bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical care unit bed availability and postoperative outcomes: a multinational cohort study
Authors: Campbell Ruaraidh A. S. , Thevathasan Tharusan , Wong Danny J. N. , Wilson Andrew M. , Lindsay Helen A. , Campbell Douglas , Popham Scott , Barneto Lisa M. , Myles Paul S. , Moonesinghe S. Ramani ,   SNAP‐2: EPICCS collaborators, Harris Steve K. 
Published: September 2024

SummaryBackgroundCritical care beds are a limited resource, yet research indicates that recommendations for postoperative critical care admission based on patient‐level risk stratification are not followed. It is unclear how prioritisation decisions are made in real‐world settings and the effect of this prioritisation on outcomes.MethodsThis was a prespecified analysis of an observational cohort study of adult patients undergoing inpatient surgery, conducted in 274 hospitals across the UK and Australasia during 2017. The primary outcome was postoperative morbidity at day 7. Logistic regression models were used to evaluate the relationship between critical care admission and patient and health system factors. The causal effect of critical care admission on outcome was estimated using variation in critical care occupancy as a natural experiment in an instrumental variable analysis.ResultsA total of 19,491 patients from 248 hospitals were eligible for analysis, of whom 2107 were directly admitted to critical care postoperatively. Postoperative morbidity occurred in 2829/19,491 (15%) patients. Increasing surgical risk was associated with critical care admission, as was increased availability of critical care beds (odds ratio (95%CI) 1.04 (1.01–1.06), p = 0.002) per available bed; however, the probability of admission varied significantly between hospitals (median odds ratio 3.05). There was no evidence of a difference in postoperative morbidity with critical care admission (odds ratio (95%CI) 0.91 (0.57–1.45), p = 0.710).DiscussionPostoperative critical care admission is variable and related to bed availability. Statistical methods that adjust for unobserved confounding lowered the estimates of harm previously reported to have been associated with postoperative critical care admission. Our findings provide a rationale for a clinical trial which would evaluate any potential benefits for postoperative critical care admission for patients in whom there is no absolute indication for admission.
How does fetal inflammatory response syndrome change fetal response to hypoxia? An experimental study in a fetal sheep model
Authors: Chevalier Geoffroy , Garabedian Charles , De Stephano Valeria , Wojtanowski Anne , Ould Hamoud Yasmine , Galan Louis , Sharma Dyuti , Le Duc Kevin , De Jonckheere Julien , Storme Laurent , Marot Guillemette , Ghesquière Louise 
Published: September 2024

AbstractIntroductionFetal inflammatory response syndrome associated with acidosis during labor is a high‐risk situation for the fetus. This study evaluated hemodynamic, gasometric, and heart rate variability changes during acute fetal inflammatory response syndrome associated with hypoxia, compared with isolated hypoxia.Material and MethodsAcute fetal inflammatory response syndrome was obtained via an intravenously injection of lipopolysaccharide derived from Escherichia coli. Hypoxia was induced by repeated umbilical cord occlusions during three phases: mild, moderate, and severe umbilical cord occlusions. Two groups were created with chronically instrumented near‐term fetal sheep: one group with isolated hypoxia, the other with hypoxia and fetal inflammatory response syndrome. Hemodynamic, gas parameters, and fetal heart rate variability were compared between the groups.ResultsThe hypoxia and fetal inflammatory response syndrome group had a higher mortality rate (n = 4/9) compared with the hypoxia group (n = 0/9). Gasometric state was altered earlier in case of lipopolysaccharide injection (pH = 7.22 (7.12–7.24) vs 7.28 (7.23–7.34) p = 0.01; lactate = 10.3 mmol/L (9.4–11.0) vs 6.0 mmol/L (4.1–8.2) p < 0.001 after mild occlusions). After mild occlusions, the hypoxia and fetal inflammatory response syndrome group had higher values on seven heart rate variability parameters compared with the hypoxia group. After moderate occlusions, two parameters remained significantly higher.ConclusionsDuring fetal inflammatory response syndrome, fetal adaptation to hypoxia is impaired. In case of fetal infection, acidosis during labor is likely to become severe more rapidly, requiring closer fetal monitoring during labor.
Psychological and emotional profiles of Australian uterine transplant potential recipients: A comparison with international trials
Authors: Gerstl Brigitte , Kehag Eva , Mallinder Hayley , Baker Tamika , Arulpragasam Kaushalya , David Catherine , Stone Meredith , Fitzsimmons Elizabeth , Hetherington Kate , Deans Rebecca 
Published: September 2024

