{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:03:49Z","timestamp":1788271429991,"version":"build-2803163510"},"reference-count":28,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The reported prevalence of cleft lip and palate within the state of Arkansas (10.63 to 12.22 per 10,000 live births) is much higher than the national average. With greater understanding of at-risk populations and risk factors, we can provide more targeted education to improve patient outcomes and potentially reduce the incidence of orofacial clefts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a database review of cleft lip and\/or palate patients using data obtained from the Arkansas Reproductive Health Monitoring System (ARHMS) database, a statewide birth defects registry that collects data from 83 regional hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Statewide database study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Patients diagnosed with cleft lip and\/or palate between the years 1993 and 2015 registered in the ARHMS database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Prevalence rates of orofacial clefts within each Arkansas county.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1345 unique patients with a diagnosis of cleft lip and\/or palate were identified in the database with an average prevalence of 14.9 per 10,000 live births [95% CI: 14.1\u201315.7]. Of the 75 counties in Arkansas, 37 counties had prevalence rates higher than the state rate. Three counties had particularly higher prevalence rates of more than 33 per 10,000 live births. On the other hand, 3 counties had very low rates of 5 or less per 10,000 live births.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The rates of orofacial cleft anomalies are not distributed as expected among Arkansas counties. Further exploration is necessary to determine what, if any, environmental factors are at play.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251326443","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T13:13:01Z","timestamp":1742217181000},"page":"1090-1098","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating Geographic Distribution and Potential Environmental Risk Factors of Orofacial Cleft Anomalies Utilizing a Statewide Birth Defects Registry"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1344-6473","authenticated-orcid":false,"given":"Clark","family":"Kennedy","sequence":"first","affiliation":[{"name":"University of Arkansas for Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0054-0627","authenticated-orcid":false,"given":"Sean","family":"Young","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Davis","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5849-6203","authenticated-orcid":false,"given":"Erin Weatherford","family":"Creighton","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8694-8665","authenticated-orcid":false,"given":"Adam","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0625-221X","authenticated-orcid":false,"given":"Larry","family":"Hartzell","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23329"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20735"},{"issue":"3","key":"e_1_3_2_4_2","first-page":"336","article-title":"The genetics of cleft lip and palate","volume":"22","author":"Fraser FC","year":"1970","unstructured":"Fraser FC. 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