bluuebunny/crossref_metadata_2025_split huggingface dataset:
DWI Positivity in Mild, Nondisabling Acute Cerebral Ischemia: Data From the PRISMS Trial
Authors: Wang Lily L. , Khatri Pooja , Prabhakaran Shyam , Sucharew Heidi , Tomsick Thomas A. , Carrozzella Janice A. , Stanton Robert J. , Broderick Joseph , Kleindorfer Dawn , Levine Steven R. , Romano Jose G. , Saver Jeffrey L. , Yeatts Sharon D. , Vagal Achala 
Published: January 2025

Background
In patients with acute cerebral ischemia (ACI) and mild deficit, acute infarction on magnetic resonance imaging (diffusion‐weighted imaging [DWI]‐positivity) is inconsistently detected. Our objective was to characterize the rate of detection in the first dedicated trial of a population with mild, nondisabling stroke and assess the detection and its association with baseline clinical and imaging characteristics. We hypothesized that white matter hyperintensity (WMH) would independently predispose patients to DWI‐positivity.

Methods
The phase 3b, randomized, double‐blinded PRISMS (Potential of Alteplase for Ischemic Strokes with Mild Symptoms) trial compared administration of intravenous alteplase to aspirin for mild (National Institutes of Health Stroke Scale score 0–5), nondisabling stroke at ≤3 hours from onset. For the current, prespecified study, patients with a final diagnosis of neurovascular mimic were excluded. Central readers, blinded to the treatment arm, assessed day 2 magnetic resonance imaging for prior infarct, WMH burden (graded quantitatively [volume] and qualitatively [(Fazekas]), and presence of DWI‐positivity (primary outcome). Alteplase treatment, demographics, and clinical covariates were prespecified for adjustment in regression modeling.

Results

Of 313 patients enrolled, 273 (87%) had a final diagnosis of ACI. Of 212 (77%) cases of ACI with magnetic resonance imaging, 109 (51%) had DWI positivity (median lesion volume 1.20 cc, interquartile range 0.57–2.50 cc). Univariately, the proportion with higher Fazekas grade (grade 2–3: 27% vs 41%;
P
= 0.02) and prior infarct (45% vs 27%,
P
<0.01) were associated with DWI positivity. WMH was not associated with DWI positivity in adjusted analysis (adjusted odds ratio [aOR]: 1.01, 95% CI: 0.99–1.03). The multivariable model also showed alteplase treatment inversely associated with DWI‐positivity (aOR: 0.48, 95% CI: 0.25–0.93).

Conclusions
Among patients presenting with mild, nondisabling ACI, WMH is not associated with DWI‐positivity. A hypothesis emerges that alteplase treatment may reduce DWI positivity in mild, nondisabling ACI.
Sex‐Based Differences in Thrombus Composition in Acute Ischemic Stroke
Authors: Schwarz Ghil , Cascio Rizzo Angelo , Cervo Amedeo , Di Como Martina , Costanza Aquilano Maria , Valtorta Emanuele , Carlo Pero Guglielmo , Piano Mariangela , Sessa Maria 
Published: January 2025

BACKGROUND
Endovascular thrombectomy allows for detailed study of thrombus composition in acute ischemic stroke. Differences in thrombus composition can affect outcomes, and the impact of sex on coagulation physiology is recognized. This study investigates whether thrombus composition in acute ischemic stroke varies between sexes.

METHODS

Retrospective study on consecutive endovascular thrombectomy‐treated patients with acute ischemic stroke at Niguarda Hospital in 2023. Thrombi were stained with hematoxylin and eosin, and the percentages of fibrin, red blood cells (RBCs), and white blood cells (WBCs) were quantified as proportions of the total thrombus area. Univariate and multivariate analyses were performed to identify histological differences between sexes—multivariate analysis adjusted for variables associated with each thrombus component with a
P
value <0.1.

