bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early versus delayed antihypertensive treatment in patients with acute ischaemic stroke: multicentre, open label, randomised, controlled trial
Authors: Liu Liping , Xie Xuewei , Pan Yuesong , Wang Aili , Wei Yufei , Liu Jingyi , Nie Ximing , Liu Dacheng , Zhao Zilin , Wang Penglian , Shen Suwen , Zhong Chongke , Xu Tan , Wang Dali , Wang Gui-Chun , Song Denghua , Ma Yunsheng , Zhao Jinguo , Jiang Yong , Jing Jing , Meng Xia , Obst Katherine , Chen Chung-Shiuan , Wang David , Wang Yilong , Zhang Yonghong , Wang Yongjun , He Jiang 
Published: October 2023

Abstract

Objectives
To compared the effect of early antihypertensive treatment started within 24-48 h of stroke onset versus delaying treatment until day eight on reducing dependency or death.

Design
Multicentre, randomised, open label trial.

Setting
106 hospitals in China between 13 June 2018 and 10 July 2022.

Participants
4810 patients (≥40 years) were enrolled with acute ischaemic stroke within 24-48 h of symptom onset and elevated systolic blood pressure between 140 mm Hg and <220 mm Hg.

Interventions
Patients were randomly assigned to receive antihypertensive treatment immediately after randomisation (aimed at reducing systolic blood pressure by 10%-20% within the first 24 h and a mean blood pressure <140/90 mm Hg within seven days) or to discontinue antihypertensive medications for seven days if they were taking them, and then receive treatment on day 8 (aimed at achieving mean blood pressure <140/90 mm Hg).

Main outcome measures
The primary outcome was the combination of functional dependency or death (modified Rankin scale score ≥3) at 90 days. Intention to treat analyses were conducted.

Results
2413 patients were assigned to the early treatment group and 2397 were assigned to the delayed treatment group. Mean systolic blood pressure was reduced by 9.7% (from 162.9 mm Hg to 146.4 mm Hg) in the early treatment group and by 4.9% (from 162.8 mm Hg to 154.3 mm Hg) in the delayed treatment group within 24 h after randomisation (P for group difference <0.001). Mean systolic blood pressure was 139.1 mm Hg in the early treatment group and 150.9 mm Hg in the delayed treatment group on day seven (P for group difference <0.001). Additionally, 54.6% of patients in the early treatment group and 22.4% in the delayed treatment group had blood pressure of less than 140/90 mm Hg (P<0.001 for group difference) on day seven. At day 90, 289 trial participants (12.0%) in the early treatment group, compared with 250 (10.5%) in the delayed treatment group, had died or experienced a dependency (odds ratio 1.18 (95% confidence interval 0.98 to 1.41), P=0.08). No significant differences in recurrent stroke or adverse events were reported between the two groups.

Conclusions
Among patients with mild-to-moderate acute ischaemic stroke and systolic blood pressure between 140 mm Hg and <220 mm Hg who did not receive intravenous thrombolytic treatment, early antihypertensive treatment did not reduce the odds of dependency or death at 90 days.

Trial registration

ClinicalTrials.gov Identifier
NCT03479554
Effectiveness of behavioural change interventions on physical activity, diet and body mass index of public primary healthcare users in Kosovo: the KOSCO cohort
Authors: Bytyçi-Katanolli Ariana , Obas Katrina Ann , Ramadani Qamile , Fota Nicu , Jerliu Naim , Merten Sonja , Gerold Jana , Zahorka Manfred , Kwiatkowski Marek , Probst-Hensch Nicole 
Published: October 2023

