bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Glucose Monitoring Underreports Blood Glucose During a Simulated Ultraendurance Run in Eumenorrheic Female Runners
Authors: Dole Andrew , Sims Stacy , Gan Han , Gill Nic , Beaven Martyn 
Published: December 2024

Purpose: Continuous-glucose-monitoring (CGM) sensors provide near-real-time glucose data and have been introduced commercially as a tool to inform nutrition decisions. The aim of this pilot study was to explore how factors such as the menstrual phase, extended running duration, and carbohydrates affect CGM outcomes among trained eumenorrheic females in an outdoor simulated ultraendurance running event. Methods: Twelve experienced female ultrarunners (age 39 [6] y) participated in this crossover study. Participants completed an ultraendurance simulation run of 4 hours in the midfollicular and midluteal phases of their menstrual cycle, which consisted of a 3-hour fasted outdoor run (FASTED) followed by a 1-hour treadmill run (TREAD), where 3 standardized 20-g oral glucose doses were provided. Results: Using a mixed linear model, the menstrual phase was statistically significant for differences in glucose measurements from CGM compared with capillary glucose sampling during TREAD (P = .02) but not FASTED. Additionally, the CGM sensor reported glucose levels with an average of −0.43 mmol·L−1 (95% CI, − 0.86 to −0.005) and −1.02 mmol·L−1 (95% CI, −1.63 to −0.42) lower in fasted and fed scenarios, respectively, when compared with capillary glucose. Conclusion: CGM underreports capillary glucose during fasted and fed exercise. Factors contributing to this underreporting between the sampling methods (CGM vs capillary) were dependent on a combination of exogenous glucose availability, individual biological differences, and the menstrual phase.
Resistance Training Versus Interval Training in Female Youth Soccer Players
Authors: Lambright Kelsi R. , Bunn Jennifer A. , Figueroa Yvette , Muñoz Mario 
Published: December 2024

This study compared the effects of resistance and high-intensity interval training on sprinting, agility, and vertical jumping. Participants included 32 female youth soccer players who were randomly assigned to one of two groups: resistance training group (RTG; n = 16, age: 16.25 ± 1.83 years, height: 164.95 ± 4.22 cm, body mass: 57.21 ± 5.28 kg, body mass index: 21.36 ± 1.34 kg/m2) or high-intensity interval training group (HIITG; n = 16, age: 16.06 ± 1.48 years, height: 163.98 ± 7.60 cm, body mass: 57.63 ± 6.51 kg, body mass index: 21.73 ± 1.75 kg/m2). Pre- and posttesting included a 36.5-m sprint, countermovement jump (CMJ), and Illinois agility test. The participants completed an 8-week training regimen for their respective groups, training 3 days/week, for 1 hr per session. No difference was found in the 36.5 m sprint time between groups, but both groups improved sprint time after 8 weeks of training (RTG: −0.18 ± 0.13 s; HIITG: −0.16 ± 0.16 s). CMJ height improved in both groups, but the improvement was greater for the HIITG than RTG (6.39 ± 3.10 cm vs. 1.19 ± 2.71 cm). For the agility times, RTG improved at −0.75 ± 0.89 s, whereas the HIITG improved at –1.76 ± 1.15 s. An 8-week preseason training period resulted in univariate tests with significant time effect in the sprint time (p < .001), CMJ height (p < .001), and Illinois agility test time (p < .001). A Time × Group effect existed in the CMJ height (p < .001) and Illinois agility test time (p = .009).
Quantifying External and Internal Loads of the Average- and High-Intensity Phase Demands of University Female Footballers
Authors: Hearn Andrew N. , Parker John K. , Hicks Kirsty M. , Fernandes John F.T. 
Published: December 2024

The match-play external and internal loads of university female footballers are not well understood. Therefore, the aims of this study were to quantify the average and 5-min high-intensity phase (HIP) match-play loads of university female footballers. With institutional ethical approval granted, 20 trained female footballers (age 20.0 ± 1.3, mass 64.9 ± 12.9 kg) volunteered to take part in the study across six competitive fixtures. Global positioning systems (Catapult) and heart rate monitors (Polar) were used to quantify external and internal loads during match-play. Linear mixed models with fixed and random effects were used to analyze match data and compare between positions. Forty-five and 53 observations were used for the average and HIP loads, respectively. Players covered total distances of 8,160 m, with 456 m covered at high speed and 151 m covered at sprint distance; central defenders completed less high-intensity running than attackers (p < .005). During 5-min HIPs, no differences were observed for accelerations (n) and PlayerLoad (in arbitrary units) between positional groups (p > .05). Attackers covered more high-speed running (p = .005) and sprint distance (p = .019) than central defenders and midfielders (p = .012; p = .017). These data describe average whole match and 5-min HIP external and internal loads of university female footballers. Coaches could use this to inform conditioning practices by exposing attacking players to greater volumes of high-intensity running.
Real-world analysis of acamprosate use in patients with cirrhosis and alcohol-associated hepatitis
Authors: Oldroyd Christopher , Wood Jonathan , Allison Michael 
Published: December 2024

