bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing of Intraoperative Transitions of Care Among Anesthesiologists Is Not Associated With Postoperative Adverse Outcomes: Retrospective Cohort Study
Authors: Mathur Piyush , Halvorson Sven , Cywinski Jacek B. , Machado Sandra , Khatib Reem , Kurz Andrea M. , Galway Ursula , Mascha Edward J. 
Published: June 2024

BACKGROUND:
The majority of published research suggests that anesthesia handovers during major surgical procedures are associated with unintended harmful consequences. It is still unclear if the number or quality of the transition of care is the main driver of the adverse outcomes. There is even less data if the timing of the anesthesiologist handovers during the critical portion of the anesthetic continuum (induction or emergence versus surgical period) plays a role in patient outcomes. Therefore, we investigated if the anesthesiologist handovers during induction and emergence are associated with adverse patient outcomes.

METHODS:
This retrospective investigation included noncardiac surgical procedures occurring between January 1, 2012 and December 31, 2019 that had exactly 1 attending anesthesiologist handover. We categorized transitions of care between attending anesthesiologists as being before incision, between incision and closing, and after closing. Our primary outcome was a composite of 6 categories of surgical complications and in-hospital mortality. We created logistic generalized estimating equation models to estimate the average relative effect odds ratio between each pair of the 3 transition timing groups across the components of the composite outcome. Inverse probability of treatment weights were used to mitigate confounding on a host of baseline variables. We used Bonferroni correction to adjust for multiple comparisons between the transition groups.

RESULTS:
In total, we studied 36,937 procedures with exactly 1 attending anesthesiologist handover. Of these records, 4370 had the transition during induction, 24,999 between incision and closure, and 7568 during emergence. No differences were found between the transition periods and the composite outcome. The estimated average relative effect odds ratio (98.3% confidence interval [CI]) across the components of the composite outcome was as follows: (1.0002 [0.81–1.24], P = .99) between the induction and surgical period; (1.10 [0.87–1.40], P = .32) between the induction and emergence periods; and (0.91 [0.79–1.04], P = .08) between the emergence and surgical periods.

CONCLUSIONS:
Timing of intraoperative handover among attending anesthesiologists during noncardiac surgery is not associated with adverse patient outcomes.
Pediatric Intraoperative Electromyographic Responses at the Adductor Pollicis and Flexor Hallucis Brevis Muscles: A Prospective, Comparative Analysis
Authors: Tobias Joseph D. , Epstein Richard H. , Rice-Weimer Julie , Yemele Kitio Sibelle Aurelie , Brull Sorin J. , Kalsotra Sidhant 
Published: June 2024

BACKGROUND:
Peripheral nerve stimulation with a train-of-four (TOF) pattern can be used intraoperatively to evaluate the depth of neuromuscular block and confirm recovery from neuromuscular blocking agents (NMBAs). Quantitative monitoring can be challenging in infants and children due to patient size, equipment technology, and limited access to monitoring sites. Although the adductor pollicis muscle is the preferred site of monitoring, the foot is an alternative when the hands are unavailable. However, there is little information on comparative evoked neuromuscular responses at those 2 sites.

METHODS:
Pediatric patients undergoing inpatient surgery requiring NMBA administration were studied after informed consent. Electromyographic (EMG) monitoring was performed simultaneously in each participant at the hand (ulnar nerve, adductor pollicis muscle) and the foot (posterior tibial nerve, flexor hallucis brevis muscle).

RESULTS:
Fifty patients with a mean age of 3.0 ± standard deviation (SD) 2.9 years were studied. The baseline first twitch amplitude (T1) of TOF at the foot (12.46 mV) was 4.47 mV higher than at the hand (P <.0001). The baseline TOF ratio (TOFR) before NMBA administration and the maximum TOFR after antagonism with sugammadex were not different at the 2 sites. The onset time until the T1 decreased to 10% or 5% of the baseline value (T1) was delayed by approximately 90 seconds (both P =.014) at the foot compared with the hand. The TOFR at the foot recovered (TOFR ≥0.9) 191 seconds later than when this threshold was achieved at the hand (P =.017). After antagonism, T1 did not return to its baseline value, a typical finding with EMG monitoring, but the fractional recovery (maximum T1 at recovery divided by the baseline T1) at the hand and foot was not different, 0.81 and 0.77, respectively (P =.68). The final TOFR achieved at recovery was approximately 100% and was not different between the 2 sites.

