bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective, randomized trial of liposomal bupivacaine compared to conventional bupivacaine on pain control and postoperative opioid use in adults receiving adductor canal blocks for total knee arthroplasty
Authors: Quaye Aurora , McAllister Brian , Garcia Joseph R. , Nohr Orion , Laduzenski Sarah J. , Mack Lucy , Kerr Christine R. , Kerr Danielle A. , Razafindralay Charonne N. , Richard Janelle M. , Craig Wendy Y. , Rodrigue Stephen 
Published: February 2024

Abstract
Background
Total knee arthroplasty (TKA) is a commonly performed procedure to alleviate pain and improve functional limitations caused by end-stage joint damage. Effective management of postoperative pain following TKA is crucial to the prevention of complications and enhancement of recovery. Adductor canal blocks (ACB) with conventional bupivacaine (CB) provide adequate analgesia after TKA, but carry a risk of rebound pain following block resolution. Liposomal bupivacaine (LB) is an extended-release local anesthetic that can provide up to 72 h of pain relief. The objective of this study was to compare postoperative outcomes between ACBs using LB and CB after TKA.

Methods
This single institution, prospective, randomized, clinical trial enrolled patients scheduled for TKA. Participants were randomized to receive ACB with either LB or CB. Pain scores up to 72 h postoperatively were assessed as the primary outcome. Opioid consumption and length of stay were evaluated as secondary outcomes.

Results
A total of 80 patients were enrolled. Demographic and clinical characteristics were similar between the two groups. LB group showed significantly lower cumulative opioid use during the 72 h evaluated (P = 0.016). There were no differences in pain scores or length of stay between the groups.

Conclusion
The study demonstrated that LB ACBs led to significantly lower opioid consumption in the days following TKA without affecting pain scores or length of stay. This finding has important implications for improving postoperative outcomes and reducing opioid use in TKA patients. Previous studies have reported inconsistent results regarding the benefits of LB, highlighting the need for further research.

Trial registration
This project was retrospectively registered with clinicaltrials.gov (NCT05635916) on 2 December 2022.
Commentary: raised c-troponin levels as a sign of myocardial injury after COVID-19 vaccination in healthy individuals are worrying
Authors: Klement Rainer Johannes , Walach Harald 
Published: February 2024

Abstract
Background
Recently, Buergin et al. (Eur J Heart Fail 25(10):1871–1881, 2023 doi:10.1002/ejhf.2978) thoroughly measured a frequency of 2.8% elevated high-sensitivity cardiac troponin T levels, a sign of myocardial damage, after mRNA-1273 (Moderna) booster vaccinations. In their discussion, they claim that before vaccinations were available, the incidence and extent of myocardial damage associated with COVID-19 infection would have been much higher. We here scrutinize this claim based on empirical data.

Main body
Burgin et al. have only cited papers in support of their claim which considered hospitalized COVID-19 patients. After extracting COVID-19 infection data from Germany and Switzerland and the expected frequency of elevated troponin levels after COVID-19 infection in both hospitalized and non-hospitalized individuals, we find that the extent of myocardial damage after vaccinating a considerable proportion of the general population is expected to be much higher than after natural infections.

Conclusions
The claim that the extent of myocardial injury after COVID-19 infection would be higher than after vaccination is not supported by empirical evidence and therefore wrong. We conclude that cross-national systematic observational studies should be conducted that allow a more precise estimation of the risk–benefit ratio of COVID-19 mRNA vaccinations.
Successful healing of aneurysmal false lumen using a second-generation drug-eluting stent in spontaneous coronary artery dissection: a case report
Authors: Niida Tomiharu , Isoda Kikuo , Tada Miho , Kitahara Satoshi , Fujino Yusuke 
Published: February 2024

Abstract
Background
According to 2023 ESC Guideline, conservative medical management is generally recommended for the treatment of spontaneous coronary artery dissection (SCAD) except for patients with signs of ongoing myocardial ischemia. However, in some cases, invasive treatment (coronary artery bypass graft surgery or percutaneous coronary intervention (PCI)) is performed because of the progression of aneurysm in SCAD. Although there is no established strategy for the management of coronary aneurysm in SCAD, we report a case of successful healing of aneurysmal false lumen (AFL) using a second-generation drug-eluting stent (DES) in SCAD.

