bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of albendazole alone versus albendazole in combination with ivermectin for the treatment of Trichuris trichiura infections: An open-label, randomized controlled superiority trial in south-western Uganda
Authors: Palmeirim Marta Sólveig , Hürlimann Eveline , Beinamaryo Prudence , Kyarisiima Hilda , Nabatte Betty , Hattendorf Jan , Steinmann Peter , Keiser Jennifer 
Published: November 2024

Trichuris trichiura, a soil-transmitted helminth (STH), often persists after a single dose of anthelminthic treatment. To overcome limited efficacy against T. trichiura of benzimidazoles (albendazole or mebendazole), the primary drugs used in mass drug administration (MDA) campaigns, the World Health Organization endorses the use of a combination of ivermectin and albendazole as a more effective treatment to be used for preventive chemotherapy. Given observed considerable differences in efficacy of the combination therapy over albendazole monotherapy between different settings, it is necessary to evaluate the performance of the combination before introducing it on a larger scale. This open-label, randomized controlled superiority trial in two Ugandan primary schools enrolled eligible 6- to 12-year-olds positive for T. trichiura. Participants were randomized 1:1 to receive either a single dose of albendazole alone or co-administered albendazole and ivermectin. Adverse events were monitored at three and 24h post-treatment. Follow-up samples were collected 14 to 21 days post-treatment for efficacy assessment. The combination of albendazole with ivermectin showed superior efficacy against T. trichiura compared to albendazole alone, both in terms of cure rates (31.3% versus 12.3%, difference 18.9%-points, 95% CI 6.2–31.2, p < 0.004) and in terms of egg reduction rates (ERRs; 91.4% versus 52.7%). A higher cure rate against co-infecting Ascaris lumbricoides was observed in the combination compared to the albendazole monotherapy arm (100% versus 83.9%). Both therapies showed an excellent safety profile with few and only mild and transient treatment emergent adverse events observed in the albendazole monotherapy and albendazole plus ivermectin arm (total of 22 and 19 events, respectively). In conclusion, the efficacy of the combination therapy against T. trichiura in Uganda is superior to that of albendazole alone. Given the high ERRs observed, albendazole-ivermectin might aid in eliminating morbidity, an important target of STH control programs.
Trial registration (clinicaltrials.gov): NCT06037876.
Gender diverse people’s psychological wellbeing and identity in the context of gender affirming speech pathology practice: A qualitative study protocol
Authors: Tanase Julia , Quinn Sterling , Corsten Sabine , Hansen Hilke , Oates Jennifer 
Published: November 2024

Background
Gender diverse people may experience discomfort with the sound of their voice. Additionally, their psychological wellbeing, closely connected to a person’s identity, or perspective of themselves, is often reduced. A primary goal of gender affirming healthcare is to support clients’ psychological wellbeing. Speech pathology practices assist clients to alter their voice to develop authentic self-presentation. These practices have been shown to have positive outcomes related to clients’ voices but have not yet been shown to improve overall client psychological wellbeing. Assisting gender diverse people to transform a negative identity perspective into a positive one could have a beneficial impact on their psychological wellbeing. Therefore, to support clients’ psychological wellbeing, gender affirming speech pathology care could benefit from focusing on gender diverse clients’ identity more broadly, i.e., beyond gender. For this type of care, speech pathologists would need to see themselves as responsible for supporting client psychological wellbeing and identity. However, some clinicians may be hesitant to incorporate more holistic approaches to provide such care. This study aims to explore gender diverse speech pathology clients’ views on psychological wellbeing and identity and speech pathologists’ perspectives and actions in supporting clients in that regard.

Methods
This qualitative study approaches the research topic through insights from gender diverse people’s and speech pathologists’ subjective perspectives and experiences on psychological wellbeing and identity. Gender diverse people will participate in one-on-one episodic interviews, whereas speech pathologists providing gender affirming care will participate in focus group discussions. Data will be analysed with reflexive thematic analysis. The study is supported by collaborators from the gender diverse community. Study findings will be disseminated in an accessible manner to healthcare professionals providing gender affirming care, mainly speech pathologists, and to the gender diverse community.

