bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Quantitative Imaging Biomarkers for Early‐phase Clinical Trials of Steatohepatitis in Adolescents
Authors: Goyal Nidhi P. , Sawh Mary Catherine , Ugalde‐Nicalo Patricia , Angeles Jorge E. , Proudfoot James A. , Newton Kimberly P. , Middleton Michael S. , Sirlin Claude B. , Schwimmer Jeffrey B. 
Published: October 2019

ABSTRACTObjectives:Early‐phase pediatric nonalcoholic fatty liver disease (NAFLD) clinical trials are designed with noninvasive parameters to assess potential efficacy. Increasingly, these parameters include magnetic resonance imaging (MRI)‐derived proton density fat fraction (PDFF) and MR elastography (MRE)‐derived shear stiffness as biomarkers of hepatic steatosis and fibrosis, respectively. Understanding fluctuations in these measures is essential for calculating trial sample sizes, interpreting results, and planning clinical drug trials in children with NAFLD. Lack of such data in children constitutes a critical knowledge gap. Therefore, the primary aim of this study was to assess whole‐liver MRI‐PDFF change in adolescents with nonalcoholic steatohepatitis (NASH) over 12 weeks.Methods:Adolescents 12 to 19 years with biopsy‐proven NASH undergoing standard‐of‐care treatment were enrolled. Baseline and week‐12 assessments of anthropometrics, transaminases, MRI‐PDFF, and MRE stiffness were obtained.Results:Fifteen adolescents were included (mean age 15.7 [SD 2.9] years). Hepatic MRI‐PDFF was stable over 12 weeks (mean absolute change −0.8%, P = 0.24). Correlation between baseline and week‐12 values of MRI‐PDFF was high (ICC = 0.97, 95% CI 0.90–0.99). MRE stiffness was stable (mean percentage change 2.7%, P = 0.44); correlation between baseline and week‐12 values was moderate (ICC = 0.47; 95% CI 0–0.79). Changes in weight, BMI, and aminotransferases were not statistically significant.Conclusion:In adolescents with NASH, fluctuations in hepatic MRI‐PDFF and MRE stiffness over 12 weeks of standard‐of‐care were small. These data on the natural fluctuations in quantitative imaging biomarkers can serve as a reference for interventional trials in pediatric NASH and inform the interpretation and planning of clinical trials.
Assessment of Radiation-Induced Xerostomia
Authors: Jiang Nan , Wei Siqi , Mårtensson Jan , Zhao Yue , Årestedt Kristofer 
Published: October 2019

Background
Xerostomia is a common complication in patients with head and neck cancer (HNC) during and after radiotherapy. The lack of a simply-administered and well-validated self-reported instrument has hampered the assessment and management of xerostomia for research and clinical purposes in China.

Objective
This study aimed to evaluate the content validity and psychometric properties of the Xerostomia Questionnaire (XQ) in Chinese patients with HNC undergoing radiotherapy.

Methods
This psychometric evaluation study enrolled 80 patients and was conducted in 2 stages: translation and evaluation of content validity and psychometric evaluation. Cognitive interviews (n = 10) were conducted using the Participant Interview Form. The psychometric evaluation (n = 80) included score distribution, homogeneity (interitem and item-total correlations), factor structure (exploratory factor analysis), internal consistency (Cronbach’s α), criterion-related validity (person correlation), and test-retest reliability (intraclass correlations).

Results
Content validity was supported by cognitive interviews. The factor analysis resulted in a 1-factor solution with strong factor loadings (0.84–0.91) that explained 75.6% of the total variance. The internal consistency was excellent, with a Cronbach’s α of .95. The XQ correlated strongly with other measures of xerostomia (0.70–0.80), which supports criterion-related validity. The test-retest reliability was excellent (intraclass correlation coefficient = 0.92).

Conclusions
The result provides evidence for the validity and reliability of the XQ in a sample of Chinese patients with HNC.

Implications for Practice
The XQ can be used in both clinical practice and research as a valuable tool to screen for problems with xerostomia, monitor the xerostomia level, and evaluate the effects of treatment and interventions among patients with HNC.
Informing New Mothers about Newborn Screening Bloodspot Repositories during Postpartum Hospitalization
Authors: Newcomb Patricia , True Barbara , Wells Jo Nell , Walsh Judith , Pehl Samantha 
Published: October 2019

Abstract

Purpose:
The primary goals of the study were to assess maternal knowledge and attitudes about the newborn screening bloodspot repository program in Texas and to evaluate the effect of a video about the bloodspot repository on the rate of parental permission to store infant bloodspots.

