bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oral Bullous Lichen Planus – A Case Report
Authors: Islam Md Shahidul , Islam Nahida , Sharmeen Atia 
Published: January 2024

Oral bullous lichen planus (BLP) is a rare and challenging variant of lichen planus affecting the oral mucosa. A 40-year-old female patient was diagnosed with Bullous lichen planus and treated with hydroxychloroquin, triamcinolone acetonide, levamisole, prednisolone and benzydamine oral rinse. Her main complaint was a burning feeling in her mouth that was linked to generalised pruritis, and skin lesions. The patient has not had any lesions during their year-long follow-up. The incidence of oral bullous lichen planus and its treatment are still poorly understood in Bangladesh. With regard to our local context, this report seeks to advance knowledge of this condition.
CBMJ 2024 January: vol. 13 no. 01 P: 98-101
An Augmented Reality Hand–Eye Sensorimotor Impairment Assessment for Spaceflight Operations
Authors: Allred Aaron R. , Weiss Hannah , Clark Torin K. , Stirling Leia 
Published: January 2024

INTRODUCTION: Following a transition from microgravity to a gravity-rich environment (e.g., Earth, Moon, or Mars), astronauts experience sensorimotor impairment, primarily from a reinterpretation of vestibular cues, which can impact their ability to perform mission-critical tasks. To enable future exploration-class missions, the development of lightweight, space-conscious assessments for astronauts transitioning between gravity environments without expert assistance is needed.
METHODS: We examined differences in performance during a two-dimensional (2D) hand–eye multidirectional tapping task, implemented in augmented reality in subjects (N = 20) with and without the presence of a vestibular-dominated sensorimotor impairment paradigm: the binaural bipolar application of a pseudorandom galvanic vestibular stimulation (GVS) signal. Metrics associated with both the impairment paradigm and task performance were assessed.
RESULTS: Medial-lateral sway during balance on an anterior-posterior sway-referenced platform with eyes closed was most affected by GVS (effect size: 1.2), in addition to anterior-posterior sway (effect size: 0.63) and the vestibular index (effect size: 0.65). During the augmented reality task, an increase in time to completion (effect size: 0.63), number of misses (effect size: 0.52), and head linear accelerations (effect size: 0.30) were found in the presence of the selected GVS waveform.
DISCUSSION: Findings indicate that this multidirectional tapping task may detect emergent vestibular-dominated impairment (near landing day performance) in astronauts. Decrements in speed and accuracy indicate this impairment may hinder crews’ ability to acquire known target locations while in a static standing posture. The ability to track these decrements can support mission operations decisions.
Allred AR, Weiss H, Clark TK, Stirling L. An augmented reality hand–eye sensorimotor impairment assessment for spaceflight operations. Aerosp Med Hum Perform. 2024; 95(2):69–78.
Heart Rate Variability as a Predictor of +Gz Tolerance During the High-G Selective Test
Authors: Bacevic Nenad , Ninkovic Milica , Drvendzija Milijana , Vidakovic Jelena , Bacevic Marina , Stepanic Pavle 
Published: January 2024

INTRODUCTION: Preselection of pilot candidates in the military is critical and determines the quality of subsequent selection. The Aero Medical Institute in Belgrade uses the following centrifuge endpoints: peripheral vision loss, heart rate above 180 bpm, cardiac arrhythmias, and G-induced loss of consciousness to assess relaxed +Gz tolerance. The aim of this study was to evaluate heart rate variability (HRV) associated with cardiovascular adaptability to different types of stress as a predictor of +Gz tolerance.
METHODS: Thirty-six candidates were exposed to centrifuge runs, consisting of the following +Gz-acceleration phases: a 2-G plateau followed by an increase to 5.5 G, a decrease to 2 G, and ending with a plateau. Time-domain HRV indices were calculated for candidates, for a 60-s 2-G plateau, and for the entire test. The correlation was made between the groups that did (Group 1) and did not meet the criteria (Group 2).
RESULTS: The results show significantly lower values in all time domain HRV indices, namely standard deviation of the normal-to-normal interval (SDNN) and root mean square of successive differences, in Group 2. Mean SDNN values were 45.98 ± 24.80 ms (2-G plateau) and 109.99 ± 39.64 ms (entire test) in Group 1, while the SDNN were 22.99 ± 12.04 ms and 69.70 ± 33.45 ms in Group 2. Root mean square of successive differences was higher in Group 1 for the 2-G plateau and for the entire test.
DISCUSSION: The results suggest that HRV is positively correlated with +Gz-tolerance and can be used as an additional selection tool for military aircrew.
Bacevic N, Ninkovic M, Drvendzija M, Vidakovic J, Bacevic M, Stepanic P. Heart rate variability as a predictor of +Gz tolerance during the high-G selective test. Aerosp Med Hum Perform. 2024; 95(2):93–100.
Longitudinal Changes in the Body Mass Index of British Army Pilots
Authors: Porter William D. , Wilde Grant D. , Jeffery Nicholas P. , Walters P. Lynne , Eke Allison J. , Bushby Alaistair J. R. , Adams Mark S. , Gaydos Steven J. 
Published: January 2024

