bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arch Symmetry in Patients Without and With Cleft Lip and Palate After Orthodontic/Rehabilitative Treatment—A Stereophotogrammetry Study
Authors: Cardoso Jefferson Freire , Pucciarelli Maria Giulia Rezende , Laurenti José Antonio Siqueira , Laposta Andreia Fernandes Emilio , Neppelenbroek Karin Hermana , Oliveira Thaís Marchini , Soares Simone 
Published: June 2022

To evaluate and compare the dental arch symmetry of individuals with and without cleft lip and palate after orthodontic/rehabilitation treatment. Cross-sectional study. Tertiary cleft center in Brazil. Fifty-five participants aged between 18 and 30 years were divided into 3 groups according to treatment. Patients that received either a fixed partial denture (FPD) or implant-supported crown (ISC) in the cleft area or only orthodontic treatment, noncleft patients (NC). An analysis was performed using digitized dental casts scanned by laser and software. The following linear measurements were evaluated: incisor-canine; canine-molar; incisor-molar; surface and volume of the palatal region. Three-way ANOVA was used to compare the study factors: group (FPD/ISC/NC) and side (right/left) followed by the Tukey test to verify their interaction (α = .05). The results showed statistically significant differences among groups for the maxillary linear measurements canine-molar and incisor-molar, but not for incisor-canine. No statistically significant differences were found regarding the side for the maxillary measurements, while the factor interaction showed similarity only for incisor-canine. The mandibular measurements showed no statistical differences among groups, sides, or factor interactions. In surface and volume, all values in patients with cleft presented lesser than in without cleft patients. Regardless of the rehabilitation, arch symmetry can be achieved in the incisor-canine dimension in the cleft area.
Cancer Incidence and Mortality in Asian Countries: A Trend Analysis
Authors: Huang Junjie , Ngai Chun Ho , Deng Yunyang , Tin Man Sing , Lok Veeleah , Zhang Lin , Yuan Jinqiu , Xu Wanghong , Zheng Zhi-Jie , Wong Martin C. S. 
Published: June 2022

Background This study aimed to evaluate the updated burden and temporal trends of cancer incidence and mortality in Asian countries. Methodology The data used in this study were retrieved from the Global Cancer Observatory, Cancer Incidence in Five Continents volumes I-XI, and the World Health Organization mortality database. These data were used to calculate the Average Annual Percentage Change (AAPC), with a 95% confidence interval (CI) by joinpoint regression analysis to determine the epidemiological trend in the past decade. Results In 2020, the cancer incidence in Asia was 169.1 per 1 00 000, accounting for 49.3% of the global cancer incidence. The most common cancers included lung (13.8%), breast (10.8%) and colorectal (10.6%) cancers. Its mortality was 101.6 per 1 00 000 (58.3% of the global cancer death) with lung (19.2%), liver (10.5%) and stomach (9.9%) cancers being the most common causes of cancer death. The cancer incidence had been increasing in female population, with Korea (AAPC = 5.73, 95% CI [5.30, 6.17], P < .001), Japan (AAPC = 2.67, 95% CI [2.12, 3.23], P < .001) and Kuwait (AAPC = 2.08, 95% CI [.49, 3.69], P = .016) showing the most significant increases in the past decade. The incidence increase was also observed among population aged <40 years old, with Korea (female AAPC = 8.42, 95% CI [7.40, 9.45], P < .001; male AAPC = 5.28, 95% CI [4.23, 6.33], P <.001), China (female AAPC = 2.94, 95% CI [2.07, 3.81], P < .001; male AAPC = 1.37, 95% CI [.57, 2.18], P = .004) and Japan (female AAPC = 2.88, 95% CI [1.88, 3.88], P = .016; male AAPC = 1.59, 95% CI [.40, 2.78], P = .015) showing the most significant increases. However, there was an overall decreasing trend of cancer mortality. Conclusions There was a substantial burden of cancer incidence and mortality in Asia. Although there was a decreasing trend in cancer mortality, its incidence had been increasing especially among female and younger populations. Future studies could be done to further investigate the potential reasons for these epidemiologic trends.
The Effect of Flaxseed Oil Supplementation on Body Composition and Inflammation Indices in Overweight Adults With Pre-Diabetes
Authors: Shareghfarid Elham , Nadjarzadeh Azadeh , Heidarzadeh-Esfahani Neda , Azamian Yasaman , Hajiahmadi Salimeh 
Published: June 2022