Implications
Study findings are anticipated to contribute to further understanding gender diverse people’s psychological wellbeing and identity in a gender affirming speech pathology context to tailor practices to the unique needs of gender diverse clients.
The impact of culturally-informed messages to reduce sugar-sweetened beverage consumption: An experiment among Black women in the United States
Authors: Vereen Rhyan N. , Hall Marissa G. , Dillman Carpentier Francesca , Goode Rachel W. , Noar Seth M. , Lazard Allison J. 
Published: November 2024

Objective
Sugar-sweetened beverage (i.e., sugary drink) consumption is associated with chronic health issues that disproportionately affect Black women. Culturally-informed (CI) health campaigns may be more effective among Black women than campaigns designed for general audiences. This study assesses the effects of a CI campaign on consumption intentions, comparing these effects to general audience and control campaigns.

Methods
We conducted an online between-persons randomized experiment with a national convenience sample of 502 Black women in February 2023. Participants were randomly assigned to view a CI, general audience, or control campaign. Outcomes were intentions to decrease sugary drink consumption (primary outcome; range 1–7), knowledge of (range 0–4) and perceived susceptibility to health harms (range 1–5) and sharing intentions (range 0–3).

Results
The CI campaign had significantly higher perceived cultural relevance (M = 4.61) than the general audience (M = 3.64) or control (M = 3.66; p’s<0.05) campaigns. Consumption intentions did not differ by campaign condition (F = 0.03, p>0.05). There was no main effect of campaign condition on knowledge or perceived susceptibility (p’s>0.05), though findings were moderated by body size. Based on body size, women reported less perceived susceptibility or knowledge when exposed to the CI campaign, compared to either the control or general audience campaign. Sharing intentions did not differ by campaign condition.

Conclusions
Future research should continue to examine the role of refining message content over a longer duration to understand whether the anticipated impact of CI messages can be achieved in the context of sugary drink consumption among Black women.
Exploring strategies for management of in-hospital stroke in Sweden: A qualitative study
Authors: Ben-Shabat Ilan , Lindvall Kristina , Salzer Jonatan 
Published: November 2024

Background
Patients with in-hospital stroke (IHS) are discovered and treated with delays compared to community-onset stroke. This qualitative study explores current routines and clinical practices for IHS in Sweden, aiming to uncover factors influencing management and propose areas for future research and development.

Methods
Six physicians in charge of stroke alerts at Swedish hospitals were individually interviewed in video calls. Informants were selected from The Swedish Stroke Register, based on the hospital-specific median processing time for delivering thrombolysis or thrombectomy to IHS patients, stratified by hospital size. Transcribed interviews were analysed using reflexive thematic analysis.

Results
Three main themes were developed. The first emphasized the crucial step of discovering IHS and outlined possible workflow pathways, including defining the “key player” with stroke expertise and mandate to proceed with the stroke alert to immediate radiology. Subsequent themes addressed obstacles to optimal practice and suggested clear guidelines for contacting the "key player” to reduce delays, as well as offering IHS education to hospital staff.

Conclusions
This study identified differences in workflows for IHS management across the six included sites. A "key player" emerged as a common denominator, who was called as the initiation of the stroke alert and had mandate to proceed with the alert to immediate radiology. Clear guidelines for contacting the “key player” and increased education about IHS were suggested as possible ways to mitigate delays to activate the stroke alert.
Dynamic changes of lung sRAGE in mice with chronic obstructive pulmonary disease induced by cigarette smoke exposure
Authors: He Yue , Liang Hongyu , Yang Xiaohui , Hao Fengyun , Huang Kai , Wang Qiang 
Published: November 2024

Objective
To study the changes of lung function, pathophysiology, inflammatory cytokines and related inflammatory responses in COPD mouse model, and to analyze the role of sRAGE in the pathogenesis of COPD induced by cigarette smoke (CS) exposure in mice.

Methods
24 healthy male C57BL/6J mice aged 6 to 8 weeks were randomly divided into Smoke-Exposed (SE) group and Control group. The mice in SE group were exposed to 7 time points at 3, 7, 15, 30, 60, 90 and 120 days, while mice in control group were exposed to fresh room air, with 3 mice in each group. Lung function of mice was detected at different exposure time points, and the lung tissue sections were stained with HE to observe the lung histopathological changes of mice in each group, and the lung tissue morphological quantitative analysis was performed to evaluate the degree of emphysema. The content of inflammatory cytokines including IL-1β, IL-6 and TNF-α in the supernatant of BALF was detected by ELISA to evaluate the pulmonary inflammation of mice. The expression of sRAGE in BALF supernatant was detected by ELISA. BALF cell precipitates were classified and counted under light microscope.

