bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social-communicative gestures at baseline predict verbal and nonverbal gains for children with autism receiving the Early Start Denver Model
Authors: Laister Dominik , Stammler Magdalena , Vivanti Giacomo , Holzinger Daniel 
Published: March 2021

In children with autism spectrum disorder, atypical gesture use is a core deficit with consequences for social learning, social interaction, and language development. Little is known about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. We found that the parent-rated “Gestural Approach Behavior” subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with developmental changes after 1 year of intervention as assessed by the Mullen Scales of Early Learning. This subscale was as strong a predictor as the Mullen nonverbal development quotient before intervention. Our findings suggest that children who use more gestures for social communication might be better equipped to respond to the learning opportunities offered by the Early Start Denver Model. Lay abstract Although there is growing evidence of the effectiveness and importance of certain early intervention programs for children with autism spectrum disorders, little is known about predictive information before intervention to search for the most accurate therapeutic approach for the individual child and his family. In children with autism spectrum disorder, atypical gesture use is one core deficit with consequences for the development of social interaction and language, but there is little knowledge about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. In this study, we found that the parent-rated “Gestural Approach Behavior” subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with clinically assessed developmental changes after 1 year of intervention. This subscale was as strong a predictor as nonverbal development before intervention. Our findings suggest that children who use more gestures in daily life might be better equipped to respond to learning opportunities offered by early interventions targeting social communication strategies such as the Early Start Denver Model. Furthermore, we conclude that the parent-rated questionnaire might be a valuable and economic set of questions with high relevance for clinical assessments.
Falls downstairs: The impact on a UK major trauma centre
Authors: Callon Joshua , Thomas Daniel , Mercer Simon J 
Published: March 2021

Introduction Major trauma centres are increasingly managing a significant injury burden in older patients, with falling downstairs being a prevalent mechanism of injury. Literature evaluating the impact of falls on stairs upon UK trauma networks is limited. Gaining a greater understanding of this may allow for more effective planning of services and improvements in training and education. This study evaluates the impact of falls downstairs on a UK major trauma centre. Methods A single centre retrospective service evaluation of local major trauma data over a 3-year period from 01/01/2017 to 31/12/2019. Included were patients who activated a trauma call whose mechanism of injury recorded at the time of admission was a fall downstairs. We excluded patients less than 16 years of age. Results There were 4480 major trauma patients who presented in the study period and of these, 860 (19.2%) sustained injuries following a fall downstairs. The most common age group presenting was 70–79 years; younger patients (<60 years) made up 43.3% with the majority (56.7%) being older. All but one patient were managed by a consultant-led trauma team, 6.4% of patients were admitted to critical care and 1% received an urgent operation. The overall mortality rate was 8.5%. Older patients made up 85% of those who died and had nearly four times longer average length of stay than younger patients (9.69 v 2.49 days). Conclusion Falls downstairs place a significant burden on the major trauma centre. There is a stark contrast in the use of hospital resources and outcomes between older and younger patients.
Effect of educative reminder telephone calls on human papillomavirus immunization rate: A randomized controlled trial
Authors: Bernard-Genest Marie-Pier , Ruel-Laliberté Jessica , Lapointe-Milot Korine 
Published: March 2021

Context: Human papillomavirus coverage varies widely among women depending on their race, incomes, geographical location and education level. Objective: To evaluate whether reminder educative phone calls increase human papillomavirus vaccination rates in adult women aged 18–45 with high-risk factors of cervical cancer. Design: We conducted a single-blind randomized controlled trial in patients who consulted at a Canadian tertiary center in October 2019 during National Cervical Cancer Awareness Week. Interventions: We randomized women to receive three standardized educative phone calls or standard care. Main outcome measure: We assessed the immunization rate at 6 months. Results: A total of 130 patients were randomized of which 62 patients were randomized to the intervention. Eight patients (15.4%) got immunized at 6 months in the intervention group as compared to seven (11.7%) in the control group (p = 0.5645). The main barrier to vaccination reported by non-immunized patients at 6 months was the cost of vaccination (42.3%). Conclusion: Reminder educative phone calls did not increase human papillomavirus vaccination rates in adult women with risk factors of cervical cancer. ISRCTN registration number: ISRCTN58518971
Predisposing Factors for 30-Day Complications Following Leg Amputation
Authors: Villarreal Joseph V. , Hussien Doha G. , Panchbhavi Vinod K. , Jupiter Daniel C. 
Published: March 2021

