bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of failure of early neurological improvement in early time window following endovascular thrombectomy: a multi-center study
Authors: Lai Yuzheng , Diana Francesco , Mofatteh Mohammad , Nguyen Thanh N. , Jou Eric , Zhou Sijie , Sun Hao , He Jianfeng , Yan Wenshan , Chen Yiying , Feng Mingzhu , Chen Junbin , Ma Jicai , Li Xinyuan , Meng Heng , Abdalkader Mohamad , Chen Yimin 
Published: September 2023

Background and objectiveEndovascular thrombectomy (EVT) has become the gold standard in the treatment of acute stroke patients. However, not all patients respond well to this treatment despite successful attempts. In this study, we aimed to identify variables associated with the failure of improvements following EVT.MethodsWe retrospectively analyzed prospectively collected data of 292 ischemic stroke patients with large vessel occlusion who underwent EVT at three academic stroke centers in China from January 2019 to February 2022. All patients were above 18 years old and had symptoms onset ≤6 h. A decrease of more than 4 points on the National Institute of Health Stroke Scale (NIHSS) after 24 h compared with admission or an NIHSS of 0 or 1 after 24 h was defined as early neurological improvement (ENI), whereas a lack of such improvement in the NIHSS was defined as a failure of early neurological improvement (FENI). A favorable outcome was defined as a modified Rankin scale (mRS) score of 0–2 after 90 days.ResultsA total of 183 patients were included in the final analyses, 126 of whom had FENI, while 57 had ENI. Favorable outcomes occurred in 80.7% of patients in the ENI group, in contrast to only 22.2% in the FENI group (p &lt; 0.001). Mortality was 7.0% in the ENI group in comparison to 42.1% in the FENI group (p &lt; 0.001). The multiple logistic regression model showed that diabetes mellitus [OR (95% CI), 2.985 (1.070–8.324), p = 0.037], pre-stroke mRS [OR (95% CI), 6.221 (1.421–27.248), p = 0.015], last known well to puncture time [OR (95% CI), 1.010 (1.003–1.016), p = 0.002], modified thrombolysis in cerebral infarction = 3 [OR (95% CI), 0.291 (0.122–0.692), p = 0.005], and number of mechanical thrombectomy passes [OR (95% CI), 1.582 (1.087–2.302), p = 0.017] were the predictors of FENI.ConclusionDiabetes mellitus history, pre-stroke mRS, longer last known well-to-puncture time, lack of modified thrombolysis in cerebral infarction = 3, and the number of mechanical thrombectomy passes are the predictors of FENI. Future large-scale studies are required to validate these findings.
The prevalence and impact of tension-type headache in school-aged children in Iran
Authors: Togha Mansoureh , Jafari Elham , Salami Zhale , Kamali Koorosh , Mirzaee Godarzee Hadis , Mirzaee Godarzee Mohadeseh , Bavarnegin Sanaz 
Published: September 2023

BackgroundTension-Type Headache (TTH) is regarded as the third most prevalent disorder worldwide, prompting children to seek medical attention. Our objective is to investigate the prevalence of TTH among students aged 6 to 18 years in various geographical regions of Iran, while also assessing the impact of headaches on their quality of life.MethodsEmploying a cross-sectional survey, we have carefully distributed self-completed structured questionnaires to students in 121 meticulously selected schools throughout the country, ensuring the representation of its diverse population.ResultsAmong the 2,958 potential participants, we have included a total of 2031 individuals in our study. This comprises 57.3% children and 42.7% adolescents, with 50.02% being males and 49.97% females. Specifically, we have examined 950 subjects with TTH and 1,081 individuals without any form of headache. TTH was diagnosed in 32.1% of the participants. Notably, we have observed a significant difference in the average age between the TTH subjects and those without headaches. Participants without headaches were more likely to be enrolled in primary schools, while those diagnosed with TTH predominantly attended high schools. We found no significant relationship between urban–rural areas or different geographic regions and the prevalence of TTH or its subtypes. Phonophobia was commonly associated with TTHs. Lastly, the mean quality-of-life score was highest for individuals without headaches, followed by those with low frequency episodic TTH, high frequency episodic TTH, and chronic TTHs. There was also a significant relation between headache severity and quality of life scores.ConclusionThe significant prevalence of TTH in children and adolescents and its adverse impact on the daily activities of individuals underscore the utmost importance of accurate diagnosis and efficient management.
Benchmarking ChatGPT-4 on a radiation oncology in-training exam and Red Journal Gray Zone cases: potentials and challenges for ai-assisted medical education and decision making in radiation oncology
Authors: Huang Yixing , Gomaa Ahmed , Semrau Sabine , Haderlein Marlen , Lettmaier Sebastian , Weissmann Thomas , Grigo Johanna , Tkhayat Hassen Ben , Frey Benjamin , Gaipl Udo , Distel Luitpold , Maier Andreas , Fietkau Rainer , Bert Christoph , Putz Florian 
Published: September 2023

