bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frontal Maintenance in Submesoscale Flows
Authors: Hetland Robert D. , Qu Lixin , Hinson Kyle E. 
Published: January 2025

Abstract
Classic deformation theory includes parameters—divergence, total strain, and vorticity—that are invariant to changes in the coordinate system. However, these parameters are sometimes ambiguous with respect to characterizing how fronts are formed and maintained because the presence of a front imposes a reference coordinate system. To help remedy this ambiguity, we propose a framework in frontal coordinates based on along- and cross-front velocity gradients to better characterize frontal maintenance, which can also be used to define divergence and normal strain in frontal coordinates. The framework with these four parameters (along-, cross-front velocity gradients, divergence, and normal strain in frontal coordinate) defines eight characteristic flow types at a front, providing a complete characterization of the flow that strengthens or weakens a front. This framework highlights the importance of the “strain efficiency” concept, which unambiguously defines the contribution of total strain to frontogenesis. Two examples, one based on a realistic simulation of submesoscales in the northern Gulf of Mexico and the other based on an idealized model with similar flow characteristics, are provided to demonstrate how this framework can be used to enhance our understanding of frontal dynamics in submesoscale flows.
Fenestrated Anaconda Endograft for the Treatment of Complex Aortic Aneurysms: Systematic Review and Meta-Analysis
Authors: Karaolanis Georgios I. , Kotopoulos Konstantinos , Jungi Silvan , Kotelis Drosos , Makaloski Vladimir 
Published: January 2025

Purpose: To perform a systematic review and meta-analysis of the outcomes of Anaconda fenestrated endograft for the treatment of complex abdominal aortic aneurysms (cAAA). Material and methods: A systematic search of all the literature reported until May 2024 was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The pooled 30-day mortality rate, technical success rate, reintervention rate as well as bridging stent occlusion rate, and corresponding 95% confidence intervals (CIs) were estimated using fixed or random effect methods. Results: A total of 526 study titles were identified by the initial search strategy, of which 6 were considered eligible for inclusion in the meta-analysis. A total of 782 patients (89% male) were identified among the eligible studies. The pooled 30-day mortality rate was 4.8% (95% CI, 3.5%–6.5%) while the reintervention rate was 7.9% (95% CI, 4.3%–14.1%) and 10.2% (95% CI, 5.8%–17.4%) in the early and late period, respectively. The pooled bridging stents occlusion was 2.7% (95% CI, 1.5%–4.9%) during 30 days and 3.5% (95% CI, 1.6%–7.6%) during follow-up. Overall technical success was 86.1% (95% CI, 62.9%–95.8%). Conclusions: The use of the Anaconda fenestrated endograft in treatment of complex aortic aneurysms involving the abdominal visceral vessels has low early and late mortality. Low rate of bridging stent occlusion occurs early postoperatively and during follow-up, mostly involving the renal arteries. Reinterventions during follow-up are mostly induced by limb occlusion. Lower early technical success rate is explained by the presence of a type Ia endoleak on final angiography, which however resolves spontaneously early postoperatively. Clinical Impact The present systematic review and meta-analysis of observational studies provide evidence-based data regarding the safety and efficacy of the fenestrated Anaconda device for the primary treatment of cAAA in the perioperative period and at long-term follow-up. Six studies with an overall 782 patients were included. The technical success in patients with cAAA treated with Anaconda fenestrated endograft was 86% while the reintervention rate was 7.9% and 10.2 during the perioperative and long-term follow up period. The pooled 30-day occlusion rate for the bridging stents was 2.7% while the late pooled occlusion rate for the bridging stents among the studies was 3.5%. The use of the Anaconda fenestrated endograft in treatment of complex aortic aneurysms involving the abdominal visceral vessels seems feasible with promising outcomes. The lower early technical success is obscured by the presence of type Ia endoleak which, resolves spontaneously early postoperatively.
Mechanisms underlying CSD initiation implicated by genetic mouse models of migraine
Authors: Pietrobon Daniela , Brennan K.C. 
Published: January 2025

