bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinico-radiologic characteristics of lacrimal sac area swellings misdiagnosed as dacryocystocele or mucocele
Authors: Diab Mostafa Mohammed , Ali Mohammad Javed , Mohammed Khaled Kotb 
Published: August 2022

Purpose Several non-lacrimal lesions can present with lacrimal sac area swelling mimicking a dacryocystocele or mucocele with a possibility of misdiagnosis. This study investigates the clinic-radiologic characteristics of the mimicking conditions compared to true lacrimal sac distension. Design Retrospective, comparative, interventional case series Participants Patients referred by primary care ophthalmologists between January 2015 and October 2021 with a misdiagnosis of dacryocystocele or lacrimal sac mucocele (n = 39) and an age-matched group of proven true lacrimal sac swelling (TLS group, n = 44). Methods Data collected included demographics, presenting features, investigations, management, histopathology, and outcomes. Both groups were statistically compared for several clinical and radiological variables. Results Final diagnoses in the mimicking group were skin/subcutaneous swellings (14/39, 35.9%), vascular malformations (10/39, 25.6%), inferomedial anterior orbital cysts (7/39, 17.9%), sino-orbital masses (5/39, 12.8%). Female gender (<0.001), epiphora (p = 0.001), and discharge (p < 0.001) were significantly more frequent in the TLS group. The mimicking group was more likely to be associated with a longer swelling duration (p < 0.001), a swelling extending beyond the lacrimal sac area (p <0.001), orbital signs (p <0.001), and periorbital abnormality. Non-patent lacrimal irrigation (p < 0.001) was significantly more frequent in the TLS group. On imaging, all swellings in the mimicking group were separate from the lacrimal pathway and 94.9% (37/39) extended beyond the lacrimal sac fossa. Conclusion Various cutaneous, subcutaneous, vascular, inferomedial orbital cystic, and sinonasal pathologies can present with lacrimal sac area swelling and mimic a TLS. A high index of suspicion, a thorough clinical evaluation and proper imaging are essential to avoid a misdiagnosis.
Effect of environmental factors on the concentration distribution of bioaerosols with different particle sizes in an enclosed space
Authors: Duan Xiaojian , Shen Chao , Chen Dongqin , Zhai Zhiqiang (John) 
Published: August 2022

COVID-19 has alerted us about the need to quantify the effect of different environmental factors on the concentration distribution of bioaerosols. An experimental investigation was carried out to evaluate the effect of environmental factors, including air temperature, relative humidity, airflow speed and ultraviolet (UV) radiation, on the potential dispersion risk of bioaerosols in an enclosed space by tracking the Serratia marcescens as the tiny organisms. Research results indicated that the concentration of bioaerosols is the highest at the indoor air temperature of 25°C among the tested conditions (20°C, 25°C, 30°C and 35°C). The particle size of bioaerosols can be influenced by temperature, resulting in changes in the amount of settling. Increasing relative humidity from 50% to 80% and airflow speed from 1.5 m/s to 2.2 m/s have a negative impact on the dispersion of bioaerosols as the amount of particle settlement increases accordingly. As for the UV radiation parameters, a better disinfection efficiency was achieved at a radiation distance of 40 cm in the tested range of 20–50 cm and a radiation exposure time of 30 min in the tested range of 10–50 min. This study delivered novel data for the concentration distribution of bioaerosol under different environmental factors for creating a safe indoor environment.
Mirror hand-ulnar dimelia: a single centre experience with 13 patients
Authors: Kumar Bhaskaranand , SM Venugopal , Chandmanne Bhavya , Das De Soumen 
Published: August 2022

Mirror hand-ulnar dimelia (MHUD) is rare congenital disorder with a wide range of clinical and radiographic features. The current nomenclature is confusing and the existing classification systems focus mainly on morphology without providing much guidance for treatment. The goal of this study was to review the clinical and radiological features in 13 children with MHUD that were treated at a single institution. Our findings support the hypothesis that MHUD typically involves the entire upper limb, and the treatment plan should consider the predictors of function at each limb segment. A logical and comprehensive management algorithm is proposed. Level of evidence: IV
Cost-Effectiveness of Intraoperative Electromyography to Determine Adequate Screw Position
Authors: Yu Charles , Owens Roger K. , Crawford Charles H. , Djurasovic Mladen , Gum Jeffrey L. , Brown Morgan , Carreon Leah Y. 
Published: August 2022