Background Although amputation rates, morbidity, and mortality have been established for select populations, the impact of general demographic factors on postoperative surgical complications remains little studied. Methods The American College of Surgeons’ National Surgical Quality Improvement Program database was searched for leg amputations from 2012 to 2017 using CPT codes 27881, 27882, 27884, and 27886, identifying 4162 patients. A total of 29 demographic variables with 4 complications (surgical infection, additional service, and deep-vein thrombosis [DVT], and sepsis) were analyzed. Results Preoperative open, contaminated, or dirty/infected wounds; longer intraoperative times; development of sepsis prior to surgery; and admission of patients from home or another hospital influenced postoperative infection rates. Preoperative open, infected, or dirty/infected wounds; height; weight; total length of hospital stay; and ethnicity affected postoperative additional service incidence. Preoperative congestive heart failure, large decreases in body weight, and total length of hospital stay influenced postoperative DVT rates. Preoperative functional heath status, total length of hospital stay, amputations conducted as emergency cases, preoperative acute renal failure, open or infected wounds, sepsis, and contaminated or dirty/infected wounds affected postoperative sepsis rates. Background Conclusion. Understanding these risk factors may allow providers to anticipate and address higher rates of complications in certain patient populations. Level of evidence: Level III: Prognostic
Patient experiences of integrated care within the United Kingdom: A systematic review
Authors: Davidson Lea , Scott Jason , Forster Natalie 
Published: March 2021

Introduction Integrated care and patient experience are central to the coordination and delivery of high quality health and social care in the UK, but their joint application is poorly understood. This systematic review aimed to gain an understanding of patient experience within current integrated care services in the UK, and specifically, whether they reflect person-centred coordinated care (PCCC). Methods Following PRISMA, electronic databases (ProQuest, EBSCO and Cochrane Library) were searched from 2012 to 2019 for primary, peer-reviewed literature. Papers were included where patients’ or carers’ experiences of integrated care were reported. Papers were excluded where they focused on acute integrated care interventions, measured experience via satisfaction scores only, or findings lacked sufficient depth to answer the research question. Quality was assessed using Mixed Methods Appraisal Tool, and findings synthesised using a framework approach, incorporating the Rainbow Model of Integrated Care and Measuring Integrated Care Patient Framework. Results Sixteen studies were included. Person-centred and shared responsibility experiences were most often discussed. Experiences were not always described as positive and some patients experienced a lack of PCCC. Clinical, professional/organisational and functional integration processes were associated with experiencing domains of PCCC. Discussion People with complex needs experience a lack of coordination across teams and wider community resources, and limited associations were made between integration processes and patient experience. Further research which gives context to individual experience, provides greater detail of integration processes and utilises validated patient experience measures of PCCC is required to understand the association between integration processes and domains of PCCC.
Detecting COVID-19 and other respiratory infections in obstructive sleep apnoea patients through CPAP device telemonitoring
Authors: Pépin Jean-Louis , Bailly Sébastien , Borel Jean-Christian , Logerot Sophie , Sapène Marc , Martinot Jean-Benoît , Lévy Patrick , Tamisier Renaud 
Published: March 2021

Objective The earliest possible detection of individuals with COVID-19 has been essential to curb the spread of infection. Existing digital tools have been scaled up to address this issue. Every night telemonitoring data on continuous positive airway pressure (CPAP) device use, the first-line therapy for obstructive sleep apnoea (OSA), is collected worldwide. We asked whether the changes in CPAP adherence patterns of might constitute an alert for COVID-19. Methods We analysed preliminary results of telemonitoring data, recorded between February 1 and April 30, 2020, on OSA patients followed by our sleep clinics and diagnosed with COVID-19. Results CPAP telemonitoring data from the first 19 patients diagnosed with COVID-19 showed a clear decrease or halt in adherence in the 20 days immediately preceding COVID-19 diagnosis compared to an earlier period (p < 0.01). Conclusion Patterns of continuous positive airway pressure device use by obstructive sleep apnoea patients collected through telemonitoring can indicate the onset of COVID-19 symptoms. Existing telemonitoring platforms could be immediately used to screen for COVID-19, and for other respiratory infections, in this large at-risk population.
Plasma D-dimer level is associated with clinical outcomes in patients with atrial fibrillation related acute ischemic stroke after pneumonia
Authors: Yang Xu , Lu Taoli , Qu Zhanli , Zhang Yi , Liu Pingping , Ma Ying 
Published: March 2021

Abstract
Background
Pneumonia is related to poor prognosis in acute ischemic stroke (AIS), and its risk might be higher in atrial fibrillation (AF) related AIS with elevated plasma D-dimer. The aim of our study was to investigate the prognostic value of D-dimer for predicting clinical outcome of AF-related AIS with pneumonia.

