bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blue Light Influences Negative Thoughts of Self
Authors: Burge Malisa T , Lumapas Ronel A , Lander Alicia C , Thomas Brianna G , Phillips Andrew J K , Cain Sean W 
Published: February 2025

Abstract
Darkness is equated with sadness. This study explored how light that differentially impacts non-visual photoreception (blue-enriched vs blue-depleted light) affects how we feel about ourselves. In a repeated-measured design, thirty-five participants (22 female participants, 13 male participants, Mage = 20.29, SD = 2.09) completed the Self-Referential Encoding Task (SRET) under both blue-enriched or blue-depleted light conditions, with light conditions randomised and counterbalanced between sessions. The SRET involved participants deciding whether positive (e.g., “good”) and negative (e.g., “terrible”) words were self-descriptive. Trial-by-trial performance analysis using logistic mixed effects models revealed that blue-enriched light significantly increased the likelihood of rejecting negative words as self-descriptive. A Hierarchical Drift Diffusion Model (HDDM) further examined latent decision-making processes and found evidence accumulation to be faster under blue-enriched light when rejecting negative descriptors, suggesting rejecting negative self-descriptors was easier under blue-enriched light. We find light can acutely influence self-perception, with blue-enriched light decreasing negative self-thoughts.
The effect and mechanism of atorvastatin regulating PI3K-Akt–mTOR pathway on radiosensitivity of hepatocellular carcinoma cells
Authors: Deng Zhengzheng , Guo Jinjing , Zhu Zihao , Qing Qiancheng , Wan Dangting , Lei Pengyuan , Liu Qi , Huang Bo 
Published: February 2025

Abstract
Radiation therapy is an important method to treat liver cancer, but because of the strong DNA repair ability of liver cancer cells, even after receiving high doses of radiation still can not get satisfactory results. Atorvastatin (ATO) is a lipophilic and tissue-selective inhibitor of HMG-CoA reductase whose anticancer effects have been validated in various cells, but its effect on the radiation sensitivity of hepatocellular carcinoma cells remains unclear. Therefore, Therefore, this study explored the radiosensitivity of ATO and its possible mechanism by pretreating HepG2 with ATO and collecting HepG2 cells after irradiation. It was found that atorvastatin can not only affect the survival of liver cancer cells when used alone, but also enhance the radiation sensitivity of HepG2 cells. The study found that ATO significantly exacerbated the inhibitory effects of IR on the growth, proliferation, and migration of HepG2 cells. Measurement of ROS, SOD, GPx, and MDA levels indicated that ATO enhanced IR-induced oxidative stress, further promoted the decrease of Mitochondrial Membrane Potential, increased the rate of apoptosis in HepG2, upregulating pro-apoptotic proteins Bax and Cleaved-Caspase 3, and downregulating anti-apoptotic proteins Bcl-2. Western blot analysis showed that the PI3K-Akt–mTOR pathway was inhibited, leading to the activation of cytotoxic autophagy in HepG2 and an increase in the expression of the LC-3II protein. In summary, ATO, in combination with IR, enhances the oxidative stress response of HepG2 induced by IR, promotes autophagy by inhibiting the PI3K-Akt–mTOR pathway, and thereby potentially enhances the radiosensitivity of HepG2 as a pharmacological intervention.
Evaluating the Association Between Physical Therapy Variables and Outcomes After Lumbar Fusion
Authors: Heard Jeremy C. , Ezeonu Teeto , Lee Yunsoo , Narayanan Rajkishen , Kellish Alec , Dulitzki Yoni , Resnick Dylan , Zucker Jeffrey , Shaer Alexander , Canseco Jose A. , Rihn Jeffrey A. , Woods Barrett , Hilibrand Alan S. , Vaccaro Alexander R. , Kepler Christopher K. , Schroeder Gregory D. 
Published: February 2025

Study Design:
Retrospective cohort study.

Objective:
The purpose of this study was to investigate how inpatient physical therapy variables impact (1) inpatient complications, (2) 90-day readmissions, (3) 1-year reoperation rates, and (4) length of stay after posterior lumbar decompression and fusion.

Summary of Background Data:
Previous studies have emphasized the role of early ambulation in postoperative spine patients as an effective method for improving pain and decreasing length of stay, but few studies have evaluated the efficacy of inpatient physical therapy.

