bluuebunny/crossref_metadata_2025_split huggingface dataset:
First dating of an early Chibanian (Middle Pleistocene) glacial overdeepening in the Alpine Foreland using the 4He/U-Th method
Authors: Tomonaga Yama , Buechi Marius W. , Deplazes Gaudenz , Kipfer Rolf 
Published: October 2024

Abstract
The 4He/U-Th dating method can be used to estimate the residence time of pore waters in low-permeable rocks and consolidated sediments, serving as a proxy for sediment deposition time. This residence time is inferred from the accumulation time of radiogenic 4He measured in the pore water being produced by the local decay of U and Th in the sediment matrix. We applied the 4He/U-Th method to date the pore waters of unconsolidated sediments from a glacial overdeepening in the Swiss Plateau (northern Alpine Foreland), where prior studies suggested sediments older than Marine Isotope Stage (MIS) 6 (191–130 ka). We show that compact and fine-grained (glaci)lacustrine sediments provide low-permeability conditions that allow 4He to accumulate in the pore water and be preserved in the pore space. The 4He/U-Th dating indicates that the sediments between 40 m and 140 m are 606 ± 122 ka. The dated infill was deposited in a glacial overdeepening eroded by a foreland glaciation larger than that of the Last Glacial Maximum (LGM). The results reveal extensive foreland glaciations and intense glacial overdeepening erosion during the early part of the Chibanian (i.e., Middle Pleistocene). This work highlights the potential of the 4He/U-Th method for dating sediments in similarly favorable hydrogeological settings.
VHLmissense mutation delineate aggressive clear cell renal cell carcinoma subtype with favorable immunotherapeutic response
Authors: Xu Ziyang , Liu Li , Jiang Wenbin , Qiu Youqi , Zhang Boyu , Cheng Jiangting , Luo Jiyan , Guo Jianming , Xu Jiejie 
Published: October 2024

Backgroundvon Hippel-Lindau (VHL) harbors the highest mutational frequency in clear cell renal cell carcinoma (ccRCC). AlthoughVHLmutational subtypes exert diverse impacts on the functionality of the VHL protein, the clinical significance ofVHLmutational heterogeneity remains largely obscure.MethodsThis study included a total of 1331 patients with ccRCC from localized data sets, including our localized Zhongshan Hospital (ZSHS) cohort (n=1270) and Zhongshan immune checkpoint blockade cohort (n=61), as well as 525 patients with ccRCC from two publicly available data sets with matched clinical annotation and multidimensional data. According to the putative biological effect, we subclassifiedVHLmutation intoVHLTruncandVHLMiss. The association ofVHLstatus with clinical outcomes, genomic, oncogenic and immunologic characteristics was further depicted.ResultsVHLMissccRCC was associated with reduced survival in the localized ZSHS and The Cancer Genome Atlas cohorts. Clinical benefit from immunotherapy was observed inVHLMisspatients in all immunotherapy cohorts.VHLMissccRCC exhibited hyper-activated cell cycle and nuclear factor kappa B (NF-κB) instead of canonical hypoxia inducible factor pathways, which might contribute to its proliferative morphology. Meanwhile,VHLMissccRCC featured an inflamed microenvironment with enriched tertiary lymphoid structures.ConclusionsVHLMissmutations delineate an aggressive ccRCC subtype with distinct clinical outcomes, likely attributed to its specific oncogenic, morphologic and immunologic features.
Genetic Variations in AMPK, FOXO3A, and POMC Increase the Risk of Extreme Obesity
Authors: Santana Cinthia Vila Nova , Magno Luiz Alexandre Viana , Ramos Adauto Versiani , Rios Maria Angélica , Sandrim Valéria Cristina , De Marco Luiz Armando , Miranda Débora Marques de , Romano-Silva Marco Aurélio 
Published: October 2024

