bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anesthesia and Sedation Exposure and Neurodevelopmental Outcomes in Infants Undergoing Congenital Cardiac Surgery: A Retrospective Cohort Study
Authors: Simpao AF , Randazzo IR , Chittams JL , Burnham N , Gerdes M , Bernbaum JC , Walker T , Imsdahl S , DeWitt AG , Zackai EH , Gaynor JW , Loepke AW 
Published: August 2024

(Anesthesiology. 2023;139(4):393–404. doi: 10.1097/ALN.0000000000004684)
Neurodevelopmental disability is common among those who undergo congenital cardiac surgery, with significant cognitive and motor delays often observed in long-term studies. Children undergoing cardiac surgery are at greater risk due to longer procedures and often many anesthetic exposures. This retrospective cohort study was a secondary analysis of a prospective observational study that investigated the impact of volatile anesthetics and sedatives on infants with congenital heart disease who had surgery at the Children’s Hospital of Philadelphia in Pennsylvania. The study sought to assess the association between neurodevelopmental outcomes and cumulative exposure to sedatives and anesthetics during the first 18 months of life, hypothesizing that greater exposure would lead to lower neurodevelopmental scores. Secondarily, the analysis also examined patterns of sedation and how anesthesia was administered in these infants.
Postnatal Recall of Epidural Information Compared Between Patients Who Attended an Anesthesiologist-led Virtual Antenatal Epidural Class and Those Who Did Not
Authors: Brady A , Hughes E , Besharatian Y , Tan T , Popivanov P 
Published: August 2024

(Eur J Anaesthesiol. 2024;41(2):148–150. doi:10.1097/EJA.0000000000001878)
Epidural analgesia is routinely used to help alleviate pain during labor. There are several conditions that must be met to obtain patient consent before a medical procedure (eg, epidural) including the patient's ability to consent, the patient not being under duress, and the patient must have been given sufficient and complete information about the conduct of the procedure, as well as associated risks, benefits, and alternatives. However, this last condition is not always met for labor neuraxial procedures and this carries legal and ethical implications.
Simple Steps Towards Improving Safety in Obstetric Airway Management
Authors: Critchley JD , Ferguson C , Kidd E , Ward P , McNarry AF , Theodosiou CA , Alexander N 
Published: August 2024

(Eur J Anaesthesiol. 2023;40(11):826–832. doi:10.1097/EJA.0000000000001897)
This project focused on simple interventions that can help improve obstetric airway management: videolaryngoscopy (VL), ramped patient positioning, low flow nasal oxygen and a preinduction checklist. It was managed by the obstetric airway management quality improvement team in a single tertiary referral obstetric center in a teaching hospital. Data was collected throughout three 6-month periods that correlate to different quality improvement intervention evaluations: June to November 2019, March to August 2021, and January to June 2022.
Examining Outcomes and Complications for Operative Versus Nonoperative Treatment of Pediatric Type II Supracondylar Humerus Fractures: A Systematic Review of Comparative Studies
Authors: Baumann Anthony N. , Anaspure Omkar , Patel Shiv , Shams Kameron , Yoder R. Garrett , Mistovich R. Justin 
Published: August 2024

Objective:
The optimal management of pediatric type II supracondylar humerus fractures (SCHFs) is debated. We conducted a systematic review comparing outcomes and complications of nonoperative versus operative management to aid decision-making and inform future research.

Methods:
We searched PubMed, Web of Science, MEDLINE, and CINAHL from their inception until February 7, 2024, including studies on pediatric patients (<18 y) with any type II SCHF, provided they compared operative to nonoperative care and were in English. The quality of articles was evaluated using the Methodological Index for Non-Randomized Studies Scale.

Results:
Out of 417 studies reviewed, 7 met the inclusion criteria. These studies involved 1446 patients (mean age: 4.9 y; mean follow-up: 5.0 mo), comparing operative (n = 427) and nonoperative (n = 1019) treatments. Functional outcomes such as carrying angle, Baumann angle, elbow range-of-motion, and patient satisfaction were similar across treatment groups. Nonoperative management showed a higher incidence of residual sagittal deformity (14.1% vs 0.0%; P < 0.0001) and a treatment failure rate of 8.9% to 20.6%, necessitating surgical intervention. Factors prompting operative care included rotational deformity, varus/valgus misalignment, and a shaft-condylar angle below 30 degrees.

