A Comparison of Intracranial Volume Growth in Normal Children and Patients With Metopic Craniosynostosis.

BACKGROUND: The impact of metopic craniosynostosis on intracranial volume (ICV) and ICV growth is unclear. In addition, the relationship between head circumference (HC) and ICV in these patients is not previously described. METHODS: A retrospective review of 72 patients with metopic craniosynostosis was performed. The ICVs were calculated from manually segmented preoperative computed tomography scans. Magnetic resonance imaging data for 270 healthy children were available. The ICVs were calculated in FreeSurfer.First, a growth curve for metopic patients was generated and a logarithmic best-fit curve was calculated. Second, the impact of metopic craniosynostosis on ICV relative to healthy controls was assessed using multivariate linear regression. Third, the growth curves for metopic patients and healthy children were compared.Pearson's correlation was used to measure the association between HC and ICV. RESULTS: Mean metopic ICV was significantly lower than normal ICV within the first 3 to 6 months (674.9 versus 813.2 cm; P = 0.002), 6 to 9 months (646.6 versus 903.9 cm; P = 0.005), and 9 to 12 months of life (848.0 versus 956.6 cm; P = 0.038). There was no difference in ICV after 12 months of age (P = 0.916).The ICV growth in patients with metopic craniosynostosis is defined by a significantly different growth curve than in normal children (P = 0.005).The ICV and HC were highly correlated across a broad range of ICVs and patient age (r = 0.98, P < 0.001). CONCLUSION: Patients with metopic craniosynostosis have significantly reduced ICVs compared to healthy children, yet greater than normal ICV growth, which allows them to achieve normal volumes by 1 year of age. The HC is a reliable metric for ICV in these patients.

MyDispense simulation in pharmacy education: a scoping review.

BACKGROUND: MyDispense is a free online virtual simulation software developed by Monash University. The software facilitates students to practise, apply and hone the skills of a pharmacist in a realistic environment without the potentially life-threatening consequences of a real-life error. Although the focus of MyDispense was initially on exposure to community pharmacy practice scenarios, its modular build and customizability, indicate that there are a wide range of applications that could be incorporated into pharmacy education. Therefore, this study reviews and appraises the literature on the use of MyDispense within pharmacy education. METHODS: A scoping review was conducted. The electronic databases (CINAHL, Ovid Embase, Ovid Medline, Google Scholar, and Scopus) were searched to identify scholarly articles related to MyDispense in pharmacy education from January 2011 and August 2022. RESULTS: Forty-three papers met the inclusion criteria and were analysed in this scoping review. A total of 418 key sentences and segments of text were extracted from the papers and subsequently categorized into 10 subthemes. The 10 subthemes were dispensing skills, communication skills, decision-making/problem-solving skills, student performance, pharmacy law, applying theoretical knowledge, support educators, pharmacy practice, feedback/reflection and practice in a risk-free environment. In total, four overarching themes summarize how MyDispense is supporting pharmacy education: supporting education; skill development; application of knowledge and student outcomes. CONCLUSION: The scoping review found that MyDispense was mostly used to support education and student skill development. These findings can be used to support pharmacy educators globally on the various uses and applications of MyDispense in their teaching.

Functional status as a marker of need for hospital admission following outpatient hernia repair.

INTRODUCTION: The careful selection of patients for hernia repair in ambulatory surgery centres is critical to prevent unanticipated inpatient admissions. The aim of this study was to evaluate risk factors associated with inpatient admission. METHODS: A multivariable logistic regression was performed utilising the ACS NSQIP database from 2007 to 2016. The primary outcome was same-day hospital discharge. The primary exposure variable was preoperative functional status. Additional covariates included sex, obesity, age, smoking status, steroid use, dyspnoea, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, hypertension, bleeding disorder, dialysis-dependence and American Society of Anesthesiologists classification score. RESULTS: A total of 194,822 patients underwent hernia repair in the outpatient setting; 8705 (4.5%) required hospital admission. The variables with the most significantly increased odds for hospital admission were partially dependent and totally dependent preoperative functional status. CONCLUSION: A non-independent baseline functional status is the strongest predictor of need for admission following outpatient hernia repair.