PurposeThe potential of large language models in medicine for education and decision-making purposes has been demonstrated as they have achieved decent scores on medical exams such as the United States Medical Licensing Exam (USMLE) and the MedQA exam. This work aims to evaluate the performance of ChatGPT-4 in the specialized field of radiation oncology.MethodsThe 38th American College of Radiology (ACR) radiation oncology in-training (TXIT) exam and the 2022 Red Journal Gray Zone cases are used to benchmark the performance of ChatGPT-4. The TXIT exam contains 300 questions covering various topics of radiation oncology. The 2022 Gray Zone collection contains 15 complex clinical cases.ResultsFor the TXIT exam, ChatGPT-3.5 and ChatGPT-4 have achieved the scores of 62.05% and 78.77%, respectively, highlighting the advantage of the latest ChatGPT-4 model. Based on the TXIT exam, ChatGPT-4’s strong and weak areas in radiation oncology are identified to some extent. Specifically, ChatGPT-4 demonstrates better knowledge of statistics, CNS &amp; eye, pediatrics, biology, and physics than knowledge of bone &amp; soft tissue and gynecology, as per the ACR knowledge domain. Regarding clinical care paths, ChatGPT-4 performs better in diagnosis, prognosis, and toxicity than brachytherapy and dosimetry. It lacks proficiency in in-depth details of clinical trials. For the Gray Zone cases, ChatGPT-4 is able to suggest a personalized treatment approach to each case with high correctness and comprehensiveness. Importantly, it provides novel treatment aspects for many cases, which are not suggested by any human experts.ConclusionBoth evaluations demonstrate the potential of ChatGPT-4 in medical education for the general public and cancer patients, as well as the potential to aid clinical decision-making, while acknowledging its limitations in certain domains. Owing to the risk of hallucinations, it is essential to verify the content generated by models such as ChatGPT for accuracy.
Post-marketing safety surveillance of dalfampridine for multiple sclerosis using FDA adverse event reporting system
Authors: Xiong Rui , Lei Jing , Pan Sicen , Zhang Hong , Tong Yongtao , Wu Wei , Huang Yi , Lai Xiaodan 
Published: September 2023

Objective: To investigate and analyze the post-marketing adverse event (AE) data of multiple sclerosis (MS) therapeutic drug dalfampridine using the US Food and Drug Administration Adverse Event Reporting System (FAERS) for its clinical safety application.Methods: Use OpenVigil2.1 platform to obtain AE data of dalfampridine from FAERS from February 2010 to September 2022. Match “adverse drug reaction” with preferred term (PT) and system organ class (SOC) according to the Medical Dictionary for Regulatory Activities (MedDRA), then merge the same PT and delete non-AE PT. Positive signals were identified by the reporting odds ratio (ROR), proportional reporting ratio (PRR), and Bayesian confidence propagation neural network (BCPNN) methods. When AE signals met the criteria of those three methods, they were identified as positive signals.Results: A total of 44,092 dalfampridine-related AE reports were obtained, and 335 AE signals were identified, including 11,889 AE reports. AEs were more common in females and in the 45–65 age group, which is consistent with the epidemiological characteristics of MS. The 335 AE signals involved 21 SOCs, including investigations, infections and infestations, eye disorders, etc. Among the top 20 PTs in signal strength, 10 were associated with abnormal lymphocyte percentage and count, and 5 were associated with abnormal urine tests, some of which were not described in the instruction, such as spinal cord injury cauda equina, haemoglobin urine present, urinary sediment abnormal and so on. The most frequently reported AE signals were urinary tract infection, dizziness, condition aggravated. In addition, 23 AE signals with death outcomes were identified, with an incidence of less than 0.1%.Conclusion: Data mining of FAERS was conducted to analyze the AEs of dalfampridine, and new AE signals were found. This study provides a reference for the safe use of dalfampridine in the treatment of MS.
Transcriptomic analysis reveals that methyl jasmonate confers salt tolerance in alfalfa by regulating antioxidant activity and ion homeostasis
Authors: Yin YanLing , Yang TianHui , Li Shuang , Li Xiaoning , Wang Wei , Fan ShuGao 
Published: September 2023

