bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defining the Concept of Acoustic Neuroprotection in the Neonate
Authors: Chumley Peyton Lewis , Dudding Katherine M. , Patrician Patricia 
Published: June 2024

Background:
It has long been understood and acknowledged that the Neonatal Intensive Care Unit (NICU) environment and the transport environments are extremely loud, with both long- and short-term sequelae to the neonate, being well over the recommended amount of noise by the American Academy of Pediatrics (AAP). This problem has yet to be properly addressed. The purpose of this manuscript is to define and explain the concept of acoustic neuroprotection. While we cannot change the internal structures of the neonates’ auditory system, we could change the acoustics of the environment to be support neuroprotection of these sensitive patients.

Evidence acquisition:
Walker and Avant’s concept analysis steps were followed to create and define the idea of acoustic neuroprotection, as it has not had a definition before. A total of 45 articles from multiple search engines were chosen. A combination of 2 concepts were used: acoustic protection and neurodevelopmental protection/support. The search was expanded past 20 years for lack of research and importance of seminal works.

Results:
To achieve acoustic neuroprotection, a neonate should not be exposed to sound greater than 45 decibels (dBa) for longer than 10 s, and exposure to sound above 80 dBa should never occur. Appropriate interventions need to include supporting the neurodevelopment of the neonate through therapeutic sound, while decreasing the amount of toxic noise exposure to safe levels.

Implications for Practice and research:
By further understanding and having a quantifiable goal of acoustic neuroprotection for neonates, neonatal clinicians can work together to create new interventions for how to better protect and support the care of our tiniest patients.
Let’s Talk Safety – Data from the Neonatal Intensive Care Unit Safety and Bed Capacity Huddles
Authors: O’Malley Teresa , Capone Jamie , Perla Brittanie , Vasbinder Sheila 
Published: June 2024

Background:
Huddles are brief team meetings designed to communicate essential information. Safety huddles provide a forum to identify and review patient safety events. In a just culture, everyone is accountable for patient safety.

Purpose:
The purpose of this project is to discuss safety issues/events at the twice daily bed capacity huddles in a Level IV Neonatal Intensive Care Unit (NICU) utilizing a just culture model. Having daily discussions of patient safety and the escalation process for follow-up promotes a just culture. The aims are to improve the unit’s culture of safety and learn from patient safety issues.

Methods:
A just culture model was adopted to promote discussion of safety events during the huddles. A structured checklist of safety events was utilized along with a script of ground rules. Twice a day, a multidisciplinary group gathers to huddle. Nurse leaders facilitate the discussion, track the results, and provide follow-up.

Results:
The structured safety huddle began in May of 2020 and continues twice daily. All required staff attend. The escalation process is defined and has prevented recurrence of some safety issues. The NICU experienced a 14% increase in favorable results on the Agency for Healthcare Research and Quality (AHRQ) culture of safety survey since the inception of the structured safety huddles.

Implications for Practice and Research:
Safety huddle discussions have impacted the culture of safety on this unit. Tracking of discussions can help to identify trends, improve processes, and impact patient safety.
Postoperative Access and Compliance Following Medial Patellofemoral Ligament Reconstruction in Hispanic Adolescents Mirrors the Non-Hispanic Adolescent Population
Authors: Howard Roland A. , Morales Jose A. , Ordaz Angel , Bryan Tracey P. , Edmonds Eric W. 
Published: June 2024

Background:
Disparity in surgical care of patellar instability patients has not been fully investigated in the adolescent Hispanic population. This demographic has been shown to have differences in their care, including a lower rate of surgical treatment for patellar instability. Socioeconomic factors have been cited as a factor that influences patient outcomes and its relationship with ethnicity in context of patellar instability has not been evaluated.

Methods:
Review performed of patients <19 years of age who underwent MPFL reconstruction between September 2008 and December 2015. Demographics, patient median household income data, and clinical variables were collected. Generalized linear mixed model (GLMM) with subject as random effects factor was utilized to evaluate differences between ethnicity groups due to nonindependence of data. It was then expanded to incorporate interactions between ethnicity and income.

Results:
Ninety-five patellar dislocation events met criteria in 85 adolescents (mean age: 15.5 y). Thirty-four (40%) adolescents identified as Hispanic. In univariate analysis no differences were found between Hispanic and non-Hispanic patients. The multivariate GLMM demonstrated a significant interaction between ethnicity and income. The Hispanic group in the >100% State median income category had the highest rate of postoperative clinic appointments attended (P=0.019). The Hispanic group in the <100% State median income category had the lowest rate of physical therapy appointments attended (P=0.044). No differences were observed for duration of follow-up (P=0.57) or final Kujala score (P=0.75).

