bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring Overcrowding in a Large Academic Tertiary Care Pediatric Emergency Department
Authors: Jadcherla Yamini , Stoner Michael , Helwig Sara , Lo Charmaine , Shi Junxin , MacDowell Doug , Bennett Berkeley L. 
Published: September 2024

Objective
Overcrowding scores have been studied extensively in adult emergency departments (EDs), but few studies have determined utility in the pediatric setting. The objective of this study was to determine the association between a modified National Emergency Department Overcrowding Score (mNEDOCS) and established ED metrics in a large academic tertiary care pediatric ED.

Methods
NEDOCS was modified to increase applicability in the pediatric setting by including the number of patients in resuscitation rooms instead of a number of patients on ventilators. Patient characteristics, ED disposition, ED length of stay (LOS), rate of left without being seen (LWBS), hospital LOS (HLOS), ED returns within 72 hours, and mNEDOCS were acquired retrospectively for every ED encounter in 2016–2019 using the electronic health record. Descriptive statistics, Spearman correlation, and multivariate analyses were calculated to evaluate the association between specific ED metrics and mNEDOCS.

Results
Modified NEDOCS positively correlated with ED LOS, LWBS, and rate of 72-hour return visits. A negative correlation was found between mNEDOCS and HLOS. When controlling for select covariates, the odds of LWBS doubled with each increase in mNEDOCS category (odds ratio, 2.03; 95% confidence interval [CI], 2.00–2.06), ED LOS was associated with an increase of 27 minutes as mNEDOCS category increased (β = 26.80; 95% CI, 26.44–27.16), and the odds of 72-hour return visits increased by 6% when mNEDOCS increased by one category (odds ratio, 1.06; 95% CI, 1.05–1.07). Hospital LOS was associated with a 100-minute decrease per increase in mNEDOCS category (β = −99.85; 95% CI, −180.68 to −18.48) when controlling for covariates.

Conclusion
Modified NEDOCS is positively associated with ED LOS, LWBS, and 72-hour return visits, consistent with adult data. Further investigation is needed to elucidate the association between mNEDOCS and HLOS. This study illustrates the utility of mNEDOCS as a measure of overcrowding in a pediatric ED.
The Effect of Step Stool Use on Chest Compression Quality During CPR in Young Children
Authors: Dutta Anuj K. , Donoghue Aaron , Sandler Alexis , Ahmed Ramzy , Neubrand Tara , Kerrey Benjamin , Myers Sage , O'Connell Karen J. 
Published: September 2024

Objective
This study aimed to determine the effect of stepstool use on chest compression (CC) quality during cardiopulmonary resuscitation (CPR) in young children.

Methods
We conducted a prospective observational study of children <8 years of age who received CC for >2 minutes in the emergency department. Data were collected through CC monitor device and video review. Data were analyzed in “CC segments” (periods of CC by individual providers). CC segments were coded “yes” or “no” for stepstool use based on video review. Univariate analyses of CC rate and depth between stepstool use and hand positions were performed through nonparametric testing, stratified by age category.

Results
Forty-two patients received 566 minutes of CC. Overall, American Heart Association (AHA)–compliant (rate and depth) CPR was achieved in 10% of CC segments for children <1 year and only 6% in children >1 year. A stepstool was used in 73% of CC segments in children <1 year and 88% in children >1 year. In children >1 year, stepstool use was associated with deeper CCs (P < 0.001) and a more compliant CC rate (P < 0.01). In children >1 year, 7% of those with a stepstool in use achieved AHA compliance, compared to those without a stepstool, where none achieved AHA compliance.

Conclusions
In children >1 year, stepstool use resulted in greater CC depth and more AHA-compliant CC rate. No CC segments in children >1 year achieved AHA compliance without a stepstool. These data support uniform stepstool use during pediatric CPR in children >1 year of age.
Transnasal Endoscopic Approach for Excision of Intracranial Nasal Dermoid Sinus Cysts
Authors: Woodyard De Brito Kiersten C. , Dembinski Douglas R. , Lawera Nathan G. , Buller Mitchell , de Alarcon Alessandro , Pan Brian S. , Skoch Jesse 
Published: September 2024

Objective:
Nasal dermoid sinus cysts (NDSCs) with intracranial extension in the form of dermal sinus tracts require careful and complete resection to prevent recurrence. Resection techniques necessitate adequate intracranial exposure, but morbidity associated with historical resection approaches has presented unique multidisciplinary challenges for surgeons treating cysts with intracranial extension.

