bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Cladribine prescription pattern in MS: an Italian multicentre study
Authors: Zanghì Aurora , Fantozzi Roberta , Foschi Matteo , Signoriello Elisabetta , Inglese Matilde , Lus Giacomo , Centonze Diego , Surcinelli Andrea , Sirito Tommaso , Bonavita Simona , Avolio Carlo , D’Amico Emanuele 
Published: January 2025

Background: Characterizing Cladribine tablets prescription pattern in daily clinical practice is crucial for optimizing multiple sclerosis (MS) treatment. Objectives: To describe efficacy, safety profile and new disease-modifying therapy (DMT) prescriptions following Cladribine treatment. Design: Independent retrospective cohort study in patients followed at six Italian MS centres. Methods: Patients diagnosed with relapsing MS (RMS) according to 2017 McDonald criteria, who initiated Cladribine between January 2019 and May 2023, were included. A generalized linear regression model was built for the outcome DMT after Cladribine course. Heatmaps were generated based on weighted pivot tables to visualize the proportion of patients requiring DMT post-Cladribine. Results: A total cohort of 352 patients was enrolled, 134 naïve to any DMT, 218 switchers from other DMTs. The last DMT was an injectable first-line DMT for 48 (22%) patients, oral first-line DMT for 141 (64.7%) patients, SP1 inhibitor-Fingolimod for 23 (10.6%) patients, and Natalizumab for 6 (2.7%) patients. Overall, Cladribine was efficacious and well tolerated, 12% of patients required a new DMT prescription after a median time of 24 months. The regression model revealed that patients aged >40 years at Cladribine prescription had a 16% decrease in likelihood of receiving a new DMT. Heatmaps showed patients previously on Fingolimod had a lower rate (72.2%) of being free from therapy after Cladribine. Conclusion: In our multicentric real-world Italian study, Cladribine therapy is generally effective during the investigated follow-up period. Understanding key characteristics of patients responding best to Cladribine can help tailor therapeutic strategies for optimal outcomes.
A prospective study to evaluate high dose daptomycin pharmacokinetics and pharmacodynamics in Staphylococcus spp. infective endocarditis
Authors: De Gregori Simona , De Silvestri Annalisa , Capone Mara , Monzillo Vincenzina , Giordani Paola , Bruno Raffaele , Seminari Elena 
Published: January 2025

Background: Daptomycin pharmacokinetics and pharmacodynamics data relative to higher doses in patients are necessary for clinical practice. Objectives: A monocentric, prospective study that enrolled patients with a diagnosis of Staphylococcus spp. infective endocarditis treated with daptomycin according to clinical practice, to evaluate the pharmacokinetics/pharmacodynamics of different daptomycin daily doses (group A: 8–10 and group B: 11–12 mg/kg). Design and methods: A monocentric, prospective, cohort study that enrolled patients with a diagnosis of Staphylococcus spp. infective endocarditis treated with daptomycin. Daptomycin was administered by intravenous infusion over a 30-min period for at least five consecutive days before PK study. Results: Twenty-two patients were included. Native valve infectious endocarditis (IE) was diagnosed in 9 patients, prosthetic valve IE was diagnosed in 10 patients and 3 patients had concomitant intracardiac device infections. All patients showed a microbiologic response with negative blood cultures by day 5 (1–3 interquartile rate (IQR) 3–8). The median calculated AUC0–24 was 1298 (1–3 IQR 1069–1484) and 1459 (1–3 IQR 1218–1711) µg*h/mL, with the corresponding clearance of 0.49 (1–3 IQR 0.37–0.57) and 0.57 (1–3 IQR 0.40–0.71) L/h, respectively. A value of area under the curve/minimum inhibitory concentration (AUC/MIC) > 666 was reached by all patients; however, 4 out of 15 patients in group A and 1 out of 14 patients in group B did not reach the pharmacokinetic/pharmacodynamic (PK/PD) target of 1061; therefore, AUC/MIC equal to or above 1061 was reached by 73.3% in group A and 92.9% in group B. Conclusion: From a PK/PD point of view, all patients reached the value of AUC/MIC > 666, while roughly 70% of patients in group A and 90% in group B reached the target value of AUC/MIC>1061. Even if this cut-off value is arbitrary, 11–12 mg/kg daily dose could be taken into consideration in case of serious infections characterised by a high inoculum or in cases of prosthetic valve infections.
People with spinal cord injury or stroke are able to reach moderate-to-vigorous intensity while exercising on an end-effector robot assisted gait trainer: A pilot study
Authors: Bonnevie Tristan , Moily Kavya , Barnes Sarah , McConaghy Melissa , Ilhan Emre 
Published: January 2025