IntroductionAlfalfa, a globally cultivated forage crop, faces significant challenges due to its vulnerability to salt stress. Jasmonates (JAs) play a pivotal role in modulating both plant growth and response to stressors.MethodsIn this study, alfalfa plants were subjected to 150 mM NaCl with or without methyl jasmonate (MeJA). The physiological parameters were detected and a transcriptomic analysis was performed to elucidate the mechanisms underlying MeJA-mediated salt tolerance in alfalfa.ResultsResults showed that exogenous MeJA regulated alfalfa seed germination and primary root growth in a dose-dependent manner, with 5µM MeJA exerting the most efficient in enhancing salt tolerance. MeJA at this concentration elavated the salt tolerance of young alfalfa seedlings by refining plant growth, enhancing antioxidant capacity and ameliorating Na+ overaccumulation. Subsequent transcriptomic analysis identified genes differentially regulated by MeJA+NaCl treatment and NaCl alone. PageMan analysis revealed several significantly enriched categories altered by MeJA+NaCl treatment, compared with NaCl treatment alone, including genes involved in secondary metabolism, glutathione-based redox regulation, cell cycle, transcription factors (TFs), and other signal transductions (such as calcium and ROS). Further weighted gene co-expression network analysis (WGCNA) uncovered that turquoise and yellow gene modules were tightly linked to antioxidant enzymes activity and ion content, respectively. Pyruvate decar-boxylase (PDC) and RNA demethylase (ALKBH10B) were identified as the most central hub genes in these two modules. Also, some TFs-hub genes were identified by WGCNA in these two modules highly positive-related to antioxidant enzymes activity and ion content.DiscussionMeJA triggered a large-scale transcriptomic remodeling, which might be mediated by transcriptional regulation through TFs or post-transcriptional regulation through demethylation. Our findings contributed new perspectives for understanding the underneath mechanisms by which JA-mediated salt tolerance in alfalfa.
Predicting student-teacher self-directed learning using intrinsic and extrinsic factors: a Theory of Planned Behavior adoption
Authors: Sukkamart Aukkapong , Pimdee Paitoon , Leekitchwatana Punnee , Kongpiboon Watcharin , Kantathanawat Thiyaporn 
Published: September 2023

IntroductionThis study set out to develop a model that illustrates the causal relationship between factors influencing Thai student-teacher self-directed learning (SDL). To achieve this, the authors analyzed and applied the Theory of Planned Behavior (TPB) to investigate the role of family support, teacher support, friend support, fellow students, and the university in influencing SDL.MethodsThe research used a sample of 468 student-teachers from five academic majors randomly selected from the King Mongkut’s Institute of Technology Ladkrabang (KMITL) Bachelor of Industrial Education Program during the 2021 academic year. The authors developed a questionnaire which was evaluated from both a panel of experts and a 30 student-teacher pilot test which found that item reliability was acceptable. LISREL 9.10 was used to analyze the data from the study’s structural equation model path analysis.ResultsThe results revealed that all the causal variables in the model positively influenced SDL, explaining the variance of influencing factors on SDL (R2) at 51%. SDL comprised five variables, when ranked in order of importance these were fellow students (FSt), teacher support (TS), family support (FS), friend support (FrS), and their university (Uni). The study also highlighted issues concerning each student-teacher’s learning time management ability and their perception of the university’s ability/willingness to allow each individual to choose their course, thus enhancing their SDL learning ability skills.DiscussionIt was speculated that some university educators even today perceive SDL as an adult education tool which they perceive is not appropriate at the university level. The authors also felt that for younger student-teachers that the COVID-19 medical emergency limited teacher/student/university interaction, thus contributing to student misconceptions about support availability. This study contributes significantly to the literature by investigating how TPB intrinsic and extrinsic factors impact a university student’s self-directed learning.
Study on anxiety, depression, and subjective wellbeing of patients with bladder cancer in their different chemotherapy stages
Authors: Yang Jie , Tan Yingchun , Yao Chunlin 
Published: September 2023

