Reference values and associated factors of controlled attenuation parameter and liver stiffness in adults: A cross-sectional study.

BACKGROUND & AIMS: The utilization of non-invasive techniques for liver fibrosis and steatosis assessment has gained acceptance as a viable substitute for liver biopsy in clinical practice. This study aimed to establish normative data for the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) by age and gender, as well as to explore the relationship between anthropometric measures, clinical status, and biochemical profile according to the 90th percentile cut-off values for CAP/LSM in a U.S. adult population. METHODS AND RESULTS: In this cross-sectional analysis, 7.522 US adults aged 20-80 years from the National Health and Nutrition Examination Survey (NHANES 2017-2020) were included. CAP and LSM were quantified using the FibroScan® 502-v2 device. A comprehensive range of data was collected, including sociodemographic, anthropometric, biochemical, lifestyle, and clinical conditions. Participants were segmented by sex and age. The median ± standard deviation (SD) for CAP was significantly lower in women (258.27 ± 61.02 dB/m) than in men (273.43 ± 63.56 dB/m), as was the median ± SD for LSM (women: 5.50 ± 4.12 kPa, men: 6.36 ± 5.63 kPa). Although median CAP and LSM values displayed an upward trend with age, statistical significance was not achieved. Notably, higher liver CAP values (above the 90th percentile) correlated with more pronounced clinical and biochemical profile differences compared to lower CAP values (below the 90th percentile) (p < 0.001). CONCLUSIONS: Our study provides age- and sex-stratified standard values for CAP and LSM in a sizeable, nationally representative cohort of adults. The evidence of sex-specific variations in TE test results from our study sets the stage for future research to further corroborate these findings.

General population normative values for the EORTC QLQ-C30 by age, sex, and health condition for the French general population.

BACKGROUND: General population normative values for the widely used health-related quality of life (HRQoL) measure EORTC QLQ-C30 support the interpretation of trial results and HRQoL of patients in clinical practice. Here, we provide sex-, age- and health condition-specific normative values for the EORTC QLQ-C30 in the French general population. METHODS: French general population data was collected in an international EORTC project. Online panels with quota samples were used to recruit sex and age groups. Number and type of comorbidities were assessed. Descriptive statistics were used to calculate general population values for each QLQ-C30 scale, separately for sex, age, and presence of one- and more chronic health conditions. A multivariate linear regression model has been developed to allow estimating the effect of sex, age, and the presence for one- and more chronic health conditions on EORTC QLQ-C30 scores. Data was weighted according to United Nation statistics adjusting for the proportion of sex and age groups. RESULTS: In total, 1001 French respondents were included in our analyses. The weighted mean age was 47.9 years, 514 (51.3%) participants were women, and 497 (52.2%) participants reported at least one health condition. Men reported statistically significant better scores for Emotional Functioning (+9.6 points, p = 0.006) and Fatigue (-7.8 point; p = 0.04); women reported better profiles for Role Functioning (+8.7 points; p = 0.008) and Financial Difficulty (-7.8 points, p = 0.011). According to the regression model, the sex effect was statistically significant in eight scales; the effect of increasing age had a statistically significant effect on seven of the 15 EORTC QLQ-C30 scales. The sex- and age effect varied in its direction across the various scales. The presence of health conditions showed a strong negative effect on all scales. CONCLUSION: This is the first publication of detailed French normative values for the EORTC QLQ-C30. It aims to support the interpretation of HRQoL profiles in French cancer populations. The strong impact of health conditions on QLQ-C30 scores highlights the importance of considering the impact of comorbidities in cancer patients when interpreting HRQoL data.

Establishing age-adjusted trabecular bone score curves using dual-energy X-ray absorptiometry in Chinese women and men: a cross-sectional study.