AbstractIntroductionUterus transplant (UTx) has emerged as a groundbreaking solution for individuals with uterine factor infertility (UFI). This study is the first in Australia to explore the psychosocial functioning of potential recipients assessed for the nation's initial UTx clinical trial and to compare their psychological profiles with those from international UTx trials.Material and MethodsThis is a mixed methods prospective study incorporating standardized psychological measures and semi‐structured interviews. Conducted at a tertiary hospital in Sydney, Australia, the study involved 10 female Australian UTx potential recipients with UFI undergoing assessment for UTx surgery. Participants underwent comprehensive psychological evaluation using validated measures and in‐depth semi‐structured interviews. Quantitative measurement tools included the Hospital Anxiety and Depression Scale, Short Form‐36 Health Survey, Fertility Quality of Life, and the Stanford Integrated Psychosocial Assessment for Transplantation. Thematic analysis was conducted on qualitative data from semi‐structured interviews.ResultsThe Australian UTx potential recipients reported significantly higher Short Form‐36 (SF‐36) scores compared to the Australian general population in general health (p < 0.04), bodily pain (p < 0.02), social functioning (p < 0.02), and emotional well‐being (p < 0.01). Compared with international UTx cohorts, the Australian UTx group showed comparable SF‐36 outcomes, with minor variations observed for general health and physical function domains. Hospital Anxiety and Depression Scale scores revealed lower anxiety, but slightly higher depression levels compared to international UTx trial cohorts. Fertility quality‐of‐life scores were significantly higher in the Australian UTx group compared to women experiencing primary infertility across four domains (p < 0.001). Thematic analysis of interviews highlighted the complex emotional impact of infertility, strong family and social support, and the perception of UTx as a transformative opportunity to achieve wholeness and motherhood.ConclusionsUTx represents a novel treatment option for women with UFI. This is the first qualitative study in Australia, it demonstrates the connection between women with UFI and their motivations for parenthood. These findings highlight the importance of tailored psychological assessments and establish a foundation for future research exploring the psychological characteristics of patient candidacy for UTxs.
Who tends to be a perfectionistic adolescent? Distinguishing perfectionism from excellencism and investigating the links with the Big Five and self‐esteem
Authors: Bien Kristina , Wagner Jenny , Brandt Naemi D. 
Published: September 2024

AbstractStriving towards perfection is an important concept of study, given its heterogenous associations with both positive and negative outcomes. To address this matter, recent work has emphasized the need to differentiate between striving towards perfection (perfectionism) and excellence (excellencism). However, the applicability of this differentiation in adolescence remains largely unexplored, despite this life phase being particularly sensitive for the development of perfectionism. To better understand striving towards perfection in adolescence, we examined the psychometric properties of the German Scale of Perfectionism and Excellencism (SCOPE) and evaluated the nomological net with the Big Five and self‐esteem in 788 German adolescents (Mage = 15.49 years; 50% female). The results underscored the distinctiveness of the different strivings in adolescents but pointed to mixed evidence regarding convergent and discriminant validities. Notably, striving towards perfection was related to lower levels of openness and self‐esteem but higher levels of neuroticism, whereas striving towards excellence was related to higher levels of every trait except neuroticism. Finally, most results remained consistent across genders and school types. We discuss how the differentiation between perfectionism and excellencism deepens our understanding of adolescents' perfectionistic strivings and how it might inform future research across different psychological fields.
Detection of the Fatty Acid Metabolism‐Linked Genes in Lung Adenocarcinoma as Biomarkers for Clinical Prognosis and Immunotherapeutic Targets
Authors: Shi Jingwei , Yang Rusong , Jiang Xinyi , Zhu Kangle , Liu Zhengcheng 
Published: September 2024

