bluuebunny/crossref_metadata_2025_split huggingface dataset:
CTP-Defined Large Core Is a Better Predictor of Poor Outcome for Endovascular Treatment Than ASPECTS-Defined Large Core
Authors: Sui Yi , Chen Wenhuo , Chen Chushuang , Chang Yanting , Bivard Andrew , Wang Peng , Geng Yu , Parsons Mark , Lin Longting ,   on behalf of INSPIRE Investigators
Published: March 2024

BACKGROUND:
Recent trials confirmed the effectiveness of endovascular therapy in patients with large ischemic cores. Yet the optimal neuroimaging modalities to define large core remains unclear. We tried to address this question by comparing the functional outcomes in patients receiving thrombectomy selected by either noncontrast computed tomography Alberta Stroke Program Early Computed Tomography Score (ASPECTS) or computed tomography perfusion (CTP).

METHODS:
This study retrospectively selected patients enrolled in the International Stroke Perfusion Registry between August 2011 and April 2022. Patients with acute stroke with large vessel occlusion in anterior circulation treated with endovascular therapy were included. All received both CTP and noncontrast computed tomography. The primary outcome was defined as poor functional outcome represented by a modified Rankin Scale score of 5 to 6 at 3 months. Large cores were defined in terms of either (1) noncontrast computed tomography ASPECTS ≤5 or (2) core volume ≥70 mL on CTP.

RESULTS:

A total of 1115 patients were included in the analysis, of which 90 patients had ASPECTS ≤5 (8.1%) and 97 patients CTP core ≥70 mL (8.7%). A fair agreement between ASPECTS and CTP with a κ value of 0.31 (0.21–0.40) was found. Compared with patients with neither CTP nor ASPECTS large cores, those with only ASPECTS-defined large cores (ie, ASPECTS ≤5; n=56) did not have a higher adjusted odds of poor outcome (29%; odds ratio, 1.84 [0.91–3.73];
P
=0.089). However, patients with CTP large core but not ASPECTS-defined large core (n=63) had a higher adjusted odds of poor outcome (60%; odds ratio, 3.91 [2.01–7.60];
P
<0.001). In time-stratified subgroup analysis (>6 versus ≤6 hours), ASPECTS showed no discriminative difference between ≤5 and >5 in poor outcome for patients receiving endovascular therapy within 6 hours.

CONCLUSIONS:
CTP core ≥70 mL-defined large cores are more predictive of poor outcome than ASPECTS ≤5-defined core in endovascular therapy patients, particularly within 6 hours after stroke onset.
A rat model for acute limb ischemia using microsized gelatin beads
Authors: Menjo Yuki , Yasui Masaya , Fukushige Kaori , Hatayama Naoyuki , Yakura Tomiko , Naito Munekazu 
Published: March 2024

Objective Acute limb ischemia (ALI) is a rapid decrease in lower limb blood flow due to acute occlusion of peripheral arteries or bypass grafts. This study aimed to establish an ALI model using microsized gelatin beads and to investigate the pathophysiological conditions. Methods Male Sprague-Dawley rats were anesthetized, and a low or high dose of microsized gelatin beads was administered into the left femoral artery on days 0 and 7. A control, that is, normal saline (NS) group in which NS was administered in the left femoral artery, a femoral artery cut (FAC) group in which the left femoral artery was cut, and a sciatic nerve cut (SNC) group in which the left sciatic nerve was cut were prepared. After 21 days, the temperature changes and the muscle weights in the lower limbs were measured. To assess nerve damage, the L1–6 sympathetic ganglia were immunostained with activating transcription factor 3 (ATF3) antibody. Results In the Low-dose, High-dose, and FAC groups, a decrease in temperature was predominantly observed in the left limb. In the High-dose and SNC groups, the weight of the soleus muscle and extensor digitorum longus in the left limb decreased; however, no weight changes were observed in the Low-dose and FAC groups. Conversely, the weight of the gastrocnemius muscle significantly decreased in the Low-dose, High-dose, FAC, and SNC groups. In the High-dose and SNC groups, the number of ATF3-positive cells in the sympathetic ganglia significantly increased, and in the Low-dose, a small number of ATF3-positive cells were observed. However, ATF3-positive cells were rarely observed in the FAC and NS groups. Conclusion We established an ALI rat model using microsized gelatin beads. The results of this study suggest that autonomic neuropathy in ALI is related to both muscle damage and peripheral neuropathy.
Ventilation retrofit design for existing primary and secondary school classrooms under epidemic conditions
Authors: Zhou Kun , Ma Siyue , Shao Xingjiang , Li Shuting , Jin Qizuo 
Published: March 2024

