bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicenter Analysis of the Relationship Between Operative Team Familiarity and Safety and Efficiency Outcomes in Cardiac Surgery
Authors: Bauer Tyler M. , Janda Allison M. , Wu Xiaoting , Ling Carol , Shook Douglas C. , Querejeta-Roca Gabriela , Shann Kenneth G. , Smith Trevor , Mathis Michael R. , Kaneko Tsuyoshi , Sundt Thoralf M. , Schonberger Robert B. , Harrington Steven D. , Dias Roger D. , Pagani Francis D. , Likosky Donald S. , Yule Steven , Caldwell Matthew D. , Corso Jason J. , Louis Nathan , Krein Sarah L. , Manojlovich Milisa , Stakich-Alpirez Korana , Sturmer David , Yalamuri Suraj , Lawton Jennifer , Abernathy Jake , Cleveland Joseph , Clendenen Nathan , Justison George , Fried Michael , Nemeh Hassan , Fitzsimons Michael G. , Dickinson Timothy , Stulak John , de la Cruz Kim I. 
Published: December 2024

BACKGROUND:
Safety in cardiac surgical procedures is predicated on effective team dynamics. This study associated operative team familiarity (ie, the extent of clinical collaboration among surgical team members) with procedural efficiency and Society of Thoracic Surgeons (STS) adjudicated patient outcomes.

METHODS:
Institutional STS adult cardiac surgery registry and electronic health record data from 2014 to 2021 were evaluated across 3 quaternary hospitals. Team familiarity was defined as the mean number of cardiac operations performed by surgeon-anesthesiologist, surgeon-perfusionist, and anesthesiologist-perfusionist dyads within 1 year of the operation. The primary outcomes were (1) safety, measured by the STS’ composite major morbidity and operative mortality measure, and (2) procedural efficiency, assessed by cardiopulmonary bypass duration. Team familiarity was stratified by terciles (low, moderate, and high) for crude analyses and analyzed continuously for adjusted analyses. Multivariable logistic and linear regression models were used to assess the association between team familiarity and outcomes.

RESULTS:

Team familiarity was calculated for 13 581 operations. The median (interquartile range) patient age was 64 (55–72) years, and 31.9% (4328/13 581) were women. Terciles of team familiarity were defined as low (<6.00 average shared operations), moderate (6.00–9.67), and high (>9.67). Teams in lower terciles had higher observed STS morbidity and mortality rates (low, 17.9%; moderate, 18.0%; high, 16.0%;
P
=0.02) and longer median cardiopulmonary bypass duration (low, 137 minutes; moderate, 131 minutes; high, 118 minutes;
P
<0.001). After risk adjustment, team familiarity was not significantly associated with STS morbidity and mortality (estimate, −0.001 [95% CI, −0.998 to 0.997]) but was inversely associated with cardiopulmonary bypass duration (estimate, −2.02 minutes per 1 unit increase in team familiarity [95% CI, −2.30 to −1.75]).

CONCLUSIONS:
Increased team familiarity was not associated with STS morbidity and mortality but was inversely correlated with cardiopulmonary bypass duration, demonstrating potential benefit. Interventions aimed at improving team familiarity among operative teams may increase procedural efficiency.
Association of Duration of Recognized Hypertension and Stroke Risk: The REGARDS Study
Authors: Howard George , Muntner Paul , Lackland Daniel T. , Plante Timothy B. , Cushman Mary , Stamm Brian , Judd Suzanne E. , Howard Virginia J. 
Published: December 2024

BACKGROUND:
The focus for reducing hypertension-related cardiovascular disease is the management of blood pressure. Limited data are available on the potential benefit of delaying the onset of hypertension.

METHODS:
Stroke-free Black and White participants from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke; recruited 2003–2007) were followed through 2022 for incident stroke events. Participants were stratified by duration of recognized hypertension: normotensive (0 years), ≤5 years, 6 to 20 years, or 21+ years. The baseline systolic blood pressure (SBP), the number of classes of antihypertensive medications, and the risk of incident stroke were assessed by duration strata adjusting for demographics, cerebrovascular risk factors, SBP, and use of antihypertensive medications (where appropriate).

