bluuebunny/crossref_metadata_2025_split huggingface dataset:
Three-Dimensional Analysis of Age-Related Orbital and Midfacial Bone Remodeling in Asians
Authors: Feng Wen-Jie , Li Fang-Wei , Zhan Wen-Feng , Lin Fu-Chuan , Luo Sheng-Kang 
Published: March 2020

BACKGROUND
Facial bony changes vary among races, yet few studies have been conducted in Asians.

OBJECTIVE
To analyze the aging of orbital and midfacial bones in Asians.

METHODS
Based on the two-dimensional data obtained from the computed tomography scanner of imaging department, 3D reconstructions were conducted to take measurements (orbital diagonal diameter, orbital width, orbital area, maxillary angle, midfacial height, pyriform angle, pyriform width, and pyriform area).

RESULTS
In this retrospective study of 261 subjects, a significant decrease in the orbital diagonal diameter, orbital width, and midfacial height was found in men, whereas women displayed a significant increase in the pyriform width and a significant decrease in maxillary angle and midfacial height by three-dimensional analysis.

CONCLUSION
This study verifies the minor female changes in the orbital region and less dramatic male changes in the midfacial region compared with that in Caucasians. Individualized treatment should be performed according to different genders and races. Further exploration of facial bone metabolism may have valuable implications for Asians.
Association between common mental disorders, sleep quality, and menopausal symptoms: a population-based study in Southern Brazil
Authors: Neutzling Agnes L. , Leite Heloísa M. , Paniz Vera Maria V. , de Bairros Fernanda Souza , Dias da Costa Juvenal S. , Olinto Maria Teresa A. 
Published: March 2020

Abstract

Objective:
To investigate the association between common mental disorders (CMD), sleep quality, and moderate and severe menopausal symptoms in adult women in southern Brazil.

Methods:
This cross-sectional, population-based study investigated a representative sample of 393 women (age 40-69 years) living in an urban area. A standardized and pretested questionnaire that included the Self-Reporting Questionnaire-20 for CMD (Self-Reporting Questionnaire-20 ≥7), the Pittsburgh Sleep Quality Index-BR for sleep disorders (Pittsburgh Sleep Quality Index >5), and the Menopause Rating Scale for moderate/severe menopausal symptoms (Menopause Rating Scale >8) was used for data collection. Unadjusted and adjusted prevalence ratios and 95% confidence intervals (95% CIs) were estimated using robust Poisson regression.

Results:
The prevalence of moderate/severe menopausal symptoms in the sample was 58.0% (95% CI 53.0-63.0), the prevalence of CMD was 40.2% (95% CI 35.3-45.2), and the prevalence of poor sleep quality was 49.4% (95% CI 44.3-54.5). CMD and poor sleep quality occurred simultaneously in 34.4% of participants (95% CI 29.6-39.3). Moderate/severe menopausal complaints were significantly more prevalent in women with CMD (P < 0.001) and poor sleep quality (P < 0.001); the presence of both CMD and poor sleep quality increased the likelihood of moderate/severe menopausal complaints threefold. After adjustment, CMD and poor sleep quality remained strongly and significantly associated with moderate/severe menopausal complaints (P < 0.001).

Conclusions:
Considering the complex time-course relationship between CMD, sleep quality, and menopausal symptoms, longitudinal studies should follow women with these issues throughout the menopausal period to identify a possible temporal link between exposures and outcome.

Video Summary:
http://links.lww.com/MENO/A554.
Improvements in Skin Quality Biological Markers in Skin Explants Using Hyaluronic Acid Filler VYC-12L
Authors: Nakab Lauren , Hee Christopher K. , Guetta Olivier 
Published: March 2020

