bluuebunny/crossref_metadata_2025_split huggingface dataset:
The comparative and correlation study of postmortem ethanol levels between axillosubclavian blood and femoral venous blood in forensic autopsy cases at Thammasat University Hospital, Thailand
Authors: Tangsermkijsakul Aphinan , Pipatchotitham Tossanai 
Published: May 2023

Abstract
Background
Femoral venous blood (FVB) is accepted as a standard sample for postmortem ethanol analysis, but owing to the nature of unnatural death cases, FVB may not always be obtainable, and subclavian blood might be used for alternative specimens. This study investigated the correlation between postmortem ethanol concentrations in FVB and axillosubclavian blood (ASB) from autopsy cases in the tropical climate of Central Thailand. Two other factors potentially affecting the correlation, the time of death and ethanol absorption state, were also investigated. FVB, ASB, and vitreous humor were collected from 100 subjects between May 2021 and May 2022. Subjects with decomposition signs and large open wounds were excluded. ASB was drawn from the axillosubclavian vein at the thoracic outlet. Ethanol concentrations in all samples were measured by headspace GC-FID.

Results
Ethanol concentrations in ASB were statistically identical to those in FVB (p = 0.6761) and their relationship was statistically correlated (r = 0.9818, p < 0.001). The correlation was not statistically influenced by time since death or absorptive statuses. The diagnostic study to assess the practical application of ASB instead of FVB at a cut-off concentration above 50 mg/dL yielded an area under the ROC curve of 0.96.

Conclusions
Our study indicated that ASB can be used as an alternative specimen for postmortem ethanol analysis when FVB is unavailable in dead bodies that are in a tropical climate.
Clinical and radiological profile of cavernous sinus syndrome: a study from eastern part of India
Authors: Rodge Vinayak Narayan , Mukherjee Adreesh , Biswas Samar , Majumdar Suchitra , Gangopadhyay Goutam 
Published: May 2023

Abstract
Background
Cavernous sinus syndrome (CSS) consists of a variable combination of involvement of the 3rd-to-6th cranial nerves. The etiologies vary across studies, and it has a significant impact on the outcome. This study was done to delineate the etiology, clinico-radiological profile and outcome of CSS. In this prospective study, patients were recruited consecutively over 2 years, and were followed up for at least 6 months. MRI of the brain and orbit with contrast was done, and other relevant investigations were performed to arrive at a specific etiology. Tolosa-Hunt Syndrome (THS) was defined in accordance with the second edition of the International Classification of Headache Disorders (ICHD-II).

Results
Of the 92 patients studied, THS was the predominant diagnosis, followed by Tuberculosis, fungal infection, aneurysm, neoplastic and Sjögren’s syndrome. Cranial nerves commonly involved were 3rd, 4th, 6th and 5th. The optic nerve was affected in 54.3% of patients. The non-THS patients showed the greater occurrence of proptosis, complete ophthalmoplegia, involvement of optic nerve and cranial nerves 7th–10th. Nasal blockage was present in fungal infection. MRI revealed more frequent involvement of orbit in non-THS cases. Bony erosions, ICA narrowing, intracranial extension and involvement of paranasal sinus were seen in fungal infection and neoplasm. THS patients improved with corticosteroid therapy, although, there was recurrence in 8 patients.

Conclusions
THS and tuberculosis were the most common cause of CSS. Clinical and radiological features were useful in distinguishing among the etiologies. Most of the patients responded to treatment, although, recurrence was seen in THS.
Perfusion index (PI) measured in the brachial plexus blocks performed by ultrasonography: investigation of correlation with block success
Authors: Bozdağ Akif , Doğukan Mevlüt , Bıçakçıoğlu Murat , Nakır Hamza , Duran Mehmet , Uludağ Öznur 
Published: May 2023

Abstract
Background
Brachial plexus block is one of the peripheral nerve blocks commonly used in regional anesthesia. We aimed to investigate whether the perfusion index (PI) measurement can be used to evaluate the adequacy of the upper limb blocks accompanied by ultrasonography. Thirty-three patients between the ages of 18 and 65 who were in the ASA I–II group who will have a hand, forearm, and arm operation were included in the study. An appropriate type of brachial plexus block was applied to these patients under the guidance of ultrasonography. After the block application was completed, the sensory and motor blocks were evaluated at the 5th, 10th, and 20th min. In addition, perfusion indices measured from both extremities of the patient were recorded at the 5th, 10th, and 20th min.

