bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency medical services level of training is associated with mortality in trauma patients: A combined prehospital and in hospital database analysis
Authors: Harrison Julia , Bhardwaj Akshay , Houck Olivia , Sather Kristiana , Sekiya Ayako , Knack Sarah , Saarunya Clarke Geetha , Puskarich Michael A. , Tignanelli Chris , Rogers Lisa , Marmor Schelomo , Beilman Greg 
Published: January 2025

BACKGROUND
There is conflicting evidence regarding emergency medical service (EMS) provider level of training and outcomes in trauma. We hypothesized that advanced life support (ALS) provider transport is associated with lower mortality compared with basic life support transport.

METHODS
We performed secondary analysis of a combined prehospital and in-hospital database of trauma patients utilizing ESO electronic medical records from 2018 to 2022. We included encounters with patients aged 15 years to 100 years transported by ground to a Level I or II trauma center with trauma-specific ICD-10-CM codes. Patients dead upon EMS arrival and transfers were excluded. We matched patients using 1:1 nearest neighbor propensity scores based on demographic, injury, and EMS characteristics, prehospital vitals, and trauma center designation. The exposure variable was EMS level of training and outcome was mortality. We conducted subgroup analyses on predefined cohorts (age > 50 years, mechanism of injury, prehospital EMS time > 30 minutes).

RESULTS
We identified 30,735 ALS and 1,758 basic life support encounters, representing 1,154 pairs following propensity matching. Mortality was lower among patients transported by ALS providers (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.18–0.88; p = 0.023). Mortality was also lower in the subgroups of patients aged > 50 years (OR, 0.35; 95% CI, 0.13–0.98; p = 0.046), and in patients with mechanisms of injury excluding falls (OR, 0.35; 95% CI, 0.13–0.98; p = 0.047). In those with prolonged prehospital time, the association approached significance (OR, 0.30; 95% CI, 0.08–1.08; p = 0.067). In those with mechanisms of injury of fall, the association was not significant.

CONCLUSION
In this retrospective, propensity matched cohort study using a national sample of trauma patients, attendance by ALS providers was associated with reduced mortality. This was observed in the entire cohort, in those aged > 50 years, and those with a higher-risk mechanism of injury. It approached significance in those with prolonged prehospital time.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Association of Community Socioeconomic Distress With Waitlist and Survival Outcomes in Liver Transplantation
Authors: Sakowitz Sara , Bakhtiyar Syed Shahyan , Mallick Saad , Kaldas Fady , Benharash Peyman 
Published: January 2025

Background.
Despite efforts to ensure equitable access to liver transplantation (LT), significant disparities remain. Although prior literature has considered the effects of patient sex, race, and income, the contemporary impact of community socioeconomic disadvantage on outcomes after waitlisting for LT remains to be elucidated. We sought to evaluate the association of community-level socioeconomic deprivation with survival after waitlisting for LT.

Methods.
All waitlisted candidates for isolated LT were identified using the 2005–2023 Organ Procurement and Transplantation Network. The previously validated Distressed Communities Index, representing poverty rate, median household income, unemployment, business growth, education level, and housing vacancies, was used to characterize community socioeconomic distress. Zip codes in the highest quintile were classified as the “distressed” cohort (others: “nondistressed”). Kaplan-Meier and Cox proportional hazard models were applied to assess patient and graft survival. We performed a Fine and Gray competing risk regression to consider the impact of distress on waitlist mortality.

Results.
Of 169 601 patients, 95 020 (56%) underwent LT and 74 581 (44%) remained on the waitlist. Among transplanted patients, 18 774 (20%) were distressed. After adjustment, distressed faced similar posttransplant survival at 1 y but greater mortality hazard at 5 y (hazard ratio [HR], 1.08; 95% confidence interval [CI], 1.04-1.12) and 10 y (HR, 1.09; 95% CI, 1.05-1.12). Considering all waitlisted patients, competing risk analysis demonstrated distressed candidates to face significantly greater cumulative incidence of death/deterioration on the waitlist (HR, 1.07; 95% CI, 1.04-1.11).

