bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Accuracy of the Progressive Collapsing Foot Deformity (PCFD) Classification
Authors: Li Shuyuan , Zhu Mingjie , Gu Wanjun , Hamati Mary , Hunt Kenneth J. , de Cesar Netto Cesar , Simonson Tatum S. , Myerson Mark S. 
Published: March 2022

Background: A consensus group recently proposed the term progressive collapsing foot deformity (PCFD) and a new classification with 2 stages plus 5 classes to describe the complex array of flatfoot deformities. This study aimed to validate different diagnostic accuracy rates of the PCFD classification. Methods: This was a survey-based study distributed among 13 foot and ankle fellowship programs for 3 groups of participants with varied experience in practice (group 1: fellows in training, group 2: surgeons in practice for 1-4 years, and group 3: surgeons in practice for ≥5 years). Each participant was asked to assign 20 different cases of flatfoot deformity to the appropriate classes and stages using the PCFD classification. The overall diagnostic accuracy, class, and stage diagnostic accuracy rates for the 20 cases were calculated first for the entire cohort and then compared among the 3 groups. The misdiagnosis rate for each class of deformity (the sum of overdiagnosis and underdiagnosis rates) of the entire cohort was calculated and compared with the other classes. Mean and standard evidence were used to describe numerical data. One-way analysis of variance was used to compare values among the 3 groups and the 5 classes. P <.05 was considered statistically significant. Results: For the whole cohort, the overall diagnostic accuracy, class diagnostic accuracy, and stage diagnostic accuracy rates were 71.0%, 78.3%, and 81.7%, respectively There was a statistically significant difference between group 1 and 2, and group 1 and 3, in overall diagnostic accuracy and class diagnostic accuracy, with no significant difference among the 3 groups regarding stage diagnostic accuracy. Class B had a significantly higher overdiagnosis rate than the rest of the classes, whereas class D was significantly underdiagnosed than others. The misdiagnosis rates for classes A to E were 3.3%, 17.5%, 11.1%, 26.0%, and 3.7%, respectively. Conclusion: The PCFD classification showed overall fair diagnostic accuracy rates. The highest diagnostic accuracy was for “hindfoot valgus deformity” and “ankle instability.” Further content validation of the PCFD classification is needed to examine the terminology and interpretation of those classes with low diagnostic accuracy including “midfoot/forefoot abduction deformity,” “forefoot varus deformity/medial column instability,” and “peritalar subluxation/dislocation.” Level of Evidence: Level II, prospective comparative study.
Association of pregnancies with risk of multiple sclerosis
Authors: Gasperi Christiane , Hapfelmeier Alexander , Schneider Antonius , Kuhn Klaus A , Donnachie Ewan , Hemmer Bernhard 
Published: March 2022

Background: Pregnancies have an impact on the disease course of multiple sclerosis (MS), but their relationship with MS risk is yet unclear. Objective: To determine the relationships of pregnancies and gynecological diagnoses with MS risk. Methods: In this retrospective case–control study, we assessed differences in gynecological International Classification of Diseases, 10th Revision (ICD-10) code recording rates between women with MS ( n = 5720), Crohn’s disease ( n = 6280), or psoriasis ( n = 40,555) and women without these autoimmune diseases ( n = 26,729) in the 5 years before diagnosis. Results: Twenty-eight ICD-10 codes were recorded less frequently for women with MS as compared to women without autoimmune disease, 18 of which are pregnancy-related. After adjustment for pregnancies, all codes unrelated to pregnancies were still negatively associated with MS. In a sensitivity analysis excluding women with evidence for possible demyelinating events before diagnosis, all associations were more pronounced. In comparison to women with psoriasis, most associations could be confirmed; that was not true in comparison to women with Crohn’s disease. Conclusion: Our findings provide evidence for a possible protective effect of pregnancies on MS risk likely independent of or in addition to a previously suggested reversed causality. The negative associations of gynecological disorders with disease risk need further investigation. The associations might be shared by different autoimmune diseases.
Reliability of 2-Dimensional Video Analysis in Adolescent Runners
Authors: Matsuzaki Yukiko , Heath Madison R. , Khan Julianne M. , Mackie Alexandra T. , Spitzer Elad , Fabricant Peter D. 
Published: March 2022