Methods:
Patients 18 years of age or older who underwent primary 1-level or 2-level posterior lumbar decompression and fusion from 2019 to 2020 were retrospectively identified. Physical therapy data, including time to first inpatient PT session, gait trial distance achieved, post-treatment pain rating, and Activity Measure for Post-Acute Care (Activity Measure for Post-Acute Care [AM-PAC]) scores were collected using manual chart review. Surgical outcome variables included length of stay, inpatient complications, 90-day readmissions, and reoperations within 1 year of primary surgery.

Results:
Overall, 425 patients were identified. There was no difference in hours to PT or total gait trial distance achieved between patients who experienced a complication and those that did not. Patients in the noncomplication group had higher AM-PAC scores than patients in the complication group. There was no difference with regards to time to PT, AM-PAC score, or gait trial distance achieved between readmitted patients and nonreadmitted patients or revision patients and nonrevision patients. Stepwise logistic regression showed that having a physical therapy session within 6 hours of surgery was predictive of a decreased length of stay both in all patients.

Conclusions:
While inpatient physical therapy within 6 hours of surgery does not appear to impact readmissions, complications, or reoperations, surgeons should encourage early ambulation postoperatively to decrease extended hospital stays. Future investigation should seek to identify factors that delay inpatient PT in the 6 hours after surgery.
The Effect of Age on Antipsychotic Serum Concentration in Males and Females: A Study Based on Therapeutic Drug Monitoring Data From 19,926 Patients
Authors: Solhaug Vigdis , Waade Ragnhild Birkeland , Molden Espen , Størset Elisabet , Høiseth Gudrun , Tveito Marit 
Published: February 2025

Background:
Antipsychotic medications are commonly prescribed for older patients; however, documentation on their safety and efficacy in this population is limited. This study aimed to investigate and compare the effect of age on dose-adjusted serum concentrations of 6 commonly used antipsychotic medications in both sexes.

Methods:
Patients with serum concentration measurements of amisulpride, aripiprazole, clozapine, olanzapine, risperidone, and zuclopenthixol were retrospectively included from a therapeutic drug monitoring service. The primary outcome measure for each antipsychotic was the dose-adjusted serum concentration (C:D ratio), assessed across groups divided by sex and age (18–49 years, 50–74 years, and ≥75 years). The data were analyzed using linear mixed modeling with restricted maximum likelihood estimation.

Results:
A total of 19,926 patients (53% male) with 74,194 serum concentration measurements were included. For most antipsychotics, the C:D ratios increased significantly with age, with generally larger differences observed in females compared with males. The largest impact of age was observed for risperidone, where C:D ratios in the age groups 50–74 years and ≥75 years were 20% and 81% higher for males, respectively, compared with the reference group (18–49 years). For females, the C:D ratios were 28% and 92% higher, respectively, compared with females aged 18–49 years (all P < 0.001). The smallest impact of age was observed for aripiprazole, with no significant differences in C:D ratios across age groups for males. For females treated with aripiprazole, C:D ratios were 8% and 28% higher in the 50–74 and ≥75 years age groups, respectively, compared with females aged 18–49 years (both P < 0.001).

Conclusions:
The age-dependent increase in dose-adjusted serum concentrations among males and females varied across different antipsychotics and was highest for risperidone. These findings emphasize the importance of proper monitoring of antipsychotic use in older adults.
Bridging the Gap: Advancing Pharmacogenetic Testing Through Comprehensive Implementation and Evaluation Strategies
Authors: Rogers Sara , Silva Patrick J. , Ramos Kenneth 
Published: February 2025

Abstract:
Pharmacogenomics (PGx) enhances drug therapy by tailoring treatment to individual genetic profiles, thereby improving safety and efficacy. However, the integration of PGx into clinical practice, particularly in hospitals, faces significant challenges, including limited testing services, variant coverage, and inconsistent guidelines. A recent review, “Implementation and Evaluation Strategies of Pharmacogenetic Testing in Hospital Settings,” highlights these challenges and current strategies. Sustaining PGx programs requires ongoing education, support, the integration of advanced technologies, and financial sustainability. Addressing inconsistent insurance coverage, developing standardized methodologies, and implementing clear policies are crucial for widespread adoption, advancement of personalized medicine, and improvement of patient care in hospital settings.
Olanzapine; Postinjection Syndrome; Pharmacokinetics in View: Grand Round/A Case Study
Authors: Rozema Johanne , van Stee Cornelis Paul , Touw Daniel J. , van Meurs Matijs 
Published: February 2025

