bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staged Norwood operation for patients with hypoplastic left heart syndrome and cor triatriatum: a report of two cases
Authors: Iijima Yukino , Hoashi Takaya , Kojima Takuro , Nagase Haruhiro , Fuchigami Yuji , Suzuki Takaaki 
Published: March 2024

AbstractTwo patients with hypoplastic left heart syndrome (HLHS) concomitant with cor triatriatum underwent the staged Norwood procedure following hybrid palliation. Cor triatriatum was diagnosed after birth in both cases. Case 1 with aortic stenosis and mitral atresia underwent bilateral pulmonary artery banding at 2 days of age. Subsequently, balloon atrial septostomy was conducted at 21 days of age due to hypoxia and increased intra-atrial pressure gradient. At 2 months of age, concomitant Norwood operation, cor triatriatum repair, and tricuspid valve repair were successfully performed. She has suffered from branch pulmonary artery hypoplasia since then; thus, Fontan operation was out of indication. Case 2 with aortic stenosis and mitral stenosis underwent bilateral pulmonary artery banding at 6 days of age. After that, the patient’s hemodynamic condition remained stable. The Norwood operation concomitant with cor triatriatum repair was performed at 2 months of age. However, during the procedure, massive pulmonary edema and hemorrhage occurred right after the initiation of cardiopulmonary bypass. She could not be weaned from cardiopulmonary bypass.
How can primary care benefit from digital health applications? – a quantitative, explorative survey on attitudes and experiences of general practitioners in Germany
Authors: Wangler Julian , Jansky Michael 
Published: March 2024

Abstract
Background
Since 2020, physicians in Germany have the possibility of prescribing approved digital health applications (DHAs) with the costs covered by the health system – a step that was unique in the world at that time and still is. So far, there have been hardly any studies that shed light on the possible applications of DHAs in the context of primary care and take stock of the benefits and potential for optimization. In 2022, a quantitative survey was carried out. The aim was to determine what attitudes, experiences and expectations GPs have with regard to the use of DHAs, under what conditions they are willing to integrate them into health care, and what experience they have already gained.

Methods
The focus was on a large-scale survey of GPs. Between spring and summer 2022, all 18,914 GPs in the federal states of Baden-Württemberg, Hesse, Lower Saxony, Rhineland-Palatinate and Saarland were invited to an online survey. 5,868 questionnaires were included in the evaluation (response rate: 31%). A t-test on independent samples was used to determine significant differences between two groups.

Results
68% of those surveyed are positive about DHAs and consider them to be reliable (69%) and safe (63%) applications that can generate efficiency benefits for the doctor-patient relationship. 24% trust themselves to competently advise patients on DHAs. 14% have already prescribed DHAs, 13% plan to do so. 85% of doctors with DHA experience rate the prescribed applications as (very) useful. Observed health care effects relate primarily to the improvement in compliance (94%), mobility (93%), and education (93%), as well as weight reduction (83%). Among other things, a further optimization of usability (59%), systematic further training of doctors on DHAs (53%) and the expansion of gamification elements (49%) are suggested. GPs lack well-founded information with regard to DHAs (52%).

Conclusion
For GPs, DHAs can be effective tools to encourage patients in their personal responsibility, compliance and motivation to behave in a health-conscious manner and to strengthen prevention in the primary care setting. Where DHAs have been used in a practical context so far, widespread positive health care effects are noticeable. Most respondents do not dare to give patients competent advice on available applications. Comprehensive training courses that provide information about the framework conditions, strategies and advantages of using DHAs appear to be important. There is also a need for more well-founded sources of information and research for doctors to select suitable applications in a targeted manner. GPs see significant added value in DHAs compared to conventional health apps. In order for DHAs to be effectively implemented in primary care, it is important to better inform GPs about the legal basis and possible applications as well as to address their concerns.
Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries
Authors: Rojnic Kuzman Martina , Padberg Frank , Amann Benedikt L. , Schouler-Ocak Meryam , Bajic Zarko , Melartin Tarja , James Adrian , Beezhold Julian , Artigue Gómez Jordi , Arango Celso , Jendricko Tihana , Ismayilov Jamila , Flannery William , Chumakov Egor , Başar Koray , Vahip Simavi , Dudek Dominika , Samochowiec Jerzy , Mihajlovic Goran , Rota Fulvia , Stoppe Gabriela , Dom Geert , Catthoor Kirsten , Chkonia Eka , Heitor Dos Santos Maria João , Telles Diogo , Falkai Peter , Courtet Philippe , Patarák Michal , Izakova Lubomira , Skugarevski Oleg , Barjaktarov Stojan , Babic Dragan , Racetovic Goran , Fiorillo Andrea , Carpiniello Bernardo , Taube Maris , Melamed Yuval , Chihai Jana , Cozman Doina Constanta Maria , Mohr Pavel , Szekeres György , Delic Mirjana , Mazaliauskienė Ramunė , Tomcuk Aleksandar , Maruta Nataliya , Gorwood Philip 
Published: March 2024

Abstract

Background
Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians’ treatment choices for post-traumatic stress disorder (PTSD).

