bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computed Tomography Aortic Valve Calcium Scoring in Patients With Aortic Stenosis
Authors: Pawade Tania , Clavel Marie-Annick , Tribouilloy Christophe , Dreyfus Julien , Mathieu Tiffany , Tastet Lionel , Renard Cedric , Gun Mesut , Jenkins William Steven Arthur , Macron Laurent , Sechrist Jacob W. , Lacomis Joan M. , Nguyen Virginia , Galian Gay Laura , Cuéllar Calabria Hug , Ntalas Ioannis , Cartlidge Timothy Robert Graham , Prendergast Bernard , Rajani Ronak , Evangelista Arturo , Cavalcante João L. , Newby David E. , Pibarot Philippe , Messika Zeitoun David , Dweck Marc R. 
Published: March 2018

Background—
Computed tomography aortic valve calcium scoring (CT-AVC) holds promise for the assessment of patients with aortic stenosis (AS). We sought to establish the clinical utility of CT-AVC in an international multicenter cohort of patients.

Methods and Results—

Patients with AS who underwent ECG-gated CT-AVC within 3 months of echocardiography were entered into an international, multicenter, observational registry. Optimal CT-AVC thresholds for diagnosing severe AS were determined in patients with concordant echocardiographic assessments, before being used to arbitrate disease severity in those with discordant measurements. In patients with long-term follow-up, we assessed whether CT-AVC thresholds predicted aortic valve replacement and death. In 918 patients from 8 centers (age, 77±10 years; 60% men; peak velocity, 3.88±0.90 m/s), 708 (77%) patients had concordant echocardiographic assessments, in whom CT-AVC provided excellent discrimination for severe AS (C statistic: women 0.92, men 0.89). Our optimal sex-specific CT-AVC thresholds (women 1377 Agatston unit and men 2062 Agatston unit) were nearly identical to those previously reported (women 1274 Agatston unit and men 2065 Agatston unit). Clinical outcomes were available in 215 patients (follow-up 1029 [126–2251] days). Sex-specific CT-AVC thresholds independently predicted aortic valve replacement and death (hazard ratio, 3.90 [95% confidence interval, 2.19–6.78];
P
<0.001) after adjustment for age, sex, peak velocity, and aortic valve area. Among 210 (23%) patients with discordant echocardiographic assessments, there was considerable heterogeneity in CT-AVC scores, which again were an independent predictor of clinical outcomes (hazard ratio, 3.67 [95% confidence interval, 1.39–9.73];
P
=0.010).

Conclusions—
Sex-specific CT-AVC thresholds accurately identify severe AS and provide powerful prognostic information. These findings support their integration into routine clinical practice.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT01358513, NCT02132026, NCT00338676, NCT00647088, NCT01679431.
Amphetamine availability predicts amphetamine-related mental health admissions: A time series analysis
Authors: Sara Grant , Baxter Clifford , Menendez Patricia , Lappin Julia 
Published: March 2018

Objective: Amphetamine use and availability have increased in Australia and there are concerns that this has led to more frequent hospital admissions with amphetamine-related psychosis. This study examines whether amphetamine-related admissions to mental health units are more common at times of greater amphetamine availability. Methods: We conducted an ecological study using aggregate crime and health service data for NSW, Australia, from January 2000 to March 2015. Amphetamine-related criminal incidents (arrests or cautions for possession or use) were used as an indirect measure of amphetamine availability. Semiparametric time series analysis was used to compare monthly arrest rates to monthly hospitalisation rates for (1) amphetamine abuse or dependence, (2) amphetamine-related psychosis and (3) any psychosis. Results: Amphetamine-related admissions to NSW mental health units have increased four- to fivefold since 2009 and comprised approximately 10% of all admissions to these units in early 2015. There was a significant association between arrests and amphetamine-related admissions. After adjustment for seasonal variation, this effect demonstrated a time lag of 1–2 months. There was no relationship between amphetamine arrests and overall admissions for psychosis. Conclusion: Greater amphetamine availability significantly predicts admissions for amphetamine use disorders and amphetamine-related psychosis. Better treatment strategies are needed to break the nexus between drug availability and drug-related harm.
A randomized controlled trial to compare two methods of constraint-induced movement therapy to improve functional ability in the affected upper limb in pre-school children with hemiplegic cerebral palsy: CATCH TRIAL
Authors: Christmas Pauline M , Sackley Catherine , Feltham Max G , Cummins Carole 
Published: March 2018

