bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sudden cardiac death after acute myocarditis with arrhythmic presentation: hunting for risk predictors − a systematic review and meta-analysis
Authors: Narducci Maria Lucia , Ballacci Federico , Giordano Federica , Collini Valentino , Imazio Massimo 
Published: December 2024

BackgroundVentricular arrhythmias (VAs) frequently occur in the acute phase of myocarditis. Possible arrhythmic recurrences and the risk of sudden cardiac death (SCD) in this setting are reasons for concern, and limited data have been published to guide clinical management of these patients. The aim of the present paper is to report the incidence of major arrhythmic events, defined as sustained VA, SCD and appropriate implantable cardiac-defibrillator (ICD) treatment, in patients with acute myocarditis and ventricular arrhythmic phenotype.MethodsWe conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to evaluate studies reporting long-term outcomes in patients with acute myocarditis and arrhythmic presentation. We systematically searched PubMed, EMBASE and Scopus databases for relevant studies up to 2 August 2024. Study quality was assessed by the Newcastle-Ottawa Scale. The primary outcome was a composite of SCD, VA recurrence and appropriate ICD therapy. Random-effect models were used to calculate pooled ORs and CIs.ResultsFive observational studies enrolling 322 patients were identified. The pooled proportion of patients who experienced VA recurrence was 0.41 (95% CI 0.30 to 0.53, p=0.13). An increased risk of adverse outcomes during follow-up was observed in patients presenting with monomorphic ventricular tachycardia (OR 3.77, 95% CI 1.23 to 11.53) and left ventricular ejection fraction (LVEF) <50% (OR 2.74, 95% CI 0.78 to 9.63). Gender and anteroseptal late gadolinium enhancement were not found as potential risk factors in this analysis.ConclusionsPatients with myocarditis with arrhythmic ventricular presentation have a high recurrence rate of VA, underscoring the importance of careful monitoring and management in this patient population. Risk stratification for SCD during follow-up should be individualised, and monomorphic VA at presentation or a reduced LVEF may be markers of poor prognosis. In these cases, an ICD implantation may be cautious pending further dedicated studies.
Comparison of Latissimus Dorsi versus Teres Major Tendon Transfer to Restore External Rotation of the Shoulder in Patients with Erb Palsy
Authors: ABDELAZIZ Ashraf M. , ABDELFATH Mohamed Ahmed , ISMAIL Mahmoud Ali , WAHD Yaser El Sayed HASSAN , ALI Abdelaziz MONSEF , AKEED Tharwat AL 
Published: December 2024

Background: The transfer of latissimus dorsi (LD) and teres major (TM) have been described for restoration of external rotation (ER) and shoulder abduction in neonatal brachial plexus palsy (NBPP). The aim of this prospective randomised study is to compare the outcomes of LD versus TM transfer in the treatment of internal rotation contracture of the shoulder in children with NBPP. Methods: The study was conducted from February 2014 to January 2018 and included NBPP patients with internal rotation contracture of the shoulder. Patients were randomised to either LD (Group 1) or TM (Group 2) tendon transfer. Patients were followed up for at least 38 months and assessed for improvements in the arc of shoulder abduction and ER. Results: The study included 30 patients with 15 patients randomised to each group respectively. Group 1 (n = 15) included 4 boys and 11 girls with a mean age of 2 years and 8 months (range: 1.5–5) and a mean follow-up of 62 months (range: 38–68). Group 2 (n = 15) included 6 boys and 9 girls with a mean age of 2 years and 6 months (range: 1.5–4.8) and a mean follow-up of 58 months (range: 38–68). All patients showed improvement in shoulder abduction and active and passive ER. There were no differences in shoulder abduction (p = 0.467), active ER (p = 0.124) and passive ER (p = 0.756) between both groups. Conclusions: Both LD and TM tendon transfers improved shoulder function in NBPP patients with internal rotation contracture of the shoulder. Level of Evidence: Level II (Therapeutic)
The Landscape of ctDNA in Appendiceal Adenocarcinoma
Authors: White Michael G. , Zeineddine Mohammad A. , Fallon Eleanor A. , Zeineddine Fadl A. , Dansby Julia , Chowdhury Saikat , Hornstein Nicholas , Yousef Abdelrahman , Yousef Mahmoud , Bhutiani Neal , Gu Yue , Kee Bryan , Dasari Arvind , Overman Michael J. , Raghav Kanwal , Kopetz Scott , Uppal Abhineet , Taggart Melissa , Newhook Timothy , Fournier Keith , Helmink Beth , Drusbosky Leylah M. , Shen John Paul 
Published: December 2024