Background: Trabecular bone score (TBS) is a relatively new gray-level textural parameter that provides information on bone microarchitecture. TBS has been shown to be a good predictor of fragility fractures independent of bone density and clinical risk factors. Estimating the normal reference values of TBS in both sexes among the Chinese population is necessary to improve the clinical fracture risk assessment. Methods: This retrospective study enrolled healthy Chinese participants living in Guangzhou, China, including 1,018 men and 3,061 women (aged 20-74 years). Bone mineral density images were obtained with dual-energy X-ray absorptiometry (DXA) scanning of the lumbar region (L1-4). Lumbar spine TBS values were calculated. The correlations between the scores and bone mineral density, age, height, and weight were calculated for men and women. A TBS reference plot was established in relation to age (20-74 years). Values 2 standard deviations below the mean score for each sex were used as the cutoff values for low-quality bone. Results: The TBS (L1-4) was significantly higher in Chinese men than in Chinese women. The scores peaked at 25-29 years (1.47±0.08 years) in men and at 20-24 years (1.43±0.08 years) in women. According to the statistical confidence interval, in Chinese males, a TBS ≥1.39 is considered normal, a TBS between 1.31 and 1.39 indicates partially degraded microarchitecture, and a TBS ≤1.31 indicates degraded microarchitecture. In Chinese females, a TBS ≥1.35 is considered normal, a TBS between 1.27 and 1.35 indicates partially degraded microarchitecture, and a TBS ≤1.27 indicates degraded microarchitecture. Conclusions: This study provides normative reference ranges for the TBS in Chinese men and women. Chinese men with a TBS score ≤1.31 and Chinese women with a TBS score ≤1.27 are can be considered to have reduced bone microarchitecture and may be at higher risk of having osteoporosis fractures.

Analysis of Neoclassical Canons in Adult Kenyans of Indian Descent.

Study Design: Descriptive cross-sectional. Objective: To establish anthropometric norms and test the validity of four neoclassical canons among Kenyans of Indian descent. Methods: Using direct anthropometric landmarks, 3 vertical and 4 horizontal measurements were made on the faces of 130 adult Kenyans of Indian descent. The mean of each anthropometric measurement was calculated and a student t-test was used to identify significant gender differences. These results were compared to four neoclassical canons and the percentage of each canon and its variants were recorded. A chi-square test was then performed to assess any gender differences between these findings. Results: When comparing sexes, the anthropometric means of males were larger than those of females except for eye fissure length. In addition, only the upper third displayed sexual dimorphism. As for the neoclassical canons, the orbital canon was found to apply to 20.0% of males and 21.6% of females, followed by the naso-oral canon found in 16.4% of males and 17.6% of females, and the orbito-nasal canon present in 14.5% of males and 18.9% of females. The vertical canon was not found to be applicable to any participant. Conclusion: The facial morphometric measurements in this population differ from the described neoclassical canons since they do not apply to the majority of these individuals. Therefore surgeons should be guided by the observed population-specific differences during reconstructive and facial aesthetic surgery.

Wide anatomical variability of PI normative values within an asymptomatic population: a systematic review.

PURPOSE: Studies on sagittal alignment parameters have solely focused on patients with preexisting spinal deformity. Limited data in the literature have analyzed pelvic incidence (PI) values in an asymptomatic patient population. The purpose of this study was to: (1) systematically review the literature to analyze normative PI values in asymptomatic patients; and (2) provide a more definitive geometric measurement guide for determining surgical interventions. METHODS: A systematic review of retrospective studies was performed by searching PubMed to identify studies that analyzed PI measurements in asymptomatic subjects. The following search phrases were used: (pelvic incidence, pelvic tilt, sacral slope, sagittal alignment, radiograph, asymptomatic, normative values, and adults) using Boolean operators AND, OR and NOT. Patients with pathology involving the osseous pelvic anatomy (including fracture, infection, tumor, previous surgery, and lumbosacral fusion) that would prevent measurement of the selected parameters were not included. Pelvic incidence (PI) values were analyzed. RESULTS: A total of 29 studies met inclusion criteria, including 3629 asymptomatic subjects who underwent standing lateral radiographs (mean age, 41.1 years; range, 24-69 years) for the purposes of analyzing pelvic incidence values. Overall, the mean PI value was 50.0° (range, 24-69) which is consistent with reported values in the literature. CONCLUSION: Wide anatomical variability and broad clinical interpretation of PI normative values do little to guide surgical planning for successful outcomes. However, this systematic review has presented PI-stratified normative values in a large sample of asymptomatic subjects which can serve as a grounded geometric reference for spine surgeons when considering surgical intervention approaches.

Swedish Normative Scores for the BREAST-Q Reduction/Mastopexy Module.

