bluuebunny/crossref_metadata_2025_split huggingface dataset:
Threshold effects of sleep duration and cognitive function in older adults with BMI ≥ 25 kg/m2
Authors: Qiu Kunyu , Liu Yilei , Hu Chengwei , Gu Jie , Huang Yanyan 
Published: January 2025

BackgroundIt has been demonstrated that older adults’ cognitive capacities can be improved with sleep duration. However, the relationship between overweight, obesity, and cognitive decline remains a subject of debate. The impact of sleep duration on cognitive performance in seniors with a body mass index (BMI) ≥ 25 kg/m2 is largely unknown. This makes it an intriguing subject to explore further.MethodsThis study used data from the National Health and Nutrition Examination Survey (NHANES) (2011–2014) with 2,243 participants. Weighted multivariate linear regression and smooth curve fitting were employed to investigate linear and non-linear relationships. A two-part linear regression model was used to determine the threshold effects. Additionally, subgroup analysis and interaction tests were conducted.ResultsResults showed that a negative association was found between sleep duration and scores in the fully adjusted model in the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) test, the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). A two-piecewise linear regression model was then applied to explore the threshold effect of sleep duration on cognitive performance. When sleep duration was less than 5 and 6 h per day, sleep duration was positively correlated with CERAD test scores [ß (95% CI): 2.11 (1.17, 3.05), p &lt; 0.0001], AFT scores [β (95% CI): 0.25 (−0.17, 0.67), p = 0.2376], and DSST scores [ß (95% CI): 0.49 (−0.57, 1.56), p = 0.3654]. However, there was a threshold effect where sleep duration reached the three inflection points.ConclusionIn overweight and obese older adults, there is a clear inverted U-shaped relationship between sleep duration and cognitive function, with consistent results across different subgroups. Sleep durations of around 5–6 h may help prevent cognitive decline in older adults with a BMI ≥ 25 kg/m2.
Prognostic analysis of endovascular mechanical thrombectomy in stroke patients with acute internal carotid artery obstruction based on circle of Willis variation
Authors: Qiu Tianlun , Luo Huagang , Bao Wuqiao 
Published: January 2025

ObjectiveEndovascular mechanical thrombectomy (EVMT) is widely employed in patients with acute intracranial carotid artery occlusion (AIICAO). This study aimed to predict the outcomes of EVMT following AIICAO by utilizing anatomic classification of the circle of Willis and its relative position to the thrombus.MethodsIn this study, we retrospectively analyzed a cohort of 108 patients with AIICAO who underwent endovascular mechanical thrombectomy (EVMT) at Shaoxing People’s Hospital. Based on variations in the circle of Willis, as well as the size and location of the thrombus occluding the middle cerebral artery (MCA), anterior cerebral artery (ACA), and posterior cerebral artery (PCA), we classified AIICAO into four grades using digital subtraction angiography (DSA). EVMT was initiated upon admission, and baseline data including demographic characteristics, vascular risk factors, angiographic features, initial National Institutes of Health Stroke Scale (NIHSS) scores, Alberta Stroke Program Early CT Score (ASPECT), and etiology classification were compared across these four grades. The prognosis and mortality rates at 90 days post-stroke were evaluated for the different grades and within each grade, patients were further categorized into two subtypes based on vascular compensation and occluded vessels.ResultsSignificant differences were observed among the four grades of Willis compensation concerning etiologic classification (p = 0.008), postoperative modified treatment in cerebral ischemia (mTICI, p = 0.017), postoperative symptomatic intracranial hemorrhage (sICH, p = 0.007), NIHSS score at admission (p = 0.001), and favorable outcomes at 90 days (modified Rankin Score 0–2) (p = 0.003). The mortality rate at 90 days exhibited a significant difference across the four grades of Willis compensation (p = 0.05). However, prognosis did not reveal any significant differences among the various subtypes within the same grade (p &gt; 0.05).ConclusionThe assessment of the degree of Willis compensation can be improved by evaluating the integrity of the circle of Willis, as well as the size and location of the clot in cases of isolated internal carotid artery occlusion (iICAo). This approach provides valuable prognostic indicators and important insights for the pre-selection of patients prior to endovascular mechanical thrombectomy (EVMT).
Associations of reverse triiodothyronine serum levels with anxiety, depression, and health related quality of life after experiencing acute ischemic stroke
Authors: Taroza Saulius , Plamondon Helene , Podlipskyte Aurelija , Kazukauskiene Nijole , Linares Nicolas Francisco Narvaez , Poitras Marilou , Burkauskas Julius , Mickuviene Narseta 
Published: January 2025