Results
After 90 days of exposure to cigarette smoke, the lung function of mice was significantly reduced, emphysema appeared significantly, and the expression of inflammatory cells and inflammatory cytokines in BALF was significantly increased (all P<0.05). sRAGE increased significantly in the early stage of CS exposure (7–15 days) compared with the control group, and the number of macrophages and levels of inflammatory cytokines in BALF also increased temporarily (P<0.05). With the gradual exposure of CS, sRAGE expression gradually decreased, and was significantly reduced after COPD formation compared with the control group.

Conclusion
In the process of the occurrence and development of chronic obstructive pulmonary disease induced by cigarette smoke exposure, the level of sRAGE in bronchoalveolar lavage fluid showed a dynamic change of first increase and then decrease. The expression of sRAGE increased in the early stage of smoke exposure and played a transient pro-inflammatory role. With long-term exposure to cigarette smoke, the inflammatory response is gradually aggravated in lung, and the expression of sRAGE is significantly decreased, and its reduction degree is closely related to the degree of reduced lung function and inflammation.
Study protocol: The effect of a Medication Coordinator on the quality of patients’ medication treatment (MEDCOOR)—Randomized controlled trial
Authors: Schlünsen Maja , Graabæk Trine , Pedersen Andreas Kristian , Kampmann Jan Dominik , Kjeldsen Lene Juel 
Published: November 2024

Patients’ safety can be compromised in the transition of care between healthcare sectors. Optimal information flow across healthcare sectors and individualized medication treatment tailored to each patient is vital to prevent adverse events like drug-related problems. When medication changes are made during hospitalization, it is essential to ensure that the relevant general practitioner (GP) is included in the communication chain. This randomized controlled trial examines the effect of a Medication Coordinator who facilitates medication reviews in close collaboration with patients using My Medication Plan. Patients in the intervention group receive the medication review in combination with including suggested medication amendments documented in their electronic discharge letter send, which is sent to their GP. The patients randomized to the control group receive standard care by the ward staff. Seventy patients from the Endocrinology and Nephrology Unit at the Hospital Sønderjylland will be included in the intervention and control groups, respectively. The primary outcome is the proportion of potentially inappropriate medications. Secondary outcomes include patient-reported outcomes, i.e., quality of life and medication burden. Additional outcomes include the patient’s medication risk score, whether the patient is readmitted, and whether the patient has contacted the staff at the hospital unit after the hospital discharge. The framework for complex intervention is applied, because it allows flexibility and adaption in meeting patients’ needs by implementing tailored, possibly complex interventions in different healthcare settings. This project will examine a particular piece in the puzzle of the complexity of conducting a medication review and communication of suggested medication amendments to the patients, healthcare at the hospital, and the GP. Hopefully, this can contribute to a reduction in the risk of potentially inappropriate post-hospital medication usage.
Trial registration: The study has been registered at ClinicalTrial.gov with the registration number: NCT06383364. https://clinicaltrials.gov/study/NCT06383364.
Association between blood pressure control in hypertension and urine sodium to potassium ratio: From the Korea National Health and Nutrition Examination Survey (2016–2021)
Authors: Yoon Youngmin , Son Minkook 
Published: November 2024

Background
Hypertension (HTN) is linked to an enhanced risk of chronic kidney disease and cardiovascular disease. While sodium and potassium intake affect blood pressure (BP) control, the urine sodium-to-potassium (Na/K) ratio, which reflects dietary balance and renal regulation of these electrolytes, could be associated with BP. This study aimed to evaluate the independent association between urine Na/K and uncontrolled HTN.

Methods
Data were collected from the Korea National Health and Nutrition Examination Survey from 2016 to 2021. A total of 5,770 participants diagnosed with HTN were enrolled in this study. Uncontrolled HTN was characterized by a systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg. Logistic regression analysis was used to assess the relationship between urine Na/K and the risk of uncontrolled HTN.

