bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vocal Fold Injection Augmentation for Post-Airway Reconstruction Dysphonia: A Case Series
Authors: Bergeron Mathieu , Giliberto John Paul , Tabangin Meredith E. , de Alarcon Alessandro 
Published: May 2021

Objectives: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD. Methods: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid). Results: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred. Conclusion: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD
Comparison of accredited person and medical officer discharge decisions under the Mental Health Act of NSW: A cohort study of deliberate self-poisoning patients
Authors: McGill Katie , Spittal Matthew J , Bryant Jennifer , Lewin Terry J , Whyte Ian M , Madden Clare , Carter Greg 
Published: May 2021

Background: The Accredited Persons Programme was introduced in 2003. The relevant Mental Health Acts (NSW) authorised reviews by appropriately credentialed non-medical health professionals as part of the process of detaining and treating a person without consent: an authority previously held by medical officers. Evaluations of the Programme are needed. Objective: To compare discharge decisions for hospital-treated deliberate self-poisoning patients made by an Accredited Person and Medical Officers. Methods: For a 10-year cohort (2003–2012) of index hospital-treated deliberate self-poisoning admissions at the Calvary Mater Newcastle, we compared Accredited Person and Medical Officer discharge decisions from the general hospital. We specifically examined discharges to the psychiatric hospital under a Mental Health Act certificate (used as an index of the Accredited Person’s use of the authority under the Accredited Persons Programme) compared to any other discharge destination. Unadjusted and adjusted logistic regression models and a propensity score analysis were used to explore the relationship between clinician type and discharge destination. Results: There were 2237 index assessments (Accredited Person = 884; Medical Officer = 1443). One-quarter (27%) were referred for assessment under the Act at the psychiatric hospital, with the Accredited Person significantly more likely (32%) to require this compared to the Medical Officers (24%); Risk Difference: 8.3% (4.5 to 12.1). However, after adjusting for patient characteristics; Risk Difference: −3.0% (−5.9 to −0.1) and for propensity score, Risk Difference: −3.3% (−6.7 to 0.1), the Accredited Person and Medical Officer likelihood of discharging for an assessment under the Act was similar. Conclusions: The Accredited Person assessed more clinically complex patients than the Medical Officers. After adjusting for clinical complexity and propensity score, the likelihood of referral for involuntary psychiatric hospital care was similar for Accredited Person and Medical Officers. Our evaluation of the Accredited Person programme in the general hospital was favourable, and wider implementation and evaluation is warranted.
Occurrence and accuracy of a register-based diagnosis of pediatric bipolar disorder: A nationwide cohort study
Authors: Laursen Mathilde Frahm , Correll Christoph U , Licht Rasmus W , Rodrigo-Domingo Maria , Pagsberg Anne Katrine , Ernst Nielsen René 
Published: May 2021

Objective: To investigate the accuracy of a diagnosis of pediatric bipolar disorder in the Danish National Register compared to the patient charts. Second, we reported on the occurrence of a diagnosis of pediatric bipolar disorder during the study period. Methods: All persons appearing in the Danish nationwide registers between 1995 and 2014 with an incident ICD-10 diagnosis of single hypomanic/manic episode or a diagnosis of bipolar disorder (summarized as bipolar disorder [BD]) before turning 18 years were identified ( n = 521) and a random sample ( n = 131) hereof was selected for chart review. Each chart was reviewed by two independent Schedules for Clinical Assessment in Neuropsychiatry (SCAN) certified raters to assess whether symptoms documented in the chart were consistent with a formal diagnosis of BD according to the ICD-10 criteria or not. Results: The formal diagnostic criteria for BD according to the ICD-10 were fulfilled in 48 charts (45.3%, 95% CI: [36.1%, 54.8%]) out of 106 reviewable charts, age at index = 16.4 ± 1.6 (range = 9.1–18.3) years. Cohen’s Kappa ranged from 94.4% to 100%. The estimate of a lifetime prevalence up till the current age for bipolar disorder for those of aged 5–18 years, was 0.019% in 2014. Conclusion: Less than half of the register-based pediatric BD diagnoses were confirmed by chart review, which was lower than expected. The occurrence of a register diagnosis of pediatric BD was relatively low.
Detection of Hostile Intent by Spatial Movements
Authors: Patton Colleen E. , Wickens Christopher D. , Smith C. A. P. , Clegg Benjamin A. 
Published: May 2021

