bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspirin‐Free Strategy for Percutaneous Coronary Intervention in Patients With Oral Anticoagulation: Prespecified Subgroup Analysis From the STOPDAPT‐3 Trial
Authors: Natsuaki Masahiro , Watanabe Hirotoshi , Morimoto Takeshi , Yamamoto Ko , Obayashi Yuki , Nishikawa Ryusuke , Ando Kenji , Suwa Satoru , Isawa Tsuyoshi , Takenaka Hiroyuki , Ishikawa Tetsuya , Yamada Minoru , Wakatsuki Tetsuzo , Nozaki Yoichi , Kitahara Hideki , Kato Ryuichi , Kawai Ryoma , Kobayashi Yohei , Ishii Mitsuru , Goto Yoshitaka , Ono Koh , Kimura Takeshi 
Published: July 2024

Background
The effects of aspirin‐free strategy on bleeding and cardiovascular events in patients undergoing percutaneous coronary intervention with oral anticoagulation (OAC) have not been fully elucidated.

Methods and Results

We conducted the prespecified subgroup analysis based on the use of OAC, including vitamin K antagonist and direct oral anticoagulants, within 7 days before percutaneous coronary intervention in the STOPDAPT‐3 (Short and Optimal Duration of Dual Antiplatelet Therapy‐3) trial, which randomly compared prasugrel monotherapy (2984 patients) to dual antiplatelet therapy (DAPT) with prasugrel and aspirin (2982 patients) in patients with acute coronary syndrome or high bleeding risk. The coprimary end points were major bleeding events (Bleeding Academic Research Consortium types 3 or 5) and cardiovascular events (a composite of cardiovascular death, myocardial infarction, definite stent thrombosis, or ischemic stroke) at 1 month. Among 5966 study patients, there were 530 patients (8.9%) with OAC (no aspirin: N=248, and DAPT: N=282) and 5436 patients (91.1%) without OAC (no aspirin: N=2736, and DAPT: N=2700). Regardless of the use of OAC, the effects of no aspirin compared with DAPT were not significant for the bleeding end point (OAC: 4.45% and 4.27%, hazard ratio [HR], 1.04 [95% CI, 0.46–2.35]; no‐OAC: 4.47% and 4.75%, HR, 0.94 [95% CI, 0.73–1.20];
P
for interaction=0.82), and for the cardiovascular end point (OAC: 4.84% and 3.20%, HR, 1.53 [95% CI, 0.64–3.62]; no‐OAC: 4.06% and 3.74%, HR, 1.09 [95% CI 0.83–1.42];
P
for interaction =0.46).

Conclusions
The no‐aspirin strategy compared with the DAPT strategy failed to reduce major bleeding events irrespective of the use of OAC. There was a numerical excess risk of the no‐aspirin strategy relative to the DAPT strategy for cardiovascular events in patients with OAC.
Frailty and Clinical Outcomes of Ticagrelor Versus Clopidogrel in Older Adults With Acute Myocardial Infarction
Authors: Ko Darae , Evans Peter T. , Lin Kueiyu Joshua , Pande Ashvin N. , Cervone Alexander , Lee Su Been , Cheng Susan , Tsacogianis Theodore , Glynn Robert J. , Kim Dae Hyun 
Published: July 2024

Background
Ticagrelor is recommended over clopidogrel in acute coronary syndrome based on the results of the PLATO (Study of Platelet Inhibition and Patient Outcomes) trial. We aimed to emulate PLATO in older adults with and without frailty and with acute coronary syndrome treated with percutaneous coronary intervention.

Methods and Results
We created a new‐user cohort of Medicare fee‐for‐service beneficiaries aged ≥65 years hospitalized for acute coronary syndrome from 2014 to 2018 and initiated ticagrelor or clopidogrel following percutaneous coronary intervention. Frailty was defined using a validated claims‐based frailty index ≥0.25. Coprimary outcomes were major adverse cardiovascular events and major bleeding. Follow‐up began on the date of first outpatient prescription for ticagrelor or clopidogrel and ended on the earliest date for an outcome event, death, discontinuation of the index drug, or disenrollment from Medicare. The study included 42 843 older adults; 23% were frail. After propensity score matching, the rates of major adverse cardiovascular events per 100 person‐years comparing ticagrelor versus clopidogrel groups were 7.8 and 7.3 in the frail cohort (hazard ratio [HR], 1.07 [95% CI, 0.84–1.36]) and 3.7 and 4.2 in the nonfrail cohort (HR, 0.87 [95% CI, 0.75–1.02]). The corresponding rates of major bleeding were 4.3 and 3.8 in the frail cohort (HR, 1.12 95% CI, [0.80–1.56]) and 2.2 and 1.8 in the nonfrail cohort (HR, 1.22 [95% CI, 0.98–1.51]).

