bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocolized care pathways in emergency general surgery: a systematic review and meta-analysis
Authors: Harji Deena P , Griffiths Ben , Stocken Deborah , Pearse Rupert , Blazeby Jane , Brown Julia M 
Published: March 2024

Abstract

Background
Emergency abdominal surgery is associated with significant postoperative morbidity and mortality. The delivery of standardized pathways in this setting may have the potential to transform clinical care and improve patient outcomes.

Methods
The OVID SP versions of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched between January 1950 and October 2022. All randomized and non-randomized cohort studies comparing protocolized care streams with standard care protocols in adult patients (&gt;18 years old) undergoing major emergency abdominal surgery with 30-day follow-up data were included. Studies were excluded if they reported on standardized care protocols in the trauma or elective setting. Outcomes assessed included length of stay, 30-day postoperative morbidity, 30-day postoperative mortality and 30-day readmission and reoperations rates. Risk of bias was assessed using ROBINS-I for non-randomized studies and RoB-2 for randomized controlled trials. Meta-analysis was performed using random effects modelling.

Results
Seventeen studies including 20 927 patients were identified, with 12 359 patients undergoing protocolized care pathways and 8568 patients undergoing standard care pathways. Thirteen unique protocolized pathways were identified, with a median of eight components (range 6–15), with compliance of 24–100%. Protocolized care pathways were associated with a shorter hospital stay compared to standard care pathways (mean difference −2.47, 95% c.i. −4.01 to −0.93, P = 0.002). Protocolized care pathways had no impact on postoperative mortality (OR 0.87, 95% c.i. 0.41 to 1.87, P = 0.72). A reduction in specific postoperative complications was observed, including postoperative pneumonia (OR 0.42 95% c.i. 0.24 to 0.73, P = 0.002) and surgical site infection (OR 0.34, 95% c.i. 0.21 to 0.55, P &lt; 0.001).

Discussion
Protocolized care pathways in the emergency setting currently lack standardization, with variable components and low compliance; however, despite this they are associated with short-term clinical benefits.
Referral rate of patients with incidental gallbladder cancer and survival: outcomes of a multicentre retrospective study
Authors: van Dooren Mike , de Savornin Lohman Elise A J , van der Post Rachel S , Erdmann Joris I , Hoogwater Frederik J H , Groot Koerkamp Bas , van den Boezem Peter B , de Reuver Philip R 
Published: March 2024

Abstract

Background
Treatment outcomes of incidental gallbladder cancer generally stem from tertiary referral centres, while many patients are initially diagnosed and managed in secondary care centres. Referral patterns of patients with incidental gallbladder cancer are poorly reported. This study aimed to evaluate incidental gallbladder cancer treatment in secondary centres, rates of referral to tertiary centres and its impact on survival.

Methods
Medical records of patients with incidental gallbladder cancer diagnosed between 2000 and 2019 in 27 Dutch secondary centres were retrospectively reviewed. Patient characteristics, surgical treatment, tumour characteristics, referral pattern and survival were assessed. Predictors for overall survival were determined using multivariable Cox regression.

Results
In total, 382 patients with incidental gallbladder cancer were included. Of 243 patients eligible for re-resection (pT1b–pT3, M0), 131 (53.9%) were referred to a tertiary centre. The reason not to refer, despite indication for re-resection, was not documented for 52 of 112 non-referred patients (46.4%). In total, 98 patients underwent additional surgery with curative intent (40.3%), 12 of these in the secondary centre. Median overall survival was 33 months (95% c.i. 24 to 42 months) in referred patients versus 17 months (95% c.i. 3 to 31 months) in the non-referred group (P = 0.019). Referral to a tertiary centre was independently associated with improved survival after correction for age, ASA classification, tumour stage and resection margin (HR 0.60, 95% c.i. 0.38 to 0.97; P = 0.037).

Conclusion
Poor incidental gallbladder cancer referral rates were associated with worse survival. Age, performance status, resection margin or tumour stage should not preclude referral of a patient with incidental gallbladder cancer to a tertiary centre.
Nomograms integrating the collagen signature and systemic immune-inflammation index for predicting prognosis in rectal cancer patients
Authors: Yu Xian , Jiang Wei , Dong Xiaoyu , Yan Botao , Xu Shuoyu , Lin Zexi , Zhuo Shuangmu , Yan Jun 
Published: March 2024

Abstract

Background
This study aimed to develop and validate a model based on the collagen signature and systemic immune-inflammation index to predict prognosis in rectal cancer patients who underwent neoadjuvant treatment.

