bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Outcomes of Patients ≥85 Years With Acute Ischemic Stroke Following EVT: A HERMES Substudy
Authors: McDonough Rosalie V. , Ospel Johanna M. , Campbell Bruce C.V. , Hill Michael D. , Saver Jeffrey L. , Dippel Diederik W.J. , Demchuk Andrew M. , Majoie Charles B.L.M. , Brown Scott B. , Mitchell Peter J. , Bracard Serge , Guillemin Francis , Jovin Tudor G. , Muir Keith W. , White Philip , Goyal Mayank ,   on behalf of the HERMES Collaborators
Published: June 2022

Background:
Observational studies have shown endovascular treatment (EVT) for acute ischemic stroke to be effective in the elderly, despite resulting in poorer outcomes and higher rates of mortality compared with younger patients. Randomized data on the effect of advanced age on outcomes following EVT are, however, lacking. Our aim was to assess the EVT effect for ischemic stroke in patients aged ≥85 years and the influence of age on outcome in a large, randomized trial dataset.

Methods:
Data were from the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration, a meta-analysis of 7 randomized trials published between January 1, 2010, and May 31, 2017, that tested the efficacy of EVT. A possible multiplicative interaction effect of age on the relationship between treatment and outcome was investigated. Ordinal logistic regression tested the association between EVT and 90-day functional outcome (modified Rankin Scale, primary outcome) in patients ≥85 years. Multivariable binary logistic regression was performed to compare primary and secondary outcomes (modified Rankin Scale score of 0–2/5–6) of patients ≥85 years versus those <85 years.

Results:

We included 1764 patients in the analysis, of whom 77 (4.4%) were ≥85 years old. A significant interaction of age and treatment on poor outcome (modified Rankin Scale score of 5–6,
P
=0.020) and mortality (
P
=0.031) was observed, with older adults having worse functional outcomes at 90 days compared with younger patients (adjusted common odds ratio, 0.20 [95% CI, 0.13–0.33]). However, a benefit of EVT was observed in the ≥85-year-old patient subgroup (common odds ratio, 4.20 [95% CI, 1.56–11.32]). Age ≥85 years was not significantly associated with differing rates of symptomatic intracerebral hemorrhage or reperfusion (adjusted odds ratio, 1.92 [95% CI, 0.71–5.15] and adjusted odds ratio, 0.91 [95% CI, 0.40–2.06], respectively).

Conclusions:
Patients ≥85 years old with independent premorbid function more often achieve good functional outcomes and have lower rates of mortality when treated with EVT compared with conservative management, with an observed treatment effect modification of age on outcome. EVT should therefore not be withheld in this subgroup.
An Evaluation of Flood Fatalities in Nigeria
Authors: Ologunorisa Temi Emmanuel , Eludoyin Adebayo Oluwole , Lateef Bola 
Published: June 2022

Abstract
Flood-induced fatalities are among the more poorly reported effects of flood disasters in many developing countries because of poor data inventory and management. Specific objectives of this study are to assess the spatial and temporal variations in flood fatalities in Nigeria, the most populous country in Africa. The study explored available datasets from the National (Nigerian) Meteorological and Emergency Management Agencies as well as those from the Dartmouth Flood Observatory (DFO) at the University of Colorado Boulder and complemented those with scattered reports from Nigerian newspapers to achieve the stated objectives. Using a mix of statistical and geographical information analysis approaches, the study showed that most of Nigeria is vulnerable to flood, given the nature of the dominant climate that often results in “medium” to “high” rainfall intensity (i.e., rainfall = 38.1–50.1 mm or > 50.1 mm in 24 h, respectively), inadequate settlement planning/land-use and land-cover management, and dam failure. Analysis of the frequency of the flood–fatality relationship indicates an increase in flood fatalities by 4.7% relative to flood cases between 1985 and 2017. The study complemented the results with information from newspapers and some other non-peer-reviewed documents (especially reports from relevant agencies) and revealed the need for a better flood information management system in the country, especially since the national database and DFO records were not the same. The study concluded that flood fatalities are on the increase but are poorly reported. It thus recommends improved information systems for flood and other disasters and their fatalities in the country.

