bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of lordosis recovery after lumbar arthrodesis and its clinical impact
Authors: Tchachoua Jiembou Gabriel , Nda Hermann Adonis , Konan Meleine Landry 
Published: June 2023

Abstract
Background
Posterior lumbar arthrodesis has become a widely used therapeutic option to correct sagittal imbalances in patients suffering from degenerative lumbar conditions. However, in western Africa, there is no study have reported long-term outcome of posterior lumbar arthrodesis. The aim of this study was to investigate the relationship between the restoration of adequate lordosis and the patient’s postoperative quality of life.

Method
The study was retrospective. From January 2012 to December 2019, 80 patients who underwent posterior lumbar arthrodesis for lumbar degenerative diseases were included with a mean follow-up of 43.2 months. Mean age was 50.8 years (SD = 12.2). Preoperative and postoperative patients’ symptoms were assessed by the visual analog scale (VAS), Oswestry Disability Index (ODI), and 12-item Short Form (SF-12). Pre- and post-operative radiographic evaluation included lumbar lordosis measured (LLm), pelvic incidence (PI), sacral slope (SS), and pelvic stilt (PS). Theoretical lumbar lordosis (LLt) was defined by the following: LL = 0.54 × PI + 27.6. Data analysis was done using the statistical software “R.” The risk of error was 5% (p < 0.05).

Result
The mean pelvic incidence was 57.23°. There was no statistically significant difference between preoperative and postoperative lumbar lordosis (p = 0.2567). There was no statistical difference between preoperative and postoperative PI-LL (p = 0.179). There was a statistically significant difference between the pre and postoperative clinical scores (p < 0.001). Statistical analysis showed a correlation between recovery of lumbar lordosis and improvement in physical component of SF-12 (PCS) (p < 0.05) and lumbar and radicular VAS (p < 0.05) for the subgroup of narrow lumbar spine. There was a statistical relationship between the restoration of lumbar lordosis and improvement in PCS (p = 0.004) and VAS (p = 0.003) for the subgroup of isthmic lysis spondylolisthesis.

Discussion
The root decompression performed in most patients could explain the clinical improvement regardless of recovery of lordosis. The failure to consider spinal parameters and sagittal balance of patients in the surgery could explain no restoration of lumbar lordosis. Our study had limitations inherent to its retrospective character such as the classic selection bias.

Conclusion
Satisfactory correction of spinopelvic alignment may improve long-term clinical signs.
Neurosarcoidosis in a young male presenting with intractable migraines, blurry vision, and other nonspecific neurological symptoms case report
Authors: Jnani Jack 
Published: June 2023

Abstract
Background
Neurosarcoidosis can have various neurological outcomes and presentations. It is an uncommon diagnosis, especially in young Caucasian males presenting with predominantly migraine headaches.

Case presentation
A Caucasian male in his 20s with no medical history presented with 1 month of intractable migraine headaches associated with left sided blurry vision, nausea and vomiting. He has also been having intermittent paresthesia’s in the left upper extremity. He reports lightheadedness when moving from sitting to standing and occasionally feels unsteady on his feet. He also endorses night sweats, generalized malaise, and fatigue. On admission, CT chest, abdomen, and pelvis showed diffuse lymphadenopathy above and below the diaphragm, as well as widespread pulmonary nodules. MR head and spine showed multiple and diffuse nodular leptomeningeal enhancements and enhancement foci along the cervical, thoracic, and lumbar spine. Lumbar puncture showed elevated total nucleated cells and protein. Surgical pathology from a right inguinal lymph node showed many scattered multinucleated giant cells and epithelioid histiocytes consistent with non-necrotizing granulomas seen in sarcoidosis. He was treated with high dose steroids with significant improvement in symptoms.

Conclusions
The diagnosis of neurosarcoidosis may be challenging, and the differential may include other infectious, neoplastic, and inflammatory conditions. Neurosarcoidosis may present in a young Caucasian male with a constellation of nonspecific neurological symptoms such as cranial nerve palsies, gait imbalance, paresthesia’s, and headaches, among other presentations. Neurosarcoidosis may present similarly to lymphoma with constitutional symptoms of night sweats, fatigue, as well as widespread lymphadenopathy. Histopathology may be useful in diagnosis. Neurosarcoidosis may initially respond well to steroid treatment.
Datura metel stramonium exacerbates behavioral deficits, medial prefrontal cortex, and hippocampal neurotoxicity in mice via redox imbalance
Authors: Igben Vincent Onoriode , Iju Wilson Josiah , Itivere Omogbiya Adrian , Oyem John Chukwuma , Akpulu Peter Sunday , Ahama Efe Endurance 
Published: June 2023

