bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benchmarks in colorectal surgery: multinational study to define quality thresholds in high and low anterior resection
Authors: Staiger Roxane D , Rössler Fabian , Kim Min Jung , Brown Carl , Trenti Loris , Sasaki Takeshi , Uluk Deniz , Campana Juan P , Giacca Massimo , Schiltz Boris , Bahadoer Renu R , Lee Kai-Yin , Kupper Bruna E C , Hu Katherine Y , Corcione Francesco , Paredes Steven R , Spampati Sebastiano , Ukegjini Kristjan , Jedrzejczak Bartlomiej , Langer Daniel , Stakelum Aine , Park Ji Won , Phang P Terry , Biondo Sebastiano , Ito Masaaki , Aigner Felix , Vaccaro Carlos A , Panis Yves , Kartheuser Alex , Peeters K C M J , Tan Ker-Kan , Aguiar Samuel , Ludwig Kirk , Bracale Umberto , Young Christopher J , Dziki Adam , Ryska Miroslav , Winter Des C , Jenkins John T , Kennedy Robin H , Clavien Pierre-Alain , Puhan Milo A , Turina Matthias 
Published: October 2022

Abstract

Background
Benchmark comparisons in surgery allow identification of gaps in the quality of care provided. The aim of this study was to determine quality thresholds for high (HAR) and low (LAR) anterior resections in colorectal cancer surgery by applying the concept of benchmarking.

Methods
This 5-year multinational retrospective study included patients who underwent anterior resection for cancer in 19 high-volume centres on five continents. Benchmarks were defined for 11 relevant postoperative variables at discharge, 3 months, and 6 months (for LAR). Benchmarks were calculated for two separate cohorts: patients without (ideal) and those with (non-ideal) outcome-relevant co-morbidities. Benchmark cut-offs were defined as the 75th percentile of each centre’s median value.

Results
A total of 3903 patients who underwent HAR and 3726 who had LAR for cancer were analysed. After 3 months’ follow-up, the mortality benchmark in HAR for ideal and non-ideal patients was 0.0 versus 3.0 per cent, and in LAR it was 0.0 versus 2.2 per cent. Benchmark results for anastomotic leakage were 5.0 versus 6.9 per cent for HAR, and 13.6 versus 11.8 per cent for LAR. The overall morbidity benchmark in HAR was a Comprehensive Complication Index (CCI®) score of 8.6 versus 14.7, and that for LAR was CCI® score 11.9 versus 18.3.

Conclusion
Regular comparison of individual-surgeon or -unit outcome data against benchmark thresholds may identify gaps in care quality that can improve patient outcome.
Updated guideline for closure of abdominal wall incisions from the European and American Hernia Societies
Authors: Deerenberg Eva B , Henriksen Nadia A , Antoniou George A , Antoniou Stavros A , Bramer Wichor M , Fischer John P , Fortelny Rene H , Gök Hakan , Harris Hobart W , Hope William , Horne Charlotte M , Jensen Thomas K , Köckerling Ferdinand , Kretschmer Alexander , López-Cano Manuel , Malcher Flavio , Shao Jenny M , Slieker Juliette C , de Smet Gijs H J , Stabilini Cesare , Torkington Jared , Muysoms Filip E 
Published: October 2022

Abstract

Background
Incisional hernia is a frequent complication of abdominal wall incision. Surgical technique is an important risk factor for the development of incisional hernia. The aim of these updated guidelines was to provide recommendations to decrease the incidence of incisional hernia.

Methods
A systematic literature search of MEDLINE, Embase, and Cochrane CENTRAL was performed on 22 January 2022. The Scottish Intercollegiate Guidelines Network instrument was used to evaluate systematic reviews and meta-analyses, RCTs, and cohort studies. The GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) was used to appraise the certainty of the evidence. The guidelines group consisted of surgical specialists, a biomedical information specialist, certified guideline methodologist, and patient representative.

Results
Thirty-nine papers were included covering seven key questions, and weak recommendations were made for all of these. Laparoscopic surgery and non-midline incisions are suggested to be preferred when safe and feasible. In laparoscopic surgery, suturing the fascial defect of trocar sites of 10 mm and larger is advised, especially after single-incision laparoscopic surgery and at the umbilicus. For closure of an elective midline laparotomy, a continuous small-bites suturing technique with a slowly absorbable suture is suggested. Prophylactic mesh augmentation after elective midline laparotomy can be considered to reduce the risk of incisional hernia; a permanent synthetic mesh in either the onlay or retromuscular position is advised.

