bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Cognitively Challenging Agility Boot Camp Program on Balance and Gait in People With Parkinson’s Disease: Does Freezing of Gait Status Matter?
Authors: Shah Vrutangkumar V. , Vitorio Rodrigo , Hasegawa Naoya , Carlson-Kuhta Patricia , Nutt John G. , King Laurie A. , Mancini Martina , Horak Fay B. 
Published: August 2022

Background and Aim: Individuals with Parkinson’s disease (PD) with and without freezing of Gait (FoG) may respond differently to exercise interventions for several reasons, including disease duration. This study aimed to determine whether both people with and without FoG benefit from the Agility Boot Camp with Cognitive Challenges (ABC-C) program. Methods: This secondary analysis of our ABC-C trial included 86 PD subjects: 44 without FoG (PD−FoG) and 42 with FoG (PD + FoG). We collected measures of standing sway balance, anticipatory postural adjustments, postural responses, and a 2-minute walk with and without a cognitive task. Two-way repeated analysis of variance, with disease duration as covariate, was used to investigate the effects of ABC-C program. Effect sizes were calculated using standardized response mean (SRM) for PD−FoG and PD + FoG, separately. Results: The ABC-C program was effective in improving gait performance in both PD−FoG and PD + FoG, even after controlling for disease duration. Specifically, dual-task gait speed ( P < .0001), dual-cost stride length ( P = .012), and these single-task measures: arm range of motion ( P < .0001), toe-off angle ( P = .005), gait cycle duration variability ( P = .019), trunk coronal range of motion ( P = .042), and stance time ( P = .046) improved in both PD−FoG and PD + FoG. There was no interaction effect between time (before and after exercise) and group (PD−FoG/PD + FoG) in all 24 objective measures of balance and gait. Dual-task gait speed improved the most in PD + FoG (SRM = 1.01), whereas single-task arm range of motion improved the most in PD−FoG (SRM = 1.01). Conclusion: The ABC-C program was similarly effective in improving gait (and not balance) performance in both PD−FoG and PD + FoG.
Intermediate to Long-Term Follow-up of the Salto Talaris Fixed-Bearing Total Ankle Prosthesis
Authors: Vesely Bryanna D. , King Matthew A. , Scott Aaron T. 
Published: August 2022

Background Total ankle arthroplasty (TAA) remains a viable option for recalcitrant, end-stage ankle arthritis. Among the various Food and Drug Administration (FDA)-approved prosthetic options is the fixed-bearing Salto Talaris implant. The aim of the present study was to evaluate the intermediate to long-term clinical outcomes and radiographic complications following implantation of the Salto Talaris TAA. Methods Nineteen Salto Talaris total ankle implants were included in the present retrospective study. Medical records were reviewed to determine pre- and postoperative visual analog scale (VAS) pain scores, and both medical records and radiographs were utilized to assess for complications. Telephone interviews were then conducted to assess for overall patient satisfaction. Results At a mean follow of 6.9 years (range, 3.5-12 years), there was a 21% complication rate according to the classification system described by Glazebrook et al. The reoperation rate was low at 10.5%, and there was 100% survivorship of the total ankle implant. The average pain decreased from 9.1 (range, 7-10) preoperatively to 2.6 (range, 0-10) postoperatively. Patients reported a 95% satisfaction rate, and 16% of patients reported using a brace postoperatively. Conclusion The Salto Talaris arthroplasty was associated with low complication and reoperation rates, and a high survivorship at intermediate to long-term follow-up. Levels of Evidence: 4
Utility of Post-Splinting Conventional Radiographs in Adult Patients With Ankle Fractures Presenting to the Emergency Department
Authors: Walraven Lucia Francisca Joseph , Ridderikhof Milan Lennaert , Schepers Tim 
Published: August 2022

