bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancing stroke safety and efficacy through early tirofiban administration after intravenous thrombolysis: The multicenter, randomized, placebo-controlled, double-blind ASSET IT trial protocol
Authors: Tao Chunrong , Liu Tianlong , Sun Jun , Zhu Yuyou , Li Rui , Wang Li , Zhang Chao , Song Jianlong , Jing Xiaozhong , Nguyen Thanh N , Nogueira Raul G , Saver Jeffrey L , Hu Wei 
Published: November 2024

Background: Intravenous thrombolysis (IVT) is the cornerstone treatment for the acute ischemic stroke (AIS) within 4.5 h after onset. Current guidelines recommend administering antiplatelet medications 24 h after IVT. However, vascular reocclusion is a common occurrence after IVT. Tirofiban, a platelet glycoprotein IIb/IIIa antagonist, can help deter macrovascular reocclusion, prevent microvascular thrombosis, and enhance cerebral blood flow. Objective: This trial aims to assess whether early administration of tirofiban can improve clinical outcomes in patients with AIS who received IVT. Methods and design: The Advancing Stroke Safety and Efficacy through Early Tirofiban Administration after Intravenous Thrombolysis (ASSET IT) Trial is an investigator-initiated, randomized, placebo-controlled, double-blind, multicenter study. Up to 832 eligible patients will be consecutively randomized in a 1:1 ratio to receive either intravenous tirofiban or placebo over a period of 2 years across 38 stroke centers in China. Outcomes: The primary endpoint is excellent functional status at day 90, defined as a modified Rankin Score of 0–1. Primary safety endpoints include symptomatic intracerebral hemorrhage at 24 h and mortality at 90 days. Trial registry number: NCT06134622 (clinicaltrials.gov).
Impact of time from symptom onset to puncture, and puncture to reperfusion, in endovascular therapy in the late time window (>6 h)
Authors: Sadeler Agathe , Finitsis Stephanos , Olivot Jean-Marc , Richard Sebastien , Marnat Gaultier , Sibon Igor , Calviere Lionel , Cognard Christophe , Mazighi Mikael , Desilles Jean-Philippe , Lapergue Bertrand , Tamazyan Ruben , Zuber Mathieu , Gory Benjamin , Maïer Benjamin 
Published: November 2024

Background: Increased time from symptom onset to puncture (TSOP) and time from puncture to reperfusion (TPTR) are associated with worse outcome in ischemic stroke patients treated with endovascular therapy (EVT) in the early time window (<6 h). However, these associations are less described in the late window (>6 h), where patients may benefit from EVT because of a more favorable imaging profile (late window paradox). We sought to compare the effect of these timeframes between these two periods on efficacy and safety outcomes. Methods: The ETIS (Endovascular Treatment in Ischemic Stroke) registry is an ongoing, prospective, observational study in 21 centers that perform EVT in France. We included adult patients with an anterior occlusion, successfully treated by EVT (modified treatment in cerebral ischemia (mTICI) 2b–3) between January 2015 and June 2023, with a known time of stroke onset. The cohort was divided into two groups according to the TSOP (⩽6 h vs >6 h). Primary outcome was favorable outcome (modified Rankin Scale 0–2 at 90 days). Results: In total, 7516 patients were included, with 5936 patients being treated ⩽6 h and 1580 >6 h. In the early window, TSOP and TPTR were associated with worse outcomes at 90 days (adjusted odds ratio (aOR) = 0.68 per hour; 95% confidence interval (CI) = 0.64–0.73; p < 0.001 and aOR = 0.92 per 10-min increment; 95% CI = 0.90–0.94, p < 0.001, respectively). TSOP was not associated with worse outcomes at 90 days in the late window ( p = 0.955), but TPTR was associated with worse outcomes (aOR = 0.91 per 10-min increment; 95% CI = 0.86–0.96, p = 0.001), every 10 additional minutes in TPTR being associated with a 1.7% (95% CI = 0.6–2.7) decreased probability of favorable outcome. Conclusion: Only EVT procedural time is associated with unfavorable outcomes at 90 days in late window patients. These results highlight how the late window paradox may end at the start of EVT and underscore the need for timely management, particularly for the EVT, even for late window patients with a presumed more favorable imaging profile.
Re-tear following rotator cuff repair: Do functional outcomes predict success?
Authors: Angerett Nathan , Maurer Timothy , Lutz Rex , Alexander Tia , Krasney Leighann , Kelly Matthew 
Published: November 2024

