bluuebunny/crossref_metadata_2025 huggingface dataset:
346 The Bons effect—evaluation of the Frailty Service provision in Bons Secours, Galway
Authors: Okpaje B , Carty J , Raftery A , Scanlon K , Gill E , Hegarty V , Mullane D
Published: September 2023

Background

The Frailty Service in the Bons Secours Galway was created following the Covid pandemic. It is a 15-bed unit led by 2 consultant geriatricians and their team. NICE published guidelines in September 2016 for Clinical Assessment and management of multi-morbidity, where they advised on approaches to care of the older person. This included individualised management plan that incorporate non-pharmacological treatments. We aimed to evaluate the non-pharmacological intervention of the multi-disciplinary team input during the inpatient stay and assessed the result of same, using the outcome of discharge destination.

Methods

We reviewed the electronic records of all patients admitted to the Bons Secours Frailty service within November 2020 and January 2023, evaluating the input of the Occupational Therapist (OT) in their management plans. We assessed the core OT assessments (which included functional, cognitive, environmental/social assessments, and liaison with community services) and rehabilitation delivered in the frailty unit. Considering that the OT also covered the discharge planning of the patients, we therefore assessed the discharge destinations of the patients as a secondary outcome.

Results

Of the 434 total admissions, of which the average age was 84 years with 37% males and 63% females, OT reviews were performed in 100% of patients. The waiting time was <24 hours from admission. An average of 2.5 interventions were performed per patient, with Core OT assessments carried out in all cases. 82% required cognitive assessments. 10% required home visits. 61% of patients required equipment on discharge. Of the 434 patients, 78.1% returned home (of which 92% required a home care package), 5.06% transitioned to Respite, 9% required Long-Term Care placement and 1.6% were re-admitted to hospital.

Conclusion

Our findings of the Frailty service provision in Bons Secours reflect the importance of a specialist geriatric service and multi-disciplinary team in producing favourable outcomes for the older person who often have multi-morbidities and are vulnerable.
106 Older adults’ perspectives on participation in a community arts-based programme (Music and Movement for Health): a qualitative study
Authors: O'Reilly S , Fitzell C , Bhriain O Ni , O'Malley N , Cheung P-S , Byrne S , Moss H , Thabane L , O’Neill D , Glynn L , Gowran R J , Woods C B , Maher C , Louw Q , Clifford A M
Published: September 2023

Background

Ireland, like most counties worldwide, has an ageing population. It is estimated that there will be greater than one million older adults by 2031, demonstrating an increase from 13% (2015) to 20% of the overall population. Physical inactivity, which increases with age, is associated with greater multimorbidity, mortality and economic burden. Arts-based exercise programmes are an emerging area of preventative healthcare. The aim of this study was to explore the opinions and experiences of older adults on Music and Movement for Health (MMH), a tailored arts-based exercise programme.

Methods

An embedded qualitative study was conducted among older adults who participated in MMH. Data were collected through four focus groups (n = 33) and telephone interviews (n = 5). Data were analysed inductively using thematic analysis.

Results

Three overarching themes were developed; ‘Encouraging Exercise Through the Arts’, ‘Socialising in the Community: Experiences and Influences’, and ‘Coming to Terms with Retirement’, with a total of six subthemes. Participants recognised that MMH was a novel and unique programme and were attracted to MMH due to an interest in music and dance. The behaviour change techniques facilitated exercise habit formation. Through MMH, participants were able to interact with others in the community and, for some, this led to new connections within the group. Finally, the findings highlight the experiences of participants who stated they faced significant changes to their lives following retirement; however, participating in MMH provided structure to their lives.

Conclusion

The inclusion of music and dance into an exercise class was desirable to many older adults and promoted exercise habit formation. Overall, MMH appears to be an enjoyable programme which had positive perceived effects on mental and physical health. MMH is a unique evidence-based programme designed with input from key stakeholders, and community-dwelling older adults can potentially benefit from this intervention across the country.
200 Higher bone mineral density in prediabetes, diabetes and with increasing HbA1c in older Irish adults: results from the TUDA study
Authors: Fitzpatrick D , Lannon R , Laird E , Ward M , Hoey L , Hughes C F , Strain J J , Cunningham C , McNulty H , Molloy A M , McCarroll K
Published: September 2023

Background

Patients with type II diabetes have higher Bone Mineral Density (BMD) but paradoxically have an increased fracture risk. However, less is known about the relationship between prediabetes and BMD or fracture risk. We aimed to evaluate the relationship between pre-diabetes, diabetes, HbA1c and BMD in older Irish adults.

Methods

Study participants were from a large cross-sectional study of adults aged >60 years; Trinity Ulster University Department of Agriculture (TUDA) study. Patients on treatment for osteoporosis, current or previous long-term glucocorticoids, aromatase inhibitors or androgen deprivation therapy were excluded. Diabetes was defined by self-report, use of diabetic medications or HBA1c ≥6.5% and after excluding same, prediabetes was defined as a HbA1c of 5.7–6.4%[1]. BMD was measured by DXA at the total hip and lumbar spine. The relationship between prediabetes, diabetes, HbA1c and BMD was explored in regression models.