ABSTRACTBackgroundLung cancer, on a global scale, leads to the most common cases of cancer mortalities. Novel therapeutic approaches are urgently needed to disrupt this lethal disease. The rapid development of tumor immunology combining breakthroughs involving fatty acid metabolism brings possibilities. Directing fatty acid metabolism is supposed to help discover potential prognostic biomarkers and treatment targets for lung cancer.MethodsThrough searching the GSE140797 dataset, we identified genes related to fatty acid metabolism as well as fatty acid metabolism‐related differentially expressed genes (DEGs). We applied various methods to ascertain the independent prognostic value of the DEGs. The methods we utilized entail prognostic analysis, differential expression analysis, as well as univariate and multivariate Cox regression analyses. The lasso Cox regression model was utilized in examining how DEGs correlate with the immune score, immune checkpoint, ferroptosis, methylation, and OCLR score. The expression levels of ACAT1 and ACSL3 in tissues derived from normal lung and lung adenocarcinoma (LUAD) tissues were compared by qRT‐PCR.ResultsIn this study, ACSL3 and ACAT1 were identified as fatty acid metabolism‐related genes utilizing independent prognostic value and as a result, the risk prognostic model was built using these factors. qRT‐PCR results implied that ACSL3 and ACAT1 expressions were upregulated and downregulated, correspondingly in tumor tissues. Additional evaluations suggested that ACSL3 and ACAT1 were affirmed to be remarkably correlated with the immune score, methylation, immune checkpoint, OCLR score, and ferroptosis.ConclusionsACSL3 and ACAT1 were effective prognostic biomarkers and potential immunotherapeutic targets in LUAD.
External Validation of a Limited Sampling Strategy for the Estimation of Mycophenolic Acid Exposure Between Different Assay Methods: PETINIA and HPLC Methods
Authors: Doki Kosuke , Yoshida Keigo , Usui Joichi , Takahashi Kazuhiro , Oda Tatsuya , Yamagata Kunihiro , Homma Masato 
Published: September 2024

ABSTRACTIntroductionA limited sampling strategy (LSS) for estimating the area under the plasma concentration–time curve (AUC0–12) of the immunosuppressant mycophenolic acid (MPA) is used for therapeutic drug monitoring (TDM) in clinical practice. Our study delves into the applicability of the MPA AUC0–12 LSS, originally developed using particle‐enhanced turbidimetric inhibition immunoassay (PETINIA) measurements, to those obtained via high‐performance liquid chromatography with ultraviolet detection (HPLC–UV).MethodsWe developed an LSS for estimating MPA AUC0–12 based on PETINIA measurements in 32 adult kidney transplant patients who were receiving mycophenolate mofetil. Validation of this strategy was conducted in an additional 14 adult kidney transplant patients (validation sets) through measurements obtained by both PETINIA and HPLC–UV. Predictive performance was assessed using mean absolute error (MAE), root mean squared error (RMSE), and “good guess” defined as predicted AUC within observed AUC ± 15%.ResultsThe three time point equation (0, 2, and 6 h) emerged as optimal for estimating MPA AUC0–12, balancing predictive performance and usefulness in clinical settings. In validation sets, the coefficient of determination for observed versus predicted AUC0–12 was consistent between PETINIA (0.978) and HPLC–UV (0.958) measurements. Comparable MAE, RMSE, and “good guess” outcomes were observed for PETINIA (6.4%, 8.1%, and 85.7%, respectively) and HPLC–UV (7.6%, 9.4%, and 85.7%, respectively) measurements.ConclusionOur findings support the application of the MPA AUC0–12 LSS, originally developed using PETINIA measurements, to those obtained via HPLC–UV.
Comorbidity burden and outcomes of endoscopic ultrasound‐guided treatment of pancreatic fluid collections: Multicenter study with nationwide data‐based validation
Authors: Hamada Tsuyoshi , Masuda Atsuhiro , Michihata Nobuaki , Saito Tomotaka , Tsujimae Masahiro , Takenaka Mamoru , Omoto Shunsuke , Iwashita Takuji , Uemura Shinya , Ota Shogo , Shiomi Hideyuki , Fujisawa Toshio , Takahashi Sho , Matsubara Saburo , Suda Kentaro , Matsui Hiroki , Maruta Akinori , Yoshida Kensaku , Iwata Keisuke , Okuno Mitsuru , Hayashi Nobuhiko , Mukai Tsuyoshi , Fushimi Kiyohide , Yasuda Ichiro , Isayama Hiroyuki , Yasunaga Hideo , Nakai Yousuke ,   the WONDERFUL study group in Japan and collaborators
Published: September 2024

