bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinct tau pathologies in the nucleus basalis of Meynert between early-onset and late-onset Alzheimer's disease patients revealed by positron emission tomography
Authors: Suzuki Hisaomi , Tagai Kenji , Ono Maiko , Shimizu Hiroshi , Endo Hironobu , Matsumoto Hideki , Kubota Manabu , Kataoka Yuko , Moriguchi Sho , Kurose Shin , Ichihashi Masanori , Shinotoh Hitoshi , Matsuoka Kiwamu , Kokubo Naomi , Tatebe Harutsugu , Matsuura Sayo , Yamamoto Yasuharu , Momota Yuki , Kawamura Kazunori , Zhang Ming-Rong , Takado Yuhei , Shimada Hitoshi , Tokuda Takahiko , Onaya Mitsumoto , Mimura Masaru , Kakita Akiyoshi , Sahara Naruhiko , Uchida Hiroyuki , Higuchi Makoto , Takahata Keisuke 
Published: November 2024

Background Tau accumulation in the nucleus basalis of Meynert (nbM) has been documented in Alzheimer's disease (AD), but its relationship to neuropathological changes in other brain regions and cognitive deficits remains unclear, particularly between early-onset AD (EOAD) and late-onset AD (LOAD). Objective To evaluate tau accumulation patterns in the nbM and other brain regions in EOAD and LOAD using 18F-florzolotau PET and examine correlations with cognitive function. Methods Thirty-eight amyloid-positive AD patients (15 EOAD, 23 LOAD) and 46 healthy controls underwent 18F-florzolotau PET. Tau levels were quantified in the nbM and Braak-staging regions. Postmortem brain samples were examined to assess 18F-florzolotau binding to tau deposits. Results EOAD showed a higher overall tau burden, including in the nbM, compared with LOAD. However, nbM tau levels correlated more strongly with cognitive decline in LOAD than EOAD. The relationship between nbM tau and neocortical tau differed between EOAD and LOAD. Histopathology revealed abundant 18F-florzolotau labeling of neurofibrillary tangles (NFTs) and ghost tangles in AD nbM samples. Conclusions This study provides the first in vivo PET evidence of differential nbM tau pathology between EOAD and LOAD, with higher accumulation but weaker correlation to cognition in EOAD. The distinct relationships between nbM and cortical tau in EOAD and LOAD suggest divergent pathological trajectories. 18F-florzolotau PET successfully visualized NFTs and extracellular ghost tangles in the nbM across AD stages. These findings highlight the importance of considering age of onset when evaluating tau pathology and its clinical correlates in AD.
Prevalence of motoric cognitive risk syndrome among older adults in Brazil and evaluation of effect modification by race
Authors: Martins João Paulo , Fukushima Fernanda Bono , Benatti Leandra Navarro , Bazan Rodrigo , Silva Katherine Di Santi Correa da , Vidal Edison Iglesias de Oliveira 
Published: November 2024

Background Motoric cognitive risk syndrome (MCRS) is a pre-dementia syndrome of growing interest, yet it remains understudied in Latin America with a significant lack of information on the interaction between its risk factors and race. Objective To estimate the prevalence of MCRS among older adults in Brazil, investigate its association with various clinical and sociodemographic variables, and explore the potential of effect modification by race. Methods This cross-sectional, population-based study was conducted among community-dwelling older adults in Brazil, with data collected between 2015 and 2016. The diagnosis of MCRS was established following the standard recommended by the original study that first described it. We used Poisson regression models to analyze the association between MCRS and a list of 21 variables identified from a systematic review. Results A total of 4677 participants aged 60 years and older were included. The prevalence of MCRS in the Brazilian population of older adults was 4.34% (95% CI: 3.20%–5.48%). Higher levels of education and physical activity showed protective associations with MCRS, while depression and stroke demonstrated risk associations. A significant cross-over interaction between race and depression regarding MCRS was observed, such that the association of depression with MCRS was approximately three times higher among White individuals than Black individuals. Conclusions Our results challenge previous estimates that Latin America is the region with the highest prevalence of MCRS among older adults and signal the need for further studies to better investigate the modification of effect of the association between depression and MCRS by race.
The recognition and assessment of pain in people with profound intellectual disabilities by nurses: An appreciative inquiry
Authors: Goodall Maeve , Irving Kate , Nevin Mary 
Published: November 2024

