bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical practice and outcomes in European pediatric cardiac anesthesia: A secondary analysis of the APRICOT and NECTARINE studies
Authors: Castellheim Albert Gyllencreutz , Habre Walid , Hansen Tom Giedsing 
Published: January 2025

AbstractBackgroundDespite advancements in surgical techniques and perioperative care, pediatric cardiac patients remain at an increased risk of adverse events. The APRICOT (2017) study aimed to establish the incidence of severe critical events in children undergoing anesthesia in Europe, while the NECTARINE (2021) study aimed to assess anesthesia practices and outcomes in neonates and infants under 60 weeks postconceptual age. Our goal was to conduct a secondary analysis of the cardiac cohorts from these two studies to determine mortality rates and other outcomes after cardiac procedures at 30 and 90 days, identify factors influencing mortality, illustrate clinical practices, and assess the methodology of the two studies.MethodsSub‐analysis of the data from APRICOT and NECTARINE. Data representativity was assessed through a systematic categorization process. European countries were divided into four income groups based on their gross national income per capita. Subsequently, the total number of patients across all four income groups was calculated for both the Apricot and Nectarine studies, and then the specific contribution of each income group to the total population of each study was determined.ResultsThis analysis comprised 1016 cases (Apricot, n = 476 and Nectarine, n = 540). There was a considerable variability in clinical practice in Europe. The overall mortality rates were 0.84% (APRICOT) and 8.1% (NECTARINE). In both cohorts, substantial mortality was observed among low‐age and low‐weight infants. Stratifying the participating countries by income illustrated that the data originated from highest‐income and upper‐middle‐income European countries and were not representative of low‐income and middle‐income countries.ConclusionsIn this secondary analysis of the APRICOT and NECTARINE studies, we found that fatal cases primarily occurred in low‐age and low‐weight neonates and infants.Editorial commentThis secondary analysis of the APRICOT and NECTARINE studies focused on pediatric cardiac surgical cases. Outcomes differed according to weight and age of the children, where mortality risk was higher for very young and low‐weight children.
Efficacy and Safety of Four Weeks of Moderately Hypofractionated Chemoradiation for Unresectable, Stage 3 Non–Small Cell Lung Cancer: A Systematic Review
Authors: Ludbrook Joanna Jane , Kumar Mahesh , Soon Yu Yang , Smith Angela , Mallesara Girish , Hau Eric , Hegi‐Johnson Fiona , Vinod Shalini 
Published: January 2025

ABSTRACTShortening treatment time with moderately hypofractionated radiotherapy benefits patients by reducing inconvenience and costs, but its use in the definitive treatment of unresectable Stage 3 non–small cell lung cancer is controversial due to lack of level one evidence and toxicity concerns. Pivotal systemic therapy trials utilize conventionally fractionated chemoradiation at 2 Gy per fraction given over 6 weeks. In practice, 4 weeks of chemoradiation at 2.75 Gy per fraction is sometimes employed to reduce the treatment burden for selected patients, especially those who are older or have comorbidities. It is uncertain if the two fractionation regimens are similar in biologically effectiveness, especially with varying systemic therapy. This systematic review aimed to collate the survival and toxicity outcomes for 4 weeks of moderately hypofractionated chemoradiation, using > 50 –60 Gy in 20 fractions. Eight studies met the eligibility criteria; seven studies were from a database search of MEDLINE, EMBASE, Cochrane Library, and Web of Science and one study was added later. Two studies were prospective randomized trials and six were retrospective cohort studies. No study included immunotherapy. The historical evidence has been limited, but emerging data is promising, especially when compared to outcomes of standard chemoradiation. Thus, further investigation of this strategy is justified.
Rural Eye Care Access, Workforce Challenges and Opportunities: Perspectives of the Eye Health Workforce in Western Australia
Authors: Chen Jingyi , Bentley Sharon A. , McKendrick Allison M. , Thompson Sandra C. , Turner Angus W. , Alam Khyber 
Published: January 2025

