bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for falling for people with Multiple Sclerosis identified in a prospective cohort study
Authors: Quinn Gillian , Comber Laura , McGuigan Chris , Hannigan Ailish , Galvin Rose , Coote Susan 
Published: December 2020

Objective: To identify risk factors for falling for people with Multiple Sclerosis. Design: Prospective cohort study. Setting: Neurology service in a tertiary hospital. Subjects: Participants were 101 people with Multiple Sclerosis and Expanded Disability Status Score of 3-6.5. One participant withdrew after the baseline assessment; data were analysed for 100 participants. Interventions: No intervention. Main measures: Outcome was rate of falls, and predictors were Timed Up and Go, Symbol Digit Modalities test, demographics and 15 self-report questions about various symptoms including fatigue, concentration, dual tasking, bladder and bowel control. Three-month prospective diaries recorded falls. Results: There were 791 falls reported over the 3-month period from a total of 56 fallers. Falls rate per person-year was 32.08 falls. Following multivariable regression analysis, the model with the greatest levels of clinical utility and discriminative ability (sensitivity 88% and area under the receiving operating curve statistic = 0.72, 95% CI 0.62–0.82), included the variables of history of a fall, not having visual problems, problems with bladder control and a slower speed on the Timed Up and Go. Conclusion: This study confirms the high incidence of falls for people with Multiple Sclerosis and provides a risk prediction model including fall history, problems with bladder control, not having visual problems and a slower Timed Up and Go speed that may be used to identify those at greater risk and in need of tailored falls prevention intervention.
A Socio-ecological Framework for Understanding Workplace Violence in China’s Health Sector: A Qualitative Analysis of Health Workers' Responses to an Open-ended Survey Question
Authors: Wu Dan , Wang Yun , Yang Sheng Zhi , Wang Nan , Sun Kai Sing , Lam Tai Pong , Zhou Xu Dong 
Published: December 2020

Workplace violence (WPV) in the health sector is a global public health issue. The magnitude of WPV is a particular concern in China’s health system. To examine the potential causes of WPV, we analyzed 3,045 qualitative responses to an open-ended question in a survey with health workers in the Zhejiang province, China. We adapted a four-level socio-ecological framework (societal/systemic, community/organizational, interpersonal, and individual) to thematically analyze the data. Ten sub-themes emerged. Within the societal/systemic level, we identified three sub-themes: (a) lack of legislation against WPV, (b) suboptimal accessibility and affordability of health services due to maldistributed health resources, commercialized health services, and inadequate health insurance, and (c) unregulated mass media reports. Within the community/organizational level, three sub-themes emerged: (a) lack of supportive health facility leadership, (b) inaction by government authorities, and (c) inefficient law enforcement agencies. Within the interpersonal level, two sub-themes were identified: (a) poor provider–patient communication and (b) distrust between health workers and patients. Finally, we identified the personal characteristics of health workers (e.g., competence and professionalism) and patients (e.g., sociodemographic background and expectations/satisfaction) as two individual-level sub-themes. We recognized interactions among different levels. The weak state of Chinese legislation in this area and lack of high-level political will and guidance (societal/systemic) has left health facilities and law enforcement agencies (community/organizational) unclear about how to address WPV. The maldistribution of quality health resources (societal/systemic) has led to overcrowded outpatient clinics at higher-level care facilities (community/organizational). In light of the insufficient government funding and profit-oriented health services (societal/systemic), health workers were motivated to seek profits by providing unnecessary services, which compromised their professionalism (individual). Provider–patient relationships deteriorated (interpersonal), and patients sometimes held unrealistically high expectations associated with high medical expenses (individual). We propose multisectoral prevention strategies to address WPV in the health sector at all levels using a socio-ecological framework.
Occlusal and Functional Improvement of Patients With Midfacial Hypoplasia Corrected Using Intraoral Tooth-Borne Mid-Maxillary Osteodistractors at Teaching Hospital-Karapitiya, Sri Lanka
Authors: Perera Wattage Kathya Leoni , Jayawardana Ranatunga Arachchige Don Tilan Madujith , Pathirage Sumith Loku , Dias Dayanath Kumara , Dasanayaka D. A. R. K. 
Published: December 2020