Background: Flaxseed has rich content of alpha linolenic acid for preventing pro inflammatory process. The aim of present study is exploring the effect of flaxseed oil supplementation on inflammatory biomarkers and body composition in overweight adults with pre-diabetes. Material and methods: this double-blind randomized clinical trial conducted with 80 overweight pre-diabetic patients in 2 clusters (flaxseed oil group (2000-mg daily) and control group) across a 14-week period. Anthropometric indices, body composition and inflammatory indices were measured between 2 groups before and after the treatment. Result: this study found a significant decrease in visceral fat level in the intervention group ( P = .009) and control group ( P = .004) at the end of the survey. However, the mean change of it ( P = .06) was not significant. Also, this study showed that percentage of body fat ( P = .31) and its mean change ( P = .6) did not have significantly different between the 2 groups at the 14th week. The skeletal muscle% had a significant rise in the intervention group ( P = .005) and control group ( P = .003) by the end of 14th week. However, the mean change of it ( P = .19) was not significant between the 2 groups. In addition, there was no significant change in the fasting blood glucose ( P = . 7), C reactive protein ( P = .12) and TNF-α ( P = .22) between the 2 groups at the end of study. Conclusion: It showed that flaxseed oil supplementation cannot improve body composition and inflammation.
Practice of Sunlight Exposure of Infants and Associated Factors Among Infant Coupled Mothers at Dejen District, Amhara Region, Northwest Ethiopia 2021
Authors: Bekalu Amare , Molla Abebaw , Asmare Bayachew , Hune Yidersal , Temesgen Habtamu 
Published: June 2022

Introduction: Currently, nutritional rickets has become a concern of many nutrition experts in many countries. Sunlight is the best and most reliable Source of vitamin D. Since, there is scarce information regarding infant sunlight exposure practice and the determinant factors. Hence, this study aimed to assess mothers’ infant sunlight exposure, practice level, and associated factors. Methods: A community-based cross-sectional study was conducted on 884 mothers from March 20 to April 4, 2017. Through the multi-stage simple random sampling method, the study areas had selected. The data were collected using a structured and pre-tested questionnaire and were entered into Epidata version 3.1 and exported to SPSS version 20 for analysis. The strength of association was measured using binary logistic regression at a 95% CI odds ratio. Finally, P < .05% was declared statistically significant. Results: From 884 infant coupled mothers, 866 were recruited in the study with a response rate of 97.9%. Only 44% of mothers had good practice of infant sunlight exposure. In multivariate analyses; Knowledge status (AOR = 1.4, 95% CI: 1.0-1.9), Attitude status (AOR = 1.4, 95% CI: 1.1-1.9), mothers age group (AOR = 8.6, 95% CI: 5.1-14.4), mothers educational status (AOR = 5.2, 95% CI: 1.6-16.9), delivery at health facility (AOR = 1.5, 95% CI: 1.0-2.1), and friend influence (AOR = 1.6, 95% CI: 1.2-2.1) were significantly associated with maternal exposure status of their infants to sunlight. Conclusion: This finding showed that the majority of the mothers did not expose their infants to sunlight appropriately. The mother’s knowledge, attitude, educational status, institutional delivery, and friend influence were the significant factors and needs to work on these.
Early versus delayed treatment with glatiramer acetate: Analysis of up to 27 years of continuous follow-up in a US open-label extension study
Authors: Ford Corey C , Cohen Jeffrey A , Goodman Andrew D , Lindsey John W , Lisak Robert P , Luzzio Christopher , Pruitt Amy , Rose John , Rus Horea , Wolinsky Jerry S , Kadosh Shaul E , Bernstein-Hanlon Emily , Stark Yafit , Alexander Jessica K 
Published: June 2022

