bluuebunny/crossref_metadata_2025_split huggingface dataset:
Re-screening adherence to multi-target stool DNA test for colorectal cancer: real-world study in a large national population
Authors: Greene Mallik , Pew Timo , Dore Michael , Ebner Derek W. , Ozbay A. Burak , Johnson William K. , Kisiel John B. , Fendrick A. Mark , Limburg Paul 
Published: February 2025

Abstract

Purpose
Adherence to colorectal cancer (CRC) re-screening is essential to maximize screening effectiveness. This study assessed adherence to a multi-target stool DNA (mt-sDNA) test among previous users in the USA across different payer types.

Methods
Data from Exact Sciences Laboratories LLC (01/01/2023–12/31/2023) were used. Insured patients (45–85 years) who were shipped an mt-sDNA test during the data coverage period and had previously completed mt-sDNA screening with a negative result ≥ 2.5 years prior were included. Mt-sDNA re-screening adherence rate and mean time to test return were compared across payer types, and their associations with patient characteristics were assessed using multivariable regression models.

Results
Of 793,567 patients (50–75 years: 89.0%; female: 62.0%), the re-screening adherence rate was 84.0% (from 66.5% for Medicaid to 90.2% for Medicare); mean (standard deviation) time to test return was 20.7 (20.8) days (from 19.2 [19.7] for Medicare to 22.4 [22.2] for Medicaid). Characteristics associated with higher likelihood of re-screening adherence included older ages (odds ratio [OR] = 1.25 and 1.11 for 65–75 and 76–85 years, respectively, relative to 45–49 years), living in a ZIP code with higher median household income (OR = 1.80 for > $200,000 relative to < $50,000), full digital outreach (OR = 1.84 relative to no digital outreach), and ≥ 3rd rounds of screening (OR = 2.44 relative to 2nd round of screening).

Conclusion
Adherence to CRC re-screening with mt-sDNA test was high across payer types, with sustained adherence in later rounds of screening. Strategies to improve re-screening rates in subgroups associated with lower re-screening adherence are warranted.
Chronic pain management for older adults in ambulatory care
Authors: Koios Daniela , Wenzel Arlett , Kuhnert Ronny , Rank Christina , Riemer Thomas Günther , Glawe Magdalena , Kreutz Reinhold , Dräger Dagmar 
Published: February 2025

Abstract
Chronic pain is a major health challenge in older populations and approaches to improve ambulatory care are urgently needed. We conducted a pragmatic trial to test whether staff-directed interventions can improve chronic pain management in older community-dwelling adults and thereby improve their pain situation. Participants of 22 ambulatory nursing services (clusters) were allocated to 3 study arms: I1 (individual intervention with recommendations for each participant’s physician and a newly trained pain nurse), I2 (digital training offered for participants’ physicians and nursing staff) and CG (control group). Survey-based face to face interviews were held at the participants’ homes. Descriptive statistics, ANOVA, and χ2-tests were utilized for data analysis. At baseline, 190 and at follow-up 144 participants were analyzed (24% dropout). Overall, the interventions were only implemented by a small proportion of involved staff. We found significant changes in documented nursing care in I1 but improvements regarding pain medication appropriateness or pain situations of participants could not be achieved. Structural challenges like time and staff shortages as well as the lack of billing options in ambulatory care were identified as major obstacles to substantially improve pain care. Policy makers need to enable appropriate compensation models for chronic pain care at home to enable aging in place for a growing population of older adults.
In-hospital outcomes of catheter ablation in atrial arrhythmias: a nationwide analysis of 2,901 patients with adult congenital heart disease compared to 787,995 without
Authors: Grundmann Sebastian , Kaier Klaus , Maier Alexander , Rilinger Jonathan , Steinfurt Johannes , Stiller Brigitte , Westermann Dirk , von zur Mühlen Constantin , Jäckel Markus 
Published: February 2025

Abstract

Background
Advances in pediatric cardiology and congenital heart surgery have increased the adult population with congenital heart disease (CHD), now facing long-term complications like atrial arrhythmias. Given the limited data and safety concerns in this unique and vulnerable patient group, this study analyzes in-hospital outcomes of atrial catheter ablation in CHD patients versus non-CHD patients from a German nationwide real-world registry.