RESULTS

Seventy‐three cases (50.7% female) were included in the study. Male patients exhibited a higher percentage of RBCs within the thrombus (median 51.5% versus 33.8%,
P
= 0.004), whereas female patients had a higher percentage of fibrin (median 58.3% versus 45.1%,
P
= 0.020) and WBCs (median 6.5% versus 4.4%,
P
= 0.045). Univariate analysis indicated that sex was associated with all 3 thrombus components: fibrin (β = 10.08 [95% CI, 1.29–18.87],
P
= 0.025), RBCs (β = −12.12 [95% CI, l−21.04 to −3.21],
P
= 0.008), and WBCs (β = 2.05 [95% CI, 0.23–3.86],
P
= 0.028). In the multivariate analysis, sex lost its association with both fibrin and RBC percentages, and only baseline RBC count maintained its independent association with these 2 components. For the percentage of WBCs in the thrombus, both sex (β = 2.13 [95% CI, 0.25–4.01],
P
= 0.027) and stroke etiology (β = 0.81 [95% CI, 0.03–1.58],
P
= 0.041) showed significant and independent associations.

CONCLUSION
Our exploratory study shows that sex independently affects the percentage of WBCs in thrombi. The percentage of fibrin and RBC does not have an independent association with sex and may be mediated by different RBC count. Future research in this field should consider sex and baseline laboratory values.
EXPRESS: Product Returns and Assortment Decisions: a Strategic Analysis of Online and Offline Competition
Authors: Li Yue , Rao Raghunath Singh , Mallucci Paola 
Published: January 2025

We present a model of product returns and assortment decisions in the context of online-offline retail competition. In equilibrium, the online store optimally offers easy-to-fit products to reduce costly returns. The competing brick-and-mortar store faces a subtle trade-off between generating higher sales and attracting more foot traffic, and thus, it might use its limited store size to stock harder-to-fit products. Our model provides a rationale for the prevalence of relatively lower-quality products sold online and the steady growth of specialty stores within the changing footprint of traditional retailing. The model is extended to include possibilities such as a physical store opening an online channel to compete with the online store. We apply this framework to investigate the possibility and consequences of retailers collaborating to handle returns. Specifically, a recent “buy online and return in store” (BORS) return policy allows consumers to return online purchases directly to a competing brick-and-mortar store. In the short run, BORS increases the BMR’s foot traffic and the returns volume. In the long run, BORS expands the OR’s assortment and increases BMR’s foot traffic. BORS can be sustained in the long run if the BMR is small or if its cost-saving effect is large.
What are patients asking and reading online? An analysis of online patient searches about treatments for developmental dysplasia of the hip
Authors: Balachandran Uma , Ren Renee , Vicioso Camila , Park Jiwoo , Nietsch Katrina S , Sacks Brittany , Busigo Torres Rodnell , Ranade Sheena C 
Published: January 2025

Purpose: We aimed to analyze frequently searched questions through Google’s “People Also Ask” feature related to four common treatments for developmental dysplasia of the hip (DDH): the Pavlik harness, rhino brace, closed reduction surgery and open reduction surgery. Methods: Search terms for each treatment were entered into Google Web Search using a clean-install Google Chrome browser. The top frequently asked questions and associated websites were extracted. Questions were categorized using the Rothwell classification model. Websites were evaluated using the JAMA Benchmark Criteria. Chi-square tests were performed. Results: The initial search yielded 828 questions. Of 479 included questions, the most popular topics were specific activities that patients with DDH can/cannot do (32.8%), technical details about treatments (30.9%) and indications for treatments (18.2%). Websites were commonly academic (59.3%), commercial (40.5%) and governmental (12.3%). There were statistically significant more specific activity questions about Pavlik harnesses than about rhino braces ( χ2 = 7.1, p = 0.008), closed reduction ( χ2 = 56.5, p < 0.001) and open reduction ( χ2 = 14.7, p < 0.001). There were statistically significant more technical details questions about Pavlik harnesses than about closed reduction ( χ2 = 4.1, p = 0.04). Conclusions: This study provides insights into common concerns that parents have about their children’s DDH treatment, enabling orthopaedic surgeons to provide more effective and targeted consultations. This is particularly important for DDH because affected patients are often diagnosed within the first few months of life, leaving parents overwhelmed by caring for a newborn child and simultaneously coping with this diagnosis.
Urban Air Mobility demand forecasting: modeling evidence from the case study of Milan (Italy)
Authors: Coppola Pierluigi , De Fabiis Francesco , Silvestri Fulvio 
Published: January 2025