Conclusions
There was a trend toward a modest reduction in risk of major adverse cardiovascular events and a trend toward a modest increase in risk of major bleeding with ticagrelor compared with clopidogrel in the nonfrail cohort. There was insufficient evidence for the benefit of ticagrelor in frail older adults.
Acute Declines in Estimated Glomerular Filtration Rate in Patients Treated With Benazepril and Hydrochlorothiazide Versus Amlodipine and Risk of Cardiovascular Outcomes
Authors: Ku Elaine , Jamerson Kenneth , Copeland Timothy P. , McCulloch Charles E. , Tighiouart Hocine , Sarnak Mark J. 
Published: July 2024

Background
Acute declines in estimated glomerular filtration rate (eGFR) occur commonly after starting angiotensin‐converting enzyme inhibitors. Whether declines in eGFR that occur after simultaneously starting angiotensin‐converting enzyme inhibitors with other antihypertensive agents modifies the benefits of these agents on cardiovascular outcomes is unclear.

Methods and Results
We identified predictors of acute declines in eGFR (>15% over 3 months) during randomization to benazepril plus amlodipine versus benazepril plus hydrochlorothiazide in the ACCOMPLISH (Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension) trial. We then determined the relation between declines in eGFR (treated as a binary variable, ≤15% versus >15% and separately, as a restricted spline variable) and the composite risk of fatal and nonfatal cardiovascular events using Cox proportional hazards models. We included 10 714 participants (median age 68 years [Q1 63, Q3 73]), of whom 1024 reached the trial end point over median follow‐up of 2.8 years. Predictors of acute declines in eGFR>15% over 3 months included assignment to hydrochlorothiazide (versus amlodipine) and higher baseline albuminuria. Overall, declines in eGFR ≥15% (versus <15%) were associated with a 26% higher hazard of cardiovascular outcomes (95% CI, 1.07–1.48). In spline‐based analysis, risk for cardiovascular outcomes was higher in the hydrochlorothiazide arm at every level of decline in eGFR compared with the same magnitude of eGFR decline in the amlodipine arm.

Conclusion
Combined use of benazepril and amlodipine remains superior to benazepril and hydrochlorothiazide for cardiovascular outcomes, regardless of the magnitude of the decline in eGFR that occurred with initiation of therapy.
Secondary Stroke Prevention in People With Schizophrenia
Authors: Kapral Moira K. , Porter Joan , Kurdyak Paul , Yu Amy Y. X. , Matheson Emilie , Fang Jiming , Casaubon Leanne K. , Kapoor Eshita , Sheehan Kathleen A. 
Published: July 2024

Background
People with schizophrenia are less likely than those without to be treated for cardiovascular disease. We aimed to evaluate the association between schizophrenia and secondary preventive care after ischemic stroke.

Methods and Results
In this retrospective cohort study, we used linked population‐based administrative data to identify adults who survived 1 year after ischemic stroke hospitalization in Ontario, Canada between 2004 and 2017. Outcomes were screening, treatment, and control of risk factors, and receipt of outpatient physician services. We used modified Poisson regression to model the relative risk of each outcome among people with and without schizophrenia, adjusting for age and other factors. Among 81 163 people with ischemic stroke, 844 (1.04%) had schizophrenia. Schizophrenia was associated with lower rates of screening for hyperlipidemia (60.5% versus 66.0%, adjusted relative risk [aRR] 0.88 [95% CI, 0.84–0.93]) and diabetes (69.4% versus 73.9%, aRR 0.93 [95% CI, 0.89–0.97]), prescription of antihypertensive medications (91.2% versus 94.7%, aRR 0.96 [95% CI, 0.93–0.99]), achievement of target lipid levels (low‐density lipoprotein <2 mmol/L) (30.6% versus 34.6%, aRR 0.86 [95% CI, 0.78–0.96]), and outpatient specialist visits (55.3% versus 67.8%, aRR 0.78 [95% CI, 0.74–0.83]) or primary care physician visits (94.5% versus 98.5%; aRR 0.96 [95% CI, 0.95–0.98]) within 1 year. There were no differences in prescription of antilipemic, antiglycemic, or anticoagulant medications, or in achievement of target hemoglobin A1c ≤7%.