BackgroundPrevalent physical inactivity and poor nutrition contribute to high non-communicable disease (NCD) morbidity and mortality in Kosovo. To improve health services for patients with NCD the Accessible Quality Healthcare project developed behaviour change interventions following the principles of the WHO Package of Essential NCD (PEN) protocol. They were implemented into the public primary healthcare (PHC) system of five early-stage implementation municipalities (ESIM, 2018) and seven late-stage implementation municipalities (2020).ObjectiveTo assess the effect of the behaviour change interventions; motivational stages of behaviour change for physical activity and nutrition; and body mass index (BMI).DesignProspective cohort study.Data collection and analysisWe included 891 public PHC users aged 40 years and above, who were enrolled in the KOSCO (Kosovo Non-Communicable Disease Cohort) cohort in 2019 and followed-up biannually until February 2021. The PHC users who consulted for themselves any health service were approached and recruited for cohort participation. Each participant contributed up to four self-reports of nutrition and physical activity, and up to three reports of motivation to change for a better lifestyle. These outcomes were modelled prospectively with robust mixed-effects Poisson regressions. The association between behaviour change interventions and BMI was quantified using linear regression.ResultsThere was a high rate of smokers 20.5% and obesity 53.1%, and high rates of self-reported diagnoses of diabetes: 57.1%; hypertension 62.6%. We found no effect of residing in an ESIM, but adherence to both guidelines was higher in ESIM at the latest follow-up time point. ESIM residence was also associated with a twofold increase in the probability of reporting a high motivation for a better lifestyle and with a statistically non-significant decrease in BMI of −0.14 kg/m2(95% CI: −0.46 to 0.19) at the latest follow-up.ConclusionThe longitudinal results extend evidence on the effect of WHO PEN protocol in promoting physical activity and nutritional behaviour in the Kosovo context.
Evaluating the impact of using mobile vaccination units to increase COVID-19 vaccination uptake in Cheshire and Merseyside, UK: a synthetic control analysis
Authors: Zhang Xingna , Tulloch John S P , Knott Shane , Allison Rachel , Parvulescu Paula , Buchan Iain E , Garcia-Finana Marta , Piroddi Roberta , Green Mark A , Baird Sophie , Barr Ben 
Published: October 2023

ObjectiveTo evaluate the impact of mobile vaccination units on COVID-19 vaccine uptake of the first dose, the percentage of vaccinated people among the total eligible population. We further investigate whether such an effect differed by deprivation, ethnicity and age.DesignSynthetic control analysis.SettingThe population registered with general practices (GPs) in nine local authority areas in Cheshire and Merseyside in Northwest England, UK.InterventionMobile vaccination units that visited 37 sites on 54 occasions between 12 April 2021 and 28 June 2021. We defined intervention neighbourhoods as having their population weighted centroid located within 1 km of mobile vaccination sites (338 006 individuals). A weighted combination of neighbourhoods that had not received the intervention (1 495 582 individuals) was used to construct a synthetic control group.OutcomeThe weekly number of first-dose vaccines received among people aged 18 years and over as a proportion of the population.ResultsThe introduction of a mobile vaccination unit into a neighbourhood increased the number of first vaccinations conducted in the neighbourhood by 25% (95% CI 21% to 28%) within 3 weeks after the first visit to a neighbourhood, compared with the synthetic control group. Interaction analyses showed smaller or no effect among older age groups, Asian and black ethnic groups, and the most socioeconomically deprived populations.ConclusionsMobile vaccination units are effective interventions for increasing vaccination uptake, at least in the short term. While mobile units can be geographically targeted to reduce inequalities, we found evidence that they may increase inequalities in vaccine uptake within targeted areas, as the intervention was less effective among groups that tended to have lower vaccination uptake. Mobile vaccination units should be used in combination with activities to maximise outreach with black and Asian communities and socioeconomically disadvantaged groups.
Prevalence and factors associated with the intention to use contraception among women of reproductive age who are not already using a contraceptive method in Liberia: findings from a secondary analysis of the 2019–2020 Liberia Demographic Health Survey
Authors: Yeboah Daudi , Issah Abdul-Nasir , Kpordoxah Mary Rachael , Akiti Caselia , Boah Michael 
Published: October 2023

