bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Accuracy of Common Mortality Prognostic Scales in Very Old Patients with Intracerebral Haemorrhage
Authors: Batista Rafael , Pereira Marta , Vaz Deise Catamo , Buque Helena , Nzwalo Hipolito , Marreiros Ana 
Published: December 2023

Background Spontaneous intracerebral haemorrhage (SICH) is the most severe form of all stroke types. Stratification of SICH severity is important for group comparisons and treatment decisions. The existing prognostic scores for clinical prediction in SICH have not been specifically validated in the very old (≥75 years). Therefore, we aimed to evaluate the accuracy of different SICH vital prognostic scores in the very old. Purpose To compare the short-term accuracy of three vital prognostic scores: Functional Outcome in Patients with Primary Intracerebral Haemorrhage (FUNC), Modified Emergency Department Intracerebral Haemorrhage (mEDICH) and the Intracerebral Haemorrhage Score (‘ICH score’) in patients aged 75 or older. Methods Comparison of the discriminative performance of three SICH prognostic scores in a consecutive case series of patients ≥75 years. The prognostic discrimination was assessed using the area under the receiver operating characteristic curve (AUROC). Additionally, a binary logistic regression was conducted to determine independent prognostic factors associated with mortality. Results The case-fatality was 40.6%. The AUROC and Younden index for the three scores was as it follows: ‘ICH score’ 0.882 and 0.648; mEDICH 0.867 and 0.571; FUNC 0.802 and 0.519. The main independent risk factors of death were presence of intraventricular extension (OR = 4.000,95% CI= 1.933–8.276), INR value (OR = 2.173, 95% CI = 1.146–4.117), haemorrhage volume (OR = 1.881, 95% CI = 1.029–3.440) and GCS (OR = 0.119, 95% CI = 0.060–0.236) for mEDICH. Haemorrhage volume (OR = 3.020, 95% CI = 1.806–5.050) and GCS (OR = 0.043, 95% CI = 0.013–0.151) for FUNC. Haemorrhage volume (OR = 4.950, 95% CI = 2.249–10.897) and intraventricular haemorrhage (OR = 3.811, 95% CI = 1.833–7.924) for ‘ICH score’. Conclusion The three scores (‘ICH score’, FUNC and mEDICH) showed an excellent capability of discriminating the group of elderly patients at risk of short-term death. Age per se may not be crucial for accurate discrimination of death in the group of elderly. Instead, the inclusion of available physiological markers of fragility would be more scientifically meaningful than age.
Fatalistic and Optimistic Coping Strategies Predict Depression in Arab Muslim Patients With End-Stage Renal Disease
Authors: Al Sharji Amal , Alaloul Fawwaz , Al Yazeedi Basma , Alharrasi Maryam 
Published: December 2023

Background: Depression is one of the common psychological problems in patients on hemodialysis. We aimed to identify the predictors associated with depressive symptoms among patients on hemodialysis from a population under-represented in research and minoritized in countries like the United States. Methods: This cross-sectional study used a convenience sample of patients in Oman. Data were analyzed using linear multiple regression. Results: A total of 157 patients on hemodialysis participated in the study, with 40.5% reporting different levels of depressive symptoms. Higher stress levels (β = .643; p < .01) and higher perceived effectiveness of the fatalistic coping style (β = .144; p < .05) were significant predictors of depressive symptoms. Patients with a higher optimistic coping style (β = −.182; p < .01) had lower levels of depressive symptoms. Conclusion: Arab Muslim hemodialysis patients have significant levels of depressive symptoms. Identifying predictors of depressive symptoms may help identify those at risk and provide culturally appropriate interventions.
Predictors of Patient Engagement With an Interprofessional Lifestyle Medicine Program
Authors: Cheng Abby L , Dwivedi Mollie E , Martin Adriana , Leslie Christina G , Pashos Madeline M , Donahue Viola B , Huecker Julia B , Salerno Elizabeth A , Steger-May Karen , Hunt Devyani M 
Published: December 2023

Background Changes in lifestyle habits can reduce morbidity and mortality, but not everyone who can benefit from lifestyle intervention is ready to do so. Purpose To describe characteristics of patients who did and did not engage with a lifestyle medicine program, and to identify predictors of engagement. Methods This was a single-center, retrospective cohort study of 276 adult patients who presented for consultation to a goal-directed, individualized, interprofessional lifestyle medicine program. The primary outcome was patients’ extent of engagement. Candidate predictors considered in multivariable multinomial logistic regression models included baseline sociodemographic, psychological, and health-related variables. Results A predictor of full engagement over no engagement was having private or Medicare insurance (rather than Medicaid, other, or no insurance) (OR 4.2 [95% CI 1.3-14.2], P = .021). A predictor of partial engagement over no engagement was having a primary goal to lose weight (OR 3.1 [1.1-8.4], P = .026). Conclusions System-level efforts to support coverage of lifestyle medicine services by all insurers may improve equitable engagement with lifestyle medicine programs. Furthermore, when assessing patients’ readiness to engage with a lifestyle medicine program, clinicians should consider and address their goals of participation.
Brand, Quality, and CSR: Which Management Strategy Achieves High Financial Performance for Agricultural Small-Medium Enterprises?
Authors: Fan Fan 
Published: December 2023