Results
In 32 of 33 patients who underwent brachial plexus block, our block was successful, and perfusion index measurements in the applied limb increased continuously from the 5th min over the 20-min observation period. In one patient who failed the block and in the arm group without block, no statistically significant difference was detected in the 5th, 10th, and 20th min perfusion index measurements.

Conclusions
Perfusion index measurement is a very valuable and usable method to evaluate the success of peripheral nerve blocks early, easily, and objectively.
Nasogastric tube feeding under physical restraint: comprehensive audit and case series across in-patient mental health units in England
Authors: Fuller Sarah J. , Tan Jacinta , De Costa Huw , Nicholls Dasha 
Published: May 2023

Aims and methodTo identify the clinical characteristics of patients receiving nasogastric tube (NGT) feeding under physical restraint. Clinicians participated via professional networks and subsequent telephone contact. In addition to completing a survey, participants were invited to submit up to ten case studies.ResultsThe survey response rate from in-patient units was 100% and 143 case studies were submitted. An estimated 622 patients received NGT feeding under restraint in England in 2020–2021. The most common diagnosis was anorexia nervosa (68.5–75.7%), with depression, anxiety and autism spectrum disorder the most frequent comorbidities. Patients receiving the intervention ranged from 11 to 60 years in age (mean 19.02 years). There was wide variation in duration of use, from once to daily for 312 weeks (mode 1 week; mean 29.1 weeks, s.d. = 50.8 weeks).Clinical implicationsNGT feeding under restraint is not uncommon in England, with variation in implementation. Further research is needed to understand how the high comorbidity and complexity contribute to initiation and termination of the intervention.
Resistance Exercise Counteracts the Impact of Androgen Deprivation Therapy on Muscle Characteristics in Cancer Patients
Authors: Overkamp Maarten , Houben Lisanne H P , Aussieker Thorben , van Kranenburg Janneau M X , Pinckaers Philippe J M , Mikkelsen Ulla R , Beelen Milou , Beijer Sandra , van Loon Luc J C , Snijders Tim 
Published: May 2023

Abstract

Context
Androgen deprivation therapy (ADT) forms the cornerstone in prostate cancer (PCa) treatment. However, ADT also lowers skeletal muscle mass.

Objective
To identify the impact of ADT with and without resistance exercise training on muscle fiber characteristics in PCa patients.

Methods
Twenty-one PCa patients (72 ± 6 years) starting ADT were included. Tissue samples from the vastus lateralis muscle were assessed at baseline and after 20 weeks of usual care (n = 11) or resistance exercise training (n = 10). Type I and II muscle fiber distribution, fiber size, and myonuclear and capillary contents were determined by immunohistochemistry.

Results
Significant decreases in type I (from 7401 ± 1183 to 6489 ± 1293 μm2, P &lt; .05) and type II (from 6225 ± 1503 to 5014 ± 714 μm2, P &lt; .05) muscle fiber size were observed in the usual care group. In addition, type I and type II individual capillary-to-fiber ratio (C/Fi) declined (−12% ± 12% and −20% ± 21%, respectively, P &lt; .05). In contrast, significant increases in type I (from 6700 ± 1464 to 7772 ± 1319 μm2, P &lt; .05) and type II (from 5248 ± 892 to 6302 ± 1385 μm2, P &lt; .05) muscle fiber size were observed in the training group, accompanied by an increase in type I and type II muscle fiber myonuclear contents (+24% ± 33% and +21% ± 23%, respectively, P &lt; .05) and type I C/Fi (+18% ± 14%, P &lt; .05).

Conclusion
The onset of ADT is followed by a decline in both type I and type II muscle fiber size and capillarization in PCa patients. Resistance exercise training offsets the negative impact of ADT and increases type I and II muscle fiber size and type I muscle fiber capillarization in these patients.
Effect of Simvastatin Treatment on Mitochondrial Function and Inflammatory Status of Human White Adipose Tissue
Authors: Christensen Ida Bager , Blom Ida , Dohlmann Tine Lovsø , Finger Fabian , Helge Jørn W , Gerhart-Hines Zachary , Dela Flemming , Larsen Steen 
Published: May 2023

Abstract

Background
Statin therapy has shown pleiotropic effects affecting both mitochondrial function and inflammatory status. However, few studies have investigated the concurrent effects of statin exposure on mitochondrial function and inflammatory status in human subcutaneous white adipose tissue.

