bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripherally acting anti-CGRP monoclonal antibodies attenuate cortical resting-state connectivity in migraine patients
Authors: Szabo Edina , Bolo Nicolas R. , Borsook David , Burstein Rami , Ashina Sait 
Published: February 2025

Background In about half of migraine patients, anti-calcitonin gene-related peptide monoclonal antibodies reduce monthly migraine days by >50%. In these patients, this class of drugs may change cortical functions by decreasing nociceptive afferent barrage. This prospective study investigated functional connectivity changes in treatment responders after three-month treatment with galcanezumab. Methods Resting-state functional magnetic resonance imaging data were acquired for patients with high-frequency episodic or chronic migraine ( N = 36) before and after treatment. Of these, 19 patients were classified as treatment responders (≥50% reduction in monthly migraine days) and 17 were considered non-responders (<50% reduction). Functional connectivity across cortical regions was assessed using a region-of-interest (ROI)-to-ROI analysis approach. Results At baseline, there were no significant differences between treatment responders and treatment non-responders. In the treatment responder group, reduced functional connectivity was observed after treatment between regions of the primary somatosensory and motor cortices, insula, and several occipital and temporo-occipital areas (within the visual network). In contrast, no such changes were seen in the non-responder group. Conclusion These findings suggest that even a relatively short period of reduced nociceptive signals may be sufficient to initiate a cortical recovery process in which its resting hyperexcitable mode shifts to a less excitable state.
Implementing reablement for community dwelling people with dementia: A formative evaluation using single-case experimental design
Authors: Campbell Alexis , Poulos Christopher J , Takla Caroline , Allen Joy , Lemsing Kylie , O’Connor Claire MC 
Published: February 2025

Background Reablement is recommended to maximise functioning in people with dementia, yet in Australia, is not routinely available. This study aimed to provide insight into the implementation and program outcomes of reablement in real-world practice for a person living with dementia. Methods Reablement was implemented for a client with dementia. In parallel, a formative mixed-methods pilot evaluation was performed, using single-case experimental A-B-A design ( n = 1), supplemented by routinely collected pre-post program clinical measures. Implementation was evaluated qualitatively via clinical notes for fidelity, feasibility and client engagement. Results Single-case experimental design outcomes indicated the program positively impacted the participant’s physical functioning. Additionally, most routinely collected pre-post clinical measures demonstrated improvement. Intervention fidelity varied, with differences in length and client engagement. Conclusion Implementation of evidence-informed reablement has been shown to be feasible in real-world practice for a community-dwelling person living with dementia. Larger implementation trials are needed to build on preliminary outcomes to ultimately improve access to these important programs.
Stone-free rate of laser lithotripsy for large pediatric stones: 15-year experience from a tertiary endourology pediatric center
Authors: Dassanayake Sohani N. , Jahrreiss Victoria , Griffin Stephen , Somani Bhaskar K. 
Published: February 2025

Background: Pediatric urolithiasis, while less common than in adults, is increasing in incidence. However, current guidelines on the optimal management of this condition vary. Technological advances have led to improvements in the quality and size of ureteroscopes, thus enabling their use in children. Despite this, there remains some hesitancy about using ureteroscopic lithotripsy in the pediatric population, particularly in cases of large stones ⩾10 mm. Objectives: In this study, our aim was to evaluate the efficacy and safety of ureteroscopy and laser stone fragmentation (URSL) for managing pediatric patients with a cumulative stone burden of ⩾10 mm in our tertiary referral center. Methods: A dataset was collected of pediatric renal tract stone patients treated at a single tertiary urological center between June 2010 and May 2024 (15 years). Pediatric patients undergoing URSL procedures for a minimum cumulative stone burden ⩾10 mm were included. A retrospective analysis of the dataset was conducted. The primary outcomes measured were stone-free rates (SFR), complications classified according to the Clavien-Dindo classification, and hospital length of stay. Results: A total of 61 pediatric patients with a mean age of 10 years (range: 2.3–16) underwent 83 URSL procedures in a tertiary endourology pediatric center over a 15-year period (2010–2024). The median initial stone burden was 17 mm (IQR: 12.5–24 mm), acquired from preoperative ultrasonography (USS). Results showed a first-pass SFR of 63.9% and a cumulative SFR of 93.4% (on USS) following one or multiple URSL procedures (1.4 procedures/patient). Immediate postoperative complications were minimal, with 6% experiencing complications classified as Clavien-Dindo I or II. The average hospital length of stay was 1.4 days. Conclusion: The findings in this study support that URSL is effective in treating pediatric urolithiasis, even for larger stone burdens. Further research is needed to standardize guidelines and optimize management strategies in this population.
Are There Differences Between Sexes in Performance-Related Variables During a Maximal Intermittent Flywheel Test?
Authors: Salse-Batán Jorge , Torrado Priscila , Marina Michel 
Published: February 2025