This study aims to investigate the mechanism for the combined influence of brand, quality, and corporate social responsibility management strategy on financial performance. These management concepts are positively used in agricultural small-medium enterprises as three research streams. However, because of resource limitations, the cost of brand management would be a burden or corporate social responsibility activities may lead to harmful performance. There are many conflicting findings in the existing research. This study analyzed data from 371 agricultural small-medium enterprises in China using fsQCA 3.0. The result reveals four solution pathways for achieving high financial performance and highlights the attributes of each solution pathway. The findings suggest that integrating brand, quality, and corporate social responsibility management, or combining brand and quality management are effective options for achieving high financial performance in agricultural small-medium enterprises. These results have significant implications for managers seeking to improve their firm’s financial performance by optimizing their management strategies. JEL Classification: M14, M31, Q13
MIBA Osteotomy vs Open Technique in Hallux Valgus Surgery: Results of a Randomized Prospective Study
Authors: Escudero Mario I. , Escobar Francisco , Chaparro Felipe , Albarran Carlos , Payá Andrés I. Medina , Pellegrini Manuel J. 
Published: December 2023

Category: Midfoot/Forefoot; Bunion Introduction/Purpose: In Hallux Valgus (HV) surgery, the open technique has traditionally been used, which implies aggressive and extensive approaches, not without complications. The goal of surgical treatment of HV is to correct the anatomical deformity and achieve a satisfactory long-term result, without interrupting the biomechanics and weight-bearing function of the first metatarsophalangeal joint complex. In recent years, the use of minimally invasive techniques (MIS) has been a valid alternative due to less soft tissue trauma. The purpose of this study is to compare short-medium term clinical results of the MIBA technique versus the traditional open technique in patients with mild-moderate HV. Methods: A randomized, multicenter clinical trial of patients with HV, operated between January 2019 - January 2022, with a minimum of 1-year follow-up. A total of 39 patients were included; 20 MIBA and 19 with the open technique (Chevron osteotomy). It was evaluated if there were statistically significant differences between: demographic variables; radiologic measurements: Intermetatarsal Angle (IMA); Metatarsal Length (ML); visual analog scale (VAS); Foot and Ankle Ability Measure (FAAM), 36-Item Short-Form Health Survey (SF-36), American Orthopaedic Foot & Ankle Society (AOFAS) metatarsophalangeal- interphalangeal (MTP-IP) and operative wound healing through Photographic Wound Assessment Tool (PWAT) and ASEPSIS score were analyzed. The radiologic measurements and functional scores were collected preoperatively, at 2-6 weeks and 1-year follow-up, while wound scores were at 3 weeks, 3 months, and 1-year follow-up. Results: There were no significant differences concerning age, hypertension, diabetes mellitus, or smoking between both groups. The average follow-up time of the MIBA group was 14 months and the open technique group 12.9 months. In relation of postoperative soft tissue, MIBA group showed significant differences at 6 weeks in PWAT score (0.06 ± 0.24) but no statistically significant differences at 3 weeks and 1 year of follow-up. There were no significant differences in IMA and ML values at 6 months (p=0.57 vs 0.40) and 1 year (p=0.35 vs 0.11). Regarding functional scores, no significant differences were found preoperatively, at 6 months, and 1-year follow-up. Complications in both groups did not have significant differences either. Conclusion: The MIBA technique is a reliable alternative to the classical technique, with significant differences at 6 weeks in a better evolution of postoperative soft tissue according to the PWAT score, but correcting in the medium term. Concerning radiological, functional outcomes and complications, no significant differences were found at 1-year follow-up. Further follow-up and casuistry are necessary to obtain definitive results.
Outcomes after Total Ankle Arthroplasty with A Minimum Average Follow-Up of 10 Years: A Systematic Review and Meta-Analysis
Authors: Bagheri Kian , Anastasio Albert T. , Cantor Nicole , Aitchison Alexandra Hunter , Poehlein Emily , Green Cynthia , Adams Samuel 
Published: December 2023

Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and causes considerable functional impairment. Total ankle arthroplasty (TAA) is growing in popularity as a motion-preserving option for ankle OA. A previously published meta-analysis evaluated the mid-term outcomes of TAA with a minimum average follow-up of 5 years, demonstrating excellent survivorship. To our knowledge, there is no such manuscript that evaluates the outcomes of TAA at the long-term, with a minimum follow-up of ten years or greater. Due to a lack of long-term follow-up of TAA implants in the current literature, the aim of this review was to aggregate findings from the most up-to-date analyses of the long-term outcomes of TAA via meta-analysis. Methods: We conducted a systematic review and meta-analysis according to the PRISMA guidelines. Electronic databases were searched from the date of inception to September 12, 2022. These databases included Medline, Embase, and Scopus. We included all studies that 1) involved patients that underwent uncemented TAA, and 2) all patients who had an average follow-up period of at least ten years. We excluded abstracts, as well as manuscripts written in languages other than English. We collected American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analog Scale (VAS) scores from the included studies for pooled meta- analysis. Due to the varying definition of survivability between studies, this metric was not assessed in our final evaluation. Results: Our data included a total of 2,562 patients and 2,895 ankles with an average follow-up of 10 years. Of the 25 studies included in the systematic review, 7 provided pre- and post-operative AOFAS means and 5 provided pre- and post-operative VAS means with associated measures of variability and were included in our meta-analysis. The weighted mean difference between pre- and post-operative AOFAS scores was -41.98 (95% CI: -48.28 to -35.69) (Fig. 1A), indicating that patients improved by almost 42 points between pre-and post-surgery. The weighted mean difference between pre-and postoperative VAS scores was 4.52 (95% CI: 2.26-6.43) (Fig. 1B), indicating patients improved by about 4.5 points on average between pre-and post-surgery. Survivability was not assessed due to the heterogeneity in survivability definition between studies. Conclusion: Outcomes following TAA are favorable and indicate patient-reported outcomes improve over long-term follow-up. Future, prospective, randomized research should be conducted to better assess TAA, and authors should work towards standardization of survivorship and complication reporting methodologies to allow for pooled metanalysis of these important outcome metrics.
Participant Satisfaction and Investigator Assessment of Collagenase Clostridium Histolyticum Injection as a Nonsurgical Intralesional Treatment Option for Plantar Fibromatosis
Authors: Anderson C. James , Pollak Richard , Dalton Shannon , Xiang Qinfang , Vijayan Saji , Ortega Luis A. , Caporusso Joseph 
Published: December 2023

Category: Midfoot/Forefoot; Basic Sciences/Biologics Introduction/Purpose: Currently, there is no safe and efficacious injectable therapy for symptomatic plantar fibromatosis (PFi) that addresses its pathophysiology. Patients with PFi nodules experience symptoms that reduce quality of life, causing functional disability leading to severe impairment in some patients. Collagenase clostridium histolyticum (CCH) is approved for Dupuytren’s and Peyronie’s disease treatment, which are both fibroproliferative disorders that may coexist in patients with PFi. This first study of CCH treatment for PFi evaluated participant satisfaction and investigator assessment of improvement. Methods: Participants were randomly allocated (1:1:1) in this Phase 1, multicenter study to receive 0.6, 1.2, or 2.25 mg/mL CCH. All participants underwent the initial treatment period (ITP) and received 1–2 intralesional injections per nodule on Day 1 with follow-up assessments at specified intervals. Participants with palpable treated nodules could enter the retreatment period (RP) and receive additional CCH doses (at 2.25 mg/mL), with follow-up at specified intervals. Assessments included the Subject Satisfaction with Treatment Rating Scale (+2: very satisfied; to -2: very dissatisfied), and the Investigator Assessment of Improvement Scale (+3: very much improvement; to -3: very much worse). Results: After ITP, ≥75% of participants reported “very” or “quite” satisfied across all treatment groups, with 2.25 mg/mL group reporting 100% satisfaction. For ≥72.7% of nodules, participants reported satisfaction with outcome. Investigators reported improvement (“minimal”, “much”, or “very much”) in ≥75% of participants and ≥80% of treated nodules. After RP, 63.6% of participants reported treatment satisfaction; participants were satisfied with 66.7% of treated nodules, indicating continued improvement from the ITP. Almost all participants (90.9%) were deemed by investigators to have shown improvement, with 86.7% of treated nodules being assessed as having improvement. Conclusion: CCH-treated PFi participants were satisfied with their improvement; physicians assessed improvement in >90% of participants. Results indicate CCH as a potential nonsurgical intralesional option for PFi treatment.
Patient Reported Outcomes Following Surgical Intervention of Isolated Lisfranc Injury: Minimum Two- year Follow-up
Authors: Scheinberg Mila , Sanchez Thomas , Shah Ashish 
Published: December 2023

