bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations Between Hypernasality, Intelligibility, and Language and Reading Skills in 10-Year-Old Children With a Palatal Cleft
Authors: Særvold Tone Kristin , Hide Øydis , Feragen Kristin Billaud , Aukner Ragnhild 
Published: January 2019

Background: This study investigated the associations between hypernasality and intelligibility, and language and reading skills in 10-year old children with a cleft palate ± lip. Design: Cross-sectional data collected during routine assessments of speech and language in a centralized treatment setting. Participants: Children aged 10, born with cleft palate ± lip from 4 birth cohorts (N = 123). Outcome Measures: Hypernasality and intelligibility: Swedish Articulation and Nasality Test-N; language: Language 6-16 (Sentence recall, Serial recall, Vocabulary); reading: word chain test and reading comprehension test. Results: A total of 71.3% of the children had no occurrence of hypernasality and 82.8% had intelligibility scores within the normal range. For all children with hypernasality and intelligibility within the normal range, reading and language scores were also within normal ranges. Children with presence of hypernasality had significantly lower language skills, with mean scores within the lower normal range. Children with reduced intelligibility had lower scores on reading comprehension. Conclusions: The findings highlight a possible association between hypernasality and language skills, and intelligibility and reading skills. Cleft teams should consider routine assessments of language and reading skills in children with speech impairment, in order to identify potential needs for intervention as early as possible.
Effect of Syndesmotic Implant Removal on Dorsiflexion
Authors: Briceno Jorge , Wusu Timilien , Kaiser Philip , Cronin Patrick , Leblanc Alyssa , Miller Christopher , Kwon John Y. 
Published: January 2019

Background: There is limited evidence that syndesmotic implant removal (SIR) is beneficial. However, many surgeons advocate removal based on studies suggesting improved motion. Methodologic difficulties make the validity and applicability of previous works questionable. The purpose of this study was to examine the effect of ankle dorsiflexion after SIR using radiographically measured motion before and after screw removal utilizing a standardized load. Methods: All patients undergoing isolated SIR were candidates for inclusion. Dorsiflexion was measured radiographically: (1) immediately before implant removal intraoperatively, (2) immediately after removal intraoperatively, and (3) 3 months after removal. A standardized torque force was applied to the ankle and a perfect lateral radiograph of the ankle was obtained. Four reviewers independently measured dorsiflexion on randomized, deidentified images. A total of 29 patients met inclusion criteria. All syndesmotic injuries were associated with rotational ankle fractures. There were 11 men (38%) and 18 women (62%). The mean, and standard deviation, age was 50.3 ± 16.9 years (range 19-80). Results: The mean ankle dorsiflexion pre-operatively, post-operatively, and at a 3-month follow-up was 13.7 ± 6.6 degrees, 13.3 ± 7.3 degrees and 11.8 ± 11.3 degrees, respectively ( P = .466). For subsequent analysis, 5 patients were excluded because of the potential confounding effect of retained suture button devices. Analysis of the remaining 24 patients (and final analysis of 21 patients who had complete 3-month follow-up) demonstrated similar results with no statistically significant difference in ankle dorsiflexion at all 3 time points. Conclusion: Removal of syndesmotic screws may not improve ankle dorsiflexion motion and should not be used as the sole indication for screw removal. Level of Evidence: Level II, prospective cohort study.
Muscular Morphomechanical Characteristics After an Achilles Repair
Authors: Peng Wei-Chen , Chao Yuan-Hung , Fu Amy S. N. , Fong Shirley S. M. , Rolf Christer , Chiang Hongsen , Chen Shiyi , Wang Hsing-Kuo 
Published: January 2019