Abstract

Purpose:
Appendiceal adenocarcinoma is a rare malignancy with distinct histopathologic subtypes and a natural history with metastasis primarily limited to the peritoneum. Little is known about the molecular pathogenesis of appendiceal adenocarcinoma relative to common tumors.

Experimental Design:
We analyzed molecular data for patients within the Guardant Health database with appendix cancer (n = 718). We then identified patients with appendiceal adenocarcinoma at our institution (from October 2004–September 2022) for whom ctDNA mutation profiling (liquid biopsy) was performed (n = 168) and extracted clinicopathologic and outcomes data. Of these 168 patients, 57 also had tissue-based tumor mutational profiling, allowing for evaluation of concordance between liquid and tissue assays.

Results:
The mutational landscape of ctDNA in appendiceal adenocarcinoma is distinct from tissue-based sequencing, with TP53 being the most frequently mutated (46%). Relative to other tumors, appendiceal adenocarcinoma seems less likely to shed ctDNA, with only 38% of patients with metastatic appendiceal adenocarcinoma having detectable ctDNA (OR = 0.26; P &lt; 0.0001 relative to colorectal cancer). When detectable, the median variant allele frequency was significantly lower in appendiceal adenocarcinoma (0.4% vs. 1.3% for colorectal cancer; P ≤ 0.001). High-grade, signet ring, or colonic-type histology, metastatic spread beyond the peritoneum, and TP53 mutation were associated with detectable ctDNA. With respect to clinical translation, patients with detectable ctDNA had worse overall survival (HR = 2.32; P = 0.048). In the Guardant Health cohort, actionable mutations were found in 93 patients (13.0%).

Conclusions:
Although metastatic appendiceal adenocarcinoma tumors are less likely to shed tumor DNA into the blood relative to colorectal cancer, ctDNA profiling in appendiceal adenocarcinoma has clinical utility.
Superior Vena Cava Isolation With Cryoballoon in AF Ablation: Randomized CAVAC AF Trial
Authors: Castro-Urda Víctor , Segura-Dominguez Melodie , Jiménez-Sánchez Diego , Aguilera-Agudo Cristina , Vela-Martín Paula , Lorente-Ros Alvaro , García-Rodriguez Daniel , Sánchez-Ortiz David , Pham-Trung Chinh , García-Izquierdo Eusebio , Mingo-Santos Susana , Toquero-Ramos Jorge , Fernández-Lozano Ignacio 
Published: December 2024

BACKGROUND:
Superior vena cava (SVC) has been considered a specific trigger in atrial fibrillation development.

METHODS:
We investigated the efficacy and safety of combining cryoballoon pulmonary vein isolation (PVI) with SVC ablation compared with PVI alone in 100 patients with paroxysmal or non–long-standing persistent atrial fibrillation. Patients were randomly assigned to either the PVI+SVC ablation group or the PVI-only group. Each patient was given a mobile device to record a daily ECG and detect atrial tachyarrhythmias.

RESULTS:

The primary end point, freedom from any atrial tachyarrhythmia recurrence between 91 and 365 days post-catheter ablation, did not significantly differ between the 2 groups (62.9% versus 72%;
P
=0.41). However, the PVI+SVC group exhibited higher rates of phrenic nerve paralysis (20.8% versus 6%;
P
=0.003) and transient sinus node injury (18.8% versus 0%;
P
=0.001) compared with the PVI-only group. The median burden of atrial tachyarrhythmia showed no significant difference (
P
=0.91).

