bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebrospinal fluid changes and clinical features of aseptic meningitis in patients with Kawasaki disease
Authors: Hu Fan , Shi Xiaoqing , Fan Yang , Liu Hanmin , Zhou Kaiyu 
Published: February 2021

Objective To assess the distinguishing features of aseptic meningitis (AM) in patients with Kawasaki disease (KD) compared with bacterial meningitis (BM) patients. Methods Thirty-eight patients with KD and 126 patients with BM were retrospectively investigated. The following clinical manifestations and laboratory parameters were compared between the two groups: duration of fever before lumbar puncture, conjunctival injection, oral cavity changes, rash, cervical lymphadenopathy and extremity changes, vomiting, front fontanel bulging, neck stiffness, leukocyte number, hemoglobin level, platelet number, C-reactive protein level, cerebrospinal fluid (CSF) content, liver enzyme level, and urinalysis. Results Vomiting and neck stiffness were more prevalent in patients with BM. KD patients with AM showed elevated blood leukocyte numbers and C-reactive protein levels in the early febrile stage. CSF glucose was significantly lower in patients with BM compared with KD patients with AM. Receiver operating characteristic curve analysis showed that the optimal cutoff value of CSF glucose for discrimination of BM and AM/KD was 2.945 mmol/L, with a sensitivity of 84.2% and a specificity of 71.4%. Conclusions Detailed investigations of clinical manifestation and laboratory parameters are necessary to distinguish AM and BM in patients with KD. Decreased CSF glucose is a potential indicator of BM.
Red cell distribution width is associated with all-cause mortality in patients with acute stroke: a retrospective analysis of a large clinical database
Authors: Zhao Han , Zhao Yuanchen , Wu Zhipeng , Cheng Yisheng , Zhao Na 
Published: February 2021

Objectives This study aimed to evaluate the association between the red blood cell distribution width (RDW) and mortality in patients with stroke. Methods We conducted a retrospective cohort study on patients with stroke in the Medical Information Mart for Intensive Care Database III. Cox proportional hazards regression models were used to estimate hazard ratios of 30-day, 90-day, and 1-year mortality in relation to the RDW level. Results A total of 4134 patients were enrolled, including 2646 patients with ischemic stroke and 1668 with hemorrhagic stroke. After adjustment for potential confounders, the hazard ratio (95% confidence interval) of 30-day mortality for the second (RDW: 13.4%–14.3%) and third (>14.3%) tertiles was 1.15 (0.96, 1.37) and 1.40 (1.17, 1.68), respectively, compared with the reference group (<13.4%). A two-piecewise linear regression model was established and the inflection point of RDW was 16.7%. When RDW was >16.7%, an increase in RDW did not increase stroke mortality. Conclusions The RDW is a prognostic factor of patients with stroke. This finding needs to be confirmed in future prospective studies.
Feasibility of oral health evaluation by intraoral digital photography: a pilot study
Authors: Guo ShuLing , Chen Yong , Mallineni Sreekanth Kumar , Huang ShuYing , Liu BaiWang , Zhang ShuYi , Lu Chang 
Published: February 2021

Objectives This study investigated the accuracy and duration of intraoral digital photograph examination (IDPE) for evaluating oral health status and explored the feasibility of remote oral health assessment. Methods Thirty-one healthy college students underwent evaluations of oral health status via clinical examination (CE) combined with panoramic X-ray assessment at baseline, followed by IDPE 1 month later using photos taken at baseline. Methods for evaluation of gingival health included the Modified Gingival Index (MGI) and Plaque Index (PI). Examinations of caries status included the decayed, missing, and filled teeth and surfaces indexes (DMFT and DMFS indexes, respectively). The duration of each evaluation was also recorded. Results There were significant differences in MGI and PI between CE and IDPE. There were no significant differences in DMFT and DMFS indexes between CE and IDPE, and there were positive correlations between CE and IDPE for each of the two indexes (DMFT index: r=0.56; DMFS index: r=0.69). The IDPE duration was shorter than the CE duration. Conclusions The feasibility of caries status assessment via IDPE is promising. Digital oral health evaluation merits further clinical consideration. Trial registration Xiamen University Training Program of Innovation and Entrepreneurship for Undergraduates, project number: 2018X0583. Registered 1 April 2018; http://cxw.xmu.edu.cn/admin/Innovation/NewInnovationDetail?id=6ce0a415-6131-496b-891a-6a1ae44e556d
A Novel Machine Learning Algorithm Predicts Dementia With Lewy Bodies Versus Parkinson’s Disease Dementia Based on Clinical and Neuropsychological Scores
Authors: Bougea Anastasia , Efthymiopoulou Efthymia , Spanou Ioanna , Zikos Panagiotis 
Published: February 2021