In the context of regular epidemic prevention and control, most primary and secondary schools in developing countries are naturally ventilated. They are unable to use measures such as air filters equipped with centralized mechanical ventilation systems and demand-controlled ventilation. Therefore, the feasibility of using automatic control of negative pressure ventilation (NPV) in conjunction with CO2 concentration detectors to reduce the rate of infection in the classroom was investigated. Firstly, the CO2 concentration threshold calculation for epidemic prevention was carried out, and then the measured data of the classroom was fitted with the Computational Fluid Dynamics (CFD) simulation data to establish a simulation and analysis platform to comprehensively evaluate different NPV conditions. The results show that NPV can control the direction of airflow and CO2 concentration in the teaching room, which can significantly reduce the risk of infection, and that Upward Supply Upward Return NPV with automatic control of the CO2 concentration detector and the combination of windshields can protect the students from cross-infection. The study aims to optimize classroom ventilation strategies for epidemic proofing through low-cost building modifications, which could inform the retrofitting of hundreds of thousands of established primary and secondary schools in developing countries. Practical Application Ventilation systems controlled by environmental parameters have the advantages of low cost, high automation, and ease of operation. This system makes designing classrooms to combat airborne epidemics easier by implementing simple retrofitting measures for developing countries where natural ventilation is predominantly used and where most classrooms are not equipped with fresh air ducts. Tests of the top inlet and top return ventilation system proposed in this paper found that the classroom’s measured indoor carbon dioxide concentrations were reduced to below the theoretical limits.
Effect of oxygen delivery during cardiopulmonary bypass on postoperative neurological outcomes in patients undergoing cardiac surgery: A scoping review of the literature
Authors: Elsebaie Abdelrahman , Shakeel Ayesha , Zhang Shetuan , Alarie Marianne , El Tahan Mohamed , El-Diasty Mohammad 
Published: March 2024

Background Reduced oxygen delivery (DO2) during cardiopulmonary bypass (CPB) was proposed as a risk factor for the development of postoperative neurological complications (PONCs), including cerebrovascular accidents (CVA), delirium, and postoperative cognitive dysfunction (POCD). We aimed to review the current evidence on the association between intraoperative DO2 and the incidence of PONCs. Methods MEDLINE, Embase, the Cochrane Library, and Web of Science were electronically searched to identify comparative studies from inception until July 2023 that reported the association between intraoperative DO2 levels and the incidence of PONCs (as defined by the scales and diagnostic tools utilized by the studies’ authors) in adults patients undergoing cardiac surgery using CPB. Results Of the 2513 papers identified, 10 studies, including 21,875 participants, were included. Of these, three studies reported on delirium, two on POCD, and five on CVA. Eight studies reported reduced intraoperative DO2 in patients who developed delirium and CVA. There was a lack of consensus on the cut-off of DO2 levels or the correlation between the period below these threshold values and the development of PONC. Conclusions Limited data suggest that maintaining intraoperative DO2 above the critical threshold levels and ensuring adequate intraoperative cerebral perfusion may play a role in minimizing the incidence of neurological events in adult patients undergoing cardiac surgery on cardiopulmonary bypass.
Extracorporeal cardio-pulmonary resuscitation in a patient with missed diagnosis of sodium nitrite intoxication
Authors: Gaiani Francesco , Giani Marco , Vergnano Beatrice , Sardella Jeff , Cappellini Fabrizio , Casati Marco , Pozzi Matteo , Foti Giuseppe 
Published: March 2024