Results
The urine Na/K was positively correlated with both SBP and mean arterial pressure. Higher urine Na/K was significantly associated with an increased risk of uncontrolled HTN using both continuous (odds ratio [95% confidence interval] 1.13 [1.09–1.16], P <0.01]) and across quartile values (with Q1 as a reference; Q2: 1.26 [1.06–1.49], P = 0.01; Q3: 1.50 [1.27–1.78], P <0.01; Q4: 1.85 [1.55–2.17], P < 0.01). The subgroup analysis also showed that higher urine Na/K were significantly related to the risk of uncontrolled HTN in the presence of proteinuria or CKD.

Conclusion
Urine Na/K ratio is independently associated with uncontrolled HTN in the general population and in patients with CKD. Our findings suggest that monitoring the urine Na/K could serve as an effective tool for identifying subjects at risk of uncontrolled HTN.
Practical Application of the COuGH RefluX Score for Patients With Laryngopharyngeal Symptoms: Real-World Assessment in Predicting Gastroesophageal Reflux Disease and Proton-Pump Inhibitor Response
Authors: Wong Ming-Wun , Hsiao Shih-Hsuan , Wang Jen-Hung , Hung Jui-Sheng , Liu Tso-Tsai , Lei Wei-Yi , Yi Chih-Hsun , Chen Peir-Rong , Gyawali C. Prakash , Chen Chien-Lin 
Published: November 2024

INTRODUCTION:
The COuGH RefluX score has been validated to predict likelihood of gastroesophageal reflux disease (GERD) in patients with laryngopharyngeal symptoms (LPS) using parameters of cough, overweight, globus, hiatal hernia, regurgitation, and male sex. The aim of this study was to assess the real-world value of the COuGH RefluX score in predicting proton-pump inhibitor (PPI) response in patients with LPS.

METHODS:
Patients with LPS for > 3 months were prospectively enrolled and assessed using the Reflux Symptom Index and 24-hour impedance-pH monitoring. Based on COuGH RefluX scores, patients were designated unlikely GERD (≤ 2.5), inconclusive GERD (3.0–4.5), and likely GERD (≥ 5.0). PPI response was defined as a 50% reduction in Reflux Symptom Index.

RESULTS:
Among 196 participants (mean age 47.8 years), 121 were unlikely, 60 were inconclusive, and 15 were likely to have GERD. Patients unlikely to have GERD had higher mean nocturnal baseline impedance (MNBI), lower hiatal hernia prevalence, and fewer confirmed GERD cases compared with inconclusive and likely GERD groups (P < 0.05). Symptom severity and acid exposure time were similar across groups (P > 0.05). PPI response rates were 12.4%, 45.0%, and 73.3% across the groups (P < 0.001). Multivariate logistic regression showed COuGH RefluX scores and lower MNBI as independent predictors of PPI responsiveness (scores 3.0–4.5, odds ratio (OR) = 4.190, P = 0.001; scores ≥5.0, OR = 15.772, P < 0.001; MNBI, OR = 0.915, P = 0.001).

DISCUSSION:
The COuGH RefluX score is effective in predicting GERD and guiding PPI use in patients with LPS without esophagitis. The score can ensure appropriate PPI use and targeted testing during initial LPS patient encounters.
Prospective Controlled Study of Endoscopic Botulinum Toxin Injection for Retrograde Cricopharyngeus Dysfunction: The Inability to Belch Syndrome
Authors: Sanagapalli Santosh , Eid Mary , Kim Matthew Bong-Sik , Tudehope Fiona 
Published: November 2024

INTRODUCTION:
Complete inability to belch due to retrograde cricopharyngeus dysfunction (R-CPD) may lead to chronic gas-related gastrointestinal complaints. We aimed to validate high-resolution manometric (HRM) diagnostic criteria and prospectively evaluate the feasibility and efficacy of cricopharyngeal botulinum toxin injection (CBTI) by flexible endoscopy.

METHODS:
Consecutive manometrically diagnosed patients with R-CPD were included. Asymptomatic volunteers were also included for diagnostic validation. Patients with R-CPD underwent CBTI (treatment group) or deferred/declined treatment (control group). Outcomes included ability to belch, clinical symptoms, and quality of life measured using self-report questionnaires.

