bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental healthcare for adults with mild intellectual disabilities: population-based database study in Dutch mental health services
Authors: Pouls Katrien P. M. , Cuypers Maarten , Mastebroek Mathilde , Wieland Jannelien , Koks-Leensen Monique C. J. , Leusink Geraline L. , Assendelft Willem J. J. 
Published: March 2023

BackgroundAdults with mild intellectual disability (MID) experience more mental health disorders than the general population. However, mental healthcare may be insufficiently tailored to match their needs. Detailed information is lacking regarding care provided to people with MID in mental health services.AimsTo compare mental health disorders and care provided to patients with and without MID in Dutch mental health services, including patients with missing MID status in the service files.MethodIn this population-based database study, we used a Statistics Netherlands mental health service database, containing health insurance claims of patients who utilised advanced mental health services in 2015–2017. Patients with MID were identified by linking this database with Statistic Netherlands’ social services and long-term care databases.ResultsWe identified 7596 patients with MID, of whom 60.6% had no intellectual disability registration in the service files. Compared with patients without intellectual disability (n= 329 864), they had different profiles of mental health disorders. They received fewer diagnostic (odds ratio 0.71, 95% CI 0.67–0.75) and treatment activities (odds ratio 0.56, 95% CI 0.53–0.59), and required more interprofessional consultations outside of the service (odds ratio 2.06, 95% CI 1.97–2.16), crisis interventions (odds ratio 2.00, 95% CI 1.90–2.10) and mental health-related hospital admissions (odds ratio 1.72, 95% CI 1.63–1.82).ConclusionsPatients with MID in mental health services have different profiles of mental health disorders and care than patients without intellectual disability. In particular, fewer diagnostics and treatments are provided, especially in those with MID with no intellectual disability registration, putting patients with MID at risk of undertreatment and poorer mental health outcomes.
If Residential Segregation Persists, What Explains Widespread Increases in Residential Diversity?
Authors: Kye Samuel H. , Halpern-Manners Andrew 
Published: March 2023

Abstract
Recent studies have identified increasing residential diversity as a near-universal trend across the United States. At the same time, a wide range of scholarship notes the persistence of White flight and other mechanisms that reproduce residential segregation. In this article, we attempt to reconcile these findings by arguing that current trends toward increased residential diversity may sometimes mask population changes that are more consistent with racial turnover and eventual resegregation. Specifically, we show that increases in diversity occur nearly identically across neighborhoods where White populations remain stable or decline in the face of non-White population growth. Our findings demonstrate that, particularly in its early stages, racial turnover decouples diversity and integration, leading to increases in diversity without corresponding increases in residential integration. These results suggest that in many neighborhoods, diversity increases may be transitory phenomena driven primarily by a neighborhood's location in the racial turnover process. In the future, stalled or decreasing levels of diversity may become more common in these areas as segregation persists and the process of racial turnover continues.
The Autocratic Academy
Authors: Kaufman-Osborn Timothy V. 
Published: March 2023

Critics of contemporary US higher education often point to the academy’s “corporatization” as one of its defining maladies. However, in The Autocratic Academy Timothy V. Kaufman-Osborn argues that American colleges and universities have always been organized as corporations in which the power to rule is legally vested in and monopolized by antidemocratic governing boards. This institutional form, Kaufman-Osborn contends, is antithetical to the free inquiry that defines the purpose of higher education. Tracing the history of the American academy from the founding of Harvard (1636), through the Supreme Court’s Dartmouth v. Woodward ruling (1819), and into the twenty-first century, Kaufman-Osborn shows how the university’s autocratic legal constitution is now yoked to its representation on the model of private property. Explaining why appeals to the cause of shared governance cannot succeed in wresting power from the academy’s autocrats, Kaufman-Osborn argues that American universities must now be reincorporated in accordance with the principles of democratic republicanism. Only then can the academy’s members hold accountable those chosen to govern and collectively determine the disposition of higher education’s unique public goods.
Utilization of Palliative Care Services Among Patients With Malignant Brain Tumors: An Analysis of the National Inpatient Sample (2016-2019)
Authors: Dullea Jonathan T. , Vasan Vikram , Devarajan Alex , Ali Muhammad , Nichols Noah , Chaluts Danielle , Henson Phil , Porras Christian , Lopez Christine , Luna Diego , Liou Lathan , Bederson Joshua , Shrivastava Raj K. 
Published: March 2023

