bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autoimmune GFAP Astrocytopathy—Beyond the Known Horizon, India’s First Multifaceted Institutional Experience
Authors: Ahmed Safwan , K. Vimala Christina Colaco , Kannoth Sudheeran , Raeesa Fathima , Misri Zulkifli , Mascarenhas Don G. , Nair Sindhu 
Published: April 2024

Background: Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is an immune-mediated inflammatory disease of the central nervous system, the clinical phenotype of which includes meningoencephalitis, myelitis, optic neuritis, seizures, movement disorders, autonomic dysfunction among others, affecting people across all ages. Due to its recent discovery, there is a paucity of literature on this topic and an absolute lack of Indian case series. Purpose: This study aims to shed light on the variable presentations of anti-GFAP astrocytopathy and review the existing literature on the topic. Methods: This was a retrospective study that included all patients who tested positive in the cerebrospinal fluid(CSF) and/or serum for GFAP immunoglobulin G between February 2023 and August 2023, after obtaining ethical clearance. Relevant clinical, demographic data was collected from the electronic medical records. A descriptive analysis of data was done and the current available literature was reviewed. Results: Our case series included four patients (F:M::3:1) with a median age of 28 years at symptom onset. Two of the cases had a relapsing-remitting disease pattern, while the other two had monophasic illnesses. The clinical spectrum we encountered included ataxia, tremors, myoclonus, seizures, recurrent myelitis, brain stem syndromes, autonomic dysfunction and psychiatric manifestations. All four patients responded remarkably to steroids and two patients are on rituximab therapy. Conclusion: Autoimmune GFAP astrocytopathy encompasses an expanding clinical spectrum and should be considered in the context of myelitis, optic neuritis, ataxia, papillitis, seizures, autonomic dysfunction and movement disorders occurring in isolation or more commonly in varying combinations. Our case series, the first in India, shows a favourable clinical profile and the primary hurdle encountered in all four cases was to establish a diagnosis, further stressing the need for a predictive diagnostic algorithm.
Alterations in Sphenoid Anatomy in Craniosynostosis: Implications for Fronto-Orbital Advancement
Authors: Santiago Gaia , Santiago Chiara , Nguyen Alvin , Choudhary Akriti , Zhao Linping , Alkureishi Lee W.T. , Patel Pravin K. , Purnell Chad A. 
Published: April 2024

Objective Fronto-orbital advancement involves removal of the fronto-orbital bandeau. Visualization of the saw blade is lost as it passes through the fronto-orbital-sphenoid junction (FOSJ), placing the temporal lobe at risk of injury. We aim to provide a 3D analysis of the space surrounding this osteotomy to differentiate various types of craniosynostoses. Design Retrospective cohort Setting Institutional. Patients Thirty patients with isolated unicoronal synostosis, nonsyndromic bicoronal synostosis, metopic synostosis, Apert syndrome, Crouzon syndrome, and Muenke syndrome. Interventions CT scans conducted between 2 months to 2 years of age were 3D reconstructed to compare craniometrics against normal controls. Main Outcome Measure(s) Craniometrics. Results The mean bone thickness of the FOSJ at the level of the supraorbital rim was significantly small for the Apert, unicoronal and bicoronal groups. The mean vertical height of the middle cranial fossa from the lesser sphenoid wing was significantly greater in the unicoronal group. The mean vertical height of the tip of the temporal lobe from the lateral sphenoid ridge was greater in the unicoronal, isolated bicoronal, and Apert groups. The mean corneal protrusion beyond the lateral orbital rim was significantly greater in the Apert and unicoronal groups. The mean horizontal depth of the orbit was smallest in the Apert group. The mean vertical distance between the dacryon and the foramen cecum, and the mean volume of temporal lobe beneath the sphenoid shelf were the largest in the Apert group. Conclusions Patients with Apert syndrome have the most unfavorable morphology of the anterior and middle cranial fossae.
Factors associated with informal and formal help-seeking among Asian adolescents with nonsuicidal self-injury
Authors: Hiew Yvette , Powell Nina Laurel , Wong Qiu Yan , Fong Zhi Hui , Fong Ying Jie , Chee Tji Tjian 
Published: April 2024

