bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic vs Open Ankle Arthrodesis: The Canadian Multi-Center Long Term Study
Authors: Li Shuyuan , Veljkovic Andrea , Wing Kevin , Gagne Oliver , Qian Hong , Hubert Wong Msc , Sadr Hooman , Penner Murray J. , Daniels Timothy R. , Morash Joel , Glazebrook Mark A. , Younger Alastair S.E. 
Published: December 2024

Category: Ankle Arthritis; Ankle Introduction/Purpose: This multi-center study aimed to compare complication rates, reoperation rates, and patient-reported outcome measures (PROMs) between open ankle arthrodesis (OAA) and arthroscopic ankle arthrodesis (AAA) in treating end-stage ankle arthritis. Methods: This was a prospectively collected retrospective study utilizing data from three medical centers in the Canadian Orthopaedic Foot and Ankle Society (COFAS) database. Primary ankle arthrodeses for the treatment of end-stage arthritis with a minimum of 2 years follow up and valid PROM scores were included. Preoperative COFAS ankle arthritis type, validated PROMs including the Ankle Osteoarthritis Scale (AOS), Short Form-36 (SF-36) with 2 components (the Physical Component Summary (PCS) and Mental Component Summary (MCS)), as well as major complications including malunion, nonunion, infection, amputations, and reoperations related to the arthrodesis were evaluated using CROCS (Canadian Reoperation Coding System). Results: 2,835 prospectively enrolled patients who underwent surgical treatment of end-stage ankle arthritis (COFAS Types 1-4) from 2001 to 2020 were screened. 447 ankle arthrodeses were included (178 AAA, 269 OAA) with 1-15 years of followup (7.13 yrs +/- 3.8). There was no difference between the two groups in demographics except more cases of type 1 and 4 arthritis in OAA group. There was a 6.9% incidence of major complications (3.79% related operations around the ankle, 0.67% deep infection, 1.78% revisions for nonunion/malunion, 0.67% amputations). For the 4 types of arthritis, AOS score improved significantly at 1 year, stabilized in type 1 group, but fluctuated in the remaining 3 types of arthritis after 8 years postoperatively. Average postoperative AOS score was better in the AAA group. Conclusion: Better outcomes were found for the arthroscopic cohort. However differences may be less after correction for confounding factors such as surgeon, site, and COFAS grade. Revision surgery is rare in both groups. AOS Treated Total Scores in Arthroscopic versus Open Ankle Arthrodesis Groups
Assessing Complication Rates of Constructs Used in Midfoot Arthrodesis
Authors: Dalloul John M. , Balu Abhinav R. , Shen Peter C. , Bergman Rachel , Chang Shaun , Kelikian Armen , Patel Milap , Kadakia Anish R. , Mutawakkil Muhammad Y. 
Published: December 2024

