bluuebunny/crossref_metadata_2025_split huggingface dataset:
An international consensus panel on the potential value of Digital Surgery
Authors: Erskine Jamie , Abrishami Payam , Bernhard Jean-Christophe , Charter Richard , Culbertson Richard , Hiatt Jo Carol , Igarashi Ataru , Purcell Jackson Gretchen , Lien Matthew , Maddern Guy , Soon Yau Ng Joseph , Patel Anita , Rha Koon Ho , Sooriakumaran Prasanna , Tackett Scott , Turchetti Giuseppe , Chalkidou Anastasia 
Published: September 2024

ObjectivesThe use of digital technology in surgery is increasing rapidly, with a wide array of new applications from presurgical planning to postsurgical performance assessment. Understanding the clinical and economic value of these technologies is vital for making appropriate health policy and purchasing decisions. We explore the potential value of digital technologies in surgery and produce expert consensus on how to assess this value.DesignA modified Delphi and consensus conference approach was adopted. Delphi rounds were used to generate priority topics and consensus statements for discussion.Setting and participantsAn international panel of 14 experts was assembled, representing relevant stakeholder groups: clinicians, health economists, health technology assessment experts, policy-makers and industry.Primary and secondary outcome measuresA scoping questionnaire was used to generate research questions to be answered. A second questionnaire was used to rate the importance of these research questions. A final questionnaire was used to generate statements for discussion during three consensus conferences. After discussion, the panel voted on their level of agreement from 1 to 9; where 1=strongly disagree and 9=strongly agree. Consensus was defined as a mean level of agreement of >7.ResultsFour priority topics were identified: (1) how data are used in digital surgery, (2) the existing evidence base for digital surgical technologies, (3) how digital technologies may assist surgical training and education and (4) methods for the assessment of these technologies. Seven consensus statements were generated and refined, with the final level of consensus ranging from 7.1 to 8.6.ConclusionPotential benefits of digital technologies in surgery include reducing unwarranted variation in surgical practice, increasing access to surgery and reducing health inequalities. Assessments to consider the value of the entire surgical ecosystem holistically are critical, especially as many digital technologies are likely to interact simultaneously in the operating theatre.
Impact of perioperative diagnostic tools on clinical outcomes and cost-effectiveness in parathyroid surgery: a decision model-based analysis
Authors: Bátora Daniel , Iskandar Rowan , Gertsch Juerg , Kaderli Reto M 
Published: September 2024

ObjectivesPreoperative and intraoperative diagnostic tools influence the surgical management of primary hyperparathyroidism (PHPT), whereby their performance of classification varies considerably for the two common causes of PHPT: solitary adenomas and multiglandular disease. A consensus on the use of such diagnostic tools for optimal perioperative management of all PHPT patients has not been reached.DesignA decision tree model was constructed to estimate and compare the clinical outcomes and the cost-effectiveness of preoperative imaging modalities and intraoperative parathyroid hormone (ioPTH) monitoring criteria in a 21-year time horizon with a 3% discount rate. The robustness of the model was assessed by conducting a one-way sensitivity analysis and probabilistic uncertainty analysis.SettingThe US healthcare system.PopulationA hypothetical population consisting of 5000 patients with sporadic, symptomatic or asymptomatic PHPT.InterventionsPreoperative and intraoperative diagnostic modalities for parathyroidectomy.Main outcome measuresCosts, quality-adjusted life-years (QALYs), net monetary benefits (NMBs) and clinical outcomes.ResultsIn the base-case analysis, four-dimensional (4D) CT was the least expensive strategy with US$10 276 and 15.333 QALYs. Ultrasound and99mTc-Sestamibi single-photon-emission CT/CT were both dominated strategies while18F-fluorocholine positron emission tomography was cost-effective with an NMB of US$416 considering a willingness to pay a threshold of US$95 958. The application of ioPTH monitoring with the Vienna criterion decreased the rate of reoperations from 10.50 to 0.58 per 1000 patients compared to not using ioPTH monitoring. Due to an increased rate of bilateral neck explorations from 257.45 to 347.45 per 1000 patients, it was not cost-effective.Conclusions4D-CT is the most cost-effective modality for the preoperative localisation of solitary parathyroid adenomas and multiglandular disease. The use of ioPTH monitoring is not cost-effective, but to minimise clinical complications, the Miami criterion should be applied for suspected solitary adenomas and the Vienna criterion for multiglandular disease.
Identifying microbiome-based changes and biomarkers prior to disease development in mother and child, with a focus on gestational diabetes mellitus: protocol for the DANish Maternal and Offspring Microbiome (DANMOM) cohort study
Authors: Rold Louise Søndergaard , Jensen Ann-Maria , Arenholt Louise , Leutscher Peter Derek Christian , Ovesen Per Glud , Hagstrøm Søren , Sørensen Suzette 
Published: September 2024

