bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of rTMS compared to SSRI as early treatment of depression – study protocol of a randomized controlled trial (Early-TMS)
Authors: Becker-Sadzio Julia , Brendel Bettina , Weller Simone , Bornheimer Edmund , Mehlig Ulrike , Padberg Frank , Vogelmann Ulrike , Kammer Thomas , Strube Wolfgang , Martus Peter , Fallgatter Andreas J. , Plewnia Christian 
Published: February 2025

Abstract
Psychotherapy and antidepressant medication are considered first-line treatment options for major depressive disorder (MDD). However, a high proportion of patients do not respond to initial treatment, underlining the need for alternative treatment methods. Repetitive transcranial magnetic stimulation (rTMS) has been established in the treatment of MDD, but the available evidence is limited to forms of MDD with varying degrees of treatment resistance. Randomized-controlled trials (RCT) investigating first-line treatment with rTMS in comparison with first-line antidepressant medication are warranted to further position rTMS within current treatment algorithms for MDD. In this two-stage, therapy response-adapted, randomized multi-center phase 2 rater blinded trial, 106 medication-naïve patients suffering from MDD will be enrolled. In Stage I, participants receive one of the two treatment options for four weeks: either daily bilateral theta burst stimulation (TBS), a patterned and time-saving form of rTMS, or antidepressant medication with selective serotonin reuptake inhibitors (SSRI). The allocation to Stage II occurs therapy response-adapted. Therefore, patients either receive maintenance treatment or will be switched to the respective other treatment arm. Primary outcome is the comparison between the two study arms with regard to therapy response measured by the Montgomery-Asberg Depression Rating Scale (MADRS) after 4 weeks at the end of Stage I. The aim of the study is to provide reliable first evidence and effect size measures of rTMS as first-line treatment compared to SSRI treatment. Positive results will help to implement rTMS in early stages of MDD. Trial registration: ClinicalTrials.gov ID: NCT06545474, August 15, 2024.
Myasthenia gravis in 2025: five new things and four hopes for the future
Authors: Binks S. N. M. , Morse I. M. , Ashraghi Mohammad , Vincent A. , Waters Patrick , Leite M Isabel 
Published: February 2025

Abstract
The last 10 years has brought transformative developments in the effective treatment of myasthenia gravis (MG). Beginning with the randomized trial of thymectomy in myasthenia gravis that demonstrated efficacy of thymectomy in nonthymomatous MG, several new treatment approaches have completed successful clinical trials and regulatory launch. These modalities, including B cell depletion, complement inhibition, and blockade of the neonatal Fc receptor, are now in use, offering prospects of sustained remission and neuromuscular protection in what is a long-term disease. In this review, we update our clinico-immunological review of 2016 with these important advances, examine their role in treatment algorithms, and focus attention on key issues of biomarkers for prognostication and the growing cohort of older patients, both those with long-term disease, and late-onset MG (‘LOMG’). We close by expressing our four hopes for the next 5–10 years: improvements in laboratory medicine to facilitate rapid diagnosis, effective strategies for neuromuscular protection, more research into and better understanding of pathophysiology and treatment response in older individuals, and the potentially transformative role of therapies aimed at delivering a durable response such as chimeric antigen receptor (CAR) T cells. Our postscript summarizes some emerging themes in the field of serological and online biomarkers, which may develop greater stature in the next epoch.
Test–retest reliability of TMS motor evoked responses and silent periods during explosive voluntary isometric contractions
Authors: Castelli F. , Mian O. S. , Bruton A. , Valappil A. C. , Tillin N. A. 
Published: February 2025

Abstract

Purpose
This study assessed the test–retest reliability of TMS motor evoked potentials (MEPs) and silent periods at early, middle, and late phases of the rising time–torque curve during explosive voluntary contractions. We also investigated how the number of consecutively averaged measurements influenced reliability.

Methods
On two separate occasions 3–7 days apart, 14 adults performed several isometric explosive (1-s) contractions of the knee extensors, some of which were superimposed with TMS to elicit MEPs in the superficial quadriceps. Of those with TMS, stimulation was timed to elicit MEPs at either 45 (early), 115 (middle), or 190 ms (late) following contraction onset (16 with-TMS contractions per time condition). TMS was also superimposed at the plateau of 15 separate MVCs. Test–retest intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated for MEPs and silent periods consecutively averaged over 3 to 15 separate contractions.

