bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fetal Fraction of Cell‐Free DNA in the Prediction of Adverse Pregnancy Outcomes: A Nationwide Retrospective Cohort Study
Authors: Becking Ellis C. , Bekker Mireille N. , Henrichs Jens , Bax Caroline J. , Sistermans Erik A. , Henneman Lidewij , Scheffer Peter G. , Schuit Ewoud 
Published: October 2024

ABSTRACTObjectiveTo assess the added value of fetal fraction of cell‐free DNA in the maternal circulation in the prediction of adverse pregnancy outcomes.DesignRetrospective cohort study.SettingNationwide implementation study on non‐invasive prenatal testing (NIPT; TRIDENT‐2 study).PopulationPregnant women in the Netherlands opting for NIPT between June 2018 and June 2019.MethodsTwo logistic regression prediction models were constructed for each adverse pregnancy outcome. The first model (base model) included prognostic clinical parameters that were selected from existing first‐trimester prediction models for adverse pregnancy outcomes. The second model (fetal fraction model) included fetal fraction as a predictor on top of the prognostic clinical parameters included in the base model. The added prognostic value of fetal fraction was assessed by comparing the base and fetal fraction models in terms of goodness of fit and predictive performance.Main Outcome MeasuresLikelihood ratio test (LRT), area under the curve (AUC) and Integrated Discrimination Improvement (IDI) index.ResultsThe study cohort consisted of 56 110 pregnancies. The incidence of adverse pregnancy outcomes was 5.7% for hypertensive disorders of pregnancy (HDP; n = 3207), 10.2% for birthweight < p10 (n = 5726), 3.2% for birthweight < p2.3 (n = 1796), 3.4% for spontaneous preterm birth (sPTB; n = 1891), 3.4% for diabetes (n = 1902) and 1.3% for congenital anomalies (n = 741). Adding fetal fraction to the base model improved model fit for HDP, birthweight < p10, birthweight < p2.3, all sPTB, and diabetes, but not for congenital anomalies (LRT p < 0.05). For HDP, the AUC improved from 0.67 to 0.68 by adding fetal fraction to the base model (p = 0.14) with an IDI of 0.0018 (p < 0.0001). For birthweight < p10, the AUC improved from 0.65 to 0.66 (p < 0.0001) with an IDI of 0.0023 (p < 0.0001). For birthweight < p2.3, the AUC improved from 0.67 to 0.69 (p < 0.0001) with an IDI of 0.0011 (p < 0.0001). For all sPTB, the AUC was similar for both models (AUC 0.63, p = 0.021) with an IDI of 0.00028 (p = 0.0023). For diabetes, the AUC was similar (AUC 0.72, p = 0.35) with an IDI of 0.00055 (p = 0.00015).ConclusionsFetal fraction has statistically significant but limited prognostic value in the prediction of adverse pregnancy outcomes in addition to known prognostic clinical parameters.
Income and wage inequality in democratic Portugal, 1974–2020
Authors: Oliveira Carlos 
Published: October 2024

AbstractThis paper investigates the evolution of income and wage inequality in Portugal from the 1974 democratic revolution up to 2020, drawing on a series of administrative records, survey data and aggregate statistics. Over this period, Portugal consistently ranked among the most unequal nations in the developed world. The transition from a deeply unequal dictatorial regime, in the wake of the 1974 revolution, brought about substantial redistribution. However, since the 1980s, income and wage inequality followed an arc‐shaped trajectory. There was a sharp rise in inequality from the early 1980s to the mid‐1990s, which, in just eight years, outpaced the infamous US growth in wage inequality of the last five decades. Then, there was stability at high levels until the mid‐2000s. Finally, there was a sharp decline in inequality until 2020, which halved both the gender wage gap and the college wage premium. Changes related to the supply and demand for education/skills emerged as key drivers of inequality dynamics. Institutional and political forces were especially relevant in reducing inequality during the transition to democracy and, more recently, with the rising importance of the minimum wage and collective bargaining.
Education and inequality: an international perspective
Authors: Bennett Patrick , Foley Kelly , Green David A. , Salvanes Kjell G. 
Published: October 2024