Objectives
In a cross-sectional study, we investigated the effects of simvastatin on mitochondrial function and inflammatory status in subcutaneous white adipose tissue of 55 human participants: 38 patients (19 females/19 males) in primary prevention with simvastatin (&gt; 40 mg/d, &gt; 3 mo) and 17 controls (9 females/8 males) with elevated plasma cholesterol. The 2 groups were matched on age, body mass index, and maximal oxygen consumption.

Methods
Anthropometrics and fasting biochemical characteristics were measured. Mitochondrial respiratory capacity was assessed in white adipose tissue by high-resolution respirometry. Subcutaneous white adipose tissue expression of the inflammatory markers IL-6, chemokine (C-C motif) ligand 2 (CCL2), CCL-5, tumor necrosis factor-α, IL-10, and IL-4 was analyzed by quantitative PCR.

Results
Simvastatin-treated patients showed lower plasma cholesterol (P &lt; .0001), low-density lipoprotein (P &lt; .0001), and triglyceride levels (P = .0116) than controls. Simvastatin-treated patients had a lower oxidative phosphorylation capacity of mitochondrial complex II (P = .0001 when normalized to wet weight, P &lt; .0001 when normalized to citrate synthase activity [intrinsic]), and a lower intrinsic mitochondrial electron transport system capacity (P = .0004). Simvastatin-treated patients showed higher IL-6 expression than controls (P = .0202).

Conclusion
Simvastatin treatment was linked to mitochondrial respiratory capacity in human subcutaneous white adipose tissue, but no clear link was found between statin exposure, respiratory changes, and inflammatory status of adipose tissue.
Remnant Cholesterol Is Associated With Gestational Diabetes Mellitus: A Cohort Study
Authors: Wang Weiming , Li Na , Wang Xiaoyi , Zhang Xu , Tu Menghan , Lin Lixia , Li Qian , Zhang Huaqi , Liu Jin , Yang Xuefeng , Hao Liping , Yang Nianhong 
Published: May 2023

Abstract

Context
The association between remnant cholesterol (RC) and gestational diabetes mellitus (GDM) risk is unclear.

Objective
This study investigated the association between RC and GDM.

Methods
We used data from the Tongji Maternal and Child Health Cohort, a prospective cohort study in China. Fasting lipid concentrations were measured around 16 weeks’ gestation. RC was calculated as total cholesterol minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. GDM was diagnosed by a 75-g oral glucose tolerance test at 24 to 28 weeks’ gestation. Log-Poisson regression models were performed to estimate relative risks (RRs) of GDM across quartiles of RC levels and triglyceride (TG) levels after adjustment for potential confounders. TG and RC were mutually adjusted.

Results
Among 2528 women, 256 (10.1%) developed GDM. The adjusted RRs (95% CIs) for GDM across increasing quartiles of RC were 1.00 (reference), 1.35 (0.91, 1.99), 1.68 (1.16, 2.45), and 1.73 (1.19, 2.50), respectively. Compared to pregnant women without 3 risk indicators (TG &lt;2.08 mmol/L, RC &lt;0.40 mmol/L, and pre-BMI &lt;24.0 kg/m2), the risk of GDM was elevated in those with normal pre-BMI but high RC (aRR: 1.54; 95% CI: 1.08, 2.19) or high TG (aRR: 2.15; 95% CI: 1.33, 3.49). For those with all 3 risk indicators, the risk of GDM was the highest (aRR: 4.80; 95% CI: 3.20, 7.18).

Conclusion
Elevated RC levels were associated with the increased risk of GDM and independent of traditional risk factors. Pregnant women with high pre-BMI, high TG, and high RC were at greatly increased risk of GDM.
Combined Double-Barrel Superficial Temporal Artery to M4 Bypass and Parent Artery Occlusion for the Treatment of Complex Intracranial Aneurysms in Internal Carotid Artery and Middle Cerebral Artery: A Retrospective Case Series
Authors: Wu Zhimin , Ling Cong , Liao Zhi , Sun Jun , Qiao Jia , Chen Chuan , Wang Hui 
Published: May 2023

BACKGROUND:
Very little research has been conducted to assess the efficacy of combined double-barrel superficial temporal artery (STA) to M4 bypass and parent artery occlusion (PAO) in the treatment of complex intracranial aneurysms.