Background: The purpose of the study was to compare the morphomechanical and functional characteristics during maximal isometric, concentric, and eccentric contractions in the legs of patients that underwent unilateral Achilles tendon repair with those in their noninjured control legs. Methods: Twenty participants (median age = 38.2 years; range, 21.1-57.3 years) who underwent Achilles repair between 3 and 12 months ago were recruited with the following measures: (1) mechanical stiffness of the aponeurosis and (2) electromyography and medial gastrocnemius fascicle angle and length, standing muscle and tendon length, and height of heel rise with isometric contraction. Results: Compared to the noninjured legs, the repaired legs showed less resting fascicle length, standing muscle length, isometric plantarflexion torque, and heel raise distance ( Ps ranged between .044 and <.001). During the concentric and eccentric phases of the raising and lowering test, the repaired legs demonstrated less fascicle length ( P ≤ .028) but greater tendinous tissue length ( Ps ranged between .084 and <.001) and fascicle angle ( Ps ranged between .247 and .008) and fewer change magnitudes of the fascicle length and tendinous tissue length ( P ≤ .003). The change magnitudes of the morphological characteristics showed correlations with the torque or distance. Conclusion: Selecting the appropriate surgical repair and rehabilitation for Achilles tendon ruptures is recommended for restoring the length and mechanical strength of the muscle-tendon unit of plantar-flexion muscles. Level of Evidence: Level III, comparative study.
Severe meningo-/encephalitis after daclizumab therapy for multiple sclerosis
Authors: Stork Lidia , Brück Wolfgang , von Gottberg Phillip , Pulkowski Ulrich , Kirsten Florian , Glatzel Markus , Rauer Sebastian , Scheibe Franziska , Radbruch Helena , Hammer Eckhard , Stürner Klarissa H , Kaulen Barbara , Heesen Christoph , Hoffmann Frank , Brock Sebastian , Pawlitzki Marc , Bopp Tobias , Metz Imke 
Published: January 2019

Background: Daclizumab is a monoclonal antibody that binds the high-affinity interleukin-2 receptor and was approved for the treatment of relapsing multiple sclerosis. Due to severe inflammatory brain disorders, the approval was suspended in March 2018. Objective and Methods: This retrospective cohort study summarizes clinical, laboratory, radiological, and histological findings of seven patients who developed meningo-/encephalitis after daclizumab therapy. Results: Patients presented with encephalitis and/or meningitis and suffered from systemic symptoms such as fever (5/7), exanthema (5/7), or gastrointestinal symptoms (4/7). Secondary autoimmune diseases developed. Blood analysis revealed an increase in eosinophils (5/7). Six patients fulfilled the diagnostic criteria for a drug reaction with eosinophilia and systemic symptoms (DRESS). Magnetic resonance imaging (MRI) showed multiple contrast-enhancing lesions, and enhancement of the ependyma (6/7), meninges (5/7), cranial or spinal nerves (2/7), and a vasculitic pattern (3/7). Histology revealed a pronounced inflammatory infiltrate consisting of lymphocytes, plasma cells and eosinophils, and densely infiltrated vessels. Most patients showed an insufficient therapeutic response and a high disability at last follow-up (median Expanded Disability Status Scale (EDSS) 8). Two patients died. Conclusion: Meningoencephalitis and DRESS may occur with daclizumab therapy. This potential lethal side effect is characterized by a dysregulated immune response. Our findings underline the importance of postmarketing drug surveillance.
The intestinal vitamin D receptor in inflammatory bowel disease: inverse correlation with inflammation but no relationship with circulating vitamin D status
Authors: Garg Mayur , Royce Simon G. , Tikellis Chris , Shallue Claire , Sluka Pavel , Wardan Hady , Hosking Patrick , Monagle Shaun , Thomas Merlin , Lubel John S. , Gibson Peter R. 
Published: January 2019

Background: The intestinal vitamin D receptor (VDR) remains poorly characterized in patients with inflammatory bowel disease (IBD). Methods: Colonoscopic biopsies and intestinal resection specimens from the terminal ileum, ascending and sigmoid colon, from patients with and without IBD, were analyzed for VDR mRNA quantification by polymerase chain reaction, and protein localization and semi-quantification by immunohistochemistry. The relationship between VDR and intestinal inflammation, serum 25(OH)D and oral vitamin D intake was elicited. Results: A total of 725 biopsies from 20 patients with Crohn’s disease (CD), 15 with ulcerative colitis (UC) and 14 non-IBD controls who underwent colonoscopy were studied. VDR gene expression and protein staining intensity was similar across all three groups, and across the intestinal segments. Sigmoid colon VDR mRNA expression inversely correlated with faecal calprotectin ( r = −0.64, p = 0.026) and histological score ( r = −0.67, p = 0.006) in UC, and histological score ( r = −0.58, p = 0.019) in patients with CD. VDR staining intensity was higher in quiescent than diseased segments. No relationship with serum 25(OH)D or oral vitamin D intake was noted. Immunohistochemical staining of 28 intestinal resection specimens from 15 patients (5 each with CD, UC and non-IBD controls) showed diffuse VDR staining in the mucosa, submucosa and circular muscle. Conclusions: VDR transcript expression and protein staining intensity are inversely related to inflammation in IBD, but unrelated to serum 25(OH)D, and similar to non-IBD controls. Strategies to upregulate intestinal VDR, potentially translating to modulation of disease activity, require investigation.
Therapeutic management of closed central slip injuries: Outcome of a service evaluation
Authors: Capon Annie , Watson Alexander , England Holly 
Published: January 2019