ObjectivePreventing return to alcohol is of critical importance for patients with alcohol-related cirrhosis and/or alcohol-associated hepatitis. Acamprosate is a widely used treatment for alcohol use disorder (AUD). We assessed the impact of acamprosate prescription in patients with advanced liver disease on abstinence rates and clinical outcomes.MethodsThis was a retrospective case–control study. We reviewed data on all patients admitted to a large tertiary centre in the UK with alcohol-related cirrhosis and/or alcohol-associated hepatitis. We used propensity risk score matching to match patients prescribed acamprosate to controls. The primary outcome was repeat hospitalisation.ResultsThere were 451 patients who met the inclusion criteria of whom 55 patients were started on acamprosate during their admission. Before matching there were significant differences between the cohorts. Patients who received acamprosate were younger (median age 51 vs 57, p<0.005), more likely to have a purely alcohol-related admission (53% vs 24%, p<0.001), and more likely to suffer from a comorbid psychiatric diagnosis (42% vs 20%, p<0.001). On average patients who were started on acamprosate consumed more alcohol (median 155 units/week vs 80 units/week, p<0.001), were less likely to have a partner (35% vs 54%, p 0.006) and more likely to be unemployed (67% vs 44%, p<0.001). After matching for factors with significant differences between groups, we generated a cohort of 53 patients prescribed acamprosate and 53 matched controls. At 1 year there was a significantly higher rate of readmission (85% vs 57%, p<0.001) in the acamprosate group. There were no statistically significant differences in abstinence rates or mortality at 1 year.ConclusionAcamprosate prescription was associated with higher rates of readmission in patients with cirrhosis and/or alcohol-associated hepatitis. This may reflect a greater severity of AUD in those patients or might indicate the limited ability of acamprosate to alter the disease course in this population.
Male involvement in antenatal care follow-up and its determinants in Ethiopia: a systematic review and meta-analysis
Authors: Abebe Gossa Fetene , Alie Melsew Setegn , Alelign Zewditu , Negesse Yilkal , Lemu Lidiya Gutema , Girma Desalegn 
Published: December 2024

ObjectiveTo determine the involvement of males in antenatal care (ANC) follow-up and its determinants in Ethiopia.DesignA systematic review and meta-analysis.Data sourcesA systematic search was done on PubMed, African Journals Online, HINARI, ScienceDirect, Google Scholar and direct Google up to 20 November 2023.Eligibility criteriaWe included cross-sectional or case–control studies reporting male involvement in ANC service and its determinants in Ethiopia, which were published as full-length articles in English.Data extraction and synthesisThe Joanna Briggs Institute checklist was used to appraise the included studies, and the I2test was used to evaluate heterogeneity among the studies. We assessed publication bias using a funnel plot and Begg’s test. The forest plot presented the combined proportion of male involvement and OR, along with a 95% CI.ResultsThe pooled proportion of male involvement in ANC follow-up in Ethiopia was 43.3% (95% CI 31.7% to 54.8%). Male partners with secondary education or higher (Adjusted Odds Ratio (AOR) 2.72, 95% CI 1.81 to 4.10), government employment (AOR 2.09, 95% CI 1.49 to 2.94), attendance at health education (AOR 3.02, 95% CI 1.39 to 6.54) and knowledge about ANC or pregnancy danger signs (AOR 2.36, 95% CI 1.33 to 4.19) demonstrated a significant association with increased male involvement.ConclusionMale involvement in ANC in Ethiopia is low. Recommendations include targeted education for males with no formal schooling, improved health education on ANC and pregnancy risks, and interventions for males in the private sector.PROSPERO registration numberCRD42021258826.
Study protocol for Adaptive ChemoTherapy for Ovarian cancer (ACTOv): a multicentre phase II randomised controlled trial to evaluate the efficacy of adaptive therapy (AT) with carboplatin, based on changes in CA125, in patients with relapsed platinum-sensitive high-grade serous or high-grade endometrioid ovarian cancer
Authors: Mukherjee Uma Anne , Hockings Helen , Counsell Nicholas , Patel Apini , Narayanan Priya , Wilkinson Katie , Dhanda Harjot , Robinson Kathy , McNeish Iain , Anderson Alexander R A , Miller Rowan , Gourley Charlie , Graham Trevor , Lockley Michelle 
Published: December 2024

