bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of GRACE risk score in patients admitted to hospital with non-ST elevation acute coronary syndrome (UKGRIS): parallel group cluster randomised controlled trial
Authors: Gale Chris P , Stocken Deborah D , Aktaa Suleman , Reynolds Catherine , Gilberts Rachael , Brieger David , Carruthers Kathryn , Chew Derek P , Goodman Shaun G , Fernandez Catherine , Sharples Linda D , Yan Andrew T , Fox Keith 
Published: June 2023

Abstract

Objective
To determine the effectiveness of risk stratification using the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) for patients presenting to hospital with suspected non-ST elevation acute coronary syndrome.

Design
Parallel group cluster randomised controlled trial.

Setting
Patients presenting with suspected non-ST elevation acute coronary syndrome to 42 hospitals in England between 9 March 2017 and 30 December 2019.

Participants
Patients aged ≥18 years with a minimum follow-up of 12 months.

Intervention
Hospitals were randomised (1:1) to patient management by standard care or according to the GRS and associated guidelines.

Main outcome measures
Primary outcome measures were use of guideline recommended management and time to the composite of cardiovascular death, non-fatal myocardial infarction, new onset heart failure hospital admission, and readmission for cardiovascular event. Secondary measures included the duration of hospital stay, EQ-5D-5L (five domain, five level version of the EuroQoL index), and the composite endpoint components.

Results

3050 participants (1440 GRS, 1610 standard care) were recruited in 38 UK clusters (20 GRS, 18 standard care). The mean age was 65.7 years (standard deviation 12), 69% were male, and the mean baseline GRACE scores were 119.5 (standard deviation 31.4) and 125.7 (34.4) for GRS and standard care, respectively. The uptake of guideline recommended processes was 77.3% for GRS and 75.3% for standard care (odds ratio 1.16, 95% confidence interval 0.70 to 1.92, P=0.56). The time to the first composite cardiac event was not significantly improved by the GRS (hazard ratio 0.89, 95% confidence interval 0.68 to 1.16, P=0.37). Baseline adjusted EQ-5D-5L utility at 12 months (difference −0.01, 95% confidence interval −0.06 to 0.04) and the duration of hospital admission within 12 months (mean 11.2 days, standard deviation 18 days
v
11.8 days, 19 days) were similar for GRS and standard care.

Conclusions
In adults presenting to hospital with suspected non-ST elevation acute coronary syndrome, the GRS did not improve adherence to guideline recommended management or reduce cardiovascular events at 12 months.

Trial registration
ISRCTN 29731761
Effectiveness of a gamified digital intervention based on lifestyle modification (iGAME) in secondary prevention: a protocol for a randomised controlled trial
Authors: Cuesta-Vargas Antonio I , Biró Attila , Escriche-Escuder Adrian , Trinidad-Fernández Manuel , García-Conejo Celia , Roldan-Jimenez Cristina , Tang Wen , Salvatore Alfredo , Nikolova Borjanka , Muro-Culebras Antonio , Martín-Martín Jaime , González-Sánchez Manuel , Ruiz-Muñoz María , Mayoral Fermin 
Published: June 2023

IntroductionCombating physical inactivity and reducing sitting time are one of the principal challenges proposed by public health systems. Gamification has been seen as an innovative, functional and motivating strategy to encourage patients to increase their physical activity (PA) and reduce sedentary lifestyles through behaviour change techniques (BCT). However, the effectiveness of these interventions is not usually studied before their use. The main objective of this study will be to analyse the effectiveness of a gamified mobile application (iGAME) developed in the context of promoting PA and reducing sitting time with the BCT approach, as an intervention of secondary prevention in sedentary patients.Methods and analysisA randomised clinical trial will be conducted among sedentary patients with one of these conditions: non-specific low back pain, cancer survivors and mild depression. The experimental group will receive a 12-week intervention based on a gamified mobile health application using BCT to promote PA and reduce sedentarism. Participants in the control group will be educated about the benefits of PA. The International Physical Activity Questionnaire will be considered the primary outcome. International Sedentary Assessment Tool, EuroQoL-5D, MEDRISK Instruments and consumption of Health System resources will be evaluated as secondary outcomes. Specific questionnaires will be administered depending on the clinical population. Outcomes will be assessed at baseline, at 6 weeks, at the end of the intervention (12 weeks), at 26 weeks and at 52 weeks.Ethics and disseminationThe study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía Ethics Committee (RCT-iGAME 24092020). All participants will be informed about the purpose and content of the study and written informed consent will be completed. The results of this study will be published in a peer-reviewed journal and disseminated electronically and in print.Trial registration numberNCT04019119
National and international programmatic perspective on facilitators and barriers for Sudan’s health sector response on female genital mutilation (2016–2018): a qualitative study
Authors: Ahmed Wisal , Adam Amira , Puttkammer Nancy , Gloyd Stephen , Farquhar Carey 
Published: June 2023