Significance Statement
The purpose of this study is to reveal the state of information on flood disasters in a typical sub-Saharan African country. This is important because information about the distribution and trend of fatalities associated with flood disasters is required for sustainable mitigation planning globally. Our results provide a guide to understanding the distribution and associated factors of flood disasters as well as the contributions of informal (newspaper) sources to the inventory of relevant records.
Measurement properties of performance-based measures to assess physical function in knee osteoarthritis: A systematic review
Authors: Chen Hongbo , Wang Cui , Wu Junhui , Wang Mengying , Wang Siyue , Wang Xiaowen , Wang Jiating , Yu Huan , Hu Yonghua , Shang Shaomei 
Published: June 2022

ObjectiveTo systematically review the measurement properties of performance-based measures to assess physical function in people with knee osteoarthritis.Data sourcesPubMed, Web of Science, Embase, Scopus, CINAHL, and PsycINFO were searched in May 2022.MethodsThis study was conducted in accordance with the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Clinical trials on the psychometric properties of performance-based tools for measuring physical function in people with knee osteoarthritis were included. Two reviewers independently rated measurement properties using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). “Best evidence synthesis” was made using COnsensus-based Standards for the selection of health Measurement INstruments outcomes and the quality of findings.ResultsThirty-six out of 3425 publications were eligible for inclusion. Thirty-two performance-based measures were evaluated including 26 single-activity measures and 6 multi-activity measures. Measurement properties evaluated included internal consistency (2 measures), reliability (23 measures), measurement error (20 measures), hypotheses testing for construct validity (22 measures), and responsiveness (23 measures). On balance of the limited evidence, the walk 40 m fast-paced test and 6-minute walking test were the best rated walking tests. The 30-second chair stand test and timed up and go test were the best rated sit-to-stand tests. The Performance Tests Measures and Physical Activity Restrictions may be the suitable multi-activity measures for knee osteoarthritis.ConclusionsFurther good quality research investigating the measurement properties, and in particular, the measurement error of performance-based measures in patients with knee osteoarthritis is needed.
Ureaplasma urealyticum induces polymorphonuclear elastase to change semen properties and reduce sperm motility: a prospective observational study
Authors: Liu Huang , Song Xiaoyan , Huang Mulan , Zhan Huashen , Wang Shiyang , Zhu Shenghui , Pang Tao , Zhang Xinzong , Zeng Qingqi 
Published: June 2022

Objective To elucidate the mechanism underlying how Ureaplasma urealyticum (UU) affects sperm quality and identify a therapeutic target. Methods In this prospective observational study, the differences in and relationships among semen volume, pH, viscosity, liquefaction time, sperm concentration, sperm motility [progressive motility (PR)], and seminal polymorphonuclear (PMN) elastase were analyzed in 198 normal semen samples (control group) and 198 UU-infected semen samples (observation group). The UU-infected samples were treated and the above parameters were compared between the two groups. Results The semen volume, viscosity, liquefaction time, and seminal PMN elastase were significantly higher in the observation than control group, but the pH and PR were significantly lower. In the observation group, the pH and PR were significantly higher after than before treatment, whereas the semen volume, PMN elastase, viscosity, and liquefaction time were lower. UU was closely related to semen volume, pH, viscosity, liquefaction time, sperm motility (PR), and PMN elastase. PMN elastase had significant negative effects on semen pH and sperm motility (PR) but positive effects on viscosity and liquefaction time. Conclusion UU might induce PMN elastase to increase the liquefaction time and viscosity of semen, eventually decreasing PR. PMN elastase might be a therapeutic target of UU.
Healthcare encounters between asylum seekers and health professionals in Maltese primary care
Authors: Depares Joanna , Culley Lorraine 
Published: June 2022

