bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a universal preschool-based program for emotional education in 3- to 5-year-old children with autism spectrum conditions
Authors: Bartroli Montse , Clotas Catrina , Bosque-Prous Marina , Espelt Albert 
Published: December 2023

The “1,2,3,emoció!” is a universal preschool program of emotional education for children aged 3–5 years that has positive effect on emotional competence. The objective of this study was to evaluate the effectiveness of this program specifically in 3- to 5-year-old children with autism spectrum conditions. The effectiveness was evaluated during the first year of implementation (school year 2018–2019) in Barcelona. We conducted a cluster randomized community trial, with schools as units of randomization. The children’s level of emotional competence was evaluated with the validated Emotional Competence Assessment Questionnaire (score range from 30 to 180). We designed a linear regression model for paired measures. The dependent variable was the final Emotional Competence Assessment Questionnaire score adjusted by the initial score, sex, and grade. The sample consisted of 49 children with autism spectrum conditions, of which 11 were girls. Children in the intervention group showed an increase from the initial score to the final score that was almost three times higher (16.1) than the increase observed in children in the comparison group (6.6). The difference between the two groups was statistically significant, with 8.9 points (95% confidence interval: 1.2–16.6) attributed to the intervention. We conclude that the “1,2,3,emoció!” universal program has the potential to be effective in children with autism spectrum conditions. Lay abstract There are numerous programs and interventions to improve social and emotional skills that expressly target children with autism spectrum conditions. However, there is less knowledge about the impact of universal (directed to all children) school programs of emotional education specifically on these children. In this context, the aim of our study was to evaluate the impact of the “1,2,3,emoció!” universal school program on them. The results show that children with autism spectrum conditions participating in the program improved their emotional competence more than the ones who did not participate. Therefore, we conclude that the “1,2,3,emoció!” universal program is effective in children with autism spectrum conditions. This promising outcome gives the opportunity to these children to benefit from group learning in an inclusive school setting, by complementing individual interventions with a universal program.
Coil embolization alone appears sufficient for middle meningeal artery embolization
Authors: Iyer Ankitha M. , Venkataraman Sidish S. , Kittel Carol A. , Fargen Kyle M. 
Published: December 2023

Background Middle meningeal artery embolization (MMAE) has shown promise as an alternative treatment for chronic subdural hematoma (cSDH); however, the most effective procedural technique is debated. We sought to assess the safety and efficacy of coil embolization as a stand-alone technique for MMAE in cSDH. Methods A single-center retrospective analysis was performed of patients who underwent MMAE for chronic SDH with coil embolization alone. Results Forty-five patients were included in the study. All underwent successful stand-alone coil MMAE, of which 51.1% were bilateral. Indications for MMAE were varied, but 13.3% of patients required ongoing anticoagulation and another 11.1% had severe thrombocytopenia. Conscious sedation or no sedation was used in 73.2% of patients; 10 patients (22.2%) were scheduled electively and discharged same day. There were no severe or minor procedural complications identified. Of the 45 patients, only 3 (6.6%) underwent unplanned repeat surgical intervention: one patient developed a large recurrence at eight weeks after MMAE and underwent burr hole drainage; the second patient received burr hole drainage prior to MMAE but needed repeat burr hole drainage two weeks later due to residual; the third patient received two burr hole drainages at two and three weeks post MMAE due to persistent disease. Conclusion Stand-alone MMAE with coiling can be performed under conscious sedation as an outpatient procedure and may be sufficient to prevent cSDH recurrence in most cases without the need for particle penetration of cSDH microvascular beds. Larger confirmatory studies are necessary.
Periprocedural antiplatelet medication assessed by VerifyNow for neuroendovascular treatment: Comparison of prasugrel with clopidogrel
Authors: Nambu Kosuke , Misaki Kouichi , Uno Takehiro , Tsutsui Taishi , Kamide Tomoya , Nakada Mitsutoshi 
Published: December 2023