Purpose The purpose of this study is to compare functional outcomes between patients who were found to have a retear on ultrasound versus those with an intact repair following arthroscopic rotator cuff repair. Methods Retrospective cohort study comparing functional outcomes of 84 patients who underwent arthroscopic rotator cuff repair and were found to have a retear versus those who did not experience a retear. Functional outcomes included American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test, strength and active range of motion (AROM) assessed preoperatively and postoperatively at 3 and 6 months. Results Patients without a retear by 6 months demonstrated greater improvements in internal rotation at 3 months (2.3° of mean change, p = 0.0356), as well as greater improvements in external rotation range of motion (8.8° of mean change, p = 0.0210) between 3 and 6 months as compared to those patients who did experience a retear. Both groups showed decreased pain scores and increased ASES scores at all points postoperatively. Conclusions Our study found statistically significant improvements in internal rotation at 3 months, and external rotation between 3 and 6 months in the non-retear group. No differences in functional outcomes existed between at final follow-up.
Predictors of disease outbreaks at continental-scale in the African region: Insights and predictions with geospatial artificial intelligence using earth observations and routine disease surveillance data
Authors: Pezanowski Scott , Koua Etien Luc , Okeibunor Joseph C , Gueye Abdou Salam 
Published: November 2024

Objectives Our research adopts computational techniques to analyze disease outbreaks weekly over a large geographic area while maintaining local-level analysis by incorporating relevant high-spatial resolution cultural and environmental datasets. The abundance of data about disease outbreaks gives scientists an excellent opportunity to uncover patterns in disease spread and make future predictions. However, data over a sizeable geographic area quickly outpace human cognition. Our study area covers a significant portion of the African continent (about 17,885,000 km2). The data size makes computational analysis vital to assist human decision-makers. Methods We first applied global and local spatial autocorrelation for malaria, cholera, meningitis, and yellow fever case counts. We then used machine learning to predict the weekly presence of these diseases in the second-level administrative district. Lastly, we used machine learning feature importance methods on the variables that affect spread. Results Our spatial autocorrelation results show that geographic nearness is critical but varies in effect and space. Moreover, we identified many interesting hot and cold spots and spatial outliers. The machine learning model infers a binary class of cases or none with the best F1 score of 0.96 for malaria. Machine learning feature importance uncovered critical cultural and environmental factors affecting outbreaks and variations between diseases. Conclusions Our study shows that data analytics and machine learning are vital to understanding and monitoring disease outbreaks locally across vast areas. The speed at which these methods produce insights can be critical during epidemics and emergencies.
Temporal Trends in Single- and Multiple-Sports Team Participation Among Adolescents in the United States: Analysis Using the Youth Risk Behavior Surveillance System, 1999-2019
Authors: Knell Gregory , Yockey Andrew , Brayton Riley P. , Johnson Ashleigh M. , Ellis Henry B. , Wilson Philip L. 
Published: November 2024