BACKGROUND:
Recent advances in treatment of malignant brain tumors have improved outcomes. However, patients continue to experience significant disability. Palliative care helps patients with advanced illnesses improve their quality of life. There is a paucity of clinical studies examining palliative care usage among patients with malignant brain tumors.

OBJECTIVE:
To assess if there were any patterns in palliative care utilization among patients hospitalized with malignant brain tumors.

METHODS:
A retrospective cohort representing hospitalizations for malignant brain tumors was created from The National Inpatient Sample (2016-2019). Palliative care utilization was identified by ICD-10 code. Univariable and multivariable logistic regression models, accounting for the sample design, were built to evaluate the demographic variables associated with palliative care consultation in all patients and fatal hospitalizations.

RESULTS:
375 010 patients admitted with a malignant brain tumor were included in this study. Over the whole cohort, 15.0% of patients used palliative care. In fatal hospitalizations, Black and Hispanic patients had 28% lower odds of receiving a palliative care consultation compared with White patients (odds ratio for both = 0.72; P = .02). For fatal hospitalizations, patients insured privately were 34% more likely to use palliative care services compared with patients insured with Medicare (odds ratio = 1.34, P = .006).

CONCLUSION:
Palliative care is underutilized among all patients with malignant brain tumors. Within this population, disparities in utilization are exacerbated by sociodemographic factors. Prospective studies investigating utilization disparities across race and insurance status are necessary to improve access to palliative care services for this population.
Approach Selection Strategies for Repeat Resection of Brain Cavernous Malformations: Cohort Study
Authors: Graffeo Christopher S. , Scherschinski Lea , Benner Dimitri , Devia Diego A. , Thomas George , Koester Stefan W. , Catapano Joshua S. , Winkler Ethan A. , Srinivasan Visish M. , Lawton Michael T. 
Published: March 2023

BACKGROUND:
Neurosurgical management of cerebral cavernous malformations (CMs) often benefits from using skull base approaches. Although many CMs are cured by resection, residual or recurrent disease may require repeat resection.

OBJECTIVE:
To review approach selection strategies for reoperation of CMs to aid decision-making for repeat procedures.

METHODS:
In this retrospective cohort study, a prospectively maintained single-surgeon registry was queried for patients with CMs who underwent repeat resection from January 1, 1997, to April 30, 2021.

RESULTS:
Of 854 consecutive patients, 68 (8%) underwent 2 operations; 40 had accessible data on both. In most reoperations (33/40 [83%]), the index approach was repeated. In most reoperations using the index approach (29/33 [88%]), that approach was deemed ideal (no equivalent or superior alternative), whereas in some (4/33 [12%]), the alternative approach was deemed unsafe because of conformation of the tract. Among patients with reoperations using an alternative approach (7/40 [18%]), 2 with index transsylvian approaches underwent bifrontal transcallosal approaches, 2 with index presigmoid approaches underwent extended retrosigmoid revisions, and 3 with index supracerebellar-infratentorial approaches underwent alternative supracerebellar-infratentorial trajectory revisions. Among patients with reoperations with an alternative approach considered or selected (11/40 [28%]), 8 of 11 patients had a different surgeon for the index resection than for the repeat resection. The extended retrosigmoid-based approaches were used most often for reoperations.

