bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of tenecteplase versus alteplase in stroke patients with carotid tandem lesions: Results from the AcT trial
Authors: Bala Fouzi , Almekhlafi Mohammed , Singh Nishita , Alhabli Ibrahim , Ademola Ayoola , Coutts Shelagh B , Deschaintre Yan , Khosravani Houman , Appireddy Ramana , Moreau Francois , Phillips Stephen , Gubitz Gord , Tkach Aleksander , Catanese Luciana , Dowlatshahi Dar , Medvedev George , Mandzia Jennifer , Pikula Aleksandra , Shankar Jay , Williams Heather , Field Thalia S , Manosalva Alejandro , Siddiqui Muzaffar , Zafar Atif , Imoukhoude Oje , Hunter Gary , Benali Faysal , Horn MacKenzie , Hill Michael D , Shamy Michel , Sajobi Tolulope T , Buck Brian H , Swartz Richard H , Menon Bijoy K , Poppe Alexandre Y 
Published: September 2023

Background: Carotid tandem lesions ((TL) ⩾70% stenosis or occlusion) account for 15–20% of acute stroke with large vessel occlusion. Aims: We investigated the safety and efficacy of intravenous tenecteplase (0.25 mg/kg) versus intravenous alteplase (0.9 mg/kg) in patients with carotid TL. Methods: This is a substudy of the alteplase compared with the tenecteplase trial. Patients with ⩾70% stenosis of the extracranial internal carotid artery (ICA) and concomitant occlusion of the intracranial ICA, M1 or M2 segments of the middle cerebral artery on baseline computed tomography angiography (CTA) were included. Primary outcome was 90-day-modified Rankin Scale (mRS) 0–1. Secondary outcomes were mRS 0–2, mortality, and symptomatic ICH (sICH). Angiographic outcomes were successful recanalization (revised Arterial Occlusive Lesion (rAOL) 2b–3) on first and successful reperfusion (eTICI 2b–3) on final angiographic acquisitions. Multivariable mixed-effects logistic regression was performed. Results: Among 1577 alteplase versus tenecteplase randomized controlled trial (AcT) patients, 128 (18.8%) had carotid TL. Of these, 93 (72.7%) underwent intravenous thrombolysis plus endovascular thrombectomy (IVT + EVT), while 35 (27.3%) were treated with IVT alone. In the IVT + EVT group, tenecteplase was associated with higher odds of 90-day-mRS 0–1 (46.0% vs. 32.6%, adjusted OR (aOR) 3.21; 95% CI = 1.06–9.71) compared with alteplase. No statistically significant differences in rates of mRS 0–2 (aOR 1.53; 95% CI = 0.51–4.55), initial rAOL 2b–3 (16.3% vs. 28.6%), final eTICI 2b–3 (83.7% vs. 85.7%), and mortality (18.0% vs. 16.3%) were found. SICH only occurred in one patient. There were no differences in outcomes between thrombolytic agents in the IVT-only group. Conclusion: In patients with carotid TL treated with EVT, intravenous tenecteplase may be associated with similar or better clinical outcomes, similar angiographic reperfusion rates, and safety outcomes as compared with alteplase.
Safety and efficacy with alemtuzumab over 13 years in relapsing-remitting multiple sclerosis: final results from the open-label TOPAZ study
Authors: Coles Alasdair J. , Achiron Anat , Traboulsee Anthony , Singer Barry A. , Pozzilli Carlo , Oreja-Guevara Celia , Giovannoni Gavin , Comi Giancarlo , Freedman Mark S. , Ziemssen Tjalf , Shiota Debora , Rawlings Andreea M. , Wong Alana T. , Chirieac Magdalena , Montalban Xavier 
Published: September 2023