Results
No one condition/phase was more reliable than another. For MEP amplitude, in all conditions except the explosive late phase, ICCs generally increased, and CV decreased, with an increase in the number of averaged contractions, and were > 0.50 ICC and < 15% CV within seven contractions. For silent period, ICCs and CVs were unaffected by the number of consecutively averaged contractions and remained > 0.50 ICC and < 10% CV.

Conclusion
Test–retest reliability of TMS responses is comparable between phases of explosive contraction and at the plateau of MVC. To maximise reliability of MEPs during explosive contractions or MVCs, we recommend future studies average data across more than the 3–5 contractions typically reported in the literature investigating MEPs at MVC plateau.
Effect of foot position during plantarflexion on the neural drive to the gastrocnemii in runners with Achilles tendinopathy
Authors: Fernandes Gabriel L. , Orssatto Lucas B. R. , Shield Anthony J. , Trajano Gabriel S. 
Published: February 2025

Abstract
Runners with Achilles tendinopathy have reduced neural drive to the gastrocnemius lateralis. Positioning feet-inwards (feet-in) can influence gastrocnemii activity in healthy individuals. Therefore, this study investigated if pointing (feet-in) during isometric plantarflexion would increase gastrocnemius lateralis electromyography root mean square amplitude (RMS) and motor unit discharge rates (MUDR), compared to feet-neutral (feet-neutral), in Achilles tendinopathy. High-density electromyograms were recorded from gastrocnemius lateralis and medialis, during 20-s feet-in and feet-neutral contraction, in runners with (n = 18) and without (n = 19) Achilles tendinopathy. During feet-in, gastrocnemius lateralis RMS was higher in both groups and gastrocnemius medialis RMS was lower in the Achilles tendinopathy, compared to feet-neutral. MUDR were lower during feet-in in gastrocnemius lateralis (p < 0.001) and in gastrocnemius medialis in the Achilles tendinopathy group. The Achilles tendinopathy group had lower triceps surae endurance during single leg heel raise. In summary, feet-in increases gastrocnemius lateralis RMS in both groups, conversely reducing MUDR in the Achilles tendinopathy group, compared to feet-neutral. Additionally, feet-in reduces gastrocnemius medialis RMS and MUDR only in the Achilles tendinopathy group, compared to feet-neutral. This would shift the gastrocnemius lateralis/medialis ratio excitation, favouring gastrocnemius lateralis. Nonetheless, while this strategy holds promise, it remains uncertain whether performing plantarflexion exercise with feet pointed inwards would provide additional benefits for the treatment of runners with Achilles tendinopathy. Our findings suggest that the increased gastrocnemius lateralis RMS during feet-in may not be as consequence of increased MUDR and, but it might be a result of recruitment of more motor units.
Sinonasal adenoid cystic carcinomas accompanied by seromucinous hamartoma and/or atypical sinonasal glands arising from seromucinous hamartoma: insight into their histogenesis
Authors: Bradová Martina , Agaimy Abbas , Laco Jan , Martínek Petr , Ing Stanislav Kormunda , Badoual Cécile , Damjanov Ivan , Leivo Ilmo , Bacchi Carlos E. , Comperat Eva , Ihrler Stephan , Rupp Niels J. , Šíma Radek , Šteiner Petr , Vaněček Tomáš , Mueller Sarina , Ventelä Sami , Skálová Alena , Michal Michal 
Published: February 2025