Objective: Genetic variability significantly impacts metabolism, weight gain, and feeding behaviors, predisposing individuals to obesity. This study explored how variations in key genes related to obesity—FOXO3A (forkhead box O3), AMPK (protein kinase AMP‐activated), and POMC (proopiomelanocortin)—are associated with extreme obesity (EOB).Methods: We conducted a case–control study with 251 EOB patients and 212 healthy controls with a body mass index (BMI) of less than 25 kg/m2. We genotyped 10 single nucleotide variants (SNVs) using TaqMan‐based assays.Results: Four SNVs—rs1536057 in FOXO3A, rs103685 in AMPK, rs934778, and rs6545975 in POMC—were associated with an increased risk of EOB. The strongest association was observed with rs934778 (POMC), which had a maximum odds ratio (OR) of 5.26 (95% CI: 2.86–9.09). While these genetic variations are closely linked to EOB, they do not affect serum glucose, triglycerides, HDL, LDL, BMI, or waist circumference.Conclusions: These findings indicate that factors beyond traditional metabolic pathways, potentially related to feeding behavior or hormonal regulation, may also link these genetic variations to obesity. Further research in a larger sample is essential to validate these findings and explore their potential to guide clinical interventions and public health strategies.
Microarray Analysis of Visceral Adipose Tissue in Obese Women Reveals Common Crossroads Among Inflammation, Metabolism, Addictive Behaviors, and Cancer
Authors: Martínez-Romero Rolando , González-Chávez Susana Aideé , Urías-Rubí Victor Roberto , Gómez-Moreno Víctor Manuel , Blanco-Cantero Manlio Favio , Bernal-Velázquez Héctor Mario , Luévano-González Arturo , Pacheco-Tena César 
Published: October 2024

Background: Visceral adipose tissue (VAT) abnormalities are directly associated with obesity‐associated disorders. The underlying mechanisms that confer increased pathological risk to VAT in obesity have not been fully described.Methods: A case‐control study was conducted that included 10 women with obesity (36.80 ± 7.39 years, BMI ≥ 30 kg/m2) and 10 women of normal weight (32.70 ± 9.45 years, BMI < 24.9 kg/m2). RNA was extracted from greater omentum biopsies, and, using a DNA microarray, differential transcriptomic expression of VAT in women with obesity was evaluated taking as a reference that of women with normal weight. The differentially expressed genes (DEGs) were classified into functional biological processes and signaling pathways; moreover, the protein–protein interaction (PPI) networks were integrated for a deeper analysis of the pathways and genes involved in the central obesity‐associated disorders. The expression of TNF‐α, MAPK, and AKT proteins was also quantified in VAT.Results: The VAT of women with obesity had 3808 DEGs, mainly associated with the cellular process of inflammation and carbohydrates and lipid metabolism. Overexpressed genes were associated with inflammatory, metabolic, hormonal, neuroendocrine, carcinogenic, and infectious pathways. Cellular processes related to addictive behaviors were notable. MAPK and PI3K‐AKT pathways were overexpressed, and Mapk1 and Akt3 genes were common crossing points among obesity‐associated disorders’ pathways. The increased expression of MAPK, AKT, and TNF proteins was confirmed in the VAT of women with obesity.Conclusion: VAT confers a complex and blended pathogenic transcriptomic profile in obese patients, where abnormal processes are mainly controlled by activating intracellular signaling pathways that exhibit a high degree of redundancy. Identifying shared cross points between those pathways could allow specific targeting treatments to exert a widespread effect over multiple pathogenic processes.
Adolescent‐Initiated Retrospective Glucose Data Review is Associated With Improved Glycemia in Type 1 Diabetes Mellitus
Authors: Chenoweth David J. , Palmer Benjamin A. , Norris Andrew W. , Tansey Michael J. , Pinnaro Catherina T. 
Published: October 2024

Objectives: Regular retrospective review of glucose data is an important aspect of type 1 diabetes (T1D) management. Continuous glucose monitors (CGMs) facilitate retrospective review by capturing glucose data and generating standardized reports. However, only a minority of adults with T1D retrospectively review their glucose data, and adolescents are understudied. The objectives of this study were to determine the prevalence of self‐reported retrospective glucose data review by adolescents with T1D, determine factors associated with self‐reported retrospective glucose data review, and assess whether self‐reported retrospective glucose data review was associated with improved glycemia.Methods: We conducted a cross‐sectional survey of adolescents aged 12–18 years with T1D in conjunction with review of the associated electronic medical record, which included age, sex, date of diagnosis, clinic hemoglobin A1c (HbA1c), type of insurance, and CGM data. The survey included the Hypoglycemia Fear Survey (HFS) and questions regarding habits and attitudes associated with retrospective review.Results: 112 out of 218 eligible individuals completed the survey (51%). Fifty‐three percent of adolescents who completed the survey reported that they had engaged in retrospective glucose data review. Of these, 88% of individuals reported that they reviewed data regularly. Age, sex, race, type of insurance, and CGM use were not associated with retrospective review status. Self‐report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and time in range (TIR) compared to adolescents who indicated they do not review glucose data (p = 0.006 and p = 0.04, respectively). There was no difference in HFS scores between reviewers and nonreviewers including the behavioral subscale, worry subscale, and total score.Conclusions: Self‐report of retrospective glucose data review was associated with improved glycemia as measured by HbA1c and TIR. Adolescent‐initiated glucose data self‐review does not appear to be driven by fear of hypoglycemia (FoH).
YouTube as a Source of Information in Trauma Management for ATLS (10th Edition) Guidelines
Authors: Yazla Merve , Akyon Seyma Handan , Aybayar Esin Aslı , Gedikaslan Seyda , Szarpak Lukasz , Turan Omer Faruk , Smereka Jacek , Ekici Mustafa , Kocak Abdullah Osman , Katipoglu Burak 
Published: October 2024

