cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.31077571
title: Supplementary Material for: Navigating Drug Related Problems (DRPs) in Hemodialysis (HD) Patients Across Dual Healthcare Systems: Bridging the Gaps for Optimal Medication Safety

description: ABSTRACT
Background: Drug-related problems (DRPs) are common in hemodialysis (HD) patients but the impact of different healthcare delivery models on DRP prevalence, characteristics and medication-related outcomes remains underexplored.

Objective: This study aimed to investigate and compare DRP prevalence and characteristics among HD patients across two healthcare settings.

Methods: This prospective cross-sectional study involved adult chronic HD patients from hospital-based (with pharmacist-led medication management program) and non-hospital-based (without) ambulatory centers. Patients on temporary HD or who had language barrier were excluded. Clinical characteristics and DRP data, identified through structured clinical review and classified using Pharmaceutical Care Network Europe (version 9.0), were analyzed using descriptive statistics, Mann-Whitney U, and chi-square tests.

Results: A total of 76 hospital-based and 149 non-hospital-based patients were recruited with significant differences between settings observed. Non-hospital-based patients showed a markedly higher DRP burden (n=145 [97.7%], 4.6 DRPs/patient) compared to hospital-based patients (n=42 [55.3%], 0.8 DRPs/patient). DRPs categorized as “Other” predominated the non-hospital-based group (n=345 [50.2%], z=+5.296, p&lt; .001, Bonferroni-adjusted) and were driven by non-clinical factors such as patient-related, patient transfer-related, and work processes (z=+5.904), with the majority of the DRPs associated with antihypertensive agents (n=145, 21.0%). Conversely, treatment-effectiveness DRPs were significantly more prevalent than expected in the hospital-based group (n=45 [67.2%], z=+5.159, p&lt;.001, Bonferroni-adjusted) and were primarily due to clinical factors such as drug selection, drug form, dose, and duration, that had direct effects on treatment (z=+5.904). Phosphate binders (n=21, 31.3%) were the most common medication class associated with DRPs in this group. 

Conclusion: This study demonstrates that variations across healthcare settings, compounded by frequent transitions of care significantly influenced DRP prevalence and characteristics among the highly vulnerable HD patients. Structured support services such as pharmacist-led medication management program play a critical role in mitigating these risks and supporting patients through complex treatment pathways. These findings underscored the importance of addressing both system-level disparities and patient-level challenges, where future research should adopt mixed-method approaches to uncover the contextual drivers of DRPs and guide the development of sustainable, pharmacist-integrated care models that would improve medication safety across diverse dialysis settings.
DOI: 10.6084/m9.figshare.31077571.v1
title: Supplementary Material for: Navigating Drug Related Problems (DRPs) in Hemodialysis (HD) Patients Across Dual Healthcare Systems: Bridging the Gaps for Optimal Medication Safety

description: ABSTRACT
Background: Drug-related problems (DRPs) are common in hemodialysis (HD) patients but the impact of different healthcare delivery models on DRP prevalence, characteristics and medication-related outcomes remains underexplored.

Objective: This study aimed to investigate and compare DRP prevalence and characteristics among HD patients across two healthcare settings.

Methods: This prospective cross-sectional study involved adult chronic HD patients from hospital-based (with pharmacist-led medication management program) and non-hospital-based (without) ambulatory centers. Patients on temporary HD or who had language barrier were excluded. Clinical characteristics and DRP data, identified through structured clinical review and classified using Pharmaceutical Care Network Europe (version 9.0), were analyzed using descriptive statistics, Mann-Whitney U, and chi-square tests.

Results: A total of 76 hospital-based and 149 non-hospital-based patients were recruited with significant differences between settings observed. Non-hospital-based patients showed a markedly higher DRP burden (n=145 [97.7%], 4.6 DRPs/patient) compared to hospital-based patients (n=42 [55.3%], 0.8 DRPs/patient). DRPs categorized as “Other” predominated the non-hospital-based group (n=345 [50.2%], z=+5.296, p&lt; .001, Bonferroni-adjusted) and were driven by non-clinical factors such as patient-related, patient transfer-related, and work processes (z=+5.904), with the majority of the DRPs associated with antihypertensive agents (n=145, 21.0%). Conversely, treatment-effectiveness DRPs were significantly more prevalent than expected in the hospital-based group (n=45 [67.2%], z=+5.159, p&lt;.001, Bonferroni-adjusted) and were primarily due to clinical factors such as drug selection, drug form, dose, and duration, that had direct effects on treatment (z=+5.904). Phosphate binders (n=21, 31.3%) were the most common medication class associated with DRPs in this group. 

