bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Language in the Social and Academic Functioning of Children With ADHD
Authors: Jepsen Ida Bonnerup , Brynskov Cecilia , Thomsen Per Hove , Rask Charlotte Ulrikka , Jensen de López Kristine , Lambek Rikke 
Published: July 2024

Objective: To provide an in-depth examination of whether pragmatic, expressive, receptive, and narrative language are associated with the social and academic functioning of children with ADHD. Method: Children with ADHD ( n = 46) and neurotypical comparison (NC) children ( n = 40) aged 7 to 11 years completed tasks measuring expressive, receptive, and narrative language, while parents rated pragmatic language and social- and academic functioning. Results: Children with ADHD differed significantly from NC children on pragmatic language, expressive language, receptive language, and narrative coherence. An examination of indirect effects revealed that a significant proportion of the association between ADHD and social functioning was shared with pragmatic language, while a significant proportion of the association between ADHD and academic difficulties was shared with pragmatic language as well as with expressive language. Conclusion: This preliminary study supports the clinical relevance of language in relation to the academic- and social functioning of children with ADHD.
Aggravated Systemic Inflammation and Atherogenicity in African Patients Living With Type 2 Diabetes and Hypertension Comorbidity
Authors: Groenewald Ernst J , Nkambule Bongani B , Nyambuya Tawanda M 
Published: July 2024

Objective: To explore routinely measured markers of systemic inflammation in hypertension (HTN) and type 2 diabetes (T2D) comorbidity, and their association with atherogenicity. Methods: This study included a total of 70 patients with T2D which were categorised into 2 groups, that is with T2D and with HTN comorbidity (T2D + HTN) (n = 35/group). All measured laboratory parameters were determined using standardised methods. Results: The neutrophil/lymphocyte ratio (NLR) was elevated in patients with T2D + HTN when compared to those with T2D ( P = .0494). This was also the case with C-reactive protein (CRP) levels ( P < .0001) and systemic immune-inflammation (SII) index ( P = .0298). Notably, the majority of patients with T2D + HTN [63% (n = 22)] were classified as having an intermediate or high atherogenic index of plasma (AIP). The correlation analysis of systemic inflammation showed significant associations between CRP and age (r = .24, P = .0477); CRP and red blood cell count (r = −.4, P = .0455), and SII and systolic blood pressure (SBP) (r = .33, P = .0056). However, there was no association between inflammatory profiles and lipograms ( P > .05). We further assessed predictors for an elevated AIP using mutivariable regression model adjusted for age, SBP, CRP and SII. Only NLR was a significant predictor of AIP (β = .287, SE: 0.1, P = .0046). Conclusion: HTN comorbidity in T2D is associated with exacerbated levels of inflammation and atherogenicity. NLR is a significant independent risk factor for increased atherogenicity in patients with T2D. Therefore, the use of therapeutic strategies that target and alleviate inflammation in patients with T2D and HTN comorbidity is imperative in reducing the initiating and progression of cardiovascular events (CVEs).
Cutaneous Melanoma Mortality-to-Incidence Ratio and Its Association With Socioeconomic and Healthcare Factors in Canada: A National Ecological Study
Authors: Conte Santina , Le Michelle , Moustaqim-Barrette Amina , Ghazawi Feras M. , Muntyanu Anastasiya , Lagacé François , Alakel Akram , Rahme Elham , Glassman Steven J. , Litvinov Ivan V. 
Published: July 2024