Conclusion:
Nonoperative treatment of type II SCHF is linked with higher rates of residual sagittal deformity and a notable failure rate requiring subsequent surgery. Both treatment strategies showed similar functional outcomes and patient satisfaction. Further research should focus on identifying anatomic criteria predictive of nonoperative treatment failure.

Level of Evidence:
Level III—systematic review.
Dorsal Preservation versus Component Dorsal Hump Reduction Rhinoplasty: An Assessment of Patient-reported Outcomes
Authors: Foppiani Jose A. , Joy Ngamthoiba , Hernandez Alvarez Angelica , Escobar-Domingo Maria J. , Lee Daniela , Taritsa Iulianna C. , Schuster Kirsten A. , Aneken Nancy Maty , Lee Bernard T. , Lin Samuel J. 
Published: August 2024

Background:
The literature on patient-reported outcomes (PROs) discussing dorsal preservation rhinoplasty (DPR) and component dorsal hump reduction (CDHR) is scarce. This study aims to fill the gap in PROs between these techniques.

Methods:
A systematic review was conducted to investigate PROs of DPR and CDHR. A proportion meta-analysis was conducted using Stata statistical software.

Results:
A total of 25 studies met our inclusion criteria, pooling 1706 participants, with 13 studies on CDHP and 12 studies on DPR. Overall satisfaction rates were high, varying from 84% to 100% across studies. A subgroup analysis revealed that both techniques exhibited equally high satisfaction with no statistical differences (P = 0.18). A random-effects model revealed that about two of 100 treated patients underwent revisions across our cohort (95% interquartile range: 0–4). Notably, the CDHR technique was associated with a significant 53.7-point reduction in the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS)-cosmetic domain [95% confidence interval (CI): −62.7 to −44.8, P < 0.001], along with a meaningful improvement in SCHNOS-obstructive scores by −27.3 points (95% CI: −50.5 to −4.04, P = 0.02). Conversely, the DPR was linked to a 55.3-point reduction in the SCHNOS-cosmetic domain (95% CI: −60.7 to −49.9, P < 0.001), and a −19.5 point change in the SCHNOS-obstructive domain (95% CI: −27.9 to −11.1, P < 0.001).

Conclusion:
Although PROs are comparable, the literature suggests that CDHR outcomes may be better than DPR in alleviating obstructive symptoms, potentially offering an evidence-based choice for addressing functional concerns in rhinoplasty.
A narrative review of lifestyle management guidelines for metabolic dysfunction–associated steatotic liver disease
Authors: Ivancovsky Wajcman Dana , Byrne Christopher J. , Dillon John F. , Brennan Paul N. , Villota-Rivas Marcela , Younossi Zobair M. , Allen Alina M. , Crespo Javier , Gerber Lynn H. , Lazarus Jeffrey V. 
Published: August 2024

Background and Aims:
Metabolic dysfunction–associated steatotic liver disease management guidelines have been published worldwide; we aimed to summarize, categorize, and compare their lifestyle intervention recommendations.

Approach and Results:
We searched metabolic dysfunction–associated steatotic liver disease/NAFLD management guidelines published between January 1, 2013, and June 31, 2024, through databases including PubMed/MEDLINE, Cochrane, and CINAHL. In total, 35 qualifying guidelines were included in the final analysis. Guideline recommendations were categorized into 5 domains (ie, weight reduction goals, physical activity, nutrition, alcohol, and tobacco smoking) and were ranked based on how frequently they appeared. A recommendation was defined as widely adopted if recommended in ≥24 (≥66.6%) of the guidelines. These included increasing physical activity; reducing body weight by 7%–10% to improve steatohepatitis and/or fibrosis; restricting caloric intake; undertaking 150–300 or 75–150 minutes/week of moderate or vigorous-intensity physical activity, respectively; and decreasing consumption of commercially produced fructose. The least mentioned topics, in ≤9 of the guidelines, evaluated environmental determinants of health, mental health, referring patients for psychological or cognitive behavioral therapy, using digital health interventions, and assessing patients’ social determinants of health.