Background: It is unclear how levels of sport participation have changed among adolescents in the United States (US) in recent years, particularly considering evidence of increasing sport professionalization and attrition. Purpose: To evaluate the differences and trends in single- and multiple-team sport participation among US high school students between 1999 and 2019. Study Design: Descriptive epidemiology study. Methods: Using the Youth Risk Behavior Surveillance System of the US Centers for Disease Control and Prevention, a biannual representative survey of US high school students, data on self-reported sport participation (no participation, single team, multiple teams) within the previous year were evaluated. Differences in sport participation prevalence between 1999 and 2019 were assessed in sex strata by grade, race/ethnicity, and US region. Weighted trends using the National Center for Health Statistics Guidelines for Analysis of Trends and logistic regression models were employed for analyses. Results: The study sample over the 20-year period (N = 149,404) was 49.8% female; the majority were in ninth grade (27.7% female, 28.7% male), were non-Hispanic White (56.1% female, 56.8% male), and resided in the Southern US (57.6% female, 57.4% male). Among girls, 27.2% (95% CI, 25.8-28.6) reported multiple sports team participation in 1999, while 21.3% (95% CI, 20.1-22.6) reported the same in 2019. Among boys, 39.5% (95% CI, 38.4-40.7) reported multiple sports team participation in 1999 versus 29.1% (95% CI, 27.7-30.6) in 2019. Analyses of trends indicated that girls experienced increasing trends in single-sport team participation (β = 0.04, SE = 0.01, P < .001). Among boys, there were increasing trends in no sport participation (β = 0.06, SE = 0.01, P < .001), while multiple-sport team participation decreased over the 20-year period (β = −0.10, SE = 0.01, P < .001). Disparities in trends were observed among female and male groups by race/ethnicity, grade, and region. Conclusion: Sport participation over a 20-year period in the US decreased significantly for boys and increased for single-sports teams among girls. Sport specialization may be contributing some of the observed trends, though limitations in the data require additional research to confirm these hypotheses. Tailored efforts to increase sport participation among both sexes is needed.
Influence of Injury to the Kaplan Fibers and Anterolateral Ligament on Pivot-Shift Phenomenon in Adult and Adolescent Patients With Anterior Cruciate Ligament Injury: A Retrospective Cohort Study
Authors: Cui Jiaming , Cheng Songmiao , Luo Yuan , Li Qiang , Li Fu , Wang Yicheng , Ming Hong 
Published: November 2024

Background: Studies have shown that Kaplan fibers (KFs) play a role in controlling anterolateral rotatory knee laxity in anterior cruciate ligament (ACL) injury. However, recent clinical studies have suggested that KF injuries are not associated with a higher-grade pivot shift in knees with acute ACL injuries. Purpose: To compare the effect of KF and anterolateral ligament injury on anterolateral rotatory laxity as measured by the pivot-shift test in both adult and adolescent patients with acute ACL injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study consisted of patients who experienced primary acute ACL tears between January 2019 and December 2021. The magnetic resonance imaging examinations and pivot-shift tests for these individuals were conducted within 14 days after injury. Variables associated with concomitant injury were included in a binary logistic regression model to evaluate risk factors of a high-grade pivot shift and a KF injury. Results: The study included 540 patients with acute ACL tears (64 adolescent patients and 476 adults). The main risk factor for a high-grade pivot shift after acute ACL injury in adults was partial or total disruption of anterolateral ligament continuity (odds ratio [OR], 2.271; 95% CI, 1.499-3.442). In adolescent patients, the main risk factor was KF injury (OR, 19.98; 95% CI, 2.367-168.669), including edema and disruption of continuity. Conclusion: The main risk factor for a high-grade pivot shift after acute ACL injury differs between adolescent patients and adults: the KF injury sign in adolescent patients indicates a higher-grade pivot shift.
Tapping into the vocal learning and rhythmic synchronization hypothesis
Authors: Theofanopoulou Constantina 
Published: November 2024

AbstractIn this article, I present three main points that could benefit the “vocal learning and rhythmic synchronization hypothesis”, encompassing neurogenetic mechanisms of gene expression transmission and single motor neuron function, classification of different behavioral motor phenotypes (e.g., spontaneous vs. voluntary), and other evolutionary considerations (i.e., the involvement of reward mechanisms).
What supports mothers of very preterm babies to start and continue breast milk feeding neonatal units? A qualitative COM-B analysis of mothers’ experiences
Authors: McLeish Jenny , Aloysius Annie , Gale Chris , Quigley Maria A. , Kurinczuk Jennifer J. , Alderdice Fiona 
Published: November 2024

Abstract
Background
It is challenging for mothers who give birth very preterm to produce sufficient breast milk by expressing for weeks before their baby is able to feed from the breast, and then to transition from tube feeding to breastfeeding. Lactation is most successful when stimulated shortly after birth, established within 72 h, and maintained by expressing 6–8 times a day. This study explored mothers’ experiences of how breast milk feeding and breastfeeding for very preterm babies can be supported by staff and the facilities of a neonatal unit.

