bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting cardiovascular risk using a novel risk score in young and middle-age adults with HIV: associations with biomarkers and carotid atherosclerotic plaque
Authors: Rodriguez Violeta J , Abbamonte John M , Parrish Manasi S , Jones Deborah L , Weiss Stephen , Pallikkuth Suresh , Toborek Michal , Alcaide Maria L , Jayaweera Dushyantha , Pahwa Savita , Rundek Tatjana , Hurwitz Barry E , Kumar Mahendra 
Published: November 2021

Background Traditional risk factors associated with cardiovascular disease (CVD) include older age, smoking, poor diet, lack of exercise, obesity, high blood pressure, high cholesterol, and family history. Young-to-middle age adults (YMAA) are less often identified as being at risk of CVD, but traditional risk scores primarily target older adults and do not accurately estimate risk among YMAA. Methods This study examined biomarkers associated with CVD risk in YMAA in the context of HIV and cocaine use; risk was assessed by two methods: (1) a relative cardiovascular (CV) risk score that includes several factors and (2) carotid atherosclerotic plaque. Associations between CVD risk (CV risk score and carotid atherosclerotic plaque) and proinflammatory cytokines, markers of immune activation, HIV status, and cocaine use were examined. Participants ( N = 506) included people with and without HIV and people who use or do not use cocaine. Results Participants’ mean age was 36 (SD = 9.53); half (51%) were men. Cocaine use and C-reactive protein were associated with greater relative CV risk scores, but no associations between biomarkers and CV risk emerged. Age and CV risk scores were associated with carotid atherosclerotic plaque, but biomarkers were not. HIV was not associated with CV risk scores or carotid atherosclerotic plaque. Conclusions Among YMAA, CV risk scores may help providers identify lifestyle changes needed among those at risk for CVD before more advanced risk (e.g., atherosclerotic plaque) is identified. Implications are discussed.
Lessons Learnt in Health Management: Paediatric Spinal Tumours: A 6-year Retrospective Review from Central India
Authors: Sharma Pranati , Rege Shrikant V. , Jain Nilesh 
Published: November 2021

Background: From the management perspective, rare medical conditions do not attract enough attention, though their management can often be resource intensive. Increased awareness among health professionals can lead to early diagnosis of cases and prevention of complications leading to improved outcomes. Paediatric spinal tumours are rare disease entities with an annual incidence of approximately 1 per 1 million children. The profile of spinal tumours in the paediatric population is significantly different than that in adults. In this study we retrospectively analyse a heterogenous variety of paediatric spinal tumours which were treated at our institution over the last 6 years, with the goal of contributing to existing knowledge of this relatively rare disease entity. Methods: This retrospective study includes paediatric patients (under 18 years of age) who underwent surgery for primary spinal tumours from 2014 to 2019. The medical records were reviewed retrospectively and the information regarding clinical presentation, tumour location, operative findings, and postoperative status and functional outcome were analysed. The modified McCormick grade was used to assess the neurological status. Patients with spinal metastasis or incomplete medical records were excluded from the study. Results: Of 74 patients with primary spinal tumours operated at our centre between 2014 to 2019, a total of 8 patients (5 males and 3 females) who met the inclusion criteria were identified for the present study. The mean age of the patients included was 12.1±5.3 and the median follow-up period was 24 months. An improvement in the neurological status, as assessed by the modified McCormick grade, was seen in 37.5% of the patients. Three of the patients received adjuvant radiotherapy, post-surgical resection. A unique feature of this series was the wide variety of cases encountered, as each case had a different histopathological diagnosis, despite being limited by its sample size. Conclusion: Primary paediatric spinal cord tumours are rare, and surgical resection remains the treatment of choice. Adjuvant therapy is warranted in cases of high-grade lesions or recurrences. Through this study, we realised that due to its relative rarity and low incidence, a lack of public awareness can often lead to disproportionately increased morbidity and mortality. Prospective multi-centric studies can provide tools to help develop future management strategies for improved survival rates and reduced complications.
Primary Cleft Lip Repair in Adults Under Local Anesthesia
Authors: Das Bijoy Krishna , Dhar Satyajit 
Published: November 2021

