bluuebunny/crossref_metadata_2025_split huggingface dataset:
Amide proton transfer-weighted imaging of pediatric brainstem glioma and its predicted value for H3 K27 alteration
Authors: Cheng Dan , Zhuo Zhizheng , Zhang Peng , Qu Liying , Duan Yunyun , Xu Xiaolu , Xie Cong , Liu Xing , Haller Sven , Barkhof Frederik , Zhang Liwei , Liu Yaou 
Published: September 2023

Background Non-invasive determination of H3 K27 alteration of pediatric brainstem glioma (pedBSG) remains a clinical challenge. Purpose To predict H3 K27-altered pedBSG using amide proton transfer-weighted (APTw) imaging. Material and Methods This retrospective study included patients with pedBSG who underwent APTw imaging and had the H3 K27 alteration status determined by immunohistochemical staining. The presence or absence of foci of markedly increased APTw signal in the lesion was visually assessed. Quantitative APTw histogram parameters within the entire solid portion of tumors were extracted and compared between H3 K27-altered and wild-type groups using Student's t-test. The ability of APTw for differential diagnosis was evaluated using logistic regression. Results Sixty pedBSG patients included 48 patients with H3 K27-altered tumor (aged 2–48 years) and 12 patients with wild-type tumor (aged 3–53 years). Visual assessment showed that the foci of markedly increased APTw signal intensity were more common in the H3 K27-altered group than in wild-type group (60% vs. 16%, P = 0.007). Histogram parameters of APTw signal intensity in the H3 K27-altered group were significantly higher than those in the wild-type group (median, 2.74% vs. 2.22%, P = 0.02). The maximum (area under the receiver operating characteristic curve [AUC] = 0.72, P = 0.01) showed the highest diagnostic performance among histogram analysis. A combination of age, median and maximum APTw signal intensity could predict H3 K27 alteration with a sensitivity of 81%, specificity of 75% and AUC of 0.80. Conclusion APTw imaging may serve as an imaging biomarker for H3 K27 alteration of pedBSGs.
Reliability of tomographic 3D ultrasound in measuring internal carotid artery plaque volume
Authors: Alzahrani Adel , Sultan Salahaden R , Aslam Mohammed 
Published: September 2023

Background Tomographic 3D ultrasound (t3DUS) is a promise imaging technique for quantifying carotid plaque through measuring the degree of stenosis and plaque volume. Carotid plaque volume (CPV) could add benefit in predicting the potential risk of stroke. Purpose To assess the reproducibility and accuracy of t3DUS for measuring CPV within the internal carotid artery in patients undergoing carotid endarterectomy. Material and Methods t3DUS was used to obtain CPV in vivo from 25 symptomatic patients prior to surgery. Ex vivo CPV from the carotid endarterectomy specimen was then measured using a validated saline displacement method as a reference standard. CPV for each patient was measured twice using both methods (total n = 50 per technique). Intraclass correlation coefficient (ICC) and Bland–Altman plot were used to establish bias and limit of agreement between CPV measurements. Results There was an excellent agreement between t3DUS and reference test with respect to measuring CPV with an ICC value of 0.98 (95% confidence interval = 0.97–0.99, P < 0.001). Bias in measurements was 0.02 ± 0.11 cm3 (95% limit of agreement = −0.19 to 0.25). Intra-observer agreement of t3DUS CPV measurements was excellent with an ICC value of 0.95 (95% confidence interval = 0.92–0.97, P < 0.001). Bias in measurements was 0.004 ± 0.07 cm3 (95% limit of agreement = −0.14 to 0.15). Conclusion t3DUS is a reproducible imaging method and showed excellent agreement with the reference standard with respect to measuring CPV. These findings suggest that t3DUS has the potential to be a valuable non-invasive tool for assessing carotid plaque burden and predicting the risk of stroke.
Arthroscopic Lysis of Adhesions for Arthrofibrosis After Anterior Cruciate Ligament Reconstruction
Authors: Lamba Abhinav , Holliday Charles L. , Marigi Erick M. , Reinholz Anna K. , Wilbur Ryan R. , Song Bryant M. , Hevesi Mario , Krych Aaron J. , Stuart Michael J. , Levy Bruce A. 
Published: September 2023

