bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical Significance of Clinocephaly in Late-Presentation Sagittal Craniosynostosis
Authors: Pfaff Miles J. , Fenton Regina , Mittal Aditya , Mocharnuk Joseph W. , Owoc Maryanna S. , Bruce Madeleine K. , Beiriger Justin W. , Losee Joseph E. , Goldstein Jesse A. 
Published: May 2022

The diagnosis of late-presentation sagittal suture craniosynostosis (SCS) can be challenging, especially in the setting of subtle physical exam findings. The clinical significance of clinocephaly—a retro-coronal concavity along the midvault—in this context remains unknown. The aim of this study is to evaluate the predictive value of clinocephaly in identifying late-presentation SCS. A retrospective chart review of all patients >1 year old presenting to the craniofacial clinic with a concern for SCS was performed. The presence or absence of SCS in the setting of clinocephaly was recorded following diagnostic imaging. Student's t test, Chi Square test, and multivariate logistic regression analysis were performed to determine predictors for SCS. 75 patients met inclusion criteria. 32 patients (42.7%, 6% female) were diagnosed with SCS. No difference in age between patients with and without SCS was detected. Stratification of patients by age (1–2, 2–4, and >4 years) revealed a higher rate of SCS in younger patients (P = 0.04). The cephalic index (C.I.) of those with sagittal synostosis was significantly smaller but within the normal range, indicating a more scaphocephalic shape (P = 0.003). Logistic regression analysis revealed that C.I. was a strong predictor for SCS (P = 0.003). Of those with SCS, a mix of complete and partial fusion of the sagittal suture was appreciated. This study found that 42.7% of patients with clinocephaly had SCS. C.I. was the only predictor for SCS and unique suture fusion patterns were identified in those with SCS. This study suggests that clinocephaly should be considered a core component of the exam and work-up for SCS. Future studies aimed at evaluating the positive predictive value of this exam finding and identifying risk factors associated with late-presentation SCS are underway.
UCSQ Method Applied on 3D Photogrammetry: Non-Invasive Objective Differentiation Between Synostotic and Positional Plagiocephaly
Authors: Kronig Sophia A.J. , Kronig Otto D.M. , Vrooman Henri A. , Van Adrichem Léon N.A. 
Published: May 2022

Objective Objective differentiation between unilateral coronal synostosis (UCS) and positional posterior plagiocephaly (PPP) based on 3D photogrammetry according to Utrecht Cranial Shape Quantificator (UCSQ). Design Retrospective study. Setting Primary craniofacial center. Patients, Participants Thirty-two unoperated patients (17 UCS; 15 PPP) (age < 1 year). Interventions Extraction of variables from sinusoid curves derived using UCSQ: asymmetry ratio forehead and occiput peak, ratio of gradient forehead and occiput peak, location forehead and occiput peak. Main Outcome Measure(s) Variables, derived using 3D photogrammetry, were analyzed for differentiation between UCS and PPP. Results Frontal peak was shifted to the right side of the head in left-sided UCS (mean x-value 207 [192-220]), and right-sided PPP (mean x-value 210 [200-216]), and to the left in right-sided UCS (mean x-value 161 [156-166]), and left-sided PPP (mean x-value 150 [144-154]). Occipital peak was significantly shifted to the right side of the head in left-sided PPP (mean x-value 338 [336-340]) and to the left in right-sided PPP (mean x-value 23 [14-32]). Mean x-value of occipital peak was 9 (354-30) in left- and 2 (350-12) in right-sided UCS. Calculated ratio of gradient of the frontal peak is, in combination with the calculated asymmetry ratio of the frontal peak, a distinctive finding. Conclusions UCSQ objectively captures shape of synostotic and positional plagiocephaly using 3D photogrammetry, we therefore developed a suitable method to objectively differentiate UCS from PPP using radiation-free methods.
The life of people with dementia who have multiple children in rural China: A phenomenological case study
Authors: Yang Juan , Zhang Xiubin , McCormack Brendan , Andrew Jane 
Published: May 2022

