bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancing stroke therapy: A deep dive into early phase of ischemic stroke and recanalization
Authors: He Qianyan , Wang Yueqing , Fang Cheng , Feng Ziying , Yin Meifang , Huang Juyang , Ma Yinzhong , Mo Zhizhun 
Published: February 2024

AbstractIschemic stroke, accounting for the majority of stroke events, significantly contributes to global morbidity and mortality. Vascular recanalization therapies, namely intravenous thrombolysis and mechanical thrombectomy, have emerged as critical interventions, yet their success hinges on timely application and patient‐specific factors. This review focuses on the early phase pathophysiological mechanisms of ischemic stroke and the nuances of recanalization. It highlights the dual role of neutrophils in tissue damage and repair, and the critical involvement of the blood–brain barrier (BBB) in stroke outcomes. Special emphasis is placed on ischemia–reperfusion injury, characterized by oxidative stress, inflammation, and endothelial dysfunction, which paradoxically exacerbates cerebral damage post‐revascularization. The review also explores the potential of targeting molecular pathways involved in BBB integrity and inflammation to enhance the efficacy of recanalization therapies. By synthesizing current research, this paper aims to provide insights into optimizing treatment protocols and developing adjuvant neuroprotective strategies, thereby advancing stroke therapy and improving patient outcomes.
Alleviating sleep disturbances and modulating neuronal activity after ischemia: Evidence for the benefits of zolpidem in stroke recovery
Authors: Zhong Zhi‐Gang , Tao Gui‐Jin , Hao Shu‐Mei , Ben Hui , Qu Wei‐Min , Sun Feng‐Yan , Huang Zhi‐Li , Qiu Mei‐Hong 
Published: February 2024

AbstractAimsSleep disorders are prevalent among stroke survivors and impede stroke recovery, yet they are still insufficiently considered in the management of stroke patients, and the mechanisms by which they occur remain unclear. There is evidence that boosting phasic GABA signaling with zolpidem during the repair phase improves stroke recovery by enhancing neural plasticity; however, as a non‐benzodiazepine hypnotic, the effects of zolpidem on post‐stroke sleep disorders remain unclear.MethodTransient ischemic stroke in male rats was induced with a 30‐minute middle cerebral artery occlusion. Zolpidem or vehicle was intraperitoneally delivered once daily from 2 to 7 days after the stroke, and the electroencephalogram and electromyogram were recorded simultaneously. At 24 h after ischemia, c‐Fos immunostaining was used to assess the effect of transient ischemic stroke and acute zolpidem treatment on neuronal activity.ResultsIn addition to the effects on reducing brain damage and mitigating behavioral deficits, repeated zolpidem treatment during the subacute phase of stroke quickly ameliorated circadian rhythm disruption, alleviated sleep fragmentation, and increased sleep depth in ischemic rats. Immunohistochemical staining showed that in contrast to robust activation in para‐infarct and some remote areas by 24 h after the onset of focal ischemia, the activity of the ipsilateral suprachiasmatic nucleus, the biological rhythm center, was strongly suppressed. A single dose of zolpidem significantly upregulated c‐Fos expression in the ipsilateral suprachiasmatic nucleus to levels comparable to the contralateral side.ConclusionStroke leads to suprachiasmatic nucleus dysfunction. Zolpidem restores suprachiasmatic nucleus activity and effectively alleviates post‐stroke sleep disturbances, indicating its potential to promote stroke recovery.
Clinical relevance of doubtful reactions in patch testing: A single‐centre retrospective study
Authors: Arora Puneet , Brumley Caroline , Hylwa Sara 
Published: February 2024