RESULTS:
Of 30 239 study participants, we included 27 310 participants (mean age, 65 years; 45% male), followed a median of 12.4 years, during which 1763 incident stroke events occurred. On average, participants with hypertension duration ≤5 years, 6 to 20 years, and 21+ years were taking 1.68 (95% CI, 1.65–1.71), 2.04 (95% CI, 2.01–2.07), and 2.28 (95% CI, 2.25–2.31) classes of antihypertensive medications, respectively. The adjusted mean SBP level was higher with each increasing duration of recognized hypertension (0, ≤5, 6–20, and 21+ years): 123.9 mm Hg (95% CI, 123.3–124.6), 129.7 mm Hg (95% CI, 129.1–130.2), 131.7 mm Hg (95% CI, 130.6–131.5), and 132.6 mm Hg (95% CI, 132.0–133.1). Compared with normotensive individuals, the hazard for incident stroke increased from 1.31 (95% CI, 1.05–1.63) for ≤5 years duration, 1.50 (95% CI, 1.21–1.87) for 6 to 20 years duration, and 1.67 (95% CI, 1.32–2.10) for 21+ years duration.

CONCLUSIONS:
Longer duration of recognized hypertension was associated with more classes of antihypertensive medications, higher mean SBP, and higher stroke risk even after adjustment for age and SBP. Collectively, this suggests that delaying the onset of hypertension could reduce the burden of stroke.
Do Amyloid Cerebral Deposits Influence the Long-Term Poststroke Cognitive Outcome?: The IDEA3 Study
Authors: Godefroy Olivier , Trinchard Niels , Marchal Etienne , Lamy Chantal , Canaple Sandrine , Meyer Marc-Etienne , Roussel Martine , Wollenweber Frank A. , Barbay M. , Courselle-Arnoux Audrey , Leclercq Claire , Despretz-Wannepain Sandrine , Berrissoul Hassan , Picard Carl , Diouf Momar , Loas Gwénolé , Deramond Hervé , Constans Jean-Marc , Shields Trevor 
Published: December 2024

BACKGROUND:
Although the presence of amyloid deposits is associated with a more severe cognitive status in patients with stroke at baseline, its influence on the subsequent cognitive outcome has not been extensively assessed. The primary objective of the present study of the IDEA3 (Imagerie des dépôts amyloïdes cérébraux par florbetapir AV-45 et diagnostic des déficits cognitifs et démence post Accident Vasculaire Cérébral) cohort was to determine the influence of amyloid positron emission tomography (PET) status on the 5-year cognitive outcome.

METHODS:
This longitudinal study performed in Amiens University Hospital (inclusions: October 2014 to October 2019; last visits: October 2018 to February 2023) has included 91 patients with stroke (ischemic stroke, 89%; hemorrhagic stroke, 11%) with florbetapir PET data at baseline (positive, n=14). Patients underwent annually comprehensive clinical and cognitive assessments for 5 years after the PET scan. The primary outcome was incident dementia; secondary outcomes were incident cognitive impairment, total prevalence of cognitive impairment, and modified Rankin Scale score.

RESULTS:

A survival analysis (mean poststroke follow-up, 80.4±27 months) showed that the incidence of incident dementia was higher in the PET-positive patients (odds ratio, 9.6 [95% CI, 2.5–36.9];
P
=0.001), as was the incidence of incident cognitive impairment (odds ratio, 10 [95% CI, 1.9–52.3];
P
=0.003). A Cox regression analysis showed that the association between amyloid status and the incidences of dementia (
P
=0.001) and cognitive impairment (
P
=0.007) was still significant after adjustment for age, education, prestroke modified Rankin Scale score and cognitive impairment, stroke type, and the PET status×stroke type interaction. Considering the overall prevalence at the last follow-up in the whole study population (n=91 patients), PET positivity was associated with an elevated risk of dementia (odds ratio, 6 [95% CI, 1.76–20.5];
P
=0.002) and poststroke cognitive impairment (odds ratio, 6.25 [95% CI, 1.77–22];
P
=0.002). The final modified Rankin Scale score did not differ (
P
=0.3) according to PET status.