Results

There were 2,127 participants and mean age was 70.0 ± 6.5 with 57.9% female. 17.7% had diabetes and 26% prediabetes. Compared to normoglycaemic participants, diabetics had higher BMD at the hip (p < 0.001) and spine (p = 0.007) and prediabetics higher BMD at the hip (p < 0.001) after adjusting for age, sex, body mass index, serum vitamin D, eGFR, smoking, alcohol intake and timed up and go. In multivariate analysis, increasing HbA1c in non-diabetics was also associated with greater BMD at the hip (p = 0.001) but not the spine.

Conclusion

This study demonstrates that BMD is increased in older adults with both diabetes and prediabetes and with increasing HbA1c in non-diabetics. Despite this, BMD is known to underestimate fracture risk in diabetics where a lower treatment threshold for starting osteoporosis medications is recommended. This might also hold true in prediabetes where altered BMD could affect material bone quality and fracture risk though studies are conflicting and more research is required.
214 A single-site retrospective review of In-Hospital Stroke
Authors: Chapman L , Kennnedy O , Bradley D , Harbison J
Published: September 2023

Background

In-Hospital Stroke (IHS) is defined as a stroke occurring while in hospital for another diagnosis. IHS represent a distinct cohort with greater deficits, higher mortality rates, and are less likely to be discharged home compared to Community-Onset Stroke (COS).

Methods

A retrospective cohort study was performed in an acute teaching hospital from January 1st 2020 to December 31st 2021 to compare quality of care and outcome measures of IHS cases with COS counterparts. Stroke cases were identified from the hospital database submitted to the Irish National Audit of Stroke (INAS) during the 2-year period. Descriptive statistics were calculated. Categorical variables were compared using Chi Square.

Results

Of the 563 stroke cases during the 2-year period, 15% (n = 88) reflected an IHS event. The median age observed in IHS and COS cohorts was 73 and 72 years respectively. COS patients were more likely to have no disability pre-stroke when compared with IHS patients (47% versus 30%, p = 0.006). Over half (52%; n = 46) of IHS patients were admitted to the intensive care unit (ICU) during their hospital admission (p = <.0001).Co-diagnosis with COVID-19 was more common among IHS than COS (9% versus 1%; p = 0.0003). The proportion of patients receiving thrombolysis was greater in the COS cohort compared to IHS cohort (12% versus 7%; p = 0.06). Fifteen percent (n = 13) of IHS cases died compared with 12% (n = 56) of COS. IHS cases were more likely to be discharged to long term care (LTC) (8% versus 3%; p = 0.04), have moderate/severe disability (38% versus 24%; p = 0.001) and have longer length of stay (LOS) (43% versus 4%; p < 0.0001) when compared with COS counterparts. COS cases were more likely than IHS cases to be admitted to the stroke unit (SU) (79% versus 43%; p < 0.0001). Swallow screening was performed more frequently on the COS cohort (76% versus 50%; p < 0.0001).

Conclusion

IHS represent a distinct stroke subgroup in terms of outcomes and performance on stroke quality of care measures.
314 Cross-sectional analysis of patient cohort transferred to a transitional care unit under a new service model
Authors: Dennehy K , O’Donovan C , Fitzgerald R , Plant R , Rynne R , Faez I , Horgan A , Ahern E , Jennings E
Published: September 2023

Background

Currently in Ireland a proportion of hospital inpatients avail of ‘transitional care funding’ which has been in place in the HSE since 2015.The funding supports patients who are awaiting long term care placement or who require a convalescent period up to six weeks prior to discharge home. The aim of this project was to analyse the patient cohort transferred to the Transitional Care Unit (TCU) during a newly trialled model of care where a consultant geriatrician co-ordinated patient care. This new model aims for best practice by synchronising patient care through assessment, care planning, treatment, discharge planning and education.

Methods

We did a cross sectional analysis of the patient population who transferred from our model 4 tertiary hospital to the TCU under the new model of care over a 6 month period assessing their inpatient stay and discharge destination.

Results

78 patients were transferred under the new model of care to this TCU unit. Patients were transferred from the emergency department (N = 1), medical (N = 55) and surgical teams (N = 22). 27% (N = 21) of patients had a documented cognitive impairment on admission to TCU, further testing was completed during inpatient period in TCU and a further 20% (N = 14) of patients had cognitive impairment identified. Bartel scores increased from admission to discharge with 54% of patients (N = 42). 62% went directly home or home with a home care package (N = 48), other discharge destinations from TCU included rehab or long term care.