CONCLUSIONS:
The addition of SVC ablation to PVI did not enhance freedom from atrial tachyarrhythmia at 12 months, and it led to increased complications. These findings do not support the routine inclusion of SVC ablation in cryoballoon procedures for first-time catheter ablation in patients with paroxysmal or non–long-standing persistent atrial fibrillation.
“A Man for Strength and a Woman for Good Looks”: Fishy Feminism and the Schooners of Gloucester
Authors: Glassie Alison 
Published: December 2024

Abstract
In the second half of the nineteenth century, Gloucester's fishing schooners bridged masculinized and feminized labor and were central to negotiations about industry risk. Reading these vessels alongside literature, newspapers, and art, I argue that their complex cultural position is legible in their design and in constructions of their gender.
A More La Niña–Like Response to Radiative Forcing after Flux Adjustment in CESM2
Authors: Zhuo Jing-Yi , Lee Chia-Ying , Sobel Adam , Seager Richard , Camargo Suzana J. , Lin Yen-Heng , Fosu Boniface , Reed Kevin A. 
Published: December 2024

Abstract
In response to greenhouse gas forcing, most coupled global climate models project the tropical Pacific SST trend toward an “El Niño–like” state, with a reduced zonal SST gradient and a weakened Walker circulation. However, observations over the last five decades reveal a trend toward a more “La Niña–like” state with a strengthening zonal SST gradient. Recent research indicates that the identified trend differences are unlikely to be entirely due to internal variability and probably result, at least in part, from systematic model biases. In this study, Community Earth System Model, version 2 (CESM2), is used to explore how mean-state biases within the model may influence its forced response to radiative forcing in the tropical Pacific. The results show that using flux adjustment to reduce the mean-state bias in CESM2 over the tropical regions results in a more La Niña–like trend pattern in the tropical Pacific, with a strengthening of the tropical Pacific zonal SST gradient and a relatively enhanced Walker circulation, as hypothesized to occur if the ocean thermostat mechanism is stronger than the atmospheric mechanisms which by themselves would weaken the Walker circulation. We also find that the historical strengthening of the tropical Pacific zonal gradient is transient but persists into the near term in a high-emissions future warming scenario. These results suggest the potential of flux adjustment as a method for developing alternative projections that represent a wider range of possible future tropical Pacific warming scenarios, especially for a better understanding of regional patterns of climate risk in the near term.
Investigating the Real Effects of Isotretinoin on Enthesopathy in Acne Vulgaris Patients: A Prospective, Controlled Study
Authors: Orenay Ozge Mine , Karaosmanoglu Nermin , Mulkoglu Cevriye , Genc Hakan , Temel Berkay , Tiftik Tulay 
Published: December 2024

Background: Isotretinoin is frequently used for treating severe, treatment-resistant, and scarring acne. A wide range of musculoskeletal side effects are reported due to isotretinoin, and one of them is enthesopathy. Objectives: In this study, we used ultrasound to evaluate tendon thickness and the presence of enthesophytes, erosions, calcifications, and bursitis. Overall, the main objective was to determine the effects of isotretinoin on enthesopathy. Methods: The study included 30 patients diagnosed with acne vulgaris (AV) and on isotretinoin treatment for ≥3 months. Thirty patients with AV without treatment or on topical treatments were included as the control group. In both groups, 5 areas in the lower limb were examined bilaterally for tendon thickness, erosion, calcifications, enthesophytes, and bursitis and compared among themselves. Moreover, the Glasgow Ultrasonographic Enthesitis Scoring System (GUESS) scores were also calculated and compared between the 2 groups. Results: The quadriceps tendon, distal patellar ligament, and right Achilles tendon thicknesses were statistically higher in the isotretinoin group than in the control group ( P = .02, P = .03, P = .04). The GUESS score was also statistically higher in the isotretinoin group ( P = .02). Conclusion: This study showed that isotretinoin has certain effects on tendon thickness. Clinicians should be alert that patients under isotretinoin treatment may develop enthesopathy even with no clinical signs.
Development and testing of a remote hybrid SMS/web-based perioperative messenger: A mixed-methods study
Authors: Hriberšek Mojca , Laxar Daniel , Hammerle Fabian Peter , Ulbing Stefan , Teufel Anna , Bartos Stefan , Gauß Nikola , Niederle Martin , Kimberger Oliver , Schaden Eva 
Published: December 2024