Abstract:
Olanzapine is a second-generation antipsychotic that is frequently administered intramuscularly as a slow-release depot and maintenance treatment for schizophrenia. Therapeutic values range from 20 to 80 mcg/L and levels >100 mcg/L are considered toxic. Postinjection delirium/sedation syndrome (PDSS) is a rare but serious adverse effect after the injection of olanzapine depot formulations. The authors present a case study in which a 64-year-old patient presented to the emergency room 30 minutes after an intramuscular injection of olanzapine with signs of possible postinjection syndrome. The patient presented with hypertension, tachycardia, delirium, and was suspected to have PDSS. On admission, his serum olanzapine levels had reached 390 mcg/L, and blood samples were collected on days 0, 1, 3, and 12. The timing of his presentation at the emergency room made it possible to track the pharmacokinetics of olanzapine in detail. On the basis of Therapeutic drug monitoring, a prolonged olanzapine half-life of 7 days was calculated. Symptoms such as agitation and hypertension improved after approximately 39 hours, and the patient had made a full recovery after 72 hours. This case study can serve as a reference for healthcare providers that will aid in the recognition and treatment of PDSS and contribute to a better understanding of the clinical problems associated with PDSS. In addition, it emphasizes how Therapeutic drug monitoring may be of added value with respect to determining when medication can be safely resumed.
Evaluation of Lateral Triangular Flaps When Combined With Bilateral Superficial Epigastric Artery Flap for Shaft-only Penile Reconstruction
Authors: Mohamed Ashraf El Eebaie , Hafez Hamza Ahmed Abdelsalam , Hussein Mohammed Ahmed 
Published: February 2025

Background:
Phalloplasty represents a challenging complex genital reconstruction surgery. Phalloplasty should result in an aesthetic composite phallus, with the ability to void while standing, allowing placement of an implantable prostheses and preserving both tactile and erogenous sensation with minimal donor site morbidity.

Methods:
A bilateral superficial epigastric artery flap was design in the supra pubic area, extending upward till the lower boarder of the umbilicus. Two triangular flaps were designed at the base of the main rectangular flap to facilitate further mobilization of the neophallus. A penile prosthesis was implanted at the same stage in some patients. Finally, the lateral abdominal flaps were dissected and mobilized to be closed primarily in the mid line.

Results:
Twenty patients who were candidate for first stage of penile reconstruction were included in our study. The average flap dimensions were 18 × 15 cm; the largest was 32 × 18 cm, whereas the smallest flap was 15 × 113 cm. Eleven patients had immediate implantation with 2 failures due to impaired sensation. Four patients had tissue expansion before flap harvesting. Three patients developed partial flap loss during the first 2 weeks postoperatively.

Conclusions:
The modified bilateral superficial epigastric artery flap is a convenient flap for neophallus reconstruction. Flap design and harvesting is simple with a minimal learning curve. The flap has good color match with well-hidden donor site morbidity. Also, the bilateral triangular flaps permit adequate caudal repositioning of the neophallus, which gives a more natural position.
Omsk hemorrhagic fever virus: review of the biology, ecology, and disease associated with a historic tick-borne pathogen
Authors: Kumar Nidhi P. , Hathaway Matthew , Demshuk Matthew K. , DeHaven Taylor O. , Farha Stefania M. , Donovan Angelena M. , Burdette Andrew J. , Walls Gracie L. , Selesky Kara M. , Beachboard Dia C. , Stobart Christopher C. 
Published: February 2025

Abstract
Omsk hemorrhagic fever virus (OHFV) is a tick-borne flavivirus associated with acute febrile illness and hemorrhagic disease in humans. OHFV was first identified in 1947 and since its identification has largely remained endemic to the Omsk region of the Russian Federation, where it continues to result in illnesses each year. However, the 2 primary tick vectors of OHFV exhibit ranges that extend far beyond the Omsk region, and the recent positive confirmation of OHFV in samples outside of the historic endemic range, in both the Russian Federation and neighboring Kazakhstan, to the south raises new concerns about the future potential of the pathogen. In this review, we comprehensively discuss the emergence, virology, ecology, and disease of OHFV.
Risk factors for anastomotic leakage and its impact on survival outcomes in radical multivisceral surgery for advanced ovarian cancer: an AGO-OVAR.OP3/LION exploratory analysis
Authors: Trillsch Fabian , Czogalla Bastian , Mahner Sven , Loidl Verena , Reuss Alexander , du Bois Andreas , Sehouli Jalid , Raspagliesi Francesco , Meier Werner , Cibula David , Mustea Alexander , Runnebaum Ingo B. , Schmalfeldt Barbara , Aletti Giovanni , Kimmig Rainer , Scambia Giovanni , Hilpert Felix , Hasenburg Annette , Wagner Uwe , Harter Philipp 
Published: February 2025