BACKGROUND: Norm values for patient reported outcomes, that is knowledge about how the general population of women rate their breast-related satisfaction and quality of life, are necessary to interpret the meaning of scores. The aims of this study were to create Swedish normative values for the BREAST-Q reduction/mastopexy module and to describe what healthy women are most satisfied/dissatisfied with regarding their breasts. METHODS: A random sample of 400 women aged 18-80, currently living in Region Västra Götaland, were sent BREAST-Q reduction/mastopexy. Descriptive data are presented. RESULTS: One hundred and forty-six women answered the questionnaire (36.5%). Mean total scores ranged from 48 to 78. No clear changes in scores could be seen with age and women with a high BMI seem to be less satisfied with their breasts. The participants were most satisfied with the appearance of the breasts when dressed, the appearance in the mirror dressed, the shape of the breasts with bra, and symmetry of size and most dissatisfied with appearance in the mirror naked and the shape of the breasts without a bra. Thirty to forty-five per cent of healthy women never or almost never feel sexually attractive. Among physical symptoms often described in breast hypertrophy, the most common among healthy women were lack of energy, pain in the neck, arms and shoulders, headache and difficulty performing intense physical activity. CONCLUSION: The norms for BREAST-Q reduction/mastopexy add another piece to the puzzle to what constitutes normal breast satisfaction and how surgical outcomes can be evaluated. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Normative Values for Corneal Tomography and Comparison of Both Eyes in Young Saudi Males with 20/20 Vision Using Pentacam-HR Scheimpflug Imaging.

Purpose: Anterior segment evaluation using Scheimpflug imaging with the Pentacam scanner allows the acquisition of a plethora of information. It aids in screening and diagnosing corneal pathologies and determining suitability for keratorefractive procedures. This research has significant benefits in terms of establishing normative tomographic values, which is crucial in countries where Keratoconus (KC) is more prevalent, especially among young age group, along with aiding future research in the field of refractive surgery by providing relevant normative data. Methods: A retrospective review of digital corneal tomography images for a group of medically and ophthalmologically free males aged between 18 and 21 years with 20/20 unaided distant visual acuity was performed. Results: A total of 1272 subjects (2544 eyes) were included. Findings revealed a mean maximal corneal curvature (Kmax) of 42.91 ± 1.40D (range 36.90-47.80D). The mean flat keratometry (K1) was 41.87 ± 1.31D (range 36.00-46.40D). The mean steep keratometry (K2) was 42.66 ± 1.35D (range 36.70-47.60D). The mean corneal astigmatism (CA) was 0.79 ± 0.37D (range 0.00D-2.30D). The mean central corneal thickness (CCT) was 558.53 ± 33.84 µm (range 421-677 µm). The mean thinnest corneal location thickness (TCLT) was 551.64 ± 34.08 µm (range 417-669µm). The mean corneal diameter (CD) and anterior chamber depth (ACD) were 12.13 ± 0.39 mm (range 10.50-13.60 mm) and 3.12 ± 0.29 mm (range 2.08-4.08 mm), respectively. The median differences between both eyes of the same subject were as follows: kmax difference of 0.20D (IQR 0.1-0.4); K1, K2 and CA difference of 0.20D (IQR 0.1-0.3) for all 3 parameters; CCT and TCLT difference of 5.00 µm (IQR 3.0-9.0) and 6.00 µm (IQR 3.0-10.0), respectively; CD difference of 0.10 mm (IQR 0.0-0.1); and ACD difference of 0.04 (IQR 0.02-0.06). Conclusion: We believe our data can aid in establishing normative tomographic values and acceptable differences between both eyes. Our data may also help detect subtle corneal pathology and be useful for researchers and innovators in the field of ophthalmology.

Reference values for MRI-derived psoas and paraspinal muscles and macroscopic fat infiltrations in paraspinal muscles in children.

