bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-centric decision-making in supplements intake and disclosure in clinical practice: a novel SIDP-12 tool to prevent drug–supplement interaction
Authors: Ait Gacem Sabrina , Huri Hasniza Zaman , Wahab Izyan A. , Abduelkarem Abduelmula R. 
Published: October 2024

Background: Self-treatment of dietary supplements may contribute to interactions and severe side effects. Limited studies have constructed a scale that can measure the disclosure practice of supplements to healthcare providers and the influencing factors. Objective: The study aims to investigate the supplement disclosure practice among the public in the UAE using a developed and validated supplement disclosure assessment scale tool. Design: A cross-sectional survey study that targeted those residing in the United Arab Emirates (UAE) aged 18 years and above from both genders through an online survey. Methods: A novel scale tool was developed and examined for its validity and reliability through three pilot studies. Results: The study included three validity and reliability pilot studies before the main study evaluation: pilot 1 ( n = 104), pilot 2 ( n = 101), pilot 3 ( n = 37), and study data ( n = 407). A total of 407 respondents provided feedback from which 137 stated that they consumed supplements. A significant indirect effect of healthcare provider initiation of enquiry (HPE) on patient-informing practice (PI) was observed through two mediating variables, patient’s beliefs (PB) and pharmacist counseling regarding supplements interactions (PC) ( B = 0.106, t = 2.120, p = 0.03 and B = 0.077, t = 2.011, p = 0.04, respectively). Most respondents were not asked about their supplement consumption by the hospital and community pharmacists (52.94 and 50.74, respectively). Most respondents (54.89%) stated that pharmacists did not counsel them about any possible interaction of supplements with laboratory tests. The mean construct scores were 1.096 for PI, 2.618 for PC, 1.552 for HPE, and 1.412 for PB. Conclusion: The instrument demonstrates desirable validity and reliability. The study results revealed a direct effect of PB and PC on the supplement disclosure practice. HPE indirectly affected PI through two mediating variables: PB and PC. The results showed a moderate HPE and PC and an excellent PB and PI construct.
Impact of an antibiotic stewardship program on adherence to antibiotic prescription in children admitted with urinary tract infection
Authors: Brigadoi Giulia , Liberati Cecilia , Gres Emelyne , Barbieri Elisa , Boreggio Elena , Rossin Sara , Tirelli Francesca , Tesser Francesca , Chiusaroli Lorenzo , Demarin Giulia Camilla , Maestri Linda , Giaquinto Carlo , Da Dalt Liviana , Bressan Silvia , Donà Daniele 
Published: October 2024

Background: Urinary tract infections (UTIs) are the most common bacterial infections in children. The high variability in pathogen susceptibility rates leads to the lack of clear guidelines for empiric and targeted therapies. In this view, local microbiological surveillance and locally adapted stewardship interventions need to be implemented. Objective: The study aims to describe the results of a pediatric antimicrobial stewardship program on antibiotic prescriptions for UTIs over 8 years in a pediatric general ward of a tertiary center. Design: This quasi-experimental study was conducted between 2015 and 2022, with two different implementations, one in 2018 and one in 2021. Methods: Demographic, clinical, microbiological, and therapeutic data were retrieved from the electronic clinical records of included patients. The primary outcomes were adherence to local guidelines for empiric therapies and the adequacy of targeted therapy. Secondary outcomes were evaluating antibiotic prescription patterns stratified by antibiotics during hospital stay and at discharge, and assessing the microbiological characteristics of UTI episodes. Results: During the study period, 7038 patients were admitted to the pediatric acute care unit (PACU), and 264 (3.7%) were included in this study. Adherence to local guidelines was highest immediately after the interventions, and it slightly decreased thereafter. Use of cephalosporins remained high throughout the 8 years but the changing microbiological scenario observed led to changing recommendations within the study period. An increase in E. coli strains resistant to co-amoxiclav was observed in the last years. Oral second-line agent consumption remained high but was adequate considering the prevalence of resistant bacteria. Conclusion: The variability of antimicrobial consumption reflects the changing resistance patterns for UTIs pathogens, underlying the importance of locally adapted, persevering antimicrobial stewardship interventions.
Exploring the characteristics of conversational agents in chronic disease management interventions: A scoping review
Authors: Uetova Ekaterina , Hederman Lucy , Ross Robert , O’Sullivan Dympna 
Published: October 2024

