bluuebunny/crossref_metadata_2025_split huggingface dataset:
Second‐Line Treatment for Patients With Primary Biliary Cholangitis: A Systematic Review With Network Meta‐Analysis
Authors: Giannini Edoardo G. , Pasta Andrea , Calabrese Francesco , Labanca Sara , Marenco Simona , Pieri Giulia , Plaz Torres Maria Corina , Strazzabosco Mario 
Published: December 2024

ABSTRACTBackground & AimsApproximately 40% of patients with Primary Biliary Cholangitis (PBC) show incomplete response to ursodeoxycholic acid, thus needing second‐line treatment to prevent disease progression. As no head‐to‐head comparison study is available, we used a network meta‐analysis (NMA) to compare efficacy and safety of available second‐line therapies.MethodsWe performed a systematic literature review including randomised, placebo‐controlled trials of patients with PBC and incomplete response, or intolerance, to ursodeoxycholic acid, and compared relative risks (RRs) for primary (biochemical response at 52‐week) and secondary outcomes [incidence of new‐onset pruritus and serious adverse events (SAEs)].ResultsThe NMA included three studies, each testing obeticholic acid (OCA), seladelpar or elafibranor versus placebo (active therapy/placebo: 379/191 patients). All treatments significantly increased the RR for biochemical response with an advantage of elafibranor versus seladelpar (RR: 4.37, 95% CI: 1.01–18.87). OCA 5–10 mg/10 mg was associated with a higher risk of new‐onset pruritus compared to placebo (RR: 1.43; 95% CI: 1.09–1.88/RR: 1.79; 95% CI: 1.37–2.33), while seladelpar decreased this risk (RR: 0.30; 95% CI: 0.12–0.80). Compared to placebo, OCA 5–10 mg/10 mg was associated with an increased risk of SAE (RR: 3.82; 95% CI: 1.46–10.02/RR 2.67; 95% CI: 1.00–7.08).ConclusionsAmong second line therapies for patients with PBC, elafibranor is slightly more effective in obtaining biochemical response than seladelpar that, on the other hand, is the only drug associated with a lower incidence of pruritus. While of similar efficacy, OCA was associated with increased pruritus and SAEs. These findings may help personalise second‐line treatment in patients with PBC.
Linking sap flow and tree water deficit in an unmanaged, mixed beech forest during the summer drought 2022
Authors: Donfack L. S. , Mund M. , Koebsch F. , Schall P. , Heidenreich M. G. , Seidel D. , Ammer C. 
Published: December 2024

Abstract
Temperate mixed forests are currently experiencing severe drought conditions and face increased risk of degradation. However, it remains unclear how critical tree physiological functions such as sap flow density (SFD) and tree water deficit (TWD, defined as reversible stem shrinkage when water is depleted), respond to extreme environmental conditions and how they interact under dry conditions.
We monitored SFD and TWD of three co‐occurring European tree species (Fagus sylvatica, Fraxinus excelsior and Acer pseudoplatanus) in dry conditions, using high temporal resolution sap flow, dendrometer, and environmental measurements.
Species‐specific SFD responses to soil drying did not differ significantly, while TWD was significantly higher in F. excelsior. Inter‐specific differences in wood anatomy and water use strategies did not consistently explain these responses. TWD and SFD responded both to soil moisture content (SWC) during wet (SWC ≥ 0.2) and dry (SWC < 0.2) phases, with SFD responding more strongly. There was a significant correlation for TWD and vapour pressure deficit (VPD) only in the wet phase, and for SFD and VPD only in the dry phase. During the dry phase, the incoming PPFD significantly correlated with SFD in all species, and with TWD only in F. sylvatica and F. excelsior. TWD negatively responded to SFD, showing hysteresis effects from which a decreasing sigmoidal phase along the soil drying gradient was observed.
The nonlinear correlations between TWD and SFD may result from a time lag between the two variables, and their different sensitivities to SWC and VPD under different drought intensities. We conclude that, under drought stress, TWD cannot be used as a proxy for SFD or vice versa.
School Heads’ Direct Supervision, Attitudes and Practices and Teachers’ Performance during the Post Pandemic Era
Authors: Tuico Edgar V. , Callo Elsa C. 
Published: December 2024