Introduction
Adaptive ChemoTherapy for Ovarian cancer (ACTOv) is a phase II, multicentre, randomised controlled trial, evaluating an adaptive therapy (AT) regimen with carboplatin in women with relapsed, platinum-sensitive high-grade serous or high-grade endometrioid cancer of the ovary, fallopian tube and peritoneum whose disease has progressed at least 6 months after day 1 of the last cycle of platinum-based chemotherapy. AT is a novel, evolutionarily informed approach to cancer treatment, which aims to exploit intratumoral competition between drug-sensitive and drug-resistant tumour subpopulations by modulating drug dose according to a patient’s own response to the last round of treatment. ACTOv is the first clinical trial of AT in this disease setting.

Methods and analysis
80 patients will be randomised 1:1 to standard therapy (control) or AT (investigational) arms. The starting and maximum carboplatin dose in both arms is area under the curve (AUC) ×5 according to absolute nuclear medicine glomerular filtration rate. The AT regimen will modify the carboplatin dose according to changes in the serum biomarker CA125, a proxy measure of total tumour burden. Patients will receive treatment intravenously every 21 days for a maximum of 6 and 12 cycles in the control and investigational arms, respectively. The primary endpoint is modified progression-free survival (investigator-assessed using RECIST 1.1 (Response Evaluation Criteria in Solid Cancers) compared with the baseline prerandomisation scan rather than the radiological nadir), clinical progression or death from any cause. Secondary endpoints will include acceptability, deliverability, compliance, toxicity, CA125, quality of life and overall survival. ACTOv is open to National Health Service hospitals throughout the UK, recruitment is anticipated to take 36 months across 10 sites and will be managed by the Cancer Research UK and University College London Cancer Trials Centre.

Ethics and dissemination
The trial has been reviewed and received approval from the London—Dulwich Research Ethics Committee (REC). Results of the trial will be disseminated through publication in peer-reviewed journals.

Trial registration number

NCT05080556
.
Developing HIV indicators for clinical care quality assessment: relevance and practicality evaluated by healthcare practitioners in South Africa and Democratic Republic of Congo
Authors: Muzumbukilwa Tambwe Willy , Manimani Riziki Gyslain , Vagiri Rajesh Vikram , Nlooto Manimbulu Zephy , Bihehe Masemo Dieudonne , Mushebenge Aganze Gloire Aime 
Published: December 2024

BackgroundThe use of quality indicators in healthcare systems is one of the factors that improve the quality of health services. However, indicators for assessing HIV clinical care in the context of low- and middle-income countries are not fully explored. Some existing indicators were established within the context of developed countries and are primarily defined for community care, with limited emphasis on the hospital setting. Additionally, these indicators often do not account for the local practicality and relevance of quality measures in the context of low- and middle-income countries.AimTo assess the clinical significance and practical applicability of these indicators from the perspective of healthcare professionals specialising in HIV care in South Africa and Democratic Republic of Congo.MethodsAfter performing a systematic review of quality indicators employed in the evaluation of clinical care for individuals with HIV, we conducted an observational, cross-sectional study. In this research, 30 physicians filled out two questionnaires with a core set of indicators, to establish the most pertinent and practically indicators for evaluation of the HIV clinical care. A Likert scale was used to rank the indicators. Kendall’s tau-B rank correlation analysis was also performed.ResultsFrom the initial list of 88 quality indicators, 43 were identified as the most relevant and practical in HIV clinical care. Healthcare professionals deemed the monitoring and therapy domain to be the most pertinent and useful indicators out of the seven different clinical domains, followed by the functional organisational structure domain.ConclusionThis instrument may be a tool for healthcare professionals and hospital administrators to improve the quality of HIV clinical care.
Efficacy of quality improvement interventions on antibiotic prescription practices for ventilator-associated pneumonia at a tertiary care centre: a prospective pre–post interventional study
Authors: Kumar Vijay , Biswas Ratnadeep , Ojha Vishnu Shankar , Kumar Sanjeev , Sarfraz Asim 
Published: December 2024

