bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ensuring the Future Pool of Gastroenterologists in the United Kingdom Is Imperative
Authors: Bharadwaj Hareesha Rishab , Rao Medha Sridhar , Gaur Aditya , Abbasher Hussien Mohamed Ahmed Khabab , Dhali Arkadeep 
Published: December 2024

ABSTRACTThis perspective article explores the importance of fostering interest in gastroenterology among medical students and addressing the barriers that deter them from pursuing careers in this specialty. The paper highlights the critical role of early exposure to research, specialized electives, and mentorship in encouraging students to consider gastroenterology as a career choice. Current challenges include limited access to specialized electives and research opportunities within UK medical schools, inadequate hands‐on experience, and a perceived lack of stability and control over future training pathways. Additionally, suboptimal working conditions in the National Health Service (NHS) and uncertainty in the allocation of foundation jobs further discourage students from specializing in gastroenterology. To address these issues, the paper proposes several strategies: expanding gastroenterology electives, increasing research opportunities through grassroots initiatives and developing targeted mentorship programs to guide and inspire students. Furthermore, enhancing diversity and representation within the specialty by removing barriers for female medical students is crucial for creating a more inclusive environment. This article combines insights from existing literature, personal experiences, and innovative educational initiatives to provide a comprehensive overview of the current state of gastroenterology training for medical students. The recommendations aim to inspire new approaches to medical education and training that will cultivate a well‐prepared, diverse, and motivated workforce ready to advance the field of gastroenterology.
Linkage to Care of People With Chronic Hepatitis B Virus and Hepatitis C Virus Infection Among Blood Donors: Experience From an Apex Treatment Centre Under National Viral Hepatitis Control Program, India
Authors: Ahammed Sk Mahiuddin , Singh Boby Maibam , Saren Swapan , Dey Pratik , Roy Raja , Chowdhury Abhijit 
Published: December 2024

ABSTRACTBackground and ObjectivesChronic viral hepatitis is a major public health challenge. The World Health Organization (WHO) and many national programs have set goals for elimination of viral hepatitis by 2030. Screening, Linkage to care (LTC), and access to treatment are very important steps to eliminate viral hepatitis. The study aimed to assess the cascade of chronic viral hepatitis care and the barrier of LTC in the National Viral Hepatitis Control Program (NVHCP).MethodsIn this observational cross‐sectional study, healthy voluntary blood donors from two leading blood banks, who were HBsAg or anti‐HCV reactive, were advised to attend the clinic of NVHCP.ResultsAmong 116 569 healthy blood donors, prevalence of chronic HBV and HCV were 0.5% and 0.2% respectively. LTC was very poor. Only 27.7% HBsAg positive and 8.9% anti HCV positive patients attended NVHCP clinic. However, those who attended the clinic, 87.8% HBV and 100% HCV‐infected patients were retained. All HCV patients (n = 16) achieved SVR‐12. Among HBV‐infected patients, treatment eligibility was 21%.ConclusionsIn this study, LTC was very poor. Only 27.7% of chronic HBV and 9% of HCV patients attended the NVHCP clinic. Immediate interventions are required to enhance LTC for asymptomatic patients with chronic viral hepatitis.
Multicenter Evaluation of the QIAstat‐Dx and the BioFire Multiplex Panel Tests for the Detection of Respiratory Pathogens
Authors: Gosert Rainer , Koller Roger , Meyer Jakob , Dräger Sarah , Ramette Alban , Bingisser Roland , Nickel Christian H. , Bassetti Stefano , Sutter Sarah Tschudin , Keller Peter M. , Bittel Pascal , Leuzinger Karoline 
Published: December 2024

