bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Fusion and Arthroplasty for Cervical Degenerative Disc Disease in Active Duty Service Members Performed at an Overseas Military Treatment Facility: A 2-Year Retrospective Analysis
Authors: Dewar Callum , Ravindra Vijay M , Woodle Samuel , Scanlon Michaela , Shields Margaret , Yokoi Hana , Meister Melissa , Porensky Paul , Bossert Sharon , Ikeda Daniel S 
Published: July 2023

ABSTRACT

Introduction
Among U.S. military active duty service members, cervicalgia, cervical radiculopathy, and myelopathy are common causes of disability, effecting job performance and readiness, often leading to medical separation from the military. Among surgical therapies, anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are options in select cases; however, elective surgeries performed while serving overseas (OCONUS) have not been studied.

Materials and Methods
A retrospective analysis of a prospectively collected surgical database from an OCONUS military treatment facility over a 2-year period (2019–2021) was queried. Patient and procedural data were collected to include ACDF or CDA surgery, military rank, age, tobacco use, pre- and post-operative visual analogue scales for pain, and presence of radiographic fusion after surgery for ACDF patients or heterotopic ossification for CDA patients. Chi-square and Student t-test analyses were performed to identify variables associated with return to full duty.

Results
A total of 47 patients (25 ACDF and 22 CDA) underwent surgery with an average follow-up of 192.1 days (range 7–819 days). Forty-one (87.2%) patients were able to return to duty without restrictions; 10.6% of patients remained on partial or limited duty at latest follow-up and one patient was medically separated from the surgical cohort. There was one complication and one patient required tour curtailment from overseas duty for ongoing symptoms.

Conclusions
Both ACDF and CDA are effective and safe surgical procedures for active duty patients with cervicalgia, cervical radiculopathy, and cervical myelopathy. They can be performed OCONUS with minimal interruption to the patient, their family, and the military unit, while helping to maintain surgical readiness for the surgeon and the military treatment facility.
Pott’s Puffy Tumor: A Rare, Life-Threatening Presentation of Periorbital Edema
Authors: Kuhar Benjamin G , Dunn Travis M , Liming Bryan J , Yakopson Vladimir S 
Published: July 2023

ABSTRACT
Pott’s puffy tumor (PPT) describes forehead swelling with associated frontal bone osteomyelitis and a subperiosteal abscess (SPA) requiring a high suspicion index for optimal outcomes. PPT is a life-threatening complication of frontal sinusitis typically found in adolescents. Our case is one of the youngest in the literature. This report describes a 3-year-old patient who developed multifocal abscesses in the epidural space with frontal and orbital SPA, requiring surgical intervention. Additionally, her course was complicated by a superior sagittal venous thrombosis, a complication commonly associated with PPT. We present an unusual case of orbital SPA and aim to highlight a life-threatening pediatric condition that is often underrecognized.
Intervertebral fusion sites in patients with ankylosing spondylitis: A computed tomography study
Authors: Kishimoto Kenji , Asai Shuji , Suzuki Mochihito , Kihira Daisuke , Sato Ryo , Terabe Kenya , Ohashi Yoshifumi , Maeda Masataka , Imagama Shiro 
Published: July 2023

ABSTRACT

Objectives
To examine intervertebral fusion sites along the whole spine of patients with ankylosing spondylitis using computed tomography.

Methods
This retrospective study examined intervertebral fusion of five sites (anterior/posterior vertebrae, left/right zygapophyseal joints, and spinous process) on 23 vertebrae in the cervical, thoracic, and lumbar regions of the spine in 40 patients diagnosed with ankylosing spondylitis at our institute between January 2004 and December 2022.

Results
Mean age [± standard deviation (SD)] was 40.5 (± 17) years, and mean disease duration (± SD) was 11.4 (± 10.5) years at computed tomography evaluation; 55.9% were human leukocyte antigen B-27–positive. Fifteen (37.5%) patients showed intervertebral fusion in the thoracic and/or cervical regions, but not in the lumbar region. Fusion of posterior vertebrae was observed most frequently in the thoracic region, compared to the cervical and lumbar regions. In particular, more than half of the patients showed fusion of posterior vertebrae Th4–Th5 to Th7–Th8.