Case presentation
A 44-year-old woman without any cardiovascular risk factors was transferred to our hospital due to inferior myocardial infarction. Coronary angiography (CAG) showed multiple SCADs in the coronary artery. We performed PCI to the distal right coronary artery (RCA) because the RCA showed severe stenosis (99%) with bradycardia. Six days after the first PCI, SCAD relapsed in the mid left anterior descending artery (LAD). Furthermore, AFL was observed by intravascular ultrasound imaging. To avoid enlargement of the AFL and progression of the dissection toward the proximal site of the LAD, we performed PCI to the mid LAD to seal the entry tear of the dissection using a second-generation DES. CAG revealed that the AFL in the mid LAD completely diminished at 1 year after PCI.

Conclusions
The implantation of a second-generation DES might be one of therapeutic options for sealing AFL in SCAD patients.
‘Am I really the priority here?’: help-seeking experiences of university students who self-harmed
Authors: Tickell Alice , Fonagy Peter , Hajdú Katalin , Obradović Sandra , Pilling Stephen 
Published: February 2024

Background
Self-harm is a significant problem in university students because of its association with emotional distress, physical harm, broader mental health issues and potential suicidality. Research suggests that fewer than half of students who have self-harmed seek professional help when at university.

Aims
This study aimed to explore the help-seeking journeys of university students who had engaged in self-harm, to identify perceived facilitators and barriers to securing both formal and informal support.

Method
Participants comprised 12 students who had self-harmed during their university tenure. Engaging in two semi-structured interviews over the academic year, they shared insights into their help-seeking behaviours and proposed enhancements to local services. Data underwent reflexive thematic analysis within a critical realist framework.

Results
The analysis identified four themes: ‘The initial university phase poses the greatest challenge’, ‘Perceived criteria for “valid” mental health problems’, ‘Evading external judgements, concerns and consequences’ and ‘The pivotal role of treatment options and flexibility in recovery’.

Conclusions
Students felt isolated and misunderstood, which amplified self-harming tendencies and diminished inclinations for help-seeking. A prevalent belief was that for self-harm to be deemed ‘valid’, it must manifest with a certain severity; however, concurrent fears existed around the ramifications of perceived excessive severity. Participants expressed a desire for streamlined pathways to mental health resources, encompassing both university and external mental health services. Insights from this study could guide future research and inform current service paradigms within academic and healthcare systems.
Advanced Breast Cancer Guidelines in Latin America: Assessment, Adaptation, and Implementation of Fifth Advanced Breast Cancer Consensus Guidelines
Authors: Valencia Fernando , Gómez Henry L. , Neciosup Silvia P. , Limón Ronald , Torrico María del Carmen , Morillas Lena , Torres Roberto , Sánchez Cesar , Araya Ingiborg , Gómez Rodolfo , Bruges Ricardo , Vargas Carlos , Soria Tannia , Muñoz René , Riofrío Mauricio , Gálvez Marco , Ruiz Rossana , Benites Pilar , Cardoso Fatima 
Published: February 2024

PURPOSE As the fifth international consensus on advanced breast cancer (ABC5) established guidelines for the management of this disease, the aim of this article was to present the applicability of the consensus recommendations and to generate knowledge to improve access. METHODS Sixty-one recommendation statements were selected and discussed by 15 breast cancer experts from Latin America (LA). After the discussion, the level of consensus was determined through a vote. In addition to this, the level of access to each of the recommendations presented, according to the country and health system, was exposed. RESULTS Latin American experts had a high level of agreement with the ABC5 consensus recommendations (range, 83%-100%). Twelve of 61 statements are not available for all patients in LA. Among the limitations to access, the following ones are described: limited access to certain technologies (stereotactic body radiotherapy, positron emission tomography-computed tomography), the high costs of drugs that limits access to treatment with CDK4/6 inhibitors, pertuzumab, or poly(ADP-ribose) polymerase inhibitors, and the lack of molecular tests for access to therapeutic targets, as well as the difficult geography and cultural diversity of our continent. CONCLUSION Despite the great relevance of the recommendations of the ABC5 consensus guidelines, we highlight that we still need to improve access for all patients, regardless of the country or health system they are in, for which we call to action to policy makers and patient groups to improve clinical outcomes of patients with advanced breast cancer in our region.
Bacterial Isolates and Characteristics of Children With Febrile Neutropenia on Treatment for Cancer at a Tertiary Hospital in Western Kenya
Authors: Kipchumba Samuel Kipkemoi , Njuguna Festus Muigai , Nyandiko Winstone Mokaya 
Published: February 2024