OBJECTIVE:
To determine whether this operation could become a reasonable flow replacement therapy and have longer-term benefits.

METHODS:
A series of double-barrel STA-M4 bypasses performed between 2016 and 2021 were reviewed. Preoperative digital subtraction angiography (DSA), computed tomography angiography (CTA), computed tomography perfusion (CTP), and balloon test occlusion were routinely performed for a thorough evaluation of individual benefits and risks. After bypass, the proximal end of the parent artery was permanently occluded with the coil. Augmentation and patency of STA were reassessed by postoperative DSA, CTA, and CTP. The blood flow volume of STA was measured by ultrasound at admission and a 3-month follow-up.

RESULTS:
This study included 12 consecutive patients (5 males, 7 females) who successfully underwent double-barrel STA-M4 bypass, including 8 complex aneurysms in the internal carotid artery (ICA) and 4 in the middle cerebral artery (MCA). Postoperative angiography and CTP suggested that all the STAs were patent, and there was a significant improvement in perfusion after the operation (P < .05). Ultrasonic measurement at the 3-month follow-up showed that the blood flow provided by STA was 76.3 to 190.5 mL/min. Postoperative ischemia was found in 1 patient, but she recovered after treatment.

CONCLUSION:
Double-barrel STA to M4 bypass can provide adequate flow for the parent artery area, which may be a reasonable flow replacement therapy for some complex intracranial aneurysms in ICA and MCA.
Clinical Outcomes After Ultra-Early Cranioplasty Using Craniectomy Contour Classification as a Patient Selection Criterion
Authors: Patel Pious D. , Khanna Omaditya , Gooch M Reid , Glener Steven R. , Mouchtouris Nikolaos , Momin Arbaz A. , Sioutas Georgios , Amllay Abdelaziz , Barsouk Adam , El Naamani Kareem , Yudkoff Clifford , Wyler David A. , Jallo Jack I , Tjoumakaris Stavropoula , Jabbour Pascal M. , Harrop James S. 
Published: May 2023

BACKGROUND:
Although not a technically difficult operation, cranioplasty is associated with high rates of complications. The optimal timing of cranioplasty to mitigate complications remains the subject of debate.

OBJECTIVE:
To report outcomes between patients undergoing cranioplasty at ultra-early (0-6 weeks), intermediate (6 weeks to 6 months), and late (>6 months) time frames. We report a novel craniectomy contour classification (CCC) as a radiographic parameter to assess readiness for cranioplasty.

METHODS:
A single-institution retrospective analysis of patients undergoing cranioplasty was performed. Patients were stratified into ultra-early (within 6 weeks of index craniectomy), intermediate (6 weeks to 6 months), and late (>6 months) cranioplasty cohorts. We have devised CCC scores, A, B, and C, based on radiographic criteria, where A represents those with a sunken brain/flap, B with a normal parenchymal contour, and C with “full” parenchyma.

RESULTS:
A total of 119 patients were included. There was no significant difference in postcranioplasty complications, including return to operating room (P = .212), seizures (P = .556), infection (P = .140), need for shunting (P = .204), and deep venous thrombosis (P = .066), between the cohorts. Univariate logistic regression revealed that ultra-early cranioplasty was significantly associated with higher rate of functional independence at >6 months (odds ratio 4.32, 95% CI 1.39-15.13, P = .015) although this did not persist when adjusting for patient selection features (odds ratio 2.90, 95% CI 0.53-19.03, P = .234).

CONCLUSION:
In appropriately selected patients, ultra-early cranioplasty is not associated with increased rate of postoperative complications and is a viable option. The CCC may help guide decision-making on timing of cranioplasty.
Adjustable, Dynamic Subcortical Stimulation Technique for Brain Tumor Resection: A Case-Series
Authors: Silverstein Justin W. , Shah Harshal A. , Greisman Jacob D. , Dadario Nicholas B. , Barbarevech Kristiana , Park Jung , D'Amico Randy S. 
Published: May 2023

BACKGROUND AND OBJECTIVES:
Subcortical stimulation (SCS) is the gold standard neuromonitoring technique for intraoperative identification of descending white matter tracts. Dynamic SCS confers several advantages over more commonly used static devices; however, current commercially available devices for dynamic SCS have not been widely adopted.