Background: Isometric and dynamic tasks of low-to-moderate intensities have been used to study sex differences in fatigability; however, maximal exertions with flywheel devices (FDs) have not been used. This study aimed to (1) detect sex differences in fatigue-related performance in a maximal intermittent fatiguing protocol on a FD, and (2) investigate the most sensitive dynamometric and mechanical variables for assessing fatigue in both sexes. Hypothesis: No sex differences should exist when performing this protocol on a FD. Study Design: Cohort observational study. Level of Evidence: Level 3. Methods: A total of 34 young adults (17 female/17 male) performed 10 sets of 10 repetitions with 3 minutes of passive recovery of a half-squat exercise on a FD. Inter- and intraset analysis of force, power, velocity, work, and impulse, together with their relative change and slope, were calculated during concentric and eccentric phases. Raw data were also normalized to body mass in the interset analysis. The relative changes in each variable were compared. Results: Men showed greater and earlier decreases in performance throughout sets ( P < .05; ηp2 ≥ 0.08), but these differences were not consistent after normalization for body mass ( P > .05; ηp2 ≤ 0.05). Irrespective of sex and phase, the intraset analysis revealed that relative change was higher in the last set ( P ≤ .03; ηp2 ≥ 0.14), with power being the most sensitive variable for detecting performance decline ( P ≤ .04; ηp2 = 0.49). Conclusion: Women experienced slower and delayed fatigue kinetics than men during a maximal intermittent fatiguing protocol with FD if body dimensionality is not considered. For training purposes, power seems to be the most sensitive and discriminative variable for detecting decreases in performance. Clinical Relevance: Body dimensionality is a key factor that must be considered when comparing both sexes in FDs.
Predictors of Skilled Nursing Facility Length of Stay and Discharge After Aneurysmal Subarachnoid Hemorrhage
Authors: Porto Carl M. , Wolman Dylan N. , Feler Joshua R. , Chuck Carlin C. , Karayi Gnaneswari , Torabi Radmehr , Moldovan Krisztina , Furie Karen L. , Mahta Ali 
Published: February 2025

Background and Purpose Aneurysmal subarachnoid hemorrhage (aSAH) carries high morbidity and mortality with survivors often requiring extended care at skilled nursing facilities (SNF). Predictors of SNF discharge to home (SNFdcH) remain unclear. Methods Retrospective review of a single-center prospectively maintained aSAH database from June 2016-March 2024 was conducted. Patients discharged to SNF were grouped by subsequent discharge to home. Predictors of discharge to home and facility length of stay (LOS) were determined using t-tests, Fisher analyses, and cumulative link modeling. Results Of 450 aSAH patients, 61 (13.5%) were discharged to SNFs. 49 (80.3%) returned home, with 61% achieving mRS <3 at discharge. Discharged patients were younger (mean 63.3 ± 11.5 vs 70.2 ± 9.3 years, P = .040) with lower median modified Fisher scores (3 [IQR 3-4] vs 4 [4-4], P = .046). Tracheostomy (OR = .14, 95% CI [.02, .75], P = .023) and gastrostomy tube (PEG) placement (OR = .13, 95% CI: .03-.51, P = .003) decreased the odds of SNFdcH. Discharged patients had shorter hospital LOS (26 ± 10 vs 39 ± 15 days, P < .001) and lower median modified Rankin scores (mRS) at hospital discharge (4 [4-5] vs 5 [4-5], P = .028) and at 90 days post-discharge (4 [3-5] vs 6 [5-6], P = .001). Multivariable regression identified age, PEG, and hospital LOS as predictors of SNFdcH. Tracheostomy and PEG predicted SNF LOS. Conclusions Most aSAH patients discharged from SNFs returned home, with 61% achieving mRS <3. Patients not discharged were medically complex with neurological deficits. These findings may guide care discussions and highlight the role of SNFs in bridging hospitalization and independence.
Mendelian randomisation to uncover causal associations between conformation, metabolism, and production as potential exposure to reproduction in German Holstein dairy cattle
Authors: Schwarz Leopold , Heise Johannes , Liu Zengting , Bennewitz Jörn , Thaller Georg , Tetens Jens 
Published: February 2025

