bluuebunny/crossref_metadata_2025 huggingface dataset:
348 Capturing the impact of an occupational therapy led falls education group with a client-centred and peer-learning approach on older inpatients
Authors: Ward K
Published: September 2023

Background

Falls and fall-related injuries have negative impacts on functional independence and quality-of-life. The risk of falling increases with age with a third of older people falling yearly. Falls can often be prevented. Research from the most up-to-date World Falls Guidelines, emphasises the significance of adopting a client-centred approach on falls efficacy. It highlights engaging with client’s attitudes and priorities about falls, along with utilising standardised outcome measures. A weekly Cccupational Therapy (OT) led evidence-informed falls education group is run weekly with older adult inpatients in a Dublin hospital. The group is informed by the World Falls Guidelines and adopts a client-centred and peer-learning approach to address falls education needs. In order to gather information on the effectiveness of the group on participants, this project saw an opportunity to introduce a standardised outcome-measure.

Methods

The Modified Falls Efficacy Scale (MFES) is recommended by the World Falls Guidelines and was trialled as an outcome measure pre and post-group to measure the success of the intervention. After a period of trialling the MFES, feedback was obtained from OT colleagues and patients and there was increased compliance. Comparison of pre and post scores identified an increase in self-efficacy and qualitatively participants advised greater insight and awareness into the impact of self-efficacy on preventing falls.

Results

Introducing the MFES successfully evaluated the efficacy of the group quantitatively while also providing clients with insights into their individual risk-factors, including self-efficacy. Further benefits were seen with the peer-support element of the group where clients had the opportunity to share their lived-experience to enable patient-empowerment.

Conclusion

Occupational therapists can play a pivotal role in supporting clients to recognise the importance of self-efficacy and education as an element of falls management. Furthermore, utilising standardised outcomes-measures which incorporate participant subjective perspectives can support greater patient insight.
351 Snapshot of Transient Ischaemic Attack inpatient management at a model three Irish hospital
Authors: Beirne E , Hickey P , O'Malley G
Published: September 2023

Background

Transient Ischaemic Attack (TIA) is a common presentation to hospitals and portends a high risk for eventual stroke. The EXPRESS study suggested the benefit of urgent outpatient assessment of TIA, which was associated with a 80% risk reduction of early recurrent stroke when compared to usual care. The HSE model of care for stroke endorses that rapid access TIA clinics could reduce costs of hospital admissions. Average length of admission for TIA is 6.7 days in Ireland. This study aimed to examine TIA admission lengths and identify possible targets for improvement in a model three Irish hospital.

Methods

All patients with a HIPE coded diagnosis of ‘Transient Ischaemic Attack’ from 17/12/21 to 20/8/22 were included. All coded diagnoses of ‘Transient Ischaemic Attack’ had a normal MRI brain DWI—abnormal MRI DWI imaging is coded as stroke. Therefore the true number of TIAs was not captured. Hospital electronic databases were used to identify baseline demographics, date of inpatient investigation request and date of inpatient investigation completion.

Results

64 cases were identified. The median age was 79 years (interquartile range 67 to 86 years). 45% were female. 52% were admitted under a stroke/geriatric team. Median length of admission was 4 days (IQR 3 to 7 days). CT was requested on median day 0. MRI, carotid doppler US and echocardiogram were requested on a median day 1. 94% underwent CT brain imaging on median day 1. 34 (53%) underwent MRI brain DWI, on median day 3. 13 (20%) underwent carotid doppler US, on median day 3. 20 (31%) underwent echocardiogram, on median day 4.

Conclusion

Length of hospital stay has improved compared to prior studies. Limited access to investigations may prolong hospital stay. Streamlining services with development of urgent outpatient TIA clinics, could improve outcomes, save clinician time, free up hospital beds and save hospital funding.
160 Frailty at the front door: a two-way street
Authors: Madden R , Connolly K , Harding N , McLoughlin R , Dunleavy N , McKenna K , Kelly L , Kelly A J , Kearin C , Ryan M , Whelan C , Hayden D , McElwaine P
Published: September 2023

Background

The National Clinical Programme for Older Adults (NCPOP) advocates for timely access to integrated care that is attuned to the complex needs of older adults. Frailty Intervention teams have been introduced in Emergency Departments (ED) around the country, and have proven effectiveness in reducing wait times and hospital length of stay in older patients. The introduction of the Pathfinder service—a collaboration between acute hospitals and the National Ambulance Service—is also proving effective in reducing ED attendances for low-acuity problems in older adults.

Methods

We aimed to develop pathways between a Gerontological Emergency Department Intervention (GEDI) team, and a new Pathfinder team within our hospital catchment area, in order to support older adults to remain at home where safe and feasible. A mapping exercise of potential pathways between these services was conducted. Suitability criteria were developed and a communication strategy for case discussion was formulated. A collaborative approach was taken to ensure continuous two-way communication, and a patient-focussed ethos maintained throughout.

