bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Stingers in the National Football League, 2015-2019
Authors: Lamplot Joseph D. , Petit Camryn , Lee Rebecca , Mack Christina D. , Herzog Mackenzie M. , Solomon Gary S. , Diekfuss Jed A. , Myer Greg D. , Hammond Kyle 
Published: January 2024

Background: Transient traumatic neuropraxia of either the brachial plexus or cervical nerve root(s) is commonly described as a “stinger” or “burner” by the athlete. Stingers in American Football commonly occur acutely as isolated injuries; however, concomitant injuries, including cervical spine pathologies, have also been reported. Hypothesis: Among National Football League (NFL) athletes, the incidence rate of stingers is higher during the regular season than during the preseason and among positions with high velocity impacts such as running backs, linebackers, defensive backs, and receivers. Study Design: Retrospective epidemiology study. Level of Evidence: Level 4. Methods: Aggregation of all in-game injuries with a clinical impression of “neck brachial plexus stretch” or “neck brachial plexus compression” entered into the NFL injury surveillance database through the centralized league-wide electronic medical record system over 5 years (2015-2019 seasons). Incidence rates per player-play were calculated and reported. Results: A total of 691 in-game stingers occurred during the study period, with a mean of 138.2 per year. Average single-season injury risk for incident stinger was 3.74% (95% CI, 3.46%-4.05%). The incidence rate was higher during regular season games than during preseason games (12.26 per 100,000 player-plays [11.30-13.31] vs 8.87 [7.31-10.76], P < 0.01, respectively). The highest reported stinger incidence rates were among running backs and linebackers (both >15 per 100,000 player-plays). Among stingers, 76.41% did not miss time. Of those that resulted in time lost from football activities, mean time missed due to injury was 4.79 days (range, 3.17-6.41 days). Concomitant injuries were relatively low (7.09%). Conclusion: In-game stinger incidence was stable across the study period and occurred most frequently in running backs and linebackers. Stingers were more common during the regular season, and most players did not miss time. Concomitant injuries were relatively rare. Clinical Relevance: An improved understanding of the expected time loss due to stinger and concomitant injuries may provide insight for medical personnel in managing these injuries.
Dual Antiplatelet Non-Responder: Resistance to Clopidogrel and Ticagrelor
Authors: Kuhn Anna Luisa , Singh Jasmeet , Puri Ajit S. 
Published: January 2024

Background Dual antiplatelet therapy is often required for neurointerventional procedures, especially when a stent or flow diverter is placed in the cervical and intracranial vessels. Patients are usually started on aspirin and clopidogrel given the simplicity of the once daily regimen with reasonable cost. Unfortunately, about a third of patients do not show the desired antiplatelet response to clopidogrel and another agent needs to be introduced. Ticagrelor is a potent antiplatelet medication that has a favorable pharmacological profile and has emerged as a reliable alternative to clopidogrel in recent years. Despite ticagrelor non-responders being rare, they do exist, and identification of these patients is important. Results A 74-year-old female was incidentally found to harbor a right posterior communicating aneurysm which was successfully treated electively with stent-assisted coiling. Platelet inhibition testing revealed non-responsiveness to Clopidogrel. Ticagrelor was initiated but the patient’s platelet reactivity unit remained in the normal range. Management algorithms to maximize a patient’s ticagrelor response by facilitating enteral absorption were applied but no platelet inhibition was achieved. The patient was eventually identified as a true ticagrelor non-responder. Conclusion Resistance to antiplatelet medication can result in devastating complications with permanent neurological deficits. Ticagrelor non-responders are rare but do exist. Platelet inhibition testing should be part of the preprocedural workup for neurointerventions.
Substance use disorder-associated infections’ treatment with dalbavancin enabling outpatient transition (SUDDEN OUT) – an investigator-initiated single-arm unblinded prospective cohort study
Authors: Krsak Martin , Scherger Sias , Miller Matthew A. , Cobb Vincent , Montague Brian T. , Henao-Martínez Andrés F. , Molina Kyle C. 
Published: January 2024