Abstract
A key unanswered question in migraine neurobiology concerns the mechanisms that make the brain of migraineurs susceptible to cortical spreading depression (CSD, a spreading depolarization that underlies migraine aura and may trigger the migraine pain mechanisms). Important insights into this question can be obtained by studying the mechanisms of facilitation of CSD initiation in genetic mouse models of the disease. These models, all generated from families with hereditary migraine, allow the investigation of the functional consequences of disease-causing mutations at the molecular, cellular, synaptic and neural circuit levels. In this review, after describing the available genetic mouse models of migraine, which all share increased susceptibility to experimentally induced CSD, we will discuss the functional alterations in their cerebral cortex and the mechanisms underlying the facilitation of CSD initiation in their cortex, as well as the insights that these mechanisms may give into the mechanisms of initiation of spontaneous CSDs in migraine.
Development and validation of an EHR-based risk prediction model for geriatric patients undergoing urgent and emergency surgery
Authors: Yap Edward N. , Huang Jie , Chiu Joshua , Chang Robert W. , Cohn Bradley , Hwang Judith C. F. , Reed Mary 
Published: January 2025

Abstract

Background
Clinical determination of patients at high risk of poor surgical outcomes is complex and may be supported by clinical tools to summarize the patient’s own personalized electronic health record (EHR) history and vitals data through predictive risk models. Since prior models were not readily available for EHR-integration, our objective was to develop and validate a risk stratification tool, named the Assessment of Geriatric Emergency Surgery (AGES) score, predicting risk of 30-day major postoperative complications in geriatric patients under consideration for urgent and emergency surgery using pre-surgical existing electronic health record (EHR) data.

Methods
Patients 65-years and older undergoing urgent or emergency non-cardiac surgery within 21 hospitals 2017–2021 were used to develop the model (randomly split: 80% training, 20% test). The primary outcome was a 30-day composite outcome including several postoperative major complications and mortality; secondary outcomes included common individual complications included in the primary composite outcome (sepsis, progressive renal insufficiency or renal failure, and mortality). Patients’ EHR-based clinical history, vital signs, labs, and demographics were included in logistic regression, LASSO, decision tree, Random Forest, and XGBoost models. Area under the receiver operating characteristics curve (AUCROC) was used to compare model performance.

Results
Overall, 66,262 patients (median [IQR] age 78 [(70.9–84.0], female 53.9%, White race 68.5%) received urgent or emergency non-cardiac surgery (25.7% orthopedic cases, 21.9% general surgery cases). AUCROC ranged from 0.655 (Decision Tree) – 0.804 (XGBoost) for the primary composite outcome. XGBoost AUCROC was 0.823, 0.781, and 0.839 in predicting outcomes of sepsis, progressive renal insufficiency or renal failure, and mortality, respectively.

Conclusions
We developed a model to accurately predict major postoperative complications in geriatric patients undergoing urgent or emergency surgery using the patient’s own existing EHR data. EHR implementation of this model could efficiently support clinicians’ surgical risk assessment and perioperative decision-making discussions in this vulnerable patient population.
Cardiovascular disease essential medicines listing by countries: changes over time and association with health outcomes
Authors: Heredia Camila , Ul Haq Moizza Zia , Buadu Adelaide , Rizvi Amal , Workentin Aine , Persaud Navindra 
Published: January 2025

Abstract

Background
Since national essential medicine lists guide the procurement of medicines for populations in many countries, and cardiovascular diseases are the leading cause of death globally, including cardiovascular medicines on these lists can significantly impact healthcare outcomes.

Methods
In this cross-sectional study, national essential medicines’ lists from 158 countries were analysed on whether or not they included medicines to treat ischemic heart disease, cerebrovascular disease, and hypertensive heart disease. A linear regression model was used to evaluate the association between countries’ coverage scores and amenable mortality.

Results
Listing of cardiovascular disease treatment was associated with amenable mortality from hypertensive heart disease. Health expenditure per capita was also associated with amendable mortality due to ischemic heart disease, and hypertensive heart disease.