Conclusions:
Hispanic ethnicity alone is not associated with inferior postoperative management after MPFL reconstruction in adolescents. However, when socioeconomic status is considered, Hispanic patients of lower-income backgrounds are found to have lower compliance with postoperative rehab recommendations.

Level of Evidence:
Level III.
Tibial Tubercle Osteotomy With and Without Medial Patellofemoral Ligament Reconstruction in Adolescent Patients Leads to Decrease in Patellar Height and Patella Tendon Length
Authors: McNamara Natalya E. , Shing Elaine Z. , Khalil Ameen Z. , Tabish Erin M. , Featherall Joseph T. , Rosenthal Reece M. , Maak Travis G. , Aoki Stephen K. , Ernat Justin J. 
Published: June 2024

Objective:
Patellar height changes after tibial tubercle osteotomy (TTO) have not yet been described. We aimed to evaluate whether TTO ± medial patellofemoral ligament reconstruction (MPFL-R) influences patellar height and tendon length, hypothesizing that TTO would decrease patellar height and tendon length.

Methods:
A retrospective review was performed of skeletally mature adolescents (<18 y) receiving primary anteromedialization or medialization TTO ± MPFL-R. Patients with at least 6 months of radiographic follow-up were included in the study. Pre and postoperative patellar heights were assessed on lateral, weight-bearing, and flexion (30 to 70 degrees) radiographs using the Blackburne-Peel Index (BPI), Caton-Deschamps Index (CDI), and Insall-Salvati Ratio (ISR). Subgroup analyses were performed to compare patellar height changes in patients with preoperative patella alta, norma, and baja, as well as between patients undergoing medialization and anteromedialization TTO. Data were analyzed for normality using a Shapiro-Wilk test, and paired-sample t tests were performed.

Results:
Forty-nine knees were included (mean age: 15 y; range: 12 to 17). A significant decrease in mean patellar height after TTO ± MPFL-R was observed across all measures: BPI (0.12, P = 0.000783), CDI (0.08, P = 0.01062), and ISR (0.15, P = 0.00000075). Patellar tendon length decreased by 2.26 mm (P = 0.001272). Subgroup analyses demonstrated a decrease in mean patellar height across all 3 measurements (P < 0.001; BPI, CDI, and ISR) for patients with preoperative patella alta but not patella norma or baja. Additional subgroup analysis showed a patellar height decrease using BPI (0.15, P = 0.004583) and ISR (0.14, P = 0.0002806) for patients receiving medialization TTO but not anteromedialization. The anteromedialization cohort did not demonstrate patellar height change using BPI and CDI; ISR demonstrated a decrease (0.10, P = 0.00917).

Conclusions:
Mean patellar height and tendon length decreases after TTO ± MPFL-R in skeletally mature, adolescent patients. Subgroup analyses suggest these changes occur in patients with preoperative patella alta and/or patients who undergo medialization TTO. These data suggest that some distalization in patellar positioning may be achieved without formal distalization osteotomy.
What is the Association of the Subsections of the Oswestry Disability Index and Overall Improvement Two Years after Lumbar Surgery for Degenerative Lumbar Spondylolisthesis?
Authors: Hambrecht Jan , Köhli Paul , Duculan Roland , Lan Ranqing , Chiapparelli Erika , Guven Ali E. , Evangelisti Gisberto , Burkhard Marco D. , Tsuchiya Koki , Shue Jennifer , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Mancuso Carol A. , Hughes Alexander P. 
Published: June 2024

Study Design.
Retrospective review of a prospective cohort study

Objective.
To identify the association between Oswestry Disability Index (ODI) subsections and overall improvement 2 years after lumbar surgery for degenerative lumbar spondylolisthesis (DLS).

Background.
DLS often necessitates lumbar surgery. The ODI is a trusted measure for patient-reported outcomes (PROMs) in assessing spinal disorder outcomes. Surgeons utilize the ODI for baseline functional assessment and post-surgery progress tracking. However, it remains uncertain if and how each subsection influences overall ODI improvement.