Abstract
Background
Datura metel (DM) stramonium is a medicinal plant often abused by Nigerians due to its psychostimulatory properties. Hallucinations, confusion, agitation, aggressiveness, anxiety, and restlessness are reported amongst DM users. Earlier studies suggest that DM induces neurotoxicity and affect brain physiology. However, the exact neurological effects of DM extract in the medial prefrontal cortex (mPFC) and hippocampal morphology have not been elucidated. In this study, we evaluated the hypothesis that oral exposure to DM extract exerts a neurotoxic effect by increasing oxidative stress in the mPFC and the hippocampus and induces behavioral deficits in mice.

Results
DM methanolic extract exposure significantly increased MDA and NO levels and reduced SOD, GSH, GPx and CAT activities in mice brains. In addition, our results showed that DM exposure produced cognitive deficits, anxiety, and depressive-like behaviour in mice following oral exposure for 28 days. Moreover, the mPFC and hippocampus showed neurodegenerative features, loss of dendritic and axonal arborization, a dose-dependent decrease in neuronal cell bodies’ length, width, area, and perimeter, and a dose-dependent increase in the distance between neuronal cell bodies.

Conclusions
Oral exposure to DM in mice induces behavioural deficits, mPFC and hippocampal neuronal degenerations via redox imbalance in the brain of mice. These observations confirm the neurotoxicity of DM extracts and raises concerns on the safety and potential adverse effects of DM in humans.

Graphical abstract
Factors affecting the outcomes after bidirectional Glenn shunt: two decades of experience from a tertiary referral center
Authors: Yousef Aly A. , Elmahrouk Ahmed F. , Hamouda Tamer E. , Helal Abdelmonem M. , Dohain Ahmed M. , Alama Abdulhadi , Shihata Mohammad S. , Al-Radi Osman O. , Jamjoom Ahmed A. , Mashali Mohamed H. 
Published: June 2023

Abstract
Background
Despite the improved management of patients with a single ventricle, the long-term outcomes are not optimal. We reported the outcomes of the bidirectional Glenn procedure (BDG) and factors affecting the length of hospital stay, operative mortality, and Nakata index before Fontan completion.

Results
This retrospective study included 259 patients who underwent BDG shunt from 2002 to 2020. The primary study outcomes were operative mortality, duration of hospital stay, and Nakata index before Fontan. Mortality occurred in 10 patients after BDG shunt (3.86%). By univariable logistic regression analysis, postoperative mortality after BDG shunt was associated with high preoperative mean pulmonary artery pressure (OR: 1.06 (95% CI 1.01–1.23); P = 0.02). The median duration of hospital stay after BDG shunt was 12 (9–19) days. Multivariable analysis indicated that Norwood palliation before BDG shunt was significantly associated with prolonged hospital stay (β: 0.53 (95% CI 0.12–0.95), P = 0.01). Fontan completion was performed in 144 patients (50.03%), and the pre-Fontan Nataka index was 173 (130.92–225.34) mm2/m2. Norwood palliation (β: − 0.61 (95% CI 62.63–20.18), P = 0.003) and preoperative saturation (β: − 2.38 (95% CI − 4.49–0.26), P = 0.03) were inversely associated with pre-Fontan Nakata index in patients who had Fontan completion.

Conclusions
BDG had a low mortality rate. Pulmonary artery pressure, Norwood palliation, cardiopulmonary bypass time, and pre-BDG shunt saturation were key factors associated with post-BDG outcomes in our series.
Salivary bypass tube in managing persistent and large pharyngocutaneous and tracheoesophageal fistulas: a series of seven cases
Authors: Zakir Nurul Najwa Mohd , Yusof Zulkifli , Mohamad Irfan 
Published: June 2023

Abstract
Background
A salivary bypass tube (SBT) is a silicone tube that directs oral content from the mouth to the esophagus. We studied a series of seven cases of persistent and large neck fistulas of different aetiologies to assess the beneficial use of SBTs in each case.