Abstract
The pathology of reactive, dysplastic, and neoplastic sinonasal seromucinous glands is complex, and their contribution to tumorigenesis of sinonasal carcinomas remains controversial. In our practice, we have observed the presence of respiratory epithelial adenomatoid hamartomas (REAH) and seromucinous hamartomas (SH) associated with adenoid cystic carcinomas (AdCC) in a subset of cases. In many of these cases, genuine atypical features and dysplastic characteristics of the glands were noted at the interface of SH and AdCC. To investigate this phenomenon further, 88 sinonasal AdCC cases were selected from the authors’ files and analyzed histologically, immunohistochemically, and genetically searching for MYB/MYBL1 and NFIB gene fusions. HPV testing was also performed. Univariate statistical analysis was conducted on our cohort. Thirty-one cases (35%) showed features of atypical sinonasal glands arising in SH (ASGSH) at the SH-AdCC interface, characterized by bilayered epithelium, architectural disarray, mild nuclear polymorphism, and atypia, sometimes with colloid-like material in the lumen. The MYB immunomarker was negative in 14 ASGSHs (with a positive internal control in AdCC cells), while only two cases showed faint and moderate to weak expression of the antibody in ASGSH glands. In 12 cases, the immunostaining of ASGSH could not be properly assessed, while AdCC cells were negative. The immunostaining was not performed in five cases. Our findings suggest that a subset of sinonasal AdCC may originate in a multistep dysplastic process within SH, consistent with an SH-ASGSH-AdCC progression sequence.
Is palatal augmentation prosthesis effective in restoring speech, swallowing, and quality of life following cancer associated glossectomy? A systematic review
Authors: Artopoulou Ioli Ioanna , Dereka Xanthippi , Papalexopoulos Dimokritos , Kouri Maria , Giannakopoulos Nikolaos Nikitas 
Published: February 2025

Abstract

Purpose
To evaluate the effect of palatal augmentation prosthesis (PAP) in improving speech intelligibility, swallowing efficacy, masticatory function, patients’ perception, and overall quality of life (QoL) in HNC survivors with partial or total glossectomy.

Methods
The systematic review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). The focused question was constructed according to the PICO (participant, intervention, comparison, and outcome) approach, and a three-stage screening in PubMed, Cochrane, Scopus, and Google Scholar databases with Medical Subject Heading (MeSH) terms was performed. The National Institute of Health (NIH) tool, “Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group,” was employed for risk of bias assessment, and the data was synthesized qualitatively, according to the Synthesis without Meta-Analysis (SWiM) reporting guideline.

Results
The initial search resulted in 131 articles, 80 were screened based on title and abstract, 11 full text articles were assessed for eligibility, and 9 articles were evaluated. Eight studies (88.9%) were characterized as fair and one as good. The total sample size included 176 participants. The “before” assessment was performed post-operatively, before PAP insertion, and the “after” at a time point ranging from after PAP insertion to a mean time of 9.3 (10.6) months, with a follow-up period ranging from 2 weeks to 82 months (mean time of 13.7 (17.3) months). Speech intelligibility was evaluated in eight studies. Six studies assessed swallowing and deglutition. Lingual movement dynamics of the center of the tongue, mastication ability, and patients’ reported experience with PAP were each evaluated in one study. QoL assessment was performed in two studies. The results of this systematic review indicate that PAP has a significant effect in improving speech intelligibility, swallowing efficacy, masticatory function, patients’ perceived outcomes, and overall QoL in HNC survivors with partial or total glossectomy.

Conclusion
Due to the particular defect site–related disabilities, patients with tongue resection could benefit from PAP prostheses. However, future studies evaluating the role of PAP in alleviating speech and swallowing by means of current methods of assessment, as well as more explicit patient’s perceived treatment outcomes and QoL evaluations, are essential.
Impact of prior antiplatelet therapy on safety and efficacy of alteplase in acute ischemic stroke: a systematic review and meta-analysis
Authors: Naeem Ahmed , Kelani Hesham , Salamah Hazem Mohamed , Elhalag Rowan H. , Ali Hossam Tharwat , Hussein Ayham Mohammad , Abdelnasser Omar , Naguib Mostafa Mahmoud , Elshenawy Salem , Abdelwahab Abdelrhman M. , Albaramony Nadia , Rageh Omar El Sayed , Allam Abdallah R. , Bakr Aliaa , Abuelazm Mohamed , Madkoor Ahmed , Quinoa Travis R. , Kay Arthur D. , Lerner David P. , Merlin Lisa R. , Raz Eytan , Spiotta Alejandro M. , Mayer Stephan A. 
Published: February 2025

Abstract

Background
Intravenous thrombolysis (IVT), utilizing the clot-dissolving medications alteplase (rt-PA) or tenecteplase (TNK), is the cornerstone in acute ischemic stroke (AIS) emergency intervention. However, the impact of prior antiplatelet therapy (APT) on post-IVT outcomes when utilizing alteplase remains controversial. We conducted a systematic review and meta-analysis to evaluate the effect of prior APT on the outcomes after using alteplase in AIS patients.

