bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of Intensive Blood Pressure Control in Ischemic Stroke Patients Following Endovascular Thrombectomy: A Update Meta-Analysis
Authors: Zhou Yitao , Zhou Yangbin , Yang Huijie , Wang Menglu , Huang Ganying 
Published: August 2024

Abstract

Objective
This meta-analysis aimed to determine the potential benefits or effectiveness of intensive blood pressure management in ischemic stroke patients who have undergone endovascular thrombectomy (EVT) and make an effective update for the evidence.
Methods
We comprehensively searched all relevant studies published before May 23, 2024, using multiple databases, including Cochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wangfang. The primary outcome was 90 days functional independence (Modified Rankin Scale, mRS score = 0–2), while the secondary outcomes comprised 90-day mortality, 7-day mortality, symptomatic intracranial hemorrhage (sICH), complications and hemicraniectomy.
Results
17 studies with a total of 5825 patients were included. The primary outcome: 90 days functional independence, a significant difference between different blood pressure management (OR = 1.58, 95% CI [1.17, 2.13]) was observed, with obvious heterogeneity (I2 = 83.20%, p < 0.01). The secondary outcomes: The significant difference were found in 90-day mortality (OR = 0.75, 95% CI [0.58, 0.99]), sICH (OR = 0.74, 95% CI [0.58, 0.95]), hemicraniectomy (OR = 0.42, 95% CI [0.22, 0.81]). No significant difference were found in 7-day mortality (OR = 0.88, 95% CI [0.49, 1.58]), complications (OR = 1.32, 95% CI [0.50, 3.50]). Subgroup analysis for the heterogeneity.
Conclusion
Our results suggested that more intensive blood pressure management may yield greater benefits in terms of patients' clinic outcomes. However, the results should be interpreted cautiously. Additionally, blood pressure target of SBP < 140 mmHg may provide fundamental insights for future randomized controlled trials.
Genomic profiling and expanded use of targeted anticancer drugs in solid cancers with exhausted evidence-based treatment options: the PRECODE study protocol
Authors: Hansen Karin Holmskov , Lyng Maria Bibi , Kodahl Annette Raskov , Asmussen Jon Thor , Arshad Arman , Petersen Henrik , Krogh Lotte , Ehmsen Sidse , Kristensen Thomas Kielsgaard , Ditzel Henrik J. 
Published: August 2024

Abstract

Background:
Genomic profiling of advanced solid cancer in patients with no further evidence based standard treatment options is a novel approach to identify potential experimental treatment options based on specific genomic alterations. Due to the expected short survival of these patients timely assessment of potential druggable targets is critical to minimize the risk of deterioration during the analysis.
The primary objective of this prospective study is to evaluate the turnaround time for genomic profiling and the feasibility of clinical investigational procedures. The secondary objectives are to investigate how often genomic alterations in tumor tissue gives rise to a matched treatment offer and evaluate the clinical outcome.
Methods:
The PRECODE study is a prospective, non-randomized, single-center cohort study conducted at Departments of Oncology and Pathology, Odense University Hospital, Denmark. Enrollment between March 1, 2019 and December 31, 2024. Eligibility criteria are age > 18 years, written informed consent, advanced solid tumors, exhausted treatment options, ECOG performance status 0-2, adequate organ function and life expectancy >3 months. A core needle biopsy is analyzed by next generation sequencing using a pan-cancer comprehensive panel. Results are discussed weekly at institutional/local and national multidisciplinary tumor boards.
Discussion:
Strategies and methods for genomic profiling of advanced solid cancers differ. Rapid analysis and interpretation of sequencing data are key to avoiding delays in initiation potential experimental treatments, as these late-stage patients may quickly deteriorate.
A highly optimized setup with fast-track clinical evaluation and genomic profiling has been established. Local and national multidisciplinary teams have been established to optimize individualized treatment decisions
Trial registration: ClinicalTrials.gov Identifier: NCT05385081 (retrospectively registered)
Iodine Deficiency Disorders in Khorasan Razavi Province, Iran: Assessing Salt Iodization and Iodine Intake Patterns
Authors: Esmaeilzadeh Nayereh , Bajestani Majid Jafari Nejad , Hoseini Seyed Javad , Abasalti Zahra , Emami Omid , Nasrollahzadeh Zohreh , Mood Zahra Izadi , Ghorbani Ahmadali , Oraee Melika 
Published: August 2024

