bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weighing In on the Controversy: Preoperative Imaging in Unicoronal Craniosynostosis Leads to Strategic Changes in Surgical Care
Authors: Ulma Raquel M. , Ranganathan Kavitha L. , Vercler Christian J. , Garton Hugh J. L. , Maher Cormac O. , Muraszko Karin M. , Buchman Steven R. 
Published: April 2021

Background:
Clinical findings in children with unilateral coronal craniosynostosis are characteristic, and therefore clinicians have questioned the need for confirmatory imaging. Preoperative computed tomographic imaging is a powerful tool for diagnosing associated anomalies that can alter treatment management and surgical planning. The authors’ aim was to determine whether and how routine preoperative imaging affected treatment management in unilateral coronal craniosynostosis patients within their institution.

Methods:
A retrospective, single-center review of all patients who underwent cranial vault remodeling for unilateral coronal craniosynostosis between 2006 and 2014 was performed. Patient data included demographics, age at computed tomographic scan, age at surgery, results of the radiographic evaluation, and modification of treatment following radiologic examination.

Results:
Of 194 patients diagnosed with single-suture craniosynostosis, 29 were diagnosed with unilateral coronal craniosynostosis. Additional radiographic anomalies were found in 19 unilateral coronal craniosynostosis patients (65.5 percent). These included severe deviation of the anterior superior sagittal sinus [n = 12 (41.4 percent)], Chiari I malformation [n = 1 (3.4 percent)], and benign external hydrocephalus [n = 2 (6.9 percent)]. The radiographic anomalies resulted in a change in management for 48.3 percent of patients. Specifically, alteration in frontal craniotomy design occurred in 12 patients (41.4 percent), and two patients (6.9 percent) required further radiographic studies.

Conclusions:
Although clinical findings in children with unilateral coronal craniosynostosis are prototypical, preoperative computed tomographic imaging is still of great consequence and continues to play an important role in surgical management. Preoperative imaging enabled surgeons to alter surgical management and avoid inadvertent complications such as damage to a deviated superior sagittal sinus. Imaging findings of Chiari malformation and hydrocephalus also permitted judicious follow-up.

CLINICAL QUESTIONS/LEVEL OF EVIDENCE:
Therapeutic, IV.
A Qualitative Study of Patient Protection against Postoperative Opioid Addiction: A Thematic Analysis of Self-Agency
Authors: Cho Hoyune E. , Billig Jessica I. , Byrnes Mary E. , Nasser Jacob S. , Kocheril Alex P. , Haase Steven C. , Waljee Jennifer F. , Chung Kevin C. 
Published: April 2021

Background:
Opioids are commonly used following outpatient surgery. However, we understand little about patients’ perspectives and how patients decide on postoperative opioid use. This study seeks to investigate aspects of patients’ thought processes that most impact their decisions.

Methods:
The authors conducted semistructured interviews with 30 adults undergoing minor elective hand surgery at one tertiary hospital. Narratives were content-coded to arrive at the authors’ thematic analysis. The authors incorporated Bandura’s concept of self-agency to interpret the data and develop a conceptual framework that best explained the implicit theory within participants’ responses.

Results:
The authors found six themes under two domains of self-agency. Participants actively sought out protective mechanisms supporting their decision on opioid use, but sometimes did so unconsciously. They would avoid opioids postoperatively because they were “tough” and wanted to evade the risk of addiction as “good citizens.” They conveyed a nuanced safety against addiction because they were “not the kind” to become addicted and because they trusted the surgeons’ prescribing. However, participants felt discouraged by the stigma associated with opioids. Both intentionally and unintentionally, participants integrated a strong sense of self in their decision-making processes.

Conclusions:
A robust understanding of how patients choose to take opioids for postoperative pain control is imperative to develop patient-centered strategies to treat the opioid epidemic. Effective opioid-reduction policies should consider patients as active agents who negotiate various internal and external influences in their decision-making processes. Surgeons must incorporate patients’ individual goals and perspectives regarding postoperative opioid use to minimize opioid-related harm after surgery.
Quantitative Analysis of the Lifting Effect of Facial Soft-Tissue Filler Injections
Authors: Haidar Rami , Freytag, M.D. David L. , Frank Konstantin , Rudolph Christina , Hamade, B.Sc. Hassan , Schenck Thilo L. , Green Jeremy B. , Giunta Riccardo E. , Gotkin Robert H. , Cotofana Sebastian 
Published: April 2021

Background:
Although injectable soft-tissue fillers are frequently used for facial rejuvenation, there is a dearth of objective data evaluating the tissue-lifting effects. Current practices for efficacy evaluation include some subjectivity. This study seeks to evaluate the lifting effects of facial soft-tissue fillers in a quantifiable, objective setting.