Methods
The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148).

Results
About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct “profiles” of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines.

Conclusions
Clinicians’ decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.
US Food and Drug Administration Approval Summary: Talazoparib in Combination With Enzalutamide for Treatment of Patients With Homologous Recombination Repair Gene-Mutated Metastatic Castration-Resistant Prostate Cancer
Authors: Heiss Brian L. , Chang Elaine , Gao Xin , Truong Tien , Brave Michael H. , Bloomquist Erik , Shah Ankit , Hamed Salaheldin , Kraft Jeffrey , Chiu Haw-Jyh , Ricks Tiffany K. , Tilley Amy , Pierce William F. , Tang Liuya , Abukhdeir Abdelrahmman , Kalavar Shyam , Philip Reena , Tang Shenghui , Pazdur Richard , Amiri-Kordestani Laleh , Kluetz Paul G. , Suzman Daniel L. 
Published: March 2024

PURPOSE The US Food and Drug Administration (FDA) approved talazoparib with enzalutamide for first-line treatment of patients with homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC). PATIENTS AND METHODS The approval was based on the HRR gene-mutated (HRRm) population of TALAPRO-2, a randomized, double-blind trial that randomly assigned 1,035 patients with mCRPC to receive enzalutamide with either talazoparib or placebo. Two cohorts enrolled sequentially: an all-comer population (Cohort 1), followed by an HRRm-only population (Cohort 2). The independent primary end points were radiographic progression-free survival (rPFS) per blinded independent central review (BICR) in Cohort 1 (all-comers) and in the combined HRRm population (all HRRm patients from Cohorts 1 and 2). Overall survival (OS) was a key secondary end point. RESULTS A statistically significant improvement in rPFS by BICR was demonstrated in both the all-comers cohort and the combined HRRm population, with hazard ratio (HR) of 0.63 (95% CI, 0.51 to 0.78; P < .0001) and 0.45 (95% CI, 0.33 to 0.61; P < .0001), respectively. In an exploratory analysis of the 155 patients with BRCA-mutated ( BRCAm) mCRPC, rPFS HR was 0.20 (95% CI, 0.11 to 0.36). In the non-HRRm/unknown stratum of Cohort 1 (n = 636), the rPFS HR was 0.70 (95% CI, 0.54 to 0.89). OS was immature. CONCLUSION Despite a statistically significant rPFS improvement in the all-comer cohort, FDA did not consider the magnitude of rPFS clinically meaningful in the context of the broad indication, combination treatment, and safety profile. Approval was therefore limited to patients with HRRm mCRPC, for whom there was a statistically significant and clinically meaningful improvement in rPFS and favorable OS results. This represents the first approval for the first-line treatment of patients with HRRm mCRPC.
Pembrolizumab Versus Placebo as Adjuvant Therapy in Resected Stage IIB or IIC Melanoma: Final Analysis of Distant Metastasis-Free Survival in the Phase III KEYNOTE-716 Study
Authors: Luke Jason J. , Ascierto Paolo A. , Khattak Muhammad A. , de la Cruz Merino Luis , Del Vecchio Michele , Rutkowski Piotr , Spagnolo Francesco , Mackiewicz Jacek , Chiarion-Sileni Vanna , Kirkwood John M. , Robert Caroline , Grob Jean-Jacques , de Galitiis Federica , Schadendorf Dirk , Carlino Matteo S. , Wu Xi Lawrence , Fukunaga-Kalabis Mizuho , Krepler Clemens , Eggermont Alexander M.M. , Long Georgina V. 
Published: March 2024

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. Pembrolizumab adjuvant therapy was shown to significantly improve recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in patients with resected stage IIB or IIC melanoma in earlier analyses of the randomized, double-blind, phase III KEYNOTE-716 study (ClinicalTrials.gov identifier: NCT03553836 ). We report results of the protocol-specified final analysis of DMFS for KEYNOTE-716. Overall, 976 patients were randomly allocated to pembrolizumab (n = 487) or placebo (n = 489). As of January 4, 2023, median follow-up was 39.4 months (range, 26.0-51.4 months). The median DMFS was not reached in either treatment group, and the estimated 36-month DMFS was 84.4% for pembrolizumab and 74.7% for placebo (hazard ratio [HR], 0.59 [95% CI, 0.44 to 0.79]). The median RFS was not reached in either treatment group, and the estimated 36-month RFS was 76.2% for pembrolizumab and 63.4% for placebo (HR, 0.62 [95% CI, 0.49 to 0.79]). DMFS and RFS results were consistent across most prespecified subgroups, including stage IIB and stage IIC melanoma. The safety profile of pembrolizumab was manageable and consistent with previous reports. These results continue to support the use of pembrolizumab adjuvant therapy in patients with resected stage IIB or IIC melanoma.
National Wounds and Gendered Harm: Reframing Abortion Pain in The Worst of Times
Authors: O’Connell Alex 
Published: March 2024

