bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Prior Cheilectomy on Outcomes of First Metatarsophalangeal Joint Fusion for Treatment of Hallux Rigidus
Authors: Rajan Lavan , Kim Jaeyoung , An Tonya , Mizher Rami , Srikumar Syian , Fuller Robert , Zhu Jiaqi , Ellis Scott J. 
Published: August 2022

Background: Patients with hallux rigidus who do not experience significant pain relief after cheilectomy often require a conversion to metatarsophalangeal (MTP) fusion. However, it is unclear whether the previous cheilectomy affects outcomes of the subsequent fusion. The aim of this study was to compare patient-reported outcomes and complications in patients undergoing MTP fusion for hallux rigidus between patients with a history of cheilectomy and those undergoing a fusion as a primary procedure. Methods: This retrospective cohort study included patients who underwent MTP fusion who had preoperative and minimum 1-year postoperative Patient Reported Outcomes Measurement Information System (PROMIS) scores. Patients were divided into a “primary MTP fusion” cohort and a “prior cheilectomy” cohort based on their history of a previous cheilectomy. Preoperative, postoperative, and improvement in PROMIS scores, along with rates of complications including nonunion, infection, interphalangeal (IP) joint pain, and removal of hardware were compared between groups. Results: The prior cheilectomy group had significantly lower preoperative physical function scores than the primary MTP fusion group ( P < .05). Postoperatively, the prior cheilectomy group had worse physical function ( P < .017) and global physical health ( P < .017) scores. However, there were no significant differences in pre- to postoperative change in PROMIS scores. There were no significant differences in rates of nonunion ( P = .99), infection ( P = .99), or hardware removal ( P = .99). More patients in the prior cheilectomy group had IP joint pain ( P = .034). Conclusion: This study found that a prior cheilectomy may not affect serious complication rates of a subsequent fusion, but it may be associated with worse baseline function. Overall, our results suggest that a prior failed cheilectomy does not influence the amount of improvement in function and pain from MTP fusion. Level of Evidence: Level III, retrospective cohort study.
Osteochondral Allograft Transplantation for Full-Thickness Chondral Defect Utilizing BioUni Technique
Authors: Campbell Michael P. , Sonnier John Hayden , Freedman Kevin B. 
Published: August 2022

Background: There are several techniques to treat chondral defects. Osteochondral allograft transplantation is an excellent option, and for elongated lesions, there are 2 techniques—the Snowman technique and the BioUni technique. Indications: Osteochondral allograft transplantation is indicated for active individuals with isolated, symptomatic full-thickness chondral defects without concomitant ligamentous injury or malalignment. Technique Description: The lesion on the native condyle is sized. A plug is then harvested from the allograft using a cutting block and sagittal saw. The recipient site is then prepared with an overlapping reamer system with a cutting block. Graft is then implanted in a press-fit manner. Results: Osteochondral allograft transplantation leads to improved patient-reported outcomes. The literature has demonstrated survival rates between 70% and 80% at 10 years. Discussion/Conclusion: Osteochondral allograft transplantation is a restorative cartilage treatment that has good clinical outcomes. The BioUni system is a good option for irregular or elongated lesions.
Is the dolphin a fish? ERP evidence for the impact of typicality during early visual processing in ultra-rapid semantic categorization in autism spectrum disorder
Authors: Beck Ann-Kathrin , Czernochowski Daniela , Lachmann Thomas , Barahona-Correa Bernardo , Carmo Joana C. 
Published: August 2022

AbstractBackgroundNeurotypical individuals categorize items even during ultra-rapid presentations (20 ms; see Thorpe et al. Nature 381: 520, 1996). In cognitively able autistic adults, these semantic categorization processes may be impaired and/or may require additional time, specifically for the categorization of atypical compared to typical items. Here, we investigated how typicality structures influence ultra-rapid categorization in cognitively able autistic and neurotypical male adults.MethodsImages representing typical or atypical exemplars of two different categories (food/animals) were presented for 23.5 vs. 82.3 ms (short/long). We analyzed detection rates, reaction times, and the event-related potential components dN150, N1, P2, N2, and P3 for each group.ResultsBehavioral results suggest slower and less correct responses to atypical compared to typical images. This typicality effect was larger for the category with less distinct boundaries (food) and observed in both groups. However, electrophysiological data indicate a different time course of typicality effects, suggesting that neurotypical adults categorize atypical images based on simple features (P2), whereas cognitively able autistic adults categorize later, based on arbitrary features of atypical images (P3).ConclusionsWe found evidence that all three factors under investigation — category, typicality, and presentation time — modulated specific aspects of semantic categorization. Additionally, we observed a qualitatively different pattern in the autistic adults, which suggests that they relied on different cognitive processes to complete the task.
Stakeholders’ perspectives of mobile x-ray services in support of healthcare-in-place in residential aged care facilities: a qualitative study
Authors: Dollard Joanne , Edwards Jane , Yadav Lalit , Gaget Virginie , Tivey David , Inacio Maria , Maddern Guy , Visvanathan Renuka 
Published: August 2022

Abstract
Background
There is interest in reducing avoidable emergency department presentations from residential aged care facilities (RACF). Mobile x-ray services may enable the delivery of healthcare in residential aged care facilities. Accordingly, the Australian Government in November 2019 introduced a Medicare Benefit Schedule rebate providing for a ‘call-out’ fee payable to radiology service providers.
This study aims to understand stakeholder perspectives on the benefits of mobile x-ray services and the factors influencing their adoption by RACFs.

