bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract WP228: Vertebral Artery Configuration as a Risk Factor for Dissection in Children
Authors: Laheji Fiza K , Dowling Michael M , Braga Bruno P 
Published: February 2024

Introduction:
Arterial ischemic strokes are estimated to occur in 1.2 to 8 per 100,000 children per year with 15-22% occurring in the posterior circulation. Vertebral artery dissection(VAD) is a known cause of posterior circulation ischemic stroke in approx 7% of cases.

Pediatric Bow Hunter syndrome, usually presents distinctively with VAD and stroke. It most commonly involves the V3 segment.
In 2021, Braga et all proposed a new protocol for management for children with spontaneous VAD.They noted 2 different configurations of the vertebral artery. In this study we go on the explore these different configurations further and their role in spontaneous VAD.

Aim & Hypothesis:
Two configurations of the vertebral artery at the V3 segment were observed. Type A and Type B depending on the angle of curvature of the V3 segment. Type A config. is more linear with > 110 degree of angulation. Type B config. is angulated with 2 < 110 degree angles.

We aim to investigate these configurations in patients without dissection vs those with vertebral artery dissection. We hypothesized that Type B configuration would be more prevalent in patients with spontaneous VAD.

Methods:
Retrospective chart review conducted at UTSW medical center. MRA/IR angiograms reviewed of 49 patients; 19 with spontaneous VAD and 30 with no vertebral pathology.

Results:
79% of the total dissected vessels(19/24) had configuration Type B and 20.83%(5/24) had configuration Type A. In the control group of 30 patients with no VAD, TypeB was present in 25.4%(13/51) and configuration A in 74.5% (38/51). Type B configuration had a statistically significant higher prevalence in V3 dissection group. (p=<0.001)

Conclusion:
Type B configuration of the V3 segment would warrant further investigation in the right setting.
Microglial TLR4 Mediates White Matter Injury in a Combined Model of Diesel Exhaust Exposure and Cerebral Hypoperfusion
Authors: Shkirkova Kristina , Demetriou Alexandra N. , Sizdahkhani Saman , Lamorie-Foote Krista , Zhang Hongqiao , Morales Manuel , Chen Selena , Zhao Lifu , Diaz Arnold , Godoy-Lugo Jose A. , Zhou Beryl , Zhang Nathan , Li Andrew , Mack Wendy J. , Sioutas Constantinos , Thorwald Max A. , Finch Caleb E. , Pike Christian , Mack William J. 
Published: February 2024

BACKGROUND:
Air pollution particulate matter exposure and chronic cerebral hypoperfusion (CCH) contribute to white matter toxicity through shared mechanisms of neuroinflammation, oxidative stress, and myelin breakdown. Prior studies showed that exposure of mice to joint particulate matter and CCH caused supra-additive injury to corpus callosum white matter. This study examines the role of TLR4 (toll-like receptor 4) signaling in mediating neurotoxicity and myelin damage observed in joint particulate matter and CCH exposures.

METHODS:
Experiments utilized a novel murine model of inducible monocyte/microglia-specific TLR4 knockout (i-mTLR4-ko). Bilateral carotid artery stenosis (BCAS) was induced surgically to model CCH. TLR4-intact (control) and i-mTLR4-ko mice were exposed to 8 weeks of either aerosolized diesel exhaust particulate (DEP) or filtered air (FA) in 8 experimental groups: (1) control/FA (n=10), (2) control/DEP (n=10), (3) control/FA+BCAS (n=9), (4) control/DEP+BCAS (n=10), (5) i-mTLR4-ko/FA (n=9), (6) i-mTLR4-ko/DEP (n=8), (7) i-mTLR4-ko/FA+BCAS (n=8), and (8) i-mTLR4-ko/DEP+BCAS (n=10). Corpus callosum levels of 4-hydroxynonenal, 8-Oxo-2’-deoxyguanosine, Iba-1 (ionized calcium-binding adapter molecule 1), and dMBP (degraded myelin basic protein) were assayed via immunofluorescence to measure oxidative stress, neuroinflammation, and myelin breakdown, respectively.