CONCLUSIONS:
Although this study in young children demonstrated the feasibility of TOF monitoring, interpretation of the depth of neuromuscular block needs to consider the delayed onset and the delayed recovery of TOFR at the foot compared to the hand. The delay in achieving these end points when monitoring the foot may impact the timing of tracheal intubation and assessment of adequate recovery of neuromuscular block to allow tracheal extubation (ie, TOFR ≥0.9).
Wittgenstein in the Moonlight
Authors: Kumar Eesha 
Published: June 2024

Abstract
Wittgenstein’s claims against private language and the existence of riddles have consolidated his reputation as a philosopher of the ordinary. This article makes a case for Wittgenstein as a thinker of enigma. His understudied remarks on riddles configure the ordinary and the transcendent in a novel and counterintuitive dynamic. This constitutes Wittgenstein’s most significant contribution to the study of the ordinary: a demarcation between language as the domain of the ordinary and mystery as the realm of meaning. The intricate interrelationship of these realms animates Wittgenstein’s abiding interest in the “limits” of knowledge and his pursuit of finely calibrated modes of analysis. The leitmotif of the riddle leads us through an exploration of Wittgenstein’s mottled oeuvre and serves as an occasion to ponder the question of “the question” in philosophy (as a matter of discursive form) as well as philosophy’s approach to “answers.” Acts of reading and interpretation, associated etymologically with “riddling,” are imbued with a special urgency in Wittgenstein’s thought, which this article brings to bear on recent debates on surface reading and close reading. To scholars of the ordinary, this article offers a critical reappraisal of Wittgenstein’s contribution, and to Wittgenstein scholars a (perhaps unfamiliar) moonlit Wittgenstein.
Dead Tired
Authors: Owen Ianna Hawkins 
Published: June 2024

Abstract
This essay concerns the descriptions of exhaustion connected to the suicidal thoughts and actions of Anyanwu, the protagonist of Octavia E. Butler’s novel Wild Seed (1980). Expanding the disability studies concept of desirelessness to graze Black diaspora studies, this essay resists the total absorption of enslaved Black women’s suicidal thoughts and actions into the collective political motivations of the living, even as it resists their banishment. Rather than speak authoritatively about an action ultimately undertaken alone, the essay feels for the ordinary edges of the limits of “diaspora” to consider more carefully those who are lost to the collective, those who turn away from it, and those for whom suicide cannot be categorized comfortably as only resistance or defeat. Or, plainly stated: Without purpose and without pity, we can still love you.
Destabilization of mRNAs enhances competence to initiate meiosis in mouse spermatogenic cells
Authors: Pfaltzgraff Natalie G. , Liu Bingrun , de Rooij Dirk G. , Page David C. , Mikedis Maria M. 
Published: June 2024

ABSTRACT
The specialized cell cycle of meiosis transforms diploid germ cells into haploid gametes. In mammals, diploid spermatogenic cells acquire the competence to initiate meiosis in response to retinoic acid. Previous mouse studies revealed that MEIOC interacts with RNA-binding proteins YTHDC2 and RBM46 to repress mitotic genes and to promote robust meiotic gene expression in spermatogenic cells that have initiated meiosis. Here, we have used the enhanced resolution of scRNA-seq and bulk RNA-seq of developmentally synchronized spermatogenesis to define how MEIOC molecularly supports early meiosis in spermatogenic cells. We demonstrate that MEIOC mediates transcriptomic changes before meiotic initiation, earlier than previously appreciated. MEIOC, acting with YTHDC2 and RBM46, destabilizes its mRNA targets, including the transcriptional repressors E2f6 and Mga, in mitotic spermatogonia. MEIOC thereby derepresses E2F6- and MGA-repressed genes, including Meiosin and other meiosis-associated genes. This confers on spermatogenic cells the molecular competence to, in response to retinoic acid, fully activate the transcriptional regulator STRA8-MEIOSIN, which is required for the meiotic G1/S phase transition and for meiotic gene expression. We conclude that, in mice, mRNA decay mediated by MEIOC-YTHDC2-RBM46 enhances the competence of spermatogenic cells to initiate meiosis.
Computational identification of disease models through cross-species phenotype comparison
Authors: Cacheiro Pilar , Pava Diego , Parkinson Helen , VanZanten Maya , Wilson Robert , Gunes Osman , the International Mouse Phenotyping Consortium  , Smedley Damian 
Published: June 2024