INTRODUCTION: Aircraft are manufactured according to design parameters that must account for the size and physical characteristics of the pilot. While cockpit dimensions, seats, restraints, and related components do not change substantially over the airframe lifecycle, it is conceivable that the occupant may, even if initially well-suited. This investigation focused on longitudinal body mass index (BMI) changes within a cohort of British Army Air Corps pilots.
METHODS: The study was a retrospective examination of electronic medical record data to assess longitudinal change within a representative cohort of Army pilots. Voluntary subjects were assigned unique subject numbers matched with individual electronic medical record data. Subject’s age, service length, height, weight, and BMI were extracted from routine historical aviation medical exams.
RESULTS: Among 106 British Army Air Corps pilots, the mean age was 35.3 yr (SD = 7.4) with average length of service as a pilot of 9.0 yr (SD = 5.2). Within the observed cohort, the mean change in individual weight over time was an increase of 4.6 kg (SD = 7.3). Height remained relatively stable with a mean increase of 0.6 cm (SD = 1.9). Given the increase in weight, BMI was noted to increase longitudinally with a mean of 1.3 kg · m−2 (SD = 2.4).
DISCUSSION: British Army pilots experience increases in BMI over time much like the general population. Results of this study serve to inform future policy related to the body composition of aviation applicants, the retention of previously qualified pilots, and the safety concerns of crashworthiness design specifications.
Porter WD, Wilde GD, Jeffery NP, Walters PL, Eke AJ, Bushby AJR, Adams MS, Gaydos SJ. Longitudinal changes in the body mass index of British Army pilots. Aerosp Med Hum Perform. 2024; 95(2):118–122.
Clinical utility of and correlation between Sniffin' Sticks and TIB smell identification test (TIBSIT) among Hong Kong Chinese with or without chronic rhinosinusitis
Authors: Mak Hugo W. F. , Ho Shi Yeung , Wong Jane C. Y. , Chiang Valerie , Lee Elaine , Yim Jackie S. H. , Wong Birgitta Y. H. , Li Philip H. 
Published: January 2024

IntroductionOlfactory dysfunction (OD) is common among patients with chronic rhinosinusitis (CRS). Validated and culturally specific tests, such as the “Sniffin’ Sticks” test (SST) and the TIB Smell Identification Test (TIBSIT), are crucial for the diagnosis and monitoring of OD. However, they have not been utilised in Hong Kong Chinese and their correlations are unknown.MethodsTwelve CRS patients and twenty healthy volunteers were prospectively recruited from a joint allergy-otorhinolaryngology clinic in Hong Kong and performed both SST and TIBSIT. Demographics, baseline characteristics and all test results were compared and analysed.ResultsPatients with CRS demonstrated significantly lower test scores than healthy controls (all p &lt; 0.001). Significant and strong correlations were observed between all composite and subtest scores, particularly between the composite SST and TIBSIT scores (ρ = 0.789, p &lt; 0.001). Multivariate analysis demonstrated that the presence of CRS and increasing age were significantly associated with OD.ConclusionBoth SST and TIBSIT are useful olfactory tests and are strongly correlated among Hong Kong Chinese. We advocate that either test can be used for measuring OD among CRS patients.
Standardized risk-stratified cardiac assessment and early posttransplant cardiovascular complications in kidney transplant recipients
Authors: Rajnochova Bloudickova Silvie , Janek Bronislav , Machackova Karolina , Hruba Petra 
Published: January 2024