Objective There are many adults with cleft lip deformities in developing countries. This is due to the lack of public awareness, social stigma, distance from the health center, and parents' financial condition. Lip repair under local anesthesia is safe, cost-effective and would be beneficial for the underprivileged population. Design A retrospective cohort study with follow-up of 1 to 8 years Setting Academic Hospital. Patients/Participants Cleft lip repair was performed in 252 patients of age more than 12 years from 2012 to 2019. Patients with cleft palate, cardiopulmonary disease, who did not consent for the procedure while awake were excluded. Interventions Cleft lip surgery done under local anesthesia Main Outcome Measures Outcome measures were patients’ self-satisfaction and comments of peer. Results Two hundred fifty-two primary cleft lip operations were done in 168 male and 84 female patients. The mean age was 23.62 years, and the mean weight was 49.66 kg. Unilateral was 227, Bilateral cleft lip 25. The postoperative period was uneventful. No case of wound dehiscence or wound infection was observed. Patients were discharged on the same day, except the ones who traveled a long distance. Conclusion Cleft lip repair in adults under local anesthesia is safe and cost-effective.
Longitudinal Skeletal Growth Analysis of Mandibular Asymmetry in Unoperated Patients With Unilateral Craniofacial Microsomia (UCFM)
Authors: Shetye Pradip R. , Grayson Barry H. , McCarthy Joseph G. 
Published: November 2021

Purpose To examine the growth rate discrepancy of the affected and unaffected ramus heights in Pruzansky Type I and Type II mandibles. Methods This is a serial retrospective longitudinal growth study of 30 untreated patients (21 males and 9 females) with UCMF (age range from 5 years to 14 years). The mean age of patients was 8.5 years, and the mean follow-up records were 3.7 years. There were 13 patients in group I with a Pruzansky Type I mandible and 17 patients in group II with a Pruzansky Type II. The unaffected side of the mandible served as a control. Eighteen cephalometric parameters were examined at each of the two-time intervals. Results In patients with Pruzansky Type I mandible, the affected ramus grew on average 1.41 mm per year; the unaffected ramus grew 1.66 mm per year during the same period. In patients with Pruzansky Type II mandible, the affected ramus grew on average 0.84 mm per year; during the same period, unaffected ramus grew 1.79 per year. When the growth rate of the ramus height on the affected side was compared to the unaffected side, there was no statistically significant difference in Pruzansky Type I mandibles (p > .05); however, there was a statistically significant difference in the Pruzansky Type II mandibles (p < .05). Conclusion The growth rate discrepancy of the affected and unaffected ramus heights was more severe in Pruzansky Type II mandibles than Pruzansky Type I mandibles explaining the progressive nature of facial asymmetry in Pruzansky II mandibles.
Multidisciplinary Presurgical Education: Clinical Impact on Children With Orofacial Clefts Undergoing Maxillary Distraction via Rigid External Distraction
Authors: Kim Erinn N. , Moss Whitney D. , Rosales Megan N. , Lyon Natalee , Lotz Analise , Yamashiro Duane K. , Gociman Barbu R. , Siddiqi Faizi A. , Johns Dana N. 
Published: November 2021