Methods:
Twenty fresh hemifaces obtained from 10 Caucasian body donors (seven women and three men) with a mean age of 83.5 ± 6.8 years and a mean body mass index of 25.3 ± 4.3 kg/m2 were injected with soft-tissue fillers following a predefined treatment algorithm. Three-dimensional surface scanning procedures were performed to assess postinjection effects.

Results:
Injections in the medial face [i.e., forehead, medial midface, and perioral (chin and labiomandibular sulcus)] increased the local surface volume by 0.67, 0.56, and 0.87 cc and created local (but not regional) lifting effects of 1.11, 0.11, and 0.74 mm. Injections in the lateral face (temple, lateral midface, and jawline) changed the local surface volume by 0.45, 0.02, and −0.38 cc, and created local lifting effects of 0.57, 0.81, and 0.29 mm, respectively. Lateral face injections, however, created additional regional lifting effects by co-influencing neighboring lateral facial regions, which was not observed for medial face injections.

Conclusions:
This cadaveric study provides evidence that soft-tissue fillers, although typically classified as volumizers, can induce lifting effects of the face. Whereas temporal deep supraperiosteal injections have limited lifting effects, the combined effects of subdermal injections of the temple, lateral midface, and mandibular angle can induce lifting effects of the total lateral face.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Scalp Reconstruction after Mohs Cancer Excision: Lessons Learned from More Than 900 Consecutive Cases
Authors: Harirah Muhammad , Sanniec Kyle , Yates Tyler , Harirah Omar , Thornton James F. 
Published: April 2021

Background:Scalp reconstruction has evolved over time. Given the large surface area, location, and high likelihood of sun exposure, the scalp is particularly prone to sun damage and skin cancer. Resection of scalp cancers often leaves a large defect that can be challenging for reconstruction. The authors present objective data and recommendations based on more than 10 years of consecutive scalp reconstructions performed by the senior author (J.F.T.). In addition, the authors describe each method of reconstruction and delineate an algorithm based on the senior author’s approach and the cases assessed.Methods:The authors conducted a retrospective review of patients who underwent scalp reconstruction after Mohs cancer excision over a 10-year period. Each case was evaluated for key patient characteristics, defect location, defect size, defect composition, reconstructive modality, and complications.Results:The senior author (J.F.T.) performed 913 scalp reconstruction procedures. Defects most commonly involved the forehead or vertex of the scalp, with a wide range of sizes. A significant majority of the patients’ defects were repaired with the use of adjacent tissue transfer or Integra dermal regeneration templates. There were 94 complications (12.5 percent) noted, ranging from graft loss to cancer recurrence.Conclusions:Reconstruction of scalp defects after Mohs cancer excision presents the plastic surgeon with numerous patient and defect preoperative variables to consider. Each defect should be evaluated, and a plan based on composition of the defect and the needs of the patient should be developed. Scalp reconstruction is safe to perform in an outpatient setting, even in elderly patients.CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.
Self-Rated Health Among Patients With Severe Traumatic Brain Injury and Their Close Relatives: The Role of Posttraumatic Stress Symptoms
Authors: Tsur Noga , Haller Chiara S. 
Published: April 2021

ABSTRACT

Objective
Severe traumatic brain injury (sTBI) is accompanied by significant declines in self-rated health (SRH). Although such deteriorations in SRH are related to various consequences of sTBI, the effect of posttraumatic reactions (i.e., posttraumatic stress [PTS] symptoms) has been tested insufficiently to date, especially among civilians. The present investigation is based on Trajectories of Recovery After Severe Traumatic brain injury—Matters In families (TRAST-MI), a unique study among civilians with sTBI and their families. Previous research revealed that civilian sTBI has effects beyond the injured patient, influencing their close relatives as well. The aim of this study was to assess the association between PTS symptoms and SRH among patients with civilian sTBI and their close relatives.

