bluuebunny/crossref_metadata_2025_split huggingface dataset:
Verrucous venous malformation with minimal or no verrucous proliferation: a report of 16 cases
Authors: Liu Yang-He , Zhu Guan-Nan , Wang Gang , Wang Lei 
Published: February 2023

Background:
Verrucous venous malformation (VVM) usually presents as verrucous hyperplasia of the epidermis and proliferation of vessels in the dermis and subcutaneous tissue. Atypical VVM without verrucous manifestation was recently reported.

Methods:
We retrospectively analyzed the clinical and histological features of VVM with minimal or no verrucous hyperplasia in 16 patients at a single dermatology department from 2002 to 2021.

Results:
All patients presented with palpable soft nodules or masses. Slightly red or light pink patches were present on the surface in 8 patients, while no obvious superficial abnormalities were present in 8 patients. In nine patients, the proliferated tissue was excised without the overlying epidermis, and in the other seven patients, the proliferated tissue with the intact epidermis was available for histological examination. All specimens showed proliferation of small to medium-sized vessels mainly in the subcutaneous tissue. Of the seven specimens with intact epidermis, five exhibited slight vascular endothelial hyperplasia in the papillary dermis and two showed no change in the papillary dermis. The endothelial cells were positive for CD31 (16/16) and focally positive for prox1 (8/16), D2-40 (14/16), Wilms tumor-1 (8/16), and Glut-1 (1/16). The pericytes around the endothelial cells were positive for smooth muscle actin (16/16).

Conclusions:
VVM with minimal or no verrucous appearance is easily misdiagnosed. Clinicopathological correlation is very important for the correct diagnosis.
Concentric Centrifugal Figurate Erythema as an Unusual COVID-19 Evanescent Skin Manifestation in a Patient With CD3+/CD45+ Lymphocyte Infiltration: A Case Report
Authors: Achell-Nava Lucía Achell , Zaldivar-Fujigaki José Luis , Pérez-Cabeza de Vaca Rebeca , Espinosa García Ana Maria , Montiel López Luis 
Published: February 2023

Introduction:
Coronavirus disease 2019 (COVID-19) may be associated with various skin manifestations. Among them, figurate erythema (FE) is rare; only a few clinical reports have been published.
Herein, we reported an unusual concentric FE lesions and their immunohistochemical profile in a patient with COVID-19.

Case presentation:
A 52-year-old woman was diagnosed with COVID-19. One month later, she developed asymptomatic annular erythematous concentric ring lesions on her inner right thigh. The margin of every ring increased in coloration, and the lesions then completely resolved in 2 weeks. A biopsy revealed vasculitis of small vessels, an increase in the fluorescence intensity of CD3 and CD45, and negativity for COVID-19 RNA.

Discussion:
The results showed an unusual FE that has a clinical mixed type between erythema annulare centrifugum and erythema gyratum repens; the physiopathological mechanism in the FE due to COVID-19 is unknown; one theory involves rapid viral passage into the cutaneous vascular system that triggers an immune and inflammatory response. Although the results exhibited a negative COVID-19 RNA in the tissue, the CD3+/CD45+ lymphocyte infiltration could explain the clinical pattern as a direct inflammatory response in the small vessel or as a delayed immune response.

Conclusion:
Our findings suggest an immunohistochemical small vessel vasculitis pattern with an unusual clinical FE that differs from other types of COVID-19–associated FE or erythema reported previously.
A Gift You Give Yourself: A Preemptive Intervention for Student Mental Health
Authors: Roman Christopher 
Published: February 2023

Introduction
Burnout, stress, and compromised mental health are known issues for clinical trainees. Various interventions have shown efficacy, but they are generally training-based and therefore not practical for “just in time” use when a student is struggling. Stigma surrounding mental health is another challenge to this aspect of wellness.

Methods
At the beginning of their training, physician assistant (PA) students from 3 cohorts at Butler University wrote short reflections on resiliency and their motivation for training. This, along with an encouraging note from a faculty member, was placed in a box and wrapped. Students then kept the box to open during a time of stress or self-doubt. An anonymous survey about this intervention was sent to these students in April 2021.

Results
Almost all survey respondents remembered the activity and had a positive impression of it. Nearly half opened the gift box during their training, with a majority opening it during the didactic phase rather than the clinical phase. Most of those who opened the gift box viewed it favorably. Participants reported high levels of self-stigma regarding mental health and help-seeking.