Abstract

Background
Reproduction is vital to welfare, health, and economics in animal husbandry and breeding. Health and reproduction are increasingly being considered because of the observed genetic correlations between reproduction, health, conformation, and performance traits in dairy cattle. Understanding the detailed genetic architecture underlying these traits would represent a major step in comprehending their interplay. Identifying known, putative or novel associations in genomics could improve animal health, welfare, and performance while allowing further adjustments in animal breeding.

Results
We conducted genome-wide association studies for 25 different traits belonging to four different complexes, namely reproduction (n = 13), conformation (n = 6), production (n = 3), and metabolism (n = 3), using a cohort of over 235,000 dairy cows. As a result, we identified genome-wide significant signals for all the studied traits. The obtained summary statistics collected served as the input for a Mendelian randomisation approach (GSMR) to infer causal associations between putative exposure and reproduction traits. The study considered conformation, production, and metabolism as exposure and reproduction as outcome. A range of 139 to 252 genome-wide significant SNPs per combination were identified as instrumental variables (IVs). Out of 156 trait combinations, 135 demonstrated statistically significant effects, thereby enabling the identification of the responsible IVs. Combinations of traits related to metabolism (38 out of 39), conformation (68 out of 78), or production (29 out of 39) were found to have significant effects on reproduction. These relationships were partially non-linear. Moreover, a separate variance component estimation supported these findings, strongly correlating with the GSMR results and offering suggestions for improvement. Downstream analyses of selected representative traits per complex resulted in identifying and investigating potential physiological mechanisms. Notably, we identified both trait-specific SNPs and genes that appeared to influence specific traits per complex, as well as more general SNPs that were common between exposure and outcome traits.

Conclusions
Our study confirms the known genetic associations between reproduction traits and the three complexes tested. It provides new insights into causality, indicating a non-linear relationship between conformation and reproduction. In addition, the downstream analyses have identified several clustered genes that may mediate this association.
The ability to race barefoot is a heritable trait in Standardbred and Coldblooded trotters
Authors: Berglund Paulina , Andonov Sreten , Jansson Anna , Olsson Christina , Lundqvist Therese , Strandberg Erling , Eriksson Susanne 
Published: February 2025

Abstract

Background
In equine sports, shoes are used to protect the hooves from wear and tear. In Swedish trotting races, pulling off the shoes to race barefoot is popular because it improves racing time. Good hoof quality is essential for high-performance horses, but not all trotting horses have hooves that tolerate barefoot racing. The ability to race barefoot is a complex trait that is known to be influenced by environmental factors, but the genetic basis of this trait has not been studied. The aim of this study was to estimate genetic parameters and correlations between estimated breeding values for three novel traits: two related to the proportion of barefoot races and “barefoot status”, a binary trait that reflects the probability of racing unshod in a race, in Swedish Standardbred trotters (SB) and Swedish-Norwegian Coldblooded trotters (CB).

Results
For the two traits describing the proportion of barefoot races, single-trait mixed linear animal models were used to estimate variance components for up to 24,958 SB and up to 4050 CB. Estimates of heritability ranged from 0.17 to 0.28. For barefoot status, a binary trait with repeated measurements, 875,056 observations from 25,973 SB, and 93,376 observations from 3384 CB were included. Using a single-trait mixed animal threshold model estimates of heritability for barefoot status were 0.07 and 0.08. The Pearson correlation coefficient between the estimated breeding values for barefoot status and each of the traits describing the proportion of barefoot races for breeding stallions was 0.63 and 0.64 for SB and 0.82 and 0.76 for CB.