IntroductionThe human gut microbiota is associated with gestational diabetes mellitus (GDM), which imposes a risk of developing long-term health problems for mother and child. Most studies on GDM and microbiota have been cross-sectional, which makes it difficult to make any conclusions on causality. Furthermore, it is important to assess if a dysbiotic microbiota is passed from the mother to the child, and then being at risk of developing metabolic health problems later in life. The DANish Maternal and Offspring Microbiome study aims to identify gut microbiota-related factors involved in metabolic dysfunction in women with GDM and their offspring. Importantly, the study design allows for early detection of biological changes associated with later development of metabolic disease. This could provide us with unique tools to support early diagnosis or implement preventative measures.Methods and analysisPregnant women are included in the study after the 11–14 weeks’ prenatal ultrasound scan and followed throughout pregnancy with enrolment of the offspring at birth. 202 women and 112 children have been included from North Denmark Regional Hospital and Aalborg University Hospital in Denmark. Mother and child are followed until the children reach the age of 5 years. From the mother, we collect faeces, urine, blood, saliva, vaginal fluid and breast milk samples, in addition to faeces and a blood sample from the child. Microbiota composition in biological samples will be analysed using 16S rRNA gene sequencing and compared with demographic and clinical data from medical charts, registers and questionnaires. Sample and data collection will continue until July 2028.Ethics and disseminationThe study protocol has been approved by the North Denmark Region Committee on Health Research Ethics (N20190007). Written informed consent is obtained from all participants prior to study participation. Study results will be published in international peer-reviewed journals and presented at international conferences. The results will also be presented to the funders of the study and study participants.
Effect of peanut butter supplementation on physical and cognitive functions in community-dwelling older adults: study protocol for a 6-month randomised controlled trial
Authors: Hettiarachchi Jeew , Feyesa Ilili , Daly Robin M , George Elena S , Georgousopoulou Ekavi N , Scott David , Baguley Brenton J , Tan Sze-Yen 
Published: September 2024

IntroductionAgeing is associated with physical and cognitive declines, which may be further exacerbated by poor nutrition. Nuts are energy and nutrient dense, and their consumption is associated with better physical and cognitive functions in older adults, but data from interventional studies are limited. This 6-month randomised controlled trial is designed to investigate the effects of consuming 43 g/day of peanut butter (equivalent to 1.5 servings of nuts) on physical function, including walking speed (primary outcome), standing and dynamic balance, upper and lower body strength, lower body power and endurance, and associated factors including muscle mass, cognitive function and DNA telomere length in community-dwelling older adults.Method and analysisA total of 120 participants aged ≥65 years will be recruited and randomly allocated (1:1 ratio) to either the intervention group (n=60) that will receive individually packaged sealed containers containing 43 g of peanut butter to be consumed once daily for 6 months alongside habitual diet, or the control group (n=60) that will maintain their habitual diet. Primary and secondary outcomes will be assessed at baseline and at 6 months. The primary outcome is walking speed assessed using the 4 m usual gait speed test. Secondary outcomes include other physical function assessments: standing balance, chair stand time, timed-up-and-go test and four-square step test; and hand grip and knee extensor muscle strength; cognitive function assessed using the Montreal Cognitive Assessment and trail making tests; body composition; nutritional status; and DNA telomere length from participants’ buccal cell samples. Linear mixed models will be used to compare changes in outcomes between intervention and control groups.Ethics and disseminationThe study protocol is approved by the Deakin University Human Research Ethics Committee. The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12622001291774. The results will be disseminated through peer-reviewed journals, conference presentations and media.Trial registration numberANZCTR12622001291774.
Stretched-exponential melting of a dynamically frozen state under imprinted phase noise in the ising chain in a transverse field
Authors: Roychowdhury Krishanu , Das Arnab 
Published: September 2024

