bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insights into brominated flame retardant neurotoxicity: mechanisms of hippocampal neural cell death and brain region-specific transcriptomic shifts in mice
Authors: Kramer Naomi E , Fillmore Courtney E , Slane Elizabeth G , Barnett Lillie M A , Wagner John J , Cummings Brian S 
Published: July 2024

Abstract
Brominated flame retardants (BFRs) reduce flammability in a wide range of products including electronics, carpets, and paint, but leach into the environment to result in continuous, population-level exposure. Epidemiology studies have correlated BFR exposure with neurological problems, including alterations in learning and memory. This study investigated the molecular mechanisms mediating BFR-induced cell death in hippocampal cells and clarified the impact of hexabromocyclododecane (HBCD) exposure on gene transcription in the hippocampus, dorsal striatum, and frontal cortex of male mice. Exposure of hippocampus-derived HT-22 cells to various flame retardants, including tetrabromobisphenol-A (current use), HBCD (phasing out), or 2,2',4,4'-tetrabromodiphenyl ether (BDE-47, phased out) resulted in time, concentration, and chemical-dependent cellular and nuclear morphology alterations, alterations in cell cycle and increases in annexin V staining. All 3 BFRs increased p53 and p21 expression; however, inhibition of p53 nuclear translocation using pifthrin-α did not decrease cell death. Transcriptomic analysis upon low (10 nM) and cytotoxic (10 μM) BFR exposure indicated that HBCD and BDE-47 altered genes mediating autophagy-related pathways. Further evaluation showed that BFR exposure increased LC3-II conversion and autophagosome/autolysosome formation, and co-exposure with the autophagy inhibitor 3-methyladenine (3-MA) attenuated cytotoxicity. Transcriptomic assessment of select brain regions from subchronically HBCD-exposed male mice demonstrated alteration of genes mediating vesicular transport, with greater impact on the frontal cortex and dorsal striatum compared with the dorsal and ventral hippocampus. Immunoblot analysis demonstrated no increases in cell death or autophagy markers, but did demonstrate increases in the SNARE binding complex protein SNAP29, specifically in the dorsal hippocampus. These data demonstrate that BFRs can induce chemical-dependent autophagy in neural cells in vitro and provide evidence that BFRs induce region-specific transcriptomic and protein expression in the brain suggestive of changes in vesicular trafficking.
Association between Intraoperative Hypotension and Postoperative Delirium: A Retrospective Cohort Analysis
Authors: Zarour Shiri , Weiss Yotam , Abu-Ghanim Maher , Iacubovici Liat , Shaylor Ruth , Rosenberg Omer , Matot Idit , Cohen Barak 
Published: July 2024

Background
Intraoperative hypotension might contribute to the development of postoperative delirium through inadequate cerebral perfusion. However, evidence regarding the association between intraoperative hypotension and postoperative delirium is equivocal. Therefore, the hypothesis that intraoperative hypotension is associated with postoperative delirium in patients older than 70 yr having elective noncardiac surgery was tested .

Methods
This was a retrospective cohort analysis of patients older than 70 yr who underwent elective noncardiac surgery in a single tertiary academic center between 2020 and 2021. Intraoperative hypotension was quantified as the area under a mean arterial pressure (MAP) threshold of 65 mmHg. Postoperative delirium was defined as a collapsed composite outcome including a positive 4 A’s test during the initial 2 postoperative days, and/or delirium identification using the Chart-based Delirium Identification Instrument. The association between hypotension and postoperative delirium was assessed using multivariable logistic regression, adjusting for potential confounding variables. Several sensitivity analyses were performed using similar regression models.

Results
In total, 2,352 patients were included (median age, 76 yr; 1,112 [47%] women; 1,166 [50%] American Society of Anesthesiologists Physical Status III or greater; 698 [31%] having high-risk surgeries). The median [interquartile range] intraoperative area under the curve below a threshold of MAP less than 65 mmHg was 28 [0, 103] mmHg · min. The overall incidence of postoperative delirium was 14% (327 of 2,352). After adjustment for potential confounding variables, hypotension was not associated with postoperative delirium. Compared to the first quartile of area under the curve below a threshold of MAP less than 65 mmHg, patients in the second, third, and fourth quartiles did not have more postoperative delirium, with adjusted odds ratios of 0.94 (95% CI, 0.64 to 1.36; P = 0.73), 0.95 (95% CI, 0.66 to 1.36; P = 0.78), and 0.95 (95% CI, 0.65 to 1.36; P = 0.78), respectively. Intraoperative hypotension was also not associated with postoperative delirium in any of the sensitivity and subgroup analyses performed.

