bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monarchical Politics in the Netherlands
Authors: Bovend’Eert Paul 
Published: January 2025

Abstract
Coming on the heels of a long republican history, the constitutional monarchy that came into being after the end of French occupation was originally marked by a strong position for the king in government. The first monarch, King William I (1814–1840), conducted a personal, authoritarian regime. Constitutional reforms in 1840 and especially 1848 then opened the way to a parliamentary democracy in the Netherlands. The centre of power gradually moved to the prime minister and cabinet ministers and to parliament. Yet, the position of the king in Dutch government remained relatively strong for a long time, even as the establishment of a parliamentary democracy was completed early in the twentieth century. Queen Wilhelmina (1898–1948) exercised strong influence, particularly over the government in exile during the Second World War. A modern constitutional monarchy within a system of a parliamentary democracy was vested during the reign of Queen Juliana (1948–1980), and confirmed in the 1983 constitution.
Toll/interleukin-1 receptor-only genes contribute to immune responses in maize
Authors: Zhang Qiang , Gao Derong , Tian Lei , Feussner Kirstin , Li Bin , Yang Long , Yang Qin , Zhang Yuelin , Li Xin , Feussner Ivo , Xu Fang 
Published: January 2025

Abstract
Proteins with Toll/interleukin-1 receptor (TIR) domains are widely distributed in both prokaryotes and eukaryotes, serving as essential components of immune signaling. Although monocots lack the major TIR nucleotide-binding leucine-rich repeat-type (TNL) immune receptors, they possess a small number of TIR-only proteins, the function of which remains largely unknown. In the monocot maize (Zea mays), there are 3 conserved TIR-only genes in the reference genome, namely ZmTIR1 to ZmTIR3. A genome-wide scan for TIR genes and comparative analysis revealed that these genes exhibit low sequence diversity and do not show copy number variation among 26 diverse inbred lines. ZmTIR1 and ZmTIR3, but not ZmTIR2, specifically trigger cell death and defense gene expression when overexpressed in Nicotiana benthamiana leaves. These responses depend on the critical glutamic acid and cysteine residues predicted to be essential for TIR-mediated NADase and 2′,3′-cAMP/cGMP synthetase activity, respectively, as well as the key TIR downstream regulator Enhanced Disease Susceptibility 1 (EDS1). Overexpression of ZmTIR3 in N. benthamiana produces signaling molecules, including 2′cADPR, 2′,3′-cAMP, and 2′,3′-cGMP, a process that requires the enzymatic glutamic acid and cysteine residues of ZmTIR3. ZmTIR expression in maize is barely detectable under normal conditions but is substantially induced by different pathogens. Importantly, the maize Zmtir3 knockout mutant exhibits enhanced susceptibility to the fungal pathogen Cochliobolus heterostrophus, highlighting the role of ZmTIR3 in maize immunity. Overall, our results unveil the function of the maize ZmTIRs. We propose that the pathogen-inducible ZmTIRs play an important role in maize immunity, likely through their enzymatic activity and via EDS1-mediated signaling.
Delusional Themes are More Varied Than Previously Assumed: A Comprehensive Systematic Review and Meta-Analysis
Authors: Pappa Elisavet , Baah Fidelia , Lynch Jessica , Shiel Lisha , Blackman Graham , Raihani Nichola , Bell Vaughan 
Published: January 2025

Abstract

Background and Hypothesis
Delusions are classified into themes but the range of themes reported in the literature has never been examined and the extent to which they differ in prevalence, or relate to clinical characteristics or cultural variation, remains poorly understood.

Study Design
We identified studies reporting delusional theme prevalence in adults with psychosis and completed two multivariate, multilevel, random-effects meta-analyses: one including data from structured assessment scales only and another also including data from ad hoc and clinical assessments to include themes from a wider range of countries and contexts. Sensitivity and meta-regression analyses examined the association with clinical and methodological variables. Analysis code and open data are available online. PROSPERO registration (CRD42019151889).

Study Results
A total of 155 studies from 37 countries met inclusion criteria. The meta-analysis of data from structured assessments included 110 studies and 173 920 patients. A total of 21 themes were identified from “persecutory/paranoid” (57.33%, 53.75-60.88) to “primary” (5.18%, 1.07-11.55). The meta-analysis of all data included 155 studies and 240 901 patients. Thirty-seven themes were identified, from “persecutory/paranoid” (57.39%, 54.38-60.37) to “made impulse” (4.90%, 0.87-11.26). Ad hoc theme classifications were more common in non-Western contexts. Including these did not substantially alter heterogeneity but increased interaction with cultural clusters. There was no evidence of publication bias or association with risk of bias rating.