ABSTRACT
The use of standardised phenotyping screens to identify abnormal phenotypes in mouse knockouts, together with the use of ontologies to describe such phenotypic features, allows the implementation of an automated and unbiased pipeline to identify new models of disease by performing phenotype comparisons across species. Using data from the International Mouse Phenotyping Consortium (IMPC), approximately half of mouse mutants are able to mimic, at least partially, the human ortholog disease phenotypes as computed by the PhenoDigm algorithm. We found the number of phenotypic abnormalities in the mouse and the corresponding Mendelian disorder, the pleiotropy and severity of the disease, and the viability and zygosity status of the mouse knockout to be associated with the ability of mouse models to recapitulate the human disorder. An analysis of the IMPC impact on disease gene discovery through a publication-tracking system revealed that the resource has been implicated in at least 109 validated rare disease–gene associations over the last decade.
Lecznicze właściwości Cynara scolymus? Krytyczny przegląd dowodów i molekularnych mechanizmów działania
Authors: Zadworny Jan 
Published: June 2024

Karczoch zwyczajny (Cynara scolymus) jest znany za sprawą dużej zawartości aktywnych biologicznie metabolitów: polifenoli oraz terpenoidów. Przypisuje im się działanie hipolipidemiczne, antydyspeptyczne, hepatoprotekcyjne oraz antyoksydacyjne. Mimo to liczba dobrej jakości badań klinicznych dokumentujących działanie lecznicze karczocha i ekstraktu z jego liści (ELK) jest stosunkowo niewielka. Zgromadzone w nich dowody zdają się potwierdzać pozytywny wpływ ELK w hipercholesterolemii i dyspepsji czynnościowej. Sugerują też możliwy efekt terapeutyczny u chorych na niealkoholowe stłuszczeniowe zapalenie wątroby i zespół jelita drażliwego. We wszystkich tych przypadkach potrzebne są dalsze rygorystyczne badania kliniczne, które pozwolą skwantykować obserwowane efekty i dawki ELK konieczne do ich wywołania. Dowody zdają się wykluczać jakiekolwiek działanie ELK w leczeniu wirusowego zapalenia wątroby typu C oraz kaca alkoholowego.
Thyroid disfunction and obesity - what comes first? A complex relationship between hypothyroidism and weight gain
Authors: Gajdzińska Natalia , Salwa Adam , Rostkowska Weronika , Rutkowski Wojciech , Sztuba Karolina , Rzepka Maciej , Basiura Karolina , Rymaszewska Katarzyna , Puchała Justyna , Starzomska Dominika 
Published: June 2024

Introduction: Obesity and mild thyroid failure are common diseases, and the complex relationship between thyroid function and excess weight gain is still being researched. This study analyzes and summarizes the current scientific reports on the intricate correlation between thyroid dysfunction and obesity.

Material and methods: We have gathered the available materials and scientific reports, analyzing and summarizing them in a single study.

Aim of study: We aimed to summarize the studies conducted so far by analyzing the available scientific reports to answer the question of ‘what comes first’ and to understand the correlation between thyroid dysfunction and excessive weight gain.

Discussion: Thyroid dysfunction in the form of hypothyroidism is associated with metabolic abnormalities, which may play a crucial role in the development of metabolic syndrome. On the other hand, excess level of leptin associated with excess adipose tissue is a potential cause of disruptions in the hypothalamic-pituitary-thyroid axis, manifested as elevated TSH levels. Therefore, it is worth considering certain aspects regarding the inclusion of hormone replacement therapy in obese patients presenting laboratory features of subclinical hypothyroidism.

Conclusion. Obesity-induced thyroid dysfunction is typically reversible with weight loss and hormone replacement therapy should be considered for obese patients with subclinical hypothyroidism only if thyroid antibodies are present to confirm an autoimmune thyroid disorder.
FOREFOOT MORPHOTYPES IN CAVOVARUS FEET: A NOVEL CLASSIFICATION
Authors: Malhotra K. , Patel S. , Cullen N. , Welck M. 
Published: June 2024