Conclusion

This cross sectional analysis identifies the baseline characteristics of patients transferring into transitional care. This patient population remains vulnerable with significant number having cognitive deficits. Transitional care placement influence outcomes for older persons including returning home. Our study highlights that oversight and advocacy for patients entering transitional care is essential to optimise care.
320 AKI-ng for better adherence: a quality improvement initiative on the medication ‘sick day rule’ in patients over 65 with acute kidney injury (AKI)
Authors: McManus C , Neves R , Rajan M , Rme R
Published: September 2023

Background

The successful mitigation of Acute Kidney Injury (AKI) among older patients is contingent on meticulous medication management, specifically adherence to the medication ‘sick day rule’. These rules, recommended by the National Institute for Health and Care Excellence (NICE) in their guidelines ‘Acute kidney injury: prevention, detection and management’, involves the temporary cessation of certain medications during episodes of acute illness. However, suboptimal adherence to this rule presents a considerable challenge in clinical practice. This quality improvement project aimed to address this issue, seeking to enhance adherence to the sick day rule among patients over the age of 65 admitted with AKI.

Methods

Initially we performed a medication reconciliation on all patients admitted to the medical take over a five-day period. Our intervention involved the distribution of information cards that clearly detailed the NICE guidelines. The cards were displayed prominently in key medical admission areas and could attach to doctors’ identification badges. We also provided education to Non-Consultant Hospital Doctors at Grand Rounds.

Results

Data collected revealed that of the 92 patients over 65 admitted, 27 met the AKI criteria. 23 of these 27 AKI patients were on medications that could exacerbate their AKI, while only 6 had all appropriate medications held. This trend extended to specific medication categories: only 8/19 patients on ACE inhibitors/ARBs, 1/5 on SGLT2 inhibitors, and 4/9 on metformin had their medication held. However, both patients on NSAIDs had their medication held, indicating a better adherence rate.

Conclusion

The goal of this quality improvement initiative is to bolster adherence to the medication sick day rule, thereby potentially reducing the incidence and severity of AKI in our older patient population. We plan to reaudit in the coming weeks to assess the impact of our intervention, affirming our ongoing commitment to improving patient outcomes through evidence-based quality improvement strategies.
Effects of defoliant exposure and medication use on the development of Parkinson’s disease in veterans
Authors: Song Seulki , Kim Jun Y , Lee Young , Jeong Hyokeun , Kim Seungyeon , Lee Eunkyung E
Published: September 2023

Background

Vietnam-era veterans were exposed to Agent Orange (AO), which is associated with a high prevalence of Parkinson’s disease (PD). However, little is known about the development of PD-like symptoms caused by drug-induced parkinsonism (DIP) in such populations. This study aimed to investigate PD incidence and PD risk following exposure to AO or DIP-risk drugs in veterans.

Methods

A retrospective cohort study was conducted using 12 years (2009–2020) of electronic medical records of the Veterans Health Service Medical Center, the largest Veterans Affairs hospital in South Korea (n = 37,246; 100% male; age, 65.57 ± 8.12 years). Exposure to AO or DIP-risk drugs, including antipsychotic, prokinetic, anti-epileptic, dopamine-depleting and anti-anginal agents, was assessed in veterans with PD, operationally defined as having a PD diagnosis and one or more prescriptions for PD treatment. The PD risk was calculated using multiple logistic regression analysis adjusted for age and comorbidities.

Results

The rates of DIP-risk drug use and AO exposure were 37.92% and 62.62%, respectively. The PD incidence from 2010 to 2020 was 3.08%; 1.30% with neither exposure, 1.63% with AO exposure, 4.38% with DIP-risk drug use, and 6.33% with both. Combined exposure to AO and DIP-risk drugs increased the PD risk (adjusted odds ratio = 1.68, 95% confidence interval, 1.36–2.08, P < 0.001).

Conclusions

The PD incidence was 1.31 times higher with AO exposure alone and 1.68 times higher with AO exposure and DIP-risk drug use. The results suggest the necessity for careful monitoring and DIP-risk drug prescription in patients with AO exposure.
Examining the Influence of Imbalanced Social Contact Matrices in Epidemic Models
Authors: Hamilton Mackenzie A , Knight Jesse , Mishra Sharmistha
Published: September 2023

Transmissible infections such as those caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread according to who contacts whom. Therefore, many epidemic models incorporate contact patterns through contact matrices. Contact matrices can be generated from social contact survey data. However, the resulting matrices are often imbalanced, such that the total number of contacts reported by group A with group B do not match those reported by group B with group A. We examined the theoretical influence of imbalanced contact matrices on the estimated basic reproduction number (R0). We then explored how imbalanced matrices may bias model-based epidemic projections using an illustrative simulation model of SARS-CoV-2 with 2 age groups (<15 and ≥15 years). Models with imbalanced matrices underestimated the initial spread of SARS-CoV-2, had later time to peak incidence, and had smaller peak incidence. Imbalanced matrices also influenced cumulative infections observed per age group, as well as the estimated impact of an age-specific vaccination strategy. Stratified transmission models that do not consider contact balancing may generate biased projections of epidemic trajectory and the impact of targeted public health interventions. Therefore, modeling studies should implement and report methods used to balance contact matrices for stratified transmission models.
White-tailed deer responses to acoustic predator cues are contingent upon past land use and contemporary fire regime
Authors: Bartel Savannah L , Kilgo John C , Orrock John L
Published: September 2023

