bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of leadership interventions on neonatal care: a systematic review of current literature
Authors: Beccia Flavia , Gualano Maria Rosaria , Fevola Gianluca , Capogna Emanuele , Scarfagna Chiara , Bonacquisti Michele , Ricciardi Walter 
Published: January 2025

Abstract
Effective leadership is essential in neonatal intensive care units (NICUs), where complex, high-stakes environments require coordinated multidisciplinary teamwork. Strong leadership improves clinical outcomes, team performance, and staff well-being. This systematic review assesses various leadership models and interventions in NICUs to identify best practices and areas for future research. A systematic search was conducted on PubMed, Web of Science, and Scopus, covering studies published from 2010 to October 2024. Articles were screened using the PRISMA guidelines, and inclusion criteria focused on primary studies in NICU settings evaluating leadership interventions. Data extraction and quality assessment were performed using the Newcastle–Ottawa Scale. Nine studies from diverse countries and research designs were included. Leadership interventions varied from simulation-based training programs to co-leadership models. High-fidelity simulation boot camps significantly improved self-perceived skills, teamwork, and leadership confidence among trainees. While most studies reported positive impacts on team performance and patient safety, one large-scale quality improvement program showed no significant improvement in clinical outcomes for very-low-birth-weight infants.

Conclusion: The findings emphasize that leadership interventions, including structured training and co-leadership, enhance team dynamics and clinical outcomes in NICUs. However, variability in study designs and reliance on self-reported data highlight the need for standardized evaluation methods. Future research should focus on long-term impacts, cross-context comparisons, and refining leadership frameworks to address the unique challenges of NICU settings. Promoting effective leadership not only improves patient care but also fosters a resilient and collaborative work environment.

What is known:
• Leadership is crucial in NICUs, where complex, high-stakes environments demand coordinated, multidisciplinary teamwork. Strong leadership enhances clinical outcomes, team performance, and staff well-being.
• No systematic review of leadership interventions in neonatal care has been conducted to date.

What is new:
• Recent studies highlight a range of tools, including simulation-based training programs and co-leadership models.
• High-fidelity simulations have been shown to significantly improve participants' self-perceived skills, teamwork, and leadership confidence.
Evaluating alignment of UK commercial baby food products with the WHO nutrient and promotion profile model
Authors: Bozkir Cigdem , Esin Kubra , Threapleton Diane , Cade Janet E. 
Published: January 2025

Abstract

Purpose
The first 1000 days of life are critical for long-term health outcomes, and there is increasing concern about the suitability of commercial food products for infants, toddlers, and children. This study evaluates the compliance of UK commercial baby food products with WHO Nutrient and Promotion Profile Model (NPPM) guidelines.

Methods
Between February and April 2023, data on 469 baby food products marketed for infants and children under 36 months were collected from the online platforms of four major UK supermarkets. Nutritional composition and labelling information were assessed using the NPPM criteria. Quantitative analyses were performed using IBM SPSS, presenting data as means with 95% confidence intervals.

Results
While 75% of products met the minimum energy content criteria, compliance with total sugar content and protein requirements was 59% and 94%, respectively. Overall, only 45% of products adhered to NPPM nutritional standards. Promotional assessments revealed that no products met the requirements for appropriate nutrient, health, or marketing claims. Furthermore, only 5% of products included adequate statements in support of breastfeeding.

Conclusion
This study highlights the need for stricter nutritional and promotional standards in the UK baby food industry to foster healthier early dietary habits. Regulatory measures are essential to align commercial baby food products with WHO recommendations, reducing inappropriate claims and improving nutritional quality.
Comparison of tibiofibular syndesmosis stability following treatment of proximal, middle, and distal third fibula fractures
Authors: Thomas Sean , Berger Garrett , O’Leary Brendan , Brumm Zachary , Schwartz Alexandra K. , Kent William T. 
Published: January 2025

Abstract
Purpose
While treatment modalities for Maisonneuve fractures involving the proximal third of the fibula are established, no studies to date have reported outcomes associated with syndesmotic-only fixation of middle third fibular shaft fractures. The purpose of this study was to evaluate outcomes associated with syndesmotic-only fixation in the treatment of Maisonneuve fractures involving the middle third of the fibula.