PURPOSE This study aimed to identify the patient characteristics of children with febrile neutropenia, the associated bacterial organisms, and their sensitivity patterns. MATERIALS AND METHODS A descriptive cross-sectional study was conducted at the Moi Teaching and Referral Hospital (MTRH) pediatric oncology ward, from June 2021 to April 2022. A total of 110 children who developed fever and neutropenia during chemotherapy were enrolled. Blood samples for culture were collected aseptically. Patient characteristics were presented in frequency tables. Antimicrobial sensitivity patterns were plotted in tables against the bacterial isolates cultured. Chi-square/Fisher's exact test was used to determine any association between patient characteristics, bacterial growth, and antimicrobial sensitivity. RESULTS The majority (n = 66; 60%) were males. The median age was 6.3 years (standard deviation, 3.7). The majority of patients 71 (64.5%) had hematologic malignancies, the most common being AML. There was a significant association between severity of neutropenia and hematologic malignancies ( P = .028). In total, 31/110 (28.2%) blood cultures were positive for bacterial growth. Gram-positive bacteria were more frequent (n = 20; 58.1%). The most common organism was Escherichia coli (n = 6; 18.2%), followed by Staphylococcus aureus (n = 5; 15.2%). All the isolates were sensitive to linezolid and vancomycin and also showed good sensitivity toward meropenem (n = 10/11; 90.9%). High resistance to cephalosporins was noted with ceftriaxone (n = 5/6; 83.3%), cefepime (n = 4/7; 57.1%), and ceftazidime (n = 3/4; 75%). CONCLUSION The most common malignancy associated with febrile neutropenia was AML. Gram-positive bacteria were the most common isolates. There was high resistance to cephalosporins.
Central Precocious Puberty in Italian Boys: Data From a Large Nationwide Cohort
Authors: Cassio Alessandra , Marescotti Gloria , Aversa Tommaso , Salerno Mariacarolina , Tornese Gianluca , Stancampiano Marianna , Tuli Gerdi , Faienza Maria Felicia , Cavarzere Paolo , Fava Daniela , Parpagnoli Maria , Bruzzi Patrizia , Ibba Anastasia , Calcaterra Valeria , Mameli Chiara , Grandone Anna , Cherubini Valentino , Assirelli Valentina , Franchina Francesca , Capalbo Donatella , Di Mase Raffaella , Tamaro Gianluca , Cavasin Julia , Munarin Jessica , Russo Gianni , Wasniewska Malgorzata ,   the Physiopathology of Growth Processes and Puberty Study Group of the Italian Society for Pediatric Endocrinology and Diabetology, Di Iorgi Natascia , Iughetti Lorenzo , Antoniazzi Franco , Loche Sandro , Gaudino Rossella , Matarazzo Patrizia , Varriale Gaia , Curatola Selenia , Aiello Francesca 
Published: February 2024

Abstract

Context
There are only a few nationwide studies on boys with central precocious puberty (CPP) and the last Italian study is a case series of 45 boys that dates back to 2000.

Objective
We aimed to evaluate the causes of CPP in boys diagnosed during the last 2 decades in Italy and the relative frequency of forms with associated central nervous system (CNS) abnormalities on magnetic resonance imaging (MRI) compared to idiopathic ones.

Methods
We performed a national multicenter retrospective study collecting data from 193 otherwise normal healthy boys with a diagnosis of CPP. Based on MRI findings, the patients were divided into: Group 1, no CNS abnormalities; Group 2, mild abnormalities (incidental findings) unrelated to CPP; and Group 3, causal pathological CNS abnormalities.