Although nonsuicidal self-injury (NSSI) is prevalent among adolescents and is associated with an increased risk of adverse outcomes, many adolescents with NSSI do not seek help. However, there is a lack of research on the factors that may increase the likelihood of help-seeking, especially within Asia. To address this gap, the present study examined whether certain factors were associated with informal and formal help-seeking – specifically gender, severity of NSSI, functions of NSSI and authoritative parenting. 121 adolescents ( Mage = 16.2 years, 71.1% female) were recruited from specialist outpatient clinics and inpatient psychiatric wards from a public hospital in Singapore. One caregiver per adolescent was also recruited. Data from self-report questionnaires were analysed using logistics regression analyses. The results suggest that the severity of NSSI increases the likelihood of informal help-seeking, while adolescents who have parents with more authoritative parenting style are less likely to seek informal help. Gender and functions of NSSI were not found to be associated with help-seeking. The findings from this study can guide professionals in their efforts to encourage help-seeking within Asian populations, as well as inform prevention and treatment programs for Asian adolescents with NSSI.
Translanguaging practices in a community-based Chinese heritage early childhood classroom
Authors: Cun Aijuan 
Published: April 2024

Aims and objectives: The purpose of this study is to explore translanguaging in a heritage classroom by asking the following central questions: (1) What translanguaging practices were available in an online community-based Chinese heritage language classroom? (2) How did the Chinese language teacher use these practices? (3) Why did the teacher use translanguaging? (4) How were the young heritage language learners involved in these practices? Methodology: A qualitative case study research design is utilized to explore translanguaging practices in the classroom. Data and analysis: The data sources included fieldnotes during observations, video recordings of class conversations, and artifacts made or provided by the participants. All the data were collected virtually via Zoom. Findings: The findings show that the teacher purposefully engaged the children in understanding vocabulary words through translanguaging and that students participated in class conversations in various ways, including initiating questions and connecting to their personal experiences. The findings also present the teacher’s perspectives on translanguaging practices. Originality: The literature has explored translanguaging practices, but limited research has focused on these practices in community-based Chinese heritage early childhood classrooms. This study describes the specific ways that a teacher created opportunities for bilingual children to engage in translanguaging practices in a Chinese heritage classroom. Implications: While research on translanguaging and children’s heritage language learning in home and school contexts has existed for decades, the findings of this study bring new attention to translanguaging practices in Chinese heritage language classrooms. The study provided an example of a pedagogical model for teachers to reconsider Chinese heritage language education and promote bilingual children’s language learning and identity construction.
Transcatheter Aortic Valve Replacement and Coronary Protection Guided by Deep Learning and 3-Dimensional Printing
Authors: Mao Yu , Zhu Guangyu , Zhai Mengen , Ma Yanyan , Li Lanlan , Jin Ping , Liu Yang , Yang Jian 
Published: April 2024