Objective: Our aim was to develop a machine learning algorithm based only on non-invasively clinic collectable predictors, for the accurate diagnosis of these disorders. Methods: This is an ongoing prospective cohort study ( ClinicalTrials.gov identifier NCT number NCT04448340) of 78 PDD and 62 DLB subjects whose diagnostic follow-up is available for at least 3 years after the baseline assessment. We used predictors such as clinico-demographic characteristics, 6 neuropsychological tests (mini mental, PD Cognitive Rating Scale, Brief Visuospatial Memory test, Symbol digit written, Wechsler adult intelligence scale, trail making A and B). We investigated logistic regression, K-Nearest Neighbors (K-NNs) Support Vector Machine (SVM), Naïve Bayes classifier, and Ensemble Model for their ability to predict successfully PDD or DLB diagnosis. Results: The K-NN classification model had an accuracy 91.2% of overall cases based on 15 best clinical and cognitive scores achieving 96.42% sensitivity and 81% specificity on discriminating between DLB and PDD. The binomial logistic regression classification model achieved an accuracy of 87.5% based on 15 best features, showing 93.93% sensitivity and 87% specificity. The SVM classification model had an accuracy 84.6% of overall cases based on 15 best features achieving 90.62% sensitivity and 78.58% specificity. A model created on Naïve Bayes classification had 82.05% accuracy, 93.10% sensitivity and 74.41% specificity. Finally, an Ensemble model, synthesized by the individual ones, achieved 89.74% accuracy, 93.75% sensitivity and 85.73% specificity. Conclusion: Machine learning method predicted with high accuracy, sensitivity and specificity PDD or DLB diagnosis based on non-invasively and easily in-the-clinic and neuropsychological tests.
Correlation between retrobulbar blood flow parameters and retinal nerve fiber, ganglion cell and inner plexus layer thickness in myopia
Authors: Grudzińska Ewa M , Zaborski Daniel , Modrzejewska Monika 
Published: February 2021

Purpose: To assess the thickness of the retinal nerve fiber layer (RNFL), ganglion cell and inner plexus layer (GCIPL) and blood flow parameters in retrobulbar vessels, and to analyze correlations between these parameters in myopes. Methods: The study included forty myopic and 20 healthy eyes. Standard eye examination was supplemented with OCT of the optic nerve and macula (GCIPL, RNFL, RNFL in each quadrant and rim area of the optic nerve) and color Doppler imaging of retrobulbar arteries [peak systolic and end-diastolic velocities, pulsatile index and resistance index (RI) in the ophthalmic (OA), central retinal (CRA), nasal posterior ciliary and temporal posterior ciliary arteries]. Results: Significant correlations were found between blood flow parameters in the CRA, RNFL and GCIPL thickness, and axial length (AL) and spherical equivalent (SE). There were significant positive correlations between RNFL with PSV and EDV in the CRA and negative correlations between RNFL and RI in the CRA. GCIPL was positively correlated with PSV and EDV in the CRA. The decrease in RA was associated with reduced blood flow velocities in the CRA, TPCA and NPCA. Conclusion: The reduced retrobulbar blood flow in healthy young myopes is correlated with increasing AL and refractive value, and thinning of the RNFL and GCIPL. Reduction of the rim-area of the optic disc is associated with vascular and retinal circulatory disorders. These phenomena indicate the vascular basis of the described changes. To the best of our knowledge, this is the first study which correlates ocular circulation with retinal structure.
From questionnaire to practical application: A quality of life profile for populations with diverse disabilities
Authors: Jespersen Louise N , Andersen Anette , Due Pernille , Ersbøll Annette K , Damsgaard Mogens T , Michelsen Susan I 
Published: February 2021