Background and objectives: Alemtuzumab demonstrated superior efficacy versus subcutaneous interferon (IFN) beta-1a in participants with relapsing-remitting multiple sclerosis in the 2-year CARE-MS I and II trials. Efficacy was maintained in the 4-year CARE-MS extension, during which alemtuzumab-treated participants (‘alemtuzumab-only’) could receive additional courses upon disease activity, and IFN-treated participants switched to alemtuzumab (‘IFN-alemtuzumab’). Participants who completed the CARE-MS extension could enroll in the open-label TOPAZ study which assessed safety and efficacy for 5–7 years (11–13 years after alemtuzumab/IFN initiation). Methods: Participants received additional alemtuzumab courses as needed. Assessments included adverse events (AEs; primary outcome), annualized relapse rate (ARR), 6-month confirmed disability worsening [CDW; ⩾1.0-point Expanded Disability Status Scale (EDSS) score increase or ⩾1.5 if baseline EDSS = 0], and 6-month confirmed disease improvement [CDI; >1.0-point EDSS decrease (baseline score ⩾2.0)]. Results: 43.5% of alemtuzumab-only participants from CARE-MS II and 54.2% from CARE-MS I received no additional alemtuzumab courses; 30.0% and 20.9%, respectively, received one additional course (the median). Incidences of AEs, including thyroid AEs and infections, declined over time. The safety profile of alemtuzumab was similar for participants who received zero, one, or two additional courses. For CARE-MS II participants, who had inadequate response to previous treatment, ARR remained low during Years 3–13 for the alemtuzumab-only [0.17; 95% confidence interval (CI) 0.15–0.20] and IFN-alemtuzumab (0.14; 0.11–0.17) groups. At Year 11, the proportions of participants who were either free from CDW or who had CDI were higher in the alemtuzumab-only group (58% and 49%, respectively) than in the IFN-alemtuzumab group (51% and 37%). For CARE-MS I participants, who were previously treatment-naïve, clinical outcomes remained improved, and no between-group differences were apparent. Conclusion: Safety risks associated with alemtuzumab treatment declined over time. Clinical benefits were maintained up to 11–13 years, and most participants did not require more than one additional course. Clinicaltrials.gov identifiers: NCT00530348; NCT00548405; NCT00930553; NCT02255656
The Associations Between Wellbeing and Injury Differ by Time Loss in Collegiate Athletes
Authors: Sanfilippo Jennifer L. , Hoffmann Courtney N. , Haraldsdottir Kristin , Steiner Quinn , Watson Andrew M. 
Published: September 2023

Background: Self-reported wellbeing measures such as mood and soreness have been identified as predictors of injury risk. However, most research has focused on investigating time-loss injuries even though nontime-loss injuries are more prevalent. Hypothesis: Impairments in sleep and subjective wellbeing would be associated with increased injury for both time-loss and nontime-loss injuries. Study Design: Prospective longitudinal study. Level of Evidence: Level 3. Methods: During 2022, 127 athletes completed a daily survey that inquired about training load and sleep from the previous day along with mood, stress, and soreness on the current day. Incidence of injury was also monitored using documentation provided by athletes’ respective athletic trainers. Mixed effect models were used to analyze the relationship between wellbeing and sleep measures with injury. Results: Self-reported wellbeing, based most closely on soreness the day of injury, by National Collegiate Athletic Association Division 1 collegiate athletes was predictive of time-loss injuries, whereas no significant relationship was identified for nontime-loss injuries. Specifically, 1 unit increase in soreness was associated with a 39% increase in odds of sustaining a time-loss injury. Conclusion: This study found that subjective wellbeing and sleep have a different relationship with injury dependent upon whether the resulting injury leads to time loss. Clinical Relevance: Self-reported wellbeing appears to be a relevant predictor of injury among collegiate athletes for time-loss injuries.
Layout considerations on compound survival shelters for blast mitigation: A finite-element approach
Authors: Caçoilo Andreia , Mourão Rodrigo , Lecompte David , Teixeira-Dias Filipe 
Published: September 2023