Methods
Patients with rectal cancer who had residual disease after neoadjuvant treatment at two Chinese institutions between 2010 and 2018 were selected, one used as a training cohort and the other as a validation cohort. In total, 142 fully quantitative collagen features were extracted using multiphoton imaging, and a collagen signature was generated by least absolute shrinkage and selection operator Cox regression. Nomograms were developed by multivariable Cox regression. The performance of the nomograms was assessed via calibration, discrimination and clinical usefulness. The outcomes of interest were overall survival and disease-free survival calculated at 1, 2 and 3 years.

Results
Of 559 eligible patients, 421 were selected (238 for the training cohort and 183 for the validation cohort). The eight-collagen-features collagen signature was built and multivariable Cox analysis demonstrated that it was an independent prognostic factor of prognosis along with the systemic immune-inflammation index, lymph node status after neoadjuvant treatment stage and tumour regression grade. Then, two nomograms that included the four predictors were computed for disease-free survival and overall survival. The nomograms showed satisfactory discrimination and calibration with a C-index of 0.792 for disease-free survival and 0.788 for overall survival in the training cohort and 0.793 for disease-free survival and 0.802 for overall survival in the validation cohort. Decision curve analysis revealed that the nomograms could add more net benefit than the traditional clinical-pathological variables.

Conclusions
The study found that the collagen signature, systemic immune-inflammation index and nomograms were significantly associated with prognosis.
The role of extracellular vesicle immune checkpoints in cancer
Authors: Zhang Weiming , Ou Mingrong , Yang Ping , Ning Mingzhe 
Published: March 2024

Summary
Immune checkpoints (ICPs) play a crucial role in regulating the immune response. In the tumor, malignant cells can hijack the immunosuppressive effects of inhibitory ICPs to promote tumor progression. Extracellular vesicles (EVs) are produced by a variety of cells and contain bioactive molecules on their surface or within their lumen. The expression of ICPs has also been detected in EVs. In vitro and in vivo studies have shown that extracellular vesicle immune checkpoints (EV ICPs) have immunomodulatory effects and are involved in tumor immunity. EV ICPs isolated from the peripheral blood of cancer patients are closely associated with the tumor progression and the prognosis of cancer patients. Blocking inhibitory ICPs has been recognized as an effective strategy in cancer treatment. However, the efficacy of immune checkpoint inhibitors (ICIs) in cancer treatment is hindered by the emergence of therapeutic resistance, which limits their widespread use. Researchers have demonstrated that EV ICPs are correlated with clinical response to ICIs therapy and were involved in therapeutic resistance. Therefore, it is essential to investigate the immunomodulatory effects, underlying mechanisms, and clinical significance of EV ICPs in cancer. This review aims to comprehensively explore these aspects. We have provided a comprehensive description of the cellular origins, immunomodulatory effects, and clinical significance of EV ICPs in cancer, based on relevant studies.
A HIV Superinfection Diagnosed in a Patient on Intramuscular Long-acting Combination of Cabotegravir and Rilpivirine
Authors: Valin Nadia , Lambert-Niclot Sidonie , Torres Emma , Meynard Jean Luc , Périllaud-Dubois Claire , Morand-Joubert Laurence , Lacombe Karine 
Published: March 2024

Abstract
A case of a male with human immunodeficiency virus with plasma genotyping detecting no resistance and a CRF02_AG subtype had a controlled HIV RNA on antiretroviral therapy since 2010. We introduced intramuscular therapy with cabotegravir and rilpivirine. One month later, his HIV RNA was 1500 copies/mL; genotyping found a subtype B with many mutations.
Autosomal dominant polycystic kidney disease and pericardial effusion: coincidence? I think not! Case report and review of the literature
Authors: Rigamonti Elia , Caruzzo Carlo Alberto , Valotta Amabile , Caretta Alessandro , Scopigni Francesca Romana 
Published: March 2024

Abstract

Background
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary disease causing chronic renal failure, with a high incidence of extra-renal manifestations including pericardial effusion.

