bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upper extremity soft tissue stiffness measured with shear wave elastography: A between-day reliability study
Authors: Day Joseph M , Merriman Harold 
Published: June 2023

Background Imbalances in soft tissue stiffness (STS) of the pectoralis and common wrist extensors (CWEs) can adversely alter upper extremity function. Shear wave elastography (SWE) has the capacity to provide precise, repeatable, objective data on STS. The purpose of this study was to determine the between-day intrarater reliability for the pectoralis and CWE tendon stiffness as measured by SWE. Methods STS measured by the shear wave modulus (kilopascals (kPa)) was captured bilaterally on the pectoralis major, pectoralis minor, and CWE tendon using 2D SWE ultrasound imaging (GE Logiq S8, 9 L transducer) on two separate days. Within examiner intraclass correlation coefficients (ICC (3, 3)) with 95% confidence intervals, standard error of the measure, and minimal detectable changes were calculated. Results The investigators recruited 10 healthy participants (mean age = 23.50  ±  1.43). Between day intrarater reliability values were obtained for the dominant pectoralis major ICC  =  0.70 (−0.15, −0.93), nondominant pectoralis major ICC  =  0.63 (−0.30, −0.91), dominant pectoralis minor ICC  = 0 .72(−0.04, −0.93), nondominant pectoralis minor ICC  = 0.75(0.08, −0.94), dominant CWE tendon ICC  =  0.75(−0.08, −0.94), and nondominant CWE tendon ICC  =  0.75(−0.12, −0.94). Discussion Our data demonstrate acceptable reliability but future studies should include methods that control for variables known to effect STS.
Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials
Authors: Alzobi Osama Z , Hantouly Ashraf T , Kenawey Mohamed , Ibrahim Talal 
Published: June 2023

Objectives: Distal forearm fractures are the most common pediatric fractures. This study aimed to investigate the effectiveness of below-elbow cast treatment for displaced distal forearm fractures in children compared to above-elbow cast through meta-analysis of randomized controlled trials. Methods: Several databases from January 1, 2000 until October 1, 2021 were searched for randomized controlled trials that assessed below versus above-elbow cast treatment of displaced distal forearm fractures in pediatric patients. The main meta-analysis comparison was based on the relative risk of loss of fracture reduction between children undergoing below versus above-elbow cast treatment. Other outcome measures including re-manipulation and cast-related complications were also investigated. Results: Nine studies were eligible of the 156 articles identified, with a total of 1049 children. Analysis was undertaken for all included studies with a sensitivity analysis conducted for studies with high quality. In the sensitivity analysis, the relative risks of loss of fracture reduction (relative risk = 0.6, 95% confidence interval = 0.38, 0.96) and re-manipulation (relative risk = 0.3, 95% confidence interval = 0.19, 0.48) between the below and above-elbow cast groups were in favor of below-elbow cast and statistically significant. Cast-related complications were in favor of below-elbow cast but did not attain statistical significance (relative risk = 0.45, 95% confidence interval = 0.05, 3.99). Loss of fracture reduction was noted in 28.9% of patients treated with above-elbow cast and 21.5% in below-elbow cast. Re-manipulation was attempted in 48.1% versus 53.8% of children who lost fracture reduction in the below-elbow cast and above-elbow cast groups, respectively. Conclusion: Below-elbow cast treatment was favored, with statistical significance, in terms of loss of fracture reduction and re-manipulation, and was not associated with a higher risk of cast-related complications. The accumulative evidence currently does not support above-elbow cast treatment and below-elbow cast treatment should be the mainstay for displaced distal forearm fractures in children. Level of evidence: Level I, meta-analysis of therapeutic level I studies.
Untargeted metabolomics characterization of the resectable pancreatic ductal adenocarcinoma
Authors: Cao Ying-Ying , Guo Kai , Zhao Rui , Li Yuan , Lv Xiao-Jing , Lu Zi-Peng , Tian Lei , Ren Shuai , Wang Zhong-Qiu 
Published: June 2023