ABSTRACTSyndromic multiplex panel testing enables simultaneous detection of multiple respiratory pathogens, but limited data is available on the comparative diagnostic performance of different testing systems. In this multicenter prospective study, we aimed to compare the QIAstat‐Dx Respiratory Panel 2.0 (QIAstat‐Dx‐RP2.0) with the widely used BioFire‐RP2.1, using 269 respiratory clinical specimens. Concordant test results were obtained in 232 (86.3%) cases. Discordant test results included 33 BioFire‐RP2.1(+)/QIAstat‐Dx‐RP2.0(−) and 4 BioFire‐RP2.1(‐)/QIAstat‐Dx‐RP2.0(+) results. Discordant samples showed significantly lower pathogen loads than concordant ones (p < 0.01). Overall, the QIAstat‐Dx‐RP2.0 showed an analytical sensitivity of 50%–100% depending on the respiratory target, with an analytical specificity ≥ 99.0%. Most significant differences were found for the detection of adenovirus, human coronaviruses, respiratory syncytial virus, human rhinovirus/enterovirus and SARS‐CoV‐2 (kappa‐score: 0.67–0.91). Co‐detections of respiratory pathogens were identified in 47 cases by BioFire‐RP2.1 and 29 by QIAstat‐Dx‐RP2.0. Agreement rates between the two multiplex panel tests decreased from 91.8% for single pathogen detections to 65.0% and 42.9% for co‐detecting two and three pathogens, respectively. Pathogen loads were significantly lower in co‐detections compared to single pathogen detections (p < 0.01), potentially explaining the lower detection rates with the QIAstat‐Dx‐RP2.0 in cases of multiple pathogens. In conclusion, our prospective multicenter evaluation showed good diagnostic performance of the QIAstat‐Dx‐RP2.0 assay, but lower detection rates for some respiratory targets compared to BioFire‐RP2.1. As QIAstat‐Dx‐RP2.0 offers advantages in handling, noise emission, cost effectiveness, and provides semi‐quantitative results compared to BioFire‐RP2.1 an updated version with enhanced analytical sensitivity would be a viable alternative syndromic testing system for detecting respiratory pathogens.
Modulation of Preceding Tibetan Plateau Tropospheric Thermal Anomaly on Summer Temperature Anomalies in the Yangtze and Huaihe River Valleys
Authors: Li Di , Zhang Ting , Liu Ge , Liu Jingpeng , Zhou Changyan , Qi Dongmei , Feng Yuhan , Zhou Yuwei 
Published: December 2024

ABSTRACTAnomalous warm surface air temperatures (SATs) appeared in eastern China, especially the middle and lower Yangtze and Huaihe River valleys (MLYHRV), in the summer of 2022. Using the 2022 SAT anomaly as a case, this study analyses the reasons for the variation of summer SATs in the MLYHRV and explores the precursory signals for the summer MLYHRV SAT and related mechanisms. The findings indicate that the preceding May mid‐upper (500–300 hPa) tropospheric temperature (TT) over the Arabian Sea and India and the western Tibetan Plateau (TP) can reflect the persistence of the TT anomaly over the western TP and its eastward extension to the Japan Sea from May to summer, which causes downstream East Asian circulation (i.e., the South Asian high and western Pacific subtropical high) and related SAT anomalies over the MLYHRV during summer (especially July–August). In addition, the May La Niña SST can reflect the summer La Niña SST pattern and therefore affect the summer MLYHRV SAT by modulating the East Asian circulations. Using TT and SST precursory signals, a statistical prediction model was developed to predict the summer MLYHRV SAT. This model based on the TT and SST signals shows better prediction ability than the model based only on the traditional La Niña SST signal. The May ASI‐WTP TT may be regarded as a crucial supplementary precursor for forecasting the summer MLYHRV SAT.
Composite Analysis of Explosive Cyclones in the Southern Atlantic Ocean
Authors: Andrade Hugo Nunes , Nunes André Becker , Teixeira Mateus Silva , de Quadro Mário Francisco Leal , de Avila Vilson Dias , de Oliveira Fabrício Sanguinetti Cruz , Alves Rita de Cássia Marques 
Published: December 2024

ABSTRACTComposite analysis of the atmospheric mechanisms in South Atlantic explosive cyclones was performed utilising ERA5 reanalysis for the 2010–2020 period. By a manual tracking method, 271 cases were found (127 weak, 104 moderate and 40 intense). The cyclones follow the preferential displacement from northwest to southeast. There is a trend that, as the explosive cyclone's intensity increases, its trajectory becomes less zonal and has a more significant impact in the coastal areas of Southern Brazil and Uruguay. These intensity frequencies were discretized through a compositing technique for studying explosive cyclones. The results revealed that explosive cyclones begin following the classical model from Bjerknes and Solberg, and, at the end of the explosive phase, they tend to become Shapiro–Keyser type, especially in moderate and intense ones. Vertical movements appeared more significantly at the beginning of the explosive stage. It was observed that intense explosive cyclones transition from the equatorial side of the high‐level jet to the polar side. In addition, surface latent heat flux may significantly impact the cyclone's development both in the beginning and during the explosive phase, especially in intense systems. A horizontal dipole pattern is seen for surface sensible heat fluxes, as the ocean loses and gains heat in the cold and warm sectors, respectively, at roughly the same amount.
Association between a 6‐h feeding protocol and postprocedure hospital length of stay following percutaneous endoscopic gastrostomy in hospitalized adults: A before‐and‐after cohort study
Authors: Roberson Jeffrey L. , Passman Jesse E. , Aloupis Marianne , Caballero‐Tilleria Yessenia , Audia Anthony , Ramirez Melissa R. , Quinones Patricia Martinez , Kim Patrick , Kaufman Elinore J. , Sharoky Catherine E. 
Published: December 2024