Objective The ability of people to infer intentions from movement of other vessels was investigated. Across three levels of variability in movements in the path of computer-controlled ships, participants attempted to determine which entity was hostile. Background Detection of hostile intentions through spatial movements of vessels is important in an array of real-world scenarios. This experiment sought to determine baseline abilities of humans to do so. Methods Participants selected a discrete movement direction of their ship. Six other ships’ locations then updated. A single entity displayed one of two hostile behaviors: shadowing, which involved mirroring the participant’s vessel’s movements; and hunting, which involved closing in on the participant’s vessel. Trials allowed up to 35 moves before identifying the hostile ship and its behavior. Uncertainty was introduced through adding variability to ships’ movements such that their path was 0%, 25%, or 50% random. Results Even with no variability in the ships’ movements, accurate detection was low, identifying the hostile entity about 60% of the time. Variability in the paths decreased detection. Detection of hunting was strongly degraded by distance between ownship and the hostile ship, but shadowing was not. Strategies employing different directions of movement across the trial, but also featuring some runs of consecutive movements, facilitated detection. Conclusions Early identification of threats based on movement characteristics alone is likely to be difficult, but particularly so when adversaries employ some level of uncertainty to mask their intentions. These findings highlight the need to develop decision aids to support human performance.
When Crime Moves Where Does It Go? Analyzing the Spatial Correlates of Robbery Incidents Displaced by a Place-based Policing Intervention
Authors: Hatten David , Piza Eric L. 
Published: May 2021

Objective: Examine the place-based correlates of robbery activity displaced by a foot-patrol intervention in Newark, NJ. We use constructs from Crime Pattern and Social Disorganization theories to test hypotheses concerned with associations between the structure of the environment and the displacement of crime. Method: Robbery incidents were spatially joined to street segments to study micro-level displacement processes. Predictor variables were operationalized using data from the Newark Police Department and Infogroup USA. Generalized Linear models tested associations between the characteristics of street segments and displaced robbery in the target area as compared to a control. Results: Environmental structure is important to understanding the settings of displacement, though this varied between spatial and temporal displacement. Relationships between displaced crime activity and model covariates did not always appear in expected directions. For example, bus stops predicted increased spatial displacement while corner stores predicted decreased levels of temporal displacement. Conclusions: While testing for displacement has become commonplace in place-based policing interventions, less attention has been paid to the micro-level factors that may facilitate the displacement of crime events. Both bus stops and corner stores show consistent associations with displaced crime activity, but the directions of these relationships suggest more complex processes requiring further examination.
Awareness and Stigma of Autism Spectrum Disorders in Undergraduate Students
Authors: Kitchin Jannessa L. , Karlin Nancy J. 
Published: May 2021

Background Social stigma is a barrier for students with autism on college campuses. The purpose of this study is to examine the relationship between autism knowledge and autism stigma endorsement. Method 144 college undergraduate students were asked to complete the Autism Stigma and Knowledge Questionnaire as well as a brief demographic questionnaire. The relationship between stigma endorsement and ASD knowledge in the areas of diagnosis and symptoms, etiology, and treatment were evaluated using a multiple linear regression. Two independent-sample t-tests were conducted to investigate group differences between participants who know someone with autism and those who do not as well as between male and female participants. Results A significant regression equation was found ( F(3,140) = 51.35, p = .000), with an R2 of .52. While Treatment and Etiology subscale scores significantly predicted Stigma subscale scores, Diagnosis/Symptom subscale score was not. In terms of knowing someone with an autism diagnosis, there was a significant difference in ASD diagnosis and symptom knowledge ( t(142) = 4.16, p = .000), etiology knowledge ( t(142) = 3.51, p = .001), treatment knowledge ( t(62.99) = 3.54, p = .001), and stigma endorsement ( t(142) = 3.03, p = .003). No significant differences were found between male and female participants. Conclusions Contrary to past studies, gender was not associated with ASD knowledge or stigma endorsement. This study suggests that an intervention designed to increase ASD knowledge, particularly in the areas of etiology and treatment, and to increase contact with students diagnosed with autism would be effective in reducing ASD stigma.
Challenges in Surveillance for Streptococcal Toxic Shock Syndrome: Active Bacterial Core Surveillance, United States, 2014-2017
Authors: Nanduri Srinivas Acharya , Onukwube Jennifer , Apostol Mirasol , Alden Nisha , Petit Susan , Farley Monica , Harrison Lee H. , Como-Sabetti Kathy , Smelser Chad , Burzlaff Kari , Cieslak Paul , Schaffner William , Van Beneden Chris A. 
Published: May 2021