BACKGROUND: Sarcopenia, defined as loss of skeletal muscle mass, is a novel term associated with adverse outcomes in children. Magnetic Resonance Imaging (MRI) is a safe and precise technique for measuring tissue compartments and is commonly used in most routine paediatric imaging protocols. Currently, there is a lack of MRI-derived normative data which can help in determining the level of sarcopenia. This study aimed to introduce reference values of total psoas muscle area (tPMA), total paraspinal muscle area (tPSMA), and total macroscopic fat infiltrations of the PSMA (tMFI). METHODS: In this retrospective study, the local database was searched for abdominal and pelvic region MRI studies of children aged from 1 to 18 years (mean age (standard deviation (SD)) of 9.8 (5.5) years) performed in the years 2010-2021. Children with chronic diseases and a history of surgical interventions were excluded from the analysis. Finally, a total of 465 healthy children (n = 233 girls, n = 232 boys) were enrolled in the study. The values of the tPMA, tPMSA, and tMFI were measured in square centimetres (cm2 ) at the level of the L4/L5 intervertebral disc as the sum of the left and right regions. Age-specific and sex-specific muscle, fat, and body mass index percentile charts were constructed using the LMS method. Inter-observer agreement and intra-observer reproducibility were assessed using the Bland-Altman plots. RESULTS: Both tPMA and tPSMA showed continuous increases in size (in cm2 ) throughout all age groups. At the age of 18, the median tPMA areas reached 26.37 cm2 in girls and 40.43 cm2 in boys. Corresponding tPSMA values were higher, reaching the level of 40.76 cm2 in girls and 56.66 cm2 in boys. The mean value of tMFI within the paraspinal muscles was 5.0% (SD 3.65%) of their total area in girls and 3.5% (SD 2.25%) in boys with the actual difference between sexes up to 0.96 cm2 . Excellent intra-observer reproducibility and inter-observer agreement were noted. Actual mean differences for tPMA were at the level of 0.43 and 0.39 cm2 , respectively. Mean bias for tPSMA was 0.1 cm2 for inter-observer and 0.05 cm2 for intra-observer measurements. CONCLUSIONS: Our findings demonstrate novel and highly reproducible sex-specific MRI-derived reference values of tPMS, tPSMA, and tMFI at the level of the L4/L5 intervertebral disc for children from 1 to 18 years old, which may guide a clinician in the assessment of sarcopenia, a prognostic outcome marker in children.

EORTC QLQ-C30 general population normative data for Italy by sex, age and health condition: an analysis of 1,036 individuals.

BACKGROUND: General population normative values for the widely used health-related quality of life (HRQoL) measure, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30), are available for a range of countries. These are mostly countries in northern Europe. However, there is still a lack of such normative values for southern Europe. Therefore, this study aims to provide sex-, age- and health condition-specific normative values for the general Italian population for the EORTC QLQ-C30. MATERIAL AND METHODS: This study is based on Italian EORTC QLQ-C30 general population data previously collected in an international EORTC project comprising over 15,000 respondents across 15 countries. Recruitment and assessment were carried out via online panels. Quota sampling was used for sex and age groups (18|-|39, 40-49, 50-59, 60-69 and ≥ 70 years), separately for each country. We applied weights to match the age and sex distribution in our sample with UN statistics for Italy. Along with descriptive statistics, linear regression models were estimated to describe the associations of sex, age and health condition with the EORTC QLQ-C30 scores. RESULTS: A total of 1,036 respondents from Italy were included in our analyses. The weighted mean age was 49.3 years, and 536 (51.7%) participants were female. Having at least one health condition was reported by 60.7% of the participants. Men reported better scores than women on all EORTC QLQ-C30 scales but diarrhoea. While the impact of age differed across scales, older age was overall associated with better HRQoL as shown by the summary score. For all scales, differences were in favour of participants who did not report any health condition, compared to those who reported at least one. CONCLUSION: The Italian normative values for the EORTC QLQ-C30 scales support the interpretation of HRQoL profiles in Italian cancer populations. The strong impact of health conditions on EORTC QLQ-C30 scores highlights the importance of adjusting for the impact of comorbidities in cancer patients when interpreting HRQoL data.

Evaluation of optic nerve diameters in individuals with neurofibromatosis and comparison of normative values in different pediatric age groups.