AbstractBackgroundDoubtful reactions in patch testing are infrequently reported in the literature; however, recent reports have suggested they be assessed with the same scrutiny as stronger reactions.ObjectiveAssess the clinical relevance of doubtful reactions in patch testing.MethodsRetrospective study of 1514 patients comprehensively patch tested via the NACDG standard series and additional allergens based on history. The clinical relevance of each reaction was graded based on the NACDG scale: definite, probable, possible, past, unknown and irritant. Reactions were considered ‘unique’ if an additional mild‐to‐strong reaction to the same chemical at a different concentration was not observed.Results68.9% (1043) of patients demonstrated at least 1 doubtful reaction. Of 4453 total doubtful reactions, 92.2% (4106) were unique. Only 3.3% (137) and 12.2% (500) of these were determined to be of definite or probable clinical relevance respectively. ‘Fragrance’ was the most common allergen family present among the unique definite doubtful reactions (37). However, 24 (64.9%) of these also had a stronger reaction to another fragrance. Cocamidopropyl betaine was the second most frequent allergen demonstrating definite doubtful reactions (27) and unique in 85.2% (23) of cases. Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was most prevalent (36) but less frequently unique (58.3%, 21).ConclusionsDoubtful reactions may not be as impactful to clinical decision making as theorised in the literature. Few demonstrate definite clinical significance, and many have related stronger reactions that capture them for clinical purposes. Identification of doubtful reactions to cocamidopropyl betaine and MCI/MI may be of greatest significance as they most frequently were not supported by stronger reactions.
Effectiveness of endoscopic ultrasound (EUS)‐guided choledochoduodenostomy vs. EUS‐guided gallbladder drainage for jaundice in patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography: Retrospective, multicenter study (GALLBLADEUS Study)
Authors: Debourdeau Antoine , Daniel Jules , Caillo Ludovic , Assenat Eric , Bertrand Martin , Bardol Thomas , Souche François‐Régis , Pouderoux Philippe , Gerard Romain , Lorenzo Diane , Bourgaux Jean‐François 
Published: February 2024

ObjectivesThe aim of this study was to compare endoscopic ultrasound‐guided choledochoduodenostomy (EUS‐CDS) vs. EUS‐gallbladder drainage (EUS‐GBD) in cases of failed endoscopic retrograde cholangiopancreatography (ERCP) for jaundice resulting from malignant distal biliary obstruction (MDBO).MethodsThis multicenter retrospective study included patients with obstructive jaundice secondary to MDBO who underwent EUS‐GBD or EUS‐CDS with lumen‐apposing metal stents after failed ERCP. The primary end‐point was clinical success rate. Secondary end‐points were technical success, periprocedural adverse events rate (<24 h), late adverse events rate (>24 h), overall survival, and time to recurrent biliary obstruction.ResultsA total of 78 patients were included: 41 underwent EUS‐GBD and 37 underwent EUS‐CDS. MDBO was mainly the result of pancreatic cancer (n = 63/78, 80.7%). Clinical success rate was similar for both procedures: 87.8% for EUS‐GBD and 89.2% for EUS‐CDS (P = 0.8). Technical success rate was 100% for EUS‐GBD and 94.6% for EUS‐CDS (P = 0.132). Periprocedural morbidity (<24 h) rates were similar between both groups: 4/41 (9.8%) for EUS‐GBD and 5/37 (13.5%) for EUS‐CDS (P = 0.368). There was a significantly higher rate of late morbidity (>24 h) among patients in the EUS‐CDS group (8/37 [21.6%]) than in the EUS‐GBD group (3/41 [7.3%]) (P = 0.042). The median follow‐up duration was 4.7 months. Overall survival and time to recurrent biliary obstruction did not significantly differ between the groups.DiscussionAfter failed ERCP for MDBO, EUS‐GBD and EUS‐CDS show comparable clinical success rates and technical success. EUS‐GBD appears to be a promising alternative for MDBO, even as a second‐line treatment after failed ERCP. Further studies are needed to validate these findings and compare the long‐term outcomes of EUS‐GBD and EUS‐CDS.
A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self care in adult men with Type 1 diabetes mellitus
Authors: Harrison Amy , Konstantara Emmanouela , Zaremba Natalie , Brown Jennie , Allan Jacqueline , Pillay Divina , Hopkins David , Treasure Janet , Ismail Khalida , Stadler Marietta 
Published: February 2024

AbstractAimsThis qualitative study aimed to develop the first cognitive behavioural (CBT) model outlining the development and maintenance of disordered eating in adult men living with Type 1 diabetes to improve on previous theoretical models of Type 1 diabetes and disordered eating and to draw comparisons to women with Type 1 diabetes and disordered eating.MethodsTwenty‐seven men (n = 16 with Type 1 diabetes and disordered eating, n = 11 with Type 1 diabetes without disordered eating) participated in semi‐structured interviews. Data were analysed using thematic analysis and individual CBT formulations were developed for each participant to inform the model.ResultsMen with Type 1 diabetes and disordered eating experience negative thoughts about food, insulin, weight/shape and diabetes itself, which cause negative emotions such as fear and vulnerability and difficulties with diabetes self care such as problems with hyper and hypoglycaemia and problems accessing structured education and technology result in men feeling more dissatisfied about their body weight/shape.ConclusionsThis CBT model of disordered eating in men with Type 1 diabetes can guide new interventions.
Glycaemic control and macrovascular and microvascular outcomes in type 2 diabetes: Systematic review and meta‐analysis of cardiovascular outcome trials of novel glucose‐lowering agents
Authors: Kunutsor Setor K. , Zaccardi Francesco , Balasubramanian Victoria G. , Gillies Clare L. , Aroda Vanita R. , Seidu Samuel , Davies Melanie J. , Khunti Kamlesh 
Published: February 2024

