bluuebunny/crossref_metadata_2025_split huggingface dataset:
Standard of Care for Patients With Cleft Lip and Palate in India—A Questionnaire-Based Study
Authors: Batra Panchali , Sybil Deborah , Izhar Arisha , Batra Puneet , Thiruvenkatachari Badri 
Published: January 2022

A national survey of cleft teams was undertaken to evaluate the current standard of care for patients with cleft lip and palate (CLP) in India as a part of Cleft Care India study.This was a cross-sectional questionnaire-based study.Cleft teams across India attending the 19th Annual Conference of the Indian Society of Cleft Lip and Palate were invited to complete the questionnaire. The questionnaire consisted of 18 questions that included demographics, institutional details, patient protocols, surgical technique, rehabilitation facilities, and accessibility. The data are descriptively reported.A total of 112 centers completed the survey. Nongovernment organizations funded 87% of the cleft centers and 8% did not receive any funding. Only 39% of the centers had centralized cleft services providing multidisciplinary care. Speech therapy was provided either onsite or through referral at 90% of the centers, whereas audiology was provided only at 4% of centers. Feeding advice was routinely provided in 52% of centers. Millard technique was the most preferred technique for unilateral cleft lip repair (66%). The 2-flap technique (37%) and pharyngeal flap (48%) were the most common surgeries for cleft palate and pharyngoplasty, respectively. Although 54% of centers reported their patients to be interested in comprehensive care, 43% reported that their patients only wanted surgical correction.There is wide diversity in access to cleft care and clinical practices across centers in India. Further work is needed to evaluate the quality of care by assessing outcomes of centers treating patients with CLP.
Evaluation of Dimension and Bridging of Sella Turcica and Presence of Ponticulus Posticus in Individuals With and Without Cleft: A Comparative Study
Authors: Mosavat Farzaneh , Sarmadi Sarvin , Amini Amirhesam , Asgari Mohadeseh 
Published: January 2022

Objective Sella turcica abnormalities such as sella turcica bridging (STB) have been observed frequently among patients with craniofacial anomalies. Ponticulus posticus (PP) is an important structure and its presence causes complications during surgeries. Due to the importance of these structures, this study aimed to evaluate the prevalence of STB, PP, and dimensions of the sella turcica in individuals with and without cleft. Design A cross-sectional study. Setting Orthodontic and Radiology Departments in a public dental school, Tehran, Iran. Patients Eighty-three lateral cephalograms of individuals with cleft and ninety-two cephalograms of class I individuals without cleft. Main outcome measures Length, depth, and maximum anterior–posterior diameter (APD) of sella turcica, presence of STB (classified as types 1, 2, and 3), and PP. Results In the group with cleft, 19.3% of individuals had type I, 65.1%, type II, and 15.7%, type III STB. In the group without cleft, 15.2% had type I, 73.9%, type II, and 10.9%, type III STB. In the group with cleft, 65.1% of individuals had no PP, 24.1%, incomplete, and 10.8%, complete PP while in the group without cleft, 56.5% had no PP, 29 31.5%, incomplete, and 12%, complete PP. Conclusion The sella turcica dimensions, STB, and PP prevalence were not significantly different between individuals with and without cleft. The sella turcica length and prevalence of STB and PP were not affected by age, sex, and cleft type. However, the depth and the APD were affected by age.
Diagnostic Protocols for Alveolar Clefting and Barriers to Acquiring Imaging: A Survey of ACPA-Approved Cleft Teams in the United States
Authors: Preston Kathryn , Chen Lucia , Brennan Tyler , Sheller Barbara 
Published: January 2022