Background: Trauma is one of the leading causes of mortality worldwide, and online platforms have become essential sources of information for trauma management. YouTube can play a significant role in helping people access medical information.Methods: YouTube was searched using the keywords management of trauma and assessment of trauma to identify relevant videos. Two authors independently evaluated the videos according to the ATLS (10th edition) guidelines, the modified DISCERN (m‐DISCERN) scale, and the Global Quality Scale (GQS) criteria. The videos that met the study criteria were evaluated based on the provider, video length, and view count.Results: Out of 939 videos, 667 were excluded resulting in 272 videos included in the study. According to the ATLS (10th edition) guidelines, the median score for videos was 8 (IQR 7‐8). Videos uploaded by official institutions and healthcare professionals received higher scores than from uncertain sources (p = 0.003). According to the GQS, 86% of the videos were low or moderate quality; uncertain sources uploaded 78% of low‐quality videos.Conclusion: YouTube is an information source about trauma management that contains videos of varying quality and has a broad audience. Official institutions and healthcare professionals should be aware of this evolving technology and publish up‐to‐date, accurate content to increase awareness about trauma management and help patients distinguish helpful information from misleading content.
Treatment and Survival Differences between Patients with Invasive Lobular Carcinoma Versus Invasive Ductal Carcinoma of the Breast
Authors: Anampa Jesus D. , Lin Shuwen , Obeng-Gyasi Samilia , Xue Xiaonan 
Published: October 2024

Abstract

Background:
Invasive lobular carcinoma (ILC) exhibits differences in molecular and biological characteristics compared with invasive ductal carcinoma (IDC). We aim to compare breast cancer–specific survival (BCSS) between patients with ILC and IDC.

Methods:
We used data from the Surveillance, Epidemiology, and End Results database (1992–2020). Logistic regression analyses were conducted to identify factors associated with treatment modalities. We examined BCSS at different time points using a cox regression model with time-dependent coefficient.

Results:
A total of 343,397 patients with IDC and 39,859 patients with ILC were included. Patients with ILC had more advanced-stage disease (stage II, 35% vs. 34%; stage III, 16% vs. 11%) and a higher rate of hormone receptor–positive disease (97% vs. 81%). Compared with patients with IDC, patients with ILC had better BCSS in the first five years (HR = 0.71; P &lt; 0.001) but worse BCSS in later years (HR = 1.30, P &lt; 0.001 in years 6–10; HR = 1.75, P &lt; 0.001 in years 11–15; and HR = 2.17, P &lt; 0.001 in years 16–20).

Conclusions:
Patients with ILC survive better in early years but worse in later years compared with patients with IDC. Future studies are required to identify patients with ILC who are at risk of late recurrence or mortality.

Impact:
The results of this study add to the currently conflicting literature of survival of ILC and demonstrate the importance of evaluating novel therapeutic approaches and extended therapy for patients with ILC.
New Practice of Environmental Governance in China
Authors: Guiyue Luo , Yuanyuan Mou 
Published: October 2024

Abstract
Preventive environmental civil public interest litigation is an institutional innovation of environmental governance in China. Previous research primarily focuses on the implementation of prevention principles and environmental risk management; however, it fails to identify the significant risks in the new practice. There are significant risks that human behaviour may result in the creation of radioactive toxins and contaminants that are not perceptible to humans and which may have dramatic short- or long-term effects on plants, animals, and humans. This paper seeks to close this research gap. A review of typical cases revealed three elements that judges should consider when identifying significant risks in preventive environmental public interest litigation. Firstly, the significant risks involved in the case must be directly related to the public interest. Secondly, the probability of significant risks occurring should be emphasised. Thirdly, the proportionality principle should be adhered to in deciding on preventive means to be used in the case. We found some ambiguities and defects in the identification of significant risks. This article makes proposals to improve environmental legislation and application ambiguities in new practice in order to contribute to better environmental governance.
Enter the CORSIA First Phase
Authors: Pratama Garry Gumelar 
Published: October 2024