AIM: Our study aimed to report the normative values for optic nerve diameter in different age groups in MR imaging (MRI) in the pediatric population and to find a cut-off value for diagnosis in different age groups to be used for the diagnosis of optic glioma in patients with Neurofibromatosis 1(NF1). MATERIALS-METHODS: Orbital MRI obtained from 2011 to 2021 for children with and without NF1 were reviewed. Patients were divided into three groups: NF1 with glioma (group 1, n = 38), NF1 without glioma (group 2, n = 57), and healthy controls (group 3, n = 295). Two radiologists assessed diameter and tortuosity using validated criteria. The optic nerve measurements were obtained by two radiologists in two plans (axial and coronal sections) at five locations; retroocular, midsegment, and prechiasmatic segment on axial plane and retroocular segment and chiasmatic on coronal plane. RESULTS: Optic nerves were divided into 4 age groups: 0-2 years, 2-6 years, 6-12 years, and 12-18 years. It was observed that optic nerve diameters increased with age in healthy individuals. In subjects in groups 1 and 2, the mean diameter of the optic nerve was significantly greater at all locations compared with control individuals. Tortuosity scores were significantly associated in NF1 subjects with optic glioma than in NF1 subjects without optic glioma. CONCLUSION: We present the normative values obtained by measuring optic nerve diameters in pediatric populations (0-18 years) on MRI of our center. A rapid increase in optic nerve diameter was observed in the first 6 years of life, followed by a slower increase. Quantitative reference values for optic nerve diameter will benefit the development of objective diagnostic criteria for optic nerve gliomas (ONGs) secondary to NF1.

The prevalence and consequences of abdominal rectus muscle diastasis among Finnish women: an epidemiological cohort study.

PURPOSE: Post-pregnancy abdominal rectus diastasis (ARD) has raised attention in the field of surgery in recent years, but there is no consensus about when to consider surgery. Our aim was to find out what is the normal inter-rectus distance in fertile aged, female population in Finland and to examine whether there is a linea alba width that would predispose to diastasis-related problems after pregnancy. METHODS: For this prospective cohort study, women participating early pregnancy ultrasound in Helsinki University Hospital Department of Obstetrics and Gynecology during 1.1.2018-8.3.2019, were recruited. The width of linea alba was measured by ultrasound during the early pregnancy ultrasound. Symptoms were measured by questionnaire including Health-Related Quality of Life (RAND-36) and Oswestry Disability Index for back symptoms and disability. RESULTS: Linea alba width was measured in total of 933 women. The average inter-rectus distance (IRD) among nulliparous women was 1.81 ± 0.72 cm. After one previous pregnancy, the average linea alba width was 2.36 cm ± 0.83 cm and after more pregnancies 2.55 ± 1.09 cm. There was a positive correlation between previous pregnancies and the increased linea alba width (p = 0.00004). We did not perceive any threshold value of linea alba width that would predispose to back pain or movement control problems in this cohort, in which severe diastasis (over 5 cm) was rare. CONCLUSION: Mean inter-rectus distance in parous population exceeds stated normative values. Moderate ARD (3.0-5.0 cm) alone does not seem to explain low back pain or functional disability in population level. Severe post-pregnancy diastasis (over 5.0 cm) is rare.

Correcting for physiological ripples improves epileptic focus identification and outcome prediction.

OBJECTIVE: The integration of high-frequency oscillations (HFOs; ripples [80-250 Hz], fast ripples [250-500 Hz]) in epilepsy evaluation is hampered by physiological HFOs, which cannot be reliably differentiated from pathological HFOs. We evaluated whether defining abnormal HFO rates by statistical comparison to region-specific physiological HFO rates observed in the healthy brain improves identification of the epileptic focus and surgical outcome prediction. METHODS: We detected HFOs in 151 consecutive patients who underwent stereo-electroencephalography and subsequent resective epilepsy surgery at two tertiary epilepsy centers. We compared how HFOs identified the resection cavity and predicted seizure-free outcome using two thresholds from the literature (HFO rate > 1/min; 50% of the total number of a patient's HFOs) and three thresholds based on normative rates from the Montreal Neurological Institute Open iEEG Atlas (https://mni-open-ieegatlas. RESEARCH: mcgill.ca/): global Atlas threshold, regional Atlas threshold, and regional + 10% threshold after regional Atlas correction. RESULTS: Using ripples, the regional + 10% threshold performed best for focus identification (77.3% accuracy, 27% sensitivity, 97.1% specificity, 80.6% positive predictive value [PPV], 78.2% negative predictive value [NPV]) and outcome prediction (69.5% accuracy, 58.6% sensitivity, 76.3% specificity, 60.7% PPV, 74.7% NPV). This was an improvement for focus identification (+1.1% accuracy, +17.0% PPV; p < .001) and outcome prediction (+12.0% sensitivity, +1.0% PPV; p = .05) compared to the 50% threshold. The improvement was particularly marked for foci in cortex, where physiological ripples are frequent (outcome: +35.3% sensitivity, +5.3% PPV; p = .014). In these cases, the regional + 10% threshold outperformed fast ripple rate > 1/min (+3.6% accuracy, +26.5% sensitivity, +21.6% PPV; p < .001) and seizure onset zone (+13.5% accuracy, +29.4% sensitivity, +17.0% PPV; p < .05-.01) for outcome prediction. Normalization did not improve the performance of fast ripples. SIGNIFICANCE: Defining abnormal HFO rates by statistical comparison to rates in healthy tissue overcomes an important weakness in the clinical use of ripples. It improves focus identification and outcome prediction compared to standard HFO measures, increasing their clinical applicability.