Objective The maintenance dose of prasugrel (PRAS) for neuroendovascular treatment requires much research. We report the antiplatelet effect of PRAS measured by VerifyNow P2Y12 reaction units (PRUs) in patients during the perioperative period of neuroendovascular treatment. Methods Between January 2017 and January 2023, 230 patients who underwent endovascular treatment for unruptured intracranial aneurysms or carotid artery stenosis at our institution were retrospectively identified. Patients received dual antiplatelet therapy with 100 mg aspirin (ASA) and 75 mg clopidogrel (CLP)/day (CLP group, n = 186) or 100 mg ASA and 3.75 mg PRAS/day (PRAS group, n = 44) 2 weeks before the procedures. The PRU value was compared between the CLP and PRAS groups. In the study, we defined 95≦PRU < 208 as the optimal range. Perioperative complications within seven days of surgery were also analyzed. Results The mean value of PRU was significantly low in the PRAS group (179.13 ± 66.03 in CLP vs. 154.75 ± 54.01 in PRAS, p = 0.024). The proportion of the patients who exhibited 95≦PRU < 208 was significantly higher in the PRAS group (55.4% vs. 72.7%, p = 0.036). Ischemic and hemorrhagic complication rates were not significantly different between the CLP and PRAS groups (7.6% vs. 0%, p = 0.076; 4.7% vs. 0%, p = 0.361). The ischemic complication rate was higher in patients with a PRU > 208 than in those with PRU < 208 (12.5% vs. 3.8%, p = 0.044). The hemorrhagic complication rate was not significantly different between the PRU < 95 and 95≦PRU groups (8.4% vs. 3.2%, p = 0.224). Conclusions Maintenance dose PRAS further decreased the PRU value and reached the optimal range in more cases than CLP during the perioperative period of neuroendovascular treatment. Ischemic complications significantly increased in the 208 < PRU group.
Value of human epididymis secretory protein 4 in differentiating malignant from benign pleural effusion: an analysis of two cohorts
Authors: Yang Qian , Niu Yan , Wen Jian-Xun , Yang Dan-Ni , Han Yu-Ling , Wen Xu-Hui , Yan Li , Huang Jin-Hong , Chen Hong , Zheng Wen-Qi , Jiang Ting-Wang , Hu Zhi-De 
Published: December 2023

Background: Lung cancer is the most common cause of malignant pleural effusion (MPE). Serum human epididymis secretory protein 4 (HE4) is a useful diagnostic marker for lung cancer. Objective: This study aimed to evaluate the diagnostic accuracy of pleural fluid HE4 for MPE. Design: A prospective, double-blind diagnostic test accuracy study. Methods: Patients with undiagnosed pleural effusion were enrolled in two cohorts (Hohhot and Changshu). Electrochemiluminescence immunoassay was used to detect pleural fluid HE4. The diagnostic accuracy of HE4 was evaluated by a receiver operating characteristic (ROC) curve, and the net benefit of HE4 was assessed by a decision curve analysis (DCA). Results: A total of 66 MPEs and 86 benign pleural effusions (BPEs) were enrolled in the Hohhot cohort. In the Changshu cohort, 26 MPEs and 32 BPEs were enrolled. In both cohorts, MPEs had significantly higher pleural fluid HE4 than BPEs. The area under the ROC curve (AUC) of HE4 was 0.73 (95% CI: 0.64–0.81) in the Hohhot cohort and 0.79 (95% CI: 0.67–0.91) in the Changshu cohort. At a threshold of 1300 pmol/L, HE4 had sensitivities of 0.44 (95% CI: 0.33–0.56) in the Hohhot cohort and 0.54 (95% CI: 0.35–0.73) in the Changshu cohort. The corresponding specificities were 0.90 (95% CI: 0.83–0.95) in the Hohhot cohort and 0.94 (95% CI: 0.84–1.00) in the Changshu cohort. In subgroup analyses, HE4 had an AUC (95% CI) of 0.78 (0.71–0.85) in exudates and an AUC of 0.69 (0.57–0.81) in patients with negative effusion cytology. The DCA revealed that HE4 determination had a net benefit in both cohorts. Conclusion: Pleural fluid HE4 has moderate diagnostic accuracy for MPE and has net benefit in pleural effusion patients with unknown etiology.
The ‘Mini-Jupette’ technique for climacturia: a systematic review
Authors: Ioannis Mykoniatis , Stavros Tsiakaras , Eliophotos Savvides , Georgios Langas , Anastasios Anastasiadis , van Renterghem Koenraad , Robert Andrianne 
Published: December 2023