Conclusions
To the extent of hypotension observed in our cohort, our results suggest that intraoperative hypotension is not associated with postoperative delirium in elderly patients having elective noncardiac surgery.

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Skin Barrier Function of Black African and White Nursing Students
Authors: Young Monica , Franken Anja , du Plessis Johannes Lodewykus 
Published: July 2024

ABSTRACTAimsAssessment of skin biophysical parameters in a South African nursing population may provide insight in long-term changes in their skin condition in a practical setting. This study aimed to investigate changes in skin barrier function parameters over a period of 2 years, in nursing students completing their tertiary education.MethodsTransepidermal water loss, stratum corneum (SC) hydration, and skin surface pH were measured in female nursing students (63 white, 42 Black African) three times a year and repeated for 2 years. Linear mixed models and Bonferroni post hoc tests were performed to test changes over time in skin barrier function parameters.ResultsTransepidermal water loss and SC hydration significantly (p< .001) decreased over 2 years in first-year students, whereas only specific differences were established for senior students. Skin surface pH significantly (p< .001) varied over the 2 years with significant increases (p< .031) in the winter months. The only significant difference (p< .001) between white and Black African students was established in skin surface pH.ConclusionThis study demonstrated the variability of skin barrier function parameters, specifically seasonal variation in skin surface pH. This study also revealed possible long-term changes in skin condition through the recovery of the SC in a practical setting.
Perihippocampal failure after hippocampal-avoidance brain radiotherapy in small cell lung cancer patients: Cases report and literature review
Authors: Ho Yi-Chia , Shieh Li-Tsun , Lin Chia-Hui , Chen Chia-Chun , Ho Sheng-Yow 
Published: July 2024

Rationale:
Brain metastasis is a major concern, and may occur in roughly 50% of patients during the clinical course of small cell lung cancer (SCLC). Because prophylactic cranial irradiation reduces the incidence of brain metastases and improves overall survival, prophylactic cranial irradiation is recommended for SCLC patients without distant metastases or an extensive stage and have responded well to systemic therapy. Hippocampal-avoidance whole-brain radiotherapy (HA-WBRT) is preferred to preserve hippocampal function while minimizing negative cognitive effects.

Patient concerns:
Reducing the dose delivered to the hippocampus below the therapeutic brain dose may increase the risk of hippocampal progression; thus, HA-WBRT may be associated with a risk of perihippocampal recurrence.

Diagnosis:
Three patients with SCLC received HA-WBRT and developed intracranial failure during clinical follow-up; 3 relapsed with intracranial failure in the perihippocampal region after 12, 13, and 7 months, respectively.

Intervention and outcomes:
Compared to the therapeutic brain dose of cases and the underdose region around the HA region, we matched MRI scans of intracranial failure and previous planning scans of simulation and found a deviation of the underdosed region within the perihippocampal failure of approximately 55% to 63%.

Lessons:
Perihippocampal failure is a rare clinical outcome in SCLC patients following HA-WBRT. Perihippocampal failure could be caused by an underdose of radiation or by the aggressiveness of the cancer itself. More research into this topic is encouraged.
Anterior quadratus lumborum block provided superior pain control and reduced opioid consumption in kidney transplantation: A randomized controlled trial
Authors: Theeraratvarasin Cheevathun , Jirativanon Tachawan , Taweemonkongsap Tawatchai , Liangkobkit Karn , Aussavavirojekul Pubordee , Jitpraphai Siros , Chotikawanich Ekkarin , Woranisarakul Varat , Hansomwong Thitipat 
Published: July 2024

Background:
The research aimed to assess the effectiveness of inside-out anterior quadratus lumborum (QL3) block and local wound infiltration in managing postoperative pain and total morphine dosage following kidney transplantation.

Methods:
In this prospective, randomized, double-blind study; 46 end-stage renal disease patients undergoing kidney transplantation were randomly allocated into 2 groups: a QL group (n = 23) receiving 20 mL of 0.25% bupivacaine using the ultrasound-assisted inside-out technique before wound closure, while the local wound infiltration (LA) group (n = 23) receiving the same dose around the surgical wound and drain at the time of skin closure. The primary outcome measure was the numerical pain rating scale, with secondary outcomes including amount of morphine consumption at various postoperative time points (2nd, 4th, 6th, 12th, 18th and 24th hours).

Results:
Patients in the QL group had significantly lower numerical rating scale scores at the 2nd and 4th hours, both at rest and during movement (P < .05). Although pain scores at rest and during movement at later time points were lower in the QL group compared to the LA group, these differences were not statistically significant. Cumulative morphine consumption at postoperative 4th, 6th, 12th, 18th and 24th hours was significantly lower in the QL group (P < .05). No patients experienced complications from the QL3 block.