Methods:
The authors primarily employed a transnasal approach through a midline nasal incision, utilizing endoscopic or microscopic access between the lateral cartilages for resection of NDSCs with intracranial extension. A retrospective review was completed for patients treated for NDSCs at the authors' pediatric quaternary referral center from 2017 to 2023. Data collection included demographics, comorbidities, perioperative data, pre and postoperative imaging, surgical outcomes, and complications.

Results:
Eighteen patients with NDSCs with possible or confirmed intracranial extension were surgically treated from 2017 to 2023. Fifteen were treated with resection performed through a midline transnasal approach with endoscopic assistance, achieving successful total resection while avoiding nasal osteotomy or frontal craniotomy. One patient had a slow cerebrospinal fluid leak from an operative durotomy, successfully treated with a lumbar drain. No other complications occurred. No patients required transfusion. Incision length and postoperative scar burden were less than approaches that used osteotomies or craniotomies and demonstrated excellent cosmetic results. No patients have had cyst recurrence or required reoperation.

Conclusions:
A transnasal approach through a midline incision with endoscopic assistance is an effective approach for resection of NDSC with intracranial extension, but utility may vary with cyst size and complexity. This approach leverages appropriate exposure for resection with decreased morbidity and decreased incision length through avoidance of osteotomies.
Analysis of the Status Quo and Influencing Factors of Revisiting Patients After Pituitary Tumor Resection: Based on a Chinese Patient Population
Authors: Wang Wei , Xiaoxu Han 
Published: September 2024

Objective:
To investigate the status of patients’ post-pituitary tumor resection and analyze influencing factors, providing evidence for improved long-term management.

Methods:
The authors screened 1209 patients who underwent pituitary tumor resection at Zhejiang University’s Second Affiliated Hospital from August 2020 to July 2022 using electronic medical records. Patients were classified into return visits (≥2 reviews/y or within 6 mo) and missing visit groups. Demographic and disease-related data were extracted from inpatient records, whereas return visits and prognosis data were collected from outpatient records and phone inquiries. Propensity score matching (1:1) was used to balance the groups, followed by univariate and multivariate logistic regression analyses to identify influencing factors.

Results:
Of the 1209 patients, 113 were unreachable. The study included 1095 patients, with 553 (50.5%) in the missing visit group and 542 (49.5%) in the return visit group. The authors matched 421 pairs, achieving balanced baseline data. Univariate analysis revealed significant differences in residence, unplanned readmission history, and current outcomes (P < 0.05). Multivariate analysis identified unplanned readmission history (odds ratio = 0.495, 95% CI: 0.307–0.799) as a protective factor. City residents had higher return visit rates than those from other provinces (odds ratio = 0.269, 95% CI: 0.610–1.579).

Conclusion:
Postdischarge return rates for pituitary tumor resection patients are low and influenced by various factors. Improving return visit policies and systems is essential for facilitating outpatient follow-ups.
Intervention effects of Naoxintong capsules on psychological and cardiac status in depressed rats after heart failure
Authors: Zhao Jie , Ouyang Yi , Hu Shaowei , Tian Guanghuan , Kong Xixian , Pan Fuzhu , Wu Hongwei , Tang Liying , Yang Hongjun 
Published: September 2024

Abstract

Background
Depression is a common clinical phenomenon in the patients with heart failure (HF). In traditional Chinese medicine (TCM), diseases in the brain and heart are thought to be correlated and interact. Naoxintong capsules (NXT) has been used for treating cardio-cerebrovascular diseases, while its therapeutic effect on depression after HF remains unclear.

Objective
The aim of the study is to evaluate the intervention effect of NXT on depression after HF.

Methods
Sprague-Dawley rats were assigned into the following 5 groups: sham, model, NXT (250, 1000 mg/kg), and valsartan (8 mg/kg). Coronary artery occlusion was performed to induce HF and subsequent depression in rats. The cardiac function was evaluated by echocardiography, hematoxylin-eosin staining, and Masson trichrome staining. The sucrose preference test and Morris water maze test were carried out to assess the depressive behaviors in rats. The ultrastructure of hippocampal CA1 neurons was observed and the levels of corticotropin-releasing hormone in the hypothalamus, brain-derived neurotrophic factor in the cortex, and adrenocorticotropic hormone (ACTH) in the plasma were determined by enzyme-linked immunosorbent assay. The levels of dopamine, 5-hydroxytryptamine, norepinephrine, and γ-aminobutyric acid in the hippocampus were measured by UPLC-QQQ-MS.