CONCLUSION:
Repeat resection of recurrent or residual CMs is a challenging neurosurgical niche at the intersection of cerebrovascular and skull base disciplines. Suboptimal index approaches may limit surgical options for repeat resection.
The Roof of the 4th Ventricle Seen From Inside: Endoscopic Anatomic Illustration—A Case Series
Authors: Longatti Pierluigi , Feletti Alberto , Basaldella Luca , Boaro Alessandro , Sala Francesco , Fiorindi Alessandro 
Published: March 2023

BACKGROUND:
The anatomy of the roof of the fourth ventricle has been illustrated in many laboratory investigations, but in vivo reports of the roof anatomy and its variants are still lacking.

OBJECTIVE:
To describe the topographical anatomy of the roof of the fourth ventricle explored through a transaqueductal approach that overcomes cerebrospinal fluid depletion, displaying in vivo anatomic images possibly quite close to normal physiological conditions.

METHODS:
We critically reviewed the intraoperative video recordings of our 838 neuroendoscopic procedures, selecting 27 cases of transaqueductal navigation that provided good quality image details of the anatomy of the roof of the fourth ventricle. Twenty-six patients affected by different forms of hydrocephalus were therefore categorized into three groups: Group A: blockage of the aqueduct-aqueductoplasty, Group B: communicating hydrocephalus, and Group C: tetraventricular obstructive hydrocephalus.

RESULTS:
Group A has shown what the roof of a normal fourth ventricle really looks like albeit the structures seemed overcrowded because of the narrow space. Images from groups B and C paradoxically allowed a more distinct identification of the roof structures flattened by ventricular dilation, making them more comparable with the topography traced on the laboratory microsurgical studies.

CONCLUSION:
Endoscopic in vivo videos and images provided a novel anatomic view and an in vivo redefinition of the real topography of the roof of the fourth ventricle. The relevant role of cerebrospinal fluid was defined and outlined, as well as the effects of hydrocephalic dilation on some structures on the roof of the fourth ventricle.
FZD2 regulates limb development by mediating β-catenin-dependent and -independent Wnt signaling pathways
Authors: Zhu Xuming , Xu Mingang , Leu N. Adrian , Morrisey Edward E. , Millar Sarah E. 
Published: March 2023

ABSTRACT
Human Robinow syndrome (RS) and dominant omodysplasia type 2 (OMOD2), characterized by skeletal limb and craniofacial defects, are associated with heterozygous mutations in the Wnt receptor FZD2. However, as FZD2 can activate both canonical and non-canonical Wnt pathways, its precise functions and mechanisms of action in limb development are unclear. To address these questions, we generated mice harboring a single-nucleotide insertion in Fzd2 (Fzd2em1Smill), causing a frameshift mutation in the final Dishevelled-interacting domain. Fzd2em1Smill mutant mice had shortened limbs, resembling those of RS and OMOD2 patients, indicating that FZD2 mutations are causative. Fzd2em1Smill mutant embryos displayed decreased canonical Wnt signaling in developing limb mesenchyme and disruption of digit chondrocyte elongation and orientation, which is controlled by the β-catenin-independent WNT5A/planar cell polarity (PCP) pathway. In line with these observations, we found that disruption of FZD function in limb mesenchyme caused formation of shortened bone elements and defects in Wnt/β-catenin and WNT5A/PCP signaling. These findings indicate that FZD2 controls limb development by mediating both canonical and non-canonical Wnt pathways and reveal causality of pathogenic FZD2 mutations in RS and OMOD2 patients.
Pregnancy and Exercise in Mountain Travelers
Authors: Keyes Linda E. , Sanders Linda 
Published: March 2023

Abstract
Pregnant women are traveling to high altitude and evidence-based recommendations are needed. Yet, there are limited data regarding the safety of short-term prenatal high-altitude exposure. There are benefits to prenatal exercise and may be benefits to altitude exposure. Studies evaluating maternofetal responses to exercise at altitude found the only complication was transient fetal bradycardia, a finding of questionable significance. There are no published cases of acute mountain sickness in pregnant women, and data suggesting an increase in preterm labor are of poor quality. Current recommendations across professional societies are overly cautious and inconsistent. Non-evidence-based restrictions to altitude exposure can have negative consequences for a pregnant women's physical, social, mental, and economic health. Available data suggest that risks of prenatal travel to altitude are low. Altitude exposure is likely safe for women with uncomplicated pregnancies. We do not recommend absolute restrictions to high altitude exposure, but rather caution and close self-monitoring.
Test–retest reliability and validity of cervical range of motion measurement using a smartphone clinometer and compass application among individuals with and without neck pain
Authors: Khan Abdur Raheem , Aafreen  , Khan Ashfaque , Ahmed Hashim , Shaphe Mohammad Abu , Qasheesh Mohammed 
Published: March 2023