Objectives The aim of this study was to explore the lived experiences of a rural dwelling person living with dementia and his children. Using a phenomenological case study methodology, it aims to explore the health-related and personal dilemmas faced by multiple family members who provide care to a person living with dementia in a rural area in Henan, China. The study also investigates the barriers to quality dementia care in this kind of setting in order to inform the relevant stakeholders. Method A phenomenological case study was designed for this study. The case that formed the focus of the research included a person living with dementia and multiple family members. Semi-structured in-depth interviews were undertaken with the five family members of the person living with dementia. Smith’s interpretative phenomenological analysis was used for data analysis. Findings Three major themes were identified: (1) Dementia as a normal ageing process or a bad disease; (2) Commitment to and challenges of family caring and (3) Life in rural areas. Conclusion With the development of China’s economy and its social-cultural changes, traditional home-based care provision in rural areas of China is being challenged for people with dementia who have multiple children. It suggests that there needs to be an exploration into providing more appropriate care for people with dementia living in rural settings. It also suggests that more support is required to increase dementia awareness and to improve the quality of life of people with dementia and their families in rural China.
Assessment tools for measurement of dementia-friendliness of a community: A scoping review
Authors: Diaz Laura G , Durocher Evelyne , Gardner Paula , McAiney Carrie , Mokashi Vishal , Letts Lori 
Published: May 2022

Background A quantitative assessment of the dementia-friendliness of a community can support planning and evaluation of dementia-friendly community (DFC) initiatives, internal review, and national/international comparisons, encouraging a more systematic and strategic approach to the advancement of DFCs. However, assessment of the dementia-friendliness of a community is not always conducted and continuous improvement and evaluation of the impact of dementia-friendly initiatives are not always undertaken. A dearth of applicable evaluation tools is one reason why there is a lack of quantitative assessments of the dementia-friendliness of communities working on DFC initiatives. Purpose A scoping review was conducted to identify and examine assessment tools that can be used to conduct quantitative assessments of the dementia-friendliness of a community. Design and methods Peer-reviewed studies related to DFCs were identified through a search of seven electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, EMCare, HealthSTAR, and AgeLine). Grey literature on DFCs was identified through a search of the World Wide Web and personal communication with community leads in Australia, Canada, New Zealand, the United Kingdom, and the United States. Characteristics of identified assessment tools were tabulated, and a narrative summary of findings was developed along with a discussion of strengths and weaknesses of identified tools. Results Forty tools that assess DFC features (built environment, dementia awareness and attitudes, and community needs) were identified. None of the identified tools were deemed comprehensive enough for the assessment of community needs of people with dementia.
Diabetic nephropathy ameliorated in patients with normal home blood pressure compared to those with isolated high home systolic blood pressure: A 5-year prospective cohort study among patients with type 2 diabetes mellitus
Authors: Kitagawa Nobuko , Ushigome Emi , Kitagawa Noriyuki , Ushigome Hidetaka , Yokota Isao , Nakanishi Naoko , Hamaguchi Masahide , Asano Mai , Yamazaki Masahiro , Fukui Michiaki 
Published: May 2022

Background: Using normal home blood pressure (home BP) as a reference, isolated high home systolic blood pressure (IH-home SBP) increases the risk of diabetic nephropathy. However, whether diabetic nephropathy would improve among diabetic patients without IH-home SBP has not been previously assessed. Methods: This prospective 5-year cohort study of 264 patients with moderate or severe albuminuria investigated the effect of IH-home SBP or normal home BP on the risk of diabetic nephropathy in patients with type 2 diabetes mellitus. Improvement of diabetic nephropathy was defined as remission or regression from moderate or severe albuminuria to normal or mildly increased albuminuria. Results: Improvement of diabetic nephropathy was shown in 59 out of 264 patients during 5 years. The adjusted odds ratio (95% confidence interval) of normal home BP for improving diabetic nephropathy was 2.52 (1.01–5.99, p = 0.05). Conclusion: Normal home BP had relation to an improvement in diabetic nephropathy among type 2 diabetic patients with moderate and severe increased albuminuria in the observation period of 5 years. Good home BP control might be valuable to ameliorate diabetic nephropathy.
Safety and effectiveness of vascular closure devices in interventional radiological procedures
Authors: Kim Esther , Sebastiao Bruno Goncalves , Lee Amy , Ande Sudharshan , Shankar Jai 
Published: May 2022