General Spanish population normative data analysis for the EORTC QLQ-C30 by sex, age, and health condition.

PURPOSE: General population normative data for the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire facilitates interpretation of data assessed from cancer patients. This study aims to present normative data of the general Spanish population. METHODS/PATIENTS: Data were obtained from a prior larger study collecting EORTC QLQ-C30 norm data across 15 countries. Data were stratified by sex and age groups (18-39, 40-49, 50-59, 60-69 and > 70 years). Sex and age distribution were weighted according to population distribution statistics. Sex- and age-specific normative values were analysed separately, as were participants with versus those without health conditions. Multiple linear regression was used to estimate the association of each of the EORTC QLQ-C30 scales with the determinants age, sex, sex-by-age interaction term, and health condition. RESULTS: In total, 1,165 Spanish individuals participated in the study. Differences were found by sex and age. The largest sex-related differences were seen in fatigue, emotional functioning, and global QOL (Quality of Life), favouring men. The largest age differences were seen in emotional functioning, insomnia, and pain, with middle-aged groups having the worst scores. Those > 60 years old scored better than those < 60 years old on all scales except for physical functioning. Participants with no health conditions scored better in all QLQ-C30 domains. CONCLUSIONS: The present study highlights differences in HRQOL between specific sex/age strata and especially between people with and without a health condition in the general Spanish population. These factors must be considered when comparing general population HRQOL data with that of cancer patients.

Age-related normative changes in cerebral perfusion: Data from The Irish Longitudinal Study on Ageing (TILDA).

OBJECTIVE: To establish normative reference values for total grey matter cerebral blood flow (CBFGM) measured using pseudo-continuous arterial spin labelling (pCASL) MRI in a large cohort of community-dwelling adults aged 54 years and older. BACKGROUND: Quantitative assessment of CBFGM may provide an imaging biomarker for the early detection of those at risk of neurodegenerative diseases, such as Alzheimer's and dementia. However, the use of this method to differentiate normal age-related decline in CBFGM from pathological reduction has been hampered by the lack of reference values for cerebral perfusion. METHODS: The study cohort comprised a subset of wave 3 (2014-2015) participants from The Irish Longitudinal Study on Ageing (TILDA), a large-scale prospective cohort study of individuals aged 50 and over. Of 4309 participants attending for health centre assessment, 578 individuals returned for 3T multi-parametric MRI brain examinations. In total, CBFGM data acquired from 468 subjects using pCASL-MRI were included in this analysis. Normative values were estimated using Generalised Additive Models for Location Shape and Scale (GAMLSS) and are presented as percentiles, means and standard deviations. RESULTS: The mean age of the cohort was 68.2 ± 6.9 years and 51.7% were female. Mean CBFGM for the cohort was 36.5 ± 8.2 ml/100 g/min. CBFGM decreased by 0.2 ml/100 g/min for each year increase in age (95% CI = -0.3, -0.1; p ≤ 0.001) and was 3.1 ml/100 g/min higher in females (95% CI = 1.6, 4.5; p ≤ 0.001). CONCLUSIONS: This study is by far the largest single-site study focused on an elderly community-dwelling cohort to present normative reference values for CBFGM measured at 3T using pCASL-MRI. Significant age- and sex-related differences exist in CBFGM.