ABSTRACTObjectiveRural residents face numerous barriers to accessing eye care services that contribute to disparities in eye health outcomes. This study aimed to explore the perspectives of the rural workforce on opportunities to improve patient access to eye care services, as well as understand the ways the workforce can be supported.SettingRegional, rural and remote Western Australia.DesignA qualitative descriptive approach was taken. Maximum variation and snowball sampling were used, and semi‐structured interviews were conducted until data saturation. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.ParticipantsSeventeen semi‐structured interviews were conducted with six ophthalmologists, 10 optometrists and one non‐clinician involved in delivering eye care services in rural Western Australia.ResultsFour major themes were identified. ‘Access to care’ pertained to barriers and facilitators of timely and appropriate eye care for rural residents. ‘Need for collaborative care framework’ between ophthalmology and optometry emerged as a key opportunity to decrease wait times and maximise efficiency of visiting services. ‘Motivation to work in rural settings’ and ‘challenges of working in rural settings’ suggested opportunities to support the workforce.ConclusionThis study finds that continued support through financial, personal, and professional means is important for workforce retention and satisfaction among eye care service providers in rural Western Australia. Although collaborative care models currently exist, the extent of collaboration between practitioners varies considerably. Further research is required on developing innovative, scalable and sustainable models of care to meet the eye care needs in rural Australia.
Development of a novel malignant colorectal polyp prognostic nomogram
Authors: Zammit Andrew P , Aksoy Yagiz Alp , Brown Ian , Hooper John D , Clark David A , Fuchs Talia L , Riddell Andrew D , Gill Anthony J 
Published: January 2025

AbstractBackgroundThere is uncertainty when determining the optimal treatment for malignant polyps. Clinicians must balance the oncological risk of a malignant polyp with the risk of morbidity and mortality from surgery. This study developed an online risk‐calculator using machine‐learning techniques to predict the risk of an adverse outcome from a malignant colorectal polyp following polypectomy.MethodsRetrospective data collection of a population‐wide database of all malignant polyps from 2011 to 2020 was performed. Utilizing an artificial intelligence‐based machine learning approach a generalized linear mixed (GLM) model was developed to predict the risk of an adverse outcome after polypectomy. The presence of an adverse outcome was determined by assessing for the presence of residual disease or lymphatic disease if colorectal resection was undertaken. Delayed disease recurrence was also assessed as an additional adverse outcome. Patient and pathological details from the Queensland Cancer Registry were collected and included in the calculator development.ResultsThe following variables were included in the final model: age, gender, polyp location (right colon, left colon, rectum), depth of tumour invasion, lymphovascular space invasion, tumour grade, associated polyp type, mismatch repair immunohistochemistry status and margin status. Based on ROC analysis, the AUC for the final GLM model was 0.76. The mean accuracy of the GLM model was 0.76 (95% CI: 0.72–0.80).ConclusionThis web‐based nomogram will facilitate the discussion of whether individual patients with malignant colorectal polyps can be safely managed with polypectomy or whether the patient should undergo colorectal resection. This nomogram is now available at https://malignantpolyp.com/risk-calculator.
Blocking the mineralocorticoid receptor prevents cardiac and mitochondrial dysfunction through the activation of NOX‐4 in female hormone deprivation rats
Authors: Rodrigues Samya Mere L. , Ximenes Carolina F. , Rodrigues Nathália , Ronconi Karoline , Costa Anna Karolina Nascimento , Vieira Livia Barroca , da Silva Maria Luiza Yago , Ferreira Katyana K. S. , Eliezeck Marcos , Scalzo Sergio , Monteiro André , Sanches Bruno , Spalenza Thiago , Fernandes Aurélia Araújo , Guatimosim Silvia , Varner Kurt J. , Ribeiro Eduardo Hertel , Stefanon Ivanita 
Published: January 2025