Methods
Twenty-three mothers of very preterm babies were interviewed, from four neonatal units in England with high or low rates of breast milk feeding at discharge. Interviews were analysed using the COM-B framework to consider how mothers’ behaviour (breast milk feeding and breastfeeding) is affected by capability, opportunity and motivation.

Results
Mothers’ motivation in the traumatic situation of very preterm birth was strongly affected by information from staff about the benefits of breast milk for their baby, the importance of early and frequent expressing, and how to assess the effectiveness of direct breastfeeding. It was maintained through positive feedback about their efforts which built their confidence, and reassurance about what is ‘normal’ growth when a baby begins direct breastfeeding. Motivation needed to be supported by opportunity, including access to equipment for expressing and facilities to stay near the neonatal unit, and also by capability, which required proactive and skilled information and support from staff. Specialist support and facilities varied between units, and some mothers were not given necessary information or had their motivation undermined by staff comments.

Conclusions
Interventions to increase breast milk feeding and breastfeeding for very preterm babies should address mothers’ motivation, capability and opportunity, aiming for systematic elimination of obstacles. Mothers value personalised and skilled specialist support, but also need other staff to be able to give consistent information and affirmation focused on their efforts rather than their success, with a trauma-informed approach. Investing in rooming-in facilities that minimise the separation of mothers and babies is likely to overcome a key obstacle.
Professionals’ ideas and observations on preschoolers’ experiences with physical symptoms: a qualitative interview study
Authors: van der Ziel Sterre , Gol Janna M. , Schoemaker Daniël , Rosmalen Judith G. M. , van Vliet Michel J. 
Published: November 2024

Abstract
Background
Preschoolers experience physical symptoms, like abdominal pain or minor injuries, almost every day. These experiences may shape how they deal with health issues later in life. To gain insight into these early life experiences, information from multiple perspectives is useful. This qualitative study aimed to explore important themes in preschoolers’ experience of physical symptoms, using adult professionals from various backgrounds as informants.

Methods
20 semi-structured interviews were performed with professionals from different fields in healthcare and education, to learn about their ideas and observations on preschoolers’ experiences with physical symptoms. The interviews were verbatim transcribed and coded in Atlas.ti by two independent coders, after which thematic content analysis was applied to define themes.

Results
Three themes emerged from the interviews: unawareness, seeking attention, and parental influence. Unawareness refers to the professionals’ idea that preschoolers have limited cognitions about causes and consequences of physical symptoms. Seeking attention was described as important for preschoolers with symptoms, both as comfort and in a social context. Professionals described diminished attention-seeking behavior in preschoolers with more severe symptoms. Parental influence was seen as highly relevant in preschoolers’ experiences with physical symptoms, with both supportive and disruptive aspects. Healthcare professionals differed from educational professionals in their observations and ideas, especially about underlying mechanisms influencing symptoms.

Conclusions
Professionals report attention-seeking and parental influence as important factors in preschoolers with physical symptoms, and they report limited cognitions about causality. Professionals in healthcare and education show different perceptions, suggesting the importance of incorporating both views into research.
Population-pharmacokinetic/pharmacodynamic model of atractylodes lancea (Thunb.) DC. administration in patients with advanced-stage intrahepatic cholangiocarcinoma: a dosage prediction
Authors: Saeheng Teerachat , Karbwang Juntra , Na-Bangchang Kesara 
Published: November 2024

Abstract
Background
A recent phase 2A clinical study of Atractylodes lancea (Thunb.) DC. (AL) in patients with advanced-stage intrahepatic cholangiocarcinoma (iCCA) demonstrated significant reduction of the risk of tumor progression and mortality with a dose ranging from 1,000 to 2,000 mg. The present study aimed to determine the potential dosage regimen of AL for further phase 2B clinical study.

Methods
Plasma-concentration time profiles of total AL bioactivity and clinical efficacy in patients with advanced-stage iCCA were obtained from Phase 2 A study. The population pharmacokinetic (pop-PK) model was developed. The pop-PK model and Monte-Carlo (MC) simulation, in conjunction with maximum concentration of AL (Cmax) as a cut-off criterion, was performed and validated with clinical data. The optimal model was used to simulate further dosage regimens and clinical efficacy of AL.