Aims and objectivesThis study aims to explore the changes in anxiety, depression, and subjective wellbeing in patients with bladder perfusion during different stages of their chemotherapy, and analyze the correlation among their anxiety, depression, and subjective wellbeing.MethodsA total of 174 patients with bladder cancer who received bladder perfusion chemotherapy were selected. The questionnaire survey was conducted with SAS, SDS, and GWB. The patients were surveyed and the data were analyzed.ResultsThe results of patients' anxiety, depression, and subjective wellbeing show a dynamic change trend. The change is most obvious after 1 month of chemotherapy and tends to be flat after 3 months of chemotherapy. The scores of anxiety, depression, and subjective wellbeing in patients with bladder perfusion at different stages are statistically significant (P &lt; 0.05). There is a negative correlation among anxiety, depression, and subjective wellbeing in patients (r = −0.605, 0.601).ConclusionPatients' emotions change obviously in the first 3 months of their chemotherapy. Clinical workers can take active intervention measures in this period, guide patients to relieve their anxiety and depression, increase their subjective wellbeing level, and improve their quality of life, which is helpful to ensure the successful completion of chemotherapy.
Implementing depression care in under-resourced communities: a school-based family resilience skill-building pilot randomized controlled trial in the United States
Authors: Marlotte Lauren , Klomhaus Alexandra , Ijadi-Maghsoodi Roya , Aralis Hilary , Lester Patricia , Griffin Esperon Kim , Kataoka Sheryl 
Published: September 2023

IntroductionYouth in under-resourced communities are more likely to have greater social risk factors for mental health needs yet have less access to needed care. School-based mental health services are effective in treating common disorders such as adolescent depression; however, few have a family-centered approach, which may especially benefit specific populations.MethodsUtilizing a community-partnered approach, we adapted an established, trauma-informed, resilience skill-building family intervention for adolescents with depression. We conducted a small randomized controlled feasibility pilot of an adapted intervention in a large school district that serves predominately low-income, Latinx students in the Southwest United States between 2014-2017. Youth between the ages of 12-18 years old with a Patient Health Questionnaire (PHQ-8) score of 10 or higher, who spoke English or Spanish, were recruited from 12 school mental health clinics. Twenty-five eligible adolescents with depression and their participating caregivers were enrolled and randomly assigned to receive either the adapted intervention, Families OverComing Under Stress for Families with Adolescent Depression (FOCUS-AD), or usual care, Cognitive Behavioral Therapy (CBT) only. Most of the sample was Latinx and female. We evaluated feasibility, acceptability, and preliminary effectiveness.ResultsAmong participants who completed standardized assessments administered at baseline and approximately five months post-randomization (n = 10 FOCUS-AD, n = 11 CBT only), effectiveness was explored by identifying significant changes over time in adolescent mental health within the FOCUS-AD and CBT only groups and comparing the magnitude of these changes between groups. Nonparametric statistical tests were used. We found the FOCUS-AD intervention to be feasible and acceptable; participant retention was high. Adolescent symptoms of depression (measured by the PHQ-8) improved significantly from baseline to follow-up for youth in both FOCUS-AD (median decrease [MD] = 10, p = 0.02) and control (MD = 6, p = 0.01) groups, with no significant difference across the two groups. Results were similar for symptoms of PTSD (measured by the Child PTSD Symptom Scale; FOCUS-AD MD = 12.5, p = 0.01; CBT only MD = 7, p = 0.04; no significant difference between groups).ConclusionFamily-centered approaches to depression treatment among adolescents living in under-resourced communities may lead to improved mental health, although further research is warranted.
Unraveling complexity in changing mental health care towards person-centered care
Authors: Lorenz-Artz Karin , Bierbooms Joyce , Bongers Inge 
Published: September 2023