Background: The literature on the reliability of qualitative and quantitative measures for running video analysis in the adolescent population is limited. Reliability of 2-dimensional (2D) video analysis has been reported in adult runners, but these findings may not apply to youth runners. Purpose: We sought to determine the intra-rater and inter-rater reliability of sagittal and frontal plane kinematics using 2D video analysis in healthy adolescent runners. Methods: High-definition (1080p) videos were recorded of 10 healthy runners between 14 and 18 years old running on a treadmill at self-selected speed with markers attached to the cervical spine, pelvis, and lower extremities. Kinematic variables in the sagittal and frontal planes were measured using Dartfish Motion Analysis Software by 3 raters (2 sports medicine physical therapists and a research assistant). Intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICCs). Results: Of the 10 runners, 4 (40%) were male and the mean age was 16 ± 1.5 years. The intra-rater ICC for all kinematic variables ranged from 0.574 to 0.999 for the experienced physical therapist, and 0.367 to 0.973 for the inexperienced research assistant. The inter-rater ICC for all raters ranged from −0.01 to 0.941. Eleven kinematic variables showed substantial agreement and 4 showed almost perfect agreement. Step width and foot progression showed fair and poor agreement, respectively. Conclusions: Running analysis using 2D video can be performed reliably in adolescents on all kinematic variables except for step width and foot progression. Inexperienced raters can be properly trained in the video analysis of running kinematics to consistently assess the same runner.
Treatment of Early-Stage Alzheimer’s Disease With CT Scans of the Brain: A Case Report
Authors: Cuttler Jerry M , Lamet Maryélise S , Calabrese Edward J 
Published: March 2022

We report the case of a patient in Massachusetts with early-stage Alzheimer’s disease who was treated with low doses of ionizing radiation to the brain. He requested this treatment after reading about a patient with severe Alzheimer’s in Michigan who improved remarkably after receiving 4 CT scans. After his first treatment in April 2016, mental clarity improved. His impaired conversation, reading, and sense of humor were restored, especially his virtuosic clarinet jazz-playing. However, executive function remained deficient. He requested a treatment every 2 weeks, but his neurologist denied this, fearing opposition to this treatment, a diagnostic procedure that used ionizing radiation. Limited recovery was observed after each CT scan, lasting from several weeks to months, depending on the endpoints/behavior and the periodicity. Despite the positive responses, the physician was reluctant to continue beyond 6 due to concerns about adverse effects and disapproval for prescribing them. The patient began hyperbaric oxygen therapy as an alternative. But after 43 treatments, no conclusive benefit was observed. The patient died in September 2020 at age 77. This experience suggests CT scans may have value in treating Alzheimer’s patients and restoring, at least temporarily, important aspects of normal life activities. Such observations need testing and validation.
A Comparative Study of Montelukast and Azelastine add on Therapy in Moderate to Severe Allergic Rhinitis Treatment: A Double-Blind Randomized Clinical Trial
Authors: Esmaeilzadeh Hossein , Far Nasrin Mortazavi , Nabavizadeh Seyed Hesamedin , Babaeian Masroor , Hadipour Maryam , Alyasin Soheila 
Published: March 2022