This study investigated the impact of school leaders' direct supervision, attitudes, and practices on teachers' performance in the post-pandemic era. This study used a quantitative method with a predictive design involving 350 permanent teachers from SDO San Pablo City's four (4) large public junior high schools for the school year 2022-2023. A survey questionnaire was used to assess the level of direct supervision provided by school heads in terms of lesson planning and delivery; the level of attitudes provided by school heads in terms of motivation, communication, respect, decision-making, and sensitivity; and the level of practices provided by school heads in terms of teachers' support during the transition period; meeting needs; maintaining communication contact and relationship; celebrating success; and maintaining quality. Using the mean and standard deviation, it was discovered that respondents' level of agreement to school heads' direct supervision in all instructional processes is very high; respondents' level of agreement to school heads' attitudes in terms of motivation, communication, and respect is also very high; respondents' level of agreement to school heads' practices in all sub-variables is also very high; and respondents' level of agreement to their performance is also very high. School leaders' direct supervision, attitudes, and practices are significantly related to teachers' performance. Likewise, teachers' performance significantly predicted school heads' practices in maintaining communication contact and relationship, as well as school heads' direct supervision in lesson planning As a result, it may be recommended that school leaders continue to direct the three (3) instructional processes to improve teaching, develop more positive attitudes to boost teacher morale, and maintain school practices, as teachers require more support in this post-pandemic era.
A systematic review of pre-registration in autism research journals
Authors: Poole Daniel , Linden Audrey , Sedgewick Felicity , Allchin Oliver , Hobson Hannah 
Published: December 2024

Pre-registration refers to the practice of researchers preparing a time-stamped document describing the plans for a study. This open research tool is used to improve transparency, so that readers can evaluate the extent to which the researcher adhered to their original plans and tested their theory appropriately. In the current study, we conducted an audit of pre-registration in autism research through a review of manuscripts published across six autism research journals between 2011 and 2022. We found that 192 publications were pre-registered, approximately 2.23% of publications in autism journals during this time frame. We also conducted a quality assessment of a sample of the pre-registrations, finding that specificity in the pre-registrations was low, particularly in the design and analysis components of the pre-registration. In addition, only 28% of sampled manuscripts adhered to their analysis plan or transparently disclosed all deviations. Autism researchers conducting confirmatory, quantitative research should consider pre-registering their work, reporting any changes in plans transparently in the published manuscript. We outline recommendations for researchers and journals to improve the transparency and robustness of the field. Lay abstract When researchers write down their plans for a study ahead of time and make this public, this is called pre-registration. Pre-registration allows others to see if the researchers stuck to their original plan or changed as they went along. Pre-registration is growing in popularity but we do not know how widely it is used in autism research. In this study, we looked at papers published in six major autism journals between 2011 and 2022. We found that only 2.23% of papers published in autism journals had been pre-registered. We also took a close look at a selection of the pre-registrations to check how good they were and if researchers stuck to their plans. We found that the pre-registrations generally lacked specifics, particularly about how the study was designed and the data would be analysed. We also found that only 28% of the papers closely followed the pre-registered plans or reported the changes. Based on these findings, we recommend that autism researchers consider pre-registering their work and transparently report any changes from their original plans. We have provided some recommendations for researchers and journals on how pre-registration could be better used in autism research.
Geo-spatial analysis of acute ischemic stroke reperfusion treatment in India: An assessment of distribution and access to centers
Authors: Asif Kaiz S , Mitra Arun , Ortega-Gutierrez Santiago , Herial Nabeel , Desai Shashvat , Jadhav Ashutosh , Al-Mufti Fawaz , Roy Adrija , Singh Romil , Brown Grant , Sarraj Amrou , Jose Arun , Alurkar Anand , Karapurkar AP , Sharma Arvind , Gupta Vipul , Goel Gaurav , Khurana Dheeraj , Das Biplab , Roy Jayanta , Das Deep , Kumar Rahul , Kuruttukulam Gigy , Kumar VG Pradeep , Srivastava MV Padma , Pandian Jeyaraj , Huded Vikram , Yavagal Dileep , Soman Biju , Sylaja PN 
Published: December 2024