Methods
Using health records, all atrial catheter ablation procedures in Germany from 2008 to 2021 were analyzed. After adjustment for confounders, safety performance endpoints were compared between patients with and without CHD.

Results
From 2008 to 2021, 790,896 patients underwent right or left atrial catheter ablation in Germany. Of these, 1004 patients were classified as simple CHD, 1,054 patients as moderate CHD and 843 patients as complex CHD. Age at time of procedure was lower with increasing complexity of the CHD. Atypical atrial flutter (5.5% vs. 21.8%; p < 0.001) and other atrial tachycardias (21.2% vs. 42.2%; p < 0.001) occurred more often in patients with complex CHD compared to patients without. Combined ablation in both atria was more often performed in complex CHD. Despite higher complexity, in-hospital mortality (< 0.2%) and other investigated complications were rare. After adjustment for baseline characteristics, type of arrhythmia and ablation location, the relative risk for serious adverse events (combination of mortality, stroke, intracerebral bleeding or pericardiocentesis) did not show a significant difference for patients with CHD.

Conclusion
Even in patients with CHD, complications are rare and after adjustment, no differences were identified concerning serious adverse events. Therefore, an ablation should not be generally avoided in patients with CHD due to concerns about complications although an individualized evaluation of the anatomy must be taken into account.

Graphical Abstract
Sex-related hormonal variances and clinical outcomes in TAVR patients
Authors: Mousa Basha Mustafa , Al-Kassou Baravan , Weber Marcel , Beiert Thomas , Bakhtiary Farhad , Zimmer Sebastian , Nickenig Georg , Goody Philip Roger , Shamekhi Jasmin 
Published: February 2025

Abstract

Background
Sex-related differences play a pivotal role in disease manifestation and outcome in patients with cardiovascular disease, including aortic valve stenosis (AS). However, data regarding sex-related hormonal differences in AS patients undergoing transcatheter aortic valve replacement (TAVR) is lacking.

Objectives
We aimed to assess sex-related hormonal variances in patients with severe symptomatic AS and to evaluate the impact of these hormonal differences on the clinical outcomes after TAVR.

Methods
In a total of 361 TAVR patients, we assessed the hormonal status, including cortisol, parathormone (PTH), insulin-like growth factor 1 (IGF-1), dehydroepiandrosterone sulfate (DHEAs), estradiol, progesterone and testosterone prior to TAVR. We compared baseline characteristics and outcome data according to sex and hormonal parameters. The primary endpoint was 1-year all-cause mortality according to sex; secondary endpoints included the risk of 1-year all-cause mortality in conjunction with hormone levels, with pre-specified cut-off values.

Results
Rates of 1-year all-cause mortality were comparable between the sexes (p = 0.285). Cox regression analysis revealed significant associations between 1-year mortality and levels of cortisol (HR 2.30; p = 0.007), PTH (HR 2.09; p = 0.019), DHEA-S (HR 0.47; p = 0.016), and IGF-1 (HR 0.42; p = 0.004) in the overall cohort. Elevated cortisol levels (p = 0.011), decreased DHEA-S levels (p = 0.007), and lower IGF-1 levels (p = 0.017) were significantly associated with higher rates of 1-year all-cause mortality in males. Conversely, higher PTH levels were significantly associated with an increased risk of 1-year mortality in females (p = 0.012).

Conclusion
Sex-specific hormonal differences significantly impact the prognosis of severe AS patients undergoing TAVR. Elevated cortisol levels and decreased DHEA-S and IGF-1 levels in males, as well as higher levels of PTH in females, were associated with an increased mortality risk.
Foodservice interventions and their influence on nutritional outcomes and satisfaction of adult oncology patients—a conceptual replication
Authors: Steer Belinda , Black Jacqueline , Cecchini Laura , Choo Clarissa , Dvarakesa Ana , Hill Martha , Ho Athena , Kennett Georgia , Woltersdorf Andre , Zilber Emily , Porter Judi 
Published: February 2025

Abstract

Background
Foodservices are vital components of care for oncology patients across all settings. This conceptual replication aimed to explore the influence of foodservice interventions across a range of nutritional outcomes and the satisfaction of hospitalised and ambulatory adult oncology patients.