Discussion
The gift box intervention was well-received and used by many students. This is a “just in time” intervention to support struggling learners when they need it most, as opposed to most interventions that are more structured in their delivery and use. The high level of self-stigma for mental health help-seeking is a concern and warrants continued investigation.
A Retrospective Comparison of Orthotic Interventions on Charcot Feet
Authors: Benson Clayton S. , VanPelt Michael D. , Wang Jijia , Johnson Matthew , Liu George T. , Raspovic Katherine , Dane Wukich , Tiffany Graham 
Published: February 2023

ABSTRACT

Introduction
This retrospective chart review aims to find evidence supporting a difference in complications rates and progression of Charcot deformity between two orthotic interventions: the CROW and the custom calf lacer ankle foot orthosis. The existing evidence base to support the use of orthoses in the prevention and treatment of diabetic foot ulcers secondary to Charcot arthropathy is extremely limited.

Methods
Subjects were diagnosed with diabetes mellitus and Charcot arthropathy and referred for orthotic treatment. A billing audit of subjects treated between September 1, 2018, and May 1, 2020, was generated using L codes L2330 and L4631.
Subjects were excluded if they received a midfoot or higher amputation before application of the offloading device. In total, 87 charts were retrospectively reviewed, and 47 subjects were included.

Results
No significant difference was found in complication rate between the two groups. The first year of orthotic intervention had the highest number of complications for both devices. In addition, most calf lacer subjects wore the orthosis for 2 to 3 years, whereas most CROW subjects wore the orthosis for 2 years.

Conclusions
These findings suggest that both orthotic interventions available to treat diabetic foot ulcers secondary to Charcot arthropathy have similar complication rates. More research is needed to determine the clinical benefits of prescribing one intervention over the other.

Clinical Relevance
Although clinical empirical evidence suggests lower complication rates with the use of calf lacer AFOs, this study found no statistical difference in the overall number of complications observed with the two orthotic interventions.
Effectiveness of Dynamic Metacarpophalangeal Splint in Treatment of Ulnar Deviation of Rheumatoid Arthritis on Pinch Strength and Functional Ability in Women
Authors: Kumari Rohina , Saharawat Sakshi 
Published: February 2023

ABSTRACT

Introduction
Rheumatoid arthritis (RA) causes structural damage that causes joint deformity including metacarpophalangeal (MCP) joint ulnar drift (UD), thus hindering the pinch strength and the functional ability of the hand. Orthosis or splints are designed to maintain the hand’s function, improve joint alignment, restore biomechanical balance, and reduce tissue stress. Limited studies have been done on the effects of dynamic splint on pinch strength and functional ability. Therefore, the purpose of this study was to evaluate and quantify the effects of dynamic MCP splint in treatment of ulnar deviation of RA on pinch strength and functional ability in women.

Methods
Twenty women with RA were recruited and completed a 4-week intervention period with dynamic MCP splint. Pinch strength and functional ability score were measured at baseline and after 4 weeks.

Results
The results showed a significant improvement in pinch strength (mean ± SD, 11.68 ± 2.14 to 13.53 ± 2.14; P = 0.000) and functional ability score (mean ± SD, 22.70 ± 9.12 to 19.70 ± 8.14; P = 0.000).

Conclusion
The results of this study show that the dynamic MCP splint had a positive impact on rheumatoid hands that align the joints in their functional position. The dynamic MCP splint improved the mechanical stability of the hand, thus reducing pain and stress on joints, which in turn improves the pinch strength and functional ability of rheumatoid hand.

Clinical Relevance
To increase patient acceptance and use of the splint, the splint designed and used in this study was compact and only covered the affected areas and joints of the hand. Because there was no involvement of the wrist joint and the fingertips were free, the splint was lightweight and allowed the patient to perform activity while wearing it.
Immediate Impacts of Two Foot Orthotic Designs on Foot Posture Index, Gait, and Comfort in Adults With Asymptomatic, Flexible Pes Planus
Authors: Mullen Ashley , Kenworthy Sally , Ewing Kathryn , Forbus Michelle , Hoelscher Thompson Regan 
Published: February 2023

ABSTRACT

Introduction
Flexible flatfeet are commonly treated with functional foot orthoses (FFOs) and University of California Berkeley Laboratory (UCBL) designs. This study sought to evaluate the immediate effects of low-profile FFOs and high-profile UCBL orthoses on Foot Posture Index (FPI), spatiotemportal measures of gait, and perceived comfort and compliance in adults with flexible flatfeet.