Background: Post-splinting radiographs are often performed in patients with ankle fractures to identify displacement that potentially occurs during splinting. The objective of this study was to investigate the significance of post-splinting conventional radiographs, with an emphasis on stable ankle fractures, not requiring reduction. Methods: A retrospective study in which all adult patients presenting with ankle fractures to the emergency department of a level 1 trauma center were included. The primary outcome was frequency of displacement at post-splinting radiographs. Secondary outcome was the rate of successful reduction attempts. Results: A total of 225 patients were included and the majority had a Supination-External Rotation (SER) type 2 or Weber B ankle fracture. One hundred fifty patients (mainly SER 2 fractures [68%] or Weber B [89%] fractures), were treated with a splint without fracture reduction. Post-splinting radiographs in these patients, as well as in all patients with a Supination-Adduction (SA) type 1 and 2 fractures, did not show loss of alignment. Conclusion: Post-splinting radiographs are probably not necessary in any SA and SER type 2 or Weber A/B ankle fractures without medical clear space widening or need for reduction as no loss of alignment occurred when applying a splint. Level of Evidence: IV—Case Series
Knee Cartilage and Subchondral Bone Evaluations by Magnetic Resonance Imaging Correlate with Histological Biomarkers in an Osteoarthritis Rabbit Model
Authors: Sifre Vicente , Ten-Esteve Amadeo , Serra C. Iván , Soler Carme , Alberich-Bayarri Ángel , Segarra Sergi , Martí-Bonmatí Luis 
Published: August 2022

Objective To evaluate pathological changes in cartilage and subchondral bone MRI biomarkers in a rabbit model of osteoarthritis (OA) and correlate these with histological variations. Design Transection of the anterior cruciate ligament was performed on the right knee of eighteen 12-week-old New Zealand white rabbits to induce OA. 3-Tesla MR images were obtained from 18 healthy control knees (left) and 18 knees with OA (right). Imaging biomarkers included volume, thickness, T1 and T2* cartilage parametric maps, and several subchondral bone features: bone volume to total volume ratio, trabecular thickness, trabecular spacing, trabecular number (TbN), 2D and 3D fractal dimensions, and quality of trabecular score (QTS). Microscopic analysis of the lateral femoral condyles was set as the ground truth. Results When healthy and osteoarthritic knees were compared, significant differences were seen in the T1 and T2* values of the femur and tibia cartilage and in the subchondral bone volume to total volume, TbN, and QTS of both the lateral and medial aspects of the femur and tibia. Histological findings revealed significant osteoarthritic changes between healthy and osteoarthritic knees in stain, structure, chondrocyte density, total score, and subchondral bone biomarker levels. A positive correlation was found between histological staining, structure, chondrocyte density, and total score variables in T1 and T2* cartilage biomarkers. A negative correlation was observed between histological subchondral bone variables and magnetic resonance D2D and QTS biomarkers. Conclusion Quantification of several cartilage and subchondral bone imaging biomarkers in a rabbit model of OA allows the detection of significant changes, which are correlated with histological findings.
Radiation modification and characterization of polyvinyl alcohol/starch/citric acid/glycerol bioblend film
Authors: Abdel-Ghaffar Ashraf M , Ali Hussein E 
Published: August 2022

Blend films of polyvinyl alcohol (PVA) with starch (St) were obtained by casting method. The effect of different contents of glycerol (Glyc) and citric acid (CA) was investigated. The successful preparations of different compositions were shown by FTIR analysis. The bioblend film of PVA/St/CA/Glyc with a composition of (2:1:1/10 vol %) was selected due to its water resistance, higher mechanical properties, and good thermal stability than other prepared bioblend films. Further improvements were obtained by irradiation with gamma rays at a dose of 10 kGy, where the water resistance was highly reduced and the tensile strength strongly improved. The thermal stability increased with the increasing of irradiation doses up to 30 kGy. The modified thermal and mechanical properties of the selected film either non-irradiated or irradiated were compared with widely used commercially packaging films such as LDPE and PP films. Compared to commercially packaging films, the selected PVA/St bioblend film has higher tensile properties, good and closely thermal properties either non-irradiated or irradiated one. Hence, the study showed the development of modified PVA/St bioblend film, which can be used in many fields such as the packaging industry.
What possibly affects nighttime heart rate? Conclusions from N-of-1 observational data
Authors: Matias Igor , Daza Eric J. , Wac Katarzyna 
Published: August 2022