Background: The leakage of urine during sexual arousal, known as climacturia, is an under-recognized clinical condition often overshadowed by erectile dysfunction in men who have undergone radical prostatectomy. Objectives: This study aims to determine and evaluate the role of the Mini-Jupette technique and its alternatives in the treatment of climacturia. Data sources and methods: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. We searched Medline via PubMed, Scopus, and the Cochrane Library databases until October 2022. Results: We included seven studies involving 120 patients with climacturia. Different types of grafts were used, ranging from synthetic mesh to autologous grafts. In all seven studies, the use of the Adrianne Mini-Jupette (AMJ) and its alternatives showed a high percentage of improvement in climacturia, with reported complete resolution ranging from 65% to 93%. Regarding postoperative complications, one study reported the highest sling explantation rate at 11% (4/38), while other studies reported complications ranging from subjective symptoms such as dysuria and perineal pain to the need for subsequent artificial urinary sphincter placement. Conclusion: The AMJ sling and its variations are low-cost, time-efficient, and relatively safe procedures with high patient satisfaction rates among those treated for climacturia.
The Impact of Physical and Environment Factors on Parental Presence for Oral Feeding in New Zealand Neonatal Intensive Care Units
Authors: Bakker Lise , Jackson Bianca , Miles Anna 
Published: December 2023

Aim: To identify physical environmental factors influencing family involvement in feeding in New Zealand neonatal units. Background: Infant oral feeding development is critical for both short-term feeding skills and longer term neurodevelopmental outcomes. The neonatal environment is well-known as challenging for neuroprotection due to negative sensory exposure. The impact of environmental factors on oral feeding in New Zealand (NZ) neonatal units is currently unexplored, and knowledge of this could allow for evidence-based unit design. Methods: Focused ethnography at five neonatal units, a national survey of NZ neonatal professionals ( n = 102), and five focus groups were carried out. Current oral feeding practice, and beliefs, experiences, and opinions of unit staff and family about these practices were explored. Data were analyzed using qualitative content analysis. Results: Units were providing the best experience to families that they could with the resources they had available. Lack of physical space, lack of privacy, limited on-site accommodation for families, and lack of coordination between maternity and neonatal services were identified as impacting on family’s comfort and sense of homeliness on the unit. Unit staff used furniture, screens, and external accommodation providers to support families where they could. Conclusions: The physical design of neonatal units in New Zealand provides barriers to family’s spending time privately developing oral feeding. Solutions are proposed to increase the size of bedspaces, provide single-family rooms, create greater on-site family accommodation options, combine maternity and neonatal healthcare, and improve family comfort and therefore connection with their infant.
Mini Open Fasciotomy for Chronic Exertional Compartment Syndrome: A Prospective Case Series
Authors: Baumfeld Daniel , Silva Matheus , Simões Ana Paula , Baumfeld Tiago 
Published: December 2023

Chronic exertional compartment syndrome (CECS) is a challenging pathology that causes pain and physical limitations. Fasciotomy is the gold standard and different techniques have been described. Techniques that allow a fast return to sports and low recurrence rates are of great interest for the athletic population. This is a prospective case series presenting a mini open surgical technique and its results regarding the level of return to sports and quality of life in 13 patients. A specific CECS questionnaire was applied and analyzed concerning the distance patients were able to run before and after treatment, Tegner score, Medical Outcomes Short-Form Health Survey (SF-36), and epidemiological measures. The minimum follow-up was 12 months. The mean distance the patients were able to run per week following the surgical treatment improved from 14.1 to 38.1 km (P = .042) and the mean Tegner score improved from 3.92 to 7.08 (P = .01). Notably, 12 out of 13 patients were satisfied or very satisfied with the outcome. In this sample, the mini open technique improved patients’ sports performance and quality of life and minimized pain. Chronic exertional compartment syndrome can be safely approached using a mini open technique with a good rate of satisfaction and return to sport. Levels of Evidence: IV
Impact of magnesium supplementation on clinical outcome and disease progression of patients with diabetic nephropathy: a prospective randomized trial
Authors: Halawa Nihal , Elsaid Tamer Wahid , El Wakeel Lamia Mohamed , Shawki May Ahmed 
Published: December 2023