Conclusions
In 37.5% of patients, intervertebral fusion was evident in the thoracic and/or cervical regions but not in the lumbar region. The most common site and region of intervertebral fusion were the posterior vertebrae of the middle thoracic region.
Exclusion by design: a case study of an Indian urban housing subsidy scheme
Authors: Khaire Manav 
Published: July 2023

Abstract
The Pradhan Mantri Awas Yojana (Urban)—Housing for All mission (PMAY-U), a flagship mission of the Government of India, aims to address the need for affordable housing in urban areas through five different schemes. One of these schemes is a housing subsidy scheme, the Credit Linked Subsidy Scheme (CLSS), which has significantly contributed to the success of PMAY-U. However, the design of the CLSS scheme favors households considered creditworthy, with stable and secure income streams. This article examines the gap between the policy design and practice of the CLSS scheme to explore how biases get embedded into the policy, resulting in the exclusion of economically vulnerable households. Schneider and Ingram’s Social Construction of Target Population (SCTP) framework is used to identify the target groups involved in the CLSS policy chain. These target groups and policymakers were interviewed to understand their interpretations of the concept of affordable housing. Using a relational lens, these interpretations are compared to know how the meanings of affordable housing get represented within CLSS policy documents. The analysis presents two key insights. First, the power and interests of the target groups predict their representation in policy design and policymaking. Second, privatized implementation design of the subsidy scheme embeds negative selectivism creating exclusionary tendencies in the CLSS design. Lastly, given the shrinking of the welfare state across the globe, this study raises the critical question of “who benefits and who loses?” while challenging the normative aspects of the policy goal of affordable housing.
The Politics of Ælfric’s Maccabees
Authors: Rubinstein S I 
Published: July 2023

Abstract
Ælfric of Eynsham’s Old English homily on the biblical books of Maccabees is a crucial text in the intellectual history of later Anglo-Saxon England, containing the only discussion of ‘just war’ in the surviving corpus of Anglo-Saxon literature, and the earliest attestation to the ‘Three Orders of Society’. It is now generally understood that Ælfric was writing for a predominantly lay audience, exhorting them to take up arms against the Vikings. This becomes particularly apparent from a close examination of Ælfric’s deviations from, and emendations to, the Vulgate, not all of which have hitherto been noticed. After supplementing this literary analysis with new observations, this article attempts to delineate the historical implications of this interpretation of the text. Once placed within its historical context, Ælfric’s Maccabees appears as a sharp critique of the direction of royal policy under Æthelred the Unready during the 990s, especially the payment of tribute to the Vikings and their conscription as mercenaries. This invites us to reconsider both Ælfric’s own intellectual trajectory and the court politics of Anglo-Saxon England in the final years of the first millennium.
Convergent alteration of the mesenchymal stem cell heterogeneity in adipose tissue during aging
Authors: Liu Qiwei , Zhao Yu , Wang Qian , Yan Li , Fu Xin , Xiao Ran 
Published: July 2023

AbstractAdipose‐derived stem cells (ASCs) from distinct age groups possess different characteristics; however, the age‐associated changes in ASCs heterogenicity remain largely unknown. In this study, several publicly available single‐cell RNA sequencing (RNA‐seq) data cohorts of inguinal adipose tissues, including young (2 weeks), adult (8 weeks), and old (18 months) C57BL/6 mice, were analyzed. Transcriptomic clustering of integrated single‐cell RNA‐seq data from different age groups revealed the existence of five ASCs subtypes. Interestingly, ASCs showed a loss of heterogeneity with aging, and ASCs subtype 4 (ASC‐4) was the dominant subpopulation accounting for more than 98% of aged ASCs converging to the terminal differentiation state. The multidirectional differentiation potentials of different ASCs subtypes were largely distinct while the adipogenic ability of ASC‐4 increased with age persistently. Regulon analysis of ASC subtypes further identified Cebpb as the ASC‐4‐specific transcription factor, which was known as one of the major adipogenic regulators. Analysis of ligand–receptor pairs between ASCs and other cell types in adipose tissue identified age‐associated upregulation of inflammatory responses‐associated factors including CCL2 and CCL7. Treatment with 100 ng/mL CCL2 in vitro could significantly promote the adipogenesis of ASCs through enhanced phosphorylation of AKT and decreased expression of β‐catenin. In addition, supplementation of 100 ng/mL CCL7 could significantly increase the expression of inflammatory genes and ASC‐4‐specific transcriptional factors in 2‐week‐old ASCs, potentially acting as a driver of ASCs convergence. Our findings help to delineate the complex biological processes of ASCs aging and shed light on better regenerative and therapeutic applications of ASCs.
Ocular surface itch and pain: key differences and similarities between the two sensations
Authors: Raolji Shyamal , Kumar Preet , Galor Anat 
Published: July 2023

Purpose of review
To review the pathophysiology and treatment of ocular itch and pain, encompassing nociceptive and neuropathic categories.