AbstractIn this paper, we summarise the existing literature and present new empirical evidence in order to address the questions of whether educational expansion is an effective tool for reducing inequality and whether some educational systems have better associations with lower inequality and others worse. We argue that – depending on the form the policies take, on the extent of intergenerational correlations in income and on the levers of educational access – policies that aim at increasing education are not necessarily beneficial in the sense of reducing inequality. Differential impacts of different systems by gender are particularly striking.
Dynamic analysis of a NiTi rotary file by using finite element analysis: Effect of cross‐section and pitch length
Authors: Akkoç Halil İbrahim , Keskin Cangül , Aslantaş Kubilay 
Published: October 2024

AbstractThis study assessed stress distribution, maximum stress values and fatigue life of experimentally designed NiTi rotary files with different cross‐sectional geometry and pitch length using finite element analysis (FEA). Four cross‐sectional shapes (Convex triangle, S‐shaped, Triple helix and Concave triangle) and two pitch lengths (2 mm and 3 mm) were tested in simulated root canals with curvatures of 30°, 45° and 60°. The FEA results indicated that convex triangle and triple helix geometries exhibited lower stress values compared to the S‐shaped and concave triangle designs. Increasing the canal curvature angle resulted in higher stress values, with the S‐shaped instrument showing the most significant increase (up to 12%). Instruments with shorter pitch lengths showed more even stress distribution enhancing fatigue life. The maximum stress was concentrated 5–8 mm from the tip, varying across cutting edges, with S‐shaped sections experiencing the lowest forces but higher stress due to lower moments of inertia.
Advances in non‐invasive imaging for dermatofibrosarcoma protuberans: A review
Authors: Algarin Yanci A. , Pulumati Anika , Tan Jiali , Zeitouni Nathalie C. 
Published: October 2024

AbstractDermatofibrosarcoma protuberans (DFSP) is a rare soft tissue sarcoma characterized by an asymmetric, infiltrative growth pattern and a high risk of local recurrence. This study aims to evaluate the effectiveness of various imaging modalities in the assessment and management of DFSP. Nine imaging modalities were reviewed including: Ultrasound (US), High‐Frequency Doppler Ultrasound (HFUS), Computed tomography (CT), Positron emission tomography–computed tomography (PET‐CT), and Magnetic Resonance Imaging (MRI), High‐resolution‐MRI (HR‐MRI), Magnetic Resonance Spectroscopy (MRS), Optical Coherence Tomography (OCT), and Dermatoscopy. Imaging is mainly used for preoperative assessment and surgical planning, not routine diagnosis. US is effective for initial evaluations, demonstrating superior ability in detecting muscle invasion and defining tumour boundaries (sensitivity – 81.8%, specificity – 100%). MRI is valuable for preoperative evaluation, surgical planning, and monitoring DFSP recurrence. It more accurately assesses tumour depth than palpation, with a sensitivity of 67% and specificity of 100%, but was inferior when compared to US. CT is utilized in cases of suspected bone involvement or pulmonary metastasis. For advanced or recurrent DFSP, PET‐CT helps manage treatment responses and imatinib therapy. Emerging technologies like MRS and OCT show potential in improving diagnostic accuracy and defining surgical margins, though more data are needed. US, MRI, and CT are the primary imaging modalities for DFSP. Emerging technologies like HR‐MRI, PET‐CT, MRS, and OCT hold promise for refining diagnostic and management strategies. Integrating multiple technologies could enhance management, particularly in atypical or aggressive cases. Further studies are required to refine imaging protocols and improve DFSP outcomes.
Anatomical compatibility of a novel total artificial heart: An in‐silico study
Authors: Narayanaswamy Krishnaraj , Petz Jakob , Bierewirtz Tim , Loewe Christian , Kertzscher Ulrich , Zimpfer Daniel , Granegger Marcus 
Published: October 2024