Conclusions:
Most guidelines recommend weight reduction through physical activity and improving nutrition, as these have proven positive effects on health outcomes when sustained. However, gaps regarding mental health and the social and environmental determinants of metabolic dysfunction–associated steatotic liver disease were found. To optimize behavioral modifications and treatment, we recommend carrying out studies that will provide further evidence on social support, environmental factors, and mental health, as well as further exploring digital health interventions.
Impact of as Needed Heparin Boluses on Supratherapeutic Activated Partial Thromboplastin Time in Patients Managed With Extracorporeal Membrane Oxygenation
Authors: Corcoran Delaney M. , Kovacevic Mary P. , Dell’Orfano Heather , Sylvester Katelyn W. , Connors Jean M. 
Published: August 2024

Introduction:
Brigham and Women’s Hospital historically used titratable weight-based heparin nomograms with as needed boluses managed by extracorporeal membrane oxygenation specialists to achieve a predetermined goal-activated partial thromboplastin time (aPTT). Due to concern amongst providers that as needed boluses may lead to supratherapeutic aPTT’s and subsequent bleeding, new nomograms without as needed boluses were implemented. The purpose of this retrospective observational analysis is to provide a comparison in safety and efficacy between the heparin nomograms with as needed boluses and the new nomograms without boluses.

Methods:
Adult patients who were cannulated on extracorporeal membrane oxygenation and initiated on an approved heparin bolus nomogram (January 1, 2018–December 31, 2019) or an approved heparin no-bolus nomogram (October 20, 2020–March 31, 2021) were screened for inclusion. The major endpoint evaluated was the percentage of supratherapeutic aPTTs, defined as an aPTT above the upper limit of the specified nomogram goal, within the first 72 hours.

Results:
A total of 23 patients were included in the bolus nomogram cohort and 9 patients in the no-bolus nomogram cohort. Within the first 72 hours of initiation, there were 11.5% supratherapeutic aPTTs in the bolus group and 5.1% in the no-bolus group (P = 0.101). Overall there was 1 bleeding event in the no-bolus group (11.1%) and 7 in the bolus group (30.4%) (P = 0.26). There were no thromboembolic events in either group.

Conclusions:
Overall, there was no difference found in the percentage of supratherapeutic aPTTs within the first 72 hours of heparin initiation between the bolus and no-bolus nomograms.
Central retinal artery and Common Carotid artery occlusions following COVID-19 infection: A case report
Authors: Eldakkak Mohamed , Kalogeropoulos Dimitrios , Lotery Andrew J 
Published: August 2024

Purpose:
To report a case of central retinal artery and common carotid artery occlusions following COVID-19 infection in a young female with no other risk factors.

Methods:
Retrospective analysis of the medical notes of a patient hospitalized with COVID 19 infection at University Hospital Southampton.

Results:
The patient was found to have dural venous sinus thrombosis and an acute infarct within the right parietal lobe. There was an occlusive thrombus within the right common carotid artery. Subsequently she was found to have a right central artery occlusion secondary to the right common carotid artery occlusion.

Conclusion:
COVID-19 infection can cause retinal artery occlusion via systemic thrombosis in previously healthy patients.
Emotional memory bias in adolescents with chronic pain: examining the relationship with neural, stress, and psychological factors
Authors: Biggs Emma E. , Timmers Inge , Heathcote Lauren C. , Tremblay-McGaw Alexandra G. , Noel Melanie , Borsook David , Simons Laura E. 
Published: August 2024

Abstract
Memory biases for pain-related information may contribute to the development and maintenance of chronic pain; however, evidence for when (and for whom) these biases occur is mixed. Therefore, we examined neural, stress, and psychological factors that could influence memory bias, focusing on memories that motivate disabling behaviors: pain perception, conditioned responses to threat-and-safety cues, and responses to aversive nonnoxious stimuli. Two studies were conducted with adolescents with and without chronic pain. Data from 58 participants were included in study 1 (chronic pain n = 34, pain free n = 24, mean age = 16 years), and 39 participants were included in study 2 (chronic pain n = 26, pain free n = 13, mean age = 16 years). Both studies used a threat–safety learning paradigm with memory recall (≈1 month later). Participants completed structural and functional (resting-state) magnetic resonance imaging, salivary cortisol measurements, and self-report measures. Adolescents with pain and pain-free peers consistently recalled being more afraid of safety cues (CS−) and, during heightened stress at encoding (higher cortisol levels), also reported being more afraid of threat cues (CS+). However, no memory bias was present for the emotional response to an aversive stimulus (US; loud scream) or for the recall of pain intensity. Functional connectivity of the amygdala and hippocampus with memory circuits related to the degree of memory bias, but the specific connections varied between the studies, and we observed no relationship between memory bias and brain morphology. Our findings highlight the value of considering the interaction between implicit and explicit memory systems, contributing to a more comprehensive understanding of emotional memory biases in the context of chronic pain.
Factor Structure and Internal Consistency of the National Alzheimer Coordinating Center’s Uniform Data Set Version 3 Neuropsychological Test Battery (UDSNB 3.0)
Authors: Ucheagwu Valentine , Odilora Chiamaka , Ugokwe-Joseph Rita , Giordani Bruno 
Published: August 2024