IntroductionCardiovascular disease (CVD) is the leading cause of morbidity and mortality in kidney transplant recipient (KTR). There is a dearth of standardized guidelines on optimal cardiovascular evaluation of transplant candidates.MethodsThis single-center cohort study aims to determine the effectiveness of our standardized risk-stratified pretransplant cardiovascular screening protocol, which includes coronary angiography (CAG), in identifying advanced CVD, the proper pretransplant management of which could lead to a reduction in the incidence of major cardiac events (MACE) in the early posttransplant period.ResultsOut of the total 776 KTR transplanted between 2017 and 2019, CAG was performed on 541 patients (69.7%), of whom 22.4% were found to have obstructive coronary artery disease (CAD). Asymptomatic obstructive CAD was observed in 70.2% of cases. In 73.6% of cases, CAG findings resulted in myocardial revascularization. MACE occurred in 5.6% (N = 44) of the 23 KTR with pretransplant CVD and 21 without pretransplant CVD. KTR with posttransplant MACE occurrence had significantly worse kidney graft function at the first year posttransplant (p = 0.00048) and worse patient survival rates (p = 0.0063) during the 3-year follow-up period compared with KTR without MACE. After adjustment, the independent significant factors for MACE were arrhythmia (HR 2.511, p = 0.02, 95% CI 1.158–5.444), pretransplant history of acute myocardial infarction (HR 0.201, p = 0.046, 95% CI 0.042–0.970), and pretransplant myocardial revascularization (HR 0.225, p = 0.045, 95% CI 0.052–0.939).ConclusionAsymptomatic CVD is largely prevalent in KTR. Posttransplant MACE has a negative effect on grafts and patient outcomes. Further research is needed to assess the benefits of pretransplant myocardial revascularization in asymptomatic kidney transplant candidates.
Association between peripheral eosinophilia, JESREC score, and olfactory dysfunction in patients with chronic rhinosinusitis
Authors: Zhang Ling , Li Haifeng , Wang Tao , Wang Zhu , Wu Yang , Guo Siquan , Li Wenjing , Zhou Yeru , Xue Haixiang , You Jianqiang 
Published: January 2024

ObjectiveThe purpose was to evaluate the relationship between peripheral eosinophilia, Japan Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) score, and olfactory dysfunction in chronic rhinosinusitis (CRS) patients and to explore the accuracy and specific cut points of the JESREC score in predicting olfactory dysfunction.MethodsIn this cross-sectional, retrospective study, olfactory function was assessed by the Sniffin’ Sticks 12-item test and multivariate logistic regression analyses were carried out. Receiver operating characteristic curves were plotted to derive accuracy and cutoff values for the JESREC scores of the olfactory dysfunction criterion.ResultsA total of 354 patients [mean (SD) age, 50.0 (14.9) years; 41.8% women] were included in the final analysis. The prevalence of olfactory dysfunction was 46.3%. Individuals who had olfactory dysfunction were more likely to be male (64.6% vs. 52.6%), have eosinophilic chronic rhinosinusitis (ECRS) (39.0% vs. 7.9%), have a longer course of CRS (2.3 years vs. 1.5 years), have higher JESREC scores (8.5 vs. 4.5), and have higher proportions of nasal polyps (78.7% vs. 18.9%) and peripheral eosinophilia (3.3% vs. 1.4%). In logistic analysis, the percentage of eosinophils (1.25, 1.13–1.37), JESREC score (1.31, 1.22–1.40), bilateral lesion (2.06, 1.25–3.41), nasal polyps (15.83, 9.23–27.16), CT shadow (2.73, 1.69–4.43), and ECRS (6.86, 3.68–12.80) were associated with olfactory dysfunction in CRS patients after controlling for covariates, while peripheral neutrophils were not significant. In addition, the area under the curve was 0.778 and the cutoff value for JESREC score for olfactory dysfunction was defined as 5.5.ConclusionsPeripheral eosinophilia and high JESREC scores were significantly associated with the risk of olfactory dysfunction in CRS patients, and special attention should be paid to patients with a JESREC score ≥6.
Periostin expression in uninvolved skin as a potential biomarker for rapid cutaneous progression in systemic sclerosis patients: a preliminary explorative study
Authors: De Luca Giacomo , Campochiaro Corrado , Burastero Samuele E. , Matucci-Cerinic Marco , Doglioni Claudio , Dagna Lorenzo 
Published: January 2024

