bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative analysis of syringes versus pump devices in benchtop aspiration thrombectomy models: A systematic review and meta-analysis
Authors: Senol Yigit Can , Li Jiahui , Orscelik Atakan , Kobeissi Hassan , Bilgin Cem , Oliver Alexander A , Ghozy Sherief , Kadirvel Ramanathan , Kallmes David F 
Published: December 2023

Background Although direct contact aspiration has emerged as one of the leading techniques for mechanical thrombectomy (MT), there is still ongoing debate about the aspiration/suction pump devices that can optimize recanalization rates. To address this gap, we conducted a meta-analysis comparing the aspiration efficacy of 60 ml syringe and pump devices in benchtop MT models. Methods Systematic literature review was conducted using Medline, Embase, Web of Science, and Scopus in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Outcomes of interest included flow rate and vacuum pressure delivered by a 60 ml syringe and several aspiration pumps. We used a random effects model to calculate the mean difference (MD) with 95% confidence intervals (CIs) and a statistically significant difference was considered as a two-sided p-value of less than 0.05. Results We included six benchtop studies comparing 60 ml syringes and vacuum pumps. Our meta-analysis showed that there were no significant differences in vacuum pressure (MD:0.71inHg, 95% CI: [−0.81;2.23], p = 0.359) and flow rate (MD:0.27 mL/s, 95% CI: [−3,07; 3.61], p = 0.873) between 60 ml syringes and vacuum pumps groups. Conclusions Our study demonstrated comparable performance in terms of vacuum pressure and flow rates between a 60 ml syringe and a heterogeneous combination of commercially available aspiration pumps.
RAPID aneurysm accurately measures aneurysm size on CT angiography compared to three-dimensional digital subtraction angiography
Authors: Snyder Sarah J , Gauden Andrew , Copeland Karen , Spiotta Alejandro M , Heit Jeremy J 
Published: December 2023

Background Cerebral aneurysms are often identified and characterized on non-invasive CT Angiography (CTA) images, but digital subtraction angiography (DSA) is the gold standard for aneurysm evaluation. Objective We compared cerebral aneurysm size measurements as measured from CTA processed by a semi-automated artificial intelligence software program (RAPID Aneurysm) and three-dimensional rotational DSA (3D-DSA). Methods We performed a retrospective cohort study of consecutive patients with a cerebral aneurysm who underwent CTA and DSA with 3D reformations. CTA images were processed by RAPID Aneurysm to determine aneurysm height, width, and neck width. The reference standard was aneurysm measurements on 3D-DSA as measured by two neurointerventionalists. Both readers were blinded to RAPID Aneurysm measurements. Correlation and bias between these measurements were determined. Results Results from 50 patients with 50 aneurysms were compared. 32 patients (64%) were female. Median age was 65 (IQR: 56.25–71.75). 37 patients (74%) presented with ruptured aneurysms. The aneurysms represented a range of aneurysm sizes (1.9–33.3 mm; IQR 3.6–7.2 mm). RAPID Aneurysm size measurements showed excellent correlation and low bias (correlation, mean difference) when compared to the reference standard for aneurysm height (0.98, −0.9 mm), width (0.98, 0.1 mm), and neck width (0.94, 1.1 mm). The inter-reader comparison between the two neurointerventionalists was similarly excellent for aneurysm height (0.97, −0.4 mm), width (0.98, −0.2 mm), and neck width (0.89, 0.8 mm). Conclusion RAPID Aneurysm measurement of cerebral aneurysm height, width, and neck width on CTA is strongly correlated to expert neurointerventionalist measurements on 3D-DSA.
A review of patient recruitment in randomised controlled trials of preoperative exercise
Authors: Steffens Daniel , Solomon Michael , Young Jane , Beckenkamp Paula R , Bartyn Jenna , Koh Cherry , Hancock Mark 
Published: December 2023