Background Individuals with profound intellectual disabilities are non-verbal and reliant on carers for pain recognition, assessment and management. Pain is a multifaceted and interconnected experience. Assessment tools designed specifically for this population are needed. This study aimed to develop methods for improved pain care practices by nurses. Methods This qualitative study followed the four phases of appreciative; Discovery, Dream, Design, Destiny. Eight nurses were recruited as co-researchers from one Irish intellectual disability organisation. Data were analysed from individual and focus group interviews, using thematic analysis and continuous reflexivity. Results A pain awareness campaign and RAPPID tool (recognition and assessment of pain in people with profound intellectual disabilities) were developed. Conclusion Respect for personhood in individuals with profound intellectual disabilities is reflected through holistic approaches to pain assessment. The empowerment of nurses enables positive change. Implicit knowledge can be communicated more proficiently with a formal, collaborative tool.
Delivery of evidence-based critical care practices across the United Kingdom: A UK-wide multi-site service evaluation in adult units
Authors: Thomson William R , Puthucheary Zudin , Stavrinou Panayiotis , Barghouthy Dalia , Champanerkar Shreekant , Findlay Douglas , Gordon Sarah , McWilliams David , Tantam Kate , Woodward Helen , Stephens Timothy J 
Published: November 2024

Background: The ICU Liberation Bundle was developed to improve outcomes for patients admitted to critical care. Despite a lack of Bundle adoption in the UK, the individual evidence-based practices (EBPs) within the bundle are defined as standards of care by the UK Intensive Care Society. There are limited data on the delivery of these EBPs. Objective: To evaluate current delivery of the EBPs of the ICU Liberation bundle in a sample of hospitals in the UK National Health Service (NHS) presenting delivery of EBP’s between hospitals, their stability of delivery across multiple weeks and in comparison to US hospitals in the original ICU Liberation Bundle study Methods: Multi-centre service evaluation, using modified definitions of compliance from the ICU Liberation Bundle study. We sampled six representative units from across the UK; data collection totalled 1116 patient days. Data were analysed using descriptive statistics. Results: Across all six units, patients received a median of 42.9% (IQR 40%–60%) of all possible bundle EBPs. Unit bundle proportional compliance (number of components completed/eligible number of components) ranged from 40.0% (IQR 28.6%–50.0%) to 71.4% (IQR 57.1%–80.0%). Units completed spontaneous awakening trials most regularly in 80.1% of eligible patients (149/186). Delirium assessments were the least adhered to EBP with only 32.2% (359/1116) of patients receiving at least two validated delirium assessments per day. Full bundle compliance was lower in the UK cohort in comparison to the original trial (4% vs 8%). Discussion: We identified substantial variation in the delivery of seven evidence-based practices that are considered standards of care in the UK. Variation existed between hospitals and within each hospital over time. These data begin to describe the current state of EBP adherence in a selection of critical care units.
First-line treatment with zolbetuximab plus CAPOX for ClDN18.2-positive gastric or gastroesophageal junction adenocarcinoma: a cost-effectiveness analysis
Authors: Lei Jianying , Zhang Jiahao , You Caicong , Fu Wu , Liu Maobai , Li Na 
Published: November 2024