AbstractAimYoung women exhibit lower rates of cardiovascular disease (CVD) than age‐matched men, a protective effect often attributed to estrogen's influence on cardiac and mitochondrial function. The risk of CVD increases in post‐menopausal women, likely due to estrogen deficiency and aldosterone's negative effects, including those on mitochondria and other cellular targets. This study aimed to explore the link between estrogen deficiency and mitochondrial dysfunction in cardiac health. We hypothesized that in estrogen‐deprived conditions, aldosterone could stimulate NADPH oxidase, leading to mitochondrial dysfunction, and reduced cardiac contractility.MethodsWistar rats were divided into four groups: Sham, Ovariectomy‐induced hormone deprivation (Ovx), Ovx with apocynin treatment, and Ovx with spironolactone treatment for 60 days.ResultsBoth apocynin and spironolactone countered the adverse effects of hormone deprivation by preserving myocardial contractility, improving cellular responses to calcium and isoproterenol, and normalizing the expression of key mitochondrial proteins. These compounds also attenuated the increase in reactive oxygen species (ROS) and maintained mitochondrial respiration rates.ConclusionWe concluded that estrogen deficiency contributes to cardiac oxidative stress via the NADPH oxidase and mitochondrial pathways. Apocynin and spironolactone offer significant protective effects, opening new avenues for treating cardiac issues related to estrogen deficiency.
The 5‐year results of the Stratified Cancer Active Surveillance programme for men with prostate cancer
Authors: Gnanapragasam Vincent J. , Keates Alexandra , Lophatananon Artitaya , Thankapannair Vineetha 
Published: January 2025

ObjectivesTo report 5‐year outcomes from the STRATified CANcer Surveillance (STRATCANS) programme based on progression risks using National Institute for Health and Clinical Excellence (NICE) Cambridge Prognostic Group (CPG) at diagnosis, prostate specific antigen density and magnetic resonance imaging (MRI) visibility.Patients and MethodsMen with CPG1 and CPG2 disease selecting active surveillance (AS) were included into STRATCANS and allocated to one of three increasing follow‐up intensities. Outcome measures were: (i) treatment for CPG≥3 progression (main outcome), (ii) any treatment, (iii) conversion to watchful waiting (WW), (iv) patient self‐attrition, and (v) mortality.ResultsA total of 297 men (median age 66.0 years) were reviewed. The median (interquartile range, mean) follow‐up for men still on AS was 4.9 (2.7–7.6, 5.3) years. In the cohort, 38.0% were CPG2 and 25.0% Grade Group (GG) 2 at AS entry. Overall, 214/297 (72.1%) remained treatment free: 158 (53.1%) were still on AS, 17 (5.7%) died of other causes, and 39 (13.1%) progressed to WW/discharge. Only 10 (3.4%) left AS from anxiety. There were no cancer deaths or metastatic events. In all, 80 men (26.9%) converted to treatment due to biopsy/MRI progression but only 35 (11.7%) of these reached CPG≥3 disease. Treatment for CPG≥3 occurred in 7.6% of CPG1 and 18.5% of CPG2 disease and 9.9% of GG1 and 17.5% of GG2 disease. By STRATCANS tier, treatment for CPG≥3 disease was 4.7% in STRATCANS 1, 12.9% in STRATCANS 2, and 27.4% in STRATCANS 3 (P < 0.001). STRATCANS had an area under the curve (AUC) of 0.74 for predicting CPG≥3 progression out‐performing stratification by GG (AUC 0.64), CPG (0.69) and Likert score (0.51) alone or a combination of MRI visibility and GG (0.64). Longitudinal data have allowed further refinement of the STRATCANS schedule.ConclusionsThe STRATCANS 5‐year outcomes demonstrate that a simple risk stratified surveillance using a prognostically meaningful endpoint is safe, durable, has low treatment rates, high patient compliance and appropriately tailors monitoring based on risks of progression. A website and implementation toolkit are now available.
Does Financial Development Affect the Emission of CO2 Uniformly Across Economies? Global Evidence From Heterogeneous Analysis
Authors: Sikhawal Shobhana 
Published: January 2025