Background: Severe gram-positive infections are frequent in people who inject drugs, and successful completion of treatment presents unique challenges in this population. Objectives: We aimed to evaluate the feasibility of a long-acting antibiotic, dalbavancin, as an alternative to standard-of-care antibiotics for severe infections due to vancomycin-susceptible pathogens requiring ⩾2 weeks of therapy. Design: We designed an investigator-initiated single-arm unblinded prospective cohort study to evaluate the safety and efficacy of an early switch to dalbavancin in two doses administered 1 week apart. Methods: We screened patients admitted with bloodstream infection, osteomyelitis, septic arthritis, infective endocarditis or deep abscesses, and comorbid substance use disorder (SUD) for eligibility. Consenting patients were switched to dalbavancin within 7 days from their index culture. They were monitored in the hospital for efficacy and safety of the treatment until the second dose of dalbavancin 7 days later and then discharged if stable. Study participants were evaluated with a decision support engine for a hypothetical appropriate level of care regarding their SUD after discharge. Their follow-up was planned for 12 months from the index culture, either in-person or via telehealth/telephone. Results: The enrollment was terminated early due to significant loss-to-follow-up. In all, 11 patients were enrolled, 4 completed 12 months of follow-up, 2 completed 8 months of follow-up, and 1 was seen once after discharge. The remaining five patients were lost to follow-up immediately after discharge. All 11 patients continued to improve after switching to dalbavancin between the first and second doses. There were two per-protocol failures of treatment. Dalbavancin was well tolerated, though some adverse events were reported. Conclusion: Dalbavancin may be a safe and effective alternative for an early switch in treating severe gram-positive infections. Trial registration: The trial was registered as NCT04847921 with clinicaltrials.gov.
Early Versus Delayed Surgery for Elderly Traumatic Cervical Spinal Injury: A Nationwide Multicenter Study in Japan
Authors: Segi Naoki , Nakashima Hiroaki , Ito Sadayuki , Yokogawa Noriaki , Sasagawa Takeshi , Watanabe Kota , Nori Satoshi , Funayama Toru , Eto Fumihiko , Nakajima Hideaki , Terashima Yoshinori , Hirota Ryosuke , Hashimoto Ko , Onoda Yoshito , Furuya Takeo , Yunde Atsushi , Ikegami Shota , Uehara Masashi , Suzuki Hidenori , Imajo Yasuaki , Uei Hiroshi , Sawada Hirokatsu , Kawaguchi Kenichi , Nakanishi Kazuo , Suzuki Nobuyuki , Oshima Yasushi , Hasegawa Tomohiko , Iizuka Yoichi , Tonomura Hitoshi , Terai Hidetomi , Akeda Koji , Seki Shoji , Ishihara Masayuki , Inoue Gen , Funao Haruki , Yoshii Toshitaka , Kaito Takashi , Kiyasu Katsuhito , Tominaga Hiroyuki , Kakutani Kenichiro , Sakai Daisuke , Ohba Tetsuro , Otsuki Bungo , Miyazaki Masashi , Murotani Kenta , Okada Seiji , Imagama Shiro , Kato Satoshi 
Published: January 2024

Study Design Retrospective multicenter study. Objectives The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes. Methods This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared. Results Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory. Conclusions Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups.
Identification and Assessment of Outcome Measurement Instruments in Cauda Equina Syndrome: A Systematic Review
Authors: Richardson George E. , Millward Christopher P. , Mitchell James W. , Clark Simon , Wilby Martin , Marson Anthony G. , Williamson Paula R. , Srikandarajah Nisaharan 
Published: January 2024

Study Design This was a systematic review of surgically managed Cauda Equina Syndrome (CES) Outcome Measurement Instruments (OMI). Objective A core outcome set (COS) defines agreed outcomes which should be reported as a minimum in any research study for a specific condition. This study identified OMIs used in the wider CES literature and compare these to the established CESCOS. Methods To identify measurement methods and instruments in the CES surgical outcome evidence base, a systematic review was performed. Medline, Embase and CINAHL plus databases were queried. In addition, a secondary search for validation studies of measurement instruments in CES was undertaken. Identified studies from this search were subject to the COSMIN risk of bias assessment. Results In total, 112 studies were identified investigating surgical outcomes for CES. The majority (80%, n = 90) of these OMI studies were retrospective in nature and only 55% (n = 62) utilised a measurement method or instrument. The remaining 50 studies used study specific definitions for surgical outcomes defined within their methods. Of the 59 measurement instruments identified, 60% (n = 38 instruments) were patient reported outcome measures. Only one validated instrument was identified, which was a patient reported outcome measure. The validated instrument was not used in any study identified in the initial search (to identify measurement instruments). Conclusions This review highlights the wide heterogeneity of measurement instruments used in surgically managed CES research. Subsequently, there is need for consensus agreement on which instrument or instruments should be used to measure each core outcome for CES surgical outcomes.
Impact of leukoaraiosis on the infarct growth rate and clinical outcome in acute large vessel occlusion stroke after endovascular thrombectomy
Authors: He Guangchen , Fang Hui , Xue Bo , Wei Liming , Lu Haitao , Deng Jiangshan , Zhu Yueqi 
Published: January 2024