Category: Midfoot/Forefoot; Other Introduction/Purpose: This is the largest cohort to date of patients who completed the patient reported outcome measurement information systems (PROMIS) along with the foot function index (FFI) following operative fixation for Lisfranc injury. The patient outcomes were compared against the mean population with inter-analysis comparing varying operative procedures used, basic demographic information, and patient comorbidities and their individual impact on PROMIS, FFI and VAS scores. Methods: 131 patients between 2010 and 2020 met inclusion criteria and were selected for this study. Utilizing the electronic medical record (EMR), patient charts were reviewed to obtain basic patient demographic information and comorbidities. Operative reports were reviewed to determine which procedure or combination of procedures was performed for definitive fixation. VAS scores were obtained from patients preoperatively and at two, six, and twelve weeks post-operatively. PROMIS and FFI scores were obtained via phone calls and when reviewing patient charts. The impact of categorical variables on complications was compared using Chi-Squared tests. Variables were analyzed with a type 3 SS ANOVA test to stratify independent risk factors on PROMIS, FFI and VAS scores and to account for confounding variables. Results: Arthrodesis procedure (p=.025) was associated with a significant decrease in complication rates. Males, HR screw placement, and arthrodesis were independent risk factors for significantly higher reports of PROMIS pain interference, FFI disability, and FFI activity limitation. Males, alcohol consumption, and those treated with arthrodesis had higher FFI pain scores (p=0.0193, p=.0498, and p=0.0351). ORIF was found to be an independent risk factor for significantly increased PROMIS physical function (p=0.046), whereas bone grafting during the procedure was associated with lower PROMIS depression scores (p=0.0096). Tobacco use at the time of operation and arthrodesis were independent risk factors for higher FFI total scores (p=0.0153 and p- 0.0273). Patient’s preoperative VAS score averaged 5.13. Postoperative VAS scores averaged 3.89, 2.65 and 2.04 for two, six and twelve respectively (p < 0.001). Conclusion: Patient reported outcomes following Lisfranc surgery reported via PROMIS, FFI and VAS scores are independently influenced by patient demographics, comorbidities, and surgical variables. Analysis of potential associations between these patient characteristics and PROMIS and FFI scores provides evidence for physicians to manage patient expectations prior to operative treatment of a non-polytraumatic Lisfranc injury.
Role of Insole Material in Treatment of Plantar Fasciitis: A Randomized Clinical Trial
Authors: Taseh Atta , Mathur Vasundhara , Weaver Bradley A. , Hashmi Mustafa , Skolnik Jennifer , Ashkani-Esfahani Soheil , Waryasz Gregory 
Published: December 2023

Category: Hindfoot; Other Introduction/Purpose: Plantar fasciitis (PF), a leading cause of persistent heel pain, results in almost a million physician visits annually. Conservative treatment is often the first line of management with insoles being frequently prescribed. While multiple studies have compared insoles based on the degree of customization to foot contour, the literature is lacking in data comparing insoles based on their material. In this randomized clinical trial, we compared the early effects of foam, polyurethane, and carbon fiber insoles in the treatment of PF, using a robust set of PROMS. Methods: A randomized clinical trial was designed at the foot and ankle research center of a tertiary care hospital in Massachusetts. Adult patients diagnosed with PF who had not received injectable or surgical treatment for it were included. Participants who consented were randomly allocated one of the three prefabricated insoles – carbon fiber insole (Group 1, n=13), polyurethane insole (Group 2, n=13), or foam insole (Group 3, n=9) for regular use. Their response was recorded using PROMIS 3a (for pain intensity), PROMIS 4a (for pain interference), FAOS (Foot and Ankle Outcome Score), and VAS for pain at baseline (T0), two (T2), six (T6) and twelve weeks (T12). A per-proto analysis was undertaken using Kruskal Wallis and Friedman tests. P< 0.05 was set as the level of significance. Results: Among groups 1, 2 and 3, the mean age of participants was 51.9±13.2, 51±12.5, and 47.9±13.5 years respectively and baseline weight varied as 211.6±32.7 lbs, 193.6±59.3 lbs, and 180.7±33 lbs respectively (p>0.05 for both). The group-wise distribution of participants based on sex and laterality of the affected foot showed no difference. Participants in each group reported similar intensity of the pain (VAS) at baseline and at all follow-up time points (p>0.05). A comparison of outcomes between baseline and subsequent timepoints showed significant improvement in quality of life (FAOS) at T12 (p=0.047) for carbon fibre insole users (Figure 1), significant pain relief on PROMIS Pain intensity and Pain Interference questionnaires for foam insoles at T3 and T12 (p=0.0003, 0.036 respectively). Conclusion: Carbon fiber insoles offered slightly better pain relief as early as six weeks into treatment and improved quality of life after twelve weeks of use. A possible link between the material of insole used and effective treatment of PF may exist. Conducting further analyses on the position of the foot during gait while using insoles and designing the insoles based on patient-specific criteria should be considered for future research.