Methods.
This retrospective cohort study analyzed patients who underwent lumbar surgery for DLS between 2016 and 2018. Preoperative and 2-year postoperative ODI assessments were conducted. The study analyzed postoperative subsection scores and defined ODI improvement as ODIpreop-ODIpostop >0. Univariate linear regression was applied, and receiver operating characteristic (ROC) analysis determined cut-offs for subsection changes and postoperative target values to achieve overall ODI improvement.

Results.
265 patients (60% female, mean age 67±8 y) with a baseline ODI of 50±6 and a postoperative ODI of 20±7 were included. ODI improvement was noted in 91% (242 patients). Achieving a postoperative target score of ≤2 in subsections correlated with overall ODI improvement. Walking had the highest predictive value for overall ODI improvement (AUC 0.91, sensitivity 79%, specificity 91%). Pain intensity (AUC 0.90, sensitivity 86%, specificity 83%) and changing degree of pain (AUC 0.87, sensitivity 86%, specificity 74%) were also highly predictive. Sleeping had the lowest predictability (AUC 0.79, sensitivity 84%, specificity 65%). Except for sleeping, all subsections had a Youden-index >50%.

Conclusion.
These findings demonstrate how the different ODI subsections associate with overall improvement post-lumbar surgery for DLS. This understanding is crucial for refining preoperative education, addressing particular disabilities, and evaluating surgical efficacy. Additionally, it shows that surgical treatment does not affect all subsections equally.
Bevacizumab Combination Therapy Versus Standard Chemotherapy for Ovarian Cancer in Shorter and Longer Follow-Up Duration
Authors: Rehman Obaid Ur , Fatima Eeshal , Imran Hiba , Akram Umar , Ahmad Amna Badar , Nadeem Zain Ali , Fatima Laveeza , Hussain Ahmad , Mabrouk Manar Alaa , Farooq Muhammad Zain 
Published: June 2024

Objective:
This systematic review and meta-analysis aims to evaluate the efficacy and safety of bevacizumab in patients with ovarian cancer over a shorter and longer follow-up period.

Methods:
We searched Medline, Cochrane CENTRAL, Scopus, and Google Scholar for all phase 3 randomized controlled trials (RCTs) that administered bevacizumab to women with ovarian cancer. Review Manager 5.4 was used to calculate risk ratios (RR) and hazard ratios (HR) with 95% CIs. We assessed the quality of the included studies using version 2 of the Cochrane Risk of Bias tool (RoB 2).

Results:
After screening the titles, abstracts, and full texts, we included nine RCTs in our systematic review and meta-analysis. Four RCTs had a low risk of bias, while 5 had some concerns. Bevacizumab was associated with a progression free survival benefit for <36 months (HR: 0.59, 95% CI: 0.45-0.76, P<0.0001, I
2=90%) and >36 months (HR: 0.66, 95% CI: 0.55-0.80, P<0.0001, I
2=80%), and an overall survival benefit for <36 months (HR: 0.87, 95% CI: 0.78-0.98, P=0.02, I
2=0%) but not for >36 months (HR: 0.98, 95% CI: 0.89-1.09, P=0.77, I
2=30%). There was no difference in deaths between intervention and control groups <36 months (RR: 0.95, 95% CI: 0.86-1.04, P=0.26, I
2=10%) or >36 months (RR: 1.02, 95% CI: 0.97-1.06, P=0.50, I
2=0%). Bevacizumab reduced disease progression <36 months (RR: 0.82, 95% CI: 0.72-0.92, P=0.0008, I
2=82%) but not at >36 months (RR: 0.83, 95% CI: 0.58-1.19, P=0.30, I
2=94%). The adverse events reported with Bevacizumab use included thrombocytopenia, neutropenia, leukocytopenia, anemia, hypertension, bleeding or hemorrhage, and gastrointestinal, cardiac, and dermatological adverse events.

Conclusion:
Bevacizumab may improve progression-free survival within and after 36 months, overall survival within 36 months, and reduce disease progression within 36 months.
Hypofractionated Radiation Therapy
Authors: Ritter Alex R. , Prasad Rahul N. , Jhawar Sachin R. , Bazan Jose G. , Gokun Yevgeniya , Vudatala Sundari , Diaz Dayssy A. 
Published: June 2024

Objectives:
For many malignancies, hypofractionated radiotherapy (HFRT) is an accepted standard associated with decreased treatment time and costs. United States provider beliefs regarding HFRT likely impact its adoption but are poorly studied. We surveyed US-based radiation oncologists (ROs) to gauge HFRT utilization rates for prostate (PC), breast (BC), and rectal cancer (RC) and to characterize the beliefs governing these decisions.