Objective Treatment of severe maxillary hypoplasia is commonly addressed via distraction osteogenesis with a rigid external device (RED). While effective, this method can be socially stigmatizing in an already vulnerable patient population. To prepare children and their caregivers for life with a RED and decrease peri-operative anxiety, we instituted a multidisciplinary pre-surgical education session (MPES). This educational team involves our cleft care coordinator, child life specialist, orthodontist and plastic surgeon 2 weeks prior to surgery. We reviewed the impact of this intervention by examining clinical outcomes before and after its implementation. Design From February 2017 to February 2020, a retrospective chart review was performed to include patients with orofacial clefts and maxillary hypoplasia who underwent maxillary distraction osteogenesis with RED at our center before (28 patients) and after (29 patients) the implementation of MPES. Results MPES was associated with a significantly shorter length of stay compared to controls who did not receive MPES (3.6 vs 3.1 days, p < 0.03) and significantly decreased usage of inpatient narcotic pain medication compared to controls (16.8 morphine equivalents vs 31.8 morphine equivalents, p < 0.02). Our intervention also demonstrated a trend towards decrease in minor complications but did not achieve statistical significance p = 0.32). Conclusions Multidisciplinary presurgical education is a beneficial adjunct in the care of patients with orofacial clefts and maxillary hypoplasia undergoing maxillary advancement with a RED.
Childhood Maltreatment and Adolescents’ Aggression: A Moderated Mediation Model of Callous-Unemotional Traits and Friendship Quality
Authors: Li Wenqing , Yang Jiping , Gao Ling , Wang Xingchao 
Published: November 2021

A growing body of research has documented that childhood maltreatment is associated with increased risk of child aggression. However, little is known about the mediating and moderating mechanisms underlying the relationships between childhood maltreatment and reactive and proactive functions of aggression. Therefore, the present study examined whether callous-unemotional traits mediated the relationships between childhood maltreatment and two subtypes of aggression and whether these mediating processes were moderated by friendship quality. A cross-sectional study was conducted among 2407 adolescents between 11 and 16 years ( Mage= 12.75, SD = .58) in Shanxi province, China. Participants filled out questionnaires regarding childhood maltreatment, callous-unemotional traits, aggression, and friendship quality. The results indicated that childhood maltreatment was significantly and positively associated with proactive and reactive aggression, and these relationships were partially mediated by callous-unemotional traits after controlling for demographic variables. Friendship quality moderated the relationship between childhood maltreatment and proactive aggression as well as callous-unemotional traits and proactive aggression. These relationships became weaker for adolescents with high levels of friendship quality. Friendship quality did not moderate the effects of childhood maltreatment and callous-unemotional traits on reactive aggression.
Governing Corporeal Movement in India during the COVID-19 Pandemic
Authors: Holwitt Pablo 
Published: November 2021

This article explores the impact of the COVID-19 pandemic on the relationship between bodies, risk and mobility. Drawing upon ethnographic data from India, it is argued that measures taken by the Indian government to contain the spread of the pandemic link mobile bodies to the notion of risk which has profound consequences for the way in which people access and engage with public spaces in Indian cities. In this process, a new type of body – the risky mobile body – is produced. At the same time, these measures run into problems due to the volatile nature of knowledge about bodies and diseases that they rely on. While the mobility of the COVID-19 virus is a subject of public debate, the fluidity and open-endedness of mobile bodies makes them difficult to regulate. This mismatch between governmental logics and unknowable bodies constitutes a significant challenge for the fight against the pandemic.
The relative importance of clinical factors in initiating interfacility transfer of major trauma patients: A discrete choice experiment
Authors: Lin Steve , Nolan Brodie , Dashi Gerhard , Nathens Avery B 
Published: November 2021

Introduction and Objectives Approximately 30% of patients meeting severe injury criteria are never transferred to lead trauma centers (LTCs). The reasons for this gap are not fully understood but involve both system-level factors and individual decision-making. We used a method called discrete choice modeling (DCM) to evaluate which clinical and demographic patient factors might make emergency physicians more likely to initiate transfers to LTCs. Methods An email survey was distributed to physicians working in emergency departments (EDs) in Ontario. The relative importance of clinical and demographic patient attributes as drivers for transfer was evaluated using DCM. Simulated patient cases were created using a random generator to combine attributes. Each respondent was presented with 36 different patients in sets of three and asked if they would transfer each patient to an LTC. The relative importance of each driver was then compared across physician characteristics. Results One hundred and fifty three emergency physicians completed the survey. The drivers for transfer, expressed as utility scores, were derangements in hemodynamics (22), CNS/head injuries (19), pelvic fractures (11), chest injuries (10), comorbidities (9), abdominal injuries (8), extremity injuries (7), mechanism of injury (7), age (5), and gender (2). Drivers for patient transfer did not differ based on physician experience or type of training. Conclusion In this DCM study, the clinical and demographic factors most likely to make emergency physicians consider patient transfers to LTCs were patient hemodynamic derangements and CNS/head injuries. Overall, these drivers did not differ by physician experience or training. An understanding of such patient-level drivers for transfers to LTCs may improve the implementation of evidence-based interfacility transfer criteria.
Clinical profile of ocular trauma at a tertiary care hospital in South India: A retrospective study
Authors: Wadwekar Bhagwati , Hansdak Amod , Sahu Pratima , Karnam Ali Hasan F , Sanjana Elfride F 
Published: November 2021