Materials and Methods
Fourteen individuals with self-reported asymptomatic flexible flatfeet participated in this randomized cross-sectional study. Custom FFOs and UCBL orthoses were fabricated for each participant, who then walked at a self-selected speed in each condition on a Zeno Mat. Foot Posture Index, perceived comfort and compliance, and spatiotemporal parameters were collected across conditions.

Results
There were no significant differences in velocity, cadence, step length, stride width, toe-in/toe-out, or stance center of pressure distance percentage. Stance phase duration significantly increased from baseline to UCBL condition. There was a statistically significant decrease bilaterally in FPI from baseline to FFO and from baseline to UCBL orthosis, but not between FFO and UCBL orthosis. There were no significant differences in comfort and compliance ratings between FFOs and UCBL orthoses.

Conclusions
With regard to immediate effects, both the UCBL and FFO designs improve foot posture without significant impact on spatiotemporal gait patterns or perceived comfort and compliance. Additional research is needed to determine the longevity of these effects.

Clinical Relevance
The results of this study support the use of both FFOs and UCBL orthoses when trying to provide foot posture correction for adults with asymptomatic flexible flatfeet.
A Survey of Clinical Practice Patterns of Physical Therapists for the Use of Ankle-Foot Orthoses or Functional Electrical Stimulation Poststroke
Authors: Brown Lisa , Johnston Therese E. , Keller Sarah , Denzer-Weiler Caitlin 
Published: February 2023

ABSTRACT

Objective
The aims of this study were (1) to understand the practice patterns and decision-making factors of physical therapists (PTs) when choosing ankle-foot orthoses (AFOs) or functional electrical stimulation (FES) for patients with mobility deficits secondary to poststroke hemiplegia and (2) to explore perceived gaps in knowledge to inform development of a clinical practice guideline (CPG).

Methods
A mixed-methods web-based survey collected quantitative and qualitative data from practicing PTs. Descriptive analysis of quantitative data and thematic content analysis of the qualitative data were completed.

Results
The 103 PTs were practicing clinicians with a doctoral degree and specialized board certification. A higher level of confidence with AFOs compared with FES was reported, along with increased inclusion of AFOs compared with FES for assessments and treatments. The PTs considered outcomes across the International Classification of Functioning, Disability and Health (ICF) when choosing devices, noting barriers in access and reimbursement as influential factors in clinical decision making. Fewer than 50% participated in continuing education on AFO or FES. Perceived knowledge gaps and educational needs included assessment and intervention strategies to support clinical decision making. The PTs considered themselves influential in the decision-making process and more than 95% of the respondents replied that a CPG on AFO and FES poststroke would impact clinical practice.

Conclusion
Themes related to education, clinical decision-making, access, and reimbursement were identified. A CPG may provide valuable information to address gaps in knowledge to improve clinical practice and decision-making.

Clinical Relevance
This research aims to inform the development of a CPG to address needs and gaps in knowledge identified by practicing clinicians. The information gained will inform knowledge translation strategies to promote best practices when implementing AFO and FES to improve activity and participation levels of individuals poststroke.
Adjusting to Changing Environments: Virtual Preseason SCAT5 Assessment in Canadian Male Youth Football Players
Authors: Syrydiuk Reid A. , Penner Linden C. , Sick Stacy , Eliason Paul , Galarneau Jean-Michel , Leggett Benjamin , Galea Olivia , Schneider Kathryn J. , Emery Carolyn A. 
Published: February 2023

Objective:
To provide preseason reference scores for Canadian youth tackle football players on the Sport Concussion Assessment Tool 5 (SCAT5) and to examine whether age, concussion history, and self-reported medical diagnoses are associated with SCAT5 subcomponent performance.

Design:
Cross-sectional study.

Setting:
Calgary, Alberta.

Participants:
Five hundred one male youth football players (ages 13-18 years) participating in the 2021 season.

Assessment of Risk Factors:
SCAT5 subcomponents were assessed by age group (13-14, 15-16, 17-18), concussion history (0, 1, 2+, and yes/no), and self-reported diagnoses (headache disorder, attention-deficit/hyperactive disorder, learning disability/dyslexia, and depression, anxiety, or other psychiatric disorder).