Abstract
This paper presents the results of a demand forecasting study about the introduction of Urban Air Mobility (UAM) services in the metropolitan area of Milan (Italy). Demand forecasting is based on random utility mode choice models, which include factors related to the individuals’ perception of vertical take-off/landing and low altitude flying over urbanized areas. The use cases of UAM services include airport shuttles, intercity air connections, and “air-taxis”, i.e., UAM services for short-trips within the metropolitan area. Several scenarios have been considered based on the number of access points (“vertiports”) and UAM fare levels. The results indicate that airport shuttles have a modal share of trips to/from airports (for both business and leisure) in a range of 2-5%. They resulted to be more attractive than air-taxis, which have a modal share in a range of 1-3%. Furthermore, the probability of choosing UAM services for intercity travels decreases with the distance and the time required for access/egress to/from the vertiports, whose catchment areas are dependent on the level of service provided by competing modes (notably the presence of good railway and highway connections).
Effects of Enterobacter cloacae extract, selenium nanoparticles and methyl jasmonate on shoot liquid cultures of Sarcocornia fruticosa under salinity stress
Authors: Salem Fathia , Rahman Raoufa Abdel , Tammam Amel 
Published: January 2025

Abstract
Background
The in vitro propagation of halophytes is innovative perspective for sustainable agriculture, conservation of natural plants and essential raw materials for industry due to increasing soil salinization and decreasing freshwater availability. Sarcocornia fruticosa, a halophytic plant, may hold promise for biosaline production systems and achieve bioactive products. Understanding the salt tolerance mechanisms of halophytes through elicitors can enhance the production of secondary metabolites, such as phenolics and flavonoids, under saline environment. This study aimed to evaluate the effects of NaCl salinity (700 mM and 1000 mM) on Sarcocornia fruticosa shoot cultures and assess the influence of different elicitors-Enterobacter cloacae extract (BE), selenium nanoparticles (SeNPs) and methyl jasmonate (MeJA) -on the plants growth, physiological and biochemical responses, and isorhamnetin production.

Methodology
Shoot cultures were grown under controlled conditions with two concentrations of NaCl, alone and in combination with BE (0.5%), SeNPs (100 ppm), or MeJA (50 µM). Growth parameters, photosynthetic pigments, ion accumulation, osmolyte content, oxidative stress marker, enzyme activity, phenolic compound levels, and isorhamnetin production were analyzed to determine the impact of salinity and elicitor treatments on S. fruticosa for 14 days.

Results
Sarcorcocnia fruticosa exhibited better tolerance up to 700 mM than 1000 mM NaCl, as evidenced by higher dry weights, chlorophyll a/b ratios, and enhanced osmolyte and antioxidant contents. Elicitation both saline cultures with BE and SeNPs improved growth mostly by increasing biomass, pigment contents, K+/Na+ ratios, and reducing lipid peroxidation, however, MeJA reduced the biomass mainly by increasing MDA and Na+ ion accumulation. In contrast, application of all elicitors stimulated the production of phenolic compounds and isorhamnetin, as well as BE can contribute for increasing resistance of S. fruticosa to stressful conditions.