Results
The MRI findings show normal findings in 86%, mild abnormalities (incidental findings) in 8.3%, and causal pathological CNS abnormalities in 5.7% of the cases. In Group 3, we found a higher proportion of patients with chronological age at diagnosis &lt; 7 years (P = .00001) and body mass index greater than +2 SDS (P &lt; .01). Gonadotropin-releasing hormone analogue therapy was started in 183/193 subjects. The final height appeared in the range of the target height in all groups and in 9 patients in whom the therapy was not started.

Conclusion
In our study on a large nationwide cohort of boys referred for precocious puberty signs, the percentage of forms associated with CNS abnormalities was one of the lowest reported in the literature.
Altered Static and Dynamic Brain Functional Topological Organization in Patients With Dysthyroid Optic Neuropathy
Authors: Zhou Jiang , Chen Wen , Jiang Wen-Hao , Wu Qian , Lu Jin-Ling , Chen Huan-Huan , Liu Hu , Xu Xiao-Quan , Wu Fei-Yun , Hu Hao 
Published: February 2024

Abstract

Context
Dysthyroid optic neuropathy (DON) is a serious vision-threatening complication of thyroid-associated ophthalmopathy (TAO). Exploration of the underlying mechanisms of DON is critical for its timely clinical diagnosis.

Objective
We hypothesized that TAO patients with DON may have altered brain functional networks. We aimed to explore the alterations of static and dynamic functional connectomes in patients with and without DON using resting-state functional magnetic resonance imaging with the graph theory method.

Methods
A cross-sectional study was conducted at a grade A tertiary hospital with 66 TAO patients (28 DON and 38 non-DON) and 30 healthy controls (HCs). Main outcome measures included topological properties of functional networks.

Results
For static properties, DON patients exhibited lower global efficiency (Eg), local efficiency, normalized clustering coefficient, small-worldness (σ), and higher characteristic path length (Lp) than HCs. DON and non-DON patients both exhibited varying degrees of abnormalities in nodal properties. Meanwhile, compared with non-DON, DON patients exhibited abnormalities in nodal properties in the orbitofrontal cortex and visual network (VN). For dynamic properties, the DON group exhibited higher variance in Eg and Lp than non-DON and HC groups. A strengthened subnetwork with VN as the core was identified in the DON cohort. Significant correlations were found between network properties and clinical variables. For distinguishing DON, the combination of static and dynamic network properties exhibited optimal diagnostic performance.

Conclusion
Functional network alterations were observed both in DON and non-DON patients, providing novel insights into the underlying neural mechanisms of disease. Functional network properties may be potential biomarkers for reflecting the progression of TAO from non-DON to DON.
Lifespan Effects of Muscle-Specific Androgen Receptor Overexpression on Body Composition of Male and Female Rats
Authors: Barsky Sabrina Tzivia , Monks Douglas Ashley 
Published: February 2024

Abstract
Androgenic actions of gonadal testosterone are thought to be a major mechanism promoting sex differences in body composition across the lifespan. However, this inference is based on studies of androgen receptor (AR) function in late adolescent or emerging adult rodents. Here we assess body composition and AR expression in skeletal muscle of rats at defined ages, comparing wild-type (WT) to transgenic human skeletal actin–driven AR overexpression (HSAAR) rats which overexpress AR in skeletal muscle. Male and female HSAAR and WT Sprague Dawley rats (N = 288) underwent dual-energy x-ray absorptiometry (DXA) scanning and tissue collection at postnatal day (PND) 1, 10, 21, 42, 70, 183, 243, and 365. Expected sex differences in body composition and muscle mass largely onset with puberty (PND-21), with no associated changes to skeletal muscle AR protein. In adulthood, HSAAR increased tibialis anterior (TA) and extensor digitorum longus mass in males, and reduced the expected gain in gonadal fat mass in both sexes. In WT rats, AR protein was reduced in soleus, but not TA, throughout life. Nonetheless, soleus AR protein expression was greater in male rats than female rats at all ages of sexual development, yet only at PND-70 in TA. Overall, despite muscle AR overexpression effects, results are inconsistent with major sex differences in body composition during sexual development being driven by changes in muscle AR, rather suggesting that changes in ligand promote sexual differentiation of body composition during pubertal timing. Nonetheless, increased skeletal muscle AR in adulthood can be sufficient to increase muscle mass in males, and reduce adipose in both sexes.
Disruption of placental ACKR3 impairs growth and hematopoietic development of offspring
Authors: Fukuoka Ayumi , Wilson Gillian J. , Pitmon Elise , Koumbas Foley Lily , Johnsson Hanna , Pingen Marieke , Graham Gerard J. 
Published: February 2024