AbstractAimUsing a systematic review and meta‐analysis of placebo‐controlled cardiovascular outcome trials (CVOTs) of newer glucose‐lowering agents [sodium‐glucose cotransporter‐2 inhibitors (SGLT‐2is), glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), and dipeptidyl peptidase‐4 inhibitors (DPP‐4is)] in type 2 diabetes (T2D), we aimed to determine the macrovascular and microvascular outcomes of these agents and clarify the relationships between glycated haemoglobin (HbA1c) reduction and risk of these outcomes.Materials and MethodsRandomized controlled trials were identified from MEDLINE, Embase and the Cochrane Library until September 2023. Study‐specific hazard ratios with 95% confidence intervals (CIs) were pooled, and meta‐regression was used to assess the relationships between outcomes and between trial arm HbA1c reductions.ResultsTwenty unique CVOTs (six SGLT‐2is, nine GLP‐1RAs, five DPP‐4is), based on 169 513 participants with T2D, were eligible. Comparing SGLT‐2is, GLP‐1RAs and DPP‐4is with placebo, the hazard ratios (95% CIs) for 3‐point major adverse cardiovascular events were 0.88 (0.82‐0.94), 0.85 (0.79‐0.92) and 1.00 (0.94‐1.06), respectively. SGLT‐2is and GLP‐1RAs consistently reduced the risk of several macrovascular and microvascular complications, particularly kidney events. DPP‐4is showed no macrovascular benefits. There was potential evidence of an inverse linear relationship between HbA1c reduction and 3‐point major adverse cardiovascular event risk (estimated risk per 1% reduction in HbA1c: 0.84, 95% CI 0.67‐1.06; p = .14; R2 = 14.2%), which was driven by the component of non‐fatal stroke (R2 = 100.0%; p = .094). There were non‐significant inverse linear relationships between HbA1c reduction and the risk of several vascular outcomes.ConclusionsSGLT‐2is and GLP‐1RAs showed consistent risk reductions in macrovascular and microvascular outcomes. The vascular benefits of SGLT‐2is and GLP‐1RAs in patients with T2D extend beyond mere glycaemic control.
Diastology in the intensive care unit: Challenges for the assessment and future directions
Authors: Gonzalez Filipe A. , Santonocito Cristina , Maybauer Marc O. , Lopes Luís Rocha , Almeida Ana G. , Sanfilippo Filippo 
Published: February 2024

AbstractMyocardial dysfunction is common in patients admitted to the intensive care unit (ICU). Septic disease frequently results in cardiac dysfunction, and sepsis represents the most common cause of admission and death in the ICU. The association between left ventricular (LV) systolic dysfunction and mortality is not clear for critically ill patients. Conversely, LV diastolic dysfunction (DD) seems increasingly recognized as a factor associated with poor outcomes, not only in sepsis but also more generally in critically ill patients. Despite recent attempts to simplify the diagnosis and grading of DD, this remains relatively complex, with the need to use several echocardiographic parameters. Furthermore, the current guidelines have several intrinsic limitations when applied to the ICU setting. In this manuscript, we discuss the challenges in DD classification when applied to critically ill patients, the importance of left atrial pressure estimates for the management of patients in ICU, and whether the study of cardiac dysfunction spectrum during critical illness may benefit from the integration of left ventricular and left atrial strain data to improve diagnostic accuracy and implications for the treatment and prognosis.
Premature gray hair development in the interbrow region owing to the loss of maxillary first molars in young mice
Authors: Furukawa Masae , Yokoi Haruna , Wang Jingshu , Ikuyo Yoriko , Tada Hirobumi , Yamada Mitsuyoshi , Shikama Yosuke , Matsushita Kenji 
Published: February 2024