ObjectiveContraception constitutes a vital aspect of sexual and reproductive healthcare. However, the high prevalence of non-use has become a great public health concern globally. This study examined the intention to use contraceptives and its associated factors among women of reproductive age who were not using any method in Liberia.Design and settingA cross-sectional population-based study was conducted. We used data from the 2019–2020 Liberia Demographic and Health Survey. The research framework used the theory of planned behaviour to identify the factors that influence women’s intention to use contraception.ParticipantsThe study analysed a weighted sample of 4504 women aged 15–49 who were not currently using any form of contraception.Data analysisThe outcome variable was the intention to use a contraceptive method. A binary logistic regression was used to identify factors associated with the intention to use contraceptives in Stata V.13.0.ResultsOf the 4504 women, 39.42% intended to use contraception. Contraception intention was significantly lower in married women than in never married women (adjusted OR (aOR) 0.78; 95% CI 0.62 to 0.98). Additionally, women aged 25–34 (aOR 0.434; 95% CI 0.339 to 0.556) and 35–49 (aOR 0.120; 95% CI 0.088 to 0.163) had a reduced intent to use contraceptives than those aged 15–24. However, women with at least one child, those with prior contraception experience and those who had their first sexual encounter at the age of 13 or older were more likely to intend to use contraception. Notably, Muslim and wealthy women displayed a lower likelihood of intending to use contraception.ConclusionThese findings highlight that attitudes, subjective norms and perceived behavioural control significantly influence women’s intentions to use contraception. Understanding and addressing these factors are crucial for promoting effective contraceptive use among women, facilitating informed reproductive choices.
What organisational and regional factors influence the outpatient provision of curettages in Germany? A longitudinal secondary data analysis using hospital quality reports data from 2013 to 2019
Authors: Volkert Anna , Stöcker Arno , Pfaff Holger , Scholten Nadine 
Published: October 2023

ObjectivesThe rate of outpatient therapeutic curettage is lower in Germany than in other countries, although there are no differences in patient safety between outpatient and inpatient management. In this context, outpatient surgery is economically advantageous and efficient. This study aims to identify organisational and regional factors that determine the rate of outpatient curettage in German hospitals.MethodsWe analysed the hospital quality reports for 2013–2019, which include data from all German hospitals with gynaecology departments (n=709). These organisational data (teaching status, size, ownership, department type and hospital group) are enhanced by contextual data (degree of urbanisation, market concentration and population income). We calculated a zero-one inflated beta regression model to identify factors that influence the rate of outpatient curettages in 2019.ResultsIncreasing numbers of curettages are provided on an outpatient basis; accordingly, the number of inpatient curettages declined during the analysis period. In 2019, 69.6% of in-hospital curettages were performed as outpatient surgery. Hospital size is significantly negative and outpatient physician department type is significantly positively associated with outpatient curettage rates. We found no effects of hospital ownership type, degree of urbanisation or market concentration. A high income in the surgical district’s population is also associated with a higher rate of outpatient curettages.ConclusionsThe analyses demonstrate that organisational factors are associated with the outpatient curettage rate. This indicates that external elements, such as reimbursements and regulations, influence outpatient surgical events in Germany, and current regulations do not incentivise hospitals to significantly increase their rate of outpatient curettages.
Colon CApsule endoscopy compared to conventional COlonoscopy in patients with colonic DIverticulitis: the study protocol for a randomised controlled superiority trial (CACODI trial)
Authors: Schelde-Olesen Benedicte , Kaalby Lasse , Deding Ulrik , Thygesen Maja M I , Andersen Per Vadgaard , Koulaouzidis Anastasios , Baatrup Gunnar , Bjørsum-Meyer Thomas 
Published: October 2023