The normative Western Ontario Rotator Cuff Index values for age and sex.

BACKGROUND: The Western Ontario Rotator Cuff Index (WORC) is a widely used disease-specific outcome tool developed for patients with rotator cuff injuries. The determination of age- and sex-adjusted normative WORC values enables us to determine whether a procedure is more beneficial in specific patient groups because the results can be compared with a matched standard. The purpose of this study was to determine normative WORC values and assess whether the WORC needs an adjusted score for age and sex. METHODS: We included participants using an online data-capturing program. We collected the following variables: age, sex, presence of shoulder pathology, Subjective Shoulder Value, and WORC score. We defined the mean normative WORC score per age category and analyzed sex differences in WORC scores per age category and in all domains of the WORC score. RESULTS: A total of 470 participants filled out the questionnaire. We excluded 44 participants because of pre-existing shoulder complaints or incomplete questionnaires. The mean total WORC score was 94% (standard deviation, 9%), and the mean total WORC score in every age and sex category was >90%. Of all participants, 85% scored between 91% and 100%; 63 participants (15%) scored 100%. The mean overall Subjective Shoulder Value was 98% (standard deviation, 6%). We found no statistically significant differences between sexes in the overall score, in the domain scores, and within the age categories. CONCLUSION: We defined normative values for the WORC questionnaire in a random prospective cohort and found no difference in scores between sexes. The mean normative scores all were within the variance of the maximum, and the WORC score did not deteriorate with age. It seems that the results of this subjective questionnaire change with the participant's perspective. An adjusted WORC score for age and sex is not necessary. This information can serve as a basis for comparison with patients with shoulder disease.

The Dysphagia Handicap Index (DHI)-Normative Values. Systematic Review and Meta-Analysis.

As the dysphagia handicap index (DHI) becomes more commonly used in clinical practice as a diagnostic tool, it is essential to establish the normative value of DHI. The main purpose of this study is to determine the normative value of DHI among subjects who had no history of dysphagia or neurological disease as well as no history of head or neck malignancy. A systematic literature search was performed using PubMed, Scopus and ScienceDirect to access relevant databases and to locate outcome studies. Eligibility criteria included type of publication, participant characteristics and report of outcomes. Data analysis were conducted using meta-analysis method. Five articles were included for the final analysis. The normative value of DHI was 2.49 with confidence interval of 0.51-4.48 for a group of 323 subjects, age range of 20-86 years.

The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores in 961 Japanese volunteers.

INTRODUCTION: Patient-reported outcomes recently have been used to assess treatment outcomes. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is a particularly convenient and useful tools. However, data on the normative values of Japanese population are lacking, so the present study was conducted to gather this information. METHODS: We assessed 1098 volunteers over 18 years of age (363 men and 735 women, average 50 years old) who had not received upper limb treatment in a medical facility. These participants included our institution's staff, their family members, and the participants in the group meetings held by institution's staff. Their occupations were also examined. We divided occupations into nonmanual and manual labor. These factors of the participants were then analyzed to clarify which (if any) influenced the QuickDASH. RESULTS: Valid answers were obtained from 961 subjects (87.5%). The median score was 2 (mean: 4.8) in the overall population, 0 (mean: 2.6) in men, and 2.5 (mean: 6.0) in women. The scores increased with age and were higher in women than in men. There were no significant differences by manual labor. Female sex and older age were identified as factors that influenced the QuickDASH score in the multiple regression analysis. There were high correlations among QuickDASH, work and sports/music scores. CONCLUSIONS: The present study provided QuickDASH scores for Japanese volunteers who had not received upper limb treatment in a medical facility. The scores were associated with older age and female sex. This study helps us to know the degree of potential upper limb impairment in the general population, and will help in populational strategies as primary and secondary preventive medicine for upper limb-related diseases.

Normative anthropometry and proportions of the Kenyan-African face and comparative anthropometry in relation to African Americans and North American Whites.