Objective In this case report, the auxiliary role of deep learning and 3-dimensional printing technology in the perioperative period was discussed to guide transcatheter aortic valve replacement and coronary stent implantation simultaneously. Case presentation A 68-year-old man had shortness of breath and chest tightness, accompanied by paroxysmal nocturnal dyspnea, 2 weeks before presenting at our hospital. Echocardiography results obtained in the outpatient department showed severe aortic stenosis combined with regurgitation and pleural effusion. The patient was first treated with closed thoracic drainage. After 800 mL of pleural effusion was collected, the patient’s symptoms were relieved and he was admitted to the hospital. Preoperative transthoracic echocardiography showed severe bicuspid aortic valve stenosis combined with calcification and aortic regurgitation (mean pressure gradient, 42 mmHg). Preoperative computed tomography results showed a type I bicuspid aortic valve with severe eccentric calcification. The leaflet could be seen from the left coronary artery plane, which indicated an extremely high possibility of coronary obstruction. After preoperative imaging assessment, deep learning and 3-dimensional printing technology were used for evaluation and simulation. Guided transcatheter aortic valve replacement and a coronary stent implant were completed successfully. Postoperative digital subtraction angiography showed that the bioprosthesis and the chimney coronary stent were in ideal positions. Transesophageal echocardiography showed normal morphology without paravalvular regurgitation. Conclusion The perioperative guidance of deep learning and 3-dimensional printing are of great help for surgical strategy formulation in patients with severe bicuspid aortic valve stenosis with calcification and high-risk coronary obstruction.
Screw Position Following Percutaneous Versus Mini-Open Intramedullary Retrograde Screw Fixation of Metacarpal Fractures
Authors: Kwan Stephanie A. , Moncman Tara Gaston , Sodha Samir , Jones Christopher , Matzon Jonas L. , Rivlin Michael 
Published: April 2024

Background: Metacarpal fracture fixation using the retrograde intramedullary screw technique can be performed through two different approaches. The mini-open approach requires greater soft tissue dissection but allows for direct visualization of the metacarpal head compared with the percutaneous approach. Our aim was to determine which approach resulted in optimal screw position. Methods: Eighty-one consecutive patients that underwent intramedullary screw fixation for metacarpal fractures from 2016 to 2021 were identified. Patients were treated by 4 fellowship-trained orthopedic hand surgeons who employed the mini-open or percutaneous approach. Postoperative radiographs were reviewed for screw position. Results: A total of 81 patients (41 mini-open, 40 percutaneous) were included in this study. There were no significant differences between the two groups in age, sex, hand dominance, or affected digit. Postoperative screw position at first postoperative visit was not significantly different between the two groups on anteroposterior or lateral radiographs. Conclusion: Postoperative screw position is not significantly different between the mini-open and percutaneous approaches for intramedullary screw fixation of metacarpal fractures. Level of Evidence: Level III, therapeutic.
Auditory Changes in Occupational Health Associated With Metabolic Diseases in Adult Workers
Authors: Barcelos Francine Varlete Leopoldina , Paiva Karina Mary de , Machado Marco José , Haas Patrícia 
Published: April 2024

Introduction: The most common hearing losses in the population are associated with genetic conditions, use of ototoxic substances or medications, infectious diseases, metabolic diseases and chronic ear diseases and the association of exposure to occupational risks or the natural aging process. Objective: Verify the association between hearing loss in workers and metabolic diseases. Method: Retrospective cross-sectional study with analysis of secondary data of subjects exposed to occupational noise and undergoing drug treatment for metabolic disease, attended in two occupational health clinics (C1 and C2) from January 2020 to December 2022, considering the data of reference examinations from the year 2005. Results: Of the n = 97 subjects evaluated, 73.20% were male, exposed to occupational noise (64.90%), with medication use for treating cardiovascular diseases (89.70%). The most recurrent auditory complaint was tinnitus (28.90%), n = 53 subjects presented sensorineural hearing loss with a statistical association between the decline of hearing loss and medications used for metabolic and hormonal regulation. Conclusion: Here was a higher frequency in the use of medications for treating cardiovascular diseases with a risk of triggering or worsening hearing loss in these subjects and greater impairment and decline of hearing thresholds were observed in the results of C2.
Effect of gait speed on clinical outcomes after crural and pedal bypass in patients with chronic limb-threatening ischemia
Authors: Kobayashi Taira , Hamamoto Masaki , Okazaki Takanobu , Okusako Ryo , Hasegawa Misa , Honma Tomoaki , Iba Kazutoshi , Nishitani Yoshiko , Takahashi Shinya 
Published: April 2024