IntroductionFollow-up after an episode of colonic diverticulitis is a common indication for colonoscopy, even though studies have shown a low risk of positive findings in this population. Our objective is to investigate colon capsule endoscopy (CCE) as a follow-up examination in patients with colonic diverticulitis compared with colonoscopy, particularly regarding patient satisfaction and clinical performance.Methods and analysisWe will conduct a single-centre prospective randomised controlled trial. Patients seen at Odense University Hospital with acute diverticulitis confirmed by CT will be included and randomised to either follow-up by colonoscopy or CCE. Detection of suspected cancer, more than two polyps or any number of polyps larger than 9 mm in CCE will generate an invitation to a diagnostic colonoscopy for biopsies or polyp removal. We will compare colonoscopy and CCE regarding patient satisfaction and tolerance, the number of complete examinations, the number of patients referred to a subsequent colonoscopy after CCE and the prevalence of diverticula, polyps, cancers and other abnormal findings.Ethics and disseminationInformed consent will be obtained from all participants before randomisation. The study was approved by the regional ethics committee (ref. S-20210127) and the Danish Data Protection Agency (ref. 22/43235). After completion of the trial, we plan to publish two articles in high-impact journals. One article on both primary and secondary outcomes.Trial registration numberNCT05700981.
COmparing Urolift andStandardTransurethral resection of prostateAhead ofRadiotherapy in men with urinary symptoms secondary to prostate enlargement in Southwest London and North Cumbria (CO-STAR): a study protocol for a randomised feasibility study
Authors: Wong Kathie , Kinsella Netty , Seth Jai , Nicol David , Cahill Declan , Kasivisvanathan Ramanathan , Withington John , Moghul Masood , Moss Charlotte Louise , Van Hemelrijck Mieke , Giorgakoudi Kyriaki , Cottrell Chris , Yates Emma , Khoo Vincent , James Nicholas D 
Published: October 2023

IntroductionPatients undergoing prostate radiotherapy with an enlarged prostate can have short-term and long-term urinary complications. Currently, transurethral resection of the prostate (TURP) is the mainstay surgical intervention for men with urinary symptoms due to an enlarged prostate prior to radiotherapy. UroLift (NeoTract, Pleasanton, CA, USA) is a recent minimally invasive alternative, widely used in benign disease but is untested in men with prostate cancer.Methods and analysisA multicentre, two-arm study designed in collaboration with a Patient Reference Group to assess the feasibility of randomising men with prostate cancer and coexisting urinary symptoms due to prostate enlargement to TURP or UroLift ahead of radiotherapy. 45 patients will be enrolled and randomised (1:1) using a computer-generated programme to TURP or UroLift. Recruitment and retention will be assessed over a 12 month period. Information on clinical outcomes, adverse events and costs will be collected. Clinical outcomes and patient reported outcome measures will be measured at baseline, 6 weeks postintervention and 3 months following radiotherapy. A further 12 in-depth interviews will be conducted with a subset of patients to assess acceptability using the Theoretical Framework of Acceptability. Descriptive analysis on all outcomes will be performed using Stata (StataCorp V.2021).Ethics and disseminationThe trial has been approved by the Research Ethics Committee (REC) NHS Health Research Authority (HRA) and Health and Care Research Wales (HCRW). The results will be published in peer-reviewed journals, presented at national meetings and disseminated to patients via social media, charity and hospital websites.Trial registration numberNCT05840549.
Cognitive impairment and outcomes in older adults with non-ST-elevation acute coronary syndrome
Authors: Dirjayanto Valerie Josephine , Alkhalil Mohammad , Dodson John , Mills Gregory , Pompei Graziella , Rubino Francesca , Kunadian Vijay 
Published: October 2023