Category: Midfoot/Forefoot; Other Introduction/Purpose: Midfoot arthrodesis is an essential procedure for restoring function and structural integrity to the foot for patients with end stage arthritis of the tarsometatarsal and naviculocuneiform joint complexes. There is little evidence regarding the optimal fixation construct for midfoot arthrodesis. In addition to fusion outcomes, complications such as revision procedures, infection, and deep vein thrombosis (DVT) are essential considerations that require analysis. The purpose of this study is to evaluate the rate of revision surgery for nonunion, infection requiring irrigation and debridement (I&D), symptomatic hardware removal, surgical site infections, and deep venous thrombosis (DVT) between the various constructs used in midfoot arthrodesis to better aid surgeon selection and preoperative decision making. Methods: Patients who underwent midfoot arthrodesis between 2010-2023 at a single institution were included in final analysis. Qualifying procedures included fusion of any of the tarsometatarsal (TMT) joints, the Lisfranc articulation, or the naviculocuneiform (NC) joint. Complications were classified as revision surgery for nonunion, infection, or other revision procedure (e.g. symptomatic hardware removal). Additional complication categories included surgical site infection and postoperative DVTs. Rates of each complication were compared across constructs used in the arthrodesis procedures and the joints being fused. P-values were calculated using Pearson’s chi-squared test. Statistical analyses were carried out using Python 3.11.7 and Microsoft Excel. Results: In total, 150 patients with arthrodesis performed across 195 joints were followed for an average of 2 years post-operatively as part of this study. Arthrodesis constructs using combination staples and screws were found to have a significantly higher total revision rate (27.2%) than those using only staples (5.4%, p = 0.048) or only screws (5.3%, p = 0.043). This relationship held true when looking specifically at revision surgery to address symptomatic hardware, with combination staple and screw constructs demonstrating a higher rate (22.7%) than either staples (0%, p = 0.011) or screws (2.6%, p = 0.040) alone. Additionally, revisions due to infection, regardless of construct, occurred at a higher rate in the 2nd TMT joint (3.9%) than in the NC joint (0%, p = 0.038). Conclusion: The combination of staples and screws for midfoot arthrodesis results in higher complication rates, particularly revision due to symptomatic hardware, than screws or staples alone. Increased hardware in the relatively small margins of the midfoot are not well tolerated and increase risk of reoperation.
Assessing Plantar Pressure Distribution and Time Parameters Following Total Ankle Replacement Surgery
Authors: Khan Ryan , Halai Mansur , Daniels Timothy R. , Kayum Shahin , Pinsker Ellie 
Published: December 2024

Category: Ankle Arthritis; Other Introduction/Purpose: This study intended to use plantar pressure analysis to obtain supplementary objective outcome assessments of total ankle replacement surgery. Methods: Twenty subjects that were previously consented and booked for total ankle replacements participated in the study. Each subject performed a 10 meter walk prior to surgery and then again at six and twelve months post-operative. Plantar pressures were measured using the Pedar® (by Novel, Munich, DE) pressure insoles. Six parameters: initial contact time, terminal contact time, maximum force time, peak pressure time, maximum force and peak pressure were calculated and averaged over trials in ten regions of foot. The parameters in each region were compared between pre and post-surgery. Results: We observed that patient’s hind foot total contact time notably increased after total ankle replacement. The average baseline hind foot contact time was 387ms, which increased to 448ms at 6 months post op and further increased to 487ms at the one-year visit. Suggesting that patients are able to better tolerate a load on the hind foot for considerably longer after having ankle replacement surgery. Conclusion: Plantar pressure measurements using the Pedar® measurement system of pressure and time showed to be strong tools for objective evaluation of ankle joint replacement surgery. Future research comparing outcomes of ankle arthrodesis is planned Pedar software
Towards a novel framework for identifying commonalities and differences in older people’s end-of-life trajectories: aims and interdisciplinary mixed-methods approach of the ERC-funded TRAJECT project
Authors: Tripathi Khyati , Gobiet Emma , Van den Block Lieve , Van den Bossche Casper , Pivodic Lara 
Published: December 2024