Design:
This descriptive, comparative study used descriptive statistics, nonparametric tests, and multivariable analyses to describe the sample, compare groups, and determine associations between factors that influenced parents' decisions to permit state storage of infant bloodspots.

Results:
There were 465 mothers in the study. Maternal knowledge about basic genetics and risks of genetic testing was poor, but mothers reported strong trust in the state to make good decisions about using genetic material for research. Race, ethnicity, and attitude toward research significantly influenced decisions to opt-in to the bloodspot storage program. Postpartum nurses provided the bulk of information about newborn screening and dried bloodspots, although 2/3 of respondents would have preferred to obtain this information prior to birth.

Clinical Implications:
Although postpartum nurses are the most common source of information about newborn screening, genuine informed consent for bloodspot storage is questionable. Information about newborn screening and bloodspot storage needs to be addressed in community venues prior to birth.
Breastfeeding Support Guided by Swanson's Theory of Caring
Authors: Miller Carrie Westmoreland , Wojnar Danuta 
Published: October 2019

Abstract

Purpose:
Many women struggle with initiation of breastfeeding. The purpose of this study was to explore mothers' perceptions of care and support received from clinicians during breastfeeding initiation and the utility of Swanson's (1991) Theory of Caring to provide person-centered care to breastfeeding mothers and infants.

Study Design and Methods:
Directed content of secondary analysis of data obtained from 11 women via in-person interviews at three time points: before birth, a week after giving birth, and 6 to 8 weeks after giving birth. All women were breastfeeding at the end of the study interview series. Swanson's Theory of Caring provided the theoretical framework for the analysis.

Results:
Two overarching themes The Acts of Caring and The Lapses in Caring summarized women's experiences of care received during the initiation of breastfeeding. Five subthemes supported the Acts of Caring theme, and three subthemes supported the Lapses in Caring theme.

Clinical Implications:
Although all study participants chose to breastfeed after hospital discharge and the majority felt well supported, some received care that was perceived as uncaring, unsupportive, or harmful. Providing breastfeeding support consistent with research evidence and underpinnings of Swanson's Theory of Caring may help women build trusting relationships with clinicians and feel confident in meeting their breastfeeding goals.
Unexpected Infant Death Due to Undiagnosed Biliary Atresia
Authors: Ventura Francesco , Barranco Rosario , Buffelli Francesca , Fulcheri Ezio , Palmieri Antonella 
Published: October 2019

Abstract
Biliary atresia (BA) is a fatal condition resulting in the lack of effective biliary drainage leading invariably to liver failure and cirrhosis within a year, and it is often lethal within a few months in the absence of corrective surgery or liver transplantation. In fact, BA is the most common indication for pediatric liver transplantation.
Herein, we present a rare case of unexpected infant death due to BA diagnosed only postmortem in a context of child neglect and carelessness on the part of the parents. It emerged from the clinical history that after a few months, the parents no longer took their daughter to any medical checkups despite the indications and express recommendations for follow-up. The autopsy revealed agenesis of the gallbladder with BA and complete disruption of the hepatic architecture and parenchyma from biliary cirrhosis. Histological examinations documented severe biliary cirrhosis from hypoplasia of the biliary ducts.
The child neglect in this case proved fatal inasmuch as an early diagnosis by a pediatrician would have likely allowed appropriate surgical treatment, thus avoiding the untimely death of the child. We highlight the importance of educating and informing parents (especially the disadvantaged) in matters of health. At the same time, primary care physicians should closely monitor the conditions and development of infants so as to recognize the early warning signs and symptoms of BA, bearing in mind that a timely diagnosis and proper surgical treatment can save the lives of most of these children.
Median Nerve Entrapment in the Ulna in a Both-Bone Pediatric Forearm Fracture
Authors: Hutchison Richard L. , Wester Christopher J. 
Published: October 2019