Objectives Routine surveillance for streptococcal toxic shock syndrome (STSS), a severe manifestation of invasive group A Streptococcus (GAS) infections, likely underestimates its true incidence. The objective of our study was to evaluate routine identification of STSS in a national surveillance system for invasive GAS infections. Methods Active Bacterial Core surveillance (ABCs) conducts active population-based surveillance for invasive GAS disease in selected US counties in 10 states. We categorized invasive GAS cases with a diagnosis of STSS made by a physician as STSS–physician and cases that met the Council of State and Territorial Epidemiologists (CSTE) clinical criteria for STSS based on data in the medical record as STSS–CSTE. We evaluated agreement between the 2 methods for identifying STSS and compared the estimated national incidence of STSS when applying proportions of STSS–CSTE and STSS–physician among invasive GAS cases from this study with national invasive GAS estimates for 2017. Results During 2014-2017, of 7572 invasive GAS cases in ABCs, we identified 1094 (14.4%) as STSS–CSTE and 203 (2.7%) as STSS–physician, a 5.3-fold difference. Of 1094 STSS–CSTE cases, we identified only 132 (12.1%) as STSS–physician cases. Agreement between the 2 methods for identifying STSS was low (κ = 0.17; 95% CI, 0.14-0.19). Using ABCs data, we estimated 591 cases of STSS–physician and 3618 cases of STSS–CSTE occurred nationally in 2017. Conclusions We found a large difference in estimates of incidence of STSS when applying different surveillance methods and definitions. These results should help with better use of currently available surveillance data to estimate the incidence of STSS and to evaluate disease prevention efforts, in addition to guiding future surveillance efforts for STSS.
A virtual multi-disciplinary meeting is a cost-effective method of triaging referrals to a regional musculoskeletal oncology service
Authors: Alanie Omer MHF , Mahendra Ashish , Mackinnon Mairi , McCleery Mark , Nicholas Christopher , Gupta Sanjay 
Published: May 2021

Background and aims In 2010, a virtual sarcoma referral model was implemented, which aims to provide a centralised multidisciplinary team (MDT) to provide rapid advice, avoiding unnecessary appointments and providing a streamlined service. The aim of this study is to examine the feasibility of this screening tool in reducing the service burden and expediting patient journey. Methods and results All referrals made to a single tertiary referral sarcoma unit from January 2010 to December 2018 were extracted from a prospective database. Only 26.0% events discussed required review directly. 30.3% were discharged back to referrer. 16.5% required further investigations. 22.5% required a biopsy prior to review. There was a reduction in the rate of patients reviewed at the sarcoma clinic, and a higher discharge rate from the MDT in 2018 versus 2010 (p < 0.001). This gives a potential cost saving of 670,700 GBP over the 9 year period. Conclusion An MDT meeting which triages referrals is cost-effective at reducing unnecessary referrals. This can limit unnecessary exposure of patients who may have an underlying diagnosis of cancer to a high-risk environment, and reduces burden on services as it copes with increasing demands during the COVID-19 pandemic.
The Impact of Strengths-Based Assessment Education on Undergraduate Students’ Knowledge of Disorders and Mental Illness Stigma
Authors: Owens Rhea L. , Heaslip Sean , Thombre Meara 
Published: May 2021

Background: While abnormal psychology courses have traditionally focused on psychopathology, there are several benefits to adopting a strengths-based approach. Objective: This study examined the teaching of a strengths-based assessment approach (the DICE-PM Model), compared to teaching as usual, in an undergraduate abnormal psychology course. Method: Two sections of an abnormal psychology course were taught a strengths-based assessment approach while two sections were taught as usual. All participants completed measures of knowledge of psychological disorders and mental illness stigma at the beginning and end of the semester. Results: Both groups demonstrated significant improvements in knowledge of disorders and a significant decrease in mental illness stigma with the exception of one category assessed (recovery), generally with small effect sizes. Those in the strengths group, compared to the control, showed a significantly greater decrease in mental illness stigma involving anxiety related to others with mental illness, though also with a small effect. Conclusion: Findings suggest strengths-based assessment education does not compromise the instruction of psychological disorders and is equivalent to a traditional abnormal psychology course in reducing mental illness stigma. Teaching Implications: Such an approach may be beneficial early in students’ education to reduce mental illness stigma and promote comprehensive assessment practices.
Effects of Supine and Prone Positions on Nasal Patency in Healthy Individuals
Authors: Chang Geng-He , Hsu Cheng-Ming , Huang Ethan I. , Tsai Hsin-Yi , Wang Yun-Ting , Tsai Ming-Shao , Chang Pey-Jium , Tsai Yao-Te 
Published: May 2021

