bluuebunny/crossref_metadata_2025_split huggingface dataset:
Totally three-dimensional endoscopic mitral valve replacement in a patient with situs inversus totalis
Authors: Kanamori Taro , Yamanaka Shota , Onga Yohei , Maekawa Koki , Takahashi Shu 
Published: September 2024

Abstract
Situs inversus totalis (SIT) with dextrocardia is a rare congenital anomaly that poses a surgical challenge. This case report presents the first known case of a totally 3D endoscopic mitral valve replacement (MVR), which was performed in a 75-year-old woman with SIT and severe functional mitral regurgitation. Despite the anatomical complexity, the procedure was successfully completed using a simplified three-port system and a 3D endoscope by requiring careful preoperative planning and intraoperative adaptation to the mirrored anatomy of SIT. This case report demonstrates the feasibility and potential benefits of totally endoscopic MVR in patients withSIT.
Motor-evoked potentials as biomarkers for sexual arousal?
Authors: Ruhland Stefanie , Poeppl Timm B , Schoisswohl Stefan , Schwitzgebel Florian , Osnabrügge Mirja , Kanig Carolina , Langguth Berthold , Schecklmann Martin 
Published: September 2024

Abstract

Background
Motor cortex excitability may represent the neuronal endpoint of motivational processes and was shown to be modulated by both sexual arousal and deceptive behavior.

Aim
This is the first study to investigate the influence of lying and sex in heterosexual women and men based on motor-evoked potentials (MEPs) measured while viewing sexually arousing pictures.

Methods
Sixteen heterosexual couples were shown 360 trials consisting of pictures displaying both almost naked females and males and neutral control images. In a subsequent forced-choice question about wanting to see the respective pictures fully naked, they were instructed to either answer in agreement with or opposite to their sexual preference. Participants went through 2 blocks of answering truthfully and 2 blocks of lying, with these 4 blocks being shown in a randomized alternating order.

Outcomes
To measure cortical excitability, MEPs were used, evoked by single transcranial magnetic stimulation pulses between image presentation and response.

Results
In normalized MEPs, women and men showed higher amplitudes for preferred over non-preferred sexual stimuli, but only on a descriptive level. Planned contrasts showed higher non-normalized MEPs for lying in all picture categories. Direct comparisons to a preliminary study showed overall lower effect sizes.

Clinical Implications
Both sexes tend to show higher MEPs in response to their sexually preferred stimuli. MEPs are not stable markers for willful volitionally controlled deception although lying does increase cortical excitability. The present experimental design does not seem valid enough to serve as a diagnostic marker for sexual preference or paraphilia and malingering.

Strengths and Limitations
This is the first study investigating whether sexual motivational stimuli modulate MEPs in women, while also examining the influence of lying for both sexes. The sample was too small for some found effects to be significant. Also, the experimental setup may have been less suited for female participants in comparison to male ones.

Conclusion
The operationalization of sexual motivation via MEPs seems to highly depend on different experimental factors including the sex of the participants, induced motivation, and lying.
Looming Large or Seeming Small? Attitudes Towards Losses in a Representative Sample
Authors: Chapman Jonathan , Snowberg Erik , Wang Stephanie W , Camerer Colin 
Published: September 2024

Abstract
We measure individual-level loss aversion using three incentivized, representative surveys of the U.S. population (combined N=3,000). We find that around 50% of the U.S. population is loss tolerant—they are willing to accept negative-expected-value gambles that contain a loss. This is counter to expert predictions and earlier findings—which mostly come from laboratory/student samples—that 70–90% of participants are loss averse. Consistent with the different findings in our study versus the prior literature, loss aversion is more prevalent in people with high cognitive ability. Further, our measure of gain–loss attitudes exhibits similar temporal stability and better predictive power outside our survey than measures of risk aversion. Loss-tolerant individuals are more likely to report recent gambling, investing a higher percentage of their assets in stocks, and experiencing financial shocks. These results support the general hypothesis that individuals value gains and losses differently, and that gain–loss attitudes are an important economic preference. However, the tendency in a large proportion of the population to emphasize gains over losses is an overlooked behavioural phenomenon.
Sleep restriction and age effects on distinct aspects of cognition in adolescents
Authors: Campbell Ian G , Kurinec Courtney A , Zhang Zoey Y , Cruz-Basilio Alejandro , Figueroa Jessica G , Bottom Vincent B , Whitney Paul , Hinson John M , Van Dongen Hans P A 
Published: September 2024