Background There is a substantial body of literature that discusses the problematic nature of asylum seeker healthcare in several European countries. However, little is known about how asylum seekers experience primary healthcare in Malta. Aim This paper draws on a qualitative study that aimed to explore the nature of healthcare encounters between asylum seekers and healthcare professionals in Maltese primary healthcare and the contextual processes which influence these interactions. Methodology The study utilised critical ethnography, informed by postcolonial theory. Data were collected through observation of encounters between healthcare professionals and asylum seekers (130 hours) and in-depth interviews with asylum seekers ( n11), cultural mediators ( n4) and Maltese healthcare professionals ( n7). Results Thematic analysis of the combined data resulted in three themes: ‘the impact of seeking refuge’, ‘seeking mutual understanding’ and ‘seeking resolution’. Healthcare encounters between asylum seekers and professionals are characterised by ‘othering’ practices, pre-conceived expectations and mutual mistrust. These are shaped by a complex interplay of factors, including damaging experiences of migration, derogatory political and public discourses and inadequate resources. Conclusion In Maltese primary care, healthcare encounters are highly problematic for both patients and professionals. Nurses could take the lead in developing services to assess complex needs and aid asylum seekers in navigating the healthcare system.
Direct cost analysis of rapid MRI in the emergency department evaluation of patients suspected of having acute ischemic stroke**
Authors: de Havenon Adam , Orlando Chris , Delic Alen , McNally Joseph Scott , Majersik Jennifer J , Harman Tyler , Alexander Matthew , Reddy Vivek , Lyden Stephanie , Anzai Yoshimi 
Published: June 2022

Background Abbreviated “rapid MRI” protocols have become more common for the evaluation of acute ischemic stroke (AIS). Prior research has not evaluated the effect of rapid MRIs on cost or hospital length of stay in AIS patients. Methods We retrospectively identified AIS patients who presented within 6 h of acute neurologic symptom onset to an emergency department (ED) and activated a “brain attack” code. We included sequential patients from January 2012 to September 2015, before rapid MRI was available, who had CT perfusion (CTP) and compared them to patients from October 2015 to May 2018 who had a rapid MRI. We used inverse-probability-weighting (IPW) to balance the cohorts. The primary outcomes were direct cost to our healthcare system and total hospital length of stay (LOS). Results We included 408 brain attack activations (mean ± SD age 62.1 ± 17.6 years, 47.8% male): 257 in the CTP cohort and 151 in the MRI cohort. Discharge diagnosis was ischemic stroke in 193/408 (47.3%). After patient matching, we found significant reductions for the MRI cohort in total cost (−18.7%, 95% CI −35.0, −2.4, p = 0.02) and hospital LOS (−17.0%, 95% CI −31.2, −2.8, p = 0.02), with no difference in ED LOS ( p = 0.74) as compared to the CTP cohort. Conclusion Although these results are preliminary and hypothesis-generating, we found that the use of a rapid MRI protocol in emergency department brain attacks was associated with a 18.7% reduction in total direct cost and 17% reduction in hospital length of stay.
Exploring the Transition to Working Life of Entrepreneurship Education Graduates: A Longitudinal Study
Authors: Killingberg Nils Magne , Kubberød Elin , Pettersen Inger Beate 
Published: June 2022

In this research, we explore the transition of entrepreneurship education (EE) graduates to working life. Even though many EE graduates find employment in established organisations rather than starting a new venture, few studies have empirically investigated the relevance of EE in this context. This paper addresses this gap by providing an in-depth longitudinal analysis of graduates’ transition from EE to working life, from entering the labour market to becoming an effective operator. In the study we interview 10 graduates from three master’s programmes directly after their graduation and then follow up with an interview 2 years into their careers. It explores how these graduates learn to become legitimate members of their workplace and how they apply their entrepreneurial competencies in this process. This study contributes to the broader debate on the relevance of EE for employability by demonstrating how entrepreneurial competencies foster the transition from EE to working life.
Practical recommendations to combine small-molecule inhibitors and direct oral anticoagulants in patients with nonsmall cell lung cancer
Authors: Otten Leila S. , Piet Berber , van den Heuvel Michel M. , Marzolini Catia , van Geel Robin M.J.M. , Gulikers Judith L. , Burger David M. , Leentjens Jenneke , ter Heine Rob 
Published: June 2022