Background:
Construct validation of cognitive batteries across Africa is imperative to understanding dementia in the region. We examined construct validity and internal consistency of the neuropsychological battery of Uniform Data Set version 3 (UDSNB 3.0) of the Alzheimer Coordinating Center in Nigeria older adults.

Method:
Three hundred forty-nine (220 females; age: 65 to 85) community dwellers were recruited. UDSNB 3.0 with 12 subscales were used to measure cognition. Two sets of data were collected. First was for exploratory factor analysis (EFA) and second was confirmatory factor analysis (CFA). Four models were specified for CFA.

Result:
EFA principal axis factor with varimax rotation yielded 4 factors: Executive function, memory, visual-spatial ability, and processing speed. Four CFA were performed based on 4 specified models, with only model 3 showing good model fit: CMIN/DF=2.13; confirmatory fit index=0.94; root mean square error of approximation=0.07. Model 3 had 5 latent variables: working memory, language, verbal memory, visual-spatial ability, and processing speed. UDSNB 3.0 had an overall Cronbach alpha of 0.73, suggesting strong internal reliability with ANOVA model F
134,1619​​​=183.65 significant at P<0.001 level of testing.

Conclusions:
Our study showed that UDSNB 3.0 has construct validity and good internal consistency in our older adult population.
The neural mechanisms of fast versus slow decision-making
Authors: Nashaat Mostafa , Oraby Hatem , Krasniqi Flutra , Goh-Sauerbier Sek Teng , Bosc Marion , Koerner Sandra , Karayel Sedef , Kepecs Adam , Larkum Matthew E. 
Published: August 2024

SummaryNot all decisions are created equal; factors such as the difficulties or associated costs affect the time spent to make decisions. This is variously interpreted as speed/accuracy, fast/slow, or impulsivity/deliberateness tradeoffs according to different models of behaviour1–5. Regardless, it is generally assumed that decision latency reflects the neural mechanisms underlying behavioural strategy and cognitive investment. However, such investigations have been difficult in mice which are consistently impulsive. Here, we show that manipulating cost, using a novel floating-platform paradigm, overcomes the natural impulsivity of mice, more closely matching human behaviour. Furthermore, this approach allowed us simultaneously to measure the flow of activity from medial to lateral frontal cortex (MFC→LFC) and record sequences of single neuron activity with 2-photon imaging. Surprisingly, MFC display a different mode of operation, with high vulnerability to optical inhibition compared to LFC. Furthermore, the balance in choice coding at the beginning of sequences in MFC correlated with trial history and behavioural strategy. We found that for optimal performance, slow sequences in MFC showed declining numbers of active neurons whereas the opposite was true in LFC. Our results suggest that while LFC acts as an integrative motor threshold, MFC plays a larger cognitive role in the selection and timing of decisions than previously thought. Our study offers a methodological and mechanistic framework in mouse frontal cortex to understand the neural basis of voluntary decision making.
Multiplexed Glycan Immunofluorescence Identification of Pancreatic Cancer Cell Subpopulations in Both Tumor and Blood Samples
Authors: Binkowski Braelyn , Klamer Zachary , Gao ChongFeng , Staal Ben , Repesh Anna , Tran Hoang-Le , Brass David M. , Bartlett Pamela , Gallinger Steven , Blomqvist Maria , Morrow J. Bradley , Allen Peter , Shi Chanjuan , Singhi Aatur , Brand Randall , Huang Ying , Hostetter Galen , Haab Brian B. 
Published: August 2024