Methods
The review protocol was registered with PROSPERO (CRD42023447351). Six databases were searched using search terms associated with the intervention and population. There were no restrictions on language or publication date. The inclusion criteria were applied to titles and abstracts, then full-text papers. All included papers were assessed for study quality. Outcome data were synthesised narratively, and vote counting was conducted based on the direction of effect.

Results
Eight studies testing the influence of a foodservice intervention were included. Interventions included technology advancement, high energy high protein meals and snacks, and patient-focused foodservice models. Study quality was assessed as positive for seven of the studies. Of nutritional outcomes reported (energy and protein intake, body weight, muscle mass), improvements were seen in all but one study. Except in one study, where reported, patient satisfaction improved as a result of the intervention.

Conclusion
Original research into the impact of systematic foodservice interventions has expanded in recent years. This conceptual replication found that the implementation of small, frequent high-energy high-protein meals and snacks, and patient-focused foodservice models may improve nutritional outcomes and satisfaction in both inpatient and ambulatory settings. Further large-scale research that explores multiple interventions and cost-effectiveness is required.
Safety and outcome of elective synthetic mesh repair for incisional ventral hernias in immunosuppressed patients – a retrospective propensity-score-matched analysis
Authors: Saidy Ramin Raul Ossami , Callister Yvonne May , Dittrich Luca , Eurich Dennis , Denecke Christian , Pratschke Johann , Raakow Jonas 
Published: February 2025

Abstract

Introduction
Incisional hernia remain an important complication after abdominal surgery. Repair often includes use of synthetic mesh, but certain risk factors for complication after mesh hernia repair have been described. Among these, immunosuppression due to co-existing conditions is hypothesized to increase postoperative complications, but data is scarce and contradicting. Therefore, the aim was to assess outcome after mesh hernia repair in immunosuppressed patients.

Material & methods
Patients with and without immunosuppression undergoing elective incisional hernia repair at our clinic between 2010 and 2019 were analyzed in this retrospective study. Pre-existing conditions, details of immunosuppression, postoperative course and outpatient follow-up for hernia recurrence were collected and impact of clinical variables on outcome was analyzed. Propensity score matching was performed for comparison of cohorts.

Results
Immunosuppression was associated with increased postoperative complications in the overall cohort of 732 patients undergoing incisional ventral hernia repair in univariate but not multivariate analysis (p = 0.036 and p = 0.25, respectively). Overall postoperative complications did not differ between patients with immunosuppression compared to the matched collective. However, use of > 2 immune suppressive agents and immunosuppression history > 48 months showed significant impact on postoperative complications in univariate and multivariate analysis (p = 0.003/p = 0.023 and p = 0.018/p = 0.03, respectively). Age (< 60 years), duration of surgery (> 120 min), midline hernia according to EHS classification and number of immunosuppressive agents administered were identified as important risk factors for recurrence in immunocompromised patients (p = 0.045, p = 0.023, p = 0.012 and 0.049, respectively).

Conclusion
In this study, overall safety with desirable outcome of mesh implantation in immunosuppressed patients was documented. Furthermore, data suggested significant impact of number of immunosuppressive agents as a predicator of postoperative complications in this collective, possibly enabling risk stratification within this subgroup.
Epilepsy as primary tumor manifestation correlates with patient status, age, and tumor volume but not with survival in elderly glioblastoma patients: a retrospective bicentric analysis
Authors: Demetz Matthias , Hecker Constantin , Salim Hamza Adel , Krigers Aleksandrs , Steinbacher Jürgen , Machegger Lukas , Kerschbaumer Johannes , Buchta Melanie , Pöppe Johannes , Geiger Philipp , Spinello Antonio , Kraus Theo F. J. , Griessenauer Christoph J. , Thomé Claudius , Freyschlag Christian F. , Schwartz Christoph 
Published: February 2025