Background: Glatiramer acetate (GA) is US-approved for relapsing multiple sclerosis. Objectives: To describe GA long-term clinical profile. To compare effectiveness of early start (ES) versus delayed start (DS; up to 3 years) with GA. Methods: Phase 3 trial participants entered a randomized placebo-controlled period then an open-label extension (OLE) with GA. Results: Overall, 208 out of 251 (82.9%) randomized participants entered the OLE; 24 out of 101 (23.8%, ES) and 28 out of 107 (26.2%, DS) participants completed the OLE. Median GA treatment was 9.8 (0.1–26.3) years. Annualized change in Expanded Disability Status Scale (EDSS) score was lower with ES versus DS ( p = 0.0858: full study; p = 0.002; Year 5). Participants with improved/stable EDSS was consistently higher with ES versus DS: 40.3% versus 31.6% ( p = 0.1590; full study); 70.8% versus 55.6% ( p = 0.015; Year 5). ES prolonged time-to-6-month confirmed disease worsening (CDW) versus DS (9.8 vs 6.7 years), time-to-12-month CDW (18.9 vs 11.6 years), and significantly reduced time-to-second-6-month CDW ( p = 0.0441). No new safety concerns arose. Conclusion: GA long-term treatment maintained clinical benefit with a similar safety profile to phase 3 results; a key limitation was that only 25% of participants completed the OLE. Early initiation of GA had sustained benefits versus delayed treatment.
Personalized knowledge to reduce the risk of stroke (PERKS-International): Protocol for a randomized controlled trial
Authors: Gall Seana L , Feigin Valery , Thrift Amanda G , Kleinig Timothy J , Cadilhac Dominique A , Bennett Derrick A , Nelson Mark R , Purvis Tara , Jalili-Moghaddam Shabnam , Kitsos Gemma , Krishnamurthi Rita 
Published: June 2022

Rationale: Theoretically, most strokes could be prevented through the management of modifiable risk factors. The Stroke Riskometer™ mobile phone application (hereon “The App”) uses an individual’s data to provide personalized information and advice to reduce their risk of stroke. Aims: To determine the effect of The App on a combined cardiovascular risk score (Life’s Simple 7®, LS7) of modifiable risk factors at 6 months post-randomization. Methods and design: PERKS-International is a Phase III, multicentre, prospective, pragmatic, open-label, single-blinded endpoint, two-arm randomized controlled trial (RCT). Inclusion criteria are as follows: age ⩾ 35 and ⩽75 years; ⩾2 LS7 risk factors; smartphone ownership; no history of stroke/myocardial infarction/cognitive impairment/terminal illness. The intervention group (IG) will be provided with The App, and the usual care group (UCG) is provided with generic online information about risk factors, but not be informed about The App. Face-to-face assessments will be conducted at baseline and 6 months, and online at 3 and 12 months. The RCT includes a process and economic evaluation. Study outcomes and sample size: The primary outcome is a difference in the mean change in LS7 (seven individual items: blood pressure, cholesterol, glucose, body mass index (BMI), smoking, physical activity, and diet) from baseline to 6 months post-randomization with intention-to-treat analysis. Secondary outcomes include: change in individual LS7 items, quality of life; stroke awareness, adverse events; health service use; and costs. Based on pilot data, 790 participants (395 IG, 395 UCG) will be required to provide 80% power (two-sided α = 0.05) to detect a mean difference in the LS7 of ⩾0.40 (SD 1.61) in IG compared to 0.01 (SD 1.44) in the UCG at 6 months post-randomization. Discussion: Stroke is largely preventable. This study will provide evidence of the effectiveness of a mobile app to reduce stroke risk. Trial registration: ACTRN12621000211864.
Predictors of health-related quality of life in patients undergoing extracorporeal membrane oxygenation for acute severe respiratory failure
Authors: Mostafa Ahmed MHAM , Tuttle Christopher J , Mckie Mikel A , Fowles Jo-Anne , Parmar Jasvir , Vuylsteke Alain 
Published: June 2022