Objective: To determine the feasibility and short-term efficacy of caregiver-directed constraint-induced movement therapy to improve upper limb function in young children with hemiplegic cerebral palsy. Design: Randomized controlled trial with masked assessment. Setting: Community paediatric therapy services. Subjects: Pre-school children with hemiplegic cerebral palsy. Interventions: Caregiver-directed constraint-induced movement therapy administered using either 24-hour short-arm restraint device (prolonged) or intermittent holding restraint during therapy (manual). Main measures: Primary measures include Assisting Hand Assessment (AHA) at 10 weeks. Secondary measures include adverse events, Quality of Upper Extremity Skills Test and Pediatric Quality of Life Inventory. Feasibility measures include recruitment, retention, data completeness and adherence. Results: About 62/81 (72%) of eligible patients in 16 centres were randomized (prolonged restraint n = 30; manual restraint n = 32) with 97% retention at 10 weeks. The mean change at 10 weeks on the AHA logit-based 0–100 unit was 9.0 (95% confidence interval (CI): 5.7, 12.4; P < 0.001) for prolonged restraint and 5.3 (95% CI: 1.3, 9.4; P = 0.01) for manual restraint with a mean group difference of 3.7 (95% CI: −1.5, 8.8; P = 0.156) (AHA smallest detectable difference = 5 units). No serious related adverse events were reported. There were no differences in secondary outcomes. More daily therapy was delivered with prolonged restraint (60 vs 30 minutes; P < 0.001). AHA data were complete at baseline and 10 weeks. Conclusion: Caregiver-directed constraint-induced movement therapy is feasible and associated with improvement in upper limb function at 10 weeks. More therapy was delivered with prolonged than with manual restraint, warranting further testing of this intervention in a longer term trial.
A probe in the connection between inflammation, cognition and suicide
Authors: Cáceda Ricardo , Griffin W Sue T , Delgado Pedro L 
Published: March 2018

Background: Increased inflammation is linked to suicide risk. However, it is unclear whether increased inflammation drives suicidal crises or is a trait associated with lifetime suicidal behavior. Limited data exist on the sources of increased inflammation observed in suicidal patients and on its downstream effects. Aims: To examine factors associated with inflammation and with suicidal ideation severity in acutely suicidal depressed patients. Methods: Fifty-two adult depressed patients of both sexes hospitalized for severe suicidal ideation were characterized for suicidality, depression, anxiety, medical comorbidity, psychological and physical pain, impulsivity, verbal fluency, C-reactive protein (CRP) and interleukin (IL) 6. Two generalized linear models were performed with either CRP or suicidal ideation severity as dependent variables. Results: CRP levels were positively associated with age, body mass index (BMI), IL6, current physical pain and number of lifetime suicide attempts. Suicidal ideation severity was not significantly correlated with either CRP or IL6. Suicidal ideation severity was positively associated with female sex, presence of an anxiety disorder, current physical pain, number of lifetime suicide attempts and with delay discounting for medium and large losses. Conclusions: Increased inflammation is not associated with acute suicidal risk, but seems to represent a trait associated with lifetime suicidal behavior.
Drug therapy for adenomyosis: a prospective, nonrandomized, parallel-controlled study
Authors: Li Qing , Ding Yan , Zhang Xu-Yin , Feng Wei-Wei , Hua Ke-Qin 
Published: March 2018

Objective To provide novel insights into the clinical treatment of adenomyosis. Methods Two hundred patients with adenomyosis were enrolled in this prospective, nonrandomized, parallel-controlled study with a 1-year follow-up in our hospital. Group 1 was treated with 3.75 mg leuprorelin acetate (LA) (n = 40), Group 2 was treated with 1.88 mg LA (n = 40), Group 3 underwent Mirena implantation (n = 40), Group 4 underwent Mirena implantation after treatment with 3.75 mg LA (n = 40), Group 5 underwent Mirena implantation after treatment with 1.88 mg LA (n = 20), and Group 6 received San-Jie-Zhen-Tong capsules alone (n = 20). Uterine volume, pain, cancer antigen 125 level, ovary function, adverse effects, and Mirena expulsion were evaluated. Results The uterine volume and pain scores were lower in the groups treated with 1.88 than 3.75 mg LA, but the lower dose was associated with significantly fewer hot flashes and sweating. The 1-year Mirena expulsion rate was higher in Group 3 than in Groups 4 and 5 (10.00% vs. 3.33%, respectively). Costs were significantly higher in Groups 1 and 4 than in Groups 2 and 5. Conclusion Administration of 1.88 mg LA may be an alternative therapy for Asian patients with adenomyosis. The combination of LA and Mirena could enhance the therapeutic effect. Registration number: ChiCTR-IPR-15005971
Biomechanical Evaluation of the Medial Stabilizers of the Patella
Authors: LaPrade Matthew D. , Kallenbach Samantha L. , Aman Zachary S. , Moatshe Gilbert , Storaci Hunter W. , Turnbull Travis Lee , Arendt Elizabeth A. , Chahla Jorge , LaPrade Robert F. 
Published: March 2018

