bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the Effectiveness of a Medicine Copay Voucher Vary by Baseline Medication Out‐Of‐Pocket Expenses? Insights From ARTEMIS
Authors: Rymer Jennifer A. , Kaltenbach Lisa A. , Peterson Eric D. , Cohen David J. , Fonarow Gregg C. , Choudhry Niteesh K. , Henry Timothy D. , Cannon Christopher P. , Wang Tracy Y. 
Published: October 2022

Background
Persistence to P2Y12 inhibitors after myocardial infarction (MI) remains low. Out‐of‐pocket cost is cited as a factor affecting medication compliance. We examined whether a copayment intervention affected 1‐year persistence to P2Y12 inhibitors and clinical outcomes.

Methods and Results

In an analysis of ARTEMIS (Affordability and Real‐World Antiplatelet Treatment Effectiveness After Myocardial Infarction Study), patients with MI discharged on a P2Y12 inhibitor were stratified by baseline out‐of‐pocket medication burden: low ($0–$49 per month), intermediate ($50–$149 per month), and high (≥$150 per month). The impact of the voucher intervention on 1‐year P2Y12 inhibitor persistence was examined using a logistic regression model with generalized estimating equations. We assessed the rates of major adverse cardiovascular events among the groups using a Kaplan–Meier estimator. Among 7351 MI‐treated patients at 282 hospitals, 54.2% patients were in the low copay group, 32.0% in the middle copay group, and 13.8% in the high copay group. Patients in higher copay groups were more likely to have a history of prior MI, heart failure, and diabetes compared with the low copay group (all
P
<0.0001). Voucher use was associated with a significantly higher likelihood of 1‐year P2Y12 inhibitor persistence regardless of copayment tier (low copay with versus without voucher: adjusted odds ratio [OR], 1.44 [95% CI, 1.25–1.66]; middle copay: adjusted OR, 1.63 [95% CI, 1.37–1.95]; high copay group: adjusted OR, 1.41 [95% CI, 1.05–1.87];
P
interaction=0.42). Patients in the high copay group without a voucher had similar risk of 1‐year major adverse cardiovascular events compared with patients in the high copay group with a voucher (adjusted hazard ratio, 0.89 [95% CI, 0.66–1.21]).

Conclusions
Medication copayment vouchers were associated with higher medication persistence at 1 year following an MI, regardless of out‐of‐pocket medication burden.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02406677.
Associations of Hypertriglyceridemia Onset Age With Cardiovascular Disease and All‐Cause Mortality in Adults: A Cohort Study
Authors: Zhou Hui , Ding Xiong , Yang Qing , Chen Shuohua , Li Yun , Zhou Xin , Wu Shouling 
Published: October 2022

Background
Limited studies have involved new‐onset hypertriglyceridemia, and this study was to evaluate the associations of hypertriglyceridemia onset age with cardiovascular diseases (CVD) and all‐cause mortality.

Methods and Results
This population‐based prospective study enrolled 98 779 participants free of hypertriglyceridemia and CVD at baseline in the Kailuan study initiated in June 2006. All participants underwent health checkups biennially until December 2017, and a total of 13 832 participants developed new hypertriglyceridemia. A 1:1 age‐ (±1 year) and sex‐matched analysis was applied to select control subject of the same year for each new‐onset case. There were 13 056 case‐control pairs included. The total follow‐up time was 179 409 person‐years, with a median follow‐up time of 7.0 years. Primary outcomes were CVD and all‐cause mortality, and hazard ratios were estimated after adjustment for baseline characteristics.
A total of 807 incident CVD events and 600 all‐cause mortality events were documented. After multivariable adjustment, participants with hypertriglyceridemia onset age <45 years had the highest risk compared with matched controls, with hazard ratios of 2.61 (95% CI, 1.59–4.27) for CVD, 4.69 (95% CI, 2.34–9.40) for all‐cause mortality, 2.23 (95% CI, 0.67–7.38) for myocardial infarction, and 2.68 (95% CI, 1.56–4.62) for stroke. The risk estimates gradually decreased with each decade increase in the onset age of hypertriglyceridemia.