Objective To report current diagnostic protocols, practices, and barriers related to imaging of alveolar clefting among American Cleft Palate-Craniofacial Association (ACPA)-approved cleft/craniofacial teams. Methods An electronic survey was sent to 162 ACPA-approved teams in the United States. Key items were team location, venue of orthodontic treatment, imaging modality(s) and access, barriers to imaging, billing, imaging protocols including team members involved in decisions pre- and post-alveolar bone grafting (ABG), and craniofacial fellowship status of team orthodontist(s). Results A total of 66 responses were received (40.7%). Responding teams were university-based (47%), hospital-based (42.4%), and independent clinics (10.6%). Orthodontic treatment for most patients was in private practice (53%). On-site 2-dimensional (2D) and 3-dimensional (3D) dental imaging capabilities were reported by 42% of teams; 29% have no on-site imaging. One or more barrier(s) to acquiring imaging were reported by 67%, with insurance challenges reported by 47%. Most teams bill medical payors for cleft-related dental imaging (58%). Pre- and post-ABG imaging was most frequently 3D (35% and 36%, respectively). Surgeons and orthodontists commonly evaluate ABG timing and outcome together (53%-65%). Periapical radiographs were included significantly more often in cleft imaging protocols by orthodontists with versus without fellowship training ( P = .011, P = .04). Conclusions Barriers to acquiring imaging are frequent. 3D is the most common imaging pre- and post-ABG. Our study endorses multi-level advocacy for improved medical insurance coverage of diagnostic cleft-related dental imaging to decrease barriers to providing timely care.
Effects of a New York Medicaid Care Management Program on Substance Use Disorder Treatment Services and Medicaid Spending: Implications for Defining the Target Population
Authors: Neighbors Charles J , Yerneni Rajeev , Sun Yi , Choi Sugy , Burke Constance , O’Grady Megan A , McDonald Rebecca , Morgenstern Jon 
Published: January 2022

Aims: We examined the effects of a statewide New York (NY) care management (CM) program for substance use disorder (SUD), Managed Addiction Treatment Services (MATS), on SUD treatment services’ utilization and spending among patients with a recent history of high Medicaid spending and among those for whom a predictive algorithm indicates a higher probability of outlier spending in the following year. Methods: We applied difference-in-difference analyses with propensity score matching using NY Medicaid claims data and a state registry of SUD-treatment episodes from 2006 to 2009. A total of 1263 CM enrollees with high SUD treatment spending (>$10K) in the prior year and a matched comparison group were included in the analysis. Crisis care utilization for SUD (detoxification and hospitalizations), outpatient SUD treatment, and Medicaid spending were examined over 12 months among both groups. CM effects among predicted high-future-spending patients (HFS) were also analyzed. Results: CM increased outpatient SUD treatment visits by approximately 10.5 days (95% CI = 0.9, 20.0). CM crisis care and spending outcomes were not statistically different from comparison since both conditions had comparable pre-post declines. Conversely, CM significantly reduced SUD treatment spending by approximately $955 (95% CI = −1518, −391) and reduced days of detox utilization by about 1.0 days (95% CI = −1.9, −0.1) among HFS. Conclusion: Findings suggest that CM can reduce SUD treatment spending and utilization when targeted at patients with a greater likelihood of high future spending, indicating the potential value of predictive models to select CM patients.
Incidence, clinical spectrum, and immunotherapy of non-ischemic cerebral enhancing lesions after endovascular therapy
Authors: Bayas Antonios , Christ Monika , Berlis Ansgar , Naumann Markus , Ertl Michael , Joachimski Felix , Müller Mona , Welzel Julia , Ann Gerdes Lisa , Seelos Klaus , Maurer Christoph 
Published: January 2022