The safety of both military personnel and equipment in unstable regions has for a long time been a major issue and concern. Protective shelters with multiple configurations have been widely used to meet safety requirements. Since military compounds are subjected to different types of threats, such as the detonation of improvised explosive devices (IED), a good understanding of the response of such shielding structures to blast waves is critical. A three-dimensional finite element (FE) model of a corner-entry ISO 20 ft container HESCO-Bastion survival shelter is developed, validated and tested under the external detonation of explosive charges. The FE model is validated against experimental data and used to investigate the protective performance of the shelter by considering several design-related parameters, such as charge location, roof extension, interior corridor dimensions and the effect of venting and its location. Results are discussed in terms of peak overpressure and maximum impulse at discrete locations around the container, and it is found that the shelter is the least efficient in mitigating the blast load propagation when the explosive material is at an angle of 45° to the entrance. Also, while the protective roof at the entrance plays a significant role in protecting the container from air-borne threats, it is observed that it contributes to higher pressure and impulse data within the shelter, for detonations at ground level, with impulse amplifications as high as 94% when fully covering the entrance area. Contrarily, varying the distance between the container and the HESCO-Bastions is found to have minimal impact on the impulse, while naturally decreasing the peak pressure for increasing distances. Venting (through openings) can lead to up to 95% reduction in the peak pressure, whilst not affecting the impulse.
Is post-traumatic stress disorder a risk factor for development of opioid use disorder among individuals with chronic non-cancer pain? A systematic review
Authors: Kendurkar Arvind , Wilson Jack , Sunderland Matthew , Dunlop Adrian , Hayes Chris , Marel Christina , Mills Katherine L 
Published: September 2023

Introduction There is emerging evidence that posttraumatic-stress disorder may have mediating effects in development of chronic-non-cancer-pain and opioid-use-disorder independently, but its impact on the development of opioid-use-disorder in people with chronic-non-cancer pain is still unclear. Objectives (i) Estimate the risk of opioid-use-disorder among individuals with chronic-non-cancer-pain and posttraumatic-stress disorder, relative to those with chronic-non-cancer-pain only, and (ii) identify potential correlates of opioid-use-disorder among people with chronic-non-cancer-pain and posttraumatic-stress disorder. Methods This systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Longitudinal, epidemiological, cohort, follow-up, retrospective, prospective and cross-sectional studies reporting measures of variance on the likelihood of developing opioid-use-disorder with posttraumatic-stress disorder among individuals with chronic-non-cancer-pain were identified from six-electronic databases (Medline, Embase, Evidence-based Medicine reviews, PsycINFO, Scopus and Web of Science) until December 2022. Results Three out of the four studies, which met the selection criteria for this analysis reported statistically significant positive association between risk of developing opioid-use-disorder with posttraumatic-stress disorder among chronic-non-cancer-pain cohort (unadjusted Relative-Risk range: 1.51–5.27) but this association was not evident in the fourth study (adjusted Relative-Risk: 0.96; statistically non-significant), when adjusted for sociodemographic variables. The increased risk was noted particularly with females and chronic musculoskeletal pain conditions. Conclusions Posttraumatic-stress disorder can increase the risk of development of opioid-use-disorder among people with chronic-non-cancer-pain and a better understanding of this relationship will help to predict and prevent the development of opioid-use-disorder and may also help in reducing the disability and burden associated with chronic-non-cancer-pain. Perspective This review quantifies the risk of developing opioid-use-disorder in the context of posttraumatic-stress disorder among individuals with chronic-non-cancer-pain. Awareness and subsequent practice change will reduce the increasing global burden associated with the chronic-non-cancer-pain.
How cyberchondria and decision self-efficacy shapes the acceptability of COVID-19 vaccine: A gender-based comparison
Authors: Shahani Riffat , Asmi Fahad , Ma Jin , Zawar Asma , Rufai Olayemi Hafeez , Muhideen Sayibu , Amosun Tunde Simeon , Jianxun Chu 
Published: September 2023