Background: Quantification of the biomechanical properties of each individual medial patellar ligament will facilitate an understanding of injury patterns and enhance anatomic reconstruction techniques by improving the selection of grafts possessing appropriate biomechanical properties for each ligament. Purpose: To determine the ultimate failure load, stiffness, and mechanism of failure of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), and medial patellomeniscal ligament (MPML) to assist with selection of graft tissue for anatomic reconstructions. Study Design: Descriptive laboratory study. Methods: Twenty-two nonpaired, fresh-frozen cadaveric knees were dissected free of all soft tissue structures except for the MPFL, MPTL, and MPML. Two specimens were ultimately excluded because their medial structure fibers were lacerated during dissection. The patella was obliquely cut to test the MPFL and the MPTL-MPML complex separately. To ensure that the common patellar insertion of the MPTL and MPML was not compromised during testing, only one each of the MPML and MPTL were tested per specimen (n = 10 each). Specimens were secured in a dynamic tensile testing machine, and the ultimate load, stiffness, and mechanism of failure of each ligament (MPFL = 20, MPML = 10, and MPTL = 10) were recorded. Results: The mean ± SD ultimate load of the MPFL (178 ± 46 N) was not significantly greater than that of the MPTL (147 ± 80 N; P = .706) but was significantly greater than that of the MPML (105 ± 62 N; P = .001). The mean ultimate load of the MPTL was not significantly different from that of the MPML ( P = .210). Of the 20 MPFLs tested, 16 failed by midsubstance rupture and 4 by bony avulsion on the femur. Of the 10 MPTLs tested, 9 failed by midsubstance rupture and 1 by bony avulsion on the patella. Finally, of the 10 MPMLs tested, all 10 failed by midsubstance rupture. No significant difference was found in mean stiffness between the MPFL (23 ± 6 N/mm2) and the MPTL (31 ± 21 N/mm2; P = .169), but a significant difference was found between the MPFL and the MPML (14 ± 8 N/mm2; P = .003) and between the MPTL and MPML ( P = .028). Conclusion: The MPFL and MPTL had comparable ultimate loads and stiffness, while the MPML had lower failure loads and stiffness. Midsubstance failure was the most common type of failure; therefore, reconstruction grafts should meet or exceed the values reported herein. Clinical Relevance: For an anatomic medial-sided knee reconstruction, the individual biomechanical contributions of the medial patellar ligamentous structures (MPFL, MPTL, and MPML) need to be characterized to facilitate an optimal reconstruction design.
Reporting of Mesenchymal Stem Cell Preparation Protocols and Composition: A Systematic Review of the Clinical Orthopaedic Literature
Authors: Robinson Patrick G. , Murray Iain R. , West Christopher C. , Goudie Ewan B. , Yong Li Y. , White Timothy O. , LaPrade Robert F. 
Published: March 2018