AimThis study intended to explore associations of reverse triiodothyronine (rT3) with emotional disturbances and health-related quality of life (HRQoL) after experiencing acute ischemic stroke (AIS).Materials and methodsSerum samples from individuals with AIS were collected on admission to three Lithuania stroke centers and investigated for free tetraiodothyronine, free triiodothyronine (fT3), rT3, and thyroid stimulating hormone levels. At discharge, emotional disturbance was evaluated using the Hospital Depression and Anxiety Scale (HADS), and HRQoL using the EQ-5D-5L scale.ResultsAnalyses included 159 individuals (59.7% male and 40.3% female; mean (SD) aged 66.4 [10.3] years), 52.83% of which showed increased rT3 levels upon admission. After adjustment for age, sex, National Institutes of Health Stroke Scale scores, previous stroke, modified Rankin Scale before AIS ≤ 2, and diabetes mellitus, multivariable linear regression revealed negative associations of rT3 with HADS total score (β = −0.163; p = 0.046) and HADS-D subscale score (β = −0.187; p = 0.019). Analyses supported a positive relationship between the fT3 ratio to rT3 with HADS-D score (β = 0.157; p = 0.046) and rT3, rT3 × fT3 product with EQ-5D index score (β = 0.157; p = 0.044 and β = 0.179; p = 0.023, respectively).ConclusionWe found that individuals who experienced AIS and had higher levels of rT3 at hospital admission had less emotional disturbance and better HRQoL when discharged.
The clinical impact of recent amphetamine exposure in aneurysmal subarachnoid hemorrhage patients
Authors: Vitt Jeffrey R. , Cheng Roger C. , Chung Jason , Caton Travis , Zhou Bo , Ko Nerissa , Meisel Karl , Amorim Edilberto 
Published: January 2025

BackgroundAmphetamines possess sympathomimetic properties that can affect cerebral vasculature though conflicting reports exist about their effect on vasospasm risk and clinical outcomes in aneurysmal subarachnoid hemorrhage. This study aimed to characterize the impact of recent amphetamine use on vasospasm development in aneurysmal subarachnoid hemorrhage as well as neurological outcomes.MethodsWe retrospectively screened 441 consecutive patients admitted with a diagnosis of subarachnoid hemorrhage who underwent at least one cerebral digital subtraction angiogram. Patients were excluded if no urinary toxicology screen was performed within 24 h of admission, if there was a diagnosis of non-aneurysmal subarachnoid hemorrhage, or if ictus was greater than 72 h from hospital admission. Vasospasm characteristics were collected from digital subtraction angiography and transcranial Doppler studies.Results129 patients were included and 24 tested positive for amphetamines on urine drug screen. No significant differences were found in respect to patient age, sex, or admission clinical severity scales (Hunt-Hess and modified Fisher) based on amphetamine use. There was no difference in the severity of vasospasm or time to peak severity based on recent amphetamine use. A trend toward more isolated posterior circulation vasospasm was observed in the amphetamine present group (16.7% vs. 4.8%, p = 0.06), while there was higher incidence of anterior circulation vasospasm in the amphetamine absent group (79.2% vs. 94.3%, p = 0.03). There was no difference in delayed cerebral ischemia incidence, length of hospital stay, need for ventriculoperitoneal shunt placement, functional outcome at discharge or hospital mortality based on amphetamine use.InterpretationRecent amphetamine use was not associated with worse vasospasm severity or delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage patients. Further investigations about localized effects in the posterior circulation and impact on long-term functional outcomes are warranted.
Statins and the incidence of post-stroke depression: a systematic review and meta-analysis
Authors: Cui Chaohua , Li Jue , Chen Weicong 
Published: January 2025