Background Randomised controlled trials (RCTs) are considered the gold standard design to determine the effectiveness of an intervention, as the only method of decreasing section bias and minimising random error. However, participant recruitment to randomised controlled trials is a major challenge, with many trials failing to recruit the targeted sample size accordingly to the planned protocol. Thus, the aim of this review is to detail the recruitment challenges of preoperative exercise clinical trials. Methods A comprehensive search was performed on MEDLINE, Embase, The Cochrane Library, CINAHL, AMED and PsycINFO from inception to July 2021. Randomised controlled trials investigating the effectiveness of preoperative exercise on postoperative complication and/or length of hospital stay in adult cancer patients were included. Main outcomes included recruitment rate, retention rate, number of days needed to screen and recruit one patient and trial recruitment duration. Descriptive statistics were used to summarise outcomes of interest. Results A total of 27 trials were identified, including 3656 patients screened (N = 21) and 1414 randomised (median recruitment rate (interquartile range) = 53.6% (25.2%–67.6%), N = 21). The sample size of the included trials ranged from 19 to 270 (median = 48.0; interquartile range = 40.0–85.0) and the duration of trial recruitment ranged from 3 to 50 months (median = 19.0 months; interquartile range = 10.5–34.0). Overall, a median of 3.6 days was needed to screen one patient, whereas 13.7 days were needed to randomise one participant. Over the trials duration, the median dropout rate was 7.9%. Variations in recruitment outcomes were observed across trials of different cancer types but were not statistically significant. Conclusion The recruitment of participants to preoperative exercise randomised controlled trials is challenging, but patient retention appears to be less of a problem. Future trials investigating the effectiveness of a preoperative exercise programme following cancer surgery should consider the time taken to recruit patients. Strategies associated with improved recruitment should be investigated in future studies.
The role of people with intellectual disability in intellectual disability research: A systematic review of Delphi studies
Authors: Piantedosi Diana K , O’Shea Amie 
Published: December 2023

Background The way intellectual disability research is designed warrants critical examination, as the knowledge produced through these approaches informs evidence-based practices. People with lived experience should be considered experts in relation to understanding their bodies, conditions, and treatment. Method This systematic review analyses the design of Delphi studies, to determine the extent to which people with intellectual disability are involved as experts. The design of Delphi studies (involving structured feedback from experts) provides an insight into the extent that ‘lived experience’ is valued as a source of expert knowledge. Results Fifty-five publications reporting on forty-nine separate Delphi studies met our inclusion criteria. Nine publications report the involvement of people with intellectual disability. However, family/informal caregivers are represented as experts in higher numbers and their voices carry greater weight. Conclusion The findings of this review include guidance for practitioners and researchers to facilitate greater participatory roles of people with intellectual disability.
Kilohertz high-frequency electrical stimulation ameliorate hyperalgesia by modulating transient receptor potential vanilloid-1 and N-methyl-D-aspartate receptor-2B signaling pathways in chronic constriction injury of sciatic nerve mice
Authors: Fang Kexin , Lu Peixin , Cheng Wen , Yu Bin 
Published: December 2023

The number of patients with neuropathic pain is increasing in recent years, but drug treatments for neuropathic pain have a low success rate and often come with significant side effects. Consequently, the development of innovative therapeutic strategies has become an urgent necessity. Kilohertz High Frequency Electrical Stimulation (KHES) offers pain relief without inducing paresthesia. However, the specific therapeutic effects of KHES on neuropathic pain and its underlying mechanisms remain ambiguous, warranting further investigation. In our previous study, we utilized the Gene Expression Omnibus (GEO) database to identify datasets related to neuropathic pain mice. The majority of the identified pathways were found to be associated with inflammatory responses. From these pathways, we selected the transient receptor potential vanilloid-1 (TRPV1) and N-methyl-D-aspartate receptor-2B (NMDAR2B) pathway for further exploration. Mice were randomly divided into four groups: a Sham group, a Sham/KHES group, a chronic constriction injury of the sciatic nerve (CCI) group, and a CCI/KHES stimulation group. KHES administered 30 min every day for 1 week. We evaluated the paw withdrawal threshold (PWT) and thermal withdrawal latency (TWL). The expression of TRPV1 and NMDAR2B in the spinal cord were analyzed using quantitative reverse-transcriptase polymerase chain reaction, Western blot, and immunofluorescence assay. KHES significantly alleviated the mechanical and thermal allodynia in neuropathic pain mice. KHES effectively suppressed the expression of TRPV1 and NMDAR2B, consequently inhibiting the activation of glial fibrillary acidic protein (GFAP) and ionized calcium binding adapter molecule 1 (IBA1) in the spinal cord. The administration of the TRPV1 pathway activator partially reversed the antinociceptive effects of KHES, while the TRPV1 pathway inhibitor achieved analgesic effects similar to KHES. KHES inhibited the activation of spinal dorsal horn glial cells, especially astrocytes and microglia, by inhibiting the activation of the TRPV1/NMDAR2B signaling pathway, ultimately alleviating neuropathic pain.
Psychometric properties of the Turkish version of the therapeutic relationship assessment scale for nurses
Authors: Duran Songül , Polat Selda 
Published: December 2023