Abstract
The Carbon Offsetting and Reduction Scheme for International Aviation (CORSIA) entered its First Phase on 1 January 2024. Aircraft operators are required to offset their emissions for the first time in this Phase to mitigate their climate impact. This note chronologises its major developmental trajectory leading up to this Phase. Furthermore, developments of climate initiatives at the regional level are related to CORSIA. It is noteworthy to see CORSIA from a European Union (EU) perspective because of the recent amendment to the EU Emissions Trading System (EU ETS). The European Commission has set a ‘deadline’ to review the effectiveness of CORSIA and made efforts to establish the EU ‘world premiere’ in the monitoring, reporting, and verification (MRV) of aviation non-CO2 emissions. This indicates a broader scope of the EU ETS than that of CORSIA. With the deadline and regional developments, CORSIA is approaching a juncture for the potential design changes from its sole focus on CO2 emissions to include non-CO2 emissions.
Trends in Soft Palate Surgery and Reimbursements for Obstructive Sleep Apnea Among the Medicare Population
Authors: Torabi Sina J. , Frank Madelyn I. , Patel Rahul A. , Manes R. Peter , Kuan Edward C. , Trask Douglas K. 
Published: October 2024

Objectives: This study aims to analyze trends in utilization and reimbursement of soft palate surgery for OSA using the Medicare national database. Methods: A retrospective analysis of the 2000 to 2021 Part B National Summery datafiles using current Procedural Terminology (CPT) codes 42145 (uvulopalatopharyngoplasty [UPPP]), 42950 (pharyngoplasty [PP]), and 42140 (uvulectomy [UVU]) was performed. Results: Between 2000 and 2021, the number of OSA surgeries fell 65.7% from 4208 to 1443. UPPP fell 87.6% from 3455 in 2000 to 428 in 2021 ( P < .001). UVU also fell in popularity, from 568 to 376 (33.8%; P < .001). In contrast, the performance of PP rose 245.4% over time, from 185 to 639 ( P < .001). When comparing 2000 to 2009, both PP and UVU rose in relative use (from 4.4% to 12.3% and from 13.5% to 20.4% of all soft palate OSA surgeries, respectively), while UPPP fell (82.1% to 67.3%; P < .001). Total Medicare payments for all 3 procedures fell 57.2% from $1 658 844 to $633 091 ( P < .001). Adjusted total UPPP payments fell 88.7% ( P < .001). Adjusted total PP payment rose 137.5% to $262 538 in 2021 ( P < .001). Conclusion: Soft palate surgery for OSA has declined amongst the Medicare population over 21 years (2000-2021). The more individualized and tissue sparing PP has risen in popularity but did not overcome the large decline of the traditional UPPP. Accordingly, there was a 75.7% fall in inflation-adjusted reimbursements. Overall, our data indicates a decline in soft palate surgery in the management of geriatric OSA, with modest relative increase in pharyngoplasty procedures.
Corrective Intra-articular Osteotomy for Malreductions of Tibial Pilon Fractures in Patients Less Than 55 Years Old
Authors: Li Ya-Xing , Gan Ting-Jiang , Ma Xi-Kun , Chen Yu , Liu Xi , Zhang Hui 
Published: October 2024