Objectives Many factors affect long-term outcomes after open bypass in patients with chronic limb-threatening ischemia (CLTI). Ambulatory status has been suggested to be associated with clinical outcomes, but there is limited knowledge on the effect of gait speed on outcomes. The purpose of this study is to evaluate the effect of gait speed assessed in a 6-min walk test (6MWT) on outcomes after crural and pedal bypass in patients with CLTI. Methods A retrospective analysis was performed in patients with CLTI who underwent a 6MWT at 1 month after crural and pedal bypass at a single center from 2014 to 2021. Comparisons were made between those with high gait speed (HG group, 6-min walk distance (6MWD) > 288 m) and those with low gait speed (LG group, 6MWD ≤288 m). The primary endpoint was survival, and the secondary endpoints were graft patency, limb salvage, wound healing, major adverse cardiovascular events (MACEs), and hospital outcomes. Results Of 104 patients with CLTI who underwent a 6MWT after crural and pedal bypass, 46 (44%) and 58 (56%) were placed in the HG and LG groups, respectively. The LG group was older ( p < .001), had more female subjects ( p = .006), and had a higher prevalence of cerebrovascular disease ( p = .042) and tissue loss ( p = .007). The median follow-up was 36 (22–57) months. The HG group had significantly higher 3-year primary patency (65% vs 42%, p = .013), 3-year secondary patency (87% vs 66%, p = .018), 3-year overall survival (89% vs 58%, p < .001), and 3-year freedom from MACE (79% vs 67%, p = .039). The 3-year limb salvage and 12-month wound healing rates did not differ between the groups. Conclusions Gait speed in patients with CLTI after crural and pedal bypass was associated with survival, freedom from MACE, and graft patency but not with limb salvage and wound healing. A detailed study of walking ability in these patients may be needed in the future.
Augmented Stress Weight-bearing CT for Evaluation of Subtle Lisfranc Injuries in the Elite Athlete
Authors: Campbell Tanner , Mok Anthony , Wolf Megan R. , Frager Luke , Long Rachel , Wentzel Dylan , Tarakemeh Armin , Morey Tucker , Everist Brian , Vopat Bryan G. 
Published: April 2024

Background Lisfranc injuries refer to a disruption or displacement of the tarsometatarsal joint of the foot. Subtle Lisfranc injuries can go undiagnosed on conventional imaging leading to devastating consequences and poor functional outcomes for elite athletes. Objective. The objective of this case study is to present a novel imaging technique using weight-bearing computed tomography (CT) with enhanced stress to identify subtle, dynamically unstable Lisfranc injuries. We illustrate this with a case presentation of an elite athlete who ultimately required surgical fixation for a subtle Lisfranc injury. Materials and Methods To perform an augmented stress weight-bearing CT, the patient was positioned standing, with their feet facing forward, and weight equally distributed. The patient was then coached to symmetrically raise both heels from the scanner platform. This plantarflexion provided augmented stress on the midfoot, allowing for more sensitive imaging of the Lisfranc injury. The weight-bearing CT and augmented stress images undergo 3D reconstruction and postprocessing to render coronal and sagittal images, allowing for comparison of the standard weight-bearing and augmented stress images. Results We present the case of a 22-year-old collegiate football lineman sustaining a Lisfranc injury. The injury diagnosis was made by magnetic resonance imaging (MRI) and clinical examination, without evidence of injury on weight-bearing XR or standard weight-bearing CT. With augmented stress CT imaging, the Lisfranc instability was noted, leading to surgical fixation, and return to sport the next season. Conclusion We propose this technique for diagnosing subtle, unstable Lisfranc injuries where clinical suspicion persists despite inconclusive imaging, particularly in elite athletes. Further research is needed with larger sample sizes to investigate the sensitivity of this novel imaging technique for the detection of Lisfranc injury. Levels of Evidence: Level 4: Case Report
Perceptions and effectiveness of episodic future thinking as digital micro-interventions based on mobile health technology
Authors: Persson Dan Roland , Bardram Jakob E. , Bækgaard Per 
Published: April 2024