Background: Stroke is a leading cause of global mortality and disability, with a disproportionately high burden in low- and middle-income countries. Access to intravenous thrombolysis (IVT) and endovascular treatment (EVT) remains extremely limited. Aims: We evaluated the spatial distribution and geographic accessibility of stroke centers in India. Methods: Data on IVT capable (IVT-C) and EVT capable (EVT-C) stroke centers were collected in March 2021 from thrombectomy devices and pharmaceutical industry providers, respectively. Data were collated and geocoded to compare and calculate zonal statistics and state/union territory (UT) summaries using descriptive statistics. Data on population centers were obtained from the Survey of India website. For estimating driving times, we used the Google Distance Matrix API to find the driving distance between each population center and its nearest stroke facility. Subsequently, population coverages were estimated as a proportion of the population having access to stroke centers for each time interval and based on the population projection for the year 2020 and compared across states. Results: A total of 566 IVT-C stroke centers were spread across 26 states and UTs, of which 361 (63%) were EVT-C. Ten UTs lacked stroke centers. The average stroke centers per million (SCPM) population was 0.41 and 0.26 for IVT-C and EVT-C, respectively. Median distances to the nearest IVT-C and EVT-C centers were 115 km (interquartile range (IQR): 66–175) and 131 km (IQR: 79–198), respectively. Access within 1 h to an IVT-C and an EVT-C center was available to 26.3% and 20.6% of the Indian population, respectively. Conclusions: Access to stroke care in India is poor, with critical regional disparities as reflected by the low SCPM population, long driving times, and a small population with access within the golden hour. There is an urgent need to establish IVT-C and EVT-C stroke centers in the existing poorly served regions of India to increase access and improve outcomes for stroke patients.
Ischemic stroke prevention in patients with atrial fibrillation and a recent ischemic stroke, TIA, or intracranial hemorrhage: A World Stroke Organization (WSO) scientific statement
Authors: Sposato Luciano A , Cameron Alan C , Johansen Michelle C , Katan Mira , Murthy Santosh B , Schachter Micaela , B Sur Nicole , Yaghi Shadi , Aspberg Sara , Caso Valeria , Hsieh Cheng-Yang , J Hilz Max , Nucera Antonia , Seiffge David J , Sheppard Mary N , Martins Sheila CO , Bahit M Cecilia , Scheitz Jan F , Shoamanesh Ashkan 
Published: December 2024

Background: Secondary stroke prevention in patients with atrial fibrillation (AF) is one of the fastest growing areas in the field of cerebrovascular diseases. This scientific statement from the World Stroke Organization Brain & Heart Task Force provides a critical analysis of the strength of current evidence on this topic, highlights areas of current controversy, identifies knowledge gaps, and proposes priorities for future research. Methods: We select topics with the highest clinical relevance and perform a systematic search to answer specific practical questions. Based on the strength of available evidence and knowledge gaps, we identify topics that need to be prioritized in future research. For this purpose, we adopt a novel classification of evidence strength based on the availability of publications in which the primary population is patients with recent (<6 months) cerebrovascular events, the primary study endpoint is a recurrent ischemic stroke, and the quality of the studies (e.g. observational versus randomized controlled trial). Summary: Priority areas include AF screening, molecular biomarkers, AF subtype classification, anticoagulation in device-detected AF, timing of anticoagulation initiation, effective management of breakthrough strokes on existing anticoagulant therapy, the role of left atrial appendage closure, novel approaches, and antithrombotic therapy post-intracranial hemorrhage. Strength of currently available evidence varies across the selected topics, with early anticoagulation being the one showing more consistent data. Conclusion: Several knowledge gaps persist in most areas related to secondary stroke prevention in AF. Prioritizing research in this field is crucial to advance current knowledge and improve clinical care.
Case Series of Infection-Related Glomerulonephritis in Quebec Indigenous Peoples
Authors: Nodzynski Thomas , Sohani Zahra , Rajaram Ajay , Fiset Pierre Olivier , Bernard Chantal , Vasilevsky Murray , Weber Catherine 
Published: December 2024