Methods
Patients with sTBI (assessed by an Abbreviated Injury Scale of the head region score >3) and their close relatives participated in TRAST-MI. One hundred twenty-six patient-relative dyads were assessed at 3, 6, and 12 months after the injury.

Results
Multilevel modeling revealed that patients’ PTS symptoms were associated with consequent SRH (slope = 0.42; p < .001), and relatives’ PTS symptoms were associated with their respective SRH (slope = 0.2; p = .012).

Conclusions
The findings of this study reveal that SRH of both patients with sTBI and their relatives are negatively affected by their own PTS symptoms. These findings underline the understanding that sTBI is not merely a medical trauma but rather a comprehensive psychosocial trauma, which has consequences for the whole family system.
Association Between the Modified Functional Movement Screen Scores, Fear of Falling, and Self-Perceived Balance in Active Older Adults
Authors: Dietze-Hermosa Martin S. , Montalvo Samuel , Gonzalez Matthew P. , Dorgo Sandor 
Published: April 2021

Aims:
To determine the association between fear of falling and self-perceived balance with the modified Functional Movement Screen (FMS) and determine whether fear of falling, self-perceived balance, and modified FMS scores differ depending on age group and sex.

Methods:
One hundred and fifty-six active older adults completed a fear of falling and self-perceived balance questionnaire and then the modified FMS.

Results:
Modified FMS scores differed by age group and sex (P < .05). Increasing age was associated with poorer modified FMS scores while females outperformed males on most components of the modified FMS (P < .05). Associations of the modified FMS with age group and sex indicated that better modified FMS scores were associated with decreased fear of falling and greater self-perceived balance.

Conclusion:
Focus on different aspects of the modified FMS may depend on age and sex. There is a small relationship between the modified FMS with fear of falling and self-perceived balance.
The Effect of Different Exercise Training Types on Functionality in Older Fallers
Authors: Abit Kocaman Ayşe , Kırdı Nuray , Aksoy Songül , Elmas Özgün , Dogu Burcu Balam 
Published: April 2021

Background:
Fall is one of the most common geriatric syndromes in the elderly population. It is important to determine the most effective exercise training in elderly individuals who are at risk of falling.

Aim:
To investigate the effects of different exercise trainings on functionality in older fallers.

Method:
A total of 30 older adults, 16 females and 14 males, were enrolled in this randomized controlled trial. The older adults were divided into 3 groups: vestibular exercise (VE), posturography balance exercise (PBE), and square step exercise (SSE) groups. All groups received VE training. Sensory Organization Test (SOT), Adaptation Test (ADT), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Vestibular Disorders Activities of Daily Life Scale (VADL), and the World Health Organization Quality of Life Scale–Older Adults Module (WHOQOL-Old) were administered before and at the end of the 24 training sessions.

Results:
The MoCA and the composite balance score of the SOT were improved in the PBE and SSE groups and the FES in all groups. According to multiple comparison analyses, toes up in the VE and PBE groups, toes down of the ADT in the PBE group, VADL in the PBE and SSE groups, the WHOQOL-Old in all groups significantly improved (P < .010).

Conclusion:
VE training alone is not sufficient for older fallers. A combination of PBE and SSE training, which was applied 3 times a week for 8 weeks, was more effective in improving functionality in older fallers.
Disaster preparedness among women with a recent live birth in Hawaii, a cross-sectional study, results from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2016
Authors: Strid Penelope , Fok Carlotta Ching Ting , Zotti Marianne , Shulman Holly B. , Awakuni Jane , House L. Duane , Morrow Brian , Kern Judy , Shim Matthew , Ellington Sascha 
Published: April 2021