Conclusions
We report the first comprehensive meta-analysis of delusional themes. Many commonly reported themes are not included in standard classifications. Relationship to culture was modest but more present when not relying solely on established scales.
Outcomes of a PA/APRN grand rounds pilot
Authors: Pinyan Elizabeth C. , Tysinger Elizabeth , Zimmer Rachel , Griffin Kathleen Wetherell , Ronsheim Eileen , McKinnond Andrea , Okoye Chisom , DeTroye Alisha T. 
Published: January 2025

ABSTRACT
This article describes a framework for the development, implementation, and effect of advanced practice provider (APP) grand rounds. A team of certified registered nurse anesthetists (CRNAs), NPs, and physician associates/assistants (PAs) developed and operationalized a grand rounds initiative in 2019. Since January 2020, 34 live monthly learning sessions have been held in person and virtually. Surveys using Likert-scale questions were provided postattendance to attendees to assess educational growth and opportunities for improvement in future programming. Attendees also were offered an opportunity to give open-ended feedback. Recordings of each presentation were analyzed to identify content alignment with stated academic medical center system goals. Most attendees reported increased projected medical competence, performance, and perceived projected effect on patient outcomes after attending grand rounds. Grand rounds are a novel model for increasing PA, NP, certified nurse-midwife, and CRNA engagement; enhancing evidence-based medical knowledge; and advancing stated academic medical center system goals.
Bullying Behaviors in Clinical Settings
Authors: Rutherford Dawna , Gillespie Gordon Lee , Bresler Scott , Johnson Kimberly , Smith Carolyn R. 
Published: January 2025

Abstract
Nursing students exposed to bullying behaviors are at risk for making medication errors. For a quasi-experimental study, 15 prelicensure nursing students at a Midwestern university were exposed to simulated bullying behaviors or common distractions while administering medications in a laboratory setting. Data were analyzed using Kruskal-Wallis tests. There was no significant difference in medication administration rubric score (H[2] = 1.489, p = .475) or time spent in room (H[2] = 1.778, p = .411) between groups. Bullying behaviors and other interruptions distracted nursing students from successfully completing the medication administration simulation.
Surgical Approach and Variation in Long-Term Survival Following Colorectal Cancer Surgery Using Instrumental Variable Analysis
Authors: Mullens Cody Lendon , Sheskey Sarah , Norton Edward C. , Thumma Jyothi R. , Nathan Hari , Regenbogen Scott E. , Sheetz Kyle H. 
Published: January 2025

Objective:
The study aimed to determine whether increased use of minimally invasive surgical approaches, compared with open, improves long-term survival after colon and rectal cancer resections.

Background:
Existing prospective and observational data comparing surgical approach for colon and rectal cancer are limited by selection bias, necessitating better approaches for causal inference to understand the relationship between surgical approach and long-term survival.

Methods:
We included colon and rectal cancer patients who underwent colon or rectal resection from the American College of Surgeons National Cancer Database between 2011 and 2018. Using an instrumental variable (IV) approach, we accounted for measured and unmeasured differences between patients undergoing colon or rectal cancer resection based on operative approach – robotic, laparoscopic, or open. The IV used in this study was rate of robotic-assisted colon and rectal cancer surgery within 81 different hospital regions based on US Census region and rurality during the 12 months before each patient’s operation. Proportional hazard modeling was used to estimate risk-adjusted mortality rates.

Results:
There were 326,406 colon and 96,979 rectal cancer patients included in this study. The risk-adjusted 5-year cumulative incidence of mortality for colon and rectal cancer was highest for patients who underwent open approaches (35.73 [95% confidence interval {CI}: 35.37–36.1] and 39.27 [95% CI: 28.44–30.13], respectively), compared with lower mortality for those undergoing laparoscopic (28.91 [95% CI: 28.55–29.27] and 22.93 [95% CI: 22.11–23.78], respectively) and robotic approaches (26.39 [95% CI: 24.51–28.42] and 19.77 [95% CI: 17.32–22.43], respectively). Growth in utilization of minimally invasive approaches outpaced improvements in long-term survival.