Rationale: Infection-related glomerulonephritis (IRGN) is an immune-mediated glomerulonephritis caused by extra-renal infectious diseases. There has been an important shift in epidemiology in recent years, with a significant proportion of adults affected. The incidence of IRGN is higher amongst Indigenous populations and especially in those with multiple comorbidities. Beginning in 2019, we observed several IRGN cases amongst adult Indigenous peoples referred to the McGill University Health Center (MUHC). The aim of this article is to describe the demographic, clinical, and outcome data of these individuals and highlight the heterogeneity of IRGN in this population through 2 illustrative cases. Presenting concerns of the patient: In total, 8 cases of IRGN were identified between 2019 and 2022. All patients presented with features of acute glomerulonephritis. Diagnoses: All patients had documented evidence of an infection that preceded their diagnosis of IRGN. IRGN was not the initial clinical diagnosis in all cases. Interventions: Half the patients received immunosuppression while the others received supportive care only. Outcomes: Four patients required initiation of hemodialysis at time of presentation and at 2 years of follow-up, 3 of the 4 remained hemodialysis-dependent. Teaching points: Our case series emphasizes the heterogenous clinical, laboratory, and pathological presentations that make the diagnosis of IRGN quite challenging. A high index of suspicion should be present when a patient presents with acute kidney injury, features of a glomerulonephritis, and an infection, especially those with multiple comorbidities and a preceding history of chronic kidney disease.
Factors Associated with Symptom Recurrence Following Operative Treatment of Interdigital Neuroma
Authors: Ghandour Samir , Suyama Emi R. , Sirls Evan , Ahn Jiyong , Burgesson Bernard , Aslan Lercan , Ashkani-Esfahani Soheil , Guss Daniel , Waryasz Gregory , Bejarano-Pineda Lorena , DiGiovanni Christopher W. 
Published: December 2024

Category: Midfoot/Forefoot; Trauma Introduction/Purpose: Interdigital Neuroma (IN) is a benign enlargement of tissue surrounding the common plantar digital nerve. Traditionally, neurectomy has been performed as the standard surgical treatment for IN. However, recent attention has been given to less invasive surgical decompression by intermetatarsal ligament (IML) release with neurolysis. This study aims to compare the outcomes of IML release with neurolysis to traditional interdigital neurectomy. Methods: A retrospective chart review was conducted on 350 consecutive patients who underwent surgical treatment for IN. Patients who satisfied our inclusion and exclusion criteria were categorized into two groups based on the surgical treatment received: IML release with neurolysis or interdigital neurectomy. Inclusion criteria were patients older than 18 years with symptomatic IN, having an indication for surgical treatment following at least three months of unsuccessful conservative treatment, and at least 12 months of postoperative follow-up. Patients with concurrent procedures at the time of surgery, multiple affected web spaces, trauma to the affected forefoot, or asymptomatic IN without clear indications for surgical treatment were excluded from the study. Evaluated outcomes included recurrence of symptoms, rate of revision surgery, and postoperative wound infection. Results: Out of the 350 patients screened, 127 fulfilled the inclusion and exclusion criteria. Forty (32%) patients experienced recurrence of symptoms within a 12-month follow-up period with an overall mean time-to-recurrence of 3.96 +/- 3.15 months. Patients who underwent IML release with neurolysis had a significantly higher recurrence rate (48%) and mean time-to-recurrence of 4.61 +/- 3.22 months compared to those who underwent interdigital neurectomy (24%) with a mean time-to-recurrence of 3.47 +/- 3.08 months (P< 0.01). The rate of postoperative wound infection was similar between the two groups. The rate of revision surgery among those with symptom recurrence in the IML release group (16%) and neurectomy group (4%) was not statistically significant between both groups (P=0.49). Conclusion: IML release with neurolysis appears to have a higher risk of symptom recurrence compared to interdigital neurectomy. However, patients who did experience symptom recurrence in either operative group had similar rates of revision surgery, which may be due to mild recurrent symptoms in the IML release group that did not warrant revision surgery in these patients. No patient-specific factors were identified as being associated with symptom recurrence. Future studies should consider objective symptom recurrence severity and patient satisfaction.
Fixed-Bearing vs Mobile-Bearing Total Ankle Replacement Survivorship. A Meta-Analysis
Authors: Alonso Marcos Gonzalez , Cubillas Ana Rosa Trapote , Gonzalez Francisco Jose Madera , Hernandez Oscar Fernandez , Lazaro Jaime Antonio Sanchez 
Published: December 2024