Methods
A retrospective review was conducted on 257 cases of syndesmotic ankle instability with associated fibular fractures at a level 1 trauma center between 2013 and 2023. Patients were divided into cohorts based on fibular fracture location in the proximal, middle, or distal third of the fibula. The Chi-square test of independence, two-sample t-test, and analysis of variance were used to compare outcome measures between cohorts.

Results
Sixty-six patients were identified including 48% (n = 32) with proximal third fibular fractures, 20% (n = 13) with middle third fibular fractures, and 32% (n = 21) with distal third fibular fractures. Rates of infection, loss of reduction, wound healing complications, and reoperation did not vary significantly between cohorts. Functional outcome measures including range of motion, time to weight-bearing, and tibiofibular/medial clear space measurements at final follow-up were similar across cohorts.

Conclusion
Patients with Maisonneuve fractures involving the middle third of the fibula demonstrated positive outcomes with syndesmotic fixation alone, with no documented cases of infection, loss of reduction, or wound healing issues. By demonstrating maintenance of anatomic reduction and low rates of complications, our results support the use of syndesmotic-only fixation in the treatment of middle third Maisonneuve fractures.
A smart tool for non expert clinicians for the dissemination of the MDS criteria for progressive supranuclear palsy
Authors: Picillo Marina , Abate Filomena , Canoro Vincenzo , Tepedino Maria Francesca , Barone Paolo , Erro Roberto 
Published: January 2025

Abstract
Due to the variety of clinical phenotypes and the massive clinical overlap with other neurodegenerative diseases, the diagnosis of Progressive Supranuclear Palsy (PSP) remains a major challenge. Notwithstanding, early and reliable clinical diagnosis of PSP is highly warranted for estimation of prognosis, appropriate allocation to therapeutic trials and development of new diagnostic tools. As reliable biomarkers are lacking, PSP diagnosis relies on the application of the clinical criteria promoted by the International Parkinson and Movement Disorder Society (MDS). Despite providing a framework including all the main PSP cornerstones (ocular dysfunction and postural instability, akinesia and cognitive dysfunction), the application of the MDS PSP criteria is complex and not straightforward to apply in a clinical setting. Herein we propose a practical tool, including a video-guided slide-set and a smartsheet, to disseminate the MDS PSP clinical criteria among healthy practitioners and increase confidence in non expert clinicians towards suspicion and diagnosis of PSP. The video-guided slide set may serve as a teaching resource for both general neurologists and practitioners, while the smartsheet may represent a valid support in attributing the degree of diagnostic certainty and phenotype based on the identified clinical features. Application of our tool may improve early recognition of patients in primary and secondary care and determine a prompt referral to third level movement disorder centers for consideration in clinical trials testing disease-modifying treatments.
Transforming cancer screening: the potential of multi-cancer early detection (MCED) technologies
Authors: Imai Mitsuho , Nakamura Yoshiaki , Yoshino Takayuki 
Published: January 2025

Abstract
Early cancer detection substantially improves the rate of patient survival; however, conventional screening methods are directed at single anatomical sites and focus primarily on a limited number of cancers, such as gastric, colorectal, lung, breast, and cervical cancer. Additionally, several cancers are inadequately screened, hindering early detection of 45.5% cases. In contrast, Multi-Cancer Early Detection (MCED) assays offer simultaneous screening of multiple cancers from a single liquid biopsy and identify molecular changes before symptom onset. These tests assess DNA mutations, abnormal DNA methylation patterns, fragmented DNA, and other tumor-derived biomarkers, indicating the presence of cancer and predicting its origin. Moreover, MCED assays concurrently detect multiple cancers without recommended screening protocols, potentially revolutionizing cancer screening and management. Large trials have reported promising results, achieving 50–95% sensitivity and 89–99% specificity for multiple cancer types. However, challenges, regarding improving accuracy, addressing ethical issues (e.g., psychosocial impact assessment), and integrating MCED into healthcare systems, must be addressed to achieve widespread adoption. Furthermore, prospective multi-institutional studies are crucial for demonstrating the clinical benefits in diverse populations. This review provides an overview of the principles, development status, and clinical significance of MCED tests, and discusses their potential and challenges.
Influence of hydrological environments on the spawning behavior of landlocked amago salmon in the headwater streams of the Tendani River, Japan
Authors: Anraku Kenta , Kubo Takehiro , Haga Hirokazu 
Published: January 2025