ABSTRACTThe study investigates financial development's heterogeneous impact on emission of CO2, especially in the pre‐ and post‐global financial crisis phases and analyzes the mediators through which financial development affects the emission of CO2. Using panel quantile estimation with non‐additive fixed effects method, on a comprehensive sample of 125 countries over the period 1991–2015, we find that the overall financial development activities increase the emission of CO2. However, financial development has a much greater effect on increasing CO2 emissions in countries with fewer emissions than in those with higher emissions.
Genomic profiles of patients with skin melanoma in the era of immune checkpoint inhibitors
Authors: Liang Yao , Maeda Osamu , Nishida Kazuki , Chretien Basile , Ando Yuichi 
Published: January 2025

AbstractThe use of immune checkpoint inhibitors (ICIs) for treating melanoma has dramatically improved patient prognosis. The genomic profiles of patients receiving ICI therapy would provide valuable information for disease management and treatment. We investigated the genomic profiles of patients with melanoma who had received ICI therapy and explored associations with clinical features and outcomes via a large‐scale nationwide database in Japan (the C‐CAT database). We identified 339 patients eligible for this study. The most frequent genetic mutations were found in the BRAF (27%), TERT (24%), and NRAS (19%) genes, and the most common copy number variations (CNVs) were in the CDKN2A (36%), CDKN2B (26%), and MTAP (19%) genes. Associations with high tumor mutational burden (TMB‐high) status were significant for TERT (p < 0.001), NF1 (p < 0.001), ROS1 (p = 0.015), POLE (p = 0.045), and POLD1 (p = 0.008) mutations, along with older age (≥65 years, p = 0.036). Patients with multiple metastases (two or more) were more likely to have NOTCH3 mutations (p = 0.017) and be younger than 65 years (p = 0.024). In particular, as well as younger age, patients with brain metastases were more likely to harbor BRAF mutations (p < 0.001), while those with liver metastases were more likely to harbor NOTCH3 mutations (p < 0.001) but not CDKN2B CNVs (p = 0.041). Patients with NRAS mutations were less likely to respond to ICI therapy (p = 0.014) and exhibited shorter overall survival (p = 0.006). In this population, the frequency of BRAF mutations was lower than that in fair‐skinned populations, but the associations between genomic profiles, clinical features, and outcomes were similar to those previously reported in fair‐skinned populations.
Cladistic estimates of evolutionary rates focused on palaeontological datasets using TNT
Authors: Pol Diego , Ezcurra Martín D. 
Published: January 2025

AbstractWe describe a protocol for estimating evolutionary rates from phylogenetic trees based on parsimony character optimization. The rate estimation is conducted through a TNT script and the results are analysed in a script for the software environment R. The TNT script allows analysing multiple optimal topologies, considering optimization ambiguity, and alternative time‐calibrations or pre‐calibrated trees. The R script summarizes estimated rates on a consensus tree and plots the variation of evolutionary rates through time, jointly with the phylogenetic diversity and a new metric (clade completeness index) that measures the distribution of missing data along the tree. We present results for simulated and empirical analyses, and evaluate the impact of missing data and alternative calibration methods in rate estimates. We found that while missing data can lower the nominal values of evolutionary rates, the overall pattern of rate variation through time remained robust. Empirical cases highlight different scenarios, such as datasets in which peaks of evolutionary rates can be coupled or decoupled from diversification dynamics (phylogenetic diversity) and cases in which missing data may influence the variation of estimated evolutionary rates. We conclude with recommendations for using this protocol and interpreting the results of parsimony‐based rate estimates.
Change in glucose, insulin and serum lipids due to ultra‐processed food consumption in children with obesity
Authors: Cortes Caroline , Brandão Joana Maia , Cunha Diana Barbosa , Paravidino Vitor Barreto , Sichieri Rosely 
Published: January 2025