AbstractPancreatic ductal adenocarcinoma (PDAC) tumor heterogeneity impedes the development of biomarker assays suitable for early disease detection that would improve patient outcomes. The CA19-9 glycan is currently used as a standalone biomarker for PDAC. Furthermore, previous studies have shown that cancer cells may display aberrant membrane-associated glycans. We therefore hypothesized that PDAC cancer cell subpopulations could be distinguished by aberrant glycan signatures. We used multiplexed glycan immunofluorescence combined with pathologist annotation and automated image processing to distinguish between PDAC cancer cell subpopulations within tumor tissue. Using a training-set/test-set approach, we found that PDAC cancer cells may be identified by signatures comprising 4 aberrant glycans (VVL, CA19-9, sTRA, and GM2) and that there are three glycan-defined PDAC tumor types: sTRA type, CA19-9 type, and intermixed. To determine whether the aberrant glycan signatures could be detected in blood samples, we developed hybrid glycan sandwich assays for membrane-associated glycans. In both patient-matched tumor and blood samples, the proportion of aberrant glycans detected was consistent. Furthermore, our multiplexed glycan immunofluorescent approach proved to be more sensitive and more specific than CA19-9 alone. Our results provide proof of concept for a novel methodology to improve early PDAC detection and patient outcomes.
Contribution of brain intrinsic branched-chain amino acid metabolism in a novel mouse model of maple syrup urine disease
Authors: Kuhs Amanda C. , Ohl Laura , Thurston Tegan , Singh Jeet , Bhuyan Sangeetha , Grandinette Sarah , Xu Jing , Siemsgluess Sophie A , Jakher Youseff , Ahrens-Nicklas Rebecca C. 
Published: August 2024

SummaryMaple syrup urine disease (MSUD) results from loss of branched-chain ketoacid dehydrogenase (BCKDH) activity, the committed, rate-limiting step of branched-chain amino acid (BCAA) oxidation. Current treatments, including a low protein diet and liver transplantation, improve peripheral biochemistry and limit episodes of metabolic decompensation but do not fully prevent chronic neuropsychiatric symptoms. The mechanisms underlying chronic neurologic phenotypes remain poorly understood. Currently available MSUD mouse models do not survive long enough to evaluate chronic central nervous system (CNS) pathology. To investigate if loss of brain-intrinsic BCAA metabolism contributes to chronic neurologic disease, we developed a new brain-specific knockout mouse model of MSUD. First, we generated a mouse harboring a floxedDbtallele (Dbtflox/flox). Then we crossed this line with Cre recombinase driver lines to induce loss ofDbtexpression in 1) all developing CNS cell populations 2) neurons alone or 3) astrocytes alone. We found that brain-specific KO mice have elevations in BCAA levels in cortex that are exacerbated by a high protein diet. They also have secondary changes in amino acids that are important for neuronal function, including glutamine and glycine. These metabolic differences result in subtle functional deficits as measured by electroencephalogram and behavioral testing. Astrocyte and neuron-specific KO mice each also demonstrate mild biochemical features of MSUD in the cortex, suggesting that both cell populations may contribute to disease pathology. Collectively, these data suggest that therapies targeting the CNS directly, in addition to the periphery, may improve outcomes in MSUD.
Personalized learning in education: a machine learning and simulation approach
Authors: Taylor Ross , Fakhimi Masoud , Ioannou Athina , Spanaki Konstantina 
Published: August 2024

PurposeThis study proposes an integrated Machine Learning and simulated framework for a personalized learning system. This framework aims to improve the integrity of the provided tasks, adapt to each student individually and ultimately enhance students' academic performance.Design/methodology/approachThis methodology comprises two components. (1) A simulation-based system that utilizes reinforcement algorithms to assign additional questions to students who do not reach pass grade thresholds. (2) A Machine Learning system that uses the data from the system to identify the drivers of passing or failing and predict the likelihood of each student passing or failing based on their engagement with the simulated system.FindingsThe results of this study offer preliminary evidence of the effectiveness of the proposed simulation system and indicate that such a system has the potential to foster improvements in learning outcomes.Research limitations/implicationsAs with all empirical studies, this research has limitations. A simulation study is an abstraction of reality and may not be completely accurate. Student performance in real-world environments may be higher than estimated in this simulation, reducing the required teacher support.Practical implicationsThe developed personalized learning (PL) system demonstrates a strong foundation for improving students' performance, particularly within a blended learning context. The findings indicate that simulated performance using the system exhibited improvement when individual students experienced higher learning benefits tailored to their needs.Social implicationsThe research offers evidence of the effectiveness of personalized learning systems and highlights their capacity to drive improvements in education. The proposed system holds the potential to enhance learning outcomes by tailoring tasks to meet the unique needs of each student.Originality/valueThis study contributes to the growing literature on personalized learning, emphasizing the importance of leveraging machine learning in educational technologies to enable precise predictions of student performance.