Case presentation
A total of seven patients underwent SBT insertion, six cases were post-total laryngectomy with underlying laryngeal malignancy, and one case was poor wound healing of a neck abscess after extensive drainage. Five cases have pharyngocutaneous fistula (PCF) and two cases have tracheoesophageal fistula (TEF), and all of the cases have failed conservative and multiple surgical management for fistula closure, with some concurrently having neopharynx stenosis. Post-insertion, all patients were able to eat orally after day 2 to 1-week. The duration of tube usage was one month in the three cases of persistent PCF post-operatively, and in two cases, the fistula was healed and the tube was removed without fistula recurrence. The other four cases (three post-radiotherapy fistulas and one stoma recurrence) were planned for lifelong use, with the duration of usage ranging from 4 months to 3 years. The outcome is their fistula is dry, and they tolerate the tube well. There were no intraoperative or immediate postoperative complications, and no complications were observed in the temporary usage cases. Among the patients who had to use the tube for a longer term, one had localised pressure necrosis of regional soft tissue that resolved after tube adjustment, and another had a loose-fitting tube that displaced distally into the oesophagus and resolved with a larger tube.

Conclusions
SBT is safe, easy-to-apply, reduces morbidity, improves mental health, reduces inpatient stay, and overall improves the patient's quality of life in the management of persistent and large TEF and PCF for temporary or long-term usage.
A Randomized Controlled Trial of Fluorouracil Plus Leucovorin, Irinotecan, and Oxaliplatin Combinations in Patients With Previously Untreated Metastatic Colorectal Cancer
Authors: Goldberg Richard M. , Sargent Daniel J. , Morton Roscoe F. , Fuchs Charles S. , Ramanathan Ramesh K. , Williamson Stephen K. , Findlay Brian P. , Pitot Henry C. , Alberts Steven R. 
Published: June 2023

PURPOSE Three agents with differing mechanisms of action are available for treatment of advanced colorectal cancer: fluorouracil, irinotecan, and oxaliplatin. In this study, we compared the activity and toxicity of three different two-drug combinations in patients with metastatic colorectal cancer who had not been treated previously for advanced disease. PATIENTS AND METHODS Patients were concurrently randomly assigned to receive irinotecan and bolus fluorouracil plus leucovorin (IFL, control combination), oxaliplatin and infused fluorouracil plus leucovorin (FOLFOX), or irinotecan and oxaliplatin (IROX). The primary end point was time to progression, with secondary end points of response rate, survival time, and toxicity. RESULTS A total of 795 patients were randomly assigned between May 1999 and April 2001. A median time to progression of 8.7 months, response rate of 45%, and median survival time of 19.5 months were observed for FOLFOX. These results were significantly superior to those observed for IFL for all end points (6.9 months, 31%, and 15.0 months, respectively) or for IROX (6.5 months, 35%, and 17.4 months, respectively) for time to progression and response. The FOLFOX regimen had significantly lower rates of severe nausea, vomiting, diarrhea, febrile neutropenia, and dehydration. Sensory neuropathy and neutropenia were more common with the regimens containing oxaliplatin. CONCLUSION The FOLFOX regimen of oxaliplatin and infused fluorouracil plus leucovorin was active and comparatively safe. It should be considered as a standard therapy for patients with advanced colorectal cancer.
Organization of Cancer Specialists in US Physician Practices and Health Systems
Authors: Nguyen Christina A. , Beaulieu Nancy D. , Wright Alexi A. , Cutler David M. , Keating Nancy L. , Landrum Mary Beth 
Published: June 2023

PURPOSE To describe the supply of cancer specialists, the organization of cancer care within versus outside of health systems, and the distance to multispecialty cancer centers. METHODS Using the 2018 Health Systems and Provider Database from the National Bureau of Economic Research and 2018 Medicare data, we identified 46,341 unique physicians providing cancer care. We stratified physicians by discipline (adult/pediatric medical oncologists, radiation oncologists, surgical/gynecologic oncologists, other surgeons performing cancer surgeries, or palliative care physicians), system type (National Cancer Institute [NCI] Cancer Center system, non-NCI academic system, nonacademic system, or nonsystem/independent practice), practice size, and composition (single disciplinary oncology, multidisciplinary oncology, or multispecialty). We computed the density of cancer specialists by county and calculated distances to the nearest NCI Cancer Center. RESULTS More than half of all cancer specialists (57.8%) practiced in health systems, but 55.0% of cancer-related visits occurred in independent practices. Most system-based physicians were in large practices with more than 100 physicians, while those in independent practices were in smaller practices. Practices in NCI Cancer Center systems (95.2%), non-NCI academic systems (95.0%), and nonacademic systems (94.3%) were primarily multispecialty, while fewer independent practices (44.8%) were. Cancer specialist density was sparse in many rural areas, where the median travel distance to an NCI Cancer Center was 98.7 miles. Distances to NCI Cancer Centers were shorter for individuals living in high-income areas than in low-income areas, even for individuals in suburban and urban areas. CONCLUSION Although many cancer specialists practiced in multispecialty health systems, many also worked in smaller-sized independent practices where most patients were treated. Access to cancer specialists and cancer centers was limited in many areas, particularly in rural and low-income areas.
How the allotropic transition temperature of solids can change with the heating rate
Authors: Gerard Maxime , Desgranges Lionel , Goupil Christophe 
Published: June 2023