Introduction: As a marker of chronic cerebral small vessel disease, leukoaraiosis (LA) was reported to impact the recruitment of collaterals in acute ischemic stroke (AIS). We intended to explore the impact of LA on the infarct growth rate (IGR) and clinical outcome by impaired collateral development in AIS patients with large vessel occlusion (LVO) who underwent endovascular thrombectomy (EVT). Patients and methods: Two hundred thirty-six AIS patients who underwent EVT were retrospectively reviewed. The severity of LA was graded using the Fazekas scale with non-contrast CT. IGR was calculated by the acute core volume on CT perfusion divided by the time from stroke onset to imaging. The collateral status after LVO was assessed using the ASITN/SIR collateral scale. The clinical outcomes after EVT were evaluated using a modified Rankin Scale ( mRS). The Alberta stroke program early CT score ( ASPECTS), the National Institutes of Health Stroke Scale (NIHSS) score at admission, and the modified treatment in cerebral infarction ( mTICI) score after EVT were also included. Correlations between those factors were analyzed. Results: Patients with severe LA had significantly larger core volume on CTP ( p = 0.022) and lower collateral grade ( p < 0.001). Faster IGR was significantly associated with higher LA severity (adjusted odds ratio [aOR]: 1.53; 95% CI: 1.02–2.33; p = 0.046), higher NIHSS (aOR: 1.04; 95% CI: 1.00–1.09; p = 0.032) and impaired collaterals (aOR: 2.26; 95% CI: 1.27–4.03; p = 0.005). In mediation analysis, collaterals explained 33% of the effect of LA on fast IGR. There was correlation between the severity of LA and mRS ( p = 0.007). Discussion and Conclusion: The increasing severity of LA is associated with impaired collateral status and fast infarct growth. These findings suggest that LA may become a predictive imaging biomarker for the likelihood of progression of tissue injury and clinical outcome after EVT in acute large vessel occlusion stroke.
The hepatokine FGL1 regulates hepcidin and iron metabolism during anemia in mice by antagonizing BMP signaling
Authors: Sardo Ugo , Perrier Prunelle , Cormier Kevin , Sotin Manon , Personnaz Jean , Medjbeur Thanina , Desquesnes Aurore , Cannizzo Lisa , Ruiz-Martinez Marc , Thevenin Julie , Billoré Benjamin , Jung Grace , Abboud Elise , Peyssonnaux Carole , Nemeth Elizabeta , Ginzburg Yelena Z. , Ganz Tomas , Kautz Léon 
Published: January 2024

Abstract
As a functional component of erythrocyte hemoglobin, iron is essential for oxygen delivery to all tissues in the body. The liver-derived peptide hepcidin is the master regulator of iron homeostasis. During anemia, the erythroid hormone erythroferrone regulates hepcidin synthesis to ensure the adequate supply of iron to the bone marrow for red blood cell production. However, mounting evidence suggested that another factor may exert a similar function. We identified the hepatokine fibrinogen-like 1 (FGL1) as a previously undescribed suppressor of hepcidin that is induced in the liver in response to hypoxia during the recovery from anemia, and in thalassemic mice. We demonstrated that FGL1 is a potent suppressor of hepcidin in vitro and in vivo. Deletion of Fgl1 in mice results in higher hepcidin levels at baseline and after bleeding. FGL1 exerts its activity by directly binding to bone morphogenetic protein 6 (BMP6), thereby inhibiting the canonical BMP-SMAD signaling cascade that controls hepcidin transcription.
Prednisone vs high-dose dexamethasone in newly diagnosed adult primary immune thrombocytopenia: a randomized trial
Authors: Mazzucconi Maria Gabriella , Rodeghiero Francesco , Avvisati Giuseppe , De Stefano Valerio , Gugliotta Luigi , Ruggeri Marco , Vianelli Nicola , Fazi Paola , Paoloni Francesca , Sargentini Valeria , Baldacci Erminia , Ferretti Antonietta , Martino Bruno , Vincelli Iolanda Donatella , Carli Giuseppe , Fortuna Stefania , Di Ianni Mauro , Ranalli Paola , Palandri Francesca , Polverelli Nicola , Lugli Elisabetta , Rivolti Elena , Patriarca Andrea , Rago Angela , D’Adda Mariella , Gentile Massimo , Siragusa Sergio , Sibilla Silvia , Carella Angelo Michele , Rossi Elena , Battistini Roberta , Zaja Francesco , Bocchia Monica , Di Renzo Nicola , Musto Pellegrino , Crugnola Monica , Giuffrida Anna Chiara , Krampera Mauro , Tafuri Agostino , Santoro Cristina 
Published: January 2024