Abstract
Insufficient sleep negatively impacts scholastic performance in children and adolescents. Here we use a dose–response time in bed (TIB) restriction study to evaluate associations between sleep loss and multiple aspects of cognition. We evaluated changes in cognitive measures across ages 10 to 23 years and determined whether the effects of sleep loss changed across this age range. A younger cohort (n = 77, age range 9.9 to 16.2 years) was studied annually for 3 years. An older cohort study (n = 82, age range 15 to 22.8 years) was interrupted by the COVID pandemic with 25 participants completing multiple years. Annually participants completed each of three TIB conditions: four consecutive nights with 7, 8.5, or 10 hours in bed. A day of cognitive testing followed the fourth night. Restricting TIB to 7 hours was associated with impaired top–down attentional control and cognitive flexibility, but performance did not differ between 8.5 and 10 hours of TIB conditions. Psychomotor vigilance test performance decreased as TIB was restricted from 10 to 8.5 hours and decreased further with restriction to 7 hours. Sternberg test measures of working memory were not significantly affected by TIB restriction. The effects of sleep loss on these cognitive measures did not change significantly with age, but age-related improvement in many of the measures may compensate for some sleep loss effects. The findings here do not indicate an adolescent decrease in sleep need; however, the minimal duration of sleep needed for optimal performance appears to differ depending on the cognitive measure.
Serum alpha-synuclein in restless legs syndrome
Authors: Tahanis Aboud , Hashem Vera , Ondo William 
Published: September 2024

Abstract

Study Objectives
To determine any correlation between serum alpha-synuclein (α-syn) concentrations and restless legs syndrome (RLS), and to explore the impact of intravenous iron supplementation on serum α-syn levels.

Methods
We collected clinical data on 113 RLS patients in whom serum α-syn levels were quantified using an ELISA kit and compared to a group of 45 age-matched controls. A subset of nine RLS patients who received intravenous (IV) iron underwent pre- and post-treatment blood sampling to assess α-syn and ferritin response.

Results
A family history of RLS was reported by 62.8% of patients, and current dopaminergic augmentation was observed in 31.0%. Low serum ferritin levels below 75 μg/L were seen in 39.8%. Serum α-syn levels were found to be significantly decreased in RLS patients (mean: 7.7 ng/mL) compared to controls (mean: 10.7 ng/mL), p &lt; .05. Stratification based on sex, age, and age of onset, did not reveal significant differences in α-syn levels. In nine RLS patients who received IV iron treatment, a linear correlation between fold change in α-syn and ferritin was observed (R: 0.7, p &lt; .05). The temporal relation between serum α-syn and IV iron treatment showed a gradual decline of α-syn and ferritin by time correlation (p = .023, R: −.739).

Conclusion
In our study of 113 RLS participants, serum α-syn levels were decreased in RLS patients compared to healthy controls, and increased in the nine patients who received IV iron treatment in correlation with ferritin. This correlation could suggest a mechanism for reduced dopamine transmission in RLS.
Exploring the potential of selenium nanoparticles and fabricated selenium nanoparticles @vitamin C nanocomposite in mitigating nicotine-induced testicular toxicity in rats
Authors: Refaat Rana M M , Fouda Atef E , El-Shishtawy Mohamed A , Kumar Adarsh , El-Shafai Nagi M , Faruk Eman M , Nafea Ola E , Hindawy Rabab F 
Published: September 2024

Abstract

Background
The tobacco epidemic signifies a major public health threat. Nicotine (NIC), a major active constituent in tobacco, impedes male fertility and semen quality. This work is implemented to explore the potential of selenium nanoparticles (SeNPs) and the newly fabricated SeNPs @vitamin C (SeNPs@VITC) nanocomposite in mitigating testicular toxicity induced by NIC.

Materials and methods
The six groups of 48 adult Wistar rats were designed as follows: the control group injected intraperitoneally with normal saline, the SeNPs group treated orally with 2 mg/kg of SeNPs, the SeNPs@VITC nanocomposite group treated orally with 2 mg/kg of SeNPs@VITC nanocomposite, the NIC group injected intraperitoneally with 1.25 mL/kg of NIC, the NIC+ SeNPs group received SeNPs plus NIC, and the NIC+ SeNPs@VITC nanocomposite group received SeNPs@VITC nanocomposite plus NIC. Treatments were administered over a 28-day period.