ObjectiveWith the increasing global burden of chronic diseases, there is the potential for conversational agents (CAs) to assist people in actively managing their conditions. This paper reviews different types of CAs used for chronic condition management, delving into their characteristics and the chosen study designs. This paper also discusses the potential of these CAs to enhance the health and well-being of people with chronic conditions.MethodsA search was performed in February 2023 on PubMed, ACM Digital Library, Scopus, and IEEE Xplore. Studies were included if they focused on chronic disease management or prevention and if systems were evaluated on target user groups.ResultsThe 42 selected studies explored diverse types of CAs across 11 health conditions. Personalization varied, with 25 CAs not adapting message content, while others incorporated user characteristics and real-time context. Only 12 studies used medical records in conjunction with CAs for conditions like diabetes, mental health, cardiovascular issues, and cancer. Despite measurement method variations, the studies predominantly emphasized improved health outcomes and positive user attitudes toward CAs.ConclusionsThe results underscore the need for CAs to adapt to evolving patient needs, customize interventions, and incorporate human support and medical records for more effective care. It also highlights the potential of CAs to play a more active role in helping individuals manage their conditions and notes the value of linguistic data generated during user interactions. The analysis acknowledges its limitations and encourages further research into the use and potential of CAs in disease-specific contexts.
Endovascular therapy in patients with acute intracranial non-terminal internal carotid artery occlusion (ICA-I)
Authors: Riegler Christoph , von Rennenberg Regina , Bollweg Kerstin , Siebert Eberhard , de Marchis Gian Marco , Kägi Georg , Mordasini Pasquale , Heldner Mirjam R , Magoni Mauro , Pezzini Alessandro , Salerno Alexander , Michel Patrik , Globas Christoph , Wegener Susanne , Martinez-Majander Nicolas , Curtze Sami , Dell’Acqua Maria Luisa , Bigliardi Guido , Wali Nabila , Nederkoorn Paul J , Jovanovic Dejana R , Padjen Visnja , Metanis Issa , Leker Ronen R. , Bianco Giovanni , Cereda Carlo W , Pascarella Rosario , Zedde Marialuisa , Viola Maria Maddalena , Zini Andrea , Ramos João Nuno , Marto João Pedro , Audebert Heinrich J , Trüssel Simon , Gensicke Henrik , Engelter Stefan T , Nolte Christian H 
Published: October 2024

Background: Acute intracranial occlusion of the internal carotid artery (ICA) can be distinguished into (a) occlusion of the terminal ICA, involving the proximal segments of the middle or anterior cerebral artery (ICA-L/-T) and (b) non-terminal intracranial occlusions of the ICA with patent circle of Willis (ICA-I). While patients with ICA-L/-T occlusion were included in all randomized controlled trials on endovascular therapy (EVT) in anterior large vessel occlusion, data on EVT in ICA-I occlusion is scarce. We thus aimed to evaluate effectiveness and safety of EVT in ICA-I occlusions in comparison to ICA-L/-T occlusions. Methods: A large international multicentre cohort was searched for patients with intracranial ICA occlusion treated with EVT between 2014 and 2023. Patients were stratified by ICA occlusion pattern, differentiating ICA-I and ICA-L/-T occlusions. Baseline factors, technical (modified thrombolysis in cerebral infarction (mTICI) scale) and functional outcomes (modified Rankin scale [mRS] at 3 months) as well as rates of (symptomatic) intracranial hemorrhage ([s]ICH) were analyzed. Results: Of 13,453 patients, 1825 (13.6%) had isolated ICA occlusion. ICA-occlusion pattern was ICA-I in 559 (4.2%) and ICA-L/-T in 1266 (9.4%) patients. Age (years: 74 vs 73), sex (female: 45.8% vs 49.0%) and pre-stroke functional independency (pre-mRS ⩽ 2: 89.9% vs 92.2%) did not differ between the groups. Stroke severity was lower in ICA-I patients (NIHSS at admission: 14 [7–19] vs 17 [13–21] points). EVT was similarly successful with respect to technical (mTICI2b/3: 76.1% (ICA-I) vs 76.6% (ICA-L/-T); aOR 1.01 [0.76–1.35]) and functional outcome (mRS ordinal shift cOR 1.01 [0.83–1.23] in adjusted analyses. Rates of ICH (18.9% vs 34.5%; aOR 0.47 [0.36–0.62] and sICH (4.7% vs 7.3%; aOR 0.58 [0.35–0.97] were lower in ICA-I patients. Conclusion: EVT might be performed safely and similarly successful in patients with ICA-I occlusions as in patients with ICA-L/-T occlusions.
Outcomes of different anesthesia techniques in nonagenarians treated with mechanical thrombectomy for anterior circulation large vessel occlusion: An inverse probability weighting analysis
Authors: Levee Viva , Valente Mariarosaria , Bax Francesco , Zhang Liqun , Sacco Simona , Foschi Matteo , Ornello Raffaele , Chulack Katherine , Marchong Emma , Sheikh Fahad , Fayez Feras , Del Regno Caterina , Aggour Mohammed , Sponza Massimo , Toraldo Francesco , Algazlan Razan , Lobotesis Kyriakos , Bagatto Daniele , Mansoor Nina , Kalladka Dheeraj , Gavrilovic Vladimir , Deana Cristian , Bassi Flavio , Stewart Berry , Gigli Gian Luigi , Banerjee Soma , Merlino Giovanni , D’Anna Lucio 
Published: October 2024