ObjectiveThis study aimed to explore the prognostic impact of cognitive impairment on the long-term risk of major adverse cardiovascular events (MACEs) in older patients with non-ST-elevation acute coronary syndrome (NSTEACS) undergoing invasive treatment.MethodsPatients aged ≥75 years with NSTEACS undergoing an invasive strategy were included in the multicentre prospective study (NCT01933581). Montreal Cognitive Assessment was used to evaluate cognitive status at baseline (scores ≥26 classified as normal, <26 as cognitive impairment). Long-term follow-up data were obtained from electronic patient care records. The primary endpoint was MACE as a composite of all-cause deaths, reinfarction, stroke/transient ischaemic attack, urgent revascularisation and significant bleeding.Results239 patients with baseline cognitive assessment completed long-term follow-up. Median age was 80.9 years (IQR 78.2–83.9 years) and 62.3% were male. On 5-year follow-up, there was no significant difference in the occurrence of MACE between the cognitively impaired group and the normal cognition group (p=0.155). Cognition status was not associated with MACE (HR 1.37 (95% CI 0.96 to 1.95); p=0.082). However, there was significantly more deaths (p=0.005) in those with cognitive impairment. Kaplan-Meier survival analysis (log-rank p=0.003) and Cox regression analysis (aHR 1.85 (95% CI 1.11 to 3.08); p=0.018) revealed increased risk of all-cause mortality, even after adjusting for frailty and GRACE (Global Registry of Acute Coronary Events) score.ConclusionCognitive impairment in older patients with NSTEACS undergoing an invasive strategy was associated with long-term all-cause mortality. Routine cognitive screening may aid risk stratification and further studies are needed to identify how this should influence management strategies and individual decision-making in this patient group.Trial registration numberNCT01933581.
Post-operative weight loss in venous sinus stenting patients: A multi-center review, systematic review, and meta-analysis
Authors: Gajjar Avi A , Rogers Aubrey , Ghosh Ritam , Abbas Rawad , Naamani Kareem El , Gooch M Reid , Field Nicholas , Dalfino John C , Paul Alexandra R 
Published: October 2023

Introduction Idiopathic intracranial hypertension (IIH) can result in headaches, pulsatile tinnitus, papilledema, and other neurological symptoms. Weight loss can alleviate some symptoms of IIH. This study aims to investigate the effect of venous sinus stenting on post-operative weight and body mass index (BMI) changes among IIH patients. The secondary objective is to investigate the relationship between post-operative weight changes and papilledema resolution. Methods Patients with papilledema undergoing venous sinus stenting for IIH were retrospectively reviewed from two comprehensive North American cerebrovascular centers. Patient demographics, surgical course, post-operative outcomes, and weight were analyzed. A systematic review and meta-analysis of post-operative weight in stented IIH patients was conducted. Results Twenty-eight patients with a diagnosis of IIH and papilledema who underwent venous sinus stenting were identified across two institutions. Patients had a mean pre-operative weight of 103.2 kg, which decreased to 101.5 kg at 3-month follow up ( p = 0.0757). Patients at 6-month follow-up saw a weight decrease to 97.4 kg ( p = 0.0066). Patients who saw papilledema resolution saw a mean greater decrease in weight (−4.5%) at 6-month follow up than those whose papilledema did not resolve (−1.7%), although this was insignificant ( p = 0.1091). A total of 41 patients were included in the meta-analysis. Patients had an average of 1.1 increase in BMI at 3-month follow up. Conclusions This study shows that venous sinus stenting leads to modest weight reduction in IIH patients, and those with resolved papilledema experience slightly greater weight loss. Further research is necessary to determine the clinical significance of these findings.
A scalable solution recipe for a Ag-based neuromorphic device
Authors: Rao Tejaswini S. , Mondal Indrajit , Bannur Bharath , Kulkarni Giridhar U. 
Published: October 2023

AbstractIntegration and scalability have posed significant problems in the advancement of brain-inspired intelligent systems. Here, we report a self-formed Ag device fabricated through a chemical dewetting process using an Ag organic precursor, which offers easy processing, scalability, and flexibility to address the above issues to a certain extent. The conditions of spin coating, precursor dilution, and use of solvents were varied to obtain different dewetted structures (broadly classified as bimodal and nearly unimodal). A microscopic study is performed to obtain insight into the dewetting mechanism. The electrical behavior of selected bimodal and nearly unimodal devices is related to the statistical analysis of their microscopic structures. A capacitance model is proposed to relate the threshold voltage (Vth) obtained electrically to the various microscopic parameters. Synaptic functionalities such as short-term potentiation (STP) and long-term potentiation (LTP) were emulated in a representative nearly unimodal and bimodal device, with the bimodal device showing a better performance. One of the cognitive behaviors, associative learning, was emulated in a bimodal device. Scalability is demonstrated by fabricating more than 1000 devices, with 96% exhibiting switching behavior. A flexible device is also fabricated, demonstrating synaptic functionalities (STP and LTP).