Introduction Critical poisoning with sodium nitrite (NaNO2) can present challenges in promptly identifying and managing acute methemoglobinemia. Case report We report the case of an overt self-intoxication by an initially unknown agent, leading to cardiac arrest. Despite prodromal signs of cyanosis, coma, desaturation, and hypotension, methemoglobinemia went unrecognized during extracorporeal cardiopulmonary resuscitation (ECPR) as the point-of-care test failed to provide methemoglobin levels, leading to untreated methemoglobinemia. The blood flowing through the oxygenator notably maintained the same brown colour. Return of spontaneous circulation was never achieved, and the patient was declared dead after 60 min of unsuccessful resuscitation. Cause of death by means of NaNO2 voluntary ingestion was later clarified and confirmed by postmortem finding of elevated nitrite and nitrate concentration. Conclusions This case highlights the risk of failure of ECPR in the context of cardiac arrest due to methemoglobinemia, emphasizing the critical need for prompt recognition of the causative agent and early administration of antidotes.
Estimation of B-inhibin and anti mullerian hormone in functional azoospermia and their correlations with surgical sperm retrieval: A prospective case-control study
Authors: GamalEl Din Sameh Fayek , Nabil Nashaat , Moawad Hanan Hosni , Amer Medhat , Zohdy Wael , Bakry Abdel Rahman , Raoof Martina Tharwat , Mohammed Asmaa , Salem Yasser 
Published: March 2024

Objectives: The current study estimated the levels of anti mullerian hormone (AMH) and inhibin-B and reproductive hormones in non obstructive azoospermic (NOA) cases and obstructive azoospermic (OA) cases as well as comparing between them as regards the sensitivity and specificity in determining the sperm retrieval hope in the NOA cases. Finally, we analyzed any potential correlation between all the hormones measured in the current study. Methods: The current case control study was conducted at the andrology outpatient clinic from June (2021) to March (2022). The study recruited 135 participants divided equally into three groups NOA cases, OA cases and controls, respectively. Results: The mean inhibin-B was significantly lower in the NOA cases compared to the OA cases and the controls. There was a positive moderate correlation between AMH and Inhibin-B. Also, there was a positive moderate correlation between inhibin-B and free testosterone (FT) and positive weak correlation between beta Inhibin and leutinizing hormone (LH). Conclusions: The current study asserts the observation that inhibin-B is also expressed by Leydig cells as it has demonstrated positive correlations with FT and LH.
Development and Validation of Knowledge Assessment Scales for Dementia and Urinary Incontinence in Community Older People
Authors: Sun Hui , Liu Wenqi , Sun Xuemei , Gao Yinyan , Chen Yancong , Lin Yali , Song Jinlu , Zhang Zixuan , Wang Betty H. , Li Lingqi , Feng Hui , Tan Hongzhuan , Chen Qiong , Peng Linlin , Dai Wenjie , Wu Irene X. Y. 
Published: March 2024

To develop and validate scales for reliably assessing dementia and urinary incontinence knowledge of older adults in the community. Items were generated through a literature review, refined through a Delphi study ( n = 19), and then revised through a pilot study ( n = 29). Item analysis and exploratory factor analysis were applied to finalize the scales ( n = 244). Construct validity, reliability, and acceptability were evaluated ( n = 243). The two knowledge assessment scales for dementia and urinary incontinence, respectively, comprised 12 items and 8 items. Model fit indicators of both met the criteria of confirmatory factor analysis. Cronbach’s α were .82 and .70, respectively. Completion ratio and completion time of the two scales was 83.51% and 4.22 ± 1.90 minutes. The knowledge assessment scales for dementia and urinary incontinence with satisfactory validity, reliability, and acceptability, could be served as valid tools for disease prevention and management among older adults in the community.
YTHDF1-mediated sphingosine kinase 2 upregulation alleviates bupivacaine-induced neurotoxicity via the PI3K/AKT axis
Authors: Yuan Ru , Wu Chunxia 
Published: March 2024