Introduction: The mortality-to-incidence ratio (MIR) can be used to approximate healthcare inequities and is helpful to understand/compare cancer survival between geographic regions/jurisdictions. We investigated cutaneous melanoma (CM) outcomes through MIR analysis in Canadian jurisdictions and census divisions (CDs) between 1992 and 2016. Methods: Data were obtained from the national databases from 1992 to 2016 for all Canadian jurisdictions, except Quebec. Age-standardized overall and median MIRs were calculated per province per year, while crude MIRs were calculated for CDs. Generalized linear regression models were conducted to study the effect of province and year on MIR, while a mixed effect regression model was used to determine how healthcare and socioeconomic factors affect MIR, while accounting for possible clustering effects (eg, year and province). Results: We identified 106,015 CM cases and 20,570 CM deaths between 1992 and 2016. National MIR from 1992 to 2016 demonstrated a significant linear decrease ( P value < .0001). The national median MIR was 15.4 (ie, 0.154 × 100), whereby Manitoba (19.9), Ontario (19.5), Saskatchewan (18.5), British Columbia (16.1), and Newfoundland and Labrador (15.9) demonstrated higher MIRs than the Canadian average. CDs with the highest MIRs were commonly identified in the southern regions of provinces. No healthcare or socioeconomic factors were found to be significantly associated with higher MIR at the provincial level. Conclusion: MIRs have decreased at the national and provincial levels in recent decades, which is reassuring. Higher MIRs were noted in select rural CDs and in the Canadian territories, reinforcing the importance of proper dermatological care in all parts of the country.
PCSK9 Inhibitor with Statin Therapy for Intracranial Artery Stenosis ( PISTIAS): Rationale and design of a multicenter randomized controlled trial
Authors: Hu Xinzhi , Zhang Zongmuyu , Liu Caiyan , Li Mingli , Liu Yiyang , Cheng Anqi , Yu Qiuyu , Guo Haoyao , Zou Yinxi , Zhou Li , Wang Hebo , Song Bo , You Yong , Xia Jian , Zhang Jingfen , Ai Zhibing , Sun Qinjian , Han Ju , Liu Jing , Lu Baoquan , Deng Qiwen , Li Guanzeng , Wang Peng-fei , Li Xiangqing , An Yi , Wu Bo , Yan Zhongrui , Wang Yining , Xu Wei-Hai 
Published: July 2024

Rationale: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors enable an additional 54–75% reduction in low-density lipoprotein cholesterol (LDL-C) in statin-treated patients, demonstrating plaque regression in coronary artery disease. However, the impact of achieving an extremely low level of LDL-C with PCSK9 inhibitors (e.g. Evolocumab) on symptomatic intracranial atherosclerosis remains unexplored. Aim and hypothesis: To determine whether combining Evolocumab and statins achieves a more significant symptomatic intracranial plaque regression than statin therapy alone. Sample size estimates: With a sample size of 1000 subjects, a two-sided α of 0.05, and 20% lost to follow-up, the study will have 83.3% power to detect the difference in intracranial plaque burden. Methods and design: This is an investigator-initiated multicenter, randomized, open-label, outcome assessor-blinded trial, evaluating the impact of combining Evolocumab and statins on intracranial plaque burden assessed by high-resolution magnetic resonance imaging at baseline in patients undergoing a clinically indicated acute stroke or transient ischemic attack due to intracranial artery stenosis, and after 24 weeks of treatment. Subjects (n = 1000) were randomized 1:1 into two groups to receive either Evolocumab 140 mg every 2 weeks with statin therapy or statin therapy alone. Study outcomes: The primary endpoint is the change in intracranial plaque burden assessed by high-resolution magnetic resonance imaging, performed at baseline and at the end of the 24-week treatment period. Discussion: This trial will explore whether more significant intracranial plaque regression is achievable with the treatment of combining Evolocumab and statins, providing information about efficacy and safety data. Trial registration number: ChiCTR2300068868; https://www.chictr.org.cn/
Oxaliplatin-associated shock in stage III colorectal cancer patients: real-world evidence in Taiwan
Authors: Wang Ling-Yi , Hsieh Hui-Hsia , Chu Sung-Chao , Chang Wei-Chuan , Kuo Yi-Ting , Wu Tien-Yuan 
Published: July 2024