Methods
We conducted a systematic review and meta-analysis synthesizing studies, which were retrieved by systematically searching PubMed, Web of Science, SCOPUS, and Cochrane through June 30, 2024. We used the R language V. 4.3. to pool dichotomous data using odds ratio (OR) with a 95% confidence interval (CI). PROSPERO ID: CRD42024495393.

Results
Thirty studies were included in our analysis, with 436,232 patients. Prior APT was significantly associated with increased odds of symptomatic intracranial hemorrhage (sICH) (OR, 1.78; 95%CI [1.48, 2.13]; P < 0.01), any ICH (OR, 1.44; 95%CI [1.16, 1.78]; P < 0.01), mortality (OR, 1.39; 95%CI [1.23, 1.58]; P < 0.01), and poor functional outcomes (modified Rankin Scale score of 3–6 [mRS 3–6]) (OR, 1.81; 95%CI [1.03, 3.19]; P = 0.04). Additionally, prior APT significantly reduced the odds of good functional outcome [mRS 0–2] (OR, 0.85; 95%CI [0.74, 0.97]; P = 0.02).

Conclusion
Prior APT increased hemorrhagic complications, mortality, and poor functional outcome, while reducing the odds of good functional outcome after IV alteplase. Future research should focus on identifying adjunctive agents that may decrease hemorrhagic complications and investigate the impact of various APT regimens and alternative thrombolytics beyond alteplase in this specific population.
A two-part beta regression with mismeasured dependent variable for modeling quasi-formal employment in Europe
Authors: Arezzo Maria Felice , Guagnano Giuseppina , Vitale Domenico 
Published: February 2025

Abstract
Quasi-formal employment refers to a situation in which a formal employer and a formal employee agree to declare only part of the wage and the rest being paid in cash to avoid tax liabilities. This phenomenon is detrimental to government budgets and to worker protection. It is therefore crucial to understand its extent and its drivers. The Eurobarometer survey no. 498 provides the information to achieve these objectives. However, several issues in the data need to be addressed with credible solutions in order to rely upon the inferences drawn. These issues are primarily concerned with the reliability of the data, which is compromised due to the phenomenon of social desirability bias. This can be defined as the tendency of respondents to provide false information when answering sensitive questions relating to socially stigmatized behaviors, such as tax evasion. In this work, we present a unified framework for modeling such survey data that overcomes the problems raised by social desirability bias and accommodates the structure of the variables of interest. In particular, we propose a two-part beta regression model where the part one models the participation in quasi-formal employment, whereas the part two models the share of annual gross income earned under the table. We allow the dependent variables of both parts of the model to be mismeasured to handle social desirability bias and generalize the part two using a beta regression framework that is suitable for the limited dependent variable representing the incidence of wage paid in cash. The performance of the estimators is evaluated through a Monte Carlo simulation study and compared with those achieved through a standard procedure that ignores the issues arising from social desirability bias. An application to the Eurobarometer survey no. 498 on quasi-formal employment is provided.
Price transparency in the Dutch market-based health care system: did price dispersion for similar hospital services reduce over time?
Authors: Franken Frédérique , Douven Rudy , van der Geest Stéphanie , Varkevisser Marco 
Published: February 2025