Conclusions.
Community-level socioeconomic inequity is associated with greater waitlist mortality and inferior post-LT survival. Novel interventions are needed to address structural barriers to care and continued inequities in outcomes.
Electrophysiological Signatures of Alpha Coma
Authors: Degano Giulio , Misirocchi Francesco , Rigoni Isotta , Kaplan Peter W. , Quintard Hervé , Vulliémoz Serge , Schaller Karl , Kleinschmidt Andreas , Seeck Margitta , De Stefano Pia 
Published: January 2025

Purpose:
Recent research on quantitative EEG in coma has proposed several metrics correlating with consciousness level. However, the heterogeneous nature of coma can challenge the generalizability of these measures. This study investigates alpha-coma, an electroclinical pattern characterized by a widespread, nonreactive alpha rhythm often linked to poor outcomes. The aim was to quantify the electrophysiological features of alpha-coma and compare them to the alpha rhythm in awake controls, seeking clearer insights into quantitative EEG analysis in comatose states.

Methods:
Fourteen alpha-coma patients were retrospectively selected from University Hospitals of Geneva and age-matched with 14 healthy control subjects from an open-source dataset. EEG data were preprocessed and analyzed to extract power spectra, spectral decay (aperiodic activity), sample entropy, and functional connectivity.

Results:
Alpha-coma patients did not differ in alpha power but exhibited significantly higher levels of spectral decay (p < 0.001), suggesting a convergence toward an inhibitory state. Sample entropy was significantly higher in alpha-coma patients (p = 0.01), indicating an increase in the cortical complexity in alpha-coma compared with healthy subjects.

Conclusions:
Alpha-coma shows increased aperiodic activity and EEG complexity, despite similar alpha power and clustering coefficient. The increased aperiodic activity aligns with findings in other comatose patients, including those sedated or with subcortical dysfunction. However, the increased entropy contradicts existing literature, suggesting that alpha-coma may represent a state of widespread cortical dysfunction likely resulting from nonhierarchical, turbulent brain activity. This indicates that the loss of consciousness does not guarantee consistent cortical measures across the whole spectrum of EEG patterns.
Science and technical priorities for private sector action to address biodiversity loss
Authors: McKenzie Emily J. , Jones Matt , Seega Nina , Siikamäki Juha , Vijay Varsha 
Published: January 2025

Target 15 of the Kunming–Montreal Global Biodiversity Framework recognizes the importance of the private sector monitoring, assessing and disclosing biodiversity-related risks, dependencies and impacts. Many businesses and financial institutions are progressing with science-based assessments, targets and disclosures and integrating into strategy, risk management and capital allocation decisions. Developments will continue in response to investor expectations, emerging corporate sustainability reporting regulations in Europe, China and elsewhere and evolving global sustainability reporting standards. Voluntary action is also being encouraged by the disclosure recommendations of the Taskforce on Nature-related Financial Disclosures and the target-setting methods of the Science Based Targets Network. Based on experience supporting the private sector in practice, we identify four critical science and technical advances needed to enable business action at scale and to redirect finance globally to halt and reverse biodiversity loss. First, consensus on indicators and metrics for measuring changes in the state of nature and provision of ecosystem services. Second, access to global, regularly updated, location-specific and consistent nature data. Third, standardized and consistent accounting systems that structure data, support risk management and create accountability at corporate, ecosystem and national levels. Fourth, integrated risk assessment approaches to help corporates, financial institutions, central banks and supervisors to assess nature-related risks.
This article is part of the discussion meeting issue ‘Bending the curve towards nature recovery: building on Georgina Mace's legacy for a biodiverse future’.
Bending the curve of biodiversity loss requires a ‘satnav’ for nature
Authors: Purvis Andy 
Published: January 2025

Georgina Mace proposed bending the curve of biodiversity loss as a fitting ambition for the Convention on Biological Diversity. The new Global Biodiversity Monitoring Framework (GBMF) may increase the chances of meeting the goals and targets in the Kunming–Montreal Global Biodiversity Framework (KMGBF), which requires bending the curve. To meet the outcome goals of KMGBF, the GBMF should support adaptive policy responses to the state of biodiversity, which in turn requires a ‘satnav’ for nature. The twin pillars of such a satnav are (i) models to predict expected future outcomes of today’s choices; and (ii) rapid feedback from monitoring to enable course corrections and model improvement. These same elements will also empower organizations to ensure that their actions are truly nature-positive, but they are not yet written into the GBMF. Without a satnav, society will effectively have to try to find its way to the outcome goals by looking in the rear-view mirror that the current headline indicators provide. Drawing contrasts and parallels with climate modelling, I discuss challenges for indicators, models, data and research culture that must be overcome if we are to bend the curve, and suggest ways forward.
This article is part of the discussion meeting issue ‘Bending the curve towards nature recovery: building on Georgina Mace's legacy for a biodiverse future’.
Whose conservation, revisited: how a focus on people–nature relationships spotlights new directions for conservation science
Authors: Reyers Belinda , Bennett Elena M. 
Published: January 2025