Abstract
In light of abortion’s recurrent political centrality in the United States, examining abortion narratives remains critically urgent. This article analyzes the abortion narratives found in the 1993 anthology The Worst of Times compiled by Patricia G. Miller, which collects individual stories of illegal abortions from the post–World War II years. It analyzes these narratives in the context of the postwar period’s growing sensational political fascination with abortion pain, alongside the second-wave feminist positioning of abortion as the paramount feminist issue and inherent basis of feminist community. Against these discourses, the semi-anonymous narrators of The Worst of Times disrupt hierarchized, universal, and exclusionary models of pain. Rather, this article argues that, in constructing life writing centered around the painful experience of illegal abortion, the narrators’ experiences cohere into relational clusters that evince commonalities while also maintaining differences. In engaging with their painful abortion experiences, these narratives reshape the medical, national, and feminist power structures that attempted to define the pain that abortion signified. In a moment when abortion legislation faces continued assaults, these narratives invite a consideration of how the embodied, personal pain of abortion can facilitate creative models of community that rethink the power structures that restrict reproductive autonomy.
“One-and-a-Half” Interdural Transcavernous Pituitary Transposition/Rotation for Protection of Hypophyseal Portal System in Adult Peripheral Retroinfundibular Craniopharyngioma
Authors: Shen Ao , Yu Yang , Lyu Liang , Jiang Shu , Zhou Dongjie , Xu Jianguo , Zhou Peizhi 
Published: March 2024

BACKGROUND AND OBJECTIVES:
Craniopharyngiomas originate from the pituitary stalk (PS) and extend along the pituitary-hypothalamic axis. Peripheral retroinfundibular craniopharyngiomas, particularly, may have worse surgery outcomes than other types. This study aims to investigate the advantage of using “one-and-a-half” interdural transcavernous pituitary transposition/rotation to dissect the tumor from the residual stalk and hypophyseal portal system for this subtype of craniopharyngioma.

METHODS:
From August 2018 to February 2023, patients with peripheral retroinfundibular craniopharyngioma underwent surgical treatment. We analyzed clinical information, surgical records, imaging, and examination findings. The surgical procedure, including “one-and-a-half” interdural transcavernous pituitary transposition and rotation, was explained. Postoperative follow-up included endocrinological tests, MRI examinations, and urination surveys.

RESULTS:
Among the 52 patients diagnosed with craniopharyngioma who underwent surgical treatment, 9 were classified as peripheral retroinfundibular craniopharyngioma, and they received “one-and-a-half” interdural transcavernous pituitary transposition and stalk rotation. In 6 cases, the residual PS and most of the hypophyseal portal system were preserved. Gross total resection was achieved in 5 patients and near total resection in 1 patient. One patient had a transection of the bilateral inferior hypophyseal arteries and 5 unilaterally. None experienced permanent diabetes insipidus, but varying degrees of anterior pituitary dysfunction postoperatively required hormone replacement therapy, which gradually decreased over time.

CONCLUSION:
The natural anatomic corridor, “one-and-a-half” interdural transcavernous pituitary transposition, and stalk rotation provide increased working space compared with intradural or extradural pituitary transposition. Simultaneously rotating the tumor and pituitary enables a specific attack angle for lesion dissection after the anteriorly displaced residual stalk is rotated laterally. This approach preserves the residual PS and hypophyseal portal system, avoiding complications of diabetes insipidus and hypopituitarism. In most cases, only one side of the inferior hypophyseal artery needs to be sacrificed, ensuring normal pituitary function.
CDX2 dose-dependently influences the gene regulatory network underlying human extraembryonic mesoderm development
Authors: Bulger Emily A. , McDevitt Todd C. , Bruneau Benoit G. 
Published: March 2024