Background: Mesenchymal stem cells (MSCs) are increasingly being used in the treatment of a wide variety of sports-related conditions. Despite this enthusiasm, the biological properties of MSCs and their effects on musculoskeletal tissue healing remain poorly understood. MSC-based strategies encompass cell populations with heterogeneous phenotypes isolated from multiple tissues and using different methods. Therefore, comprehensive reporting of the source, preparation methods, and characteristics of MSC strategies is essential to enable interpretation of results. Purpose: To perform a systematic review of levels of reporting of key variables in MSC preparation and composition for clinical studies evaluating MSC-based therapies in the treatment of musculoskeletal conditions. Study Design: Systematic review. Methods: A systematic review of the clinical orthopaedic and sports medicine literature from 2002 to 2017 was performed. The following inclusion criteria were used: human clinical trials, published in the English language, involving the administration of MSC-based therapies for orthopaedic or sports medicine applications. In vitro or ex vivo studies, editorials, letters to the editor, and studies relating to cosmetic, neurological, or dental applications were excluded. Results: Of the 1259 studies identified on the initial search, 36 studies were found to satisfy the inclusion criteria for analysis on comprehensive review. Fifty-seven percent of studies evaluated bone marrow–derived MSCs, 41% evaluated adipose-derived MSCs, and 2% evaluated synovium-derived MSCs. Considerable deficiencies in the reporting of key variables, including the details of stem cell processing, culture conditions, and the characteristics of cell populations delivered, were noted. Overall, studies reported only 52% (range, 30%-80%) of variables that may critically influence outcome. No study provided adequate information relating to all of these variables. Conclusion: All existing clinical studies evaluating MSCs for orthopaedic or sports medicine applications are limited by inadequate reporting of both preparation protocols and composition. Deficient reporting of the variables that may critically influence outcome precludes interpretation, prevents others from reproducing experimental conditions, and makes comparisons across studies difficult. We encourage the adoption of emerging minimum reporting standards for clinical studies evaluating the use of MSCs in orthopaedics.
Gender Differences in the Association Between Alcohol Use and Sedentary Behavior Among Adults
Authors: Agrawal Pooja , Mercer Andrew , Hassanali Jamila , Carmack Chakema , Doss Darleesa , Murillo Rosenda 
Published: March 2018

Purpose: We examined differences in the association between alcohol use and sedentary behavior by gender among adults. Design: Cross-sectional study that employs a complex, multistage stratified probability cluster sample design. Setting: National Health and Nutrition Examination Survey (NHANES) 2007 to 2014. Participants: NHANES participants aged ≥20 years and identifying as Hispanic, white, or black (N = 18 441). Measures: Demographic characteristics, sedentary behavior, and alcohol consumption. Sedentary behavior was measured based on the number of minutes of sedentary activity per week. Alcohol consumption in the last year was measured based on responses to items assessing whether the participant consumes alcoholic beverages and the number of alcoholic beverages consumed on average. Analysis: Multinomial logistic regression analysis was used to estimate associations of alcohol use with categories of sedentary behavior by gender. Results: Compared to women who reported not consuming alcohol, women who were heavy drinkers were significantly more likely to engage in high sedentary activity (odds ratio [OR]: 1.47; 95% confidence interval [CI]: 1.16-1.87), relative to low levels of sedentary activity. Similarly, women who were binge drinkers were more likely to engage in moderate levels of sedentary activity (OR: 1.39; 95% CI: 1.05-1.85). There were no significant associations between alcohol use and sedentary activity among men. Conclusion: Findings suggest that alcohol consumption should be considered in health promotion efforts targeting sedentary behavior among women.
Use of Bauru Yardstick in Patients With Complete Bilateral Cleft Lip and Palate at an Indian Center
Authors: Batra Puneet , Annavarapv Gopala Krishna , Chopra Ashish , Srivastava Amit , Sadhu Partha , Mevda Keyur 
Published: March 2018

Objective: To evaluate dental arch relationship in treated bilateral cleft lip and palate (BCLP) cases at an Indian cleft center using the Bauru yardstick. Patients and methods: Digital photographs of the dental cast of 50 consecutively treated patients (28 males and 22 females) with nonsyndromic BCLP at an Indian cleft center were rated by 2 examiners as per the Bauru yardstick for the 12-year-old age group. The average age group was 12 ± 0.62 years. All cases were treated with same surgical protocol. Results: The inter-examiner agreement between the 3 examiners was found to be very high, with weighted kappa values ranging from 0.894 to 0.951. The intraexaminer agreement between the 2 examinations for all the examiners was also found to be very high, with weighted kappa values ranging from 0.894 to 0.931. Seventy-eight percent of patients were rated with a Bauru yardstick score of 1+2. In addition, 10% of patients were rated with a score of 3, 8% as 4, and 4% as 5. The overall Bauru yardstick score for the center was 2.36. Conclusion: The protocol followed for the repair of BCLP cases by the center was found to be a good regimen in regard to the Bauru yardstick score.
Clinical Significance of the Levator Veli Palatini Muscle in Velocardiofacial Syndrome Patients
Authors: Myung Yujin , Ahn Taeseon , Kim Baek-kyu , Jeong Jae Hoon , Baek Rong-Min 
Published: March 2018