Conclusions:
Patients undergoing minimally invasive surgical approaches for colon and rectal cancer had improved long-term survival. However, long-term survival changes did not correlate with the large expansion of minimally invasive approaches, which suggests that growing these approaches is not a viable strategy to improve long-term patient outcomes.
Utilizing Image Processing Techniques for Wound Management and Evaluation in Clinical Practice: Establishing the Feasibility of Implementing Artificial Intelligence in Routine Wound Care
Authors: Dabas Mai , Kapp Suzanne , Gefen Amit 
Published: January 2025

ABSTRACT

OBJECTIVE
To develop a generalizable and accurate method for automatically analyzing wound images captured in clinical practice and extracting key wound characteristics such as surface area measurement.

METHODS
The authors used image processing techniques to create a robust algorithm for segmenting pressure injuries from digital images captured by nurses during clinical practice. The algorithm also measured the real-world wound surface area. They used the hue-saturation-value color space to analyze red color values and to detect and segment the wound region within the entire image. To assess the accuracy of the algorithm’s wound segmentation, the authors compared the results against wound image annotations.

RESULTS
The algorithm performed impressively, achieving an intersection-over-union score of up to 0.85 and 100% intersection with the annotations. The algorithm effectively analyzed wound images obtained during clinical practice and accurately extracted the surface area of the documented pressure injuries. These results support the feasibility and applicability of this methodology.

CONCLUSIONS
Accurate determination of wound size and healing supports decision-making regarding treatment and is essential to successful outcomes. This innovative approach for visual assessment of chronic wounds highlights the potential of computerized wound analysis in clinical practice. By leveraging advanced computational techniques, healthcare providers can gain valuable insights into wound progression, enabling more accurate assessments to support their decision-making.
Adjunctive Hyperbaric Oxygen Therapy for Patients with Chronic Refractory Osteomyelitis: A Report of Treatment Outcomes and Risk Factors for Treatment Failure
Authors: Jackson J. Benjamin , Bakaes Yianni , Jacques Ben , Gauthier Chase , Mills William L. , Nguyen Kenny , Gonzalez Tyler , Cone David L. 
Published: January 2025

ABSTRACT

OBJECTIVE
To evaluate the effect of hyperbaric oxygen (HBO) therapy on the outcomes of patients with chronic refractory osteomyelitis (CRO) when combined with modern antibiotics with modern delivery methods and/or surgical treatments.

METHODS
The authors conducted a retrospective review on 58 patients with CRO from a single institution who underwent HBO therapy along with standard treatment between January 2009 and December 2019. To investigate associations with binary outcomes of interest, they estimated logistic regression models. All models were adjusted for sex, smoking status, and pertinent comorbidities. Exponentiated logistic regression model coefficients were interpreted as odds ratios for each outcome of interest. Multivariable logistic regression was used to control for potential confounding variables.

RESULTS
When controlling for multiple confounding factors, patients who completed HBO treatment had 7.76 times the odds of having improvement of their CRO compared with patients who started HBO treatment but did not complete it (P = .015). Further, patients who completed HBO treatment had 7.7 times the odds of experiencing CRO improvement when controlling for CRO stage (P = .006). However, completion of HBO did not statistically significantly impact the resolution of CRO or the odds of further surgery or amputation. Patients with diabetes, peripheral vascular disease, and congestive heart failure had increased odds of having an amputation (Ps = .026, .037, and .024, respectively).

CONCLUSIONS
Patients who completed HBO treatment had increased odds of experiencing improvement of their CRO compared with patients who started HBO treatment but did not complete it. Patients with CRO who had diabetes and congestive heart failure had increased odds of undergoing an amputation.
Scleredema: An Unusual Cutaneous Manifestation of Coronavirus Infection
Authors: Hemrajani Priyanka , Sharma Mona , Gupta Piyush , Dhali Tapan Kumar , D’souza Paschal 
Published: January 2025