Conclusion: This study demonstrates that variations across healthcare settings, compounded by frequent transitions of care significantly influenced DRP prevalence and characteristics among the highly vulnerable HD patients. Structured support services such as pharmacist-led medication management program play a critical role in mitigating these risks and supporting patients through complex treatment pathways. These findings underscored the importance of addressing both system-level disparities and patient-level challenges, where future research should adopt mixed-method approaches to uncover the contextual drivers of DRPs and guide the development of sustainable, pharmacist-integrated care models that would improve medication safety across diverse dialysis settings.
DOI: 10.6084/m9.figshare.31077574
title: Supplementary Material for: Intraoperative continuous renal replacement therapy in non-cardiac, non-liver transplantation surgery: an observational cohort feasibility study.

description: Introduction: Renal replacement therapy (RRT) is commonly used to manage metabolic disturbances in critically ill patients with acute kidney injury. While intraoperative RRT has been assessed in liver transplantation and cardiac surgery, its use in other surgical contexts remains unexplored. This study aimed to assess the feasibility of intraoperative continuous RRT (IoCRRT) in non-cardiac, non-liver transplant surgeries. Secondary objectives included evaluating safety and describing the patient population.
Methods: This retrospective study included all adult patients who underwent IoCRRT between January 2013 and January 2021 at Hospices Civils de Lyon (Lyon, France). Patients were classified as undergoing emergency or elective surgery. Data on IoCRRT indication, feasibility, safety, renal function at hospital discharge and mortality were analyzed.
Results: IoCRRT was successfully implemented in all 43 patients. Severe acidosis (pH &lt; 7.2) was the main indication for IoCRRT in 27 patients (82%) of the emergency group, while IoCRRT was initiated to prevent metabolic complications and electrolyte imbalances in elective surgeries. Regional citrate anticoagulation was used in 36 (84%) cases. No adverse event was reported. At hospital discharge, no survivor progressed to end-stage renal disease; 4 (29%) patients exhibited a glomerular filtration rate (GFR) of 60–90 mL/min/1.73m², and 10 (71%) an GFR &gt; 90 mL/min/1.73m². Twenty-seven patients (63%) died within 30 days. 
Conclusion: IoCRRT seems to be a feasible and safe adjunctive therapy during emergency or elective surgery in patients with severe metabolic disorders. No IoCRRT-related complication was reported. Renal function appeared preserved. Further prospective studies are warranted to confirm these findings.
DOI: 10.6084/m9.figshare.31077574.v1
title: Supplementary Material for: Intraoperative continuous renal replacement therapy in non-cardiac, non-liver transplantation surgery: an observational cohort feasibility study.

description: Introduction: Renal replacement therapy (RRT) is commonly used to manage metabolic disturbances in critically ill patients with acute kidney injury. While intraoperative RRT has been assessed in liver transplantation and cardiac surgery, its use in other surgical contexts remains unexplored. This study aimed to assess the feasibility of intraoperative continuous RRT (IoCRRT) in non-cardiac, non-liver transplant surgeries. Secondary objectives included evaluating safety and describing the patient population.
Methods: This retrospective study included all adult patients who underwent IoCRRT between January 2013 and January 2021 at Hospices Civils de Lyon (Lyon, France). Patients were classified as undergoing emergency or elective surgery. Data on IoCRRT indication, feasibility, safety, renal function at hospital discharge and mortality were analyzed.
Results: IoCRRT was successfully implemented in all 43 patients. Severe acidosis (pH &lt; 7.2) was the main indication for IoCRRT in 27 patients (82%) of the emergency group, while IoCRRT was initiated to prevent metabolic complications and electrolyte imbalances in elective surgeries. Regional citrate anticoagulation was used in 36 (84%) cases. No adverse event was reported. At hospital discharge, no survivor progressed to end-stage renal disease; 4 (29%) patients exhibited a glomerular filtration rate (GFR) of 60–90 mL/min/1.73m², and 10 (71%) an GFR &gt; 90 mL/min/1.73m². Twenty-seven patients (63%) died within 30 days. 
Conclusion: IoCRRT seems to be a feasible and safe adjunctive therapy during emergency or elective surgery in patients with severe metabolic disorders. No IoCRRT-related complication was reported. Renal function appeared preserved. Further prospective studies are warranted to confirm these findings.
DOI: 10.6084/m9.figshare.31077577
title: Supplementary Material for: Diagnosed Polycystic Ovary Syndrome and Associated Severe Maternal Morbidity

description: Objectives: 
Women with pre-pregnancy polycystic ovary syndrome (PCOS) may face higher risks during pregnancy, yet evidence on its link to severe maternal morbidity (SMM) is limited. This population-based study addresses these gaps.