BackgroundMental health care (MHC) needs to shift towards person-centered care to better meet people’s individual needs. Open Dialogue (OD) is well-aligned with this perspective and brings it into practice. This study focuses on exploring the change process within a pilot project involving three MHC teams as they transition to a person-centered OD practice. Our aim is to identify and reflect on the challenges faced by MHC professionals in adopting person-centered care, and shedding light on the underlying complexity of these challenges. By gaining a better understanding of these obstacles, we hope to contribute to the adoption of the person-centered approach in MHC practice.MethodsOur research employed a qualitative design, involving a total of 14 semi-structured interviews with MHC professionals who were either trained in OD, OD trainees, or MHC professionals without OD training. To analyze the data, we utilized a hybrid approach that combined deductive – and inductive thematic analysis.ResultsWe identified four distinctive challenges: (1) understanding and knowledge transfer, (2) (inter)personal process, (3) emotional discomfort, and (4) the need for multi-stakeholder participation and support. In practice, these challenges intersect and the appearance of and relationships between these challenges are not linear or disentangleable.ConclusionUpon careful consideration of these interdependent challenges, it became evident that embedding a person-centered approach like OD brings about systemic change, leading to an unfamiliar situation X. The research findings indicated that understanding and conveying the concept of person-centered care in practical settings poses significant challenges. The field of knowledge management helps to capture the complexity of understanding and transferring this knowledge. The change process necessitates an (inter)personal process and elicits emotional discomfort, as person-centered OD practice confronts a deeply entrenched paradigm in MHC. Achieving a shared understanding of person-centered care requires dedicated time and attention, while introducing this approach prompts broader discussions on underlying values and human rights in MHC. Current implementation efforts may underestimate or overlook these underlying values, but initiating an open dialogue can serve as an initial step in addressing the complexities.
Factors influencing COVID-19 testing among Native Americans and Latinos in two rural agricultural communities: a qualitative study
Authors: Van Rensburg Dillon , Adams Alexandra K. , Perez Georgina , Bishop Sonia , Warne Teresa , Hassell Laurie , Quigley Thomas , Garza Lorenzo , Dupuis Virgil , Drain Paul K. , Whiting Sorrell Anna , Ko Linda K. 
Published: September 2023

ObjectiveTo examine factors influencing decisions to test for COVID-19 among Native Americans on the Flathead Reservation in Montana and the Latino community in the Yakima Valley of Washington state.MethodsWe conducted 30 key informant interviews with community leaders and six focus groups with community members to examine factors impacting decisions to test for COVID-19 during the second year of the COVID-19 pandemic from May 2021 to June 2021.ResultsThree major themes that impacted testing for COVID-19 were identified: (1) Social factors, including the influence of families and friends and employment practices; (2) health factors, including testing procedures, home-based testing, and health communication; and (3) contextual factors, including distrust for government and medical communities and the impact on cultural practices and celebrations.ConclusionsSocial, health, and contextual factors influence the decision to test for COVID-19. Understanding the community's perception is critical for successful implementation of preventive strategies.
Qualitative assessment in the third month of life allows for a better prognosis of the achievement of motor milestones versus assessment of pathological reflexes- prospective studies on Polish children
Authors: Surowińska Joanna , Sobieska Magdalena , Gajewska Ewa 
Published: September 2023

IntroductionThe characteristic feature of primitive reflexes is that they occur early in development and must expire at a well-defined age. The study was conducted prospectively on a group of 107 children (74 boys). The study population included 83 infants born on time (weight 3,465 ± 395 g) and 24 born prematurely (weight 2,225 ± 793 g).MethodsAn analysis of motor development at 3 months of age consisting of a qualitative assessment (motor performance) and a check of reflexes was performed; at 9 months, the child was checked for crawling and sitting down, and at 16 months for walking.ResultsThe more abnormal reflexes, the less likely it was to achieve the assessed milestones in time. It is possible to notice that the qualitative assessment is, in each case, a better predictor of the milestones than any of the reflexes, except for walking, where the Babkin reflex was strongly predictive. However, the qualitative assessment sum still occupies the second and third positions in prone and supine positions.DiscussionThe occurrence of Babkin’s reflex at 3 months of age impacts the achievement of sitting down and walking functions. An abnormal Galant reflex was strongly associated with the lack of occurrence of crawling on time. At the same time, a high-quality score at 3 months of age guarantees the development of crawling on time, sitting down, and walking.