Background:
Anastomotic leakage is a significant complication following bowel resection in cytoreductive surgery for ovarian cancer. Previous studies have highlighted the detrimental effects of anastomotic leakage on patients’ postoperative course. However, there is still a lack of precise identification of the high-risk population and established strategies for preventing its occurrence.

Materials and methods:
Patients who underwent bowel resection within the surgical phase III trial AGO-OVAR.OP3/LION investigating the impact of systematic pelvic and paraaortic lymphadenectomy in cytoreductive surgery for primary ovarian cancer were included in this analysis. All patients in the AGO-OVAR.OP3/LION trial had undergone complete cytoreduction with no macroscopic residual disease. We analyzed the occurrence of anastomotic leakage regarding surgical procedure (non-lymphadenectomy vs. lymphadenectomy and non-stoma vs. stoma) using the Fisher test. Risk factors for anastomotic leakage and its prognostic impact on survival were analyzed.

Results:
Overall rate of anastomotic leakage was 7.1%. Notably, the Non-lymphadenectomy subgroup had a lower anastomotic leakage rate of 3.0% compared to the lymphadenectomy subgroup (11.2%, P = 0.005). The use of protective stoma placement resulted in an anastomotic leakage rate of 5.5% regardless of lymphadenectomy compared to the Non-Stoma subgroup (7.5%, P = 0.78). Increased blood loss (odds ratio [OR] 1.04 per 100cc, 95% confidence interval [CI] 1.0001–1.09) and lymphadenectomy (OR 3.67, 95% CI 1.41–11.40) were associated with a higher risk of anastomotic leakage. Although anastomotic leakage demonstrated a numerical detrimental impact on median progression-free survival (PFS) (18 months with anastomotic leakage vs. 19 months with Non-anastomotic leakage, hazard ratio [HR] 0.86; 95% CI 0.5 to 1.4, P = 0.53) and median overall survival (OS) (31 months with anastomotic leakage vs. 58 months with Non-anastomotic leakage, HR 0.69; 95% CI 0.4 to 1.2, P = 0.17), the differences were not statistically significant.

Conclusion:
Anastomotic leakage rates were lower in the Non-lymphadenectomy arm, the current standard of care. Blood loss and lymphadenectomy, as surrogate markers for extensive surgery, were associated with increased risk for anastomotic leakage. These findings highlight the importance of strategies to reduce surgical complexity and perioperative risk to improve clinical outcomes.
Time-burden insults of neuromonitoring signals: practical implications for the management of acute brain injury
Authors: Pörteners Brenda , Güiza Fabian , Meyfroidt Geert 
Published: February 2025

Purpose of review
To explore recent insights into measures of time-burden insults in intracranial pressure (ICP) monitoring, and potential implications for clinical management.

Recent findings
The ICP is an important therapeutic target in patients with traumatic brain injury (TBI) and some other brain injuries. Current clinical guidelines in TBI recommend starting treatment above a fixed ICP threshold of 22 mmHg. The concept of ICP burden was introduced recently, which takes both intensity and duration of an episode of elevated ICP into account. This burden of ICP is visualized in a colour-coded plot. In different cohorts of brain injured patients, prolonged ICP elevations, even at values below 20 or 22 mmHg, are associated with worse outcomes, and higher ICPs can only be tolerated briefly. The ICP burden plots are influenced by age, cerebral perfusion pressure, and cerebrovascular autoregulation, illustrating the complexity and dynamic aspect of secondary insults of elevated ICP events, and the need for personalization. Two clinical trials are currently investigating the impact of presenting this information at the bedside to clinicians.

