bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified Medial Incision Small Double-Opposing Z-Plasty for Treating Veau Type I Cleft Palate: Is the Early Result Reproducible?
Authors: Denadai Rafael , Seo Hyung Joon , Go Pascasio Dax Carlo , Sato Nobuhiro , Murali Srinisha , Lo Chi-Chin , Chou Pang-Yung , Lo Lun-Jou 
Published: September 2022

Objective An inspiring early result with no oronasal fistula formation was recently described for a modified medial incision small double-opposing Z-plasty (MIsDOZ) for treating Veau type I cleft palate. This study describes an early single-surgeon experience in applying this newly proposed surgical approach. Design Retrospective single-surgeon study. Patients Consecutive nonsyndromic patients (n  =  27) with Veau I cleft palate. Interventions Topographic anatomical-guided MIsDOZ palatoplasty with pyramidal space dissection (releasing of the ligamentous fibers in the greater palatine neurovascular bundle and pyramidal process region, in-fracture of the pterygoid hamulus, and widening of space of Ernst) performed by a novice surgeon (RD). Mean Outcome Measures Age at surgery, the presence of cleft lip, palatal cleft width, use of lateral relaxing incision, and 6-month complication rate (bleeding, dehiscence, fistula, and flap necrosis). A published senior surgeon-based outcome dataset (n  =  24) was retrieved for comparison purposes. Results Twenty-two (81.5%) and 5 (18.5%) patients received the medial incision only technique and lateral incision technique, respectively ( P  =  .002). Age, presence of cleft lip, and cleft width were not associated (all P > .05) with the use of lateral incision. Comparative analysis between the novice surgeon- and senior surgeon-based datasets revealed no significant differences for sex (females: 74.1% vs 62.5%; P  =  .546), age (10.2  ±  1.7 vs 9.6  ±  1.2 months; P  =  .143), rate of lateral incision (18.5% vs 4.2%; P  =  .195), and postoperative complication rate (0% vs 0%). Conclusion This modified DOZ palatoplasty proved to be a reproducible procedure for Veau I cleft palate closure, with reduced need for lateral incision and with no early complication.
Proptosis secondary to bilateral extraocular muscle enlargement in Noonan syndrome with hypertrophic cardiomyopathy: A case report
Authors: Marchione Giulia , Pilotto Elisabetta , Midena Giulia 
Published: September 2022

Purpose To report and investigate proptosis in a young girl with Noonan syndrome. Methods Observational case report. Results A 16-year-old girl affected by Noonan syndrome underwent a complete ophthalmological examination showing bilateral proptosis with hypofunction of lateral rectus and superior oblique muscles. Visual acuity, color discrimination and fundus examination were unremarkable. The orbital MRI showed bilateral proptosis and symmetrical enlargement of extraocular muscles, with bellies thickening and tendon sparing. The young patient also complained restrictive hypertrophic cardiomyopathy. Conclusions Proptosis is an uncommon ocular manifestation of Noonan syndrome and its pathophysiology has never been clarified. The MRI evidence of extraocular muscles enlargement associated with hypertrophic cardiomyopathy, led us to hypothesize a common altered pathway beneath these features, more specifically the MAP kinase pathway, since extraocular and cardiac muscles share a mesenchymal embryological origin.
Long peripheral cannula in COVID-19 patients: 769 catheter days experience from a semi-intensive respiratory COVID unit
Authors: Gilardi Emanuele , Grandi Tommaso , Giannuzzi Rosangela , Valletta Fabio , Fugger Solange , Mazzaroppi Silvia , Petrucci Martina , Piano Alfonso , Piccioni Andrea , WoldeSellasie Kidane , Sambuco Federica , Travaglino Francesco 
Published: September 2022

