bluuebunny/crossref_metadata_2025_split huggingface dataset:
Triptan non-response in a London tertiary headache centre: What can we learn? A retrospective study
Authors: Wilcha Robyn-Jenia , Goadsby Peter J. 
Published: September 2024

Background Triptans revolutionized the acute treatment of migraine; however, varied responses to triptans, as a result of poor efficacy and tolerability, are reported. A standardized definition of triptan non-response was recently proposed by the European Headache Federation (EHF). There is currently limited data available on the prevalence of triptan non-response. Methods We used clinic letters over a two-year duration to evaluate the triptan response and triptan efficacy or tolerability failure, or both, in a London-based tertiary headache service. Results In total, 419 adult migraine patients (females: 83.8%, age: 46 ± 18 years, chronic migraine: 88.5%) were included in a service evaluation. In line with the EHF definitions, “triptan non-response” was seen in 63.8% of patients (264/414), whereas 37.7% of patients (156/414) had failed at least two triptans (EHF “triptan resistant”) and 4.6% of patients (19/414) had failed at least three triptans, including a subcutaneous formulation (EHF “triptan refractory”). Notably, 21.3% of patients (88/414) had failed at least three triptans inclusive and exclusive of subcutaneous triptan use. Advancing age ( p < 0.001) and the presence of medication overuse ( p = 0.006) increased the probability of triptan response, whereas an increased number of failed preventives ( p < 0.001) and the use of calcitonin gene-related peptide monoclonal antibodies ( p = 0.022) increased the probability of triptan non-response. The largest proportion of patients responded to eletriptan (49.5%), followed by nasal zolmitriptan (44.4%) and rizatriptan (35.7%). Conclusions Our findings highlight an alarming prevalence of triptan non-response among adult migraineurs receiving treatment in a London-based tertiary headache service. It is imperative for clinicians to explore methods to optimize acute medication efficacy, whether this comprises changing to a triptan with a superior response rate, advocating for early intervention or considering alternative acute medication classes, such as gepants or ditans.
The Correlation Between Quality of Care and Mental Health and Behavioral Problems Among Vietnamese Adolescents in Social Support Facilities
Authors: Pham Sy Tien , Duong Thanh Thanh Thi , Nguyen Hoai Phuong Thi , Truong Xuan Nhi Thi 
Published: September 2024

Background: Previous studies have shown the negative impact of institutional care on children’s physical and mental health. However, in addition to the form of care, the quality of care is an important factor in children’s mental health. This study explored the quality of care and the association between the quality of care and mental health issues among adolescents in Vietnam social support facilities (SSFs). Methods: A cross-sectional study was conducted with 273 institutionalized adolescents who lived in SSFs and 273 adolescents cared for by family. Depressive symptoms, anxiety symptoms, sleep problems, behavioral problems, and quality of care were measured. Descriptive statistics were calculated, and multiple linear regression analysis was performed. Results: The quality of care was rated as quite high by institutionalized adolescents. However, the mean score for quality of care was significantly lower for institutionalized adolescents than for the comparison group. The quality of physical care did not show a significant relationship with mental health risk, except for anxiety. In contrast, emotional care was negatively associated with all common mental health problems including anxiety (beta = –0.40, P < .001), depression (beta = –0.31, P < .01), conduct behavior (beta = –0.30, P < .01) and sleep problems (beta = –0.30, P < .01). An increase in emotional care was therefore associated with a decrease in mental health problems. Conclusions: Emotional care is more important than physical care for adolescents in SSFs. It is necessary to improve the quality of care, particularly emotional care, for adolescents to reduce the risk of mental health problems.
Study of Correlation of Apgar Score and Thompson Score with Hepatic Function in Perinatal Asphyxia Affected Neonates—A Prospective Observational Study
Authors: Siddhanta Meghna , Ghoshal Bhaswati , Basu Kaushambi 
Published: September 2024

