bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do We Need a Strictly Lateral Radiograph for Fracture Management of Forearm Buckle Fractures in Children?
Authors: Harbrecht Andreas , Hackl Michael , Leschinger Tim , Krane Felix , Müller Lars P. , Wegmann Kilian 
Published: March 2023

Objectives
Buckle fractures of the distal forearm are a common fracture entity in children treated conservatively. Diagnostics primarily include radiographs in 2 planes. Inadequate images may occur in the mostly very young patients. Therefore, additional lateral radiographs are often obtained to assess a possible angular tilt. The aim of this study is to investigate whether a strictly lateral x-ray image has an influence on fracture management.

Methods
Seventy-three children with buckle fractures of the distal forearm were included in this retrospective analysis. All cases were analyzed by quality of radiographs, necessity to obtain an additional lateral radiograph, and what influence on fracture management resulted. Follow-up was performed 2 to 4 weeks after immobilization.

Results
Thirty-five girls and 38 boys with a mean age of 7.16 years were included; 40 had fractured right and 33 had fractured left arms, respectively. Isolated distal radius fractures occurred in 48 cases, isolated distal ulna fractures in 6 cases, and both bones in 19 cases. Initial radiographic images were evaluated as inadequate in 25 cases. In each of those cases, an additional lateral image was obtained by fluoroscopy without resulting in an alternated fracture management protocol, which was chosen conservatively in each case and resulted in excellent clinical outcome at follow-up examination.

Conclusions
Based on our results, the acquisition of additional lateral radiographs seems to be unnecessary in the diagnostic procedure of buckle fractures of the distal forearm, in case a possible palmar or dorsal angulation cannot be entirely assessed on the initial set of radiographs. An additional lateral image had no influence on fracture management, which was chosen conservatively in every case and led to excellent clinical results.
Level of evidence: level III.
Methodological Issues Relevant to Blinding in Physical Medicine and Rehabilitation Research
Authors: Annaswamy Thiru , Cunniff Kegan , Rizzo JR , Naeimi Tahereh , Kumbhare Dinesh , Batavia Mitchell 
Published: March 2023

Abstract
Blinding in research is important and the field of PM&R poses special consideration due to the patient populations and treatment methodologies used. Historically, blinding has been increasingly relevant to conducting good quality research. The main reason to blind is to reduce bias. There are several strategies to blinding. At times, when blinding is not possible, alternatives to blinding include sham control and description of study and control groups. Illustrative examples of blinding used in PM&R research are described in this article along with how to assess success and fidelity of blinding.
Comparison Clinical Effects of Hypertonic Dextrose and Steroid Injections on Chronic Subacromial Bursitis: A Double-Blind Randomized Controlled Trial
Authors: Lin Lien-Chieh , Lee Yu-Hao , Chen Yi-Wen , Hsu Tzu-Herng , Vitoonpong Timporn , Liou Tsan-Hon , Huang Shih-Wei 
Published: March 2023

Abstract

Objective
To determine and compare the treatment efficacy of subacromial steroid injections and dextrose prolotherapy (DPT) for chronic subacromial bursitis patients.

Design
54 patients with chronic subacromial bursitis were enrolled in this double-blind randomized controlled trial. Shoulder pain and disability index (SPADI) and visual analog scale (VAS) were the primary outcomes.

Results
The steroid group (n = 26) exhibited significant VAS score improvements comparing to baseline at weeks 2, 6, and 12; the DPT group (n = 28) exhibited VAS score improvements at weeks 6, and 12. The steroid group displayed significant SPADI score improvements compared to baseline at weeks 2, 6, and 12, the DPT group exhibited significant score decreases at weeks 2, and 6. Compared with the DPT group, the steroid group demonstrated significantly greater decreases in VAS scores at weeks 2, and 6; the steroid group showed significantly greater decreases in SPADI scores at weeks 2, 6, and 12.

