bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographic variations in gender differences in cataract surgery volume among a national cohort of ophthalmologists
Authors: Cai Cindy X. , Klawe Janek , Ahmad Sumayya , Zeger Scott L. , Wang Jiangxia , Sun Grace , Ramulu Pradeep , Srikumaran Divya 
Published: March 2022

Purpose:
To assess factors associated with gender disparities in cataract surgery volume and evaluate how these differences have changed over time.

Setting:
Cataract surgeons in the 2012 to 2018 Medicare database.

Design:
Retrospective study.

Methods:
The association of provider gender with the number of cataract surgeries per office visit billed was assessed with negative binomial regression models, controlling for calendar year, years in practice, hospital affiliation, geographic region, rurality, density of ophthalmologists, and the national percentile of Area Deprivation Index (ADI) score for the practice location.

Results:
There were 8480 cataract surgeons, most of whom were male (78%). Male surgeons worked in more deprived areas with a higher ADI (median: 40 vs 33, P < .001). Female surgeons performed fewer cataracts per year (140 [95% CI, 126-154] vs 276 [95% CI, 263-288], P < .001) and billed fewer office visits (1038 [95% CI, 1008-1068] vs 1505 [95% CI, 1484-1526], P < .001). In multivariate analysis, the number of cataract surgeries per office visit was greater for males compared with females in all years in the South (average incidence rate ratio 1.80), Midwest (1.50), and West (1.53), but not in the Northeast (1.16). The relative rate of cataract surgeries between male and female surgeons in each region did not change significantly over time from 2012 to 2018 (P > .05 in each region).

Conclusions:
Gender disparities in cataract volume among male and female surgeons have remained unchanged over time from 2012 to 2018. The higher cataract volume among male surgeons may be explained in part by provider practice location. Further studies are needed to better understand and address gender disparities.
Evidence to Eliminate Double-Leg Conditions From the Modified Balance Error Scoring System and Balance Error Scoring System
Authors: Fraser Melissa A. , Kuo Michael , Boeckmann Anne Marie , Kilchrist Leah M. 
Published: March 2022

Objective:
The purpose of our study was to assess the differences between the Balance Error Scoring System (BESS), modified BESS (mBESS), and both measures with the double-leg (DL) stances removed [BESS-revised (BESS-R) and mBESS-revised (mBESS-R)] among healthy and concussed collegiate student-athletes.

Design:
Retrospective, repeated-measures cohort study.

Setting:
Clinical.

Patients or Other Participants:
Healthy and concussed collegiate athletes (baseline n = 622, postinjury n = 41) from 12 National Collegiate Athletic Association Division I sports cheer and dance at a single university.

Intervention (Or Independent Variables):
Balance Error Scoring System, mBESS, BESS-R, and mBESS-R test versions from baseline and postinjury testing.

Main Outcome Measures:
The mBESS and BESS and their revised versions with DL stances removed (mBESS-R and BESS-R) scores were compared at baseline. Baseline and postinjury scores for all 4 BESS variations and the 6 BESS conditions were compared for those who sustained a concussion.

Results:
The BESS and BESS-R were statistically different at baseline for the entire sample (99.6% confidence interval 0.32, 0.38, P > 0.0001). None of the other comparisons were significantly different (P > 0.004).

Conclusion:
Although our results do suggest statistically significant differences between the BESS and BESS-R test versions, they do not represent clinically meaningful differences. The greatest mean difference between all test versions was <1 error; therefore, these BESS versions may not be specific enough to identify balance deficits at baseline or postinjury. Elimination of the time intensive DL measures in the revised BESS variations may be a more clinically practical alternative.
Accessory Flexor Digitorum Longus Presenting as Tarsal Tunnel Syndrome: A Case Series
Authors: Parkhurst Drew B. , Saffarian Mathew R. , Andary Michael T. , Fajardo Ryan S. , Knake Jeffrey J. 
Published: March 2022