AbstractObjectivesThis study examines emergency preparedness behaviors among women with a recent live birth in Hawaii.MethodsUsing the 2016 Hawaii Pregnancy Risk Assessment Monitoring Survey we estimated weighted prevalence of eight preparedness behaviors.ResultsAmong 1010 respondents (weighted response rate=56.3%), 79.3% reported at least one preparedness behavior and 11.2% performed all eight behaviors. The prevalence of women with a recent live birth in Hawaii reporting preparedness behaviors includes: 63.0% (95% CI: 58.7-67.1%) having enough supplies at home for at least seven days, 41.3% (95% CI: 37.1-45.6%) having an evacuation plan for their child(ren), 38.7% (95% CI: 34.5, 43.0) having methods to keep in touch, 37.8% (95% CI: 33.7, 42.1) having an emergency meeting place, 36.6% (95% CI: 32.6, 40.9) having an evacuation plan to leave home, 34.9% (95% CI: 30.9, 39.2) having emergencies supplies to take with if they have to leave quickly, 31.8% (95% CI: 27.9, 36.0) having copies of important documents, 31.6% (95% CI: 27.7, 35.8) having practiced what to do.ConclusionOne in ten women practiced all eight behaviors indicating more awareness efforts are needed among this at-risk population in Hawaii. Hawaii can measure the effect of interventions to increase preparedness by tracking this question over time.Significance“What is already known on this subject?”Preparedness is associated with reduced vulnerability, and postpartum women are considered an at-risk population in the post-disaster period with special clinical needs. One prior study has assessed disaster preparedness among postpartum women.“What this study adds?”This is the first study to describe a methodology to analyze the eight-part PRAMS emergency preparedness question. Among recently postpartum women in Hawaii, about 80% practiced at least one of eight emergency preparedness measures assessed and about 10% practiced all behaviors.
FutureMS Cohort Profile: A Scottish Multi-Centre Inception Cohort Study of Relapsing-Remitting Multiple Sclerosis
Authors: Kearns P.K.A. , Martin S.J. , Chang J. , Meijboom R. , York E.N. , Chen Y. , Weaver C. , Stenson A. , Hafezi K. , Thomson S. , Freyer E. , Murphy L. , Harroud A. , Foley P. , Hunt D. , McLeod M. , O’Riordan J. , Carod-Artal F.J. , MacDougall N.J.J. , Baranzini S.E. , Waldman A.D. , Connick P. , Chandran S. 
Published: April 2021

ABSTRACTMultiple sclerosis (MS) is an immune-mediated, neuroinflammatory disease of the central nervous system and in industrialised countries is the most common cause of progressive neurological disability in working age persons. However, there is significant inter-individual heterogeneity in disease activity and response to treatment. Currently, the ability to predict at diagnosis who will have a benign, intermediate, or aggressive disease course is very limited. There is therefore a need for integrated predictive tools to inform individualised treatment decision-making. FutureMS is a nationally representative, prospective observation cohort study comprising of 440 participants with a new diagnosis of relapsing remitting MS living in Scotland between May 2016 and March 2019. Established with the aim of addressing this need for individualised predictive tools, the cohort is designed to combine detailed clinical phenotyping with imaging, genetic and biomarker metrics of disease activity and progression. Recruitment, baseline assessment and follow up at year one is complete and longer term follow up is planned, beginning at five years after first visit. The study aims to explore the pathobiology and determinants of disease heterogeneity in MS. Here we describe the cohort design and present a profile of the participants at baseline and one year of follow up.
Understanding the barriers to pooled SARS-CoV-2 testing in the United States
Authors: Fenichel Eli P. , Gilbert Anna , Gonsalves Gregg , Wyllie Anne L. 
Published: April 2021

AbstractPooled testing for SARS-CoV-2 detection is instrumental for increasing test capacity while decreasing test cost, key factors for sustainable, long-term surveillance measures. While numerous pooled approaches have been described, uptake by labs has been limited. We surveyed 90 US labs to understand the barriers to implementing pooled testing.
Mid-Regional pro-Adrenomedullin (MR-proADM), C-Reactive Protein (CRP) and Other Biomarkers in the Early Identification of Disease Progression in COVID-19 Patients in the Acute NHS Setting
Authors: Moore Nathan , Williams Rebecca , Mori Matilde , Bertolusso Beatrice , Vernet Gabrielle , Lynch Jessica , Philipson Peter , Ledgerwood Thomas , Kidd Stephen P. , Thomas Claire , Garcia-Arias Veronica , Young Michelle , Saeed Kordo , Gordon Kirsty , Cortes Nicholas 
Published: April 2021