Background: In the daily management of peripheral venous access, the health emergency linked to the COVID-19 pandemic led to re-examining the criteria for choosing, positioning and maintaining the different types of peripheral venous access. Objectives: This study aimed to observe the dwell time of long peripheral cannula (LPC, also known as mini-midline) in patients affected by COVID 19 related pneumonia. The secondary objective is to study any complications due to mini-midline insertion. Materials and methods: We conducted a prospective observational study on COVID19 patients who arrived at our Semi-Intensive Respiratory Unit from territorial ED between January and April 2021, to whom were positioned an LPC at the time of admission following the SIPUA protocol (Safe Insertion of Peripheral Ultrasound-guided Access). We used Vygon™ Leader-Cath© 18G in polyethylene and 8 cm long catheter. Results: We enrolled 53 consecutive patients, reaching 769 catheter days. The procedure was performed without immediate complications in 37 patients out of 53 (69.8%). In 14 patients (26.4%), we observed a local hematoma (no one led to a failure or early removal of the device) and in two patients (3.7%) was not possible to draw blood. The average catheter dwell time was 14.5 days, from 3 to 41 days. In 42 patients (79.2%), the device was removed at the end of use. In 11 patients out of 53 (20.8%), the device was removed early due to complications: seven accidental removals, one obstruction, two vein thrombosis, and one superficial thrombophlebitis. Conclusions: The ultrasound-guided implantation of an 18G LPC in COVID19 patients, regardless of the state of their venous heritage, would seem to be an excellent strategy for these patients, reducing the number of venipunctures and CVC implantation, as well as allowing multiple and high pressure (contrast) infusions.
Tendency to Breast Cancer Screening Among Rural Women in Southern Iran: A Structural Equation Modeling (SEM) Analysis of Theory of Planned Behavior
Authors: Keshavarzi Ameneh , Asadi Saeedeh , Asadollahi Abdolrahim , Mohammadkhah Fatemeh , Khani Jeihooni Ali 
Published: September 2022

Background: Early detection of breast cancer is a crucial factor in surviving the disease. This study aimed to investigate the mammography screening based on the theory of planned behavior (TPB) among rural women in Fasa and Shiraz cities, Iran. Methods: This study is a cross-sectional study performed on 800 female clients referring to rural health centers in Fasa and Shiraz cities in southern Iran in early 2021. The authors decided to send and distribute the electronic questionnaire form through the WhatsApp application in collaboration with the health staff of rural health centers for the people covered by these centers. Data gathering tools were a questionnaire on demographic characteristics, a questionnaire based on constructs of TPB, and behavior of mammography screening. Using the structural equation model (SEM), the TPB constructs and demographic variables were entered into the model. Data analysis was executed employing SPSS software version 26 and Amos version 24 (IBM Co., Ann Arbor, MI, USA). Analyzing the data was carried out using the 1-way analysis of variance (ANOVA), logistic regression, and structural equation analysis. During data analysis, various model indicators such as the goodness of fit, including comparative fit index (CFI), goodness-of-fit index (GFI), root mean square error of approximation (RMSEA), and chi-square index/ df were evaluated. The significance level in all tests was considered 0.05. Results: The knowledge, attitude, and perceived behavioral control were the predictors of intention and behavior of mammography screening among the women. Among demographic variables, age, literacy, being menopausal, cancer in family, city, and ethnicity contribute more to the variance variation in TPB constructs. In this study, 7.2% of Persians, 8% of Qashqai Turks, and 4.5% of Arabs are contemplating going to mammography screening. In total, 6.8% (54 people) of all individuals intended to go mammography screening, and 5.4% (43 people) had a history of mammography screening. Goodness-of-fit indices (χ2 = 18.45, df = 10, n = 800, χ2/ df = 1.845, RMSEA = 0.032, GFI = 0.90, non-normed fit index (NNFI) = 0.91) of conceptual model of this study indicate the suitability of the model. Conclusions: The results of the study indicated that the constructs of the TPB can predict mammography screening behaviors in rural women. It has also demonstrated that mammographic behavior can be improved in rural women using education based on the TPB model, emphasizing critical psychological factors of creating or changing behavior.
Using a telemedicine-assisted airway model to improve the communication and teamwork of tracheal intubation during the coronavirus disease 2019 pandemic
Authors: Lin Chien-Hao , Lin Hao-Yang , Wu Shih-Ni , Tseng Wen-Pin , Chen Wei-Ting , Tien Yu-Tzu , Wu Cheng-Yi , Huang Chien-Hua , Tsai Min-Shan 
Published: September 2022