Conclusion
These updated guidelines may help surgeons in selecting the optimal approach and location of abdominal wall incisions.
Ultrasound-assisted carbon nanoparticle suspension mapping versus dual tracer-guided sentinel lymph node biopsy in patients with early breast cancer (ultraCars): phase III randomized clinical trial
Authors: Zhang Liulu , Cheng Minyi , Lin Yingyi , Zhang Junsheng , Shen Bo , Chen Yuanqi , Yang Ciqiu , Yang Mei , Zhu Teng , Gao Hongfei , Ji Fei , Li Jieqing , Wang Kun 
Published: October 2022

Abstract

Background
Appropriate tracing methods for sentinel lymph node biopsy (SLNB) play a key role in accurate axillary staging. This prospective, non-inferiority, phase III RCT compared the feasibility and diagnostic performance of ultrasound-assisted carbon nanoparticle suspension (CNS) mapping with dual tracer-guided SLNB in patients with early breast cancer.

Methods
Eligible patients had primary breast cancer without nodal involvement (cN0), or had clinically positive lymph nodes (cN1) that were downstaged to cN0 after neoadjuvant chemotherapy. Patients were randomly assigned (1 : 1) to undergo either ultrasound-assisted CNS sentinel lymph node (SLN) mapping (UC group) or dual tracer-guided mapping with CNS plus indocyanine green (ICG) (GC group). The primary endpoint was the SLN identification rate.

Results
Between 1 December 2019 and 30 April 2021, 330 patients were assigned randomly to the UC (163 patients) or GC (167 patients) group. The SLN identification rate was 94.5 (95 per cent c.i. 90.9 to 98.0) per cent in the UC group and 95.8 (92.7 to 98.9) per cent in the GC group. The observed difference of –1.3 (–5.9 to 3.3) per cent was lower than the prespecified non-inferiority margin of 6 per cent (Pnon–inferiority = 0.024). No significant difference was observed in metastatic node rate (30.5 versus 24.4 per cent; P = 0.222), median number of SLNs harvested (3 (range 1–7) versus 3 (1–8); P = 0.181), or duration of surgery (mean(s.d.) 7.53(2.77) versus 7.63(3.27) min; P = 0.316) between the groups. Among the subgroup of patients who had undergone neoadjuvant treatment, the SLN identification rate was 91.7 (82.2 to 100) per cent in the UC group and 90.7 (81.7 to 99.7) per cent in the GC group.

Conclusion
The diagnostic performance of ultrasound-assisted CNS mapping was non-inferior to that of dual tracer-guided SLN mapping with CNS plus ICG in patients with early breast cancer.

Registration number
NCT04951245 (http://www.clinicaltrials.gov).
Pathological response to neoadjuvant chemoradiotherapy for oesophageal squamous cell carcinoma: multicentre East Asian and Dutch database comparison
Authors: Eyck Ben M , Gao Xing , Yang Yang , van der Wilk Berend J , Wong Ian , Wijnhoven Bas P L , Liu Jun , Lagarde Sjoerd M , Ka-On Lam , Hulshof Maarten C C M , Li Zhigang , Law Simon , Chao Yin Kai , van Lanschot J Jan B ,   Dutch Upper Gastrointestinal Cancer Audit (DUCA), Nieboer D 
Published: October 2022

Abstract

Background
Patients with different ethnic and genetic backgrounds may respond differently to anticancer therapies. This study aimed to assess whether patients with oesophageal squamous cell carcinoma (OSCC) treated with neoadjuvant chemoradiotherapy (nCRT) in East Asia had an inferior pathological response compared with patients treated in Northwest Europe.

Methods
Patients with OSCC who underwent nCRT according to the CROSS regimen (carboplatin and paclitaxel with concurrent 41.4 Gy radiotherapy) followed by oesophagectomy between June 2012 and April 2020 were identified from East Asian and Dutch databases. The primary outcome was pCR, defined as ypT0 N0. Groups were compared using propensity score matching, adjusting for sex, Charlson Co-morbidity Index score, tumour location, cT and cN categories, interval between nCRT and surgery, and number of resected lymph nodes.