Background: Arthrofibrosis (AF) after anterior cruciate ligament reconstruction (ACLR) remains a challenge. There is a paucity of data on arthroscopic interventions for AF after ACLR. Purpose: To (1) describe the patient, injury, and surgical characteristics and patient-reported outcomes (PROs) of those requiring an arthroscopic intervention for loss of motion after ACLR and (2) compare outcomes between patients undergoing an early intervention (within 3 months) versus those undergoing a late intervention (after 3 months). Study Design: Case series; Level of evidence, 4. Methods: Patients with a history of ACLR and a subsequent operative procedure for postoperative AF at a single institution between 2000 and 2018 were retrospectively identified. Arthroscopic interventions included lysis of adhesions, capsular release with or without manipulation under anesthesia, and excision of cyclops lesions. Patients were excluded if they had a knee dislocation or multiple-ligament injury, a periarticular fracture, or less than 2-year follow-up from the arthroscopic intervention. PROs including the Tegner activity score, visual analog scale pain score, and International Knee Documentation Committee score as well as knee range of motion (ROM) were recorded. Results: A total of 40 patients were included with a mean age of 27.2 years (range, 11.0-63.8 years) at surgery and a mean follow-up of 10.0 years (range, 2.9-20.7 years). The mean preoperative flexion and extension were 102° (range, 40°-150°) and 8° (range, 0°-25°), respectively. The mean postoperative flexion and extension were 131° (range, 110° to 150°) and 0° (range, –10° to 5°), respectively. After the arthroscopic intervention, the mean ROM improved from 94° (range, 40°-140°) preoperatively to 131° (range, 107°-152°) at final follow-up ( P < .001), and the visual analog scale pain score improved from 3.0 preoperatively to 1.2 postoperatively ( P = .001). Overall, 13 patients (32.5%) underwent an intervention within 3 months and 27 (67.5%) after 3 months. The early intervention group had a higher postoperative International Knee Documentation Committee score compared with the late intervention group (86.8 vs 71.7, respectively; P = .035). Conclusion: An arthroscopic intervention for AF after ACLR successfully improved knee ROM and pain. Patients who underwent either early or late surgery obtained satisfactory motion and function, although improved PROs were observed when the intervention occurred within 3 months of the primary procedure.
The Rise of Guard Labor in the United States: Evidence from Local Labor Markets
Authors: Petach Luke , Wilson Anastasia 
Published: September 2023

We examine the rise of “Guard Labor”—defined as occupations devoted to labor extraction—at the commuting zone level in the United States. Between 1950 and 2017 the share of the labor force employed in guard labor increased from 19.5 percent to 29.4 percent. We explore the local labor market correlates of guard labor and validate several predictions of the labor discipline model, while extending the model to the context of contemporary racial capitalism. The share of the labor force employed in guard labor is positively correlated with the household income Gini coefficient, negatively correlated with the fraction of the labor force in a union, and positively correlated with contemporary measures of local racial animosity. Consistent with the labor discipline model, an increase in the share of the labor force employed in supervisory occupations has a significant negative effect on nonsupervisory wages. JEL Classification: O17, P16, Z13, B51, B52
Vitamin D Deficiency is Associated With Increased Plasminogen Activator Inhibitor 1/Plasminogen Activator Inhibitor 2 Ratio in Pregnancy
Authors: Andersen Matilde Kanstrup , Rüdiger Isabella Hangaard , Vestergaard Anna Louise , Palarasah Yaseelan , Bor Pinar , Larsen Agnete , Bor Mustafa Vakur 
Published: September 2023