Recent findings
Ocular itch and pain are sensations that arise from activation of ocular surface polymodal nerves. Nociceptive itch, commonly comorbid with ocular pain complaints, is mainly driven by a histamine-mediated type 1 hypersensitivity reaction. Beyond topical therapy, novel drug delivery systems are being explored to improve ocular residence time of nonsteroidal anti-inflammatory drugs (NSAIDs) and antihistamines. Nociceptive ocular pain can be driven by a variety of factors. Treatment focuses on addressing the causative sources of pain. Neuropathic ocular itch and pain are driven by nerve damage and dysfunction and as such, topical and oral neuromodulation have been explored as treatments. Oral neuromodulators include alpha 2 delta ligands, tricyclic antidepressants (TCAs), and low dose naltrexone. Novel therapies are being evaluated for both modalities such as difelikefalin (κ-opioid receptor agonist) for neuropathic itch and libvatrep (transient receptor potential vanilloid 1 antagonist) for neuropathic pain.

Summary
Both ocular itch and pain can be driven by nociceptive and/or neuropathic mechanisms. Identifying contributors to abnormal ocular sensations is vital for precise medical care. Novel therapeutics for these conditions aim to improve patient outcomes and quality of life.
New arrivals in anaphylaxis to foods
Authors: Olivieri Bianca , Skypala Isabel J. 
Published: July 2023

Purpose of review
More people are excluding wheat from their diet, or turning to a more sustainable diet in which includes meat substitutes or is mainly or wholly plant-based. This increases the availability of new foods and with it the increasing likelihood of novel allergens.

Recent findings
There is a growing body of evidence which suggests that allergies to seeds and legumes are increasing potentially due to their use in concentrated form in vegan or health foods. Insects can be a sustainable source of protein, but mealworm could provoke symptoms in individuals sensitized or allergic to shellfish or house dust mite. Novel plant food allergens such as gibberellin-regulated proteins and thaumatin-like proteins are increasingly being reported as significant causes of severe reactions to fruits.

Summary
these findings make it even more imperative to take a full dietary history to ensure apparent idiopathic anaphylaxis is not in reality due to a novel food, especially in cases where other forms of the food are tolerated. Given the lack of diagnostic tests for these novel foods, a prick-to-prick skin prick test should be performed with the suspected food. There is currently more work needed to define and sequence many of the allergens involved.
B7-H3 confers stemness characteristics to gastric cancer cells by promoting glutathione metabolism through AKT/pAKT/Nrf2 pathway
Authors: Xia Lu , Chen Yuqi , Li Juntao , Wang Jiayu , Shen Kanger , Zhao Anjing , Jin Haiyan , Zhang Guangbo , Xi Qinhua , Xia Suhua , Shi Tongguo , Li Rui 
Published: July 2023

Abstract

Background:
Cancer stem-like cells (CSCs) are a small subset of cells in tumors that exhibit self-renewal and differentiation properties. CSCs play a vital role in tumor formation, progression, relapse, and therapeutic resistance. B7-H3, an immunoregulatory protein, has many protumor functions. However, little is known about the mechanism underlying the role of B7-H3 in regulating gastric cancer (GC) stemness. Our study aimed to explore the impacts of B7-H3 on GC stemness and its underlying mechanism.

Methods:
GC stemness influenced by B7-H3 was detected both in vitro and in vivo. The expression of stemness-related markers was examined by reverse transcription quantitative polymerase chain reaction, Western blotting, and flow cytometry. Sphere formation assay was used to detect the sphere-forming ability. The underlying regulatory mechanism of B7-H3 on the stemness of GC was investigated by mass spectrometry and subsequent validation experiments. The signaling pathway (Protein kinase B [Akt]/Nuclear factor erythroid 2-related factor 2 [Nrf2] pathway) of B7-H3 on the regulation of glutathione (GSH) metabolism was examined by Western blotting assay. Multi-color immunohistochemistry (mIHC) was used to detect the expression of B7-H3, cluster of differentiation 44 (CD44), and Nrf2 on human GC tissues. Student's t-test was used to compare the difference between two groups. Pearson correlation analysis was used to analyze the relationship between two molecules. The Kaplan–Meier method was used for survival analysis.