RESULTS:

Compared with control/FA mice, control/DEP+BCAS mice exhibited increased dMBP (41%;
P
<0.01), Iba-1 (51%;
P
<0.0001), 4-hydroxynonenal (100%;
P
<0.0001), and 8-Oxo-2’-deoxyguanosine (65%;
P
<0.05). I-mTLR4 knockout attenuated responses to DEP/BCAS for all markers.

CONCLUSIONS:
i-mTLR4-ko markedly reduced neuroinflammation and oxidative stress and attenuated white matter degradation following DEP and CCH exposures. This suggests a potential role for targeting TLR4 signaling in individuals with vascular cognitive impairment, particularly those exposed to substantial ambient air pollution.
Metamodernism as the Pedagogy of Revolution
Authors: Storm Jason Ānanda Josephson 
Published: February 2024

Abstract
This article is a response to reviews of Metamodernism: The Future of Theory. It examines the intersection of Metamodernism and pedagogy, drawing inspiration from Paulo Freire’s Pedagogy of the Oppressed and other works. It explores how educational practices can contribute to societal transformation, emphasizing the role of humility, understanding the social world (especially process social kinds), compassion, hope, and critical consciousness in fostering revolutionary change. The paper advocates for a pedagogy that not only challenges existing power structures but also promotes the flourishing of diverse species, extending its concern beyond human-centric perspectives.
Fast Enhancement of the Stratification in the Indian Ocean over the Past 20 Years
Authors: Peng Suqi , Wang Qiang 
Published: February 2024

Abstract
Indian Ocean (IO) stratification has important effects on the air–sea interaction, ocean dynamics, and ecology. It is, therefore, of significance to investigate the changes in IO stratification. In this study, we use ensemble empirical mode decomposition (EEMD) to extract the nonlinear long-term trend in the upper IO stratification quantified by potential energy anomalies. The results show that the strengthening of the stratification is spatially and temporally nonuniform. Specifically, the trend of stratification intensified gradually before 1996, but accelerated rapidly after 1996. Temperature and salinity changes play a crucial role in the fast enhancement of stratification and its regional differences. Temperature variations dominate the stratification trend in ∼90% of the IO area, while the contributions of salinity changes are mainly in the southeast Indian Ocean (SEIO). Vertically, the rapid enhancement of stratification is caused by the trend of temperature and salt in the upper 400 m. We further perform temperature budget analysis and find that the warming trend in the upper 400 m south of the IO is mainly modulated by vertical advection and meridional advection, while the warming in the north of the IO is mainly induced by air–sea heat fluxes. Salinity budget analysis shows that ocean advection has played a primary role in modulating SEIO salinity over the past 20 years.
The Influence of Contextual and Theoretical Expertise on Generic and Occupation-Specific Lifting Strategy
Authors: Armstrong Daniel P. , Beach Tyson A. C. , Fischer Steven L. 
Published: February 2024

Objective To determine whether (i) low back loads and/or (ii) kinematic coordination patterns differed across theoretical expert, contextual expert and novice groups when completing both generic and occupation-specific lifts. Background Experience has been proposed as a factor that could reduce biomechanical exposures in lifting, but the literature reports mixed effects. The inconsistent relationship between experience and exposures may be partially attributable to the broad classification of experience and experimental lifting protocols not replicating the environment where experience was gained. Methods Purposive sampling was used to recruit 72 participants including theoretical experts (formal training on lifting mechanics), contextual experts (paramedics), and novices. Participants performed 10 barbell and crate (generic) lifts, as well as backboard and stretcher (occupation-specific) lifts while whole-body kinematics and ground reaction forces were collected. Peak low back compression and anteroposterior shear loads normalized to body mass, as well as kinematic coordination patterns, were calculated as dependent variables. Results No significant differences in low back loads were observed across expertise groups. However, significant differences were seen in kinematic coordination patterns across expertise groups in occupation-specific lifts, but not in generic lifts. Conclusion Increasing expertise is unlikely to minimize low back loads in lifting. However, contextual expertise did influence lifting kinematics, but only when performing occupationally specific lifts. Application Contextual expertise may help lifters adopt lifting kinematics that enhance the tolerance of their musculoskeletal system to withstand applied loads, but does not seem to reduce the applied low back loads relative to noncontextual expert groups.
Return to Sport After Pediatric Anterior Cruciate Ligament Reconstruction: A Systematic Review of the Criteria
Authors: Lorange Justin-Pierre , Senécal Laurianne , Moisan Philippe , Nault Marie-Lyne 
Published: February 2024

