational attainment, Medicaid insurance, concomitant drug use, liver disease, acute healthcare utilization, and greater alcohol-related problems. Conclusion: Identification of the factors associated with receipt of alcohol-related treatment, including race and ethnicity, age, education, insurance, and drug use can inform interventions to increase treatment receipt.