Background:Hyaluronic acid (HA), both crosslinked and uncrosslinked, is used clinically to treat fine lines and provides additional improvements in skin quality attributes. The purpose of this study was to assess potential early differences in the expression of biological markers of skin quality in living human skin explants injected with uncrosslinked and crosslinked HA gels.Methods:Living human skin explants injected with VYC-12L or noncrosslinked HA with mannitol (HYD) and noninjected controls were assessed via microscopy, histology, and immunohistochemistry on days 3 and/or 8 for biological markers of elasticity (collagen density, elastin, fibrillin-1) and hydration [aquaporin-3, acidic glycosaminoglycans (GAGs), HA]. Hydration was also assessed via a corneometer probe on days 0, 1, 2, and 8.Results:On day 3 versus controls, VYC-12L moderately increased collagen density in the upper reticular dermis and clearly increased fibrillin-1 expression, with slight increases persisting on day 8. Increases with HYD were smaller and did not persist on day 8. Both VYC-12L and HYD increased aquaporin-3 expression and GAG content on days 3 and 8, but VYC-12L produced greater GAG increases in the reticular dermis. Day 8 instrument-assessed hydration increased by 49% and 22% for VYC-12L and HYD, respectively. Elastin expression in oxytalan and elaunin fibers was unchanged. Upper-dermal HA reductions suggested HA injection-induced hyaluronidase expression.Conclusion:VYC-12L produced greater, more lasting improvements in biological markers of skin quality than HYD.
Single-phase computed tomography angiography sufficiently predicts outcomes after mechanical thrombectomy
Authors: Yu Kai-Wei , Lin Chung-Jung , Luo Chao-Bao , Lin Yung-Yang , Guo Wan-Yuo , Chang Feng-Chi , Lee I-Hui , Lin Chun-Jen , Chung Chih-Ping , Chien Chun 
Published: March 2020

Background:
Arterial collateral (AC) assessed by single-phase computed tomography angiography (CTA) or multiphase CTA has been used to predict clinical outcomes in patients undergoing mechanical thrombectomy (MT). Recently, venous opacification (VO) was proposed as another accurate image marker. This study aimed to compare the efficacy using AC and VO as predictors of MT outcome.

Methods:
Patients with occlusion of the proximal anterior circulation undergoing MT were included retrospectively. We assessed the AC status respectively according to different methods: modified Tan score, Miteff score in single-phase CTA, and pial arterial filling score in multiphase CTA. VO was assessed according to cortical vein opacification score. Favorable clinical outcome was defined as modified Rankin Scale 0-2 90 days after MT. Logistic regression models were established and receiver operating characteristics curve were used to determine the predictability of favorable outcome in patients with adequate AC and VO.

Results:
A total of 75 patients were enrolled. Adequate AC identified by modified Tan score (odds ratio, 7.3; p < 0.001), Miteff score (odds ratio, 4.5; p = 0.009), significantly predicted favorable outcome, but not adequate VO. The area under the curve was largest for adequate AC in model of modified Tan score 0.730 (95% CI, 0.60-0.86), while adequate VO showed the least area under the curve: 0.577 (95% CI, 0.43-0.73).

Conclusion:
We considered adequate AC in single-phase CTA could be reliable enough as an imaging marker rather than adequate VO to predict favorable outcome after MT.
Comparison of objective nutritional indexes for the prediction of in-hospital mortality among elderly patients with acute heart failure
Authors: Alataş Ömer Doğan , Biteker Murat , Yildirim Birdal , Acar Ethem , Gökçek Kemal 
Published: March 2020

Objectives:
The association between objective nutritional indexes and prognosis in patients with acute heart failure have not been well studied. Therefore, we aimed to compare the prognostic value of modified Glasgow prognostic score, prognostic nutritional index, controlling nutritional status score, and geriatric nutritional risk index for the prediction of in-hospital mortality in patients with acute heart failure.

Methods:
All consecutive elderly patients (aged ≥65 years) who had tests for C-reactive protein, total lymphocyte count, total cholesterol, and albumin levels at admission, and hospitalized due to acute heart failure were retrospectively included. The primary endpoint of the study was in-hospital mortality. We used a base model for the prediction of in-hospital mortality, including age, gender, log N-terminal pro-B-type natriuretic peptide, and the presence of coronary artery disease. We added each of the malnutrition scores, in turn, to the base model and used C-statistics to evaluate model discrimination in survival analysis.

Results:
A total of 628 patients were included, and 80 (12.7%) of the patients died during the hospital stay. Multivariate analysis showed that older age, prognostic nutritional index < 41.2, controlling nutritional status score > 5, geriatric nutritional risk index <92, and modified Glasgow prognostic score were independent predictors of in-hospital mortality. Among the malnutrition scores, geriatric nutritional risk index increased model performance most compared with base model.