Background: Postoperative rehabilitation is an important component of recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), facilitating successful return to sport (RTS) by reducing risk factors for repeat injury. Purpose: This systematic review aimed to determine the best protocol for RTS after ACLR in children. Study Design: Systematic review; Level of evidence, 4. Methods: PubMed, Embase, PEDro, SPORTDiscus, and Web of Science databases were searched from October 3, 2014, to November 3, 2022. The inclusion criteria were the pediatric population (<18 years old) after ACLR with clear RTS criteria and/or mean/median time to RTS. Multiligament knee injuries were excluded from this study. The methodologic quality of the included articles was assessed using the methodological index for non-randomized studies (MINORS). The highest possible score was 24 points for comparative studies (ie, a study comparing 2 protocols or more). Noncomparative studies or studies with a single protocol could score a maximum of 16 points as assessed by the MINORS score. Results: The search yielded 1816 titles, and 24 were retained based on the inclusion and exclusion criteria. Every study was published between 2015 and 2022. Among the 24 studies included, 13 were retrospective and 11 were prospective. The mean MINORS score for the noncomparative studies was 13 of 16 (n = 23) and 23 of 24 for the comparative study (n = 1). The studies were categorized into unspecified clearance (n = 10), milestone based (n = 13), and combined time and milestone (n = 1). A total of 1978 patients (57% female) were included in the review. The mean age at ACLR was 14.7 years. The most common endpoint used was graft rupture (0% to 35%). In the unspecified group, the quickest RTS was 5.8 months and the longest was 9.6 months. Statistically significant risk factors for ACL reinjury included younger age and earlier RTS. The latter was a significant contributor to graft failure for combined time-based and milestone-based RTS. In the milestone-based group, the most common criteria were ≥90% limb symmetry measured using hamstring strength, quadriceps strength, and/or hop tests. The mean RTS time was 6.8 to 13.5 months. Conclusion: RTS should be delayed, when possible, especially in the younger population. A combination of quantitative tests and qualitative tests is also recommended. However, optimal RTS criteria have yet to be determined. Future prospective studies should focus on comparing the different times and milestones currently available.
Myopia control efficacy of peripheral defocus soft contact lenses in children and adolescents: A meta-analysis
Authors: Fan Haobo , Zhang Xuemin , Wei Qiumei , Zhong Qiao , Liu Meng , Li Bingqian , Li Shilin , Zhang Renwei , Xie Airui 
Published: February 2024

Objectives To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs) on controlling myopia progression in children and adolescents, and to compare it with orthokeratology (Ortho-K) and single vision lenses (SVLs). Methods We conducted a systematic search of PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP, and WanFang Data databases for randomized controlled trials (RCTs) and cohort studies that investigated the effects of PDSCLs on myopia control in children and adolescents. The published languages were limited to English and Chinese. The risk bias tool provided by the Cochrane risk-of-bias tool and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by Egger`s test. Results We included 21 studies, comprising 13 RCTs and 8 cohort studies, with a total of 1337 participants in the PDSCLs group, 428 in the Ortho-K group, and 707 in the SVLs group. The meta-analysis indicated no significant difference between PDSCLs and Ortho-K in controlling the increase of diopter ( MD = 0.01, 95% CI: −0.06, 0.09; P = 0.69) and axial length ( MD = -0.01, 95% CI: −0.02, 0.00; P = 0.28). Compared with SVLs, PDSCLs had a better effect in controlling the increase of diopter ( MD = 0.23, 95% CI: 0.17, 0.28; P < 0.00001) and axial length ( MD = -0.11, 95% CI: −0.12, −0.09; P < 0.00001) in children and adolescents. Conclusions Children and adolescents wearing PDSCLs can achieve better myopia control than those wearing SVLs, and their effect is comparable to that of Ortho-K.
Advances in the long-term treatment of neuromyelitis optica spectrum disorder
Authors: Anderson Monique , Levy Michael 
Published: February 2024