Introduction: There is a lack of evidence for the optimal type of anesthesia technique in patients ⩾ 90 years with acute ischemic stroke undergoing mechanical thrombectomy (MT) as this subgroup of patients was often excluded or under-represented in previous trials. We aimed to compare outcomes between general anesthesia (GA) and non-GA techniques in patients ⩾ 90 years with large vessel occlusion (LVO) undergoing MT. Patients and methods: Our study included patients ⩾ 90 years with anterior circulation LVO, NIHSS ⩾ 6, ASPECTS ⩾ 5 consecutively treated with MT within 6 h after stroke onset in three thrombectomy capable centers between January 1st, 2016 and March 30th, 2023. Inverse probability weighting (IPW) was used to reduce bias by indication of the anesthesia type on study outcomes. We used a weighted ordinal robust logistic regression analysis to explore the primary outcome of modified Rankin Scale (mRS) shift at 90 days in GA versus non-GA treated patients. Secondary outcomes included 90-day mortality, symptomatic intracranial hemorrhage (sICH) and TICI score of 2b, 2c, or 3. Results We included 139 patients ⩾ 90 years treated with MT, 62 were in GA group and 77 in non-GA group. There was a significant shift for worse mRS scores at 90-day in non-GA treated patients (cOR 3.65, 95% CI 1.77–7.77, p = 0.001). The weighted logistic regression showed that non-GA technique was an independent predictor of 90-day mortality (OR 7.49, 95% CI 2.00–28.09; p = 0.003). Conclusion: Our study indicated that nonagenarians with acute ischemic stroke treated with MT without GA have a worse prognosis than their counterparts undergoing MT with GA. Further studies in larger cohorts are warranted to evaluate the optimal type of anesthesia in this patient population.
Comparing the properties of traditional and novel approaches to the modified Rankin scale: Systematic review and meta-analysis
Authors: Tvrda Lucie , Mavromati Kalliopi , Taylor-Rowan Martin , Quinn Terence J 
Published: October 2024

Introduction: The Modified Rankin Scale (mRS) is the most commonly used functional measure in stroke research but is limited by inter-rater reliability (IRR). Various interventions to improve mRS application have been described. We aimed to compare properties of differing approaches to mRS assessment. Patients and methods: Multidisciplinary databases (MEDLINE, EMBASE, Health and Psychosocial Instruments [OVID], CINAHL, PsycINFO [EBSCO]) were searched for adult human stroke studies describing psychometric properties of mRS. Two researchers independently screened 20% titles and abstracts, reviewed all full studies, extracted data, and conducted risk of bias (ROB) analysis. Primary outcomes for random-effects meta-analysis were IRR measured by kappa (K) and weighted kappa (KW). Validity and inter-modality reliability measures (Spearman’s rho, KW) were also summarised. Results: From 897 titles, 46 studies were eligible, including twelve differing approaches to mRS, 8608 participants. There was high ROB in 14 (30.4%) studies. Overall, reliability was substantial ( n = 29 studies, K = 0.65, 95% CI: 0.58–0.71) but IRR was higher for novel approaches to mRS, for example, the Rankin Focussed Assessment ( n = 2 studies, K = 0.94, 95% CI: 0.90–0.98) than standard mRS ( n = 13 studies, K = 0.55, 95%CI:0.46–0.64). Reliability improved following the introduction of mRS training ( K = 0.56, 95% CI: 0.44–0.67; vs K = 0.69, 95% CI: 0.62–0.77). Validity ranged from poor to excellent, with an excellent overall concurrent validity of novel scales ( n = 6 studies, KW = 0.86, 95% CI: 0.75–0.97). The agreement between face-to-face and telephone administration was substantial ( n = 5 studies, KW = 0.80, 95% CI: 0.74–0.87). Discussion: The mRS is a valid measure of function but IRR remains an issue. The present findings are limited by a high ROB and possible publication bias. Conclusion: Interventions to improve mRS reliability (training, structured interview, adjudication) seem to be beneficial, but single interventions do not completely remove reliability concerns.
Reliability of ABC/2 volumetric estimation in spontaneous intracerebral hemorrhage for hematoma expansion prediction scores
Authors: Tanioka Satoru , Aydin Orhun Utku , Hilbert Adam , Kitano Yotaro , Ishida Fujimaro , Tsuda Kazuhiko , Araki Tomohiro , Nakatsuka Yoshinari , Yago Tetsushi , Kishimoto Tomoyuki , Ikezawa Munenari , Suzuki Hidenori , Frey Dietmar 
Published: October 2024