AbstractBackgroundShuttlePump is a novel total artificial heart (TAH) recently introduced to potentially overcome the limitations associated with the current state‐of‐the‐art mechanical circulatory support devices intended for adults. In this study, we adapted the outflow cannulation of the previously established ShuttlePump TAH and evaluated the anatomical compatibility using the virtual implantation technique.MethodsWe retrospectively assessed the anatomical compatibility of the ShuttlePump using virtual implantation techniques within 3D‐reconstructed anatomies of adult heart failure patients. Additionally, we examined the impact of outflow cannula modification on the hemocompatibility of the ShuttlePump through computational fluid dynamic simulations.ResultsA successful virtual implantation in 9/11 patients was achieved. However, in 2 patients, pump interaction with the thoracic cage was observed and considered unsuccessful virtual implantation. A strong correlation (r <−0.78) observed between the measured anatomical parameters and the ShuttlePump volume exceeding pericardium highlights the importance of these measurements apart from body surface area. The numerical simulation revealed that the angled outflow cannulation resulted in a maximum pressure drop of 1.8 mmHg higher than that of the straight outflow cannulation. With comparable hemolysis index, the shear stress thresholds of angled outflow differ marginally (<5%) from the established pump model. Similar washout behavior between the pump models indicate that the curvature did not introduce stagnation zone.ConclusionThis study demonstrates the anatomic compatibility of the ShuttlePump in patients with biventricular failure, which was achieved by optimizing the outflow cannulation without compromising hemocompatibility. Nevertheless, clinical validation is critical to ensure the clinical applicability of these findings.
Intravenous enoxaparin guided by anti‐Xa in venovenous extracorporeal membrane oxygenation: A retrospective, single‐center study
Authors: Durila Miroslav , Vajter Jaromir , Garaj Michal , Berousek Jan , Lischke Robert , Hlavacek Michal , Vymazal Tomas 
Published: October 2024

AbstractBackgroundUnfractionated heparin is used as the most common anticoagulation for venovenous extracorporeal membrane oxygenation (VV ECMO) patients. However, it is accompanied by frequent bleeding and thrombotic complications. The aim of the study was to demonstrate the feasibility of Enoxaparin anticoagulation for VV ECMO patients.MethodsThis study is a retrospective analysis of VV ECMO patients on continuous intravenous Enoxaparin anticoagulation. The primary outcome was the incidence of bleeding, thrombotic, and neurological complications during ECMO support. The secondary outcome was an analysis of secondary and primary hemostasis profiles.ResultsData from 38 patients were analyzed in this study. The incidence of bleeding complications was 5.3%, for thrombotic complications it was 2.6% and for neurological (bleeding/ischemic events) complications it was 10.5%. The targeted anti‐Xa activity of 0.4–0.6 IU/mL was achieved and maintained during whole ECMO period in 28 patients (73.8%), not affecting the hemocoagulation profile represented by APTT‐r 1.15 ± 0.2, TT 18.67 ± 3.35 s, PT/INR 1.21 ± 0.19, fibrinogen 5.39 ± 1.49 g/L, antithrombin, and platelet count. Primary hemostasis pathology was diagnosed in all patients by PFA 200 tests Col/EPI 279 ± 38 s and Col/ADP 249 ± 66 s. The running time of ECMO was 7.8 ± 3.4 days.ConclusionsEnoxaparin anticoagulation appears to be feasible for VV ECMO patients without an increase in adverse events. Further larger‐sampled and comparative studies are needed in the future to support our findings.
A 10‐year cross‐sectional study showed that anti‐coagulation therapy was not always of value when treating paediatric cases with septic cerebral venous thrombosis
Authors: Eloy Juliette , Hochart Audrey , Soto‐Ares Gustavo , Lagree Marion , Kuchcinski Grégory , Karnoub Mélodie‐Anne , Maltezeanu Alix , Leteurtre Stéphane , Dubos François 
Published: October 2024

AbstractAimCerebral venous thrombosis (CVT) is a rare complication of ear, nose and throat (ENT) infections. Although recent guidelines recommend the systematic use of anti‐coagulation therapy (ACT) in the treatment of these CVT, literature data are scarce. The present study's objective was to determine the value of ACT in achieving recanalisation after thrombosis and its effect on patient outcomes.MethodsAll paediatric patients with CVT and a concomitant ENT infection who attended Lille University Hospital (Lille, France) between January 2012 and December 2021 were retrospectively included.ResultsWe included 43 children (63% boys), with a mean age of 4 years. The most frequent infection was mastoiditis (54%). ACT was initiated in 23 patients (53%), one of whom had an intracranial haemorrhage. Partial or full recanalisation was observed in 33 (80%) of the 41 survivors. In patients with no neurological signs and symptoms on admission and in patients with mastoiditis‐related CVT, the clinical and radiological outcomes were favourable and did not differ according to the administration of ACT. Likewise, ACT did not appear to influence the recanalisation rate or sequelae.ConclusionACT was not necessary for all patients with mastoiditis‐related CVT and those with no neurological signs and symptoms on admission.
Palliative care‐based arguments against assisted dying
Authors: Colburn Ben 
Published: October 2024