BackgroundHeart rate (HR), especially at nighttime, is an important biomarker for cardiovascular health. It is known to be influenced by overall physical fitness, as well as daily life physical or psychological stressors like exercise, insufficient sleep, excess alcohol, certain foods, socialization, or air travel causing physiological arousal of the body. However, the exact mechanisms by which these stressors affect nighttime HR are unclear and may be highly idiographic (i.e. individual-specific). A single-case or “ n-of-1” observational study (N1OS) is useful in exploring such suggested effects by examining each subject's exposure to both stressors and baseline conditions, thereby characterizing suggested effects specific to that individual.ObjectiveOur objective was to test and generate individual-specific N1OS hypotheses of the suggested effects of daily life stressors on nighttime HR. As an N1OS, this study provides conclusions for each participant, thus not requiring a representative population.MethodsWe studied three healthy, nonathlete individuals, collecting the data for up to four years. Additionally, we evaluated model-twin randomization (MoTR), a novel Monte Carlo method facilitating the discovery of personalized interventions on stressors in daily life.ResultsWe found that physical activity can increase the nighttime heart rate amplitude, whereas there were no strong conclusions about its suggested effect on total sleep time. Self-reported states such as exercise, yoga, and stress were associated with increased (for the first two) and decreased (last one) average nighttime heart rate.ConclusionsThis study implemented the MoTR method evaluating the suggested effects of daily stressors on nighttime heart rate, sleep time, and physical activity in an individualized way: via the N-of-1 approach. A Python implementation of MoTR is freely available.
Fluid Intake and Hydration Status Among North Carolina Farmworkers: A Mixed Methods Study
Authors: Mizelle Elizabeth , Larson Kim L. , Bolin Linda P. , Kearney Gregory D. 
Published: August 2022

Background: Agricultural workers are disproportionately at risk for heat-related morbidity and mortality. The purpose of this study was to explore how sociocultural and occupational factors, and environmental heat stress influenced fluid intake and hydration status among Latino farmworkers working in eastern North Carolina. Methods: A community-informed, mixed methods research study was conducted in partnership with staff at a federally qualified health center. In summer 2020, we recruited Latino farmworkers at migrant camps. Twenty-eight male, migrant farmworkers participated in focus group discussions and 30 completed surveys and provided urine specimens. Wet bulb globe temperatures were measured in fields where workers labored. Content analysis and parametric analyses were performed. Data integration was completed using a meta-matrix. Results: Prior to work, 46.7% of farmworkers’ urine specific gravity measurements indicated dehydration, which increased to 100% after work. The farmworkers spent between 2 and 7.5 hours of their day working in conditions above the recommended limits for workplace heat exposure. Farmworkers described exposure to extreme heat and inconsistent occupational policy compliance. Farmworkers expressed the opportunity to drink water but accessibility and poor water quality limited hydration. The integrated data supported congruent findings of extreme heat, few work breaks, and substandard housing. Conclusion/Application to Practice: Farmworkers are dehydrated at work, placing them at higher risk for heat-related illness (HRI). By engaging with agricultural stakeholders, occupational health nurses can combine efforts and advocate for effective health and safety work policies to reduce HRIs and deaths among farmworkers. Legislation stipulating cooling and hydration practices would support safer work environments.
Effects of Sodium Hyaluronate in the Treatment of Rotator Cuff Lesions: A Systematic Review and Meta-analysis
Authors: Liu Weijun , Lin Bendan , Yao Hongbin , Chen Zhanpeng , Hu Yishan 
Published: August 2022

