bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orlando Protocol for single session ductal clearance of common bile duct stones at endosopic retrograde cholangiopancreatography
Authors: Bang Ji Young , Wilcox C. Mel , Navaneethan Udayakumar , Hawes Robert , Varadarajulu Shyam 
Published: November 2023

ObjectivesApproach to management of common bile duct stones (CBDS) by endoscopic retrograde cholangiopancreatography (ERCP) is not standardized. We examined outcomes by applying predetermined protocol for CBDS management.MethodsWhen standard extraction techniques failed at ERCP, presence of tapered bile duct and stone–duct ratio were calculated. Large balloon sphincteroplasty (LBS) and/or mechanical/single‐operator cholangioscopy‐guided lithotripsy was performed based on presence of tapered bile duct and stone–duct mismatch. Primary outcome was single‐session ductal clearance. Secondary outcome was adverse events.ResultsOf 409 patients treated over 16 months, 321 (78.5%) had no tapered bile duct or stone–duct mismatch, and single‐session ductal clearance was achieved using standard techniques in 99.7% over median duration of 14 min (interquartile range [IQR] 9–21 min). Of 88 (21.5%) patients with difficult CBDS, tapered duct was seen in 79 (89.8%) and/or stone–duct mismatch in 36 (40.9%). Single‐session ductal clearance was achieved in all 88 patients (100%) by LBS in 79 (89.8%), mechanical lithotripsy in 20 (22.7%), and single‐operator cholangioscopy‐guided lithotripsy in 16 (18.2%) over a median duration of 29 min (IQR 17–47 min). Overall, single‐session ductal clearance was achieved in 99.8% with adverse events in 17 (4.2%) that included perforation in two, postsphincterotomy bleeding in one, and mild/moderate post‐ERCP pancreatitis in 14 patients.ConclusionsA predetermined protocol optimized outcomes by enabling single‐session ductal clearance of CBDS with high technical success and low adverse events.
Apmerrke Areye‐kenhe Utnenge Rlterrke‐irrirtne‐tyenhenge
Authors: Liddle Joel , Langton Marcia , Rose James , Rice Simon 
Published: November 2023

AbstractArrurle‐nge‐ntyele researchers lhentere areye‐le intelhe‐ilepe‐ileme apmerrke areye‐akerte. Itne akaltye‐arle‐irreke apmerrke areye akwele urreme‐urreme‐irreme, utnenge alhwarrpe awelhemele. Kenhe alhentere nhenhe areye akaltye‐irretyakenhe iwenhenge‐arle apmerrke areye alakenhe anerlte‐aneme. Itne itelaretyakenhe nthakenhe‐arle arne ingkirreke urrperle‐areye‐kenhe‐le apmerrke areye atnerre ilirtnemere. Researchers itne akaltye‐irreke artwe apmerrke Central Australia‐arenye‐arle akwele health akurne anthurre‐ulkere, Australia arenye‐arrpenhe areye‐nge. Arrpenheme apeke clinic‐werne alheme, kenhe itne akenhe itelaretyakenhe iwenhe‐arle alhentere ngangkere‐le itneke ileme, health itnekenhe‐akerte, medications‐akerte‐arlke. Artwe atningke apeke itelaretyakenhe iwenhenge‐arle itne ilkelhetyakenhe uthene akangketyakenhe uthene. The kwenhe PhD project mpwarerle‐aneme apmerrke anwerneke‐akerte. Anwerne ahentye aneme apmerrke areye atyenpe‐irrirtnetyeke, atnerre anemele. Project nhenhe arne atyeperre anwerne‐kenhe areye‐akerte, angkentye, anpernirrentye, nthakenhe angkentye anwernekenhe intelhetyeke, anyenhenge, apmere‐kenhe arritnye ingkirreke, thipe‐kenhe arritnye, arne‐kenhe arritnye, atnunthe apmere‐altye‐arlke. Apmerrke areye kwenhe akaltye‐irretyeke nthakenhe English angketyeke, read‐eme‐iletyeke, intelhetyeke‐arlke. Apmerrke areye apeke akaltye‐irretyeke Akngerrepate arrwekelenye areye‐ke, arne mwerre areye itne‐arle mpware‐warretyarte, kele itne anteme itnenhe ingkentetyeke. Artwe akaperte altywere‐areye role models anwernekenhe aneme. 1930's‐nge‐ntyele governments‐le laws mpwareke arritnye Assimilation Policy. Yanhe‐iperre, atningke areye uye‐akaltye‐irreke urrperle‐kenhe arne areye‐kenhe‐ke. Alhentere areye‐le anamelhe‐ileke arrpenheme apmere itnekenhe‐nge‐ntyele bungalow‐atheke, ayerrere‐werne atheke, antekerre‐arlke. Assimilation Policys‐nge ularre, tyerrtye atningke angkentye‐ke uye akaltye‐irreke, apmere‐akerte, apmere‐ke‐artweye‐ke, kwertengwerle‐ke, laws anwernekenhe‐arlke. Lhentere arrpenheme ahentye‐aneke akaltye‐irretyeke Tywerrenge‐ke. Arne arrpenheme‐ke itne‐arle akaltye‐irreke artwe‐kenhe‐ante, kenhe arrpenhe akenhe ingkirreke‐ke. Arne nhenhe areye museums‐uthene‐le organisations arrpenhe areye uthene‐le akwete atnyeneme. Alhentere areye‐le itnenhe akeme “archives.” Itnekenge‐ntyele anwerne apmerrke areye akaltye‐le‐anthetyeke, nthakenhe arrwekelenye anwernekenhe anirntyeke‐arteke. Kele, the pipe nhenhe intelhe‐ileke apmerrke itnenhe alpeme‐iletyeke rlterrke‐irrirtnetyeke.
High risk of ischaemic stroke amongst patients with hereditary haemorrhagic telangiectasia
Authors: Kofoed Mikkel Seremet , Tørring Pernille M. , Christensen Alex Alban , Lange Bibi , Kjeldsen Anette Drøhse , Nielsen Troels Halfeld 
Published: November 2023