Background Diagnosis of pancreatic ductal adenocarcinoma (PDAC) is difficult due to the lack of specific symptoms and screening methods. Only less than 10% of PDAC patients are candidates for surgery at the time of diagnosis. Thus, there is a great global unmet need for valuable biomarkers that could improve the opportunity to detect PDAC at the resectable stage. This study aimed to develop a potential biomarker model for the detection of resectable PDAC by tissue and serum metabolomics. Methods Ultra-high-performance liquid chromatography and quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS/MS) was performed for metabolome quantification in 98 serum samples (49 PDAC patients and 49 healthy controls (HCs)) and 20 pairs of matched pancreatic cancer tissues (PCTs) and adjacent noncancerous tissues (ANTs) from PDAC patients. Univariate and multivariate analyses were used to profile the differential metabolites between PDAC and HC. Results A total of 12 differential metabolites were present in both serum and tissue samples of PDAC. Among them, a total of eight differential metabolites showed the same expressional levels, including four upregulated and four downregulated metabolites. Finally, a panel of three metabolites including 16-hydroxypalmitic acid, phenylalanine, and norleucine was constructed by logistic regression analysis. Notably, the panel was capable of distinguishing resectable PDAC from HC with an AUC value of 0.942. Additionally, a multimarker model based on the 3-metabolites-based panel and CA19-9 showed a better performance than the metabolites panel or CA19-9 alone (AUC: 0.968 vs. 0.942, 0.850). Conclusions Taken together, the resectable early-stage PDAC has unique metabolic features in serum and tissue samples. The defined panel of three metabolites has the potential value for early screening of PDAC at the resectable stage.
Diaphragm dome height on chest radiography as a predictor of dynamic lung hyperinflation in COPD
Authors: Shiraishi Masashi , Higashimoto Yuji , Sugiya Ryuji , Mizusawa Hiroki , Takeda Yu , Noguchi Masaya , Nishiyama Osamu , Yamazaki Ryo , Kudo Shintarou , Kimura Tamotsu , Tohda Yuji , Matsumoto Hisako 
Published: June 2023

Background and objectiveDynamic lung hyperinflation (DLH) can play a central role in exertional dyspnoea in patients with COPD. Chest radiography is the basic tool for assessing static lung hyperinflation in COPD. However, the predictive capacity of DLH using chest radiography remains unknown. This study was conducted to determine whether DLH can be predicted by measuring the height of the right diaphragm (dome height) on chest radiography.MethodsThis single-centre, retrospective cohort study included patients with stable COPD with pulmonary function test, cardiopulmonary exercise test, constant load test and pulmonary images. They were divided into two groups according to the median of changes of inspiratory capacity (ΔIC=IC lowest − IC at rest). The right diaphragm dome height and lung height were measured on plain chest radiography.ResultsOf the 48 patients included, 24 were classified as having higher DLH (ΔIC ≤−0.59 L from rest; −0.59 L, median of all) and 24 as having lower DLH. Dome height correlated with ΔIC (r=0.66, p<0.001). Multivariate analysis revealed that dome height was associated with higher DLH independent of % low attenuation area on chest computed tomography and forced expiratory volume in 1 s (FEV1) % predicted. Furthermore, the area under the receiver operating characteristic curve of dome height to predict higher DLH was 0.86, with sensitivity and specificity of 83% and 75%, respectively, at a cut-off of 20.5 mm. Lung height was unrelated to ΔIC.ConclusionDiaphragm dome height on chest radiography may adequately predict higher DLH in patients with COPD.
Evaluating the impact of cash transfers on tuberculosis (ExaCT TB): a stepped wedge cluster randomised controlled trial
Authors: Shete Priya B. , Kadota Jillian L. , Nanyunja Grace , Namale Catherine , Nalugwa Talemwa , Oyuku Denis , Turyahabwe Stavia , Kiwanuka Noah , Cattamanchi Adithya , Katamba Achilles 
Published: June 2023