Abstract
Assessment of the potential impact of epilepsy as primary tumor manifestation on survival in elderly glioblastoma multiforme (GBM) patients. Two academic neurosurgical centers retrospectively analyzed all GBM patients aged 65 years and older with de-novo tumors, who underwent surgery between 2006 and 2021. Epidemiological, histopathological, imaging and survival data were obtained from patients’ electronic charts, and screened for the presence of epilepsy preoperatively and during follow-up. Patient status was assessed by the Karnofsky Performance Scale (KPS), epilepsy was evaluated using the Engel classification. Patients were categorized in an epilepsy cohort (i.e. patients with epilepsy as primary GBM manifestation, and a reference cohort (i.e. patients with no initial epilepsy). This study analyzed 451 GBM patients (55% males); median age at tumor diagnosis was 73 years. The epilepsy cohort was younger (71.0 vs. 74.0 year; p = 0.001), had better KPS (80 vs. 70; p = 0.039), and had smaller tumors (127 vs. 221 cm3; p = 0.001) compared to the reference cohort. There were no differences with regard to neurosurgical treatment (i.e. resection vs. biopsy), tumor biomarkers, surgery-associated complications, and performed adjuvant treatment (all p > 0.05). We did not detect a significant difference in median survival between the epilepsy and reference cohorts (8 vs. 6 months; p = 0.21). New epilepsy during follow-up often coincided with tumor recurrence/progression, but also did not significantly affect survival. The majority of patients (98%) achieved seizure freedom by a combination of tumor-specific treatments and antiseizure medication. Epilepsy as primary tumor manifestation does not correlate with survival in elderly GBM patients.
The Inner Ear and Aging Brain: A Cross-Sectional Study of Vestibular Function and Morphometric Variations in the Entorhinal and Trans-Entorhinal Cortex
Authors: Vania Claire J. , Padova Dominic , Ratnanather J. Tilak , Agrawal Yuri 
Published: February 2025

Abstract

Purpose
While the vestibular system is crucial for balance, posture, and stable vision, emerging evidence connects vestibular loss in older adults to spatial cognitive deficits. However, the specific neural pathways remain unclear. This study examines morphometric changes in the entorhinal cortex (ERC) and trans-entorhinal cortex (TEC), key regions in the vestibular spatial cognitive network, with vestibular function.

Methods
This cross-sectional study used T1-weighted MRI images and vestibular physiological data from 103 Baltimore Longitudinal Study of Aging participants (74 males and 29 females). Vestibular function was assessed through the cervical vestibular-evoked myogenic potential (cVEMP), ocular VEMP (oVEMP), and video head–impulse test (vHIT), examining both categorical presence/absence of responses and continuous measures (cVEMP amplitude, oVEMP amplitude, and VOR gain). Morphometric changes in the ERC and TEC were analyzed by examining surface expansions and contractions relative to average shapes.

Results
Reduced saccular function correlated with surface expansion in the left ERC’s pro-rhinal, right ERC’s intermediate caudal and superior regions, and right TEC’s sulcal region. The decreased utricular function was associated with surface contraction in the left lateral TEC, left ERC’s anterior sulcal and trans-entorhinal regions, and surface expansion in the lateral region of the left ERC. Reduced canal function showed surface contraction in the right ERC’s pro-rhinal and lateral regions and the right TEC’s posterior sulcal and trans-entorhinal regions.

Conclusion
These findings highlight the intricate link between vestibular function and ERC/TEC morphology, emphasizing their role in spatial and cognitive abilities. Future research will assess if structural changes due to vestibular loss contribute to cognitive deficits in aging and Alzheimer’s disease.
Life-cycle seismic resilience of deteriorating highway bridges under mainshock-aftershock sequences
Authors: Feng Ruiwei , Elghazouli Ahmed Y. , Li Yaohan , Dong You , Wang Zhengnan 
Published: February 2025