Abstract
Though classical thermodynamics predict a single temperature for the allotropic phase transition, the phase transition temperature is often seen to change with the heating rate. Herein we propose a simple method to predict the change in the phase transition temperature as a function of the heating rate. The method is based on the comparison of entropy production between two paths, with or without a phase transition. This method was applied to the zircaloy α-β phase transition and the resulting experimental data were processed to determine the molar transformation rate as a function of temperature.
Predictors of Angiographic Outcome After Failed Thrombectomy for Large Vessel Occlusion: Insights from the Stroke Thrombectomy and Aneurysm Registry
Authors: Webb Matthew , Essibayi Muhammed Amir , Al Kasab Sami , Maier Ilko L. , Psychogios Marios-Nikos , Grossberg Jonathan A. , Alawieh Ali , Wolfe Stacey Quintero , Arthur Adam , Dumont Travis , Kan Peter , Kim Joon-Tae , De Leacy Reade , Osbun Joshua , Rai Ansaar , Jabbour Pascal , Park Min S. , Crosa Roberto , Levitt Michael R. , Polifka Adam , Yoshimura Shinichi , Matouk Charles , Williamson Richard W. , Fragata Isabel , Chowdhry Shakeel A. , Starke Robert M. , Samaniego Edgar A. , Cuellar Hugo , Spiotta Alejandro , Mascitelli Justin 
Published: June 2023

BACKGROUND:
Mechanical thrombectomy failure (MTF) occurs in approximately 15% of cases.

OBJECTIVE:
To investigate factors that predict MTF.

METHODS:
This was a retrospective review of prospectively collected data from the Stroke Thrombectomy and Aneurysm Registry. Patients who underwent mechanical thrombectomy (MT) for large vessel occlusion (LVO) were included. Patients were categorized by mechanical thrombectomy success (MTS) (≥mTICI 2b) or MTF (<mTICI 2b). Demographics, pretreatment, and treatment information were included in a univariate (UVA) and multivariate (MVA) analysis for prediction of MTF.

RESULTS:
A total of 6780 patients were included, and 1001 experienced anterior circulation MTF. Patients in the MTF group were older (73 vs 72, P = .044) and had higher poor premorbid modified Rankin Scale (mRS) (10.8% vs 8.4%, P = .017). Onset to puncture time was greater in the MTF group (273 vs 260 min, P = .08). No significant differences were found between the access site, use of balloon guide catheter, frontline technique, or first-pass devices between the MTF and MTS groups. More complications occurred in the MTF group (14% vs 5.8%), including symptomatic intracerebral hemorrhage (9.4% vs 6.1%) and craniectomies (10% vs 2.8%) (P < .001). On UVA, age, poor pretreatment mRS, increased number of passes, and increased procedure time were associated with MTF. Internal carotid artery, M1, and M2 occlusions had decreased odds of MTF. Poor preprocedure mRS, number of passes, and procedure time remained significant on MVA. A subgroup analysis of posterior circulation LVO revealed that number of passes and total procedure time correlated with increased odds of MTF (P < .001) while rescue stenting was associated with less odds of MTF (odds ratio 0.20, 95% CI 0.06-0.63). Number of passes remained significant on MVA of posterior circulation occlusion subgroup analysis.

CONCLUSION:
Anterior circulation MTF is associated with more complications and worse outcomes. No differences were found between techniques or devises used for the first pass during MT. Rescue intracranial stenting may decrease the likelihood of MTF for posterior circulation MT.
A Novel Method for Angioscopic Imaging and Visualizing the Skull Base Using Complementary Metal Oxide Semiconductor Cameras
Authors: Porwal Mokshal H. , Feller Christina , Bales Justine , Sacho Raphael 
Published: June 2023

BACKGROUND AND OBJECTIVES:
Complementary metal oxide semiconductor (CMOS) electrode arrays are a novel technology for miniaturized endoscopes; however, its use for neurointervention is yet to be investigated. In this proof-of-concept study, we aimed to demonstrate the feasibility of CMOS endoscopes in a canine model by providing direct visualization of the endothelial surface, deploying stents and coils, and accessing the spinal subdural space and skull base.