Background Allergic Rhinitis (AR) is a prevalent chronic inflammatory nasal condition with significant negative effects on the patients’ quality of life. This study aimed to investigate the efficacy of Montelukast and intranasal antihistamine in combination with intranasal corticosteroid (INCS) in moderate to severe allergic rhinitis on the patients’ quality of life and AR control. Method This double-blind randomized clinical trial study was carried out on 66 moderate to severe AR patients referred to Namazi Hospital, Shiraz, Iran from 2020 to 2021, who were randomly divided into 3 groups. Group one received Montelukast add-on therapy and Budesonide nasal spray. The second group received intranasal antihistamine (Azelastine) add-on therapy and Budesonide nasal spray and the third group as the control group received intranasal Budesonide spray with a placebo tablet. To measure the impact of each medication on the patient's quality of life and AR control, we employed the Sino-Nasal Outcome Test-22 questionnaire (SNOT 22). We evaluated the symptoms and compared them at baseline, one and three months after the start of treatments. Spirometry was performed to investigate the possibility of co-morbid asthma at baseline and end of the study. Results The patients’ mean age was 30.13 ± 12.7 years. Most patients experienced perennial AR (65.2%). Reduction of mean scores SNOT22 was statistically different between groups (P-value < 0.001). Three months after treatment, the mean decrease of SNOT-22 in the Azelastine group was statistically significant compared to both Montelukast (P-value < 0.001) and control groups (P-value < 0.001). No significant difference was observed between the Montelukast and control groups (P-value = 0.142). 23 of 66 patients were diagnosed with asthma and asthma treatment was initiated. The amount of FEV1 change after AR treatment was not statistically significant between the groups in asthmatic patients (P-value = 0.351). Conclusion Based on our findings, we recommend Azelastine in conjunction with an intranasal corticosteroid for the treatment of moderate to severe allergic rhinitis. In moderate to severe AR or even asthma management, Montelukast has no greater impact than INCS.
Long-chain omega-3 polyunsaturated fatty acids and the risk of heart failure
Authors: Zheng Sulin , Qiu Min , Wu Jason H.Y. , Pan Xiong-fei , Liu Xiong , Sun Lichang , Zhu Hailan , Wu Jiandi , Huang Yuli 
Published: March 2022

Aims: Adequate intake of long-chain (LC) omega-3 polyunsaturated fatty acids ( n-3 PUFAs) is considered important for cardiovascular health. However, the effects of LC n-3 PUFAs on the risk of heart failure (HF) remain unclear. This systematic review and meta-analysis aimed to determine the role of LC n-3 PUFAs in the incidence of HF. Materials and Methods: Electronic databases were searched for studies up to 31 July 2021. Studies were included for the meta-analysis if they reported the adjusted associations between different dietary intakes or circulating concentrations of LC n-3 PUFAs and the risk of HF. A random-effect model was used to calculate the pooled estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for higher LC n-3 PUFA concentrations. Results: Thirteen studies were included in the meta-analysis. Eight studies comprising 316,698 individuals (11,244 incident HF cases), with a median follow-up of 10.7 years, showed that a higher dietary intake of LC n-3 PUFAs was associated with a lower risk of HF (highest versus lowest quintile: HR = 0.84, 95% CI = 0.75–0.94). Six studies, comprising 17,163 participants (2520 HF cases) with a median follow-up of 9.7 years, showed that higher circulating LC n-3 PUFA concentrations were associated with a lower risk of HF (highest versus lowest quintile: HR = 0.59, 95% CI = 0.39–0.91). Higher circulating docosahexaenoic acid concentrations were associated with a decreased risk of HF (top versus bottom quintile: HR = 0.44, 95% CI = 0.26–0.77). The associations between eicosapentaenoic acid (HR = 0.58, 95% CI = 0.26–1.25), docosahexaenoic acid (HR = 0.66, 95% CI = 0.24–1.82), and the risk of HF were not significant. Conclusion: High LC n-3 PUFA concentrations measured by dietary intake or circulating biomarkers are associated with a lower risk of developing HF.
Comparison of Hard and Soft Cervical Collars for the Management of Odontoid Peg Fractures in the Elderly
Authors: Coleman Nichola , Chan Hoi-Ying H. , Gibbons Veronique , Baker Joseph F 
Published: March 2022