Background: It is essential for nurses who care for individuals diagnosed with mental illness to establish a therapeutic relationship. There is no measurement tool available in Türkiye to assess the therapeutic relationship between patient and nurse. Aim: The objective of this study is to perform a validity and reliability study of the Turkish version of a scale that enables the evaluation of the quality of the therapeutic relationship established between nurses and patients. Methods: 140 nurses were included in this study. The data were analysed using the exploratory and confirmatory analyses. Results: The scale consists of 25 items and four sub-dimensions. In confirmatory factor analysis (CFA), all factor loads were >0.30. As a result of CFA, all fit indices were >0.85 and the root mean square approximation was <0.080. Cronbach alpha was 0.93 for the whole scale. Conclusion: The Turkish version of the TRAS-Nurse scale and its original version were compatible with each other and gave similar results. This scale can be used to determine the therapeutic relationship of nurses who care for psychiatric patients in Türkiye and can be a useful measurement tool when evaluating the factors that may be effective in improving the therapeutic relationship.
Moral distress in nurses in developing economies: an integrative literature review
Authors: Afoko Vivian , Hewison Alistair , Newham Roger , Neilson Susan 
Published: December 2023

Background: Moral distress has been extensively studied in developed economies; however, not much in terms of studies has been carried out in developing economies. Objective: To review the literature reporting the experience of moral distress in nurses in health care settings in developing economies. Design: An integrative literataure review was used. Method: Cumulative Index of Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online Cochrane and Psych INFO were searched to retrieve titles and abstracts of papers on the experience of moral distress in nurses in developing economies. Results: Sixteen articles reporting the experience of moral distress in nurses in developing economies published between 1984 and March 2019 were used for the review. Analysis of the findings revealed seven themes, nurses’ experience of moral distress, inadequate material and human resources, end-of-life challenges, cultural and religious beliefs as a source of moral distress, perceived inactions of medical and nursing staff, impact of moral distress on nurses in developing economies and coping strategies. Conclusion: There is paucity of empirical studies on moral distress in nurses in developing economies. More qualitative studies are needed in various cultural settings to enhance its understanding in nurses working in developing economies.
Effect of pioglitazone on vascular events in post-stroke cognitive impairment: Post hoc analysis of the IRIS trial
Authors: Schmidt Kat , Power Melinda C. , Ciarleglio Adam , Nadareishvili Zurab 
Published: December 2023

Background: In stroke patients with insulin resistance (IR), post-stroke cognitive impairment (PSCI) is associated with higher risk of recurrent stroke, but the effect of pioglitazone on that risk has not been explored. The goal of this study was to compare the secondary stroke prevention effect of pioglitazone against placebo in patients with versus without PSCI. Methods: We studied patients enrolled in the Insulin Resistance Intervention after Stroke (IRIS) trial with a post-stroke modified Mini-Mental State Examination (3MS) cognitive assessment (mean time of assessment: 79 days post-stroke). We considered a baseline score of ⩽ 88 on the 3MS to indicate global PSCI, and domain-specific summary scores in the lowest quartile to indicate attention, language, memory, orientation, and visuospatial impairments. Results: In n = 3338 patients with IR, the effect of pioglitazone versus placebo on secondary stroke significantly differed by initial post-stroke global (interaction p = 0.0127) and memory impairment status (interaction p = 0.0003). Hazard ratios (HRs) were time-dependent such that, among those with either global or memory impairment, pioglitazone has an increasingly stronger protective effect at later timepoints. There was no statistically significant effect of pioglitazone among those without either global or memory impairment. The effect of pioglitazone versus placebo on myocardial infarction (MI) also significantly differed by global impairment status (interaction p = 0.030). Pioglitazone was protective among those with global impairment (HR = 0.23 [95% CI: 0.08, 0.71]) but not among those without (HR = 0.88 [95% CI: 0.59, 1.31]). Conclusion: These data indicate that pioglitazone treatment may be more effective at reducing risk of recurrent stroke and MI in stroke patients with PSCI. Simple cognitive testing 2–3 months post-stroke may identify patients for whom treatment would be most beneficial.
Ammonia Inhalants: Use, Misuse, and Role in Sports Performance
Authors: Bender Joshua M. , Popkin Charles A. 
Published: December 2023

