bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Haglund Deformity Size and Insertional Achilles Tendinopathy
Authors: Lee Wonyong , Giro Margaret Elizabeth , Crymes Colt 
Published: May 2023

Background: We aimed to investigate the effect of Haglund deformity size on insertional Achilles tendinopathy (IAT) using a new measurement system and identify independent risk factors of IAT with Haglund deformity. Methods: We reviewed medical records of patients with IAT and age/sex-matched patients with diagnoses other than Achilles tendinopathy. Radiographs were reviewed to identify posterior heel spur, plantar heel spur, and intra–Achilles tendon calcification, and to measure Fowler-Philip angle, calcaneal pitch angle, and Haglund deformity angle and height. We introduced a new measurement system for Haglund deformity angle and height and evaluated its intraobserver and interobserver reliability. Multivariate logistic regression analysis was performed to identify independent risk factors of IAT with Haglund deformity. Results: Fifty patients (55 feet) were enrolled in the study group, equaling the size of the age/sex-matched control group. The new Haglund deformity measurement system showed excellent intraobserver and interobserver reliability. No significant differences between the 2 groups were noted in Haglund deformity angle and height: 6.0 degrees in both groups, and 3.3 mm vs 3.2 mm in the study and control group, respectively. The study group had significantly higher calcaneal pitch angle, incidence of posterior heel spur, plantar heel spur, and intra–Achilles tendon calcification: 5.2 vs 23.1 degrees ( P = .044), 81.8% vs 36.4% ( P < .001), 76.4% vs 34.5% ( P = .003), and 67.3% vs 5.5% ( P < .001), respectively. Multivariate logistic regression analysis identified independent risk factors of IAT: posterior heel spur (OR = 3.650, 95% CI = 1.063, 12.532), intra–Achilles tendon calcification (OR = 55.671, 95% CI = 11.233, 275.905), and increased calcaneal pitch angle (OR = 6.317). Conclusion: Based on our results, the actual size of Haglund deformity as we have reliably measured was not associated with IAT, suggesting a routine Haglund deformity resection may be unnecessary in the surgical treatment of IAT. If patients with Haglund deformity have posterior heel spur, intra–Achilles tendon calcification, or increased calcaneal pitch angle, a higher chance of IAT can be predicted. Level of Evidence: Level III, retrospective cohort study.
Retrospective study on the efficacy and tolerability of dose modification of PD-1 and PD-L1 inhibitors in hospital-system community outpatient cancer clinics
Authors: Allen Emily , Brown Erika N. , Torre Rodrigo De La , Murthy Asha 
Published: May 2023

Background Anti-programmed cell death (PD)-1 and anti-PD-L1 medications inhibit the PD-1 and PD-L1 interaction and have been shown to be effective in treating several forms of advanced cancers. Since the approval of these agents, standard dosing protocols have been utilized. However, a small population of patients in the community setting has received dose-modified PD-1 and PD-L1 inhibitors secondary to a lack of tolerability. Data from this study suggests possible benefit with different dosing strategies. Objectives The purpose of this retrospective study is to assess the efficacy and tolerability in terms of time to progression and adverse effects in patients receiving dose-modified PD-1 and PD-L1 inhibitors in Food and Drug Administration (FDA)-labeled indications. Methods This single-institution retrospective chart review was conducted in an outpatient community setting on patients with cancer that received nivolumab, pembrolizumab, durvalumab, or atezolizumab for an FDA indication at one of the Houston Methodist Hospital infusion clinic site between September 1, 2017 and September 30, 2019. Data collection included demographics, adverse effects, dosing, treatment delay, and number of immunotherapy cycles administered per patient. Results This study included 221 patients, who received either nivolumab (n = 81), pembrolizumab (n = 93), atezolizumab (n = 21), or durvalumab (n = 26). There were 11 patients who experienced a dose reduction and 103 patients who experienced a treatment delay. Of the patients with a treatment delay, the median time to progression was 197 days, and for patients with a dose reduction, the median time to progression was 299 days. Conclusion The results of this study found that the immunotherapy associated adverse effects led to dosing and frequency changes for tolerance with continued therapy. Our data suggests that there could be potential benefits of dose modifications to immunotherapy treatment, but further large studies are needed to assess the efficacy of specific immunotherapy dose modifications on both outcomes and adverse effects.
Trajectories and Predictors of Change in Emotion Dysregulation and Deliberate Self-Harm Amongst Adolescents with Borderline Features
Authors: Dibaj Iselin Solerød , Tørmoen Anita Johanna , Klungsøyr Ole , Haga Egil , Mehlum Lars 
Published: May 2023