Prey can assess the immediate risk of predation by detecting cues of predator presence, and it is expected that prey should invest in costly antipredator behaviors when a cue of predator presence is detected. Features of the habitat in which the cue is detected, such as vegetative concealment, serve as indirect cues of risk and can mediate how prey respond to direct cues of predator presence. Past agricultural land use and contemporary fire regimes are common disturbances that may modify prey perceptions of risk and could, therefore, alter prey responses to direct cues of predator presence. We examined whether the overlap of these two disturbances affected white-tailed deer (Odocoileus virginianus) responses to cues of predator presence by measuring deer vigilance and foraging bout duration in response to coyote (Canis latrans) vocalizations across 20 woodlands that varied in past land use and contemporary fire regime. Frequent fire regimes consistently increased deer visibility to predators across both land-use history contexts. Deer exhibited no behavioral response to the predator cue in habitats containing infrequent fire regimes or agricultural legacies. Deer responded to the cue in frequently burned woodlands without agricultural legacies through increased vigilance and time spent at a foraging location. These findings reveal that land-use legacies and contemporary fire regimes can mediate how prey respond to direct cues of risk. They also suggest that prey may balance the uncertainty associated with cues of predation risk with the urgency of responding to a potential attack by being vigilant and remaining in place.
INTEGRATE-Circ and INTEGRATE-Vis: unbiased detection and visualization of fusion-derived circular RNA
Authors: Webster Jace , Mai Hung , Ly Amy , Maher Christopher
Published: September 2023

Motivation

Backsplicing of RNA results in circularized rather than linear transcripts, known as circular RNA (circRNA). A recently discovered and poorly understood subset of circRNAs that are composed of multiple genes, termed fusion-derived circular RNAs (fcircRNAs), represent a class of potential biomarkers shown to have oncogenic potential. Detection of fcircRNAs eludes existing analytical tools, making it difficult to more comprehensively assess their prevalence and function. Improved detection methods may lead to additional biological and clinical insights related to fcircRNAs.

Results

We developed the first unbiased tool for detecting fcircRNAs (INTEGRATE-Circ) and visualizing fcircRNAs (INTEGRATE-Vis) from RNA-Seq data. We found that INTEGRATE-Circ was more sensitive, precise and accurate than other tools based on our analysis of simulated RNA-Seq data and our tool was able to outperform other tools in an analysis of public lymphoblast cell line data. Finally, we were able to validate in vitro three novel fcircRNAs detected by INTEGRATE-Circ in a well-characterized breast cancer cell line.

Availability and implementation

Open source code for INTEGRATE-Circ and INTEGRATE-Vis is available at https://www.github.com/ChrisMaherLab/INTEGRATE-CIRC and https://www.github.com/ChrisMaherLab/INTEGRATE-Vis.
AFsample: improving multimer prediction with AlphaFold using massive sampling
Authors: Wallner Björn
Published: September 2023

The AlphaFold2 neural network model has revolutionized structural biology with unprecedented performance. We demonstrate that by stochastically perturbing the neural network by enabling dropout at inference combined with massive sampling, it is possible to improve the quality of the generated models. We generated ∼6000 models per target compared with 25 default for AlphaFold-Multimer, with v1 and v2 multimer network models, with and without templates, and increased the number of recycles within the network. The method was benchmarked in CASP15, and compared with AlphaFold-Multimer v2 it improved the average DockQ from 0.41 to 0.55 using identical input and was ranked at the very top in the protein assembly category when compared with all other groups participating in CASP15. The simplicity of the method should facilitate the adaptation by the field, and the method should be useful for anyone interested in modeling multimeric structures, alternate conformations, or flexible structures.

Availability and implementation

AFsample is available online at http://wallnerlab.org/AFsample.
Demographic processes, refugia and dispersal routes during the Pleistocene in a sigmodontine rodent assemblage from the South American Pampas
Authors: Ortiz N , Pinotti J D , Trimarchi L I , Gardenal C N , González-Ittig R E , Rivera P C
Published: September 2023

The Pampas of South America represents one of the most extended subtropical–temperate grasslands in the world. This ecoregion was influenced by Pleistocene climate oscillations. The sigmodontine rodent assemblage inhabiting this region is a good model system to analyse the impact of these climate changes on evolutionary histories. We performed a comparative phylogeographical study on seven species to evaluate the concordance of phylogeographical patterns among them, to assess if they experienced congruent and synchronous demographic changes, and posit putative centres of origin and dispersal routes. Four species (Calomys musculinus, Oligoryzomys flavescens, Oxymycterus nasutus and Oligoryzomys nigripes) showed evidence of demographic expansion. In the first three, population increases started during Marine Isotope Stage 5 (MIS 5) while in Ol. nigripes, the rise started during MIS 7; this rise would have continued to the present in all cases. Necromys lasiurus, Scapteromys tumidus and Scapteromys aquaticus did not show a pattern of expansion. Four centres of origin were identified; in general, populations sharing the same putative refugium followed common dispersal routes. Our results indicate that the Pampas offered relatively stable habitats over time, mainly in areas associated with watercourses or coastlines, suggesting that recent Pleistocene climate oscillations have had a moderate impact on this ecoregion compared to other regions of South America.
The Sphagnum cuspidatum complex: phylogeny, species delimitation, and morphology
Authors: Robinson Sean C , Nieto-Lugilde Marta , Duffy Aaron M , Martinez Muñoz Katherine , Aguero Blanka , Merced Amelia , Hassel Kristian , Flatberg Kjell Ivar , Shaw A Jonathan
Published: September 2023