AimsThere is a lack of biomarkers validated for assessing clinical deterioration in COVID-19 patients upon presentation to secondary or tertiary care. This evaluation looked at the potential clinical application of C-Reactive Protein, Procalcitonin, Mid-Regional pro-adrenomedullin (MR-proADM) and White Cell Count to support prediction of clinical outcomes.Methods135 patients presenting to Hampshire Hospitals NHS Foundation Trust between April and June 2020 confirmed to have COVID-19 via RT-qPCR were included. Biomarkers from within 24 hours of admission were used to predict disease progression by Cox regression and area under the receiver operating characteristic (AUROC) curves. The endpoints assessed were 30-day all-cause mortality, intubation and ventilation, critical care admission and non-invasive ventilation (NIV) use.ResultsElevated MR-proADM was shown to have the greatest ability to predict 30-day mortality adjusting for age, cardiovascular, renal and neurological disease. A significant association was also noted between raised MR-proADM and CRP concentrations and the requirement for critical care admission and non-invasive ventilation.ConclusionsThe measurement of MR-proADM and CRP in patients with confirmed COVID-19 infection upon admission shows significant potential to support clinicians in identifying those at increased risk of disease progression and need for higher level care, subsequently enabling prompt escalation in clinical interventions.
Public Perception of COVID-19 Vaccines through Analysis of Twitter Content and Users
Authors: Saleh Sameh N. , McDonald Samuel A. , Basit Mujeeb A. , Kumar Sanat , Arasaratnam Reuben J. , Perl Trish M. , Lehmann Christoph U. , Medford Richard J. 
Published: April 2021

AbstractTwitter is a robust medium to understand wide-scale, organic public perception about the COVID-19 vaccine. In this cross-sectional observational study, we evaluated 2.4 million English tweets from nearly 1 million user accounts matching keywords ((‘covid*’ OR ‘coronavirus’) AND ‘vaccine’) during vaccine development from Feb 1stthrough Dec 11th, 2020. We applied topic modeling, sentiment and emotion analysis, and demographic inference of users on the COVID-19 vaccine related tweets to provide insight into the evolution of public attitudes. Individuals generated 87.9% (n=834,224) of tweets. Of individuals, men (n=560,824) outnumbered women (n=273,400) by 2:1 and 39.5% (n=329,776) of individuals were ≥ 40 years old. Daily mean sentiment fluctuated congruent with news events, but overall trended positively. Trust, anticipation, and fear were the three most predominant emotions; while fear was the most predominant emotion early in the study period, trust outpaced fear from April 2020 onward. Fear was more prevalent in tweets by individuals (26.3% vs. organizations 19.4%; p<0.001), specifically among women (28.4% vs. males 25.4%; p <0.001). Multiple topics had a monthly trend towards more positive sentiment. Tweets comparing COVID-19 to the influenza vaccine had strongly negative early sentiment but improved over time. Our findings are concerning for COVID-19 vaccine hesitancy, but also identify targets for educational interventions.
Comparison of SARS-CoV-2 serological assays for use in epidemiological surveillance in Scotland
Authors: McDonald Lindsay , Wise Helen , Muecksch Frauke , Poston Daniel , Mavin Sally , Templeton Kate , Furrie Elizabeth , Richardson Claire , McGuire Jaqueline , Jarvis Lisa , Malloy Kristen , McAuley Andrew , Palmateer Norah , Dickson Elizabeth , Hatziioannou Theodora , Bieniasz Paul , Jenks Sara 
Published: April 2021

AbstractBackgroundSero-surveillance of SARS-CoV-2 is crucial to monitoring levels of population exposure and informing public health responses, but may be influenced by variability in performance between available assays.MethodsFive commercial immunoassays and a neutralising activity assay were used to detect antibodies to SARS-CoV-2 in routine primary care and paediatric samples collected during the first wave of the pandemic in NHS Lothian, Scotland as part of ongoing surveillance efforts. For each assay, sensitivity and specificity was calculated relative to consensus results and neutralising activity. Quantitative correlation was performed between serological and neutralising titres.ResultsSeroprevalence ranged from 3.4-7.3 % in primary care patients and 3-5.9 % in paediatric patients according to different immunoassays. Neutralising activity was detectable in 2.8 % and 1.3 % respectively. Relative assay performance changed depending on comparison to immunoassay consensus versus neutralising activity and qualititative versus quantitative agreement. Cross-reactivity with endemic seasonal coronaviruses was confirmed by neutralising assay in false positives for one immunoassay. Presence of false positives for another assay was found specifically in paediatric but not adult samples.ConclusionsFive serological assays show variable accuracy when applied to the general population, impacting seroprevalence estimates. Assay performance may also vary in detection of protective neutralising antibody levels. These aspects should be considered in assay selection and interpretation in epidemiological studies.