Background Perioperative messengers as tools for hospitals to communicate with patients’ loved ones during surgery have been described in form of pagers, SMS, email, and apps. The approach of combining multiple means of communication to create a secure and reliable messenger promises several advantages and has not been investigated to date. Objective The aim was to develop and test the technical feasibility and acceptance of a remote hybrid SMS/web-based perioperative messenger that keeps patients’ loved ones informed around the time of surgery. Methods Three focus groups were held with six physicians, five nurses, and 11 members of the Austrian Patient Council separately to understand their concerns and needs regarding the perioperative messenger. Their input was used to develop the perioperative messenger. Twenty-five patients and their selected loved one tested the messenger in a feasibility study. Data were collected between September 2021 and August 2023. Results Focus groups indicated that the most important characteristics of a messenger were transparent and prompt communication, ease-of-use, data security, and no additional workload for healthcare professionals. Our developed perioperative messenger uses SMS notifications to link to new information on a secure web platform. Participating patients were aged between 18 and 78, their loved ones between 18 and 71. Thirteen patients and 15 loved ones were female. A total of 173 messages regarding the 25 surgeries were sent, 99% of which were read on a mobile device. The median time between sending and reading surgery-related messages was 63s. All loved ones were either “fairly satisfied” or “very satisfied”. Conclusion The idea of a perioperative messenger was received positively by physicians, nurses, and members of the Austrian Patient Council. The developed SMS/web-based hybrid messenger system for receiving perioperative updates was shown to be feasible, and of interest and satisfaction to the loved ones.
Patients with Darier disease have an increased risk of keratinocyte carcinoma: a Swedish registry-based nationwide cohort study
Authors: Inci Rahime , Gillstedt Martin , Kallionpää Roope A. , Peltonen Sirkku , Polesie Sam 
Published: December 2024

Abstract
Background
Darier disease is a genodermatosis which manifests as hyperkeratotic papules and superficial erosions mainly in seborrheic skin areas. This retrospective registry-based cohort study aimed to estimate the association between Darier disease and skin cancer.

Results
Patients diagnosed with Darier disease were identified from the patient registry of Sahlgrenska University Hospital (Gothenburg, Sweden) in 2016–2020. The local cohort included 13 patients. Verification of Darier disease diagnosis in the National Patient Registry showed positive predictive value of more than 90%. National Patient Registry was searched for Darier disease in 2001–2020, Swedish Cancer Registry for cancers and Prescribed Drug Register for medications. The national cohort included 770 patients and tenfold matched control cohort. Patients with Darier disease had an increased relative risk of keratinocyte carcinoma (basal cell carcinoma and cutaneous squamous cell carcinoma combined) (hazard ratio [HR], 1.6, 95% confidence interval [CI], 1.0-2.5, P = 0.036). The risk increase was significant for basal cell carcinoma (HR, 1.8, 95% CI, 1.1–2.9, P = 0.012), whereas there was a trend for cutaneous squamous cell carcinoma, (HR, 1.9, 95% CI, 0.9–4.1, P = 0.086) and cutaneous melanoma (HR, 2.4, 95% CI, 0.9–6.2, P = 0.083). Standardized incidence ratio for keratinocyte cancers was 2.9 (95% CI, 2.4–3.3. The results were consistent in two subgroup analyses adjusting for use of retinoid and/or immunosuppressive drugs.

Conclusion
Patients with Darier disease have an increased risk of skin cancer, particularly keratinocyte carcinoma. This risk was consistent even when known risk modifiers for keratinocyte carcinoma were excluded in sensitivity analyses. The results support previously proposed molecular links between Darier disease and skin cancer, but further investigations are needed. Additional studies are also required to develop clinical management recommendations for Darier disease. In the meantime, dermatologists should be aware of the cancer risk in these patients and remain vigilant, as detecting cancer can be challenging in hyperkeratotic and/or eroded skin.
The microbiome alterations of supragingival plaque among adolescents using clear aligners: a metagenomic sequencing analysis
Authors: Wang Chunlin , Zhang Chao , He Shan , Wang Qiuyu , Gao Hai 
Published: December 2024

Abstract
Background
White spot lesions (WSLs) may develop in adolescents undergoing clear aligner (CA) therapy with poor oral hygiene. The specific effects of CAs on the microbial composition and functional characteristics of supragingival plaques remain unclear. The present study investigated the shift in the supragingival microbial community induced by CAs in adolescents through metagenomic technology.