Background: Rotator cuff pathology is a common cause of pain and shoulder dysfunction. Several nonoperative treatment modalities have been developed for rotator cuff lesions, but their relative efficacy is not well-established. Purpose/Hypothesis: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of sodium hyaluronate (SH) in the treatment of patients with rotator cuff lesions. It was hypothesized that SH would be found to be more effective than other nonoperative regimens. Study Design: Systematic review; Level of evidence, 3. Methods: We searched various databases to identify eligible studies that evaluated the effects of SH on the pain and shoulder dysfunction attributed to rotator cuff lesions. Outcome measures were pain visual analog scale (VAS) score; Constant score; University of California, Los Angeles (UCLA) score; satisfaction rate; complications; and factors affecting the pain VAS score. Outcomes were reported as weighted mean difference (WMD) or risk ratio. Results: A total of 9 studies were identified for data analysis. Compared with patients treated with other nonoperative treatments (controls), those treated with SH had significantly improved pain VAS scores at 1 week (WMD = −0.95; 95% CI, −1.75 to −0.16; P = .019), 2 weeks (WMD = −1.05; 95% CI, −2.07 to −0.03; P = .044), 3 weeks (WMD = −1.49; 95% CI, −2.88 to −0.11; P = .035), and 4 weeks (WMD = −2.12; 95% CI, −4.05 to −0.19; P = .031). The Constant score was significantly improved in the SH group versus controls at 2 weeks (WMD = 3.25; 95% CI, 2.36 to 4.13; P < .001), 3 months (WMD = 20.28; 95% CI, 0.54 to 40.03; P = .044), and 6 months (WMD = 5.58; 95% CI, 0.94 to 10.21; P = .018). The UCLA score and satisfaction rate did not differ significantly between the 2 groups. No complications associated with SH were reported in the included studies. Metaregression analysis showed that, except for study design (coefficient = −1.64; 95% CI, −2.64 to −0.63; P = .002), none of the variables (sample size, tear type, control treatments) significantly predicted the difference in VAS pain score between SH and other treatments. Conclusion: The present meta-analysis demonstrated that SH was effective in treating patients with rotator cuff lesions.
Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair
Authors: Deemer Alexa R. , Drake Jack H. , Littlefield Connor P. , Egol Kenneth A. 
Published: August 2022

Background: The purpose of this study was to determine the impact of surgeon volume on outcomes following ankle fracture fixation. Methods: Over 7 years, 362 patients who met inclusion criteria (>18 years with rotational ankle fractures) were identified and treated by orthopaedic surgeons at several hospitals within an academic medical center and were retrospectively reviewed. Surgeons that completed less than 24 ankle fixations per year (<90th percentile) during the study period were classified as low-volume (LV) and surgeons completing 24 or more ankle fixations per year (>90th percentile) were classified as high-volume (HV). Chart review was conducted to gather data regarding perioperative, radiographic, inpatient, and long-term outcome data (average 12-month follow-up). Results: One hundred thirty-four patients (37.0%) were treated by LV surgeons and 228 (63.0%) were treated by HV surgeons. Although both cohorts had a similar breakdown of fracture patterns ( P = .638), the LV cohort had a greater incidence of open fractures ( P = .024). No differences were found regarding wait time to surgery, surgery duration, and LOS. Radiographically, more patients in the HV cohort achieved anatomic mortise after surgery (96.5% vs 89.6%, P = .008). Patients in the LV cohort took longer to heal radiographically (4.27 ± 2.4 months vs 5.59 ± 2.9 months, P < .001), and also had higher rates of reoperation and hardware removal ( P < .05). Lastly, all cost variables were lower for high-volume surgeons ( P < .05). Conclusion: In this single-center study, we found that patients treated by LV surgeons took 30% longer to heal radiographically and had greater reoperation rates than those treated by HV surgeons. Additionally, patients treated by high-volume surgeons had more anatomic postoperative radiographic ankle mortise reductions and was less cost-effective than when performed by high-volume surgeons. Level of Evidence: Level III, retrospective comparative study.
Diagnostic agreement among experts assessing adults presenting with possible cystic fibrosis: need for improvement and implications for patient care
Authors: Franciosi Alessandro N. , Tanzler April , Goodwin Jodi , Wilcox Pearce G. , Solomon George M. , Faro Albert , McElvaney Noel G. , Downey Damian G. , Quon Bradley S. 
Published: August 2022