Conclusions
Among Chinese adults, hypertriglyceridemia identified at an earlier onset age was associated with higher risks for CVD and all‐cause mortality.
Divergence and Convergence of Sex‐Specific Time Trends in Ischemic Stroke: 10‐Year Analysis of a State‐Wide Registry in Germany
Authors: Schaefer Jan Hendrik , Bohmann Ferdinand O. , Lieschke Franziska , Misselwitz Björn , Foerch Christian 
Published: October 2022

Background
The incidence of ischemic stroke was previously expected to rise among countries with an aging population. Lately, several studies from developed countries have reported a decline in certain cohorts. Whether this applies to all sexes, however, is uncertain, with limited data on the temporal development in incidence, treatment, and recovery.

Methods and Results

We analyzed a prospective stroke inpatient quality‐assurance registry of the federal state of Hesse, Germany. Recruitment of all patients with a final diagnosis of ischemic stroke at hospital discharge (
International Classification of Diseases
,
Tenth Revision
[
ICD‐10
]: I63) is mandatory by law. Incidence rates were calculated based on census data of all inhabitants and stratified according to age. Between 2010 and 2019, there were 141 277 patients included, 73 770 (52.2%) male patients and 67 507 (47.8%) female patients. Overall, the incidence of ischemic stroke was 228 per 100 000 in 2010 and 226 per 100 000 in 2019 (−0.8%; odds ratio [OR], 0.99 [95% CI, 0.96–1.02];
P
=0.50). For male patients, the incidence increased continuously from 236 per 100 000 to 245 per 100 000 (+3.8%); in female patients it decreased from 220 per 100 000 to 208 per 100 000 (−5.6%). After adjusting for age, the OR for ischemic stroke between male and female patients was 1.40 in 2010 (95% CI, 1.35–1.44;
P
<0.001) and 1.48 in 2019 (95% CI, 1.43–1.53;
P
<0.001). This development was most pronounced in male patients aged 45 to 59 years with an increase from 151 per 100 000 to 176 per 100 000. In this age group, male patients showed increasing rates of prior strokes and atrial fibrillation, surpassing the prevalence in female patients over time. After multivariable regression analysis, male patients had a lower modified Rankin Scale at discharge compared with female patients, but this difference has decreased since 2015 (common OR in 2010, 0.83 [95% CI, 0.78–0.88]; common OR in 2019, 0.90 [95% CI, 0.84–0.95]), which coincided with rising rates of endovascular treatment.

Conclusions
Over the past decade in the federal state of Hesse, the overall incidence of ischemic stroke has declined predominantly in the female population. In contrast, for male patients, the incidence has risen by about 4%, with a steeper increase of 16% in male patients aged 45 to 59 years, which might be related to increasing rates of recurrent strokes and atrial fibrillation in this cohort. This finding provides a cautionary tale for effective secondary prevention. Female patients were generally less likely to achieve a favorable outcome, but since the introduction of endovascular treatment, the outcome gap is decreasing.
Does Use of Information Sources Outside the Treating Oncologist Influence Patient Decision-Making in Patients Receiving Non-Curative Intent Therapy for Advanced Cancer
Authors: Patell Rushad , Miller Eric , Einstein David , Dodge Laura E. , Halleck Jennifer , Buss Mary K. 
Published: October 2022

Background Patients’ decision-making and perceptions of outcomes may be impacted by information sources. We investigated use of information by patients and tested the association with patients’ perception of treatment outcomes. Methods We prospectively surveyed patients with advanced solid cancers and their oncologists regarding benefits/risks of non-curative cancer therapies. We previously reported misperception comparing patients’ perceptions of treatment outcomes to those of their oncologist. We report external information use as proportions with binomial confidence intervals (CI) and examined correlations with misperception levels using Spearman’s correlation coefficient. Results Of 125 participants, 70% (95% CI: 61-78) stated that they wanted as much information as possible from their oncologist, and nearly all (95%, 95% CI: 90-98) felt the amount of information provided by their clinician was “just right.” Over half (60%, 95% CI: 51-69) wanted at least “a moderate amount” of information from sources outside their oncologist, and 58% (95% CI: 49-67) reported obtaining information from sources outside their oncologist. Over two-thirds (69%, 95% CI: 57-79) of participants felt the information from external sources influenced their decisions “a small amount” or less. There was no correlation between information use and misperception regarding tumor response (r: −.04; P = .60) or treatment toxicity (r: .05; P = .60). Conclusion Many patients sought information from sources outside their oncologist; few felt it substantially influenced treatment choices. External information use was not associated with greater misperception of treatment outcomes. These data suggest sources of information outside the treating oncologists did not substantially influence patient’s decision making.
CGRP-induced migraine-like headache in persistent post-traumatic headache attributed to mild traumatic brain injury
Authors: Ashina Håkan , Iljazi Afrim , Al-Khazali Haidar M. , Do Thien Phu , Eigenbrodt Anna K. , Larsen Eigil L. , Andersen Amalie M. , Hansen Kevin J. , Bräuner Karoline B. , Chaudhry Basit Ali , Christensen Casper E. , Amin Faisal Mohammad , Schytz Henrik W. 
Published: October 2022