AbstractThe behavioral activity of freshwater fishes is highly influenced by the hydrological regime. However, the relationship between the hydrological environment and the spawning behavior of landlocked amago salmon Oncorhynchus masou ishikawae in headwater streams remains unclear. We investigated the effects of rainfall-induced changes in the hydrological environment on the spawning behavior of the landlocked amago salmon. We recorded digging activities and hydraulic parameters in an 1,800-m reach in the Tendani River, Okayama Prefecture, Japan, in their spawning season. Our results revealed that increased turbidity and water velocity over the redds enhanced digging behavior. This may be attributed to increased water discharge, creating a more suitable hydraulic environment for spawning, and decreasing the risk of egg predation due to increased turbidity. Our results indicate that the timing selection of the spawning behavior in amago salmon could be influenced by the hydrological environment.
Odd generalized Einstein metrics on Lie groups
Authors: Cortés Vicente , David Liana 
Published: January 2025

Abstract
An odd generalized metric

$$E_{-}$$

E
-

on a Lie group G of dimension n is a left-invariant generalized metric on a Courant algebroid

$$E_{H, F}$$

E

H
,
F

of type

$$B_{n}$$

B
n

over G with left-invariant twisting forms

$$H\in \Omega ^{3}(G)$$

H
∈

Ω
3

(
G
)

and

$$F\in \Omega ^{2}(G)$$

F
∈

Ω
2

(
G
)

. Given an odd generalized metric

$$E_{-}$$

E
-

on G we determine the affine space of left-invariant Levi-Civita generalized connections of

$$E_{-}$$

E
-

. Given in addition a left-invariant divergence operator

$$\delta $$

δ

we show that there is a left-invariant Levi-Civita generalized connection of

$$E_{-}$$

E
-

with divergence

$$\delta $$

δ

and we compute the corresponding Ricci tensor

$$\textrm{Ric}^{\delta }$$

Ric
δ

of the pair

$$(E_{-}, \delta )$$

(

E
-

,
δ
)

. The odd generalized metric

$$E_{-}$$

E
-

is called odd generalized Einstein with divergence

$$\delta $$

δ

if

$$\textrm{Ric}^{\delta }=0$$

Ric
δ

=
0

. As an application of our theory, we describe all odd generalized Einstein metrics of arbitrary left-invariant divergence on all 3-dimensional unimodular Lie groups.
A novel prototype national-scale landslide nowcasting system for Italy combining rainfall thresholds and risk indicators
Authors: Segoni Samuele , Nocentini Nicola , Barbadori Francesco , Medici Camilla , Gatto Alessio , Rosi Ascanio , Casagli Nicola 
Published: January 2025

AbstractRegional- and national-scale landslide warning systems are usually based on rainfall thresholds that forecast the possibility of landslide occurrence over wide spatial units called alert zones (AZs). This work proposes a substantial improvement of the state-of-the-art by combining the rainfall threshold outcomes with a set of spatially explicit risk indicators aggregated at the municipality level. The combination of these two different techniques is performed by means of a dynamic matrix, which was purposely calibrated to provide an output in the form of five possible levels of risk (from R0 to R4), which are connected to the growing intensity of expected impacts and a pre-defined confidence in issuing warnings without omitting alarms. Italy (about 300,000 km2) is used as a case study, producing a set of rainfall thresholds differentiated for 150 AZs and providing a specific calibration of the dynamic risk matrix for each of them. The verification of the matrix outputs was satisfactory as no AZs experienced landslides at the R0 level; only two of them had more than 10% of landslides at the R1 level, and most of the AZs had more than 90% of the landslides in the R2 to R4 risk classes. A comparison with a nation-wide dataset of very severe hydrogeological disasters further corroborated the consistency of the model outputs with real scenarios, as most part of the impacts occurred in places and times when the matrix outputs were at the highest levels. The proposed methodology represents a reliable improvement for state-of-the-art territorial warning systems, as it brings two main advances: the spatial resolution is greatly improved, as the basic spatial unit for warning is downscaled from AZs to municipalities (whose average extension, in Italy, is about 1770 and 38 km2, respectively); second, the outputs can better address the needs of landslide emergency management, as the warning are specifically addressed to small areas based on the expected impacts (since risk indicators are used in the dynamic matrices), rather than on the mere probability of landslide occurrence.
Monitoring of Selected Swine Viral Diseases in Peruvian Amazon Peccaries
Authors: Menajovsky Maria F. , Mayor Pedro , Bodmer Richard , Pérez-Peña Pedro , Ulloa Gabriela M. , Greenwood Alex D. , Montero Stephanie , Lescano Andrés G. , Santolalla Meddly L. , Segalés Joaquim , Sibila Marina , Cabezón Oscar , Espunyes Johan 
Published: January 2025