Objective Alarmingly, the individuals’ reach and coverage to get vaccinated in developing regions during the pandemic is a massive challenge for concerned authorities. This study aimed to demonstrate how cyberchondria play a significant role in a classical health belief model. Cyberchondria may influence cognitive factors (e.g. self-efficacy), which may contribute to an increase in attitude–behavior gap. Especially in the context of a health-centric scenario, it may discourage individuals to take protective measures. Method By using the cross-sectional research design, the authors conducted a quantitative survey in Pakistan and collected 563 responses from 303 male respondents (rural = 91; urban = 212) with (Urban M:35.5, standard deviation (SD):13.4) and rural M:37.5, SD:8.4). Result The findings indicate that decision self-efficacy among males is stronger than that in females. It dominates other determinants, which can dampen the individuals’ intentions to get vaccinated. For instance, the effect of conspiracies and perceived seriousness was noted nonsignificant and weak. In females, perceived seriousness was stronger determinant than in males. In addition, the negative effect of decision self-efficacy was noted in the case of females, and conspiracy and cyberchondria had a negative role. Conclusion This study highlights valuable implications for future research in infodemic, health communication and health literacy, and practical implications for regulatory bodies and public administration.
Software-related challenges in Swedish healthcare through the lens of incident reports: A desktop study
Authors: Rahman Jabin Md Shafiqur , Pan Ding 
Published: September 2023

Objective To identify a subset of software issues occurring in daily Swedish healthcare practice and devise a set of local solutions to overcome the challenges. Methods A sample of 46 incident reports was collected from one of Sweden's national incident reporting repositories, ranging from June 2019 to December 2021. The reports were first subjected to an algorithm to identify if they were health information technology-related incidents and were analysed using an existing framework, i.e., the Health Information Technology Classification System, to identify the software-related incidents. The incidents associated with software issues were then subjected to thematic analysis, in which themes were extracted and presented under the category assigned by the existing framework used. Results Of 46 reports, 45 (with one exception) were included using the algorithm. Of 45 incidents, 31 software-related incidents were identified using the classification system. Six types of software issues were identified, including software functionality ( n = 10), interface with other software systems or components ( n = 10), system configuration ( n = 7), interface with devices ( n = 2), record migration ( n = 1) and increased volume of transactions ( n = 1). Each issue was further categorised into different themes; for example, software interface-related problems were grouped into ‘two patients being active in the system simultaneously’ ( n = 6) and ‘transfer of patient information’ ( n = 4). Conclusions The study provided some insights into software issues and relevant consequences. A set of local solutions were devised to overcome the present challenges encountered in Swedish healthcare in their daily clinical practice. Systematic identification and characterisation of such software challenges should be a routine part of clinical practice for all major health information technology implementations.
Effects of computer-based cognitive training combined with physical training for older adults with cognitive impairment: A four-arm randomized controlled trial
Authors: Chuang I-Ching , Chiau Hui-Yan , Liao Wan-Wen , Wu Yih-Ru , Chang Chih-Hung , Wu Ching-Yi 
Published: September 2023

Objective Combined physical (PHY) and cognitive (COG) training in sequential (SEQ) and simultaneous (SIMUL) sessions may delay the progression of cognitive impairment. To date, no study has directly compared in older adults with cognitive impairment the effects of COG training, PHY training, SEQ motor-cognitive training and SIMUL motor-cognitve training on specific indices of cognitive performance and activities of daily living (ADL). The purpose of this study was to determine whether SEQ and SIMUL motor-cognitive training can improve treatment outcomes compared with PHY or COG training alone. We also aimed to compare the effects of SEQ versus SIMUL motor-cognitive training on cognitive functions and instrumental ADL (IADL) in older adults with cognitive impairment. Methods A cluster randomized controlled trial was conducted. Eighty older adults with cognitive impairment were randomly assigned to COG, PHY, SEQ or SIMUL training groups. The intervention consisted of 90-min training sessions, totaling 36 sessions. Outcome measures were the Montreal Cognitive Assessment, three subtests of the Wechsler Memory Scale (WMS) and the Lawton IADL scale. Results Significant interaction effects between group and time were found in WMS-spatial span ( p = 0.04) and WMS-word lists ( p = 0.041). For WMS-spatial span, the SIMUL group showed outperformed the COG ( p = 0.039), PHY ( p = 0.010) and SEQ groups ( p = 0.017). For WMS-word lists, the SEQ group improve more than COG ( p = 0.013), PHY ( p = 0.030) and SIMUL ( p = 0.019) groups. No significant differences were found in IADL performance among four groups ( p = 0.645). Conclusions Our study showed SEQ and SIMUL motor-cognitive training led to more pronounced improvements in visuospatial working memory or verbal memory compared with isolated COG or PHY training for community-based older adults with cognitive impairment. For enhancing effects on IADL, we suggest the use of sensitive measurement tools and context-enriched cognitive training involving real-life task demands.
Systemic evaluation of the relationship between asthma and osteoarthritis: Evidence from a meta-analysis and Mendelian randomization study
Authors: Nie Yaoyao , Liu Houpu , Wang Jing , Yang Ye , Zhao Wenxia , Chen Dingwan , Li Yingjun 
Published: September 2023