Background: Symptomatic and asymptomatic delayed non-ischemic cerebral enhancing (NICE) lesions in magnetic resonance imaging (MRI) have been reported as a rare complication after endovascular therapy (EVT) in recent years with incidence rates between 0.05% and 0.9% in most studies. Information on long-term clinical course and immunotherapies is scarce or has not been reported in detail in the literature. Objective: Aims of our study were to assess the incidence of NICE lesions in patients after cerebral EVT over a period of more than 12 years, describe clinical and EVT characteristics, and immunotherapies applied. Methods: A retrospective chart review of all patients treated by endovascular therapy for symptomatic or asymptomatic aneurysms at the University Hospital of Augsburg from May 1, 2008 to December 31, 2020 was performed. Patients were identified retrospectively and followed-up prospectively where appropriate. In addition, one case treated at another institution was included. Results: Five out of 746 patients, 0.67%, developed NICE lesions after EVT, all with non-ruptured aneurysms and all symptomatic upon detection of NICE lesions by MRI. In total, the disease course of 6 female patients is reported. Symptoms occurred after a mean time of 15 days (±13.42, SD) after EVT with headache (6/6 patients), focal neurological signs (6/6 patients), epileptic seizures (2/6 patients) and cognitive deficits (3/6 patients). All 6 patients received glucocorticosteroids (GCS), 1/6 azathioprine (AZA), 4/6 mycophenolate mofetil (MMF), 1/6 methotrexate (MTX), 1/6 rituximab (RTX), 2/6 cyclophosphamide (CYC) and 3/6 tocilizumab (TCZ). A treatment response could be observed for GCS, TCZ and MMF (in two of four cases), RTX and AZA did not result in disease stabilization. Conclusions: Delayed NICE lesions are a rare complication after EVT, requiring immunotherapies in all patients reported here. Physicians should be aware of this disorder in case of new symptoms or contrast enhancing lesions after EVT.
Safety and efficacy of SHR4640 combined with febuxostat for primary hyperuricemia: a multicenter, randomized, double-blind, phase II study
Authors: Tang Honghu , Cui Beibei , Chen Yiyu , Chen Lin , Wang Zhihong , Zhang Ning , Yang Yanlan , Wang Xiaodong , Xie Xiangliang , Sun Lingyun , Dang Wantai , Wang Xianyang , Li Runzi , Zou Jianjun , Zhao Yi , Liu Yi 
Published: January 2022

Background: To evaluate the safety, tolerability, and efficacy of SHR4640, a highly selective urate transporter-1 inhibitor, in combination with febuxostat, in patients with primary hyperuricemia. Methods: In this randomized, double-blind, parallel-controlled phase II study, patients whose fasting serum uric acid (sUA) levels were ⩾ 480 μmol/L at screening with gout or sUA levels were ⩾ 420 μmol/L lasting for at least 3 months without gout, either with sUA levels ⩾ 540 μmol/L at screening or sUA levels ⩾ 480 μmol/L with comorbidities at screening, were enrolled. Patients were randomized (1:1:1) to receive SHR4640 10 mg plus febuxostat 80 mg, SHR4640 10 mg plus febuxostat 40 mg, and SHR4640 5 mg plus febuxostat 20 mg orally once daily. The primary end point was the incidence of treatment-emergent adverse events (TEAEs). Results: A total of 93 patients were randomized and received treatment. TEAEs occurred in 55.9% of patients. The incidence of TEAEs was comparable among all the groups. Serious TEAEs occurred in one patient (1.1%), with no deaths observed. The proportion of patients who achieved the target sUA levels by week 4 was 79.3%, 96.6%, and 75.0% in the SHR4640 10 mg plus febuxostat 80 mg, SHR4640 10 mg plus febuxostat 40 mg, and SHR4640 5 mg plus febuxostat 20 mg groups, respectively. The mean percent reduction of sUA was 59.7%, 63.7%, and 41.8%, respectively. Conclusion: SHR4640 plus febuxostat exhibited a tolerable safety profile and substantial sUA lowering activity in patients with primary hyperuricemia. Registration: www.chinadrugtrials.org.cn ; CTR 20192429
A Geospatial Analysis of the Rhinologist Workforce in the United States
Authors: Hassanin Samir , Kshirsagar Rijul S. , Steele Toby O. , Liang Jonathan 
Published: January 2022

Background Six percent of practicing otolaryngologists identified by the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) are rhinologists. This is the first study to investigate both the distribution of rhinologists in the United States and the sociodemographic characteristics that may predict their practice locations. Objective We aim to describe the geospatial distribution of the rhinology workforce and analyze sociodemographic characteristics associated with practice distribution. Methods We conducted a cross-sectional study of 662 rhinologists queried from the 2020 American Rhinologic Society (ARS) database. Rhinologist practice addresses were compared with ZIP code tabulation area (ZCTA) sociodemographic data from the 2010 US Census Bureau and from the 2014 to 2018 American Community Surveys. Geospatial mapping and multivariate statistics were employed to visualize rhinologist practice locations and analyze which community characteristics were associated with greater densities of rhinologists in ZCTAs. Results The largest and smallest densities of rhinologists were in coastal areas and in the Central and Midwestern US, respectively. Population characteristics that significantly predicted a higher number of practicing rhinologists included: greater percentage of non-citizens and greater educational attainment (p < 0.001). Population characteristics that significantly predicted a lower number of practicing rhinologists included: greater percentage of self-identified white/Caucasians, median household income, and greater percentage of population aged 65 or older (p < 0.001). Conclusion Disparities in healthcare access in the US is evident and applies to rhinologic subspecialty care. Through visual geospatial analysis, we demonstrate the distribution of rhinologists and the population characteristics that may be predictive of whether patients have access to rhinological care.
Loading during Midstance of Gait Is Associated with Magnetic Resonance Imaging of Cartilage Composition Following Anterior Cruciate Ligament Reconstruction
Authors: Bjornsen Elizabeth , Schwartz Todd A. , Lisee Caroline , Blackburn Troy , Lalush David , Nissman Daniel , Spang Jeffrey , Pietrosimone Brian 
Published: January 2022

