bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and patient-reported outcomes in women offered oncoplastic breast-conserving surgery as an alternative to mastectomy: ANTHEM multicentre prospective cohort study
Authors: Davies Charlotte , Johnson Leigh , Conefrey Carmel , Mills Nicola , Fairbrother Patricia , Holcombe Chris , Whisker Lisa , Hollingworth William , Skillman Joanna , White Paul , Macmillan Douglas , Comins Charles , Potter Shelley 
Published: December 2024

Abstract

Background
Oncoplastic breast-conserving surgery may be a better option than mastectomy, but high-quality comparative evidence is lacking. The aim of the ANTHEM study (ISRCTN18238549) was to explore clinical and patient-reported outcomes in a multicentre cohort of women offered oncoplastic breast-conserving surgery as an alternative to mastectomy with or without immediate breast reconstruction.

Methods
Women with invasive/pre-invasive breast cancer who were offered oncoplastic breast-conserving surgery with volume replacement or displacement techniques to avoid mastectomy were recruited prospectively. Demographic, operative, oncological, and 3- and 12-month complication data were collected. The proportion of women choosing oncoplastic breast-conserving surgery and the proportion in whom breast conservation was successful were calculated. Participants completed the validated BREAST-Q questionnaire at baseline, 3 months after surgery, and 12 months after surgery. Questionnaires were scored according to the developers’ instructions and scores for each group were compared over time.

Results
In total, 362 women from 32 UK breast units participated, of whom 294 (81.2%) chose oncoplastic breast-conserving surgery. Of the oncoplastic breast-conserving surgery patients in whom postoperative margin status was reported, 210 of 255 (82.4%) had clear margins after initial surgery and only 10 (3.9%) required completion mastectomy. Major complications were significantly more likely after immediate breast reconstruction. Women having oncoplastic breast-conserving surgery with volume displacement techniques reported significant improvements in baseline ‘satisfaction with breasts’ and ‘psychosocial well-being’ scores at 3 and 12 months, but both oncoplastic breast-conserving surgery groups reported significant decreases in ‘physical well-being: chest’ at 3 and 12 months.

Conclusion
Oncoplastic breast-conserving surgery allows greater than 95% of women to avoid mastectomy, with lower major complication rates than immediate breast reconstruction, and may improve satisfaction with outcome. Oncoplastic breast-conserving surgery should be offered as an alternative to mastectomy in all women in whom it is technically feasible.
Weakness acquired in the cardiac intensive care unit: still the elephant in the room?
Authors: Van Aerde Nathalie , Hermans Greet 
Published: December 2024

Abstract
Over the past two decades, the cardiac critical care population has shifted to increasingly comorbid and elderly patients often presenting with nonprimary cardiac conditions that exacerbate underlying advanced cardiac disease. Consequently, the modern cardiac intensive care unit (CICU) patient has poor outcome regardless of left ventricular ejection fraction. Importantly, delayed liberation from organ support, independent from premorbid health status and admission severity of illness, has been associated with increased morbidity and mortality up to years post-general critical care. Although a constellation of several acquired morbidities is at play, the most prominent enactor of poor long-term outcome in this population appears to be intensive care unit acquired weakness. Although the specific burden of ICU-acquired morbidities in CICU patients is yet to be clearly defined, it seems unfathomable that patients will not accrue some sort of ICU-related morbidity. There is hence an urgent need to better establish the exact benefit and cost of resource-intensive strategies in both short- and long-term survival of the CICU patient. Consequent and standardized documentation of admission comorbidities, severity of illness indicators, relevant ICU-related complications including weakness, and long-term post-ICU morbidity outcomes can help our understanding of the disease continuum and how to better care for the CICU survivor and their families and caregivers. Given increasing budgetary pressure on healthcare systems worldwide, interventions targeting CICU patients should focus on improving patient-centred long-term outcomes in a cost-effective manner. It will require a holistic and transmural continuity of care model to meet the challenges associated with treating critically ill cardiac patients in the future.
The impact of restricted chests on long-term lung function parameters following lung transplantation in patients with interstitial lung disease
Authors: Nakanishi Keita , Schweiger Thomas , Schwarz Stefan , Taghavi Shahrokh , Hillebrand Caroline , Begic Merjem , Auner Sophia , Boehm Panja M , Mosleh Berta , Jaksch Peter , Benazzo Alberto , Chen-Yoshikawa Toyofumi Fengshi , Hoetzenecker Konrad 
Published: December 2024

Abstract

OBJECTIVES
In patients with interstitial lung disease (ILD), the diaphragm typically rises as the lungs chronically shrink. However, the grade of restriction differs in each patient. It is currently unknown, how disparities between actual and predicted recipient total lung capacity (TLC), impact changes in lung function parameters and long-term outcomes following lung transplantation (LTx).