ObjectivesTo explore the facilitators and barriers that affected the design and implementation of the first 3 years of Sudan’s largest health programme on female genital mutilation (FGM).DesignWe used a qualitative case study guided by the Consolidated Framework for Implementation Research to conduct in-depth interviews with programme managers and for thematic data analysis.SettingAbout 14 million girls and women in Sudan are affected by FGM, which is mainly performed by midwives (77%). Since 2016, Sudan has received substantial donor funding to develop and implement the largest global health programme to stop midwives’ involvement and improve the quality of FGM prevention and care services.ParticipantsEight Sudanese and two international programme managers representing governmental, international and national organisations and donor agencies participated in interviews. Their job positions required detailed involvement in planning, implementing and evaluating diverse health interventions in the areas of governance, building knowledge and skills of health workers, strengthening accountability, monitoring and evaluation and creating an enabling environment.ResultsRespondents identified funding availability and comprehensive plans, integration of FGM-related interventions within existing priority health intervention packages and presence of an evaluation and feedback culture within international organisations as implementation facilitators. The barriers were low health system functionality, low inter-organisational coordination culture, power asymmetries in decision-making during planning and implementation of nationally-funded and internationally-funded interventions, and non-supportive attitudes among health workers.ConclusionUnderstanding the factors affecting planning and implementation of Sudan’s health programme addressing FGM may potentially mitigate barriers and improve results. Interventions which change midwives’ supportive values and attitudes towards FGM, strengthen health system function and increase intersectoral and multisectoral coordination including equitable decision-making among relevant actors, may be needed to address the reported barriers. The impact of these interventions on the scale, effectiveness and sustainability of the health sector response merits further study.
Effects of ticagrelor and prasugrel on coronary microcirculation in elective percutaneous coronary intervention
Authors: Mangiacapra Fabio , Colaiori Iginio , Di Gioia Giuseppe , Pellicano Mariano , Heyse Alex , Paolucci Luca , Peace Aaron , Bartunek Jozef , de Bruyne Bernard , Barbato Emanuele 
Published: June 2023

ObjectiveTo compare the effects of ticagrelor and prasugrel on absolute coronary blood flow (Q) and microvascular resistance (R) in patients with stable coronary artery disease (CAD) treated with elective percutaneous coronary intervention (PCI) (NCT05643586). Besides being at least as effective as prasugrel in inhibiting platelet aggregation, ticagrelor has been shown to have additional properties potentially affecting coronary microcirculation.MethodsWe randomly assigned 50 patients to ticagrelor (180 mg) or prasugrel (60 mg) at least 12 hours before intervention. Continuous thermodilution was used to measure Q and R before and after PCI. Platelet reactivity was measured before PCI. Troponin I was measured before, 8 and 24 hours after PCI.ResultsAt baseline, fractional flow reserve, Q and R were similar in two study groups. Patients in the ticagrelor group showed higher post-PCI Q (242±49 vs 205±53 mL/min, p=0.015) and lower R values (311 (263, 366) vs 362 (319, 382) mm Hg/L/min, p=0.032). Platelet reactivity showed a negative correlation with periprocedural variation of Q values (r=−0.582, p<0.001) and a positive correlation with periprocedural variation of R values (r=0.645, p<0.001). The periprocedural increase in high-sensitivity troponin I was significantly lower in the ticagrelor compared with the prasugrel group (5 (4, 9) ng/mL vs 14 (10, 24) ng/mL, p<0.001).ConclusionsIn patients with stable CAD undergoing PCI, pretreatment with a loading dose of ticagrelor compared with prasugrel improves post-procedural coronary flow and microvascular function and seems to reduce the related myocardial injury.
Nuclear physics midterm plan in Italy: introduction to the series
Authors: Benzoni G. , Bettoni D. , Bossi F. , Colonna M. , Di Leva A. , Fioretto E. , Formicola A. , Fortunato L. , Gammino S. , Gramegna F. , Gustavino C. , Junker M. , La Cognata M. , Lombardo I. , Nania R. , Pisano S. , Previtali E. , Romano S. , Russotto P. , Soramel F. , Valiente-Dobón J. J. 
Published: June 2023