Conclusion
Both hypertonic DPT and steroid injections can provide short-term improvements of pain and disability among chronic subacromial bursitis patients. Moreover, steroid injections showed better effectiveness than hypertonic DPT in ameliorating pain and improving function.
Artifact Reduction From Dental Material in Photon-Counting Detector Computed Tomography Data Sets Based on High-keV Monoenergetic Imaging and Iterative Metal Artifact Reduction Reconstructions—Can We Combine the Best of Two Worlds?
Authors: Risch Franka , Decker Josua A. , Popp Daniel , Sinzinger Andrea , Braun Franziska , Bette Stefanie , Jehs Bertram , Haerting Mark , Wollny Claudia , Scheurig-Muenkler Christian , Kroencke Thomas J. , Schwarz Florian 
Published: March 2023

Objective
The aim of this study was to compare the effectiveness of common strategies for artifact reduction of dental material in photon-counting detector computed tomography data sets.

Materials and Methods
Patients with dental material who underwent clinically indicated CT of the neck were enrolled. Image series were reconstructed using a standard and sharp kernel, with and without iterative metal artifact reduction (IMAR) (Qr40, Qr40IMAR, Qr60, Qr60IMAR) at different virtual monoenergetic imaging (VMI) levels (40–190 keV). On representative slice positions with and without dental artifacts, mean and standard deviation of CT values were measured in all series at identical locations. The mean absolute error of CT values (

) and the artifact index (AIX) were calculated and analyzed focusing on 3 main comparisons: (a) different VMI levels versus 70 keV, (b) standard versus sharp kernel, and (c) nonuse or use of IMAR reconstruction. The Wilcoxon test was used to assess differences for nonparametric data.

Results
The final cohort comprised 50 patients. Artifact measures decreased for VMI levels >70 keV, yet only significantly so for reconstructions using IMAR (maximum reduction, 25%). The higher image noise of the sharp versus standard kernel is reflected in higher AIX values and is more pronounced in IMAR series (maximum increase, 38%). The most profound artifact reduction was observed for IMAR reconstructions (maximum reduction

: 84%; AIX: 90%).

Conclusions
Metal artifacts caused by large amounts of dental material can be substantially reduced by IMAR, regardless of kernel choice or VMI settings. Increasing the keV level of VMI series, on the other hand, only slightly reduces dental artifacts; this effect, however, is additive to the benefit conferred by IMAR reconstructions.
The Downside of Botulinum Injections for Anterocollis: A Case Series and a Review of the Literature
Authors: Yahalom Gilad , Atlan Eden , Janah Amir , Dominko Melania , Israel Ilana , Rajz Gustavo , Mausbach Stefan , Eichel Roni 
Published: March 2023

Objectives
This is a case series and a review of the literature of therapeutic outcomes of botulinum toxin (BT) injections for anterocollis.

Methods
Data collected included gender, age, age at onset, muscles targeted, and doses injected. Routine forms were filled out during each visit: Patient Global Impression of Change, Clinician Global Impression of Severity, Tsui scale. The effect duration and side effects (SEs) of the previous treatment were noted.

Results
We described 4 patients (3 men, 13 visits) with anterocollis, as primary postural abnormality of the neck, emphasizing the therapeutic response to BT injection. Mean age at onset was 75.3 ± 7.0 years, age at first injection was 80.7 ± 3.5 years. The mean total dose per treatment was 290.0 ± 95.6 units. Patient Global Impression of Change with any grade of favorable effect was reported in 27.3% of the treatments. In objective assessment, Global Impression of Severity and Tsui scores did not show a consistent tendency of improvement. Neck weakness was prevalent in 18.2% of the visits of the anterocollis group while no other SEs were noted. We found 15 articles describing experience with BT for anterocollis in 67 patients (19 in deep and 48 in superficial neck muscles).

Conclusions
This case series describes the poor outcome of BT treatment for anterocollis, with low efficacy and bothersome SE. Levator scapulae injection for anterocollis is not effective and is highly associated with head drop and should perhaps be abandoned. Injection to the longus colli might give some benefit in non-responders.
Influences on policy-formulation, decision-making, organisation and management for maternal, newborn and child health in Bangladesh, Ethiopia, Malawi and Uganda: the roles and legitimacy of a multi-country network
Authors: Akter Kohenour , Shawar Yusra Ribhi , Tesfa Anene , Daniels-Howell Callie , Seruwagi Gloria , Kyamulabi Agnes , Dube Albert , Gonfa Geremew , Mwaba Kasonde ,   QCN Evaluation Group, Kinney Mary , English Mike , Shiffman Jeremy , Djellouli Nehla , Colbourn Tim 
Published: March 2023