Background Bupivacaine (BUP), a long-acting local anesthetic, has been widely used in analgesia and anesthesia. However, evidence strongly suggests that excessive application of BUP may lead to neurotoxicity in neurons. Sphingosine kinase 2 (SPHK2) has been reported to exert neuroprotective effects. In this study, we intended to investigate the potential role and mechanism of SPHK2 in BUP-induced neurotoxicity in dorsal root ganglion (DRG) neurons. Methods DRG neurons were cultured with BUP to simulate BUP-induced neurotoxicity in vitro. CCK-8, LDH, and flow cytometry assays were performed to detect the viability, LDH activity, and apoptosis of DRG neurons. RT-qPCR and western blotting was applied to measure gene and protein expression. Levels. MeRIP-qPCR was applied for quantification of m6A modification. RIP-qPCR was used to analyze the interaction between SPHK2 and YTHDF1. Results SPHK2 expression significantly declined in DRG neurons upon exposure to BUP. BUP challenge substantially reduced the cell viability and increased the apoptosis rate in DRG neurons, which was partly abolished by SPHK2 upregulation. YTHDF1, an N6-methyladenosine (m6A) reader, promoted SPHK2 expression in BUP-treated DRG neurons in an m6A-dependent manner. YTHDF1 knockdown partly eliminated the increase in SPHK2 protein level and the protection against BUP-triggered neurotoxicity in DRG neurons mediated by SPHK2 overexpression. Moreover, SPHK2 activated the PI3K/AKT signaling to protect against BUP-induced cytotoxic effects on DRG neurons. Conclusions In sum, YTHDF1-mediated SPHK2 upregulation ameliorated BUP-induced neurotoxicity in DRG neurons via promoting activation of the PI3K/AKT signaling pathway.
Can MRI Replace Nasopharyngoscopy in the Evaluation of Velopharyngeal Insufficiency?
Authors: Williams Jessica L. , Perry Jamie L. , Snodgrass Taylor D. , Singh Davinder J. , Temkit M’hamed , Sitzman Thomas J. 
Published: March 2024

Objective To investigate whether flexible nasopharyngoscopy, when performed in addition to magnetic resonance imaging (MRI), influences the type of surgery selected or success of surgery in patients with velopharyngeal insufficiency (VPI). Design Cohort study. Setting A metropolitan children's hospital. Patients Patients with non-syndromic, repaired cleft palate presenting for management of VPI. Interventions MRI and nasopharyngoscopy or MRI alone for preoperative imaging of the velopharyngeal mechanism. Main Outcome Measures (1) Surgical selection and (2) resolution of hypernasality. All speech, MRI, and nasopharyngoscopy measurements were performed by raters blinded to patients’ medical and surgical history. Results Of the 25 patients referred for nasopharyngoscopy, 76% completed the exam. Of the 41 patients referred for MRI, the scan was successfully completed by 98% of patients. Completion of nasopharyngoscopy was significantly (p=0.01) lower than MRI. Surgical selection did not significantly differ (p=0.73) between the group receiving MRI and nasopharyngoscopy and the group receiving MRI alone, nor was there a significant difference between these groups in the proportion of patients achieving resolution of hypernasality postoperatively (p=0.63). Percent total velopharyngeal closure assessments on nasopharyngoscopy and MRI were strongly correlated (r=0.73). Conclusions In patients receiving MRI as part of their preoperative VPI evaluation, the addition of nasopharyngoscopy did not result in a difference in surgical selection or resolution of hypernasality. Routine inclusion of nasopharyngoscopy may not be necessary for the evaluation of velopharyngeal anatomy when MRI is available.
Feeding Management and Palate Repair Timing in Infants with Cleft Palate with and without Pierre Robin Sequence: A Multisite Study
Authors: Williams Jessica L , Lien Kari M , Kirschner Richard , Allen Gregory , Chapman Kathy ,   on behalf of the Cleft Outcomes Research NETwork (CORNET) Consortium
Published: March 2024

ObjectivesCompare the feeding management practices in infants with cleft palate with and without Pierre Robin sequence (PRS) and determine if specific feeding difficulties or interventions predict delayed palate repair.DesignRetrospective cross-sectional study.SettingSeventeen cleft palate teams contributed data.Patients414 infants were included in this study: 268 infants with cleft palate only and 146 infants with cleft palate and PRS.ProceduresData were collected via parent interview and electronic health records.Main Outcome MeasuresOutcomes for the primary objective included categorical data for: history of poor growth, feeding therapy, milk fortification, use of enteral feeding, and feeding difficulties. The outcome for the secondary objective was age in months at primary palate repair.ResultsInfants with PRS had a significantly higher prevalence of feeding difficulties (81% versus 61%) and poor growth (29% versus 15%) compared to infants with cleft palate only. Infants with PRS received all feeding interventions—including feeding therapy, milk fortification, and enteral feeding—at a significantly higher frequency. Infants with PRS underwent primary palate repair at a mean age of 13.55 months (SD = 3.29) which was significantly ( P < .00001) later than infants with cleft palate only who underwent palate repair at a mean age of 12.05 months (SD = 2.36). Predictors of delayed palate repair included diagnosis of PRS as well as Hispanic ethnicity and a history of poor growth.ConclusionsThese findings can be used to establish clinical directives focused on providing early, multimodal feeding interventions to promote optimal growth and timely palate repair for infants with PRS.
Therapeutics of urticaria: Results from a hospital-based multicenter study in China
Authors: Wang Xin , Li Lin-Feng 
Published: March 2024