Objective: Mid-maxillary osteodistraction (MMOD) is a novel technique. This study seeks to assess the occlusal and functional improvement of patients with midfacial hypoplasia secondary to cleft lip and palate. Design: This was done as a retrospective study at the Regional Cleft Centre of the Teaching Hospital-Karapitiya (THK). Participants: A total of 81 patient records were accessed on those who underwent MMOD with a tooth-borne intraoral device from January 1, 2007, to December 31, 2016, at THK. Methods: Records of the patients included pre- and post-treatment lateral cephalograms, study models, speech assessments, and photographs. Results: An advancement ranging from 5 to 12 mm (mean, 8.14 mm) was achieved in all patients; 80% (n = 63) and 87.65% (n = 71) showed improvement in consonant production and quality of speech. These were statistically significant (P < .05). With regard to the Peer Assessment Rating score assessing the occlusal improvement, 97.6% showed an improvement whereas only 2 patients showed no improvement. There was a significant improvement in sella (S), nasion (N), and point A (SNA) angle; point A, the nasion, and point B (ANB) angle; and the maxillary length over the treatment period (P < .05). The change in the ANB angle and maxillary length significantly differed between genders with males having a comparatively higher improvement. The profile improvements were noteworthy on the profile photographs. Conclusion: This relatively novel approach to maxillary advancement by maxillary distraction using a combined surgical and modified orthodontic technique has proven to be successful. This protocol and the technique have improved function, occlusion, and the aesthetics.
Cleft Care Readability: Can Patients Access Helpful Online Resources?
Authors: Wasserburg J. Roscoe , Sayegh Farah , Sanati-Mehrizy Paymon , Graziano Francis D. , Taub Peter J. 
Published: December 2020

Objective: The present study identifies and analyzes online patient resources for cleft lip with or without cleft palate to survey the online educational landscape relative to the recommended difficulty set by the National Institutes of Health (NIH) and American Medical Association (AMA). Methods: An internet search of “cleft palate,” “cleft lip,” and 12 similar inputs were entered into a search engine. The first 50 links for each search term were identified, collected, and reviewed individually for relevance and accessibility. The content of the websites was analyzed with Readability Studio Version 2019.1. The following readability metrics were utilized in this study: (1) Coleman-Liau (grade levels), (2) New Dale-Chall, (3) Flesch-Kincaid, (4) Flesch Reading Ease, (5) FORCAST, (6) Fry, (7) Gunning Fog, (8) New Fog Count, (9) Raygor Readability Estimate, and (10) Simple Measure of Gobbledygook. Results: In no combination of search terms did any collection of links provide information within the mid-seventh grade levels recommended by the NIH. The analysis of 143 unique websites in the “Cleft Palate” group showed a readability level appropriate to high school students. The analysis of 144 unique websites in the “Cleft Lip” group showed a readability level appropriate for eighth grade students with 6 months of class complete. Conclusions: The information presented to patients on cleft care is too complex and well above the recommended 7th-grade reading level target set forth by the NIH and AMA, which hinders functional health literacy.
Patterns of complementary and alternative medicine use among Tunisian cancer patients
Authors: Toukabri Imen , Said Azza Ben , Hamdi Adel , Mokrani Amina , Gabsi Azza , Ayed Wiem Ben , Tounsi Karawen , Limayem Imen 
Published: December 2020