Introduction Closed central slip injuries can be difficult to manage and there is a lack of published research to support evidence-based clinical decision making in practice. This article presents the results of a service review in a busy trauma hospital hand therapy department. Method Following a literature review and retrospective review of outcomes, new clinical guidelines for central slip injuries were developed. These were implemented with 22 patients referred to hand therapy for conservative management of closed central slip injuries during a one-year period. Results The majority of patients (72%) had either an excellent or good outcome using the Strickland-Glogovac outcome measure and an average total active motion of 90% compared to their unaffected hand. Conclusions The outcomes following implementation of new treatment guidelines following the service review are in line with the small amount of published data currently available. They provide detailed guidelines for the conservative management of closed central slip injuries in a busy out-patient setting.
Improving Glucose Prediction Accuracy in Physically Active Adolescents With Type 1 Diabetes
Authors: Hobbs Nicole , Hajizadeh Iman , Rashid Mudassir , Turksoy Kamuran , Breton Marc , Cinar Ali 
Published: January 2019

Background: Physical activity presents a significant challenge for glycemic control in individuals with type 1 diabetes. As accurate glycemic predictions are key to successful automated decision-making systems (eg, artificial pancreas, AP), the inclusion of additional physiological variables in the estimation of the metabolic state may improve the glucose prediction accuracy during exercise. Methods: Predictor-based subspace identification is applied to a dynamic glucose prediction model including heart rate measurements along with variables representing the carbohydrate consumption and insulin boluses. To demonstrate the improvement in prediction ability due to the additional heart rate variable, the performance of the proposed modeling technique is evaluated with (SID-HR) and without heart rate (SID-2) as an additional input using experimental data involving adolescents at ski camp. Furthermore, the performance of the proposed approach is compared to that of the metabolic state observer (MSO) model currently used in the University of Virginia AP algorithm. Results: The addition of heart rate in the subspace-based model (SID-HR) yields a statistically significant improvement in the root-mean-square error compared to the SID-2 model ( P < .001) and the standard MSO ( P < .001). Furthermore, the SID-HR model performed favorably in comparison to the SID-2 and MSO models after accounting for its increased complexity. Conclusions: Directly considering the effects of physical activity levels on glycemic dynamics through the inclusion of heart rate as an additional input variable in the glucose dynamics model improves the glucose prediction accuracy. The proposed methodology could improve exercise-informed model-based predictive control algorithms in artificial pancreas systems.
Feasibility of a Low-Intensity, Technology-Based Intervention for Increasing Physical Activity in Adults at Risk for a Diabetic Foot Ulcer: A Mixed-Methods Study
Authors: Schneider Kristin L. , Crews Ryan T. , Subramanian Vasanth , Moxley Elizabeth , Hwang Sungsoon , DiLiberto Frank E. , Aylward Laura , Bean Jermaine , Yalla Sai 
Published: January 2019