Design, setting, participants
Twenty-two semi-structured interviews were conducted between October 2020 and February 2021 with a range of stakeholders involved in healthcare delivery to residents: a) general practitioners; b) emergency department clinicians; c) paramedic clinicians; d) a hospital avoidance clinician; e) radiology clinicians and managers; and f) aged care clinicians and managers. Thematic analysis was conducted.

Results
Mobile x-ray services were considered valuable for RACF residents. Lack of timely general practitioner in-person assessment and referral, as well as staffing deficits in residential aged care facilities, reduces optimal use of mobile x-ray services and results in potentially unnecessary hospital transfers.

Conclusions
The use of mobile x-ray services, as a hospital avoidance strategy, depends on the capacity of RACFs to provide more complex healthcare-in-place. However, this requires greater access to general practitioners for in-person assessment and referral, adequate staffing numbers and appropriately skilled nursing staff within residential aged care facilities.
A cross-sectional study to assess pragmatic strengths and weaknesses in healthy ageing
Authors: Hilviu Dize , Gabbatore Ilaria , Parola Alberto , Bosco Francesca M. 
Published: August 2022

AbstractBackgroundAgeing refers to the natural and physiological changes that individuals experience over the years. This process also involves modifications in terms of communicative-pragmatics, namely the ability to convey meanings in social contexts and to interact with other people using various expressive means, such as linguistic, extralinguistic and paralinguistic aspects of communication. Very few studies have provided a complete assessment of communicative-pragmatic performance in healthy ageing.MethodsThe aim of this study was to comprehensively assess communicative-pragmatic ability in three samples of 20 (N= 60) healthy adults, each belonging to a different age range (20–40, 65–75, 76–86 years old) and to compare their performance in order to observe any potential changes in their ability to communicate. We also explored the potential role of education and sex on the communicative-pragmatic abilities observed. The three age groups were evaluated with a between-study design by means of the Assessment Battery for Communication (ABaCo), a validated assessment tool characterised by five scales: linguistic, extralinguistic, paralinguistic, contextual and conversational.ResultsThe results indicated that the pragmatic ability assessed by the ABaCo is poorer in older participants when compared to the younger ones (main effect of age group:F(2,56) = 9.097;p < .001). Specifically, significant differences were detected in tasks on the extralinguistic, paralinguistic and contextual scales. Whereas the data highlighted a significant role of education (F(1,56) = 4.713;p = .034), no sex-related differences were detected.ConclusionsOur results suggest that the ageing process may also affect communicative-pragmatic ability and a comprehensive assessment of the components of such ability may help to better identify difficulties often experienced by older individuals in their daily life activities.
Experiences of family caregivers of persons living with dementia with and without a smart- clothes assisted home nursing program during the heightened COVID-19 alert
Authors: Sung Ya-Li , Huang Huei-Ling , Lin Chung-Chih , Kröger Teppo , Hsu Wen-Chuin , Hsu Jung-Lung , Lin Yueh-E. , Shyu Yea-Ing L. 
Published: August 2022

Abstract
Background
The COVID-19 pandemic has required restrictions of daily activities, which has been found to impact the lives of persons living with dementia (PLWDs) and their family caregivers, who have multiple care demands. The lack of relevant studies in Taiwan emphasized the need to explore the experiences of family caregivers of older PLWDs faced with the intensified restrictions to control the spread of COVID-19, and the impact of the availability of a smart-clothes home nursing program.

Methods
This qualitative study used semi-structured interviews with family caregivers of older PLWDs. Participants were recruited from dementia clinics of a medical center in northern Taiwan from a subset of a sample from a larger study on smart-clothes assisted home nursing care. A total of 12 family caregivers who participated in the original study were interviewed during the follow-up period; seven family caregivers of a PLWD wearing a smart-vest, which transmitted information to a home care nurse; five caregivers of a PLWD not wearing a smart-vest. Interviews were conducted by telephone because the conditions of the pandemic prevented face-to-face interviews. Recorded interviews were transcribed and analyzed using content analysis.