Case summary
We present the case of a 41-year-old female, known for ADPKD, who presented to our emergency department with epigastric pain radiating to the interscapular area. Blood exams showed moderate increase in inflammatory markers. Echocardiography revealed a circumferential pericardial effusion of 10 mm. She was put under treatment with colchicine therapy (1 mg b.i.d.) based on a presumptive diagnosis of acute pericarditis with pericardial effusion. She was hospitalized due to increase in pericardial effusion, underwent pericardial drainage, and started prednisone therapy with rapid recovery. We started a close follow-up on a monthly basis, with progressive decrease in pericardial effusion and progressive amelioration in symptoms, although the patient continued to report mild asthenia.

Discussion
Pericardial effusion and ADPKD are conditions that both require an interdisciplinary discussion for optimal patient care that avoids neglecting pivotal symptoms and avoidable invasive examinations.
Practices, beliefs, and challenges of teacher research in Nepal
Authors: Phyak Prem , Negi Janak Singh , Acharya Devi Ram 
Published: March 2024

Abstract
This article analyses the practices, beliefs, and challenges of in-service Nepali EFL teachers who are required to carry out action research and submit a written report for their performance appraisal. We have analysed action research reports (n = 88) and interviews (n = 6) with public-school EFL teachers. The findings show that speaking, classroom participation, and writing are the three major problem areas teachers have pointed out in their action research reports. In theory, teachers have positive beliefs about the importance of action research for better teaching and professional development. They have claimed that action research has helped them address classroom problems. However, the analysis of the reports indicates that teachers lack data/evidence to support their claims about research problems and the effectiveness of the actions they have introduced in the classroom. The findings of the study show that teachers need mentoring support to carry out and write up action research reports.
Association of Plasma n-3 Polyunsaturated Fatty Acid Levels and the Prevalence of Frailty in Older Adults: A Cross-Sectional Analysis of UK Biobank
Authors: Kim Junghyun , Westra Jason , Tintle Nathan , Harris William S , Park Yongsoon 
Published: March 2024

Abstract

Background
Circulating levels of n-3 polyunsaturated fatty acids (PUFAs) have been associated with frailty among Koreans (a population with a high intake of fish), but whether this association exists in Western populations with low fish intake is unknown. The present study examined the hypothesis that the prevalence of frailty was inversely associated with plasma levels of n-3 PUFAs, with the intake of oily fish, and with fish oil supplementation in older adults in the United Kingdom.

Methods
UK Biobank including 79 330 adults aged ≥65 years with dietary data, and 18 802 participants with plasma fatty acid data were used. Frailty was defined using the Cardiovascular Health Study index, plasma levels of n-3 PUFAs were measured by nuclear magnetic resonance, and intake of oily fish and/or fish oil supplements was collected via food frequency questionnaire.

Results
Frailty prevalence was inversely associated with n-3 PUFA levels [odds ratios (OR) per SD: 0.86, 95% confidence interval (CI) 0.79–0.94; p &lt; .001], with oily fish intake (never vs ≥2 servings per week; OR 0.59, 95% CI 0.52–0.68, p &lt; .001), and with the use of fish oil supplements (OR 0.72; 95% CI 0.66–0.78; p &lt; .001) after adjusting for confounding factors. All 3 exposures were also associated with each frailty criterion, particularly low physical activity and walking pace.

Conclusions
Inverse associations between plasma n-3 PUFA levels and measures of frailty suggest that higher intakes of oily fish or the use of fish oil supplements may help prevent frailty in older adults in the United Kingdom.
US exceptionalism? International trends in midlife mortality
Authors: Dowd Jennifer Beam , Doniec Katarzyna , Zhang Luyin , Tilstra Andrea 
Published: March 2024

Abstract

Background
Rising midlife mortality in the USA has raised concerns, particularly the increase in ‘deaths of despair’ (due to drugs, alcohol and suicide). Life expectancy is also stalling in other countries such as the UK, but how trends in midlife mortality are evolving outside the USA is less understood. We provide a synthesis of cause-specific mortality trends in midlife (25–64 years of age) for the USA and the UK as well as other high-income and Central and Eastern European (CEE) countries.