Conclusions
People with stroke and schizophrenia are less likely than those without to receive secondary preventive care. This may inform interventions to improve poststroke care and outcomes in those with schizophrenia.
Endothelial Cell‐Specific Prolyl Hydroxylase‐2 Deficiency Augments Angiotensin II–Induced Arterial Stiffness and Cardiac Pericyte Recruitment in Mice
Authors: Liu Bo , Zeng Heng , Su Han , Williams Quinesha A. , Besanson Jessie , Chen Yingjie , Chen Jian‐Xiong 
Published: July 2024

Background
Endothelial prolyl hydroxylase‐2 (PHD2) is essential for pulmonary remodeling and hypertension. In the present study, we investigated the role of endothelial PHD2 in angiotensin II–mediated arterial stiffness, pericyte recruitment, and cardiac fibrosis.

Methods and Results

Chondroitin sulfate proteoglycan 4 tracing reporter chondroitin sulfate proteoglycan 4– red fluorescent protein (DsRed) transgenic mice were crossed with PHD2
flox/flox
(PHD2
f/f
) mice and endothelial‐specific knockout of PHD2 (PHD2
EC
KO) mice. Transgenic PHD2
f/f
(TgPHD2
f/f
) mice and TgPHD2
EC
KO mice were infused with angiotensin II for 4 weeks. Arterial thickness, stiffness, and histological and immunofluorescence of pericytes and fibrosis were measured. Infusion of TgPHD2
f/f
mice with angiotensin II resulted in a time‐dependent increase in pulse‐wave velocity. Angiotensin II–induced pulse‐wave velocity was further elevated in the TgPHD2
EC
KO mice. TgPHD2
EC
KO also reduced coronary flow reserve compared with TgPHD2
f/f
mice infused with angiotensin II. Mechanistically, knockout of endothelial PHD2 promoted aortic arginase activity and angiotensin II–induced aortic thickness together with increased transforming growth factor‐β1 and ICAM‐1/VCAM‐1 expression in coronary arteries. TgPHD2
f/f
mice infused with angiotensin II for 4 weeks exhibited a significant increase in cardiac fibrosis and hypertrophy, which was further developed in the TgPHD2
EC
KO mice. Chondroitin sulfate proteoglycan 4 pericyte was traced by DsRed
+
staining and angiotensin II infusion displayed a significant increase of DsRed
+
pericytes in the heart, as well as a deficiency of endothelial PHD2, which further promoted angiotensin II–induced pericyte increase. DsRed
+
pericytes were costained with fibroblast‐specific protein 1 and α‐smooth muscle actin for measuring pericyte–myofibroblast cell transition. The knockout of endothelial PHD2 increased the amount of DsRed
+
/fibroblast‐specific protein 1
+
and DsRed
+
/α‐smooth muscle actin
+
cells induced by angiotensin II infusion.

Conclusions
Knockout of endothelial PHD2 enhanced angiotensin II–induced cardiac fibrosis by mechanisms involving increasing arterial stiffness and pericyte–myofibroblast cell transitions.
Plasma Brain-Derived Tau in Prognosis of Large Vessel Occlusion Ischemic Stroke
Authors: Varela Ricardo , Gonzalez-Ortiz Fernando , Dias Alexandre , Knuth Nicoló Luca , Fonte Joana , Pinto Beatriz , Yuksekel Idil , Abreu Vasco , Silva Isabel , Igreja Liliana , Lopes Joana , Silva José , Dias Rafael , Filipe João Pedro , Malaquias Maria João , Moutinho Ana , Gabriel Denis , Aires Ana , Antunes Rui , Rocha José Pedro , Felgueiras Rui , Almendra Ricardo , Castro Pedro , Zetterberg Henrik , Magalhães Rui , Karikari Thomas K. , Correia Manuel , Blennow Kaj , Maia Luís F. 
Published: July 2024

BACKGROUND:
Large vessel occlusion acute ischemic stroke prognosis improved following the 2015 endovascular therapy (EVT) trials. Blood-based biomarkers may improve outcome prediction. We aimed to assess plasma brain-derived tau (BD-Tau) performance in predicting post-EVT large vessel occlusion acute ischemic stroke outcomes.