Background: Oxaliplatin-associated shock (referred to as shock) is a rare but life-threatening adverse event. Objectives: This pioneering cohort study aimed to quantitatively investigate the association between oxaliplatin use and shock in patients with stage III colorectal cancer (CRC), identify potential independent risk factors for shock, and assess the cycle-to-shock during oxaliplatin treatment. Design: The study utilized a nested case–control (NCC) design to assess the association between oxaliplatin and shock and employed a case-crossover approach to address unmeasured confounders. Methods: All newly diagnosed stage III CRC patients were identified from the CRC Health Database (2012–2016). Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CIs) for oxaliplatin’s link to shock incidence. Results: Among 6932 oxaliplatin recipients, 331 suffered shock. In all, 3309 controls were selected via risk-set sampling for the shock cases. Oxaliplatin use is associated with a doubled risk of shock (adjusted OR: 2.08, 95% CI: 1.23–3.52). Two independent risk factors were male sex (adjusted OR: 1.33, 95% CI: 1.05–1.69) and heart diseases (adjusted OR: 1.65, 95% CI: 1.17–2.32). The case-crossover analysis revealed a more than fourfold risk (OR: 4.4, 95% CI: 1.67–11.62). In total, 22 of 331 shock cases were exposed to oxaliplatin within 2 days of shock onset, with a median cycle-to-shock time at the seventh cycle. Conclusion: Oxaliplatin use significantly increased shock risk in stage III CRC patients. Male sex and heart disease are two independent risk factors.
Minimally Invasive Surgery For Management of Bunionette Deformity (Tailor’s Bunion) Using Fifth Metatarsal Osteotomies: A Systematic Review and Meta-Analysis
Authors: Lewis Thomas L. , Lam Peter , Alkhalfan Yousif , Ray Robbie 
Published: July 2024

Background: There has been increasing interest in the use of percutaneous or minimally invasive osteotomy techniques for bunionette correction. The aim of this systematic review was to investigate the clinical and radiographic outcomes following percutaneous or minimally invasive surgery for bunionette deformity correction. Methods: A systematic review following PRISMA guidelines was undertaken. All clinical studies published in MEDLINE, Embase, PubMed, and the Cochrane Library Database from inception until December 2023 reporting on the use of percutaneous or minimally invasive osteotomy techniques for bunionette deformity correction were included. The primary outcome was radiographic deformity correction. A meta-analysis of clinical and radiographic outcomes was performed to assess the mean difference following surgery. Risk of bias was assessed using the ROBINS-I tool. Results: A total of 942 potential studies were identified, of which 18 were included encompassing 714 feet in 580 patients. There were no comparative studies identified. The majority of studies (n = 14/18) used an unfixed distal osteotomy technique. All studies showed a statistically significant improvement in clinical outcomes (American Orthopaedic Foot & Ankle Society ankle-hindfoot score and visual analog scale for pain) and radiologic outcomes (fourth-fifth intermetatarsal angle and fifth metatarsophalangeal angle). Complication rates ranged from 0% to 21.4%. The nonunion rate was 0% to 5.6%. Overall risk of bias was low to moderate. The most common complication was development of a hypertrophic callus that tended to resorb over time without needing further surgical intervention. Conclusion: The results of this systematic review must be considered in light of the methodologic limitations of the studies analyzed—including additional procedures performed at the same time as the bunionette correction, lack of comparative studies, and heterogeneity of the case series included. Despite these limitations, our review suggests that percutaneous techniques for bunionette deformity correction are generally clinically safe and associated with improvement in radiographic alignment and patient-reported outcome measures.
Arthroscopy-Assisted Open Fabella Excision With Medial Meniscus Revision Repair
Authors: Iwuoha Chukwuma T. , Tollefson Luke V. , Larson Joey , Kennedy Nicholas I. , LaPrade Robert F. 
Published: July 2024