Abstract
This case report presents entrapment with subsequent complete disruption of the median nerve in the distal ulna in a both-bone fracture of the forearm in a 9-year-old girl. Closed fractures of the radius and ulna commonly occur in pediatric populations. Postinjury nerve dysfunction is often seen. Severe nerve injury is rare. There are only 3 reports of the median nerve becoming entrapped in an ulnar fracture in a child, with no reports of entrapment in the distal forearm. Features seen on examination and the radiographs supported possible nerve entrapment. Although uncommon, nerve entrapment or transection should be considered in all forearm fractures with sensory or motor nerve dysfunction. If suspicions are high, an early diagnosis of nerve entrapment may be obtained with magnetic resonance imaging evaluation.
Saddle Deformity After Septoplasty and Immediate Correction
Authors: Kim Jooyeon , Kim Chang Hoi , Oh Jung Ho , Choi Gwan , Kwon Jae Hwan 
Published: October 2019

Objective:
The aim of this study is to assess the saddle deformity after septoplasty and the usefulness of immediate correction.

Design:
Retrospective study.

Setting:
University medical center.

Patients:
Of 658 patients who underwent endonasal septoplasty from January 2011 to July 2018, 14 underwent immediate cartilage dorsal augmentations following septoplasty for saddle deformity and were enrolled in this study.

Main Outcome Measures:
A total of 14 patients received immediate cartilage augmentation and were followed for >3 months after surgery. External nose status, patterns of septal deformity, and surgical results were investigated with profile view photographs, paranasal sinus computed tomography scans, and nasal endoscopy. Symptom improvement was measured using the Nasal Obstruction Symptom Evaluation scale.

Results:
All patients had middle to high site septal deviation. Anterior deviation and central deviation have statistical significance compared to posterior part deviation (P = 0.025, P = 0.002) and mid part deviation has statistical significance compared to basal part deviation (P = 0.005). Postoperative subjective nasal symptoms of the 14 patients were improved from preoperation (18.54 ± 2.46) to 1 month (7.54 ± 2.16) and 3 months (1.72 ± 1.55) postoperatively.

Conclusions:
Immediate endonasal cartilage augmentation for iatrogenic saddle deformity after septoplasty is easy, safe, and effective. Furthermore, this corrective treatment for post op complication is very important for both of surgeon and patient. Predispositions to postoperative saddle deformity included site and severity of preoperative nasal septal deviation.
Modified Cartilage Sparing Tip Plasty Technique for Extra Projection: Hemitransdomal Suture With Submucosal Dissection: A New Approach to Nasal Tip Dynamics
Authors: Yücel Sercan , Ünverdi Ömer Faruk 
Published: October 2019

Abstract
The nasal tip projection and rotation to be obtained with tip plasty play a key role in achieving successful results. Cartilage sparing techniques provide extra ease to reshape the cartilage in revision rhinoplasty. Freed dome cartilage eliminates the restricting forces of mucosa. The authors recommend to free the dome cartilage from mucosa during the tip plasty which ensures the desired dome shape and extra projection. A total of 218 patients who were operated between the dates of January 2017 and August 2018 were included in this study. About 3 mm parts of the marked domes toward medial and lateral crurae were dissected from the mucosa. New domes were created with bilateral hemitransdomal sutures. The outcome of the operation was asked to the patients verbally and answers were recorded. Of 218 patients who were included in the study, 182 were females and 36 were males. Patients had a mean age of 26.5 years. The length of follow-up was 11.8 months. About 205 patients had primary rhinoplasty while 12 patients had secondary rhinoplasty and 1 patient had revision rhinoplasty. Of the patients, 89.9% (196/218) were very satisfied with the result and 7.4% (16/218) were satisfied, whereas 2.7% (6/218) were dissatisfied. Only 5 patients who were dissatisfied with the result underwent revision rhinoplasty operation. The combination of the modified free dome suture with the mucosal dissection in dome area provides achieving the desired tip projection and symmetry.
Morbidity in Patients With Separation of Cartilaginous Framework: Temporoparietal Fascia Flap and Treatment With Dermal Regeneration Template
Authors: Lesta-Compagnucci Lucas , Arámburo-García Rigoberto , Galaso-Trujillo José Roberto , Apellaniz-Campo Armando G. , Pérez-Caro Emilio 
Published: October 2019

Background:
The full creation of an ear requires 2 reconstruction stages. In the second stage of reconstruction, the cartilaginous framework placed at first stage is separated from the head creating an auriculocephalic sulcus. Then a piece of rib cartilage is placed in the sulcus to maintain this separation and is covered with tissue that allows the integration of a full-thickness skin graft.