Results

A total of four open-ended pathways were identified between the two services: (1) Pathfinder convey patient to ED via GEDI team, and patient discharged from ED back to Pathfinder for follow up; (2) GEDI identify patient suitable for ED discharge, supported by Pathfinder team; (3) Patients discharged outside of GEDI operational hours (08:00–18:30) supported by Pathfinder team (where already assessed by GEDI); (4) Patients conveyed by Pathfinder, identified as suitable for Age-Related ANP-led Assessment Unit.

Conclusion

Close collaboration between two frailty-focussed older persons’ teams has helped to avoid unnecessary hospital admissions among frail older adults, and provide more gerontologically-attuned care on the acute floor. Through this close collaboration, we are reflecting the NCPOP aims of using integration and Comprehensive Geriatric Assessment to support older people to live well in their own homes.
189 Incidence of hospital admission among Long-Term Care Facility residents versus Community Dwelling older adults: a population based observational study
Authors: Power L , Rana W , Coen N , Bambrick P , Mello S
Published: September 2023

Background

Long-Term Care Facility (LTCF) residents are prone to acute illness and hospital admission due to underlying factors including advanced age, chronic comorbidity and increased frailty. This study aims to determine the incidence of hospital admission among LTCF residents in comparison to their Community Dwelling (CD) counterparts, and to describe reasons for hospitalisation, and admission-related adverse outcomes.

Methods

Hospital In-Patient Enquiry (HIPE) data was obtained for all LTCF residents and CD adults over the age of 75 residing in Waterford County, Ireland, who were acutely admitted in 2022. This included demographic data, International Classification of Diseases (ICD-10) diagnosis, Length of Stay (LoS), and discharge outcome. Incidence was calculated by dividing the number of persons admitted to hospital by the total population at risk over a one-year period. Chi-squared test was used to determine significant difference between the two groups.

Results

Admission incidence was 0.40 for LTCF residents and 0.28 for CD (p < 0.001). Average age was 83 years, and median LOS was seven days in both groups. The most common causes for admission among LTCF residents were infection (56%, n = 147) and falls (12%, n = 31). CD were mostly admitted with infection (31%, n = 805), cardiac issues (16%, n = 414), and falls (12%, n = 303). LTCF residents were more likely than CD to be admitted with Covid-19 infection (9% vs 4%, p = 0.003). There was no difference in mortality rates (8% LTCF vs 6% CD, p = 0.33). LTCF residents were more likely to have a diagnosis of dementia (43% vs 11%, p < 0.001) and develop delirium during admission (30% vs 16%, p < 0.0001).

Conclusion

LTCF residents are significantly more likely to be hospitalised than CD, and to experience delirium during admission. Proper advanced care planning and provision for treatment with intravenous antibiotics in the LTCF may reduce admissions to hospital, but more importantly will provide person-centred care and potentially improve clinical outcomes.
When to expect scalp hair regrowth during treatment of severe alopecia areata with baricitinib: insights from trajectories analyses of patients enrolled in two phase III trials
Authors: King Brett , Shapiro Jerry , Ohyama Manabu , Egeberg Alexander , Piraccini Bianca Maria , Craiglow Brittany , Sinclair Rodney , Chen Yun-Fei , Wu Wen-Shuo , Ding Yuxin , Somani Najwa , Dutronc Yves
Published: September 2023

Background

Baricitinib is approved for the treatment of adults with severe alopecia areata (AA). In the absence of robust data on the patterns of regrowth during treatment of severe AA, there is a gap in the knowledge regarding treatment expectations.

Objectives

To examine whether different clinical response subgroups could be identified in baricitinib-treated patients with severe AA and factors that contribute to these subgroups.

Methods

The BRAVE-AA1 and BRAVE-AA2 phase III trials enrolled patients with severe AA [Severity of Alopecia Tool (SALT) score ≥ 50 (≥ 50% scalp hair loss)]. Patients randomized to baricitinib 4 mg or 2 mg retained their treatment allocation for 52 weeks. Based on patterns identified through growth mixture modelling (GMM), patients were categorized into responder subgroups according to when they first achieved ≥ 30% improvement from baseline in SALT score (SALT30). For each responder subgroup, trajectories of response (i.e. achievement of a SALT score ≤ 20, SALT score ≤ 10 and ≥ 50% change from baseline in SALT score) and baseline disease characteristics are reported.

