bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does socioeconomic status modify how individuals perceive or describe their own health? An assessment of reporting heterogeneity in the Health Survey for England
Authors: Fforde Rosanna , Parsons Nicholas , Oyebode Oyinlola 
Published: September 2024

BackgroundSelf-reported health (SRH) is widely used as a proxy for health status; it is a simple, holistic measure of health and has been associated with other health outcomes. However, variation in these associations has been found by subgroup, leaving open the possibility of systematic reporting differences, including by socioeconomic status.MethodsUsing data from the 2017 and 2018 waves of the Health Survey for England, we assessed the relationship between deprivation quintile and SRH using multiple linear regression models for EQ-5D score, a health-related quality of life measure. Reporting heterogeneity between deprivation quintiles was assessed by the significance of model interaction terms. Analyses were stratified by sex and accounted for age group, ethnicity, marital status and religion (females only).ResultsSignificant interactions were found between deprivation quintile and SRH in the models for EQ-5D score for participants reporting poor health in the two most deprived quintiles, with coefficients ranging from –0.041 to –0.098. The largest differences were in the second most deprived quintile for men (–0.075, 95% CI: –0.110 to –0.040, p<0.001) and the most deprived quintile for women (–0.098, 95% CI: –0.128 to –0.067, p<0.001). Secondary analyses using body mass index as the response variable, for models structured in a similar way to those for EQ-5D, found no significant interaction terms between deprivation quintile and SRH.ConclusionsThis analysis suggests that people from more deprived areas who report themselves to be in poor health may have worse health, as measured by EQ-5D, than those from less deprived areas. This could lead to an underestimation of health inequalities, including in measures, such as healthy life expectancy in England, that incorporate SRH data.
How do emergency departments respond to ambulance pre-alert calls? A qualitative exploration of the management of pre-alerts in UK emergency departments
Authors: Long Jaqui , Sampson Fiona C , Coster Joanne , O’Hara Rachel , Bell Fiona , Goodacre Steve 
Published: September 2024

BackgroundCalls to emergency departments (EDs) from ambulances to alert them to a critical case being transported to that facility that requires a special response (‘pre-alerts’) have been shown to improve outcomes for patients requiring immediate time-critical treatment (eg, stroke). However, little is known about their usefulness for other patients and the processes involved in ED responses to them. This study aimed to understand how pre-alerts influence patient care in the ED.MethodsWe undertook non-participant observation (162 hours, 143 pre-alerts) and semi-structured interviews with staff (n=40) in six UK EDs between August 2022 and April 2023 focusing on how ED staff respond to pre-alert calls and what influences their response. Observation notes and interview transcripts were imported into NVivo and analysed using a thematic approach.ResultsPre-alert calls involved significant time and resources for ED staff but they were valued as they enabled staff to prepare for a patient’s arrival (practically and psychologically). High demand and handover delays at ED created additional pre-alerts due to ambulance clinician concerns about the impact of long waits on patients.Despite the risk of pre-alert fatigue from calls for patients considered not to require a special response, ED clinicians appreciated timely pre-alert information, perceiving a higher risk from underalerting than overalerting. Variation in ED response was influenced by individual and organisational factors, particularly the resources available at the time of pre-alert. Unclear ED processes for receiving, documenting and sharing information about pre-alerts increased the risk of information loss.ConclusionImproving processes for receiving and sharing pre-alert information may help ED clinicians prepare appropriately for incoming patients. Alternative routes for ambulance clinicians to seek advice on borderline pre-alert patients may help to improve the appropriateness of pre-alerts.
Impact of double stent retriever configuration on first-pass effect in stroke: a multicenter study
Authors: Pérez-García Carlos , Castaño Miguel , Llibre Juan Carlos , Vargas Luis , López-Frías Alfonso , Rosati Santiago , López Jose Luis , Venegas Jesus , González Eva , Fondevila Jon , Espinosa de Rueda Mariano , Zamarro Joaquín , Baldi Sebastián , Díaz Teresa , de la Rosa Carmen , Chaviano Grajera Juan , Ballenilla Marco Federico , Cuba Victor , Muñoz Olmedo José M , Mendez Jose Carlos , Remollo Sebastian , Bermejo Rebeca , Morales Edison , Gómez-Escalonilla Carlos , Moreu Manuel 
Published: September 2024