Background: Spinal cord injury and stroke are neurological disorders that lead to aerobic deconditioning and increased likelihood of cardiovascular disease. Sessions of at least 20 minutes of moderate-to-vigorous intensity exercise is recommended but decreased mobility limits engagement in such exercise. The aim of the study was to assess whether individuals can achieve exercise recommendations with the assistance of an end-effector robot assisted gait trainer (E-RAGT). Methods: We conducted an observational study during which participants were required to complete one exercise session on an E-RAGT. Heart rate, dyspnea, lower limb fatigue and enjoyment were monitored. Based on current guidelines, participants were considered to have reached exercise recommendations if they reached prespecified intensity thresholds for at least 20 minutes. Results: Five people with spinal cord injury and ten people with stroke agreed to participate. Every participant was able to reach moderate-to-vigorous exercise intensity and 3 out of 5 participants with spinal cord injury and 4 out of 10 participants with stroke were able to maintain this intensity for at least 20 minutes. Overall, participants rated their session as very enjoyable with a median score of 4 out of 5 on a Likert Scale (IQR 3 to 4). Discussion: Individuals with spinal cord injury or stroke who use an E-RAGT can reach moderate-to-vigorous exercise intensity, but not all are able to maintain this intensity of exercise according to disease-specific recommendations. Future research should explore the effectiveness of a training program using an E-RAGT.
Integrated Care for People Living With Rare Disease: A Scoping Review on Primary Care Models in Organization for Economic Cooperation and Development Countries
Authors: Vidic Nada , McGlynn Anna , Abdi Fatemeh , Tam Chun Wah Michael , Crampton Reginald Michael , Lim Kean-Seng , Palmer Elizabeth Emma , Taylor Natalie , Harris-Roxas Ben 
Published: January 2025

Introduction/Objectives: Individually rare, rare diseases are collectively common resulting in frequent health system use. Navigating the health system persists as a challenge. Primary care provides longitudinal contact with the health system and is placed to provide integrated rare-disease-care. Methods: This scoping review used Joanna Briggs Institute and PRISMA methods with a Consolidated Framework for Implementation Research based data extraction tool to find how integrated rare-disease-care is delivered, enablers and barriers to the same, in primary care settings in contemporary literature in OECD countries. Results: The Primary Care Provider (PCP) role varies from routine primary care to shared-rare-disease-care models. In the 26 papers, the most frequently cited PCP roles included involvement in diagnosis (n = 14), care coordination (n = 16), primary and preventative care (n = 18), management of components of rare-disease-care (n = 13), and treatment monitoring (n = 10). Individuals whose PCP was actively involved in their care were reported to have shortened diagnostic delay, improved transitions of care across the lifespan, reduced unplanned utilization of emergency and hospital services, comprehensive psychosocial care, improved quality of life across environments including home, school and work and improved palliative care experiences. Conclusions: Sufficient communication from specialists, information, resources, time and reimbursement for complex care are still needed. Future integrated-rare-disease-care models should be developed by, or with, PCPs.
Sell the losers? Keep the winners? None of the above – Focus on the median!
Authors: Kumar Valath Sree , Pinsky Eugene 
Published: January 2025

This paper presents an approach to index portfolio re-balancing, focusing on the median slice of asset performance instead of the more traditional focus on “winners” and “losers.” In the proposed approach, one constructs an equal-weight portfolio from the index’s median (by returns) component. We consider the Dow Jones Industrial Average (DJIA) as a case study and introduce a systematic re-balancing strategy that targets the middle third (“median”) segment of asset performers within the index. The proposed methodology provides significantly better returns and mitigates drawdowns compared with a passive “buy-and-hold” strategy while promoting a disciplined and simple portfolio re-balancing strategy. The study empirically evaluates the effectiveness of the median-based re-balancing strategy over historical data. We compare our strategy to a benchmark portfolio closely tracking the DJIA index and other popular re-balancing strategies focusing on winners and losers, including the Dogs of the Dow strategy. We provide a simple model to compare factor loadings offered by such strategies and show that the median strategy provides broad diversification across sectors. We also analyze factor exposures of the proposed strategy using the 3-factor Fama-French model. The analysis demonstrates that the “median” rotation strategy consistently outperforms the Dow Jones and the broad market index S&P-500, yielding higher returns and reduced drawdowns.
Endoscopic Lesser Trochanter Excision for Ischiofemoral Impingement
Authors: Anderson Devon E. , Scott Elizabeth J. , Mather R. Chad 
Published: January 2025