Background Although it is well known that vascular closure devices (VCD) are commonly used in therapeutic interventional radiological procedures, standard use in diagnostic procedures is not as well studied. Purpose The aim of this study was to determine the real-world safety and effectiveness of the VCD in both diagnostic and therapeutic interventional radiological procedures. Materials and methods A retrospective, single center study included all patients where VCDs were used for either a diagnostic or therapeutic interventional procedure. Various demographic and clinical risk factors were recorded and examined for any significant association with successful deployment and complications. Results A total of 2072 patients were included. VCDs were successfully deployed in 95.2% of the patients with 4.8% of perioperative complications, which included minor oozing from the puncture site, small hematoma less than or equal to 5 cm, large hematoma greater than 5 cm, pain, and loss of vascular access. Therapeutic (vascular interventional radiology (VIR) and neuro-interventional radiology (NIR)) procedures (OR 3.03, 95% CI 1.51–6.09, p = 0.002), use of Angioseal (OR 5.26, 95% CI 3.13–8.33), p < 0.001), and no use of antiplatelet medications (OR 0.47, 95% CI 0.22–0.97, p = 0.041) were independently associated with successful deployment of VCDs when controlled for other risk factors. Smoking (OR 3.50, 95% CI 2.00–6.05, p = <0.001), use of antiplatelet (OR 2.01, 95% CI 1.04–3.87, p = 0.037) and use of heparin (OR 1.78, 95% CI 1.10–2.86, p = 0.018) were independently associated with higher complication rates. Conclusion VCD's were successfully deployed in 95.2% of the patients with 4.8% of perioperative minor complications.
Association of endoscopic variceal treatment with portal venous system thrombosis in liver cirrhosis: a case–control study
Authors: Wang Le , Guo Xiaozhong , Shao Xiaodong , Xu Xiangbo , Zheng Kexin , Wang Ran , Chawla Saurabh , Basaranoglu Metin , Qi Xingshun 
Published: May 2022

Background: The association of endoscopic variceal treatment (EVT) with portal venous system thrombosis (PVST) in liver cirrhosis is still unclear. Methods: PVST was assessed by contrast-enhanced CT or MRI in 406 cirrhotic patients from our prospective database. Case and control groups, which are defined as patients with and without PVST, respectively, were matched at a ratio of 1:1 according to age, gender, Child-Pugh class, and MELD score. History of EVT was reviewed. Logistic regression analysis was used to identify the risk factors for PVST. Odds ratios (ORs) were calculated. Subgroup analyses were further performed in terms of degree and location of PVST. Results: Overall, 109 patients each were included in case and control groups. The case group had a significantly higher proportion of patients who had undergone EVT than the control group (53.2% versus 18.3%; p < 0.001). In detail, the case group had significantly higher proportions of patients who had undergone EVT for controlling bleeding (45.9% versus 14.7%; p < 0.001), endoscopic variceal ligation (EVL) alone (19.3% versus 9.2%; p = 0.033), and EVL combined with endoscopic cyanoacrylate glue injection (24.8% versus 5.5%; p < 0.001). EVT was independently associated with PVST (OR = 4.258; p < 0.001). In subgroup analyses, EVT remained independently associated with partial PVST (OR = 10.063; p < 0.001), complete PVST/fibrotic cord (OR = 4.889; p = 0.008), thrombosis within main portal vein (OR = 5.985; p < 0.001), and thrombosis within superior mesenteric and splenic veins (OR = 5.747; p < 0.001). Conclusions: EVT may lead to a higher risk of PVST, especially more severe PVST, in liver cirrhosis. Screening for and prophylaxis of PVST after EVT should be further explored.
Complex neurocysticercosis lesions on imaging: Explained through correlative histomorphology
Authors: Singh Paramjeet , Paramjit Ekta , Ahuja Chirag K , Modi Manish , Vyas Sameer , Goyal Manoj , Kumar Ajay , Bhatia Vikas , Prabhakar Anuj , Sharma Sudarshan K 
Published: May 2022