BackgroundVentilator-associated pneumonia (VAP) is a prevalent nosocomial infection in the intensive care unit (ICU), significantly increasing patient morbidity, mortality, and healthcare costs. Effective management is essential, particularly in the context of antimicrobial resistance and the frequent use of antibiotics in ICUs.MethodsThis prospective pre–post interventional study was conducted in the medical ICU of a tertiary care centre, over 6 months. Adult patients diagnosed with VAP and receiving antibiotics for more than 48 hours were included. The study involved three phases: preintervention (baseline antibiotic prescription audit), intervention (educational sessions, multidisciplinary meetings and tailored feedback) and postintervention (follow-up audit). Data analysis included Kaplan-Meier survival curves and statistical comparisons of ICU stay durations.ResultsIn the preintervention phase, the median treatment duration was 24 days, while the postintervention phase reduced this to 17 days. Kaplan-Meier curves showed improved survival probabilities and shorter ICU stays in the postintervention phase. The mean ICU stay decreased significantly from 24 days preintervention to 11.3 days postintervention (p=0.027). Mortality rates also improved, with 38.5% discharged and 61.5% deaths postintervention, compared with 23.5% discharged and 76.5% deaths preintervention. Antibiotic prescription patterns shifted towards more targeted therapy, adhering better to culture and sensitivity results and reducing the use of broad-spectrum antibiotics and polypharmacy.ConclusionQuality improvement interventions significantly improved VAP management by reducing treatment duration, ICU stay and mortality rates. Educational sessions, multidisciplinary collaboration and tailored feedback enhanced antibiotic prescription practices, highlighting the importance of continuous quality improvement in ICU settings. Further research and sustained efforts in antimicrobial stewardship are essential to combat VAP and improve patient outcomes.
TFAP2Eis implicated in central nervous system, orofacial and maxillofacial anomalies
Authors: Kalanithy Jeshurun C , Mingardo Enrico , Stegmann Jil D , Dhakar Ramgopal , Dakal Tikam Chand , Rosenfeld Jill A , Tan Wen-Hann , Coury Stephanie A , Woerner Audrey C , Sebastian Jessica , Levy Paul A , Fleming Leah R , Waffenschmidt Lea , Lindenberg Tobias T , Yilmaz Öznur , Channab Khadija , Babra Bimaljeet K , Christ Andrea , Eiberger Britta , Hölzel Selina , Vidic Clara , Häberlein Felix , Ishorst Nina , Rodriguez-Gatica Juan E , Pezeshkpoor Behnaz , Kupczyk Patrick A , Vanakker Olivier M , Loddo Sara , Novelli Antonio , Dentici Maria L , Becker Albert , Thiele Holger , Posey Jennifer E , Lupski James R , Hilger Alina C , Reutter Heiko M , Merz Waltraut M , Dworschak Gabriel C , Odermatt Benjamin 
Published: December 2024

BackgroundPrevious studies in mouse,Xenopusand zebrafish embryos show strongtfap2eexpression in progenitor cells of neuronal and neural crest tissues suggesting its involvement in neural crest specification. However, the role of human transcription factor activator protein 2 (TFAP2E)in human embryonic central nervous system (CNS), orofacial and maxillofacial development is unknown.MethodsThrough a collaborative work, exome survey was performed in families with congenital CNS, orofacial and maxillofacial anomalies. Exome variant prioritisation promptedTFAP2Egene for functional analysis in zebrafish embryos. Embryonic morphology and development were assessed after antisense morpholino (MO) knockdown (KD), CRISPR/Cas9 knockout and overexpression oftfap2ein fluorescent zebrafish reporter lines using in vivo microscopy. Computational structural protein modelling of the identified human variants was performed.ResultsIn total, exome survey identified novel or ultra-rare heterozygous missense variants inTFAP2Ein seven individuals from five independent families with predominantly CNS, orofacial and maxillofacial anomalies. One variant was found de novo and another variant segregated in an affected multiplex family. Protein modelling of the identified variants indicated potential distortion of TFAP2E in the transactivation or dimerisation domain. MO KD and CRISPR/Cas9 knockout oftfap2ein zebrafish revealed hydrocephalus and a significant reduction of brain volume, consistent with a microencephaly phenotype. Furthermore, mRNA overexpression ofTFAP2Eindicates dosage-sensitive phenotype expression. In addition, zebrafish showed orofacial and maxillofacial anomalies followingtfap2eKD, recapitulating the human phenotype.ConclusionOur human genetic data and analysis of Tfap2e manipulation in zebrafish indicate a potential role ofTFAP2Ein human CNS, orofacial and maxillofacial anomalies.
Changes in systolic blood pressure during hospitalisation and bleeding events after percutaneous coronary intervention
Authors: Otsuka Yasuhiro , Ishii Masanobu , Ikebe So , Nakamura Taishi , Tsujita Kenichi , Matoba Tetsuya , Kohro Takahide , Oba Yusuke , Kabutoya Tomoyuki , Kario Kazuomi , Imai Yasushi , Kiyosue Arihiro , Mizuno Yoshiko , Nochioka Kotaro , Nakayama Masaharu , Iwai Takamasa , Miyamoto Yoshihiro , Sato Hisahiko , Akashi Naoyuki , Fujita Hideo , Nagai Ryozo 
Published: December 2024

