bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring health-related quality of life in chronic headache: A comparative evaluation of the Chronic Headache Quality of Life Questionnaire and Headache Impact Test (HIT-6)
Authors: Haywood Kirstie L , Achana Felix , Nichols Vivien , Pearce Gemma , Box Barbara , Muldoon Lynne , Patel Shilpa , Griffiths Frances , Stewart Kimberly , Underwood Martin , Matharu Manjit M ,   on behalf of the CHESS Team
Published: May 2021

Objective To compare the quality and acceptability of a new headache-specific patient-reported measure, the Chronic Headache Quality of Life Questionnaire (CHQLQ) with the six-item Headache Impact Test (HIT-6), in people meeting an epidemiological definition of chronic headaches. Methods Participants in the feasibility stage of the Chronic Headache Education and Self-management Study (CHESS) (n = 130) completed measures three times during a 12-week prospective cohort study. Data quality, measurement acceptability, reliability, validity, responsiveness to change, and score interpretation were determined. Semi-structured cognitive interviews explored measurement relevance, acceptability, clarity, and comprehensiveness. Results Both measures were well completed with few missing items. The CHQLQ’s inclusion of emotional wellbeing items increased its relevance to participant’s experience of chronic headache. End effects were present at item level only for both measures. Structural assessment supported the three and one-factor solutions of the CHQLQ and HIT-6, respectively. Both the CHQLQ (range 0.87 to 0.94) and HIT-6 (0.90) were internally consistent, with acceptable temporal stability over 2 weeks (CHQLQ range 0.74 to 0.80; HIT-6 0.86). Both measures responded to change in headache-specific health at 12 weeks (CHQLQ smallest detectable change (improvement) range 3 to 5; HIT-6 2.1). Conclusions While both measures are structurally valid, internally consistent, temporally stable, and responsive to change, the CHQLQ has greater relevance to the patient experience of chronic headache. Trial registration number: ISRCTN79708100. Registered 16th December 2015, http://www.isrctn.com/ISRCTN79708100
Validation of a Risk Calculator to Personalize Graft Choice and Reduce Rupture Rates for Anterior Cruciate Ligament Reconstruction
Authors: Marmura Hana , Getgood Alan M.J. , Spindler Kurt P. , Kattan Michael W. , Briskin Isaac , Bryant Dianne M. 
Published: May 2021

Background: Anterior cruciate ligament reconstructions (ACLRs) fail at an alarmingly high rate in young active individuals. The Multicenter Orthopaedic Outcomes Network (MOON) knee group has developed an autograft risk calculator that uses patient characteristics and lifestyle to predict the probability of graft rupture if the surgeon uses a hamstring tendon (HT) or a bone–patellar tendon–bone (BPTB) graft to reconstruct the ligament. If validated, this risk calculator can be used during the shared decision-making process to make optimal ACLR autograft choices and reduce rupture rates. The STABILITY 1 randomized clinical trial offers a large, rigorously collected data set of similar young active patients who received HT autograft with or without lateral extra-articular tenodesis (LET) for ACLR. Purpose/Hypothesis: The purpose was to validate the ACLR graft rupture risk calculator in a large external data set and to investigate the utility of BPTB and LET for ACLR. We hypothesized that the risk calculator would maintain adequate discriminative ability and calibration in the external STABILITY 1 data set when compared with the initial MOON development data set. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: The model predictors for the risk calculator include age, sex, body mass index, sport played at the time of injury, Marx Activity Score, preoperative knee laxity, and graft type. The STABILITY 1 trial data set was used for external validation. Discriminative ability, calibration, and diagnostic test validity of the model were assessed. Finally, predictor strength in the initial and validation samples was compared. Results: The model showed acceptable discriminative ability (area under the curve = 0.73), calibration (Brier score = 0.07), and specificity (85.3%) to detect patients who will experience a graft rupture. Age, high-grade preoperative knee laxity, and graft type were significant predictors of graft rupture in young active patients. BPTB and the addition of LET to HT were protective against graft rupture versus HT autograft alone. Conclusion: The MOON risk calculator is a valid predictor of ACLR graft rupture and is appropriate for clinical practice. This study provides evidence supporting the idea that isolated HT autografts should be avoided for young active patients undergoing ACLR. Registration: NCT00463099 (MOON); NCT02018354 (STABILITY 1) ( ClinicalTrials.gov identifiers)
The effects of centralizing cancer surgery on postoperative mortality: A systematic review and meta-analysis
Authors: Grilli Roberto , Violi Federica , Bassi Maria Chiara , Marino Massimiliano 
Published: May 2021