Background: Among adults with diabetes, 19-34% will develop a diabetic foot ulcer (DFU), which increases amputation risk and health care costs, and worsens quality of life. Regular physical activity, when increased gradually, may help prevent DFUs. In this mixed-methods study, we examined the feasibility of a low-intensity, technology-based behavioral intervention to increase activity in adults at risk for DFUs. Method: Participants at risk for a DFU (n = 12; 66% female; mean age = 59.9 years) received four in-person exercise and behavioral counseling sessions over 2-3 weeks, supplemented with use of an activity monitor (to track steps) and text messages (to reinforce behavioral strategies) for an added 8 weeks. Pre- and postintervention assessments of accelerometer measured activity, daily mobility, and glycemic control (A1C) were completed. Treatment acceptability was assessed by questionnaire and via key informant interview. Results: The program appears feasible since all but one participant attended all four sessions, all used the activity monitor and all responded to text messages. Treatment acceptability (scale: 1 = very dissatisfied, 5 = extremely satisfied) was high; average item ratings were 4.79 (SD = 0.24). Participants increased their steps by an average of 881.89 steps/day ( d = 0.66). A1C decreased on average by 0.33% ( d = 0.23). Daily mobility did not change. Interview results suggest that participants perceived benefits from the intervention. Participant recommended improvements included providing more physical activity information, addressing pain, and intervention delivery in a podiatry clinic. Conclusion: Individuals at risk for a DFU might benefit from a minimally intensive, technology-based intervention to increase their physical activity. Future research comparing the intervention to usual care is warranted.
Implications of a Decentralized Postpartum Unit Design and Clinical Operations
Authors: Freihoefer Kara , Lindval Scott , Bayramzadeh Sara , Hanson Leah 
Published: January 2019

Objectives: This postoccupancy study sought to understand whether a decentralized unit design supported a postpartum care delivery model by evaluating nurses’ efficiency, staff perception, acoustical conditions, and patient satisfaction. Background: Today, standardization and decentralization design concepts are being applied to all types of inpatient unit. There have been many studies that investigated how these concepts influence care delivery on medical-surgical units, but no study has evaluated a postpartum unit. Methods: This study utilized a mixed-method approach that involved unobtrusive shadowing (roughly 25 hr) and surveying ( n = 19) of nursing staff, physical acoustic readings (eight, 24-hr readings), and comparison of patient satisfaction pre- and postmove. Results: On average, nurses spent roughly 36.90% of their time at charting stations. Nurses were observed mostly using the central charting station located at the entry of the unit and adjacent to the well-baby nursery rather than the five decentralized chart stations. This was due to nurses operating with old workflow habits, not fully integrating electronic medical records, and needing to be near the nursery and other nurses. Nurses were satisfied with their ability to interact and their proximity to supplies, patients, and team members while in the central charting station. Additionally, patient satisfaction significantly increased postmove, particularly with the overall hospital’s quietness and cleanliness. Conclusion: This study highlights the importance of aligning administrative operations of the unit with the design intent. Although standardization and decentralization design concepts aimed to improve nurses’ workflow, misalignment with the operations may not deliver the most optimal outcomes.
Lund–Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients
Authors: Kariya Shin , Okano Mitsuhiro , Higaki Takaya , Tachibana Tomoyasu , Rikimaru Toru , Nishizaki Kazunori 
Published: January 2019

Background A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined. Objective The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities. Methods A total of 1412 patients with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund–Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples were examined. The Sino-Nasal Outcome Test was used to determine the severity of clinical symptoms. Results The patients with an abnormal soft tissue shadow in the paranasal sinus had significant obstructive lung function. The percent predicted forced expiratory volume in 1 second (FEV1.0) and the FEV1.0/forced vital capacity ratio negatively correlated with Lund–Mackay CT scores both before and after bronchodilator inhalation. There was a statistically significant correlation between pulmonary function and eosinophil count. Conclusion The patients with chronic cough frequently had paranasal sinus abnormalities. The Lund–Mackay CT score may be useful for assessing the condition of the lower airway in chronic cough patients. Upper airway examinations should play a part in the management of chronic cough.
Turbinate-Specific IgE in Normal and Rhinitic Patients
Authors: Hamizan Aneeza W. , Rimmer Janet , Alvarado Raquel , Sewell William A. , Tatersall Jessica , Barham Henry P. , Kalish Larry , Harvey Richard J. 
Published: January 2019

