bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mother Support Groups for Raising Awareness in the Community About Kangaroo Mother Care and Breastfeeding in the Era of COVID-19: Experiential Learning
Authors: Sameer K. , Nimbalkar Somashekhar Marutirao , Pujara Reshma , Patel Dipen 
Published: April 2024

Introduction This article explores the establishment and subsequent challenges faced by a Mother Support Group (MSG) initiated in Gujarat, India, focusing on promoting Kangaroo Mother Care (KMC) and exclusive breastfeeding, particularly amid the COVID-19 era. Methods The methodology involved adapting to COVID-19 restrictions, utilizing online platforms for training and webinars, and collaborating with ASHA workers for community outreach. The MSG members received training on breastfeeding and KMC, followed by practical demonstrations and community visits. Although initial efforts were promising, the group’s sustainability faltered when key stakeholders withdrew, revealing challenges in maintaining community-driven interventions. Results and discussion The article underscores the importance of sustained efforts in establishing and retaining parent support groups. The lack of comprehensive data collection limits the ability to evaluate specific outcomes, but we highlight the potential benefits of MSG, including improved breastfeeding practices and KMC adherence. We acknowledge the need for robust frameworks and standard operating procedures to enhance the sustainability of such initiatives, emphasizing the importance of community involvement and leadership in supporting disadvantaged newborns. Conclusion We draw attention to the complexities of sustaining grassroots initiatives and call for further research to develop effective models that address the unique needs of marginalized communities, particularly regarding the care of preterm newborns.
Half of the adolescent idiopathic scoliosis patients may have lumbar adjacent segment degeneration following spinal fusion: A systemic review and meta-analysis
Authors: Liu Fuze , Liu Fuhui , Wang Hai 
Published: April 2024

Objective This study aims to assess the impact of surgical approaches and other factors on the incidence of Adjacent Segment Degeneration (ASD) following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS). Methods We conducted a comprehensive search of four electronic databases from their inception until March 30, 2023. Two independent reviewers screened titles, abstracts, and full texts and evaluated the methodological quality of the studies. A random-effects model was used to calculate the incidence of ASD. Results Our analysis included 14 studies involving 651 individuals. The overall incidence of ASD was 47% (95%CI: 0.37, 0.56). Subgroup analyses revealed that the prevalence of ASD increased with postoperative time (53% (95%CI: 0.31, 0.75) versus 48% (95%CI: 0.36, 0.60) versus 39% (95%CI: 0.22, 0.56)). For the number of fused segments, a group with more than 10 segments had a higher prevalence (49% (95%CI: 0.38, 0.60) versus 44% (95%CI: 0.21, 0.69)). In terms of regions, East Asia had the highest prevalence, followed by Occident and West Asia (52% (95%CI: 0.41, 0.62) versus 43% (95%CI: 0.20, 0.68) versus 37% (95%CI: 0.17, 0.59)). However, the surgical approach, male ratio, and the position of the lowest instrumented vertebra (LIV) did not show significant differences between groups. Funnel plots and Egger’s test did not reveal any significant publication bias (Egger’s test: t = 1.62, p-value = .1274). Conclusion This meta-analysis found that nearly half of AIS patients following spinal fusion surgery experienced ASD. Long-term follow-up, regular screening, and timely interventions are essential to reduce the prevalence of ASD.
Robot-assisted retractor in spine surgery: Preliminary evaluation of its feasibility and two operation mode in beagles
Authors: Jiang Yuzhen , Xiang Lei , He Da , Tian Wei 
Published: April 2024

Objective To assess the feasibility of the robot-assisted retractor. To compare the muscle injury of the two operation modes, intermittent retraction mode and continuous retraction mode in the robot-assisted retractor to find a better robot operation mode. Methods A new robot-assisted retractor experimental platform was developed. Three incisions were made on the backs of three beagles. The robot-assisted retractor was used to retract the muscle on both sides of the incisions in intermittent retraction mode and continuous retraction mode, and the operation of the robot system was observed. The muscle samples were stained with hematoxylin-eosin (HE) to observe the muscle injury. The difference between the muscle injuries of the two groups was statistically compared using paired t test. Results The robot-assisted retractor can precisely retract to the specified position without malfunction or dangerous actions. Histologic evaluation showed that fewer muscle injury was found in the intermittent retraction mode group of the robot-assisted retractor compared to the continuous retraction mode group. Conclusion The robot-assisted retractor offers a certain degree of feasibility and safety. The robot-assisted retractor is able to effectively reduce muscle injury with the intermittent retraction mode.
How Can Debiasing Research Aid Efforts to Reduce Discrimination?
Authors: Axt Jordan , To Jeffrey 
Published: April 2024