Background: Anatomical variation and deficits of velocardiofacial syndrome patients are related to unsatisfactory treatment results in surgical correction of speech abnormalities. The main purpose of the article is to investigate the clinical significance of thinned levator veli palatini muscle in VCFS patients. Methods: The authors reviewed medical records of all children with velocardiofacial syndrome who received pharyngeal flap surgery between March 2007 and September 2015. Data including thickness of levator veli palatini in magnetic resonance examination; preoperative velopharyngeal gap size from nasoendoscopy; and preoperative and postoperative speech outcomes were collected. Results: Total of 36 velocardiofacial syndrome patients with preoperative objective data and postoperative speech outcomes were identified. Preoperative velopharyngeal gap showed significant correlation with thickness of levator veli palatini (correlation coefficient: 0.297/0.397, P = .02/.03) and gap size showed correlation with postoperative speech improvement (0.347/0.413, P = .04/.02). However, muscle thickness showed no correlation with speech outcomes (0.046/0.037, P = .77/.86). Conclusion: Thinned levator veli palatini muscle in velocardiofacial syndrome patients are related to widened velopharyngeal gap and production of hypernasal speech, and can give negative impact on postoperative surgical outcome of pharyngeal flap surgery.
Young Person and Parent Perspectives on the Impact of Cleft Lip and/or Palate Within an Educational Setting
Authors: Stock Nicola Marie , Ridley Matthew 
Published: March 2018

Background: During the school years, a cleft of the lip and/or palate (CL/P) may pose a risk to educational achievement. To further understand this multifaceted association, and to offer suggestions as to how young people’s educational experiences might be improved, qualitative investigation is warranted. Design: Semi-structured telephone interviews were conducted with young people born with CL/P (n = 10; aged 10-16 years) and their parents (n = 10). The resulting data were subjected to inductive thematic analysis. Results: Negative social interactions, cleft-related treatment, the presence of an additional condition, and a lack of appropriate support from teachers was found to influence young people’s educational experience. Methods for promoting diversity, support from clinical teams, facilitation of positive school transitions, implementation of training for teachers, and a holistic approach to the measurement of “success” were suggested by participants as potential ways of improving this experience. Conclusions: The findings of this study point to a need for a range of school-focused interventions, as well as the inclusion of a number of potentially impactful variables within future quantitative research.
In Utero Glossoptosis in Fetuses With Robin Sequence
Authors: Resnick Cory M. , Kooiman Tessa D. , Calabrese Carly E. , Didier Ryne , Padwa Bonnie L. , Estroff Judy A. , Koudstaal Maarten J. 
Published: March 2018

Objective: Glossoptosis causes airway obstruction in patients with Robin sequence (RS), but little is known about the in-utero tongue. The purpose of this study was to assess shape and position of the fetal tongue on prenatal magnetic resonance imaging (MRI) to determine if this is predictive of postnatal RS. Design: Retrospective case-control study including fetuses with prenatal MRIs performed from 2002 to 2017. Inclusion criteria were (1) prenatal MRI of adequate quality, (2) live born and evaluated postnatally for craniofacial findings. Subjects were divided into groups based on postnatal findings: (1) RS, (2) micrognathia without RS, and (3) a gestational-age-matched control group with normal craniofacial morphology. Outcome variables were based on the prenatal MRI and included fetal tongue height, length, and width, tongue shape index (TSI, ratio of height to length), and observation of tongue touching the posterior pharyngeal wall. Results: A total of 116 subjects with mean gestational age at MRI of 25.6 ± 5.1 weeks were included: RS, n = 27 (23%); micrognathia, n = 35 (30%); control, n = 54 (47%). Tongue length was significantly shorter ( P = .009) and TSI was significantly larger in the RS group ( P < .0001). The tongue touched the posterior pharyngeal wall in 5 (19%) of the RS group and in no subjects in the other groups ( P < .0001). Conclusion: In utero tongue shape and position were significantly different in fetuses with postnatal RS compared to those with isolated micrognathia and controls. Prenatal MRI tongue characteristics may be predictors for postnatal RS.