ABSTRACT
The global pandemic caused by COVID-19 led to numerous novel cases of autoimmune and rheumatologic disorders that developed postinfection. Along these lines, these authors report an unusual case of scleredema following SARS-CoV-2 infection in an individual who lacked any known risk factors. Given the emergence of newer mutant strains of COVID-19 and steadily rising numbers of people receiving COVID-19 vaccinations, physicians should remain alert for as yet unrecognized manifestations of the disease.
Healthcare Costs of Pressure Injuries among Patients with a Spinal Cord Injury within a Dutch Rehabilitation Center
Authors: Wijker Boas J. , de Groot Sonja , Boertje Anne-Fleur , Adriaansen Jacinthe J. E. , Achterberg-Warmer Wendy J. , Wighman Amber , van Tulder Maurits W. , Janssen Thomas W. J. , van Dongen Johanna M. 
Published: January 2025

ABSTRACT

OBJECTIVE
To assess the healthcare costs of pressure injuries (PIs) among patients with a spinal cord injury (SCI) in a Dutch rehabilitation center and determine if those costs were associated with patients’ age or sex.

METHODS
The direct healthcare costs of PIs were estimated using data from electronic health records of a Dutch rehabilitation center. This dataset contained demographic, clinical, and resource use information of all patients with an SCI or a PI who were treated at the rehabilitation center because of a PI between 2009 and 2022. Standard prices were used to value inpatient rehabilitation, whereas a micro-costing approach was used to value outpatient consultations and material costs. Using ordinary least squares regression analyses, the authors assessed whether the costs were associated with age and sex, after correcting for the patients’ length of PI care.

RESULTS
Between 2009 and 2022, 409 patients with an SCI were treated at the rehabilitation center for a PI. The patients’ mean total length of PI care was 883 ± 1,266 days (median, 137 days; interquartile range, 10–1,620). The mean total rehabilitation cost of PIs among these patients was €15,412 (USD $16,836) per patient with a mean total annual rehabilitation cost of €6,368 (USD $6,956) per patient. Costs were not significantly associated with age and sex.

CONCLUSIONS
The healthcare costs of PIs among patients with an SCI in a Dutch rehabilitation center represent a significant economic burden. Prevention of PIs seems warranted, not only from a clinical perspective, but also from a health economic perspective.
Neuromuscular Electrostimulation Increases Microcirculatory Flux in Mixed Etiology Leg Ulcers
Authors: Harding Keith Gordon , Blow Melissa , Ashton Faye , Bosanquet David C. 
Published: January 2025

ABSTRACT

OBJECTIVE
To determine if intermittent neuromuscular electrostimulation (NMES) of the common peroneal nerve increases microvascular flow and pulsatility in and around the wound bed of patients with combined venous and arterial etiology.

METHODS
Seven consenting participants presenting with mixed etiology leg ulcers participated in this study. Microvascular flow and pulsatility was measured in the wound bed and in the skin surrounding the wound using laser speckle contrast imaging. Measurements were made at baseline and when the venous pumps of the leg were activated by 1 Hz intermittent neuromuscular stimulation of the common peroneal nerve. The nerve was stimulated transdermally at the head of the fibula.

RESULTS
When activated by NMES, wound bed flux increased by 38% (95% CI, 11%–73%; P = .023), and periwound flux increased by 19% (95% CI, 9%–32%; P = .009). Pulsatility increased in the wound bed by 214% (95% CI, 51%–985%; P = .017) and in the periwound by 122% (95% CI, 38%–299%; P = .014).

CONCLUSIONS
The results indicate that NMES is effective in augmenting microvascular flow in leg ulcers with combined venous and arterial etiology.
Managing Calciphylaxis: Insights from Real-World Cases at a Tertiary Academic Center
Authors: Kochhar Kanika , O’Dell Brennen , Torrence Garneisha , Johnson Alton , Spitler Carey , Schmidt Brian 
Published: January 2025