Methods:
From July to October 2021, an anonymized, online survey was electronically distributed to ROs actively practicing in the United States. Demographic and practice characteristic information was collected. Questions assessing rates of offering HFRT for PC, BC, and RC and perceived limitations towards using HFRT were administered.

Results:
A total of 203 eligible respondents (72% male, 72% White, 53% nonacademic practice, 69% with 11+ years in practice) were identified. Approximately 50% offered stereotactic body radiation therapy (SBRT) for early/favorable intermediate risk PC. Although >90% of ROs offered whole-breast HFRT for early-stage BC, only 33% offered accelerated partial-breast irradiation (APBI). Overall, 41% of ROs offered short-course neoadjuvant RT for RC. The primary reported barriers to HFRT utilization were lack of data, inexperience, and referring provider concerns.

Conclusions:
HFRT is safe, effective, and beneficial, yet underutilized—particularly prostate SBRT, APBI, and short-course RT for RC. Skills retraining and education of ROs and referring providers may increase utilization rates.
Convective forces contribute to post-traumatic degeneration after spinal cord injury
Authors: Kwon Hoi Y , Streilein Christopher , Chase Cornelison R. 
Published: June 2024

AbstractSpinal cord injury (SCI) initiates a complex cascade of chemical and biophysical phenomena that result in tissue swelling, progressive neural degeneration, and formation of a fluid-filled cavity. Previous studies show fluid pressure above the spinal cord (supraspinal) is elevated for at least three days after injury and contributes to a phase of damage called secondary injury. Currently, it is unknown how fluid forces within the spinal cord itself (interstitial) are affected by SCI and if they contribute to secondary injury. We find spinal interstitial pressure increases from -3 mmHg in the naive cord to a peak of 13 mmHg at 3 days post-injury (DPI) but relatively normalizes to 2 mmHg by 7 DPI. A computational fluid dynamics model predicts interstitial flow velocities up to 0.9 μm/s at 3 DPI, returning to near baseline by 7 DPI. By quantifying vascular leakage of Evans Blue dye after a cervical hemi-contusion in rats, we confirm an increase in dye infiltration at 3 DPI compared to 7 DPI, suggestive of higher fluid velocities at the time of peak fluid pressure.In vivoexpression of the apoptosis marker caspase-3 is strongly correlated with regions of interstitial flow at 3 DPI, and exogenously enhancing interstitial flow exacerbates tissue damage.In vitro, we show overnight exposure of neuronal cells to low pathological shear stress (0.1 dynes/cm2) significantly reduces cell count and neurite length. Collectively, these results indicate that interstitial fluid flow and shear stress may play a detrimental role in post-traumatic neural degeneration.Translational Impact StatementTrauma to the central nervous system induces neural tissue degeneration, resulting in permanent disability and loss of function. A better understanding of this degenerative process is needed, towards developing new clinical treatments that effectively minimize tissue damage and preserve neural function after injury. The present study identifies a potential role for altered fluid transport within the injured spinal cord. These results provide new insight into basic pathophysiology and may inform therapeutic development for neuroprotection.
Genome-wide Mapping of Topoisomerase Binding Sites Suggests Topoisomerase 3α (TOP3A) as a Reader of Transcription-Replication Conflicts (TRC)
Authors: Zhang Hongliang , Sun Yilun , Saha Sourav , Saha Liton Kumar , Pongor Lorinc S. , Dhall Anjali , Pommier Yves 
Published: June 2024

ABSTRACTBoth transcription and replication can take place simultaneously on the same DNA template, potentially leading to transcription-replication conflicts (TRCs) and topological problems. Here we asked which topoisomerase(s) is/are the best candidate(s) for sensing TRC. Genome-wide topoisomerase binding sites were mapped in parallel for all the nuclear topoisomerases (TOP1, TOP2A, TOP2B, TOP3A and TOP3B). To increase the signal to noise ratio (SNR), we used ectopic expression of those topoisomerases in H293 cells followed by a modified CUT&Tag method. Although each topoisomerase showed distinct binding patterns, all topoisomerase binding signals positively correlated with gene transcription. TOP3A binding signals were suppressed by DNA replication inhibition. This was also observed but to a lesser extent for TOP2A and TOP2B. Hence, we propose the involvement of TOP3A in sensing both head-on TRCs (HO-TRCs) and codirectional TRCs (CD-TRCs). In which case, the TOP3A signals appear concentrated within the promoters and first 20 kb regions of the 5’ -end of genes, suggesting the prevalence of TRCs and the recruitment of TOP3A in the 5’-regions of transcribed and replicated genes.GRAPHICAL ABSTRACT
A Multi-Country Evaluation of Patient Preferences for Tuberculosis Diagnostics: A Discrete Choice Experiment to Inform WHO Target Product Profiles
Authors: Shah Kinari , Nalugwa Talemwa , Marcelo Danaida , Nakawunde Robinah , Trinh Trang , Shankar Deepa , Nakaweesa Annet , Schraufnagel Ann , Andama Alfred , Christopher DJ , Van Luong Dinh , Theron Grant , Worodria William , del Mar Castro Maria , Nahid Payam , Denkinger Claudia M. , Cattamanchi Adithya , Yu Charles , Kerkhoff Andrew D. 
Published: June 2024