AbstractThe exact sites of premature hair graying and whether tooth loss causes this condition remain unknown. In this study, we aimed to explore the effect of reduced mastication on premature hair graying. Maxillary first molars were extracted from young mice, and the mice were observed for 3 months, along with non‐extraction control group mice. After 3 months, gray hair emerged in the interbrow region of mice in the tooth extraction group but not in the control group. The expression of tyrosinase‐related protein‐2 (TRP‐2) mRNA was lower in the interbrow tissues of young mice without maxillary molars than in those with maxillary molars. Tooth loss leads to interbrow gray hair growth, possibly because of weakened trigeminal nerve input, suggesting that reduced mastication causes premature graying. Thus, prompt prosthetic treatment after molar loss is highly recommended.
Regulatory focus as a mediator in the relationship between nurses' organizational silence and professional identity
Authors: Zhang Wenxia , Zhu Quanli , Yu Renhe , He Taotao , Huang Jing 
Published: February 2024

AbstractAimsThis work aims to analyse the current state of the professional identity of Chinese nurses; examine the relationship amongst regulatory focus, organizational silence and professional identity and determine how regulatory focus affects the relationship between professional identity and organizational silence.DesignThis study conducted a cross‐sectional survey.MethodsFrom June to August 2023, 420 nurses from six hospitals in Hunan Province, China, were selected through convenience sampling and surveyed by using a general information questionnaire, the regulatory focus scale, the organizational silence scale and the professional identity scale. The relationship amongst the regulatory focus, organizational silence and professional identity of nurses was examined by utilizing SPSS 25.0 and the mediating role of regulatory focus between organizational silence and nurses' professional identity was examined by applying AMOS 24.0.ResultsNurses had a moderate level of professional identity. Professional identity was positively correlated with regulatory focus and negatively correlated with organizational silence. Regulatory focus was negatively correlated with organizational silence. Mediation effect studies revealed that organizational silence and professional identity were partially mediated by regulatory focus.ConclusionIn accordance with research showing that nurses' organizational silence can indirectly affect professional identity via regulatory focus, clinical nursing managers should concentrate on the interaction amongst these three variables to strengthen professional identity.ImpactThe results of this study serve as a reminder to nurses to select a preventive or promotive focus based on their career objectives and to effectively express their views to enhance their professional identity. This also reminds nursing managers assess nurse‐led regulatory focus, identify their underlying qualities and understand their professional aspirations and career orientation, create a good atmosphere for advice and encourage nurses to express their views, so as to improve nurses ‘professional identity.Patient or Public ContributionNo patient or public contribution.
Making Markets Through Coalitions: The European Union and the Debate Over Ukraine's National Resources
Authors: Buzogány Aron , Varga Mihai 
Published: February 2024

AbstractThis article studies how the European Union (EU) influences the dynamics between supporters and opponents of market liberalization in partner countries. We focus on Ukraine's attempts to safeguard timber trade and agricultural land sales from international markets through moratoria before 2022. We find that the EU intervenes in domestic debates both directly and through domestic pro‐market coalitions to frame these moratoria as expressions of ‘vested interests’ and instances of state weakness. The EU effectively linked the free trade argument with protecting the environment (as the moratorium tolerated illegal logging) and human rights (as the land moratorium denied landowners their property rights). The EU thus fostered discourses and coalitions prioritizing liberalization over protectionist interests and environmental concerns. This article implies that the EU should encourage debates around market liberalization rather than de‐legitimize opponents, as reconstruction in Ukraine following Russian aggression will require both EU assistance and broader internal coalitions.
Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: a realist evidence synthesis of what works, for whom, in what context and why
Authors: Westrop S. C. , Rana D. , Jaiswal N. , Wu O. , McGarty A. M. , Melville C. , Ells L. , Lally P. , McEwan M. , Harris L. , Germeni E. 
Published: February 2024

AbstractBackgroundLifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances.MethodsA realist evidence synthesis was conducted that incorporated input from adults with intellectual disabilities and expert researchers. Following the development of an initial programme theory based on key literature and input from people with lived experience and academics working in this field, five major databases (MEDLINE, EMBASE, CINAHL, PsycINFO and ASSIA) and clinical trial repositories were systematically searched. Data from 79 studies were synthesised to develop context, mechanism and outcome configurations (CMOCs).ResultsThe contexts and mechanisms identified related to the ability of adults with intellectual disabilities to actively take part in the intervention, which in turn contributes to what works, for whom and in what circumstances. The included CMOCs related to support involvement, negotiating the balance between autonomy and behaviour change, fostering social connectedness and fun, accessibility and suitability of intervention strategies and delivery and broader behavioural pathways to lifestyle change. It is also essential to work with people with lived experiences when developing and evaluating interventions.ConclusionsFuture lifestyle interventions research should be participatory in nature, and accessible data collection methods should also be explored as a way of including people with severe and profound intellectual disabilities in research. More emphasis should be given to the broader benefits of lifestyle change, such as opportunities for social interaction and connectedness.
Ultrahigh thermal gradient granulites in the Narryer Terrane, Yilgarn Craton, Western Australia, provide a window into the composition and formation of Archean lower crust
Authors: Tucker Naomi M. , Hammerli Johannes , Kemp Anthony I. S. , Rowe Matthew L. , Gray Chris M. , Jeon Heejin , Whitehouse Martin J. , Roberts Malcolm P. 
Published: February 2024

AbstractGranulites from the Narryer Terrane in the northern Yilgarn Craton, Australia, record evidence for high to ultrahigh thermal gradients during the Meso–Neoarchean. U–Pb zircon ages reflect a complex history of high‐grade, prolonged and poly‐phase metamorphism, with evidence for several thermal pulses at ca. 2745–2725, ca. 2690–2660, and ca. 2650–2610 Ma. Forward phase equilibrium modeling on rocks with varying bulk compositions and mineral assemblages suggests that peak temperatures reached 880–920°C at pressures of 5.5–6 kbar at ca. 2690–2665 Ma, followed by near‐isobaric cooling. These new P–T results also indicate that these rocks experienced some of the hottest thermal gradient regimes in the metamorphic record (≥150°C/kbar). Based on P–T models, U–Pb ages, and geochemical constraints, our data suggest that the geodynamic setting for the formation of this unusual thermal regime is ultimately tied to cratonization of the Yilgarn Craton. Previous models have inferred that ultrahigh thermal gradients and coeval large‐scale anatexis in the Narryer Terrane were primarily generated by mantle‐driven processes, despite most of the lithological, isotopic, and geochemical observations being at odds with the expected geological expression of large‐scale mantle upwelling. We re‐evaluate the mechanisms for high‐grade metamorphism in the Narryer terrane and propose that long‐lived high crustal temperatures between ca. 2690 Ma and 2610 Ma were instead facilitated by elevated radiogenic heat production in thickened, highly differentiated ancient crust. Mantle‐derived magma input and new crustal addition may not be the only drivers for high‐ to ultrahigh‐temperature metamorphism and stabilization of ancient crustal blocks.
Vernal growth of vocal control nucleus Area X, but not HVC, precedes gonadal recrudescence in wild black‐capped chickadees (Poecile atricapillus)
Authors: Parks Broderick M. B. , McVea Kyle , Phillmore Leslie S. 
Published: February 2024

AbstractIn temperate‐zone songbirds, the neuroanatomical changes which occur in advance of breeding, including the growth of nuclei of the vocal control system, are believed to occur downstream of gonadal recrudescence. However, evidence from wild birds is mixed. Here, we captured black‐capped chickadees from the wild in early spring (March–April), summer (August–September), and winter (December–January); in addition to measuring the volumes of two vocal control nuclei (Area X and HVC), we also quantified two indicators of reproductive state (gonads and circulating gonadal steroids). Most birds captured in early spring had regressed gonads and low levels of circulating gonadal steroids, indicating these birds were not yet in full breeding condition. However, these early spring birds still had a significantly larger Area X than winter birds, while HVC did not differ in size across groups. Using data from a previously published seasonal study of black‐capped chickadees (Phillmore et al., Developmental Neurobiology, 2015;75:203–216), we then compared Area X and HVC volumes from our early spring group to a breeding group of chickadees captured 3–4 weeks later in the spring. While Area X volume did not differ between the studies, breeding males in Phillmore et al. (2015) had a significantly larger HVC. Taken together, this suggests that the vernal growth of Area X occurs ahead of HVC in black‐capped chickadees, and that the overall vernal changes in the vocal control system occur at least partially in advance of the breeding‐associated upregulation of the hypothalamic–pituitary–gonadal axis.