BackgroundThe cavovarus foot is a complex 3-dimensional deformity. Although a multitude of techniques are described for its surgical management, few of these are evidence based or guided by classification systems. Surgical management involves realignment of the hindfoot and soft tissue balancing, followed by forefoot balancing. Our aim was to classify the pattern of residual forefoot deformities once the hindfoot is corrected, to guide forefoot correction.MethodsWe included 20 cavovarus feet from adult patients with Charcot-Marie-Tooth who underwent weightbearing CT (mean age 43.4 years, 14 males). Patients included had flexible deformities, with no previous surgery. Previous work established majority of rotational deformity in cavovarus feet occurs at the talonavicular joint, which is often reduced during surgery. Using specialised software (Bonelogic 2.1, Disior) a 3-dimensional, virtual model was created. Using data from normal feet as a guide, the talonavicular joint of the cavovarus feet was digitally reduced to a ‘normal’ position. Models of the corrected position were exported and geometrically analysed using Blender 3.6 to identify anatomical trends.ResultsWe identified 3 types of cavovarus forefoot morphotypes. Type 1 was seen in 13 cases (65%) and was defined as a foot where only the first metatarsal was relatively plantarflexed to the rest of the foot, with no significant residual adduction after talonavicular correction. Type 2 was seen in 4 cases (20%) and was defined as a foot where the second and first metatarsals were progressively plantarflexed, with no significant adduction. Type 3 was seen in 3 cases (15%) and was defined as a foot where the metatarsals were still adducted after talonavicular de-rotation.ConclusionWe classify 3 forefoot morphotypes in cavovarus feet. It is important to recognise and anticipate the residual forefoot deformities after hindfoot correction as different treatment strategies may be required for different morphotypes to achieve balanced correction.
THE OXFAT SCORE: A NEW SCORE FOR PREDICTING MALIGNANCY IN FOOT AND ANKLE TUMOURS
Authors: Abboud A. , Colta R. , White H. Branford , Kendal A. , Brown R. 
Published: June 2024

BackgroundMasses are not uncommon in the foot and ankle. Most of these masses are benign, often leading clinicians to underestimate their potential for malignancy.MethodsWe conducted a retrospective review of our clinical records, on patients with histologically confirmed musculoskeletal tumours of the foot and ankle, treated in a single nstitution between 2010 and 2019. The maximum diameter of each lesion was determined through MRI or Ultrasound analysis in centimeters. To develop a scoring system we compared the risk of malignancy with five criteria: site (proximal or distal to the first TMTJ), gender, age, composition and the diameter as observed.ResultsOur study included 496 patients, of whom 39 (7.9%) were identified as having malignancies. The incidence of malignancy demonstrated an increased propensity among male patients, patients over 50 years of age and lesions located proximal to the TMTJ. A ROC Analysis determined that lesions measuring over 2.85 cm had an increased risk of malignancy, with a PPV of 31.1%, a NPV of 94.2%, a Sensitivity of 0.82, and a Specificity of 0.62. These identified patterns of risk were employed to formulate a scoring system, aimed at facilitating informed clinical judgment in the referral of patients to regional tumor services.ConclusionThe new OxFAT scoring system highlights the importance of lesion size, site, age and gender of the patient in determining the risk of malignancy in lump in the foot and ankle. We propose this new scoring system to aid health care professionals in managing these patients. Based on our results any patient with a foot or ankle mass of less than 2.85cm, an OxFAT score < 4/7 and no malignant or sinister features on MRI or USS can be managed locally with excision biopsy. All other patients should be referred urgently to a Regional Tumour Service.
IMPACTION BONE GRAFTING OF LARGE DEFECTS IN ANKLE AND HINDFOOT FUSIONS
Authors: Jamjoom B. , Malhotra K. , Patel S. , Cullen N. , Welck M. , Clough T. 
Published: June 2024

BackgroundAnkle and hindfoot fusion in the presence of large bony defects represents a challenging problem. Treatment options include acute shortening and fusion or void filling with metal cages or structural allograft, which both have historically low union rates. Impaction grafting is an alternative option.MethodsA 2 centre retrospective review of consecutive series of 32 patients undergoing hindfoot fusions with impaction bone grafting of morselised femoral head allograft to fill large bony void defects was performed. Union was assessed clinically and with either plain radiography or weightbearing CT scanning. Indications included failed total ankle replacement (24 patients), talar osteonecrosis (6 patients) and fracture non-union (2 patients). Mean depth of the defect was 29 ±10.7 mm and mean maximal cross-sectional area was 15.9 ±5.8 cm2. Tibiotalocalcaneal (TTC) arthrodesis was performed in 24 patients, ankle arthrodesis in 7 patients and triple arthrodesis in 1 patient.ResultsMean age was 57 years (19–76 years). Mean follow-up of 22.8 ±8.3 months. 22% were smokers. There were 4 tibiotalar non-unions (12.5%), two of which were symptomatic. 10 TTC arthrodesis patients united at the tibiotalar joint but not at the subtalar joint (31.3%), but only two of these were symptomatic. The combined symptomatic non-union rate was 12.5%. Mean time to union was 9.6 ±5.9 months. One subtalar non-union patient underwent re-operation at 78 months post-operatively after failure of metalwork. Two (13%) patients developed a stress fracture above the metalwork that healed with non-operative measures. There was no bone graft collapse with all patients maintaining bone length.ConclusionImpaction of morselised femoral head allograft can be used to fill large bony voids around the ankle and hindfoot when undertaking arthrodesis, with rapid graft incorporation and no graft collapse despite early loading. This technique offers satisfactory union outcomes without the need for shortening or synthetic cages.
The usefulness of narrow-band Imaging (NBI) in nasopharyngeal lesions—Validation of the Ni NBI classification dedicated for vascular pattern in the nasopharynx
Authors: Klimza Hanna , Maćkowiak Bartosz , Zagaja Kacper , Jackowska Joanna , Banaszewski Jacek , Wierzbicka Małgorzata 
Published: June 2024