Abstract

Considering iodine deficiency, researchers examine salt consumption by healthcare providers, health ambassadors and the general population in Khorasan Razavi province, Iran. This cross-sectional study used validated questionnaires and tested salt samples with standardized test kits and iodometry. Analyses were descriptive and kappa-based.
This study included 3115 participants, including 812 health workers and 912 health ambassadors, as well as 1,391 households. Higher levels of iodine deficiency may be detected due to new and stricter WHO standards that was least likely to be met all participants. (Kappa=0.0793) shows poor concordance. More than 90% of participants buy bagged salt but 31-63% store salt away from light, heat, and humidity. 42-66% store their salt in dark containers. Up to 38% of health workers add salt after cooking. Only 30-63% of groups knew about iodine deficiency diseases. About 37-66 % of participants consider iodization when purchasing salt.
Our findings provide rural and urban areas face disparities, as do households and health workers. Using updated WHO/UNICEF/ICCIDD standards to assess iodine deficiency led to lower compliance rates. The region can address iodine deficiency disorders with targeted interventions, awareness campaigns, monitoring, and quality control to enhance public health.
Exploring Determinants of Vaccination Rates among Pediatric Populations in East Gojam, Amhara Region, Ethiopia
Authors: Woudneh Awoke Fetahi , Shiferaw Nigatu Tiruneh 
Published: August 2024

Abstract

Introduction: Vaccination is a critical public health intervention that significantly reduces morbidity and mortality among children. Despite its importance, vaccination coverage remains suboptimal in many regions, including East Gojam, Amhara Region, Ethiopia. This study investigates the socio-demographic, economic, and cultural determinants of vaccination status among pediatric populations in East Gojam.
Methods: Using a cross-sectional design, data were collected from 1,900 respondents, categorizing vaccination status as not vaccinated, partially vaccinated, or fully vaccinated. Multinomial logistic regression analyzed the impact of predictors such as child age, gender, parental education level, household income, geographic location, and access to healthcare, and trust in healthcare providers, sources of vaccination information, cultural beliefs, and perceived government support for vaccination.
Results: The results revealed that higher parental education levels and urban residence positively influence vaccination rates. Older children were less likely to be fully vaccinated, indicating a need for targeted outreach. Access to healthcare services and trust in healthcare providers significantly promoted vaccination, while negative cultural beliefs and misinformation adversely affected vaccination rates. Perceived government support for vaccination was also a significant predictor.
Conclusion: The study concludes that addressing these multifaceted determinants through educational programs, improved healthcare access, trust-building initiatives, accurate information dissemination, and stronger governmental support, targeted outreach for older children, community engagement, and multi-sectoral collaboration can enhance vaccination coverage and improve public health outcomes in East Gojam and similar settings.
Anticoagulant therapy in neonatal acute infectious peritonitis based on the TAT, PIC, tPAIC, and sTM: a new case series
Authors: Wang Wenya , Gao Yue , Qiao Yan , Wu Yang , Zhang Ge , Li Jiao , Zhang Li 
Published: August 2024

Abstract

Background: Neonatal acute peritonitis is a leading cause of morbidity and mortality and poses challenges that demand prompt diagnosis and treatment, particularly in infants with disseminated intravascular coagulation.
Case presentation：Here, we report a case series of four infants with acute perionitis caused by necrotising enterocolitis, gastrointestinal perforation, and meconium peritonitis. Laboratory tests for thrombin-antithrombin complex(TAT), α2-plasmin inhibitor-plasmin complex(PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator-inhibitor complex (tPAIC) suggested the activation of the coagulation system followed by treatment with anticoagulant therapy in these infants.
Conclusions: Overall, thrombin-antithrombin complex, α2-plasmin inhibitor-plasmin complex, soluble thrombomodulin, and tissue plasminogen activator-inhibitor complex may guide anticoagulant therapy, offering prospects for improving the outcomes in neonates with acute peritonitis.
Myocarditis and pericarditis are temporally associated with BNT162b2 COVID-19 vaccine in adolescents: a systematic review and meta-analysis
Authors: Choi Yongyeon , Lee Jue Seong , Lee Hyeran , Yoon Yoonsun , Shin Seung Hwan , Hwang Myung-Jae , Choi HyoSug , Na Sara , Kim Jong Hee , Kang Hyun Mi , Ahn Bin , Seo Kyoungsan , Choe Young June , Park Sangshin 
Published: August 2024