AbstractThe Network for Improving Quality of Care for Maternal, Newborn and Child Health (QCN) is intended to facilitate learning, action, leadership and accountability for improving quality of care in member countries. This requires legitimacy—a network’s right to exert power within national contexts. This is reflected, for example, in a government’s buy-in and perceived ownership of the work of the network.During 2019– 2022 we conducted iterative rounds of stakeholder interviews, observations of meetings, document review, and hospital observations in Bangladesh, Ethiopia, Malawi, Uganda and at the global level. We developed a framework drawing on three frameworks: Tallberg and Zurn which conceptualizes legitimacy of international organisations dependent on their features, the legitimation process and beliefs of audiences; Nasiritousi and Faber, which looks at legitimacy in terms of problem, purpose, procedure, and performance of institutions; Sanderink and Nasiritousi, to characterize networks in terms of political, normative and cognitive interactions. We used thematic analysis to characterize, compare and contrast institutional interactions in a cross-case synthesis to determine salient features.Political and normative interactions were favourable within and between countries and at global level since collective decisions, collaborative efforts, and commitment to QCN goals were observed at all levels. Sharing resources and common principles were not common between network countries, indicating limits of the network. Cognitive interactions—those related to information sharing and transfer of ideas— were more challenging, with the bi-directional transfer, synthesis and harmonization of concepts and methods, being largely absent among and within countries. These may be required for increasing government ownership of QCN work, the embeddedness of the network, and its legitimacy.While we find evidence supporting the legitimacy of QCN from the perspective of country governments, further work and time are required for governments to own and embed the work of QCN in routine care.
Mendelian randomization study of diabetes and dementia in the Million Veteran Program
Authors: Litkowski Elizabeth M , Logue Mark W , Zhang Rui , Charest Brian R , Lange Ethan M , Hokanson John E , Lynch Julie A , Vujkovic Marijana , Phillips Lawrence S , Hauger Richard L , Lange Leslie A , Raghavan Sridharan 
Published: March 2023

Structured AbstractINTRODUCTIONDiabetes and dementia are diseases of high healthcare burden worldwide. Individuals with diabetes have 1.4 to 2.2 times higher risk of dementia. Our objective was to evaluate evidence of causality between these two common diseases.METHODSWe conducted a one-sample Mendelian randomization (MR) analysis in the U.S. Department of Veterans Affairs Million Veteran program. The study included 334,672 participants ≥65 years of age with type 2 diabetes and dementia case-control status and genotype data.RESULTSFor each standard deviation increase in genetically-predicted diabetes, we found increased odds of three dementia diagnoses in non-Hispanic White participants (all-cause: OR=1.07[1.05-1.08],P=3.40E-18; vascular: OR=1.11[1.07-1.15],P=3.63E-09, Alzheimer’s: OR=1.06[1.02-1.09],P=6.84E-04) and non-Hispanic Black participants (all-cause: OR=1.06[1.02-1.10],P=3.66E-03, vascular: OR=1.11[1.04-1.19],P=2.20E-03, Alzheimer’s: OR=1.12 [1.02-1.23],P=1.60E-02) but not in Hispanic participants (allP>.05).DISCUSSIONWe found evidence of causality between diabetes and dementia using a one-sample MR study, with access to individual level data, overcoming limitations of prior studies utilizing two-sample MR techniques.
Mpox vaccine and infection-driven human immune signatures
Authors: Cohn Hallie , Bloom Nathaniel , Cai Gianna , Clark Jordan , Tarke Alison , Bermúdez-González Maria C , Altman Deena , Lugo Luz Amarilis , Lobo Francisco Pereira , Marquez Susanna ,   PVI study group, Chen Jin-Qiu , Ren Wenlin , Qin Lili , Crotty Shane , Krammer Florian , Grifoni Alba , Sette Alessandro , Simon Viviana , Coelho Camila H. 
Published: March 2023