IntroductionPost-stroke depression (PSD) can lead to poorer functional outcomes and prognosis. Brain inflammation is a risk factor for PSD. Statins might be beneficial due to their anti-inflammatory properties. Different studies have yielded varying results regarding the effects of statins. Therefore, this meta-analysis aims to clarify the effect of statins on PSD.MethodsObjectives: To evaluate the relationship between PSD and the use of statins. Data Sources: Databases including PubMed, Web of Science, Embase, and Cochrane Library. Eligibility Criteria: Original observational cohort studies. Participants: Patients with ischemic stroke. Interventions: Use of statins. Appraisal and Synthesis Methods: Forest plot to display pooled results; I2 test to evaluate heterogeneity.ResultsOf the 37 studies selected, four were eligible. The four studies included 93,893 patients (with statins: 45,598) and more than 17,470 PSD patients. The mean age ranged from 62.1 to 70.8 years. The percentage of female participants ranged from 42.1% to 57.9%. For PSD in different regions, the pooled OR for all regions using random-effects methods was 1.21 (95% CI: 0.44–3.33). The pooled OR for Asian populations was 1.42 (95% CI: 0.37–5.40), and for European populations, it was 0.76 (95% CI: 0.73–0.78). The pooled OR for all regions using fixed-effects methods was 0.84 (95% CI: 0.81–0.86). The pooled OR for Asian populations was 2.62 (95% CI: 2.34–2.93).ConclusionDepending on the pooling method used, statin use in Asia either increased or had no relationship with PSD. For European patients, statin use reduced the incidence of PSD.
Low hemoglobin is associated with postoperative cerebral infarction in moyamoya disease: development of a predictive model based on low hemoglobin
Authors: Wu Haitao , Wang Tingxuan , Li Fangbao , Bao Yue , Lu Bin , Li Luo 
Published: January 2025

BackgroundAnemia is considered a risk factor for cardiovascular disease. However, there is little evidence regarding the relationship between hemoglobin (HB) and cerebral infarction after revascularization in patients with moyamoya disease (MMD). This study aimed to explore the relationship between postoperative cerebral infarction and HB in patients with MMD and to establish a predictive model.MethodsDemographic information and different HB levels (the preoperative and postoperative HB, highest and lowest HB, and mean HB during hospitalization) of 112 patients with MMD were collected, of which 11 had cerebral infarction after revascularization.ResultsIn the binomial logistic regression analysis, low HB levels were an independent risk factor for cerebral infarction after revascularization, which also led to a worse long-term prognosis in patients with MMD. The risk factors, including Pre-HB, Post-HB, type of MMD, and hypertension (HTN), were incorporated into the receiver operating characteristic curve, which yielded an area under the curve (AUC) of 0.83.ConclusionThe prediction model was visualized using a nomogram, and a clinical decision curve was drawn to evaluate the net benefit of clinical decisions.
Intravenous fosphenytoin therapy for the rescue of acute trigeminal neuralgia crisis in pre- and post-neurosurgical patients: a retrospective observational study
Authors: Noro Shusaku , Endo Hideki , Asayama Bunsho , Amano Yuki , Okuma Masahiro , Nomura Ryota , Honjo Kaori , Seo Yoshinobu , Nakamura Hirohiko 
Published: January 2025