AbstractOpponents of legalised assisted dying often assert that palliative care is worse in countries where assisted dying has been legalised, and imply that legalised assisted dying makes palliative care worse. This study considers five versions of this claim: that it is difficulty to access expert palliative care in countries where assisted dying has been legalised, that those countries rank low in their quality of end‐of‐life care; that legalising assisted dying doesn't expand patient choice in respect of palliative care; that growth in palliative care services has stalled in countries where assisted dying has been legalised; and that legalised assisted dying impedes the growth of palliative care or causes it to decline. In each case, it concludes that neither argumentation nor evidence supports these claims.
Public preferences regarding slow codes in critical care
Authors: Sprengholz Philipp 
Published: October 2024

AbstractThe term slow code refers to an intentional reduction in the pace or intensity of resuscitative efforts during a medical emergency. This can be understood as an intermediate level between full code (full resuscitation efforts) and no code (no resuscitation efforts) and serves as a symbolic gesture when intervention is considered medically futile. While some previous research acknowledges the slow code as an integral part of clinical practice, many ethicists have condemned the practice as dishonest and causing unnecessary pain for the patient. As the public's views on this issue have been largely absent from the discussion to date, two vignette experiments were performed to investigate their perceptions. The findings indicate that laypersons believe that slow codes are commonplace and often prefer them over a no code. While a full code was perceived as the standard approach and rated most ethical and least punishable, the present results do not support the widespread assumption that laypersons generally oppose slow codes, and this finding should inform ethical discussion and clinical practice.
Listen to yourself! Prioritization of self‐associated and own voice cues
Authors: Kirk Neil W. , Cunningham Sheila J. 
Published: October 2024

AbstractSelf‐cues such as one's own name or face attract attention, reflecting a bias for stimuli connected to self to be prioritized in cognition. Recent evidence suggests that even external voices can elicit this self‐prioritization effect; in a voice‐label matching task, external voices assigned to the Self‐identity label ‘you’ elicited faster responses than those assigned to ‘friend’ or ‘stranger’ (Payne et al., Br. J. Psychology, 112, 585‐610). However, it is not clear whether external voices assigned to Self are prioritized over participants' own voices. We explore this issue in two experiments. In Exp 1 (N = 35), a voice‐label matching task comprising three external voices confirmed that reaction time and accuracy are improved when an external voice cue is assigned to Self rather than Friend or Stranger. In Exp 2 (N = 90), one of the voice cues was replaced with a recording of the participant's own voice. Reaction time and accuracy showed a consistent advantage for the participant's own‐voice, even when it was assigned to the ‘friend’ or ‘stranger’ identity. These findings show that external voices can elicit self‐prioritization effects if associated with Self, but they are not prioritized above individuals' own voices. This has implications for external voice production technology, suggesting own‐voice imitation may be beneficial.
Do home mathematical activities relate to early mathematical skills? A systematic review and meta‐analysis
Authors: James‐Brabham Ella , von Bastian Claudia C. , Brough Carmel , Blakey Emma 
Published: October 2024

AbstractChildren's foundational mathematical skills are critical for future academic attainment. While home mathematical activities (HMAs) have been proposed to support these skills, the extent to which engaging in them supports mathematical skills remains unclear. This preregistered systematic review and multilevel meta‐analysis identified 351 effect sizes from 72 samples in 20 countries, exploring the relation between frequency of HMAs and mathematical skills in children aged 7 years and under (Mage = 61 months). A small significant positive relation was found (r = .13), moderated by risk of bias, with larger effects associated with a higher risk of bias. Specific ways the field can move forward are discussed to better understand the role of the home mathematical environment in early mathematics.
Biomarkers and Diagnostic Thresholds for Congenital Hyperinsulinism
Authors: Petkovic Grace , Park Julie , Collingwood Catherine , Senniappan Senthil , Didi Mohammed 
Published: October 2024