Conclusion:
Ultrasound-assisted inside-out QL3 block significantly reduced postoperative pain levels at the 2nd and 4th hours, both at rest and during movement, and led to a reduction in cumulative morphine consumption from the 4th hour postoperatively, and persisting throughout the 24-hour period.
Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials
Authors: Deng Yun-Peng , Zhou Yan-Li , Wei Teng-Teng , He Guang-Shuai , Zhu Zhi-Xin , Zhang Shu-Ning , Liu Mei-Jun , Xue Jing-Jing , Zhang Wei-Xing , Yang Xu-Guang 
Published: July 2024

Background:
Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA).

Methods:
In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0.

Results:
This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate.

Conclusion:
The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.
Injection, hematoma, abscess, systemic inflammatory response syndrome, stairway to hell: Case report
Authors: Gokkus Kemal , Sargin Baris , Haberal Bahtiyar , Sahin Mehmet Sukru 
Published: July 2024

Rationale:
Intramuscular injections are routine outpatient procedure performed at healthcare institutions worldwide. In the current literature, there have been very few reports of gluteal superior artery injuries due to incorrect injection techniques. However, no one has ever reported a healthy middle-aged man with systemic inflammatory response syndrome with possible injection-related bleeding from the gluteus superior artery, followed by a hematoma, and then a deep abscess after 3 weeks of not receiving treatment.

Patient concerns:
A 40-year-old man presented with pain in his buttock, a fever of 40°, and a lump after a dorso-gluteal injection. (November, 2022) The patient was diagnosed with systemic inflammatory response syndrome due to a deep abscess related to a hematoma caused by a possible superior gluteal artery branch injury.

Diagnoses:
He was admitted to our institution with a lump, pain in his buttock, and a fever of 40° after a dorso-gluteal injection. The patient had diffuse swelling and tenderness in the upper-posterior aspect of the gluteal region. Systemic examination revealed yellow sclera and icteric skin appearance. Blood tests showed low hemoglobin levels and increased pre-sepsis parameters (procalcitonin and indirect bilirubin). Pelvic MRI and ultrasonography revealed a gluteal abscess.

Interventions:
The patient was transferred to the operating theater, where a curved incision was made behind the trochanter. The gluteus maximus was bluntly dissected, and abscess fluid was drained from the muscle. Continuous bleeding was detected, suggesting iatrogenic superior gluteal artery branch injury at the time of the injection.

Outcome:
After drainage and antibiotic treatment, the patient’s parameters normalized within 5 days, and the patient was discharged. The patient’s weekly follow-up examinations were normal, and he was able to walk without a limp. A postoperative visit to the outpatient clinic 2 months after the operation and a telephone call 17 months later showed that the patient was completely healthy and able to work.

Lessons:
The dorso-gluteal technique has potential risks, including possible injury to the sciatic nerve and superior gluteal artery and irritation of the subcutaneous adipose tissue. This article aims to highlight the potential risks of a particular technique and advocate the use of the ventrogluteal technique instead of the traditional dorso-gluteal technique.
Association of Surgeon Self-Reported Gender and Surgical Outcomes in Current US Practice
Authors: Scali Salvatore T. , Columbo Jesse A. , Hawn Mary T. , Mitchell Erica L. , Neal Dan , Wong Sandra L. , Huber Thomas S. , Upchurch Gilbert R. , Stone David H. 
Published: July 2024

Objective:
This study aimed to evaluate the association of surgeon self-reported gender on clinical outcomes in contemporary US surgical practice.

Background:
Previous research has suggested that there are potentially improved surgical outcomes for female surgeons, yet the underlying causal path for this association remains unclear.

Methods:
Using the Vizient Clinical Database(2016–2021), 39 operations categorized by the CDC’s National Healthcare Safety Network were analyzed. The surgeon self-reported gender as the primary exposure. The primary outcome was a composite of in-hospital death, complications, and/or 30-day readmission. Multivariable logistic regression and propensity score matching were used for risk adjustment.

Results:
The analysis included 4,882,784 patients operated on by 11,955 female surgeons (33% of surgeons performing 21% of procedures) and 23,799 male surgeons (67% of surgeons performing 79% of procedures). Female surgeons were younger (45±9 vs males-53±11 y; P<0.0001) and had lower operative volumes. Unadjusted incidence of the primary outcome was 13.6%(10.7%-female surgeons, 14.3%-male surgeons; P<0.0001). After propensity matching, the primary outcome occurred in 13.0% of patients [12.9%-female, 13.0%-male; OR (M vs. F)=1.02, 95% CI: 1.01–1.03; P=0.001), with female surgeons having small statistical associations with lower mortality and complication rates but not readmissions. Procedure-specific analyses revealed inconsistent or no surgeon-gender associations.