Background Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment response in outcome trajectories of DSH and emotion dysregulation. Methods Response trajectories of DSH and ED were investigated using Latent Class Analysis on RCT data comparing DBT-A and EUC for 77 adolescents treated for deliberate self-harm and borderline traits. Logistic regression analysis was used to examine baseline predictors. Results Two-class solutions were selected for both indicators, distinguishing between early and late responders in DSH, and responders and non-responders in ED. Higher levels of depression, shorter DSH histories and not receiving DBT-A predicted less favourable response in DSH, while DBT-A was the only predictor of treatment response in ED. Conclusions DBT-A was associated with a significantly faster reduction of deliberate self-harm in the short-term and improved emotion regulation in the long-term.
The Nexus Between Foreign Direct Investment, Informal and Formal Sectors in Sri Lanka
Authors: Bhavan T. 
Published: May 2023

The purpose of this study is to investigate the bilateral relationship among formal, informal and foreign direct investment (FDI) in the case of Sri Lanka during the period from 1990 to 2019. Using annual time series data, the Two Stage Least Square method is employed to investigate the relationship among the endogenous variables. The results derived from the analysis suggest that the integration between formal and informal sectors and formal sector and FDI are positive and have significant impacts on each other. However, the negative and significant impacts of the informal sector and FDI on each other further suggest that the integration between the informal sector and FDI did not give an optimistic signal to the country to contemplate that the informal sector is supporting foreign investors. At the same time, a sign that FDI discourages informal sector progression in the results has triggered the attention of further investigations on whether foreign investment agglomeration in Sri Lanka promotes informal-formal sectoral transformation at the cost of the informal sector. However, this study proposes an interest in sound policy requirements to reshape the informal sector towards the interest of foreign direct investors and informal-formal sector transformation.JEL Codes: E26, F21, J21, J46
Does Rising Energy Prices Lead to Production Fragmentation? An Example from Indian Manufacturing Industries
Authors: Guha Supratik 
Published: May 2023

How does the price of energy affect the extent of production fragmentation in India’s manufacturing industries? The prevailing literature has engaged with production fragmentation and trade in middle products for a long time, but the relationship between energy prices and production fragmentation is less understood. This article deals with firm-level panel data of India’s manufacturing industries between 2005 and 2018 to estimate the impact of rising energy prices on the outsourcing decisions/production organization of the manufacturing firms. The article also uses a number of covariates, including wages, welfare expenses, sales, profit after tax, dividend rate, foreign exchange earnings and an interaction term between energy prices and foreign exchange earnings. The empirical results of this article indicate that larger firms tend to outsource production in part to smaller firms in order to cope with rising energy prices and keep their profitability intact. Static and dynamic panel estimates with a variety of robustness analyses support the main conjectures. JEL Classification: F18, L23, Q410, Q500
Day-by-day symptom relief after corticosteroid injection for trigger digit: a randomized controlled study of two techniques
Authors: Bitar Hasan , Zachrisson Anna K , Byström Martin , Strömberg Joakim 
Published: May 2023

This prospective randomized controlled study compared two injection techniques for trigger digit: either dorsal to the tendons in the proximal phalanx (PP group) or anterior to the tendons at the A1 pulley level (A1 group) in 106 patients. The primary outcome was the number of days to total relief of pain, stiffness and triggering, as recorded by the patients on visual analogue scales day-by-day for 6 weeks. The median number of days to complete symptom relief was 9 days in the PP group and 11 days in the A1 group for pain, 11 days and 15 days for stiffness and 21 and 20 days for triggering, respectively. Ninety-one per cent of all patients did not require any additional treatment, but 11 patients in both groups reported some remaining symptoms at 6 weeks. This study did not detect any significant difference between the two injection techniques, but provides detailed data of the rate and order of symptomatic relief after corticosteroid injection for this common condition. Level of evidence: I
Caring for patients with advanced COPD: beyond the inhalers…
Authors: Murray Michelle A. , Mulryan Kathryn , Ní Chléirigh Maedhbh , Redmond Karen C. , Kelly Emer 
Published: May 2023