Introduction Odontoid peg fractures (OF) are the most common cervical spine fracture in the elderly. This retrospective analysis aimed to compare the outcomes of older patients with OF who had been managed non-operatively with either a hard or soft cervical collar. Materials and Methods We analysed the retrospective data of the clinical and radiographic records of patients 60 years or older who presented over a 10-year period with OF and were treated non-operatively with a cervical collar. Mortality was the primary outcome measure with mechanism of injury, complications, and fracture healing secondary measures. Results 45 patients (hard collar n = 22; soft collar n = 23) were included with comparable demographics for frailty and co-morbidities in each group; age was significantly higher in the soft collar group (80.6 vs 86.4 years; P = .0065). Associated injuries and complications were not significantly different overall, or when Type II fractures were separately analysed ( P = .435 associated injuries, P = .121 complications). All-cause mortality was greater in the soft collar group (30-day mortality hard: 0%, soft: 9%; 1-year mortality hard: 18%, soft: 48% P = .035). However, once corrected for age, this proved not to reach significance ( P = .333) in any fracture type. Non-union was common (77%) but was not significantly different (hard = 70%; soft = 87%; P = .419). Discussion Consistent with other reports, non-union rates remained substantial regardless of which collar was used. After controlling for age, there was no difference in all-cause mortality between elderly patients treated with a hard or soft cervical collar for odontoid peg fractures. Conclusions Soft collars appear suitable for the treatment of odontoid peg fractures in the elderly without compromising outcome. Larger cohort analyses will help confirm this finding.
Antibiotic prophylaxis in total joint arthroplasty – the usual practice and variability among joint replacement surgeons in Hong Kong
Authors: Tong Chi Him , Cheung Amy , Chan Ping Keung , Yan Chun Hoi , Ng Fu Yuen , Chiu Kwong Yuen 
Published: March 2022

Background Perioperative antibiotics is a well established measure to prevent periprosthetic joint infection (PJI). However, the usual practice of prescription vary from surgeon to surgeon. This study aims to investigate and compare the usual practice and variability of prescribing antibiotic prophylaxis among different joint replacement surgeons in Hong Kong. Methods An online questionnaire was prepared and sent to members of the Adult Joint Reconstruction (AJR) Chapter of the Hong Kong Orthopaedic Association (HKOA). The questionnaire consists of a total of 15 questions in 3 categories: choice of antibiotics, dose of antibiotics and duration of antibiotics prescribed by the surgeon. Results A total of 25 responses were received and data collected. Participants were from a diverse background from different hospitals with variable years of experience. Results showed a general consensus on the choice of antibiotics, but also a wide variability on the actual prescription, particularly about the weight-adjusted dose and total duration of antibiotics given. Conclusion There is a wide variability among surgeons regarding the actual prescription of antibiotic prophylaxis. Correlation between rate of PJI and specific aspects of antibiotic prescription is needed to give recommendations to surgeons regarding perioperative antibiotic usage in total joint arthroplasties.
A Prospective Registry Analysis on Soft-to-Hard Tissue Ratios in Profile View; Midline Changes in the Lip Region after Mono- and Bimaxillary Repositioning Surgery
Authors: Bral Alexander , Olate Sergio , Zaror Carlos , Mensink Gertjan , Coscia Giuseppe , Loomans Natalie , Mommaerts Maurice Y. 
Published: March 2022

Introduction We aimed to determine the ratios of the lower and upper lip landmarks in the sagittal and vertical direction for maxillary osteotomies and mandibular lengthening surgeries, in a prospective way. Methods This prospective cohort study is the second part of the OSRES (Orthognathic/orthofacial Surgery RESearch group); patients that underwent mandibular and/or Le Fort I surgery without genioplasty were included. Pearson correlation determined significant patient and surgical variables. The relationship between hard and soft tissue changes was determined by correlation analysis. Results An average ratio of 103% was found for sB:B for mandibular advancement surgery without genioplasty and 83% for sB:Pg with genioplasty. Lower jaw surgery yielded a ratio of 68% for Li:Ili in the horizontal direction and 69% with a genioplasty. Displacement of the upper jaw gave a ratio of 83% for Ls:Iui anteriorly for all surgery groups combined. Horizontal displacement of the upper jaw yielded a strong correlation with a ratio of 88% for sA:A. Conclusions The equations presented in this study for landmark sB, sA, labrale inferius, and labrale superius can aid preoperative planning of lip position. No accurate way was found to predict stomion inferius and stomion superius. Highlights We prospectively arranged for computerized measurements of sB:B, Li:Ili, Ls: Iui, Stoi:Ili, Stos: Iui, and sA:A ratios on lateral cephalograms using FaceWizz. The influences of direction and the type of surgery were studied. Moderate to strong correlations were found for horizontal ratios of sB:B, Li:Lli, Ls:Iui, and sA:A. Weak correlations were found for vertical movement of Stos:Iui and Stoi:Ili.
Response characteristics of highland barley under freeze-thaw, drought and artemisinin stresses
Authors: Liu Huichen , Bao Guozhang , Dou Zihao , Liu Haoyuan , Bai Jingqi , Chen Yingyi , Yuan Yifu , Zhang Xin , Xi Jinghui 
Published: March 2022