Background Specific immunoglobulin E (sIgE) within the nasal airway is likely to be the most ideal marker of allergic status, but little is known of the normative values in asymptomatic patients and those with rhinitis. Objective The aim of this study was to assess the diagnostic characteristics of inferior turbinate tissue biopsy sIgE in asymptomatic and rhinitic patients. Methods A diagnostic cross-sectional study was undertaken, involving patients who underwent inferior turbinate surgery with or without other surgical interventions. Inferior turbinate tissue biopsy was performed during surgery and was assessed for allergen sIgE (dust mite, grass [temperate or subtropical], and animal epithelium) using an automated immunoassay. Tissue sIgE was assessed among asymptomatic patients and those with nasal symptoms. Data were presented as median (interquartile range). A receiver operating curve was used to predict the diagnostic utility of turbinate tissue sIgE in determining allergic rhinitis. Results A total of 160 patients (41.89 ± 14.65 years, 36.9% females) were included. The median tissue sIgE concentration among the asymptomatic nonatopic group of patients was 0.09 (0.08–0.10) kUA/L and tissue sIgE > 0.10 kUA/L was determined as a positive threshold. Inferior turbinate tissue sIgE was shown to be a predictive test for allergic rhinitis (area under curve: 0.87, 95% confidence interval: 0.84–0.90) with 90% sensitivity and 89% negative predictive value. Conclusion Inferior turbinate tissue biopsy sIgE is a sensitive tool to predict allergic rhinitis. The threshold value of 0.1 kUA/L corresponded well with the asymptomatic nonatopic group of patients. This method detects sIgE in the nasal mucosa and may be a useful test for allergic rhinitis in future research.
Complementary Function of the Meniscofemoral Ligament and Lateral Meniscus Posterior Root to Stabilize the Lateral Meniscus Posterior Horn: A Biomechanical Study in a Porcine Knee Model
Authors: Ohori Tomoki , Mae Tatsuo , Shino Konsei , Tachibana Yuta , Fujie Hiromichi , Yoshikawa Hideki , Nakata Ken 
Published: January 2019

Background: It has been demonstrated that the load distribution function of the lateral meniscus (LM) is compromised by resecting both the meniscofemoral ligament (MFL) and LM posterior root (LMPR). However, the effect of resecting these fibers on load transmission through the LM needs to be investigated. Purpose: To evaluate using a porcine knee model (1) the in situ forces of the MFL and LMPR and (2) the effect of resecting these fibers on the in situ force of the LM under a compressive load and valgus torque to the lateral knee compartment. Study Design: Controlled laboratory study. Methods: Twenty fresh-frozen porcine knees and a 6 degrees of freedom robotic system were utilized. An axial compressive load of 250 N and 5 N·m of valgus torque were applied to intact, MFL-deficient, LMPR-deficient, and MFL/LMPR-deficient knees at 30°, 60°, and 90° of flexion. The valgus angles under the applied loads were compared among the 4 states. The in situ forces of the MFL and LMPR under the applied loads were calculated under the principle of superposition. The in situ forces of the LM under the applied loads were also calculated and compared among the 4 conditions (intact, without the MFL, without LMPR, and without the MFL/LMPR). Results: The valgus angles significantly increased after resecting both the MFL and LMPR at all the flexion angles. The in situ forces of the MFL and LMPR changed reciprocally as the knee flexed. The in situ forces of the LM significantly decreased after resecting both the MFL and LMPR, although resecting only the MFL or LMPR represented no significant effect. Conclusion: The MFL and LMPR functioned complementarily as the posterior attachments of the LM against a compressive load and valgus torque to the lateral knee compartment in porcine knee joints. Clinical Relevance: If the LMPR is completely detached and needs to be repaired, the MFL should be preserved because it may provide some stability to the LM posterior horn and protect the repaired LMPR.
Documentation of Sexual History by Psychiatry Postgraduate Trainees: Lessons to Be Learnt
Authors: Sreedaran Priya 
Published: January 2019

Aim: The author reports on whether sexual history was documented in files of persons with alcohol-use disorders as part of initial intake by psychiatry postgraduate trainees. Methodology: Chart review of files of persons with alcohol use disorders. Results: A total of 53 charts were reviewed to determine whether sexual history was documented. Sexual history was not documented in 79.24% of the files as part of the initial psychiatric intake. Conclusions: Postgraduate psychiatric trainees do not document sexual history in files of persons with alcohol-use disorders as part of initial intake. This is an important issue to be addressed as part of postgraduate psychiatry training.