Introduction: Prediction scores for hematoma expansion in spontaneous intracerebral hemorrhage (ICH), such as the 9-point and BRAIN scores, were developed predominantly using planimetry to measure hematoma volume. In this study, we aim to investigate whether the ABC/2 formula, which is known to overestimate hematoma volume, can be reliably used as a substitute for planimetry in these prediction scores. Patients and methods: A total of 429 patients from four hospitals were retrospectively enrolled. CT scan and clinical data at admission and follow-up CT scan were collected. The 9-point and BRAIN scores were calculated using hematoma volume from ABC/2 and planimetry. Hematoma expansion was assessed using hematoma volume from planimetry. Results: The median hematoma volume measured by ABC/2 was 11.97 ml (interquartile range [IQR], 4.8–30.0), whereas the volume measured by planimetry was 11.70 ml (IQR, 4.9–26.6). The median measurement error between ABC/2 and planimetry was 0.30 ml (IQR, −0.72–2.87). ABC/2 overestimated hematoma volume in 244 patients (56.9%) compared to planimetry. In the 9-point score, the area under the curves (AUCs) for predicting hematoma expansion were 0.735 (95% confidence interval [CI], 0.675–0.796) with ABC/2 and 0.732 (95% CI, 0.672–0.793) with planimetry. In the BRAIN score, the AUCs were 0.753 (95% CI, 0.693–0.813) with ABC/2 and 0.745 (95% CI, 0.688–0.803) with planimetry. Discussion and conclusion: The 9-point and BRAIN scores using hematoma volume measured by ABC/2 and planimetry showed good performance in predicting hematoma expansion in ICH. ABC/2 volumetric estimation proved to be reliable for these scores.
Initial blood pressure and adverse cardiac events following acute ischaemic stroke: An individual patient data pooled analysis from the VISTA database
Authors: Ishiguchi Hironori , Huang Bi , El-Bouri Wahbi K. , Dawson Jesse , Lip Gregory Y. H. , Abdul-Rahim Azmil H. , Lees (Chair) K.R. , Alexandrov A. , Bath P.M. , Bluhmki E. , Bornstein N. , Chen C. , Claesson L. , Curram J. , Davis S.M. , Diener H-C. , Donnan G. , Fisher M. , Ginsberg M. , Gregson B. , Grotta J. , Hacke W. , Hennerici M.G. , Hommel M. , Kaste M. , Lyden P. , Marler J. , Muir K. , Roffe C. , Sacco R. , Shuaib A . , Teal P. , Venketasubramanian N. , Wahlgren N.G. , Warach S. 
Published: October 2024