Results
The pop-PK properties of total AL bioactivity were best described by a compartmental model with zero-order absorption (without delay) and linear clearance. None of the investigated covariates improved model accuracy.The developed pop-PK with MC simulations following once-daily dosing of 1,000 mg and 2,000 mg adequately predicted the clinical efficacy (tumor progression and mortality). The once-daily dose of 2,500 mg is recommended for further phase 2B clinical study due to its relatively high efficacy on tumor progression inhibition (73%) and mortality rate reduction (71%) without excessive number of the administered capsules (23 capsules) and low risk of toxicities (<5%).

Conclusions
The applied pop-PK model with MC simulation, along with the appropriate cut-off pharmacokinetic parameters, can be used as a potential tool for supporting dosage prediction and selection for clinical studies, and thus reducing the rate of drug development failures.

Trial registration
www.thaiclinicaltrials.org, WHO ICTRP search, TCTR20210129007, Registed 29 January 2021.
Drug-coated balloons versus drug-eluting stents in patients with in-stent restenosis: An updated meta-analysis with trial sequential analysis
Authors: Abdelaziz Ahmed , Atta Karim , Hafez Abdelrahman H. , Elsayed Hanaa , Ibrahim Ahmed A. , Abdelaziz Mohamed , Kadhim Hallas , Mechi Ahmed , Elaraby Ahmed , Ezzat Mahmoud , Fadel Ahmed , Nouh Abdullah , Ibrahim Rahma AbdElfattah , Ellabban Mohamed Hatem , Bakr Ali , Nasr Ahmed , Suppah Mustafa 
Published: November 2024

Abstract
Background
Drug-coated balloons (DCB) have promising results in the management of in-stent restenosis (ISR), still their role remains a major challenge, and not well established in contemporary clinical practice.

Aims
To provide a comprehensive appraisal of the efficacy and safety of DCBs in patients with in-stent restenosis (ISR).

Methods
We searched PubMed, Scopus, web of Science, Ovid, and Cochrane Central from inception until 30 March, 2023. We included randomized controlled trials (RCTs) that compared DCB versus DES in ISR patients. Our primary endpoints were major adverse cardiac events (MACE) and late lumen loss (LLL). Secondary clinical endpoints were all-cause death, cardiac death, MI, TLR, TVR, and stent thrombosis, and angiographic outcomes were MLD, and in-stent binary restenosis.

Results
Ten RCTs comprising 1977 patients were included in this meta-analysis. The incidence of MACE was 15.57% in the DCB group compared to 14.13% in the DES group, with no significant difference in the risk of MACE following DCB (odds ratio [OR] 1.04, 95% confidence interval [CI]: 0.87 to 1.44). Compared with the DES intervention, the risk of LLL was comparable to the DCB intervention (mean difference [MD] -0.08, 95% CI: -0.18 to 0.02), while the incidence of TLR was increased in the DCB intervention (OR: 1.54, 95% CI: 1.2 to 1.99).

Conclusion
DCB was comparable to DES implantation is ISR patients regarding clinical outcomes, however it showed an increase in TLR events. Moreover, a RCT with large sample size and longer follow-up duration is warrened to validate these results.
Curating genomic disease-gene relationships with Gene2Phenotype (G2P)
Authors: Yates T. Michael , Ansari Morad , Thompson Louise , Hunt Sarah E. , Uhalte Elena Cibrian , Hobson Rachel J. , Marsh Joseph A. , Wright Caroline F. , Firth Helen V. 
Published: November 2024

Abstract
Genetically determined disorders are highly heterogenous in clinical presentation and underlying molecular mechanism. The evidence underpinning these conditions in the peer-reviewed literature requires robust critical evaluation for diagnostic use. Here, we present a structured curation process for Gene2Phenotype (G2P). This draws on multiple lines of clinical, bioinformatic and functional evidence. The process utilises and extends existing terminologies, allows for precise definition of the molecular basis of disease, and confidence levels to be attributed to a given gene-disease assertion. In-depth disease curation using this process will prove useful in applications including in diagnostics, research and development of targeted therapeutics. G2P: www.ebi.ac.uk/gene2phenotype.