Results
Of 725 patients identified, 133 remained in each group after matching. A pCR was achieved in 37 patients (27.8 per cent) in the Asian database and 58 (43.6 per cent) in the Dutch database (P = 0.010). The rate of ypT1–4 was higher in Asian than Dutch data (66.2 and 49.6 per cent; P = 0.004). The ypN1–3 rate was 44.4 per cent in the Asian and 33.1 per cent in the Dutch data set. Clear margins were achieved in 92.5 per cent of Asian and 95.5 per cent of Dutch patients.

Conclusion
Regional differences in responses to CROSS nCRT for oesophageal cancer were apparent, the origin of which will need evaluation.
Risk-standardized mortality metric to monitor hospital performance for chest pain presentations
Authors: Dawson Luke P , Andrew Emily , Nehme Ziad , Bloom Jason , Okyere Daniel , Cox Shelley , Anderson David , Stephenson Michael , Lefkovits Jeffrey , Taylor Andrew J , Kaye David , Smith Karen , Stub Dion 
Published: October 2022

Abstract

Aims
Risk-standardized mortality rates (RSMR) have been used to monitor hospital performance in procedural and disease-based registries, but limitations include the potential to promote risk-averse clinician decisions and a lack of assessment of the whole patient journey. We aimed to determine whether it is feasible to use RSMR at the symptom-level to monitor hospital performance using routinely collected, linked, clinical and administrative data of chest pain presentations.

Methods and results
We included 192 978 consecutive adult patients (mean age 62 years; 51% female) with acute chest pain without ST-elevation brought via emergency medical services (EMS) to 53 emergency departments in Victoria, Australia (1/1/2015–30/6/2019). From 32 candidate variables, a risk-adjusted logistic regression model for 30-day mortality (C-statistic 0.899) was developed, with excellent calibration in the full cohort and with optimism-adjusted bootstrap internal validation. Annual 30-day RSMR was calculated by dividing each hospital's observed mortality by the expected mortality rate and multiplying it by the annual mean 30-day mortality rate. Hospital performance according to annual 30-day RSMR was lower for outer regional or remote locations and at hospitals without revascularisation capabilities. Hospital rates of angiography or transfer for patients diagnosed with non-ST elevation myocardial infarction (NSTEMI) correlated with annual 30-day RSMR, but no correlations were observed with other existing key performance indicators.

Conclusion
Annual hospital 30-day RSMR can be feasibly calculated at the symptom-level using routinely collected, linked clinical, and administrative data. This outcome-based metric appears to provide additional information for monitoring hospital performance in comparison with existing process of care key performance measures.
Data standards for transcatheter aortic valve implantation: the European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart)
Authors: Aktaa Suleman , Batra Gorav , James Stefan K , Blackman Daniel J , Ludman Peter F , Mamas Mamas A , Abdel-Wahab Mohamed , Angelini Gianni D , Czerny Martin , Delgado Victoria , De Luca Giuseppe , Agricola Eustachio , Foldager Dan , Hamm Christian W , Iung Bernard , Mangner Norman , Mehilli Julinda , Murphy Gavin J , Mylotte Darren , Parma Radoslaw , Petronio Anna Sonia , Popescu Bodgan A , Sondergaard Lars , Teles Rui C , Sabaté Manel , Terkelsen Christian J , Testa Luca , Wu Jianhua , Maggioni Aldo P , Wallentin Lars , Casadei Barbara , Gale Chris P 
Published: October 2022

AbstractAimsStandardized data definitions are necessary for the quantification of quality of care and patient outcomes in observational studies and randomised controlled trials (RCTs). The European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart) project of the European Society of Cardiology (ESC) aims to create pan-European data standards for cardiovascular diseases and interventions, including transcatheter aortic valve implantation (TAVI).Methods and resultsWe followed the EuroHeart methodology for cardiovascular data standard development. A Working Group of 29 members representing 12 countries was established and included a patient representative, as well as experts in the management of valvular heart disease from the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the European Association of Cardiovascular Imaging (EACVI) and the Working Group on Cardiovascular Surgery. We conducted a systematic review of the literature and used a modified Delphi method to reach consensus on a final set of variables. For each variable, the Working Group provided a definition, permissible values, and categorized the variable as mandatory (Level 1) or additional (Level 2) based on its clinical importance and feasibility. In total, 93 Level 1 and 113 Level 2 variables were selected, with the level 1 variables providing the dataset for registration of patients undergoing TAVI on the EuroHeart IT platform.ConclusionThis document provides details of the EuroHeart data standards for TAVI processes of care and in-hospital outcomes. In the context of EuroHeart, this will facilitate quality improvement, observational research, registry-based RCTs and post-marketing surveillance of devices, and pharmacotherapies.One-sentence summaryThe EuroHeart data standards for transcatheter aortic valve implantation (TAVI) are a set of internationally agreed data variables and definitions that once implemented will facilitate improvement of quality of care and outcomes for patients receiving TAVI.
Congenital heart disease: changes in recorded birth prevalence and cardiac interventions over the past half-century in Sweden
Authors: Giang Kok Wai , Mandalenakis Zacharias , Fedchenko Maria , Eriksson Peter , Rosengren Annika , Norman Mikael , Hanséus Katarina , Dellborg Mikael 
Published: October 2022