Background: Patients with HER2-negative locally advanced or unresectable metastatic gastric cancer and gastroesophageal junction (G/GEJ) adenocarcinoma have limited first-line treatment options and a poor prognosis. The GLOW clinical trial showed that zolbetuximab plus capecitabine plus oxaliplatin (CAPOX) significantly prolonged these patients’ overall survival (OS) and progression-free survival (PFS). Objectives: This study evaluated the cost-effectiveness of zolbetuximab plus CAPOX as a first-line treatment for HER2-negative locally advanced or unresectable metastatic G/GEJ adenocarcinoma in the United States and China. Design: The cost-effective analysis. Methods: Based on the GLOW clinical trial data (NCT03653507), we constructed a 10-year Markov model to assess the cost-effectiveness of the zolbetuximab or placebo plus CAPOX treatment regimen. Only direct medical costs were considered. The primary outcomes of the model were quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). One-way and probabilistic sensitivity analyses were employed to assess the robustness of the model. Results: In the United States, zolbetuximab plus CAPOX added 0.24 QALYs and resulted in an incremental cost of $196,791.11 compared with placebo plus CAPOX, which had an ICER of $821,515.65 per QALY gained. For China, the zolbetuximab group gained 0.23 QALYs at an incremental cost of $62,822.69, resulting in an ICER of $273,568.01/QALY. One-way sensitivity analysis revealed that the results were most sensitive to the price of zolbetuximab. Zolbetuximab plus CAPOX had 0% cost-effectiveness at the willingness-to-pay thresholds of $150,000/QALY in the United States and $38,188/QALY in China. Conclusion: Zolbetuximab plus CAPOX may be a cost-effective option for patients with locally advanced, unresectable, or metastatic G/GEJ adenocarcinoma when the price of zolbetuximab reduced by 83.37% ($367.7/100 mg) in the United States and 82.25% ($110.8/100 mg) in China.
Double-Stacked One-Third Tubular Plating for Suprasyndesmotic Fibula Fractures Technique Description and Clinical Case Series
Authors: Kaspar Wagner Robert , Borgida Jacob S. , Wong Alice W. , Jensen Bryce , Stenquist Derek S. , Ly Thuan V. 
Published: November 2024

Fixation for suprasyndesmotic fibula fractures (AO/OTA type 44C, consistent with Weber C) is classically achieved using a single one-third tubular plate. However, these fractures may sometimes require stronger fixation due to the diaphyseal fracture location and the lack of structural support from injured ligaments. To increase stability, 3.5 mm plates can be used, but these plates are bulky and too stiff to contour. As alternative, the authors present the technique and clinical and patient-reported outcomes (PROs) of using stacked one-third tubular plating for suprasyndesmotic fibula fractures to increase stability of fixation. Between 2021 and 2023, 14 patients were treated with stacked one-third tubular plating. All patients healed uneventfully. One patient developed an infection with wound breakdown and exposed hardware after fracture healing. Thirteen patients (93%) responded to PROs. The median Olerud-Molander ankle score was 75 (interquartile range [IQR]: 30-80), the median EQ-5D-5L score was 80 (IQR: 69-81), and the median numeric rating scale (NRS) score was 3 (IQR: 0-5). The use of double-stacked one-third tubular plates is a simple and safe technique that can be used to increase stability of suprasyndesmotic fibula fractures leading to reliable healing rates and satisfactory PROs. Levels of Evidence: Level IV Retrospective Case Series
Could Motor Imagery Training Provide a Novel Load Management Solution for Athletes? Recommendations for Sport Medicine and Performance Practitioners
Authors: McNeil Dominic G. , Lindsay Riki S. , Worn Ryan , Spittle Michael , Gabbett Tim J. 
Published: November 2024

Context: Athletes often face the dual challenge of high training loads with insufficient time to recover. Equally, in any team, sports medicine and performance staff are required to progress training loads in healthy athletes and avoid prolonged reductions in training load in injured athletes. In both cases, the implementation of a well-established psychological technique known as motor imagery (MI) can be used to counteract adverse training adaptations such as excessive fatigue, reduced capacity, diminished performance, and heightened injury susceptibility. Study Design: Narrative overview. Level of Evidence: Level 5. Results: MI has been shown to enhance performance outcomes in a range of contexts including rehabilitation, skill acquisition, return-to-sport protocols, and strength and conditioning. Specific performance outcomes include reduction of strength loss and muscular atrophy, improved training engagement of injured and/or rehabilitating athletes, promotion of recovery, and development of sport-specific skills/game tactics. To achieve improvements in such outcomes, it is recommended that practitioners consider the following factors when implementing MI: individual skill level (ie, more time may be required for novices to obtain benefits), MI ability (ie, athletes with greater capacity to create vivid and controllable mental images of their performance will likely benefit more from MI training), and the perspective employed (ie, an internal perspective may be more beneficial for increasing neurophysiological activity whereas an external perspective may be better for practicing technique-focused movements). Conclusion: We provide practical recommendations grounded in established frameworks on how MI can be used to reduce strength loss and fear of reinjury in athletes with acute injury, improve physical qualities in rehabilitating athletes, reduce physical loads in overtrained athletes, and to develop tactical and technical skills in healthy athletes.
Impact on mortality at 90 days of acute kidney injuries in endovascularly treated stroke: A systematic review, meta-analysis, and meta-regression
Authors: De Rubeis Gianluca , Alessiani Michele , Fabiano Sebastiano , Bertaccini Luca , Wlderk Andrea , Pezzella Francesca Romana , Anticoli Sabrina , Barber Peter Alan , Saba Luca , Pampana Enrico 
Published: November 2024