AbstractBackground and purposeHereditary haemorrhagic telangiectasia (HHT) is a genetic disease with fragile blood vessels and vascular malformations, potentially causing neurological manifestations, including stroke and cerebral abscesses. The study aimed to investigate neurological manifestations in the Danish HHT database, focusing on pulmonary arteriovenous malformations (PAVMs) as a risk factor for cerebral events.MethodsRetrospective analysis of the Danish HHT database was conducted, cross‐referencing neurological outcomes with the Danish Apoplexy Register for accuracy. Patients were stratified by HHT type. Primary outcomes included ischaemic stroke, transient ischaemic attack and cerebral haemorrhage. Secondary outcomes comprised age, age at HHT diagnosis, age at cerebral ischaemic event, and PAVM and cerebral arteriovenous malformation status.ResultsSix hundred and sixty‐four HHT patients were included. PAVM was diagnosed in 54% of patients, with higher prevalence in HHT type 1 (70%) compared to HHT type 2 (34%) and juvenile polyposis HHT (66%). Ischaemic stroke or transient ischaemic attack occurred in 12.5%, with a higher risk associated with macroscopic PAVM. Logistic regression showed a nearly 10 times increased risk of ischaemic stroke with macroscopic PAVM. Cerebral abscesses occurred in 3.2% of patients, all with macroscopic PAVM. Incomplete PAVM closure increased cerebral abscess risk.ConclusionThis study provides valuable insights into the prevalence of neurological manifestations and vascular events in HHT patients. The presence of PAVM was associated with an increased risk of ischaemic stroke, highlighting the importance of early screening and intervention. The findings emphasize the need for comprehensive management strategies targeting both vascular and neurological complications in HHT patients, especially regarding secondary stroke prevention.
Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: post hoc analysis of the DELIVER randomized clinical trial
Authors: Ashina Messoud , Lipton Richard B. , Ailani Jessica , Versijpt Jan , Sacco Simona , Mitsikostas Dimos D. , Christoffersen Cecilie Laurberg , Sperling Bjørn , Ettrup Anders 
Published: November 2023