METHODS:
We included 2 temporally independent prospective cohorts of anterior circulation in patients with large vessel occlusion acute ischemic stroke who successfully recanalized post-EVT. We measured plasma BD-Tau, GFAP (glial-fibrillary-acidic-protein), NfL (neurofilament-light-chain), and total-Tau upon admission, immediately, 24 hours, and 72 hours post-EVT. Twenty-four-hour neuroimaging and 90-day functional outcomes were independently assessed using the Alberta Stroke Program Early Computed Tomography Score (good outcome: >7 or unchanged) and the modified Rankin Scale (favorable outcome <3 or unchanged), respectively. Based on the first cohort (derivation), we built a multivariable logistic regression model to predict a 90-day functional outcome. Model results were evaluated using the second cohort (evaluation).

RESULTS:

In the derivation cohort (n=78, mean age=72.9 years, 50% women), 62% of patients had a good 24-hour neuroimaging outcome, and 45% had a favorable 90-day functional outcome. GFAP admission-to-EVT rate-of-change was the best predictor for early neuroimaging outcome but not for 90-day functional outcome. At admission, BD-Tau levels presented the highest discriminative performance for 90-day functional outcomes (area under the curve, 0.76 [95% CI, 0.65–0.87];
P
<0.001). The model incorporating age, admission BD-Tau, and 24-hour Alberta Stroke Program Early Computed Tomography Score achieved excellent discrimination of 90-day functional outcome (area under the curve, 0.89 [95% CI, 0.82–0.97];
P
<0.001). The score’s predictive performance was maintained in the evaluation cohort (n=66; area under the curve, 0.82 [95% CI, 0.71–0.92];
P
<0.001).

CONCLUSIONS:
Admission plasma BD-Tau accurately predicted 90-day functional outcomes in patients with large vessel occlusion acute ischemic stroke after successful EVT. The proposed model may predict functional outcomes using objective measures, minimizing human-related biases and serving as a simplified prognostic tool for AIS.
Design and Interrater Reliability of the Pediatric Version of the Race Scale: PedRACE
Authors: Turón-Viñas Eulàlia , Boronat Susana , Gich Ignasi , González Álvarez Verónica , García-Puig Montserrat , Camós Carreras Maria , Rodriguez-Palmero Agustí , Felipe-Rucián Ana , Aznar-Laín Gemma , Jiménez-Fàbrega Xavier , Pérez de la Ossa Natalia , Álvarez-Molinero Mireia , Barceló Irene , Brió Sonia , Casellas-Vidal Dolors , Coca-Fernández Elisabeth , Costa-Comellas Laura , Delgadillo-Chilabert Verónica , Díaz-Gómez Asunción , Díaz-Simal Laura , Dougherty-de Miguel Lucía , Escofet Conxita , Esteban Elisabeth , Gómez-Andrés David , González-Rioja Xoan , Molina-Anguita Cristina , Monlleó-Neila Laura , Paredes-Carmona Fernando , Pujol Montserrat , Raspall-Chaure Miquel , Renter-Valdovinos Luis , Sala-Colomina Júlia , Sensarrich Mireia , Solà Silvia , Soto Angels , Torrents Carme , Turon-Viñas Anna , Turon Marc , Valle-T-Figueras Jose Maria 
Published: July 2024

BACKGROUND:
Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0–2; arm motor function 0–2; leg motor function 0–2; head/gaze deviation 0–1; and aphasia or agnosia 0–2), has good sensitivity and specificity in detecting large vessel occlusion.

METHODS:
We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability.

RESULTS:

The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852;
P
<0.001) and prehospital/emergency staff (Spearman ρ, 0.781;
P
<0.001). The median Pediatric RACE score was significantly higher in patients with large vessel occlusion (6.5; interquartile range, 6–7) than with other etiologies.

CONCLUSIONS:
Pediatric RACE, showing good interrater reliability and correlation with the Pediatric National Institutes of Health Stroke Scale, is a simple scale to detect candidates for pediatric acute stroke treatment, designed for both prehospital and in-hospital use by non-neurologist medical staff.
Characterisation of laminar and vascular spatiotemporal dynamics of CBV and BOLD signals using VASO and ME-GRE at 7T in humans
Authors: Dresbach Sebastian , Huber Renzo , Gülban Ömer Faruk , Pizzuti Alessandra , Trampel Robert , Ivanov Dimo , Weiskopf Nikolaus , Goebel Rainer 
Published: July 2024