ObjectivesThis study aimed to evaluate periostin serum levels and skin expression in patients with systemic sclerosis (SSc).MethodsWe enrolled 35 patients with diffuse (d-SSc) or limited (l-SSc) SSc, 15 patients with very early diagnosis of systemic sclerosis (VEDOSS), and 30 sex-matched healthy controls. Periostin serum levels were determined by an enzyme-linked immunosorbent assay (ELISA). Periostin skin expression was determined by immunohistochemistry (IHC) on paired involved and uninvolved 5-mm skin biopsy samples in a subgroup of 10 d-SSc and 10 L-SSc patients. A 12-month follow-up was considered.ResultsWe included 50 patients (mean age 53.1 ± 16.1 years; women 94%; mean disease duration 38.2 ± 45.1 months; anti-centromere 50%; anti-Scl70 40%), 35 of them with a definite SSc (68.8% l-SSc; 31.4% d-SSc; mean mRSS 9.0 ± 7.2) and 15 with VEDOSS; 30 controls were also included in this study. Periostin serum levels were higher in SSc patients compared to controls (32.7 ± 8.0 ng/mL vs. 27.7 ± 7.3 ng/mL; p &lt; 0.001), while these levels were comparable among different groups of patients (29.7 ± 6.9 ng/mL in VEDOSS, 33.4 ± 7.8 ng/mL in lc-SSc; and 34.0 ± 8.5 in dc-SSc; p = ns). SSc patients with digital ulcers had higher periostin serum levels (36.2 ± 7.9 ng/mL vs. 30.6 ± 7.3 ng/mL, p &lt; 0.02). Samples from the involved skin of l-SSc and d-SSc patients showed a significant dermal expression of periostin; an identical periostin expression was evident in the uninvolved skin of patients with d-SSc. In 7 out of 10 L-SSc patients, periostin expression was absent on uninvolved skin. In the remaining three l-SSc patients, a mild periostin expression on IHC was detectable on uninvolved skin and all of these three l-SSc patients presented a dramatic skin progression.ConclusionPeriostin skin expression may be a useful biomarker to indicate the presence of a disease at a higher risk of rapid cutaneous involvement.
High-frequency rTMS over bilateral primary motor cortex improves freezing of gait and emotion regulation in patients with Parkinson’s disease: a randomized controlled trial
Authors: Song Wenjing , Zhang Zixuan , Lv Bingchen , Li Jinyu , Chen Hao , Zhang Shenyang , Zu Jie , Dong Liguo , Xu Chuanying , Zhou Manli , Zhang Tao , Xu Ran , Zhu Jienan , Shen Tong , Zhou Su , Cui Chenchen , Huang Shuming , Wang Xi , Nie Yujing , Aftab Kainat , Xiao Qihua , Zhang Xueling , Cui Guiyun , Zhang Wei 
Published: January 2024

BackgroundFreezing of gait (FOG) is a common and disabling phenomenon in patients with Parkinson’s disease (PD), but effective treatment approach remains inconclusive. Dysfunctional emotional factors play a key role in FOG. Since primary motor cortex (M1) connects with prefrontal areas via the frontal longitudinal system, where are responsible for emotional regulation, we hypothesized M1 may be a potential neuromodulation target for FOG therapy. The purpose of this study is to explore whether high-frequency rTMS over bilateral M1 could relieve FOG and emotional dysregulation in patients with PD.MethodsThis study is a single-center, randomized double-blind clinical trial. Forty-eight patients with PD and FOG from the Affiliated Hospital of Xuzhou Medical University were randomly assigned to receive 10 sessions of either active (N = 24) or sham (N = 24) 10 Hz rTMS over the bilateral M1. Patients were evaluated at baseline (T0), after the last session of treatment (T1) and 30 days after the last session (T2). The primary outcomes were Freezing of Gait Questionnaire (FOGQ) scores, with Timed Up and Go Test (TUG) time, Standing-Start 180° Turn (SS-180) time, SS-180 steps, United Parkinson Disease Rating Scales (UPDRS) III, Hamilton Depression scale (HAMD)-24 and Hamilton Anxiety scale (HAMA)-14 as secondary outcomes.ResultsTwo patients in each group dropped out at T2 and no serious adverse events were reported by any subject. Two-way repeated ANOVAs revealed significant group × time interactions in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14. Post-hoc analyses showed that compared to T0, the active group exhibited remarkable improvements in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14 at T1 and T2. No significant improvement was found in the sham group. The Spearman correlation analysis revealed a significantly positive association between the changes in HAMD-24 and HAMA-14 scores and FOGQ scores at T1.ConclusionHigh-frequency rTMS over bilateral M1 can improve FOG and reduce depression and anxiety in patients with PD.
Application of deep brain stimulation for the treatment of childhood-onset dystonia in patients with MEPAN syndrome
Authors: Nataraj Jaya , MacLean Jennifer A. , Davies Jordan , Kurtz Joshua , Salisbury Amanda , Liker Mark A. , Sanger Terence D. , Olaya Joffre 
Published: January 2024