AbstractPeccaries (collared peccary—CP—and white-lipped peccary—WLP) are an essential source of protein and income for rural communities in the Amazon region. Since 1980s, researchers in the Amazon have reported recurrent local disappearances of WLP populations. Although such disappearances impact the species conservation and the food security of rural societies, no studies have drawn consistent conclusions about the causes of these population collapses. However, it has recently been proposed that the overabundance of this species before its decline would be related to infectious disease outbreaks. In the current study, we aimed to determine the circulation (occurrence and exposure) of viruses relevant to swine health in CP and WLP populations, namely classical swine fever virus (CSFV), Aujeszky's disease virus (ADV), swine vesicular disease virus (SVDV), and porcine circoviruses (PCV). The study was conducted in two areas of the northeastern Peruvian Amazon: the Yavarí-Mirín River basin (2008 -2020), where WLPs experienced extreme population fluctuations, and the Pucacuro National Reserve (2012–2014), where no WLP disappearances have been reported. Since WLP is not easily found during population declines, we also sampled CP as an indicator of virus circulation in the area as they are likely to be susceptible to the same pathogens. CSFV and ADV antibodies were detected in both peccary species and both areas. Diseases caused by CSFV and ADV have the potential to act as ultimate causes of population collapse, especially in large WLP populations where overabundance could increase the rate of pathogen transmission. Our results were inconclusive in establishing whether or not these viruses drove the WLP population to collapse, but their potential role warrants deeper investigation, expanding the geographical coverage of studies on infectious diseases in peccaries.
A novel approach to use the DayCent model for simulating agroforestry systems with multiple components
Authors: Laub Moritz , Le Goff Ulysse , Prébandier Marc , Six Johan , Cardinael Rémi 
Published: January 2025

Abstract
Agroforestry can offer carbon sequestration, higher system productivity and biodiversity. However, a limited number of field experiments exist to study their feasibility and trade-offs for large scale deployment. Agroecosystem models could represent a valuable tool for their ex ante assessment. Here, we present ZonalCent, a novel approach to use the DayCent model to simulate multi-component agroforestry systems by splitting them into several independent zones, and simulating each zone individually. We used six agroforestry sites in France to evaluate how well ZonalCent represented carbon sequestration in tree biomass, soil organic carbon stocks and in the total system. This proved promising because with the default parameter set of DayCent, ZonalCent was highly suitable to represent tree carbon sequestration (Nash–Sutcliffe modelling efficiency; NSE of 0.86), and suitable for total system carbon sequestration potential (NSE of 0.55), despite a tendency to overestimate SOC stocks (NSE of 0.38). Only one site had yield data and there, ZonalCent approach could approximate the mean yield reduction—yet more detailed evaluation is necessary. Negative correlations showed that simulated yield was most strongly affected by (a) shading by mature trees and (b) the loss of arable area due to grass strips. While more detailed models may be needed for a detailed process understanding, ZonalCent includes the most important interactions (light, water, nutrients, temperature) in a simple but effective way and can be readily used—because it is based on DayCent—to estimate the potential carbon sequestration of agroforestry systems at larger scales.
Compositions of gilthead sea bream (Sparus aurata Linnaeus, 1758) from different culture systems
Authors: Ünal-Şengör Gülgün F. , Yildiz Mustafa , Metin Ömer , Ofori-Mensah Samuel , Ceylan Zafer 
Published: January 2025

