{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T03:38:28Z","timestamp":1788752308956,"version":"build-2803163510"},"reference-count":19,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Decompressive craniectomy (DC) is a venerable clinical tool to manage moderate-to-severe traumatic brain injury (TBI). The utility of recently approved neuroinflammatory biomarkers glial fibrillary acidic protein (\n                      <jats:italic toggle=\"yes\">GFAP<\/jats:italic>\n                      ) and ubiquitin C-terminal hydrolase-L1 (\n                      <jats:italic toggle=\"yes\">UCH-L1<\/jats:italic>\n                      ) is unclear in DC patients as does the timing of cranioplasty to repair\/restore the missing cranial bone. We hypothesize that DC diminishes acute neuroinflammatory biomarkers\n                      <jats:italic toggle=\"yes\">GFAP<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">UCH-L1<\/jats:italic>\n                      and that early cranioplasty improves motor recovery following DC in moderate-to-severe TBI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A rodent TBI paradigm utilized a \u201chit-and-run\u201d closed cortical impact to induce moderate-to-severe trauma. GFAP and UCH-L1 were quantified in CD1 mice (ELISA) in sham, TBI, and TBI-DC. Concurrently, Long-Evans rats received early or delayed alloplastic cranioplasty, with beam walk to assess motor proficiency. A 2-way ANOVA with Dunnett's post hoc determined group-level differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      GFAP and UCH-L1 were elevated in TBI at post-TBI day 1 (GFAP:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0233; UCH-L1:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0005) and partially elevated in TBI-DC (GFAP:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0603; UCH-L1:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0326). By day 7, biomarker levels converged (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05), indicating acute neuroinflammation resolution. Early cranioplasty maintained near-sham motor performance at day 4 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.9925). Absence of cranioplasty (TBI-DC) produced persistent deficits (day 4:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0319; day 11:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0069; day 18:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0112). Late cranioplasty yielded improvement, achieving near-sham results by day 11 or post-cranioplasty day 5 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.9166).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this moderate-to-severe TBI model, DC significantly mitigates astroglial and neuronal biomarker expression. Timely cranioplasty further augments motor recovery, underscoring its relevance for optimizing neurological convalescence following decompressive surgery in acute TBI management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251357992","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T07:20:26Z","timestamp":1752564026000},"page":"1968-1973","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["TBI Biomarker Improvements Following Rodent Decompressive Craniectomy and Motor Outcome Validation of Early Cranioplasty"],"prefix":"10.1177","volume":"63","author":[{"given":"Steffen G","family":"Osborn","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C","family":"Bartelt","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Hong","sequence":"additional","affiliation":[{"name":"Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Zanaty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlan R","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"},{"name":"Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8460-1249","authenticated-orcid":false,"given":"Terry C","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3994-6808","authenticated-orcid":false,"given":"Brian T","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"},{"name":"Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-190805000-00001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/3-211-30714-1_4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2019.6869"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00702-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039727"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3171\/2016.11.JNS161917"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.1106"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10225437"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.622"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2024.2306876"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000002897"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006777"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-79155-8"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2013.30"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(06)61024-8"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193910000-00002"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006836"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_802_2020"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.3171\/2024.1.JNS232172"}],"container-title":["The 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