Objective A complex association exists between aberrant gait biomechanics and posttraumatic knee osteoarthritis (PTOA) development. Previous research has primarily focused on the link between peak loading during the loading phase of stance and joint tissue changes following anterior cruciate ligament reconstruction (ACLR). However, the associations between loading and cartilage composition at other portions of stance, including midstance and late stance, is unclear. The objective of this study was to explore associations between vertical ground reaction force (vGRF) at each 1% increment of stance phase and tibiofemoral articular cartilage magnetic resonance imaging (MRI) T1ρ relaxation times following ACLR. Design Twenty-three individuals (47.82% female, 22.1 ±4.1 years old) with unilateral ACLR participated in a gait assessment and T1ρ MRI collection at 12.25 ± 0.61 months post-ACLR. T1ρ relaxation times were calculated for the articular cartilage of the weightbearing medial and lateral femoral (MFC, LFC) and tibial (MTC, LTC) condyles. Separate bivariate, Pearson product moment correlation coefficients ( r) were used to estimate strength of associations between T1ρ MRI relaxation times in the medial and lateral tibiofemoral articular cartilage with vGRF across the entire stance phase. Results Greater vGRF during midstance (46%-56% of stance phase) was associated with greater T1ρ MRI relaxation times in the MFC ( r ranging between 0.43 and 0.46). Conclusions Biomechanical gait profiles that include greater vGRF during midstance are associated with MRI estimates of lesser proteoglycan density in the MFC. Inability to unload the ACLR limb during midstance may be linked to joint tissue changes associated with PTOA development.
Molecular detection of polycystic kidney disease in Persian and Persian-related breeds in Iran
Authors: Moazezi Ghavihelm Ali , Jamshidi Shahram , Ashrafi Tamai Iraj , Zangisheh Mahsa 
Published: January 2022

Objectives This study was aimed at detecting feline autosomal dominant polycystic kidney disease in a population of Persian and Persian-related breeds by a molecular method in Iran. Methods Buccal swab samples were collected from 47 cats and examined with a touchdown PCR method. Additionally, partial sequencing was performed in two cats with bilateral renal cysts. Results Twenty-two cats (46.8%) were diagnosed as heterozygous for this mutation. Sequence analysis of two cats showed C to A point mutation in the PKD1 gene, as in previous studies. Conclusions and relevance Prevalence of this disease is high in Iran, highlighting the need for molecular screening tests before including cats in breeding programmes.
To Be(Ar) Or Not to Be(Ar) – Jones Dilemma?
Authors: Andrews Nicholas A. , Singh Neha , Agarwal Abhinav , Hughes Austin , Jacob Roshan , Harrelson Whitt , Rallapalle Vyshnavi , Shah Ashish 
Published: January 2022