Abstract:
Tarsal tunnel syndrome (TTS) typically occurs from extrinsic or intrinsic sources of compression on the tibial nerve. We present 3 cases of patients, all of whom have a prolonged time to diagnosis after evaluation with multiple specialties, with foot pain ultimately secondary to an accessory flexor digitorum longus muscle causing TTS. The literature describing the association between TTS and accessory musculature has been limited to single case reports and frequently demonstrate abnormal electrodiagnostic testing. In our series, 2 cases had normal electrodiagnostic findings despite magnetic resonance imaging (MRI) that later revealed TTS and improvement with eventual resection. A normal electromyogram should not preclude the diagnosis of TTS and MRI of the ankle; it should be considered a useful diagnostic tool when examining atypical foot pain.
Obsessive-Compulsive Disorder During the Initial Stage of COVID-19 Pandemic
Authors: Tulacı Rıza Gökçer , Tulacı Özge Demircan , Dolapoğlu Nazan 
Published: March 2022

Abstract
We aimed to investigate the effect of the COVID-19 pandemic on the symptom severity and dimensions of obsessive-compulsive disorder (OCD) and how patients with different levels of insight have been impacted by the pandemic. This study included 58 patients with OCD. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS)–Obsession, Y-BOCS–Compulsion, and Y-BOCS–Total scores during the pandemic were significantly higher than the prepandemic scores (p = 0.001, p < 0.001, p = 0.002, respectively). Compared with the pre-COVID-19 period, severity of OCD symptoms increased in 39.7% patients, remained the same in 44.8% patients, and reduced in 15.5% patients during the pandemic. The obsession with contamination, Brown Assessment of Beliefs Scale (for insight assessment) score, and time spent following the news/data about COVID-19 were significantly associated with an increase in OCD severity. In patients with contamination obsessions as well as poor insight, close monitoring and facilitating access to treatment may reduce the negative impact of the COVID-19 pandemic.
Urination Frequency Ranges in Healthy Women
Authors: Wyman Jean F. , Cain Charles H. , Epperson C. Neill , Fitzgerald Colleen M. , Gahagan Sheila , Newman Diane K. , Rudser Kyle , Smith Ariana L. , Vaughan Camille P. , Sutcliffe Siobhan ,   For the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
Published: March 2022

Background
Limited information on the normal range of urination frequencies in women is available to guide bladder health promotion efforts.

Objectives
This study used data from the Boston Area Community Health (BACH) Survey to (a) estimate normative reference ranges in daytime and nighttime urination frequencies in healthy women based on two operational definitions of “healthy” and (b) compare urination frequencies by age, race/ethnicity, and fluid intake.

Methods
A secondary analysis of cross-sectional interview data collected from female participants was performed using less restrictive (“healthy”) and strict (“elite healthy”) inclusion criteria. All analyses were weighted to account for the BACH sampling design. Normative reference values corresponding to the middle 95% of the distribution of daytime and nighttime urination frequencies were calculated overall and stratified by age, race/ethnicity, and fluid intake. Generalized linear regression with a log-link was used to estimate rate ratios of daytime and nighttime urination frequencies by age, race/ethnicity, and fluid intake.

Results
Of the 2,534 women who completed the BACH follow-up interviews, 1,505 women met healthy eligibility criteria, and 300 met elite healthy criteria. Overall, reference ranges for urination frequencies were 2–10 times/day and 0–4 times/night in healthy women and 2–9 times/day and 0–2 times/night in elite healthy women. Women ages 45–64 years, but not 65+ years, reported a greater number of daytime urination than those aged 31–44 years, whereas women 65+ years reported a greater number of nighttime urination. Black women reported fewer daytime urination and more nighttime urinations than White women. Women who consumed less than 49 oz daily reported fewer daytime and nighttime urinations than those who drank 50–74 oz; drinking 75+ oz had only a small effect on urination frequencies.

Discussion
Normative reference values for daytime and nighttime urination frequencies were similar in women using strict and relaxed definitions of health. These results indicate a wide range of “normal” urination frequencies, with some differences by age, race/ethnicity, and fluid intake. Future research is needed to examine urination frequencies in minority women and whether fluid intake amount and type influence the development of lower urinary tract symptoms.
Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study
Authors: Seo Na Jin , Barry Alex , Ghassemi Mohammad , Triandafilou Kristen M. , Stoykov Mary Ellen , Vidakovic Lynn , Roth Elliot , Kamper Derek G. 
Published: March 2022

Background/Purpose:
To determine the feasibility of training with electromyographically (EMG) controlled games to improve control of muscle activation patterns in stroke survivors.