Abstract
The aim of the present study was to investigate the effects of seasons (summer and winter) on the proximate, amino acid and fatty acid compositions of gilthead sea bream fish fed with commercial diets in sea cages and earthen ponds in the Aegean Sea in Türkiye. In general, the nutrient composition of the diets met the nutritional needs of the fish. Proximate analysis of fish fillets revealed that fish reared in earthen ponds had the lowest moisture and highest lipid content in the winter season (p < 0.05). Although fillet protein contents were comparatively higher in the winter (p < 0.05), there was no significant difference between systems in the same season (p > 0.05). Growing gilthead sea bream in marine cages produced fillets with high contents of the essential fatty acids (EFA) eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3). On the other hand, the 18:1n-9 and 18:3n-3 contents of fish reared in earthen ponds increased by 25.64 and 18.80% respectively, compared to those in marine cages. Fillet content of total n-3 fatty acid were comparatively higher (p < 0.05) in gilthead sea bream from marine cages, and this increase was even more evident in the winter months. The n-3/n-6 ratios of fillets were significantly high in gilthead sea bream from marine cages in the summer. The levels of the essential amino acids (EAAs) arginine and leucine were higher in fillets from both systems in the winter. On the other hand, fillet contents of lysine were higher in the summer. In general, the total EAA content of fillets was higher in fish from the sea cages in summer. EAA/NEAA ratios in both systems in summer and winter were found to be at good levels in terms of fish fillet quality. Fillet contents of EFA and EAA from both systems and seasons were found to be good for human consumption and will have positive effects on human nutrition. In conclusion, commercial diets used in feeding gilthead sea bream improved the proximate, fatty acid and amino acid compositions of fillets to a good extent. Different seasons and culture systems may affect the nutritional composition of fish fillets, especially on fillet EFA contents. Results of fillet samples in marine cages and earthen ponds in summer and winter showed that the fish were of good quality for human health. Evaluation of the results in the present study shows that that gilthead sea bream can also be successfully cultured in earthen ponds in areas unsuitable for agriculture.
The prognostic value of changes in Ki67 following neoadjuvant chemotherapy in residual triple-negative breast cancer: a Swedish nationwide registry-based study
Authors: Nyqvist-Streng Jenny , Helou Mikael , Helou Khalil , Chamalidou Chaido , Kovács Anikó , Parris Toshima Z. 
Published: January 2025

Abstract

Purpose
To evaluate the prognostic significance of changes in pre- and post-neoadjuvant chemotherapy (NACT) Ki67 in patients with primary invasive triple-negative breast cancer (TNBC).

Methods
Population-based registry data were retrieved for patients diagnosed with TNBC between 2007 and 2021 (n = 9262). Multivariable Cox regression analysis was performed for disease-specific survival (DSS) and overall survival (OS) adjusted for age and residual disease in the breast and nodes (RDBN).

Results
Of the 1777 TNBC patients receiving NACT, 54 achieved pathologic complete response (pCR) and 755 had residual disease. Most patients were overweight with stage II disease (78%), grade 3 tumors (53%), and RDBN score 3 (42%). Compared to baseline, tumor size (30 vs. 15 mm; P < 0.0001) and Ki67 levels (63% vs. 48%; P < 2.2e − 16) generally decreased after NACT. Although only 5% of samples increased in size, Ki67 levels often remained unchanged (75%) or increased (0.9%) after treatment, respectively. However, 34% of patients discontinued treatment. Patients showing no changes in Ki67% had more unfavorable OS (P < 0.0001) and DSS (P = 0.00032), with significantly lower 5-year survival probabilities (OS: 66%; DSS: 78%) than those with decreased Ki67% (OS: 87%; DSS: 89%). All patients reaching pCR were alive 5 years after diagnosis. However, only the RDBN score was an independent predictor of survival in the multivariable analyses.

Conclusion
Ki67 often remained unchanged in TNBC patients treated with neoadjuvant chemotherapy, resulting in adverse clinical outcomes. These findings highlight the need for individualized treatment regimens and dynamic monitoring of TNBC patients with high Ki67 post-NACT.