Design: 
Population-based cohort study using linked administrative health data from Ontario, Canada. All hospital livebirths and stillbirths 2006-2021, in women aged 15–50 years were included.

Participants/Materials, Setting, Methods:
PCOS was identified using a validated algorithm combining diagnostic codes for PCOS or hirsutism with irregular menses. Among 1,596,228 pregnancies, 110,910 (6.9%) had prior PCOS, diagnosed a median 11 years before delivery.

Results: 
Women with PCOS were older and more often obese. SMM occurred in 2.6 vs. 2.2 per 100 births among women with and without PCOS, respectively (adjusted relative risk 1.10, 95% CI 1.06–1.15). 

Limitations: 
Limitations include potential residual confounding and misclassification inherent in administrative data.

Conclusions:
Polycystic Ovary Syndrome confers a modest but significant increase in severe maternal morbidity, underscoring the need for targeted risk assessment and preventive strategies. Awareness of this association may inform clinical risk assessment and management strategies to mitigate serious maternal complications.
DOI: 10.6084/m9.figshare.31077577.v1
title: Supplementary Material for: Diagnosed Polycystic Ovary Syndrome and Associated Severe Maternal Morbidity

description: Objectives: 
Women with pre-pregnancy polycystic ovary syndrome (PCOS) may face higher risks during pregnancy, yet evidence on its link to severe maternal morbidity (SMM) is limited. This population-based study addresses these gaps.

Design: 
Population-based cohort study using linked administrative health data from Ontario, Canada. All hospital livebirths and stillbirths 2006-2021, in women aged 15–50 years were included.

Participants/Materials, Setting, Methods:
PCOS was identified using a validated algorithm combining diagnostic codes for PCOS or hirsutism with irregular menses. Among 1,596,228 pregnancies, 110,910 (6.9%) had prior PCOS, diagnosed a median 11 years before delivery.

Results: 
Women with PCOS were older and more often obese. SMM occurred in 2.6 vs. 2.2 per 100 births among women with and without PCOS, respectively (adjusted relative risk 1.10, 95% CI 1.06–1.15). 

Limitations: 
Limitations include potential residual confounding and misclassification inherent in administrative data.

Conclusions:
Polycystic Ovary Syndrome confers a modest but significant increase in severe maternal morbidity, underscoring the need for targeted risk assessment and preventive strategies. Awareness of this association may inform clinical risk assessment and management strategies to mitigate serious maternal complications.
DOI: 10.6084/m9.figshare.31077580
title: Supplementary Material for: Comparative Prognostic Value of Four Urinary Biomarkers for Cardiovascular and Renal Outcomes After Transcatheter Aortic Valve Implantation

description: Introduction: Renal risk stratification after transcatheter aortic valve implantation (TAVI) remains anchored to filtration metrics such as serum creatinine and estimated glomerular filtration rate (eGFR). These indices may not capture early tubular injury, which is clinically relevant in older TAVI populations. We therefore investigated whether four urinary biomarkers—N-acetyl-β-D-glucosaminidase (NAG), liver-type fatty acid–binding protein (L-FABP), β2-microglobulin, and α1-microglobulin—measured the day after TAVI, are associated with subsequent cardio-renal outcomes.
Methods: We enrolled 191 consecutive patients undergoing TAVI in a single-center cohort within the LAPLACE-TAVI registry (February 2016–December 2019). Spot urine collected 12–18 hours post-procedure was assayed for four urinary markers. The primary endpoint was a 24-month composite of all-cause death or first heart-failure hospitalization; a renal composite used contemporary surrogate criteria. Multivariable Cox models adjusted for clinical covariates including eGFR. Biomarkers were examined using cohort medians as prespecified cut points.
Results: Median follow-up was 1.8 years (interquartile range [IQR] 1.1–2.0); the primary endpoint occurred in 27/191 (14.1%). NAG showed no correlation with eGFR (r = −0.03, p = 0.68), whereas β2-microglobulin and α1-microglobulin correlated inversely with eGFR (r = −0.27, p = 0.002; r = −0.34, p &lt; 0.001); L-FABP was not correlated (r = −0.09, p = 0.21). Patients above the cohort median for NAG (6.8 IU/L) experienced higher 2-year event rates, with early separation of Kaplan–Meier curves (log-rank p = 0.02). In adjusted models, both high NAG (hazard ratio [HR] 2.63, 95% confidence interval (CI) 1.17–6.46; p = 0.02) and high L-FABP (HR 2.48, 95% CI 1.08–6.16; p = 0.03) remained independently associated with the primary endpoint, whereas β2-microglobulin and α1-microglobulin were not. Creatinine and eGFR were comparable across NAG strata; renal composite events were higher in the high-NAG group but did not reach statistical significance.
Conclusion: A single urinary NAG and L-FABP measurement within 24 hours post TAVI identified increased 2-year risk of death or heart-failure hospitalization despite preserved filtration indices. Although limited by sample size and single-center design, these pilot data support external validation and the evaluation of biomarker-guided surveillance and reno-protective strategies following TAVI.
DOI: 10.6084/m9.figshare.31077580.v1
title: Supplementary Material for: Comparative Prognostic Value of Four Urinary Biomarkers for Cardiovascular and Renal Outcomes After Transcatheter Aortic Valve Implantation