AbstractBackground and purposeEptinezumab reduced monthly migraine days more than placebo in the DELIVER study, a clinical trial with patients with difficult‐to‐treat migraine and prior preventive treatment failures. This post hoc analysis assesses the sustained response to eptinezumab at the population and patient level and evaluates the potential for response in initial non‐responders.MethodsAdults with chronic or episodic migraine and two to four prior preventive treatment failures were randomized to eptinezumab 100 mg, 300 mg or placebo every 12 weeks. Primary outcomes in this post hoc analysis are the proportion of patients with ≥30%, ≥50% or ≥75% reduction in monthly migraine days (i.e., migraine responder rates [MRRs]) during weeks 1–12 and weeks 13–24 and across 4‐week intervals. Secondary outcomes are maintenance and shifts in MRRs from weeks 1–12 to weeks 13–24.ResultsBetween weeks 1–12 and 13–24, ≥30% MRRs increased from 65.9% to 70.4% (100 mg) and from 71.0% to 74.5% (300 mg), versus 36.9% to 43.1% (placebo). The ≥50% and ≥75% MRRs were sustained or increased over the 24‐week period. The largest increase in ≥30% MRRs occurred after the second infusion with eptinezumab. The percentage of initial non‐responders (<30% MRRs during weeks 1–12) who experienced response (≥30% MRRs during weeks 13–24) to the second dose was 34.7% (100 mg) and 30.4% (300 mg) with eptinezumab versus 21.1% with placebo.ConclusionAcross MRR thresholds, most patients who responded to eptinezumab during weeks 1–12 maintained or improved response during weeks 13–24. More than one‐third of initial non‐responders became responders after their second infusion.
Dopamine agonist serum concentrations and impulse control disorders in Parkinson's disease
Authors: Staubo Sara C. , Fuskevåg Ole Martin , Toft Mathias , Lie Ingeborg H. , Alvik Kirsti M. J. , Jostad Pål , Tingvoll Stein H. , Lilleng Hallvard , Rosqvist Kristina , Størset Elisabet , Odin Per , Dietrichs Espen , Dietrichs Erik Sveberg 
Published: November 2023

AbstractBackground and purposeImpulse control disorders (ICDs) are common among Parkinson's disease patients using dopamine agonists. We wanted to determine whether ICD patients have higher dopamine agonist serum concentrations than those without any sign of ICD.MethodsPatients who used either pramipexole or ropinirole depot once daily were screened for ICDs using the validated Questionnaire for Impulsive‐Compulsive Disorders in Parkinson's Disease–Rating Scale. Those who scored above the cut‐off for one or more of the four defined ICDs (gambling, compulsive sexual behavior, compulsive shopping, and binge‐eating) were compared in a case–control study to patients who scored zero points (no evidence of ICD) on the same items. They were examined clinically and evaluated using relevant scales. Three blood samples were taken on the same day: before daily dose, and then 6 and 12 h later.ResultsForty‐six patients were included: 19 ICD‐positive and 27 controls. Ropinirole serum concentrations 6 h after daily intake (Cmax) were higher in the case group compared to the control group, as was the daily ropinirole dosage. No differences were observed in serum concentrations, dosage or total drug exposure for pramipexole. Disease duration and length of dopamine agonist treatment was significantly longer among ICD patients for ropinirole, but not for pramipexole.ConclusionsThe use of pramipexole may in itself confer high ICD risk, whereas ICDs among ropinirole users depend more on serum concentration and drug exposure. The pharmacokinetic properties of ropinirole make it challenging to predict its effects on patients, which supports the need for therapeutic drug monitoring to reduce risk of ICD.
Delays to care in infantile epileptic spasms syndrome: Racial and ethnic inequities
Authors: Abath Christina Briscoe , Gupta Nishtha , Hadjinicolaou Aristides , Donatelli Stephanie , Singh Avantika , Merchant Sabrina , Ryan Morgan E. , Soby Meghann , Ryan Christopher , Nelson Adrianne Katrina , Maldonado Pacheco John E. , Zhang Bo , Williams David N. , Yuskaitis Christopher J. , Harini Chellamani 
Published: November 2023

AbstractObjectiveNon‐Hispanic (NH) Black children are less likely to receive a standard treatment course for infantile epileptic spasms syndrome (IESS) than White/NH children at pediatric tertiary care epilepsy centers in the United States. However, if inequities exist in time to diagnosis is unknown. Diagnostic delays as little as 1 week can be associated with worse developmental outcomes.MethodsDiagnostic delays were evaluated in a retrospective cohort of 100 children with new onset IESS between January 2019 and May 2022.ResultsChildren with Black, Indigenous, and People of Color (BIPOC) caregivers were more likely to experience clinically significant delays in referral from first provider to neurologist, when compared to White/NH children, even after controlling for other demographic and clinical variables (odds ratio = 4.98, confidence interval = 1.24–19.94, p = .023).SignificanceDisproportionate diagnostic delays place BIPOC children at risk of adverse developmental and epilepsy outcomes. Further interventional prospective and qualitative studies are needed to address inequities in care.
Bergmann patterns in planktivorous fishes: A light‐size or zooplankton community‐size rule is just as valid explanation as the temperature‐size rule
Authors: Ljungström Gabriella , Langbehn Tom , Jørgensen Christian 
Published: November 2023