Objective Delay discounting denotes the tendency for humans to favor short-term immediate benefits over long-term future benefits. Episodic future thinking (EFT) is an intervention that addresses this tendency by having a person mentally “pre-experience” a future event to increase the perceived value of future benefits. This study explores the feasibility of using mobile health (mHealth) technology to deliver EFT micro-interventions. Micro-interventions are small, focused interventions aiming to achieve goals while matching users’ often limited willingness or capacity to engage with interventions. We aim to explore whether EFT delivered as digital micro-interventions can reduce delay discounting, the users’ perceptions, and if there are differences between regular EFT and goal-oriented EFT (gEFT), a variant where goals are embedded into future events. Method A randomized study was conducted with 208 participants allocated to either gEFT, EFT, or a control group for a 21-day study. Results Results indicate intervention groups when combined achieved a significant reduction of [Formula: see text] in delay discounting ([Formula: see text]) compared to the control. When split into gEFT and EFT separately only the reduction of [Formula: see text] in EFT delay discounting was significant ([Formula: see text]). We further explore and discuss thematic user perceptions. Conclusions Overall, user perceptions indicate gEFT may be slightly better for use in micro-interventions. However, perceptions also indicate that audio-based EFT micro-interventions were not always preferable to users, with findings suggesting that future EFT micro-interventions should be delivered using different forms of multimedia based on user preference and context and supported by other micro-interventions to maintain interest.
Return to Sports and Clinical Results After All-Arthroscopic Biceps Tenodesis Using a 2.7-mm Knotless PEEK Suture Anchor
Authors: Bischofreiter Martin , Gattringer Michael , Gruber Michael S. , Kindermann Harald , Himmelstoss Paul , Ortmaier Reinhold , Mattiassich Georg 
Published: April 2024

Background: The long head of the biceps tendon (LHBT) is a well-known source of pain in the shoulder, especially in active patients. Purpose: To evaluate the outcomes and return-to-sports rate after all-arthroscopic suprapectoral tenodesis of the LHBT using a small knotless anchor. Study Design: Case series; Level of evidence, 4. Methods: In this retrospective study, 27 patients—who underwent all-arthroscopic tenodesis of the LHBT using a 2.7-mm knotless polyether ether ketone anchor—were evaluated. Sports activities, the return-to-sports rate, and other sports-related parameters (eg, pain during sports, level of sports) were examined. Sports-related data, the Constant score with isometric force (at 90° of abduction in the scapular plane), the American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST) score, the visual analog scale (VAS) score for satisfaction, range of motion, and the presence of a Popeye deformity were assessed at a mean follow-up of 15.3 ± 8.7 months. The data were initially analyzed using descriptive statistics. Results: The postoperative ASES, Constant, and SST scores were 81.61, 85.74 and 8.85, respectively. Of the 27 patients, 4 patients (14.8%) showed a Popeye deformity. Preoperatively, 25 patients (92.6%) participated regularly in some type of sports activity. All 25 patients (100.0%) were able to return to sports activities after surgery. 24 (96.0%) returned to the same level preoperatively, with 88.0% (22/25) within 6 months. Patient satisfaction with the outcome was high (VAS score: 2.15 ± 2.78). Neither bicipital groove pain nor cramping was reported. There were no signs of osteolytic bone around the anchor or a fracture of the humeral bone. Conclusion: Our clinical results after using a 2.7-mm knotless anchor for LHBT tenodesis as well as the return-to-sports rate were satisfying. Using an anchor this size can lower the risk of cortical bone damage and therefore the risk of fractures of the humeral head while still enabling patients to perform at a high level.
Analysis of the Most Popular Online Ankle Fracture–Related Patient Education Materials
Authors: Arif Haad A. , LeBrun Gavin , Moore Simon T. , Friscia David A. 
Published: April 2024

Background: Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. Methods: After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI). Results: A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an “acceptable” quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. Conclusion: We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.