Context: Ammonia inhalants, also known as smelling salts, are preparations of ammonia designed to treat fainting but more commonly used by athletes to boost awareness and arousal during competition. Despite their widespread use, the physiological and performance-enhancing effects of ammonia inhalants remain poorly understood. The aim of the present study was to review the current literature surrounding the benefits, risks, and physiological effects of ammonia inhalants. Evidence Acquisition: An extensive literature review of articles pertaining to ammonia inhalants was performed through MEDLINE and Google Scholar. The search terms “smelling salts,” “ammonia inhalants,” “strength,” “performance,” “head injury,” and “concussion” were used. Study Design: Clinical review. Level of Evidence: Level 4. Results: The physiological response to acute ammonia inhalation includes cerebral vasodilation and heart rate elevation without change in blood pressure. The existing evidence demonstrates an ergogenic benefit to ammonia inhalant use only during repeated bouts of high-intensity exercise; in these subjects, ammonia inhalation was associated with increased power as measured by the Wingate anaerobic test. In contrast, there is no performance benefit to ammonia inhalants in a short burst of maximal effort despite elevated arousal and an associated perception of performance enhancement. Importantly, ammonia inhalants have no role in medical management of head injuries, as they have the potential to exacerbate an underlying brain injury due to the involuntary withdrawal reflex associated with ammonia inhalation. Furthermore, the signs and symptoms of a concussion or more threatening head injury may be masked by ammonia inhalation and lead to continued participation in competition, causing additional harm. Conclusion: Ammonia inhalants have no role in medical management of head injuries and have limited benefit with regards to sports performance. Strength of Recommendation: B
Comparison of the Buffalo Concussion Treadmill Test With a Physiologically Informed Cycle Test: Calgary Concussion Cycle Test
Authors: Miutz Lauren N. , Burma Joel S. , Brassard Patrice , Phillips Aaron A. , Emery Carolyn A. , Smirl Jonathan D. 
Published: December 2023

Background: Sport-related concussions are a complex injury requiring multifaceted assessment, including physical exertion. Currently, concussion testing relies primarily on a treadmill-based protocol for assessing exertion-related symptoms in persons after concussion. This study compared a modified cycle protocol (Calgary Concussion Cycle Test [CCCT]) with the clinically adopted standard, the Buffalo Concussion Treadmill Test (BCTT), across multiple physiological parameters. Hypothesis: Treadmill and cycle matched workload protocols would produce similar results for cerebral blood velocity, mean arterial pressure (MAP), and end-tidal carbon dioxide partial pressure (PETCO2), but heart rate (HR) and oxygen consumption (VO2) would be higher on the treadmill than the cycle modality. Study Design: Crossover study design. Level of Evidence: Level 3. Methods: A total of 17 healthy adults (8 men, 9 women; age, 26 ± 3 years; body mass index, 23.8 ± 2.7 kg/m2) completed the BCTT and CCCT protocols, 7 days apart in a randomized order. During both exertional protocols, the physiological parameters measured were middle cerebral artery mean blood velocity (MCAv), MAP, PETCO2, VO2, and HR. Analysis of variance with effect size computations, coefficient of variation, and Bland-Altman plots with 95% limits of agreement were used to compare exercise tests. Results: The BCTT and CCCT produced comparable results for both male and female participants with no significant differences for average MCAv, MAP, and PETCO2 (all P > 0.05; all generalized eta squared [η2G] < 0.02 [negligible]; P value range, 0.29-0.99) between stages. When accounting for exercise stage and modality, VO2 ( P < 0.01) and HR ( P < 0.01) were higher on the treadmill compared with the cycle. Aside from the final few stages, all physiology measures displayed good-to-excellent agreeability/variability. Conclusion: The CCCT was physiologically similar to the BCTT in terms of MCAv, PETCO2, and MAP; however, HR and VO2 differed between modalities. Clinical Relevance: Providing a cycle-based modality to exertional testing after injury may increase accessibility to determine symptom thresholds in the future.
Acute care bundles should be used for patients with intracerebral haemorrhage: An expert consensus statement
Authors: Parry-Jones Adrian R , Järhult Susann J , Kreitzer Natalie , Morotti Andrea , Toni Danilo , Seiffge David , Mendelow Alexander David , Patel Hiren , Brouwers Hens Bart , Klijn Catharina JM , Steiner Thorsten , Gibler Walter Brian , Goldstein Joshua N 
Published: December 2023