BackgroundIncreasing awareness of milder presentations of cystic fibrosis (CF) and greater interest in non-CF bronchiectasis are likely to lead to more CF screening by respiratory clinicians. As a result, adults who may not strictly fulfil CF diagnostic criteria yet display evidence of abnormal CF transmembrane conductance regulator (CFTR) function are being identified. The degree of agreement on diagnosis and care needs in these cases between CF clinicians remains unknown, and has implications for patient care, including access to CFTR modulator therapies.MethodsWe surveyed adult CF physicians in Canada, the USA, the UK and Ireland, and presented them with anonymised vignettes of adult patients referred for assessment of possible CF. Diagnostic inter-rater agreement over diagnosis, ease of classifying cases and appropriate follow-up was assessed using Krippendorff's reliability coefficient (α).ResultsAgreement over diagnosis (α=0.282), ease of classification (α= −0.01) and recommended follow-up (α=0.054) was weak. Clinician experience (>10 and 5–10 yearsversus<5 years) and location (UK and IrelandversusCanada) were associated with higher odds of recommending further testing compared with selecting a formal diagnosis (respectively, OR 2.87; p=0.022, OR 3.74; p=0.013 and OR 3.16; p=0.007). A modified standard of care was recommended in 28.7% of cases labelled as CF. 70% of respondents agreed with the statement that “Accurate distinction between CF and CFTR-related disorder has become significantly more pertinent with the advent of highly effective CFTR modulators”.ConclusionsOur results demonstrate low diagnostic concordance among CF specialists assessing cases of possible adult CF and highlight an area in need of improvement.
Mixed-methods feasibility cluster randomised controlled trial of a paramedic-administered breathlessness management intervention for acute-on-chronic breathlessness (BREATHE): study findings
Authors: Hutchinson Ann , Allgar Victoria , Cohen Judith , Currow David C. , Griffin Susan , Hart Simon , Hird Kelly , Hodge Andrew , Mason Suzanne , Northgraves Matthew , Reeve Joanne , Swan Flavia , Johnson Miriam J. 
Published: August 2022

IntroductionOne-fifth of emergency department presentations by ambulance are due to acute-on-chronic breathlessness. We explored the feasibility of an evaluation-phase, cluster randomised controlled trial (cRCT) of the effectiveness and cost-effectiveness of a paramedic-administered, non-pharmacological breathlessness intervention for people with acute-on-chronic breathlessness at ambulance call-out (BREATHE) regarding breathlessness intensity and conveyance to hospital.MethodsThis mixed-methods, feasibility cRCT (ISRCTN80330546) randomised paramedics to usual care or intervention plus usual care. Retrospective patient consent to use call-out data (primary end-point) and prospective patient/carer consent for follow-up was sought. Potential primary outcomes included breathlessness intensity (numerical rating scale) and conveyance. Follow-up included: interviews with patients/carers and questionnaires at 14 days, 1 and 6 months; paramedic focus groups and surveys.ResultsRecruitment was during COVID-19, with high demands on paramedics and fewer call-outs by eligible patients. We enrolled 29 paramedics; nine withdrew. Randomisation/trial procedures were acceptable. Paramedics recruited 13 patients, not meeting recruitment target (n=36); eight patients and three carers were followed-up. Data quality was good but insufficient for future sample size estimation. The intervention did not extend call-out time, was delivered with fidelity and was acceptable to patients, carers and paramedics. There were no repeat call-outs within 48 h. All trained paramedics strongly recommended BREATHE as a highly relevant, simple intervention.ConclusionPatient recruitment to target was not feasible during the pandemic. Training and intervention were acceptable and delivered with fidelity. Results include valuable information on recruitment, consent, attrition and data collection that will inform the design and delivery of a definitive trial.
Sustained population decline of rodents is linked to accelerated climate warming and human disturbance
Authors: Wan Xinru , Yan Chuan , Wang Zhenyu , Zhang Zhibin 
Published: August 2022

AbstractBackgroundDuring the past three decades, sustained population decline or disappearance of cycles in small rodents have been observed. Both anthropogenic disturbance and climate warming are likely to be potential drivers of population decline, but quantitative analysis on their distinct effects is still lacking.ResultsUsing time series monitoring of 115 populations (80 populations from 18 known rodent species, 35 mixed populations from unknown species) from 1980 in China (spanning 20–33 yrs), we analyzed association of human disturbances and climate warming with population dynamics of these rodent species. We found 54 of 115 populations showed a decreasing trend since 1980, and 16 of 115 showed an increasing trend. Human disturbances and climate warming showed significant positive associations with the population declines of most rodent species, and the population declines were more pronounced in habitats with more intensified human disturbance such as cities and farmlands or in high-latitude regions which experienced more increase of temperature.ConclusionsOur results indicate that the large-scale sustained population decline of small mammals in various ecosystems driven by the rapid increase of both climate warming and human disturbance is likely a signal of ecosystem dysfunction or transition. There is an urgent need to assess the risks of accelerated climate warming and human disturbance imposes on our ecosystems.