Conclusion
This study demonstrated that PTC techniques and appropriate elicitors can optimize halophyte propagation and secondary metabolite production under saline conditions. The findings suggest that BE and SeNPs significantly enhanced the growth and biochemical resilience of S. fruticosa under salinity stress, with a notable increase in isorhamnetin production. MEJA.
Nebulized dexmedetomidine in the treatment of obstetric post-dural puncture headache: two case reports
Authors: Thomas Jeffrey , Soloniuk Leonard J. , Mehdizadeh Chris , Cheng Peter , Sinha Ashish 
Published: January 2025

AbstractPost-dural puncture headache (PDPH) is a debilitating complication of neuraxial anesthesia, particularly prevalent in obstetric patients, usually characterized by a postural headache. PDPH is hypothesized to result from cerebrospinal fluid leakage through a dural puncture, triggering symptoms like neck stiffness and subjective hearing changes. While conservative measures are common for treatment, more refractory cases may require invasive interventions such as an epidural blood patch (EBP). Recent studies have shown promise in using nebulized dexmedetomidine (nDEX) for PDPH, offering a non-invasive alternative to EBP. Two case presentations illustrate the efficacy of nDEX in resolving PDPH symptoms rapidly and completely. These cases underscore the need for exploring novel therapeutic options, especially in obstetric patients where safe and prompt relief is essential for maternal and newborn well-being. While the EBP remains the gold standard, its limitations of accessibility and invasiveness highlight the significance of investigating alternatives like nDEX.
Efficacy of Xpert MTB/RIF assay in detecting Mycobacterium tuberculosis in samples with different results by smear and culture in a coastal city with high incidence of tuberculosis
Authors: Feng Gang , Jiang Hongyu , Chen Ying 
Published: January 2025

Abstract
Background
Tuberculosis (TB) is a global problem that seriously jeopardizes human health. Among them, the diagnosis and treatment of smear- or culture-negative TB patients is a challenge. The Xpert MTB/RIF (Xpert) assay has been reported to be a novel molecular diagnostic tool for rapidly detecting TB. Still, there is limited data on this assay's performance in subgroups of TB patients. This study aimed to evaluate the diagnostic value of the Xpert method in patients with different smear and culture results and to assess its efficacy for rifampicin resistance (RR) detection.

Methods
We retrospectively collected data from 1,721 patients with a clinical diagnosis of tuberculosis. Smear, Xpert, and traditional solid culture methods were used to detect TB infection and explore the detection rate of Xpert in the grouping of results from different smear and culture methods. Information on RR detected by the Xpert method and proportional method of drug sensitivity test (DST) was also recorded and kappa values, sensitivity, and specificity were calculated.

Results
We observed that among the three methods, the Xpert method had the highest detection rate of 66.8%, followed by the culture method at 56.0% and the smear method had the lowest at 40.0%. The detection rate of Xpert was 98.3% (642/653) when both smear and culture were positive, 85.1% (296/348) when only one of the two methods, smear and culture, was positive, and 29.4% (212/720) when both smear and culture were negative. The Xpert method and DST showed a high agreement (κ = 0.92) for RR detection. The highest mutation rate was observed for probe E (64.7%), and the least number of probe C mutations occurred (1.5%).

Conclusion
The Xpert method has high detection efficiency. It has good diagnostic value in detecting MTB and RR, especially in cases where traditional culture and sputum smear results are negative, and significantly reduces the rate of missed diagnosis.
Prediction of oral diseases in care dependent older people
Authors: Andersen Christina , Jespersen Astrid Pernille , Ekstrand Kim , Øzhayat Esben Boeskov 
Published: January 2025

Abstract
Background
A large number of older people depend on others for help with their daily personal care, including oral health care. Nursing home and elder-care staff often face challenges identifying older people, who are exposed to or at an increased risk of oral diseases. Thus, the aim of this study was to identify risk factors that non-dental care staff can use to identify older people at risk of oral diseases and poor oral hygiene.

Methods
In this cross-sectional study, the oral health and risk factors for poor oral health were determined for 217 care dependent older people living in two nursing homes and a rehabilitation centre or receiving home care in two Danish municipalities. The outcome variables for oral disease i.e. caries, periodontitis, and gingivitis, and oral hygiene, i.e. plaque and calculus, were assessed using standardised oral examinations. Risk factors for oral diseases and poor oral hygiene were assessed based on a questionnaire concerning (1) background information, (2) health status, (3) social support, (4) oral health behaviours, and (5) self-reported oral health. The associations between oral health and risk factors were investigated using logistic regression analyses.