Background: Older people who die from serious chronic disease typically experience long periods (months or years) of illness and complex fluctuations in their physical health and in their social, psychological and existential well-being. Our understanding of these end-of-life trajectories is very limited, focuses predominantly on physical function and clinical predictors and neglects inter-individual differences. A better understanding of end-of-life trajectories, including what is shared among people and what is individually specific, is needed for an optimal provision of palliative care and health services planning. Objectives: TRAJECT is a European Research Council-funded interdisciplinary project with a central aim to gain understanding of what is generalisable and what is individually specific in older people’s end-of-life trajectories and in the circumstances that shape them. Design: Convergent mixed-methods design including a quantitative longitudinal survey study, a serial narrative study and a mortality follow-back survey. Methods and analysis: TRAJECT applies a novel methodological and analytical framework, examining trajectories through two distinct scientific lenses, both suited for uncovering variability as well as general principles: a structured quantitative approach to capture fluctuations in a standardised way, and an experience-focused qualitative approach to study the subjective stories and meanings behind changes in health. The findings of the quantitative and qualitative methods will be integrated through triangulation and by systematically threading key findings from one method across to the other. The research is conducted in Belgium. Discussion: This project will lead to a new understanding of the varied ways in which older people’s end-of-life trajectories unfold and which circumstances and experiences shape them. It will also reveal which elements of trajectories are shared across groups of people and which are individually specific. These new insights will provide a much-needed evidence base concerning groups at risk of poor well-being as they near death, which is needed to optimise palliative care practice, needs assessment, as well as health service planning.
A qualitative exploration of the experiences of self-diagnosed autistic women and gender-diverse individuals who are not pursuing an autism diagnosis
Authors: Friedman Alina , Paltoglou Aspasia , Sorte Rossella 
Published: December 2024

A growing number of adults are choosing to self-identify as autistic without obtaining a formal diagnosis; yet, research into this population remains scarce. Women and gender non-conforming autistics are particularly underresearched, with women facing additional barriers to diagnosis. This study examined the lived experiences of self-diagnosed autistic women and gender-diverse adults and explored how autistic identity is constructed outside of formal diagnosis in this population. Participants ( n = 6) between the ages of 18 and 69 took part in semi-structured one-to-one online interviews with an autistic researcher to discuss their experiences of being self-diagnosed. Interview transcripts were analysed using interpretive phenomenological analysis. Three superordinate themes were found: (1) autistic self-discovery, (2) living without a diagnosis and (3) self-doubt and self-diagnosis. The findings suggest that many of the experiences of self-diagnosed autistic women and gender-diverse adults are similar to those who are diagnosed but with unique challenges and benefits. This study offers a new perspective on self-diagnosis as an empowering way of attaining a positive autistic identity outside of the deficit paradigm embedded within the diagnostic pathway. Lay Abstract As awareness of neurodiversity continues to grow, more adults are seeking autism assessments. This rise in demand is placing pressures on diagnostic services resulting in long waiting lists and high private costs. Many autistic adults are choosing to self-diagnose as an alternative to a lengthy and expensive diagnostic process which pathologizes their experiences. Research into this population remains very scarce, and little is known about how and why autistic adults choose to self-diagnose. Autistic women are especially underdiagnosed and underresearched, with gender-diverse autistics rarely included. This study explored how autistic women and gender-diverse adults acquire and shape their autistic identity outside of formal diagnosis and what effect this has had on their lives. An autistic researcher recruited six self-diagnosed autistic adults through social media and conducted online one-to-one video interviews with them. Three main themes were found: (1) autistic self-discovery, (2) living without a diagnosis, and (3) self-doubt and self-diagnosis. The findings offer new insights into the lives of self-diagnosed autistic women and gender-diverse adults and how their experiences are often similar to those who are diagnosed but with unique challenges and benefits. This study offers a new perspective on self-diagnosis as an empowering way of gaining a positive autistic identity outside of the diagnostic model which views autism as a disorder rather than a difference. This may help self-diagnosed autistics feel more able to disclose their identity to others, access more support and experience less invalidation, stigma and self-doubt.
Predictors of Functional Impairment in Severe COVID-19 Patients Two Months After Discharge
Authors: El Kik Antoine , Eid Hind , Nassim Nabil , Hoyek Karim , Riachy Albert , Habr Bassem , Sleilaty Ghassan , Riachy Moussa 
Published: December 2024