Results
Interview data showed family caregivers’ felt the care recipient’s health was compromised and functional conditions intensified as Covid-19-related pandemic restrictions increased. Specific concerns included a lack social interactions, decreased daily activity levels, loss of interest and lack of motivation for activities, increased mood and behavioral problems, a decline in physical function and an increase in health problems. Family caregivers were also impacted by these restrictions, with significant increases in severity of caregiver role strain, including feeling trapped, a lack of in-home support, profound powerlessness, and worries about the PLWD contracting the coronavirus. The smart-clothes assisted home nursing care program offered supplementary support to family caregivers by providing on-time interactions, helping them manage health problems, enhancing predictability of the care recipient’s behaviors, and providing caregivers with emotional support.

Conclusions
The findings of this study support alternative care such as implementation of technology-assisted home health services to meet caregiver needs to facilitate family caregiving of PLWDs during the necessary restrictions in activities implemented during the COVID-19 pandemic.

Trial registration
ClinicalTrials.gov Protocol Record NCT05063045.
Clinical features and imaging markers of small vessel disease in symptomatic acute subcortical cerebral microinfarcts
Authors: Tao Wendan , Cheng Yajun , Guo Wen , Kwapong William Robert , Ye Chen , Wu Bo , Zhang Shuting , Liu Ming 
Published: August 2022

Abstract
Background
As currently defined, recent small subcortical infarcts (RSSI) do not have a lower size boundary, and the smallest diffusion-weighted imaging (DWI) infarcts, which we term acute subcortical cerebral microinfarcts (As-CMI) with lesion diameter less than 5 mm, might have clinical implications distinct from RSSI. We aimed to investigate the distinct characteristics of As-CMI as compared to the larger size of RSSI regarding vascular risk factors, clinical manifestation, radiological markers of SVD distribution, and outcomes.

Methods
In a consecutive cohort, patients were selected with a magnetic resonance DWI-confirmed RSSI between January 2010 and November 2020. We measured axial infarct diameter and classified patients into two groups: The As-CMI group (diameter < 5 mm) versus the Larger RSSI group (diameter 5-20 mm). Clinical variables, including vascular risk factors, clinical symptoms/signs, lesion locations, and radiological markers of cerebral small vessel disease (SVD) on MRI were analyzed between the two groups. Patients were followed up for 12 months and functional outcomes were measured by the modified ranking scale (mRS).

Results
In a total of 584 patients with RSSI, 23 (3.9%) were defined as As-CMI. The most common neurological deficits with As-CMI were hemiparalysis (n = 20), followed by central facial/lingual palsy (n = 10) and hemidysesthesia (n = 10). Most As-CMIs were located in the basal ganglia (n = 11), followed by the thalamus (n = 5) and centrum semiovale (n = 4). No different regional distributions and symptoms/signs frequencies were found between the two groups except for a lower percentage of dysarthria in the As-CMI group (p = 0.008). In a multivariate analysis, patients with As-CMI were independently associated with the presence of lacunes (adjusted odds ratio [aOR] 2.88; 95% confidence interval [CI] 1.21–6.84), multiple lacunes (aOR 3.5, CI 1.29–9.48) and higher total SVD burden (aOR 1.68, CI 1.11–2.53). Patients with As-CMI did not show a better functional outcome after 12 months of follow-up.

Conclusions
Patients with As-CMI had a non-specific clinical profile but a higher burden of SVD, indicating As-CMI might be s sign of more severe small vascular injury. Whether its vascular features are associated with worse cognitive outcomes requires further investigation.
Integrating tick density and park visitor behaviors to assess the risk of tick exposure in urban parks on Staten Island, New York
Authors: Hassett Erin , Diuk-Wasser Maria , Harrington Laura , Fernandez Pilar 
Published: August 2022

Abstract
Background
Public green spaces are important for human health, but they may expose visitors to ticks and tick-borne pathogens. We sought to understand, for the first time, visitors’ exposure risk and drivers of tick-preventative behavior in three popular parks on Staten Island, New York City, NY, USA, by integrating tick hazard and park visitors’ behaviors, risk perceptions and knowledge.

Methods
We conducted tick sampling in three parks, across three site types (open spaces, the edge of open spaces, and trails) and three within-park habitats (maintained grass, unmaintained herbaceous, and leaf litter) to estimate tick density during May-August 2019. Human behavior was assessed by observations of time spent and activity type in each site. We integrated the time spent in each location by park visitors and the tick density to estimate the probability of human-tick encounter. To assess visitors’ tick prevention behaviors, a knowledge, attitude, and practices (KAP) survey was administered.

Results
Three tick species (Ixodes scapularis, Amblyomma americanum and Haemaphysalis longicornis) were collected. For all species, the density of nymphs was greatest in unmaintained herbaceous habitats and trails, however, the fewest people entered these hazardous locations. The KAP survey revealed that most respondents (N = 190) identified parks as the main location for tick exposure, but most believed they had minimal risk for tick encounter. Consequently, many visitors did not conduct tick checks. People were most likely to practice tick checks if they knew multiple prevention methods and perceived a high likelihood of tick encounter.