Objectives To review the evidence of the effects of centralization of cancer surgery on postoperative mortality. Methods We searched Medline, Embase, Cinahl, Cochrane and Scopus (up to November 2019) for studies that (i) assessed the effects of centralization of cancer surgery policies on in-hospital or 30-day mortality, or (ii) described changes in both postoperative mortality for a surgical intervention and degree of centralization using reduction in the number of hospitals or increases in the proportion of patients undergoing cancer surgery at high volume hospitals as proxy. PRISMA guidelines were followed. We estimated pooled odds ratios (OR) and conducted meta-regression to assess the relationship between degree of centralization and mortality. Results A total of 41 studies met our inclusion criteria of which 15 evaluated the effect of centralization policies on postoperative mortality after cancer surgery and 26 described concurrent changes in the degree of centralization and postoperative mortality. Policy evaluation studies mainly used before-after designs (n = 13) or interrupted time series analysis (n = 2), mainly focusing on pancreatic, oesophageal and gastric cancer. All but one showed some degree of reduction in postoperative mortality, with statistically significant effects demonstrated by six studies. The pooled odds ratio for centralization policy effect was 0.68 (95% Confidence interval: 0.54–0.85; I2 = 80%). Meta-regression analysis of the 26 descriptive studies found that an increase of the proportion of patients treated at high volume hospitals was associated with greater reduction in postoperative mortality. Conclusions Centralization of cancer surgery is associated with reduced postoperative mortality. However, existing evidence tends to be of low quality and estimates of the effect size are likely inflated. There is a need for prospective studies using more robust approaches, and for centralization efforts to be accompanied by well-designed evaluations of their effectiveness.
Early Childhood Neglect Among 3- to 6-Year-Old Children in China: A Meta-Analysis
Authors: Zhang Huiping , Ji Mengmeng , Wang Yang , Xu Shuo , Shi Rui 
Published: May 2021

Background: This review aims to estimate the prevalence of the neglect of 3- to 6-year-old children in China. Method: We systematically searched both English- (Web of Science, PsychINFO, PubMed, and Cochrane Library) and Chinese-language databases (China National Knowledge Infrastructure, Wanfang, Weipu, and Biomedical Database). We extracted data related to the prevalence of early childhood neglect and its subtypes and pooled it using random effects models. Findings: We included 21 eligible studies, with a total of 35,175 3- to 6-year-old children, in the analyses. The pooled neglect prevalence was 32.1% at a 95% confidence interval (95% CI [27.0%, 37.2%]). The prevalence of physical, emotional, educational, security, and medical neglect was 15.2% (95% CI [11.9%, 18.5%]), 15.2% (95% CI [10.7%, 19.6%]), 10.4% (95% CI [7.4%, 13.4%]), 13.8% (95% CI [9.9%, 17.8%]), and 11.5% (95% CI [8.1%, 14.9%]), respectively. No gender or location differences were found to affect early childhood neglect or its subtypes. Interpretation: Our results revealed a high prevalence of early childhood neglect—including all its subtypes—among 3- to 6-year-old children in China. Improved child policies and prevention programs tailored to preschool children are needed to protect the well-being of younger children.
Modeling of a controlled flow cup for improved transitional drinking development in children
Authors: Bailey-Van Kuren Michael M , Scarborough Donna 
Published: May 2021