Abstract

Aims
Our objective was to assess changes in the birth prevalence of CHD over a half-century in a high-resource, nationwide setting, as well as changes in the prevalence of cardiac interventions in this population.

Methods and results
The Swedish National Patient and Cause of Death registers were linked to estimate the annual rates of CHD and cardiac interventions among live-born infants from 1970 to 2017. Additionally, separate estimates were obtained by lesion complexity, from mild to the most complex forms of CHD. Overall, the numbers of live-born infants with a CHD identified varied from 624 to 2459 annual cases, with rates increasing steadily from 5.7 to an average of 20 per 1000 live births at the end of the study period, and with a more pronounced increase from 1996 to 2005. The largest increase over time was observed for mild CHD lesions. Overall, the proportion of cardiac interventions among patients with CHD declined from 40.7% in 1970 to below 15.0% after 2014. However, in the most complex CHD lesion groups, overall cardiac interventions increased from 57.1 to 76.8% in patients with conotruncal defects and from 32.8 to 39.5% in those with severe non-conotruncal defects.

Conclusion
The live-birth prevalence of CHD in Sweden more than tripled during the past half-century, most likely resulting from more accurate diagnostic capabilities. The largest increase over time was observed among patients with simple defects. During the same period, overall cardiac interventions decreased whereas interventions for the most complex CHD groups increased.
Shifting school health priorities pre–post cannabis legalization in Canada: Ontario secondary school rankings of student substance use as a health-related issue
Authors: Butler Alexandra , Doggett Amanda , Vermeer Julianne , Magier Megan , Patte Karen A , Maginn Drew , Markham Chris , Leatherdale Scott T 
Published: October 2022

Abstract
This study examined how schools prioritize ten key health concerns among their student populations over time and whether schools’ prioritization of alcohol and other drug use (AODU) corresponds to students’ substance use behaviours and cannabis legalization as a major policy change. Data were collected from a sample of secondary schools in Ontario, Canada across four years (2015/16–2018/19 [N2015/16 = 65, N2016/17 = 68, N2017/18 = 61 and N2018/19 = 60]) as a part of the COMPASS study. School-level prevalence of cannabis and alcohol use between schools that did and did not prioritize student AODU as a health concern was examined. Ordinal mixed models examined whether student cannabis and alcohol use were associated with school prioritization of AODU. Chi-square tests examined changing health priorities among schools pre–post cannabis legalization. School priority ranking for AODU was mostly stable over time. While AODU was identified as an important health concern, most schools identified mental health as their first priority across the four years of the study. No significant changes to school AODU priorities were observed pre–post cannabis legalization nor was school prioritization of AODU associated with student cannabis and alcohol use behaviours. This study suggests that schools may benefit from guidance in identifying and addressing priority health concerns among their student population.
Productivity, pressure, and new perspectives: impacts of the COVID-19 pandemic on marine early-career researchers
Authors: Schadeberg Amanda , Ford Eleanor , Wieczorek Alina M , Gammage Louise C , López-Acosta María , Buselic Ivana , Turk Dermastia Timotej , Fontela Marcos , Galobart Cristina , Llopis Monferrer Natalia , Lubośny Marek , Piarulli Stefania , Suaria Giuseppe 
Published: October 2022