Abstract

The incidence of myocarditis and pericarditis has been documented in adolescents after COVID-19 vaccinations. This study aims to assess the risk of myopericarditis in adolescents following COVID-19 vaccination, using a meta-analysis of the published cases. We performed a comprehensive literature search of the following databases on July 5, 2023: MEDLINE, EMBASE, PubMed, and the Cochrane Library. We performed a meta-analysis using a random-effects model to estimate the incidence of myopericarditis per million of administered COVID-19 vaccine doses or COVID-19 infections. A total of 33 studies were included in the meta-analysis. Twenty-nine studies reported the incidence of myopericarditis after COVID-19 vaccination, whereas four studies reported the incidence following COVID-19 infection. The incidence of myopericarditis per million COVID-19 infections (1583.9 cases, 95% CI 751.8–2713.8) was approximately 42 times higher than that for COVID-19 vaccine administrations (37.6 cases, 95% CI 24.2–53.8). The risk of myopericarditis after COVID-19 vaccination was particularly high among the 16–19 age group (39.5 cases, 95% CI 25.8–56.0), males (43.1 cases, 95% CI 21.6–71.9), and those who received the second dose (47.7 cases, 95% CI: 22.2–82.2). Regionally, the highest incidence rate of myopericarditis following COVID-19 vaccination was observed in Europe (49.0 cases, 95% CI: 16.4–98.4), followed by the Western Pacific (39.7 cases, 95% CI: 18.1–69.5) and the Americas (27.7 cases, 95% CI: 14.0-45.7), although no statistically significant differences were noted (p = 0.51). Adolescents faced a potential risk of myopericarditis after COVID-19 vaccination, but this risk is less harmful than that of myopericarditis following COVID-19 infection.
Cost-effectiveness analysis of S-ademetionine compared with ursodeoxycholic acid for the treatment of Intrahepatic Cholestasis in China
Authors: Kim Hansoo , Lyu Juntao , Royle Ruth , Kim Kyoo , Morales-Castillo Mauricio , Byrnes Joshua 
Published: August 2024

Abstract

Chronic liver disease is a costly health problem that is increasing in prevalence in China. Intrahepatic cholestasis (IHC), such as alcoholic liver disease and non-alcoholic fatty liver disease, are the leading causes of chronic liver disease. In China, the recommended treatments for IHC are S-Adenosylmethionine (SAMe) and ursodeoxycholic acid (UDCA). Despite its use as a supplement in liver disease in China and worldwide, no studies assessing the cost-effectiveness or cost-utility of SAMe compared with UDCA in IHC have been identified in the literature. The aim of this study is to assess the cost-effectiveness of SAMe compared with UDCA in a Chinese clinical setting. The modelled economic evaluation was undertaken using two paralleled decision-analytic Markov models: SAMe compared with placebo and UDCA compared with placebo. The results show that SAMe yielded an additional 3.49 QALYs at CNY263,417 per 100 patients, resulting in an ICER of CNY75,423 compared to placebo. UDCA resulted in a gain of 0.87 QALYs at an additional cost of CNY358,197 per 100 patients and an ICER=CNY410,361 compared to placebo. SAMe is dominating UDCA with an ICER of -CNY36,175, and it is estimated to be a cost-effective option for improving health outcomes and saving costs in China.
Proteomic Evaluation of the Thrombosis-inflammation Interplay in STEMI with MVO
Authors: Qi Yu , Li Yufang , Wei Xuan , Wu Han , Li Guannan , Chen Jianzhou , Kang Lina , Wang Kun 
Published: August 2024