Introduction Clinical observations of children with swallowing disorders using a traditional “sippy” or transitional drinking cup identified a need for a novel cup. Children with swallowing disorders are often unable to initiate the forces required to activate the cup and/or maintain suction pressure. Furthermore, fast flow rates can result in choking. Methods A new cup design tool is proposed using fluid-cup interactions to capture the changing geometry of the fluid during drinking. A Petri net formulation is integrated with standard fluid flow principles. A new parametric cup simulation provides visualization and direct implementation for microcontroller prototypes. A vent-based controller is developed and modeled for a novel transitional drinking cup design. A simulated pouring study is performed for water and a baseline liquid volume of 200 ml in the cup. The study varies rotation rates, initial volume, system control and desired flow rates. Results Volumetric flow rate curves over time are generated and compared in relation to a target flow rate. The simulation results show expected behavior for variations in cup parameters. Conclusion The new simulation model facilitates future dysphagia research through rapid prototyping by tuning cup geometry, liquid parameters and control signals to meet the varying needs of the users.
Transplantation for Congenital Heart Disease: Focus on the Impact of Functionally Univentricular Versus Biventricular Circulation
Authors: Riggs Kyle W. , Broderick John T. , Price Nina , Chin Clifford , Zafar Farhan , Morales David L. S. 
Published: May 2021

Background: Varying single center data exist regarding the posttransplant outcomes of patients with single ventricle circulation, particularly following the Fontan operation. We sought to better elucidate these results in patients with congenital heart disease (CHD) through combining two national databases. Methods: The United Network for Organ Sharing (UNOS) transplantation database was merged with the Pediatric Health Information System (PHIS), an administrative database with 71% of UNOS patients matched. Patients undergoing transplantation at a PHIS hospital from 2006 to 2017 were categorized as single ventricle or biventricular strategy based on their diagnoses and procedures in 90% of patients. When known, single ventricle patients were further analyzed by their palliative stage post-Glenn or post-Fontan (known in 31%). Results: A total of 1,517 CHD transplantations were identified, 67% with single ventricle strategy (1,016). Single ventricle, biventricular, and indeterminate patients had similar survival (log-rank P > .1). Risk factors for mortality in patients with CHD were extracorporeal membrane oxygenation (ECMO) support at transplant (hazard: 2.27), ABO blood type incompatibility (hazard: 1.61), African American recipient (hazard 1.42), and liver dysfunction (hazard 1.29). A total of 130 confirmed Fontan and 185 confirmed bidirectional Glenn patients underwent transplantation, each with survival equivalent to biventricular patients (log-rank P > .500). For Fontan patients, renal dysfunction (hazard: 5.40) and transplant <1 year after Fontan (hazard 2.82) were found to be associated with mortality. Conclusions: Single ventricle patients, as a group, experience similar outcomes as biventricular patients with CHD undergoing transplantation, and this extends to Fontan patients. Risk factors for mortality correlate with end-organ dysfunction as well as race and ABO blood type incompatibility in the CHD population.
Factors Affecting Health-Related Quality of Life After the Arterial Switch Operation
Authors: Cleuziou Julie , Huber Anna-Katharina , Strbad Martina , Ono Masamichi , Hager Alfred , Hörer Jürgen , Lange Rüdiger 
Published: May 2021

Background: Long-term morbidity and mortality outcomes of the arterial switch operation (ASO) in patients with transposition of the great arteries and Taussig-Bing anomaly are excellent. With an increasing number of patients reaching adolescence and adulthood, more attention is directed toward quality of life. Our study aimed to determine the health-related quality of life (hrQoL) outcomes in patients after the ASO and identify factors influencing their hrQoL. Methods: In this cross-sectional study, hrQoL of patients after ASO was assessed with the German version of the Short Form-36 (SF-36) and the potential association of specified clinical factors was analyzed. Patients of at least 14 years of age who underwent ASO in our institution from 1983 were considered eligible. Results: Of the 355 questionnaires sent to eligible patients, 261 (73%) were available for analysis. Compared to the reference population, patients who had undergone ASO had a significantly higher score in all subscales of the SF-36 except for vitality ( P < .01). Patients with an implanted pacemaker ( P = .002), patients who required at least one reoperation ( P < .001), and patients currently taking cardiac medication ( P < .004) or oral anticoagulation ( P = .036) had lower physical component scores compared to patients without these factors. Conclusions: Patients’ self-assessed and self-reported hrQoL after ASO (using German version of the Short Form 36) is very good. In this population, hrQoL is influenced by reoperation, the need for a pacemaker, and current cardiac medication or anticoagulant use. The development of strategies designed to mitigate or minimize the requirements for, and/or impact of these factors may lead to better hrQoL in this patient population.
Revision Arthroscopic Bankart Repair Versus Arthroscopic Latarjet for Failed Primary Arthroscopic Stabilization With Subcritical Bone Loss
Authors: Calvo Emilio , Luengo Gonzalo , Morcillo Diana , Foruria Antonio M. , Valencia María 
Published: May 2021