Abstract
Interpretation of cortical laminar functional magnetic resonance imaging (fMRI) activity requires detailed knowledge of the spatiotemporal haemodynamic response across vascular compartments due to the well-known vascular biases (e.g., the draining veins). Further complications arise from the fact that the spatiotemporal haemodynamic response differs depending on the duration of stimulation. Information about haemodynamic response characteristics across different stimulus durations, cortical depth, and vascular compartments is crucial for future studies using depth-dependent cerebral blood volume (CBV) measurements, which promise higher specificity for the cortical microvasculature than the blood oxygenation level dependent (BOLD) contrast. To date, direct information about CBV dynamics with respect to stimulus duration, cortical depth, and vasculature is missing in humans. Therefore, we characterised the cortical depth-dependent CBV-haemodynamic responses across a wide set of stimulus durations with 0.9 mm isotropic spatial and 0.785 seconds effective temporal resolution in humans using slice-selective slab-inversion vascular space occupancy (SS-SI VASO). Additionally, we investigated signal contributions from macrovascular compartments using fine-scale vascular information from multi-echo gradient-echo (ME-GRE) data at 0.35 mm isotropic resolution. In total, this resulted in &gt;7.5 hours of scanning per participant (n = 5). We have three major findings: (I) While we could demonstrate that 1 second stimulation is viable using VASO, more than 12 seconds stimulation provides better CBV responses in terms of specificity to the microvasculature, but durations beyond 24 seconds of stimulation may be wasteful for certain applications. (II) We observed that CBV responses were slightly delayed for superficial compared deeper layers for stimuli ≤4 seconds. (III) While we found increasingly strong BOLD signal responses in vessel-dominated voxels with longer stimulation durations, we found increasingly strong CBV signal responses in vessel-dominated voxels only until 4 second stimulation durations. After 4 seconds, only the signal from non-vessel-dominated voxels kept increasing. This might explain why CBV responses are more specific to the underlying neuronal activity for long stimulus durations.
Embodied leisure experiences of nature-based activities for people living with dementia
Authors: Owen Steven , Page Stephen , Ledingham Katie , Price Stephan , Connell Joanne , Quinn Catherine , Clare Linda 
Published: July 2024

Purpose This article adopts an embodiment lens to explore the individual leisure experiences of people living with dementia when engaging in nature-based pursuits. It focuses on how people living with dementia frame their everyday experiences of nature and how these are shaped by any cognitive challenges and/or other comorbidities affecting physical health. Design/methodology/approach Taking a phenomenological research approach, we interviewed 15 people living with dementia and 15 family carers of people with dementia to explore how people with dementia engage with nature as a subjective leisure experience. We analysed their accounts using reflexive thematic analysis. Findings The findings reveal how people living with dementia frame their experiences of nature-based pursuits through three interlinked themes of ‘bodily feelings and emotions’, ‘sense of self and identity’ and ‘connectivity to others’. Originality/value The paper contributes to knowledge by examining through the lens of embodiment a neglected and overlooked dimension of everyday leisure: how nature is encountered, negotiated and enjoyed. The paper illustrates how nature and the outdoors may help people living with dementia to continue to enjoy prior leisure pursuits and thus achieve a degree of continuity in their everyday lives.
Clavipectoral fascial plane block for clavicle fracture surgery: A case report
Authors: Pereira Cândida Sofia , Ferros Catarina , Dinis Inês , Pereira Dulce , Miguel Diogo , Vico Manuel 
Published: July 2024

Background: Regional anaesthesia can be an attractive alternative anaesthetic approach in clavicle surgery, but it requires the peripheral block of multiple cervical and brachial nerves that transmit nociceptive information. Deep cervical plexus blocks, as paravertebral nerve block, can lead to severe side effects, such as unilateral diaphragmatic paralysis. Case report: A 66-year-old male patient, American Society of Anesthesiologists physical status III, was scheduled for open reduction and internal fixation of the right clavicle with plates and screws after a high-energy trauma. Pre-anaesthetic evaluation revealed right hemopneumothorax and bilateral rib fractures. We decided to perform regional anaesthesia (superficial cervical plexus block and clavipectoral fascial plane block), combined with dexmedetomidine perfusion to avoid invasive mechanical ventilation and prevent additional pulmonary complications. The surgical procedure was successfully completed without any further anaesthesia requirements. The patient remained comfortable during the postoperative period. Conclusion: Regional anaesthesia for clavicle surgeries has the advantage of promoting non-opioid free anaesthesia. Effective pain control enhances patient satisfaction and reduces the length of stay in hospital. In our case report, a combined superficial cervical plexus block and clavipectoral fascial plane block was a safe and effective regional anaesthetic approach.