Background: Tibial pilon malreductions are challenging to correctively reconstruct, and the relevant literature is limited. This study aims to assess whether corrective intra-articular osteotomy is worthwhile to treat relatively younger (<55-year-old) patients with intra-articular malreductions of pilon fractures. Methods: This is a retrospective observational study with a minimum follow-up of 2 years. From 2013 to 2021, 21 patients (mean age: 39.2 ± 11.2 years) with intra-articular pilon malreductions ≥6 weeks treated with intra-articular osteotomies were analyzed. The median interval time until intra-articular osteotomy was 76 (interquartile range [IQR], 49-149) days. Plain radiographs and computed tomography were used for radiographic assessments. Clinical outcomes were evaluated with visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, the 36-Item Short-Form Health Survey (SF-36) score, and ankle range of motion (ROM). Results: The median follow-up duration was 34.6 (IQR, 26.1-74.3) months. The median articular displacement was reduced from 12.7 mm preoperatively to 2.7 mm postoperatively ( P < .05). According to the Kellgren-Lawrence grading, 16 patients were assigned to stage II, 4 to stage III, and 1 to stage IV. In the 10 patients with available preoperative assessments, substantial improvement was found in the VAS score, from 5.90 to 2.0 at the final follow-up ( P < .05). Similarly, the AOFAS ankle-hindfoot score and SF-36 scores improved ( P < .05). Ankle ROM did not change a clinically meaningful amount. Progressive degenerative changes were noted in 2 of 10 patients who had adequate preoperative imaging. Four patients had VAS scores ≥4 including 1 patient who is scheduled for an arthrodesis. Conclusion: In this small series, we found that the corrective osteotomies generally provided reasonable improvement at 3 years in patients <55 years old with intra-articular malreduction of pilon fractures. Prospective cohort studies are needed to determine if it is worthwhile in long-term outcome.
A novel technique for snuffbox fistula creation
Authors: Wang Xiaohe , Zhi Jia , Hou Guocun 
Published: October 2024

Background: In this pilot study, we describe a novel technique for creating a snuffbox fistula (SBF) and present the preliminary outcomes after 4–6 weeks of follow-up. Methods: The study included eight male patients with a mean age of 50 years (range 36–66 years). All patients received an SBF using the modified no-touch technique (MNTT) and piggyback straight-line on-lay technique (pSLOT). Results: Immediate patency was obtained for all patients. In one case, a thrombosis developed at the juxta anastomosis. The remaining seven SBFs met the clinical arteriovenous fistula maturity criteria at the physical examination performed 4–6 weeks after surgery, showing an easily palpable vein, a straight superficial segment >10 cm in length and a sufficient diameter, and good palpable thrill. In addition, an ultrasound examination showed that the diameter of the drainage vein was 4–6 mm, and the brachial blood flow was ⩾500 mL/min. Conclusions: The combination of MNTT and pSLOT was used to successfully establish SBFs, and the success rate of surgery and access maturity were high.
Collaborative and integrated working between general practice and community pharmacies: A realist review of what works, for whom, and in which contexts
Authors: Owen-Boukra Emily , Cai Ziyue , Duddy Claire , Fudge Nina , Hamer-Hunt Julia , Husson Fran , Mahtani Kamal R , Ogden Margaret , Swinglehurst Deborah , Turner Malcolm , Whittlesea Cate , Wong Geoff , Park Sophie 
Published: October 2024

Objectives Collaborative and integrated (C + I) working between general practice and community pharmacies has the potential to increase accessibility to services, improve service efficiency and quality of care, and reduce health care expenditures. Many existing studies report challenges and complexities inherent in establishing effective C + I ways of working. The aim of our review is to understand how, when and why working arrangements between General Practitioners (GP) and Community Pharmacists (CP) can provide the conditions necessary for effective communication, decision-making, and C + I working. Methods We conducted a realist review to explore the key contextual factors and mechanisms through which GP-CP C + I working may be achieved. MEDLINE, Embase, CINAHL, PsycINFO, HMIC, Web of Science, IBSS, ASSIA, Sociological Abstracts, Sociology Database and the King’s Fund Library Database were searched for articles and grey literature published between January 2000 and April 2022. Results A total of 136 documents were included in the final synthesis. Our findings highlight the importance of mutually beneficial remuneration models to support effective integration of services; supportive organisational cultures and values; flexible and agile IT systems/technologies; adequate physical infrastructure and space design to support multidisciplinary teamworking; the importance of establishing patient’s trust in collaborative processes between GP-CP; and the need to acknowledge, support and utilise effective triadic relationships. Conclusions Our research generates new insights regarding how, why and in which contexts C + I working can be achieved between GPs and CPs. The findings of our review can be used to inform future policy, research and clinical practice guidelines for designing and delivering C + I care.
Residual Rotatory Instability after ACL Reconstruction Surgery
Authors: Pontoh Ludwig Andre 
Published: October 2024

Despite improvement of the reconstruction techniques of the anterior cruciate ligament (ACL), a number of patients continue to present residual rotational instability and pivot shift following surgery. This has led to a search for the causes of such instability in other structures of the knee and in the bone morphology itself. The reconstruction surgery of the ACL is not the only consideration; the rest of the structures that may be affected and which will need correct treatment. Diagnosing and adequately treating the ligamentous, meniscal and bony lesions associated to ACL rupture is mandatory.