Background Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a form of life support used in severe respiratory failure. While the short-term complications of VV-ECMO are well described, impacts on health-related quality of life (HRQOL) are less well characterised. This study aims to assess the HRQOL of patients who underwent VV-ECMO for acute severe respiratory failure and explore predictors of poor HRQOL. Methods We performed a retrospective, observational study of a large cohort of adults who underwent VV-ECMO for acute severe respiratory failure in a single tertiary centre (June 2013–March 2019). Patients surviving critical care discharge were invited to a six-month clinic, where they completed an EQ-5D-5L questionnaire assessing HRQOL. Multivariate analysis was performed to assess prognostic factors for HRQOL. Results Among the 245 consecutive patients included in this study (median age 45 years), 187 (76.3%) survived until ECMO decannulation and 172 (70.2%) until hospital discharge. Of those, 98 (57.3%) attended a follow-up clinic at a mean (±SD) of 204 (±45) days post-discharge. Patients reported problems with pain/discomfort (56%), usual daily activities (53%), anxiety/depression (49%), mobility (46%), and personal care (21%). Multivariate analysis identified limb ischaemia (−0.266, 95% C.I. [−0.116; −0.415], p = 0.0005), renal replacement therapy (−0.149, [−0.046; −0.252], p = 0.0044), and having received more than four platelet units (−0.157, [−0.031; −0.283], p = 0.0146) as predictors of poor HRQOL. Conclusion We report that survivors of VV-ECMO have reduced HRQOL in multiple domains at 6 months, with pain reported most frequently. Patients who had limb ischaemia, renal replacement therapy or were transfused more than four units of platelets are particularly at risk of poor HRQOL and may benefit from added support measures.
A retrospective cohort study about hip luxation in non-ambulatory cerebral palsy patients: The point of no return
Authors: Faccioli Silvia , Sassi Silvia , Corradini Elena , Toni Francesca , Kaleci Shaniko , Lombardi Francesco , Benedetti Maria Grazia 
Published: June 2022

Purpose: The migration percentage is a widely used criterion for surgery in displaced hips. Literature suggests that no hip can spontaneously improve if the migration percentage exceeds 45%, in a mixed population of cerebral palsy children. The aim of the present article was to identify the point of no return of the migration percentage in a selected sample of non-ambulatory cerebral palsy children, being the most exposed to hip luxation. Methods: This single-center retrospective cohort study included patients with spastic or dyskinetic cerebral palsy, Gross Motor Function Classification System level IV or V, age 0–18, having at least three pelvic radiographies, excluding radiographies relative to hips having previously undergone surgery. The following information was collected: sex, cerebral palsy subtype, Gross Motor Function Classification System level, presence of drug-resistant epilepsy, migration percentage, age at assessment, use of walking or standing assistive devices, previous botulinum injection, oral or intrathecal baclofen, and hip pain. Data were analyzed at the level of the individual hips. Descriptive statistics were presented. Receiver operating characteristic curve analysis was conducted to investigate which value of the migration percentage could be adopted as the “point of no return”: that is, the cutoff value beyond which no migration percentage reduction, by more than 5%, could be expected. Results: The optimal cutoff value was identified as migration percentage ≥50%, with a sensitivity of 84.5% and a specificity of 100% (p-value <0.001). Conclusion: Based on the present study, migration percentage ≥50% is the “point of no return” for Gross Motor Function Classification System IV-V cerebral palsy patients, representing the cutoff value beyond which no spontaneous cerebral palsy reduction may be expected, unless addressing surgery. Level of evidence: level II—retrospective study.
Children treated for developmental dysplasia of the hip at birth and with normal acetabular index at 1 year: How many had residual dysplasia at 5 years?
Authors: Håberg Øyvind , Bremnes Thomas , Foss Olav A , Angenete Oskar , Lian Øystein B , Holen Ketil J 
Published: June 2022

Purpose: The purpose of the study was to assess the effect of further follow-up for children treated for developmental dysplasia of the hip, with normal clinical and radiological findings at 1-year time point. The effect was quantified by the number of hips with a pathologic deterioration up to 5 years. Methods: Among 47,289 children born in Sør-Trøndelag county in Norway between 2003 and 2015, 265 children had developmental dysplasia of the hip. Of these, 164 children (239 hips) treated for developmental dysplasia of the hip with normal clinical findings and normal acetabular index at the 1-year time point were included in the study. The number of hips with pathologic acetabular index at the 5-year time point were reported. The diagnostic uncertainty related to radiological measurements was quantified together with the effect of introducing a second radiographic measurement, the center edge angle. Results: A total of 239 treated hips were normal at the 1-year time point. At 5-year time point, 10 (4.2%) hips had a pathologic acetabular index measurement and none classified to have developmental dysplasia of the hip caused by measurement inaccuracy. Eight (3.3%) hips had pathologic center edge angle measurement. Four hips had both pathologic acetabular index and center edge angle measurements, with three later treated with surgery. The intra- and interobserver repeatability coefficients were within 3.1°–6.6°. Conclusion: The repeatability coefficient of the acetabular index measurements was high and no hips could be classified to have developmental dysplasia of the hip at the 5-year time point when taking this repeatability into account. Hips classified as pathologic combining acetabular index and center edge angle measurements were likely to be treated with surgery for residual dysplasia. We recommend further follow-up for these children. Level of evidence: level II.
Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society
Authors: Pavone Vito , Vescio Andrea , Accadbled Franck , Andreacchio Antonio , Wirth Thomas , Testa Gianluca , Canavese Federico 
Published: June 2022