BackgroundThere is no established treatment for the acute exacerbation of trigeminal neuralgia. We aimed to investigate the efficacy and safety of intravenous fosphenytoin for this disease.MethodsWe conducted a retrospective observational study of data from 41 patients with trigeminal neuralgia who received intravenous fosphenytoin therapy. Fosphenytoin diluted with physiological saline was administered intravenously at a loading dose of 9.8–20.7 mg/kg or at a dose of 7.5–9.5 mg/kg when maintenance therapy was needed. Pain was evaluated using a numerical rating scale (NRS), assessed immediately before administration (baseline) and at 2, 12, and 24 h after administration.ResultsThe mean (± standard deviation) NRS score was 9.85 ± 0.69, 0.49 ± 1.47, 1.60 ± 2.19, and 3.46 ± 3.19 at baseline, 2, 12, and 24 h after administration, respectively (p &lt; 0.001). Intravenous fosphenytoin therapy was effective for the acute exacerbation of trigeminal neuralgia regardless of whether it was administered during the perioperative period of microvascular decompression (MVD) or the type of drugs used concomitantly. Fosphenytoin was effective when re-administered (n = 14) or at a maintenance dose (n = 2). The adverse drug reactions observed were mild dizziness in six patients, abnormal auditory perception and thirst in three patients each, and somnolence, decreased SpO2, and drug eruption in one patient each, all of which were transient.ConclusionsIntravenous fosphenytoin therapy can immediately eliminate pain during acute exacerbation of trigeminal neuralgia and can be a useful therapeutic drug in emergency response or until elective treatment, such as MVD, is performed.
Enhancing intracranial aneurysm rupture risk prediction with a novel multivariable logistic regression model incorporating high-resolution vessel wall imaging
Authors: Wang Zihang , Yan Chang , Yuan Wenqing , Jiang Shuangyan , Jiang Yongxiang , Chen Ting 
Published: January 2025

ObjectiveThis study aimed to develop and validate a multivariate logistic regression model for predicting intracranial aneurysm (IA) rupture by integrating clinical data, aneurysm morphology, and parent artery characteristics using high-resolution vessel wall imaging (HR-VWI).MethodsA retrospective analysis was conducted on 298 patients with 386 aneurysms. Patients were randomly divided into training (n = 308) and validation (n = 78) sets. Key predictors, including aneurysm size, shape, aneurysm wall and parent artery wall enhancement, were identified through univariate analysis and then used to build the prediction model using multivariate logistic regression. The model was visualized as a nomogram and compared to PHASES and ELAPSS scores.ResultsThe logistic regression model demonstrated superior predictive performance with an area under the curve of 0.814, which was significantly higher than PHASES and ELAPSS scores (p &lt; 0.05). The model revealed strong calibration and good agreement between predicted and observed rupture probabilities.ConclusionThe multivariate model based on HR-VWI, which incorporates aneurysm and parent artery features, provides a more accurate prediction of IA rupture risk than conventional scoring systems, offering a valuable tool for clinical decision-making.
Retrospective cohort study based on the MIMIC-IV database: analysis of factors influencing all-cause mortality at 30 days, 90 days, 1 year, and 3 years in patients with different types of stroke
Authors: Fan Xuehui , Xu Jing , Ye Ruixue , Zhang Qiu , Wang Yulong 
Published: January 2025

ObjectiveThis study aims to evaluate key factors influencing the short-term and long-term prognosis of stroke patients, with a particular focus on variables such as body weight, hemoglobin, electrolytes, kidney function, organ function scores, and comorbidities. Stroke poses a significant global health burden, and understanding its prognostic factors is crucial for clinical management.MethodsThis is a retrospective cohort study based on data from the MIMIC-IV database, including stroke patients from 2010 to 2020. A total of 5,110 patients aged 18 and older were included in the study. The exposure variables included body weight and hemoglobin levels, while the outcome variables were the 30-day, 90-day, 1-year, and 3-year mortality risks. Covariates included electrolyte levels, kidney function, organ function scores, and comorbidities. Random forest and gradient boosting tree models were employed for data analysis to assess mortality risk.ResultsKaplan–Meier survival analysis showed that ischemic stroke patients had the highest 30-day mortality rate at 8.5%, with only 20% 1-year survival. Traumatic subarachnoid hemorrhage patients had the best prognosis, with a 1-year survival rate of 60%. Multivariable Cox regression analysis revealed that each 1-point increase in the Charlson Comorbidity Index raised the 1-year and 3-year mortality risks by 1.39 times (95% CI: 1.10–1.56) and 1.44 times, respectively. Each 1-point increase in the SOFA score increased the 30-day, 90-day, 1-year, and 3-year mortality risks by 2.11 times, 2.03 times, and 1.84 times, respectively. Additionally, lower hemoglobin levels were significantly associated with increased mortality, with 30-day, 90-day, and 1-year mortality risks increasing by 3.33 times, 3.34 times, and 4.16 times, respectively (p &lt; 0.005). Age ≥ 71 years, longer hospital stays, and organ dysfunction were also significant factors affecting mortality.ConclusionThis study highlights the critical role of stroke type, comorbidity index, SOFA score, hemoglobin levels, and length of hospital stay in stroke prognosis. These findings provide valuable insights for clinical risk assessment and the development of individualized treatment strategies, which may improve the management and outcomes of stroke patients. The predictive model constructed effectively assesses mortality risks in stroke patients, offering support for future clinical practice.
Prebiotics as an adjunct therapy for posttraumatic stress disorder: a pilot randomized controlled trial
Authors: Voigt Robin M. , Engen Phillip A. , Villanueva Michelle , Bambi Simona A. , Green Stefan J. , Naqib Ankur , Raeisi Shohreh , Shaikh Maliha , Hamaker Bruce R. , Cantu-Jungles Thaisa M. , Pridgen Sarah A. , Held Philip , Keshavarzian Ali 
Published: January 2025