Results
NXT reduced myocardial injury and pathological changes in the cardiac tissue and increased the left ventricular ejection fraction, left ventricular fractional shortening, and cardiac output. NXT increased the sugar preference rate and number of crossings and shortened the escape latency. Furthermore, the NXT treatment restored the levels of corticotropin-releasing hormone, adrenocorticotropic hormone, brain-derived neurotrophic factor, dopamine, and γ-aminobutyric acid to the baseline values.

Conclusions
NXT not only demonstrates cardioprotective effect but also attenuates depression in the rats after HF. It may exert the antidepressant effect by inhibiting the hyperactivity of the hypothalamic-pituitary-adrenal axis and recovering the levels of neurotrophic factors and neurotransmitters.
Uncovering Plaque-Glia Niches in Human Alzheimer’s Disease Brains Using Spatial Transcriptomics
Authors: Avey Denis R. , Ng Bernard , Vialle Ricardo A. , Kearns Nicola A. , de Paiva Lopes Katia , Iatrou Artemis , De Tissera Sashini , Vyas Himanshu , Saunders Devin M. , Flood Daniel J. , Xu Jishu , Tasaki Shinya , Gaiteri Chris , Bennett David A. , Wang Yanling 
Published: September 2024

AbstractAmyloid-beta (Aβ) plaques and surrounding glial activation are prominent histopathological hallmarks of Alzheimer’s Disease (AD). However, it is unclear how Aβ plaques interact with surrounding glial cells in the human brain. Here, we applied spatial transcriptomics (ST) and immunohistochemistry (IHC) for Aβ, GFAP, and IBA1 to acquire data from 258,987 ST spots within 78 postmortem brain sections of 21 individuals. By coupling ST and adjacent-section IHC, we showed that low Aβ spots exhibit transcriptomic profiles indicative of greater neuronal loss than high Aβ spots, and high-glia spots present transcriptomic changes indicative of more significant inflammation and neurodegeneration. Furthermore, we observed that this ST glial response bears signatures of reported mouse gene modules of plaque-induced genes (PIG), oligodendrocyte (OLIG) response, disease-associated microglia (DAM), and disease-associated astrocytes (DAA), as well as different microglia (MG) states identified in human AD brains, indicating that multiple glial cell states arise around plaques and contribute to local immune response. We then validated the observed effects of Aβ on cell apoptosis and plaque-surrounding glia on inflammation and synaptic loss using IHC. In addition, transcriptomic changes of iPSC-derived microglia-like cells upon short-interval Aβ treatment mimic the ST glial response and mirror the reported activated MG states. Our results demonstrate an exacerbation of synaptic and neuronal loss in low-Aβ or high-glia areas, indicating that microglia response to Aβ-oligomers likely initiates glial activation in plaque-glia niches. Our study lays the groundwork for future pathology genomics studies, opening the door for investigating pathological heterogeneity and causal effects in neurodegenerative diseases.
Oxidative stress markers predict treatment outcomes in patients with generalized anxiety disorder treated with selective serotonin reuptake inhibitors
Authors: Cui Lijun , Lu Jingjing , Shen Zhongxia , Zhu Jielin , Chen Huanxin , Yang Shenliang , Wang Shikai , Shen Xinhua 
Published: September 2024