BackgroundEfficient recanalization of occluded cerebral arteries is crucial in the treatment of acute ischemic stroke. Double stent retrievers have shown the potential to enhance the rates of recanalization on the first pass. This study aims to evaluate the efficacy and safety of the double stent retriever technique and the predictors of achieving first-pass effect in patients with acute ischemic stroke.MethodsThis prospective multicenter study involved 209 patients from 16 comprehensive stroke centers in Spain. Patients with occlusions in the anterior circulation were treated using the Aperio Hybrid double stent retriever. The study examined various deployment techniques, including simultaneous and sequential deployment and stent configurations, comparing the Y-shaped and parallel configurations.ResultsThe double stent retriever technique achieved a first-pass effect in 72.7% of cases and a final successful recanalization rate of 99.5%. The Y-shaped configuration was significantly associated with higher recanalization rates on the first pass (OR 2.59, 95% CI 1.18 to 5.68, P=0.02). Procedural complications were mild to moderate in 6.7% and severe in 1.5% of cases, with symptomatic intracranial hemorrhage occurring in 3.3% of patients. At 3 months follow-up, 57.2% of patients achieved a good clinical outcome, with a mortality rate of 15.1%.ConclusionThe findings support the efficacy of the double stent retriever technique, particularly the Y-shaped configuration, in achieving high recanalization rates on the first pass with an acceptable safety profile. This technique may offer clinical benefits for future acute ischemic stroke treatment protocols.
Is speech function lateralised in the basal ganglia? Evidence from de novo Parkinson’s disease
Authors: Rusz Jan , Dusek Petr , Tykalova Tereza , Novotny Michal , Illner Vojtech , Simek Michal , Kouba Tomas , Kryze Petr , Zogala David , Ruzicka Evzen , Sousa Mário , Jorge Adriana , Nef Tobias , Krack Paul 
Published: September 2024

BackgroundResearch on the possible influence of lateralised basal ganglia dysfunction on speech in Parkinson’s disease is scarce. This study aimed to compare speech in de-novo, drug-naive patients with Parkinson’s disease (PD) with asymmetric nigral dopaminergic dysfunction, predominantly in either the right or left hemisphere.MethodsAcoustic analyses of reading passages were performed. Asymmetry of nigral dysfunction was defined using dopamine transporter-single-photon emission CT (DAT-SPECT).ResultsFrom a total of 135 de novo patients with PD assessed, 47 patients had a lower right and 36 lower left DAT availability in putamen based on DAT-SPECT. Patients with PD with lower left DAT availability had higher dysarthria severity via composite dysarthria index compared with patients with lower right DAT availability (p=0.01).ConclusionOur data support the crucial role of DAT availability in the left putamen in speech. This finding might provide important clues for managing speech following deep brain stimulation.
Management of low-level HIV viremia during antiretroviral therapy: Delphi consensus statement and appraisal of the evidence
Authors: Rindi Lorenzo Vittorio , Zaçe Drieda , Compagno Mirko , Colagrossi Luna , Santoro Maria Mercedes , Andreoni Massimo , Perno Carlo Federico , Sarmati Loredana 
Published: September 2024

Objective
While antiretroviral therapy (ART) is highly effective, detection of low levels of HIV-1 RNA in plasma is common in treated individuals. Given the uncertainties on the topic, we convened a panel of experts to consider different clinical scenarios, producing a Delphi consensus to help guide clinical practice.

Methods
A panel of 17 experts in infectious diseases, virology and immunology rated 32 statements related to four distinct scenarios: (1) low-level viremia during stable (≥6 months) first-line ART (≥2 consecutive HIV-1 RNA measurements 50–500 copies/mL); (2) a viral blip during otherwise suppressive ART (a HIV-1 RNA measurement 50–1000 copies/mL with adjacent measurements <50 copies/mL); (3) low-level viral rebound during previously suppressive ART (≥2 consecutive HIV-1 RNA measurements 50–500 copies/mL); (4) residual viremia during suppressive ART (persistent HIV-1 RNA quantification below 50 copies/mL). A systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement, informed the 32 statements. The Delphi procedure was modified to include two voting rounds separated by a moderated group discussion. Grading of Recommendations, Assessment, Development, and Evaluations-based recommendations were developed.