Results
NIC treatment significantly caused poor sperm quality, decreased serum testosterone, increased follicle-stimulating hormone (FSH), luteinizing hormone (LH) concentrations, reduced hemoglobin levels, leukocytosis, disrupted testicular oxidant/antioxidant balance, and disorganized testicular structure. The construction of the novel SeNPs@VITC nanocomposite, compared to NIC plus SeNPs alone, demonstrated a more potent ameliorative effect on NIC-induced reproductive toxicity in adult rats. The SeNPs@VITC nanocomposite significantly increased sperm count, reduced the percentage of sperm head abnormalities, lowered both serum FSH and LH concentrations, and improved the hemoglobin response.

Conclusions
Both SeNPs and SeNPs@VITC nanocomposite alleviated the testicular toxicity induced by NIC, but the SeNPs@VITC nanocomposite exhibited superior efficacy. The SeNPs@VITC nanocomposite could be employed to advance enhanced therapeutic strategies for addressing male infertility.
Effect of Erector Spinae Plane Block on Postoperative Quality of Recovery in Patients Undergoing Transforaminal or Oblique Lumbar Interbody Fusion: A Randomized Controlled Trial
Authors: Jo Woo-Young , Shin Kyung Won , Lee Hyung-Chul , Park Hee-Pyoung , Kim Jun-Hoe , Lee Chang-Hyun , Kim Chi Heon , Chung Chun Kee , Oh Hyongmin 
Published: September 2024

Background:
Erector spinae plane block (ESPB) can has been used for analgesia after lumbar spine surgery. However, its effect on postoperative quality of recovery (QoR) remains underexplored in patients undergoing transforaminal lumbar interbody fusion (TLIF) or oblique lumbar interbody fusion (OLIF). This study hypothesized that ESPB would improve postoperative QoR in this patient cohort.

Methods:
Patients undergoing TLIF or OLIF were randomized into ESPB (n=38) and control groups (n=38). In the ESPB group, 25 mL of 0.375% bupivacaine was injected into each erector spinae plane at the T12 level under ultrasound guidance before skin incision. Multimodal analgesia, including wound infiltration, was applied in both groups. The QoR-15 score was measured before surgery and 1 day (primary outcome) and 3 days after surgery. Postoperative pain at rest and during ambulation and postoperative ambulation were also evaluated for 3 days after surgery.

Results:
Perioperative QoR-15 scores were not significantly different between the ESPB and control groups including at 1 day after surgery (80±28 vs. 81±25, respectively; P=0.897). Patients in the ESPB group had a significantly lower mean (±SD) pain score during ambulation 1 hour after surgery (7±3 vs. 9±1, respectively; P=0.013) and significantly shorter median (interquartile range) time to the first ambulation after surgery (2.0 [1.0 to 5.5] h vs. 5.0 [1.8 to 10.0] h, respectively; P=0.038). There were no between-group differences in pain scores at other times or in the cumulative number of postoperative ambulations.

Conclusion:
ESPB, as performed in this study, did not improve the QoR after TLIF or OLIF with multimodal analgesia.
Free Vascularized Osseous Fibula Flap for Vertebral Body Defect in a Patient with Tuberculosis Spondylitis
Authors: Atmodiwirjo Parintosa , Ramadan Mohamad Rachadian , Lumbuun Ruth , Gunawan Kevin , Saekhu Mohamad , Nugroho Setyo Widi , Ralena Nadhira Anindita 
Published: September 2024

Summary:
In the context of tuberculous spondylitis, a rare form of extrapulmonary tuberculosis causing significant discomfort and neurological deficits, surgery becomes imperative to alleviate symptoms alongside antituberculosis treatment. However, the utilization of free vascularized fibula flaps for repairing vertebral deformities remains uncommon. This report presents the case of a 21-year-old man with limb weakness and sensory disturbances who was referred to our hospital, where contrast magnetic resonance imaging revealed a paravertebral abscess spanning several thoracic vertebrae. Collaborating with neurosurgeons, we performed decompression laminectomy, pedicle screw fixation, thoracic vertebrectomy, and restoration of the corporal defect using a free fibula flap. Utilizing a 2.5-cm fibula segment from the patient’s left leg without a skin paddle, the surgery demonstrated a pedicle length of 12 cm and a total ischemic time of 183 minutes. The fibula was press-fitted, with recipient vessels identified as 1-mm artery and vein from the intercostal artery perforator. Postsurgery, flap vitality was assessed using Doppler ultrasound, showing positive signals immediately and at 1-month follow-up, with the patient experiencing reduced pain and improved leg strength. Despite its rarity, free fibula flap reconstruction for spinal defects proves effective, safe, and beneficial, necessitating thorough preoperative planning and interdisciplinary collaboration for successful outcomes, marking this case as the first reported instance in Indonesia.
Dorsal Hand Reconstruction with Web Contracture Release Using Free Superficial Inferior Epigastric Artery Flap
Authors: Nomaguchi Matoku , Niimi Yosuke , Hasegawa Yuki , Matsumine Hajime , Sakurai Hiroyuki 
Published: September 2024