AbstractIntroductionThe etiology of generalized anxiety disorder (GAD) has not been fully understood, and oxidative stress may potentially contribute to its pathogenesis. However, there is no published evidence concerning the possible influence of oxidative stress on antidepressant treatment outcomes. This study investigated the ability of oxidative stress markers to predict treatment outcomes in GAD patients treated with selective serotonin reuptake inhibitors (SSRIs).MethodsOne hundred-one GAD patients and 100 healthy controls (HCs) were included in this study. The 101 GAD patients were selected for treatment with escitalopram (n=52) or sertraline (n=49) for eight weeks. Hamilton Anxiety Rating Scale (HAM-A) assessments were conducted before and after treatment. The serum levels of eight oxidative stress makers, malondialdehyde (MDA), lipid hydroperoxides (LPO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), cortisol, high-density lipoprotein (HDL), and nitric oxide (NO) were measured using enzyme-linked immunosorbent assays (ELISA) before and after SSRI treatment in GAD patients and at the time of HCs enrollment.ResultsThe serum levels of MDA, cortisol, and LPO were higher in GAD patients than in HCs (allp<.001), while SOD, GSH-Px, and CAT were lower than in HCs (allp<.001). The baseline MDA, LPO, NO, and cortisol levels were positively correlated with anxiety severity, while GSH-Px was negatively correlated. After eight weeks of SSRI treatment, the GSH-Px levels increased, and MDA and LPO decreased (allp<.05). Alterations in MDA levels co-varied with changes in anxiety measures (allp<.05). The ability of the receiver operating characteristic (ROC) area of the baseline MDA levels to predict the SSRI endpoint treatment response was 0.804 (p<.05).ConclusionThe pathogenesis of GAD might involve oxidative stress. Moreover, serum MDA levels might predict treatment response to SSRIs. However, more research is warranted to confirm these findings.
Early life stress influences epilepsy outcomes in mice
Authors: Coleman Emanuel M , White Maya , Antonoudiou Pantelis , Weiss Grant L , Scarpa Garrett , Stone Bradly , Maguire Jamie 
Published: September 2024

AbstractStress is a common seizure trigger that has been implicated in worsening epilepsy outcomes. The neuroendocrine response to stress is mediated by the hypothalamic-pituitary-adrenal (HPA) axis and HPA axis dysfunction worsens epilepsy outcomes, increasing seizure burden, behavioral comorbidities, and risk for sudden unexpected death in epilepsy (SUDEP) in mice. Early life stress (ELS) reprograms the HPA axis into adulthood, impacting both the basal and stress-induced activity. Thus, we propose that ELS may influence epilepsy outcomes by influencing the function of the HPA axis. To test this hypothesis, we utilized the maternal separation paradigm and examined the impact on seizure susceptibility. We show that ELS exerts a sex dependent effect on seizure susceptibility in response to acute administration of the chemoconvulsant, kainic acid, which is associated with an altered relationship between seizure activity and HPA axis function. To further examine the impact of ELS on epilepsy outcomes, we utilized the intrahippocampal kainic acid model of chronic epilepsy in mice previously exposed to maternal separation. We find that the relationship between corticosterone levels and the extent of epileptiform activity is altered in mice subjected to ELS. We demonstrate that ELS impacts behavioral outcomes associated with chronic epilepsy in a sex-dependent manner, with females being more affected. We also observe reduced mortality (presumed SUDEP) in female mice subjected to ELS, consistent with previous findings suggesting a role for HPA axis dysfunction in SUDEP risk. These data demonstrate for the first time that ELS influences epilepsy outcomes and suggest that previous life experiences may impact the trajectory of epilepsy.
The chromatin remodeler DEK promotes proliferation of mammary epithelium and is associated with H3K27me3 epigenetic modifications
Authors: Johnstone Megan , Leck Ashley , Lange Taylor , Wilcher Katherine , Shephard Miranda S. , Paranjpe Aditi , Schutte Sophia , Wells Susanne , Kappes Ferdinand , Salomonis Nathan , Privette Vinnedge Lisa M. 
Published: September 2024

AbstractThe DEK chromatin remodeling protein was previously shown to confer oncogenic phenotypes to human and mouse mammary epithelial cells usingin vitroand knockout mouse models. However, its functional role in normal mammary gland epithelium remained unexplored. We developed two novel mouse models to study the role of Dek in normal mammary gland biologyin vivo. Mammary gland-specific Dek over-expression in mice resulted in hyperproliferation of cells that visually resembled alveolar cells, and a transcriptional profile that indicated increased expression of cell cycle, mammary stem/progenitor, and lactation-associated genes. Conversely, Dek knockout mice exhibited an alveologenesis or lactation defect, resulting in dramatically reduced pup survival. Analysis of previously published single-cell RNA-sequencing of mouse mammary glands revealed thatDekis most highly expressed in mammary stem cells and alveolar progenitor cells, and to a lesser extent in basal epithelial cells, supporting the observed phenotypes. Mechanistically, we discovered that Dek is a modifier of Ezh2 methyltransferase activity, upregulating the levels of histone H3 trimethylation on lysine 27 (H3K27me3) to control gene transcription. Combined, this work indicates that Dek promotes proliferation of mammary epithelial cells via cell cycle deregulation. Furthermore, we report a novel function for Dek in alveologenesis and histone H3 K27 trimethylation.
NMR at operational temperature for resonance assignments of a PET degrading enzyme
Authors: Gabrielli Valeria , Grga Jelena , Gavalda Sabine , Perrot Laura , Boll Emmanuelle , Lippens Guy , Charlier Cyril 
Published: September 2024