Purpose: Intracerebral haemorrhage (ICH) is the most devastating form of stroke and a major cause of disability. Clinical trials of individual therapies have failed to definitively establish a specific beneficial treatment. However, clinical trials of introducing care bundles, with multiple therapies provided in parallel, appear to clearly reduce morbidity and mortality. Currently, not enough patients receive these interventions in the acute phase. Methods: We convened an expert group to discuss best practices in ICH and to develop recommendations for bundled care that can be delivered in all settings that treat acute ICH, with a focus on European healthcare systems. Findings: In this consensus paper, we argue for widespread implementation of formalised care bundles in ICH, including specific metrics for time to treatment and criteria for the consideration of neurosurgical therapy. Discussion: There is an extraordinary opportunity to improve clinical care and clinical outcomes in this devastating disease. Substantial evidence already exists for a range of therapies that can and should be implemented now.
Detection of microemboli in patients with acute ischaemic stroke and atrial fibrillation suggests poor functional outcome
Authors: Castro Pedro , Ferreira J , Malojcic Branko , Bazadona Danira , Baracchini Claudio , Pieroni Alessio , Skoloudik David , Azevedo Elsa , Kaps Manfred 
Published: December 2023

Introduction: We investigated the burden of microembolic signals (MES) in patients with acute ischaemic stroke (AIS) and atrial fibrillation (AF), assessing their impact on functional outcomes. Patients and methods: This multicentre international prospective cohort study involved patients with AIS and either a known or newly diagnosed anticoagulant-naïve AF. All centres utilised the same transcranial Doppler machine for 1-h monitoring with bilateral 2 MHz probes within 24 h of symptom onset. Recordings underwent MES analysis by a blinded central reader. The primary objectives were to ascertain the MES proportion and its association with functional outcomes assessed by the modified Rankin scale (mRS) score at 90 days. Results: Between September 2019 and May 2021, we enrolled 61 patients, with a median age of 78 years (interquartile range 73–83) and a median stroke severity score of 11 (interquartile range 4–18). MES were observed in 14 patients (23%), predominantly unilateral (12/14, 86%), with a median rate of 6 counts/hour (interquartile range 4–18). MES occurrence was higher post-thrombectomy and among those with elevated brain natriuretic peptide levels ( p < 0.05). A worse mRS score of 3–6 was more frequent in patients with MES, occurring in 11/14 (79%), compared to those without MES, 20/47 (43%), with an adjusted odds ratio of 5.04 (95% CI, 1.15–39.4), p = 0.04. Conclusions: Nearly a quarter of patients with AIS and AF exhibited silent microembolization after the index event. Detecting MES within 24 h post-stroke (using transcranial Doppler) could signify a marker of poor functional outcomes. Subsequent trials will assess if very early antithrombotic treatment might enhance outcomes in this highly selective group of cardioembolic stroke patients. (Clinicaltrials.gov ID: NCT06018090).