BACKGROUND: There is no normative craniofacial anthropometric data for the Kenyan-African population. The purpose of this investigation was to determine normative anthropometric craniofacial measurements and proportional relationships for Kenyans of African descent and to compare the data with African Americans (AA), North American Whites (NAW), and neoclassical canons. METHODS: Twenty-five direct facial anthropometric measurements, and 4 angular measurements, were taken on 72 Kenyan-African participants (age range 18-30 years) recruited at the University of Nairobi in Kenya. The data were compared with AA and NAW populations, and neoclassical canons. Descriptive statistics of the variables were computed for the study population. RESULTS: Significant differences between both Kenyan males and females were detected in forehead height (~ 5 mm greater for males, ~ 4.5 mm for females), nasal height (reduced by ~ 4 mm in males, ~ 3 mm in females), nasal width (8-9 mm greater), upper lip height (> 3 mm), and eye width (greater by ~ 3 mm) compared to NAW subjects. All vertical measurements obtained were significantly different compared with NAW. Differences were observed in comparison with AA subjects, but less marked. Mouth width was similar in all groups. Angular measurements were variable. Neoclassical canons did not apply to the Kenyan population. CONCLUSIONS: Anthropometric measurements of NAW showed clear differences when compared with the Kenyan population, and variations exist with comparative AA data. The anthropometric data in terms of linear measurements, angular measurements, and proportional values described may serve as a database for facial analysis in the Kenyan-African population.

Extrapolation of Normative KOOS, JR Data for the Young Patient Population Undergoing Knee Arthroplasty Procedures.

BACKGROUND: The Knee Injury and Osteoarthritis Outcome (KOOS), JR is a patient-reported outcome measure that is validated for patients undergoing total knee arthroplasty. The objective of this study was to provide normative data for the KOOS, JR in a relatively healthy US population visiting an outpatient orthopedic setting. This study is a cross-sectional study. METHODS: Normative data from the KOOS questionnaire was used to calculate the subscale (pain, activity of daily living, and symptoms), raw, and interval scores for the KOOS, JR. The participants who completed the KOOS were devoid of current complaints of the hip, knee, and ankle. The means, standard deviations, medians, interquartile ranges, and percentiles for the KOOS, JR subscale, raw and interval scores were calculated by age decades, sex, laterality, and history of knee injuries in the past year. RESULTS: Four hundred two men and 598 women were involved in the analysis. The lowest mean interval scores were noted in the 56- to 64-year group with the greatest disparity between male and female compared to the rest of the age cohorts. Females scored high in all 3 subscales with a higher score in the pain subscale, denoting a lower normative value. Patients with hypertension scored with a significantly lower mean interval score than those without hypertension. In all subscales, tobacco use and hypertension were associated with a statistically significant negative effect on the normative scores. CONCLUSION: The normative values for the KOOS, JR can be used to set goals and follow the progress of patient satisfaction in regard to the knee after a knee arthroplasty procedure.

Age- and Gender-Specific Normative Values for the Self-Reported Foot and Ankle Score (SEFAS).

BACKGROUND: The Self-Reported Foot and Ankle Score (SEFAS) is a foot- and ankle-specific patient-reported outcome measurement (PROM) score that has been validated with good results for a variety of foot and ankle disorders. SEFAS is sensitive detecting improvement or deterioration after surgery. However, normative values, required to put a specific patient's summary score into perspective, are lacking. METHODS: In this report, we included 396 population-based men and 383 women (43% of the invited individuals), age 20-89 years, who had completed the SEFAS questionnaire and questions regarding anthropometrics and health. We used Mann-Whitney U test to test gender differences and Spearman correlation coefficients to determine any association between SEFAS score and age. We present gender-specific median SEFAS scores with range and 5th to 95th percentiles and mean with standard deviation. RESULTS: The SEFAS normative values were median 48 in men (range 11-48), 5th to 95th percentiles 31 to 48 and mean 45 ± 6, and in women, median 47 (range 6-48), 5th to 95th percentiles 23 to 48 and mean 43 ± 8 (gender comparison P < .001). SEFAS normative values correlated inversely with age (r = -0.12, P < .001). CONCLUSION: In the general population, older age was associated with lower SEFAS value, and men had higher values than women. The population-based normative SEFAS values provided in this study can facilitate quantification of disability related to foot and ankle with and without surgery in the foot and ankle. LEVEL OF EVIDENCE: Level II, prospective comparative study.