Background/Aims Cervical disorders are major health problems in our society and an important source of disability. Assessing range of motion is a significant part of the physical therapist’s role when evaluating a patient presenting with cervical disorders. The purpose of this study was to evaluate the intrarater relibility as well as the criterion validity of two phone applications (clinometer and compass) when assessing the cervical range of motion among individuals with and without neck pain. Methods In total, 80 participants were included in this study and split into two groups. Group A comprised 40 participants (18 women and 22 men) without neck pain. Group B included 40 participants (26 women and 14 men) with neck pain (mean pain rating on visual analogue scale 3.76 ± 0.93). Cervical range of motion was measured with the clinometer application (flexion, extension, right and left lateral flexion) and compass application (right and left rotation). The readings were compared with a universal goniometer. Estimates of reliability and validity were then established using the intraclass correlation coefficient, standard error of measurement and minimum detectable change. Results The smartphone applications had good intrarater reliability when compared to a universal goniometer, showing good to excellent validity (intraclass correlation coefficient >0.65) for all six cervical ranges of motion in participants with and without neck pain. Conclusions The smartphone clinometer application was found to be valid and reliable in measuring frontal and sagittal cervical ranges of motion in participants with and without neck pain. The compass application was found to be valid and reliable when assessing the horizontal cervical range of motion in a seated position. The applications will benefit physiotherapists when assessing cervical range of motion.
Scabies: an update for nurses
Authors: Nazarko Linda 
Published: March 2023

Nurses may encounter scabies in homeless people, those living in prisons, people living at home or in people living in care homes. Scabies is more prevalent in older adults and there is evidence that this infection is becoming more prevalent and difficult to treat. This article aims to enable the nurse to be aware of the clinical features of scabies and how it is treated. Practice nurses may come across increasing numbers of cases of scabies. Linda Nazarko provides an overview of the clinical features, treatment and complications
A COMPARATIVE ANALYSIS OF INTEROBSERVER RELIABILITY AND INTRAOBSERVER REPRODUCIBILITY OF OSWESTRY BRISTOL CLASSIFICATION AND THE DEJOUR CLASSIFICATION FOR TROCHLEAR DYSPLASIA OF THE KNEE
Authors: Roy K.D. , Joshi P. , Ali I. , Shenoy P. , Syed A. , Barlow D. , Malek I. , Joshi Y. 
Published: March 2023

Classifying trochlear dysplasia (TD) is useful to determine the treatment options for patients suffering from patellofemoral instability (PFI). There is no consensus on which classification system is more reliable and reproducible for this purpose to guide clinicians in order to treat PFI. There are also concerns about validity of the Dejour classification (DJC), which is the most widely used classification for TD, having only a fair reliability score.The Oswestry-Bristol classification (OBC) is a recently proposed system of classification of TD and the authors report a fair-to-good interobserver agreement and good-to-excellent intra-observer agreement in the assessment of TD. The aim of this study was to compare the reliability and reproducibility of these two classifications.6 assessors (4 consultants and 2 registrars) independently evaluated 100 magnetic resonance axial images of the patella-femoral joint for TD and classified them according to OBC and DJC. These assessments were again repeated by all raters after 4 weeks. The inter and intra-observer reliability scores were calculated using Cohen's kappa and Cronbach's alpha.Both classifications showed good to excellent interobserver reliability with high alpha scores. The OBC classification showed a substantial intra-observer agreement (mean kappa 0.628)[p<0.005] whereas the DJC showed a moderate agreement (mean kappa 0.572) [p<0.005]. There was no significant difference in the kappa values when comparing the assessments by consultants to those by registrars, in either classification systems.This large study from a non-founding institute shows both classification systems to be reliable for classifying TD based on magnetic resonance axial images of the patella-femoral joint, with the simple to use OBC having a higher intra-observer reliability score compared to the DJC.
THE CLINICAL IMPLICATIONS OF GRAF TYPE IIA HIP DYSPLASIA
Authors: Poacher A. , Ramage G. , Froud J. , Carpenter C. 
Published: March 2023