Abstract
Reinforced concrete highway bridges often experience seismic events coupled with progressive deterioration due to corrosion over their lifespan. In many cases, the seismic mainshocks are followed by significant aftershocks, causing cumulative damage that disrupts normal operations and delays the restoration of bridges. Current research however lacks detailed assessment of seismic resilience considering the effects of aftershocks and corrosion deterioration over the lifetime of bridges. This study proposes a methodology for evaluating the life-cycle seismic resilience of deteriorating structures under mainshock and aftershock (MS-AS) sequences. Three multi-span reinforced concrete highway bridges with different geometries are used as benchmarks. A suite of 80 pairs of ground motion sequences is selected for undertaking the resilience evaluations based on the seismic scenarios considered. The Park-Ang damage index is adopted for the purpose of quantifying the cumulative damage. Nonlinear dynamic analysis is used to provide detailed insights into the mechanisms through which the aftershocks affect the cumulative damage. Based on the results, time-dependent system fragility curves under MS-AS sequences are developed in conjunction with a cumulative damage capacity model for the bridge piers. The seismic resilience of the bridges is subsequently assessed under ground motion sequences at different service times, and the effects of aftershocks and corrosion-induced deterioration on the resilience are examined. Finally, the life-cycle seismic resilience of the deteriorating benchmark bridges under MS-AS sequences is evaluated using the suggested framework. It is shown that the influence of aftershocks on the cumulative damage depends on a number of inter-related factors, including the relative mainshock-aftershock intensity as well as the dynamic characteristics of the bridges. The findings highlight the merits of the proposed framework in evaluating the life-cycle seismic resilience of bridges for different hazard scenarios and deterioration conditions.
A review of threatened and poorly known samphires in Australia: their distribution, observed environmental threats and ecological responses
Authors: Monie Kristin , Turner Shane R. , Palmer Grant , Florentine Singarayer 
Published: February 2025

Abstract
Australia is home to a rich assemblage of samphires (Tecticornia and Salicornia spp.) which are largely endemic, inhabiting saline and semi-saline areas across climatically diverse regions. While these plants are adapted to harsh conditions, they are vulnerable to the effects of climate change which is anticipated to exacerbate existing management and environmental pressures. Despite the threatened and priority status of many samphires, there is an overall lack of knowledge surrounding their distribution, ecology and responses to environmental threats, data which we believe is critical to support their conservation and management. We have compiled and critically assessed peer-reviewed and online grey literature and databases to provide an overview of threatened and poorly known samphires in Australia, with particular reference to their distribution, threats and ecological responses. Of the 58 species and 19 subspecies recorded in Australia, two are federally listed as threatened, eight have a formal conservation listing in at least one state or territory, and 25 are recognised as data deficient or priority taxa. Five samphire communities are also listed as threatened and seven are considered Priority Ecological Communities. We found gaps in data relevant to these threatened and priority species, with 40% having fewer than 20 distribution records available nationally. Species were distributed across 11 Conservation Management Zones (and 27 biogeographic regions). Despite their legislative protection, few species have management or recovery plans or peer reviewed ecological studies to guide conservation and management efforts. We propose further research to support effective management of these unique species and ecological communities.
A Value-Free, Diversity-Sensitive Measure of Freedom
Authors: Côté Nicolas 
Published: February 2025

Abstract
Numerous philosophers and economists have argued that the extent of one’s freedom depends in part on how diverse one’s options are. However, such efforts have met resistance from political philosophers who regard diversity-sensitive measures of freedom as objectionably value-laden. I present a new way of incorporating diversity considerations in the measure of freedom that is scrupulously value-neutral. It is also quite successful in capturing common intuitions about freedom and diversity: in particular, it is sensitive to the degree of dissimilarity between extremal and non-extremal options.
Max-semistable extreme value laws for autoregressive processes with Cantor-like marginals
Authors: Sterk Alef E. 
Published: February 2025

Abstract
This paper considers a family of autoregressive processes with marginal distributions resembling the Cantor function. It is shown that the marginal distribution is in the domain of attraction of a max-semistable distribution. The main result is that the extreme value law for the autoregressive process is obtained by including an extremal index in the law for an i.i.d. process with the same marginal distribution. Connections with extremes in deterministic dynamical systems and the relevance of max-semistable distributions in that context are also pointed out.