AbstractThe freeze-thaw of early spring in China’s Qinghai-Tibet Plateau is often accompanied by severe droughts. Artemisia annua, widely distributed in China, releases allelopathic substances, mainly artemisinin, to the environment and exerts a wide range of effects on crops. This paper studied the physiological effects of highland barley under freeze-thaw, drought, and artemisinin stress through indoor simulation experiments. The physiological response characteristics of superoxide dismutase (SOD) activity, catalase (POD) activity, net photosynthetic rate, relative water content (RWC), relative electrical conductivity, malondialdehyde (MDA) content, and soluble protein content in highland barley were analyzed. The results showed that artemisinin and drought contributed to the increase of SOD activity and the decrease of POD activity. Under the freeze-thaw stress, the SOD and POD activities both decreased firstly and then increased, but the effect of compound stress on POD was more complicated. Either artemisinin, drought, or low temperature could reduce the net photosynthetic rate of highland barley. Low temperature had more significant impacts on photosynthesis, and compound stress would show a single stress superimposed effect. Artemisinin, drought, and low temperature could reduce the RWC of highland barley, and increase the relative electrical conductivity and the concentration of soluble protein (except for low temperature stress above zero, which reduces the concentration of soluble protein). However, the effect of compound stress on soluble protein is more complex. The single stress of artemisinin and drought had no obvious effect on MDA content, while the MDA content was increased significantly under the freeze-thaw stress and the compound stress of artemisinin and drought, and the MDA content reached its peak at T1. The results are helpful to explore the effects of freeze-thaw, drought and artemisinin stress on the growth of highland barley under the background of the aridification of the Qinghai-Tibet Plateau, and provide ideas for rational agricultural management.
AL amyloidosis with primary presentation of multiple serous cavity effusion and severe cholestasis: a case report and review of literature
Authors: Liu Kehui , Ding Yezhou , Xu Yumin , Tang Weiliang , Feng Mingyang , Liu Yunye , Bao Shisan , Wang Hui 
Published: March 2022

Abstract
Background
Immunoglobulin light chain (AL) amyloidosis commonly affects the kidney or heart, but may also involve the liver at a histopathological level. Early diagnosis of AL amyloidosis is important for proper management with desirable outcome. We reported here an unusual case of AL amyloidosis, presenting primarily with multiple serous cavity effusion, accompanied with rapidly progressive cholestasis.

Case presentation
A previously healthy 63-year-old man presented with dysuria, frequent urination, oliguria and oedema of lower extremities for one month, accompanied with jaundice and hypoproteinemia. CT demonstrated multiple serous cavity effusion, focal hypodense lesions in the liver, and focal low-density in the spleen. Laparoscopy with liver biopsy revealed liver and spleen fibrosis with congestion, no visceral rupture, following haemorrhagic ascites from abdominocentesis. This patient was transferred to our (tertiary) hospital. The diagnosis of amyloidosis was confirmed with histopathology/immunohistochemistry. Haematopoietic stem cell transplantation was not applicable, however chemotherapy was advised, due to the patient’s Mayo score 3. The patient declined chemotherapy and was self-discharged back to his hometown hospital with palliative care, however only lasted a further one-month.

Discussion
The lesson we have learnt from this case that any patients with multiple serous cavity effusion and isolated hepatic involvement, primary amyloidosis should be considered. Multiple serous cavity effusion may serve as an indicator for poor prognosis of hepatic AL amyloidosis.