Background: Ischiofemoral impingement (IFI) is a rare yet underrecognized cause of posterior hip, low back/sacroiliac region, and deep gluteal pain. Patient anatomy, including femoral anteversion, coxa valga, posterior pelvic tilt, and lumbar stiffness, contributes to symptomatic IFI. Indications: Indications for surgical intervention include exclusion of alternative causes of posterior gluteal pain, failed nonoperative intervention including physical therapy and injection targeting the ischiofemoral space, and narrow ischiofemoral distance with quadratus femoris edema with or without sciatic nerve entrapment and protection of hamstring repair. Technique Description: Our preferred technique includes endoscopic lesser trochanter (LT) excision through a posterior approach in the prone position. The patient is positioned with the hips in slight flexion and the knees at 60° of flexion to take tension off the sciatic nerve. Fluoroscopy is used to localize the LT for 4 planned portal sites, creating a diamond around the LT: 2 for sciatic nerve retraction, 1 for endoscopic visualization, and 1 for working. The sciatic nerve is identified, bluntly mobilized, and protected. Radiofrequency ablation is used to dissect through the quadratus femoris from the posterior-central LT and expose the posterior LT. A 5.5-mm diamond-tip bur is then used to fully excise the LT flush with the femoral cortex. The patient is kept touch-down weightbearing for 6 weeks to reduce the risk of proximal femur stress fracture. Results: Endoscopic LT excision has been widely reported as a reliable method to increase ischiofemoral distance and relieve mechanical bone impingement and sciatic nerve entrapment. In our experience, the posterior approach in the prone position allows for maximum visualization to identify and protect the neurovascular structures, completely excise the LT, and treat concomitant pathology. Conclusions: Our preferred technique for surgical treatment of IFI with posterior endoscopic LT excision in the prone position is safe based on sciatic nerve visualization and effective with complete LT excision. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
A park-based group mobility program for older adults with difficulty walking outdoors: a qualitative process evaluation of the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial
Authors: Kokorelias Kristina M. , Ripat Jacquie , Barclay Ruth , Jones C. Allyson , Mayo Nancy E. , Grant Theresa , Scodras Stephanie , Alsbury-Nealy Kyla , Ryder-Burbidge Charlotte , Salbach Nancy M. 
Published: January 2025

Abstract
Background
The Getting Older Adults Outdoors (GO-OUT) randomized controlled trial showed that a workshop and 10-week park-based outdoor walk group (OWG) was superior to the workshop and 10 weekly reminders (WR) with increasing walking capacity, but not outdoor walking activity, health-promoting behavior, or successful aging, among older adults with difficulty walking outdoors. The objective of this planned process evaluation was to explore participants’ perceptions of mechanisms of impact of and contextual factors influencing experiences with the interventions to help explain the observed intervention effects on study outcomes.

Methods
A qualitative descriptive study involving semi-structured interviews conducted at 6-months post-baseline was conducted. A directed content analysis was undertaken.

Participants
We interviewed 27 adults (52% male, 48% female, mean age 76 years) from the OWG (n = 13) and WR group (n = 14).

Results
We identified two themes including: “Holding Me Accountable to Walk More Frequently”, and “We Walked Farther, With More Ease and Confidence, and We Felt Better”. Participants in both groups described how the OWG and WR programs provided some degree of structure and accountability to others that increased their motivation to walk outdoors. Participants described how the OWG led to improved walking capacity (e.g., increased walking distance) and confidence. Interacting with people during OWG sessions led to a sense of enjoyment, and well-being.

Conclusions
Community programs that incorporate structure, accountability, and opportunities for social interaction, can help improve motivation to increase outdoor walking activity and a sense of belonging for older adults with difficulty walking outdoors. Park-based OWG programs appear to convey additional important benefits related to improved physical function and well-being.

Trial registration
ClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017.
Public health economic modelling in evaluations of salt and/or alcohol policies: a systematic scoping review
Authors: Mensah Joseph Prince , Thomas Chloe , Akparibo Robert , Brennan Alan 
Published: January 2025

Abstract
Background
Public health economic modelling is an approach capable of managing the intricacies involved in evaluating interventions without direct observational evidence. It is used to estimate potential long-term health benefits and cost outcomes. The aim of this review was to determine the scope of health economic models in the evaluation of salt and/or alcohol interventions globally, to provide an overview of the literature and the modelling methods and structures used.

Methods
Searches were conducted in Medline, Embase, and EconLit, and complemented with citation searching of key reviews. The searches were conducted between 13/11/2022 and 8/11/2023, with no limits to publication date. We applied a health economic search filter to select model-based economic evaluations of public health policies and interventions related to alcohol consumption, dietary salt intake, or both. Data on the study characteristics, modelling approaches, and the interventions were extracted and synthesised.

Results
The search identified 1,958 articles, 82 of which were included. These included comparative risk assessments (29%), multistate lifetables (27%), Markov cohort (22%), microsimulation (13%), and other (9%) modelling methods. The included studies evaluated alcohol and/or salt interventions in a combined total of 64 countries. Policies from the UK (23%) and Australia (18%) were the most frequently evaluated. A total of 58% of the models evaluated salt policies, 38% evaluated alcohol policies, and only three (4% of included modelling studies) evaluated both alcohol- and salt-related policies.
The range of diseases modelled covered diabetes and cardiovascular disease-related outcomes, cancers, and alcohol-attributable harm. Systolic blood pressure was a key intermediate risk factor in the excessive salt-to-disease modelling pathway for 40 (83%) of the salt modelling studies. The effects of alcohol consumption on adverse health effects were modelled directly using estimates of the relative risk of alcohol-attributable diseases.