AbstractBackgroundMpox (formerly known as monkeypox) outbreaks outside endemic areas peaked in July 2022, infecting > 85,000 people and raising concerns about our preparedness against this emerging viral pathogen. Licensed and approved for mpox, the JYNNEOS vaccine has fewer side effects than previous smallpox vaccines and demonstrated efficacy against mpox infection in humans. Comparing JYNNEOS vaccine- and mpox-induced immunity is imperative to evaluate JYNNEOS’ immunogenicity and inform vaccine administration and design.MethodsWe examined the polyclonal serum (ELISA) and single B cell (heavy chain gene and transcriptome data) antibody repertoires and T cells (AIM and ICS assays) induced by the JYNNEOS vaccine as well as mpox infection.FindingsGene-level plasmablast and antibody responses were negligible and JYNNEOS vaccinee sera displayed minimal binding to recombinant mpox proteins and native proteins from the 2022 outbreak strain. In contrast, recent mpox infection (within 20-102 days) induced robust serum antibody responses to A29L, A35R, A33R, B18R, and A30L, and to native mpox proteins, compared to vaccinees. JYNNEOS vaccine recipients presented comparable CD4 and CD8 T cell responses against orthopox peptides to those observed after mpox infection.InterpretationJYNNEOS immunization does not elicit a robust B cell response, and its immunogenicity may be mediated by T cells.FundingResearch reported in this publication was supported, in part, by the National Cancer Institute of the National Institutes of Health under Award Number U54CA267776, U19AI168631(VS), as well as institutional funds from the Icahn School of Medicine.
Deep learning based phenotyping of medical images improves power for gene discovery of complex disease
Authors: Flynn Brianna I. , Javan Emily M. , Lin Eugenia , Trutner Zoe , Koenig Karl , Anighoro Kenoma O. , Kun Eucharist , Gupta Alaukik , Singh Tarjinder , Jayakumar Prakash , Narasimhan Vagheesh M. 
Published: March 2023

AbstractElectronic health records (EHRs) are often incomplete and inaccurate, reducing the power of genome-wide association studies (GWAS). Moreover, the variables within these records are often represented in binary codes, masking variation in disease severity among individuals. For some diseases, such as knee osteoarthritis (OA), radiographic assessment is the primary means of diagnosis and can be performed directly from medical images. In this work, we trained a deep learning model (DL-binary) to ascertain knee OA cases from anteroposterior (AP) dual-energy absorptiometry (DXA) scans and achieved clinician level performance. Applying this model across 29,257 individuals from the UK Biobank (UKB), we identified 2,603 (240%) more cases than currently diagnosed in the ICD-10 record. Individuals diagnosed as cases by DL-binary had higher rates of self-reported knee pain, knee pain for longer durations and with increased severity compared to control individuals. We trained another deep learning model to measure the minimum knee joint space width (mJSW), a quantitative phenotype linked to knee OA severity. Despite the DL-binary phenotype and mJSW being highly genetically correlated (92%), the heritability of mJSW was an order of magnitude greater than the ICD-10 code M17 or DL-binary phenotypes. In a GWAS run on mJSW, we identified 18 genome-wide significant loci, as opposed to 1 and 6 at the same sample size using either case-control (DL-binary and ICD-10 code M17) phenotype. This improved power also translated to better polygenic risk score (PRS) prediction for knee OA diagnosis in a holdout dataset of 371,686 individuals. We also show that reduced mJSW, but neither case-control phenotype is associated with increased risk of adult fractures, a leading cause of injury-related death in older individuals. For diseases with radiographic diagnosis, our results demonstrate the enormous potential for using deep learning to phenotype at biobank scale, both for improving power for gene discovery and for epidemiological analysis.
Cross-sectional analysis of Open payments for physicians at designated hemophilia centers in the US (2018-2020)
Authors: Haslam Alyson , Prasad Vinay 
Published: March 2023