COPD affects millions of people worldwide. Patients with advanced COPD have a high symptom burden. Breathlessness, cough and fatigue are frequent daily symptoms. Guidelines often focus on pharmacological treatment, especially inhaler therapy, but other approaches in combination with medications offer symptomatic benefit.In this review, we take a multidisciplinary approach with contributions from pulmonary physicians, cardiothoracic surgeons and a physiotherapist. The following areas are addressed: oxygen therapy and noninvasive ventilation (NIV), dyspnoea management, surgical and bronchoscopic options, lung transplantation and palliative care. Oxygen therapy prescribed within guidelines improves mortality in patients with COPD. NIV guidelines offer only low-certainty instruction on the use of this therapy on the basis of the limited available evidence. Dyspnoea management can take place through pulmonary rehabilitation. Specific criteria aid decisions on referral for lung volume reduction treatments through surgical or bronchoscopic approaches. Lung transplantation requires precise disease severity assessment to determine which patients have the most urgent need for lung transplantation and are likely to have the longest survival. The palliative approach runs in parallel with these other treatments, focusing on symptoms and aiming to improve the quality of life of patients and their families facing the problems associated with life-threatening illness. In combination with appropriate medication and an individual approach to symptom management, patients' experiences can be optimised.Educational aimsTo understand the multidisciplinary approach to management of patients with advanced COPD.To recognise the parallel approaches to oxygen, NIV and dyspnoea management with consideration of more interventional options with lung volume reduction therapy or lung transplantation.To understand the high level of symptomatology present in advanced COPD and the relevance of palliative care alongside optimal medical management.
Imaging the brain and vascular reactions to headache treatments: a systematic review
Authors: Messina R. , Christensen R. H. , Cetta I. , Ashina M. , Filippi M. 
Published: May 2023

Abstract
Background
Neuroimaging studies have made an important contribution to our understanding of headache pathophysiology. This systematic review aims to provide a comprehensive overview and critical appraisal of mechanisms of actions of headache treatments and potential biomarkers of treatment response disclosed by imaging studies.

Main body
We performed a systematic literature search on PubMed and Embase databases for imaging studies investigating central and vascular effects of pharmacological and non-pharmacological treatments used to abort and prevent headache attacks. Sixty-three studies were included in the final qualitative analysis. Of these, 54 investigated migraine patients, 4 cluster headache patients and 5 patients with medication overuse headache. Most studies used functional magnetic resonance imaging (MRI) (n = 33) or molecular imaging (n = 14). Eleven studies employed structural MRI and a few used arterial spin labeling (n = 3), magnetic resonance spectroscopy (n = 3) or magnetic resonance angiography (n = 2). Different imaging modalities were combined in eight studies.
Despite of the variety of imaging approaches and results, some findings were consistent. This systematic review suggests that triptans may cross the blood–brain barrier to some extent, though perhaps not sufficiently to alter the intracranial cerebral blood flow. Acupuncture in migraine, neuromodulation in migraine and cluster headache patients, and medication withdrawal in patients with medication overuse headache could promote headache improvement by reverting headache-affected pain processing brain areas. Yet, there is currently no clear evidence for where each treatment acts, and no firm imaging predictors of efficacy. This is mainly due to a scarcity of studies and heterogeneous treatment schemes, study designs, subjects, and imaging techniques. In addition, most studies used small sample sizes and inadequate statistical approaches, which precludes generalizable conclusions.

Conclusion
Several aspects of headache treatments remain to be elucidated using imaging approaches, such as how pharmacological preventive therapies work, whether treatment-related brain changes may influence therapy effectiveness, and imaging biomarkers of clinical response. In the future, well-designed studies with homogeneous study populations, adequate sample sizes and statistical approaches are needed.
SVcnn: an accurate deep learning-based method for detecting structural variation based on long-read data
Authors: Zheng Yan , Shang Xuequn 
Published: May 2023

Abstract
Background
Structural variations (SVs) refer to variations in an organism’s chromosome structure that exceed a length of 50 base pairs. They play a significant role in genetic diseases and evolutionary mechanisms. While long-read sequencing technology has led to the development of numerous SV caller methods, their performance results have been suboptimal. Researchers have observed that current SV callers often miss true SVs and generate many false SVs, especially in repetitive regions and areas with multi-allelic SVs. These errors are due to the messy alignments of long-read data, which are affected by their high error rate. Therefore, there is a need for a more accurate SV caller method.

Result
We propose a new method-SVcnn, a more accurate deep learning-based method for detecting SVs by using long-read sequencing data. We run SVcnn and other SV callers in three real datasets and find that SVcnn improves the F1-score by 2–8% compared with the second-best method when the read depth is greater than 5×. More importantly, SVcnn has better performance for detecting multi-allelic SVs.