Background Vitamin D deficiency has recently been suggested as an independent risk factor for thrombosis. Notably, vitamin D deficiency is common in pregnant populations, whom already have an increased thrombotic risk. However, pregnant women are commonly excluded from studies investigating the hemostatic system, and knowledge on the impact of vitamin D on hemostasis in pregnancy is therefore limited. Methods A cross-sectional study comparing the hemostatic profile of pregnant women (gestational week 12.9 ± 0.7) with vitamin D deficiency (≤50 nmol/L) (n = 70) and high adequate vitamin D status (≥100 nmol/L) (n = 59). Results Vitamin D deficient women displayed increased plasminogen activator inhibitor 1 levels and an increased plasminogen activator inhibitor 1/plasminogen activator inhibitor 2 ratio, even after adjusting for factors with potential influence on hemostasis (body mass index, smoking and use of fish oil supplements). Conclusions Vitamin D deficiency is associated with increased plasminogen activator inhibitor 1/plasminogen activator inhibitor 2 ratio in pregnant women. As an increased plasminogen activator inhibitor 1/plasminogen activator inhibitor 2 ratio with high plasminogen activator inhibitor 1 levels may increase thrombotic risk and is associated with the development of pregnancy complications, further research is needed to determine the optimal vitamin D supplementation in pregnancy.
What Do Doors Do? Door Storyings, Matterings, Adventurings, and Commonings
Authors: Taylor Carol A. , Albin-Clark Jo , Broadhurst Healey Karen , Hogarth Hannah , Lewis Zoe , Pihkala Suvi , Smith Sharon Louise , Cranham Joy , Latto Liz 
Published: September 2023

What do doors do? Open Close Invite In Shut Out Jam Stick Wedge open Welcome: Entice and Invite Offer a glimpse into Bar SLAM SHUT Get kicked in Get kicked shut Splinter Warp Hang Sit ajar Gently linger in our minds Cause hurt and separation Affecting thoughts Moments of joy or pain Longing, Waiting Fearful longing, Fearful waiting, Anticipating Wondering Haunting “Come-on-in” This article is based on research-creation experimentations arising from the provocations “what do doors do?” and “how do doors matter?” We ponder how knowledge-making practices come to life when you take a little time to notice the mattering of doors. We use collaborative feminist praxis to generate arts-based post-qualitative entanglements as generative invitations for door storying that illuminate the potentialities of commoning practices.
TACE Combined with Lenvatinib and Camrelizumab for Unresectable Multiple Nodular and Large Hepatocellular Carcinoma (>5 cm)
Authors: Xiang Zhanwang , Li Guohong , Mu Luwen , Wang Haofan , Zhou Churen , Yan Huzheng , Huang Mingsheng 
Published: September 2023

Background The incidence and mortality of hepatocellular carcinoma (HCC) had increased globally over the past decades. Previous studies found that transarterial chemoembolization (TACE) combined with lenvatinib had also shown efficacy in the unresectable HCC. We aimed to evaluate the safety and efficacy of TACE combined with lenvatinib and camrelizumab to treat unresectable multiple nodular and large HCC (>5 cm). Materials and methods Between November 2018 and June 2021, we retrospectively recruited 82 patients with unresectable multiple nodular and large HCC (BCLC stage B or C with a single nodular diameter of >5 cm). Of the patients who had not previously been treated, 33 patients received TACE + lenvatinib + camrelizumab (group A, TLC), and 49 patients treated with TACE + lenvatinib (group B, TLB) as the initial treatment. Related efficacy and safety results were recorded and assessed. Results The median follow-up periods of groups A and B were 14.5 ± 7.9 months (range, 3-36) and 12.5 ± 8.2 months (range, 3-32), respectively (P = 0.799). The progression-free survival (PFS) of groups A and B was 9.4 months and 5.9 months (P < 0.01), respectively, and overall survival (OS) was significantly longer in group A (16.4 months vs 11.0 months, P < 0.01). In group A, the local response rate (LRR) and disease control rate (DCR) were 51.5% and 81.8%, respectively, which was higher than the corresponding 46.9% and 77.6% observed in group B (P = 0.233; 0.429). Patients with BCLC B stage had better PFS and OS (P < 0.05). The BCLC stage was an independent factor that affected PFS and OS. There were no massive bleeding or treatment-related deaths. Conclusions In patients with unresectable multiple nodular and large HCC (single nodular diameter of >5 cm), TACE combined with target therapy and immunotherapy is safe and effective.
Elective musculoskeletal surgery is associated with postoperative weight changes in pediatric and adolescent patients
Authors: Huang Sharon G , Wilson Philip L , Worrall Hannah M , Ramo Brandon A , Kapadia Ami , Ellis Henry B 
Published: September 2023