Background: Adverse cardiac events following ischaemic stroke (stroke-heart syndrome, SHS) pose a clinical challenge. We investigated the association between initial blood pressure at stroke presentation and the risk of SHS. Methods: We utilised data from the Virtual International Stroke Trials Archive (VISTA). We defined SHS as the incidence of cardiac complications within 30 days post-ischaemic stroke. These presentations included acute coronary syndrome encompassing myocardial injury, heart failure/left ventricular dysfunction, atrial fibrillation/flutter, other arrhythmia/electrocardiogram abnormalities, and cardiorespiratory arrest. Using Cox proportional hazards models, we assessed the risk trajectories for developing SHS and its presentations associated with initial blood pressure. We also explored the risk trajectories for 90-day mortality related to initial blood pressure. Results: From 16,095 patients with acute ischaemic stroke, 14,965 (mean age 69 ± 12 years; 55% male) were analysed. Of these, 1774 (11.8%) developed SHS. The risk of SHS and initial blood pressure showed a U-shaped relationship. The lowest blood pressures (⩽130 mmHg systolic and ⩽55 mmHg diastolic) were associated with the highest risks (adjusted hazard ratio [95%confidence interval]: 1.40 [1.21–1.63]; p < 0.001, 1.71 [1.39–2.10]; p < 0.001, respectively, compared to referential blood pressure range). Cardiorespiratory arrest posed the greatest risk at higher blood pressure levels (2.34 [1.16–4.73]; p = 0.017 for systolic blood pressure >190 mmHg), whereas other presentations exhibited the highest risk at lower pressures. The 90-day mortality risk also followed a U-shaped distribution, with greater risks observed at high blood pressure thresholds. Conclusions: There is a U-shaped relationship between initial blood pressure at ischaemic stroke presentation and the risk of subsequent SHS.
Genetic and clinical spectrum of SAMD9 and SAMD9L syndromes: from variant interpretation to patient management
Authors: Sahoo Sushree S. , Erlacher Miriam , Wlodarski Marcin W. 
Published: October 2024

Abstract
Sterile alpha motif domain–containing protein 9 (SAMD9) and SAMD9-like (SAMD9L) are paralogous genes encoding antiviral proteins that negatively regulate cell proliferation. Heterozygous germ line gain-of-function (GoF) SAMD9/9L variants cause multisystem syndromes with variable manifestations. The unifying features are cytopenia, immunodeficiency, infections, bone marrow failure, myelodysplasia, and monosomy 7. Nonhematopoietic presentations can affect almost every organ system. Growth impairment and adrenal insufficiency are typical in SAMD9, whereas progressive neurologic deficits characterize SAMD9L. Most patients (&gt;90%) carry germ line missense GoF variants. A subgroup of patients presenting with SAMD9L-associated inflammatory disease carry frameshift-truncating variants that are also GoF. Somatic genetic rescue occurs in two-third of patients or more and involves monosomy 7, which may spontaneously disappear (transient monosomy 7) or progress to myelodysplastic syndrome (MDS)/leukemia, and adaptive clones with somatic SAMD9/9L compensatory mutations or uniparental disomy 7q (UPD7q), both associated with remission. This manuscript examines the clinical and genetic spectrum, therapies, and outcome based on 243 published patients compiled in our registry, with additional genetic information on 62 unpublished cases. We consolidate the diverse clinical manifestations and diagnostic challenges of SAMD9/9L syndromes to enhance recognition and improve patient care. We highlight the knowledge gaps in pathomechanisms and emphasize the importance of genetic surveillance assessing disease remission vs disease progression. Insights are provided into variant curation and the necessity of testing for somatic SAMD9/9L mutations and UPD7q. Multidisciplinary care in specialized centers is critical to manage these complex disorders. Future natural history studies, especially in patients with monosomy 7, will help formulate evidence-based surveillance protocols and optimize transplant timing and outcomes.
Physiological phenotyping of transpiration response to vapour pressure deficit in wheat
Authors: Moritz Anna , Eckert Andreas , Vukasovic Stjepan , Snowdon Rod , Stahl Andreas 
Published: October 2024

Abstract
Background
Precision phenotyping of short-term transpiration response to environmental conditions and transpiration patterns throughout wheat development enables a better understanding of specific trait compositions that lead to improved transpiration efficiency. Transpiration and related traits were evaluated in a set of 79 winter wheat lines using the custom-built “DroughtSpotter XXL” facility. The 120 l plant growth containers implemented in this phenotyping platform enable gravimetric quantification of water use in real-time under semi-controlled, yet field-like conditions across the entire crop life cycle.

Results
The resulting high-resolution data enabled identification of significant developmental stage-specific variation for genotype rankings in transpiration efficiency. In addition, for all examined genotypes we identified the genotype-specific breakpoint in transpiration in response to increasing vapour pressure deficit, with breakpoints ranging between 2.75 and 4.1 kPa.

Conclusion
Continuous monitoring of transpiration efficiency and diurnal transpiration patterns enables identification of hidden, heritable genotypic variation for transpiration traits relevant for wheat under drought stress. Since the unique experimental setup mimics field-like growth conditions, the results of this study have good transferability to field conditions.