Results
Overall, 18/32 statements (56.2%) achieved a strong consensus, 3/32 (9.4%) achieved a moderate consensus and 11/32 (34.4%) did not achieve a consensus. Across the four scenarios, the panel unanimously emphasised the importance of implementing specific interventions prior to considering therapy changes, including assessing adherence, testing for genotypic drug resistance and scheduling more frequent follow-up visits. Strategies indicated in selected circumstances included therapeutic drug monitoring, quantifying total HIV-1 DNA and evaluating concomitant chronic infections.

Conclusions
While acknowledging the many uncertainties about source, significance and optimal management of low-level viremia during ART, the findings provide insights to help harmonise clinical practice. There is a need for well-designed randomised studies assessing different interventions to manage low-level viremia and future research regarding its definition.
Marine migration, thermal habitat use and feeding habits of Arctic charr (Salvelinus alpinus) in SW Greenland
Authors: Davidsen J.G. , Eldøy S.H. , Piper A.T. , Moccetti C. , Brodersen J. , Whoriskey F. , Power M. 
Published: September 2024

Climate change is altering northern coastal aquatic habitats, especially in fjords. Data on current ecosystem structure and biodiversity in many northern fjord and coastal ecosystems, especially for Greenland, are lacking. We used acoustic telemetry combined with stable isotope analyses in a southwest Greenland fjord to investigate marine migrations, marine, and freshwater thermal habitat use, and the marine feeding habits of 80 acoustically tagged Arctic charr over one year. During summer, most Arctic charr occupied the inner fjord. Models of Arctic charr thermal habitat use suggested higher experienced water temperatures in the inner compared to outer fjord (estimated 1.59 °C difference) during tagged charr mean 70-day (SD = 14 days) residencies. During February and March, non-migratory individuals used warmer waters (+0.56 °C higher) than fish that ultimately migrated to sea, suggesting that over-wintering habitat use patterns influenced migration tactics. Stable isotope mixing model analysis indicated that Arctic charr fed mainly on capelin, marine gammarids, and three-spine sticklebacks. The results provide a contemporary baseline for assessing predictions of potential changes in the ecology of Arctic charr in SW Greenland fjords.
Chitosan‐Based Hemostatic Pad Reduced Vascular Complications After Transradial Coronary Intervention in Uncontrolled Hypertensive Patients: Application of Chitosan‐Based Hemostatic Pad on CAG or PCI
Authors: Qian Lu , Cao Ming-Qiang , Feng Ze-Xiong , Zou Cao , Sun Si-Jia , Hu Sheng-Da 
Published: September 2024

Background: Vascular complications after coronary angiography (CAG) or percutaneous coronary intervention (PCI) are a major concern for revascularization therapies. In this study, we investigated whether the application of a chitosan‐based hemostatic pad (HP) could ameliorate vascular complications after CAG or PCI procedures.Methods: We retrospectively analyzed patients undergoing CAG or PCI in our cardiovascular center from January 2019 to December 2021. The incidence of total vascular complications including errhysis, large hematoma, pseudoaneurysm, radial artery occlusion (RAO), blister, and pain was recorded. Subgroup analyses of patients with a history of hypertension, patients with uncontrolled hypertension, and patients with controlled hypertension were performed.Results: Our results demonstrated that the application of chitosan‐based HP had no effect on vascular complications after CAG or PCI procedures (odds ratio [OR]: 1.03 (0.84–1.26), p = 0.80). Nevertheless, chitosan‐based HP treatment markedly decreased the incidence of vascular complications in uncontrolled hypertensive patients (OR: 0.32 (0.11–0.95), p = 0.04), but not in hypertensive patients with controlled blood pressure (BP) (OR: 1.09 (0.88–1.35), p = 0.42).Conclusions: Chitosan‐based HP treatment could reduce the incidence of vascular complications in patients with uncontrolled hypertension. Nonetheless, applying chitosan‐based HP treatment after CAG or PCI procedures is not recommendable for controlled hypertensive patients.
A Case of Rapidly Progressive De Novo Metastatic Small‐Cell Neuroendocrine Prostate Cancer
Authors: Dalal Aryan , Clark-Garvey Sean , Gdowski Andrew , Zhang Sophia , Wobker Sara E. , Rowe Steven P. , Altun Ersan , Beltran Himisha , Milowsky Matthew I. 
Published: September 2024