AbstractIn this contribution, the motivations for a Focus Point on the future nuclear physics researches in the Italian laboratories are described. The organization of the preliminary workshops and of the final reports in this series is described.
Thermal neutron measurement in the STU Mini Labyrinth experiment
Authors: Čerba Š. , Vrban B. , Lüley J. , Filová V. , Nečas V. 
Published: June 2023

AbstractAs part of an international cooperation the research team from the Slovak University of Technology is involved in the development of new radiation shielding experimental workplaces for code verification and demonstration of radiation shielding principles. One of these activities is the so called “Mini Labyrinth” experiment. It is a simple neutron and gamma shielding benchmark, inspired by the ALARM-CF-AIR-LAB-001 ICSBEP experiment. The STU Mini Labyrinth, as its name implies, is a mini version of the original IHEP Labyrinth, currently with dimensions of 96 × 60 × 25 cm. The experimental setup is placed on a special deck in the neutron physics laboratory of STU and uses remote source handling mechanism and video surveillance. It consists of several NEUTRONSTOP C5 shielding blocks (polyethylene with 5% boron), several detector positions and two channels to insert the neutron source and to generate thermal neutrons. The first one is a plastic tank filled with liquid moderator and a second one is a solid graphite prism, which is ideal to produce thermal neutrons. In the previous works of the research team, efforts were made to find the best setup for measurement inside and outside the Mini Labyrinth. It was found out that the 25 cm height was not appropriate, therefore it was increased to 50 cm by adding an extra level of NEUTRONSTOP blocks. This paper brings the results of first measurements performed on the V3-50-R measurement geometry and their comparisons with simulations using the Monaco code from the SCALE 6 system. In this measurement setup, the neutron source is placed inside the graphite prism and the aim is to measure and simulate the thermal neutron count-rate.
Context-aware Big Data Quality Assessment: A Scoping Review
Authors: Fadlallah Hadi , Kilany Rima , Dhayne Houssein , El Haddad Rami , Haque Rafiqul , Taher Yehia , Jaber Ali 
Published: June 2023

The term data quality refers to measuring the fitness of data regarding the intended usage. Poor data quality leads to inadequate, inconsistent, and erroneous decisions that could escalate the computational cost, cause a decline in profits, and cause customer churn. Thus, data quality is crucial for researchers and industry practitioners.Different factors drive the assessment of data quality. Data context is deemed one of the key factors due to the contextual diversity of real-world use cases of various entities such as people and organizations. Data used in a specific context (e.g., an organization policy) may need to be more efficacious for another context. Hence, implementing a data quality assessment solution in different contexts is challenging.Traditional technologies for data quality assessment reached the pinnacle of maturity. Existing solutions can solve most of the quality issues. The data context in these solutions is defined as validation rules applied within the ETL (extract, transform, load) process, i.e., the data warehousing process. In contrast to traditional data quality management, it is impossible to specify all the data semantics beforehand for big data. We need context-aware data quality rules to detect semantic errors in a massive amount of heterogeneous data generated at high speed. While many researchers tackle the quality issues of big data, they define the data context from a specific standpoint. Although data quality is a longstanding research issue in academia and industries, it remains an open issue, especially with the advent of big data, which has fostered the challenge of data quality assessment more than ever.This article provides a scoping review to study the existing context-aware data quality assessment solutions, starting with the existing big data quality solutions in general and then covering context-aware solutions. The strength and weaknesses of such solutions are outlined and discussed. The survey showed that none of the existing data quality assessment solutions could guarantee context awareness with the ability to handle big data. Notably, each solution dealt only with a partial view of the context. We compared the existing quality models and solutions to reach a comprehensive view covering the aspects of context awareness when assessing data quality. This led us to a set of recommendations framed in a methodological framework shaping the design and implementation of any context-aware data quality service for big data. Open challenges are then identified and discussed.
B-cell Receptor Pathway Mutations Are Infrequent in Patients with Chronic Lymphocytic Leukemia on Continuous Ibrutinib Therapy
Authors: Woyach Jennifer A. , Ghia Paolo , Byrd John C. , Ahn Inhye E. , Moreno Carol , O'Brien Susan M. , Jones Daniel , Cheung Leo W.K. , Chong Elizabeth , Kwei Kevin , Dean James P. , James Danelle F. , Wiestner Adrian 
Published: June 2023