Methods:
Twenty chronic stroke survivors (>6 months) with moderate hand impairment were randomized to train either unilaterally (paretic only) or bilaterally over 9 one-hour training sessions. EMG signals from the unilateral or bilateral limbs controlled a cursor location on a computer screen for gameplay. The EMG muscle activation vector was projected onto the plane defined by the first 2 principal components of the activation workspace for the nonparetic hand. These principal components formed the x- and y-axes of the computer screen.

Results:
The recruitment goal (n = 20) was met over 9 months, with no screen failure, no attrition, and 97.8% adherence rate. After training, both groups significantly decreased the time to move the cursor to a novel sequence of targets (P = 0.006) by reducing normalized path length of the cursor movement (P = 0.005), and improved the Wolf Motor Function Test (WMFT) quality score (P = 0.01). No significant group difference was observed. No significant change was seen in the WMFT time or Box and Block Test.

Discussion/Conclusions:
Stroke survivors could successfully use the EMG-controlled games to train control of muscle activation patterns. While the nonparetic limb EMG was used in this study to create target EMG patterns, the system supports various means for creating target patterns per user desires. Future studies will employ training with the EMG-controlled games in conjunction with functional task practice for a longer intervention duration to improve overall hand function.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A379).
Performance of molecular tests in the diagnosis of syphilis from 2009 to 2019: a systematic review and meta-analysis
Authors: Simpore Abibou , Bazie Bapio Valérie , Zoure Abdou Azaque , Ouattara Abdoul Karim , Compaore Rebeca T , Kiba-Koumare Alice , Yooda Paul A , Djigma Florencia W. , Sombié Hermann , Bisseye Cyrille , Simpore Jacques 
Published: March 2022

ABSTRACT

Background
Syphilis continues to be a public health problem and its diagnosis still has limitations. Molecular diagnosis provides an alternative for rapid and effective management. The objective is to determine the accuracy of tests in the molecular diagnosis of syphilis.

Methods
We searched PubMed and Web of Sciences for articles related to molecular detection of syphilis during January 01, 2009, to December 31, 2019. The bivariate Reitsma model and the hierarchical Receiver Operating Characteristic (ROC) curve model were used to evaluate the diagnostic performance of molecular tests at a 95% confidence interval (CI). A subgroup meta-analysis was performed to explore sources of heterogeneity.

Results
47 articles were identified for qualitative synthesis, of which 23 met the inclusion criteria for meta-analysis. The pooled sensitivities in conventional PCR (Polymerase chain reaction) and real-time PCR were 77.52 (59.50-89.01) and 68.43 (54.96-79.39) respectively. The pooled specificities were 98.00(90.73-99.59) and 98.84(97.55-99.46) respectively. Ulcer samples had a better performance (sensitivity of 79.88 (69.00- 87.62)) and specificity of 98.58 (97.25-99.27) and the major target genes were Polymerase A gene and tpp47 gene.

Conclusion
Our work showed that conventional PCR was more widely used than real-time PCR in the diagnosis of syphilis and ulcers were the best specimens. Sample types and target genes are factors that may influence the quality of the different tests. These results could provide evidence for further work in the direction of providing a more efficient diagnostic test.
Reliability of three different methods for assessing amputee residuum shape and volume: 3D scanners vs. circumferential measurements
Authors: Seminati Elena , Young Matthew , Canepa Talamas David , Twiste Martin , Dhokia Vimal , Bilzon James 
Published: March 2022

Background:
Objective and reliable methods are necessary to monitor and manage amputee residuum shape and volume and design prosthetic residuum-prosthesis interfaces. Portable 3D scanners are potential solutions for digitally recording the amputee residuum characteristics.

Objective:
To investigate test-operator reliability when measuring lower limb residuum shape and volume using two different types of 3D laser-free scanners compared with tape measurements generally adopted in clinic.

Study design:
Ten lower limb amputees took part in this study. Residuum volume, cross sectional areas, and perimeter lengths were measured by three different operators on three different occasions using two types of 3D scanners (Artec Eva scanner and OMEGA Scanner 3D) and circumferential measurements.