Introduction Isolated spaces impair communication and teamwork during tracheal intubation (TI) in suspected coronavirus disease 2019 patients. We thus aimed to evaluate the telemedicine-assisted airway model (TAM) to improve communication and teamwork during the pandemic. Methods This two-stage prospective study included adult patients intubated in the emergency department of the National Taiwan University Hospital between 1 August 2020 and 31 July 2021. First, we randomised patients receiving TI in the standard setting into the conventional group (Con-G) and the isolation area into the isolation group (Iso-G). We evaluated the obstacles to communication and teamwork in an isolation scenario. Second, we developed the TAM to facilitate communication and teamwork between staff in separate spaces during TI and assigned patients to the TAM group (TAM-G). Communication and teamwork were evaluated using the Team Emergency Assessment Measure (TEAM). Subjective evaluations were conducted using a questionnaire administered to medical staff. Results Eighty-nine patients were enrolled: 17, 34, and 38 in the Con-G, Iso-G, and TAM-G, respectively. The communication frequency (CF) of the Con-G and Iso-G was the highest and lowest, respectively. The CF of the TAM-G increased and approached that of the Con-G. The overall TEAM score was the highest in the Con-G and the lowest in the Iso-G, while the overall score in the TAM-G was comparable to that of the Con-G. Discussion The TAM may improve communication and teamwork for TIs without compromising efficacy during the pandemic. This study was registered at ClinicalTrials.gov; registration numbers: NCT04479332 and NCT04591873.
Toward deeper understanding and wide-scale implementation of naturalistic developmental behavioral interventions
Authors: D’Agostino Sophia R , Dueñas Ana D , Bravo Alice , Tyson Kelsie , Straiton Diondra , Salvatore Giovanna L , Pacia Cressida , Pellecchia Melanie 
Published: September 2022

Naturalistic Developmental Behavioral Interventions (NDBIs) have a strong and growing evidence base. Yet, NDBIs are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons for the slow adoption of NDBIs likely stem from the differing theoretical orientations of behavioral and developmental sciences from which NDBI are derived, and a lack of training, knowledge, and support for implementing NDBIs within the behavior analytic community. In support of efforts to promote wide-scale implementation of NDBIs, we clarify their common features, discuss possible misconceptions, offer reasons why NDBIs should be widely implemented, and provide recommendations to the autism service community, intervention developers, and researchers to improve their dissemination and implementation. Lay Abstract Naturalistic Developmental Behavioral Interventions (NDBIs) are a group of early interventions that use a variety of strategies from applied behavioral and developmental sciences. Although Naturalistic Developmental Behavioral Interventions have been demonstrated effective, Naturalistic Developmental Behavioral Interventions are not implemented on a wide scale within early intervention programs for children on the autism spectrum. Potential reasons likely stem from differing theoretical orientations of developmental and behavioral sciences and practitioners’ lack training, knowledge, and support for implementing Naturalistic Developmental Behavioral Interventions. In support of efforts to promote wide-scale implementation of Naturalistic Developmental Behavioral Interventions, we (1) clarify their common features, (2) discuss possible misconceptions, and (3) offer reasons why Naturalistic Developmental Behavioral Interventions should be widely implemented. We also provide recommendations to the autism service community, intervention developers, and researchers.
A suite of evaluation resources for Dementia Friendly Communities: Development and guidance for use
Authors: Buckner Stefanie , Lafortune Louise , Darlington Nicole , Dickinson Angela , Killett Anne , Mathie Elspeth , Mayrhofer Andrea , Woodward Michael , Goodman Claire 
Published: September 2022

Objectives In the context of a growing number of dementia friendly communities (DFCs) globally, a need remains for robust evaluation, and for tools to capture relevant evidence. This paper reports the development of a suite of evaluation resources for DFCs through a national study in England. Methods Fieldwork took place in six diverse case study sites across England. A mixed methods design was adopted that entailed documentary analysis, focus groups, interviews, observations, and a survey. Participants were people affected by dementia and practice-based stakeholders. A national stakeholder workshop was held to obtain input beyond the research sites. A workshop at the end of the study served to check the resonance of the findings and emerging outputs with stakeholders from the case study DFCs. Results The study had three key outputs for the evaluation of DFCs: First, an evaluation framework that highlights thematic areas to be considered in evaluating DFCs. Second, a Theory of Change that presents inputs into a DFC and short, medium and longer term outcomes. Third, a matrix for assessing a DFC’s degree of maturity, which enables a sense of the kinds of outcomes a DFC might realistically aspire to. These three outputs form a suite of interlinking and complementary evaluation resources for DFCs. Conclusions The study has contributed evidence-based resources for monitoring and evaluation that complement existing frameworks. They can be applied to arrive at a detailed assessment of how well a DFC works for people affected by dementia, and at insights into the underlying factors that can guide future policy and practice.
Transcranial Color-Coded Doppler Cerebral Hemodynamics Following Aerobic Exercise Training: Outcomes From a Pilot Randomized Clinical Trial
Authors: Mitchell Carol , Gaitán J. Max , Pewowaruk Ryan J. , Gepner Adam D. , Hess Timothy , Wilbrand Stephanie M. , Dempsey Robert J. , Dougherty Ryan J. , Cook Dane B. , Okonkwo Ozioma 
Published: September 2022