Summary:
We present a case in which reconstruction of the dorsum of the hand and finger web space was carried out concurrently with the insertion of a superficial inferior epigastric artery flap into the interdigital spaces. This approach was taken to prevent the potential development of subsequent web space contracture. The patient, a 57-year-old woman, presented with a necrotizing soft tissue infection on the dorsum of her left hand, resulting in a full-thickness skin defect extending from the metacarpophalangeal joint to the wrist, with exposure of the extensor tendons. The reconstructive surgery involved raising a superficial inferior epigastric artery flap and transplanting it onto the tissue defect, to cover not only the dorsal defect but also the interdigital spaces after releasing web space contracture. Consequently, the surgery successfully released scar contractures on the dorsum of the hand and provided adequate interdigital space formation without requiring additional procedures, except defatting. At the 7-month postoperative follow-up, the patient had a good outcome with shoulder and hand (Quick Disabilities of Arm, Shoulder and Hand) score of 28.9 points. Interdigital scar contractures often lead to decreased fine motor skills and functional impairment, affect aesthetics, and require a prolonged period for social reintegration. This surgical technique involves simultaneous one-stage closure of the dorsal defect with a flap and interdigital reconstruction to prevent future scar contractures and functional impairments, and is a valuable approach for shortening the treatment duration.
Experiences and Challenges Updating a Living Evidence-Based Review of Randomized Controlled Trials on Mental Health and Behavioral Disorders in Individuals With Moderate to Severe Traumatic Brain Injury
Authors: Teasell Robert , MacKenzie Heather M. , Flores-Sandoval Cecilia , McIntyre Amanda , Barua Ujjoyinee , Mehta Swati , Bayley Mark , Bateman Emma A. 
Published: September 2024

Objective:
To describe experiences and challenges when updating a living evidence-based review database of randomized controlled trials (RCTs) on mental health and behavioral disorders in moderate to severe traumatic brain injury (MSTBI).

Method:
This commentary derives from our experience developing an extensive database of RCTs on MSTBI that has been conceptualized as a living evidence-based review. Our working group focused on mental health and behavior RCTs and reflected upon their experiences and challenges using the living systematic approach. We discuss challenges associated with metrics of study quality, injury etiology and severity, time post-injury, country of origin, and variability in outcome measures.

Results:
RCTs were conducted almost solely in high income countries, with smaller sample sizes, and most conducted in the chronic phase post-TBI. Issues related to lack of transparency, unclear and incomplete reporting of injury severity, etiology, and time post-injury remain a concern and can lead to challenges associated with interpretation of results, validity, and reliability of the data. There was significant heterogeneity regarding the use of outcome measures and constructs, underscoring the need for standardization.

Conclusion:
Lack of standardization and incomplete reporting of injury characteristics makes it difficult to compare data between RCTs of MSTBI, perform meta-analyses, and generate evidence-based clinical recommendations.
Identification of Retinal Amyloid-Beta in Ex Vivo Human Glaucoma Eyes Using a Novel Ocular Tracer
Authors: Pilotte Julie , Khoury Sami , Tafreshi Ali , Mandel Zachary T. , Sharma Svasti V. , Vanderklish Peter W. , Sarraf Stella T. , Sadun Alfredo A. , Weinreb Robert N. , Huang Alex S. 
Published: September 2024

Purpose:
To characterize the presence of amyloid-beta (Aβ) in human glaucoma retina and to test the identification of retinal Aβ using a novel fluorescent Aβ-binding small molecule (AMDX-2011).

Methods:
Postmortem human eyes with (n=4) and without (n=4) glaucoma were acquired from an eye bank. Retinas were dissected, flat-mounted, and fixed. Using the flat mounts, immunofluorescence was performed against Aβ, AMDX-2011 staining was conducted, and images were acquired using fluorescence microscopy.