Category: Ankle Arthritis; Ankle Introduction/Purpose: Main objective of this research is to know if there is a different survival ‎rate between fixed bearing (FB) and mobile bearing (MB) total ankle replacement ‎‎(TAR). We hypothesized that there are no differences between the survival rates of ‎both implants.‎ Methods: A systematic search was performed in PubMed, Cochrane, EMBASE and ‎ClinicalTrials.gov databases‎ to identify published studies from August 2018 to ‎September 2022 including results for FB and MB TAR survivorship. Inclusion criteria ‎included 1) primary TAR in one or both feet in which implant could be identified‎, 2) a ‎minimum of 20 procedures reported, 3) reported implant survivorship or calculable ‎and 4) a minimum of 12 months follow-up for level 1-3 studies or 60 months for level ‎‎4 studies.‎ Results: 3902 ankles in 28 studies were included. 719 were FB and 3104 MB with an overall ‎survivorship of 94% (95% CI [0.89; 0.97]) and 89% (95% CI [0.86; 0.92]) respectively. ‎After subgroup analysis, we did not find differences among both groups (p = ‎0.429‎). ‎Meta-regression analysis showed that longer follow-up was associated with lower ‎survival rates in MB group (p = 0.000) while no other relationships were found with ‎other factors (age, level of evidence or conflict of interests).‎ Conclusion: No differences in survival rates between both groups were found. Age and other ‎studied confounders were not found to be related with implant survivorship. ‎However, longer follow-up was found to be related with lower survival rates. Studies ‎with longer follow-up and higher level of evidence are needed to confirm results.‎
Fourth-Generation Metatarsal Extra-Capsular Transverse Akin (META) Osteotomies for Percutaneous Hallux Valgus Correction: A Series of 729 Consecutive Feet
Authors: Lam Peter , Murphy Evelyn , Jia Chua Min , Robinson Peter , Watt Clare , Ray Robbie , Lewis Thomas L. 
Published: December 2024

Category: Bunion; Lesser Toes Introduction/Purpose: Fourth-generation percutaneous or minimally invasive hallux valgus surgery utilises a transverse osteotomy to achieve deformity correction. There are only a small number of series reporting the clinical and radiological outcomes of transverse osteotomies, many of which have methodological limitations such as small sample size, limited radiographic follow up or use of non-validated outcome measures. The aim of this study was to provide a methodological robust investigation into percutaneous transverse osteotomies for hallux valgus deformity. Methods: A prospective case series of consecutive patients undergoing fourth generation metatarsal extra-capsular transverse osteotomy (META) performed by a single surgeon (PL) between November 2017 and January 2023. The primary outcomes were radiographic deformity correction and clinical foot function assessed using the Manchester-Oxford Foot questionnaire (MOXFQ-a validated patient reported outcome measure). Radiographic deformity (Hallux valgus angle (HVA) and 1-2 Intermetatarsal angle(IMA), sesamoid position) was assessed according to AOFAS guidelines. Secondary outcomes included Visual Analogue Scale for Pain and radiographic deformity recurrence (defined as HVA >20° at final radiographic follow up). All p-values < 0.05 were considered significant. Results: 729 feet from 483 patients (456 Female, 27 Male, mean age 57.9±11.9 years) underwent META. Radiographic data (minimum 12 months post-surgery) was available for all feet with mean follow up of 2.6±1.3 years (range 1.0-5.7). There was a statistically significant improvement (p< 0.05) in both HVA; 29.5±8.5° to 7.3±6.7°, and IMA, 12.9±3.4° to 4.6±2.5°. All MOXFQ domains showed significant improvement (p< 0.05); Index 36.6±19.1 to 11.8±13.8, Pain 40.1±22.1 to 15.6±16.4, Walking/Standing 32.2±23.2 to 10.2±15.8 and Social Interaction 40.0±20.6 to 9.7±14.0. The recurrence rate was 4.6% (n=33) with a significantly higher proportion of sesamoids in Grade 2 and 3 in the recurrence group (p< 0.05). There was 1 non-union, 1 deep infection and 20 cases of superficial infection. No avascular necrosis of the first metatarsal head occurred. Conclusion: This is the largest consecutive series of any percutaneous osteotomy technique to correct hallux valgus deformity. This study demonstrates that the technique leads to significant improvement in clinical and radiographic outcomes with a low rate of recurrence. Recurrence may be linked to incomplete sesamoid reduction at the time of surgery.