METHODS
This retrospective study included 170 LTx for the patients with ILD performed in a European high-volume LTx center between 09/2011 and 12/2022. The preoperative median ratio of recipient actual to predicted (a/p) TLC was 0.55. Patients were stratified into two groups: low a/p TLC ratio group, corresponding to a more restricted chest cavity (&lt; 0.55: n = 85), and high a/p TLC ratio group, corresponding to a more preserved chest cavity (≥ 0.55: n = 85). Perioperative and long-term outcomes, including lung function and overall survival, were analyzed.

RESULTS
Between the two groups, tracheostomy and reintubation rates, length of mechanical ventilation, ICU-stay and hospital-stay were not significantly different. Although lung function measurements obtained early after LTx were better in the high a/p TLC ratio group, no significant differences were observed in the long term. 5-year overall survival was not significantly different between the two groups.

CONCLUSIONS
Although LTx for ILD patients with a restricted chest is considered technically more challenging, the perioperative course is similar to ILD patients with a preserved chest. In addition, no significant differences were observed between both groups in long-term lung function and overall survival, suggesting an improvement in chest wall compliance.
Arterial conduits for coronary bypass grafting: the set-point concept
Authors: Calafiore Antonio M , Prapas Sotirios , Gaudino Mario 
Published: December 2024

Abstract
Endothelial cells control the vascular tone of arterial grafts used for coronary artery bypass surgery and react to changes in local shear stress. The vascular adaptations induced by endothelial cell activation affect the outcome of surgical grafts and can be predicted based on the set-point theory. In this Hypothesis piece, it is proposed that the set-point concept should inform surgical decision making for coronary artery bypass surgery.
Stereotactic cardiac radiotherapy for refractory ventricular tachycardia in structural heart disease patients: a systematic review
Authors: Gupta Amulya , Sattar Zeeshan , Chaaban Nourhan , Ranka Sagar , Carlson Cameron , Sami Farhad , Robinson Clifford G , Cuculich Phillip S , Sheldon Seth H , Reddy Madhu , Akhavan David , Noheria Amit 
Published: December 2024

Abstract

Aims
Among patients with structural heart disease with ventricular tachycardia (VT) refractory to medical therapy and catheter ablation, cardiac stereotactic body radiotherapy (SBRT) is a paradigm-changing treatment option. This study aims to assess the efficacy of cardiac SBRT in refractory VT by comparing the rates of VT episodes, anti-tachycardia pacing (ATP) therapies, and implantable cardioverter-defibrillator (ICD) shocks post-SBRT with pre-SBRT.

Methods and results
We performed a comprehensive literature search and included all clinical studies reporting outcomes on cardiac SBRT for VT. Treatment efficacy was evaluated as random-effects pooled rate-ratios of VT episodes, ATP therapies and ICD shocks post-SBRT (after 6-week blanking) and pre-SBRT, with patients serving as their own controls. Post-SBRT overall survival was assessed using Kaplan–Meier method. We included 23 studies published 2017–24 reporting on 225 patients who received cardiac SBRT, with median follow-up 5.8–28 months. There was significant heterogeneity among the studies for all three efficacy endpoints (P &lt; 0.00001). The random-effects pooled rate-ratios of VT episodes, ATP therapies and ICD shocks post- vs. pre-SBRT were 0.10 (95% CI 0.06, 0.16), 0.09 (0.05, 0.15), and 0.09 (0.05, 0.17), respectively (all P &lt; 0.00001). The most common reported complications included pericardial (8.0%, including 0.9% late oesophagogastro-pericardial fistula) and pulmonary (5.8%). There was no change in left ventricular ejection fraction post-SBRT (P = 0.3) but some studies reported an increase in mitral regurgitation. The combined 3-, 12-, and 24-month overall patient survival was 0.86 (0.80, 0.90), 0.72 (0.65, 0.78), and 0.57 (0.47, 0.67), respectively.