Aim To investigate the prognostic implication (mortality at 3 months) of acute kidney injury (AKI) in acute ischemic stroke treated with mechanical thrombectomy (MT). Material and Methods A literature search was performed using PubMed/OVID/Cochran’s CENTRAL database (time frame: inception to January 2023). Study characteristics, patient status, clinical outcomes, AKI incidence, and sample size were recorded. The exclusion criteria were non-English literature, no human subjects, and <10 patients as the sample size. Studies were assessed using the MINORS/GRADE system. Meta-analysis and meta-regression with a random-effects model were performed. Results 3314 studies were retrieved. After applying the exclusion criteria, the final population included of 18/3314 studies (0.5%). Among them, only 6/18 (33.3%) studies reported results in two separate groups (AKI vs non-AKI), allowing for inference statistics for a total population of 3229 (538.6 ± 403.7). The I^2 was 34.6 and Q’s Cochrane was 7.80. The pooled odds ratio (OR) for mortality at 3 months in patients with AKI was 5.8 (95% confidence interval [95% CI] 95% CI 3.62 to 9.52). Leave-one-out meta-analysis showed no significant sources of heterogeneity. In the meta-regression, diabetes prevalence was associated with a higher mortality rate (OR 1.14, 95% CI 1.03 to 1.28), and lower age and a small amount of contrast media were negatively correlated (0.91 [95% CI 0.83 to 0.99] and OR 0.97 [95% CI 0.94 to 1.00], respectively). Conclusion AKI was significantly associated with the mortality rate in MT-treated stroke patients (OR 5.8 [95% CI 3.62 to 9.36]).
A systematic review, ANCOVA meta-analysis, and meta-regression of clinical trials: Orlistat and body mass index of overweight and obese patients
Authors: Salim Jonathan , Tandy Sutiono , Puspitasari Gita 
Published: November 2024

Background: Obesity or overfat (i.e., excessive fat accumulation in the host) contributes to cerebrocardiovascular and other diseases. Orlistat is a good obesity medication, unlike other drugs that have higher cardiac toxicity. It reversibly inhibits pancreatic and gastric lipases, and improves oxysterol metabolism. This study summarizes and elaborates the impact of orlistat on BMI in overweight and obese adult patients. Methods: All authors systematically searched and retrieved 288 controlled trial articles on orlistat and BMI from three databases, two registries, and citation searches using specific keywords. The quality and bias risks were determined by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), Risk of Bias in Non-Randomized Study (ROBINS-I), and modified Jadad scale. R version 4.2.2 software calculated the effect size and the analysis of covariance (ANCOVA) effect, and subsequently analyzed using metafor. Results: This novel meta-analysis included 114 studies with 24,600 overweight or obese participants. We showed that orlistat substantially reduced BMI (mean difference −0.78 [−0.94, −0.63], p < 0.0001; I2 = 90.19%, pheterogeneity < 0.0001). Similarly, meta-regression showed a significant impact of orlistat daily dose (ß = −0.0019), yet not for duration (ß = −0.0024) and location (ß = −0.8591, −0.0190). Conclusion: Orlistat has the capacity to reduce BMI in overweight and obese individuals. Medical practitioners shall prescribe orlistat as a BMI lowering agent to complement other intervention in those patients
Hormone replacement therapy and non-gynaecological cancers
Authors: Sekar Sindhu , Kumar Bid 
Published: November 2024