Conclusion:
Though all objective nutritional indexes were associated with prognosis in elderly patients with acute heart failure, geriatric nutritional risk index was superior to other scores in predicting in-hospital mortality.
Hemophagocytic Lymphohistiocytosis in Children: Clinical Profile and Outcome
Authors: Simon Anna C. , Delhi Kumar Chinnaiah Govindhareddy , Basu Debdatta , Ramesh Kumar Ramachandran 
Published: March 2020

Objectives:
The objectives of this study were to describe the clinical and etiologic profile and outcomes of children with hemophagocytic lymphohistiocytosis (HLH) in a tertiary care hospital in South India.

Methods:
This is a combined 2-year prospective (2017 to 2018) and 5-year retrospective (2012 to 2016) descriptive study in which children from birth to 18 years who satisfied the HLH-2004 diagnostic criteria were included. Case details from patient records were analyzed.

Results:
Fifty-three cases were enrolled of which 20 were prospective and 33 were retrospective. Fever, hepatomegaly, anemia, and hyperferritinemia were the common presentations. Infectious triggers were found in 33 (62%) cases. Five cases were secondary to rheumatic diseases, and 8 were primary HLH. Bacterial (14 cases) followed by viral infections (10 cases) were the leading triggers. Scrub typhus (6 cases) and dengue (4 cases) were the most common infectious agents. Major complications include febrile neutropenia (38%) and multiorgan dysfunction (26%). One child developed secondary malignancy. The most frequently used immunosuppressive drug for the treatment of HLH was steroid (70%), while 28% of cases recovered with only supportive therapy. The overall mortality was 41%.

Conclusions:
Infections were the most common triggers for HLH of which tropical infectious agents constituted the majority. Treatment with steroids alone or regimens without cytotoxic drugs may result in resolution of secondary HLH with mild to moderate disease activity. Without stem cell transplant, primary HLH has a high mortality rate.
Infertility After Cancer
Authors: Patterson Pandora , Perz Janette , Tindle Richard , McDonald Fiona E.J. , Ussher Jane M. 
Published: March 2020

Background
Adolescents and young adults (AYAs) given a diagnosis of cancer who experience infertility concerns often report having poorer quality of life (QoL). However, the role of infertility-related stressors and illness acceptance on QoL is not clear.

Objective
The aim of this study was to describe the impact of psychosocial factors surrounding cancer treatment and infertility on QoL. We hypothesized that need for parenthood and infertility-related social concerns would be directly related to QoL and indirectly related to QoL through acceptance of illness.

Methods
Cancer patients/survivors (n = 178; 75.3% female) aged 15 to 29 years completed measures of QoL, acceptance of illness, infertility-related social concerns, and need for parenthood. Path analysis was used to test the hypothesized and subsequent models to determine the best fit for predictors of QoL.

Results
The final model explained 28.36% of the variance in QoL. Lower infertility-related social concerns were directly and indirectly related to higher QoL scores. Need for parenthood did not directly relate to QoL, instead relating directly to increased infertility-related social concerns. Higher acceptance of illness (β = .39) and older age (β = .19) were directly related to higher QoL scores. Female patients had higher need for parenthood (β = .17).

Conclusions
These findings suggest that social concerns and expectations surrounding infertility have a negative impact on AYA cancer survivors' and patients' QoL, which increases as AYAs approach socially normative parenting age.

Implications for Practice
Providing survivors with specialist support to manage their infertility-related social concerns and improve their acceptance of illness has the potential to improve their QoL.
Adapting and Going the Extra Mile
Authors: Ervik Bente , Brøndbo Birgit , Johansen May-Lill 
Published: March 2020

Background
Despite significant developments in palliative care in recent decades, we still find important differences in access to and delivery of care in rural Norway.

Objective
The aim of this study was to explore what healthcare professionals consider necessary to provide equality in care for palliative patients in rural areas.

Methods
A qualitative approach with focus group discussions and individual interviews with 52 health professionals was used, starting with 5 uniprofessional focus groups of general practitioners and nurses/cancer nurses, followed by 5 interprofessional groups and 6 individual interviews. Interview transcripts were analyzed thematically.

Results
We found local variations in organization, competence and access to palliative care, and challenging geographical conditions. It was essential to be proactive, flexible and willing to go the extra mile, but this may conceal the need for a stronger focus on competence and organization of palliative care. Access to written guidelines and practical tools was important, as was forming palliative teams for particular situations.