Background Perinatal asphyxia is one of the leading causes of neonatal morbidity and mortality in the country. It leads to multi-organ failure with brain involvement as the major organ of concern (hypoxic-ischemic encephalopathy). Hepatic dysfunction is also a feature of perinatal asphyxia. Objectives To detect hepatic dysfunction in birth asphyxia. To correlate the liver damage with increasing severity of birth asphyxia and hypoxic-ischemic encephalopathy through Apgar score and Thompson score. Methods In this prospective observational study, after ethical clearance and informed consent from the parents, babies of gestational age >35 weeks weighing >1.8 kg, Apgar score <7 at 1 minute received in the newborn unit of a tertiary care hospital in West Bengal, India were enrolled. Thompson’s score was assessed every day. The liver function test of these patients was assessed on days 1, 3, 10, and 15. Ultrasonography of the whole abdomen was performed on days 1 and 14 of life to rule out other probable causes of hepatic injury. Results A total of 308 neonates were studied, of which Apgar score at 1 minute indicates that 99 (32.14%) of the newborns had severe birth asphyxia and the rest had moderate birth asphyxia. All the liver enzymes except total protein and albumin showed a significant rise on days 1 and 3 with increasing severity of asphyxia. This correlation was seen with Apgar score at 1 minute on day 1 with TSB (r = -0.256, P < .001), AST (r = -0.209, P < .01), ALT (r = -0.178, P < .002), ALP (r = -0.174, P < .002). As per Thompson score, total serum bilirubin, aspartate aminotransferase and alkaline phosphatase showed maximum correlation on days 1 (r = 0.253, P < .001, r = 0.187, P < .001 and r = 0.268, P < .001, respectively) and on day 3 (r = 0.159, P < .005, r = 0.231, P < .001, and r = 0.190, P < .002, respectively). Conclusion Thompson score and Apgar score can be correlated to perinatal asphyxia-related hepatic injury.
Efficacy and Safety of Testosterone Replacement in Testicular Cancer Survivors With Treatment-Influenced Hypogonadism: A Systematic Review
Authors: Fritz Andrew A. , Reinert Justin P. 
Published: September 2024

Objective: The objective is to evaluate the efficacy and safety of testosterone supplementation in testicular cancer survivors with treatment-related hypogonadism. Data Sources: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and used Embase, PubMed/MEDLINE, Cochrane Central, Web of Science Core Collection, Korean Journal Index, SciELO, and Global Index Medicus to obtain data in June of 2024. Study Selection and Data Extraction: Analyses evaluating testosterone supplementation in testicular cancer survivors with treatment-induced hypogonadism were included. Any analyses not assessing supplementation in this population or deemed unretrievable were excluded. Data Synthesis: Ten analyses were included for analysis. A total of 332 bilateral or unilateral testicular cancer survivors with treatment-influenced hypogonadism were reviewed, with 238 patients receiving testosterone replacement. Eight of the 10 analyses assessed participants without poor quality-of-life (QOL) metrics, metabolic factors, and bone mineral density (BMD) at baseline and only found a significant benefit in fat distribution metrics with testosterone supplementation. Two analyses evaluated participants with poor QOL metrics or BMD at baseline and showed improvements in QOL or BMD with testosterone supplementation. Relevance to Patient Care and Clinical Practice: There is robust evidence regarding the efficacy and safety of testosterone replacement in hypogonadal individuals but limited evidence specifically evaluating supplementation in testicular cancer survivors with treatment-influenced hypogonadism. Conclusions: The results suggest testosterone replacement may be beneficial in patients with impaired QOL metrics, metabolic factors, and BMD at baseline; the results also suggest that routine supplementation for all individuals in this patient population lacks efficacy.
Evaluation of collateral circulation in patients with internal carotid artery occlusion: A clinical and ultrasonographic multicenter study
Authors: Liu Ran , Gao Mingjie , Zhao Xinyu 
Published: September 2024