Study Design Prospective observational cohort. Objectives To examine the cost-effectiveness of IntraOperative ElectroMyeloGraphy (IO-EMG) by evaluating how often an abnormal IO-EMG signal changed the surgeon’s surgical plan, or replaced a pedicle screw either intra-operatively or as a second unplanned surgery. Methods Patients undergoing instrumented posterolateral lumbar fusion were monitored with intraoperative triggered EMG’s. Pedicle screws were placed freehand from L1 to S1 by attending physicians and fellows. Concern for pedicle breach was a screw stimulation<10 mA. Results There were 145 cases with a total of 725 pedicle screws placed. Mean age was 57.8 ± 14.2 yrs, OR time was 238 ± 95 minutes, EBL was 426.8 ± 354.3cc. Mean number of surgical levels fused was 2.7 ± 1.1. 686 (95%) screws stimulated at >10 mA and 39 (5%) screws stimulated at <10 mA. All 39 screws were removed and pedicles re-examined. Intraoperative screw repositioning was necessary in 8 of 145 cases (6%). No patient required a return to the OR for screw repositioning. As a worst case cost analysis, assuming the 8 patients requiring intraoperative screw positioning would have returned to the OR at a cost of $11,798 per readmission, the per patient cost is $651 which is less than the ION per patient cost of $750. Conclusions Only 1% of the 725 lumbar pedicle screws placed in 8 of 145 cases required repositioning. Due to the infrequency of pedicle wall breaches and the cost of ION, the utility of this modality in straightforward lumbar fusions should be critically evaluated.
A 3-Dimensional Classification for Degenerative Glenohumeral Arthritis Based on Humeroscapular Alignment
Authors: Kleim Benjamin D. , Hinz Maximilian , Geyer Stephanie , Scheiderer Bastian , Imhoff Andreas B. , Siebenlist Sebastian 
Published: August 2022

Background: Seminal classifications of degenerative arthritis of the shoulder (DAS) describe either cuff tear arthropathy in the coronal plane or primary osteoarthritis in the cross-sectional plane. None consider a biplanar eccentricity. Purpose/Hypothesis: The purpose of this study was to investigate humeroscapular alignment (HSA) of patients with DAS in both the anteroposterior (A-P) and superoinferior (S-I) planes on computed tomography (CT) after 3-dimensional (3D) reconstruction and develop a classification based on biplanar HSA in 9 quadrants. It was hypothesized that biplanar eccentricity would occur frequently. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The authors analyzed 130 CT scans of patients who had undergone shoulder arthroplasty. The glenoid center, trigonum, and inferior angle of the scapula were aligned in a single plane using 3D reconstruction software. Subluxation of the HSA was measured as the distance from the center of rotation of the humeral head to the scapular axis (line from trigonum through glenoid center) and was expressed as a percentage of the radius of the humeral head in both the A-P and the S-I directions. HSA was described in terms of A-P alignment first (posterior/central/anterior), then S-I alignment (superior/central/inferior), for a total of 9 different alignment combinations. Additionally, glenoid erosion was graded 1-3. Results: Subluxation of the HSA was 74.1% posterior to 23.5% anterior in the A-P direction and 17.2% inferior to 68.6% superior in the S-I direction. A central HSA was calculated as between 20% posterior to 5% anterior (A-P) and 5% inferior to 20% superior (S-I), after a graphical analysis. Posterior subluxation >60% of the radius was labeled as extraposterior, and static acetabularization was labeled as extrasuperior. Overall, 21 patients had central-central, 40 centrosuperior, and 1 centroinferior alignment. Of 60 shoulders with posterior subluxation, alignment was posterocentral in 31, posterosuperior in 25, and posteroinferior in 5. There were 3 patients with anterocentral and 4 anterosuperior subluxation; in addition, 4 cases with extraposterior and 17 with extrasuperior subluxation were identified. Conclusion: There was a high prevalence of biplanar eccentricity in DAS. The 3D classification system using combined HSA and glenoid erosion can be applied to describe DAS comprehensively.
External Validation of the FEAR Index in Borderline Acetabular Dysplasia
Authors: Schwabe Maria T. , Clohisy John C. , A. Graesser Elizabeth , Pascual-Garrido Cecilia , Nepple Jeffrey J. 
Published: August 2022