Method
AF-related AIS patients with pneumonia were prospectively enrolled. Receiver operating characteristic (ROC) curve was used to determine the optimal D-dimer point for 3-month mortality and death/severe disability. The associations between the D-dimer and 3-month mortality and death/severe disability were assessed by multivariable logistic regression analysis.

Results
A total of 415 patients were enrolled in this study. ROC curve analysis showed that the optimal cut point of D-dimer for 3-month death/severe disability and mortality were D-dimer≥2.35 mg/l and D-dimer≥3.35 mg/l, respectively. Multivariable logistic regression analysis showed that D-dimer≥2.35 mg/l [adjusted odds ratio (aOR) 5.99, 95% confidence interval (CI): 3.04–11.83, P<0.001], higher NIHISS score (aOR:1.53, 95% CI: 1.38–1.69, P<0.001) and larger infarct volume (aOR 1.01, 95% CI: 1.01–1.02, P<0.001) were associated with increased risk of 3-month death/severe disability), and anticoagulant was associated with decreased risk of death/severe disability (aOR:0.21, 95% CI: 0.09–0.47, P<0.001). Higher NIHISS score (aOR:1.64, 95% CI: 1.38–1.94, P<0.001), older age (aOR 1.08, 95% CI: 1.02–1.14, P = 0.007), D-dimer≥3.35 mg/l (OR 8.49, 95% CI: 4.13–17.84,P<0.001), larger infarct volume (aOR 1.02, 95% CI: 1.00–1.03, P = 0.014), and higher CRUB-65 score (aOR 6.43, 95% CI: 3.10–13.34, P<0.001) were associated with increased risk of 3-month mortality.

Conclusions
AF-related AIS patients with concurrent high D-dimer and pneumonia increased risk of 3-month mortality and death/severe disability, plasma D-dimer may have predictive value in outcome after AF-related AIS with pneumonia.
Placental glucose transporter 1 and 3 gene expression in Monochorionic twin pregnancies with selective fetal growth restriction
Authors: Chang Yao-Lung , Chao An-Shine , Chang Shuenn-Dyh , Cheng Po-Jen 
Published: March 2021

Abstract
Background
In monochorionic twin (MC) gestations with selective fetal growth restriction (FGR), the discordant fetal growth usually is due to unequal placental sharing. Glucose, which is essential for oxidative metabolism in the growing placenta and fetus, is transferred from maternal blood by facilitated carrier-mediated diffusion via glucose transporters (GLUTs). How the GLUTs expression varies in the two placenta territories manifests discordant perfusion in MC twin pregnancy with selective FGR is unknown. This study evaluates the human placental GLUT1 and GLUT3 gene expression in MC twin gestations with selective FGR.

Methods
MC twin pregnancy with selective FGR was defined as the presence of inter-twin birth weight discordance of > 25% and the smaller twin with a birth weight less than the 10th percentile in third trimester. Fetal umbilical artery Doppler was checked within 1 week before delivery in the two fetuses. An abnormal umbilical artery Doppler was defined as persistently absent or reverse end-diastolic flow (UA-AREDF). GLUT1, GLUT3 and HIF-1α gene expression were assayed in each twin’s placental territories. The inter-twin placental gene expression ratio was calculated as the placenta GLUTs or HIF-1α expression level of the selective FGR twin divided by expression level of the appropriate-for-gestational-age (AGA) cotwin. Higher gene expression ratio means elevated gene expression in the selective FGR twin’s placenta territory compared to AGA twin’s placenta territory.

Results
15 MC twin gestations with selective FGR including nine with normal (group 1) and six with abnormal selective FGR twin UA Doppler (group 2) were included into this study. The GLUT3 and HIF-1α gene expression are significantly elevated in selective FGR twin’s placenta territory in group 2 twin pregnancies (mean gene expression ratio as 2.23 and 1.65, p values as 0.015 and 0.045, respectively), but not in in group 1 twin pregnancies.