AbstractBackgroundTolerance of enteral nutrition following percutaneous endoscopic gastrostomy is a barrier to discharge. This study investigated the impact of an expedited feeding protocol following percutaneous endoscopic gastrostomy on postprocedure length of stay (LOS).MethodsWe performed a before‐and‐after cohort study on hospitalized adults in whom percutaneous endoscopic gastrostomy was placed by surgeons following the implementation of a standardized feeding protocol in which enteral feeds were resumed at the preoperative rate 6 h later.ResultsEnteral feeding resumed within 6 h postoperatively in 93% of patients after protocol initiation. The mean ± SD time to the goal enteral rate after percutaneous endoscopic gastrostomy was significantly shorter following protocol implementation (15 ± 10 vs 50 ± 26 h, P ≤ 0.0001). Compared with the preprotocol cohort, there was no change in postoperative aspiration at 1 week (6% vs 4%, P = 0.531) or rates of tube dislodgement (10% vs 9%, P = 0.89), return to the operating room (10% vs 6%, P = 0.36), and surgical‐site infection (9% vs 8%, P = 0.92) at 1 month in the protocol implementation cohort. On multivariable regression, an expedited feeding protocol generated a significantly shorter postprocedure LOS for patients remaining in the hospital for ≤1 week (β = −2.14, 95% CI, −2.98 to −1.30; P < 0.001).ConclusionAn expedited feeding protocol following percutaneous endoscopic gastrostomy placement had a high degree of provider uptake without any significant change in safety outcomes. Beginning enteral nutrition within 6 h postoperatively at the preoperative rate reduced LOS by >2 days, suggesting that these protocols can address common delays to discharge.
Enhancing Patient Decision‐Making in Breast Reconstruction: A Systematic Review of Decision Aid Efficacy
Authors: Graziano Francis D. , White Donovan R. , Plotsker Ethan L. , Shammas Ronnie L. , Smith‐Montes Elizabeth , Nelson Jonas A. , Stern Carrie S. 
Published: December 2024

ABSTRACTBackgroundPatients often struggle to select a breast reconstruction option that aligns with their personal values. Decision aids have become popular tools to assist patients in navigating these choices. This systematic review assesses the effectiveness of available breast reconstruction decision aids.MethodsWe conducted a comprehensive search across five databases from inception to December 2022, identifying studies related to the development, validation, or implementation of decision aids in breast reconstruction.ResultsOut of 4621 reports, 24 studies met inclusion criteria, covering 14 unique decision aids. These included 13 randomized controlled trials, 9 qualitative studies, and 2 case series. Nine studies reported reduced decisional conflict and 2 studies showed decreased decisional regret. Additionally, 13 studies found improved satisfaction with the information provided, and all seven studies that measured knowledge retention showed improvements. However, none of the studies found a reduction in anxiety or depression following the use of decision aids.ConclusionsDecision aids are effective in reducing decisional conflict, enhancing patient satisfaction, and improving knowledge retention in breast reconstruction. Future research should focus on integrating these tools into clinical practice.
Evaluating the Role of Surgical Resection and Reconstruction in the Management of Ewing sarcoma of the Chest Wall in the Paediatric Population: A Systematic Review
Authors: Rice Darragh , Barrett Seán , Lavan Naomi , Daly Patricia , Owens Cormac , Pears Jane , Capra Michael , McGuinness Jonathan 
Published: December 2024

ABSTRACTBackground and ObjectivesEwing sarcoma is the most common malignant chest wall tumour in the paediatric population. Following neoadjuvant chemotherapy regimens, the role and extent of surgical resection and reconstruction of the chest wall remain unclear.MethodsA systematic review was conducted in accordance with PRISMA guidelines across four major literature databases. Data regarding overall survival, rate of recurrence, role of surgery and adjuvant therapy role was extracted.ResultsThree thousand ninety‐one studies were initially identified via the search, with 25 single‐centre observational studies (458 patients) and 10 retrospective reviews of multicentre trials (961 patients) included in the final analysis. Five‐year overall survival ranged from 35% to 90%.DiscussionAlong with chemotherapy, local control with surgical resection provides the cornerstone of the management of Ewing sarcoma of the chest wall in children. The literature favours delaying surgery until after neoadjuvant chemotherapy, and there appear to be limited benefits to extensive resection according to pre‐chemotherapy margins, advocated for in current guidelines. Radiotherapy is no longer advocated for all patients, but rather should be guided by surgical margins and the histological response to chemotherapy in the resected specimens. Surgical reconstructive techniques need to be tailored for the growth potential of these paediatric patients to avoid long‐term sequalae, including scoliosis and pulmonary restrictive disease.
Outcomes of Minimally Invasive Rectal Cancer Resection: Insights From a Resource‐Limited Setting
Authors: Nadarajan Abinaya R. , Krishnan Nair Chandramohan , Muralee Madhu , Wagh Mira Sudam , T. M. Anoop , George Preethi Sara 
Published: December 2024

ABSTRACTBackgroundMinimally invasive approaches for rectal cancer treatment are emerging as the standard of care. Robotic surgery is unfeasible across the country due to constrained resource allocation. This study aimed to assess the oncologic efficacy of laparoscopic resection for rectal cancer in a resource‐limited setting.MethodsA propensity score‐matched analysis was carried out to compare the oncological outcomes of laparoscopic and open rectal cancer resection at a high‐volume tertiary cancer centre in South India.ResultsTwo hundred and twenty patients were included (110 patients in each group). The median follow‐up was 93 months. There was no difference in positive circumferential resection margin between laparoscopic and open group (4.5% vs. 6.4%, p = 0.55), with a significantly better nodal yield in laparoscopic group. There was no significant difference between the laparoscopic and open groups in terms of local recurrence (5.1% vs. 8.3%, p = 0.12), 5‐year disease‐free survival (86% vs. 81%, p = 0.22, HR 0.699, 95% CI 0.353–1.27) or overall survival (85% vs. 76%, p = 0.21, HR 0.658, 95% CI 0.340–1.27). The mean cost between the two groups had no difference.ConclusionIn a resource‐limited setting with good expertise, laparoscopic surgery is an effective minimally invasive option that has good survival outcomes without imposing a financial burden on patients.
CD24 Positive Nucleus Pulposus Cells in Adult Human Intervertebral Discs Maintain a More Notochordal Phenotype Than GD2 Positive Cells
Authors: Ionescu Andra‐Maria , Baird Pauline , Patel Sonal , Howell Gareth , Hoyland Judith A. , Richardson Stephen M. 
Published: December 2024

ABSTRACTBackgroundNotochordal cells (NCs) present in the nucleus pulposus (NP) of the developing human intervertebral disc (IVD) disappear during the first decade of life. This loss coincides with the onset of IVD degeneration, therefore these cells are hypothesized to be important in NP homeostasis. Putative NC‐derived (CD24+) and progenitor (TIE2+/GD2+) cell sub‐populations have previously been identified in the adult human NP, but their characteristics have yet to be compared. Here, we used CD24, TIE2 and GD2 to identify and then isolate discrete cell sub‐populations to assess cell phenotype.MethodsCD24, GD2 and TIE2 positivity was assessed in a cohort of human pediatric and adult NP samples across a range of ages and histological degeneration grades using immunohistochemistry and flow cytometry. FACS sorting was used to isolate different cell sub‐populations (CD24+/GD2+; CD24+/GD2−; CD24−/GD2+; CD24−/GD2−). Cell phenotype was assessed using qPCR for known NC and NP markers as well as catabolic genes.ResultsCD24+ and GD2+ cells were localized in all samples, irrespective of age or degeneration grade, while TIE2+ cell number was consistently very low. The same positivity trend was confirmed using flow cytometry. A small CD24+/GD2+ sub‐population was present and maintained marker expression with time in culture. CD24+ subpopulations showed a significantly higher expression of NC markers than the CD24− subpopulations and unsorted samples, suggesting a healthier phenotype in the CD24+ cells. GD2 did not appear to influence gene expression.ConclusionsThis study provides a better understanding of different cell sub‐populations present in the adult NP, with identification of CD24+/GD2+ cells that are maintained with aging and degeneration. Healthy, NC‐like phenotypic profiles appeared reliant on CD24, rather than GD2. The study highlights the importance of studying discrete cell sub‐populations, especially CD24+ NP cells to better understand their role in NP homeostasis.
Habitat heterogeneity over multiple scales supports dense and diverse megafaunal communities on a northeast Pacific ridge
Authors: Girard Fanny , Caress David W. , Paduan Jennifer B. , Kuhnz Linda A. , Litvin Steven Y. , Flattery Emma , Kahn Amanda S. , DeVogelaere Andrew , Burton Erica J. , Lovera Christopher , Martin Eric J. , Barry James P. 
Published: December 2024