Conclusions
Palliative care needs strengthening in rural areas, and increased competence for all healthcare professionals is vital to increase equality in care. Geographical conditions require locally adapted solutions. Access to guidelines and interprofessional collaboration are essential.

Implications for Practice
Rural palliative care needs in Norway are improving, as exemplified by at least 1 cancer nurse assigned to each local authority, and access to guidelines and palliative tools and interprofessional collaboration.
Bilateral Total Knee Arthroplasty
Authors: Thomas Tonda , Coombs Nicholas C. , Mullette Elizabeth J. , Bick Tom , Brant Jeannine M. 
Published: March 2020

BACKGROUND:
Total knee arthroplasty is on the rise. Some patients choose to undergo simultaneous bilateral total knee arthroplasty (simultaneous BTKA). No studies were found that examined which patients may be better candidates to successfully undergo this procedure.

PURPOSE:
The purpose of this study was to determine personal and comorbid characteristics of patients undergoing simultaneous BTKA that are predictive of length of stay (LOS) and discharge to a skilled nursing facility (SNF).

METHODS:
A retrospective database study of 125 patients post-simultaneous BTKA was conducted. Binary and multiple linear regression models identified personal and clinical predictors of LOS and SNF discharge.

RESULTS:
Body mass index (BMI) (p < .001) and SNF discharge (p = .025) were significant predictors of increased LOS and explained 18% of the variance. Older age, female sex, and presence of cardiopulmonary disease predicted SNF admission; 21% of the variance for SNF discharge was explained by the model.

CONCLUSION:
Patients with a high BMI should be carefully screened before undergoing simultaneous BTKA; older patients, women, and those with cardiopulmonary disease may benefit from early discharge planning for SNF transfer, thereby decreasing LOS and hospital utilization.
Feasibility and Reliability of Functional Mobility Measures in Children With Cri du Chat (5P−) Syndrome
Authors: Abbruzzese Laurel D. , Ruggeri Anneliese R. , Esquerre Jennifer C. , Patel Prina , Raske Lisa 
Published: March 2020

Purpose:To investigate feasibility and reliability of functional mobility measures in children with Cri du Chat syndrome (CdCS).Methods:Nine children with CdCS and 9 children with typical development (TD) completed the Timed Up and Go, 5 times sit-to-stand test, Timed Floor to Stand, and 4 Square Step Test. Feasibility was determined using testing time and need for modifications. Intraclass correlation coefficients were calculated for intrarater and interrater reliability.Results:Children with CdCS required modifications to complete all tests. One child with CdCS completed the 4 Square Step Test. Good reliability was found for both groups.Conclusions:The Timed Up and Go, 5 times sit-to-stand test, and Timed Floor to Stand are feasible and reliable tools for children with TD between ages of 5 and 15 years; however, may require modifications to the protocols to be feasible in children with CdCS. The 4 Square Step Test is not a feasible tool for children with CdCS.
Psychometric Properties of Clinical Tests of Balance and Vestibular-Related Function in Children With Cerebral Palsy
Authors: Almutairi Anwar B. , Christy Jennifer B. , Vogtle Laura 
Published: March 2020

Purpose:
The purpose of this study was to establish the psychometric properties of clinical tests of balance and vestibular-related function in children with cerebral palsy (CP), aged 7 to 12 years, Gross Motor Function Classification System levels I to III.

Methods:
Forty-two children with CP and 33 children with typical development were examined using Clinical Dynamic Visual Acuity Test, Modified Clinical Test of Sensory Interaction on Balance, Head Impulse Test, Bucket Test, and Northeastern State University College of Optometry oculomotor test. A subgroup was tested twice for reliability. Reference tests included rotary chair and sensory organization test.

Results:
Most children with CP had central rather than peripheral vestibular dysfunction. Clinical tests except Northeastern State University College of Optometry oculomotor test had moderate to good reliability, good sensitivity but poor specificity to identify central vestibular-related impairments.