The use of species as a concept is an important metric for assessing biological diversity and ecosystem function. However, delimiting species based on morphological characters can be difficult, especially in aquatic plants that exhibit high levels of variation and overlap. The Sphagnum cuspidatum complex, which includes plants that dominate peatland hollows, provides an example of challenges in species delimitation. Microscopic characters that have been used to define taxa and the possibility that these characters may simply be phenoplastic responses to variation in water availability make species delimitation in this group especially difficult. In particular, the use of leaf shape and serration, which have been used to separate species in the complex, have resulted in divergent taxonomic treatments. Using a combination of high-resolution population genomic data (RADseq) and a robust morphological assessment of plants representing the focal species, we provide evidence to evaluate putative species in this complex. Our data support the recognition of S. cuspidatum, S. fitzgeraldii, S. mississippiense, and S. trinitense as genetically distinct species that can be separated morphologically. These results indicate that S. viride does not differ genetically from S. cuspidatum. Our results are broadly relevant to other aquatic groups where leaf shape and marginal teeth are used to distinguish species.
Rapid cryptic divergence of the Anastrepha fraterculus complex in the Late Pleistocene: a phylogeographical–ecological approach
Authors: Freilij Damián , Vilardi Juan César , Gómez-Cendra Paula
Published: September 2023

The Anastrepha fraterculus complex (AF complex) is a complex of fruit fly species consisting of eight morphotypes distributed across the Americas. In this study, landscape genetics, phylogeographical inferences and coalescence simulations were used to unveil the evolutionary history of the AF complex. Nuclear ribosomal ITS1 sequences from 331 samples distributed in 10 American countries throughout 32 ecoregions and seven biomes were analysed. Results showed high levels of diversity, intraspecific divergence and structuring associated with the different morphotypes of the complex. The analysis of gene flow and genetic diversity showed a clear geographical and environmental pattern. The morphotype–environment association suggested that the cryptic divergence process has involved local adaptation as a mechanism to withstand harsh, novel or variable conditions. The analysis showed a rapid divergence between morphotypes. Haplotypes have been diverging for ~27 000 years before the present, probably enhanced by environmental changes during the Last Glacial Maximum. Diversity estimators and neutrality tests revealed that populations have been experiencing a recent linear growth, starting in the Early Holocene (~11 500 years before the present). The Bayesian phylogeographical and ecological clustering approach detected five spatially separated and ecologically differentiated clusters. Additionally, equatorial Amazonia was indicated to be the most probable ancestral centre of origin for the AF complex.
Olfactory training: effects of multisensory integration, attention towards odors and physical activity
Authors: Li Zetian , Anne Abriat , Hummel Thomas
Published: September 2023

Olfactory training (OT) has been shown to be of value in the treatment of olfactory dysfunction. The present study aimed to investigate whether the efficacy of OT could be modulated with multisensory integration, attention towards odors, odor complexity, or physical activity assessed with a questionnaire. One hundred healthy participants were recruited and divided into 4 groups. Except for controls (n = 26, mean age ± SD = 36 ± 15 years) all participants performed OT 4 times a day. In the “video” group (n = 26, age 39 ± 19 years) OT was performed while watching specific and congruent video sequences. In the “counter” group (n = 24, 38 ± 17 years) participants additionally counted the number of odors 1 day per week, and in the “training only” group no additional measures were taken in addition to OT (n = 24, 38 ± 20 years). “Single-molecule” odorants or “complex mixtures” were distributed randomly for training stimulation. Sniffin’ sticks tests (odor identification, odor discrimination, and odor threshold), cognitive tests, and a series of scales were measured at both baseline and after 3 months of OT. The degree of physical activity was recorded with a questionnaire. Olfactory function improved in the video and counter groups after OT, especially for odor threshold and discrimination. Yet, odor complexity and the degree of physical activity had limited effects on olfactory improvement after OT. Both multisensory interaction and attention towards odors plus OT appeared to facilitate improvement of olfactory function in healthy individuals compared with OT alone and controls, which could provide new promising treatments for clinical applications.
Pattern of cardiovascular admission diagnoses during the month of Ramadan: a single center experience
Authors: Taha Hesham S , Youssef Ghada , Shaker Mirna M , Ghalab Mohamed , Sayed Hadeer G , Abdullah Suzan H , Thabet Mohamed A , Mostafa Amir
Published: September 2023

Background

Fasting Ramadan has been linked to favorable health profile, yet some unhealthy behaviors were shown to affect the progression of cardiovascular diseases during the holy month.

Purpose

To detect the prevalent diagnoses of cardiovascular admissions during the month of Ramadan and to compare them to the admission diagnoses during the rest of the year.