Introduction: An active lifestyle with regular exercise is thought to decrease or delay the onset of Alzheimer dementia through increasing blood flow to the brain. We examined the mean flow velocity (MFV) and pulsatility index (PI) in the middle cerebral arteries of individuals randomized into 2 groups—a usual physical activity (UPA) group and an enhanced physical activity (EPA) exercise intervention group—to determine whether exercise training is related to changes in cerebral blood flow. Methods: We examined 23 participants, randomized into a UPA group (n = 12) and an EPA group (n = 11), with transcranial color-coded Doppler (TCCD) and cardiorespiratory fitness (VO2peak) testing at baseline and following a 26-week intervention. Transcranial color-coded Doppler was used to measure MFV and PI. Participants in the EPA group completed supervised aerobic exercise training for 26 weeks. Kendall’s tau-b correlation was used to examine relationships between variables. The Wilcoxon rank-sum tests were used to examine changes between the UPA and EPA groups. Results: There was no significant change in MFV or PI in the UPA group or the EPA group ( P values >.05) between baseline and 26 weeks; the change between the UPA and EPA groups was also not significant ( P = .603). There was no evidence of an association between change in VO2peak and change in MFV or PI (all P values >.05). Participants in the EPA group significantly increased their VO2peak compared with the UPA group ( P = .027). Conclusion: This study did not demonstrate evidence of a significant change in the MFV in the middle cerebral arteries or evidence of a significant change in the PI between UPA and EPA groups. Future studies should be performed in larger cohorts and should consider use of personalized exercise programs to maximize understanding of how cerebrovascular hemodynamics change in structure and function with exercise for adults at risk of Alzheimer dementia.
Women decision-making autonomy on maternal health service and associated factors in low- and middle-income countries: Systematic review and meta-analysis
Authors: Gebeyehu Natnael Atnafu , Gelaw Kelemu Abebe , Lake Eyasu Alem , Adela Getachew Asmare , Tegegne Kirubel Dagnaw , Shewangashaw Nathan Estifanos 
Published: September 2022

Objective: This study was done to determine the overall estimate of decision-making autonomy on maternal health services and associated factors in low- and middle-income countries. Method: PubMed, Science Direct, Google Scholar, Scopus, and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (version 14). Publication bias was checked by forest plot, Begg’s rank test, and Egger’s regression test. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by country, year, and publication. Joanna Briggs Institute quality assessment tool was used to check the quality of each study. We carried out a leave-one-out sensitivity analysis. Results: Out of 1305 articles retrieved, 19 studies (with 104,871 study participants) met eligibility criteria and were included in this study. The pooled prevalence of women’s decision-making autonomy on maternal health services in low- and middle-income countries was 55.15% (95% confidence interval: 44.11–66.19; I2 = 98.6%, P < 0.001). Based on subgroup analysis, decision-making autonomy in maternal health services was the highest in Ethiopia at 61.36% (95% confidence interval: 50.58–72.15) and the lowest in Nigeria at 36.16% (95% confidence interval: 12.99–43.39). It was 32.16% (95% confidence interval: 32.72–39.60) and 60.18% (95% confidence interval: 47.92–72.44) before and after 2016, respectively. It was also 54.64% (95% confidence interval: 42.51–66.78) in published studies and 57.91% (95% confidence interval: 54.80–61.02) in unpublished studies. Age (adjusted odds ratio = 2.67; 95% confidence interval: (1.29–5.55), I2 = 90.1%), primary level of education (adjusted odds ratio = 1.75; 95% confidence interval: (1.39–2.21), I2 = 63.8%), secondary education level (adjusted odds ratio = 2.09; 95% confidence interval: (1.32–3.32), I2 = 87.8%), being urban resident (adjusted odds ratio = 1.80; 95% confidence interval: (1.22–2.66), I2 = 73%), and monthly income (adjusted odds ratio = 3.23; 95% confidence interval: (1.85–5.65), I2 = 97%) were positively associated with decision-making autonomy on maternal health service. Conclusion: Decision-making autonomy on maternal health services in low- and middle-income countries was low. Sociodemographic factors also influenced it. Educational accessibility and income generation should have been recommended, enabling women to decide for themselves.
Mesenteric abnormalities play an important role in grading intestinal fibrosis in patients with Crohn’s disease: a computed tomography and clinical marker-based nomogram
Authors: Meng Jixin , Mao Yitao , Zhou Jie , Chen Zhao , Huang Siyun , Wang Yangdi , Huang Li , Zhang Ruonan , Shen Xiaodi , Lv Wen , Xiao Juxiong , Ye Ziyin , Chen Zhihui , Mao Ren , Sun Canhui , Li Ziping , Feng Shi-Ting , Lin Shaochun , Li Xuehua 
Published: September 2022