Abstract
A debate exists regarding which type of corticosteroids (standard-dose prednisone [PDN] or high-dose dexamethasone [HD-DXM]) is the best first-line treatment for adult patients with newly diagnosed untreated primary immune thrombocytopenia (pITP). An ad hoc study compared PDN with HD-DXM in newly diagnosed untreated patients with pITP (aged ≥18 but ≤80 years, platelet count of ≤20 or &gt;20 but &lt;50 × 109/L, and bleeding score of ≥8). Patients were randomised to receive PDN 1 mg/kg per day from days 0 to 28 (Arm A) or HD-DXM 40 mg per day for 4 days, every 14 days, for 3 consecutive courses (Arm B). Fifty-nine of 113 patients (52.2%) were randomized to Arm A and 54 of 113 (47.8%) to Arm B. In evaluable patients, total initial responses (complete response [CR], partial response [PR], minimal response [MR]) were 44 of 56 (78.57%) in Arm A and 46 of 49 (93.88%) in Arm B at days 42 and 46, respectively (P = 0.0284). Total final responses (at day 180 from initial response) were 26 of 43 (60.47%) in Arm A and 23 of 39 (58.97%) in Arm B (P = 0.8907). Total persistent responses (at 12 months from initial response) were 25 of 31 (80.65%) in Arm A and 20 of 36 (55.56%) in Arm B (P = 0.0292). Seven relapses occurred. Median follow-up was 44.4 months. Overall survival was 100% at 48 months, overall disease-free survival was 81.11% at 48 months from day 180. PDN and pulsed HD-DXM were well tolerated; HD-DXM allows effective initial responses but less long lasting than PDN. This trial was registered at www.clinicaltrials.gov as #NCT00657410.
Next-generation sequencing reveals genetic heterogeneity and resistance mechanisms in patients withEGFR-mutated non-small cell lung cancer treated with afatinib
Authors: Liang Sheng-Kai , Wei Pin-Fei , Hsieh Min-Shu , Wu Chia-Ling , Shih Jin-Yuan 
Published: January 2024

BackgroundAfatinib, an irreversible ErbB family inhibitor, is widely used as first-line treatment in advanced lung adenocarcinoma patients harbouring mutant epidermal growth factor receptor (EGFR). With the advancements in next-generation sequencing (NGS), comprehensive research into the clinical impact of co-occurring genetic mutations and the molecular mechanisms of acquired resistance is required for afatinib users.MaterialsFrom January 2010 to December 2019, we enrolled patients with advanced lung adenocarcinoma withEGFRmutations using afatinib as first-line treatment, and we retrospectively collected pre- and post-afatinib treatment specimens from these patients for NGS testing.ResultsOf the 362 enrolled patients, 73 samples (68.9%) from 56 patients successfully returned complete NGS reports. In pre-afatinib treatment specimens, the most frequent co-occurring alterations wereTP53,MUC16,USH2A,SNYE1,RECQL4andFAT1; however, they were not related to progression-free survival. Small cell lung cancer transformation,EGFRp.T790M, amplification ofMET,ERBB2,KRAS,EGFR, cell cycle-regulated genes andMDM2, andPTENalterations were identified as acquired resistance mechanisms.EGFRp.T790M (p=0.0304) andAPCalterations (p=0.0311) in post-afatinib specimens were significantly associated with longer overall survival, whileMETamplification was significantly associated with poor overall survival (p=0.0324). The co-occurrence ofTP53alterations was significantly associated with shorter overall survival (p=0.0298).ConclusionsOur results show that the frequent co-occurring alterations in advancedEGFR-mutated lung adenocarcinoma did not influence the effectiveness of afatinib.EGFRp.T790M is not only the major resistance mechanism to afatinib but also related to favourable survival outcomes.METamplification andTP53mutations were associated with poorer overall survival.
YGL3 Encoding an IPP and DMAPP Synthase Interacts with OsPIL11 to Regulate Chloroplast Development in Rice
Authors: Chen Wei , Tang Liqun , Li Qianlong , Cai Yicong , Ahmad Shakeel , Wang Yakun , Tang Shengjia , Guo Naihui , Wei Xiangjin , Tang Shaoqing , Shao Gaoneng , Jiao Guiai , Xie Lihong , Hu Shikai , Sheng Zhonghua , Hu Peisong 
Published: January 2024