CONCLUSIONS:
Our results demonstrate the major impact of amyloid deposition on the stroke outcome and emphasized the need for comprehensive etiologic workup in patients with poststroke cognitive impairment.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02813434.
Effect of the Variable Kuroshio Intrusion Pathway on Deep Flow in the Northern South China Sea
Authors: Quan Qi , Zhang Han , Liu Xiaohui , Yu Yi , Yang Yang , He Qingyou , Wang Ya Ping 
Published: December 2024

Abstract
The effect of the variable Kuroshio intrusion pathway on deep flow in the northern South China Sea (NSCS) is investigated using observational and theoretical analyses. With significant seasonality in path variation, the leaking path is found to be most frequent, whereas the looping (leaping) path is transient and prefers to occur in winter (summer). Such multipath variability contributes greatly to the highest surface eddy kinetic energy in the NSCS, with the energy peaking for the looping path in winter, followed by the leaking and leaping paths. The information flow–based causality analysis suggests that the energetic surface perturbations in the Kuroshio intrusion region are causal to the intraseasonal variability in deep flow east of the Dongsha Islands, wherein the linkage is strongest within the Kuroshio Loop Current eddy shedding event related to the looping path. Therefore, the underlying dynamics for the vertical coupling is illustrated by this event, in which the eddy is highly compressed to the surface because of sloping topography and its energy is partially transferred downward through vertical pressure work to force the abyssal topographic Rossby waves. Moreover, the energetics and instability analyses reveal that barotropic instability dominates the energy transfer from background flow to eddies in the Kuroshio intrusion region, which energizes the surface perturbations most intensively for the looping path, followed by the leaking and leaping paths. The characteristic scales of the most unstable mode estimated by the reduced-gravity model are analogous to the observations and account for the rapid growth of surface perturbations in the Kuroshio intrusion region.
Development and Validation of a Global Thin Ice Thickness Algorithm for SMMR
Authors: Kashiwase Haruhiko , Ohshima Kay I. , Tamura Takeshi 
Published: December 2024

Abstract
Thin ice thickness algorithms using satellite passive microwave radiometers are frequently used to quantify sea ice production in coastal polynyas. The objective of this paper is to develop and validate a thin ice thickness algorithm using only low-frequency (LF) data (19- and 37-GHz channels), applicable back to 1978 when the Scanning Multichannel Microwave Radiometer (SMMR) observations started. We compared several recent satellite observations for 22 cases of typical polynya events in the Southern Ocean and developed a new method to discriminate three types of thin ice (active frazil, thin solid ice, and a mixture of the two) using only LF data. Combined with ice-type discrimination, the obtained LF ice thickness (20 cm or less) has a bias of less than 1 cm and an RMSD of about 5 cm, as shown by validation data from 24 cases of typical polynya events that occurred prior to 1992 in the Southern Ocean and the Bering Sea. Although the error in ice-type discrimination with LF data is relatively large in comparison with previous studies, these results still suggest that the LF ice thickness could be a continuous global data since 1978. We also developed a false thin ice detection algorithm using only LF data and created daily false thin ice masks from 1978 to the present, which are also essential for estimating global sea ice production. The use of our new LF algorithm will allow quantification of the global sea ice production over nearly half a century since 1978.

Significance Statement
Sea ice production is a key element for dense water formation and thus deep/intermediate overturning circulation. Global estimation of sea ice production will be achieved through a heat budget analysis incorporating a thin ice thickness algorithm of satellite passive microwave radiometers. The previous algorithms use high-frequency channel data that only became available after 1992. In this study, we have developed an algorithm of ice type and thin ice thickness using only low-frequency channels (19 and 37 GHz) data, which allows us to obtain the thin ice thickness distribution on a global scale from 1978 to the present. This will further lead to a unified global estimate of sea ice production over a time scale of nearly half a century.
Formulation of nasal analgesic sprays with diclofenac sodium, ibuprofen, paracetamol, and evaluation of in vitro toxicity
Authors: Yenigun Vildan Betul , Yenigun Alper , Sagiroglu Ali Asram , Kocyigit Abdurrahim , Ozturan Orhan 
Published: December 2024