ObjectivesThe appropriate holistic management is mandatory for successful endoscopic ultrasound (EUS)‐guided treatment of pancreatic fluid collections (PFCs). However, comorbidity status has not been fully examined in relation to clinical outcomes of this treatment.MethodsUsing a multi‐institutional cohort of 406 patients receiving EUS‐guided treatment of PFCs in 2010–2020, we examined the associations of Charlson Comorbidity Index (CCI) with in‐hospital mortality and other clinical outcomes. Multivariable logistic regression analysis was conducted with adjustment for potential confounders. The findings were validated using a Japanese nationwide inpatient database including 4053 patients treated at 486 hospitals in 2010–2020.ResultsIn the clinical multi‐institutional cohort, CCI was positively associated with the risk of in‐hospital mortality (Ptrend < 0.001). Compared to patients with CCI = 0, patients with CCI of 1–2, 3–5, and ≥6 had adjusted odds ratios (95% confidence intervals) of 0.76 (0.22–2.54), 5.39 (1.74–16.7), and 8.77 (2.36–32.6), respectively. In the nationwide validation cohort, a similar positive association was observed; the corresponding odds ratios (95% confidence interval) were 1.21 (0.90–1.64), 1.52 (0.92–2.49), and 4.84 (2.63–8.88), respectively (Ptrend < 0.001). The association of higher CCI with longer length of stay was observed in the nationwide cohort (Ptrend < 0.001), but not in the clinical cohort (Ptrend = 0.18). CCI was not associated with the risk of procedure‐related adverse events.ConclusionsHigher levels of CCI were associated with a higher risk of in‐hospital mortality among patients receiving EUS‐guided treatment of PFCs, suggesting the potential of CCI in stratifying the periprocedural mortality risk.Trial registrationThe research based on the clinical data from the WONDERFUL cohort was registered with UMIN‐CTR (registration number UMIN000044130).
Elevated serum circulating cell‐free mitochondrial DNA in amyotrophic lateral sclerosis
Authors: Li Jieyu , Gao Chao , Wang Qingqing , Liu Jing , Xie Zhiying , Zhao Yawen , Yu Meng , Zheng Yiming , Lv He , Zhang Wei , Yuan Yun , Meng Lingchao , Deng Jianwen , Wang Zhaoxia 
Published: September 2024

AbstractBackground and PurposeThe substantial role of inflammation in amyotrophic lateral sclerosis (ALS) is gaining support from recent research. Studies indicate that circulating cell‐free mitochondrial DNA (ccf‐mtDNA) can activate the immune system and is associated with neurodegenerative diseases. This research was designed to quantify ccf‐mtDNA levels in the serum of ALS patients.MethodsThe medical records of ALS patients were reviewed. Serum ccf‐mtDNA levels of patients with ALS (n = 62) and age‐matched healthy controls (n = 46) were measured and compared. Additionally, serum interleukin‐6 (IL‐6) levels were measured using an enzyme‐linked immunosorbent assay in 26 ALS patients. Correlations between variables were analyzed.ResultsSerum ccf‐mtDNA was notably higher in the patients with ALS. When stratified by genotype, the superoxide dismutase 1 (SOD1) mutation group showed the greatest increase in ccf‐mtDNA levels relative to other ALS patients. Among all 108 individuals, a cut‐off set at 1.1 × 105 mtDNA copies on a receiver‐operating characteristic curve identified patients with ALS with 80.7% sensitivity and 50.0% specificity; the area under the curve was 0.69 (p < 0.001). Furthermore, serum ccf‐mtDNA levels correlated negatively with the progression rate of ALS (ΔFS; rs = −0.26, p = 0.044), but not the ALSFRS‐R score (rs = 0.06, p = 0.625). Importantly, the correlation between ccf‐mtDNA and ΔFS was more pronounced in the SOD1 mutation group (rs = −0.62, p = 0.018). Lastly, a significant positive association was observed between serum ccf‐mtDNA levels and IL‐6 levels in ALS (r s= 0.41, p = 0.038).ConclusionOur study found increased serum ccf‐mtDNA in ALS patients, suggesting a link to inflammatory processes and disease mechanism. Moreover, ccf‐mtDNA could be an indicator for ALS progression, especially in those with the SOD1 mutation.
Efficacy and safety of different oral prednisone tapering courses in adult anti‐NMDAR encephalitis: A multicenter prospective cohort study
Authors: Cai Linjun , Li Gaowei , Abdulaziz Ammar T. , Gong Xue , Liu Xu , Kong Xueying , Guo Kundian , Li Aiqing , Li Jinmei , Zhou Dong , Hong Zhen 
Published: September 2024