BackgroundHypertension is a risk factor for bleeding events and is included in the HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/Alcohol concomitantly)score. However, the effects of blood pressure (BP) and changes in BP on bleeding events in patients undergoing percutaneous coronary intervention (PCI) remain poorly understood. This study is aimed to investigate the relationship between systolic BP (SBP) changes during hospitalisation and bleeding events in patients undergoing PCI.MethodsFrom the Clinical Deep Data Accumulation System database, a multicentre database encompassing seven tertiary medical hospitals in Japan that includes data for patient characteristics, medications, laboratory tests, physiological tests, cardiac catheterisation and PCI treatment, data for 6351 patients undergoing PCI between April 2013 and March 2019 were obtained. The study population was categorised into three groups based on the changes in SBP during hospitalisation: (1) elevated BP (≥20 mm Hg), (2) no change (≥−20 to <20 mm Hg) and (3) decreased BP (<−20 mm Hg) groups. The primary outcome was a 3-year major bleeding event defined as moderate or severe bleeding according to the Global Use of Streptokinase and t-PA for Occluded Coronary Arteries bleeding criteria.ResultsThe elevated BP group exhibited significantly lower SBP at admission and higher SBP at discharge (p<0.001). Multivariable Cox hazard regression models showed that elevated BP was associated with a high risk of bleeding events (HR: 1.885; 95% CI, 1.294 to 2.748). The multivariable logistic regression model identified female sex, chronic coronary syndrome, peripheral artery disease and chronic kidney disease as independent factors associated with elevated BP.ConclusionsThese findings suggest that BP management is essential to prevent bleeding events after PCI.
Different disease activity trajectories in early axial spondyloarthritis lead to significantly different long-term outcomes: a trajectory-based analysis of the DESIR cohort over 10 years
Authors: Portier Elodie , Benattar Leslie , Resche-Rigon Matthieu , Dougados Maxime , Gossec Laure , Molto Anna 
Published: December 2024

IntroductionThe study aimed to identify and describe disease activity trajectories over 10 years in patients with recent-onset axial spondyloarthritis (axSpA) and determine their impact on long-term outcomes.MethodsThis prospective, multicentre study (Devenir des Spondylarthropathies Indifférenciées Récentes cohort, ClinicalTrials.gov NCT) followed patients with early axSpA for 10 years. Only patients with at least three Axial Spondylitis Disease Activity Score (ASDAS) values were included. Long-term outcomes assessed were TNF inhibitors (TNFi) exposure, structural progression, function (Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index), quality of life (36-items Short Form Survey), sick leave days and cardiovascular (CV) events. ASDAS trajectories were identified using k-means clustering. Multinomial multivariable regression estimated associations between baseline characteristics and trajectories. Long-term outcomes for each trajectory were described.ResultsAmong 601 patients, five ASDAS trajectories were identified: persistent low disease activity/remission (tA), clinically important improvement (tD) and persistent moderate (tB), high (tC) or very high (tE) disease activity. Patients in tA were more likely to be male, have a university degree, have white-collar jobs, have positive HLA B27 status and have less fibromyalgia. Trajectory tE was linked to poorer function (BASFI 50/100 vs 7/100 for lower ASDAS trajectory), higher TNFi exposure (74% vs 29%) and more CV events (5.7% vs 0). Structural progression was low but comparable across trajectories, except for higher sacroiliac joint progression in tB.ConclusionThe k-means method revealed distinct disease activity trajectories in axSpA. Higher disease activity trajectories were associated with a higher prevalence of fibromyalgia and poorer outcomes, except for structural progression, which was comparable across trajectories.