Conclusions
By integrating acarological indices with park visitor behaviors, we found a mismatch between areas with higher tick densities and areas more frequently used by park visitors. However, this exposure risk varied among demographic groups, the type of activities and parks, with a higher probability of human-tick encounters in trails compared to open spaces. Furthermore, we showed that people’s KAP did not change across parks even if parks represented different exposure risks. Our research is a first step towards identifying visitor risk, attitudes, and practices that could be targeted by optimized messaging strategies for tick bite prevention among park visitors.
Possible long COVID healthcare pathways: a scoping review
Authors: Wolf Sarah , Zechmeister-Koss Ingrid , Erdös Judit 
Published: August 2022

Abstract
Background
Individuals of all ages and with all degrees of severity of the coronavirus disease (COVID) can suffer from persisting or reappearing symptoms called long COVID. Long COVID involves various symptoms, such as shortness of breath, fatigue, or organ damage. The growing number of long COVID cases places a burden on the patients and the broader economy and, hence, has gained more weight in political decisions. This scoping review aimed to give an overview of recommendations about possible long COVID healthcare pathways and requirements regarding decision-making and communication for healthcare professionals.

Methods
A systematic search in four databases and biweekly update-hand searches were conducted. In addition to guidelines and reviews, expert opinions in consensus statements or clinical perspectives were also considered. Data were systematically extracted and subsequently narratively and graphically summarised.

Results
Fourteen references, five guidelines, four reviews, one consensus paper, and four clinical perspectives were included. The evidence recommended that most long COVID-related healthcare should be in primary care. Patients with complex symptoms should be referred to specialized long COVID outpatient assessment clinics. In contrast, patients with one dominant symptom should be directed to the respective specialist for a second assessment. Depending on the patients’ needs, further referral options include, e.g. rehabilitation or non-medical health services. Self-management and good communication between healthcare professionals and patients are crucial aspects of the long COVID management recommendations.

Conclusions
The quality of the included guidelines and reviews is limited in the methods applied due to the novelty of this topic and the associated urgency for research. Hence, an update review with more rigorous data is recommended. Furthermore, the systematic collection of real-world data on long COVID surveillance needs to be set up soon to gather further information on the duration and severity of long COVID and thereby facilitate long COVID care planning.
Association of the cumulative triglyceride-glucose index with major adverse cardiovascular events in patients with type 2 diabetes
Authors: Tai Shi , Fu Liyao , Zhang Ningjie , Yang Rukai , Zhou Yuying , Xing Zhenhua , Wang Yongjun , Zhou Shenghua 
Published: August 2022

Abstract
Background
The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance and is associated with major adverse cardiovascular events (MACEs) in patients with type 2 diabetes mellitus (T2DM). However, the long-term effect of the TyG index on the incidence of MACEs remains unclear. We aimed to investigate the association between the cumulative TyG index and the risk of MACEs in patients with T2DM.

Methods
This post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial assessed patients’ (T2DM > 3 months) cumulative TyG index and MACE data from the study database. Five fasting blood glucose and triglyceride measurements, at baseline and the first four visits, were taken from 5695 participants who had not experienced MACEs. Cumulative exposure to the TyG index was calculated as the weighted sum of the mean TyG index value for each time interval (value × time). Multivariable-adjusted Cox proportional hazard models and restricted cubic spline analysis were used to determine the association between the cumulative TyG index and MACEs. The incremental predictive value of the cumulative TyG index was further assessed.

Results
Over a median follow-up of 5.09 years, 673 (11.82%) MACEs occurred, including 256 (4.50%) cardiovascular disease (CVD) deaths, 288 (5.06%) non-fatal myocardial infarctions (MIs), and 197 (3.46%) strokes. The risk of developing MACEs increased with the cumulative TyG index quartile. After adjusting for multiple potential confounders, the hazard ratios for the very high cumulative TyG index group versus the low group were 1.59 (95% confidence interval [CI], 1.17–2.16), 1.97 (95% CI 1.19–3.26), and 1.66 (95% CI 1.02–2.70) for overall MACEs, CVD death, and non-fatal MI, respectively. Restricted cubic spline analysis also showed a cumulative increase in the risk of MACEs with an increase in the magnitude of the cumulative TyG index. The addition of the cumulative TyG index to a conventional risk model for MACEs improved the C-statistics, net reclassification improvement value, and integrated discrimination improvement value.

Conclusions
In patients with T2DM, the cumulative TyG index independently predicts the incidence of MACEs, and monitoring the long-term TyG index may assist with optimized-for-risk stratification and outcome prediction for MACEs.
Trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620.