Background: Magnesium (Mg) deficiency is closely linked with proteinuria. Objectives: To assess the impact of oral Mg citrate supplementation on the clinical outcome of diabetic nephropathy (DN) patients. Design: This was a prospective, randomized, controlled, open-label study. Methods: Sixty DN patients were recruited from Nephrology and Endocrinology departments, Ain Shams University Hospitals, Cairo, Egypt. Patients were assigned by stratified randomization based on their Mg status, to either Mg citrate group, ( n = 30), who received the standard regimen + oral Mg citrate 2.25 g/day or Control group, ( n = 30), who received the standard regimen only. The primary endpoint was a change in urinary albumin to creatinine ratio (UACR) after 12 weeks. Secondary outcomes were insulin resistance, glycemic control, lipid profile, serum osteocalcin, quality of life (QoL) and Mg tolerability. Results: Out of a total of 60 patients enrolled, only 54 patients (26 in Mg citrate group and 28 in the control group) completed the study. Groups were comparable at baseline. The UACR median percent reduction was significantly higher in the Mg citrate group (−6.87%) versus (−0.9%) in the Control group, p = 0.001. After 12 weeks, the estimated glomerular filtration rate significantly improved in the Mg citrate group versus Control group ( p = 0.001). Comparable change was observed in glycemic indices. Lipid profile significantly improved in the Mg citrate group versus Control group ( p = 0.001). Serum osteocalcin levels significantly declined in the Mg citrate group ( p = 0.001) versus control group. Regarding QoL, the total score and all domains significantly improved in the Mg citrate group compared to control. The Mg supplement was tolerable with only mild reported side effects that required no intervention. Conclusion: Oral Mg citrate supplementation improved microalbuminuria in DN patients. It also had favorable effects on serum osteocalcin, lipid profile and QoL with no reported major side effects. Trial registration: ClinicalTrials.gov identifier: NCT03824379.
Cost Benefit of Implementation of Risk Stratification Models for Adult Spinal Deformity Surgery
Authors: Passias Peter G. , Williamson Tyler K. , Kummer Nicholas A. , Pellisé Ferran , Lafage Virginie , Lafage Renaud , Serra-Burriel Miguel , Smith Justin S. , Line Breton , Vira Shaleen , Gum Jeffrey L. , Haddad Sleiman , Sánchez Pérez-Grueso Francisco Javier , Schoenfeld Andrew J. , Daniels Alan H. , Chou Dean , Klineberg Eric O. , Gupta Munish C. , Kebaish Khaled M. , Kelly Michael P. , Hart Robert A. , Burton Douglas C. , Kleinstück Frank , Obeid Ibrahim , Shaffrey Christopher I. , Alanay Ahmet , Ames Christopher P. , Schwab Frank J. , Hostin Richard A. , Bess Shay ,   International Spine Study Group
Published: December 2023

Study Design/Setting Retrospective cohort study. Objective Assess the extent to which defined risk factors of adverse events are drivers of cost-utility in spinal deformity (ASD) surgery. Methods ASD patients with 2-year (2Y) data were included. Tertiles were used to define high degrees of frailty, sagittal deformity, blood loss, and surgical time. Cost was calculated using the Pearl Diver registry and cost-utility at 2Y was compared between cohorts based on the number of risk factors present. Statistically significant differences in cost-utility by number of baseline risk factors were determined using ANOVA, followed by a generalized linear model, adjusting for clinical site and surgeon, to assess the effects of increasing risk score on overall cost-utility. Results By 2 years, 31% experienced a major complication and 23% underwent reoperation. Patients with ≤2 risk factors had significantly less major complications. Patients with 2 risk factors improved the most from baseline to 2Y in ODI. Average cost increased by $8234 per risk factor (R2 = .981). Cost-per-QALY at 2Y increased by $122,650 per risk factor (R2 = .794). Adjusted generalized linear model demonstrated a significant trend between increasing risk score and increasing cost-utility (r2 = .408, P < .001). Conclusions The number of defined patient-specific and surgical risk factors, especially those with greater than two, were associated with increased index surgical costs and diminished cost-utility. Efforts to optimize patient physiology and minimize surgical risk would likely reduce healthcare expenditures and improve the overall cost-utility profile for ASD interventions. Level of evidence: III
Harvesting the Quadriceps Tendon With a Minimally Invasive Approach
Authors: Pires Diego , Monteiro Leonardo , Rego Marcelo Cabral Fagundes , de Souza Gustavo Luiz Pezzi Costa , de Paula Rafael Erthal , Pádua Vitor Barion Castro de , Goes Rodrigo de Araújo , Salim Rodrigo , Soares Francisco Rafael do Couto , Rocha de Faria José Leonardo 
Published: December 2023