AbstractAimBergman patterns, the tendency of organisms to be larger at higher latitudes and lower temperatures, are a well‐studied biogeographic pattern. Yet, there is no consensus on the driver or underlying mechanisms. We aim to scrutinize the influence of several key proposed drivers of Bergmann patterns (temperature, seasonal light availability, prey size and seasonal abundance) on optimal body size in planktivorous fishes across high latitudes in the Northeast Atlantic.LocationNortheast Atlantic between 55 and 75° N, with implications for high‐latitude oceans globally.Time periodPresent day.Major taxa studiedPelagic planktivorous fishes, with Atlantic herring (Clupea harengus) as model organism.MethodsWe use a model that incorporates explicit mechanisms for vision‐based feeding and temperature‐dependent physiology of a planktivorous fish to explore how intrinsic and extrinsic constraints affect energy budgeting and thereby expected optimal body size based on bioenergetics. We run the model at latitudes with increasing seasonality and test the individual and joint effects of relevant drivers.ResultsA Bergmann pattern emerges from the interaction between visual feeding opportunities and temperature‐dependent physiology. Small individuals profit from faster energy processing at higher temperatures in the south, whereas large individuals benefit from a lower metabolic cost at colder temperatures and more daylight hours for feeding in the north. In isolation temperature, daylight hours, and prey size each produced Bergmann patterns, but the most pronounced pattern arose from all drivers combined.Main conclusionsStudying biogeographic body size patterns requires a holistic view, accounting for interactions between drivers and both intrinsic and extrinsic constraints on energy budgeting. Across latitudes, temperature effects on digestion and metabolism interact with effects of light availability, prey size and abundance on food accessibility, and thereby shape the optimal size. Our study highlights how details of ecological mechanisms and lifestyles are important for improving predictive ability.
Numbers needed to treat or harm and likelihood of being helped versus harmed for fremanezumab in patients who had prior inadequate response to two to four classes of migraine preventive medications: A post hoc analysis
Authors: Ashina Messoud , Mitsikostas Dimos D. , Ramirez Campos Verena , Barash Steve , Ning Xiaoping , Diener Hans‐Christoph 
Published: November 2023

AbstractObjectiveThis study aimed to determine the number needed to treat (NNT), number needed to harm (NNH), and likelihood of being helped or harmed (LHH) in a post hoc analysis of the phase 3b FOCUS trial.BackgroundFremanezumab, a humanized monoclonal antibody that selectively targets calcitonin gene–related peptide (CGRP), has demonstrated efficacy, tolerability, and safety in adults with episodic migraine (EM) or chronic migraine (CM), with documented previous inadequate response to two to four classes of migraine preventive medications.MethodsIn the 12‐week double‐blind period of the FOCUS study, patients were randomized (1:1:1) to quarterly fremanezumab, monthly fremanezumab, or matched monthly placebo. NNT was based on responder analysis, defined as ≥50% reduction in monthly average number of migraine days at 12 weeks. NNH was based on discontinuations due to adverse events (AEs).ResultsAmong patients with CM (n = 509), response rates and discontinuation rates were 27% (45/169) and 0 for quarterly fremanezumab, 29% (50/173) and 2% (3/173) for monthly fremanezumab, and 8% (13/167) and <1% (1/167) for placebo, respectively. These results translated to NNTs of 5.3 and 4.7, NNHs of 1000 and 88, and LHHs of 188 and 19 for quarterly and monthly fremanezumab, respectively. Among patients with EM (n = 328), response rates were 47% (50/107) for quarterly fremanezumab, 43% (47/110) for monthly fremanezumab, and 10% (11/111) for placebo. Discontinuation rates were <1% (n = 1) in all three groups. These results translated to NNTs of 2.7 and 3.0, NNHs of 1000 and 1000, and LHHs of 368 and 328 for quarterly and monthly fremanezumab, respectively.ConclusionsThe NNT, NNH, and LHH for quarterly and monthly fremanezumab compare favorably with those for traditional oral preventive medications, including topiramate, valproate, and propranolol.
Implementation and expansion of laboratory capacity for molecular diagnostics in response to COVID‐19 and preparedness for other emerging infectious diseases in the Islamic Emirate of Afghanistan
Authors: Khan Murad Momin , Tahoun Mohamed Mostafa , Meredith Luke W. , Barakat Amal , Safi Hafizullah , Hanifi Ahmed Nasir , Mashal Mohammad Omar , Amiri Abdul Wahid , Abouzeid Alaa 
Published: November 2023