ABSTRACT
Loss of Cdx2 in vivo leads to stunted development of the allantois, an extraembryonic mesoderm-derived structure critical for nutrient delivery and waste removal in the early embryo. Here, we investigate how CDX2 dose-dependently influences the gene regulatory network underlying extraembryonic mesoderm development. By engineering human induced pluripotent stem cells (hiPSCs) consisting of wild-type (WT), heterozygous (CDX2-Het), and homozygous null CDX2 (CDX2-KO) genotypes, differentiating these cells in a 2D gastruloid model, and subjecting these cells to single-nucleus RNA and ATAC sequencing, we identify several pathways that are dose-dependently regulated by CDX2 including VEGF and non-canonical WNT. snATAC-seq reveals that CDX2-Het cells retain a WT-like chromatin accessibility profile, suggesting accessibility alone is not sufficient to drive this variability in gene expression. Because the loss of CDX2 or TBXT phenocopy one another in vivo, we compared differentially expressed genes in our CDX2-KO to those from TBXT-KO hiPSCs differentiated in an analogous experiment. This comparison identifies several communally misregulated genes that are critical for cytoskeletal integrity and tissue permeability. Together, these results clarify how CDX2 dose-dependently regulates gene expression in the extraembryonic mesoderm and reveal pathways that may underlie the defects in vascular development and allantoic elongation seen in vivo.
Physical Activity and Public Health for Adults: Is the Glass Mostly Empty or Half Full?
Authors: MATTHEWS CHARLES E. , SAINT-MAURICE PEDRO F. , BERRIGAN DAVID 
Published: March 2024

ABSTRACT
Early observations that only a small proportion of U.S. adults were engaging in enough aerobic physical activity to provide substantial health benefit helped shape our public health messaging for physical activity. This messaging has consistently indicated that most adults should increase their activity levels. However, it has been difficult to accurately estimate the proportion of adults who engage in sufficient levels of aerobic activity in the population, with survey-based estimates ranging from 22% in 1994 to 54% in 2018 and widely differing estimates from device-based measures. Recent accelerometer-based studies of physical activity and mortality risk provide new evidence that at least 50% of U.S. adults engage in enough aerobic physical activity to be at low risk for premature mortality. We argue that this observation should lend greater confidence to our current survey-based surveillance estimates, which indicate that a large proportion of adults is physically active. This new insight may also provide clues that could further strengthen our public health messaging for physical activity by placing more emphasis on the maintenance of healthy activity levels throughout life and possibly by using descriptive social norms as an additional intervention element—while continuing current efforts to encourage the adoption of healthy activity levels for less active adults in the population.
Physiological and Metabolic Responses to Low-Volume Sprint Interval Exercises: Influence of Sprint Duration and Repetitions
Authors: YAMAGISHI TAKAKI , IWATA SOYA , OTSUKA SHUN , ICHINOSE HOSHIZORA , KAWAKAMI YASUO 
Published: March 2024

ABSTRACT

Purpose
This study aimed to determine physiological and metabolic responses to two different sprint interval exercises (SIE) matched for total sprint duration and sprint–rest ratio.

Methods
After having measured peak oxygen uptake (V̇O2peak), 14 healthy males (27.1 ± 4.8 yr, 169.6 ± 6.0 cm, 64.5 ± 8.4 kg, V̇O2peak: 47.2 ± 7.7 mL·kg−1·min−1) performed four 10-s sprints with 80-s recovery (SIE10) and two 20-s sprints with 160-s recovery (SIE20) on different occasions in a counterbalanced crossover manner. Pulmonary V̇O2 and changes in tissue oxygenation index (∆TOI) at vastus lateralis (VL) and rectus femoris (RF) were measured during the SIE. Furthermore, T2-weighted magnetic resonance imaging was taken immediately before and after the SIE to determine the activation levels of VL, RF, vastus medialis, vastus intermedius, adductor magnus, biceps femoris long head, semitendinosus, and semimembranosus at 50% of right thigh length.

Results
In SIE10, increases in V̇O2 and ∆TOI at VL and RF plateaued after the second sprint, whereas session-averaged ∆TOI was greater in SIE20 than SIE10 in both muscles (VL: 20.9 ± 7.4 vs 14.2% ± 5.9%, RF: 22.8 ± 9.3 vs 12.9% ± 6.6%, P = 0.00). Although both SIE significantly increased T2 values in all eight muscles, those magnitudes were similar between the conditions (SIE10 vs SIE20: 5%–16% vs 8%–16%).

Conclusions
This study showed blunted responses of whole-body (V̇O2) and peripheral (∆TOI) oxidative responses with successive sprints (sprint 1 < sprints 2–4) in SIE10, suggesting that increasing sprint repetitions does not necessarily induce greater oxidative metabolism or stimulus. Moreover, greater peripheral oxygen extraction (∆TOI) was achieved with SIE20, whereas %changes of T2 indicates that the thigh muscles were similarly activated between the SIE conditions.
Determinants of Change in Physical Activity in Children during the Transition from Elementary to High School
Authors: PATE RUSSELL R. , DOWDA MARSHA , DISHMAN ROD K. , SAUNDERS RUTH P. , CORDAN KERRY L. , SHULL EMILY R. , BUCKO AGNES G. , COLABIANCHI NATALIE 
Published: March 2024

ABSTRACT

Introduction
Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school.

Methods
Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th to 11th grades in 2010–2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age.

Results
As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years.

Conclusions
Interventions should target multiple domains of influences that may vary by age.