Background: This article describes a standardized, minimally invasive approach for harvesting the quadriceps tendon through a 2 to 3 cm transverse skin incision, presenting it as a viable option. Indications: This procedure is indicated for patients undergoing anterior cruciate ligament (ACL), posterior cruciate ligament, medial collateral ligament, or lateral collateral ligament reconstruction surgery using soft tissue quadriceps grafts. Technique Description: A transverse incision is made on the anterior face of the knee, followed by a longitudinal incision of the central third of the rectus femoris. We perform the distal detachment of the patella of the same tendon. Then, the tendon is extracted using a closed stripper. The graft is prepared and folded on itself, resulting in a double graft. Results: Twenty patients, 16 male and 4 female with complete rupture of ACL, were submitted to an ACL reconstruction using the quadriceps soft tissue graft with minimally invasive harvesting technique. The results were satisfactory for all patients. All patients showed good evolution in the immediate and late postoperative period, with no cases of joint stiffness, wound dehiscence, and no infections. Discussion/Conclusion: We can conclude that harvesting the quadriceps tendon with a minimally invasive approach is a valid and reliable option for the treatment of ligament tears of the knee. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.
Modified Lip Lift Technique for Pediatric Columellar Reconstruction: A Case Report
Authors: Layon Sarah A. , Burns Heather R. , Wang Daniel S. , Buchanan Edward P. 
Published: December 2023

The nasal columella presents one of the most intricate challenges in facial reconstruction due to its unique contours and limited availability of adjacent tissue. Several surgical techniques exist for successful columellar reconstruction, and the choice of approach depends on factors such as the size of the defect, surgical expertise, and overall esthetic goals. In cases involving substantial columellar defects, or deformities affecting multiple nasal subunits, local or regional flaps are often necessary to achieve optimal reconstruction. In this report, the authors present a case of pediatric columellar reconstruction utilizing a modified local flap technique derived from the upper lip lift used in esthetic surgery for facial rejuvenation and lip enhancement. This method distinguishes itself from previous adaptations by remaining entirely subnasal, without extending beyond the width of the alar base, disrupting the philtrum, or disturbing the orbicularis oris muscle. This technique offers notable advantages for pediatric patients, such as its ability to minimize scarring, prevent additional deformities, and be performed in a single stage. Level of Evidence: Level IV, case study.
Exploring Self-Perception and Peer-Perception in Adolescents With Secondary Cleft Lip Deformities Using Eye-Tracking
Authors: Rizvi Imran , Jackson Sarah A. , Kane Alex A. , Hallac Rami R. 
Published: December 2023

Background: Patients with cleft lip often have a secondary cleft-lip deformity (SCLD), resulting from the initial repair procedure for their congenital cleft. Patients with SCLD often undergo multiple surgeries to achieve symmetry of the lip and nose. However, little is known about how patients perceive their deformity, and if those deformities are noticeable to their peers. The purpose of this study is to use eye-tracking to evaluate how patients with cleft lip repair look at themselves and evaluate how this perception changes when the same photo is perceived by 2 different cohorts: patients who have undergone cleft-lip surgeries and control subjects who have no craniofacial pathology. Methods: Participants were divided into 4 cohorts: adolescents with SCLD viewing images of themselves (Cohort 1), adolescents with SCLD viewing images of peers with SCLD (Cohort 2), adolescents without SCLD viewing images of peers with SCLD (Cohort 3), and healthy adolescents without SCLD viewing images of themselves (Cohort 4). Surveys were conducted after the eye-tracking portion to determine correlations between objective gaze data and subjective opinions. Results: Total fixation duration was highest in the eye region for all 3 cohorts, followed by the upper lip region. Cohort 2 fixated the longest on all areas of pathology, while Cohort 1 fixated the least on all areas of pathology. Cohort 4 spent significantly more time looking at the nose bridge compared to Cohort 1. Conclusions: The results provide insight into how adolescents with SCLD are perceived by themselves and others and can help to better understand the complexities of the roles different areas of pathology play in self-perception.