description: Introduction: Renal risk stratification after transcatheter aortic valve implantation (TAVI) remains anchored to filtration metrics such as serum creatinine and estimated glomerular filtration rate (eGFR). These indices may not capture early tubular injury, which is clinically relevant in older TAVI populations. We therefore investigated whether four urinary biomarkers—N-acetyl-β-D-glucosaminidase (NAG), liver-type fatty acid–binding protein (L-FABP), β2-microglobulin, and α1-microglobulin—measured the day after TAVI, are associated with subsequent cardio-renal outcomes.
Methods: We enrolled 191 consecutive patients undergoing TAVI in a single-center cohort within the LAPLACE-TAVI registry (February 2016–December 2019). Spot urine collected 12–18 hours post-procedure was assayed for four urinary markers. The primary endpoint was a 24-month composite of all-cause death or first heart-failure hospitalization; a renal composite used contemporary surrogate criteria. Multivariable Cox models adjusted for clinical covariates including eGFR. Biomarkers were examined using cohort medians as prespecified cut points.
Results: Median follow-up was 1.8 years (interquartile range [IQR] 1.1–2.0); the primary endpoint occurred in 27/191 (14.1%). NAG showed no correlation with eGFR (r = −0.03, p = 0.68), whereas β2-microglobulin and α1-microglobulin correlated inversely with eGFR (r = −0.27, p = 0.002; r = −0.34, p &lt; 0.001); L-FABP was not correlated (r = −0.09, p = 0.21). Patients above the cohort median for NAG (6.8 IU/L) experienced higher 2-year event rates, with early separation of Kaplan–Meier curves (log-rank p = 0.02). In adjusted models, both high NAG (hazard ratio [HR] 2.63, 95% confidence interval (CI) 1.17–6.46; p = 0.02) and high L-FABP (HR 2.48, 95% CI 1.08–6.16; p = 0.03) remained independently associated with the primary endpoint, whereas β2-microglobulin and α1-microglobulin were not. Creatinine and eGFR were comparable across NAG strata; renal composite events were higher in the high-NAG group but did not reach statistical significance.
Conclusion: A single urinary NAG and L-FABP measurement within 24 hours post TAVI identified increased 2-year risk of death or heart-failure hospitalization despite preserved filtration indices. Although limited by sample size and single-center design, these pilot data support external validation and the evaluation of biomarker-guided surveillance and reno-protective strategies following TAVI.
DOI: 10.6084/m9.figshare.31077583
title: Supplementary Material for: Tissue-Based Multiomic Exploratory Analysis of the uPa/uPAR System and Matrix Metalloproteinases in SARIFA-Positive Gastrointestinal Cancers

description: Introduction: We recently proposed SARIFA (Stroma AReactive Invasion Front Areas), defined as direct tumour-adipocyte interaction, as an H&E-based histopathologic biomarker in gastrointestinal cancers, particularly gastric (GC) and colorectal cancer (CRC). Despite SARIFA’s well-validated prognostic value, its mechanistic underpinnings remain unclear. We hypothesized that extracellular matrix remodelling, specifically the plasmin/plasminogen activator system, may contribute to SARIFA formation. 
Methods: To test this, we compared the prognostic value of H&E-based SARIFA-status with ELISA-based protein levels of the serine proteases urokinase-type plasminogen activator (uPA, encoded by PLAU) and plasminogen activator inhibitor-1 (PAI-1, encoded by SERPINE1) in CRC. We further examined associations between SARIFA-status and the plasmin/plasminogen activator system as well as downstream metalloproteinases using both protein (ELISA, immunohistochemistry) and bulk gene expression data (TCGA-COAD/READ and TCGA-STAD), as well as spatial gene expression profiling in CRC (n=8) and GC (n=12). 
Results: Our findings show that high expression of the plasmin/plasminogen activator system and downstream metalloproteinases correlates with SARIFA-positivity. Digital spatial profiling revealed PLAU upregulation in tumour cells and PLAUR (encoding uPAR) upregulation in adjacent stromal cells at SARIFAs, suggesting a potential receptor-ligand interaction. Notably, SARIFA-positive tumours showed significantly higher numbers of tumour buds.
Conclusion: These results provide new insights into the biological basis of SARIFAs and suggest therapeutic vulnerabilities related to the plasmin/plasminogen activator system.
DOI: 10.6084/m9.figshare.31077583.v1
title: Supplementary Material for: Tissue-Based Multiomic Exploratory Analysis of the uPa/uPAR System and Matrix Metalloproteinases in SARIFA-Positive Gastrointestinal Cancers