IntroductionThere is little evidence surrounding the clinical implications of a diagnosis of IIa hip dysplasia with no consensus as to its efficacy as a predictor pathological dysplasia or treatment. Therefore, we evaluated the importance of categorising 2a hip dysplasia in to 2a- and 2a+ to better understand the clinical outcomes of each.MethodsA 9-year retrospective cohort study of patients with a diagnosis of type IIa hip dysplasia between 2011 – 2020 (n=341) in our centre. Ultrasound scans were graded using Graf's classification, assessment of management and DDH progression was completed through prospective data collection by the authors.ResultsThe prevalence of IIa hip dysplasia within our population was 6.7/1000 live births. There was significantly higher incidence of treatment in the IIa- (31.4%, n=17/54) group when compared to the 2a+ group (10%, n=28/287), (p<0.01). In those that had an abnormality (torticollis and/or foot abnormality) treatment rates (24% n=7/29) were significantly (p<0.05) higher than those without anatomical abnormality (15%, n=48/312).ConclusionThis study has demonstrated the significant clinical impact of a IIa- diagnosis on progression to pathological dysplasia and therefore higher rates of treatment in IIa- hips. Furthermore, we have demonstrated the importance of detection of IIa hips through a national screening program, to allow for timely intervention to prevent missing the acetabular maturation window. Therefore, it is our recommendation that all patients with additional anatomical abnormalities and those with a diagnosis of type IIa- hip dysplasia be considered for immediate treatment or urgent follow up following their diagnosis to prevent late conservative intervention.
A VIRTUAL FRACTURE CLINIC AUDIT: ARE WALES MATCHING THE OUTCOMES IN ENGLAND?
Authors: Ramage G. , Poacher A. , Ramsden M. , Lewis J. , Robertson A. , Wilson C. 
Published: March 2023

IntroductionVirtual fracture clinics (VFC's) aim to reduce the number of outpatient appointments while improving the clinical effectiveness and patients experience through standardisation of treatment pathways. With 4.6% of ED admissions due to trauma the VFC prevents unnecessary face to face appointments providing a cost savings benefit to the NHS.MethodsThis project demonstrates the importance of efficient VFC process in reducing the burden on the fracture clinics. We completed preformed a retrospective cross-sectional study, analysing two cycles in May (n=305) and September (n=332) 2021. We reviewed all VFC referrals during this time assessing the quality of the referral, if they went on to require a face to face follow up and who the referring health care professional was. Following the cycle in May we provided ongoing education to A&E staff before re-auditing in September.ResultsBetween the two cycles there was an average 19% improvement in quality of the referrals, significant reduction in number of inappropriate referrals for soft tissue knee and shoulder injuries from 15.1% (n=50) to 4.5% (n=15) following our intervention. There was an 8% increase in number of fracture clinic appointments to 74.4% (n=247), primarily due to an increase number of referrals from nurse practitioners. Radial head fractures were targeted as one group that were able to be successfully managed in VFC, despite this 64% (n=27) of patients were still seen in the outpatient department following VFC referral.ConclusionDespite the decrease in the number of inappropriate referrals, and the increase in quality of referrals following our intervention. The percentage of VFC referrals in CAVUHB is still higher than other centres in with established VFCs in England. This possibly highlights the need for further education to emergency staff around describing what injuries are appropriate for referral, specifically soft tissue injuries and radial head fractures. In order to optimise the VFC process and provide further cost savings benefits while reducing the strain on fracture clinics.