Conclusions
Listing essential medicines for cardiovascular disease is an important aspect of healthcare quality that is associated with cardiovascular mortality.
Empiric antibiotic therapy resistance and mortality in emergency department patients with bloodstream infection: a retrospective cohort study
Authors: von Beck Leonhard M. , Rapszky Gabriella Anna , Kiss Veronika E. , Sandor Szilard , Gaal-Marschal Szabolcs , Berenyi Tamas , Varga Csaba , Fenyves Bank G. 
Published: January 2025

Abstract

Background
Timely management of sepsis in the emergency department, including the use of appropriate antimicrobials, is crucial for improving patient outcomes. Inadequate empiric antimicrobial treatment is associated with potential changes in patient outcomes. We aimed to pinpoint risk factors, characterize antibiotic resistance trends, and investigate the association between antibiotic resistance and mortality among patients with bacteremia admitted to the emergency department.

Methods
We conducted a retrospective analysis of emergency department patients admitted between 15/06/2016 and 30/09/2022. Patients with a positive blood culture receiving emergency department-initiated antibiotic therapy were included. Antibiotic administration, resistance, and survival data were collected. Descriptive statistics, survival analysis, and Cox proportional hazards models were performed.

Results
Of 157,884 emergency department visits, 1,136 patients had a positive blood culture and received antibiotic therapy initiated in the emergency department. Resistance against empiric antibiotics was 14.5%. The overall 30-day and one-year mortality was 38.6% and 61.8%, respectively. In adjusted Cox models, patients with Escherichia coli or Staphylococcus aureus infection had 36% lower and 44% higher risk of death, respectively. Although resistance to emergency department-administered antibiotic therapy was not associated with overall mortality, one-year mortality of patients with Escherichia coli bacteremia was higher in those with antibiotic resistance (69.0% vs. 49.4%, p = 0.011); these patients had a 1.5-fold increased risk of death in an adjusted Cox model.

Conclusion
The mortality of patients with bloodstream infection is high. The association of mortality with empiric emergency department-initiated antibiotic adequacy is pathogen-dependent.
Antenatal care and breastfeeding practices in Sub-Saharan Africa: an analysis of demographic and health surveys
Authors: Olapeju Bolanle , Bride Michael , Wamala Mariam , Atobrah Deborah , Lee Elizabeth H. , Hendrickson Zoé M. 
Published: January 2025

Abstract

Background
The World Health Organization (WHO) recommends immediate breastfeeding (within the first hour after birth) and exclusive breastfeeding (for the first six months of life), particularly in low-resource settings such as sub-Saharan Africa. In 2016, WHO updated its antenatal care (ANC) guidelines, recommending at least eight (8+) ANC contacts during pregnancy to improve maternal and child health outcomes. This study investigates i) trends in breastfeeding practices across sub-Saharan Africa following the rollout of the revised WHO 2016 ANC policy and ii) the relationship between ANC uptake and exclusive or early breastfeeding.

Methods
We performed a secondary analysis of Demographic and Health Survey data from 19 countries, from 2018-2023. Key variables included exclusive breastfeeding, early initiation of breastfeeding (within one hour of birth), and the number of ANC contacts (categorized into 0-3, 4-7, and 8 + visits) among mothers with a live birth in the six months preceding the survey.

Results
Exclusive breastfeeding rates ranged from 19% in Gabon to 81% in Rwanda (median = 53%), while early initiation of breastfeeding ranged from 32% in Senegal to 85% in Rwanda (median = 60%). The percentage of women with 8 + ANC contacts ranged from 0.3% in Rwanda to 39% in Ghana (median = 4%). Women with 8 + ANC contacts did not show increased odds of early initiation (aOR: 0.94; 95% CI: 0.84, 1.05) or exclusive breastfeeding (aOR: 0.85; 95% CI: 0.76, 0.94) compared to women with 4-7 contacts.