Main Outcome Measures:
Virtual video administration (vs traditional in-person testing) of the SCAT5 was completed, and subcomponent scores included total number of symptoms (/22), symptom-severity score (/132), Standardized Assessment of Concussion [orientation (/5), immediate memory (/30), concentration (/5), delayed recall (/10)], and modified Balance Error Scoring System (/30). Kruskal–Wallis, one-way analysis of variance , Mann–Whitney U, or independent t tests were used to assess possible associations depending on number of groups and data normality.

Results:
Virtual SCAT5 assessment scores across all outcomes did not differ by age group or concussion history. The median number of symptoms and median symptom-severity score at baseline was 2, and 173 players (34.5%) reported no symptoms. Median total number of errors on the modified Balance Error Scoring System was 3. Participants with certain self-reported diagnoses (attention-deficit/hyperactive disorder, dyslexia) demonstrated poorer performance on some SCAT5 subcomponents (symptom reporting, Standardized Assessment of Concussion).

Conclusions:
Baseline SCAT5 performance did not differ by age group or concussion history in male youth football players. Diagnoses of the self-reported disorders examined may be important considerations for interpretation of the SCAT5 assessment.
Injuries in Youth Volleyball Players at a National Championship: Incidence, Risk Factors, and Mechanisms of Injury
Authors: Vaandering Kenzie , Meeuwisse Derek , MacDonald Kerry , Eliason Paul H. , Graham Robert F. , Chadder Michaela K. , Lebrun Constance M. , Emery Carolyn A. , Schneider Kathryn J. 
Published: February 2023

Objective:
To evaluate injury incidence rates, types, mechanisms, and potential risk factors in youth volleyball.

Design:
Prospective cohort.

Setting:
2018 Canadian Youth National Volleyball Tournament.

Participants:
Thousand eight hundred seventy-six players [466 males, 1391 females, mean age 16.2 years (±1.26)] consented to participate (19.5%).

Assessment of Risk Factors:
Sex (male/female), age group, position, and underage players.

Main Outcome Measures:
Players completed a questionnaire (demographic information, injury, and concussion history). Medical attention injuries were recorded by tournament medical personnel through an injury report form (eg, mechanism and type). Injury was defined as any physical complaint seeking onsite medical attention. Concussion was defined using the fifth International Consensus. Injury rates adjusted for cluster by team were calculated by sex. Exploratory multivariable Poisson regression was used to analyze potential risk factors (eg, sex, age group, position, and underage players) for injury, adjusted for cluster by team and offset by athlete exposures (AEs).

Results:
There were 101 injuries in the 7-day tournament {IRFemale = 6.78 injuries/1000 AEs [95% confidence interval (CI), 5.27-8.72]; IRMale = 4.30 injuries/1000 AEs (95% CI, 2.55-7.24)}. Joint sprain (n = 29, 28.71%) and concussion (n = 26, 25.74%) were the most common. Most concussions were associated with ball-to-head contact (61.5%). There was no statistically significant difference in injury rate by sex (IRRF/M: 1.47; 95% CI, 0.80-2.69). The rates of injury in U14 were higher than U18 (IRRU14: 2.57; 95% CI, 1.11-5.98).

Conclusions:
Injury rates are high in youth volleyball tournament play, with the highest rates in U14. More research is needed to inform the development of volleyball-specific injury prevention strategies.
Injury Burden in Professional European Football (Soccer): Systematic Review, Meta-Analysis, and Economic Considerations
Authors: Pulici Luca , Certa Denis , Zago Matteo , Volpi Piero , Esposito Fabio 
Published: February 2023

Objective:
We performed a systematic review and meta-analysis to evaluate the injury burden and the related economic cost in European professional male football players.

Data Sources:
Multiple database research was performed up to August 5, 2022 (PubMed, EMbase, Scopus, Cochrane Library), including only studies that reported severity in the number of days of absence for each injury, incidence reported in the number of injuries/1000 hours, or reported number of injuries and exposure time and adult male football players, professionals from European clubs. Two reviewers extracted data and assessed paper quality with the Strengthening the Reporting of Observational Studies in Epidemiology statement and the Newcastle–Ottawa Scale.