Conclusions:
In the largest analysis to date, surgeon self-reported gender had a small statistical, clinically marginal correlation with postoperative outcomes. The variation across surgical specialties and procedures suggests that the association with surgeon gender is unlikely causal for the observed differences in outcomes. Patients should be reassured that surgeon gender alone does not have a clinically meaningful impact on their outcome.
How perceived local iconness of culturally mixed products enhances purchase intention:the mediating role of consumer perceived value
Authors: Zeng Wanping , Kim Eunmi 
Published: July 2024

PurposeThis study investigates the underlying mechanism through which perceived local iconness increases customers’ purchase intentions for culturally mixed products.Design/methodology/approachIt utilizes an online survey with purposive sampling to gather data. Structural equation modeling is applied to examine data gathered from 471 Chinese customers.FindingsConsumers’ perceived local iconness of culturally mixed products positively influences their purchase intentions, and this connection is mediated by perceptions of quality, social and emotional values.Practical implicationsIncorporating Chinese cultural elements that can evoke local iconness perceptions among Chinese consumers is necessary for global brands. Moreover, when creating or promoting culturally mixed products, global brands should carefully consider consumers’ perceived quality, social and emotional values.Originality/valueDrawing on the signaling theory, this study advances knowledge on how local iconness increases the value of and customers’ desire to purchase culturally mixed products. It provides practical suggestions on how global brands can succeed when launching culturally mixed products in emerging markets.
How do temporal psychological distance and grandiose narcissism affect tourists’ travel motivation and attraction visit intention?
Authors: Tan Wee Kheng , Yang Chieh-Yu 
Published: July 2024

PurposeLiterature has paid limited attention to narcissism’s influence on tourism. The pre-trip planning stage involves temporal psychological distance, where decision-making regarding the trip stretches over a period of time and occurs anytime during that period. Using narcissism theory and with temporal distance (6 months and 1 week before the trip) as the moderator, this study examines how tourists’ self-sacrificing self-enhancement and grandiose fantasy – grandiose narcissism facets – and travel motivations affect attraction visit intentions.Design/methodology/approachPartial least squares (PLS) analysis was applied on survey information obtained from 374 individuals (200 and 174 were six-months and one-week scenarios, respectively).FindingsGrandiose narcissism facets affect motivations and visit intentions to various attractions at different temporal distances. The consequences of grandiose fantasy and self-sacrificing self-enhancement on motivation become evident as temporal distance decreases. At large temporal distances, grandiose fantasy positively influences social recognition motivation. At short temporal distances, it positively influences social recognition and ego and negatively influences scenery and relaxation motivations. Self-sacrificing self-enhancement positively influences socialization, exploration, scenery, relaxation and escape motivations at large temporal distances. At short temporal distances, self-sacrificing self-enhancement positively influences historical attraction visit intentions.Originality/valueGrandiose narcissism facets’ influence on tourism is rarely examined. This study extends the temporal distance concept to the narcissism theory. It integrates the effects of grandiose narcissism and temporal distance on tourists’ motivations and different attraction type visit intentions and shows that motivation is temporally distance-specific.
Driving organizational value through sustainable business processes and green information technology
Authors: Haleem Fazal , Ilyas Muhammad , Jehangir Muhammad 
Published: July 2024

PurposeThe study explores the pivotal role of green information technology and sustainable business processes and their impact on organizational value in an underdeveloped economy. It aims to develop a comprehensive model for driving organizational value through sustainable initiatives.Design/methodology/approachData was gathered through 474 survey instruments (41% response rate) from top managers of IT firms using a convenience sampling technique. After ensuring reliability and validity, hypotheses were tested using structural equation modeling. Data analysis utilized SPSS and AMOS 21.0.FindingsThe study revealed a significant positive impact of green information technology initiatives on financial and non-financial aspects, enhancing overall organizational value. Similarly, green information technology significantly influences sustainable business processes. Furthermore, sustainable business processes, encompassing economic, social, and environmental dimensions, enhance organizational value, including financial and non-financial performance. Consequently, a multifaceted sustainable model has been developed to optimize organizational value, providing new insights.Practical implicationsThe findings imply that firms should focus on acquiring new green technologies and adopting sustainable processes, leading to enhanced profits and non-financial gains. This study aids managers in strategy development and implementation and guides policymakers in formulating context-specific policies. It enriches the existing literature on green IT, business process management, and organizational value.Originality/valueThe study rigorously tested a framework for fostering organizational value through green information technology and sustainable business processes in information technology firms. The proposed framework was validated using structural equation modeling.