Conclusions
This scoping review highlights the substantial utilisation of health economic modelling for estimating the health and economic impact of interventions targeting salt or alcohol consumption. The limited use of combined alcohol and salt policy models presents a pressing need for models that could explore their integrated risk factor pathways for cost-effectiveness comparisons between salt and alcohol policies to inform primary prevention policymaking.
L-shaped association of dietary inflammatory index (DII) and chronic diarrhea: results from NHANES 2005–2010
Authors: Zhao Qing , Xu Yue , Li Xiangrui , Chen Xiaotian 
Published: January 2025

Abstract
Background
Since diet is a known modulator of inflammation, the Dietary Inflammatory Index (DII), which quantifies the inflammatory potential of an individual’s diet, becomes a significant parameter to consider. Chronic diarrhea is commonly linked to inflammatory processes within the gut. Thus, this study aimed to explore the potential link between DII and chronic diarrhea.

Methods
This research utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010. The DII was calculated according to the average intake of 28 nutrients using information gathered from two 24-hour recall interviews. The Bristol Stool Form Scale (BSFS) was adopted to describe chronic diarrhea, identifying stool Type 6 and Type 7. Multivariate logistic regression models examined the causal connection between DII and chronic diarrhea. Additionally, subgroup analyses and interaction tests were conducted.

Results
The study encompassed 11,219 adults, among whom 7.45% reported chronic diarrhea. Initially, multivariate logistic regression analysis revealed a positive association between DII and chronic diarrhea. Nevertheless, this connection lost statistical significance (OR = 1.00; 95% CI, 0.96–1.05; P = 0.8501) after adjusting for all confounding variables. Stratified by sex, the analysis revealed a notable rise in the risk of chronic diarrhea with increasing DII among female participants (all P for trend < 0.05). This tendency remained constant even after full adjustment (P for trend = 0.0192), whereas no significant association was noted in males (all P for trend > 0.05). Furthermore, an L-shaped association emerged between DII and chronic diarrhea, with an inflection point of -1.34. In the population with DII scores below -1.34, each unit increase in DII correlated with a 27% reduction in the probability of chronic diarrhea (OR = 0.73; 95% CI, 0.57–0.93), whereas in the population with DII scores above -1.34, the risk increased by 4% (OR = 1.04; 95% CI, 0.98–1.10). Merely, the gender interaction was shown to be statistically significant based on subgroup analyses and interaction tests.

Conclusions
A favorable association between DII and chronic diarrhea exists in adults in the United States. Nevertheless, additional long-term prospective studies are required to confirm and solidify those findings.
Comparative assessment of a virtual performance measure with self-report and performance-based outcomes in patients with hip osteoarthritis
Authors: Razmjou Helen , Denis Suzanne , Robarts Susan , Wainwright Amy , Dickson Patricia , Roszkowski Ania , Murnaghan John 
Published: January 2025

Abstract
Background
The purposes of this study were to examine the reliability and factorial and convergent validity of a virtual performance measure (VPM) in patients with osteoarthritis (OA) of the hip joint and to compare the known-group validity of the VPM with traditional self-report and performance-based outcomes.

Methods
The VPM score was based on the results of 10 videos showing increasing difficulty in performing specific functional tasks. Patients were requested to choose the video that best reflected their own level of function. Clinical presentation and radiological findings were documented. Self-report measures were the lower extremity functional score (LEFS) and pain scale. The performance-based measures were the 30- second Chair Stand Test (CST) and the 40-meter fast paced walk test (40 m FPWT) test.

Results
Data of 100 patients, 64 (64%) females, mean age: 67 ±10 were examined. The Cronbach’s alpha coefficient that examined internal consistency of the VPM total score was 0.88. Factor analysis showed two distinct domains. Moderate correlations were observed between the VPM total score and the LEFS, pain score, and 40 m FPWT (r > 0.50). The VPM and the LEFS were able to differentiate between candidates and non-candidates for hip arthroplasty and between those with and without assistive walking devices. There was no statistically significant difference between the overall accuracy of the VPM and LEFS in the area under the curve value (0.72 vs. 0.71) with respect to candidacy for surgery.

Conclusions
This study provides substantial evidence towards the validity and reliability of the VPM outcome measure in patients with moderate to severe OA of the hip joint. Digitally based outcome measures have the potential of enhancing remote measurement of functional difficulties in specific situations.

Clinical trial number
Not applicable.