Methods

This retrospective observational study included all patients who were admitted to the Cardiology department and the Coronary Care Unit from April 2019 to May 2022, with 4 Ramadan months included. The median number of specific cardiac admission diagnoses during Ramadan months were compared to the median number of similar admission diagnoses during the other months of the year.

Results

The number of patients admitted during the 4 year-study period were 8170 patients, 14.6% of them (n = 1194 patients) were admitted during the 4 Ramadan months. All cardiovascular diagnoses were comparable during Ramadan admissions as compared to the rest of the year, Table. There was a trend towards higher cardiovascular admission rates during Ramadan in almost all diagnoses except for unstable angina, infective endocarditis and pericardial diseases.

Conclusions

The pattern of specific cardiovascular disease admission during Ramadan was not different from the pattern of admission during the rest of the year. Yet, there were numerically higher cardiovascular admissions during the 4 Ramadan months.

Table Comparison of the median number of admission diagnoses in the 4 Ramadan months and the monthly average of the 4 years Ramadan months Median (range) Monthly average of the 4 years Median (range) P value IHD 145.5 (63) 106 (74) 0.486 * CCS 39.5 (35) 17 (11) 0.057 * ACS 107.5 (71) 89 (83) 0.686 - STEMI 49.5 (34) 39 (24) 0.343 - NSTEMI 41 (46) 39.5 (56) 1.0 - UA 8.5 (8) 10 (4) 0.686 ADHF & cardiogenic shock 113.5 (111) 56 (37) 0.486 Arrhythmia 43.5 (39) 34 (10) 0.343 - AF 18.5 (22) 22.5 (5) 0.686 - SVT 9.5 (15) 6 (9) 0.486 - AFL 6 (12) 2.5 (2) 0.2 - CHB 4 (5) 3.5 (3) 0.686 IE 10.5 (7) 14 (6) 0.2 PE 3 (11) 2.5 (1) 0.686 Pericardial disease 2 (6) 6 (11) 0.2 Hypertensive urgency & emergency 12 (23) 9.5 (7) 1.0 IHD, ischemic heart disease; CCS, chronic coronary syndrome; ACS, acute coronary syndrome; STEMI, ST elevation myocardial infarction; NSTEMI, non-ST elevation myocardial infarction; UA, unstable angina; ADHF, acute decompensated heart failure; AF, atrial fibrillation; SVT, supraventricular tachycardia; AFL, atrial flutter; CHD, complete heart block; IE, infective endocarditis; PE, pulmonary embolism.

Additional Content

An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.
Steps to bridge the gap for better kidney care for cardiac nurses
Authors: El-Khatib Mohamed , Elsayed Hassan , Kandel Mohamed , Mostafa Saber
Published: September 2023

Background

Kidney diseases have been identified as a major threat to patients with cardiac diseases as they can affect 50% of patients with cardiovascular diseases stages 4 and 5. World Kidney Day (WKD) is a global campaign aimed at raising the awareness of the importance of our kidneys.

Aim

Aswan Heart Centre was celebrating WKD by conducting an educational awareness day aiming to enhance and fill the knowledge gap for healthcare workers and patients.

Process

This event was divided as follows:Patients and families: nurses in different departments of the facility ran several educational sessions, and patients group discussions to promote the wellbeing of patients and families regarding the Chronic Kidney Disease (CKD) and the 8 golden rules through the utilization of some interactive materials such as videos and educational posters written in Arabic.Healthcare workers: An online session was conducted for all nurses in Aswan Heart Centre to enhance the knowledge background regarding chronic kidney disease.

Furthermore, an online survey was completed by the nurses to assess the current understanding of the chronic kidney disease prior the online session. Graph1.

Survey result

71 nursing staff took the survey.

Data analysis

Most of the staff were aware about the kidney health as the average of the correctly answered questions is 67.25% as shown in Chart 1.

Recommendation

Such event raises the awareness about our kidneys and encourage patients for systematic screening.

Additional Content

An author video to accompany this abstract is available on https://academic.oup.com/eurheartjsupp. Please click on the arrow next to ‘More Content’ and then click on ‘Author videos’.
Clinical relevance of salivary pepsin detection in diagnosing gastroesophageal reflux disease subtypes
Authors: Zhang Mengyu , Wu Tingting , Tan Niandi , Chen Songfeng , Zhuang Qianjun , Luo Yu , Xiao Yinglian
Published: September 2023

Background

Gastroesophageal reflux disease (GERD) is heterogeneous with a varied symptom spectrum and reflux profiles. Its definite diagnosis often requires invasive tools including endoscopy or reflux monitoring. The aim of this study was to investigate the clinical relevance of salivary pepsin detection as a non-invasive screening tool to diagnose GERD of different subtypes.

Methods

A total of 77 patients with suspected GERD symptoms and 12 asymptomatic controls were analysed. All participants performed symptom evaluation, upper endoscopy, esophageal manometry, and 24-hour multichannel intraluminal impedance-dual pH probe monitoring. Saliva was self-collected across three different time points: at early fasting, postprandially, and at symptom occurrence. Salivary pepsin levels were measured via Peptest. The optimal threshold of salivary pepsin for diagnosing distal or proximal reflux was determined according to a receiver-operating characteristic curve.