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune neuroinflammatory disorder with a prevalence of 1-5/100,000 globally, characterized by attacks of the central nervous system including but not limited to optic neuritis, transverse myelitis and brainstem lesions, including area postrema lesions. These autoimmune attacks can lead to irreversible damage if left untreated, therefore strategies have been developed to prevent relapses. Initial off-label treatments have achieved variable levels of success in relapse prevention, but improved relapse prevention and quality of life remain a goal in the field. A better understanding of the underlying pathophysiology of NMOSD over the last 10 years has led to newer, more specific approaches in treatment, culminating in the first FDA approved treatments in the disease. In this review, we will discuss the seminal trials of PREVENT or Eculizumab in the treatment of aquaporin-4 (AQP4)-IgG positive NMOSD, N-Momentum or Inebilizumab in the study of NMOSD (both AQP4-IgG positive and negative) and SAkura Sky and SAkuraStar which studied satralizumab in AQP4-IgG seropositive and seronegative NMOSD patients. We will also discuss the extension trials of each of these medications and what lead to their approval in AQP4-IgG seropositive NMOSD patients. We will then examine treatments in the pipeline for adult and pediatric NMOSD patients and conclude with discussions on treatment considerations in pregnant patients and how to approach treatment of NMOSD patients during COVID.
Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty
Authors: Seibold Bruce Tanner , Quan Theodore , Zhao Amy Y , Parel Philip M , Mikula Jacob D , Mun Frederick , Srikumaran Umasuthan , Zimmer Zachary R 
Published: February 2024

Background Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA). Methods Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications. Results Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84). Discussion The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.
Lipid metabolism-related genes are involved in the occurrence of asthma and regulate the immune microenvironment
Authors: Jia Yuanmin , Wang Haixia , Ma Bin , Zhang Zeyi , Wang Jingjing , Wang Jin , Chen Ou 
Published: February 2024

AbstractBackgroundLipid metabolism plays a pivotal role in asthma pathogenesis. However, a comprehensive analysis of the importance of lipid metabolism-related genes (LMRGs) in regulating the immune microenvironment in asthma remains lacking. The transcriptome matrix was downloaded from the Gene Expression Omnibus (GEO) dataset. Differentially expressed analysis and weighted gene coexpression network analysis (WGCNA) were conducted on the GSE74986 dataset to select hub LMRGs, and gene set enrichment analysis (GSEA) was conducted to explore their biological functions. The CIBERSORT algorithm was used to determine immune infiltration in the asthma and control groups, and the correlation of diagnostic biomarkers and immune cells was performed via Spearman correlation analysis. Subsequently, a competitive endogenous RNA (ceRNA) network was constructed to investigate the hidden molecular mechanism of asthma. The expression levels of the hub genes were further validated in the GSE143192 dataset, and RT‒qPCR and immunofluorescence were performed to verify the reliability of the results in the OVA asthma model. Lastly, the ceRNA network was confirmed by qRT-PCR and RNAi experiments in the characteristic cytokine (IL-13)-induced asthma cellular model.ResultsASAH1,ACER3andSGPP1were identified as hub LMRGs and were mainly involved in protein secretion, mTORC1 signaling, and fatty acid metabolism. We found more infiltration of CD8+T cells, activated NK cells, and monocytes and less M0 macrophage infiltration in the asthma group than in the healthy control group. In addition,ASAH1,ACER3, andSGPP1were negatively correlated with CD8+T cells and activated NK cells, but positively correlated with M0 macrophages. Within the ceRNA network,SNHG9-hsa-miR-615-3p-ACER3,hsa-miR-212-5pandhsa-miR-5682may play crucial roles in asthma pathogenesis. The low expression ofASAH1andSGPP1in asthma was also validated in the GSE74075 dataset. AfterSNHG9knockdown,miR-615-3pexpression was significantly upregulated, while that ofACER3was significantly downregulated.ConclusionASAH1,ACER3andSGPP1might be diagnostic biomarkers for asthma, and are associated with increased immune system activation. In addition,SNHG9-hsa-miR-615-3p-ACER3may be viewed as effective therapeutic targets for asthma. Our findings might provide a novel perspective for future research on asthma.
Effect of esketamine on postoperative analgesia and postoperative delirium in elderly patients undergoing gastrointestinal surgery
Authors: Liu Jing , Wang TingTing , Song Jian , Cao Li 
Published: February 2024

Abstract
Objective
To investigate the analgesic effect of esketamine combined with low-dose sufentanil in elderly patients after gastrointestinal surgery, and whether the anti-inflammatory effect of esketamine is involved in the mechanism of postoperative delirium.