BackgroundMitigating financial barriers to tuberculosis (TB) diagnosis and treatment is a core priority of the global TB agenda. We evaluated the impact of a cash transfer intervention on completion of TB testing and treatment initiation in Uganda.MethodsWe conducted a pragmatic complete stepped wedge randomised trial of a one-time unconditional cash transfer at 10 health centres between September 2019 and March 2020. People referred for sputum-based TB testing were enrolled to receive UGX 20 000 (∼USD 5.39) upon sputum submission. The primary outcome was the number initiating treatment for micro-bacteriologically confirmed TB within 2 weeks of initial evaluation. The primary analysis included cluster-level intent-to-treat and per-protocol analyses using negative binomial regression.Results4288 people were eligible. The number diagnosed with TB initiating treatment was higher in the intervention periodversusthe pre-intervention period (adjusted rate ratio (aRR)=1.34) with a 95% CI of 0.62–2.91 (p=0.46), indicating a wide range of plausible true intervention effects. More were referred for TB testing (aRR=2.60, 95% CI 1.86–3.62; p<0.001) and completed TB testing (aRR=3.22, 95% CI 1.37–7.60; p=0.007) per National Guidelines. Results were similar but attenuated in per-protocol analyses. Surveys revealed that while the cash transfer supported testing completion, it was insufficient to address long-term underlying social/economic barriers.InterpretationWhile it is uncertain whether a single unconditional cash transfer increased the number of people diagnosed and treated for TB, it did support higher completion of diagnostic evaluation in a programmatic setting. A one-time cash transfer may offset some but not all of the social/economic barriers to improving TB diagnosis outcomes.
Transthyretin derived amyloid deposits in the atrium and the aortic valve: insights from multimodality evaluations and mid-term follow up
Authors: Okada Atsushi , Kakuta Takashi , Tadokoro Naoki , Tateishi Emi , Morita Yoshiaki , Kitai Takeshi , Amaki Makoto , Kanzaki Hideaki , Ohta-Ogo Keiko , Ikeda Yoshihiko , Fukushima Satsuki , Fujita Tomoyuki , Kusano Kengo , Noguchi Teruo , Izumi Chisato 
Published: June 2023

Abstract
Background
Recent studies have reported atrial involvement and coexistence of aortic stenosis in transthyretin (ATTR) cardiac amyloidosis (CA). However, pathological reports of extraventricular ATTR amyloid deposits in atrial structures or heart valves are limited, and the clinical implications of ATTR amyloid deposits outside the ventricles are not fully elucidated.

Case presentation
We report 3 cases of extraventricular ATTR amyloid deposits confirmed in surgically resected aortic valves and left atrial structures, all of which were unlikely to have significant ATTR amyloidosis infiltrating the ventricles as determined by multimodality evaluation including 99mtechnetium-pyrophosphate scintigraphy, cardiac magnetic resonance, endomyocardial biopsy and their mid-term clinical course up to 5 years. These findings suggested that these were extraventricular ATTR amyloid deposits localized in the aortic valve and the left atrium.

Conclusions
While long-term observation is required to fully clarify whether these extraventricular ATTR amyloid deposits are truly localized outside the ventricles or are early stages of ATTR-CA infiltrating the ventricles, our 3 cases with multimodality evaluations and mid-term follow up suggest the existence of extraventricular ATTR amyloid deposits localized in the aortic valve and left atrial structures.
Combined exercise and nutrition intervention for older women with spinal sarcopenia: an open-label single-arm trial
Authors: Kim Seungcheol , Park Jinhee , Kim Dong Hyun , Sun Jiyu , Lee Sang Yoon 
Published: June 2023

Abstract
Purpose
Spinal sarcopenia is a multifactorial disorder associated with atrophy and fatty changes in paraspinal muscles. Interventional studies for spinal sarcopenia are limited. We aimed to evaluate the effectiveness of a combined exercise and nutrition intervention for the treatment of spinal sarcopenia.

Methods
35 community-dwelling older women diagnosed with spinal sarcopenia in a previous cohort study were included. The 12-week combined intervention consisted of back extensor strengthening exercises and protein supplementation. The following outcomes were measured at baseline (week 0), after the intervention (week 12), and follow-up (week 24): conventional variables of sarcopenia (appendicular skeletal muscle mass, handgrip strength, 6-meter gait speed, and short physical performance battery); lumbar extensor muscle mass; lumbar extensor muscle volume and signal intensity; back extensor isokinetic strength; and back performance scale. We used the intention-to-treat analysis method, and repeated measures analysis of variance was used to analyze the data.