Objective Intranasal analgesic sprays represent a safe, efficacious method for pain relief, with a shorter working time compared to oral painkillers. This study aimed to develop nasal sprays using commonly available over-the-counter analgesics, providing an alternative treatment option that is more convenient and potentially more effective in managing pain, particularly in pediatric patients. Methods Three different nasal spray formulations with the contents of diclofenac sodium, ibuprofen, and paracetamol were created, and characterization studies were completed. The possible cytotoxic, genotoxic, and apoptotic effects of nasal sprays were studied on human normal skin fibroblastic cells (CCD-1079Sk) using WST cell viability test, alkaline single-cell gel electrophoresis analysis, and acridine orange/ethidium bromide staining, respectively. Results The formulations’ physical appearance and drug content were assessed, yielding nonsignificant results ( p > 0.05). All formulations were determined at pH 5.5–6.2 so that the pH values of the prepared formulations were compatible with the pH value of the nasal mucosa. Selected nasal spray formulations were stable for 90 days, and the safe doses were chosen as 0.0625, 0.375, and 1.25 mg/mL for diclofenac, ibuprofen, and paracetamol, respectively, by not showing toxicity even at 24 h. Conclusion This study demonstrated that nasal sprays containing paracetamol, ibuprofen, and diclofenac sodium can be successfully formulated. These new formulations may provide alternative treatment and easier application for patients unable to swallow or refuse to take oral analgesics.
Acute resistance to BET inhibitors remodels compensatory transcriptional programs via p300 coactivation
Authors: Shah Viral , Giotopoulos George , Osaki Hikari , Meyerhöfer Markus , Meduri Eshwar , Gallego-Crespo Aaron , Behrendt Malte A. , Saura-Pañella Maria , Tarkar Aarti , Schubert Benedict , Yun Haiyang , Horton Sarah J. , Agrawal-Singh Shuchi , Haehnel Patricia S. , Basheer Faisal , Lugo Dave , Eleftheriadou Ioanna , Barbash Olena , Dhar Arindam , Kühn Michael W. M. , Guezguez Borhane , Theobald Matthias , Kindler Thomas , Gallipoli Paolo , Yeh Paul , Dawson Mark A. , Prinjha Rab K. , Huntly Brian J. P. , Sasca Daniel 
Published: December 2024

Abstract
Initial clinical trials with drugs targeting epigenetic modulators, such as bromodomain and extraterminal protein (BET) inhibitors, demonstrate modest results in acute myeloid leukemia (AML). A major reason for this involves an increased transcriptional plasticity within AML, which allows the cells to escape therapeutic pressure. In this study, we investigated the immediate epigenetic and transcriptional responses after BET inhibition and demonstrated that BET inhibitor–mediated release of bromodomain-containing protein 4 from chromatin is accompanied by acute compensatory feedback that attenuates downregulation or even increases the expression of specific transcriptional modules. This adaptation is marked at key AML maintenance genes and is mediated by p300, suggesting a rational therapeutic opportunity to improve outcomes by combining BET and p300 inhibition. p300 activity is required during all steps of resistance adaptation; however, the specific transcriptional programs that p300 regulates to induce resistance to BET inhibition differ, in part, between AML subtypes. As a consequence, in some AMLs, the requirement for p300 is highest during the earlier stages of resistance to BET inhibition, when p300 regulates transitional transcriptional patterns that allow leukemia-homeostatic adjustments. In other AMLs, p300 shapes a linear resistance to BET inhibition and remains critical throughout all stages of the evolution of resistance. Altogether, our study elucidates the mechanisms that underlie an “acute” state of resistance to BET inhibition, achieved through p300 activity, and how these mechanisms remodel to mediate “chronic” resistance. Importantly, our data also suggest that sequential treatment with BET and p300 inhibition may prevent resistance development, thereby improving outcomes.
The roadmap to integrate diversity, equity, and inclusion in hematology clinical trials: an American Society of Hematology initiative
Authors: Kuaban Alice , Croker Alysha K. , Keefer Jeffrey , Valentino Leonard A. , Bierer Barbara E. , Boateng Stephen , DiMichele Donna , Fogarty Patrick , Gibson C. Michael , Hood Anna M. , Hubbard Lloryn , Isgrò Antonella , Knobe Karin , Lake Leslie , Martin Iman , Reid Michel , Roberts Jonathan C. , Tomlinson Wendy , Tunji-Ajayi Lanre , Van Spall Harriette G.C. , Voltz-Girolt Caroline , Wheeler Allison P. , Mast Alan E. , Seremetis Stephanie 
Published: December 2024

Abstract
Clinical trial design for classical hematologic diseases is difficult because samples sizes are often small and not representative of the disease population. The American Society of Hematology initiated a roadmap project to identify barriers and make progress to integrate diversity, equity, and inclusion into trial design and conduct. Focus groups of international experts from across the clinical trial ecosystem were conducted. Eight issues identified include (1) harmonization of demographic terminology; (2) engagement of lived experience experts across the entire study timeline; (3) awareness of how implicit biases impede patient enrollment; (4) the need for institutional review boards to uphold the justice principle of clinical trial enrollment; (5) broadening of eligibility criteria; (6) decentralized trial design; (7) improving access to clinical trial information; and (8) increased community physician involvement. By addressing these issues, the hematology community can promote accessible and inclusive trials that will further inform research, clinical decision-making, and care for patients.
Requirements for automated micro-vehicles from the German public: a survey study
Authors: Schomakers Eva-Maria , Lotz Vivian , Ziefle Martina 
Published: December 2024