METHODS:
Using 3 canine models, standard guide catheters were introduced into the internal carotid and vertebral arteries through the transfemoral route using fluoroscopy. A 1.2-mm CMOS camera was delivered through the guide catheter to inspect the endothelium. Next, the camera was introduced alongside standard neuroendovascular devices including coils and stents to provide direct visualization of their deployment within the endothelium during fluoroscopy. One canine was used for skull base and extravascular visualization. A lumbar laminectomy was performed, and the camera was navigated within the spinal subdural space until the posterior circulation intracranial vasculature was visualized.

RESULTS:
We successfully visualized the endothelial surface and performed several endovascular procedures such as deployment of coils and stents under direct endovascular, angioscopic vision. We also demonstrated a proof of concept for accessing the skull base and posterior cerebral vasculature using CMOS cameras through the spinal subdural space.

CONCLUSION:
This proof-of-concept study demonstrates the feasibility of CMOS camera technology to directly visualize endothelium, perform common neuroendovascular procedures, and access the base of the skull in a canine model.
Defining developmental trajectories of prosensory cells in human inner ear organoids at single-cell resolution
Authors: Ueda Yoshitomo , Nakamura Takashi , Nie Jing , Solivais Alexander J. , Hoffman John R. , Daye Becca J. , Hashino Eri 
Published: June 2023

ABSTRACT
The inner ear sensory epithelia contain mechanosensitive hair cells and supporting cells. Both cell types arise from SOX2-expressing prosensory cells, but the mechanisms underlying the diversification of these cell lineages remain unclear. To determine the transcriptional trajectory of prosensory cells, we established a SOX2-2A-ntdTomato human embryonic stem cell line using CRISPR/Cas9, and performed single-cell RNA-sequencing analyses with SOX2-positive cells isolated from inner ear organoids at various time points between differentiation days 20 and 60. Our pseudotime analysis suggests that vestibular type II hair cells arise primarily from supporting cells, rather than bi-fated prosensory cells in organoids. Moreover, ion channel- and ion-transporter-related gene sets were enriched in supporting cells versus prosensory cells, whereas Wnt signaling-related gene sets were enriched in hair cells versus supporting cells. These findings provide valuable insights into how prosensory cells give rise to hair cells and supporting cells during human inner ear development, and may provide a clue to promote hair cell regeneration from resident supporting cells in individuals with hearing loss or balance disorders.
The lipid transfer proteins Nir2 and Nir3 sustain phosphoinositide signaling and actin dynamics during phagocytosis
Authors: Kaba Mayis , Carreras-Sureda Amado , Nunes-Hasler Paula , Demaurex Nicolas 
Published: June 2023

ABSTRACT
Changes in membrane phosphoinositides and local Ca2+ elevations at sites of particle capture coordinate the dynamic remodeling of the actin cytoskeleton during phagocytosis. Here, we show that the phosphatidylinositol (PI) transfer proteins PITPNM1 (Nir2) and PITPNM2 (Nir3) maintain phosphatidylinositol 4,5-bisphosphate [PI(4,5)P2] homeostasis at phagocytic cups, thereby promoting actin contractility and the sealing of phagosomes. Nir3 and to a lesser extent Nir2 accumulated on endoplasmic reticulum (ER) cisternae juxtaposed to phagocytic cups when expressed in phagocytic COS-7 cells. CRISPR-Cas9 editing of Nir2 and Nir3 genes decreased plasma membrane PI(4,5)P2 levels, store-operated Ca2+ entry (SOCE) and receptor-mediated phagocytosis, stalling particle capture at the cup stage. Re-expression of either Nir2 or Nir3 restored phagocytosis, but not SOCE, proportionally to the PM PI(4,5)P2 levels. Phagosomes forming in Nir2 and Nir3 (Nir2/3) double-knockout cells had decreased overall PI(4,5)P2 levels but normal periphagosomal Ca2+ signals. Nir2/3 depletion reduced the density of contractile actin rings at sites of particle capture, causing repetitive low-intensity contractile events indicative of abortive phagosome closure. We conclude that Nir proteins maintain phosphoinositide homeostasis at phagocytic cups, thereby sustaining the signals that initiate the remodeling of the actin cytoskeleton during phagocytosis.