Background The Post-COVID-19 Functional Status (PCFS) scale is a validated tool used to measure the functional status of patients discharged from the hospital. Objectives To describe the functional limitations of hospitalized COVID-19 patients at the time of discharge and two months afterward, and to identify risk factors associated with functional impairment. Design Retrospective study. Methods A total of 540 patients were included in this monocentric study. The functional status assessment using the PCFS scale and ventilatory needs were recorded at discharge and two months later. Univariate and multivariate analyses were performed in order to identify the risk factors of a high PCFS score. Results Two months after discharge, the PCFS grade was 0 in 60,6% of the survivors, 1 in 24.5%, 2 in 6.9%, 3 in 2.8%, and 4 in 5.3%. The identified risk factors of a high PCFS scale were: age, arterial hypertension, diabetes mellitus, immunosuppression, cardiovascular disease, high need for oxygen and high News2 score at admission, a high percentage of ground glass at chest CT scan performed at admission or during follow-up, elevated leukocytes, neutrophils, LDH, D-dimers, procalcitonin, and serum creatinine levels. During the hospital stay, treatment with steroids, tocilizumab, longer duration of hospitalization, ICU admission and prolonged stay, and the occurrence of thromboembolic or hemorrhagic events were also significantly associated with a higher PCFS. Multivariate analysis identified that only age and a high News2 score at admission were independent risk factors of a low PCFS score. Conclusion Multiple risk factors for a higher PCFS score were identified, but only age and a high News2 score at admission were found to be independent risk factors.
Burden of urolithiasis: a systematic review of epidemiological and clinical trends in Somalia
Authors: Dirie Najib Isse , Hassan Jihaan , Hussein Abdirahman Omar , Garba Bashiru , Asowe Hodo Aideed , Orey Fartun Abdullahi Hassan , Mohamud Abdirahman Khalif , Adam Mohamed Hussein , Mohamoud Jamal Hassan , Ahmed Mohamed Mustaf , Nur Maryan Abdullahi Sh. 
Published: December 2024

Abstract
Background
Urolithiasis has become a global major disease that affects millions of people every year. The data regarding the disease in sub-Saharan Africa are limited. Our purpose is to evaluate the prevalence, epidemiological, and clinical data related to urolithiasis in Somalia.

Methods
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic review utilized Medical Subject Headings (MeSH) on the following sites; PubMed, Web of Science, EBSCO host, EMBase, Medline, and Cochrane Libraries, using the keywords “Urolithiasis”, “Urinary stone disease”, “Urinary stones” “Renal stone” “Nephrolithiasis”, “Kidney stone”, “Ureter stone”, “Uretero-lithiasis”, “Bladder stone”, “Cystolithiasis”, and “Urethral stone” singly and in combinations terms like “Somalia”, “Somaliland”, “Puntland” and “Mogadishu” to identify relevant published studies. After removing 57 duplicate articles and those with incomplete published results, 141 articles were screened based on their abstracts and titles. Finally, only six studies were eligible to be included in the final systematic review.

Results
Of the six articles included, 14,612 patient records were reviewed for urinary stone disease prevalence, patient demographics, radiological stone characteristics, and urinary stone management. The mean patient age was 34.6. Males were predominantly affected compared to females with 65.7% and 34.3%, respectively. Adults (≥ 18 years old) accounted for 87.9% of the patients while 12.1% being children. Reported urolithiasis prevalence ranged from 8.1% to 17%. Of the 1,442 nephrolithiasis cases, 180 (14.6%) were staghorn calculi while 72.4% had a single stone and 27.6% had multiple stones. The mean stone size was 14.13 mm (± 5.96). The majority of the patients, 389 (36.8%), underwent open lithotomy. Percutaneous nephrolithotomy (PCNL) was performed in 234 (22.1%) of cases, out of which 126 (11.9%) underwent standard PCNL and 108 (10.2%) super mini PCNL (SMP). Ureteroscopic pneumatic surgery (URS) and retrograde intrarenal surgery (RIRS) were performed in 122 (11.5%) and 199 (18%) cases, respectively.