Introduction Ocular injury is the commonest ocular emergency and can vary across geographical and socioeconomic regions. This study was conducted to determine the pattern of ocular injuries presenting to our tertiary care hospital located in Puducherry, Southern India. Methods A retrospective hospital-based study was performed and analyzed the records of the patients who presented with ocular injuries to the emergency department between January 2016 and December 2017. Data were collected using a structured format and noted the demographic profile and clinical profile of ocular injury. Results Of the 392 ocular emergencies, 318 (81.1%) were caused by ocular trauma. Mechanical trauma was most common (306; 96.2%). Males were more frequently affected (ratio; 3.7:1). Most cases of trauma belonged to the 21–30 years age group (86, 28.1%) and were caused by road traffic accidents (RTAs) (197; 64.4%). Adnexal injuries were commonest (285; 93.1%). The ocular injury was close globe type in 93 (30.4%) and the open globe in three (1.0%). Serious lid injury was present in 71 cases (23.2%). Serious injuries such as globe rupture and traumatic optic neuropathy were present in three (1.0%) and eleven (3.6%) cases, respectively. Conclusion Ocular trauma is the most common cause of ocular emergencies and RTA is the commonest cause of ocular trauma. We need to explore strategies to minimize ocular trauma as a priority.
Characteristics associated with delays in decision to transfer injured patients
Authors: Myers Victoria , Nolan Brodie 
Published: November 2021

Introduction The regionalized nature of trauma care necessitates interfacility transfer which is vulnerable to delays given its complexity. Little is known about the interval of time a patient spends at the sending hospital prior to when the transfer is initiated—the “decision to transfer” time. This primary objective of the study was to explore the impact of patient, environmental, and institutional characteristics on decision to transfer time. Methods This was a retrospective cohort study of injured adult patients who underwent emergent interfacility transfer by a provincial critical care transport organization over a 31-month period. Quantile regression was used to evaluate the impact of patient, environmental, and institutional characteristics on the time to decision to transfer. Results A total of 1128 patients were included. The median decision to transfer time was 2.42 h and the median total transport time was 3.12 h. The following variables were associated with an increase in time to decision to transfer at the 90th percentile of time: age >75 (+2.47 h), age 66–75 (+3.70 h), age 56–65 (+1.20 h), transfer between 00:00 and 07:59 (+2.08 h), and transfer in the summer (+2.25 h). The following variables were associated with a decrease in time to decision to transfer at the 90th percentile of time: Glasgow Coma Scale 3–8 (−2.21 h), respiratory rate >30 (−2.01 h), sending site being a community hospital with <100 beds (−4.11 h), or the sending site being a nursing station (−5.66 h). Conclusion Time to decision to transfer was a sizable proportion of the patients interfacility transfer. Older patients were associated with a delay in decision to transfer as were patients transferred overnight and in the summer. These findings may be used to support the implementation of geriatric trauma triage guidelines and promote ongoing education and quality improvement initiatives to decrease delay.
A cross-sectional study of exposure across social media platforms for the British Orthodontic Society retention awareness campaign: #HoldthatSmile
Authors: Lam Yung , Seehra Jadbinder , Abela Stefan , Cobourne Martyn T 
Published: November 2021