Methods
We document trends in midlife mortality in the USA, UK and a group of 13 high-income countries in Western Europe, Australia, Canada and Japan, as well as seven CEE countries from 1990 to 2019. We use annual mortality data from the World Health Organization Mortality Database to analyse sex- and age-specific (25–44, 45–54 and 55–64 years) age-standardized death rates across 15 major cause-of-death categories.

Results
US midlife mortality rates have worsened since 1990 for several causes of death including drug-related, alcohol-related, suicide, metabolic diseases, nervous system diseases, respiratory diseases and infectious/parasitic diseases. Deaths due to homicide, transport accidents and cardiovascular diseases have declined since 1990 but saw recent increases or stalling of improvements. Midlife mortality also increased in the UK for people aged 45–54 year and in Canada, Poland and Sweden among for those aged 25–44 years.

Conclusions
The USA is increasingly falling behind not only high-income, but also CEE countries, some of which were heavily impacted by the post-socialist mortality crisis of the 1990s. Although levels of midlife mortality in the UK are substantially lower than those in the USA overall, there are signs that UK midlife mortality is worsening relative to that in Western Europe.
Against Diffusion: Power and Institutions in African–European Relations
Authors: Sharman J C 
Published: March 2024

Abstract
Four centuries of precolonial diplomatic, economic, and military African–European relations have been neglected in international relations. Refuting common presumptions about European dominance, before, during, and after the heyday of the Atlantic slave trade, African rulers and merchants were generally in a position of equality or superiority in their relations with Europeans. Contrary to expectations that long-term interaction promotes homogenization via institutional diffusion from core to periphery, Africans generally eschewed European political, economic, and military models such as the Westphalian state, the corporation, and the salaried standing army. Instead, they utilized external opportunities in ways that reinforced evolving local differences, or adopted institutions from the Islamic world; Europeans in Africa were more likely to adopt African models than vice versa. That African polities held out against European dominance longer than larger, richer, and more militarily powerful Asian polities, and that stateless African societies held out longest of all, brings into question fundamental assumptions about survival under international anarchy.
Improving feed intake and rumen fermentation in lambs using mixed-dimensional attapulgite clay to adsorb naturally occurring mycotoxins
Authors: Chen Liang , Li Fei , Ma Zhiyuan , Wang Aiqin , Kang Yuru , Liu Baocang , Xu Hui , Li Jiandong , Wang Xinji , Li Kaidong 
Published: March 2024

Abstract
This experiment was conducted to evaluate the effects of including a mixed-dimensional attapulgite clay (MDA) into a naturally moldly diet for Hu lambs. Fifty male Hu lambs with similar initial body weight (28.24 ± 1.80 kg) were randomly allocated into five dietary treatments: a basal diet containing naturally occurring mycotoxins with 0, 0.5, 1.0, and 2.0 kg/t MDA, and basal diet with a commercial mycotoxin adsorbent Solis with montmorillonite as the major component at 1 kg/t. Both MDA and Solis increased average daily gain (ADG) and dry matter intake (DMI; P ≤ 0.004), and there was no difference in growth performance between MDA and Solis (P ≥ 0.26). The final body weight, DMI, and ADG were linearly increased with increasing MDA supplementation (P &lt; 0.01). Lambs treated with both MDA and Solis demonstrated greater apparent digestibility of dry matter (DM), organic matter (OM), and energy compared with the control group (P ≤ 0.03), and there were no differences in nutrient digestibilities between MDA and Solis (P ≥ 0.38). Digestibility of CP was linearly increased with the increasing MDA supplementation (P = 0.01). Neither MDA nor Solis affected rumen total volatile fatty acid (TVFA) concentration (P ≥ 0.39), but decreased the acetate-to-propionate ratio and molar proportion of n-butyrate (P ≤ 0.01), and MDA also increased the concentration of ammonia (P = 0.003). Besides, increasing MDA supplementation linearly reduced the acetate-to-propionate ratio and molar proportion of n-butyrate (P = 0.01), but linearly and quadratically increased the concentration of ammonia (P ≥ 0.003). These results showed that the incorporation of MDA into a naturally moldy diet of Hu lambs yielded comparable results to the Solis product, with higher growth performance and nutrient digestibility but lower acetate-to-propionate ratio observed. In conclusion, including ≥ 1 kg/t of MDA in high mycotoxin risk diets for growing lambs improves feed intake and rumen fermentation.
A reference genome for the Andean cavefish Trichomycterus rosablanca (Siluriformes, Trichomycteridae): Building genomic resources to study evolution in cave environments
Authors: Cadena Carlos Daniel , Pabón Laura , DoNascimiento Carlos , Abueg Linelle , Tilley Tatiana , O-Toole Brian , Absolon Dominic , Sims Ying , Formenti Giulio , Fedrigo Olivier , Jarvis Erich D , Torres Mauricio 
Published: March 2024