Purpose: Patients of elective orthopedic surgeries often reduce activity levels during postoperative recovery. It is unclear whether these extended periods of modified activities lead to weight changes. The purpose of this study was to evaluate changes in body mass index percentile in pediatric patients over 2.5 years following primary musculoskeletal surgeries. Methods: Institutional records for utilized current procedural terminology codes were used to identify patients aged 21 years or younger who underwent elective surgery at a single pediatric orthopedic institution between October 2016 and December 2018. Non-primary surgeries and patients without preoperative body mass index measurements were excluded. Demographic characteristics, height, weight, and body mass index within 30 months of surgery were collected. Body mass index relative to age was calculated. Analysis of body mass index changes at follow-up intervals of 3–7, 9–18, and 24–30 months after surgery was performed for the overall sample, within surgical categories, and within preoperative weight classifications. Results: A total of 1566 patients (53.1% female, average age 12.4 years) were included. Over one-third of patients were overweight or obese at presentation. The average change in body mass index percentile relative to baseline was increased at all follow-up intervals. Values reached significance at 9–18 months ( p = .002) and 24–30 months ( p = .001). While underweight and normal-weight patients had increased body mass index at all three timepoints, overweight or obese patients decreased. Conclusions: Patients undergoing elective orthopedic procedures may experience significant changes in body mass index percentile postoperatively. At extremes of weight, patients experience improvement toward the mean, but most patients may undergo body mass index increases beyond what would be expected during normal growth. Level of evidence: Retrospective level III.
Evaluation of Glycemic Variability and Discharge Outcomes in Patients with Ischemic Stroke Following Thrombolysis
Authors: Steck Mackenzie , Wells Drew A. , Stoffel Jaclyn M. , Hudson Joanna Q. , Saeed Omar , Elangovan Cheran , Krishnaiah Balaji , Shah Samarth P. 
Published: September 2023

Background and Purpose Hyperglycemia following acute ischemic stroke (AIS) is associated with adverse outcomes including, hemorrhagic conversion and increased length of stay; however, the impact of glycemic variability is largely unknown. This study aims to evaluate the effect of glycemic variability on discharge outcomes in patients treated with alteplase for AIS. Methods A retrospective review of ischemic stroke patients who presented within 4.5 hours from symptom onset and received alteplase was completed. Patients hospitalized for at least 48 hours were included. Glycemic variability was measured using J-index. Groups were defined by normal or abnormal J-indices. Logistic regression models were developed to determine odds ratios for select clinical characteristics, NIHSS score, mRS, and disposition at discharge. Results Of the 229 patients, 97 (42%) had an abnormal J-index. In the univariate analysis, abnormal J-index was associated with worse outcomes in terms of NIHSS score, mRS, and discharge disposition compared to a normal J-index. In the unadjusted multivariate analysis, abnormal J-index was associated with higher odds of unfavorable mRS (3-6) at discharge (OR 2.1; 95% CI 1.2 – 3.5, P = .009). In the adjusted multivariate analysis, patients with an abnormal J-index had higher odds of hemorrhagic transformation (OR 5.7; 95% CI 2.1 – 15.6, P < .0001). There was no difference in mortality. Conclusion Glycemic variability with abnormal J-index following AIS is associated with adverse functional outcomes at discharge and increased odds of hemorrhagic conversion in patients treated with alteplase. Additional studies validating glycemic variability indices post-ischemic stroke are needed to determine the full clinical impact.
Femoroacetabular Impingement and the Effect of Osteochondroplasty on Hip Osteoarthritis Prevention: The Pandora’s Box Opening Process
Authors: Lamo-Espinosa José M. , Gómez-Álvarez Jorge , Pascual Roquet-Jalmar Elena , Iribarren Asier , Recke Anne , Roa María Cruz , Valentí-Azcárate Andrés , Granero-Moltó Froilán , San-Julián Mikel 
Published: September 2023

Objective: This study was conducted to assess the effect of osteochondroplasty on osteoarthritis (OA) prevention, comparing radiological evolution between identical hips from the same patient who had undergone unilateral surgery. Design: We retrospectively reviewed radiological evolution between hips with similar shape from the same patient who had undergone unilateral surgery. In all, 56 FAI patients (112 hips) with a mean age of 42.18 ± 9.16 years and had undergone unilateral arthroscopy treatment have been included. Four independent researchers measured Wiberg, Acetabular and Alpha angles, Extrusion index, and Tönnis classification preoperatively to verify that operated and non-operated hips had the same shape. OA evolution was assessed by joint space width (JSW) in 3 different articular points and Tönnis classification. Results: No preoperative anatomical differences were present between groups ( P > 0.05). At the end of follow-up (31.9 months), a decrease of JSW in the 3 points measured was found in OP hips (OP vs. N-OP; P < 0.01). These results were correlated with changes in the proportion of patients who progressed to grade III in Tönnis classification (from 1.3% preoperative to 23.2% at the end of follow-up). Conclusions: Osteochondroplasty and labrum procedures were not associated with OA prevention. The OP hips showed a faster OA degeneration, which was not seen in the N-OP. These results will encourage hip surgeons to perform further investigations to avoid the “Pandora’s Box Opening Process.”
Parents’ Perspectives on Climate Change Education: A Case Study From New Jersey
Authors: Madden Lauren , Joshi Arti , Wang Margaret , Turner Julia , Lindsay Samantha 
Published: September 2023