Discussion
These findings reveal low rates of 8 + ANC contacts against a backdrop of suboptimal breastfeeding practices across sub-Saharan Africa. Furthermore, the results suggest limited additional benefits of 8 + ANC contacts over 4-7 contacts in promoting immediate and exclusive breastfeeding, as recommended by the WHO 2016 ANC policy. Urgent efforts are needed to promote ANC uptake and improve the quality of ANC contacts through behavior change interventions and complementary health service delivery. Sub-national, national, and global stakeholders should prioritize these interventions.
External beam radiation therapy versus radical prostatectomy for high-risk prostate cancer: protocol of the RECOVER study
Authors: van der Starre Caroline M. , Bangma Chris H. , Bijlsma Maarten J. , van den Bergh Alfons C.M. , Kiemeney Lambertus A.L.M. , Kievit Wietske , Vos Kees , Somford Diederik M. , Wildeman Sally M. , Aben Katja K.H. , de Jong Igle J. , Pos Floris J. , Heesterman Berdine L. 
Published: January 2025

Abstract

Background
This paper describes the rationale and design of the RECOVER study. Currently, there is no consensus regarding the optimal treatment for high-risk, non-metastatic prostate cancer (PCa). The study primarily aims to evaluate and compare the impact of treatment with robot-assisted radical prostatectomy (RP) versus external beam radiation therapy (EBRT) with androgen deprivation therapy (ADT) for men with high-risk, non-metastatic PCa regarding health-related quality of life (HRQoL) and functional outcomes. Secondary objectives are progression-free survival (PFS), distant metastasis-free survival (DMFS), costs and cost-effectiveness.

Methods
The RECOVER study is a comparative effectiveness study that prospectively includes newly diagnosed high-risk (cT3a-bN0M0, ISUP-grade ≥ 4 and/or PSA > 20 ng/mL), non-metastatic PCa patients. Four Dutch prostate cancer networks, comprising 29 hospitals, are currently participating in the study. Patient reported outcomes are collected before treatment initiation, 12 months and 36 months after treatment initiation and include the EORTC-QLQ-C30, the EPIC-26, an adapted version of the SCQ, an adapted version of the iMTA Productivity Cost Questionnaire and several specific questions regarding patient characteristics, treatment of PCa specific complaints and health resources used. Clinical data regarding patient-, tumor- and treatment characteristics and oncological outcomes are collected up to 5 years after diagnosis. For sufficient power, patient reported outcomes of 471 patients must be collected 36 months after treatment initiation. Descriptive statistics and mixed-effects models are used to assess differences in HRQoL and functional outcomes over time between the patients treated with radical prostatectomy versus EBRT (+ ADT). Inverse probability of treatment weighting or the g-formula are used to adjust for confounding covariates associated with treatment. Secondary endpoints PFS and DMFS are evaluated using a competing risk analysis and cost-utility and budget-impact analyses will be performed to determine cost and cost-effectiveness.

Discussion
An observational prospective design was chosen since a randomized controlled trial comparing surgery and radiotherapy was not deemed feasible. This study evaluates effectiveness of treatment in a routine clinical setting (with adjustment for confounding) and its findings will enhance patients’ and healthcare professionals’ awareness for the impact of both treatment modalities on (long-term) daily functioning and HRQoL and aid treatment decision making.

Trial registration
This study is registered at ClinicalTrials.gov (NCT05931419).
Critical thinking about health and treatments in the United States: a cross-sectional assessment of parents and undergraduate college students
Authors: Ringle Vanesa A. Mora , Dahlgren Astrid , Rosenbaum Sarah , Jensen-Doss Amanda 
Published: January 2025

Abstract

Background
There is an urgent need to study and increase the public’s ability to think critically about health and treatments. Unfortunately, we do not currently have a clear, in-depth understanding of critical thinking about health in the United States, especially its rates among parents and college students, two particularly important groups. This study assessed and characterized critical thinking about health with U. S. parents and college students. We also explored whether critical thinking about health varied as a function of sociodemographic determinants.

Methods
Parents (N = 142) and college students (N = 145) in the U. S. completed an online test of critical thinking about health, and answered questions about their background.

Results
Both parents and college students in the U. S. struggled to think critically about health and treatments based on various science literacy and evidence-based practice principles. Parents with higher educational attainment had lower critical thinking about health, and college students who reported a liberal political affiliation had higher critical thinking scores.