Academic Abstract Understanding and reducing intergroup discrimination is at the forefront of psychological research. However, efforts to find flexible, scalable, and durable interventions to reduce discrimination have produced only mixed results. In this review, we highlight one potential avenue for developing new strategies for addressing discrimination: adapting prior research on debiasing—the process of lessening bias in judgment errors (e.g., motivated reasoning, overconfidence, and the anchoring heuristic). We first introduce a taxonomy for understanding intervention strategies that are common in the debiasing literature, then highlight existing approaches that have already proven successful for decreasing intergroup discrimination. Finally, we draw attention to promising debiasing interventions that have not yet been applied to the context of discrimination. A greater understanding of prior efforts to mitigate judgment biases more generally can expand efforts to reduce discrimination. Public Abstract Scientists studying intergroup biases are often concerned with lessening discrimination (unequal treatment of one social group versus another), but many interventions for reducing such biased behavior have weak or limited evidence. In this review article, we argue one productive avenue for reducing discrimination comes from adapting interventions in a separate field—judgment and decision-making—that has historically studied “debiasing”: the ways people can lessen the unwanted influence of irrelevant information on decision-making. While debiasing research shares several commonalities with research on reducing intergroup discrimination, many debiasing interventions have relied on methods that differ from those deployed in the intergroup bias literature. We review several instances where debiasing principles have been successfully applied toward reducing intergroup biases in behavior and introduce other debiasing techniques that may be well-suited for future efforts in lessening discrimination.
Characterization of central-involved diabetic macular edema using OCT and OCTA
Authors: Reste-Ferreira Débora , Santos Torcato , Marques Inês Pereira , Ribeiro Maria Luísa , Santos Ana Rita , Martinho António Cunha-Vaz , Lobo Conceição , Cunha-Vaz José 
Published: April 2024

Purpose To characterize the occurrence of diabetic macular edema and the presence of abnormal retinal fluid accumulation in nonproliferative diabetic retinopathy (NPDR). Methods In this two-year prospective study, a total of 122 eyes with diabetes type 2 underwent optical coherence tomography (OCT) and OCT-Angiography in association with OCT-Fluid imaging, a novel algorithm of OCT analysis allowing quantification of abnormal accumulation of fluid in the retina through low optical reflectivity ratios (LOR). Early Treatment Diabetic Retinopathy Study (ETDRS) grading for diabetic retinopathy (DR) severity assessment was performed using 7-field color fundus photography. Best corrected visual acuity was also recorded. Results During the 2-year follow-up, 23 eyes (19%) developed central-involved diabetic macular edema (CI-DME) and 2 eyes (2%) developed clinically significant macular edema (CSME). In the two-year period of the study, eyes that developed CI-DME showed a progressive increase in central retinal thickness (CRT) ( β = 7.7 ± 2.1 µm/year, p < 0.001) and in LOR values ( β = 0.009 ± 0.004 ratio/year, p = 0.027). The increase in CRT and abnormal retinal fluid, represented by increased LOR ratios, are associated with increased retinal perfusion in the deep capillary plexus (DCP) (skeletonized vessel density, p = 0.039). In contrast, the eyes with CSME showed decreased retinal perfusion and abnormal fluid located in the outer layers of the retina. Conclusions CI-DME and CSME appear to represent different entities. Eyes with CI-DME show increases in abnormal retinal fluid associated with increased retinal vascular perfusion in the DCP. Eyes with CSME are apparently associated with decreased retinal vascular perfusion in the DCP and abnormal fluid in the outer retina.
Atypical case of choroidal osteoma associated to polypoidal choroidal vasculopathy and preretinal neovascular membrane
Authors: Ben Brahem Mohamed , EL MATRI Khaled , Fafloul Yousra , Chebbi Amel , Fekih Olfa , Nacef Leila , EL MATRI Leila 
Published: April 2024