RESULTS:
Sixty-five subjects were included (52 treatment group, 7 controls, and 6 asymptomatic volunteers). All patients with R-CPD had inability to belch since childhood. During HRM with carbonated drink provocative testing, all R-CPD patients demonstrated characteristic esophageal pressurization patterns associated with failure of upper esophageal sphincter relaxation; these findings were never seen in asymptomatic volunteers. At 3 months, 92% patients who received CBTI were able to belch (compared with 0 controls; P < 0.001) and experienced improved clinical symptoms (global symptom score improved from 7.3 ± 1.7 to 1.8 ± 2.3, whereas in controls was static 7.5 ± 2.1 to 7.7 ± 1.8; P < 0.0001 for comparison). Quality of life significantly improved in the treatment group but not controls (P = 0.0002). At 3 months, 43/51 (84%) of the treatment group reported being satisfied or very satisfied with therapeutic outcome.

DISCUSSION:
HRM with carbonated drink provocation demonstrates pathognomonic signs of R-CPD that were not seen in health. Flexible endoscopic CBTI is highly effective for symptomatic relief compared with no treatment.
Persistence, Effectiveness, and Safety of Upadacitinib in Crohn's Disease and Ulcerative Colitis in Real Life: Results From a Spanish Nationwide Study (Ureal Study)
Authors: García María José , Brenes Yanire , Vicuña Miren , Bermejo Fernando , Sierra-Ausín Mónica , Vicente Raquel , Arroyo María Teresa , Martínez Montiel Pilar , Villoria Albert , Ferrer Juan Ángel , Hernandez Vicent , Piñero Alexis , Carrillo-Palau Marta , Martín-Arranz María Dolores , Miranda-Bautista José , Pajares Ramón , Arranz Hernández Laura , Bejarano Ana , Guardiola Jordi , Iyo Eduardo , Muñoz-Villafranca Carmen , Talavera Aurora , Alonso-Galán Horacio , Barreiro-de Acosta Manuel , Bosca-Watts Maia , Vázquez Rey Teresa , Echarri Ana , Rodríguez-Grau María del Carmen , Gutiérrez Ana , Huguet José María , López-Martín M. Carmen , Mesonero Francisco , Pérez-Martínez Isabel , Plaza Rocío , Ramírez de la Piscina Patricia , Gisbert Javier P. , Chaparro María 
Published: November 2024

INTRODUCTION:
Real-world data on the effectiveness of upadacitinib for inflammatory bowel disease (IBD) are limited. To assess upadacitinib persistence, effectiveness, and safety in a real-world scenario.

METHODS:
Retrospective multicenter study of patients with IBD who received upadacitinib before 31st December 2022 and at least 12 weeks before the recruitment date. Clinical effectiveness was assessed based on partial Mayo score for ulcerative colitis (UC) and Harvey–Bradshaw index for Crohn's disease (CD).

RESULTS:
We included 100 patients (68 with CD, and 32 with UC). Patients had previously received a median of 4 advanced therapies. Twenty-three discontinued the treatment (median follow-up 7.6 months). CD (vs UC) (hazard ratio 3.7; 95% confidence interval [CI]: 1.04–12.9) and age below 40 years at upadacitinib initiation (hazard ratio 2.4; 95% CI: 1.0–5.8) were associated with treatment discontinuation in multivariable analysis. Clinical remission for IBD was achieved in 59% of patients at week 8, 64% at week 12, and 42% at week 52. The proportion of patients with UC previously exposed to tofacitinib (n = 25) who achieved clinical remission was 78% at week 12, and 50% at week 52. Factors associated with clinical remission at week 12 were UC diagnosis (odds ratio [OR] 4.6; 95% CI: 1.3–17), mild or moderate activity at baseline (OR 8; 95% CI: 1.1–56), and not smoking (OR 4.4; 95% CI: 1.5–13). Dose escalation recaptured remission in 60% of patients with relapse. Eighty percent of patients with active immune-mediated diseases or extraintestinal manifestations improved with upadacitinib. Forty-three patients reported adverse events, 11 of them serious.

DISCUSSION:
Upadacitinib is effective and safe for treating patients with highly refractory IBD, even in previously treated with Janus kinase inhibitors.