Conclusion
Among patients with refractory VT in context of structural heart disease, VT burden and ICD shocks are dramatically reduced following cardiac SBRT. The overall mortality in this population with heart failure and refractory VT receiving palliative cardiac SBRT remains high.
Quantifying architectural uniqueness of Scots pine trees using terrestrial laser scanning: toward individual tree fingerprinting
Authors: Yrttimaa Tuomas , Junttila Samuli , Hyyppä Juha , Holopainen Markus , Wulder Michael A , Vastaranta Mikko 
Published: December 2024

Abstract
Tree architecture reflects a hierarchical growth pattern shaped by the interplay between genetics and the environment. Environmental variation leads to unique resource availability, resulting in each tree developing distinct structural features, akin to the uniqueness of a human fingerprint. In this study, we propose a nondestructive method for quantifying this architectural uniqueness using terrestrial laser scanning for tree identification. While tree identification is commonly based on their precise geospatial location, this information may not always be available. Instead, we hypothesized that a tree’s stem profile (diameters along the stem) and branching arrangement (locations of branch origins on the stem surface) could distinguish individuals within a population. The experimental setup included 65 Scots pine (Pinus sylvestris L.) trees in a managed boreal forest stand, scanned with terrestrial laser scanning in September 2021 (T1) and November 2022 (T2). We investigated whether individual trees could be identified based on architectural similarities between their point cloud reconstructions from T1 and T2. In total, 52 trees (80.0%) were identified based on their architectural characteristics. The results supported our hypothesis, showing that identifying ≥10 branch origins from independent reconstructions was sufficient to establish architectural uniqueness, resulting in 100% identification accuracy (n = 20 trees). These findings suggest that the complex three-dimensional tree architecture can be condensed into a two-dimensional pattern of points representing branch arrangement, which we term the “tree fingerprint.” These architectural characteristics, which can be reconstructed from the lower half of the tree, are well suited for acquisition via ground-based sensing techniques such as terrestrial or mobile laser scanning. If point cloud data capable of characterizing individual branches is acquired during forest operations, the proposed methodology can facilitate tree identification for applications such as wood tracking, even without geospatial coordinates.
The genome of the solitary bee Tetrapedia diversipes (Hymenoptera, Apidae)
Authors: Santos Priscila K F , de Souza Araujo Natalia , Françoso Elaine , Werren John H , Kapheim Karen M , Arias Maria Cristina 
Published: December 2024

Abstract
Tetrapedia diversipes is a Neotropical solitary bee commonly found in trap-nests, known for its morphological adaptations for floral oil collection and prepupal diapause during the cold and dry season. Here, we present the genome assembly of T. diversipes (332 Mbp), comprising 2,575 scaffolds, with 15,028 predicted protein-coding genes. Repetitive elements constitute 38.68% of the genome, notably Class II transposable elements. An investigation into lateral gene transfers identified a low frequency (0.037%) of nuclear copies of mitochondrial DNA and 18 candidate regions from bacterial origins. Furthermore, the annotation of 3 scaffolds reveals the presence of the Wolbachia endosymbiont genome, confirming the infection by 2 strains in T. diversipes populations. This genome contributes valuable insights into Neotropical bee genomics, offering a resource for comparative studies and enhancing our understanding of the molecular basis of solitary bee adaptations and interactions.
Monitoring slow uplift and subsidence in shallow seafloor environments using bottom pressure measurements
Authors: Morelli Rebecca Sveva , Riccio Rosario , Guardato Sergio , Chierici Francesco , Caliro Stefano , Macedonio Giovanni , Iannaccone Giovanni 
Published: December 2024