Results
Of the total 35 potential participants, 26 older women participated in the study (mean age 72.5 ± 4.0 years old). After 12 weeks of combined exercise and nutrition intervention, there were no changes in the appendicular skeletal muscle mass, lumbar extensor muscle mass, volume, or signal intensity. Handgrip strength and back extensor isokinetic strength did not change significantly. Short physical performance battery significantly increased (P = 0.042) from 11.46 ± 0.86 to 11.77 ± 0.53 at week 12 and 11.82 ± 0.40 at week 24. The back performance scale sum score also significantly improved (P = 0.034) from 2.68 ± 1.81 to 1.95 ± 1.21 at week 12 and 2.09 ± 1.34 at week 24.

Conclusion
The combined exercise and nutrition intervention for community-dwelling older women with spinal sarcopenia could be feasible and helpful in improving the physical performance as well as back performance.
Real-time risk ranking of emerging epidemics based on optimized moving average prediction limit—taking the COVID-19 pandemic as an example
Authors: Wang Zhongliang , Liu Bin , Luan Jie , Lu Shanshan , Zhang Zhijie , Ba Jianbo 
Published: June 2023

AbstractBackgroundMathematical models to forecast the risk trend of the COVID-19 pandemic timely are of great significance to control the pandemic, but the requirement of manual operation and many parameters hinders their efficiency and value for application. This study aimed to establish a convenient and prompt one for monitoring emerging infectious diseases online and achieving risk assessment in real time.MethodsThe Optimized Moving Average Prediction Limit (Op-MAPL) algorithm model analysed real-time COVID-19 data online and was validated using the data of the Delta variant in India and the Omicron in the United States. Then, the model was utilized to determine the infection risk level of the Omicron in Shanghai and Beijing.ResultsThe Op-MAPL model can predict the epidemic peak accurately. The daily risk ranking was stable and predictive, with an average accuracy of 87.85% within next 7 days. Early warning signals were issued for Shanghai and Beijing on February 28 and April 23, 2022, respectively. The two cities were rated as medium–high risk or above from March 27 to April 20 and from April 24 to May 5, indicating that the pandemic had entered a period of rapid increase. After April 21 and May 26, the risk level was downgraded to medium and became stable by the algorithm, indicating that the pandemic had been controlled well and mitigated gradually.ConclusionsThe Op-MAPL relies on nothing but an indicator to assess the risk level of the COVID-19 pandemic with different data sources and granularities. This forward-looking method realizes real-time monitoring and early warning effectively to provide a valuable reference to prevent and control infectious diseases.
Obesity and risk of hearing loss in the middle-aged and elderly: a national cohort of Chinese adults
Authors: Zhang Chen , Wang Weiwei , Chang Xiaotian , Zhan Siyan , Wang Shengfeng , Feng Lei , Song Yongfeng 
Published: June 2023

AbstractBackgroundThe relationship between obesity and hearing loss among the middle-aged and older population remained unclear. Moreover, few studies have focused on the impact of gender on this association.MethodsThis cohort study extracted the data from the China Health and Retirement Longitudinal Study, a national survey of adults aged 45 years or over. Waist circumference was categorized into three groups: normal, pre-central obesity, and central obesity. We classified BMI into four categories: underweight, normal weight, overweight, and obese. The primary endpoint was the incidence of self-reported hearing loss.ResultsOf the 14,237 participants, 1972 incidents of hearing loss were identified during a median 6.9 years of follow-up. The cumulative incidence of hearing loss was 13.9% (95% CI 13.3% -14.4%). Our study showed that central obesity was significantly associated with hearing loss (HR 0.84, 95%CI 0.75–0.94), and this relationship was more prominent in males (HR 0.76, 95%CI 0.63–0.91). Among male participants, the underweight group was at the highest risk of hearing loss (HR 1.39, 95%CI 1.08–1.79). Compared with the normal weight group, the adjusted HR for hearing loss in the obese groups was 0.69 (95%CI 0.51–0.94) among men. Among female participants, only the overweight group had a lower risk of hearing loss than the normal weight group (HR 0.83, 95%CI 0.71–0.96).ConclusionsBeing overweight and obese were significantly associated with a decreased risk of hearing loss, whereas being underweight was associated with an increased risk of hearing loss.
Acceptance of HPV vaccination in boys among mothers from selected churches in Accra, Ghana
Authors: Appiah Evans Osei , Oti-Boadi Ezekiel , Appiah Stella , Bakkari Mohammed Ali , Menka Manuela Akosua , Awuah Dorothy Baffour , Kontoh Samuel , Menlah Awube , Garti Isabella , Boateng Susana Agyekum 
Published: June 2023