description: Introduction: We recently proposed SARIFA (Stroma AReactive Invasion Front Areas), defined as direct tumour-adipocyte interaction, as an H&E-based histopathologic biomarker in gastrointestinal cancers, particularly gastric (GC) and colorectal cancer (CRC). Despite SARIFA’s well-validated prognostic value, its mechanistic underpinnings remain unclear. We hypothesized that extracellular matrix remodelling, specifically the plasmin/plasminogen activator system, may contribute to SARIFA formation. 
Methods: To test this, we compared the prognostic value of H&E-based SARIFA-status with ELISA-based protein levels of the serine proteases urokinase-type plasminogen activator (uPA, encoded by PLAU) and plasminogen activator inhibitor-1 (PAI-1, encoded by SERPINE1) in CRC. We further examined associations between SARIFA-status and the plasmin/plasminogen activator system as well as downstream metalloproteinases using both protein (ELISA, immunohistochemistry) and bulk gene expression data (TCGA-COAD/READ and TCGA-STAD), as well as spatial gene expression profiling in CRC (n=8) and GC (n=12). 
Results: Our findings show that high expression of the plasmin/plasminogen activator system and downstream metalloproteinases correlates with SARIFA-positivity. Digital spatial profiling revealed PLAU upregulation in tumour cells and PLAUR (encoding uPAR) upregulation in adjacent stromal cells at SARIFAs, suggesting a potential receptor-ligand interaction. Notably, SARIFA-positive tumours showed significantly higher numbers of tumour buds.
Conclusion: These results provide new insights into the biological basis of SARIFAs and suggest therapeutic vulnerabilities related to the plasmin/plasminogen activator system.
DOI: 10.15468/dl.czax6r
title: Occurrence Download

description: A dataset containing 368 species occurrences available in GBIF matching the query:
{
 "TaxonKey" : [
 "is Dipterocarpus turbinatus"
 ]
}

 The dataset includes 368 records from 32 constituent datasets; see https://api.gbif.org/v1/occurrence/download/0013681-260108223611665/datasets/export for details.
 
Data from some individual datasets included in this download may be licensed under less restrictive terms.
DOI: 10.6084/m9.figshare.31077586
title: Supplementary Material for: The Evolution of Cephalocentesis in Contemporary Obstetric Practice: From Emergency Intervention to Planned Procedure

description: Objective: To analyze the evolution, indications and outcomes of cephalocentesis over a 38-year period at two tertiary fetal medicine centers.
Methods: Retrospective review of 70 cephalocentesis procedures (1985-2023) at Mount Sinai Hospital, Toronto and the National Maternity Hospital, Dublin. Cases were divided into pre-2002 (n=37) and 2002-onwards (n=33) cohorts in order to evaluate practice evolution.
Results: Mean gestational age at diagnosis was 32.7 ± 5.4 weeks with severe hydrocephalus in 95.7% (67/70) and hydranencephaly in 4.3% (3/70) of cases. Pre-2002, 94.6% (35/37) of procedures were performed intrapartum; 2002-onwards, this shifted to 66.7% (22/33) pre-labor planned procedures with 84.8% (28/33) using a transabdominal approach. Concurrent fetal analgesia and potassium chloride to achieve fetal asystole was introduced in 2002. Vaginal delivery was achieved in 95.7% (67/70) of cases. Perinatal mortality (excluding KCl cases) was 91.8% (45/49). All four survivors (5.8%) demonstrated neurodevelopmental impairment.
Conclusion: Cephalocentesis has evolved from an intrapartum intervention to a planned procedure with standardized protocols. Our findings support reserving this procedure for cases where there is no expectation of postnatal survival, with the primary purpose of facilitating vaginal delivery when caesarean section could unnecessarily increase maternal morbidity.