Abstract

Purpose:
Acquired mutations in Bruton's tyrosine kinase (BTK) or phospholipase C-γ2 (PLCG2) genes are associated with clinical progressive disease (PD) in patients with chronic lymphocytic leukemia (CLL) treated with BTK inhibitors. Data on mutation rates in patients without PD on ibrutinib treatment are limited.

Experimental Design:
We evaluated frequency and time to detection of BTK and PLCG2 mutations in peripheral blood samples from 388 patients with previously untreated (n = 238) or relapsed/refractory (n = 150) CLL across five clinical trials.

Results:
With median follow-up of 35 months (range, 0–72) without PD at last sampling, mutations in BTK (3%), PLCG2 (2%), or both genes (1%) were rare in previously untreated patients. With median follow-up of 35 months (range, 1–70) without PD at last sample, mutations in BTK (30%), PLCG2 (7%), or both genes (5%) were more common in patients with relapsed/refractory CLL. Median time to first detection of BTK C481S mutation was not reached in previously untreated patients and was &gt;5 years in patients with relapsed/refractory CLL. Among patients evaluable at PD, previously untreated patients (n = 12) had lower rates than those with relapsed/refractory disease (n = 45) of BTK (25% vs. 49%) and PLCG2 mutations (8% vs. 13%). Time from first detection of BTK C481S mutation to PD was 11.3 months in 1 previously untreated patient and median 8.5 months (range, 0–35.7) among 23 patients with relapsed/refractory CLL.

Conclusions:
This systematic investigation describes development of mutations over time in patients without PD and informs the potential clinical opportunity to optimize ongoing benefits for such patients.
Balloon‐Expandable Stenting as a Bridging Therapy in Patients With Acute Stroke and Tandem Occlusions
Authors: Rodríguez‐Villatoro Noelia , Rodríguez‐Luna David , Muchada Marian , Pancorbo Olalla , Deck Matías , Lozano Prudencio , Boned Sandra , García‐Tornel Álvaro , Olivé Marta , Juega Jesús , Pagola Jorge , Rubiera Marta , Hernández David , Molina Carlos , Piñana Carlos , Rodriguez Isabel , De Dios Marta , Cuevas Jose Luis , Requena Manuel , Gramegna Laura Ludovica , Ribó Marc , Tomasello Alejandro 
Published: June 2023

Background
Stenting extracranial internal carotid artery (ICA) lesions in acute ischemic stroke with tandem lesions is technically challenging. Its safety is highly debated because of the requirement of dual‐antiplatelet therapy. The optimal stenting device, timing, and periprocedural antiplatelet therapy for extracranial ICA stenting in the setting of acute tandem occlusion are still unclear.

Methods
We performed a retrospective study of patients with acute ischemic stroke attributable to tandem lesions who underwent endovascular treatment during a 5‐year period receiving either conventional self‐expanding carotid stents (SX) or balloon‐expandable carotid stent (BX). BX stents were restented with an SX in the subacute phase. Primary outcomes of interest were extracranial ICA patency at follow‐up and symptomatic intracranial hemorrhage.

Results

A total of 112 patients admitted from April 2016 to April 2021 were included. Dual‐antiplatelet therapy immediately following endovascular treatment was more frequently administered in the SX group (35/39 [89.7%]) compared with the BX group (20/73 [27.4%]) (
P
<0.001). Patients in the BX stent group (3/73 [4.1%]) developed a lower rate of symptomatic intracranial hemorrhage compared with patients in the SX stent group (7/39 [17.9%]) (
P
=0.031). No differences in extracranial ICA high‐grade restenosis or reocclusion were found between groups at 24 hours after procedure (BX: 20/73 [27.4%]; SX: 9/39 [23.1%];
P
=0.673).