IntroductionPosttraumatic stress disorder (PTSD) is a debilitating disorder characterized by intrusive memories, avoidance, negative thoughts and moods, and heightened arousal. Many patients also report gastrointestinal symptoms. Cognitive behavioral therapy (CBT) is an evidence-based treatment approach for PTSD that successfully reduces symptoms. However, many patients still meet criteria for PTSD after treatment or continue to have symptoms indicating the need for new treatment strategies for PTSD. Patients with PTSD have a disrupted intestinal microbiome (i.e., dysbiosis) which can promote neuroinflammation; thus, modulation of the microbiome could be an alternative or adjunct treatment approach for PTSD.MethodsThe current study was a 12-week, double-blind, placebo-controlled trial seeking to understand if CBT combined with a microbiota-modifying, prebiotic fiber intervention would beneficially impact clinical outcomes in veterans with PTSD (n = 70). This proof-of-concept, pilot trial was designed to assess: (1) the relationship between severity of PTSD symptoms and microbiota composition and SCFA levels (i.e., acetate, propionate, butyrate), (2) if CBT treatment with a concomitant prebiotic fiber intervention would beneficially impact clinical outcomes in veterans with PTSD, (3) evaluate the feasibility and acceptability of a prebiotic intervention as an adjunct treatment to CBT, and (4) assess the impact of treatment on the intestinal microbiota and stool SCFA (i.e., mechanism).ResultsThis study found that PTSD severity may be associated with reduced abundance of taxa capable of producing the SCFA propionate, and that a subset of individuals with PTSD may benefit from a microbiota-modifying prebiotic intervention.ConclusionThis study suggests that targeting the intestinal microbiome through prebiotic supplementation could represent a promising avenue for enhancing treatment outcomes in some individuals with PTSD.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT05424146.
ClinClip: a Multimodal Language Pre-training model integrating EEG data for enhanced English medical listening assessment
Authors: Sun Guangyu 
Published: January 2025

IntroductionIn the field of medical listening assessments,accurate transcription and effective cognitive load management are critical for enhancing healthcare delivery. Traditional speech recognition systems, while successful in general applications often struggle in medical contexts where the cognitive state of the listener plays a significant role. These conventional methods typically rely on audio–only inputs and lack the ability to account for the listener's cognitive load, leading to reduced accuracy and effectiveness in complex medical environments.MethodsTo address these limitations, this study introduces ClinClip, a novel multimodal model that integrates EEG signals with audio data through a transformer-based architecture. ClinClip is designed to dynamically adjust to the cognitive state of the listener, thereby improving transcription accuracy and robustness in medical settings. The model leverages cognitive-enhanced strategies, including EEG-based modulation and hierarchical fusion of multimodal data, to overcome the challenges faced by traditional methods.Results and discussionExperiments conducted on four datasets–EEGEyeNet, DEAP, PhyAAt, and eSports Sensors–demonstrate that ClinClip significantly outperforms six state-of-the-art models in both Word Error Rate (WER) and Cognitive Modulation Efficiency (CME). These results underscore the model's effectiveness in handling complex medical audio scenarios and highlight its potential to improve the accuracy of medical listening assessments. By addressing the cognitive aspects of the listening process. ClinClip contributes to more reliable and effective healthcare delivery, offering a substantial advancement over traditional speech recognition approaches.