Georgina Mace introduced a compelling perspective on the major shifts in conservation science’s framing and purpose from 1960 to 2010. A decade ago, she proposed that the conservation community had begun to move into a new framing of ‘people and nature’ based on changes in perspectives on the relationships between people and nature and new interdisciplinary concepts and methods used in conservation. Progress in using this frame is clear as ‘two-way dynamic relationships between people and nature’ have since taken centre stage in science, practice and policy. Now, responding to concerns raised that current approaches to conservation are still not meeting the scale and complexity of the challenges of the Anthropocene, we explore a newly emerging framing of ‘people with nature’—an inextricably intertwined perspective on people–nature relationships. This framing builds on Mace’s recognition of interconnections and change, as well as new directions offered by conservation’s recent transdisciplinary engagements, to go beyond the notion of two-way flows connecting people and nature to emphasize the relationships and inseparability of ‘people with nature’. This emerging framing suggests new directions for conservation science and practice to make visible, improve and reimagine degraded people–nature relationships needed to bend the curve of biodiversity loss.
This article is part of the discussion meeting issue ‘Bending the curve towards nature recovery: building on Georgina Mace's legacy for a biodiverse future’.
Brain White Matter Microstructure are not associated with Blood Markers of the GSH Redox cycle in Schizophrenia
Authors: Pavan Tommaso , Steullet Pascal , Alemán-Gómez Yasser , Jenni Raoul , Schilliger Zoé , Cleusix Martine , Alameda Luis , Do Kim Q. , Conus Philippe , Hagmann Patric , Dwir Daniella , Klauser Paul , Jelescu Ileana 
Published: January 2025

AbstractIn groups of patients suffering from schizophrenia (SZ), redox dysregulation was reported in both peripheral fluids and brain. It has been hypothesized that such dysregulation, including alterations of the glutathione (GSH) cycle could participate in the brain white matter (WM) abnormalities in SZ due to the oligodendrocytes’ susceptibility to oxidative stress (OxS).In this study we aim to assess the differences between 82 schizophrenia patients (PT) and 86 healthy controls (HC) in GSH-redox peripheral blood markers: GSH peroxidase (GPx), reductase (GR) enzymatic activities and their ratio (GPx/GR-ratio), evaluating the hypotheses that alterations in the homeostasis of the systemic GSH cycle may be associated with pathological mechanisms in the brain WM in PT. To do so, we employ the advanced diffusion MRI methods: Diffusion Kurtosis Imaging (DKI) and White Matter Tract Integrity-Watson (WMTI-W), which provide excellent sensitivity to demyelination and neuroinflammation.We show that GPx levels are higher (p=0.00071) in female participants (HC and PT combined) and decrease with aging (p=0.026). We find differences between PT and HC in the association of GR and mean kurtosis (MK, p<0.0001). Namely, lower MK was associated with higher blood GR activity in HC, but not in PT, suggesting that high GR activity (a hallmark of reductive stress) in HC was linked to changes in myelin integrity. However, GSH-redox peripheral blood markers did not explain the WM anomalies detected in PT, or the design of the present study could not detect subtle phenomenon, if present.
Combining mpox vaccination and behavioural changes for mpox control among men who have sex with men: a mathematical modelling study
Authors: Xiridou Maria , van Wees Daphne Amanda , Adam Philippe , Miura Fuminari , Op de Coul Eline , Reitsema Maarten , de Wit John , van Benthem Birgit , Wallinga Jacco 
Published: January 2025