Methods
Fifteen adolescents (12–15 years old) with Invisalign appliances were recruited. Supragingival plaque specimens were obtained twice, before treatment (T1) and three months after treatment (T2). All the bacterial plaque specimens were analyzed for microbial communities and functions using metagenomic analyses.

Results
A total of 2,840,242,722 reads disclosed 180 phyla, 3,975 genera, and 16,497 microbiome species. During the first three months, the microbial community was relatively stable. The genus level revealed a higher relative abundance of Capnocytophaga, Neisseria, and Arachnia in the T2 period. Furthermore, the functional analysis suggested that the relative abundances of folate biosynthesis, biotin metabolism and biofilm formation-vibrio cholerae were increased in the T2 period compared to the T1 period. Finally, virulence factor analysis demonstrated that the relative abundance of genes associated with type IV pili (VF0082) and polar flagella (VF0473) was higher in the T2 period than in the T1 period.

Conclusion
In adolescents undergoing CA therapy with poor plaque control, caries progresses quickly within three months and noticeable WSLs develop on the tooth surface. Although the microbial community remained relatively steady and CA therapy did not cause significant changes in the overall functional gene composition in the first three months, virulence factors, including type IV pili and flagella, were more abundant and actively contributed to microorganism adhesion and biofilm formation.
Advancements in regulatory agility, regional collaboration, and digital transformation: insights from the Asia Partnership Conference of Pharmaceutical Associations (APAC)
Authors: Chong Sannie Siaw Foong , Ong Stephanie Hui Min , Long Siew Mei , Kanno Masaaki , Harnpramukkul Usanee , Wong Kum Cheun , Sathaye Asawari , Singh Mamta , Paliwal Manish , Do Huyen , Sou Helene , Binos Richard Simon R. 
Published: December 2024

Abstract
Purpose
The Asia Partnership Conference of Pharmaceutical Associations (APAC) examines recent developments in regulatory practices across Asia, focusing on regulatory agility, regional collaboration, and digital transformation. The paper identifies key improvements made by national regulatory authorities (NRAs) in adopting regulatory agilities over a two-year span. It also suggests optimizing regional reliance pathways and recommends best practices for implementing e-submission, real-world evidence (RWE), decentralized clinical trials (DCTs), and paperless e-labelling.

Methods
APAC surveyed all 14 member associations to track progress in regulatory agility implemented by our NRAs from 2022 through April 2024. Additionally, APAC assessed the uptake of regional reliance pathways and the implementation levels of e-submission, RWE, DCTs, and paperless e-labelling. Through the analysis of case studies and survey results, the paper aims to identify key trends, challenges, and opportunities in the regulatory landscape.

Results
Nine of twelve NRAs have advanced in regulatory agility, with Thai FDA leading with a 36% improvement and ranking 7th in the number of best practices implemented. e-Labeling adoption rose by 50%, and there was a 17% increase in the use of multiple sites under one license, good reliance practices, and acceptance of electronic Certificates of Pharmaceutical Product (eCPP) and Good Manufacturing Practice (eGMP). Perceived issues with the ASEAN Joint Assessment (JA) procedure include timeline constraints, limited flexibility in choosing participating NRAs, and country-specific requirements. NRAs have achieved 100% adoption of e-submissions and 50% for paperless e-labeling. Additionally, 67% accept data from DCTs and RWE using good reliance practices. However, 42% still require paper documents in e-submissions, and 50% continue to accept dossier format different from the International Council for Harmonisation Electronic Common Technical Document (ICH CTD).

Conclusions
APAC supports adopting agility best practices to reduce country-specific requirements, optimizing the ASEAN JA procedure. APAC also values strategic partnerships with NRAs, as demonstrated by the case studies of Vietnam and India. The shift towards digital transformation is evident, with 50% adoption of paperless e-labeling and 100% adoption of e-submissions, though not all processes are paperless with the use of ICH CTD dossier format. Overall, continued alignment with international standards for implementing eCTD, RWE, and DCTs is required in all 12 economies to realize the full benefits of globally harmonized digital advancement.