ABSTRACT
ACKR3 scavenges and degrades the stem cell recruiting chemokine CXCL12, which is essential for proper embryonic and, in particular, haematopoietic development. Here, we demonstrate strong expression of ACKR3 on trophoblasts. Using a maternally administered pharmacological blocker and Cre-mediated genetic approaches, we demonstrate that trophoblast ACKR3 is essential for preventing movement of CXCL12 from the mother to the embryo, with elevated plasma CXCL12 levels being detected in embryos from ACKR3-blocker-treated mothers. Mice born to mothers treated with the blocker are lighter and shorter than those born to vehicle-treated mothers and, in addition, display profound anaemia associated with a markedly reduced bone marrow haematopoietic stem cell population. Importantly, although the haematopoietic abnormalities are corrected as mice age, our studies reveal a postnatal window during which offspring of ACKR3-blocker-treated mice are unable to mount effective inflammatory responses to inflammatory/infectious stimuli. Overall, these data demonstrate that ACKR3 is essential for preventing CXCL12 transfer from mother to embryo and for ensuring properly regulated CXCL12 control over the development of the haematopoietic system.
Paradigm Shifting Research: Key Studies in Urologic Oncology
Authors: Dason Shawn , Lee Cheryl T. 
Published: February 2024

Abstract
Background
Genitourinary malignancies have a substantial impact on men and women in the USA as they include three of the ten most common cancers (prostate, renal, and bladder). Other urinary tract cancers are less common (testis and penile) but still have profound treatment implications related to potential deficits in sexual, urinary, and reproductive function. Evidenced-based practice remains the cornerstone of treatment for urologic malignancies.

Methods
The authors reviewed the literature in consideration of the four top articles influencing clinical practice in the prior calendar year, 2022.

Results
The PROTECT trial demonstrates favorable 15-years outcomes for active monitoring of localized prostate cancer. The SEMS trial establishes retroperitoneal lymph node dissection as a viable option for patients with seminoma of the testis with limited retroperitoneal lymph node metastases. CheckMate 274 supports adjuvant immunotherapy following radical cystectomy for muscle-invasive bladder cancer with a high risk of recurrence. Data reported from the IROCK consortium reinforce stereotactic ablative radiotherapy as an option for localized renal cell carcinoma.

Conclusion
The care for patients with urologic cancers has been greatly improved through advances in surgical, medical, and radiation oncologic treatments realized through prospective randomized clinical trials and large multicenter collaborative groups.
Migration as a Tool for Social Resilience: Lessons From Two Case Studies
Authors: Göler Daniel , Krišjāne Zaiga 
Published: February 2024

Following the fall of socialism in East and Southeast Europe, widespread destabilisation of living conditions was accompanied by immense skill and cost mismatches. Both of these factors continue to contribute to substantial levels of brain drain, brain waste and de-skilling. We propose and discuss the migration-resilience nexus as a new paradigm that emphasises the instrumental dimension of movements and migrants’ agency in terms of the aspiration-capabilities framework. In this paper, we look at migration-specific contexts in two countries suffering from long-term emigration for different reasons. Migratory movements, including emigration and circular and return migration, are interpreted as “tools for social resilience”.
In many cases, migrants do not necessarily have the aspiration to migrate. Nevertheless, they can do so when conditions in their individual situation, such as material income, individual well-being or family status, change. Thus, in contrast to the few studies that have looked at migration and resilience so far, we focus on aspirations, decisions and movements as fundamental elements of a resilience strategy adopted by individuals to cope with permanent existential risk, constant harassment, socio-psychological stress or other threats. Our analysis pursues a comparative empirical approach. To cover the broad scope of this phenomenon, we chose Latvia and Albania as the study’s examples. Data on Albania is gathered using qualitative methods, while a quantitative approach is adopted in Latvia.
* This article belongs to a special issue on “Demographic Developments in Eastern and Western Europe Before and After the Transformation of Socialist Countries”.