Results
In general, older people with different living arrangements had quite similarly distributed risk factors. The oral examinations showed that 54.5% had oral diseases, and 14.8% had poor oral hygiene. Not seeing a dentist regularly was significantly associated with having oral diseases (Odds Ratio, 2.87; CI, 1.53–5.39) and poor oral hygiene (OR, 4.50; CI, 1.83–11.05). A significant association was found between the presence of an oral disease and adversely affected quality of life (OR, 2.65; CI, 1.42–4.95), especially due to challenges eating (OR, 3.76; CI, 1.64–8.60) and/or smiling and showing teeth (OR, 3.64; CI, 1.27–10.42). A significant association was also found between poor oral hygiene and taking psychotropic drugs (OR, 2.61; CI, 1.08–6.30).

Conclusion
Questions regarding the use of the dental care system and oral health problems could be used by nondental care staff in conversations with older people to determine their risk of oral diseases and poor oral hygiene.
Fit accuracy and fracture resistance evaluation of advanced lithium disilicate crowns (in- vitro study)
Authors: Fayed Amro Khalil , Azer Amir Shoukry , AboElhassan Rewaa Gaber 
Published: January 2025

Abstract
Background
Increasing demand for durable and aesthetically pleasing dental restorations, including laminates, inlays, onlays, and crowns, has led to advancements in all-ceramic systems, particularly with the development of advanced lithium disilicate materials. However, limited data on the fit accuracy and fracture resistance of these materials restricts their wider application in clinical restorative practices.

Aim of the study
This in vitro study aims to compare the marginal and internal fit, assess the fracture resistance, and evaluate the failure modes of crowns fabricated from advanced and conventional lithium disilicate materials.

Materials and methods
Thirty two (n = 32) crowns were fabricated and categorized into two groups based on the material used: Group (CT), where crowns were milled from CEREC Tessera (n = 16), and Group (EM), where crowns were milled from IPS e.max CAD (n = 16) using a CAD/CAM system. The marginal and internal fit were assessed digitally via a triple scan protocol. All samples were subjected to a fracture resistance test with a universal testing machine, followed by an analysis of failure modes under a stereomicroscope.

Results
In the evaluation of marginal, internal and total gaps, CEREC Tessera (CT) showed slightly better fit with lower gap values compared to e.max CAD (EM). However, an independent samples t-test indicated no statistically significant differences between the two groups (p = 0.141, p = 0.471). For fracture resistance (N), the CT group demonstrated higher values than the EM group; however, the independent samples t-test indicated no statistically significant difference (p = 0.053). Additionally, the Chi-squared test with Monte Carlo correction revealed no statistically significant differences in the modes of fracture between the two groups (p = 0.484).

Conclusion
Considering the limitations of this study, advanced lithium disilicate crowns demonstrated better results in terms of marginal fit, internal adaptation, and fracture resistance compared to traditional lithium disilicate crowns; however, the differences were not statistically significant. Both materials exhibited comparable fracture patterns.
Commentary on “Epigenome-wide analysis across the development span of pediatric acute lymphoblastic leukemia: backtracking to birth”
Authors: Raitoharju Emma , Marttila Saara 
Published: January 2025

AbstractVTRNA2-1 is a polymorphically imprinted locus. The proportion of individuals with a maternally imprinted VTRNA2-1 locus is consistently approximately 75% in populations of European origin, with the remaining circa 25% having a non-methylated VTRNA2-1 locus. Recently, VTRNA2-1 hypermethylation at birth was suggested to be a precursor of paediatric acute lymphoblastic leukaemia with biomarker potential. The results presented by Ghantous et al. [1] allow for an alternative interpretation to what the authors discussed, and we argue that the observed methylation difference at birth is due to an uneven distribution of imprinted and non-methylated individuals among the cases and controls, with all individuals presenting normative physiological VTRNA2-1 methylation levels. In addition, the notable interindividual variation arising from the polymorphic imprinting in VTRNA2-1 methylation levels calls into question the validity of VTRNA2-1 methylation as a biomarker.