Background: Given the lack of established, externally validated criteria for the diagnosis of unstable hips, the Femoro-Epiphyseal Acetabular Roof (FEAR) index has been proposed as a useful tool for identifying hips with instability in the setting of borderline acetabular dysplasia. Purposes: To (1) determine the external performance of the FEAR index in identifying hips with a clinical diagnosis of instability in the setting of borderline dysplasia and (2) assess the performance of the FEAR index compared with acetabular inclination or physeal scar angle alone. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The authors reviewed 176 patients with borderline acetabular dysplasia (lateral center-edge angle, 20°-25°). A positive FEAR index was defined as ≥5°. An alternative threshold ≥2° was also assessed. Significant instability was determined by the senior surgeon based on the combination of patient and radiographic features; unstable hips were treated with periacetabular osteotomy (with or without hip arthroscopy), and stable hips were treated with isolated hip arthroscopy. Results: Only 18% of borderline hips had a positive FEAR index. The ≥5° positive FEAR index threshold had a sensitivity of 33% (23/70) and specificity of 92% (98/106) in predicting the clinical diagnosis of instability. The ≥2° FEAR index threshold had a sensitivity of 39% (27/70) and specificity of 89% (94/106) in predicting the clinical diagnosis of instability. No alternative threshold for the FEAR index resulted in high levels of sensitivity and specificity. A threshold of –5° was required to reach an adequate sensitivity of 74%. The FEAR index remained a significant predictor of hip instability even after controlling for acetabular inclination (odds ratio, 1.12; P < .001) or physeal scar angle (odds ratio, 1.6; P < .001). Conclusion: In the current study, a positive FEAR index was generally indicative of the presence of clinical instability, but the FEAR index alone remained inadequate to fully define the instability of a given hip, as it demonstrated low sensitivity (only 33%) in the external validation. The FEAR index is best used in the context of other clinical and radiographic features.
Fluorsigaiite, Ca2Sr3(PO4)3F, a new mineral of the apatite supergroup from the Saima alkaline complex, Liaoning Province, China
Authors: Wu Bin , Gu Xiang-ping , Rao Can , Wang Ru-cheng , Xing Xing-qing , Zhong Fu-jun , Wan Jian-jun , Bonnetti Christophe 
Published: August 2022

AbstractFluorsigaiite, ideally Ca2Sr3(PO4)3F, is a new Sr analogue of fluorphosphohedyphane and a new member of the apatite supergroup. It was discovered in lujavrite from the Saima alkaline complex, Liaoning Province, China. Fluorsigaiite commonly occurs as individual prismatic, columnar and platy crystals of 10 to 50 μm in size, associated with microcline, nepheline, aegirine, natrolite, eudialyte, fluorapatite, a fluorstrophite-like mineral, stronadelphite and calcite. Occasionally, crystals of fluorsigaiite form prismatic aggregates in the interstices of lujavrite. Fluorsigaiite is translucent to transparent, colourless to yellowish white with a vitreous lustre and without fluorescence. The estimated Mohs hardness is 5, and the tenacity is brittle with uneven fractures. The calculated density is 3.842 g/cm3. Optically, fluorsigaiite is uniaxial (–) with ω = 1.64(1) and ɛ = 1.63(1) in white light and without dispersion. The mean chemical composition (in wt.%) of fluorsigaiite is Na2O 0.75, CaO 15.17, SrO 44.44, La2O3 3.64, Ce2O3 2.22, Pr2O3 0.19, Nd2O3 0.13, Sm2O3 0.05, Gd2O3 0.23, P2O5 31.87, F 1.91, H2O 0.46, sum 100.26, giving the empirical formula (Sr2.82Ca1.79Na0.16La0.15Ce0.09Pr0.01Nd0.01Gd0.01)Σ5.04P2.97O12[F0.66(OH)0.34]Σ1, which is calculated on the basis of 13 total anions and F+(OH) = 1. The strongest eight lines of its powder X-ray diffraction pattern [d, Å (I, %) (hkl)] are: 3.563 (15) (002), 3.275 (15) (102), 3.144 (19) (120), 2.876 (100) (121), 2.861 (96) (112), 2.772 (27) (300), 1.991 (17) (222) and 1.895 (23) (213). Fluorsigaiite is hexagonal, in the space group P63/m and unit-cell parameters refined from single-crystal X-ray diffraction data are: a = 9.6101(2) Å, c = 7.1311(1) Å, V = 570.35(3) Å3 and Z = 2. It is isostructural with hedyphane-group minerals, and contains different prevailing (species-defining) Ca and Sr cations at the Ca1 and Ca2 sites, respectively. Fluorsigaiite was probably formed from Sr-rich fluids at late-magmatic or hydrothermal stage of the Saima lujavrite.
Functional clinical impairments and frailty in interstitial lung disease patients
Authors: Tremblay Labrecque Pierre-François , Dion Geneviève , Saey Didier 
Published: August 2022