ABSTRACTContextCongenital Hyperinsulinism (CHI) is associated with inappropriately high levels of C‐peptide in the context of hypoglycemia.ObjectiveWe aimed to better clarify a diagnostic threshold value of C‐peptide for children presenting with CHI.DesignThis was a retrospective case‐control analysis, examining all hypoglycemia screens, undertaken between 2009 and 2019 at a quaternary paediatrics unit. Plasma C‐peptide, insulin, free fatty acid (FFA) and B‐hydroxybutyrate (BHOB) concentrations in children diagnosed with CHI were compared with concentrations in children diagnosed with other conditions.PatientsAll patients requiring hypoglycaemic screens at the quaternary children's hospital were analysed.ResultsMedian [C‐peptide] were statistically significantly different between CHI (147) and non‐CHI (72) patients, p < 0.05. The Youden Index indicated that a [C‐peptide] value of 291.5 pmol/L would give the greatest optimization of sensitivity (82%) and specificity (99%) for detecting CHI. Median [insulin] differed significantly between the cohorts with a level of 64 pmol/L for CHI patients compared with 0 pmol/L with non‐CHI patients (p < 0.01). Median [BOHB] was 0 μmol/L in CHI patients as compared with 2378 μmol/L for non‐CHI patients (p < 0.01). Median [FFA] levels were 1910 μmol/L in the non‐CHI cohort, compared with 0 in the CHI cohort (p < 0.01).ConclusionsThis study suggests that a C‐peptide concentration greater than 291.5 pmol/L is diagnostic of CHI in children. C‐peptide appears to offer the greatest utility as a biochemical diagnostic test for CHI and could be prioritised for laboratory analysis.
Full‐arch prostheses supported by implants with different macrostructures: A multicenter randomized controlled trial
Authors: Marcantonio Ana Carolina Monachini , de Oliveira Guilherme José Pimentel Lopes , Tassi Paulo Afonso , Manfrinato João Paulo Lavagnoli , Segnini Bruno , de Souza Bezerra Araújo Raphael Ferreira , Trojan Larissa Carvalho , Fontão Flávia Noemy Gasparini Kiatake , de Mattias Sartori Ivete Aparecida , Sartori Elisa Mattias , Padovan Luis Eduardo Marques , Zandim‐Barcelos Daniela Leal , Marcantonio Elcio 
Published: October 2024

AbstractObjectivesThis study evaluates the clinical performance of implants with hydrophilic surface and two different macrostructures: cylindrical with perforating triangular threads (CT) and cylindrical‐tapered with the association of square and condensing and perforating triangular threads (TST).Materials and methodsThis was a multicenter split‐mouth, simple‐blinded, randomized, and controlled trial. Thirty patients with edentulous mandible received two CT and two TST implants. Primary stability was determined by insertion torque and resonance frequency analysis (RFA). Implants were loaded with full fixed‐arch prostheses within 24 h after insertion. Clinical parameters (visible plaque index, marginal bleeding index; bleeding on probing; probing depth; and clinical attachment level) and the RFA were assessed at 2, 6, 12, and 24 months after implant loading. Marginal bone level changes were measured by comparison of standardized radiographs taken on the day of implant placement and 6, 12, and 24 months thereafter.ResultsTwenty‐eight patients completed the 2‐year follow‐up. The survival rates were 99.16% for CT implants and 100% for TST implants. One CT implant was lost until the 2 months follow‐up. No significant differences were found between the two implant types for marginal bone level changes (CT 0.34 [0.24; 0.55 mm]; 0.33 [0.18; 0.55 mm]; 0.41 [0.12; 0.7 mm] vs TST 0.36 [0.14; 0.74 mm]; 0.33 [0.23; 0.63 mm]; 0.30 [0.20; 0.64 mm] at 6, 12, and 24 months, respectively) and other clinical parameters.ConclusionThe macrostructure of the implants had no influence on survival rate, primary and secondary stability, marginal bone level changes, and peri‐implant clinical parameters outcomes. Both implants can be predictably used for immediate loading of full‐arch mandibular prostheses.