Introduction The use of complementary and alternative medicine (CAM) among cancer patients is prevalent worldwide as cancer patient are perpetually seeking for a way to improve their quality of life and to cure their disease. Unfortunately, the majority ignore the danger that can resort when they use CAM currently with conventional therapies. The purpose of this study is to assess prevalence and predictors of CAM use in cancer patients. Methods Cross-sectional study using a questionnaire administered to cancer patients, who were attending Salah Azaiz institute, Tunis, Tunisia. The study took place from September to December 2018. Results In 222 cancer patients, the overall prevalence of CAM use was 40.54%. On univariate analysis, patients who had university education level were less likely to use CAM (p = 0.05). Based on multivariate analysis, CAM users had more likely metastatic tumor (p = 0.047; OR = 1.913).It is reported that the majority of the population used herbal medicine. The most common herbal products consuming by patients, included Ephedra foeminea (51.8%), Annona muricata (12%) and Curcuma longa L. (10.84%).The main source of information was entourage (family, friends, hospital entourage) (74.44%).The majority of CAM users (61.11%) reported to consume CAM currently with conventional therapies. Conclusion This survey revealed a high prevalence of CAM use. The most common type of CAM use is herbal products. Some of the used herbal products are known to interact with conventional anticancer medication. This emphasizes the importance of patients disclosure of CAM use to health professionals in order to avoid herb-medications interactions.
Birds of a Feather: An Examination of ADHD Symptoms and Associated Concerns in Partners of Adults with ADHD
Authors: Steele Christina M. , Wymbs Brian T. , Capps R. Elizabeth 
Published: December 2020

Objective: Adults often select romantic partners who behave like they do (i.e. assortative mating). However, little is known about whether assortative mating is common among adults with attention-deficit/hyperactivity disorder (ADHD) and whether it is related to associated problems. Method: About 94 adults without ADHD, 43 adults with childhood ADHD histories but without current symptoms or impairment (ADHD-Desist), 27 adults with childhood ADHD histories and elevated current symptoms and impairment (ADHD-Persist) rated their partners’ ADHD symptoms and their own associated problems (e.g., intimate partner violence, financial difficulties). Results: The ADHD-Persist group reported that their partners exhibited more ADHD symptoms than the ADHD-Desist group and those without ADHD. Adults in the ADHD-Persist group who had partners with elevated ADHD symptoms endorsed high intimate partner violence and financial difficulties. Conclusion: Assortative mating appears to be common among adults with ADHD, especially those with persistent symptoms, and to increase risk of additional problems.
Progressive development of large choroidal excavation in neovascular age-related macular degeneration
Authors: Arrigo Alessandro , Mansour Ahmad , Viganò Chiara , Gorgoni Francesca , Bandello Francesco , Battaglia Parodi Maurizio 
Published: December 2020

Purpose: Focal choroidal excavation (CE) is an unusual concavity in the choroid without posterior staphyloma or scleral ectasia and with pathogenesis is still unknown. In this article we present a case of de novo progressive focal choroidal excavation associated with exudative age-related macular degeneration (AMD). Methods: This study was designed as a descriptive case report based on clinical and imaging data collected during patient’s observation and follow-ups. Results: A 67-year-old man with systemic hypertension and hypercholesterolemia, with a previous diagnosis of bilateral AMD complicated by already treated macular neovascularization, underwent our attention to perform follow-up visits. Over the 5-year follow-up, the left eye remained stable, requiring no further treatments and disclosing a BCVA of 0.0 LogMAR. On the contrary, the right eye showed several exudation recurrences, requiring further anti-VEGF injections. Structural OCT detected the progressive development of a focal CE, which gradually enlarged converting into a large CE. Structural OCT examinations reported even growing defects of the Bruch’s membrane. Despite the evident progression of the CE, BCVA disclosed stable values over the 5-years follow-up (1.0 LogMAR), with a worsening of metamorphopsia. Conclusion: Large CE may be a complication of neovascular AMD. Bruch’s membrane abnormalities, including thickness and reflectivity changes, detectable on structural OCT, can be considered early biomarkers of potentially developing CE.
Is choriocapillaris the early target in acute maculopathy secondary to hand, foot, and mouth disease? A case report
Authors: Talli Pietro Maria , Bendo Edlira , Pedrotti Emilio , Pazzaglia Alberto 
Published: December 2020