BackgroundPatients with interstitial lung disease (ILD) often present with persistent dyspnoea and reduced exercise capacity and quality of life (QoL), but their functional limitation in relation to their frailty status remains unclear. We thus aimed to compare exercise tolerance, functional mobility, and muscle function and composition between ILD participants and healthy subjects and according to their frailty status.MethodsA total of 36 ILD participants and 15 heathy subjects performed a 6-min walk test, a 1-min sit-to-stand test, a Short Physical Performance Battery test, a hand grip test and complete quadriceps function testing. Patient-related impacts were assessedviaquestionnaires. Muscle composition was obtained using noncontrast computed tomography scans. The frailty status of patients with ILD was determined using the Fried frailty phenotype assessment.ResultsCompared with control subjects, ILD participants exhibited significantly lower performance in every exercise and functional capacity test, higher dyspnoea and depression scores, and worse QoL. In ILD participants, the same observations were noted for the frail subgroup compared with the robust subgroup. No differences in muscle function and composition were observed between the ILD and control group, but mid-thigh muscle cross-sectional area and skeletal muscle index were significantly reduced in frail ILD participants.ConclusionsILD patients present reduced exercise tolerance and functional capacity, and have decreased health-related QoL, when compared with healthy subjects. Physical frailty seems to be associated with worse clinical status, exercise tolerance, muscle and functional impairment, and decreased QoL. The 1-min sit-to-stand test may be a good discriminatory test for frailty status in ILD patients.
Analysis of real-world data and a mouse model indicates that pirfenidone causes pellagra
Authors: Kuronuma Koji , Susai Natsumi , Kuroita Tomohiro , Yamamoto Hiroki , Yoshioka Takeshi , Kaneko Shuji , Chiba Hirofumi 
Published: August 2022

Background
Pirfenidone (PFD) is widely used in patients with idiopathic pulmonary fibrosis (IPF) and its adverse effects, such as nausea and photosensitivity, are well known. Many patients with IPF have reduced doses or even cessation of PFD because of its side-effects. No solutions have been found for these side-effects because the current mechanistic insights are insufficient.

Methods
Using the results of real-world data analysis from the US Food and Drug Administration Adverse Events Reporting System, we hypothesised that PFD-related symptoms may be similar to pellagra. Reverse translational experiments using female BALB/c mice were performed to validate and estimate this hypothesis. Niacin and its metabolite responses were compared between patients with IPF treated with PFD and those treated without PFD.

Results

The pellagra hypothesis was translated from real-world data analysis. Pharmacological and comprehensive genetic investigations showed that PFD caused pellagra-related nausea and photosensitivity in a mouse model, which may have been mediated by the actions of nicotinamide
N-
methyltransferase (NNMT). Higher NNMT substrate responses were observed in urine from patients and mice with PFD than in those without PFD.

Conclusions
PFD may cause pellagra or pellagra-like symptoms such as photosensitivity. Further studies are required to investigate whether niacin prevents pellagra-like symptoms caused by PFD in patients with IPF.
Haemodynamic effects of initial combination therapy in pulmonary arterial hypertension: a systematic review and meta-analysis
Authors: Farmakis Ioannis T. , Vrana Elena , Mouratoglou Sophia-Anastasia , Zafeiropoulos Stefanos , Zanos Stavros , Giannakoulas George 
Published: August 2022