Conclusion
Somalia reported high urolithiasis prevalence. Urological centers in the capital have started using the new advanced techniques for stone management, nevertheless, open lithotomy is still predominantly utilized. No study has detailed patient demographics and stone composition has still not been reported.
Role of vascularised fibula graft in the surgical management of radiation-induced midshaft femoral fractures. Case report and literature review
Authors: Khasin Monique , Darcy Genevieve M. , Mah Eldon , Bella Claudia Di 
Published: December 2024

Abstract
Background
Post-radiation fractures (PRF) are a recognised complication of radiation treatment for soft tissue sarcomas. They have a low incidence and typically occur up to 5 years following treatment, more commonly affecting the pelvis, ribs and femur. Due to radiation-induced changes in bone, PRFs typically require more complicated intervention compared to post-trauma fractures, however, limited literature exists, particularly in regards to mid-shaft femoral PRFs. We report a case of a mid-shaft femoral PRF managed with a modified onlay free vascularised fibular grafting (FVFG).

Case presentation
A 40-year-old male with a history of left quadriceps clear cell sarcoma successfully treated with wide local excision, chemotherapy and radiotherapy 18 years prior presented with a displaced oblique pathological fracture of his left femoral shaft. He was initially treated operatively with intramedullary nailing, however, repeat imaging at the one-year post-operative review demonstrated persistent hypotrophic non-union of the fracture. 16 months following the initial fracture, the patient underwent further surgical intervention with implantation of a modified onlay FVFG to the anterior aspect of the distal femur without nail removal. One-year post-revision, the patient was pain-free with normal mobility and imaging of both the graft and fracture site demonstrated complete union.

Conclusion
Despite their operative complexity, we suggest that FVFGs should be considered for treating non-union of mid-shaft femoral PRFs due to their ability to promote healing and bone union in irradiated bone. Here we describe an original technique of a modified onlay FVFG which can be used in PRFs, and we have put this technique in the context of the current literature in FVFG.
Improved aboveground biomass estimation and regional assessment with aerial lidar in California’s subalpine forests
Authors: Winsemius Sara , Babcock Chad , Kane Van R. , Bormann Kat J. , Safford Hugh D. , Jin Yufang 
Published: December 2024

Abstract
Background
Understanding the impacts of climate change on forest aboveground biomass is a high priority for land managers. High elevation subalpine forests provide many important ecosystem services, including carbon sequestration, and are vulnerable to climate change, which has altered forest structure and disturbance regimes. Although large, regional studies have advanced aboveground biomass mapping with satellite data, typically using a general approach broadly calibrated or trained with available field data, it is unclear how well these models work in less prevalent and highly heterogeneous forest types such as the subalpine. Monitoring biomass using methods that model uncertainty at multiple scales is critical to ensure that local relationships between biomass and input variables are retained. Forest structure metrics from lidar are particularly valuable alongside field data for mapping aboveground biomass, due to their high correlation with biomass.

Results
We estimated aboveground woody biomass of live and dead trees and uncertainty at 30 m resolution in subalpine forests of the Sierra Nevada, California, from aerial lidar data in combination with a collection of field inventory data, using a Bayesian geostatistical model. The ten-fold cross-validation resulted in excellent model calibration of our subalpine-specific model (94.7% of measured plot biomass within the predicted 95% credible interval). When evaluated against two commonly referenced regional estimates based on Landsat optical imagery, root mean square error, relative standard error, and bias of our estimations were substantially lower, demonstrating the benefits of local modeling for subalpine forests. We mapped AGB over four management units in the Sierra Nevada and found variable biomass density ranging from 92.4 to 199.2 Mg/ha across these management units, highlighting the importance of high quality, local field and remote sensing data.

Conclusions
By applying a relatively new Bayesian geostatistical modeling method to a novel forest type, our study produced the most accurate and precise aboveground biomass estimates to date for Sierra Nevada subalpine forests at 30 m pixel and management unit scales. Our estimates of total aboveground biomass within the management units had low uncertainty and can be used effectively in carbon accounting and carbon trading markets.