ABSTRACT
Calciphylaxis is a rare and potentially fatal condition involving chronic, nonhealing wounds caused by microvascular calcification. There is currently no approved treatment for calciphylaxis, contributing to its devastating impacts on quality of life. In this case series, the authors highlight instances of potentially misdiagnosed calciphylaxis in a cohort of patients and emphasize the importance of accurate diagnosis through multidisciplinary management approaches.
The authors report on three patients treated at a large tertiary academic center between March 2021 and March 2023. Consent was obtained from all patients, including for the use of patient images. The first and second patients, a 75-year-old man and 62-year-old woman, respectively, both underwent an extensive course of local wound care as well as sodium thiosulfate therapy. The third patient, a 61-year-old woman, was treated with a combination of medication adjustments, lymphedema therapy, pulse lavage treatment, and cadaveric skin substitute. Tissue biopsy was also obtained in two of the three subjects to aid in the diagnosis of calciphylaxis. Unfortunately, these procedures lead to diagnostic challenges and misadventures, highlighting the risks associated with biopsy of calciphylaxis.
This case series demonstrates how correctly diagnosing calciphylaxis relies heavily on providers maintaining a high index of clinical suspicion based on patient history, presentation, and risk factors. The primary goals of treatment for calciphylaxis include appropriate wound care, management of infection and pain, and close monitoring.
Outcomes of elective total knee arthroplasty in nonagenarians and centenarians
Authors: Plantz Mark A. , Goedderz Cody , Hilow Henry , Peabody Michael , Dooley Jennings , Weissman Joshua P. , Hardt Kevin 
Published: January 2025

Introduction:
Among the fastest growing age demographics are individuals in their ninth decade of life. As the population in the United States ages and life expectancy increases, more elderly individuals are pursuing elective orthopaedic procedures, including total knee arthroplasty (TKA).

Methods:
The American College of Surgeons NSQIP database was used to identify patients undergoing elective TKA between January 1st, 2007 and December 31st, 2017. Exact propensity score matching was used to match patients aged 90 years and older to patients between 65-89 years-old based on demographic factors and comorbidities. 30-day outcome measures and complications were compared between the two age groups. Binary logistic regression was used to identify risk factors for adverse events in the matched nonagenarian patients.

Results:
150,326 patients were included in the final cohort (65-89 year-olds: 149,721; 90+ year-olds: 605). 585 patients aged 65-89 years-old were then propensity matched to 585 patients aged 90+ years-old. Statistically similar rates of reoperation (P=0.207), mortality (P>0.999), and overall medical complications (P=0.055) were noted between the two groups; however, nonagenarians and centenarians were more likely to have an unplanned hospital readmission (P=0.049) and non-home discharge (P<0.001). 90+ year-olds were less likely to experience bleeding requiring transfusion (P<0.001). Hypertension, ASA class IV, and a history of bleeding disorder were independent risk factors for adverse outcomes.

Conclusion:
TKA can be a safe and viable treatment option for nonagenarians and centenarians and recommend that comorbidity profiles, rather than age, principally guide shared clinical decision making.
Multiple Model Optimal Sampling Promotes Accurate Vancomycin Area-Under-the-Curve Estimation Using a Single Sample in Critically Ill Children
Authors: Downes Kevin J. , Sharova Anna , Malone Judith , Odom John Audrey R. , Zuppa Athena F. , Neely Michael N. 
Published: January 2025

Background:
Area-under-the-curve (AUC)-directed vancomycin therapy is recommended; however, AUC estimation in critically ill children is difficult owing to the need for multiple samples and lack of informative models.

Methods:
The authors prospectively enrolled critically ill children receiving intravenous (IV) vancomycin for suspected infection and evaluated the accuracy of Bayesian estimation of AUC from a single, optimally timed sample. During the dosing interval, when clinical therapeutic drug monitoring was performed, an optimally timed sample was collected, which was determined for each subject using an established population pharmacokinetic model and the multiple model optimal function of Pmetrics, a nonparametric population pharmacokinetic modeling software. The model was embedded in InsightRx NOVA (InsightRx, Inc.) for individual Bayesian estimation of AUC using the optimal sample versus all available samples (optimally timed sample + clinical samples).

Results:
Eighteen children were included. The optimal sampling time to inform Bayesian estimation of vancomycin AUC was highly variable, with trough samples being optimally informative in 32% of children. Optimal samples were collected by clinical nurses within 15 minutes of the goal time in 14 of 18 participants (78%). Compared with all samples, Bayesian AUC estimation with optimal samples had a mean bias of 0.4% (±5.9%) and mean imprecision of 4.6% (±3.6%). Bias of optimal sampling was <10% for 17 of the 18 participants (94%). When estimating AUC using only a peak sample (≤2 hours after dose) or only a trough (≤30 minutes before next dose), bias was <10% for 78% and 86% of participants, respectively.

Conclusions:
Optimal sampling supports accurate Bayesian estimation of vancomycin AUC from a single plasma sample in critically ill children.