Objectives: Supine position reduces nasal patency compared with that in the sitting position; however, data on the effects of prone position on nasal patency is lacking. Methods: We assessed the nasal patency of 30 healthy individuals without upper respiratory tract disorders by using visual analog scale (VAS) score and acoustic rhinometry in 7 positions: sitting; frontal, right, and left supine; and frontal, right, and left prone. Results: According to the VAS scores, compared with that in the sitting position, both the supine and prone positions significantly increased subjective nasal obstruction ( P < .001). The prone position had a more significant effect than did the supine position ( P = .017). The results of minimal cross-sectional area measured through acoustic rhinometry demonstrated that both the supine and prone positions reduced the nasal patency significantly, but without significant differences between the effects of prone and supine positions ( P = .794). Conclusion: This is the first study to elucidate that the prone position can significantly reduce the nasal patency in healthy individuals through subjective and objective assessments. Level of Evidence: IV
Otologic Manifestations of Langerhans Cell Histiocytosis: A Systematic Review
Authors: Chen Tiffany , Ashman Peter E. , Bojrab Dennis I. , Johnson Andrew P. , Benson Brian , Hong Robert S. , Svider Peter F. 
Published: May 2021

ObjectiveTo perform a systematic review to investigate common otologic manifestations of Langerhans cell histiocytosis, the incidence of these findings, methods for diagnosis, as well as medical and surgical managementData SourcesPubMed/MEDLINE, Embase, and Cochrane Library.Review MethodsA search of PubMed/MEDLINE, Embase, and Cochrane Library for all articles published between 1963 to 2020 was performed with variations and combinations of the following search terms: Langerhans cell histiocytosis, eosinophilic granuloma, Letterer‐Siwe, Hand‐Schüller‐Christian, otitis, otologic, ear. A review of the references of all included articles was also conducted.ResultsSixty‐two articles encompassing 631 patients met inclusion criteria. Otologic symptoms at presentation were found in 246 (39%) patients in the reported studies with 48% reporting bilaterality. The mean age was 14.8 years with a male predominance (64%). The most common otologic presenting symptom was otorrhea (46%). A majority had the multisystem variant (52%). The most common treatment modalities were chemotherapy (52%), followed by surgery (50%), systemic steroids (45%), and radiotherapy (31%). Surgery was performed in 75.8% with unisystem involvement and in 50.6% with multisystem involvement. The most effective treatments included radiotherapy (56% success rate, 17% of treated patients), systemic steroids (44% success, 20% treated), chemotherapy (41% success, 21% treated), and surgical modalities (36% success, 19% treated).ConclusionsOtologic manifestations that occur with the multisystem variant or are at high risk for central nervous system involvement necessitate systemic treatment. For unifocal lesions, surgery is recommended. Lastly, radiotherapy should be reserved for extensive lesions involving vital structures or presenting in older patients.
Early safety performance of a modified technique of aorta replacement with sinotubular stabilization
Authors: Moscarelli Marco , Di Bari Nicola , Nasso Giuseppe , Fattouch Khalil , Athanasiou Thanos , Bonifazi Raffaele , Speziale Giuseppe 
Published: May 2021

Background We sought to determine if a modified technique for ascending aorta replacement with sinotubular junction reduction and stabilization was safe. Methods This technique was performed by suspension of the three commissures, invagination of the aortic Dacron graft and advancing the graft into the ventricles. We included patients with dilatation of the ascending aorta, normal sinuses of Valsalva dimension (<45 mm), with or without aortic annulus enlargement (>25 mm) and with various degree of aortic insufficiency (from grade 1 to 3). Results From April to October 2019, 20 patients were recruited from two centers; mean age was 66.9 ± 12.8 years, 13 were male; grade 1, 2 and 3 was present in 12, 2 and 6 patients, respectively. All patients underwent ascending aorta replacement with modified technique; an additional open subvalvular ring was used in 8 patients with aortic insufficiency ≥ 2; cusps repair was performed in 6 patients (5 plicating central stitches/1 shaving); concomitant coronary artery bypass grafting was performed in 10 patients. There was no 30-day mortality. One patient was re-explored for bleeding. All patients completed six-month follow-up; at the transthoracic echocardiography, there was no aortic insufficiency ≥ 1 except one patient with aortic insufficiency grade 1 who underwent ascending aorta replacement and subvalvular ring; no patients underwent reintervention. Conclusions This modified technique for ascending aorta replacement and sinotubular junction stabilization was safe. It could be associated with other aortic valve sparing techniques. However, such remodeling approach has to be validated in a larger cohort of patients with longer follow-up.