AbstractObjectiveIn adult anti‐N‐methyl‐d‐aspartate receptor (NMDAR) encephalitis, corticosteroids are commonly used as first‐line treatment. However, the optimal oral prednisone tapering (OPT) following intravenous methylprednisolone pulse therapy remains unclear. We aim to compare the efficacy and safety of different OPT courses in anti‐NMDAR encephalitis.MethodsThe CHASE study, a multicenter prospective observational cohort study, enrolled patients with autoimmune encephalitis from October 2011 to March 2023. Patients were grouped based on oral prednisone tapering course: ≤3 months (Group ≤3 month), 3–6 months (Group 3–6 months, including 3 months), and >6 months (Group > 6 months). Kaplan–Meier plots were used to analyze time to relapse and time to total recovery within 2 years.ResultsAmong 666 screened patients, 171 (median [IQR] age 27 [21.0–36.5] years, 55.0% female) met selection criteria. Responders at 3 months were prevalent in Group ≤3 months (OR 7.251 [95% CI 2.252 to 23.344] and Group 3–6 months (OR, 3.857 [95% CI 1.107 to 13.440] than in Group >6 months. Clinical Assessment Scale for Autoimmune Encephalitis (CASE) scores at 12 months were higher in Group >6 months than in Group ≤3 months and Group 3–6 months (β, −2.329 [95% CI −3.784 to −.875]; β, −2.871 [95% CI −4.490, −1.253]). CASE seizures subscore was higher in Group >6 months than in Group 3–6 months (β, −.452 [95% CI −.788 to −.116]). No significant difference in seizure freedom rates among the groups. Adverse events were higher in Group 3–6 months and Group >6 months than in Group ≤3 months (OR 6.045 [95% CI 2.352 to 15.538]; OR 6.782 [95% CI 1.911 to 24.073]).SignificanceLonger oral prednisone courses for adult patients with anti‐NMDAR encephalitis did not show superior effects compared to shorter courses in improving modified Rankin Scale (mRS) scores and CASE scores, reducing the risk of relapse within 2 years, or achieving seizure freedom. Instead, extended prednisone courses may lead to more side effects— particularly weight gain. This outcome recommends evaluating the possibility of shortening the duration of oral prednisone after a thorough patient assessment.
Temporal patterns and regional comparisons of recruitment rates of United States fish stocks
Authors: Marshall Rachel C. , Collie Jeremy S. , Bell Richard J. , Spencer Paul D. , Minto Cóilín 
Published: September 2024

AbstractSeveral previous studies of marine fish stocks have demonstrated time‐varying recruitment productivity and indicated that including time‐varying parameters can track process variation in recruitment. Few studies have synthesized signal‐to‐noise ratios and underlying reasons for time‐variation across stocks and regions. Using Peterman's productivity method (PPM), we provide a broad synthesis of time‐varying density‐independent productivity in 84 stocks across five regions of the United States. Of all stocks investigated, 50 were found to have time‐varying productivity, challenging assumptions on the stationarity of recruitment parameters and dependent reference points. Our results demonstrate the power of PPM for synthesizing the form and pattern of recruitment time‐variation among regions, including general summaries of directional change over time. Furthermore, our results show regional differences in time‐varying patterns, particularly the signal‐to‐noise ratio (SNR) of low‐ to high‐frequency variation. The SNR was lower in the California Current region than in two Atlantic regions and two Alaska regions. Generalized linear modelling used to synthesize results suggests that stocks with higher contrast in spawning stock biomass over time, standardized regardless of actual spawning stock size, were more likely to have time‐varying productivity than stocks with low contrast. The likelihood of time‐variation in productivity of a given stock was also found to be closely related to the autocorrelation of the recruitment time series. Such inter‐regional and inter‐stock comparisons of variation are vital in understanding the roles of local and global environmental change on fish productivity.
Physiology, Not Nutrient Availability, May Have Limited Primary Productivity After the Emergence of Oxygenic Photosynthesis
Authors: Grettenberger Christen L. , Sumner Dawn Y. 
Published: September 2024

ABSTRACTThe evolution of oxygenic photosynthesis in Cyanobacteria was a transformative event in Earth's history. However, the scientific community disagrees over the duration of the delay between the origin of oxygenic photosynthesis and oxygenation of Earth's atmosphere, with estimates ranging from less than a hundred thousand to more than a billion years, depending on assumptions about rates of oxygen production and fluxes of reductants. Here, we propose a novel ecological hypothesis that a geologically significant delay could have been caused by biomolecular inefficiencies within proto‐Cyanobacteria—ancestors of modern Cyanobacteria—that limited their maximum rates of oxygen production. Consideration of evolutionary processes and genomic data suggest to us that proto‐cyanobacterial primary productivity was initially limited by photosystem instability, oxidative damage, and photoinhibition rather than nutrients or ecological competition. We propose that during the Archean era, cyanobacterial photosystems experienced protracted evolution, with biomolecular inefficiencies initially limiting primary productivity and oxygen production. Natural selection led to increases in efficiency and thus primary productivity through time. Eventually, evolutionary advances produced sufficient biomolecular efficiency that environmental factors, such as nutrient availability, limited primary productivity and shifted controls on oxygen production from physiological to environmental limitations. If correct, our novel hypothesis predicts a geologically significant interval of time between the first local oxygen production and sufficient production for oxygenation of environments. It also predicts that evolutionary rates were likely highly variable due to strong environmental selection pressures and potentially high mutation rates but low competitive interactions.