AbstractThis study investigates public requirements for and acceptance of semi-sized automated micro-vehicles (AMVs) in urban traffic in Germany, addressing safety and functional expectations from both incidentally co-present persons and potential delivery customers. A two-step approach, combining qualitative pre-studies and a quantitative survey was employed. Qualitative research consists of interviews, focus groups, and expert workshops to identify requirements, which are quantified in a survey involving 1000 urban-dwelling Germans. The results show that safety-related requirements are paramount. The top priority is basic vehicle safety, such as “safe braking behaviour,” “visibility,” and “safety in all weather conditions”. Autonomous behaviours for safety and delivery-specific attributes are also significant, though some autonomous functions received mixed responses. Social and sustainability requirements are also important—size and speed restrictions only moderately. The novelty of the research approach lies in focusing not only on the identification of acceptance factors, i.e. showing that size is important to public acceptance, but to study tangible requirements and accepted limits regarding vehicle design, behaviour and integration into public spaces, such as speed and size limits, evaluation of specific autonomous behaviours and technical details. The study emphasises the need for infrastructure, regulations, and trust-building efforts in AMV adoption.
The effect of labour tightness on wages at the regional level in Central Europe
Authors: Szabó Lajos Tamás 
Published: December 2024

AbstractI estimate the effect of tightness on wages in Hungary and Slovakia. The Mortensen Pissarides model predicts a positive relationship but the empirical evidence is scarce. I instrument tightness by the distance of a district from the Austrian border, interacted with a dummy that marks the opening of the Austrian labour market to these countries in 2011. I find a positive effect of tightness on wages, which is in line with the conclusion of the models. If tightness increase by 1 per cent than ceteris paribus wages increase by roughly 0.2 per cent both in Hungary and Slovakia as well.
Inequality in modern contraceptive use and unmet need for contraception among women of reproductive age in Zambia. A trend and decomposition analysis 2007–2018
Authors: Kazibwe Joseph , Masiye Felix , Klingberg-Allvin Marie , Ekman Björn , Sundewall Jesper 
Published: December 2024

Abstract
Background
Access to contraception can be a transformational intervention towards advancement of education, health, and freedom of choice. Countries have committed to improving access to contraception enshrined in the sustainable development goals (SDGs), indicator 3.7.1. Our study seeks to investigate the level of inequality in current use of modern contraception and unmet need for contraception among sexually active women of reproductive age in Zambia during 2007, 2013/14 and 2018 to inform family planning policy.

Methods
We use three rounds of Zambia demographic and health survey datasets for the years 2007, 2013/14 and 2018, which are nationally representative surveys. We included a total of 19,973 sexually active women of reproductive age from 15 to 49 years living in Zambia. The level of inequality was assessed using concentration curves, and indices. The concentration indices were decomposed to identify the causes of the inequality.

Results
Our analysis shows that there was inequality in the current use of modern contraception across the years 2007, 2013/14 and 2018. The concentration curves showed that current use of modern contraception was higher among the wealthy than the poor. This pro-rich trend was consistent throughout the study period. Erreygers concentration Index (EI) values were 0.2046 in 2007, 0.1816 in 2013/14, and 0.1124 in 2018. The inequality in current use of modern contraception was significantly influenced by having access to contraceptive counselling, education level and being in a union (living with a partner). In addition, there was inequality in unmet need for contraception with concentration curves showing that unmet need for modern contraception was experienced more among the poor compared to the wealthy. Unmet need was thus pro poor. The EI values were – 0.0484 in 2007, – 0.0940 in 2013/14 and – 0.0427 in 2018. This inequality was significantly influenced by education, employment status, being in a union, and having health insurance.

Conclusion
Inequality in modern contraceptive use and unmet need for contraception exists and has persisted over the years in Zambia. Such inequality can be addressed through a multipronged approach that includes encouraging women to visit health facilities, access to contraceptive counselling, and promoting formal education.