Aims: Existing quality of life questionnaires are either disease specific or generic in their assessment of themes which are perceived important to the quality of life in populations with disabilities. To be able to improve quality of life in a population with diverse disabilities there was a need for a cross-disability instrument. The Electronic Quality of Life (EQOL)-questionnaire was developed to meet this need. It is crucial that such an instrument is validated, easy to use, and interpret by, for example, clinicians and policy planners. This study aims to test the content validity of the EQOL questionnaire and to construct a user-friendly, cross-disability quality of life profile. Methods: To further test the content validity of the EQOL-questionnaire, we conducted field test analyses on 318 individuals (aged 16–64) with self-reported disabilities. Comments on the questionnaire were scrutinised and sorted. A profile with six domains of quality of life was developed. Model fit was evaluated by confirmatory factor analysis and content validity was evaluated based on distributions. Results: The EQOL-questionnaire was found to have an acceptable content validity and respondents from the field test found that it features important themes of quality of life. The confirmatory factor analysis estimated a satisfying model fit by the root-mean-squared error of approximation (0.06), whereas the comparative fit index and goodness of fit index indicated poorer model fit. Graphical charts, with colour categories for user-friendly interpretation, were constructed. Conclusion: By identifying themes reported as problematic, the EQOL-profile can be used to inform and target interventions aiming to improve quality of life in populations with diverse disabilities.
Predictors of Secondary Ulnar Shortening and Reoperation After Arthroscopic TFCC Debridement
Authors: Verhiel Svenna H. W. L. , Ritt Marco J. P. F. , Chen Neal C. 
Published: February 2021

Background: Predicting which patients will do well with arthroscopic triangular fibrocartilage complex (TFCC) debridement alone or which patients may benefit from arthroscopic debridement and ulnar shortening at the same time can be challenging. In this retrospective cohort study, we aimed to assess the rate and type of complications and reoperations after arthroscopic TFCC debridement. Furthermore, we aimed to identify factors associated with reoperation and specifically ulnar shortening osteotomy (USO) after this procedure. Methods: We included 163 patients who underwent arthroscopic TFCC debridement as a first surgery for treatment of their ulnar-sided wrist pain. Patient charts were manually reviewed, and ulnar variance was measured on preoperative posteroanterior radiographs of the wrist. Bivariate analysis and multivariable logistic regression analysis were performed to identify factors associated with reoperation. Additional subgroup analyses looking at USO after TFCC debridement were performed with Kaplan-Meier analysis and Cox regression survival analysis. Results: We found a complication rate of 14% and a reoperation rate of 19% (most common USO with 10%). Chondromalacia was independently associated with reoperation. Forty percent of patients with a positive ulnar variance later proceeded to USO. A hazard ratio of 1.8 per millimeter of ulnar variance was found. Conclusions: Our data suggest that patients with a positive ulnar variance with frank chondral loss at the time of arthroscopic TFCC debridement may benefit from simultaneous USO.
Is Opioid-Limiting Legislation Effective for Hand Surgery Patients?
Authors: Shah Kalpit N. , Reid Daniel B. C. , Ruddell Jack H. , Shapiro Benjamin H. , James Peter , Gil Joseph A. , Daniels Alan H. , Akelman Edward 
Published: February 2021