BackgroundThe risk for thromboembolisms in nonsmall cell lung cancer (NSCLC) patients is increased and often requires treatment or prophylaxis with direct oral anticoagulants (DOACs). Small-molecule inhibitors (SMIs) to treat NSCLC may cause relevant drug–drug interactions (DDIs) with DOACs. Guidance on how to combine these drugs is lacking, leaving patients at risk of clotting or bleeding. Here, we give practical recommendations to manage these DDIs.MethodsFor all DOACs and SMIs approved in Europe and the USA up to December 2021, a literature review was executed and reviews by the US Food and Drug Administration and European Medicines Agency were analysed for information on DDIs. A DDI potency classification for DOACs was composed and brought together with DDI characteristics of each SMI, resulting in recommendations for each combination.ResultsHalf of the combinations result in relevant DDIs, requiring an intervention to prevent ineffective or toxic treatment with DOACs. These actions include dose adjustments, separation of administration or switching between anticoagulant therapies. Combinations of SMIs with edoxaban never cause relevant DDIs, compared to more than half of combinations with other DOACs and even increasing to almost all combinations with rivaroxaban.ConclusionsCombinations of SMIs and DOACs often result in relevant DDIs that can be prevented by adjusting the DOAC dosage, separation of administration or switching between anticoagulants.
The impact of androgen deprivation therapy on the lipid profile in patients with prostate carcinoma
Authors: Kumar Niraj , Vasudeva Vibha , Yadav Siddharth , Prasad Vishnu , Patel Samarth 
Published: June 2022

Abstract
Background
Dyslipidemia is directly related to morbidity and mortality in elderly prostate carcinoma patients. The purpose of this study was to evaluate the effects of androgen deprivation therapy (ADT) on the lipid profile among Indian patients with locally advanced and metastatic prostate carcinoma.

Methods
The prospective database of prostate carcinoma patients, who received ADT and whose lipid profile data for the first two years of treatment with ADT was available, were divided into two groups for retrospective analysis: Group A patients are those who had undergone bilateral orchidectomy, while group B patients received luteinizing hormone-releasing hormone agonist (LHRHa). The data analyzed include baseline characteristics, prostate-specific antigen (PSA), and lipid profile.

Results
A total of 69 eligible patients were divided into two groups: group A—29 patients and group B—40 patients. Patients of both the groups reported a significant decrease in the mean serum PSA level from the commencement of ADT and remained close to nadir level till 24 months. In the group A patients, lipid profile parameters except high-density lipoprotein cholesterol showed statistically insignificant deterioration with maximum impact at 6 months. Among the group B patients, the total cholesterol (11.9%), triglycerides (22.2%), and low-density lipoprotein cholesterol (21.1%) increased significantly at 6 months and returned to the near baseline at 12 months and thereafter persisted at the similar level. The mean very low-density lipoprotein level (15.5%) also increased significantly at 6 months and then showed a gradual decline till 24 months of follow-up.

Conclusions
LHRH agonist used as ADT for prostate carcinoma leads to a statistically significant but clinically insignificant temporary worsening in the lipid profile.
Assessment of iron overload in a cohort of Sri Lankan patients with transfusion dependent beta thalassaemia and its correlation with pathogenic variants in HBB, HFE, SLC40A1, and TFR2 genes
Authors: Dissanayake Ruwangi , Samarasinghe Nayana , Waidyanatha Samantha , Pathirana Sajeewani , Neththikumara Nilaksha , Dissanayake Vajira H. W. , Wetthasinghe Kalum , Gooneratne Lallindra , Wickramasinghe Pujitha 
Published: June 2022

Abstract
Background
Iron overload (IO) is a complication in transfusion dependent beta thalassaemia (TDT). Pathogenic variants in genes involving iron metabolism may confer increased risk of IO. The objective of this study was to determine the magnitude of the cardiac and hepatic IO and determine whether pathogenic variants in HFE, SLC40A1 and TFR2 genes increase the risk of IO in a cohort of TDT patients in Sri Lanka.

Materials and Methods
Fifty-seven (57) patients with TDT were recruited for this study. Serum ferritin was done once in 3 months for a period of one year in all. Those who were ≥ 8 years of age (40 patients) underwent T2* MRI of the liver and heart. Fifty-two (52) patients underwent next generation sequencing (NGS) to identify pathogenic variants in HBB, HFE, SLC40A1 and TFR2 genes.