SummaryWhile the association between ultra‐processed food (UPF) consumption and chronic non‐communicable diseases in adults is well‐established, its relationship with serum markers of chronic diseases in children remains underexplored. This research investigates changes in serum markers in children with obesity during a trial aimed at reducing UPF consumption. The study is a prospective cohort, based on a parallel randomized controlled trial conducted between August 2018 and February 2020, with children aged 7–12 years. Over 6 months, children and their guardians attended monthly consultations and educational activities aimed at reducing UPF consumption. Body weight, height, and 24‐h dietary recall were measured at all visits. Serum markers were collected at baseline and at the 2‐ and 5‐month visit (during the intervention). Data from 95 children were analysed. Body mass index (BMI), UPF consumption in grams and energy, and percentage of UPF in grams showed a quadratic trend, initially decreasing, followed by an increase in the following months. Glucose, insulin, and HOMA‐IR decreased throughout the study, but after adjustment for BMI, the associations no longer persisted, except for glucose levels, which decreased linearly by 2.25 mg/dL. Reducing UPF consumption may lower blood glucose levels in children with obesity, independent of BMI changes.
Oral antibiotic prophylaxis induces changes in the microbiology of surgical site infection after colorectal surgery. A matched comparative study
Authors: Flores‐Yelamos Miriam , Juvany Montserrat , Badia Josep M. , Vázquez Ana , Pascual Marta , Parés David , Almendral Alexander , Limón Enric , Pujol Miquel , Gomila‐Grange Aina ,   Members of the VINCat Colorectal Surveillance Team
Published: January 2025

AbstractAimOral antibiotic prophylaxis (OAP) lowers rates of surgical site infection (SSI) and may aid anastomotic healing in colorectal surgery. The aim of this study was to analyse the understudied impact of OAP on SSI microbiology after colorectal surgery.MethodA post hoc analysis was performed on a previous prospective, multicentre study of elective colorectal surgery. For 1000 patients with SSI, this study compared the microbiology of SSIs in procedures without OAP (SSI/OAP–) and with OAP (SSI/OAP+).ResultsThere were 340 patients in the SSI/OAP– group and 660 in the SSI/OAP+ group. The use of OAP increased the presence of Gram‐positive cocci (GPC) (OR 1.542, 95% CI 1.153–2.062) and fungi (OR 2.037, 95% CI 1.206–3.440), but reduced rates of Gram‐negative bacteria (GNB) (OR 1.461, 95% CI 1.022–2.088) and anaerobe isolation (OR 0.331, 95% CI 0.158–0.696). Specifically, it led to increases in the isolation of Enterococcus faecium (OR 1.450, 95% CI 0.812–2.591), methicillin‐resistant Staphylococcus aureus (OR 2.000, 95% CI 1.043–3.834) and Candida spp. (OR 2.037, 95% CI 1.206–3.440). In colon surgery with OAP, GPC infections were more likely (OR 1.461, 95% CI 1.022–2.088). In rectal surgery, organ/space SSIs had a higher risk of harbouring GPC (OR 1.860, 95% CI 1.153–2.999) and a lower risk of GNB (OR 0.321, 95% CI 0.200–0.515).ConclusionOAP reduced the presence of anaerobes and GNB in SSIs, but increased the isolation of GPCs and fungi, with E. faecium and Candida being of particular concern. This information should guide empirical antibiotic therapy for postoperative colorectal SSIs in patients who have received preoperative OAP.
Public pathways to influencing pro‐nature decision‐making in government: A case study in southeastern Australia
Authors: van Eeden Lily M. , Smith Liam , Bekessy Sarah , Dovers Stephen , Lowe Kim W. , Hames Fern M. 
Published: January 2025

AbstractThe biodiversity crisis calls for more collective effort, and a close examination of the tools available to effect change. We documented insider knowledge into how pro‐nature decision‐making can be influenced in the Australian state of Victoria, focusing on the role of public advocacy targeting government. We interviewed 12 experts who currently or previously held influential roles in government or advocacy‐focused environmental non‐government organizations (ENGOs) and used thematic analysis to explore their responses. Experts described influence from individuals, grassroots groups, or ENGOs, and factors shaping success. These included attributes of the decision‐making context, having resources and commitment to see out long‐term change, having relevant networks, and being able to act when opportunities arise. Barriers described included lack of environmental literacy among the public and some decision‐makers, biodiversity concern being crowded out by climate change concern, and the difficulty of shifting from incremental to systemic change. Understanding these factors can better equip advocates to have impact. Democratic governments recognize that societies make progress where there is two‐way exchange between public and state, so should foster public pathways toward political engagement in conservation.