Background: Internal carotid artery (ICA) occlusion is the major cause of ischemic stroke. The effect of collateral vessels on cerebral hemodynamics in ICA occlusion remains unclear. This study investigated the correlation between collateral vessels and the peak systolic velocity of the middle cerebral artery (MCA) in patients with ICA occlusion. Methods: The relevant collateral vessels included the anterior communicating (ACoA), posterior communicating (PCoA), and internal-external carotid (IECCA) arteries, respectively. Patients with unilateral ICA occlusion ( n = 251) underwent transcranial Doppler imaging to detect the peak systolic velocity (PSV) of the MCA and other intracranial arteries. The clinical symptoms were assessed using the National Institutes of Health Stroke Scale (NIHSS). Results: Patients with ACoA collaterals had significantly higher PSVMCA scores and significantly lower NIHSS scores than those without ACoA collaterals ( p < 0.001). Patients without any notable collaterals and those with only IECCA had the lowest PSVMCA and highest NIHSS scores. The PSVMCA and NIHSS scores were negatively correlated ( r = −0.566, p < 0.001). Conclusion: Collateral circulation patency in unilateral ICA occlusion was closely associated with clinical symptoms, and patients with ACoA collaterals may have favorable outcomes. (ClinicalTrials.gov Identifier: NCT02397655)
Beyond the battle: A cross-sectional study on cancer-related fatigue and predictors of quality of life in female adolescent and young adult survivors
Authors: Naittee George Prema , MP Ganesh 
Published: September 2024

Objectives The study delves into the intricacies of cancer-related fatigue (CRF), the quality of life (QoL), and other demographic variables of female adolescent and young adult cancer survivors (AYACS) in the landscape of Kerala, India. Methods The cross-sectional study included 288 female AYACS who were selected through purposive sampling and completed self-reported questionnaires on CRF, QoL, and demographic and clinical data. Statistical analyses were applied, including correlation, one-way ANOVA, and regression. Results and discussion: The temporal dimension is particularly interesting, as individuals three to five years post-treatment report heightened CRF and QoL scores. Furthermore, the research unveils the pivotal role played by predictors such as marital status, educational attainment, and employment status in shaping QoL. Marital status and education emerge as positive predictors of well-being. The study unveils compelling insights into AYA cancer survivorship, revealing a profound impact of CRF on the quality of life dimensions. The role of spirituality, sometimes affecting social connectedness, adds intrigue. Conclusion The findings provide insights into the complex world of female AYACS, compelling researchers to ponder the significance of addressing CRF and tailoring rehabilitation systems during the critical post-treatment phase, with recognition of gender-specific challenges.
Effect of methylprednisolone in reducing severe COVID-19 and mortality in high-risk patients: A retrospective study
Authors: Xiao Yan , Wang Jinwei , Yang Kai , Jiang Meiling , Luo Jialin , Chen Kun , Zhang Bo 
Published: September 2024

Introduction: The treatment of COVID-19 patients, especially high-risk patients, remains a large challenge. Glucocorticoids have been accepted as effective medicines for severe COVID-19. However, the glucocorticoid usage guidelines do not cover all the indications for high-risk patients. Objective: To identify more effective treatments for high-risk patients with COVID-19, this retrospective study analyzed routine epidemiological, clinical, and laboratory data from 33 high-risk patients with COVID-19 in Beijing Gobroad Boren Hospital, Beijing, China, most of whom responded well to treatment. Methods: Severe acute respiratory syndrome coronavirus-2 infection was confirmed via real-time reverse transcriptase polymerase chain reaction assays. Outcome measures such as duration of mechanical ventilation, intensive care unit length of stay, and 28-day mortality were analyzed. Patients were divided into two groups: mild to moderate COVID-19 ( n = 26) and severe COVID-19 ( n = 7). Chest computed tomography images were used to guide methylprednisolone administration or withdrawal. Results: Upon intensive care unit admission, 12.1% of patients were mechanically ventilated with an average partial pressure of oxygen/fraction of inspired oxygen(PaO2/FiO2) ratio of 279 ± 146. No coinfections with other endemic viruses were observed. The duration of mechanical ventilation was 16 days (interquartile range: 8–28); the intensive care unit length of stay was 11 (interquartile range: 2–33) days; and the 28-day total mortality was 3.0%. Conclusion: Multivariate regression analysis revealed that low-dose, timely methylprednisolone administration was associated with a lower severe COVID-19 rate and mortality in high-risk patients. For high-risk patients, once there are ground-glass opacities (GGO) in the computed tomography image, continuous and low-dose methylprednisolone administration promotes inflammation remission and protects them from severe COVID-19 or mortality.
Risk Factors, Clinical Profile, and Outcomes of Coronary Artery Disease in the Elderly
Authors: Garikapati Vrandha , Mondal Sudipta , P Abhilash Sreevilasam , Sivadasanpillai Harikrishnan , Kumaran Ajit Kumar Valaparambil 
Published: September 2024