Purpose: To report the case of a 33-year old man who disclosed the first case of bilateral ocular involvement of hand, foot, and mouth disease (HFMD) with a different stage of the disease in each eye. Methods: Retrospective case report. Results: The study included a patient who incurred in a bilateral HFMD maculopathy. During 6 months follow-up period persistent abnormalities in fundus examination and in OCT scans were reported. Conclusion: We consider that our case shows that choriocapillaris is the primary target of HFMD maculopathy, for this reason we consider that ICGA is mandatory for early diagnosis and an effective treatment.
Metal-on-metal total hip arthroplasty: does increasing modularity affect clinical outcome?
Authors: Ilo Kevin C , Hothi Harry S , Skinner John A , Hart Alister J 
Published: December 2020

Background: Modularity of metal-on-metal (MoM) implants has come under scrutiny due to concerns regarding additional sources of metal debris. This study is a retrieval analysis of implants from the same manufacturer with the same MoM bearing surface. The difference between the implants was presence or absence of modular junctions. Methods: This is a retrospective study of 31 retrieved implants from 31 patients who received a Conserve Wright Medical MoM hip prosthesis. The 31 implants consisted of 16 resurfacings and 15 implants with modular junctions; 4 conventional THAs and 11 modular-neck THAs. Results: 43% of pre-revision MRI scans performed on resurfacing implants and 91% performed on the modular implants illustrated evidence of an adverse local tissue reaction. There was no difference in pre-revision blood metal ion levels or bearing surface wear between the resurfacings and modular implants. The neck-head tapers of the modular group showed low levels of material loss. However, the neck-stem tapers showed increased severity of corrosion and material loss Conclusions: The modular implants had an increased incidence of adverse local tissue reaction. This could be related to the presence of modular junctions, particular the neck-stem junction which showed increased susceptibly to corrosion
Relationship between vascular cell adhesion molecule-1 (VCAM-1), soluble receptor for advanced glycation end products (sRAGE) and functional hemodynamic parameters of arteriovenous fistula
Authors: Ticala Maria , Rusu Crina Claudia , Moldovan Diana , Potra Alina Ramona , Tirinescu Dacian Calin , Coman Anca Laura , Bondor Cosmina Ioana , Budisan Livia , Kacso Ina Maria 
Published: December 2020

Background: The preferred vascular access for hemodialysis is represented by arteriovenous fistula (AVF) due to fewer complications and more prolonged survival. Considerable efforts have been made to identify biomarkers associated with AVF dysfunction, but results are conflicting. Vascular cell adhesion molecule (VCAM-1) and advanced glycation end products are involved in atherogenesis, vascular calcification, peripheral artery disease, and neointimal hyperplasia in renal and non-renal patients. The objective of this study was to evaluate whether there is an association between VCAM-1, soluble receptor for advanced glycation end products (sRAGE), NcarboxymethylLysine (CML), and arteriovenous fistula dysfunction (AVF). Methods: VCAM-1, sRAGE, and CML were performed using the ELISA technique in 88 HD patients. Ultrasound assessment of AVF reports brachial artery blood flow (Qa), brachial resistivity index (RI), presence of calcification, and the diameter. AVF dysfunction was defined as a brachial artery Qa ⩽ 500 ml/min or RI ⩾ 0.5. Results: The median level of VCAM-1 [2676.5(2206.8–4203.9) versus 2613.2(1885.7–3161.8), p 0.026] was significantly higher in patients with AVF dysfunction compared to the rest of the patients. sRAGE and CML were higher in this group but without statistical significance. In patients with AVF dysfunction, significant positive correlations were found between VCAM-1and sRAGE ( r = 0.417, p = 0.001), RI ( r = 0.313, p = 0.046), dialysis vintage ( r = 0.540, p < 0.001), AVF vintage ( r = 0.336, p = 0.032), intima-media thickness ( r = 0.423, p = 0.006) and C-reactive protein ( r = 0.315, p = 0.045). VCAM-1 correlated inversely with cholesterol ( r = −0.312, p = 0.047), triglycerides ( r = −0.358, p = 0.021), body mass index ( r = −0.388, p = 0.012). In multivariate regression analysis, VCAM-1 ( p = 0.013) and sRAGE ( p = 0.01) remained significant predictors of RI and Qa. Logistic regression disclosed calcification, VCAM-1, as risks factors for AVF dysfunction. Conclusion: The results we obtained showed that patients with AVF dysfunction had a significantly higher level of VCAM-l. A positive correlation between VCAM-1 and sRAGE was identified in this group.
Physical health needs and self-reported health status among adults with autism
Authors: Turcotte Paul , Shea Lindsay 
Published: December 2020