Abstract
Objective
To ascertain whether intravenous infusion of calcitonin gene-related peptide (CGRP) can induce migraine-like headache in people with persistent post-traumatic headache attributed to mild traumatic brain injury (TBI) and no pre-existing migraine.

Methods
A non-randomized, single-arm, open-label study at a single site in Denmark. Eligible participants were aged 18 to 65 years and had a known history of persistent post-traumatic headache attributed to mild TBI for ≥ 12 months. All participants received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min. A headache diary was used to collect outcome data until 12 h after the start of CGRP infusion. The primary end point was the incidence of migraine-like headache during 12-hour observational period.

Results
A total of 60 participants completed the study protocol and provided data for the analysis of the primary end point. The median age was 32.5 (IQR, 25.5–43.0) years; 43 participants (72%) were female. Following CGRP infusion, 43 (72%) of 60 participants developed migraine-like headache during the 12-hour observational period. The median time to peak headache intensity was 40 min (IQR, 20–60), and the median peak headache intensity was 6 (IQR, 5–8) on the 11-point numeric rating scale.

Conclusion
Intravenous infusion of CGRP is a potent inducer of migraine-like headache in people with persistent post-traumatic headache attributed to mild TBI. This observation underscores the importance of CGRP in the genesis of migraine-like headache that is often experienced by individuals who are afflicted by persistent post-traumatic headache. Further research is warranted to ascertain whether other signaling molecules also contribute to the disease mechanisms underlying post-traumatic headache.
Genome-wide identification of biotin carboxyl carrier subunits of acetyl-CoA carboxylase in Brassica and their role in stress tolerance in oilseed Brassica napus
Authors: Megha Swati , Wang Zhengping , Kav Nat N. V. , Rahman Habibur 
Published: October 2022

Abstract
Background
Biotin carboxyl carrier protein (BCCP) is a subunit of Acetyl CoA-carboxylase (ACCase) which catalyzes the conversion of acetyl-CoA to malonyl-CoA in a committed step during the de novo biosynthesis of fatty acids. Lipids, lipid metabolites, lipid-metabolizing and -modifying enzymes are known to play a role in biotic and abiotic stress tolerance in plants. In this regard, an understanding of the Brassica napus BCCP genes will aid in the improvement of biotic and abiotic stress tolerance in canola.

Results
In this study, we identified 43 BCCP genes in five Brassica species based on published genome data. Among them, Brassica rapa, Brassica oleracea, Brassica nigra, Brassica napus and Brassica juncea had six, seven, seven, 10 and 13 BCCP homologs, respectively. Phylogenetic analysis categorized them into five classes, each with unique conserved domains. The promoter regions of all BCCP genes contained stress-related cis-acting elements as determined by cis-element analysis. We identified four and three duplicated gene pairs (segmental) in B. napus and B. juncea respectively, indicating the role of segmental duplication in the expansion of this gene family. The Ka/Ks ratios of orthologous gene pairs between Arabidopsis thaliana and five Brassica species were mostly less than 1.0, implying that purifying selection, i.e., selective removal of deleterious alleles, played a role during the evolution of Brassica genomes. Analysis of 10 BnaBCCP genes using qRT-PCR showed a different pattern of expression because of exposure of the plants to biotic stresses, such as clubroot and sclerotinia diseases, and abiotic stresses such as drought, low temperature and salinity stresses.

Conclusions
The identification and functional analysis of the Brassica BCCPs demonstrated that some of these genes might play important roles in biotic and abiotic stress responses. Results from this study could lay the foundation for a better understanding of these genes for the improvement of Brassica crops for stress tolerance.
The efficiency of arbuscular mycorrhiza in increasing tolerance of Triticum aestivum L. to alkaline stress
Authors: Farghaly Fatma Aly , Nafady Nivien Allam , Abdel-Wahab Dalia Ahmed 
Published: October 2022

AbstractBackgroundEvaluation of native soil microbes is a realistic way to develop bio-agents for ecological restoration. Soil alkalinity, which has a high pH, is one of the most common concerns in dry and semi-arid climates. Alkaline soils face problems due to poor physical properties, which affect plant growth and crop production. A pot experiment was carried out to investigate the impact of native mycorrhizal fungi (AMF) on the wheat plant (Triticum aestivumL.) under two levels of alkalinity stress -T1 (37 mM NaHCO3), T2 (74 mM NaHCO3) - at two developmental stages (the vegetative and productive stages).ResultsAlkalinity stress significantly inhibited the germination percentage, plant biomass, photosynthetic pigments, and some nutrients (K, N, and P). Mycorrhizal inoculation improved growth parameters and productivity of wheat-stressed plants. However, lipid peroxidation was significantly lowered in mycorrhizal-inoculated plants compared to non-inoculated plants. Catalase and peroxidase were inhibited in wheat leaves and roots by alkalinity, while mycorrhiza promoted the activity of these enzymes.ConclusionThe results of this study demonstrated that alkalinity stress had highly negative effects on some growth parameters of the wheat plant, while AMF inoculation attenuated these detrimental effects of alkalinity stress at two stages by reducing the pH and Na concentration and increasing the availability of P and the productivity of wheat in particular crop yield parameters.
Effect of intravenous lidocaine on the ED50 of propofol for inserting gastroscope without body movement in adult patients: a randomized, controlled study
Authors: Qi Xiu-Ru , Sun Jing-Yi , An Li-Xin , Zhang Ke 
Published: October 2022

Abstract
Background
Circulatory and respiratory depression are common  problems that occur in propofol alone sedation during gastroscopy. As a widely used analgesic adjuvant, intravenous lidocaine can reduce the consumption of propofol during Endoscopic retrograde cholangiopancreatography (ERCP) or colonoscopy. However, it is still unknown the median effective dose (ED50) of propofol when combined with lidocaine intravenously. This study aimed to compare the ED50 of propofol with or without intravenous lidocaine for inserting gastrointestinal endoscope successfully.

Methods
Fifty nine patients undergoing gastroscopy or gastrointestinal (GI) endoscopy were randomly divided into control group (Group C, normal saline + propofol) or lidocaine group (Group L, lidocaine + propofol). Patients were initially injected a bolus of 1.5 mg/kg lidocaine in Group L, whereas equivalent volume of 0.9% saline in Group C. Anaesthesia was then induced with a single bolus of propofol in all subjects. The induction dose of propofol was determined by the modified Dixon’s up-and-down method, and the initial dose was 1.5 mg/kg in both groups. The primary outcome was the ED50 of propofol induction dose with or without intravenous lidocaine. The secondary outcomes were the induction time, the first propofol bolus time (FPBT: from MOAA/S score ≤ 1 to first rescue bolus propofol), and adverse events (AEs: hypoxemia, bradycardia, hypotension, and body movements).

Results
Totally, 59 patients were enrolled and completed this study. The ED50 of propofol combined with lidocaine was 1.68 ± 0.11 mg/kg, significantly reduced compared with the normal saline group, 1.88 ± 0.13 mg/kg (P = 0.002). There was no statistical difference in induction time (P = 0.115) and the FPBT (P = 0.655) between the two groups. There was no significantly difference about the AEs between the two groups.

Conclusion
The ED50 of propofol combined with intravenous lidocaine for successful endoscope insertion in adult patients, was 1.68 ± 0.11 mg/kg significantly reduced compared with the control group.

Trial registration
Chinese Clinical Trial Registry, No: ChiCTR2200059450. Registered on 29 April 2022. Prospective registration. http://www.chictr.org.cn.
Group-level comparison of brain connectivity networks
Authors: Pourmotahari Fatemeh , Doosti Hassan , Borumandnia Nasrin , Tabatabaei Seyyed Mohammad , Alavi Majd Hamid 
Published: October 2022

Abstract
Background
Functional connectivity (FC) studies are often performed to discern different patterns of brain connectivity networks between healthy and patient groups. Since many neuropsychiatric disorders are related to the change in these patterns, accurate modelling of FC data can provide useful information about disease pathologies. However, analysing functional connectivity data faces several challenges, including the correlations of the connectivity edges associated with network topological characteristics, the large number of parameters in the covariance matrix, and taking into account the heterogeneity across subjects.

Methods
This study provides a new statistical approach to compare the FC networks between subgroups that consider the network topological structure of brain regions and subject heterogeneity.

Results
The power based on the heterogeneity structure of identity scaled in a sample size of 25 exhibited values greater than 0.90 without influencing the degree of correlation, heterogeneity, and the number of regions. This index had values above 0.80 in the small sample size and high correlation. In most scenarios, the type I error was close to 0.05. Moreover, the application of this model on real data related to autism was also investigated, which indicated no significant difference in FC networks between healthy and patient individuals.

Conclusions
The results from simulation data indicated that the proposed model has high power and near-nominal type I error rates in most scenarios.
Risk for morbidity and mortality after neurosurgery in older patients with high grade gliomas – a retrospective population based study
Authors: Löfgren David , Valachis Antonios , Olivecrona Magnus 
Published: October 2022

Abstract
Background
Although high grade gliomas largely affect older patients, current evidence on neurosurgical complications is mostly based on studies including younger study populations. We aimed to investigate the risk for postoperative complications after neurosurgery in a population-based cohort of older patients with high grade gliomas, and explore changes over time.

Methods
In this retrospective study we have used data from the Swedish Brain Tumour Registry and included patients in Sweden age 65 years or older, with surgery 1999–2017 for high grade gliomas. We analysed number of surgical procedures per year and which factors contribute to postoperative morbidity and mortality.

Results
The study included 1998 surgical interventions from an area representing 60% of the Swedish population. Over time, there was an increase in surgical interventions in relation to the age specific population (p < 0.001).
Postoperative morbidity for 2006–2017 was 24%. Resection and not having a multifocal tumour were associated with higher risk for postoperative morbidity. Postoperative mortality for the same period was 5%. Increased age, biopsy, and poor performance status was associated with higher risk for postoperative mortality.

Conclusions
This study shows an increase in surgical interventions over time, probably representing a more active treatment approach.
The relatively low postoperative morbidity- and mortality-rates suggests that surgery in older patients with suspected high grade gliomas can be a feasible option. However, caution is advised in patients with poor performance status where the possible surgical intervention would be a biopsy only.
Further, this study underlines the need for more standardised methods of reporting neurosurgical complications.
Evaluation of two different semi-automated homogenization techniques in microbiological diagnosis of periprosthetic joint infection: disperser vs. bead milling method
Authors: Rieber Heime , Frontzek Andre , Heinrich Stephanie , Barden Bertram , Kortstegge Thomas , Dienstknecht Thomas , Breil-Wirth Andreas , Herwig Mathias , Jerosch Jörg , Pinkernell Ralf , Ulatowski Martin 
Published: October 2022

Abstract
Background
In microbiological diagnosis of periprosthetic joint infection (PJI) there is no consensus regarding the most suitable and optimal number of specimens to be cultured or the most effective technique of tissue processing. This comparative study analysed the accuracy of two semi-automated homogenization methods with special focus on the volume and exact origin of each sample.

Methods
We investigated a total of 722 periprosthetic tissue samples. PJI was defined according to the new scoring system for preoperative and intraoperative criteria. We compared the performance of our routinely used single tissue processing by disposable high-frequency disperser with the bead milling method.

Results
Eighty patients were included. Among forty classified PJIs, 34 patients yielded positive culture results. In 23 cases (68%) exact concordant results were generated with both techniques. However, in seven cases (20%) processing by the disperser and in four cases (12%) by bead milling provided additional positive samples, but without significant difference since the major definition criteria were met in all cases. The percentage of positive results was influenced by the volume and origin of the tissue samples. Results for small tissue samples tended to be better using the bead milling method. This might lead to improved preoperative arthroscopic diagnosis, as the volume of biopsies is generally limited. Six patients had negative results due to previous antimicrobial therapy. Forty other patients were classified as aseptic failures. Neither procedure resulted in any contamination.

Conclusion
Both methods enable reliable processing of tissue samples for diagnosis of PJI and are suitable for routine use.