Introduction: Neuroendocrine/small‐cell prostate cancer (NEPC) is a rare and aggressive subtype of prostate cancer, which typically develops after prolonged treatment for metastatic castration‐resistant disease, but can, less commonly, occur de novo.Case Presentation: We describe a case of de novo NEPC in a tumor with mixed pathology including acinar adenocarcinoma and neuroendocrine/small‐cell carcinoma with rapid progression of metastatic disease. Despite initiation of treatment with androgen deprivation therapy (ADT) and chemotherapy, the patient continued to exhibit progression leading to multiple complications including a large bowel obstruction and ultimately progressive hepatic metastases resulting in liver failure.Conclusion: This case illustrates the clinical presentation and highly aggressive nature of de novo NEPC. Recognizing atypical clinical progression in prostate cancer is critical for the detection of NEPC; however, despite early identification and initiation of treatment, the prognosis remains poor, thus highlighting the need for further study into NEPC biology and novel therapeutic approaches.
Precise In Situ Delivery of a Photo-Enhanceable Inflammasome-Activating Nanovaccine Activates Anticancer Immunity
Authors: Zhou Yang , Pang Li , Ding Tao , Chen Kang , Liu Jinzhao , Wu Meicen , Wang Weiping , Man Kwan 
Published: September 2024

Abstract
A variety of state-of-the-art nanovaccines (NV) combined with immunotherapies have recently been developed to treat malignant tumors, showing promising results. However, immunosuppression in the tumor microenvironment (TME) restrains cytotoxic T-cell infiltration and limits the efficacy of immunotherapies in solid tumors. Therefore, tactics for enhancing antigen cross-presentation and reshaping the TME need to be explored to enhance the activity of NVs. Here, we developed photo-enhanceable inflammasome-activating NVs (PIN) to achieve precise in situ delivery of a tumor antigen and a hydrophobic small molecule activating the nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain–containing protein 3 inflammasome (NLRP3) pathway. Near-infrared light irradiation promoted PIN accumulation in tumor sites through photo-triggered charge reversal of the nanocarrier. Systematic PIN administration facilitated intratumoral NLRP3 inflammasome activation and antigen cross-presentation in antigen-presenting cells upon light irradiation at tumor sites. Furthermore, PIN treatment triggered immune responses by promoting the production of proinflammatory cytokines and activating antitumor immunity without significant systematic toxicity. Importantly, the PIN enhanced the efficacy of immune checkpoint blockade and supported the establishment of long-term immune memory in mouse models of melanoma and hepatocellular carcinoma. Collectively, this study reports a safe and efficient photoresponsive system for codelivery of antigens and immune modulators into tumor tissues, with promising therapeutic potential.
Significance: The development of a photoresponsive nanovaccine with spatiotemporal controllability enables robust tumor microenvironment modulation and enhances the efficacy of immune checkpoint blockade, providing an effective immunotherapeutic strategy for cancer treatment.
See related commentary by Zhen and Chen, p. 3709
Construction and Validation of a Novel Forecasting Nomogram to the Risk of Colorectal Adenomas: Preventing Colorectal Cancer at Its Origin
Authors: Li Mao , Cui Mingyu , Zhou Xiaobin , Song Ying 
Published: September 2024