Background
This study aims to explore the applicability of narrow-band imaging (NBI) involving the Ni classification for the diagnosis of nasopharyngeal mucosal lesions in order to distinguish malignant tumours (NPT) from non-malignant lesions.

Methods
Each patient (n = 53) with a suspected nasopharyngeal lesion underwent a trans-nasal flexible video endoscopy with an optical filter for NBI. We assessed the suspected area using white light imaging (WLI) in terms of location and morphology as well as the vascular pattern (using Ni classification of nasopharyngeal microvessels) and surrounding tissue by using NBI. Based on the results of the NBI and WLI, patients were classified into "positive" or "negative" groups. All lesions of the nasopharynx were biopsied and submitted for final histological evaluation.

Results
NBI showed higher sensitivity, specificity, and accuracy than WLI. There was a significant correlation between the final histological result and the NBI pattern of the NPT: Chi2(1) = 31.34; p = 0.000001 and the WLI assessment of the NPT: Chi2(1) = 14.78; p = 0.00012.

Conclusions
The assessment of the NPT in NBI using Ni NBI classification proved valuable in suspected mucosa assessment. NBI not only confirms the suspicious areas in WLI, but it also shows microlesions beyond the scope of WLI and allows for proper sampling.
Performance study of microwave photonic links by considering the effect of phase shifters and bias conditions on dual-drive dual parallel Mach–Zehnder modulator
Authors: Singh Sarika , Arya Sandeep K. , Singla Shelly , Berwal Pulkit 
Published: June 2024

Abstract
This paper presents the performance analysis of different schemes for generating linearized photonic signal by varying phase shifter arrangements of a dual-drive dual parallel Mach–Zehnder modulator (DD-DPMZM). The RF signals at the electrodes of sub-modulators of DD-DPMZM are fed using different phase angles to generate optically modulated signals in the output. The proposed system consists of a DD-DPMZM and phase shifters. Spurious free dynamic range (SFDR) is evaluated for different configurations of sub modulators in upper and lower arm of DD-DPMZM. SFDR of 135.6 dB Hz4/5 is obtained for quadrature and optical carrier suppression modulation in upper and lower submodulators by suppressing third order intermodulation distortion completely. It is found to be high performance configuration for dual parallel Mach–Zehnder modulator based linear microwave photonic link.
Investigating hormesis, aging, and neurodegeneration: From bench to clinics
Authors: Calabrese Vittorio , Wenzel Uwe , Piccoli Tommaso , Jacob Ursula M. , Nicolosi Lidia , Fazzolari Giovanni , Failla Gabriella , Fritsch Tilman , Osakabe Naomi , Calabrese Edward J. 
Published: June 2024

Abstract
Mitochondria-derived reactive oxygen species production at a moderate physiological level plays a fundamental role in the anti-aging signaling, due to their action as redox-active sensors for the maintenance of optimal mitochondrial balance between intracellular energy status and hormetic nutrients. Iron regulatory protein dysregulation, systematically increased iron levels, mitochondrial dysfunction, and the consequent oxidative stress are recognized to underlie the pathogenesis of multiple neurodegenerative diseases, such as Parkinson’s disease and Alzheimer’s disease. Central to their pathogenesis, Nrf2 signaling dysfunction occurs with disruption of metabolic homeostasis. We highlight the potential therapeutic importance of nutritional polyphenols as substantive regulators of the Nrf2 pathway. Here, we discuss the common mechanisms targeting the Nrf2/vitagene pathway, as novel therapeutic strategies to minimize consequences of oxidative stress and neuroinflammation, generally associated to cognitive dysfunction, and demonstrate its key neuroprotective and anti-neuroinflammatory properties, summarizing pharmacotherapeutic aspects relevant to brain pathophysiology.