Results:
B7-H3 knockdown suppressed the stemness of GC cells both in vitro and in vivo. Mass spectrometric analysis showed the downregulation of GSH metabolism in short hairpin B7-H3 GC cells, which was further confirmed by the experimental results. Meanwhile, stemness characteristics in B7-H3 overexpressing cells were suppressed after the inhibition of GSH metabolism. Furthermore, Western blotting suggested that B7-H3-induced activation of GSH metabolism occurred through the AKT/Nrf2 pathway, and inhibition of AKT signaling pathway could suppress not only GSH metabolism but also GC stemness. mIHC showed that B7-H3 was highly expressed in GC tissues and was positively correlated with the expression of CD44 and Nrf2. Importantly, GC patients with high expression of B7-H3, CD44, and Nrf2 had worse prognosis (P = 0.02).

Conclusions:
B7-H3 has a regulatory effect on GC stemness and the regulatory effect is achieved through the AKT/Nrf2/GSH pathway. Inhibiting B7-H3 expression may be a new therapeutic strategy against GC.
Family Presence at the PICU Bedside: A Single-Center Retrospective Cohort Study*
Authors: Smith Mallory B. , Dervan Leslie A. , Watson R. Scott , Ohman Robert T. , Albert J. Elaine-Marie , Rhee Eileen J. , Vavilala Monica S. , Rivara Frederick P. , Killien Elizabeth Y. 
Published: July 2023

OBJECTIVES:To determine factors associated with bedside family presence in the PICU and to understand how individual factors interact as barriers to family presence.DESIGN:Mixed methods study.SETTING:Tertiary children’s hospital PICU.SUBJECTS:Five hundred twenty-three children of less than 18 years enrolled in the Seattle Children’s Hospital Outcomes Assessment Program from 2011 to 2017.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Quantitative: Family was documented every 2 hours. Exposures included patient and illness characteristics and family demographic and socioeconomic characteristics. We used multivariable logistic regression to identify factors associated with presence of less than 80% and stratified results by self-reported race. Longer PICU length of stay (LOS), public insurance, and complex chronic conditions (C-CD) were associated with family presence of less than 80%. Self-reported race modified these associations; no factors were associated with lower bedside presence for White families, in contrast with multiple associations for non-White families including public insurance, C-CD, and longer LOS. Qualitative: Thematic analysis of social work notes for the 48 patients with family presence of less than 80% matched on age, LOS, and diagnosis to 48 patients with greater than or equal to 95% family presence. Three themes emerged: the primary caregiver’s prior experiences with the hospital, relationships outside of the hospital, and additional stressors during the hospitalization affected bedside presence.CONCLUSIONS:We identified sociodemographic and illness factors associated with family bedside presence in the PICU. Self-reported race modified these associations, representing racism within healthcare. Family presence at the bedside may help identify families facing greater disparities in healthcare access.
The Role of Radiation Therapy in Adult and Pediatric Keloid Management
Authors: Laspro Matteo , Onuh Ogechukwu C. , Cohen Richard F. , Cooper Benjamin T. , Chiu Ernest S. 
Published: July 2023

Introduction
Radiation therapy is a promising modality for treating keloids after surgical excision. However, it is currently not standard practice among physicians because of concern surrounding the risk of radiation-induced secondary cancers, especially among pediatric patients. There is minimal research assessing the complications for radiation therapy in keloid management.

Aim
The goal of this study was to determine radiation oncologists' perspectives about the utility and appropriateness of radiation therapy for keloid management in both adult and pediatric patients. This study also aimed to characterize radiation modality, dose, fractionation, and secondary complications observed by providers.

Methods
An electronic survey was delivered to 3102 members of the American Society for Radiation Oncology. The survey subjects were radiation oncologists who are currently practicing in the United States. Rates of responses were analyzed.