Hormone replacement therapy (HRT) in cancer survivors gives rise to many uncertainties. The British Menopause Society has recently produced guidance on prescription and use of HRT amongst gynaecological cancer survivors. Background There is lack of knowledge and awareness about HRT use in non-gynaecological cancer survivors. The decision to advocate or discourage HRT in such women depends on various factors, including cancer type, hormone sensitivity, and individual patient characteristics. The paucity of available good quality clinical evidence and epidemiological data leads to lack of consensus in such cases. This article aims to address this knowledge gap by conducting a comprehensive qualitative analysis of the existing literature pertaining to HRT use in non-gynaecological cancer survivors. Materials and Methods We conducted a literature review. A systematic review was not possible because of lack of good quality research. We excluded case reports. Results A total of 55 papers were identified and all of these have been referenced. We have presented the inconsistencies and uncertainties in the evidence available from the limited information available from cohort studies. Conclusion Prescription of HRT in cancer survivors of many hormone dependent non-gynaecological cancers needs careful consideration of histology of the cancer and consideration about liaison with the concerned oncology team.
Use of 1 mm Cerclage Cables in Surgical Treatment of Periprosthetic Femur Fractures
Authors: Brown Harrison S. , Wall Bryce , Mears Simon C. , Stronach Benjamin M. , Siegel Eric R. , Stambough Jeffrey B. 
Published: November 2024

Introduction 1 mm cerclage cables have been introduced that can be placed under plates and hold reduction of periprosthetic femur fractures (PPFFx) around total hip arthroplasty (THA). Their utilization remains controversial due to the risk of nonunion secondary to periosteal stripping associated for their application. We compared surgical outcomes in patients with THA PPFFx treated with open reduction internal fixation (ORIF) and cables vs patients with PPFFx treated with ORIF without cables. We hypothesized that cable use would decrease hardware failure and nonunion rates. Materials & Methods We retrospectively reviewed 42 cases of PPFFx around THA performed from 2015 to 2021. Twenty-three PPFFx were treated with plate and 1 mm cerclage cables, and 19 PPFFx were treated with plate without cables. Primary surgical outcomes included hardware failure, nonunion, reoperation, and time to radiographic union. Results There was no significant difference in nonunion rates: 9% in the cerclage cable group vs 16% in the plate-only group ( P = .64). The average time to union was 6.0 months among 17 observed unions in the cerclage cable group, vs 8.0 months among 15 observed unions in the plate-only group, but this failed to reach significance ( P = .12). There was no statistical difference in overall complication rates (13% cerclage vs 16% plate) requiring reoperation ( P = 1.0). Discussion & Conclusion The utilization of 1 mm cerclage cables to hold reduction of PPFFx provides an easy method to hold fixation with a low overall complication rate and no significant differences in nonunion rate or time to union when compared to cases performed without cables.
Is Cervical Disc Degeneration a Compensatory Mechanism in Hirayama Disease? A Retrospective Case‒Control Study
Authors: Wang Zhaoxuan , Ren Jianhua , Chang Hengrui , Xue Rui , Liang Guzhen , Kou Junkai , Meng Xianzhong 
Published: November 2024

Study Design Retrospective Cohort Study. Objective This study aimed to explore the association between cervical disc degeneration and disease progression in patients with Hirayama disease, with a particular focus on changes in the cervical intervertebral disc space height and potential compensatory mechanisms. Methods This retrospective study included 35 patients diagnosed with Hirayama disease (HD), who were compared with 35 healthy control subjects matched for age and sex. This study focused on collecting and analyzing cervical disc grades and intervertebral space heights from C2 to C7, aiming to assess the extent of cervical disc degeneration between HD patients and the control group. The analysis used independent sample t tests and Mann‒Whitney U tests for demographic data and Spearman’s correlation coefficient to explore the relationship between disc degeneration and age. Results Compared with the control group, patients with Hirayama disease presented significant reductions in intervertebral disc height ( P < .01) and increased disc degeneration. Within the HD group, most patients displayed multisegment degeneration (30 out of 35), and more than half presented with full-segment disc degeneration (20 out of 35), which was significantly different from the normal population ( P < .01). Conclusion Patients with Hirayama disease exhibit disc degeneration and reduced intervertebral space height, which may represent a compensatory response.