Methods:
Variance components, intraclass correlation coefficients and intra-rater and inter-rater reliability coefficients were calculated for all measurement conditions.

Results:
Residuum volume outputs ranged from 569 to 3115 mL. The factor contributing mostly to the residuum volume error variance was the shape of the residuum (75.85%). Volume intraclass correlation coefficients for both intra-rater and inter-rater reliability exceeded 0.9 for all three conditions. Volume reliability coefficients ranged from 70.68 mL (Artec Eva intra-rater reliability) to 256.85 mL (circumferential measurements inter-rater reliability). Shape relative error reached the highest values for the circumferential measurements (>10% for the cross-sectional areas and >5% for the perimeters).

Conclusions:
The Artec Eva scanner resulted in the lowest test-operator reliability coefficients. However, both investigated scanners are a potential alternative for measuring small and macroscopic changes in residuum characteristics.
Comparison of the effects of foot-toe orthoses on three-dimensional pelvic kinematics in individuals with hallux valgus during gait
Authors: Kim Yongwook 
Published: March 2022

Background:Most previous studies focused on the possible relationship between hallux valgus deformity and biomechanical characteristics in the foot and lower leg. Very few investigated the association of pelvic kinematics and hallux valgus during gait according to various foot-toe orthoses for hallux valgus.Objective:To investigate the effect of soft or hard foot-toe orthoses on pelvic kinematics in individuals with hallux valgus deformity during gait.Study design:This study has a repeated measures design.Methods:Three-dimensional range of motion in the pelvic segment was collected from 22 individuals (18 women and 4 men) aged 21 to 52 years (mean 31.7 years, SD 8.7) with hallux valgus. All participants exhibited a hallux valgus angle of more than 20 degree in both feet. A motion analysis system with eight infrared cameras was used to obtain pelvic kinematic data in the hard plastic orthosis, soft silicone orthosis, and without foot-toe orthosis conditions during gait. The two types of hallux valgus orthoses used in this experiment were commercially available products. The participants performed 8–10 walking trials. The walkway length was 6 m. Repeated-measures analysis of variance was used to determine the effects of each orthosis condition on the pelvic kinematic values.Results:The hard plastic orthosis condition was associated with decreased pelvic motion compared with the soft-type orthosis and no orthosis conditions for depression (F(2,42)= 7.329,P= 0.004), external rotation (F(2,42)= 4.367,P= 0.027), and overall transverse motion (F(2,42)= 4.897,P= 0.019) of the pelvic segment during gait. There were no significant differences in other pelvic motion variables between the without foot-toe orthosis and soft silicone orthosis conditions (P> 0.05).Conclusions:The results of this study suggest that the hard-type foot-toe orthosis for hallux valgus reduced pelvic motion and contributed to preventing excessive pelvic movement during gait.
Clinical Features of ANCA-Associated Vasculitis in African American Patients in the United States
Authors: Palomino Luis , Gaffo Angelo , Sun Dongmei , Sattui Sebastian E. 
Published: March 2022

Background/Purpose
The aim of this study was to compare the clinical features at presentation of ANCA-associated vasculitis (AAV) between African American (AA) and White patients.

Methods
This is a chart review of cases between January 2003 and December 2018. African American patients with AAV were identified and matched in a 1:2 ratio with White comparators based on the year of diagnosis (±4 years). Data on demographics, clinical, and laboratory features and outcomes at presentation were collected. Descriptive statistics were used to compare the characteristics between groups.

Results
Thirty-two of 56 AA patients with AAV had complete data and were included for analysis. When compared with 64 matched White patients with AAV, AA patients were younger (47.5 vs 61.0 years, p = 0.001). Compared with White patients, AA patients with granulomatosis with polyangiitis (GPA) (35 vs 55 years, p = 0.0006) and microscopic polyangiitis (MPA) (55.5 vs 65.0 years, p = 0.05) were younger. African American patients with GPA were more frequently female (p = 0.008), whereas AA patients with MPA were more frequently male (p = 0.03). No differences in disease manifestations, disease activity, and outcomes were observed between AA and White patients with AAV.