Abstract
The concept of dynamical freezing is a phenomenon where a suitable set of local observables freezes under a strong periodic drive in a quantum many-body system. This happens because of the emergence of approximate but perpetual conservation laws when the drive is strong enough. In this work, we probe the resilience of dynamical freezing to random perturbations added to the relative phases between the interfering states (elements of a natural basis) in the time-evolving wave function after each drive cycle. We study this in an integrable Ising chain in a time-periodic transverse field. Our key finding is, that the imprinted phase noise melts the dynamically frozen state, but the decay is “slow”: a stretched-exponential decay rather than an exponential one. Stretched-exponential decays (also known as Kohlrausch relaxation) are usually expected in complex systems with time-scale hierarchies due to strong disorders or other inhomogeneities resulting in jamming, glassiness, or localization. Here we observe this in a simple translationally invariant system dynamically frozen under a periodic drive. Moreover, the melting here does not obliterate the entire memory of the initial state but leaves behind a steady remnant that depends on the initial conditions. This underscores the stability of dynamically frozen states.

Graphical abstract
Testing the coupling of dark radiations in light of the Hubble tension
Authors: Lu Zhiyu , Imtiaz Batool , Zhang Dongdong , Cai Yi-Fu 
Published: September 2024

AbstractWe are studying the effects of Self-Interacting dark radiation (SIdr) on the evolution of the universe. Our main focus is on the cosmic microwave background (CMB) and how SIdr could potentially help resolve the Hubble tension. We are looking into different scenarios by mixing SIdr with Free-Streaming dark radiation (FSdr) or not to determine whether SIdr can indeed contribute to solving the Hubble tension. We find that SIdr alone can increase the Hubble constant ($$H_0$$

H
0

) to $$70.1_{-1.6}^{+1.3}, \text {km/s/Mpc}$$

70
.

1

-
1.6

+
1.3

,
km/s/Mpc

with a value of $$N_\textrm{eff}=3.27_{-0.31}^{+0.23}$$

N
eff

=
3
.

27

-
0.31

+
0.23

. However, including FSdr disfavors the existence of SIdr $${\tilde{N}}_\textrm{si}\approx 0.37$$

N
~

si

≈
0.37

. Even though the Hubble constant is increased compared to the predicted value, it entails $$N_\textrm{eff}=3.52\pm 0.25$$

N
eff

=
3.52
±
0.25

. Finally, we implement the Fisher method for future experiments and a $$7.64\sigma $$

7.64
σ

measurement of $${\tilde{N}}_\textrm{si}$$

N
~

si

will be obtained when combing data from Planck, AliCPT, and CMB-S4.
Mental Health Consequences of the COVID‐19 Outbreak Among Emergency Department Healthcare Workers
Authors: Douplat Marion , Subtil Fabien , Termoz Anne , Jacquin Laurent , Verbois Frédéric , Potinet Veronique , Hernu Romain , Landel Verena , Mazza Stéphanie , Berthiller Julien , Haesebaert Julie , Tazarourte Karim 
Published: September 2024