Results

The average salivary pepsin concentration of suspected GERD patients was significantly higher than that of controls (100.63 [68.46, 141.38] vs 67.90 [31.60, 115.06] ng/mL, P = 0.044), although no difference was found among patients with different symptom spectrums. The distal reflux group had a higher average pepsin concentration than non-reflux patients (170.54 [106.31, 262.76] vs 91.13 [63.35, 127.63] ng/mL, P = 0.043), while no difference was observed between the distal reflux group and the proximal reflux group. The optimal cut-off value of salivary pepsin concentration for diagnosing pathological distal reflux was 157.10 ng/mL, which was higher than that for diagnosing pathological proximal reflux (122.65 ng/mL). The salivary pepsin concentration was significantly correlated with distal and proximal reflux parameters.

Conclusions

Salivary pepsin measurement can help in identifying true GERD with pathological distal reflux or proximal reflux, regardless of different symptom spectrums. A higher threshold should be applied for diagnosing distal reflux than for proximal reflux.
Genomic Basis of Adaptive Divergence in Leg Length between Ground- and Tree-Dwelling Species within a Bird Family
Authors: Huang Miaomiao , Liu Yanrui , Lu Xin
Published: September 2023

Hind limbs of tetrapods vary greatly in length and the variability can be associated with locomotor adaptation. Although the phenotypic evolution has been well documented, the underlying genetic basis remains poorly understood. We address this issue by integrating comparative genomics and functional prediction with a study system consisting of ground-dwelling, long-legged and tree-dwelling, short-legged species within the avian family Paridae. Genome-wide divergence and phenotypic correlation analyses jointly identified five highly divergent genomic regions that are significantly related with the difference in leg length between these two groups. Gene annotation for these regions detected three genes involved in skeletal development, that is, PTPA, BRINP1, and MIGA2, with the first one being under the strongest selection. Furthermore, four single nucleotide polymorphisms (SNPs) in the coding region of PTPA can well distinguish the two groups with distinct leg length. Among the four SNPs, one is non-synonymous mutation, and according to the prediction for protein structure and function, it can affect the 3D structure of the encoded protein by altering the corresponding amino acid's position. The alleles of PTPA were found in all sequenced species of the orders Palaeognathae and Psittaciformes, which typically take a ground locomotion style. A whole-genome scanning across bird species uncovered that the four SNPs are more likely to be present in resident passerines with increased leg length/wing length ratios (a proxy of leg-dependent locomotion efficiency). Our findings provide insight into the molecular evolution of locomotion performance based on leg morphology in birds.
Population Genomics of Two Closely Related Anhydrobiotic Midges Reveals Differences in Adaptation to Extreme Desiccation
Authors: Shaikhutdinov Nurislam M , Klink Galya V , Garushyants Sofya K , Kozlova Olga S , Cherkasov Alexander V , Kikawada Takahiro , Okuda Takashi , Pemba Dylo , Shagimardanova Elena I , Penin Aleksey A , Deviatiiarov Ruslan M , Gazizova Guzel R , Cornette Richard , Gusev Oleg A , Bazykin Georgii A
Published: September 2023

The sleeping chironomid Polypedilum vanderplanki is capable of anhydrobiosis, a striking example of adaptation to extreme desiccation. Tolerance to complete desiccation in this species is associated with emergence of multiple paralogs of protective genes. One of the gene families highly expressed under anhydrobiosis and involved in this process is protein-L-isoaspartate (D-aspartate) O-methyltransferases (PIMTs). Recently, another closely related midge was discovered, Polypedilum pembai, which is able not only to tolerate desiccation but also to survive multiple desiccation–rehydration cycles. To investigate the evolution of anhydrobiosis in these species, we sequenced and assembled the genome of P. pembai and compared it with P. vanderplanki and also performed a population genomics analysis of several populations of P. vanderplanki and one population of P. pembai. We observe positive selection and radical changes in the genetic architecture of the PIMT locus between the two species, including its amplification in the P. pembai lineage. In particular, PIMT-4, the most highly expressed of these PIMTs, is present in six copies in the P. pembai; these copies differ in expression profiles, suggesting possible sub- or neofunctionalization. The nucleotide diversity of the genomic region carrying these new genes is decreased in P. pembai, but not in the orthologous region carrying the ancestral gene in P. vanderplanki, providing evidence for a selective sweep associated with postduplication adaptation in the former. Overall, our results suggest an extensive relatively recent and likely ongoing adaptation of the mechanisms of anhydrobiosis.
Consumer Buying Behaviour
Authors: Paul Baines , Sara Rosengren , Paolo Antonetti
Published: September 2023

This chapter discusses consumer buying behaviour. It acknowledges the rational and irrational components of the behaviour as numerous biases influence the decision-making processes. According to researchers, confirmation bias, availability effect, endowment effect, present bias, Dunning-Kruger effect, sunk-cost fallacy, and anchoring are significant factors of consumer behaviour. Despite the individual personality and characteristics of consumers, the opinions, attitudes, and values of others also affect how we consume. The chapter then details how reference groups and cultural differences influence consumer behaviour, highlighting how celebrity endorsers are powerful influencers. It highlights the complexity of human perception, learning, and memory processes when involved with consumer decision-making.
Introduction to Human Resource Management
Authors: Banfield Paul , Kay Rebecca , Royles Dean
Published: September 2023