Abstract

Background
Coronary microvascular obstruction (MVO) occurs in up to half of acute myocardial infarction patients receiving successful primary percutaneous coronary intervention (pPCI) and is associated with a much worse outcome. Whereas the fluid phase cross-talk between thrombosis and inflammation is well appreciated, the pathophysiological implication is still scant.
Objectives
This study sought to investigate the differentially expressed proteins and possible biological processes involved in MVO after pPCI in ST-segment elevation myocardial infarction (STEMI) patients based on thrombus proteomics.
Methods
Aspirated thrombi and pPCI from 16 STEMI patients within 12 h of symptom onset were collected, including 8 MI with MVO (MVO+) and 8 MI without MVO (MVO-). 4D label-free proteomics was used to explore the differentially expressed proteins. Gene ontology enrichment analysis was performed using Metascape software and protein‒protein interaction analysis was performed using Cystoscope software. Afterward, the Connectivity Map database was used to select drug candidates for MVO treatment.
Results
We identified a total of 471 proteins with expression changes greater than 1.5-fold at P < 0.05, of which 50 were significantly upregulated and 421 were downregulated in the MVO + group compared with the MVO- group. Gene ontology enrichment analysis of significant differentially expressed proteins revealed the central role of platelet activation and neutrophil degranulation processes in patients with MVO. The protein‒protein interaction network also confirmed the significant interaction of inflammation and platelet activation, which may mediate the role of thrombus-inflammation in the pathogenesis of MVO. Drug screening revealed 4 drug candidates for MVO treatment: D-64131, TC-1, SB-431542 and alvespimycin.
Conclusions
Using the thrombus proteomic approach, we revealed the central role of the thrombus-inflammation interaction and potential drug candidates in STEMI with MVO. The findings from our study will contribute to the treatment of MVO in the future.
The influence of coronal alignment changes according to the degree of articular congruency in lateral tibial plateau fracture reduction
Authors: Sim Jae Ang , Kim Han Soul , Lim Ji-Sup , Lee Byung Hoon 
Published: August 2024

Abstract

Purpose
Surgical treatment of tibial plateau fractures involves anatomic reduction and rigid fixation. A residual articular depression may alter the joint contact pressure and lower limb alignment and precipitate posttraumatic osteoarthritis. The degree of acceptable articular incongruency remains controversial, and the correlation between malreduction and malalignment has not been thoroughly investigated. We investigated the correlation between postoperative articular congruency in different fracture zones in the sagittal plane and whole lower limb alignment after surgery for lateral tibial plateau fractures.
Materials and Methods
Among the 254 patients surgically treated for plateau tibia fractures between January 2010 and December 2022 at a single center, 67 patients of all ages with lateral tibial plateau fractures (Schatzker types I–III) were selected and retrospectively reviewed. All patients underwent open reduction and internal fixation (ORIF) via plate and screw construct, with or without an augmentation procedure. We used simple radiographs and preoperative three-dimensional computed tomography to measure lower extremity alignment variables, intra-articular step-offs, and fracture zones in the sagittal plane. We stratified the fracture site into three zones in the sagittal plane at the joint center of the lateral tibial plateau. Malreduction was defined as an articular step-off ≥ 2 mm. Malalignment was defined as a difference > 5° in hip-knee-ankle angle (HKA).
Results
HKA strongly correlated with postoperative articular step-off (Spearman's ρ = -0.69; p < 0.001). Postoperative valgization of HKA was significantly associated with increased articular incongruency (β= -0.96, p < 0.001), particularly with step-offs ≥ 2 mm (β= -3.77, p < 0.001). Linear regression of articular step-offs and fracture locations did not demonstrate any significance. However, 13 of 24 malreduced fractures (54%) were in zone 2. Only zone 2 significantly affected postoperative valgization when assessing the association between fracture location and HKA (β = -2.68, p < 0.001). Articular incongruency located in zone 2 showed a significant association with HKA valgization after controlling for fractures in zones 1 and 3 (β = -0.775, p < 0.001).
Conclusion
This study highlighted that the articular step-off should be minimized to < 2 mm during surgery for lateral tibial plateau fractures to prevent valgus malalignment of the whole lower limb.
Minimum Dietary Diversity and Its Associated Factors Among Children of 6–23 Months in Rural, Ethiopia, 2023
Authors: Darebo Teshale , Dereje Rahel , Fufa Dinaol Abdissa 
Published: August 2024