Abstract
In market-based health care systems, insurers negotiate prices of hospital care products with providers. While few countries disclose these negotiated prices, in 2016, the Dutch government required the disclosure of insurer-provider negotiated prices for hospital products up to €885 – the maximum deductible in the Netherlands – to enhance price transparency. This aimed to increase price awareness among and price transparency for consumers, insurers, and providers, fostering price competition. We study if price dispersion for relatively homogeneous hospital care products decreased post-publication, resulting in price convergence. We used negotiated price data from three major Dutch health insurers on over 200 hospital products. Using descriptive statistics and linear regression, with the coefficient of variation (a measure of dispersion) regressed on the year, we examined the development of price dispersion and the occurrence of price convergence. Price dispersion for the studied sample of hospital products decreased by an average of 29% between 2016 and 2022. This decrease was not accompanied by a price level increase that was larger than expected based on general inflation. Regression analysis showed a significant negative association between year and the coefficient of variation, indicating price convergence. These findings support our hypothesis that price dispersion decreased after mandatory price disclosure. The government mandate potentially increased awareness of largely unexplainable price differences for products priced below €885, encouraging insurers and providers to reduce these through the negotiation process. The observed price convergence likely benefits patients, as it results in less random out-of-pocket payments across providers for the same hospitals products.
Towards a Greater Understanding of the Role of the Environment: A Systematic Review of Qualitative MZ Twin Differences Studies
Authors: Marzecki Filip , Widanaralalage Kennath , Bhandoh Nandini , McAdams Tom A. , Ahmadzadeh Yasmin I. , Zavos Helena M. S. 
Published: February 2025

Abstract
The environment is an important influence in the development of human behaviours and health outcomes. However, one of the most consistent findings from behavioural genetic studies is that most environmental influences are not shared between members of the same family. A compelling way of investigating these non-shared environmental influences is by using a monozygotic (MZ) twin differences design. Quantitative MZ differences studies have uncovered systematic non-shared environmental factors, i.e., those acting according to a general pattern in a population, for many traits, but may be omitting idiosyncratic or distinctive factors and mechanisms. Qualitative MZ differences design provides an alternative. In this study design, identical twins discordant on an outcome are interviewed in depth about the origins and context of their discordance, providing an insight into distinctive lived experiences. We conducted a systematic review examining the results and methodological features of studies using qualitative data collection and analyses to investigate differences in identical twins' experiences and outcomes. We applied a narrative synthesis. We identified seven studies, covering a range of phenotypes (e.g., anxiety or smoking) and participants (from children to older adults), which found a wide range of themes related to twins’ discordance. A major theme arising from the narrative synthesis was the role of personality and individual traits, e.g., confidence or sexual orientation, in explaining MZ twins’ discordant experiences and outcomes. Non-shared environmental factors are at least partly idiosyncratic and are therefore suitable for exploration with a qualitative research design, ideally in parallel with quantitative twin research in mixed-method research projects or programmes.
Refining management strategies in marine protected areas in oceanic islands: a non-indigenous species risk index for strategic prioritization
Authors: Castro Nuno , Monteiro João Gama , Gouveia Marisa Marques , Parretti Paola , Schäfer Susanne , Álvarez Soledad , Ramalhosa Patrício , Canning-Clode João 
Published: February 2025

Abstract
Non-indigenous Species (NIS) pose significant threats to marine biodiversity globally, especially in ecologically sensitive habitats such as Marine Protected Areas (MPAs). This study uses data collected in the Autonomous Region of Madeira (North Atlantic), Portugal, to create a spatial model aiming to (1) develop a spatially explicit index of NIS dispersal from known hotspots such as ports, harbours, marinas, and anchoring areas; (2) assess the relative vulnerability of Madeira's MPAs to local NIS dispersion and establishment; and (3) provide insights for a scalable NIS monitoring framework and evaluating invasion risks. The spatial model integrates maritime traffic intensity and proximity to NIS hotspots, using a straightforward approach that can be applied in data-limited contexts. While designed to address Madeira's regional challenges, the model is adaptable to other biogeographic contexts and can incorporate additional complexity, such as species-specific traits or ecological layers, to suit different settings. Our findings underscore the role of maritime infrastructure and vessel traffic in NIS spread, revealing the vulnerability of Madeira's MPAs due to insufficient ecological monitoring and the absence of NIS monitoring and early detection programs. This study provides practical recommendations for improving MPA management and mitigating NIS risks, contributing to regional conservation efforts. Additionally, it establishes a baseline risk assessment approach that can be customised and expanded to guide NIS management and biodiversity conservation in other regions, particularly those with similar challenges.