Objective Osteoarthritis (OA) and asthma are two common chronic diseases with increasing incidence and prevalence, whereas there has been rare evidence to suggest the relationship between OA and asthma. This study aimed to analyze the causal relationship between OA and asthma. Methods Existing studies of the relationship between asthma and OA published till July 18, 2023, were identified from PubMed and Web of Science databases for meta-analysis. Subsequently, the causal relationship of all and site-specific OA with asthma was explored through a bidirectional two-sample Mendelian randomization (MR) analysis. Results A total of four eligible studies were included in the meta-analysis. In these studies, 80,550 participants were recruited, of whom 13,781 patients had OA. The asthma group had a significantly higher prevalence of OA than the control group (odds ratio (OR) = 2.08; 95% confidence intervals (CI): 1.42–3.03). However, MR analysis did not support a causal relationship between asthma and all OA and site-specific OA: knee and hip OA (OR = 1.03; 95% CI: 0.98–1.09), knee OA (OR = 1.02; 95% CI:0.96–1.08), and hip OA (OR = 1.04; 95% CI: 0.97–1.12). No causal relationship between OA and asthma was found through reverse MR analysis. Conclusions This meta-analysis suggests that patients with asthma are likely to have a greater prevalence of OA. However, the result of MR analysis reveals that asthma does not have a causal relationship to all OA or site-specific OA.
Parents’ Perceptions of Online Teaching During the Pandemic: A Shanghai Survey Report
Authors: Rong (荣佳妮) Jiani , Chen (陈霜叶) Shuangye , Yang (杨晓哲) Xiaozhe 
Published: September 2023

Highlights This survey report outlined parents’ evaluation of the Shanghai online learning program during the pandemic. According to the survey results, most parents favorably accepted the Shanghai online learning initiative, while some parents held some concerns about the forms and impacts. This report reveals nuanced analysis of parents’ perception and their education backgrounds, stresses, and expectations.
Development of pregnancy class with husband’s assistance on the outcome of teenage pregnancy
Authors: Riyanti  , Salim Lutfi Agus , Heriteluna Marselinus , Legawati  
Published: September 2023

Background: Teenage pregnancy is an international phenomenon without a definite solution to date. Globally, an estimated 16 million girls aged 15–19 give birth each year. Husbands need to play their assistance role in order to thwart the negative impact of the outcome of teenage pregnancy. Research objective: To identify the effect of the development of Pregnancy Classes with the Husband’s Assistance on the Outcome of Teenage Pregnancy in the Dayak community, Central Kalimantan. Research methods: This was a quasi-experimental study with the posttest-only non-equivalent control group design involving the husband’s assistance in pregnancy classes. The respondents were 60 individuals where 30 of them were given the pregnancy class assistance intervention while the other 30 were not given any intervention (control group). Results and discussion: Pregnancy class with Assistance by the husband increases positive pregnancy outcomes 2.4 times compared to without the husband’s assistance. Family support increases positive pregnancy outcomes 2.5 times compared to pregnant women without support from the family. Pregnant women that are highly motivated regarding antenatal care are likely to have positive pregnancy outcomes 5.4 times greater than pregnant women with low motivation. Based on the analysis, then the variables that have no effect are the history of antenatal care, frequency of antenatal care, and support from health workers. Conclusions: Pregnancy class with husband’s assistance affects positive outcomes of teenage pregnancy. Other factors with meaningful influence on pregnancy outcomes include family support and motivation to seek teenage antenatal care. Furthermore, other factors that have no influence include the teenager’s age, history of antenatal care, frequency of antenatal care, and support from health workers. An intervention is needed that involves the husband/partner in the form of active assistance.