SUMMARY
Ultraslow seafloor deformations are frequent in several marine environments like volcanic calderas, offshore oil and gas extraction fields subject to subsidence and river delta regions; they can exhibit unpredictable behaviours, particularly in caldera systems situated along coastlines. However, offshore monitoring of seafloor uplift and subsidence is still very challenging. Here, we present a new method to recover vertical seafloor deformation at Campi Flegrei caldera, Southern Italy, using bottom pressure recorder (BPR) sensors, tide gauges and a barometer. Using data from two BPRs installed on the seabed within the multiparametric elastic-beacon devices and underwater sensors acquisition (MEDUSA) marine infrastructure of the Istituto Nazionale Geofisica e Vulcanologia (INGV) -‘Osservatorio Vesuviano’, we transform pressure measurements into equivalent water level changes to derive the vertical seafloor displacements. We obtain high-accuracy vertical deformation records from the BPR measurements by taking into account the high-resolution mean seawater density variation over time, estimated by applying an innovative procedure to the BPRs data and using additional barometric and sea level data. We obtained for the two BPRs an uplift of 22.8 cm over about 2 yr and 7 cm over about 18 months, respectively. We compare the results with data acquired by GPSs installed on the top of MEDUSA buoys, deployed at the same sites as the BPRs, which recorded the vertical seafloor deformation values of 22 and 6.9 cm, respectively, over the same periods. These independent data sets show a strong correlation, with correlation coefficient values of 0.98 and 0.87, and very good agreement in both the trend and amplitude of vertical motion, proving the reliability of BPRs in accurately measuring vertical seafloor deformation. The methodology we developed allows a cost-effective implementation of high-accuracy seafloor vertical deformation monitoring networks.
DNA Methylation Analysis on Anal Swabs for Anal Cancer Screening in People Living With Human Immunodeficiency Virus
Authors: Dias Gonçalves Lima Fernando , Rozemeijer Kirsten , van der Zee Ramon P , Dick Stèfanie , ter Braak Timo J , Geijsen Debby E , Meijnen Philip , Lissenberg-Witte Birgit I , van Noesel Carel J M , de Vries Henry J C , Prins Jan M , Steenbergen Renske D M 
Published: December 2024

Abstract

Background
High-resolution anoscopy (HRA) to prevent anal cancer is complex and screening capacity is limited. Previously, DNA methylation analysis of anal high-grade squamous intraepithelial lesion (HSIL) biopsies was shown to distinguish between HSIL with an increased and a low cancer risk, supporting personalized treatment. Here, methylation analysis on anal swabs was assessed to detect underlying HSIL with an increased cancer risk.

Methods
A cross-sectional series of paired anal swabs and biopsies of 215 persons with human immunodeficiency virus and swabs of 19 cancer patients were tested for 6 methylation markers. Data were analyzed by logistic regression analysis. The primary endpoint was methylation-positive biopsy HSIL (M+ HSIL), indicating increased cancer risk. Test performance of methylation markers, human papillomavirus (HPV), and/or cytology, and cancer detection and HRA referral, were calculated.

Results
Anal cancer swabs showed highest methylation. ZNF582 and panels ASCL1/ZNF582 and LHX8/ZNF582 yielded an area under the curve of 0.68–0.70 to detect underlying M+ HSIL. Methylation at 80% sensitivity corresponded to 43% fewer patients requiring HRA, without missing any cancers and detecting 79% of HPV-16–positive HSIL-AIN3. Methylation/HPV and cytology/HPV co-testing performed similarly.

Conclusions
Methylation levels in anal swabs reflect underlying anal disease. Methylation analysis could reduce HRA referrals substantially, while maintaining a high sensitivity for M+ HSIL and detecting all cancers. These results encourage screening on anal swabs to preselect patients needing HRA.
Staphylococcus aureus Tetracycline Resistance and Co-resistance in a Doxycycline Postexposure Prophylaxis–Eligible Population
Authors: Mittelstaedt Rachel , Kanjilal Sanjat , Helekal David , Robbins Gregory K , Grad Yonatan H 
Published: December 2024

Abstract
Among doxycycline postexposure prophylaxis (doxy-PEP)–eligible men, Staphylococcus aureus tetracycline nonsusceptibility is more prevalent than in the overall population and is associated with resistance to trimethoprim-sulfamethoxazole and clindamycin. Doxy-PEP may select for multidrug-resistant S aureus, underscoring the importance of surveillance.
Addition of Macrolide Antibiotics for Hospital Treatment of Community-Acquired Pneumonia
Authors: Wei Jia , Walker A Sarah , Eyre David W 
Published: December 2024

Abstract

Background
Guidelines recommend combining macrolides with β-lactam antibiotics for moderate-to-high severity community-acquired pneumonia (CAP); however, macrolides pose risks of adverse events and anti-microbial resistance.