Abstract
Animals living in caves are of broad relevance to evolutionary biologists interested in understanding the mechanisms underpinning convergent evolution. In the Eastern Andes of Colombia, populations from at least two distinct clades of Trichomycterus catfishes (Siluriformes) independently colonized cave environments and converged in phenotype by losing their eyes and pigmentation. We are pursuing several research questions using genomics to understand the evolutionary forces and molecular mechanisms responsible for repeated morphological changes in this system. As a foundation for such studies, here we describe a diploid, chromosome-scale, long-read reference genome for Trichomycterus rosablanca, a blind, depigmented species endemic to the karstic system of the department of Santander. The nuclear genome comprises 1 Gb in 27 chromosomes, with a 40.0× HiFi long-read genome coverage having an N50 scaffold of 40.4 Mb and N50 contig of 13.1 Mb, with 96.9% (Eukaryota) and 95.4% (Actinopterygii) universal single-copy orthologs (BUSCO). This assembly provides the first reference genome for the speciose genus Trichomycterus, serving as a key resource for research on the genomics of phenotypic evolution.
Mapping non-monetary poverty at multiple geographical scales
Authors: De Nicolò Silvia , Fabrizi Enrico , Gardini Aldo 
Published: March 2024

Abstract
Poverty mapping is a powerful tool to study the geography of poverty. The choice of the spatial resolution is central as poverty measures defined at a coarser level may mask their heterogeneity at finer levels. We introduce a small area multi-scale approach integrating survey and remote sensing data that leverages information at different spatial resolutions and accounts for hierarchical dependencies, preserving estimates coherence. We map poverty rates by proposing a Bayesian Beta-based model equipped with a new benchmarking algorithm accounting for the double-bounded support. A simulation study shows the effectiveness of our proposal and an application on Bangladesh is discussed.
Cosmological baryon spread and impact on matter clustering in CAMELS
Authors: Gebhardt Matthew , Anglés-Alcázar Daniel , Borrow Josh , Genel Shy , Villaescusa-Navarro Francisco , Ni Yueying , Lovell Christopher C , Nagai Daisuke , Davé Romeel , Marinacci Federico , Vogelsberger Mark , Hernquist Lars 
Published: March 2024

ABSTRACT
We quantify the cosmological spread of baryons relative to their initial neighbouring dark matter distribution using thousands of state-of-the-art simulations from the Cosmology and Astrophysics with MachinE Learning Simulations (CAMELS) project. We show that dark matter particles spread relative to their initial neighbouring distribution owing to chaotic gravitational dynamics on spatial scales comparable to their host dark matter halo. In contrast, gas in hydrodynamic simulations spreads much further from the initial neighbouring dark matter owing to feedback from supernovae (SNe) and active galactic nuclei (AGN). We show that large-scale baryon spread is very sensitive to model implementation details, with the fiducial simba model spreading ∼40 per cent of baryons &gt;1 Mpc away compared to ∼10 per cent for the IllustrisTNG and astrid models. Increasing the efficiency of AGN-driven outflows greatly increases baryon spread while increasing the strength of SNe-driven winds can decrease spreading due to non-linear coupling of stellar and AGN feedback. We compare total matter power spectra between hydrodynamic and paired N-body simulations and demonstrate that the baryonic spread metric broadly captures the global impact of feedback on matter clustering over variations of cosmological and astrophysical parameters, initial conditions, and (to a lesser extent) galaxy formation models. Using symbolic regression, we find a function that reproduces the suppression of power by feedback as a function of wave number (k) and baryonic spread up to $k \sim 10\, h$ Mpc−1 in SIMBA while highlighting the challenge of developing models robust to variations in galaxy formation physics implementation.