ABSTRACTBackgroundThe 2022 outbreak of mpox subclade IIb in the Netherlands affected primarily men who have sex with men (MSM). Despite the sharp decline in cases, there are concerns about future mpox outbreaks. We investigated the impact of mpox introductions, accounting for vaccination, behavioural changes, and introductions of subclades with different characteristics.MethodsWe developed a compartmental model for mpox among MSM. We accounted for three risk levels for mpox, based on sexual activity, and allowed individuals to change risk level. We examined several scenarios with mpox introductions.ResultsIn January 2024, 54% of MSM at high risk for mpox had immunity; this declined to 39% a year later, due to changes in risk levels. Mpox introductions in May 2025 resulted in small outbreaks, but the numbers of cases were 34% or 48% lower with vaccination carried out in August-October 2024 or February-April 2025, respectively, compared to the situation without vaccination in 2024-2025. With earlier initiation or greater magnitude of behavioural adaptations, the number of mpox cases was 17-51% smaller. Introduction of a subclade with 10% higher transmission probability than subclade IIb resulted in 77% more cases.ConclusionsDue to changing levels of mpox risk, the fraction immune in the high-risk group will decline, leading to a greater possibilities for future mpox outbreaks. The number of cases can be reduced with preventive vaccination and behavioural adaptations. Recurring vaccination campaigns should prioritise individuals most at risk, ensuring those entering high-risk groups are reached. Campaigns promoting timely behavioural changes remain crucial.
Strategic Modulation of Polarity and Viscosity Sensitivity of Bimane Molecular Rotor-Based Fluorophores for Imaging α-Synuclein
Authors: Venkatesh Yarra , Narayan Karthik B. , Baumgart Tobias , Petersson E. James 
Published: January 2025

ABSTRACTMolecular rotor-based fluorophores (RBFs) that are target-selective and sensitive to both polarity and viscosity are valuable for diverse biological applications. Here, we have designed next-generation RBFs based on the underexplored bimane fluorophore through either changing in aryl substitution or varying π-linkages between the rotatable electron donors and acceptors to produce red-shifted fluorescence emissions with large Stokes shifts. RBFs exhibit a twisted intramolecular charge transfer mechanism that enables control of polarity and viscosity sensitivity, as well as target selectivity. These features enable their application in: (1) turn-on fluorescent detection of α-synuclein (αS) fibrils, a hallmark of Parkinson’s disease (PD), including amplified fibrils from patient samples; (2) monitoring early misfolding and oligomer formation during αS aggregation; and (3) selective imaging of αS condensates formed by liquid-liquid phase separation (LLPS). In all three cases, we show that our probes have high levels of selectivity for αS versus other aggregating proteins. These properties enable one to study the interplay of αS and tau in amyloid aggregation and the mechanisms underlying neurodegenerative disorders.
Noise-induced hearing loss enhances Ca2+-dependent spontaneous bursting activity in lateral cochlear efferents
Authors: Hong Hui , Trussell Laurence O 
Published: January 2025

AbstractExposure to loud and/or prolonged noise damages cochlear hair cells and triggers downstream changes in synaptic and electrical activity in multiple brain regions, resulting in hearing loss and altered speech comprehension. It remains unclear however whether or not noise exposure also compromises the cochlear efferent system, a feedback pathway in the brain that fine-tunes hearing sensitivity in the cochlea. We examined the effects of noise-induced hearing loss on the spontaneous action potential (AP) firing pattern in mouse lateral olivocochlear (LOC) neurons. This spontaneous firing exhibits a characteristic burst pattern dependent on Ca2+channels, and we therefore also examined the effects of noise-induced hearing loss on the function of these and other ion channels. The burst pattern was sustained by an interaction between inactivating Ca2+currents contributed largely by L-type channels, and steady outward currents mediated by Ba2+-sensitive inwardly-rectifying and two-pore domain K+channels. One week following exposure to loud broadband noise, hearing thresholds were significantly elevated, and the duration of AP bursts was increased, likely as a result of an enhanced Ca2+current. Additional effects of noise-induced hearing loss included alteration of Ca2+-dependent inactivation of Ca2+currents and a small elevation of outward K+currents. We propose that noise-induced hearing loss enhances efferent activity and may thus amplify the release of neurotransmitters and neuromodulators (i.e., neuropeptides), potentially altering sensory coding within the damaged cochlea.Significance StatementAlthough the effects of noise-induced hearing loss on the auditory afferent system have been extensively studied, little is known about its impact on the auditory efferent system, which modulates hearing sensitivity via feedback from the brain. Additionally, while Ca2+channels are related to numerous neurological diseases, their involvement in auditory disorders is underexplored. This study bridges these gaps by examining Ca2+channel-driven spontaneous burst firing in lateral olivocochlear (LOC) neurons, the most numerous auditory efferent neurons. Noise-induced hearing loss differentially affects Ca2+channel subtypes by increasing high-voltage activated currents that further prolong burst firing and suggesting altered intracellular Ca2+signaling. These significant changes in LOC firing behavior may profoundly impact their downstream targets in the cochlea.
Chest Wall Restriction Device for Modeling Respiratory Challenges and Dysfunction
Authors: Rodrigues Victoria Ribeiro , Mejia Lizuannette , Zucchi Rafael G. , Davenport Paul W. , Napoli Nicholas J. 
Published: January 2025