Abstract
The worldwide disruption caused by the beginning of the COVID-19 pandemic has dramatically impacted the activities of marine scientists working towards the goals of the UN Ocean Decade. As in other disciplines, marine early-career researchers (ECRs) are essential contributors to the development of novel and innovative science. Based on a survey of 322 of our peers, we show that the pandemic negatively impacted marine ECRs in ways that further exacerbate existing structural challenges such as social isolation, job insecurity, and short-term contracts, competitive funding, and work pressure. Furthermore, we find that the success and wellbeing of marine ECRs depends heavily on networking opportunities, gaining practical experience, collecting data, and producing publications, all of which were disrupted by the pandemic. Our analysis shows that those in the earliest stages of their careers feel most vulnerable to long-term career disadvantage as a result of the pandemic. This paper contributes to the empirical body of work about the impacts of the pandemic on marine science and offers recommendations on how marine ECRs should be supported to achieve the UN Ocean Decade’s goal of producing “the science we need for the ocean we want”.
Comparison of behaviors of black bears with and without habituation to humans and supplemental research feeding
Authors: Powell Roger A , Mansfield Susan A , Rogers Lynn L 
Published: October 2022

Abstract
Humans interact with wildlife regularly, mostly without conflict. Interactions between humans and bears, however, have a history of conflict. Using data from female black bears in two populations, we compared behaviors related to a series of hypotheses about habituation and food supplementation via research feeding. We livetrapped bears in the southern boreal forests and cove forests of the Pisgah National Forest, North Carolina, in barrel traps or modified leg-hold snares and outfitted them with very high frequency (VHF) transmitters, for 95 bear-years of data. In the southern boreal forests of Superior National Forest, Minnesota, we habituated bears and outfitted them with VHF collars supplemented with GPS units, for 42 bear-years. Some human residents of the Superior study area fed local black bears and we established a research feeding site. Bears in both populations avoided roads and habituated: Superior bears avoided houses where they were not fed; the study site for Pisgah bears (no habituation or feeding) had too few houses to test for avoidance. Bears in both populations gained weight faster during their active seasons when wild foods were abundant. Habituated, supplemented Superior bears averaged a smaller proportion of a day active, longer activity bouts, and less sinuous movements than did not-habituated or supplemented Pisgah bears. The bears in the two populations did not differ with respect to distances traveled per 2 h or mean lengths of activity bouts. The abundance of wild foods affected time active, distance traveled, and sinuosity of travel by not-habituated or supplemented Pisgah bears. Females in breeding condition in both populations were more active, had longer activity bouts, traveled further, and had more linear travel in spring and early summer while females with cubs pushed these activities into late summer and autumn. This timing pattern for bout length, distance moved, and sinuosity was less pronounced for habituated and research-fed Superior bears than for not-habituated or supplemented Pisgah bears. Thus, habituation to a small number of researchers appeared to not affect many behaviors of bears in our habituated and research-fed Superior population; research feeding appeared to affect some behaviors in a manner consistent with a food supply that had low annual variance. Because we have samples of one for each treatment (one site with habituation and feeding, one site without), our results do not establish that differences documented between the populations were caused by the differences in habituation and feeding. The effects of habituation, research feeding, or other forms of food supplementation on backcountry behaviors of black bears need broader testing across the range of black bears.
Content Validity and Inter-rater Reliability of the Music Interventions in Pediatric DoC Behavior Observation Record
Authors: Bower Janeen , Magee Wendy L , Catroppa Cathy , Baker Felicity A 
Published: October 2022

Abstract
Aligned with best practice guidelines for patients presenting with a disorder of consciousness (DoC), music therapy interventions with this population aim to increase arousal and awareness to support emergence to consciousness. There is a significant evidence base supporting music therapy for adults with a DoC; however, there are currently no published tools that systematically capture behavioral responses of this population during rehabilitative music therapy interventions. Further, the developmentally specific response to severe brain injury in the pediatric population means pediatric-specific research is required. The Music Interventions in Pediatric DoC Behavior Observation Record (Music Behavior Record [MBR]) was developed to objectively record responses during music therapy interventions for children presenting with a DoC. To establish content validity and inter-rater reliability, a pragmatic pilot study was undertaken. Results established that the MBR has content validity with 100% agreement among participants. Overall fair-substantial inter-rater reliability in &gt;70% of the behavioral responses recorded in the MBR indicate the MBR is an early but promising tool to objectively capture responses during music therapy interventions. The use of the MBR may ultimately support clinical advancement and intervention research to optimize consciousness recovery for the pediatric DoC population.