Methods
We analyzed electronic health data from 8872 adults hospitalized with CAP in Oxfordshire, UK (2016-2024), initially treated with amoxicillin or co-amoxiclav. Using inverse probability treatment weighting, we examined the effects of adjunctive macrolides on 30-day all-cause mortality, time to hospital discharge, and changes in Sequential Organ Failure Assessment (SOFA) score.

Results
There was no evidence of an association between adjunctive macrolides and 30-day mortality (marginal odds ratio 1.05 [95% CI 0.75-1.47] for amoxicillin with vs. without macrolide; 1.12 [0.93-1.34] for co-amoxiclav with vs. without macrolide); and no evidence of a difference in time to discharge (restricted mean days lost +1.76 days [−1.66, +5.19] for amoxicillin, +0.44 days [−1.63, +2.51] for co-amoxiclav). Macrolide use was not associated with SOFA score decreases. Results were consistent across severity sub-groups and sensitivity analyses with missing covariates imputed.

Conclusions
At a population level, the addition of macrolides was not associated with improved clinical outcomes for patients with CAP. The potential benefits of additional macrolides should be weighed against the risks of adverse effects and anti-microbial resistance.
Litter quality modulates changes in bacterial and fungal communities during the gut transit of earthworm species of different ecological groups
Authors: Chao Huizhen , Zhong Linlin , Schaefer Ina , Sun Mingming , Junggebauer André , Hu Feng , Scheu Stefan 
Published: December 2024

Abstract
Earthworms are keystone animals stimulating litter decomposition and nutrient cycling. However, earthworms comprise diverse species which live in different soil layers and consume different types of food. Microorganisms in the gut of earthworms are likely to contribute significantly to their ability to digest organic matter, but this may vary among earthworm species. Here, we analyse the effect of food (litter) quality on gut microbiota and their changes during the gut passage (from foregut to hindgut) of earthworms of different ecological groups. The endogeic (soil living) species Aporrectodea caliginosa and the anecic (litter feeding) species Lumbricus terrestris were fed with high- (rape leaves) and low-quality litter (wheat straw) in a microcosm experiment for 18 weeks. Irrespective of earthworm species, alpha diversity of bacterial and fungal communities changed little during the gut passage, with the composition and diversity of microbial communities in the gut generally resembling those in soil more than in litter. In addition, the low-quality litter supported higher alpha diversity and more complex communities than high-quality litter. Further, gut microbial communities of the anecic L. terrestris changed less during gut passage than those of the endogeic A. caliginosa, especially when fed low-quality litter. Our findings indicate that earthworm gut microbial communities are predominantly shaped by the soil they ingest, but are modulated by the quality of litter they feed on and earthworm ecological group. Overall, the results suggest that earthworms primarily influence soil microbiota by mixing and spreading microorganisms from different microhabitats through bioturbation rather than by digesting microorganisms.
Consumer Credit with Over-Optimistic Borrowers
Authors: Exler Florian , Livshits Igor , MacGee James , Tertilt Michèle 
Published: December 2024

Abstract
Do cognitive biases call for regulation to limit the use of credit? We incorporate over-optimistic and rational borrowers into an incomplete markets model with consumer bankruptcy. Over-optimists face worse income risk but incorrectly believe they are rational. Thus, both types behave identically. Lenders price loans forming beliefs-type scores-about borrower types. This gives rise to a tractable theory of type scoring. As lenders cannot screen types, borrowers are partially pooled. Over-optimists face cross-subsidized interest rates but make financial mistakes: borrowing too much and defaulting too little. In equilibrium, the welfare losses from mistakes are more than compensated by cross-subsidization. We calibrate the model to the US and quantitatively evaluate policies to address these frictions: financial literacy education, reducing default cost, increasing borrowing costs, and debt limits. While some policies lower debt and filings, only reducing default costs and financial literacy education improve welfare. However, financial literacy education benefits only rationals at the expense of over-optimists. Score-dependent borrowing limits can reduce financial mistakes but lower welfare.