Purpose: The purpose of this study was to evaluate the current trends in the treatment of supracondylar humerus fractures as well as the preferred post-operative follow-up protocol among members of the European Paediatric Orthopaedic Society. Methods: The survey was composed by four main domains and 26 items: (1) surgeon information (3 items); (2) treatment (8 items); (3) post-operative treatment (3 items); and (4) factors influencing the outcome (12 items). All active members of European Paediatric Orthopaedic Society were invited by email to answer an electronic questionnaire. Results: The survey was submitted to 397 European Paediatric Orthopaedic Society active members; 184 members answered (46.3%) the questionnaire. Among respondents, 64.1% declared >10 years of experience and 55.4% declared to treat >20 supracondylar humerus fractures per year. Closed reduction, percutaneous pinning, and supine position were the preferred treatment option for Gartland type II and III supracondylar humerus fractures by 79.9%, 95.5%, and 84.8% of respondents, respectively. Supracondylar humerus fractures are treated within 24 h from trauma by 33.2% of respondents. Pins are removed 4 weeks from index procedure by 58.2% of respondents. Fracture type (72.3%), surgeon experience, and (71.2%) are of “crucial importance” for expected outcome of supracondylar humerus fractures treatment. Conclusion: Surgeon experience, type of fracture, treatment modality, and pins configuration were considered the main factors potentially influencing the outcome of supracondylar humerus fractures. European Paediatric Orthopaedic Society members agreed on the treatment modality of Gartland type II and III supracondylar humerus fractures, patient positioning, and timing of hardware removal. Other important issues such as timing of surgery, pins configuration, surgical approach, and post-operative protocol are still debated. Level of evidence: level II.
The modified Kocher criteria for septic hip: Does it apply to the knee?
Authors: Bisht Roy U , Burns Jessica D , Smith Casey L , Kang Paul , Shrader M Wade , Belthur Mohan V 
Published: June 2022

Background: Pediatric septic arthritis is a surgical emergency and timely diagnosis prevents serious complications. To differentiate between septic hip and transient synovitis, the predictive value of four original Kocher criteria (fever, inability to bear weight, elevated serum white blood cell count, and elevated erythrocyte sedimentation rate) plus Caird’s addition of elevated C-reactive protein have been studied, termed the modified Kocher criteria. These criteria have not been tested extensively on septic knee. This study tested the utility of the modified Kocher criteria in predicting septic knee while validating it for septic hip. Methods: A retrospective chart review was conducted of pediatric patients evaluated at a single institution for irritable hip or knee between 2009 and 2018. Patients who underwent arthrocentesis were included and the modified Kocher criteria were applied to all. Results: One hundred fifty-five patients (96 hips and 59 knees) were identified. One hundred four (67.1%) patients had septic arthritis with 44/59 (74.6%) of knees and 60/96 (62.5%) of hips. The strongest predictors for septic hip and knee were elevated C-reactive protein (odds ratio = 26.9, p < 0.0001) and refusal to bear weight (odds ratio = 14.5, p < 0.0001), respectively. For hips, 5/5 criteria produced a 100% positive predictive value for septic arthritis. For knees, the combination of inability to bear weight and elevated C-reactive protein had a positive predictive value of 89.7%. Conclusion: While all five of the modified Kocher criteria are not predictive of pediatric septic knee, the combination of two specific factors (inability to bear weight and elevated C-reactive protein) is strongly predictive. This study validates previous work that the modified Kocher criteria are predictive of septic hip. Level of evidence: level III