Conclusions
In patients with acute ischemic stroke and tandem occlusions, a bridging therapy including BX stents with less‐aggressive antiplatelet therapy and subsequent definitive SX stenting to treat extracranial ICA lesions resulted in a lower rate of symptomatic hemorrhagic transformation and no differences in stent patency.
Endovascular Surgery Revascularization of Chronic Cervical Carotid Occlusions: Systematic Review and Meta‐Analysis
Authors: Ortega‐Gutierrez Santiago , Galecio‐Castillo Milagros , Zevallos Cynthia B. , Rodriguez‐Calienes Aaron , Vivanco‐Suarez Juan , Weng Julie , Samaniego Edgar A. , Farooqui Mudassir , Derdeyn Colin 
Published: June 2023

Background
Chronic symptomatic internal carotid artery occlusion is an important cause of ischemic strokes. Medical management alone remains suboptimal for secondary prevention, and randomized controlled trials failed to demonstrate the efficacy and safety of extracranial‐intracranial vascular bypass. Carotid occlusion endovascular surgery (COES) is a promising technique, yet its efficacy and safety remain unclear.

Methods
This systematic review and meta‐analysis included studies in which patients with chronic symptomatic internal carotid artery occlusion underwent treatment with COES and medical management. Primary outcomes included successful reperfusion rates and periprocedural ischemic and hemorrhagic events rates. Secondary outcomes included rates of ischemic events recurrence, other periprocedural events, and mortality. Studies contained at least one of the treatment groups and outcomes of interest.

Results

Twenty‐two studies were selected for systematic review, with 18 of them for meta‐analysis. From 14 studies (N=561) the rate of successful recanalization was achieved in 74% of all patients undergoing COES. Thirteen studies (N=534) showed that the rate of COES was 2% both for periprocedural ischemic and hemorrhagic events. At long‐term follow‐up, the COES cohort included a total of 10 studies (N=311) and had a 12% rate of ischemic events, while the medical management group, which included 5 studies (N=313), showed a rate of 19%, with nonsignificant subgroup differences (
P
=0.09,
I
2
, 12%). Rates of other periprocedural mortality were 4% and 1%, respectively.

Conclusion
This meta‐analysis supports the use of COES as a promising and innovative technique for the secondary prevention of symptomatic internal carotid artery occlusion. Our findings suggest that COES may be superior to medical management alone, although further research is needed to fully evaluate its efficacy and safety.
Civil Rights or Civil Wrongs?
Authors: Azuwike Anthony Okechukwu 
Published: June 2023

Abstract
Although the Declaration of Independence stated that “[a]ll men are created equal,” due to the institution of slavery, this statement was not to be grounded in law in the U.S until after the Civil War. Often, American blacks looked to the courts to protect important social values and when the courts ruled in favor, there was always a backlash and resistance to judicial fiat. This paper makes a historical analysis of the South’s response to judicial social change. For instance, when Brown v. Board of Education of Tepeka was decided in 1954, school boards in portions of the country actively resisted the court mandated school integration. Thus, the paper argues that social change should be a gradual process and not a forced enterprise by the courts or indeed, any governmental structure since an assertive judiciary can spark a political and cultural backlash that may hurt, more than help, progressive values.
Unmooring Literary Multilingualism Studies
Authors: Gilmour Rachael 
Published: June 2023

Abstract
This article asks what it would mean for literary multilingualism studies to start by challenging dominant paradigms that govern conceptions of what “multilingualism” means, along lines suggested in applied linguistics in moves towards language practices of the Global South. It takes a cue from Alison Phipps’s call to decolonize multilingualism: turning away from fluency in “too many colonial languages” and towards more contingent ways of being in language, typified by the linguistic “unmooring” experienced by those who become refugees. It finds its model in the poetry of Yousif M. Qasmiyeh, born in Baddawi camp in Lebanon, as a means to reflect on multilingualism beginning from the space of the camp.