Background: The fabella is a sesamoid bone that is a normal anatomic variant yet a rare cause of pathology in the posterolateral portion of the knee. The fabella can cause chronic knee pain in patients with knee osteoarthritis and athletes at all levels and in rare cases can cause neuropathy. Initially, treatment for a painful fabella includes conservative measures, with surgical intervention after conservative treatments have failed. This technique describes our arthroscopic-assisted fabella removal technique with a concomitant medial meniscus revision repair. Indications: The goal of treatment is to relieve pain and numbness. Conservative measures (i.e., nonsteroidal anti-inflammatory drugs [NSAIDs], range of motion exercises, heel cord stretching, etc.) are the initial step in treatment. Patients are treated surgically after conservative measures have failed. The surgical approach involves an open incision, arthroscopy, or a combination. Technique Description: With the patient in the supine position, a physical examination is performed under anesthesia to compare to validate clinical findings. An open lateral knee approach helps to locate the fabella which is grasped with an Alice clap. An arthroscopy is performed, and viewing posterolaterally will confirm that the fabella is within the grips of the Alice clamp. After repair of the meniscus, the surgical bed is repositioned to identify the fabella properly. Excision of the fabella is performed sharply from the lateral gastrocnemius tendon, and palpation is demonstrated to ensure complete removal. Caution is essential to avoid complications including damage to nearby anatomic structures, such as the lateral gastrocnemius tendon, and incomplete fabella removal. Results: A clinical study by Dekker et al reported that 80% of patients were able to return to full activities and postoperative patient-reported outcomes improved from preoperative to postoperative. Fabella excision is recommended for patients with fabella pain who do not respond to conservative treatment. Discussion: We describe a technique for removing the fabella with arthroscopic assistance. Patients who have not responded appropriately to conservative treatment for a painful fabella should consider surgical intervention. With the early initiation of rehabilitation, patients will have an increased likelihood of decreased pain, resolution of symptoms, and reduced knee stiffness. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Th1 cells reduce the osteoblast-like phenotype in valvular interstitial cells by inhibiting NLRP3 inflammasome activation in macrophages
Authors: Lu Jing , meng Jiaming , Wu Gang , Wei Wulong , Xie Huabao , Liu Yanli 
Published: July 2024

Abstract
Background and aims
Inflammation is initiates the propagation phase of aortic valve calcification. The activation of NLRP3 signaling in macrophages plays a crucial role in the progression of calcific aortic valve stenosis (CAVS). IFN-γ regulates NLRP3 activity in macrophages. This study aimed to explore the mechanism of IFN-γ regulation and its impact on CAVS progression and valve interstitial cell transdifferentiation.

Methods and results
The number of Th1 cells and the expression of IFN-γ and STAT1 in the aortic valve, spleen and peripheral blood increased significantly as CAVS progressed. To explore the mechanisms underlying the roles of Th1 cells and IFN-γ, we treated CAVS mice with IFN-γ-AAV9 or an anti-IFN-γ neutralizing antibody. While IFN-γ promoted aortic valve calcification and dysfunction, it significantly decreased NLRP3 signaling in splenic macrophages and Ly6C+ monocytes. In vitro coculture showed that Th1 cells inhibited NLPR3 activation in ox-LDL-treated macrophages through the IFN-γR1/IFN-γR2-STAT1 pathway. Compared with untreated medium, conditioned medium from Th1-treated bone marrow–derived macrophages reduced the osteogenic calcification of valvular interstitial cells.

Conclusion
Inhibition of the NLRP3 inflammasome by Th1 cells protects against valvular interstitial cell calcification as a negative feedback mechanism of adaptive immunity toward innate immunity. This study provides a precision medicine strategy for CAVS based on the targeting of anti-inflammatory mechanisms.

Graphical Abstract
Closure Effect of I + II Mixed-mode Crack for EA4T Axle Steel
Authors: Wang Shuancheng , Yang Bing , Zhou Shuwei , Li Jian , Xiao Shoune 
Published: July 2024

AbstractThe crack-closure effect is a crucial factor that affects the crack growth rate and should be considered in simulation analysis and testing. A mixed-mode I + II loading fatigue crack growth test was performed using EA4T axle steel specimens. The variation of the plastic-induced crack closure (PICC) effect and the roughness-induced crack closure (RICC) effect during crack deflection in the mixed-mode is examined in this study. The results show that the load perpendicular to the crack propagation direction hinders the slip effect caused by the load parallel to the crack propagation direction under mixed-mode loading, and the crack deflection is an intuitive manifestation of the interaction between the PICC and RICC. The proportion of the RA value change on the crack side caused by contact friction was reduced by the interaction between PICC and RICC. The roughness of the crack surface before and after the crack deflection is different, and the spatial torsion crack surface is formed during the crack propagation process. With the increase of the crack length, the roughness of the fracture surface increases. During the crack deflection process, the PICC value fluctuates around 0.2, and the RICC value is increased to 0.15.
The influence of geographical location on moisture distribution in wood cross sections: a numerical simulation study using Austria as an example
Authors: Brandstätter Florian , Autengruber Maximilian , Lukacevic Markus , Füssl Josef 
Published: July 2024