Results
A total of 114 responses from practicing radiation oncologists were received. Of these, 113 providers (99.1%) supported radiation therapy for keloid management in adults, whereas only 54.9% supported radiation therapy for pediatric patients. Of 101 providers that treated adults in the past year, the majority used external beam: electrons (84.2%), applied 3 fraction regimens (54.4%), and delivered radiation within 24 hours postexcision (45.5%). In pediatric patients, only 42 providers reported treating at least 1 patient. The majority used electron beam radiation (76.2%), applied 3 faction regimens (65%), and delivered radiation on the same day of keloid excision (50.0%) The main concern when treating pediatric patients were risk of secondary malignancy (92.1%).

Conclusion
Although radiation therapy appears to be a widely accepted adjuvant treatment option for adults with keloids, the use of radiation therapy for pediatric patients is less widely accepted because of concerns regarding secondary malignancy. The findings suggest additional studies need to be carried out to assess the risk of those complications.
Demographic Study and Description of the Surgical Demand in Aesthetic Surgery
Authors: Mendes Vanessa Marron , Diluiso Giuseppe , Kamdem Catherine Jidjouc , Goulliart Stephen , Schettino Michela , Dziubek Melvin , Miszewska Claudia , Di Fiore Christella , Carrillo Socorro Ortiz , Delhaye Marie 
Published: July 2023

Background
The demand for aesthetic surgery presents a continuously growing trend over the years. The population wishing to undergo this type of surgery presents unique characteristics that are profoundly different in motivational, demographic, and clinical features from patients in other specialties.

Objectives
The aim of our multicenter study is to objectively define the surgical demand and the demographic characteristics of our patients comparing them with general population. We try to better define who are our patients.

Methods
We conducted an observational, multicenter, retrospective study analyzing 3329 consultations involving a total of 2092 patients between January 2019 and June 2019. Based on the inclusion criteria, we selected 524 patients whose demographic characteristics, body mass index, addictions, comorbidities, and aesthetic surgery demand were analyzed.

Results
The mean age of our population is 38.58 years (female-to-male ratio, 9:1). The mean body mass index is 27.50 (5.23). A total of 22.90% of the sample have smoking habits, 3.63% have alcohol addiction, 1.53% have drugs addiction, and 53.63% of the population have relevant comorbidities.
The 56.68% of the patients have already undergone surgery. The conversion rate of our first consultations to surgery is 49.05%. The most requested operation is abdominoplasty (36.45%), followed by liposuction (22.90%), breast reduction (17.56%), mastopexy (14.79%), and rhinoplasty (7.63%).

Conclusions
This topic is downplayed and seldom studied in the literature; our effort is to make patient profiling crucial and evidence-based in aesthetic surgery.
Toileting Behaviors and Lower Urinary Tract Symptoms Among Female Physicians and Medical Students
Authors: Perlow Aaron , Joyce Cara J. , Bennis Stacey , Mueller Elizabeth R. , Fitzgerald Colleen M. 
Published: July 2023

Importance
A greater understanding of the relationship between toileting behaviors and lower urinary tract symptoms (LUTS) has the potential to generate awareness and improvement of overall bladder health in specific populations.

Objective
The aim of the study was to investigate the prevalence and correlation between maladaptive toileting behaviors and LUTS among female medical trainees and attending physicians.

Study Design
We surveyed female medical students, residents, fellows, and attending physicians at an academic hospital, capturing demographics, voiding behaviors, LUTS, and fluid intake using the Bristol Female Lower Urinary Tract Symptoms Short Form, the Toileting Behavior-Women’s Elimination Behaviors, and the Beverage Intake Questionnaire.

Results
A total of 146 medical students and physicians participated in the study. Eighty-three percent reported at least 1 LUTS, most commonly storage symptoms, particularly incontinence (30%, stress urinary incontinence > urgency urinary incontinence). Altered toileting behaviors included “worrying about public toilet cleanliness” (82%), “emptying the bladder before leaving home” (81%), “delaying emptying their bladder when busy” (87%), and “waiting until they could not hold urine any longer” (57%). Total Toileting Behavior-Women’s Elimination Behaviors scores were significantly associated with total Bristol Female Lower Urinary Tract Symptoms scores (β = 0.27; 95% CI, 0.12–0.42; P<0.01). This remained true after adjusting for total fluid intake in medical students (β = 0.41, P<0.01) and resident physicians (β = 0.28, P = 0.03) but was not correlated among attending physicians (β = −0.07, P = 0.77).

Conclusions
Female physicians and medical students experience a high prevalence of LUTS. Many engage in maladaptive toileting behaviors, which highly correlate with LUTS (especially among medical students and residents) and may lead to impaired bladder health.