Conclusions:
Tests of balance and vestibular-related function may help guide clinical management of children with CP.
Intravoxel Incoherent Motion Diffusion-Weighted Imaging of Lung Cancer: Comparison Between Turbo Spin-Echo and Echo-Planar Imaging
Authors: Wan Qi , Lei Qiang , Wang Peng , Hu Jianfeng , Zhang Tianjing , Yu Deng , Li Xinchun , Liang Changhong 
Published: March 2020

Objective
The aim of the study was to compare intravoxel incoherent motion diffusion-weighted imaging (DWI) for evaluating lung cancer using single-shot turbo spin-echo (TSE) and single-shot echo-planar imaging (EPI) in a 3T MR system.

Methods
Both single-shot TSE-DWI and single-shot EPI-DWI were scanned twice respectively for 15 patients with lung cancer. Distortion ratio, signal-to-noise ratio, and contrast-to-noise ratio were compared between the 2 techniques. The Bland-Altman analysis was performed to analyze reproducibility between the parameters of TSE-DWI and EPI-DWI. Short-term test-retest repeatability, as well as interobserver agreement, was evaluated using the coefficient of variation (CV) and the intraclass correlation coefficient (ICC).

Result
Turbo spin-echo DWI has lower signal-to-noise ratio and similar contrast-to-noise ratio compared with EPI-DWI. Distortion ratio of TSE-DWI was significantly smaller than that of EPI-DWI. The apparent diffusion coefficient (ADC) and true diffusivity (D) of TSE-DWI showed higher values than those of EPI-DWI. The Bland-Altman analysis showed unacceptable limits of agreement between these 2 sequences. Test-retest repeatability was good for ADC and D of EPI-DWI (CV, 14.11%–16.60% and 17.08%–19.53%) and excellent for ADC and D of TSE-DWI (CV, 4.8%–6.19% and 6.05%–8.71%), but relatively poor for perfusion fraction (f) and pseudo-diffusion coefficient (D*) (CV, 25.95%–27.70% and 56.92%–71.84% for EPI, 23.67%–28.67% and 60.85%–70.17% for TSE). For interobserver agreement, both techniques were good to excellent in ADC and D (The lower limit of 95% confidence interval for ICC was almost all greater than 0.75), whereas D* and f had higher interobserver variabilities with D* of TSE-DWI showing poorest reproducibility (ICC, −0.27 to 0.12).

Conclusions
Lung DWI or IVIM using TSE could provide distortion-free images and improve the test-retest robustness of ADC and D as compared with EPI-DWI; however, it might exert a negative effect on perfusion parameter D*.
Diffusion Tensor Imaging of Microstructural Changes in the Gray and White Matter in Patients With Crigler-Najjar Syndrome Type I
Authors: Razek Ahmed Abdel Khalek Abdel , Taman Saher Ebrahiem , El Regal Mohamed Ezz , Megahed Ahmed , Elzeny Sherine , El Tantawi Noha 
Published: March 2020

Purpose
This study aimed to evaluate the role of diffusion tensor imaging of microstructural changes in gray and white matter in Crigler-Najjar syndrome type I.

Patient and Methods
A prospective study was conducted on 10 patients with Crigler-Najjar syndrome type I and 10 age- and sex-matched children who underwent diffusion tensor imaging of the brain. Mean diffusivity (MD) and fractional anisotropy (FA) of gray and white matter were measured.

Results
There was a significantly higher MD of the gray matter regions including the globus pallidus, thalamus, caudate head, substantia nigra, and dentate nucleus in patients versus controls (P = 0.007, 0.001, 0.014, 0.003, and 0.002), respectively. The areas under the curve (AUC) of MD of the globus pallidus and thalamus used to differentiate patients from controls were 0.93 and 0.925, respectively. There was a significant difference in MD of the frontal white matter and posterior limb of the internal capsule in patients versus controls (P = 0.001 and 0.02), respectively. The AUCs of MD of these regions used to differentiate patients from controls were 0.82 and 0.8. There was a significant difference in FA of the frontal white matter and posterior limb of the internal capsule in patients versus controls (P = 0.006 and 0.006), respectively. The AUCs of FA of these regions were 0.83 and 0.85, respectively. The MD of the globus pallidus correlated with serum bilirubin (r = 0.87 and P = 0.001).

Conclusion
Diffusion tensor imaging can detect microstructural changes of deep gray matter and some regions of white matter in Crigler-Najjar syndrome type I.