AbstractBreathing relies on unrestricted movement of the chest wall to maintain O2 and CO2 balance. Understanding the effects of chest and abdominal restrictions on respiratory function is critical for studying conditions such as respiratory diseases, extreme environments, and load-induced impairments. However, existing methods to simulate these restrictions are limited, lacking the ability to provide both static and dynamic conditions or precise load control. To address these gaps, we developed a novel chest wall and abdomen restriction device capable of independently applying and measuring static and dynamic loads with adjustable and reproducible force levels. Separate bands for the chest and abdomen enable targeted restrictions, with constant force springs providing resistance during dynamic conditions and immobilization during static conditions. Integrated sensors quantify applied loads and respiratory mechanics. To validate the device, healthy participants underwent pulmonary function testing under baseline, static, and dynamic restriction conditions. Significant reductions in forced expiratory volume (FEV1) and forced vital capacity (FVC) were observed under restrictions compared to baseline. Other respiratory metrics also differed significantly, highlighting distinct effects of static and dynamic restrictions. Pressure variability tests confirmed reproducibility and adjustability of loads, while displacement data from linear variable differential transducers (LVDTs) validated the device’s ability to distinguish static and dynamic effects. This device addresses prior limitations by enabling precise, reproducible loading and independent control of chest and abdominal restrictions, supporting research into respiratory diseases, extreme environments, and respiratory mechanics. Our results demonstrate its potential to advance respiratory function research and expand clinical and experimental applications.
VTE incidence shortens survival in IDH-WT glioblastoma
Authors: Sloan Anthony R. , Gordillo Alan J. , Kennemer Austin , Khorana Alok A. , Horbinski Craig , Kaelber David C. , Cameron Scott J. , Lathia Justin D. 
Published: January 2025

AbstractBackgroundVenous thromboembolisms (VTE’s) are the second leading cause of death in cancer patients. While previous analyses have demonstrated VTE rates are greater in GBM patients using smaller patient cohorts in high-grade glioma, since the release of the update 5thedition of the World Health Organization (WHO) classification a systematic analysis in a large-scale cohort of patients with IDH-wildtype GBM with clinical outcomes is lacking.MethodsThis study utilizes the online database, TriNetx, to build patient cohorts for outcomes analysis. TriNetX is a database comprised of over 50 healthcare organization patient information that is quarriable by CPT, ICD, RxNorm, and other proprietary codes. Patient cohort demographics were used for propensity score matching. Risk ratios, odds ratios, hazard ratios, and Kaplan Meier curves were utilized for primary outcomes including survival and time-to-event analyses.Results24% of patients with GBM experienced at least 1 VTE or PE after their diagnosis. Compared to a population of patients with no cancer history with an index event of an inpatient visit, patients with GBM were at 20.4 (12.23-34.17) and 5.96 (3.85-9.23) times higher risk of experiencing a VTE/PE at 1- and 5-year follow-up, respectively. Sex differences were not seen between VTE/PE rates and survival after VTE/PE at 1- and 5-year follow-up (p>0.05). Lastly, patients with GBM and a VTE/PE after diagnosis experienced worse survival at 1- and 5-year follow-up compared to those without a VTE/PE (p<0.0001 and p = 0.0014, respectively).ConclusionsPatients with GBM experience increased risks of thrombotic events after diagnosis. These risks are not sex-dependent but do affect overall survival.