AbstractWood constantly interacts with the surrounding, locally varying climate, leading to changes in the moisture content. Advanced simulation tools can predict the two-dimensional moisture distributions caused by these changing climate conditions within wood cross sections over time. However, there is a notable absence of systematic simulation results for diverse climatic conditions and various wood cross sections. This study seeks to bridge this gap in research. Here, we present moisture fields in three solid timber and three glued laminated timber cross sections in Austria and show the effect of the location and the altitude on the moisture content distribution. The results reveal decreasing influence of the location on the moisture content development with increasing cross section size, and primarily the altitude affecting the moisture content. In addition, the results are compared with the standard for the design of timber–concrete composite structures (ONR CEN/TS 19103), revealing appropriate values in most of the cases. Only for cross sections with a width of 14 cm and larger, assigned to a specific region, the standard value is assumed underestimated. Furthermore, the distribution of moisture gradients, which are related to the crack depth development, are analyzed for Austria, demonstrating the influence of mountain areas in the moisture gradient development.
Unraveling the interplay of neuroinflammatory signaling between parenchymal and meningeal cells in migraine headache
Authors: Dalkara Turgay , Kaya Zeynep , Erdener Şefik Evren 
Published: July 2024

Abstract
Background
The initiation of migraine headaches and the involvement of neuroinflammatory signaling between parenchymal and meningeal cells remain unclear. Experimental evidence suggests that a cascade of inflammatory signaling originating from neurons may extend to the meninges, thereby inducing neurogenic inflammation and headache. This review explores the role of parenchymal inflammatory signaling in migraine headaches, drawing upon recent advancements.

Body
Studies in rodents have demonstrated that sterile meningeal inflammation can stimulate and sensitize meningeal nociceptors, culminating in headaches. The efficacy of relatively blood-brain barrier-impermeable anti-calcitonin gene-related peptide antibodies and triptans in treating migraine attacks, both with and without aura, supports the concept of migraine pain originating in meninges. Additionally, PET studies utilizing inflammation markers have revealed meningeal inflammatory activity in patients experiencing migraine with aura, particularly over the occipital cortex generating visual auras. The parenchymal neuroinflammatory signaling involving neurons, astrocytes, and microglia, which eventually extends to the meninges, can link non-homeostatic perturbations in the insensate brain to pain-sensitive meninges. Recent experimental research has brought deeper insight into parenchymal signaling mechanisms: Neuronal pannexin-1 channels act as stress sensors, initiating the inflammatory signaling by inflammasome formation and high-mobility group box-1 release in response to transient perturbations such as cortical spreading depolarization (CSD) or synaptic metabolic insufficiency caused by transcriptional changes induced by migraine triggers like sleep deprivation and stress. After a single CSD, astrocytes respond by upregulating the transcription of proinflammatory enzymes and mediators, while microglia are involved in restoring neuronal structural integrity; however, repeated CSDs may prompt microglia to adopt a pro-inflammatory state. Transcriptional changes from pro- to anti-inflammatory within 24 h may serve to dampen the inflammatory signaling. The extensive coverage of brain surface and perivascular areas by astrocyte endfeet suggests their role as an interface for transporting inflammatory mediators to the cerebrospinal fluid to contribute to meningeal nociception.

Conclusion
We propose that neuronal stress induced by CSD or synaptic activity-energy mismatch may initiate a parenchymal inflammatory signaling cascade, transmitted to the meninges, thereby triggering lasting headaches characteristic of migraine, with or without aura. This neuroinflammatory interplay between parenchymal and meningeal cells points to the potential for novel targets for migraine treatment and prophylaxis.