Main Results:
Twenty-two studies have reported incidence, severity, and burden of injuries in professional football. The highest injury burden was found for ligament–joint injuries (37.9 days/1000 hours; 222 397 €/1000 hours) and for muscle injuries (34.7 days/1000 hours; 203 620 €/1000 hours). Injury locations with high burden were knee injuries (34.8 days/1000 hours; 20 4206 €/1000 hours)—mainly anterior cruciate ligament injuries (14.4 days/1000 hours; 84 499 €/1000 h)–followed by thigh injuries (25.0 days/1000 hours; 146 700 €/1000 hours), hamstrings injuries (15.4 days/1000 hours; 90 367 €/1000 hours), hip-and-groin injuries (16.1 days/1000 hours; 94 475 €/1000 hours), primarily adductor muscles injuries (9.4 days/1000 hours; 55 159€/1000 hours), and ankle injuries (13.1 days/1000 h; 76 871 €/1000 hours) with ankle sprains (7.4 days/1000 hours; 43 423 €/1000 hours).

Conclusions:
Being exposed to injury risk has serious consequences for individual and club performance and economy. This review identified the most relevant targets in injury management, compared their injury data with reference values, and provided economic evidence when trying to gain buy-in from the key decision makers.
Injuries and Illnesses During the 53rd FIS Nordic World Ski Championships 2021 in Oberstdorf: A Prospective Cohort Study
Authors: Kastner Tom , Junge Astrid , Weith Moritz , Porzig Florian , Disch Alexander C. , Edouard Pascal , Wolfarth Bernd , Hollander Karsten 
Published: February 2023

Objective:
For the 3 Nordic ski disciplines of cross-country skiing, Nordic combined, and ski jumping, data on injuries and illnesses during major sporting events only exist from the Winter Olympics of 2010 to 2018. So far, an investigation has not been conducted during the Nordic World Ski Championships.

Design:
Prospective cohort study.

Setting:
Fédération Internationale de Ski (FIS) Nordic World Ski Championships 2021 in Oberstdorf, Germany.

Participants:
Overall, 663 athletes from 65 nations participated in the FIS Nordic World Ski Championships 2021. The study population included 344 athletes from 32 nations.

Interventions:
National medical teams were invited to report daily all newly incurred or exacerbated injuries and illnesses.

Main Outcome Measures:
All reported injuries and illnesses that occurred during the championships from February 23 until March 7, 2021, were analyzed. Injury and illness rates were calculated with 95% confidence intervals (95% CIs).

Results:
The 32 reporting nations returned 88.4% of the daily report forms. The incidence of injuries was 4.7 (95% CI, 2.4-6.9) per 100 athletes in the 3 Nordic ski disciplines. The incidence of illness was also 4.7 (95% CI, 2.4-6.9) per 100 athletes with a relative proportion of infection-related illnesses of 31.3%.

Conclusions:
Although the incidence of injuries of the Nordic disciplines was comparable with those of the 2010 to 2018 Winter Olympics, the incidence of illnesses was lower than during the previous 3 Winter Olympic Games with a lower rate of infection-related illnesses. This might be caused by the high hygiene measures due to the coronavirus disease 2019 pandemic.
Improving chlamydia risk screening by using the CDC's 5 Ps approach to sexual health history
Authors: Gautam Ramesh , Orrino Jacob 
Published: February 2023

ABSTRACT

Background:

Chlamydia trachomatis is infecting service members (SMs) at a rate of two to three times that of the U.S. population. Currently, the military only screens female SMs under the age of 25 years, leaving many at-risk males to go undetected leading to further transmission.

Local Problem:
Service members are not routinely assessed for high-risk sexual activities, leading to increased chlamydia rate in Fort Bragg. At the primary care project site, screening was only done per HEDIS measure leading to only 5% STI positivity rate. The purpose of this project was to identify and screen SMs who are at high risk for chlamydia using the CDC's 5 Ps approach.

Methods:
This project took place at a large primary care clinic that only cared for active-duty soldiers over a 3-month period.

Interventions:
The CDC's 5 Ps questionnaire was administered to SMs 30 years and younger during routine appointments. The SMs deemed high risk from the questionnaire were screened using urine G/C NAAT testing.

Results:
Four hundred forty-nine SMs were assessed using the CDC's 5 Ps approach. The questionnaire identified 91 SMs (20%) at higher risk for STIs. Of the 45 urine samples submitted, six were positive for STIs. Of the six positive cases, five were male. Targeted screening resulted in 13.3% positive rate compared with the 5% in the current practice.

Conclusion:
The result suggests that targeted screening of young males and females can identify high-risk sexual behaviors leading to increased findings of asymptomatic chlamydia carriers, ultimately leading to decreased chlamydia incidence.