Results
The median age of the patients of this cohort was 10 years. It comprised of 30 (52.6%) boys and 27 (47.4%) girls. The median level of serum ferritin was 2452 ng/dl. Hepatic IO was seen in 37 (92.5%) patients and cardiac IO was seen in 17 (42.5%) patients. There was no statistically significant correlation between serum ferritin and hepatic or cardiac IO.
Thirty-two (61.5%), 18 (34.6%), 2 (3.8%) of patients were homozygotes, compound heterozygotes and heterozygotes for pathogenic variants in the HBB gene. Eight (15.4%) and 1 (1.9%) patients were heterozygotes for pathogenic and likely pathogenic variants of HFE genes respectively. There were no pathogenic variants for the TfR2 and SLC40A1 genes. The heterozygotes of the pathogenic variants of the HFE were not at increased risk of IO.

Conclusions
Cardiac T2* MRI helps to detect cardiac IO in asymptomatic patients. It is important to perform hepatic and cardiac T2* MRI to detect IO in patients with TDT. There was no statistically significant correlation between pathogenic variants of HBB and HFE genes with hepatic and cardiac IO in this cohort of patients.
The causal relationship between sleep traits and the risk of schizophrenia: a two-sample bidirectional Mendelian randomization study
Authors: Wang Zhen , Chen Miao , Wei Yin-ze , Zhuo Chen-gui , Xu Hong-fei , Li Wei-dong , Ma Liang 
Published: June 2022

Abstract
Background
Observational studies suggest that sleep disturbances are commonly associated with schizophrenia. However, it is uncertain whether this relationship is causal. To investigate the bidirectional causal relation between sleep traits and schizophrenia, we performed a two-sample bidirectional Mendelian randomization (MR) study with the fixed effects inverse-variance weighted (IVW) method.

Methods
As genetic variants for sleep traits, we selected variants from each meta-analysis of genome-wide association studies (GWASs) conducted using data from the UK Biobank (UKB).

Results
We found that morning diurnal preference was associated with a lower risk of schizophrenia, while long sleep duration and daytime napping were associated with a higher risk of schizophrenia. Multivariable MR analysis also showed that sleep duration was associated with a higher risk of schizophrenia after adjusting for other sleep traits. Furthermore, genetically predicted schizophrenia was negatively associated with morning diurnal preference and short sleep duration and was positively associated with daytime napping and long sleep duration.

Conclusions
Therefore, sleep traits were identified as a potential treatment target for patients with schizophrenia.
Sagittal femoral bowing contributes to distal femoral valgus angle deviation in malrotated preoperative radiographs
Authors: Kokubu Yasuhiko , Kawahara Shinya , Hamai Satoshi , Akasaki Yukio , Tsushima Hidetoshi , Momii Kenta , Nakashima Yasuharu 
Published: June 2022

Abstract
Background
The coronal whole-leg radiograph is generally used for preoperative planning in total knee arthroplasty. The distal femoral valgus angle (DFVA) is measured for distal femoral bone resection using an intramedullary guide rod. The effect of coronal and sagittal femoral shaft bowing on DFVA measurement in the presence of malrotation or knee flexion contracture has not been well reported. The objectives of this study were: (1) to investigate the effects of whole-leg malrotation and knee flexion contracture on the DFVA in detail, (2) to determine the additional effect of coronal or sagittal femoral shaft bowing.

Methods
We studied 100 consecutive varus and 100 valgus knees that underwent total or unicompartmental knee arthroplasty. Preoperative CT scans were used to create digitally reconstructed radiography (DRR) images in neutral rotation (NR, parallel to the surgical epicondylar axis), and at 5° and 10° external rotation (ER) and internal rotation (IR). The images were also reconstructed at 10° femoral flexion. The DFVA was evaluated in each DRR image, and the angular variation due to lower limb malposition was investigated.

Results
The DFVA increased as the DRR image shifted from IR to ER, and all angles increased further from extension to 10° flexion. The DFVA variation in each position was 1.3° on average. A larger variation than 2° was seen in 12% of all. Multivariate regression analysis showed that sagittal femoral shaft bowing was independently associated with a large variation of DFVA. Receiver operating characteristic analysis showed that more than 12° of sagittal bowing caused the variation.

Conclusion
If femoral sagittal bowing is more than 12°, close attention should be paid to the lower limb position when taking whole-leg radiographs. Preoperative planning with whole-leg CT data should be considered.