Background: Therapeutics of urticaria in Chinese outpatients remain to be illustrated. Objectives: To investigate clinical treatment of outpatients with urticaria, and provide real-world evidence for selection of medication regimens. Methods: In this hospital-based multicenter study, urticaria outpatients filled in a questionnaire at initial visit and were followed-up (once per week, for 4 weeks). Results: We recruited 1715 urticaria outpatients and 647 completed 4 week’s follow-up. Their total UAS7 was reduced (27.44 at baseline, 16.87 in 1 week, 12.39 in 2 weeks, 7.21 in 3 weeks, 4.2 in 4 weeks). 71.8% patients recovered from urticaria (therapy was highly effective in 11%, whereas effective in 14.2%). The second-generation H1 antihistamines (sgAHs) (at conventional dose) were the most commonly prescribed drugs, with ebastine, levocetirizine and olopatadine being the leading ones (41.1%, 36.2%, and 16%, respectively). Combinations of several antihistamines (649 cases, 37.8%) at conventional dose were far more common than a single drug at escalated dose (59 cases, 3.4%). The combination of ebastine with levocetirizine was the most frequent options (18.25%, 313 cases), followed by combination of ebastine with compound glycyrrhizin (18.2%, 312 cases). The usage rates of tripterygium glycoside (19.6%), hydroxychloroquine (17.2%) and system application glucocorticoids (5.5%) in angioedema were much higher than in symptomatic dermographism and chronic spontaneous urticaria. Conclusions: This study identifies curative therapy for Chinese outpatients with urticaria. The sgAHs, especially ebastine, are the most commonly prescribed drugs. Olopatadine has fast-acting and curative effects. Compound glycyrrhizin holds potential as a versatile collaborator. Combinations of several antihistamines at conventional dose is common.
Mortality in patients with Dupuytren’s disease in the first 5 years after diagnosis: a population-based survival analysis
Authors: van den Berge Bente A. , Groenhof Feikje , Werker Paul M. N. , Furniss Dominic , Kuo Rachel , van den Heuvel Edwin R. , Broekstra Dieuwke C. 
Published: March 2024

Previous studies suggest that Dupuytren’s disease is associated with increased mortality, but most studies failed to account for important confounders. In this population-based cohort study, general practitioners’ (GP) data were linked to Statistics Netherlands to register all-cause and disease-specific mortality. Patients with Dupuytren’s disease were identified using the corresponding diagnosis code and assessing free-text fields from GP consultations. Multiple imputations were performed to estimate missing values of covariates, followed by 1:7 propensity score matching to balance cases with controls on confounding factors. A frailty proportional hazard model was used to compare mortality between both groups. Out of 209,966 individuals, 2561 patients with Dupuytren’s disease were identified and matched to at least four controls. After a median follow-up of 5 years, mortality was found to be actually reduced in patients with Dupuytren’s disease. There was no difference in mortality secondary to cancer or cardiovascular disease. Future studies with longer average follow-up using longitudinal data should clarify these associations in the longer term. Level of evidence: III
Current concepts and new trends in management of isolated triangular fibrocartilage complex injuries
Authors: Lim Rebecca Q. R. , Lim Lincoln J. R. , Atzei Andrea , Liu Bo 
Published: March 2024

The triangular fibrocartilaginous complex is made of multiple components, of which the palmar and dorsal radioulnar ligaments play an important role in distal radioulnar joint stability. The ulnar wrist ligaments may be injured during forearm and wrist trauma. There are several aspects of triangular fibrocartilaginous complex management that are still open to debate. The aim of the present study was to review the current concepts and discuss emerging trends to better elucidate and treat this important ligament complex. Level of evidence: V