Abstract
Colorectal adenomas are responsible for the origin of most colorectal cancers. Early detection together with active intervention of colorectal adenomas plays a crucial role in the prevention of colorectal cancer. This study aimed to construct and validate a new nomogram for the forecasting of the risk of colorectal adenomas based on lifestyle risk factors that could offer potential benefits for colorectal cancer prevention. Colonoscopy reports, pathology reports, physical factors, family history, personal history of disease, diet, and lifestyle habits were collected from 1,133 subjects who underwent complete colonoscopy. All subjects were divided into the training cohort (n = 792) and the validation cohort (n = 341). A nomogram predicting the risk of colorectal adenoma development was constructed using the training cohort, and the C-index was calculated. The predictive accuracy and clinical applicability of the nomogram were verified in the validation cohort. The nomogram was constructed by six statistically significant variables selected from 18 health factors, including advanced age, male, smoking, drinking, pickles, and irregular defecation. The C-index of the training cohort was 0.778, and the C-index of the validation cohort was 0.754. The calibration curve and decision curve analysis also confirmed that the model has good predictive ability and high profit. The nomogram constructed in this study was validated and can be applied to predicting the occurrence risk of colorectal adenoma. The model can guide the identification of patients with nonsymptomatic colorectal adenomas and the recognition of high-risk individuals for whom colonoscopy is advisable.
Prevention Relevance: Colorectal adenomas are the origin of most colorectal cancers. In this research, we explored the risk factors of colorectal adenomas and constructed a colorectal adenoma risk prediction nomogram in the expectation of early detection of patients with nonsymptomatic colorectal adenoma and advocated for their aggressive treatment to achieve colorectal cancer prevention.
CCTA-Guided Invasive Coronary Angiography in Patients With CABG: A Multicenter, Randomized Study
Authors: Tsigkas Grigorios , Toulgaridis Fotios , Apostolos Anastasios , Kalogeropoulos Andreas , Karamasis Grigoris V. , Vasilagkos Georgios , Pappas Loukas , Toutouzas Konstantinos , Tsioufis Konstantinos , Korkonikitas Panagiotis , Tsiafoutis Ioannis , Hamilos Michalis , Ziakas Antonios , Kanakakis Ioannis , Moulias Athanasios , Zampakis Petros , Davlouros Periklis , Papanikolaou Amalia , Spyropoulou Panagiota , Chlorogiannis Dimitrios David , Chamakioti Mirsini , Spanou Eleftheria , Kartas Nikolaos , Vithoulkas Nikolaos , Sideris Antonios , Zacharoulis Achilleas , Lampropoulos Konstantinos , Georgopoulos Stamatis , Synetos Andreas , Latsios Georgios , Alexopoulos Dimitrios , Argentos Stilianos , Xenogiannis Iosif , Triantafyllou Konstantinos , Patsilinakos Sotirios , Fagkrezos Dimitrios , Mantis Christos , Pappa Aikaterini , Koutouzis Michail , Sakellaropoulou Antigoni , Kochiadakis Georgios , Kladou Eleni , Sianos Georgios , Kouparanis Antonios , Karagiannidis Efstratios , Daios Stylianos , Papoutsis Dimitrios , Sertedaki Eleni 
Published: September 2024

BACKGROUND:
Coronary computed tomography angiography (CCTA) in patients with post–coronary artery bypass graft (CABG) has a high diagnostic accuracy for visualization of grafts. Invasive coronary angiography (ICA) in patients with CABG is associated with increased procedural time, contrast agent administration, radiation exposure, and complications, compared with non-CABG patients. The aim of this multicenter, randomized controlled trial was to compare the strategy of CCTA-guided ICA versus classic ICA in patients with prior CABG.

METHODS:
Patients with prior CABG were randomly assigned (1:1 ratio) to have a CCTA before ICA (CCTA-ICA, group A) or not (ICA-only, group B). The primary end point of the study was the total volume (milliliters) of the contrast agent administered.

RESULTS:

A total of 251 patients were randomized, and 225 were included in analysis; 110 in group A and 115 in group B. The total contrast volume was higher in group A (184.5 [143–255] versus 154 [102–240] mL;
P
=0.001). The contrast volume administered during the invasive procedure was lower in group A (101.5 [60–151] versus 154 [102–240];
P
<0.001). Total fluoroscopy time was decreased in group A (480 [259–873] versus 594 [360–1080] seconds;
P
=0.027), but total effective dose was increased (24.1 [17.7–32] versus 10.8 [5.6–18] mSv;
P
<0.001). The rate of contrast-induced nephropathy, periprocedural complications, and major adverse cardiac events during 3 to 5 and 30 days did not differ significantly between the 2 groups.

CONCLUSIONS:
A CCTA-directed ICA strategy for patients with CABG is associated with expedition of the invasive procedure, and less fluoroscopy time, at the cost of higher total contrast volume and effective radiation dose, compared with the classic ICA approach.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04631809.