Method
We enrolled sixty elderly patients (age ≥ 65 years old, American Society of Anesthesiologists (ASA) grade I-III) who underwent gastrointestinal surgery. Patients were randomly assigned to Group C (control group) who received sufentanil 2 ug/kg, and Group E (experimental group) who received sufentanil 1.5 ug/kg + esketamine 1 mg/kg, with 30 patients in each group. All patients underwent total intravenous anesthesia during the surgery and were connected to a patient-controlled intravenous analgesia (PCIA) pump after surgery. The primary outcome was the evaluation of pain at 4, 24, 48 h after surgery which was evaluated by NRS scores. In secondary outcomes, inflammation was assessed by measuring IL-6 levels using ELISA. The postoperative delirium and the occurrence of adverse reactions were observed on the 1st and 3rd day after surgery.

Results
The NRS scores at 4, 24, and 48 h after surgery in the experimental group [(4.53 ± 1.22), (3.46 ± 0.73), (1.37 ± 0.99)] were lower than that in the control group [(5.23 ± 1.16), (4.46 ± 0.77), (2.13 ± 0.78)] (P < 0.05). The concentration of serum IL-6 in the experimental group at 24 and 48 h after operation [(15.96 ± 4.65), (11.8 ± 3.24)] were lower than that in the control group [(23.07 ± 4.86), (15.41 ± 4.01)] (P < 0.05); the incidence of postoperative delirium in the experimental group was less than that in the control group (P < 0.05); there was no significant difference in the incidence of postoperative nausea and vomiting between the two groups (P > 0.05), and neither group had nightmares or delirium.

Conclusion
Esketamine may enhance postoperative pain management compare with sufentanil, and esketamine has anti-inflammatory effects that reduce the incidence of postoperative delirium.

Trial registration
Full name of the registry: Chinese Clinical Trial Registry. Trial registration number: ChiCTR2300072374. Date of registration:2023/06/12
Effectiveness of bevacizumab in the treatment of metastatic colorectal cancer: a systematic review and meta-analysis
Authors: Song Yu , Mao Qianqian , Zhou Manling , Liu Cheng-Jiang , Kong Li , Hu Ting 
Published: February 2024

Abstract
Objective
To evaluate the benefit of bevacizumab under the comprehensive treatment strategy and its advantages over other drugs, so as to provide reference for the formulation of clinical plans.

Methods
As of October 1, 2022, the randomized controlled clinical trials of bevacizumab in combination with metastatic colorectal cancer published in PubMed, Cochrane Library and Medline databases were searched. The odds ratio (OR) and its 95% confidence interval (CI) were used to evaluate the short-term disease control effect and long-term survival of the treatment strategy.

Results
21 RCTs (6665 patients; 3356 patients in the experimental group and 3309 patients in the control group; average age, 55–75 years) were treated with bevacizumab as the experimental group for metastatic colorectal cancer. BEV has stronger anti-tumor activity than the single treatment scheme (OR = 1.30, 95% CI: 1.11–1.52). And Benefits of the BEV group were 0.73 (0.55, 0.96), 1.26 (0.71, 2.24), 1.63 (0.92, 2.87) and 0.07 (0.02, 0.25) compared with CET, VAN, CED and PAN respectively. The disease control of BEV combined therapy was better (OR = 1.36, 95% CI: 1.04–1.78). The same as compared with cediranib (OR = 1.94, 95% CI: 1.06–3.55). However, the long-term prognosis of BEV, including the overall survival (HRs = 0.98, 95% CI: 0.84–1.15) and progression-free survival (HRs = 1.05,95% CI: 0.97–1.13) were not prolonged. The survival benefits of cetuximab and panitumumab were not reflected.

Conclusion
The addition of BEV can enhance the anti-tumor ability and disease control, while cetuximab and panitumumab may have stronger ability. However, it did not effectively improve the survival of patients. A more reasonable and effective treatment plan needs more clinical experimental support.