Conclusions
The traits analyzed reflecting the ability to race barefoot are heritable, with the traits for the proportion of barefoot races showing higher heritability estimates for both breeds than barefoot status. Estimated breeding values for breeding stallions were moderately to strongly correlated for the three traits. The average accuracy of estimated breeding values for breeding stallions was moderate to high for all traits. To breed for the ability to race barefoot, further studies on the genetic correlation of the ability to race barefoot with performance traits and the impact of racing barefoot on career length, are necessary.
Acute tubulointerstitial nephritis (ATIN) including drug-induced, tubulointerstitial nephritis and uveitis (TINU), ANCA-associated vasculitis (AAV), kidney- limited sarcoidosis, and hemolysis: a case series from Syria
Authors: Alsultan Mohammad , Kliea Marwa , Hassan Qussai 
Published: February 2025

Abstract

Background
This study aimed to detail acute tubulointerstitial nephritis (ATIN) patients, from relevant clinical manifestations to outcomes.

Methods
We reviewed ATIN patients between 2018 and 2022. All demographic data, labs, biopsy findings, treatment protocols, and outcomes were reported.

Results
ATIN was diagnosed in nine patients, eight by kidney biopsy and one clinically. Drug-induced ATIN (DI-ATIN) was reported in five patients, including rifampin (RIF), allopurinol, mesalamine, and two with cephalosporins. Severe ATIN resulted after the first dose of RIF aligned with liver injury, hemolysis, and thrombocytopenia. Also, mesalamine and allopurinol induced gradual kidney failure a few months after the drug initiation. A patient with Tubulointerstitial nephritis and uveitis (TINU) syndrome showed refractory uveitis presenting during glucocorticoids (GCs) tapering, which resolved quickly with azathioprine (AZA) when not responding to GCs reescalation. Among the rarest cases, ATIN induced by a kidney-limited sarcoidosis, G6PD patient with hemolysis induced ATIN, and isolated ATIN induced by ANCA-associated vasculitis (AAV) with positive C-ANCA, which the latter representing the first case in our country and the fourth case worldwide. Labs showed anemia (88.8%), ESR elevation (85.7%), microscopic hematuria (in all patients), pyuria (44.4%), and proteinuria (77.7%). Biopsies showed interstitial infiltrations mainly with lymphocytes and monocytes. Eosinophils were found in one biopsy and neutrophils showed in 4 biopsies (50%).

Conclusion
ATIN is a disease with a diagnostic challenge, thus clinicians should maintain a high suspicion for diagnosis. The combination of AKI with positive tests (especially abnormal urine sediment, ESR elevation, and anemia) may suggest ATIN diagnosis and further support the treatment initiation, particularly when kidney biopsy is unable to be performed or when the inciting agent is predictable.
The association between Ki-67 expression and survival in breast cancer subtypes: a cross-sectional study of Ki-67 cut-point in northern Thailand
Authors: Wongmaneerung Phanchaporn , Chitapanarux Imjai , Traisathit Patrinee , Prasitwattanaseree Sukon , Rottuntikarn Wisanu , Somwangprasert Areewan , Ditsatham Chagkrit , Watcharachan Kirati , Klunklin Pitchayaponne , Onchan Wimrak 
Published: February 2025

Abstract

Background
Breast cancer is a major health concern worldwide, and Ki-67 level index is a prognostic factor that indicates tumor proliferation and predicts survival outcomes. However, the standard Ki 67 cut-off level varies between local laboratories, and in Thailand, there is no established optimal cut-off level.

Objective
This study aimed to determine the optimal cut-off point for Ki-67 expression and investigate the association between Ki-67 levels and other prognostic factors with 8-year overall survival.

Method
A retrospective review of Ki-67 levels was conducted in non-metastatic breast cancer patients treated at Maharaj Nakorn Chiangmai hospital from January 2013-December 2015, including 507 breast cancer patients.

Results
The ROC curve analysis identified the optimal Ki-67 cut-point as ≥ 30%, with 75% sensitivity and 48.85% specificity. Age over 60 was associated with higher mortality regardless of cancer stage. Locally advanced staging, nodal involvement, Ki-67 ≥ 30%, and triple-negative subtype correlated with poorer survival. Even after adjustments, these factors remained significant in prognostic evaluation. Chemotherapy notably improved survival, especially in high Ki-67 (≥ 30) patients. However, this effect was not seen in low Ki-67 patients. High Ki-67 patients receiving chemotherapy showed improved survival in early-stage, node-negative cases compared to those who did not receive chemotherapy. HER2-positive patients with high Ki-67 benefited from chemotherapy, but statistical significance was not reached in hormone-positive patients.