Background: The Rhode Island State Legislature passed the Uniform Controlled Substances Act in 2016 to limit opioid prescriptions. We aimed to objectively evaluate its effect on opioid prescribing for hand surgery patients and also identify risk factors for prolonged opioid use. Methods: A 6-month period (January-June 2016) prior to passage of the law was compared with a period following its implementation (July-December 2017). Thumb carpometacarpal arthroplasty and distal radius fracture fixation were classified as “major surgery” and carpal tunnel and trigger finger release as “minor surgery.” Prescription Drug Monitoring Database was used to review controlled substances filled during the study periods. Results: A total of 1380 patients met our inclusion criteria, with 644 prelaw and 736 postlaw patients. Patients undergoing “major surgery” saw a significant decrease in the number of pills issued in the first postoperative prescription (41.1 vs 21.0) and a corresponding decrease in morphine milligram equivalents (MMEs) (318.6 vs 159.2 MMEs) after implementation. A 30% decrease in MMEs was also seen in those undergoing “major surgery” in the first 30 days postoperatively (544.7 vs 381.7 MMEs). Risk factors for prolonged opioid use included male sex and preoperative opioid use. Conclusions: In Rhode Island, opioid-limiting legislation resulted in a significant decrease in the number of pills and MMEs of the initial prescription and a 30% decrease in total MMEs in the 30-day postoperative period after “major hand surgery.” Additional research is needed to explore the association between legislation and clinical outcomes.
Evaluation of Trueness and Precision of a Bench-Top Laboratory Glucose Analyzer Using Reference Materials
Authors: Baumstark Annette , Pleus Stefan , Hartwig Matthias , Freckmann Guido 
Published: February 2021

SUPER GL compact is a bench-top analyzer for glucose, lactate, and hemoglobin concentrations. Glucose measurements in the biosensor are based on an enzymatic-amperometric reaction of glucose with glucose oxidase. In this study, trueness and precision were assessed with Standard Reference Material 965b (National Institute of Standards and Technology, Gaithersburg, MD) for 2 SUPER GL compact (S1 and S2) and 1 YSI 2300 STAT Plus (Y) device, using a protocol based on CLSI EP05-A3. Precision was similar among S1, S2, and Y. S1 and S2 exhibited negative bias at low concentrations and positive bias at high concentrations, whereas Y showed negative bias that increased with higher concentrations. Overall, SUPER GL compact’s performance was comparable to that of YSI 2300 STAT Plus.
Prevalence and Consequences of Sport Specialization Among Little League Baseball Players
Authors: Post Eric G. , Rosenthal Michael D. , Pennock Andrew T. , Rauh Mitchell J. 
Published: February 2021

Background: Baseball is one of the most popular boy’s youth sports, and there has been a rise in the rates of certain overuse injuries among players. Specialization has been identified as a risk factor for overuse injury in high school athlete populations, but there is little understanding of the prevalence or consequences of sport specialization in Little League baseball players. Hypothesis: Sport specialization will be highly prevalent among Little League baseball players and specialization will be associated with worse throwing arm health. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 246 Little League baseball players (male; N = 241; age, 9.5 ± 1.6 years) between 7 and 12 years old completed an anonymous, online questionnaire with their parent’s assistance. The questionnaire consisted of participant demographics and baseball participation information, including sport specialization status and the Youth Throwing Score (YTS), a valid and reliable patient-reported outcome measure for youth baseball players. Results: Only 29 (11.8%) players met the criteria for high specialization. Approximately one-third of all players (n = 77; 31.3%) reported participating in baseball year-round or receiving private coaching outside of their league (n = 81; 32.9%). Highly specialized athletes demonstrated worse scores on the YTS on average compared with low-specialization athletes (mean [SE]: 56.9 [1.6] vs 61.1 [1.2]; P = 0.01). Similarly, pitching in the previous year ( P < 0.01) or traveling overnight regularly for showcases ( P = 0.01) were associated with a worse score on the YTS. Conclusion: While the prevalence of high sport specialization was low among Little League baseball players, other behaviors associated with specialization such as year-round play and the receiving of private coaching were more common. Highly specialized Little League players demonstrated worse throwing arm health compared with low-specialization players. Clinical Relevance: Little League players and their parents may represent a potential target audience for dissemination campaigns regarding sport specialization.
Confidence to Return to Play After Anterior Cruciate Ligament Reconstruction Is Influenced by Quadriceps Strength Symmetry and Injury Mechanism
Authors: Della Villa Francesco , Straub Rachel K. , Mandelbaum Bert , Powers Christopher M. 
Published: February 2021