Introduction to Human Resource Management is made up of three parts. Part One looks at the foundations of human resource management (HRM). This includes an examination of managing people at work, the evolution of the human resources (HR) function, and a strategic perspective. Part Two looks at operational challenges, including talent management, ethics and leadership, HRM in an international context, recruitment and selection, employee relations, and misconduct. The last part looks HRM processes, which encompass workforce planning and management; learning, training, and development; managing performance; and managing rewards.
Strategic Human Resource Management
Authors: Bailey Catherine , Mankin David , Kelliher Clare , Garavan Thomas
Published: September 2023

Strategic Human Resource Management is made up of four parts. The first part looks at the context of strategic human resources management (SHRM). It considers the global context. The second part looks at strategic SHRM in terms of the role of the human resources (HR) function, HR strategy, resources-based and institutional perspectives on SHRM, and performance. The third part looks at strategic imperatives which includes examinations of talent management, employment relations, employee engagement, and business ethics. The last part is about new forms of SHRM.
Winning Customers and Competing Effectively
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter discusses how to win over customers while competing effectively in the market. It looks at the concept of order qualifiers (OQs) as characteristics of a product or service with recognized quality standards, while order winners (OWs) are those characteristics that contribute to winning business from customers. The chapter lists the five main performance objects: cost, quality, flexibility, dependability, and speed. It then discusses the seven types of market structures such as perfect competition, imperfect competition, oligopoly, duopoly, monopoly, oligopsony, and monopsony. Additionally, the chapter explores alternative approaches to customer market segmentation. It also notes how companies compete on the basis of order qualifiers and order winners.
Operations Processes and Life Cycles
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter looks into operations processes and life cycles. It notes how process types have evolved through the craft, mass production, and strategic productions eras. The chapter explores the five basic types of materials processing operations such as project, job shop, batch production, assembly line, and continuous flow. It also includes the list of three basic types of customers: mass service, service factory, and service shop. In addition, the chapter discusses the product life cycle and service firm life cycle. It shares the principles of good process design using various types of process charts while referencing characteristics like consistency and cost-effectiveness.
Managing Capacity and Demand
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter looks into managing capacity and demand. It defines capacity as the maximum possible output of an operation or process in a given time. The chapter explores different types of capacity measurement alongside its management in a customer processing operation. Additionally, it discusses alternative methods for forecasting demand and managing capacity by referencing time series forecasting, causal forecasting, qualitative techniques, level capacity, chase demand, and demand management. The chapter also lists the four types of labour flexibility. It mentions revenue management as the system for operators to maximize profitability through their senior management in operations.
Managing Quality
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter discusses quality. It clarifies quality in terms of operations perspective as fitness for purpose, service, durability, and reliability. Moreover, the chapter looks into the quality gap model as it is used to identify five main ways in which quality may be lower than desired. It also explores the differences between quality inspection, quality control, quality assurance, total quality management, and continuous improvement. The chapter then lists major tools and techniques for managing quality such as poka-yoke and quality circles. It narrates the alternative approaches to the external accreditation of quality by referencing ISO 9001, the Customer Service Excellence scheme, and the EFQM scheme.
Managing the Workforce and Technology
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter looks into workforce and technology management. It explores how labour structures impact people management in operations and alternative approaches to rewarding employees. The chapter also discusses the benefits of job enlargement and job enrichment in line with empowerment in the workplace. It notes the different types of organizational culture such as power culture, role culture, task culture, and person culture. Additionally, the chapter includes the concept of a socio-technical system. It then provides a list of different types of technology and their respective roles in the operation of material processing, socio-technical systems in customer processing, and information processing.
Managing Projects, Crises, and Business Continuity
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter focuses on managing projects, crises, and businesses’ continuity. It clarifies the difference between project management and operations management by referencing tools used in project management. A project is a temporary endeavour with a definite beginning and end, which appear alongside limitations and agreed costs. Thus, project management is defined as the planning, organizing, directing, and controlling of company resources for a relatively short-term objective. Additionally, the chapter looks into waterfall project management and agile management. It explores the principles of risk management while differentiating between a crisis and disaster. Moreover, the chapter discusses businesses continuity planning which has five main phases: impact analysis, solution design, implementation, testing and organization acceptance, and maintenance.
Lean, Agile, and Mass Customization Strategies
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter focuses on lean, agile, and mass customization strategies. It discusses lean production alongside its main principles which are often associated with just-in-time (JIT) operations. The chapter then includes the eight wastes of lean production alongside the application of tools and techniques for lean production like single minute exchange of die and kanban. It explores total productive maintenance wherein it focuses on the condition and maintenance of equipment. Next, the chapter explains the development of lean thinking with regards to its application to customer processing operations. It adds the tools used to implement agility. The chapter then expounds on the process of mass customization.