Conclusions
SVcnn is an accurate deep learning-based method to detect SVs. The program is available at https://github.com/nwpuzhengyan/SVcnn.
Association between serum apolipoprotein A1 and atrial fibrillation in the Chinese population: a case–control study
Authors: Zhong Xia , Yu Jie , Zhao Dongsheng , Teng Jing , Jiao Huachen 
Published: May 2023

Abstract
Background
The relationship between serum apolipoprotein A1 (APOA1) and atrial fibrillation (AF) is not known. Therefore, we sought to investigate the associations between APOA1 and AF in the Chinese population.

Methods
This case–control study included 950 patients with AF (29–83 years old, 50.42% male) who were hospitalized consecutively in China between January 2019 and September 2021. Controls with sinus rhythm and without AF were matched (1:1) to cases by sex and age. Pearson correlation analysis was performed to investigate the correlation between APOA1 and blood lipid profiles. Multivariate regression models were used to explore the association between APOA1 and AF. The receiver operator characteristic (ROC) curve was constructed to examine the performance of APOA1.

Results
Multivariate regression analysis showed that low serum APOA1 in men and women with AF was significantly associated with AF (OR = 0.261, 95% CI: 0.162–0.422, P < 0.001). Pearson correlation analysis indicated that serum APOA1 was positively correlated with total cholesterol (TC) (r = 0.456, p < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = 0.825, p < 0.001), high-density lipoprotein cholesterol (HDL-C) (r = 0.238, p < 0.001), and apolipoprotein B (APOB) (r = 0.083, p = 0.011). ROC curve analysis showed that APOA1 levels of 1.105 g/L and 1.205 g/L were the optimal cut-off values for predicting AF in males and females, respectively.

Conclusion
Low APOA1 in male and female patients is significantly associated with AF in the Chinese population of non-statin users. APOA1 may be a potential biomarker for AF and contribute to the pathological progression of AF along with low blood lipid profiles. Potential mechanisms remain to be further explored.
Association of absolute and relative hand grip strength with all-cause mortality among middle-aged and old-aged people
Authors: Jeong Wonjeong , Moon Jong Youn , Kim Jae-Hyun 
Published: May 2023

Abstract
Objectives
This study aimed to examine the association of absolute and relative hand grip strength (HGS) with the risk of all-cause mortality among middle-aged and old-aged people in South Korea. Considering that both absolute HGS and relative HGS could be effective measures, an in-depth investigation is necessary to compare the effects of both measures on mortality.

Methods
Data of 9,102 participants, derived from the Korean Longitudinal Study of Aging from 2006 to 2018, were examined. HGS was divided into two categories: absolute HGS and relative HGS (defined as HGS divided by body mass index). The risk of all-cause mortality was the dependent variable. Cox proportional hazard regression was used to analyze the association between HGS and all-cause mortality.

Results
The average of absolute and relative HGS were 25.6 ± 8.7 kg and 1.1 ± 0.4 kg/BMI, respectively. The all-cause mortality rate decreased by 3.2% as absolute HGS increased by 1 kg (adjusted hazard ratio [HR] = 0.968, 95% CI = 0.958–0.978). An increase in relative HGS by 1 kg/BMI was associated with a 22% reduction in risk of all-cause mortality (adjusted HR = 0.780, 95% CI = 0.634–0.960). Individuals with more than two chronic diseases, there was a decrease in all-cause mortality as absolute HGS increased by 1 kg and relative HGS by 1 kg/BMI (absolute HGS; adjusted HR = 0.97, 95% CI = 0.959–0.982, relative HGS; adjusted HR = 0.483, 95% CI = 0.325–0.718).

Conclusions
Our study findings showed that both absolute and relative HGS were inversely associated with the risk of all-cause mortality; a higher absolute/relative HGS was associated with a lower risk of all-cause mortality. Moreover, these findings highlight the importance of improving HGS to alleviate the burden of adverse health problems.
Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers
Authors: Qi Caiyun , Wang Yuan , Qi Xiaonan , Jiao Yunhe , Que Chuanqi , Chen Yufei 
Published: May 2023

Abstract
Background
Due to the increasingly aging population in China and the changes in social and family structure, older adults’ care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers.

Methods
In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers’ daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis.

Results
We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies’ excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm.

Conclusion
We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.