METHODS:
We fashioned a dynamic SCS device using a stainless-steel suction and commonly available materials and assessed its efficacy in a series of 14 patients with brain tumors. The device was used to provide continuous SCS during tumor resection. Preoperative and postoperative motor function were characterized, and preoperative and postoperative imaging were analyzed to determine extent of tumor resection and proximity to motor-eloquent structures. Inferential statistics were used to correlate study parameters.

RESULTS:
Fourteen patients (12 male and 2 female, median age 52.5 years) were analyzed. The lowest intraoperative SCS intensities were 10 to 15 mA (3 surgeries), 5 to 10 mA (4 surgeries), and <5 mA (2 surgeries). SCS with this device did not elicit motor evoked potentials in 5 surgeries because of distance from the corticospinal tract (CST) and served as negative controls. Three patients (21.4%) experienced new postoperative motor deficits immediately after surgery that resolved by discharge. We observed no instances of mechanical CST injury resulting in permanent postoperative motor deficits using this technique and no correlation between lower SCS intensity and the presence of new motor impairments after surgery. No patient experienced an intraoperative seizure.

CONCLUSION:
The novel dynamic SCS device is easily adoptable and allows accurate intraoperative identification of the CST, facilitating safe resection of tumors near motor-eloquent structures.
A dynamical systems treatment of transcriptomic trajectories in hematopoiesis
Authors: Freedman Simon L. , Xu Bingxian , Goyal Sidhartha , Mani Madhav 
Published: May 2023

ABSTRACT
Inspired by Waddington's illustration of an epigenetic landscape, cell-fate transitions have been envisioned as bifurcating dynamical systems, wherein exogenous signaling dynamics couple to the enormously complex signaling and transcriptional machinery of a cell to elicit qualitative transitions in its collective state. Single-cell RNA sequencing (scRNA-seq), which measures the distributions of possible transcriptional states in large populations of differentiating cells, provides an alternate view, in which development is marked by the variations of a myriad of genes. Here, we present a mathematical formalism for rigorously evaluating, from a dynamical systems perspective, whether scRNA-seq trajectories display statistical signatures consistent with bifurcations and, as a case study, pinpoint regions of multistability along the neutrophil branch of hematopoeitic differentiation. Additionally, we leverage the geometric features of linear instability to identify the low-dimensional phase plane in gene expression space within which the multistability unfolds, highlighting novel genetic players that are crucial for neutrophil differentiation. Broadly, we show that a dynamical systems treatment of scRNA-seq data provides mechanistic insights into the high-dimensional processes of cellular differentiation, taking a step toward systematic construction of mathematical models for transcriptomic dynamics.
Genetic knockdown of genes that are obscure, conserved and essential using CRISPR interference methods in the fission yeast S. pombe
Authors: Ishikawa Ken , Soejima Saeko , Saitoh Shigeaki 
Published: May 2023

ABSTRACT
Characterizing functions of essential genes is challenging, as perturbing them is generally lethal. Conditional gene perturbation, including use of temperature-sensitive mutants, has been widely utilized to reveal functions of essential genes in the fission yeast Schizosaccharomyces pombe. However, recently we implemented a systematic and less time-consuming knockdown method, CRISPR interference (CRISPRi), in this organism using catalytically inactive Cas9 (dCas9). This technology has been expected to facilitate characterization of essential genes in S. pombe, although this still has not occurred. Here, CRISPRi was harnessed to study uncharacterized essential genes that are evolutionally conserved from yeasts to mammals. Transcription of these genes, which we call conserved essential obscure (ceo) genes, was repressed using conventional dCas9-mediated CRISPRi and by implementing technologies that enhance repression efficiency or alleviate limitations on small guide RNA (sgRNA) design. These CRISPRi methods successfully reduced transcription of target genes and allowed us to characterize resulting phenotypes. Knockdown of ceo genes inhibited cell proliferation and altered cellular morphology. Thus, dCas9-based CRISPRi methods utilized in this study enhanced accessibility of genetic analyses targeting essential genes in S. pombe.