Objectives Neurocysticercosis, the commonest neuro-parasite, sometimes presents as complex ring enhancing lesion causing diagnostic dilemma. We aim to establish radio-histo-morphological equivalents of early events in degeneration of the parasite to explain such imaging phenotypes. Methods We compared patterns of degeneration in 23 randomly selected complex NCC on MRI with histo-morphology in 30 cysts obtained from an unrelated post mortem brain. Results The anatomy of the parasite and the degenerative patterns of the scolex (hydropic changes, calcification, evagination, and fragmentation) and the cyst wall (undulation, accessory loculi, and frank disruption) were well demonstrated on both. The intact scolex remarkably resembled head of intestinal Taenia. The complex lesions were conglomeration of multiple communicating cysts with a single parent cyst and multiple daughter cysts. The parent cysts contained a solitary variably degenerated scolex, had thicker walls and associated chronic inflammation. The remaining cysts of the lesion complex contained no scolex, had poorly organized walls, turbid contents, and florid perilesional enhancement with leakage of contrast. Three lesions assumed a multi-cystic pseudo-tumorous pattern, of which two resolved into solitary calcific remnants on follow up. Conclusion Complex lesion in NCC result from degeneration of solitary parasite with perilesional gliosis, surrounded by multiple non-larval daughter cysts inciting acute intra and perilesional inflammation due to enhanced antigenic challenge. Possibly, attempted abortive asexual reproduction by the cellulose cyst as a preterminal event results in a “limited Racemose like transition.” Correct interpretation has diagnostic and therapeutic implications as active lesions and their fibrocalcific residue may have greater epileptogenic potential.
Measurement of the cardiac time intervals of the fetal ECG utilising a computerised algorithm: A retrospective observational study
Authors: Chivers SC , Vasavan T , Nandi M , Hayes-Gill BR , Jayawardane IA , Simpson JM , Williamson C , Fifer WP , Lucchini M 
Published: May 2022

Objective Establish whether the reliable measurement of cardiac time intervals of the fetal ECG can be automated and to address whether this approach could be used to investigate large datasets. Design Retrospective observational study. Setting Teaching hospitals in London UK, Nottingham UK and New York USA. Participants Singleton pregnancies with no known fetal abnormality. Methods Archived fetal ECG's performed using the MonicaAN24 monitor. A single ECG (PQRST) complex was generated from 5000 signal-averaged beats and electrical cardiac time intervals measured in an automated way and manually. Main Outcome measure Validation of a newly developed algorithm to measure the cardiac time intervals of the fetal ECG. Results 188/236 (79.7%) subjects with fECGs of suitable signal:noise ratio were included for analysis comparing manual with automated measurement. PR interval was measured in 173/188 (92%), QRS complex in 170/188 (90%) and QT interval in 123/188 (65.4%). PR interval was 107.6 (12.07) ms [mean(SD)] manual vs 109.11 (14.7) ms algorithm. QRS duration was 54.72(6.35) ms manual vs 58.34(5.73) ms algorithm. QT-interval was 268.93 (21.59) ms manual vs 261.63 (36.16) ms algorithm. QTc was 407.5(32.71) ms manual vs 396.4 (54.78) ms algorithm. The QRS-duration increased with gestational age in both manual and algorithm measurements. Conclusion Accurate measurement of fetal ECG cardiac time intervals can be automated with potential application to interpretation of larger datasets.
Handgrip strength is associated with length of stay and functional outcomes at 1-year follow up in fragility hip fracture patients
Authors: Au Ivan Long Yin , Lau Nicole Yan Nok , Lee Shirley Ka Wai , Tiu Kwok Leung , Bong Lee Kin , Chan Andy Chi Ming 
Published: May 2022