Purpose To report a very rare and atypical case of an elderly Caucasian female patient who developed perilesional multiple polypoidal choroidal vasculopathy (PCV) as a probable complication of choroidal osteoma (CO), associated to preretinal neovascular membrane overlying the lesion. Methods Observational case report. Case observation A 60-year-old Caucasian woman presented with blurred vision in her right eye (RE). Fundus examination revealed a round white-yellowish calcified deep lesion in the juxta-papillary superior area, measuring 4 disc-diameters, with well-defined scalloped margins and an irregular surface. B-scan ultrasonography and orbital tomography confirmed the diagnosis of choroidal osteoma (CO). Further investigation with multimodal imaging including infracyanine green angiography, fluorescein angiography, swept source optical coherence tomography and angiography highlighted the presence of multiple aneurysmal choroidal dilations around the CO, corresponding to PCV. We also noted the presence of a preretinal neovascular membrane overlying the CO. The patient was monitored with regular follow-up since no signs of activity were detected on multimodal imaging. Conclusion Our case report represents an exceptional and atypical association between pre-retinal neovascularization, PCV and choroidal osteoma. While the mechanisms underlying the development of PCV and pre-retinal neovascularization in the setting of CO are not well understood, it is imperative for ophthalmologists to recognize this association as a potential cause of sudden vision loss in patients with CO, and to consider appropriate diagnostic and management strategies.
Optic chiasm involvement in multiple sclerosis, aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein–associated disease
Authors: Bianchi Alessia , Cortese Rosa , Prados Ferran , Tur Carmen , Kanber Baris , Yiannakas Marios C , Samson Rebecca , De Angelis Floriana , Magnollay Lise , Jacob Anu , Brownlee Wallace , Trip Anand , Nicholas Richard , Hacohen Yael , Barkhof Frederik , Ciccarelli Olga , Toosy Ahmed T 
Published: April 2024

Background: Optic neuritis (ON) is a common feature of inflammatory demyelinating diseases (IDDs) such as multiple sclerosis (MS), aquaporin 4-antibody neuromyelitis optica spectrum disorder (AQP4 + NMOSD) and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD). However, the involvement of the optic chiasm (OC) in IDD has not been fully investigated. Aims: To examine OC differences in non-acute IDD patients with (ON+) and without ON (ON−) using magnetisation transfer ratio (MTR), to compare differences between MS, AQP4 + NMOSD and MOGAD and understand their associations with other neuro-ophthalmological markers. Methods: Twenty-eight relapsing-remitting multiple sclerosis (RRMS), 24 AQP4 + NMOSD, 28 MOGAD patients and 32 healthy controls (HCs) underwent clinical evaluation, MRI and optical coherence tomography (OCT) scan. Multivariable linear regression models were applied. Results: ON + IDD patients showed lower OC MTR than HCs (28.87 ± 4.58 vs 31.65 ± 4.93; p = 0.004). When compared with HCs, lower OC MTR was found in ON + AQP4 + NMOSD (28.55 ± 4.18 vs 31.65 ± 4.93; p = 0.020) and MOGAD (28.73 ± 4.99 vs 31.65 ± 4.93; p = 0.007) and in ON− AQP4 + NMOSD (28.37 ± 7.27 vs 31.65 ± 4.93; p = 0.035). ON+ RRMS had lower MTR than ON− RRMS (28.87 ± 4.58 vs 30.99 ± 4.76; p = 0.038). Lower OC MTR was associated with higher number of ON (regression coefficient (RC) = −1.15, 95% confidence interval (CI) = −1.819 to −0.490, p = 0.001), worse visual acuity (RC = −0.026, 95% CI = −0.041 to −0.011, p = 0.001) and lower peripapillary retinal nerve fibre layer (pRNFL) thickness (RC = 1.129, 95% CI = 0.199 to 2.059, p = 0.018) when considering the whole IDD group. Conclusion: OC microstructural damage indicates prior ON in IDD and is linked to reduced vision and thinner pRNFL.
The role of increasing synchronous telehealth use during the COVID-19 pandemic on disparities in access to healthcare: A systematic review
Authors: Ternes Sara , Lavin Lauren , Vakkalanka J Priyanka , Healy Heather S , Merchant Kimberly AS , Ward Marcia M , Mohr Nicholas M 
Published: April 2024