Self-reported health status is an integral method to understand how adults on the autism spectrum perceive their healthcare and service needs. The objective of the study is to examine how self-reported health changes with use and need of physical health services. The Pennsylvania autism needs assessment included a survey of adults on the autism spectrum responding for themselves. Self-reported health status change over the previous year was reported as improved, decreased, or stable. Adjusted multinomial logistic regression was used to identify characteristics of individuals who experienced decreased or improved health. A total of 1197 adults responded, with most respondents’ health remaining stable (68%). Respondents who had a decreased health status reported needing more physical health services (1.64 services) compared to respondents with stable health (1.07 services) and improved health (1.18 services). Respondents with a decreased health status had 1.23 higher odds (95% confidence interval: 1.08–1.40) of having an increase in one physical health service need as compared to those whose health remained stable. Increased physical health service needs were associated with a decreased health status. Adults on the autism spectrum can present with a complex array of needs and determining the role physical health services play in improving and maintaining health remains critical. Lay abstract Self-reported health can be a powerful measure of how adults with autism spectrum disorder view their overall health. The goal of this study was to determine how health statuses of adults with autism spectrum disorder change, when they are currently receiving or need more physical health services. The Pennsylvania autism needs assessment included a survey of individuals with autism aged 18 years or older responding for themselves. They indicated whether their health status changed over the previous year as improved, decreased, or remained stable. We found that most adults with autism spectrum disorder had their health remain the same (68%). We also found that adults who said their health got worse needed more physical health services, compared to those whose health remained stable, or got better. Supporting the health of adults with autism can be complex and finding out more about how physical health services play a role in that care is important.
Living life with cerebral palsy? A description of the social safety nets for individuals with cerebral palsy in the Nordic countries
Authors: Alriksson-Schmidt Ann I. , Jeglinsky Ira , Jonsdottir Gudny , Kedir Seid Abdu , Klevberg Gunvor , Buschmann Eva , Jahnsen Reidun 
Published: December 2020

Aims: This report reviews major laws, acts and regulations of social benefits and services for individuals with disabilities, focusing on cerebral palsy in the five Nordic countries. It summarizes the available benefits and services and the re-application process and provides comparative analyses among the countries. Methods: Published reports, articles and relevant government and municipal websites were reviewed for each respective country and used to compile an overview and comparison between the countries. Results: In the Nordic countries, there are a number of laws and regulations in place to support individuals with cerebral palsy and their families. In addition, there are numerous social benefits available for which individuals with disabilities can apply. Although there are national differences, the similarities across the five countries regarding laws, social benefits offered for individuals with cerebral palsy and the application processes are clear. However, the application processes seem cumbersome and, at times, redundant. Physicians and other healthcare specialists repeatedly need to write ‘medical certificates’ describing the diagnosis and its consequences for a disability that is chronic and lifelong. Conclusions: Participation in society for individuals with cerebral palsy disabilities can be enabled by social benefits. By extension, social benefits may indirectly have implications for public health in individuals with disabilities. Although the lives of individuals with cerebral palsy – as with others – can improve in certain areas, the need for social benefits will generally increase, not decrease, over time. Although it is clearly important to have checks and balances that prevent system misuse, it might be worthwhile from a cost-benefit perspective to investigate whether the current systems could be improved to better manage time and resources and avoid emotional distress by streamlining the application process.