Results:
Fluorescence microscopy demonstrated the presence of an Aβ signal that colocalized with AMDX-2011 staining in the glaucoma retina. Colabeled puncta appeared in all quadrants of the retina, including the retina temporal to the optic nerve. The puncta were mainly located within the inner layers of the retina. Glaucoma retinas had more colabeled puncta than control retinas in all locations (P=0.002–0.02). Colabeled puncta were also larger in the superior quadrant of glaucoma compared with control retinas (P=0.02).

Conclusions:
Aβ was detected in human glaucomatous retina, and its distribution was mapped. AMDX-2011 identification of Aβ may lead to future diagnostic tests aimed at detecting Aβ in glaucoma patients.
Association between pre-arrest left ventricular ejection fraction and survival in nontraumatic out-of-hospital cardiac arrest
Authors: Ho Yi-Ju , Lien Chun-Ju , Tsai Ren-Jie , Fan Cheng-Yi , Chen Chi-Hsin , Huang Chien-Tai , Chen Ching-Yu , Chen Yun-Chang , Huang Chun-Hsiang , Chiang Wen-Chu , Huang Chien-Hua , Sung Chih-Wei , Huang Edward Pei-Chuan 
Published: September 2024

Background and importance:
Out-of-hospital cardiac arrest (OHCA) poses major public health issues. Pre-arrest heart function is a prognostic factor, but the specific contribution of pre-arrest echocardiographic evaluation in predicting OHCA outcome remains limited.

Objective:
The primary objective was to investigate the association between left ventricular ejection fraction (LVEF) measured in echocardiography prior to OHCA and survival to hospital discharge.

Design, settings, and participants:
This multicenter retrospective cohort study analyzed data from the National Taiwan University Hospital and its affiliated hospitals. We included adult nontraumatic OHCA patients who were treated by the emergency medical services (EMS) and underwent echocardiography within 6 months prior to the OHCA event from January 2016 to December 2022. Data included demographics, preexisting diseases, resuscitation events, and echocardiographic reports.

Outcomes measure and analysis:
The primary outcome was the survival to hospital discharge after post-arrest care. Statistical analysis involved multivariable logistic regression to modify potential confounders, reported as adjusted odds ratio (aOR) and 95% confidence interval (CI), and evaluate the association between echocardiographic findings and survival to hospital discharge.

Main results:
This study analyzed 950 patients, with 33.6% surviving to discharge. A higher pre-arrest LVEF was independently associated with increased survival. Compared to patients with LVEF < 40%, those with LVEF between 40% and 60% had significantly higher odds of survival (aOR = 3.68, 95% CI = 2.14–6.35, P < 0.001), and those with LVEF > 60% had even greater odds of survival (aOR = 5.46, 95% CI = 3.09–9.66, P < 0.001). There was also an association between lower tricuspid regurgitation pressure gradient and survival (aOR = 0.98, 95% CI = 0.97–1.00, P = 0.015). Younger age, male gender, dyslipidemia, stroke, cancer, witnessed arrest, initial shockable rhythm, and shorter low-flow time are other significant predictors of survival.

Conclusion:
In adult, nontraumatic, EMS-treated OHCA patients, a higher LVEF 6 months prior to OHCA was associated with improved survival at hospital discharge.
International equity in access to home dialysis
Authors: Iyengar Arpana , Kalyesubula Robert , Darwish Rasha , Luyckx Valerie A. 
Published: September 2024

Purpose of review
Discussion of inequalities and inequities in global distribution of and access to home dialysis.

Recent findings
The majority of patients receiving home dialysis receive peritoneal dialysis, but these are concentrated in few countries across the globe. Peritoneal dialysis as the most common form of home dialysis has many advantages in terms of individual freedoms, similar outcomes to haemodialysis, being less costly in some countries, and more scalable than in-centre haemodialysis. Despite this there are many inequities in access at the patient, clinician, health system and geopolitical levels. Poverty, discrimination and lack of support at home are important drivers of inequities at the patient level. At the clinician and health systems level lack of experience in home dialysis, lack of resources and lack of time drive patients towards in-centre dialysis. At the geopolitical level, high costs associated with procurement and distribution of peritoneal dialysis solutions exacerbate inequities in access.

Summary
The challenge of reducing global inequities in access to home dialysis in low- and middle-income countries are vast and would require training of the doctors, nurses, families, patients, leaders and community partners. Once this is achieved, dealing with costs and logistics of supplies is crucial to improve and sustain equitable access.