Conclusions
This investigation demonstrates a need to increase critical thinking about health among U. S. parents and college students so they can be empowered to make informed health choices.
An empowerment programme to improve diet quality during pregnancy – the Power 4 a Healthy Pregnancy cluster randomised controlled trial
Authors: van Lonkhuijzen Renske M. , de Vries Jeanne H. M. , Brouwer-Brolsma Elske , Cremers Susanne , Faessen Janine P. M. , Feskens Edith J. M. , Wagemakers Annemarie 
Published: January 2025

Abstract

Background
A healthy diet during pregnancy is vital for the well-being of both mothers and babies. However, navigating dietary choices amidst the unique psychological and physiological changes of pregnancy can be challenging. Empowerment, defined as the ability to improve capacities, critically analyse situations, and take actions to improve them, can support pregnant women to make healthier choices. This intervention study assessed the effects of the ‘Power 4 a Healthy Pregnancy’ (P4HP) programme on diet quality and empowerment.

Methods
In a nonblinded, two-arm, parallel cluster randomised controlled trial, the P4HP programme was implemented in 16 randomly allocated Dutch midwifery practices, recruiting 342 participants. Participants were assigned to either the intervention (n = 186) or the control group (n = 156). The P4HP programme offered four additional consultations during pregnancy to discuss nutrition with both a midwife and dietitian, using an empowerment approach. The effectiveness of the P4HP programme was evaluated using pre- and post-intervention questionnaires assessing diet quality, empowerment, quality of life, sense of coherence, and self-rated health. The data were analysed using linear mixed models with an intention-to-treat approach.

Results
The P4HP programme was conducted from approximately week 11 to week 34 of pregnancy. The total diet quality score significantly improved during pregnancy in the intervention group compared to the control group (4.28; 95% CI: 1.00 to 7.56; p = 0.011), particularly driven by improvements in the scores for vitamin D, iodine, and fish. Although other components, including fruit, whole-grain foods, nuts, dairy foods, iodine, and fish showed greater average increases in diet quality scores within the intervention group, these differences were not significant. Women across all empowerment levels expressed uncertainty regarding their weight gain during pregnancy.

Conclusion
The P4HP programme positively influenced the dietary habits of pregnant women through empowerment. The observed improvement in diet quality underscores the potential of the P4HP programme as an effective intervention during pregnancy. This study lays the foundation for future empowerment-based interventions in maternal health contexts.

Trial registration
International Clinical Trial Registry Platform NL-OMON23191, date of registration: 19/05/2021.
Intensive care nurses’ experiences of teamwork during the covid-19 pandemic. a qualitative study.
Authors: Eckerblad Jeanette , Dorell Åsa , Conte Helen 
Published: January 2025

Abstract

Background
Teamwork is a core competence for all health care professionals and quality of care is a vital outcome. The pandemic backdrop of 2020–2022 led to initial chaos and adaptation of the nurses’ roles and responsibilities in the intensive care unit. Therefore, the purpose was to describe the intensive care nurses’ experiences of working in teams during the Covid-19 pandemic and discussing the results through the lens of transitiontheory.

Methods
Individual and semi-structured interviews were conducted with 16 intensive care nurses. The interview transcripts were analysed using Braun & Clarke’s six-step inductive thematic analysis.

Results
The intensive and critical care nurses’ experiences during the first 18 months of the Covid-19 pandemic captured chronological and conceptual commonalities, which were represented in three themes, “Losing the security of the ICU team”, “Having time to adapt and finding structure for collaborative work”, and “Gaining professional growth through adapting collaborative work to contextual challenges”.

Conclusion
Losing the security of the intensive care unit team, having to adapt to constant changes, and the need to provide care to an increased number of critically ill patients led to a sense of being left to manage on their own. The intensive care unit nurses missed the interprofessional collaboration that had previously been a core part of their professional role. The adaptability and willingness to find solutions helped nurses regain control, manage the challenges they faced and find new ways to collaborate.

Clinical trial number
Not applicable.