IntroductionMitochondrial Enoyl CoA Reductase Protein-Associated Neurodegeneration (MEPAN) syndrome is a rare inherited metabolic condition caused by MECR gene mutations. This gene encodes a protein essential for fatty acid synthesis, and defects cause progressively worsening childhood-onset dystonia, optic atrophy, and basal ganglia abnormalities. Deep brain stimulation (DBS) has shown mixed improvement in other childhood-onset dystonia conditions. To the best of our knowledge, DBS has not been investigated as a treatment for dystonia in patients with MEPAN syndrome.MethodsTwo children with MEPAN were identified as possible DBS candidates due to severe generalized dystonia unresponsive to pharmacotherapy. Temporary depth electrodes were placed in six locations bilaterally and tested during a 6-day hospitalization to determine the best locations for permanent electrode placement. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and Barry-Albright Dystonia Scale (BADS) were used for preoperative and postoperative testing to quantitatively assess dystonia severity changes. Patient 1 had permanent electrodes placed at the globus pallidus internus (GPi) and pedunculopontine nucleus (PPN). Patient 2 had permanent electrodes placed at the GPi and ventralis intermedius nucleus of the thalamus (VIM).ResultsBoth patients successfully underwent DBS placement with no perioperative complications and significant improvement in their BFMDRS score. Patient 2 also demonstrated improvement in the BADS.DiscussionWe demonstrated a novel application of DBS in MEPAN syndrome patients with childhood-onset dystonia. These patients showed clinically significant improvements in dystonia following DBS, indicating that DBS can be considered for dystonia in patients with rare metabolic disorders that currently have no other proven treatment options.
Acquired tonsillar herniation related to spontaneous intracranial hypotension: case reports
Authors: Chen Lili , Wu Haijian , Hu Xingyue , Ying Guangyu 
Published: January 2024

BackgroundAcquired prolapse of the cerebellar tonsils in spontaneous intracranial hypotension (SIH) patients is rare. This study aims to evaluate neuroimaging changes of acquired prolapse of the cerebellar tonsils below the foramen magnum in SIH patients due to spontaneous spinal cerebrospinal fluid leakage, which was treated by targeted epidural blood patches (EBP).MethodsWe retrospectively reviewed clinical and neuroimaging characteristics of 5 cases of SIH with acquired prolapse of the cerebellar tonsils that received targeted EBP in our institution from January 2013 to December 2016.ResultsOf these SIH patients, all of them suffered from an orthostatic headache. Initial cranial MRI demonstrated descent of the cerebellar tonsils ≥5 mm. Intrathecal gadolinium-enhanced spinal MR myelography and/or spinal MR hydrography were performed to evaluate the level of spinal cerebrospinal fluid leakage. Symptoms were alleviated in all 5 patients after two (n = 4), or three (n = 1) targeted EBP during hospitalization. Follow-up cranial MRI revealed that the descent of cerebellar tonsils was reversed after EBP treatment.ConclusionAcquired tonsillar herniation can occur in patients with SIH and spinal cerebrospinal fluid leakage. Symptoms of these patients may be resolved and radiologic findings may be reversed after EBP treatment.
Psychological mechanisms of English academic stress and academic burnout: the mediating role of rumination and moderating effect of neuroticism
Authors: Zuo Xiaoyi , Zhao LuLu , Li Yue , He Wanting , Yu Chengfu , Wang Zhenhai 
Published: January 2024

IntroductionAcademic stress is a significant and prevalent phenomenon among college students. According to the Demands-Resources Model, when individuals are unable to cope with stress that exceeds their capacity, burnout may occur. Although English courses hold a significant position in university education, there has been limited research on the mechanisms linking English academic stress to English academic burnout.MethodsThis study recruited 1,130 undergraduate students taking English courses. Participants completed online questionnaires assessing English academic stress, rumination, English academic burnout, and neuroticism traits. A moderated mediation model was constructed to examine the relationship among these variables.ResultsThe results indicate that (1) Rumination serves as a mediator in the relationship between English academic stress and burnout; (2) neuroticism significantly moderates the pathway between English academic stress and rumination. Specifically, students with high neuroticism tendencies are more prone to developing rumination when faced with high levels of English academic stress.ConclusionThese findings offer valuable insights into the psychological mechanisms underlying the association between English learning stress and academic burnout. They emphasize the importance of addressing rumination as a mediator and considering individuals’ levels of neuroticism in interventions aimed at preventing and alleviating academic burnout among university students.