AbstractIntroductionPhysicians who treat hemophilia, and especially directors at hemophilia centers, are in a position to be unduly influenced by payments from pharmaceutical companies who make costly hemophilia drugs. It is from this perspective that we analyzed payments made to physicians at hemophilia centers in the US, focusing on center directors.Materials and methodsIn a cross-sectional analysis we searched the CDC’s Hemophilia Treatment Center Directory for physicians (2022) and then abstracted general payments for physicians on Open Payments (2018-2020) and calculated one-year average payments. We searched academic websites to determine physician role (hemophilia center director, non-director, or non-center director).ResultsThere were 420 physicians in the hemophilia physician directory – 270 physicians/professors, 103 directors of hemophilia centers, and 47 other directors. Directors of hemophilia centers had higher median one-year general payments, compared to other directors and physician/professors ($4910 vs $79 vs $87, respectively; p<0.0001). Takeda Pharmaceutical Company Limited, F-Hoffmann La Roche Ltd/Genentech, and Novo Nordisk have the largest hemophilia drug market share and were the three companies with the most payments to physicians.ConclusionsHigh payments, especially among individuals who have responsibility over the success of hemophilia centers and clinics, may result in competition with the interest of the patients at these centers and clinics.
Rapid whole-brain high-resolution myelin water fraction mapping from extremely under-sampled magnetic resonance imaging data using deep neural network
Authors: Gong Zhaoyuan , Khattar Nikkita , Kiely Matthew , Triebswetter Curtis , Bouhrara Mustapha 
Published: March 2023

AbstractChanges in myelination are a cardinal feature of brain development and the pathophysiology of several cerebral diseases, including multiple sclerosis and dementias. Advanced magnetic resonance imaging (MRI) methods have been developed to probe myelin content through the measurement of myelin water fraction (MWF). However, the prolonged data acquisition and post-processing times of current MWF mapping methods pose substantial hurdles to their clinical implementation. Recently, fast steady-state MRI sequences have been implemented to produce high spatial resolution whole-brain MWF mapping within ∼ 20 min. Despite the subsequent significant advances in the inversion algorithm to derive MWF maps from steady-state MRI, the high-dimensional nature of such inversion does not permit further reduction of the acquisition time by data under-sampling. In this work, we present an unprecedented reduction in the computation (∼ 30 s) and the acquisition time (∼ 7 min) required for whole-brain high-resolution MWF mapping through a new Neural Network (NN)-based approach, named: Relaxometry of Extremely Under-SamplEd Data (NN-REUSED). Our analyses demonstrate virtually similar accuracy and precision in derived MWF values using the NN-REUSED approach as compared to results derived from the fully-sampled reference method. The reduction in the acquisition and computation times represents a breakthrough toward clinically practical MWF mapping.
Efficacy and Safety of Cannabis Transdermal Patch for Alleviating Psoriasis Symptoms: Protocol for a Randomized Controlled Trial (CanPatch)
Authors: Sermsaksasithorn Pim , Asawanonda Pravit , Phutrakool Phanupong , Ondee Thunnicha , Chariyavilaskul Pajaree , Payungporn Sunchai , Pongpirul Krit , Hirankarn Nattiya 
Published: March 2023

ABSTRACTBackgroundExisting topical psoriasis treatments are partially effective or have long-term side effects for a proportion of people with psoriasis; therefore, effective and safe treatment options are required. Cannabidiol, a cannabinoid inCannabis sativa, reverses the etiology of psoriasis through skin receptors according to in vitro research. Cannabidiol transdermal patches may be an effective treatment for psoriasis, although the efficacy and safety data are limited.Methods and analysisThis is a randomized double-blind controlled trial comparing cannabidiol (CBD) with minimal tetrahydrocannabinol (THC) patches with placebo patches (1:1 ratio) daily applied to comparable lesions of each patient with mild to moderate plaque-type psoriasis performed in a university hospital in Thailand (n=60). The primary outcome is the local psoriasis severity index (LPSI). The local severity index of psoriasis, the itch score using the visual analog scale, and adverse events will be evaluated on day 0, 30, 60, and 90 of the study. Furthermore, on days 0 and 90 of this study, biological samples will be taken for the evaluation of the skin, gut, and mouth microbial profile of 50% of randomly selected individuals.ConclusionsThis study aims to investigate the efficacy and safety of cannabidiol transdermal patches in alleviating the symptoms of psoriasis. We will also examine personal impacts on the efficacy and safety of patches, such as the microbial profile. The results of this study may highlight a novel topical treatment option that reduces suffering in patients with psoriasis.Ethics and disseminationThis study was registered with the. The protocol is being considered by the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University. The results of this study will be faithfully presented through conferences or published articles.