AbstractBackgroundAfghanistan experienced various outbreaks before and during the Covid‐19 pandemic, including dengue, Crimean Congo hemorrhagic fever (CCHF), measles, and acute watery diarrhea (AWD). Diagnostic and surveillance support was limited, with only the Central Public Health Laboratory equipped to handle outbreak responses. This article highlights initiatives taken to improve diagnostic capabilities for COVID‐19 and other outbreaks of public health concern encountered during the pandemic.BackgroundThe World Health Organization (WHO) Afghanistan Country Office collaborated with the WHO Eastern Mediterranean Regional Office (EMRO), Central Public Health Laboratory (CPHL), and National Influenza Center (NIC) to enhance COVID‐19 diagnostic capacity at national and subnational facilities. To alleviate pressure on CPHL, a state‐of‐the‐art laboratory was established at the National Infectious Disease Hospital (NIDH) in Kabul in 2021–2022, while WHO EMRO facilitated the regionalization of testing to subnational facilities for dengue, CCHF, and AWD in 2022–2023.ResultsCOVID‐19 testing capacity expanded nationwide to 34 Biosafety Level II labs, improving diagnosis time. Daily testing rose from 1000 in 2020 to 9200 in 2023, with 848,799 cumulative tests. NIDH identified 229 CCHF cases and 45 cases nationally. Dengue and CCHF testing, decentralized to Nangarhar and Kandahar labs, identified 338 dengue and 18 CCHF cases. AWD testing shifted to NIDH and five subnational facilities (Kandahar, Paktia, Balkh, Herat, and Nangarhar labs), while measles testing also decentralized to nine subnational facilities.ConclusionAfghanistan implemented a remarkable, multisectoral response to priority pathogens. The nation now possesses diagnostic expertise at national and subnational levels, supported by genomic surveillance. Future efforts should concentrate on expanding and sustaining this capacity to enhance public health responses.
From respiratory diseases to nervous system disorders: Unraveling the certified causes of influenza‐associated deaths in Poland from 2000 to 2019
Authors: Walkowiak Marcin Piotr , Walkowiak Dariusz 
Published: November 2023

AbstractBackgroundThis study aims to accurately estimate influenza‐associated deaths in Poland and their certified cause of death, due to significant discrepancies between official numbers and expected impact.MethodsExcess influenza‐associated mortality in Poland from 2000 to 2019 was calculated using Seasonal‐Trend Decomposition Procedure based on LOESS (STL), which can detect non‐linear trends and non‐sinusoidal cycles. Excess mortality was then used as an explanatory variable in a model predicting monthly fluctuations of officially recorded causes of death from 2010 to 2019.ResultsA total of 142,000 conservative estimates of influenza‐associated deaths were identified, representing 1.86% of overall mortality. Only 0.61% of influenza‐associated deaths were officially recorded as influenza. Nearly half of certified influenza deaths were attributed to the seasonal baseline mortality, potentially doubling estimated impact based solely on influenza peaks. Influenza‐associated deaths were frequently recorded as respiratory diseases (24.36%), with majority attributed to underlying conditions such as cardiovascular diseases (45.31%), cancer (9.06%), or diabetes (2.66%). Influenza‐associated deaths were more commonly certified as nervous system diseases (1.84%) or mental disorders (1.04%), rather than influenza itself. There was a noticeable impact of influenza on secondary infections, such as meningococcal and gastrointestinal infections.ConclusionThese findings highlight the importance of improved estimation for informing public health policy decisions.
RETRACTED: Effects of rapid rehabilitation nursing model on surgical site wound infection and pain of patients with ovarian cancer: A meta‐analysis
Authors: Fan Erlin , Zhang Keke , Wan Yinglu , Hu Shifu 
Published: November 2023

AbstractTo explore the effect of rapid rehabilitation nursing model on surgical site wound infection and pain of patients with ovarian cancer. Computer searches were performed on randomised controlled trials (RCTs) of rapid rehabilitation nursing model applied to ovarian cancer patients in PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (SinoMed), VIP and Wanfang Database from the time each database was constructed to May 2023. Two researchers independently screened the literature, extracted data and completed an assessment of the quality of the literature based on the inclusion and exclusion criteria. Meta‐analysis was performed using RevMan 5.4 software. The database was searched to obtain 255 articles, and 22 articles were finally included, containing 966 patients in the experimental group and 954 patients in the control group, for a total of 1920 patients. The results of the meta‐analysis showed that, compared with other nursing models, the use of the rapid rehabilitation nursing model significantly reduced surgical site wound infections in patients with ovarian cancer (OR = 0.30, 95% CI: 0.15–0.61, p < 0.001) and the rate of post‐operative complications (OR = 0.27, 95% CI: 0.19–0.38, p < 0.001) also reduced the patients' post‐operative wound pain (MD = −0.70, 95% CI: −0.85 to −0.55, p < 0.001). The rapid rehabilitation nursing model applied to patients with ovarian cancer surgery can effectively reduce the rate of post‐operative complications and wound infections, and it can also reduce the post‐operative wound pain.