Methods:
A descriptive study based on the pre and postoperative medical records and photographic archives of patients diagnosed with microtia who underwent separation of the cartilaginous framework from February 2010 to July 2015 in the Plastic and Reconstructive Surgery Department at Hospital General Dr. Manuel Gea González.

Results:
Fifty-four patients met the selection criteria. The temporoparietal fascial flap was performed on 85% (n = 46), and 8 cases with random occipito-temporal fascial flap in association to a dermal regeneration template. The average time at the operating room was 177 minutes in patients with temporoparietal fascial flap versus 84.5 minutes in dermal regeneration template. The complication rate was 25.9% (n = 14), being similar rate with both techniques.

Conclusions:
Coverage with dermal regeneration template and random occipito-temporal fascia flap as an alternative use instead of temporoparietal fascial flaps, offers good postoperative results, lower operating times, and similar rate of complications, with the advantage of producing no visible scars and reserve the temporoparietal fascial flap for possible exposure of the cartilaginous framework.
What Are We Missing From Asymmetric Relationship Between the Retinal Nerve Fiber Layer Thickness Profiles and Sphenoid Sinus Volume?
Authors: Findik Huseyin , Kanat Ayhan , Celiker Fatma Beyazal , Celiker Metin , Beyazal Mehmet , Ozdemir Bulent , Ozdemir Vacide , Batcik Osman Ersegun , Ozdemir Dogukan , Dursun Engin 
Published: October 2019

Purpose/Aim of the Study:
Detailed analysis of retinal structure such as the retinal nerve fiber layer can be performed by spectral-domain optical coherence tomography (OCT). There are no published studies concerning a relationship between retinal nerve fiber layer and human sphenoid sinus volumes. We investigated this relationship.

Material and Methods:
Spectral-domain OCT. The peripapillary retinal nerve fiber layer (RNFL) thickness and sphenoid sinus volume estimation of both sides of sex-matched patients were retrospectively analyzed.

Results:
The mean RNFL thicknesses at the left side (91.8 μm) were significantly smaller than the right side (94.5 μm) (P = 0.040). However, the mean left sinus volume (44.5 cm3) is larger than the right side, (34.5 mm3) (P < 0.005). Left and right differences of both parameters are statistically significant (P < 0.05).

Conclusion:
There is a negative correlation between mean RNFL thicknesses and mean sinus volumes. To our knowledge, this article is the first report demonstrating the asymmetry relationship between RNFL and sphenoid sinus volumes.
Release of the Lateral Pharyngeal Mucosa Using a Palatal Elevator
Authors: Hwang Kun , Ma Sung Hwan , Lee Se Il 
Published: October 2019

Abstract
The aim of this paper is to present how to release the nasal mucosa from the hard palate and from the lateral pharyngeal wall using palatal elevator.
After mucoperiosteal flap is raised, the nasal mucosa is detached with an instrument pushed laterally behind the palatine vessels to meet the medial pterygoid plate. The palatal elevator is passed around the spine at the posterior medial border of the bony palate and then moved forward in the cleft to separate the nasal mucosa from bone. The palatal elevator is now introduced behind the greater palatine vessels, maintaining contact with the medial pterygoid plate. The elevator is pushed deeply up toward the base of the skull to elevate the lateral pharyngeal mucosa medially. When this mucosa is freed, the elevator can be moved anteriorly to separate the nasal mucosa from nasal side wall and upper surface of the hard palate. After closure of the buccal layer, 2 posterior flaps are joined to the small anterior flap. Finally, an A suture is made to hold the buccal layers together with the nasal mucosa and lateral pharyngeal mucosa to obliterate dead space.
Herein, the authors present how to completely free the nasal mucosa from the hard palate and from the lateral pharyngeal wall before medial shifting and suturing. In our series of 60 cases of complete or incomplete cleft palate, fistula rate was low (6.7%), which the authors suggest was due to the low tension of the sutured nasal lining with the released lateral pharyngeal wall.
Association Between Neuropsychiatric Symptom Trajectory and Conversion to Alzheimer Disease
Authors: Lo Tsz Wai Bentley , Karameh Wael K. , Barfett Joseph J. , Fornazzari Luis R. , Munoz David G. , Schweizer Tom A. , Fischer Corinne E. 
Published: October 2019

Introduction:
Neuropsychiatric symptoms (NPS) are both common in mild cognitive impairment and Alzheimer disease (AD). Studies have shown that some NPS such as apathy and depression are a key indicator for progression to AD.