Background: Limited evidence is available regarding the recommended technique of revision surgery for recurrent shoulder instability. Only 1 previous study has compared the results of soft tissue repair and the Latarjet technique in patients with persistent shoulder instability after primary surgical stabilization. Purpose/Hypothesis: To evaluate the results of revision surgery in patients with previous surgical stabilization failure and subcritical glenoid bone defects, comparing repeated Bankart repair versus arthroscopic Latarjet technique. The hypothesis was that Latarjet would be superior to soft tissue procedures in terms of objective and subjective functional scores, recurrence rates, and range of movement. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 45 patients (mean age, 29.1 ± 8.9 years) with subcritical bone loss (<15% of articular surface) who had undergone revision anterior shoulder instability repair after failed Bankart repair. Of these, 17 patients had arthroscopic Bankart repair and 28 had arthroscopic Latarjet surgery. Patients were evaluated at a minimum of 2 years postoperatively with the Rowe score, Western Ontario Shoulder Instability Index, and Subjective Shoulder Value. Subluxation or dislocation episodes were considered failures. Results: No statistically significant differences were found between groups in age, sex, sporting activity, preoperative Rowe score, or the presence of hyperlaxity or bony lesions. At revision arthroscopy, 20 shoulders showed a persistent Bankart lesion, 13 a medially healed labrum, and 6 a bony Bankart. In 6 patients, no abnormalities were present that could explain postoperative recurrence. In the Bankart repair group, 7 patients underwent isolated Bankart procedures; in the remaining 10 cases, a capsular shift was added. No significant differences were found between the Bankart and Latarjet groups in outcome scores, recurrence rate (11.8% vs 17.9%, respectively), or postoperative athletic activity level. The mean loss of passive external rotation at 0° and 90° of abduction was similar between groups. Conclusion: Arthroscopic Latarjet did not lead to superior results compared with repeated Bankart repair in patients with subcritical glenoid bone loss and recurrent anterior shoulder instability after Bankart repair.
The Phenotypic Spectrum of Tuberous Sclerosis Complex: A Canadian Cohort
Authors: Alsowat Daad , Whitney Robyn , Hewson Stacy , Jain Puneet , Chan Valerie , Kabir Nadia , Amburgey Kimberly , Noone Damien , Lemaire Mathieu , McCoy Blathnaid , Zak Maria 
Published: May 2021

Objective: We aimed to further elucidate the phenotypic spectrum of Tuberous Sclerosis Complex (TSC) depending on genotype. Methods: A retrospective review of patients seen in the TSC clinic at the Hospital for Sick Children was conducted and the frequency of TSC manifestations was compared based on genotype. Results: Nineteen-patients had TSC1 mutations, 36 had TSC2 mutations and 11 had no mutation identified (NMI). Patients with TSC2 mutations had a higher frequency of early-onset epilepsy and more frequent systemic manifestations. The NMI group had milder neurologic and systemic manifestations. Our data did not demonstrate that intellectual disability and infantile spasms were more common in TSC2 mutations. Conclusions: This is the first Canadian pediatric cohort exploring the genotype-phenotype relationship in TSC. We report that some manifestations are more frequent and severe in TSC2 mutations and that NMI may have a milder phenotype. Disease surveillance and counseling should continue regardless of genotype until this is better elucidated.
Vasculature in the Margin of the Psoriatic Lesion
Authors: Hanssen Sabina C. A. , Seyger Marieke M. B. , van Erp Piet E. J. , der Vleuten Catharina J. M. van , de Kerkhof Peter C. M. van 
Published: May 2021