Background/Purpose Fragility hip fracture (FHF) is the most prevalent fragility fracture, causing deterioration in ambulatory ability and disability. Early detection of patients who are at risk of prolonged hospitalization and functional decline after FHF is crucial as this facilitates post-operative management and healthcare resources allocation. Handgrip strength (HGS) is an easily-administered and cost-effective tool to assess whole body strength. The objectives of this study were to examine the relationship between pre-operative HGS, length of stay (LOS) and functional outcomes at 1-year follow up in patients with FHF in Hong Kong. Methods Patients aged 65 years old or above who were admitted to a local acute hospital from April 2017 to March 2020 due to FHF that were treated operatively, and subsequently attended the multidisciplinary fragility fracture clinic at 1-year follow up were evaluated. HGS measured at pre-operative physiotherapy initial assessment, post-fracture total LOS, Modified Functional Ambulation Classification (MFAC) and Elderly Mobility Scale (EMS) at 1-year follow up were retrieved for analysis. Correlation between HGS and LOS was analyzed using Pearson's correlation coefficient. Correlations between HGS and MFAC, and HGS and EMS were analyzed using Spearman's rank correlation coefficient. Results One hundred and nineteen patients (mean age = 80.8 ± 7.3 years) (33 males, 86 females) were evaluated. Statistical significant negative correlation between HGS and LOS was found ( r = -0.245, p = 0.007), implying that the lower the HGS, the longer the period of hospitalization. HGS also showed statistical significant positive correlation with MFAC ( r = 0.358, p < 0.001) and EMS ( r = 0.507, p < 0.001), suggesting that the greater the HGS, the better the functional outcomes after 1 year. In short, pre-operative HGS measured by physiotherapists was shown to be associated with LOS and functional outcomes at 1-year follow up. Conclusion HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan, such as intensive training, caregiver education and potential prediction of discharge destination. Key Messages HGS is significantly associated with patient's LOS, MFAC and EMS after FHF. HGS is an easily-administered and cost-effective tool to facilitate frontline practitioners to determine and stratify patients’ rehabilitation potential and subsequently establish customized rehabilitation and discharge plan.
Evaluation of Tibial Fixation Devices for Quadrupled Hamstring ACL Reconstruction
Authors: Ammann Elias , Hecker Andreas , Bachmann Elias , Snedeker Jess G. , Fucentese Sandro F. 
Published: May 2022

Background: Shortcomings to tibial-side fixation have been reported as causes of failure after anterior cruciate ligament reconstruction. Adjustable-loop suspensory devices have become popular; however, no comparison with hybrid fixation (ie, interference screw and cortical button) exists to our knowledge. Purpose: The purpose of this study was to compare the biomechanical properties of adjustable loop devices (ALDs) in full-tunnel and closed-socket configurations in relation to hybrid fixation. We hypothesized that primary stability of fixation by a tibial ALD will not be inferior to hybrid fixation. Study Design: Controlled laboratory study. Methods: Tibial fixation of a quadrupled tendon graft was biomechanically investigated in a porcine tibia–bovine tendon model using 5 techniques (n = 6 specimens each). The tested constructs included hybrid fixation with a cortical fixation button and interference screw (group 1), single cortical fixation with the full-tunnel technique using an open-suture strand button (group 2) or an ALD (group 3), or closed-socket fixation using 2 different types of ALDs (groups 4 and 5). Each specimen was evaluated using a materials testing machine (1000 cycles from 50-250 N and pull to failure). Force at failure, cyclic displacement, stiffness, and ability to pretension the graft during insertion were compared among the groups. Results: No differences in ultimate load to failure were found between the ALD constructs (groups 3, 4, and 5) and hybrid fixation (group 1). Cyclic displacement was significantly higher in group 2 vs all other groups ( P < .001); however, no difference was observed in groups 3, 4, and 5 as compared with group 1. The remaining tension on the construct after fixation was significantly higher in groups 3 and 4 vs groups 1, 2, and 5 ( P < .02 for all comparisons), irrespective of whether a full-tunnel or closed-socket approach was used. Conclusion: Tibial anterior cruciate ligament graft fixation with knotless ALDs achieved comparable results with hybrid fixation in the full-tunnel and closed-socket techniques. The retention of graft tension appears to be biomechanically more relevant than tunnel type. Clinical Relevance: The study findings emphasize the importance of the tension at which fixation is performed.