AbstractPETases are enzymes that can break down the PET polymer in its constituent building blocks, and thereby recycle starting material for new high-quality plastics. NMR spectroscopy can help in the understanding and ultimately improvement of these PETases, but is always confronted with the lengthy step of acquisition and interpretation of triple resonance spectra for the spectral assignment. Here, we explore whether this step can be made more efficient by recording the spectra directly at high temperature, which also corresponds to more realistic working conditions for the enzyme. Taking the inactive variant of LCCICCGin which the Serine 165 has been replaced by an Alanine (LCCICCG-S165A) as an example, we evaluate spectral quality at 30°C and 50°C, and find that the latter condition greatly improves the Signal-to-Noise (S/N) ratio of the different spectra. As a result, we present an exhaustive backbone and side-chain assignment of LCCICCG-S165A based on a minimal set of triple resonance spectra acquired at 50°C, that can act as a basis for future work on bio-structural studies on this PETase.
Prerelaxation in quantum, classical, and quantum-classical two-impurity models
Authors: Elbracht Michael , Potthoff Michael 
Published: September 2024

We numerically study the relaxation dynamics of impurity-host systems, focusing on the presence of long-lived metastable states in the nonequilibrium dynamics after an initial excitation of the impurities. In generic systems, an excited impurity coupled to a large bath at zero temperature is expected to relax and approach its ground state over time. However, certain exceptional cases exhibit metastability, where the system remains in an excited state on timescales largely exceeding the typical relaxation time. We study this phenomenon for three prototypical impurity models: a tight-binding quantum model of independent spinless fermions on a lattice with two stub impurities, a classical-spin Heisenberg model with two weakly coupled classical impurity spins, and a tight-binding quantum model of independent electrons with two classical impurity spins. Through numerical integration of the fundamental equations of motion, we find that all three models exhibit similar qualitative behavior: complete relaxation for nearest-neighbor impurities and incomplete or strongly delayed relaxation for next-nearest-neighbor impurities. The underlying mechanisms leading to this behavior differ between models and include impurity-induced bound states, emergent approximately conserved local observables, and exact cancellation of local and nonlocal dissipation effects.

Published by the American Physical Society
2024
Navigating barriers to organic food purchase intention: a mixed method longitudinal approach in emerging market
Authors: Chakraborty Debarun , Choubey Vardhan , Joshi Prasad , Dash Ganesh , Camilleri Mark Anthony , Zhang Justin 
Published: September 2024

PurposeThis study investigates barriers to consumers’ organic food purchasing. It identifies the factors and the extent to which they influence their purchase behaviours and future purchase intentions (i.e. continuance purchase intentions).Design/methodology/approachIt combines qualitative and quantitative methods across two phases. Longitudinal research was carried out in two phases. It involved a thematic analysis and a covariance-based structural equation modelling approach. During Phase-1 and Phase-2, responses were collected from 376 and 351 respondents, respectively.FindingsPhase 1 found the value barrier was significantly affecting the consumers’ purchase intention, while Phase 2 identified the impacts from both image and value barriers on purchase intentions. Notably, purchase intention affected continuance intention in both phases, while ethnocentrism showed no influence.Originality/valueUsing the innovation resistance theory, this study sheds light on the factors that prevent purchase intention. It offers valuable insights for policymakers and for the marketers of organic foods. This contribution implies that value and usage barriers were affecting the consumers’ purchase intentions in the short as well as in the long term. In sum, it suggests that consumers were not purchasing organic food as they felt it was either overpriced, not available in the market or because they were sceptical about its organic labelling.