Background: While the grading of intestinal fibrosis is closely related to the therapeutic strategy of patients with Crohn’s disease (CD), it has not yet been well resolved. Mesenteric abnormalities are inextricably linked to intestinal fibrosis. Objectives: We aimed to establish an optimal model for assessing intestinal fibrosis using computed tomography enterography (CTE) and clinical markers. Design: A total of 174 patients with CD between January 2014 and June 2020 were included in this retrospective multicentre study. Methods: All patients underwent CTE within 3 months prior to surgery. Intestinal fibrosis was pathologically scored as non-mild or moderate-to-severe. Selected imaging of the intestinal walls and mesentery and/or clinical factors were used to develop the diagnostic models. The area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the discrimination performance of the models. A decision curve analysis was performed to evaluate the clinical usefulness of the models. Results: One-, two-, and three-variable models were identified as possible diagnostic models. Model 1 [mesenteric creeping fat index (MCFI)], Model 2 (mesenteric oedema and MCFI), and Model 3 (mesenteric oedema, MCFI, and disease duration) were established. The AUCs of Model 1 in training and test cohorts 1 and 2 were 0.799, 0.859, and 0.693, respectively; Model 2 was 0.851, 0.833, and 0.757, respectively; and Model 3 was 0.832, 0.821, and 0.850, respectively. We did not observe any significant difference in diagnostic performance between the training and total test cohorts in any model (all p > 0.05). The decision curves showed that Model 3 had the highest net clinical benefit in test cohort 2. The nomogram of this optimal model was constructed by considering the favourable and robust performance of Model 3. Conclusion: A nomogram integrating mesenteric abnormalities on CTE with a clinical marker was optimal for differentiating between non-mild and moderate-to-severe fibrosis in patients with CD.
MRI pattern in acute optic neuritis: Comparing multiple sclerosis, NMO and MOGAD
Authors: Darakdjian Maximiliano , Chaves Hernan , Hernandez Jairo , Cejas Claudia 
Published: September 2022

Background Several MRI findings of optic neuritis (ON) have been described and correlated with specific underlying etiologies. Specifically, optic nerve enhancement is considered an accurate biomarker of acute ON. Objective To identify differences in MRI patterns of optic nerve enhancement in certain demyelinating etiologies presenting with acute ON. Methods Retrospective analysis of enhancement patterns on fat-suppressed T1-weighted images from patients presenting clinical and radiological acute ON, treated at our institution between January 2014 and June 2022. Location and extension of enhancing optic nerve segments, as well as presence of perineural enhancement were evaluated in three predetermined demyelinating conditions. Fisher’s exact test and chi2 were calculated. Results Fifty-six subjects met eligibility criteria. Mean age was 31 years (range 6–79) and 70% were females. Thirty-four (61%) patients were diagnosed with multiple sclerosis (MS), 8 (14%) with neuromyelitis optica (NMO), and 14 (25%) with anti-myelin oligodendrocyte glycoprotein disease (MOGAD). Bilateral involvement was more frequent in MOGAD, compared to MS and NMO (43 vs 3% and 12.5% respectively, p = 0.002). MS patients showed shorter optic nerve involvement, whereas MOGAD showed more extensive lesions ( p = 0.006). Site of involvement was intraorbital in 63% MS, 89% NMO, 90% MOGAD ( p = 0.051) and canalicular in 43% MS, 33% NMO and 75% MOGAD ( p = 0.039). Intracranial or chiasmatic involvement and presence of perineural enhancement were not statistically different between entities. Conclusion In the setting of acute ON, patients presenting MOGAD were more likely to show bilateral, longitudinally extended and anterior (intraorbital and canalicular) optic nerve involvement compared to patients with MS or NMO.