Conclusion
This study identified the optimal cut point for Ki-67 in Northern Thailand as 30%. Patients with KI-67 above 30% show significantly lower 8-year survival rates. This is especially relevant for low-risk patients, like those with hormonal subtypes or early-stage nodal negativity. In these cases, KI-67 becomes crucial for treatment decisions. Our study not only aids Northern Thailand’s understanding but also aligns with broader research, emphasizing KI-67’s vital role in planning treatment for low-risk breast cancer patients.
Detection of COPD exacerbations with continuous monitoring of breathing rate and inspiratory amplitude under oxygen therapy
Authors: Alves Pegoraro Juliana , Guerder Antoine , Similowski Thomas , Salamitou Philippe , Gonzalez-Bermejo Jesus , Birmelé Etienne 
Published: February 2025

Abstract

Background
Chronic Obstructive Pulmonary Disease (COPD) is one of the main causes of morbidity and mortality worldwide. Its management represents real economic and public health burdens, accentuated by periods of acute disease deterioration, called exacerbations. Some researchers have studied the interest of monitoring patients’ breathing rate as an indicator of exacerbation, although achieving limited sensitivity and/or specificity. In this study, we look to improve the previously described method, by combining breathing variables, using multiple daily measures, and using an artificial intelligence-based novelty detection approach.

Methods
Patients with COPD were monitored with a telemedicine device during their stay in a rehabilitation care center. Daily measures are compared to individually trained reference models based on: i. oxygen therapy duration ii. mean breathing rate, iii. mean inspiratory amplitude, iv. mean breathing rate and mean inspiratory amplitude, v. average distribution of breathing rate and inspiratory amplitude, vi. hidden Markov model (HMM) from a time series of breathing rate and inspiratory amplitude.

Results
A set of 16 recordings with exacerbation and 23 recordings without exacerbation was obtained. When using a daily measure of breathing rate, pre-exacerbation periods were identified with a specificity of 50% and a sensitivity of 55.6%. The method based on daily oxygen therapy usage and the method based on time series obtain a sensitivity of 76.8% and 73.2%, respectively, for a fixed specificity of 50%.

Conclusion
A single daily measure of breathing rate alone is not sufficient for the detection of pre-exacerbation periods. More complete models also achieve limited performance, equivalent to models based on changes in the duration of therapy usage.
Effect of educational program on nurses’ performance regarding application of liberation bundle in pediatric intensive care unit
Authors: Ali Reem Mohamed Seddik , Mosbeh Asmaa Nasreldin , Hafez Mona Mohamed 
Published: February 2025

Abstract

Background
Recent guidelines in paediatric critical care emphasize the implementation of the evidence-based liberation bundle to improve patient outcomes in paediatric intensive care units (PICUs). However, there is limited information on the application of this bundle in Egyptian hospitals, and the effectiveness of educational programs on nurse performance in this context remains unclear.

Aim
This study aimed to evaluate the effect of an educational program on nurses’ performance regarding the application of the liberation bundle in paediatric intensive care unit.

Methods
A one-group pre/post quasi-experimental design was employed. The study was conducted in the PICUs of Al-Azhar University Hospital and Menoufia University Hospital, involving a convenient sample of 52 paediatric nurses. Data were collected using two tools: a predesigned questionnaire to assess knowledge about the liberation bundle and an observational checklist to evaluate nurse practices before and after the educational program.

Results
The results demonstrated significant improvements in nurses’ knowledge and practices post-intervention. The studied nurses’ total level of knowledge regarding the liberation bundle increased from 13.7 to 92.3% post-educational program X2 (P. value) = 89.143(0.000). The studied nurses’ total level of practices regarding the liberation bundle increased from 9.6 to 80.8% post-educational program X2 (P. value) = 89.143(0.000).

Conclusion
The educational program significantly enhanced the nurses’ knowledge and practices in applying the liberation bundle in PICUs. This improvement in knowledge and practices is expected to lead to better outcomes for paediatric patients, including reduced mortality, shorter PICU stays, and fewer post-intensive care complications. By equipping nurses with the skills to implement the bundle, the program can improve recovery and long-term health outcomes in critically ill children.