Objectives This study aimed to identify risk factors in patients diagnosed with angiographically significant coronary artery disease (CAD) after 65 years of age (elderly) with a subset analysis of more than 75 years, analyze their clinical, angiographic profile and assess their major acute cardiovascular and cerebrovascular events (MACCE). Methods This was an observational retrospective and prospective study conducted from January 2022 to June 2023 among consecutive elderly who underwent CAG for suspected or diagnosed CAD between 2010 and 2018 at a tertiary center in South India. Results A total of 1,511 patients satisfied eligibility criteria with mean age of 69.38 years and male preponderance (69%). Male gender, dyslipidemia and current tobacco use contributed to angiographically significant CAD by multiple logistic regression analysis but none of the risk factors contributed in the more than 75-year age group. Female patients had higher incidence of atypical presentation, less revascularizations and higher MACCE. Fourteen percent of patients with significant CAD developed MACCE over a median 3.5-year hospital follow-up. Survival analysis of 1,027 patients with significant CAD showed one, three, 5-year mortality rate of 4.3%, 6.9% and 10.8%, respectively, with left ventricular dysfunction and triple vessel disease being associated with worse survival. MACCE and 5-year survival was significantly better among those who underwent revascularization including those with significant left main or triple vessel disease. Conclusion This study showed a high prevalence of traditional risk factors in elderly patients among which male gender, dyslipidemia, current tobacco use were found to predict angiographically significant CAD. Triple vessel disease and left ventricular dysfunction were associated with worse survival. Mortality was significantly lower among elderly who underwent revascularization compared to medical management.
Effect of population density in aging societies and severity of motor vehicle crash injuries: the case of Spain
Authors: Cespedes Luis , Ayuso Mercedes , Santolino Miguel 
Published: September 2024

AbstractThe concentration of population in cities and processes of rural depopulation coupled with the generational shift to older societies represent new challenges in road safety. Here, we examine the severity of injuries suffered by the occupants of motor vehicles involved in a crash based on the population density of the area in which the crash occurs, the driver’s age and the density of their place of residence. We conduct the study in Spain, a country with one of the highest levels of elderly population concentrated in rural areas in Europe. Relational methods are used to match Eurostat’s urbanization classifications with the accident database of Spain’s Directorate General of Traffic so as to correlate each crash with the population density of the place where it occurred. A set of generalized linear models with random effects is fitted to analyze the relationship between population density and the bodily injury severity of the occupants of the vehicle(s) involved in a crash, measuring the effect of drivers’ relocation and aging by geographical area. Independence of injury severity and the degree of urbanization was rejected at the 5% significance level. While 53.8% of the Spanish population is living in densely populated areas and only 13.5% in rural areas, the latter concentrates most crashes with fatalities: 2.3 times more than in urban areas (43.5 and 18.6%, respectively). Drivers living in rural areas are more likely to be associated with serious or fatal injuries when involved in a crash in urban and intermediate areas. Moreover, drivers aged over 75 are significantly more likely to be associated with serious and fatal injuries, especially when the crash occurred in urban areas. Recent research alerts on the implications for rural (often elderly) residents of concentrating public services, particularly healthcare, in densely populated areas. Our study shows that motor crashes in more densely populated areas are also a rural health concern. Policy decision-makers need to address this issue to reduce the number of victims and their bodily injury severity.
The frail-LESS (LEss sitting and sarcopenia in frail older adults) remote intervention to improve sarcopenia and maintain independent living via reductions in sedentary behaviour: findings from a randomised controlled feasibility trial
Authors: Bailey Daniel P. , Harper Jamie H. , Kilbride Cherry , McGowan Laura J. , Victor Christina , Brierley Marsha L. , Chater Angel M. 
Published: September 2024

Abstract
Background
Sarcopenia leads to functional disability, dependence in activities of daily living (ADL), and is a key contributor to frailty. Reducing and breaking up sedentary time is associated with improved sarcopenia and frailty-related outcomes. The aim of this study was to determine the feasibility of delivering and evaluating a remote sedentary behaviour intervention to improve sarcopenia and independent living in older adults with frailty.