Methods:
We compared Neuropsychiatric Inventory (NPI) total score and NPI subdomain score between mild cognitive impairment-converters (MCI-C) and mild cognitive impairment-nonconverters (MCI-NC) longitudinally for 6 years using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. In addition to the NPI, Mini-Mental State Examination (MMSE) scores were also compared to find out if MMSE scores would differ between different NPI groups. Lastly, a linear regression model was done on MMSE and NPI total score to establish a relationship between MMSE and NPI total score.

Results:
The results in this study showed that NPI total scores between MCI-C and MCI-NC differed significantly throughout 6 years. MCI-C subjects had a higher mean NPI total score and lower MMSE score compared with MCI-NC subjects. In addition, MMSE scores were significantly different between the 3 groups of NPI total score. Subjects who have a high NPI score have the lowest mean MMSE score, thus demonstrating that NPI scores do indeed affect MMSE scores. Further analyses using a regression model revealed that a unit change in NPI total score lead to 0.1 to 0.3 decrease in MMSE.

Discussion:
On the basis of the findings, this study showed evidence that increase in NPS burden (reflected by increase in NPI) over time predicts conversion to AD, whereas stability of symptoms (reflected by stable NPI score) favors nonconversion. Further study should investigate the underlying mechanisms that drive both NPS burden and cognitive decline.
Reorganization of nurse scheduling reduces the risk of healthcare associated infections
Authors: Valdano Eugenio , Poletto Chiara , Boëlle Pierre-Yves , Colizza Vittoria 
Published: October 2019

ABSTRACTBackgroundEfficient prevention and control of healthcare associated infections (HAIs) is still an open problem.ObjectiveTo design efficient hospital infection control strategies by reorganizing nurse scheduling.Design, setting, and participantsProof-of-concept modeling study based on high-resolution contact data from wearable sensors between patients, nurses, doctors, and administrative staff at a short-stay geriatric ward of a University hospital.MethodsWe considered isolation and contact removal to identify the most important class of individuals for HAI dissemination. We introduced a novel intervention based on the reorganization of nurse scheduling. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. We evaluated the impact of interventions through a Susceptible-Colonized-Susceptible transmission model on the empirical and reorganized contacts.ResultsIsolation and contact removal produced the largest risk reduction when acting on nurses. Reorganizing their schedules reduced HAI risk by 27% (95% confidence interval [24,29]%) while preserving the timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. No overall change in the number of nurses per patient resulted from the intervention.ConclusionsReorganization of nurse scheduling offers an alternative change of practice that substantially limits HAI risk in the ward while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for better infection control in hospitals.
Sugar or Salt (“SOS”): a protocol for a UK multicentre randomised trial of mannitol and hypertonic saline in severe traumatic brain injury and intracranial hypertension
Authors: Rowland MJ , Veenith T , Scomparin C , Wilson MH , Hutchinson PJ , Kolias AG , Lall R , Regan S , Mason J , Andrews PJD , Horner D , Naisbitt J , Devrell A , Malins A , Dark P , McAuley DF , Perkins GD 
Published: October 2019

AbstractHyperosmolar solutions are widely used to treat raised intracranial pressure (ICP) following severe traumatic brain injury (TBI). Although mannitol has historically been the most frequently administered, hypertonic saline (HTS) solutions are increasingly being used. However, definitive evidence regarding their comparative effectiveness is lacking. The Sugar or Salt (SOS) Trial is a UK randomised, allocation concealed open label multicentre pragmatic trial designed to determine the clinical and cost-effectiveness of hypertonic saline (HTS) compared with mannitol in the management of patients with severe TBI. Patients requiring intensive care unit admission and intracranial pressure (ICP) monitoring post-TBI will be allocated at random to receive equi-osmolar boluses of either mannitol or HTS following failure of routine first line measures to control ICP. The primary outcome for the study will be the Extended Glasgow Outcome Scale (GOS-E) assessed at 6 months after randomisation. Results will inform current clinical practice in the routine use of hyperosmolar therapy as well as assess the impact of potential side effects. Pre-planned longer term clinical and cost effectiveness analyses will further inform the use of these treatments.