AbstractBackgroundRecognizing new and improved diagnostics as a key step to reducing the global tuberculosis (TB) burden, the World Health Organization (WHO) publishes target product profiles (TPPs) to guide development of novel TB diagnostics; however, TPPs have not included the preferences of people undergoing TB testing. Understanding their preferences is crucial for optimizing the acceptability and uptake of TB diagnostic services.Design/methodsWe conducted a discrete choice experiment (DCE) among adults with presumptive or microbiologically confirmed TB in 5 countries (Philippines, Vietnam, South Africa, Uganda, and India). The DCE evaluated preferences for 5 TB diagnostic test attributes (sample type, accuracy, cost, location, time to result) with 3-4 levels per attribute. We estimated mean preference weights for attribute levels using Hierarchical Bayesian models and conducted willingness-to-trade analyses for preferred test features.ResultsAmong 1,033 participants (median age 43 years, Interquartile Range: 30-55), 52% were female, 10% had HIV, 14% had diabetes, 36% had current or prior TB), the most strongly valued test features were free cost, high diagnostic accuracy, and rapid (within 15 minutes) result availability. Among less valued attributes, facility-based testing (location) and sputum (sample type) were most preferred. The relative importance of attributes and their levels differed by country. In willingness-to-trade simulations, participants in each country were willing to trade 10-20% lower accuracy for the availability of rapid tests but were unwilling to trade accuracy for alternative sample types (e.g., tongue-swab, urine, blood) or testing locations (e.g., home- or community-based); participants in India and Vietnam were willing to pay $3.20 and $4.00 USD, respectively, for tests with rapid results.ConclusionsPersons accessing TB services in five high-burden countries universally value free cost, high diagnostic accuracy, and rapid result availability. However, many were willing to accept lower test accuracy and some were willing to incur small out-of-pocket costs to access rapid tests. To align with preferences of TB-affected communities, future TPP updates and new test development should prioritize rapid results while maintaining high accuracy and minimizing costs.
Single-cell multi-omics analysis reveals cooperative transcription factors for gene regulation in oligodendrocytes
Authors: Choi Jerome J. , Svaren John , Wang Daifeng 
Published: June 2024

AbstractOligodendrocytes are the myelinating cells within the central nervous system. Many oligodendrocyte genes have been associated with brain disorders. However, how transcription factors (TFs) cooperate for gene regulation in oligodendrocytes remains largely uncharacterized. To address this, we integrated scRNA-seq and scATAC-seq data to identify the cooperative TFs that co-regulate the target gene (TG) expression in oligodendrocytes. First, we identified co- binding TF pairs whose binding sites overlapped in oligodendrocyte-specific regulatory regions. Second, we trained a deep learning model to predict the expression level of each TG using the expression levels of co-binding TFs. Third, using the trained models, we computed the TF importance and TF-TF interaction scores for predicting TG expression by the Shapley interaction scores. We found that the co-binding TF pairs involving known important TF pairs for oligodendrocyte differentiation, such as SOX10-TCF12, SOX10-MYRF, and SOX10-OLIG2, exhibited significantly higher Shapley scores than others (t-test, p-value < 1e-4). Furthermore, we identified 153 oligodendrocyte-associated eQTLs that reside in oligodendrocyte-specific enhancers or promoters where their eGenes (TGs) are regulated by cooperative TFs, suggesting potential novel regulatory roles from genetic variants. We also experimentally validated some identified TF pairs such as SOX10-OLIG2 and SOX10-NKX2.2 by co-enrichment analysis, using ChIP-seq data from rat peripheral nerve.