Summary
The implementation of information on ICP burden at the patient's bedside could assist clinicians in recognizing secondary brain injury and result in more personalized ICP management.
The prognostic value of left ventricular diastolic dyssynchrony combined with myocardial perfusion, systolic dyssynchrony, and cardiovascular risk factors in patients with normal left ventricular ejection fraction
Authors: Wang Jingwen , Liu Bao , Zhang Feifei , Wang Jianfeng , Yu Wenji , Hu Yurui , Yang Zhimin , Wan Peng , Yang Xiaoyu , Wang Yuetao 
Published: February 2025

Objective
Major adverse cardiovascular events (MACE) still occur in the normal left ventricular ejection fraction (LVEF) patients with coronary artery disease (CAD). Currently, there are no studies related to the prognostic value of left ventricular diastolic dyssynchrony (LVDD) in combination with perfusion, systolic dyssynchrony, and cardiovascular risk factors in patients with normal LVEF. Therefore, we aimed to investigate the incremental prognostic value of LVDD in patients with normal LVEF and to establish a model to predict MACE.

Methods
This study included 239 suspected or known CAD patients with a normal LVEF who underwent gated single-photon emission computerized tomography myocardial perfusion imaging. Clinical data such as age, sex, and cardiovascular risk factors were collected. Myocardial perfusion, and left ventricular dyssynchrony parameters were assessed using QPS and Emory Toolbox software, respectively. The least absolute shrinkage and selection operator and multivariable Cox regression were used to select the variables.

Results
The subjects were followed up for a total of 73.2±16.4 months and MACE occurred in 28 patients. In multivariate Cox regression, rest diastolic bandwidth (BW) was closely related to MACE [hazard ratio (95% confidence interval), 10.78 (1.65–70.35); P=0.013]. The C-index of the model was increased from 0.748 to 0.783 by increasing the rest diastolic BW on the basis of summed difference score (SDS), stress systolic SD, age, hypertension, and chest pain (P<0.001). A final model for predicting MACE was constructed based on age, hypertension, chest pain, SDS, stress systolic SD, and rest diastolic BW. The C-index of the model was 0.783, and the area under the curves of the model predicting the occurrence of 3-year and 5-year MACE events were 0.766 and 0.827, respectively. The calibration curve showed a good calibration of the model.

Conclusion
LVDD is associated with MACE in patients with normal LVEF. In addition, based on SDS, stress systolic SD, age, hypertension, and chest pain, rest diastolic BW had an incremental predictive value for MACE.
Emergency Management of Animal-Related Injuries in Children
Authors: Di Mita Onorina , Rosa Margherita , Ruggiero Laura , Tipo Vincenzo , Savoia Fabio , Fiorilla Claudio , Liguoro Ilaria , Cogo Paola , Bozzola Elena , La Penna Francesco , Cardinale Fabio , La Torre Francesco , Marchetti Federico , Troisi Angela , Cella Andrea , Biasucci Giacomo , Rossi Nadia , Rossi Roberta , Pacenza Caterina , Manieri Sergio , Di Cara Giuseppe , Corrias Francesca , Patano Giuseppe , Maglione Marco 
Published: February 2025

Objectives:
Animal-related injuries (ARIs) represent a common reason for emergency department (ED) visits in children. Limited data regarding treatment in Italian EDs are available. The aims of the study were to assess the epidemiological features of these patients and to investigate the association between their characteristics and therapeutic approaches, particularly antibiotic prescription.

Materials and Methods:
Patients presenting to 13 pediatric EDs from 11 Italian regions because of ARIs were prospectively enrolled for 20 months. Patients’ clinical data, injury characteristics, and performed treatment were recorded.

Results:
We enrolled 442 patients aged 6.1 years (3.9) who were grouped in non–insect-related injuries (non-IRIs, n=236) and insect-related injuries (IRIs, n=206). Most injuries occurred in an outdoor setting during the afternoon. Except for IRIs, the most frequently involved animals were pets, mostly dogs (91.5%). In 59.1% of cases, the injury extent was <15 mm. The antibiotic prescription was more likely in children presenting with a lesion by a wild animal [odds ratio (OR): 5.8 (CI 95%: 1.27-26.57), P=0.02], in those with lacerations [OR: 2.90 (CI 95%: 1.13-6.54), P=0.01], and in those with larger injuries [OR: 2.66 (CI 95%: 1.49-4.76), P<0.01]. Antibiotics were more frequently prescribed in non-IRIs compared with IRIs (P<0.001), whereas IRIs more commonly received oral or topical steroids, topical antibiotics, or antihistamines (P<0.001).

Conclusions:
Most pediatric ARIs require limited emergency management. Antibiotic prescriptions are more likely in large lesions determined by wild animals. Monitoring non-IRIs and IRIs may provide useful information to improve and uniform therapeutic management and to plan public health preventive interventions.