AbstractAs the source of isoprenoid precursors, the plastidial methylerythritol phosphate (MEP) pathway plays an essential role in plant development. Here, we report a novel rice (Oryza sativa L.) mutant ygl3 (yellow-green leaf3) that exhibits yellow-green leaves and lower photosynthetic efficiency compared to the wild type due to abnormal chloroplast ultrastructure and reduced chlorophyll content. Map-based cloning showed that YGL3, one of the major genes involved in the MEP pathway, encodes 4-hydroxy-3-methylbut-2-enyl diphosphate reductase, which is localized in the thylakoid membrane. A single base substitution in ygl3 plants resulted in lower 4-hydroxy-3-methylbut-2-enyl diphosphate reductase activity and lower contents of isopentenyl diphosphate (IPP) compared to the wild type. The transcript levels of genes involved in the syntheses of chlorophyll and thylakoid membrane proteins were significantly reduced in the ygl3 mutant compared to the wild type. The phytochrome interacting factor-like gene OsPIL11 regulated chlorophyll synthesis during the de-etiolation process by directly binding to the promoter of YGL3 to activate its expression. The findings provides a theoretical basis for understanding the molecular mechanisms by which the MEP pathway regulate chloroplast development in rice.
Combined transcriptome and metabolome analysis reveals breed-specific regulatory mechanisms in Dorper and Tan sheep
Authors: Ma Yuhao , Cai Ganxian , Chen Jianfei , Yang Xue , Hua Guoying , Han Deping , Li Xinhai , Feng Dengzhen , Deng Xuemei 
Published: January 2024

Abstract
Background
Dorper and Tan sheep are renowned for their rapid growth and exceptional meat quality, respectively. Previous research has provided evidence of the impact of gut microbiota on breed characteristics. The precise correlation between the gastrointestinal tract and peripheral organs in each breed is still unclear. Investigating the metabolic network of the intestinal organ has the potential to improve animal growth performance and enhance economic benefits through the regulation of intestinal metabolites.

Results
In this study, we identified the growth advantage of Dorper sheep and the high fat content of Tan sheep. A transcriptome study of the brain, liver, skeletal muscle, and intestinal tissues of both breeds revealed 3,750 differentially expressed genes (DEGs). The genes PPARGC1A, LPL, and PHGDH were found to be highly expressed in Doper, resulting in the up-regulation of pathways related to lipid oxidation, glycerophospholipid metabolism, and amino acid anabolism. Tan sheep highly express the BSEP, LDLR, and ACHE genes, which up-regulate the pathways involved in bile transport and cholesterol homeostasis. Hindgut content analysis identified 200 differentially accumulated metabolites (DAMs). Purines, pyrimidines, bile acids, and fatty acid substances were more abundant in Dorper sheep. Based on combined gene and metabolite analyses, we have identified glycine, serine, and threonine metabolism, tryptophan metabolism, bile secretion, cholesterol metabolism, and neuroactive ligand-receptor interaction as key factors contributing to the differences among the breeds.

Conclusions
This study indicates that different breeds of sheep exhibit unique breed characteristics through various physiological regulatory methods. Dorper sheep upregulate metabolic signals related to glycine, serine, and threonine, resulting in an increase in purine and pyrimidine substances. This, in turn, promotes the synthesis of amino acids and facilitates body development, resulting in a faster rate of weight gain. Tan sheep accelerate bile transport, reduce bile accumulation in the intestine, and upregulate cholesterol homeostasis signals in skeletal muscles. This promotes the accumulation of peripheral and intramuscular fat, resulting in improved meat quality. This work adopts a joint analysis method of multi-tissue transcriptome and gut metabolome, providing a successful case for analyzing the mechanisms underlying the formation of various traits.