Conclusions
In this single-center study, AA patients with AAV were diagnosed at a younger age than Whites; this was found in both the GPA and MPA disease phenotypes. No other significant differences were observed. Future studies are needed to confirm our findings and better describe differences of AAV in racial/ethnic minorities.
A mixed methods end-user assessment to determine the ideal supraglottic airway device for inclusion into the medic's aid bag
Authors: Schauer Steven G. , Tapia Ashley D. , Hudson Ian L. , Jeschke Erika A. , Mendez Jessica , Escandon Mireya A. , Uhaa Nguvan , April Michael D. , De Lorenzo Robert A. 
Published: March 2022

BACKGROUND
Many advancements in supraglottic airway technology have occurred since the start of the Global War on Terrorism. While the Tactical Combat Casualty Care guidelines previously recommend the i-gel device, this is based on little data and minimal end-user input.

OBJECTIVE
We sought to use a mixed methods approach to investigate the properties of an ideal device for inclusion into the medic's aid bag.

METHODS
We performed prospective, serial qualitative studies to uncover and articulate themes relative to airway device usability with 68W-combat medics. 68W are trained roughly to the level of a civilian advanced emergency medical technician with a heavier focus on trauma care. Physicians with airway expertise demonstrated the use of each device and provided formal training on all the presented devices. We then administered performed focus groups to solicit end-user feedback along with survey data.

RESULTS
We enrolled 250 medics during the study. The preponderance of medics were of the rank E4 (28%) and E5 (44%). Only 35% reported ever placing a supraglottic airway in a real human. When reporting on usability, the i-gel had the highest median score, ease of manipulation, grip comfort and ease of insertion while also scoring the best in regard to requiring minimal training. The other compared devices had no clear highest score. Qualitative data saturated around a strong preference for the BaskaMask and/or the i-gel airway device, with the least favorite being the AirQ and the LMA Fastrach airway devises. There was a strong qualitative alignment in how both the BaskaMask and i-gel provided ease of use and simplicity of training.

CONCLUSION
There were strong qualitative preferences for two specific airway devices: Baska Mask and i-gel. However, many medics commented on their previous experience with the i-gel compared with the other devices, which may have biased them toward the i-gel. The overall data suggest that medics would prefer a device engineered with features from several devices.

LEVEL OF EVIDENCE
Therapeutic/care management; Level V.
Not all is lost: Functional recovery in older adults following emergency general surgery
Authors: Guttman Matthew P. , Tillmann Bourke W. , Nathens Avery B. , Bronskill Susan E. , Saskin Refik , Huang Anjie , Haas Barbara 
Published: March 2022

BACKGROUND
Although functional decline and death are common long-term outcomes among older adults following emergency general surgery (EGS), we hypothesized that patients' postdischarge function may wax and wane over time. Periods of fluctuation in function may represent opportunities to intervene to prevent further decline. Our objective was to describe the functional trajectories of older adults following EGS admission.

METHODS
This was a population-based retrospective cohort study of all independent, community-dwelling older adults (age ≥65 years) in Ontario with an EGS admission (2006–2016). A multistate model was used to examine patients' functional trajectories over the 5 years following discharge. Patients were followed as they transitioned back and forth between functional independence, use of chronic home care (in-home assistance for personal care, homemaking, or medical care for at least 90 days), nursing home admission, and death.

RESULTS
We identified 78,820 older adults with an EGS admission (mean age, 77 years; 53% female). In the 5 years following admission, 32% (n = 24,928) required new chronic home care, 21% (n = 5,249) of whom had two or more episodes of chronic home care separated by periods of independence. The average time spent in chronic home care was 11 months, and 50% (n = 12,679) of chronic home care episodes ended with a return to independence. For patients requiring chronic home care at any time, the probability of returning to independent living during the subsequent 5 years ranged from 36% to 43% annually.

CONCLUSION
Not all is lost for older adults who experience functional decline following EGS admission. Half of those who require chronic home care will recover to independence, and one-third will have a durable recovery, remaining independent after 5 years. Fluctuations in function in the years following EGS may represent a unique opportunity for interventions to promote rehabilitation and recovery among older adults.

LEVEL OF EVIDENCE
Prognostic and Epidemiologic; Level III.