Methods
A two-arm randomised controlled feasibility trial was conducted with a target of 60 older adults (mean age 74 ± 6 years) with very mild or mild frailty. Participants were randomised to the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or usual care control group for six months. The intervention included tailored feedback on sitting, standing and stepping; an education workbook that included goal setting and action planning; one-to-one health coaching; peer support; and a wearable device to self-monitor sedentary behaviour. Participant recruitment (percentage of eligible individuals recruited), retention and data completion rates were used to assess trial feasibility. Acceptability of the trial was explored through interviews and safety was evaluated via unplanned healthcare utilisation and number of falls. Sitting, standing, stepping and sarcopenia were measured to evaluate potential intervention effects.

Results
Sixty participants were recruited. Recruitment and retention rates were 72% and 83%, respectively. Completion rates for outcome measures ranged from 70 to 100%. The trial was safe (< 1 fall per participant on average at each timepoint) and trial procedures were acceptable. Descriptive analysis (mean ± SD) showed that daily sitting was 25.1 ± 82.1 min/day lower in the intervention group, and 6.4 ± 60.5 min/day higher in the control group, at 6 months compared with baseline. Hand grip strength and sit-to-stand score were improved by 1.3 ± 2.4 kg and 0.7 ± 1.0, respectively, in the intervention group.

Conclusions
This study demonstrates the feasibility and safety of delivering and evaluating a remote intervention to reduce and break up sitting in older adults with frailty. The intervention showed evidence towards reducing daily sitting and improving sarcopenia, supporting its evaluation in a definitive randomised controlled trial.

Trial registration
ISRCTN registry (registration number: ISRCTN17158017). Registered 6th August 2021.
Genomic approach to determine sources of neonatal Staphylococcus aureus infection from carriage in the Gambia
Authors: Bojang Abdoulie , Chung Matthew , Camara Bully , Jagne Isatou , Guérillot Romain , Ndure Ebrahim , Howden Benjamin P , Roca Anna , Ghedin Elodie 
Published: September 2024

AbstractStaphylococcus aureus is a major cause of neonatal infections in various anatomical sites, resulting in high morbidity and mortality in The Gambia. These clinical infections are often preceded by nasal carriage of S. aureus, a known risk factor. To determine whether potential sources of newborn S. aureus infections were from carriage, and to characterize S. aureus present in different anatomical sites (blood, ear, eye, umbilical cord, skin, pus, oropharynx, breast milk and vagina), we performed whole-genome sequencing of 172 isolates from clinical sites as well as from healthy and unhealthy carriage. A random selection of mothers (n = 90) and newborns (n = 42) participating in a clinical trial and testing positive for S. aureus were considered for this study. Sequence data were analyzed to determine S. aureus multilocus sequence types and selected antimicrobial and virulence gene profiles. Our findings revealed that in The Gambia, ST15 is the dominant sequence type associated with both carriage and clinical infection. In addition, S. aureus isolates causing clinical infection among neonates were genetically similar to those colonizing their oropharynx, and the different anatomical sites were not found to be uniquely colonized by S. aureus of a single genomic profile. Furthermore, while S. aureus associated with clinical infection had similar antimicrobial resistance gene profiles to carriage isolates, only hemolysin and adhesive factor virulence genes were significantly higher among clinical isolates. In conclusion, this study confirmed S. aureus oropharyngeal colonization among neonates as a potential source of clinical infection in The Gambia. Hence, interventions aiming to reduce neonatal clinical infections in The Gambia should consider decreasing oropharyngeal S. aureus carriage.Trial registration The trial was registered at ClinicalTrials.gov NCT03199547.