Abstract
Background
Almost all cases of cervical and anal cancer have been linked to the human papillomavirus (HPV). However, in addition to women who develop HPV-related cervical cancer, both men and women can also develop cancers of the anus, oral cavity, and oropharynx that are attributed to HPV. However, literature on HPV vaccination among boys globally, in Africa, and most especially in Ghana is scarce. Thus, the main objective of this study was to explore the acceptance of HPV vaccination in boys among mothers from selected churches in Accra, Ghana.

Methods
In this study, a qualitative exploratory design was utilized to enlist 30 mothers who have male children aged between 9 and 12 years from the Greater Accra Region of Ghana. The recruitment of participants was carried out using a purposive sampling technique, and they were subsequently interviewed in-depth in a face-to-face setting, with the entire conversation being recorded for reference. After transcription, the recorded data were analyzed through content analysis.

Findings
Upon analyzing the data, two (2) primary themes and 11 sub-themes emerged. The research showed that although the majority of the mothers were unaware of HPV in boys, they perceived it as a positive initiative and expressed a willingness to allow their sons to receive the vaccine. However, some participants mentioned certain factors that they believed could hinder the acceptance of HPV vaccination in boys among mothers. These included concerns about injection-related pain, high cost, and fears that the vaccine could make men immoral or infertile.

Conclusion
The study revealed poor awareness of HPV vaccination in boys among mothers, and hence, suggested the need to increase the awareness on HPV vaccination in boys among mothers as well as the public to increase its acceptance.
Clinical analysis of successful insertion of orthodontic mini-implants in infrazygomatic crest
Authors: He Yinxue , Liu Jinan , Huang Rui , Chen Xing , Jia Xueting , Zeng Na , Fan Xiaochuan , Huang Xiaofeng 
Published: June 2023

AbstractBackgroundThe insertion positions of mini-implant in infrazygomatic crest has been reported, but due to the anatomical variation, the precise location of this site is not clear yet. This study used cone-beam computed tomography (CBCT) to analyze the position and angle of mini-implants successfully inserted in the infrazygomatic crest, with the goal of providing reference data for clinical practice.MethodsCBCT was used to image 40 mini-implants and their surrounding tissues in adult orthodontic patients who successfully underwent mini-implant insertion in the infrazygomatic crest. The insertion positions and angles of mini-implants were measured, and the thicknesses of buccal and palatal bone adjacent to the mini-implants were also recorded. Then, we proposed the position and implantation angle for infrazygomatic crest insertion. According to the position and angle, the cortical bone thickness and distance to the root of another 54 randomly selected infrazygomatic crests were recorded to verify its feasibility.ResultsIn the coordinate system, the implantation position of the 40 successful mini-implants was (-0.4 ± 2, 8.2 ± 2.5) and the implantation angle between the long axis of the mini-implant and horizontal reference plane was 56.4° ± 7.7°. The bone thicknesses on buccal and palatal sides of infrazygomatic crest adjacent to mini-implants were 4.1 ± 2.5 mm and 7.2 ± 3.2 mm, respectively, and the cortical bone thickness was 2.4 ± 0.6 mm. Among 54 infrazygomatic crests, 75.9% of them met the safety and stability requirements. When the implantation height was increased by 1, 2, and 3 mm, the proportions of implants that met requirements for success were 81.5%, 90.7%, and 94.4%, respectively. But, the proportions of eligible implants were limited at implantation angle increases of 5° and 10°.ConclusionsUsing the long axis of the maxillary first permanent molar (U6) as the vertical reference line, mini-implants could be safely inserted in the infrazygomatic crest at a distal distance of 0.4 mm and height of 8.2 mm from the central cementum-enamel junction of U6, with an implantation angle of 56.4°. The success rate increased when the implant height increased, but the proportion of eligible implantation was limited with the increase of implantation angle.