Category: Midfoot/Forefoot Introduction/Purpose: Jones fracture is the fracture of the base of 5th metatarsal and is a commonly encountered in the clinical setting. Its management has always been a subject of great debate with paucity of consensus on post- operative weight bearing protocols. We aim to evaluate the efficacy of early weight bearing in the post-operative management of Jones fracture and assess its association with radiological union and patient reported outcomes. Methods: Retrospectively, patients undergoing fixation of Jones fracture from January 2011 to December 2020 were identified. Radiographic follow-up of at least 8 weeks was required for inclusion yielding 40 patients. Patients were grouped by early weight bearing (EWB) as tolerated (26 patients) and non-weight bearing (NWB) for 2 weeks followed by partial weight bearing (14 patients). Medical records were reviewed for demographic variables, associated comorbidities, type of surgical construct used, fracture type, mode of injury and union. Delayed union was defined as patients without radiographic evidence of union at 12.5 weeks. Patients completed PROMIS physical function, PROMIS pain interference, and FFI scoring postoperatively. Results: The mean age was 42.83+- 17.03 years with a female gender predominance (n=23; 57.5%) and an average BMI of 32.2 +- 8.7. Thirteen (50%) in the EWB and 5 (43%) in NWB groups experienced delayed radiological union (>12 weeks) and this did not differ by group. There was one nonunion in the NWB group and none in the EWB group. The number of wound complications did not vary by group. Seventeen patients completed postoperative FFI and PROMIS scores at a median of 40 months (41.5 IQR). The FFI and PROMIS scores did not differ by group. In the EWB group, the median PROMIS scores were physical function 43.7 (6.7 (IQR)) and pain interference 52.8 (10.1) compared to physical function 44.0 (11.6) and pain interference 55.2 (11.8) in the NWB group. The median total FFI score in the EWB group was 20.0 (27) compared to 32 (32) in the NWB group. Conclusion: The EWB group exhibited comparable results to the NWB group after surgical fixation of Jones fracture. Importantly, PROMIS scores indicate both groups had comparable functional outcomes at long term follow up and were within a standard deviation of the general population of the United States (Score of 50 with SD of 10) for both pain and function. While further investigation is required, EWB may have equivocal results in terms of union, wound complications, and functional outcomes while allowing for early mobilization after Jones fracture fixation.
Non-Operative Management of Chronic Achilles Tendon Ruptures: Short Term Outcomes
Authors: Arshad Zaki , Bhatia Maneesh 
Published: January 2022

Category: Hindfoot; Sports; Trauma Introduction/Purpose: The incidence of Achilles tendon rupture in the United States is approximately 2.6 per 100,000 person years, with a significant increase in incidence over recent years reported. Should the acute rupture not be diagnosed promptly, as is the case in up to 20% of patients, the injury may be termed chronic. A number of operative treatment strategies for chronic Achilles ruptures have been described, including v-y tendinous flap, flexor hallucis longus tendon transfer, peroneus brevis graft and free gracilis transfer. Despite the extensive investigation of non-operative treatment in acute ruptures, there is a lack of similar research into chronic injuries. This article aims to address this gap in the literature, reporting treatment results of patients treated conservatively after being deemed unfit for operative intervention. Methods: A retrospective review of all patients receiving non-operative treatment for chronic Achilles ruptures, in the senior author's clinic between December 2014 and May 2019 was performed. A chronic injury was defined as occurring when there was a delay of at least 28 days between initial injury and start of treatment. Patients with a minimum final follow up of less than 6 months were excluded. All patients were managed according to the previously described Leicester Achilles Management Protocol (LAMP), an eight-week functional dynamic regime with use of a VACOped boot (OPED, Valley, Germany). Formal physiotherapy treatment was also provided following completion of the LAMP. Hospital records were searched for relevant data including patient age and sex, side of injury, time between injury and start of treatment and post-treatment Achilles tendon total rupture score (ATRS). Results: A total of 17 consecutive patients with a minimum follow up of 6 months were managed non-operatively during the stated time period. The cohort included eight males and nine females with a mean age of 63.4 14.3 years. The right side was injured in five cases, with the left side affected in 12. The mean time from initial injury to start of treatment was 43.9 days (range 30 - 102 days). The mean ATRS at 6 months post treatment was 53+-17.8. A total of 10 patients were also available for follow up at 12 months. The mean ATRS in these patients at 12 months was 73 +-15.2. Conclusion: The mean 12-month ATRS of 73 achieved is lower than figures of 89-92.5 reported in previous studies describing operative treatment. However, our results indicate that good outcomes may be achieved using a non-operative protocol in patients who decline or are unfit for surgery. Recent research reports that the mean age of Achilles rupture has increased by 0.721 years every five years, since 1953. It could therefore be likely that an increasing number of patients suffering chronic Achilles ruptures may be unfit for surgical treatment. It is important that further research into the non-operative treatment of these patients is conducted.