Objective: The use of media campaigns in health promotion has become more common in recent years. #HoldthatSmile is a British Orthodontic Society life-long retention awareness campaign aimed at the general public and dental profession launched in 2017. This study investigated #HoldthatSmile exposure on social media platforms over a 12-month period following campaign launch. Design: A cross-sectional content analysis. Setting: Public-facing, English-language posts tagged #HoldthatSmile on the Facebook, Instagram and Twitter social media platforms. Methods: Data were collected relating to a 12-month period, from September 2017 immediately following campaign launch, to the end of September 2018. The primary outcome was exposure to the #HoldthatSmile campaign on the different platforms through analysis of posts, measurement of audience reached and engagement. Secondary outcomes included demographics of user-types and content analysis of reactive comments on posts. Results: A total of 205 relevant posts with #HoldthatSmile were identified on Twitter (n=90, 43.9%), Facebook (n=64, 31.2%) and Instagram (n=51, 24.9%) with an overall calculated audience reach of 108,807 individuals. There were 1849 reactions across the three platforms. The percentage of reactions that generated comments was low at 3%, 6.1% and 5.7% for Twitter, Facebook and Instagram, respectively. Just over three-quarters of users were either Dental Surgeries (53%) or Professional Dental Bodies (28%) and the vast majority were from the United Kingdom. Overall, most comments were positive (46%, n=36) or neutral (44%, n=35) with only 10% (n=8) negative. The overriding theme was a person’s name, with the user commonly typing a friend’s name in order to bring their attention to the post. Conclusion: There were a relatively low number of posts relevant to #HoldthatSmile on Twitter, Facebook and Instagram over the campaign’s first 12 months. However, the majority of these did convey positive or neutral messages.
Cost-effectiveness of mechanical thrombectomy for acute ischemic stroke in Brazil: Results from the RESILIENT trial
Authors: de Souza Ana Claudia , Martins Sheila O , Polanczyk Carisi Anne , Araújo Denizar Vianna , Etges Ana Paula BS , Zanotto Bruna Stella , Neyeloff Jeruza Lavanholi , Carbonera Leonardo Augusto , Chaves Márcia Lorena Fagundes , de Carvalho João José Freitas , Rebello Letícia Costa , Abud Daniel Giansante , Cabral Lucas Scotta , Lima Fabrício O , Mont’Alverne Francisco , SC Magalhães Pedro , Diegoli Henrique , Safanelli Juliana , André Silveira Salvetti Thales , de Sousa Mendes Parente Bruno , Eli Frudit Michel , Silva Gisele Sampaio , Pontes-Neto Octávio M , Nogueira Raul G 
Published: November 2021

Background The RESILIENT trial demonstrated the clinical benefit of mechanical thrombectomy in patients presenting acute ischemic stroke secondary to anterior circulation large vessel occlusion in Brazil. Aims This economic evaluation aims to assess the cost-utility of mechanical thrombectomy in the RESILIENT trial from a public healthcare perspective. Methods A cost-utility analysis was applied to compare mechanical thrombectomy plus standard medical care (n = 78) vs. standard medical care alone (n = 73), from a subset sample of the RESILIENT trial (151 of 221 patients). Real-world direct costs were considered, and utilities were imputed according to the Utility-Weighted modified Rankin Score. A Markov model was structured, and probabilistic and deterministic sensitivity analyses were performed to evaluate the robustness of results. Results The incremental costs and quality-adjusted life years gained with mechanical thrombectomy plus standard medical care were estimated at Int$ 7440 and 1.04, respectively, compared to standard medical care alone, yielding an incremental cost-effectiveness ratio of Int$ 7153 per quality-adjusted life year. The deterministic sensitivity analysis demonstrated that mRS-6 costs of the first year most affected the incremental cost-effectiveness ratio. After 1000 simulations, most of results were below the cost-effective threshold. Conclusions The intervention's clear long-term benefits offset the initially higher costs of mechanical thrombectomy in the Brazilian public healthcare system. Such therapy is likely to be cost-effective and these results were crucial to incorporate mechanical thrombectomy in the Brazilian public stroke centers.