Purpose With climate change education becoming more prevalent in schools around the globe, it is increasingly important that we understand parental perspectives on this topic. Children cross the boundaries between home and school culture every day, and their parents’ attitudes, beliefs, and practices can influence their academic engagement in all content areas. In the 2022–2023 academic year, New Jersey (NJ) adopted climate change education standards across grade levels and subject areas. We seek to understand parental perspectives on this curriculum change. Design/Approach/Methods In October–November 2022, a survey was distributed to parents of children attending public (state) school in NJ to identify how they discuss, support, and question their children's education about climate change. A total of 83 parents responded to the survey. Findings Survey results revealed that parents talk to their children about climate change with the support of various tools and strategies. However, parents expressed concerns about teachers’ preparedness to introduce climate change topics appropriately and their own readiness to support this instruction at home. Furthermore, several respondents voiced concerns about how to approach climate change discussions in a way that is mindful of children's developmental and mental health needs. Originality/Value Little is known about the way in which parents view educational innovations affect their implementation. This study examines parents’ perspectives on a novel approach to integrating climate change instruction across subject areas and grade levels.
The ISSG-AO Complication Intervention Score, but Not Major/Minor Designation, is Correlated With Length of Stay Following Adult Spinal Deformity Surgery
Authors: Wick Joseph B. , Blandino Andrew , Smith Justin S. , Line Breton G. , Lafage Virginie , Lafage Renaud , Kim Han Jo , Passias Peter G. , Gum Jeffrey L. , Kebaish Khaled M. , Eastlack Robert K. , Daniels Alan , Mundis Gregory , Hostin Richard , Protopsaltis Themistocles , Hamilton D. Kojo , Kelly Michael P. , Gupta Munish , Hart Robert A. , Schwab Frank J. , Burton Douglas C. , Ames Christopher P. , Lenke Lawrence G. , Shaffrey Christopher I. , Bess Shay , Klineberg Eric ,   International Spine Study Group
Published: September 2023

Study Design Retrospective review. Objectives The International Spine Study Group-AO (ISSG-AO) Adult Spinal Deformity (ASD) Complication Classification System was developed to improve classification, reporting, and study of complications among patients undergoing ASD surgery. The ISSG-AO system classifies interventions to address complications by level of invasiveness: grade zero (none); grade 1, mild (e.g., medication change); grade 2, moderate (e.g., ICU admission); grade 3, severe (e.g., reoperation related to surgery of interest). To evaluate the efficacy of the ISSG-AO ASD Complication Classification System, we aimed to compare correlations between postoperative length of stay (LOS) and complication severity as classified by the ISSG-AO ASD and traditional major/minor complication classification systems. Methods Patients age ≥18 in a multicenter ASD database who sustained in-hospital complications were identified. Complications were classified with the major/minor and ISSG-AO systems and correlated with LOS using an ensemble-based machine learning algorithm (conditional random forest) and a generalized linear mixed model. Results 490 patients at 19 sites were included. 64.9% of complications were major, and 35.1% were minor. By ISSG-AO classification, 20.4%, 66.1%, 6.7%, and 6.7% were grades 0-3, respectively. ISSG-AO complication grading demonstrated significant correlation with LOS, whereas major/minor complication classification demonstrated inverse correlation with LOS. In conditional random forest analysis, ISSG-AO classification had the greatest relative importance when assessing correlations across multiple variables with LOS. Conclusions The ISSG-AO system may help identify specific complications associated with prolonged LOS. Targeted interventions to avoid or reduce these complications may improve ASD surgical quality and resource utilization.