Background: Although the restoration of quadriceps strength symmetry is a primary rehabilitation goal after anterior cruciate ligament reconstruction (ACLR), little is known about the potential relationship between quadriceps strength symmetry and psychological readiness to return to play (RTP). Hypothesis: Quadriceps strength symmetry will be associated with psychological readiness to RTP after ACLR. Secondarily, injury mechanism will influence the association between quadriceps strength and psychological readiness to RTP. Study Design: Retrospective cohort. Level of Evidence: Level 3 (cohort study). Methods: A total of 78 female patients completed strength testing and the Injury–Psychological Readiness to Return to Sport (I-PRRS) scale at an outpatient clinical facility as part of return to sport testing after ACLR. Linear regression analysis was used to assess the relationship between the I-PRRS and the independent variables of interest (quadriceps strength symmetry and injury mechanism). Results: For all patients combined, a significant symmetry × mechanism interaction was found. When split by injury mechanism, a significant linear relationship was found between quadriceps strength symmetry and the I-PRRS score in patients who experienced a noncontact injury (n = 55; P = 0.01; R2 = 0.24). No such relationship was found for those who experienced a contact injury (n = 23; P = 0.97; R2 = 0.01). Conclusion: Greater quadriceps strength symmetry was associated with greater psychological readiness to RTP in female athletes after ACLR. This relationship, however, was present only in those who experienced a noncontact injury. Clinical Relevance: Clinicians should consider both the physical and the psychological factors in assessing a patient’s readiness to RTP. This may be particularly important for those who have experienced an ACL tear through a noncontact mechanism.
Flexible cystoscopy and laser stone fragmentation via Mitrofanoff stoma: A case series
Authors: Conway Joanne M , Christodoulidou Michelle , Reid Sheilagh , Patterson Jake M 
Published: February 2021

Objective: This case series aimed to demonstrate that flexible cystoscopy and laser stone fragmentation via a Mitrofanoff stoma is possible and an effective treatment for symptomatic bladder stones in complex patients with inaccessible urethras and challenging anatomy. Patients and methods: We present three cases which were managed in a tertiary centre. The procedure involved using a flexible cystoscope via the Mitrofanoff stoma and laser stone fragmentation without the need for an access sheath. Results: This technique was performed safely and demonstrated successful bladder stone clearance on follow-up, with no postoperative complications. Conclusion: Our case series illustrates a technique that can be performed in this select group of patients in specialist centres with the relevant surgical exposure and expertise. Level of evidence Level 4.
Successful Closed Reduction of Atlantoaxial Rotatory Fixation in Children—A Retrospective Study of 30 Patients
Authors: Xu Ping , Zhang Zhiqiang , Zheng Yiming , Meng Junrong , Qian Chuang , Fu Dong , Wang Dahui 
Published: February 2021

Study Design: Retrospective cohort study. Objectives: To review our treatment experience and to investigate the process of this disease. Methods: Clinical data of AARF patients, who received closed reduction, was retrospectively reviewed. Patients were divided into 2 groups according to the length of delay (Group I: 1 month ≤ delayed time < 3 months), Group II (delayed time < 1 months). The correlation between the length of delayed time and clinical recovery (CR), radiological recovery (RR), and total recovery time were measured. The atlantodental interval (ADI), lateral mass-dens interval (LDI) and lateral joint space (LJS) were compared at admission and final follow-up. Results: 30 children (12 girls and 18 boys) with AARF had received conservative treatment. The mean age at initial treatment was 8.13-year-old, ranging from 5 to 14. The mean follow-up time was 26.93 months (range, 6-87 months). The average length of delayed time was 28.53 days (range, 2-80 days). When the LDI, LJS, and ADI differences are compared at admission and the final visit, the differences are reduced significantly on LDI and LJS. A positive correlation is observed between the length of the delay and CR time and total recovery time (r = 0.63, p = 0.00 and r = 0.47, p = 0.01) respectively. Conclusions: Pediatric AARF patients who have a delay time < 3 months can be treated with closed reduction successfully. The longer the delayed time, the longer the traction time, but the cervical collar time is almost the same. The LDI and LJS on the anteroposterior of X-rays are convenient to estimate the progress of this condition during the treatment.