Study Objective: The present study is aimed at providing an assessment of the changes in burnout, job strain, isostrain, sleepiness, and fatigue levels over time and identifying factors associated with these symptoms among healthcare workers in French emergency departments (EDs).Method: We conducted a prospective, multicenter study in four EDs and an emergency medical service. Participants completed questionnaires at inclusion and at 90 days to assess burnout, job strain, isostrain, sleepiness, and fatigue.Results: A total of 211 respondents (43.5%) completed the questionnaires at inclusion. At the beginning of the study, 84 (40.8%) participants presented symptoms of burnout, 86 (43.2%) had symptoms of job strain, and 58 (29.4%) of isostrain. Forty‐two (20.1%) healthcare workers presented symptoms of sleepiness, and 8 (3.8%) had symptoms of fatigue. We found that symptoms of burnout were more frequent for healthcare workers with a previous psychiatric history (55.3% vs. 39.1%, p = 0.02) and were lower among participants who had at least one dependent child (33.1% vs. 48.3%, p = 0.013). Symptoms of job strain were higher among administrative staff compared to physicians (55.6% vs. 28.7%, p = 0.01) and among healthcare workers with managerial responsibilities compared to those without (45.6% vs. 28.8%, p = 0.015). Symptoms of isostrain were higher among administrative staff (42.3%) compared to paramedics (34.1%) and physicians (19.8%, p = 0.026).Conclusion: We identified that potential factors associated with the emergence of symptoms of burnout and job strain are suggested, underlining several areas of improvement for the prevention against mental health disorders in the specific population of ED healthcare workers.Trial Registration: ClinicalTrials.gov identifier: NCT04383886.
Therapeutic Efficacy of IL7/CCL19-Expressing CAR-T Cells in Intractable Solid Tumor Models of Glioblastoma and Pancreatic Cancer
Authors: Ohta Keisuke , Sakoda Yukimi , Adachi Keishi , Shinozaki Taro , Nakajima Masao , Yasuda Hiroyuki , Nagano Hiroaki , Tamada Koji 
Published: September 2024

Abstract

Cancer immunotherapy using immune checkpoint inhibitors and its combination with other anticancer therapies has emerged as a new standard of care because of the encouraging therapeutic effects in various solid cancers. Nonetheless, glioblastoma and pancreatic cancer remain resistant to immunotherapy and represent intractable cancers with the poorest prognosis. We investigated the therapeutic effects of next-generation chimeric antigen receptor (CAR) T cells producing IL7 and chemokine (C–C motif) ligand 19 (CCL19; referred to as 7 × 19 CAR-T) in these intractable cancers. Cytotoxic activities and therapeutic effects of 7 × 19 CAR-T were evaluated in vitro and in vivo, in a model using EGFR variant III (EGFRvIII)–positive glioblastoma and anti-EGFRvIII CAR-T generated from healthy donor peripheral blood mononuclear cells (PBMC), or a model using HER2-positive pancreatic cancer organoids and anti-HER2 CAR-T generated from the same patient’s PBMC. Anti-EGFRvIII 7 × 19 CAR-T exhibited cytotoxic activity specific to EGFRvIII-positive tumor, induced complete rejection of glioblastoma with massive T-cell infiltration and tumor cell death in the tumor tissues, and consequently prolonged mouse survival. Anti-HER2 7 × 19 CAR-T demonstrated a potent cytotoxic activity against autologous HER2-positive pancreatic cancer organoids and induced complete rejection of autologous tumor along with prolonged mouse survival. Our results suggest that 7 × 19 CAR-T could become a therapeutic option for glioblastoma and pancreatic cancer. To the best of our knowledge, this is the first study to demonstrate the therapeutic efficacy of next-generation CAR-T in an autologous model using patient-derived tumor organoids and CAR-T generated from the same patient’s PBMC, in which unwanted allogeneic immune responses are fully excluded.

Significance:
Despite the clinical development of CAR T-cell therapy, its efficacy in solid cancers has yet to be established. This study explored the therapeutic potential and immunologic mechanisms of IL7/CCL19-producing CAR-T therapy in preclinical solid cancer models of glioblastoma and pancreatic cancer. We found that IL7/CCL19-producing CAR-T cells generated from the patient’s PBMC showed potent therapeutic effects against the solid cancer model established by inoculating organoids from the autologous tumor tissue.
Associations of Adipokine Levels With Levels of Remnant Cholesterol: The Multi‐Ethnic Study of Atherosclerosis
Authors: Quispe Renato , Sweeney Ty , Martin Seth S. , Jones Steven R. , Allison Matthew A. , Budoff Matthew J. , Ndumele Chiadi E. , Elshazly Mohamed B. , Michos Erin D. 
Published: September 2024

Background
The metabolic syndrome phenotype of individuals with obesity is characterized by elevated levels of triglyceride‐rich lipoproteins and remnant particles, which have been shown to be significantly atherogenic. Understanding the association between adipokines, endogenous hormones produced by adipose tissue, and remnant cholesterol (RC) would give insight into the link between obesity and atherosclerotic cardiovascular disease.