Introduction The COVID-19 public health emergency led to an unprecedented rapid increase in telehealth use, but the role of telehealth in reducing disparities in access to care has been questioned. The objective of this study was to conduct a systematic review to summarize the available evidence on how telehealth during the COVID-19 pandemic was associated with telehealth utilization for minority groups and its role in health disparities. Methods We conducted a systematic review focused on health equity and access to care by searching for interventional and observational studies using the following four search domains: telehealth, COVID-19, health equity, and access to care. We searched PubMed, Embase, Cochrane CENTRAL, CINAHL, telehealth.hhs.gov, and the Rural Health Research Gateway, and included any study that reported quantitative results with a control group. Results Our initial search yielded 1970 studies, and we included 48 in our final review. The most common dimensions of health equity studied were race/ethnicity, rurality, insurance status, language, and socioeconomic status, and the telehealth applications studied were diverse. Included studies had a moderate risk of bias. In aggregate, most studies reported increased telehealth use during the pandemic, with the greatest increase in non-minority populations, including White, younger, English-speaking people from urban areas. Discussion We found that despite rapid adoption and increased telehealth use during the public health emergency, telehealth did not reduce existing disparities in access to care. We recommend that future work measuring the impact of telehealth focus on equity so that features of telehealth innovation can reduce disparities in health outcomes.
Retrocarotid dissection technique compared to the caudocranial approach for the surgical treatment of carotid body tumors: A 15-year experience
Authors: Bobadilla-Rosado Luis O , Anaya-Ayala Javier E , Santos-Chavez Eros , Mier y Teran-Ellis Santiago , Bonilla-Salas Aliberth , Rivas-Redonda Kenia , Gomez-Serafin Xandra , Laparra-Escareno Hugo , Mendez-Dominguez Nina , Hinojosa Carlos A 
Published: April 2024

Introduction: Carotid body tumors are rare neoplasms with malignant potential. We aim to follow up on our initial experience published in 2015 and compare the occurrence of complications and postoperative outcomes with the use of retrocarotid dissection (RCD) against the standard caudocranial (SCCD) technique. Methods: This was an observational, case–control study in which we analyzed all of the carotid body tumor resections performed from 1986 to 2022. Parametric and nonparametric tests were used accordingly. Statistical analysis was performed on Stata 17. Results: A total of 181 surgical procedures were included, mean age was 56 years (± 13.63), and 168 (93%) were performed in women. The mean medio-lateral diameter was larger in the RCD group (2.85 ± 1.57 cm vs 1.93 ±1.85 cm; p = 0.002) and presurgical embolization was more frequently performed in the SCCD group (27.5% vs 0.7%; p < 0.001). A total of 40 (22.09%) resections were performed using the SCCD technique. In contrast, in 141 (77.91%) procedures the RCD technique was used. The mean surgical time in the RCD group was lower (197.37 ± 70.56 min vs 232 ± 98.34 min; p = 0.01). No statistically significant difference was found between SCCD and RCD in terms of vascular lesions ( n = 20 [11.04%], 15% vs 9%, respectively; p = 0.36), transient or permanent nerve injuries (25% vs 33%, respectively; p = 0.31), or mean intraoperative bleeding (SCCD: 689.95 ± 680.05 mL vs RCD: 619.64 ± 837.94 mL; p > 0.05). Conclusions: RCD appears to be a safe and equivalent alternative to the standard caudocranial approach in terms of intraoperative bleeding or vascular lesions, with a sustained, significant decrease in surgical time.
Spinal tumor embolization with Onyx: A systematic review and meta-analysis
Authors: Batista Savio , Fim Andreão Filipi , Sousa Marcelo Porto , Oliveira Leonardo de Barros , Palavani Lucca Biolcati , Melo Silva Guilherme , de Abreu Livia V , Bertani Raphael , Gomes Quadros Danilo 
Published: April 2024

Introduction Onyx embolization has emerged as a promising technique for spinal tumor embolization due to its high devascularization rate and low incidence of complications. Objective Evaluate the safety and efficacy of Onyx embolization in spinal tumor procedures. Methods Following the PRISMA guidelines, we conducted a systematic review and meta-analysis. To be included, the articles had to report specific outcomes of Onyx embolization for spinal tumors (complications, mortality, blood loss, tumor devascularization, or reduction in tumor blush). Results We selected 11 out of 2941 articles, encompassing 127 patients. Among them, no major complications or persistent neurological deficits were reported, and no deaths occurred as a result of the embolization procedure. Of the 63 patients with available data, two complications were observed: one infarct leading to transient neurological deficit and one clinically silent vessel perforation related to the microcatheter. Thus, the complication rate was 1% (95% confidence interval (CI): 0% to 6%). Blood loss during surgery ranged from 100 to 1500 mL (four studies). Complete tumor blush reduction was achieved in 52% of the cases (95% CI: 16% to 88%) across 32 patients. Three studies reported a median percentage of tumor devascularization of 91% (86.1% to 97.5%). Conclusion Onyx embolization for spinal tumor procedures appears to be a safe technique, as evidenced by the absence of major complications or deaths. However, the determination of its efficacy remains challenging due to limited data availability and substantial heterogeneity across studies. These findings highlight the need for future research to address this knowledge gap and further validate our results.
How is range of motion of the fingers measured in hand therapy practice? A survey study
Authors: Kadakia Zeal , VanderKaay Sandra , Kuspinar Ayse , Packham Tara 
Published: April 2024