BackgroundAlthough the initial use of combination treatment has been proven to be beneficial for patients’ clinical outcomes, there are scarce data on its haemodynamic effects. The objective of the present study was to evaluate the effect of an initial combination of pulmonary arterial hypertension (PAH)-targeted therapies on haemodynamic parameters in treatment-naïve PAH patients.MethodsA systematic search of PubMed, Cochrane Central Register of Controlled Trials and Web of Science was performed. We considered eligible studies with an intervention of initial PAH-targeted combination therapy in treatment-naïve PAH patients with or without monotherapy control. A random-effects meta-analysis was performed for the difference between baseline and follow-up in pulmonary vascular resistance (PVR) and other haemodynamic parameters.ResultsIn 880 patients receiving initial combination therapy PVR was reduced by −6.5 Wood Units (95% CI −7.4–−5.7 Wood Units) or by −52% (95% CI −56%–−48%, I2=0%) compared to baseline. Initial triple therapy including a parenteral prostanoid resulted in significantly greater PVR reduction (−67%versus−50% with all other combination therapies, p=0.01). The effect was more pronounced in younger patients (p=0.02). Compared to baseline, there was −12.2 mmHg (95% CI −14.0–−10.4 mmHg) decrease in mean pulmonary artery pressure, 0.9 L·min−1·m−2(95% CI 0.8–1.1 L·min−1·m−2) increase in cardiac index, −3.2 mmHg (95% CI −4.1–−2.3 mmHg) decrease in right atrial pressure and 8.6% (95% CI 6.9–10.3%) increase in mixed venous oxygen saturation. In the controlled studies, initial combination therapy reduced PVR by −4.2 Wood Units (95% CI −6.1–−2.4 Wood Units) compared to monotherapy.ConclusionInitial combination therapy leads to remarkable haemodynamic amelioration. Parenteral prostanoids should be considered early, especially in more severely affected patients, to enable right ventricular reverse remodelling.
Defining the normal range of fractional exhaled nitric oxide in children: one size does not fit all
Authors: Wang Ran , Fowler Stephen J. , Turner Stephen W. , Drake Sarah , Healy Laura , Lowe Lesley , Wardman Hannah , Bennett Miriam , Custovic Adnan , Simpson Angela , Murray Clare S. 
Published: August 2022

BackgroundThe normal range of fractional exhaled nitric oxide (FENO) is influenced by demographic factors. However, single, fixed cut-off values are used for clinical interpretation in children despite rapid growth. We aimed to define the normal range ofFENOduring childhood and evaluate its utility in a diagnostic setting.MethodFENOpercentile charts were developed using data from nonasthmatic children in a population-based birth cohort (Manchester Asthma and Allergy Study). Children were skin prick tested,FENOmeasured at the ages of 8, 11, 13–16 and 18 years and clinical information collected. This chart was externally validated in the Study of Eczema and Asthma to Observe the Influence of Nutrition (SEATON) cohort before being prospectively tested in symptomatic, treatment-naïve patients with suspected asthma in a diagnostic setting (Rapid Access Diagnostics for Asthma study).ResultsHeight, weight, body mass index and age were predictive ofFENOin univariate analysis using 1220FENOmeasurements. Only height remained significant after adjustment in the overall, nonatopic and atopic populations, and was included in the predictive equations for 50th, 75th 90th and 98th percentiles. The proposed percentile lines corresponded to the 57th (95% CI 53rd–61st), 80th (76th–83rd), 90th (87th–92nd) and 98th (96th–99th) percentiles in the SEATON cohort (660 measurements). When tested in 73 symptomatic treatment-naïve children and young adults (median (interquartile range) age: 11 (8–14) years), anFENO>90th percentile gave a 96% specificity and positive predictive value of 97%, identifying 59% of children who were subsequently diagnosed with asthma after extensive testing.ConclusionWe developed a height-basedFENOpercentile chart which quantifies the probability of asthma in symptomatic children and merits further validation towards clinical implementation.
Digital Twin-based Quality Management Method for the Assembly Process of Aerospace Products with the Grey-Markov Model and Apriori Algorithm
Authors: Zhuang Cunbo , Liu Ziwen , Liu Jianhua , Ma Hailong , Zhai Sikuan , Wu Ying 
Published: August 2022

AbstractThe assembly process of aerospace products such as satellites and rockets has the characteristics of single- or small-batch production, a long development period, high reliability, and frequent disturbances. How to predict and avoid quality abnormalities, quickly locate their causes, and improve product assembly quality and efficiency are urgent engineering issues. As the core technology to realize the integration of virtual and physical space, digital twin (DT) technology can make full use of the low cost, high efficiency, and predictable advantages of digital space to provide a feasible solution to such problems. Hence, a quality management method for the assembly process of aerospace products based on DT is proposed. Given that traditional quality control methods for the assembly process of aerospace products are mostly post-inspection, the Grey-Markov model and T-K control chart are used with a small sample of assembly quality data to predict the value of quality data and the status of an assembly system. The Apriori algorithm is applied to mine the strong association rules related to quality data anomalies and uncontrolled assembly systems so as to solve the issue that the causes of abnormal quality are complicated and difficult to trace. The implementation of the proposed approach is described, taking the collected centroid data of an aerospace product’s cabin, one of the key quality data in the assembly process of aerospace products, as an example. A DT-based quality management system for the assembly process of aerospace products is developed, which can effectively improve the efficiency of quality management for the assembly process of aerospace products and reduce quality abnormalities.