Methods and Results

We studied 1791 MESA (Multi‐Ethnic Study of Atherosclerosis) participants who took part in an ancillary study on body composition with adipokine levels measured (leptin, adiponectin, and resistin) at either visit 2 or visit 3. RC was calculated as non–high‐density lipoprotein cholesterol minus low‐density lipoprotein cholesterol, measured at the same visit as the adipokines, as well as subsequent visits 4 through 6. Multivariable‐adjusted linear mixed‐effects models were used to assess the cross‐sectional and longitudinal associations between adipokines and log‐transformed levels of RC. Mean±SD age was 64.5±9.6 years; mean±SD body mass index was 29.9±5.0 kg/m
2
; and 52.0% were women. In fully adjusted cross‐sectional models that included body mass index, diabetes, low‐density lipoprotein cholesterol, and lipid‐lowering therapy, for each 1‐unit increment in adiponectin, there was 14.6% (95% CI, 12.2–16.9) lower RC. With each 1‐unit increment in leptin and resistin, there was 4.8% (95% CI, 2.7–7.0) and 4.0% (95% CI, 0.2–8.1) higher RC, respectively. Lower adiponectin and higher leptin were also associated with longitudinal increases in RC levels over median follow‐up of 5 (interquartile range, 4–8) years.

Conclusions
Lower adiponectin and higher leptin levels were independently associated with higher levels of RC at baseline and longitudinal RC increase, even after accounting for body mass index and low‐density lipoprotein cholesterol.
Effect of Denosumab or Alendronate on Vascular Calcification: Secondary Analysis of SALTIRE2 Randomized Controlled Trial
Authors: Geers Jolien , Bing Rong , Pawade Tania A. , Doris Mhairi K. , Daghem Marwa , Fletcher Alexander J. , White Audrey C. , Forsyth Laura , Evans Emily , Kwieciński Jacek , Williams Michelle C. , van Beek Edwin J. R. , Kwak Soongu , Peeters Frederique E.C.M. , Tzolos Evangelos , Slomka Piotr J , Lucatelli Christophe , Ralston Stuart H. , Prendergast Bernard , Newby David E. , Dweck Marc R. 
Published: September 2024

Background
Patients with osteoporosis demonstrate increased vascular calcification but the effect of osteoporosis treatments on vascular calcification remains unclear. The present study aimed to examine whether coronary or aortic calcification are influenced by denosumab and alendronic acid treatment.

Methods and Results

In a double‐blind randomized controlled SALTIRE2 (Study Investigating the Effect of Drugs Used to Treat Osteoporosis on the Progression of Calcific Aortic Stenosis) trial, patients with aortic stenosis were randomized 2:1:2:1 to denosumab, placebo injection, alendronic acid, or placebo capsule. Participants underwent serial imaging with computed tomography and 18F‐sodium fluoride positron emission tomography for the assessment of vascular calcium burden and calcification activity, respectively. We report the prespecified secondary analyses of 24‐month change in coronary calcium score, and 12‐month changes in thoracic aorta calcium score, coronary and aortic 18F‐sodium fluoride activity. One hundred fifty patients with aortic stenosis (72±8 years; 21% female) were randomized to denosumab (n=49), alendronic acid (n=51), and placebo (injection n=25, capsule n=25). There were no differences in change in coronary calcium scores between placebo (16 [−64 to 148] Agatston units) and either denosumab (94 [0–212] Agatston units,
P
=0.24) or alendronic acid (34 [−62 to 134],
P
=0.99). There were no differences in change in thoracic aorta calcium scores between placebo (132 [22–512] Agatston units) and either denosumab (118 [11–340],
P
=0.75) or alendronic acid (116 [26–498] Agatston units,
P
=0.62). There were no differences in changes in coronary or aortic 18F‐sodium fluoride activity between treatment groups.

Conclusions
Neither alendronic acid nor denosumab are associated with changes in the activity or progression of coronary or aortic calcification. Osteoporosis treatments do not appear to have major impact on vascular calcification of atherosclerosis.

registration

https://www.clinicaltrials.gov
; Unique identifier: NCT02132026.