Introduction A variety of techniques for measuring finger range of motion (ROM) are available for hand therapist use, however, there is no clear description of which finger ROM methods are preferred in practice. This study explored the preferred measurement techniques, the factors influencing clinical decision-making, and the clinical reasoning processes employed when faced with practice-based measurement scenarios. Methods This was a cross-sectional online survey study of hand therapists and American or Canadian Society of Hand Therapists members. Quantitative methods were employed for participant demographics and categorical clinical questions about practice patterns. Qualitative descriptive questions and vignettes were analysed using inductive and deductive content analysis, respectively. Results Four hundred and eighty-one responses were included, representing hand therapists with a median age of 51 years and median experience of 19 years. Participants preferred measuring individual joints with a goniometer ( N = 210, 44%) for perceived utility in informing treatment decisions, reliability, and confidence in measurement skills. Participants also preferred active functional ROM ( N = 117, 24%) for being quick, easy, and useful in informing treatment decisions. Participants reported using different methods with time constraints in a busy clinic, taking precautions with pins/wounds, bulky dressings/casts, pain tolerance levels of patients, or with specific pathologies. Participants’ responses to the multi-stage vignette identified distinct patterns of clinical reasoning approaches within individual vignettes. Conclusions Hand therapists use multiple methods to measure finger ROM while preferring to use goniometers to measure individual finger joints. They engage procedural and pragmatic reasoning modified by contextual factors when measuring finger ROM.
Predictors of Subjective Olfactory Dysfunction and Sinonasal Quality-of-Life After Endoscopic Transsphenoidal Pituitary Surgery
Authors: Naimi Bita R. , Farquhar Douglas , Duffy Alexander N. , Garvey Emily A. , Kelly Patrick , Kahn Chase , Doshi Riyana , Shah Riya , Rabinowitz Mindy R. , Toskala Elina , Rosen Marc , Evans James J. , Nyquist Gurston G. 
Published: April 2024

Background This is the largest study in North America investigating olfactory outcomes after pituitary surgery to date. Objective Characterize factors associated with subjective olfactory dysfunction (OD) and worsened sinonasal quality-of-life (QOL) after endoscopic TSA. Methods Patients undergoing primary TSA for secreting and non-secreting pituitary adenomas between 2017 and 2021 with pre- and post-operative SNOT-22 scores were included. Subjective OD was determined by the smell/taste dysfunction question on the SNOT-22 (smell-SNOT). Results 159 patients with pre- and post-operative SNOT-22 scores were included. Average total SNOT-22 scores worsened from pre-operative (16.91 ± 16.91) to POM1 (25.15 ± 20.83, P < .001), with no difference from pre-operative (16.40 ± 15.88) to POM6 (16.27 ± 17.92, P = .936) or pre-operative (13.63 ± 13.54) to POM12 (12.60 ± 16.45, P = .651). Average smell-SNOT scores worsened from pre-operative (0.40 ± 1.27) to POM1 (2.09 ± 2.01, P < .001), and pre-operative (0.46 ± 1.29) to POM6 (1.13 ± 2.45, P = .002), with no difference from pre-operative (0.40 ± 1.07) to POM12 (0.71 ± 1.32, P = .100). Female gender had a 0.9-point (95% CI 0.1 to 1.6) P = .021, increase in smell-SNOT at POM1, resolving by POM6 (0.1 [−0.9 to 1.1], P = .800) and POM12 (0.0 [−1.0 to 0.9], P = .942). Septoplasty with tunnel approach had a 1.1 [0.2 to 2.0] out of 5-point ( P = .023) increase in smell-SNOT at POM1, resolving by POM6 (0.2 [−1.1 to 1.6], P = .764) and POM12 (0.4 [−0.9 to 1.6], P = .567). Female gender had a 9.5 (4.0 to 15.1)-point ( P = .001) increase in SNOT-22 scores at POM1, resolving by POM6 (3.4 [−3.0 to 9.8], P = .292) and POM12 (6.4 [−5.4 to 18.2], P = .276). Intra-operative CSF leak had an 8.6 [2.1 to 15.1]-point ( P = .009) increase in SNOT-22 scores at POM1, resolving by POM6 (5.4 [−1.7 to 12.5], P = .135), and POM12 (1.1 [−12.9 to 15.1], P = .873). Conclusion Changes in subjective olfaction and sinonasal QOL after TSA may be associated with gender, operative approach, and intra-operative CSF leak, resolving 6-12 months post-operatively.