Conclusion
The upregulation of placental GLUT3 gene expression in selective FGR fetus with abnormal UA Doppler may be due to hypo-perfusion which is mediated by up -regulation of HIF-1α gene expression.
Increasing the spectrum of white matter diseases with tigroid pattern on MRI: glutaric aciduria type 1 – case report
Authors: Bekiesinska-Figatowska Monika , Duczkowski Marek , Duczkowska Agnieszka , Taybert Joanna , Krzywdzinska Amanda , Sykut-Cegielska Jolanta 
Published: March 2021

Abstract
Background
Most white matter diseases present on magnetic resonance imaging as focal or diffuse T2-hyperintensities. However, in a few of them, radially oriented stripes of low (relatively normal) signal intensity are observed within diffusely affected T2-hyperintense cerebral white matter and are called “tigroid pattern” in the literature. The fornix is a tiny white matter fibers bundle playing crucial role in cognitive functioning, easily overlooked on magnetic resonance imaging and not described in inborn errors of metabolism.

Case presentation
We present a case of glutaric aciduria type 1 with a follow-up of over nine years. The course of the disease is presented in three magnetic resonance scans at the age of 8 and 21 months, and 10 years, with diffusion restriction in the fornix in scan 1 and 2 and with tigroid pattern in scan 3. Despite appropriate diet and supplementation, injury of white matter progressed achieving diffuse stage with tigroid pattern. Psychological tests revealed deficits in patient’s specific cognitive skills, most likely related to damage to the fornix.

Conclusions
To our knowledge, this is the first report of tigroid pattern of white matter involvement in glutaric aciduria type 1 and the first report of forniceal injury in this disease which seems to be correlated with patient’s low functioning in all kinds of memory skills, previously not reported in glutaric aciduria type 1.
Impacts of injury severity on long-term outcomes following motor vehicle crashes
Authors:   On behalf of the FISH Investigators, Hung Kevin K. C. , Kifley Annette , Brown Katherine , Jagnoor Jagnoor , Craig Ashley , Gabbe Belinda , Derrett Sarah , Dinh Michael , Gopinath Bamini , Cameron Ian D. 
Published: March 2021

Abstract
Background
There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia.

Methods
This inception cohort study followed 2019 people injured in MVCs, for 6 and 12 months post-injury. We categorised moderate injury as hospital length-of-stay (LOS) of 2–6 days and Injury Severity Score (ISS) of 4–11, while severe injury as LOS ≥7 days or ISS ≥ 12. We examined differences in paid work status, 12-Item Short Form Survey (SF12), EQ-5D and World Health Organisation Disability Assessment Schedule II (WHODAS) outcomes longitudinally from baseline to 12 months between levels of injury severity using linear mixed models for repeated measures. We first considered minimally sufficient adjustment factors (age, sex, crash role, perceived danger in crash, pre-injury health, pre-injury EQ-5D, recruitment source), and then more extensive adjustments including post-injury factors. The presence of mediating pathways for SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) via post-injury factors was evaluated.

Results
Based on hospital length of stay (LOS), 25 and 10% of participants sustained moderate and severe injuries, respectively, while 43 and 4% had these injuries based on ISS. Twelve months post-injury LOS ≥7 days versus ≤1 day was associated with an estimated 9 units lower mean SF12 PCS using a minimally sufficient adjustment model, and LOS ≥ 7 days was associated with a 3 units lower mean SF12 MCS score. Mediation analyses (LOS ≥ 7 days vs ≤1 day) found for SF12 MCS outcomes, effects of injury severity were small and mostly indirect (direct effect − 0.03, indirect effect − 0.22). Whereas for SF12 PCS outcomes the effect of having a more severe injury rather than mild were both direct and indirect (direct effect − 0.50, indirect effect − 0.38).

Conclusions
Individuals with severe injuries (those with LOS ≥ 7 days and ISS 12+) had poorer recovery 12 months after the injury. In addition, post-injury mediators have an important role in influencing long-term health outcomes.

Trial registration
Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752.
Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study
Authors: Say Yee-How , Heng Anna Hwee Sing , Reginald Kavita , Wong Yi Ru , Teh Keng Foo , Rawanan Shah Smyrna Moti , Sio Yang Yie , Ng Yu Ting , Matta Sri Anusha , Pang Sze Lei , Chew Fook Tim 
Published: March 2021

AbstractBackgroundAcne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese.MethodsA total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel.ResultsMajority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne.ConclusionsIn conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation.