bluuebunny/crossref_metadata_2025_split huggingface dataset:
SOOTHER TRIAL: Observational study of an over-the-counter ointment to heal anal itch
Authors: Felemovicius Isaac , Ganz Robert A. , Saremi Mohammad , Christopfel William 
Published: September 2022

IntroductionPruritus ani, or rectal or anal itch, is a common perianal disorder that affects ~5% of the population of the developed world. Treatments for this disorder are somewhat limited and include conservative non-medical perianal hygiene care, and topical medical treatments including topical steroids, antibacterial and antifungal agents, and topical anesthetic/analgesics such as lidocaine or capsaicin; astringents and vasoconstrictors such as ephedrine can also be used.MethodsThe study was IRB approved. We assessed the efficacy of a novel, composite, over-the-counter, topical lidocaine ointment that included an epidermal barrier and antimicrobial effect along with the typical lidocaine anesthetizing effect, in a single arm, observational, longitudinal, population of 20 ambulatory pruritus ani patients. Patients applied the ointment twice daily, and were studied for 2 weeks; primary outcomes included time to symptom resolution and clinical exam resolution as measured on a 5-point visual analog scale.ResultsTwenty-nine consecutive patients were screened and 20 patients (12 males; 8 females) were enrolled in the study. Ninety percent of patients achieved 100% symptom resolution by 2 weeks, and most were improved within 72 h of initiating treatment; 95% of patients had a normal visual exam by the 2 week endpoint. There were no significant adverse events attributable to the therapy.ConclusionUse of a novel composite topical lidocaine agent, demonstrated rapid and effective relief of pruritus ani in an ambulatory population. Additional studies are underway.Clinical trial registeredClinicaltrials.gov, identifier NCT05288907.
Pregnancy in women with Hereditary Angioedema due to C1-inhibitor deficiency: Results from the ITACA cohort study on outcome of mothers and children with in utero exposure to plasma-derived C1-inhibitor
Authors: Triggianese P. , Senter R. , Petraroli A. , Zoli A. , Lo Pizzo M. , Bignardi D. , Di Agosta E. , Agolini S. , Arcoleo F. , Rossi O. , Modica S. , Greco E. , Chimenti M. S. , Spadaro G. , De Carolis C. , Cancian M. 
Published: September 2022

BackgroundIn women with Hereditary Angioedema (HAE) due to C1-inhibitor (C1INH) deficiency (C1INH-HAE), pregnancy counseling and treatment can be challenging. Despite the evidence of the immediate favorable outcome and safety of plasma-derived (pd)C1INH concentrate, there are no data regarding any difference among women who underwent or not pdC1INH during pregnancy or on children with in utero exposure to pdC1INH. The present interview study aimed at analyzing outcome of C1INH-HAE mothers and children according to pdC1INH-exposure during pregnancies.MethodsC1INH-HAE women who experienced at least 1 pregnancy were included from seven centers of the Italian Network for Hereditary and Acquired Angioedema (ITACA). The interview study retrospectively analyzed pregnancies who underwent (group 1) or not (group 2) pdC1INH. The overall goals of the study included immediate and long-term outcomes, in terms of outcomes in the time interval between pregnancy and survey.ResultsA total of 168 pregnancies from 87 included women were analyzed. At term delivery (&gt;37 gestation-week, GW) has been registered in 73.8% of cases, while spontaneous abortion (SA) occurred in 14.2% of cases with a mean GW 7 ± 2. The group 1 including pdC1INH-treated pregnancies comprised a third of the cohort (51/168, time interval 1.5 ± 10.4 yrs), while the group 2 represented 69.6% (117/168, time interval 32.8 ± 14 yrs). The same prevalence of SA occurred when comparing group 1 (11.7%) with group 2 (15.4%) with a similar GW at SA. The group 1 was older at the pregnancy time and younger at the interview than the group 2 (P &lt; 0.01 for both); moreover, the group 1 showed a higher prevalence of cesarean delivery (P &lt; 0.0001). The overall prevalence of obstetrical syndromes was similar between two groups: however, gestational diabetes was described only in pdC1INH-untreated pregnancies. In utero pdC1INH-exposed children (n = 45) did not show differences compared with unexposed ones (n = 99) in neonatal short-term outcomes.ConclusionThrough appropriate management and counseling, most of C1INH-HAE women undergo successful pregnancy and delivery. For pregnant C1INH-HAE women being treated with pdC1INH, our findings are reassuring and might lead to an improvement of both the knowledge about treatments and the experience of HAE itself.
A single-center retrospective study comparing safety and efficacy of endoscopic biliary stenting only vs. EBS plus nasobiliary drain for obstructive jaundice
Authors: Liu Huan , Shi Chuanke , Yan Zhideng , Luo Ming 
Published: September 2022

PurposeBiliary drainage is an important modality for extrahepatic obstructive jaundice both in patients with palliative and resectable. Currently, endoscopic biliary drainage is preferred in clinical practice, including endoscopic nasobiliary drainage (ENBD) and endoscopic biliary stenting (EBS), both of which have their own advantages and disadvantages. The purpose of our study was to compare the safety and efficacy of endoscopic biliary stenting (EBS) only vs. EBS plus nasobiliary drain for obstructive jaundice.MethodsWe consecutively reviewed patients with endoscopic biliary drainage in our institution from November 2014 to March 2021. Combined (ENBD plus stent) and single approach (EBS only) were defined as combined approach and single modality, respectively, and all eligible patients were divided into a combined approach group and a single modality group. We compared combined vs. single modality approaches to investigate whether there were statistical differences in liver chemistries, postoperative adverse events, and stent patency time.ResultsIn 271 patients, a total of 356 times endoscopic biliary drainages were performed. All eligible patients were divided into the combined approach group (n = 74) and the single modality group (n = 271). The combined approach was associated with a lower incidence of postoperative cholangitis and bleeding and greater improvement in liver chemistries, although it was not statistically significant. However, it was superior to the single modality group in terms of hospital stay (12.7 ± 5.2 vs. 14.5 ± 7.9 days, p = 0.020 &lt; 0.05) and stent patency time (8.1 ± 3.9 vs. 4.3±2.7 months, p = 0.001 &lt; 0.05).ConclusionEndoscopic combined (ENBD plus stent) drainage is a more advantageous biliary drainage method that is characterized by more adequate biliary drainage, a lower incidence of postoperative adverse events, and longer effective biliary drainage time.
Development and validation of virtual reality-based Rey Auditory Verbal Learning Test
Authors: Gottlieb Amihai , Doniger Glen M. , Kimel-Naor Shani , Ben-Gal Oran , Cohen Maya , Iny Hila , Beeri Michal Schnaider , Plotnik Meir 
Published: September 2022

ObjectiveTranslations and adaptations of traditional neuropsychological tests to virtual reality (VR) technology bear the potential to increase their ecological validity since the technology enables simulating everyday life conditions in a controlled manner. The current paper describes our translation of a commonly used neuropsychological test to VR, the Rey Auditory Verbal Learning Test (RAVLT). For this aim, we developed a VR adaptation of the RAVLT (VR-RAVLT) Which is based on a conversation with a secretary in a virtual office using a fully immersive VR system. To validate the VR-RAVLT, we tested its construct validity, its age-related discriminant validity and its test-retest validity in reference to the original gold standard RAVLT (GS-RAVLT).MethodSeventy-eight participants from different age groups performed the GS-RAVLT and the VR-RAVLT tests in a counterbalanced order in addition to other neuropsychological tests. Construct validity was validated using Pearson’s correlations coefficients and serial position effects; discriminant validity was validated using receiver operating characteristic area under the curve values and test-retest reliability was validated using intraclass correlation coefficients.ResultsComparing both RAVLTs’ format results indicates that the VR-RAVLT has comparable construct, discriminant and test–retest validities.Conclusionthe novel VR-RAVLT and the GS-RAVLT share similar psychometric properties suggesting that the two tests measure the same cognitive construct. This is an indication of the feasibility of adapting the RAVLT to the VR environment. Future developments will employ this approach for clinical diagnosis and treatment.
Dreamers’ evaluation of the emotional valence of their day-to-day dreams is indicative of some mood regulation function
Authors: Barbeau Kheana , Turpin Chloé , Lafrenière Alexandre , Campbell Emma , De Koninck Joseph 
Published: September 2022

Dreams may contribute to psychological adaptation by aiding in mood regulation. One way it could be achieved is through a desensitization process whereby negative events are replayed within the dream under lower conditions of negative emotionality. Evidence of this theory is supported by the tendency of dreamers to evaluate their emotions felt in their dreams more positively compared to an independent judge (i.e., positivity bias). Additionally, it has been observed that while dream emotions are typically more negative than pre-sleep emotions, morning emotions are more positive, suggesting that emotional regulation occurs overnight and may help improve mood in the morning. The present study aimed to examine the relationships between pre-sleep, dream, and morning mood and the potential desensitization function of remembered dreams as indicated by their effects on morning mood and stress.Methodology: Participants (N = 188; Mean age = 19.2, SD = 3.0) recorded their dreams (N = 345 dreams) and self-reported their stress and mood at bedtime, during their dream retrospectively, and upon waking. A judge also evaluated the subjects’ dream moods. Subjects’ positivity bias was defined as the difference between the subjects and the judge’s evaluation of the positive emotions in the dream.Results: A MANOVA revealed that subjects perceived a higher level of positive emotions in their dreams compared to a judge. Multi-group path analysis revealed that some relationships between pre-sleep, dream, and morning emotions and stress differed in positive and negative dream nights. In both groups, the strongest predictors of morning mood and stress were pre-sleep mood and stress, respectively. The second strongest predictor of positive morning mood was the subjects’ dream positivity bias.Conclusion: Results provide some support for the association of dreaming in mood regulation attributable to REM sleep. They also highlight that pathways implicated in mood regulation may be distinct from stress regulation.
General anesthesia but not conscious sedation improves functional outcome in patients receiving endovascular thrombectomy for acute ischemic stroke: A meta-analysis of randomized clinical trials and trial sequence analysis
Authors: Lee Chia-Wei , Chang Yang-Pei , Huang Yen-Ta , Hsing Chung-Hsi , Pang Yu-Li , Chuang Min-Hsiang , Wu Su-Zhen , Sun Cheuk-Kwan , Hung Kuo-Chuan 
Published: September 2022

BackgroundThis study aimed at comparing the difference in prognostic outcomes between patients receiving general anesthesia (GA) and conscious sedation (CS) for endovascular thrombectomy after acute ischemic stroke.MethodsDatabases from Medline, Embase, Google scholar, and Cochrane library were searched for randomized controlled studies (RCTs) comparing patients undergoing GA and CS for endovascular thrombectomy following anterior circulation ischemic stroke. The primary outcome was frequency of 90-day good functional outcome [defined as modified Rankin Scale score of ≤ 2], while secondary outcomes included successful recanalization rate (SRR) [i.e., modified thrombolysis in cerebral infarction = 2b or 3], mortality risk, symptomatic intracranial hemorrhage (ICH), procedure-related complications, hypotension, pneumonia, neurological outcome at post-procedure 24–48 h, and puncture-to-recanalization time.ResultsSix RCTs including 883 patients published between 2016 and 2022 were included. Merged results revealed a higher SRR [risk ratio (RR) = 1.11, 95% CI: 1.03–1.2, p = 0.007; I2 = 29%] and favorable neurological outcomes at 3-months (RR = 1.2, 95% CI: 1.01–1.41, p = 0.04; I2 = 8%) in the GA group compared to CS group, without difference in the risk of mortality (RR = 0.88), symptomatic ICH (RR = 0.91), procedure-related complications (RR = 1.05), and pneumonia (RR = 1.9) as well as post-procedure neurological outcome (MD = −0.21) and successful recanalization time (MD = 3.33 min). However, GA was associated with a higher risk of hypotension compared with that of CS.ConclusionPatients with acute anterior circulation ischemic stroke receiving GA were associated with a higher successful recanalization rate as well as a better 3-month neurological outcome compared to the use of CS. Further investigations are warranted to verify our findings.Systematic review registrationwww.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022342483, identifier: CRD42022342483.
New evidence on the association of occupation with amyotrophic lateral sclerosis: A register-based case-control study in Finland
Authors: Saastamoinen Peppiina , Laaksovirta Hannu , Leino-Arjas Päivi , Rahkonen Ossi 
Published: September 2022

ObjectivesAmyotrophic lateral sclerosis (ALS) is a serious neurodegenerative disease that usually leads to death within a few years from diagnosis. The risk factors for ALS are still largely unknown. However, it is assumed that environmental factors play a role in disease onset. Occupation is suggested as a potential risk factor, but findings are inconsistent. The aim of this study was to assess the association of occupation with ALS in Finland. Register data were used to avoid recall bias and to obtain a large enough sample to detect the potential associations.MethodsThis case-control study included ALS cases that occurred between 1980 and 2015 in Finland (n = 4,781). ALS cases were identified from the causes of death register. For each ALS case, six controls were selected matched for sex and birth-year. The date of death of the ALS case was set as index date. Information on occupation was obtained from Statistics Finland for all subjects. The focus was on the longest-held occupation on 2-digit level (70 groups). The association of occupation with ALS was analyzed using conditional logistic regression.ResultsCompared to “clerical work and other office work,” the risk of ALS was increased in “packing and wrapping work” (OR 1.53, 95% CI 1.08–2.17), “laundering, dry cleaning and pressing work” (OR 1.83, 95% CI 1.08–3.08), and “travel service work” (OR 8.75, CI 2.76–27.74). A decreased risk was found in “planning, administrative and research work in the technical fields” (OR 0.69, 95% CI 0.48–0.98). Of the significant associations identified, only “travel service work” was significant after FDR multiple testing correction.ConclusionsThis study identified occupations in which the risk of ALS was increased. Further studies are needed to pinpoint the potential exposures in these occupations that may trigger the disease.
Retrospective real-world pilot data on transcranial pulse stimulation in mild to severe Alzheimer's patients
Authors: Cont Celine , Stute Nathalie , Galli Anastasia , Schulte Christina , Logmin Kazimierz , Trenado Carlos , Wojtecki Lars 
Published: September 2022

IntroductionTranscranial pulse stimulation (TPS) is a non-invasive neuromodulation therapy that uses short, repetitive shockwaves through a neuro-navigated device. Current research suggests that these pulses lead to a wide range of vascular, metabolic, and neurotrophic changes. This relatively new CE-marked treatment provided first promising results in a clinical pilot study for improving cognition in mild-to-moderate Alzheimer's. Data from other centers is lacking, so here we analyzed safety and pilot real-world short-term results of TPS from the first center in Germany. To gain information about effects in different stages, patients with not only mild but also moderate-to-severe Alzheimer's were analyzed.MethodsA total of 11 patients were retrospectively examined for cognitive and emotional function before and after the first stimulation series. The effect was assessed using several neuropsychological tests [Alzheimer's Disease Assessment Scale (ADAS), including the ADAS cognitive score (ADAS Cog) and ADAS affective scores, Mini-Mental Status Examination (MMSE), and Montreal Cognitive Assessment (MoCA)] including in comparison between the groups of mild-to-severe patients. Moreover, subjective improvement of symptom severity, potential effects on depressive symptoms, and side effects were analyzed using Numeric Rating Scales (NRS).ResultsSide effects were rare (in 4% of sessions) with moderate subjective severity and only transient. Patients significantly improved in the ADAS and ADAS Cog, while there was no significant effect in MMSE and MoCA. Patients' self-reported symptom severity improved significantly. The depressive symptoms measured in an ADAS subscale also improved significantly. Statistical data analyses revealed no significant correlation of clinical improvement with baseline symptom severity.ConclusionTPS might be a safe and promising add-on therapy for Alzheimer's, even for moderate-to-severe patients. More research on long-term effects in patients as well as studies with sham control groups is needed. Moreover, translational research on the mechanisms of action and effects on cerebral network physiology will be needed to understand this new neuromodulation technique.
A web-based dynamic nomogram for rupture risk of posterior communicating artery aneurysms utilizing clinical, morphological, and hemodynamic characteristics
Authors: Wei Heng , Han Wenrui , Tian Qi , Yao Kun , He Peibang , Wang Jianfeng , Guo Yujia , Chen Qianxue , Li Mingchang 
Published: September 2022

BackgroundPredicting rupture risk is important for aneurysm management. This research aimed to develop and validate a nomogram model to forecast the rupture risk of posterior communicating artery (PcomA) aneurysms.MethodsClinical, morphological, and hemodynamic parameters of 107 unruptured PcomA aneurysms and 225 ruptured PcomA aneurysms were retrospectively analyzed. The least absolute shrinkage and selection operator (LASSO) analysis was applied to identify the optimal rupture risk factors, and a web-based dynamic nomogram was developed accordingly. The nomogram model was internally validated and externally validated independently. The receiver operating characteristic (ROC) curve was used to assess the discrimination of nomogram, and simultaneously the Hosmer–Lemeshow test and calibration plots were used to assess the calibration. Decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the clinical utility of nomogram additionally.ResultsFour optimal rupture predictors of PcomA aneurysms were selected by LASSO and identified by multivariate logistic analysis, including hypertension, aspect ratio (AR), oscillatory shear index (OSI), and wall shear stress (WSS). A web-based dynamic nomogram was then developed. The area under the curve (AUC) in the training and external validation cohorts was 0.872 and 0.867, respectively. The Hosmer–Lemeshow p &gt; 0.05 and calibration curves showed an appropriate fit. The results of DCA and CIC indicated that the net benefit rate of the nomogram model is higher than other models.ConclusionHypertension, high AR, high OSI, and low WSS were the most relevant risk factors for rupture of PcomA aneurysms. A web-based dynamic nomogram thus established demonstrated adequate discrimination and calibration after internal and external validation. We hope that this tool will provide guidance for the management of PcomA aneurysms.
Effect of vertebrobasilar dolichoectasia on endovascular therapy in acute posterior circulation infarction
Authors: Zhou Jing , Peng Daizhou , Sun Dong , Dai Weipeng , Long Ceng , Meng Renliang , Wang Jing , Yan Zhizhong , Wang Tao , Wang Li , Yue Chengsong , Li Linyu , Zi Wenjie , Wang Lingling , Wang Xiaoming , Wu Youlin , Jiang Guohui 
Published: September 2022

Background and purposeThis study aimed to analyze the feasibility and safety of endovascular therapy (EVT) in patients with acute posterior circulation stroke and vertebrobasilar dolichoectasia (VBD).Materials and methodsBASILAR was a national prospective registry of consecutive patients with symptomatic and imaging-confirmed acute stroke in the posterior circulation within 24 h of symptom onset. We evaluated EVT feasibility and safety in patients with VBD. Primary outcomes included improvement in modified Rankin Scale scores (mRS) at 90 days and mortality within 90 days. The secondary outcome was the rate of favorable functional outcome, defined as mRS ≤ 3 (indicating independent ambulation) at 90 days. Safety outcomes included surgery-related complications and other serious adverse events.ResultsA total of 534 cases were included: 159 with VBD and 375 controls. No significant difference in mRS at 90 days was found between groups, but patients with VBD had a higher baseline National Institutes of Health Stroke Scale (NIHSS) score [30 (19–33) vs. 25 (15–32)] and were older [65 (59–74) vs. 63 (55–72) year]. After propensity score matching, there were no significant differences in baseline NIHSS score between the two groups, and the efficacy and safety of EVT were similar between patients with or without VBD. Furthermore, the prognostic effect of puncture-to-recanalization time on the probability of mortality within 90 days in EVT-treated patients with VBD was significant {adjusted odds ratio, 1.008 [95% confidence interval (1.001–1.015)]}.ConclusionEndovascular therapy is safe and feasible in patients with acute posterior circulation stroke and VBD. The puncture-to-recanalization time is important for predicting the prognosis of EVT-treated patients with VBD.