Abstract

Background: Dietary diversity is a useful indicator of diet quality and nutrient adequacy, which plays an important role in children's growth and development. Meeting this standard of dietary diversity remains a challenge in developing countries. However, in Ethiopia, including the study area, there is limited evidence on dietary diversity and associated factors in children aged 6 to 23 months.
Objectives: To assess the prevalence of dietary diversity and associated factors among children aged 6-23 Months in rural, Ethiopia, 2023.
Methods: A Community -based cross-sectional study design was conducted from April 11, 2023 to May 20, 2023 among 597 study participants. Face-to-face interviews were conducted by structured questioners, and the data was entered into Epi-data version 3.1 software. Later, IBM SPSS version 27 was used to perform bivariate and multivariate logistic regression analyses. To check for multicollinearity, the tolerance test and variance inflation factors (VIF) were used. The Hosmer-Lemeshow goodness of fit test was used to assess model fitness. Adjusted odds ratios and their 95% confidence intervals were used to identify statistically significant factors at P values 0.05.
Result: The results showed that the prevalence of optimal dietary diversity was 35.5% [95% CI: 31.5, 39.7]. The study also found that factors such as Decision-making power (AOR: 2.46, 95% CI: (1, 24, 4.9)), participation in cooking demonstrations (AOR = 1.61, 95% CI (1.10, 2.363), attendance at ANC follow-ups (AOR = 5.027, 95% CI (2.02, 12.46)), have nutrition counseling (AOR=2.450, 95% CI, (1.32), 4.54), good food security (AOR=2.7, 95% CI, (1.8, 4.06), child growth and development-monitoring behavior (AOR=1.8, 95% CI: 1.24, 2.6) were significantly associated with unacceptable dietary diversity.
Neonatal Cardiac POCUS - A Survey of Academic Neonatal Centers in the United States
Authors: McNamara Patrick , Aleem Numra , Wren John , Ruoss Lauren , Stanford Amy , Hyland Rachael , Thomas Brady , Giesinger Regan 
Published: August 2024

Abstract

Objective
To investigate the current state of clinical practice and training regarding the use of cardiac point of care ultrasound (cPOCUS) in neonatal intensive care units.
Study Design:
An online survey was disseminated through the Association of Academic Directors of Neonatology to appraise clinical usage, infrastructure, and training for cPOCUS. A single response per center was obtained.
Results
Overall survey response rate was 51% (48/94). Of respondents [40/48 (83%)] who reported having a POCUS program, 19/40 (47%) reported performing cPOCUS. In 74% of centers, < 10 cPOCUS studies are performed monthly. Only 16% (3/19) of centers had standardized imaging protocols. The most common indication for cPOCUS was central line evaluation. Only 9 (19%) programs reported cPOCUS training, of whom 4 had a formalized process of ongoing competency assessment.
Conclusion
Although use of cPOCUS is increasing, program infrastructure and governance, training, and evaluation vary markedly between institutions and are missing in many. There is an urgent need to develop consensus standards regarding clinical practice and training.
Alterations in sleep-activity cycles and clock gene expression across the synucleinopathy spectrum
Authors: Comas Maria , Vidal Xavier , Rawashdeh Oliver , Grunstein Ronald R. , Lewis Simon J.G. , Matar Elie 
Published: August 2024

Abstract

Background
Neurodegenerative synucleinopathies including Parkinson's disease (PD) and Dementia with Lewy bodies (DLB) are strongly associated with sleep disturbances. Furthermore, isolated Rapid Eye Movement Sleep Behaviour Disorder (iRBD) is now established as the strongest risk factor for developing PD or DLB, often preceding the clinical diagnosis by several years.
Objectives
We aimed to investigate sleep/wake cycles and circadian rhythms in patients with early PD and DLB, along with ‘at risk’ prodromal subjects diagnosed with iRBD.
Methods
Fifteen healthy controls, 20 iRBD, 16 PD and 17 DLB patients within 5 years of diagnosis, underwent assessment. Sleep/wake cycles were evaluated using questionnaires and actigraphy. Salivary and oral mucosa samples were collected every 3 hours to measure melatonin levels and Bmal1 clock gene expression over 24-hours.
Results
Both subjective and objective measures of sleep/wake cycles demonstrated that the DLB group exhibited the most significant sleep/wake cycle disruption. In the DLB group, no fundamental sine wave could be fitted to the level of melatonin secretion, indicating a severe disruption in the daily rhythm of this hormone. There was a statistically significant pattern of decreasing median Bmal1 amplitude from HC, to iRBD, to PD and then to DLB (p = 0.037).
Conclusions
This work highlights a differential gradient of objective disruption in the daily circadian rhythms from iRBD to established PD and DLB and is the first to directly demonstrate disruption of clock gene expression and melatonin in DLB. The findings support sleep/wake disruption as a marker of neuropathological severity and potentially a novel therapeutic target across the synucleinopathy spectrum.