ABSTRACTMarine environments are highly heterogeneous, varying across scales of a few meters to entire ocean basins. Understanding the relationship between environmental variability and species distribution is essential for area‐based management and conservation. However, this requires a precise alignment of seabed mapping with environmental and biological sampling, which is often difficult to achieve in the deep sea. There is thus an urgent need to tackle this challenge to effectively manage high‐diversity habitats such as deep‐sea coral and sponge aggregations. Relying on multiple subsea platforms, seafloor mapping, and imaging techniques, we mapped the distribution of megafaunal communities at Sur Ridge (780–1525‐m depth; off central California) across multiple spatial scales. First, remotely operated vehicle video transects were conducted to characterize community distribution along the ridge in relation to substratum type, environmental conditions, and 1‐m resolution bathymetry. Five distinct communities, located in specific areas of the ridge, were identified. These communities were primarily structured by depth, availability of hard substrata, and terrain complexity (slope and rugosity). Indicator taxa were identified for each community and their distributions were characterized at the centimeter scale from coregistered 5‐mm resolution photomosaic and 5‐cm lateral resolution bathymetry produced during low altitude remotely operated vehicle surveys. High‐resolution mapping allowed the identification of associations between deep‐sea coral and sponge and other benthic taxa and showed that, even at these small scales, different taxa associate with distinct microhabitats. These results highlight the importance of accounting for habitat heterogeneity, and its role in supporting biodiversity when designing management and conservation strategies.
In Situ Monitoring of Mechanofluorescence in Polymeric Nanofibers
Authors: Dini Valentina A. , Kiebala Derek J. , Genovese Damiano , Zaccheroni Nelsi , Calvino Céline , Contini Emma , Weder Christoph , Schrettl Stephen , Gualandi Chiara 
Published: December 2024

AbstractMechanofluorescent polymers represent a promising class of materials exhibiting fluorescence changes in response to mechanical stimuli. One approach to fabricating these polymers involves incorporating aggregachromic dyes, whose emission properties are governed by the intermolecular distance, which can, in turn, be readily altered by microstructural changes in the surrounding polymer matrix during mechanical deformation. In this study, a mechanofluorescent additive featuring excimer‐forming oligo(p‐phenylene vinylene) dyes (tOPV) is incorporated into electrospun polyurethane fibers, producing mats of fibers with diameters ranging from 300 to 700 nm. The influence of the additive concentration and fiber orientation on the mechanofluorescent response under tensile deformation is investigated. In situ fluorescence spectroscopy and microscopy imaging reveal a strain‐dependent change of the fluorescence color from orange to yellow or green, with a more pronounced response in prealigned fibers. Stresses experienced by the nanofibers during elongation are mapped in real‐time. The data reveal that forces initially concentrate in fibers that are aligned parallel to the applied strain, and only later redistribute as other fibers once they also align. These findings advance the understanding of force transfer within fibrous polymer mats and are expected to facilitate the development of self‐reporting nanofibers for applications in load‐bearing devices, wearable technologies, and mechanochromic textiles.
A Method for Detecting Bias in Human Archaeological Cemetery Samples
Authors: Taylor Bonnie R. , Oxenham Marc F. 
Published: December 2024

ABSTRACTThis paper aims to provide a methodological approach to identify potential bias in cemetery sample age‐at‐death distributions and provide an alternative way to report fertility despite underenumeration. The method involves comparing total fertility rate (TFR) estimates from two empirically derived models developed on a United Nations mortality and fertility dataset. The models utilize different age cohorts in their calculations (one relies on the proportion of pre‐adults aged < 15 years, whereas the other excludes all those aged < 15 years). The tested hypothesis is that similar TFR estimates using both models indicate a relatively unbiased sample, although the converse would suggest cemetery sample bias in one broad age cohort. Results comparing the respective TFR estimates from D0–14/D and D15–49/D15+ models confirm that fertility estimates are comparable for unbiased samples. From this, a method for the coordinated application of the D0–14/D and D15–49/D15+ models were found to be valid in determining if a cemetery sample was biased. Following the determination of potential underrepresentation, an approach is outlined for dealing with biased and unbiased cemetery samples in terms of reporting on demographic variables such as TFRs.