Background: Factors initiating capillary conversion in the immunopathogenesis of psoriasis are not well established and quantification of vascular changes in- and outside visible psoriatic plaque has not been studied extensively. Objectives: To assess the pathological involvement of capillaries in the context of well-established features of psoriasis in different phases: symptomless psoriatic skin distant from a lesion (SDL), adjacent to a lesion (SAL), the margin zone of the lesion (ML) and the center of the psoriatic lesion (CL). Methods: In 10 patients with chronic plaque psoriasis, and 10 healthy matched controls, vascular parameters (vascular tonicity (VD), vascular surface area (VAR), microvascular density (MVD), angiogenesis (pEC)) and hypoxia in the context of well-established features (keratinocyte proliferation, neutrophils and T-cells) were analyzed within the psoriatic lesion and symptomless psoriatic skin, using immunohistochemical markers (Ki67/CD31 double-staining and HIF-1α-, Elastase- and T-Bet-staining). Results: VD and neutrophils were significantly increased in all sites, compared to healthy controls. The VAR, MVD, Ki67+ nuclei, HIF-1α and T-Bet start to augment in the SAL. Within the overt psoriatic plaque angiogenesis increases. Biopsies closer to the center of a plaque, exhibited increased values of the MVD, VAR, VD, Ki67+ nuclei, T-Bet+ Th1 cells and neutrophils. Conclusion: In SDL, vasodilatation and activation of the innate immune system (increased neutrophils) was detected. This could indicate that psoriasis is not restricted to lesional skin, but rather is a systemic disease. Closer to the psoriatic plaque, vascular and epithelial proliferation was observed, along with hypoxic cells and activation of the acquired immunity (augmented T-Bet cells).
SLAP Tears
Authors: Cohen Steven B. , Matthews John R. 
Published: May 2021

Background: Superior labral tears are frequently encountered during shoulder arthroscopy. Outcomes following superior labral anterior-posterior (SLAP) repairs in young athletes have been well documented. Superior labral repairs in older patient population continue to remain controversial due to concerns of postoperative complications including persistent preoperative symptoms, pain, stiffness, and higher rates of revision surgery. Indications: We present a case of a highly active 38-year-old woman who failed 1½ years of nonoperative management of a type IIB SLAP tear with extension to the posterior labrum. Her symptoms continued to limit her hobbies and work. Technique: A knotless single-anchor SLAP repair was performed along with debridement of the posterior frayed labrum. No biceps tenotomy or tenodesis was performed after full evaluation of the tendon failed to demonstrate evidence of synovitis, tendinopathy, or tear. The patient also did not have any concomitant shoulder pathology, including a rotator cuff tear or chondral lesion. Results: At 6 months, the patient had regained full range of motion similar to the contralateral side. She had returned to her normal activities and sports, including tennis. Discussion/Conclusion: Successful outcomes following SLAP repairs in patients over 35 years can be achieved, but treatment should be individualized with particular attention to concomitant pathology involving the rotator cuff, chondral surface, or biceps tendon which may require tenodesis or tenotomy.
Water immersion tolerance by larval instars of stable fly, Stomoxys calcitrans, L1758 (Diptera: Muscidae) impairs the fitness performance of their subsequent stages
Authors: Baleba Steve B. S. 
Published: May 2021

Abstract
Background
In holometabolous insects, environmental factors experienced in pre-imaginal life stages affect the life-history traits within that stage and can also influence subsequent life stages. Here, I assessed tolerance to water immersion by the larval instars of the stable fly, Stomoxys calcitrans L. (Diptera: Muscidae) and its impact on the life-history traits of their subsequent life stages.

Results
After submerging the three larval instars of S. calcitrans in distilled water, I found that the first instar larvae remained active for longer as compared to the second and third instar larvae. Also, the first instar larvae took a longer period to recover from the stress-induced immobility when removed from the water and returned to ambient temperature. When I followed the development of individuals of each larval instar that survived from water immersion, I found that their developmental time, weight, pupation percentage, adult emergence percentage and adult weight were negatively affected by this stressor. However, the weight of S. calcitrans adults developed from immersed first larval instar individuals was not affected by water immersion whereas their counterparts developed from immersed second and third larval instars had lower body weight. This suggests that in S. calcitrans, water immersion stress at the earlier stage is less detrimental than that experienced at late stages.

Conclusion
This study provides a comparative overview of the fitness consequences associated with water immersion stress during S. calcitrans larval ontogeny. The results prove that the fitness shift induced by water immersion in S. calcitrans is stage-specific. My results illustrate the importance of considering each larval instar when assessing the impact of environmental factors on holometabolous insect performance as these may be decoupled by metamorphosis.