Results

Respectively, 515 and 340 patients were randomized to once-daily baricitinib 4 mg and 2 mg at baseline; 69% and 51%, respectively, achieved SALT30 at least once by week 52. Based on GMM findings, we identified three responder subgroups: early (SALT30 by week 12), gradual (SALT30 after week 12–week 36) and late (SALT30 after week 36–week 52). The proportions of early, gradual and late responders and nonresponders were, respectively, 33%, 28%, 8% and 31% among patients treated with baricitinib 4 mg, and 20%, 23%, 9% and 49%, respectively, among those treated with baricitinib 2 mg. Early responders had a shorter trajectory to maximal clinical outcomes (e.g. > 78% achieved a SALT score ≤ 20 by week 36) vs. gradual or late responders. Early responders were more frequent among patients with baseline severe AA (SALT score 50 to < 95) vs. very severe AA (SALT score 95–100). Overall, responders (early to late) were more frequent in patients with short (< 4 years) episodes of hair loss.

Conclusions

These analyses identified early, gradual and late responder subgroups for scalp hair regrowth in baricitinib-treated patients with severe AA, and that these subgroups are influenced by baseline characteristics. Findings from these analyses will help to inform treatment expectations for scalp hair regrowth.
Athena: Specialty Certificate Examination case for general dermatology
Authors: Singh Sukhdeep , Mehta Hitaishi , Bishnoi Anuradha , Chatterjee Debajoti
Published: September 2023

This Athena concerns a 45-year-old man who presented with a 1-year history of recurrent tense fluid-filled lesions over his forearms, hands, feet and face associated with scarring and pigmentary changes. He had a history of regular alcohol intake (> 3 units daily). Lesion biopsy revealed a thick granular deposition of IgG along the basement membrane with thick homogeneous positivity of papillary dermal vessels for various immunoreactants (IgG, IgA, C3, IgM).
Topical medication packaging: can more be done to facilitate recycling?
Authors: O’Malley Seán , Feighery Cliona
Published: September 2023

Topical medications form the cornerstone of a dermatologist’s prescribing and these are provided in packaging made from a variety of materials including aluminium and plastics. Given the importance of increased awareness about sustainability and recycling, we evaluated whether these materials had potential for recycling and, if so, was any information provided on the packaging of some commonly prescribed topical preparations. Our small analysis suggests there is significant room to highlight the potential recyclability of materials in this packaging, in particular aluminium.
IL-21, not IL-17A, exacerbates murine primary biliary cholangitis
Authors: Chan Chun-Wen , Chen Hung-Wen , Wang Yu-Wen , Lin Chia-I , Chuang Ya-Hui
Published: September 2023

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease caused by intrahepatic bile duct injuries, resulting in fibrosis, cirrhosis, and eventually liver failure. T helper (Th) 17 cells are proposed to involve in the pathogenesis of PBC. However, how and which Th17 cell-derived cytokines affect PBC remains unclear. In this study, we investigated the effects of Th17 effector cytokines, including interleukin (IL)-17A, IL-17F, and IL-21 in PBC using a xenobiotic-induced mouse model of autoimmune cholangitis (inducible chemical xenobiotic models of PBC) treated with cytokine-expressing adeno-associated virus. Our results showed that administration of IL-17A, the well-known main cytokine produced by Th17 cells, did not augment liver inflammation or fibrosis. In contrast, we noted IL-17A-treated mice had lower hepatic Th1 cell numbers and higher hepatic CD11b+Ly6G+ polymorphonuclear myeloid-derived suppressor cell numbers. IL-17F did not alter liver inflammation or fibrosis. However, the administration of IL-21 exacerbated liver inflammatory responses and portal cell infiltration. IL-21 markedly increased the numbers of activated CD8+ T cells and liver tissue-resident memory CD8+ T cells. Moreover, IL-21 aggravates liver fibrosis in mice with autoimmune cholangitis. These results emphasized that not IL-17A but IL-21 in Th17 cell-derived cytokines affected the pathogenesis of PBC. IL-21 enhanced liver inflammation and progression to fibrosis by enhancing the numbers and effector activities of CD8+ T cells. Delineation of the effects of different Th17 effector cytokines in PBC offers clues for developing new therapeutic approaches.
Cardiomyocyte and endothelial cells play distinct roles in the tumour necrosis factor (TNF)-dependent atrial responses and increased atrial fibrillation vulnerability induced by endurance exercise training in mice
Authors: Lakin Robert , Polidovitch Nazari , Yang Sibao , Parikh Mihir , Liu Xueyan , Debi Ryan , Gao Xiaodong , Chen Wenliang , Guzman Camilo , Yakobov Simona , Izaddoustdar Farzad , Wauchop Marianne , Lei Qian , Xu Weimin , Nedospasov Sergei A , Christoffels Vincent M , Backx Peter H
Published: September 2023

Aims

Endurance exercise is associated with an increased risk of atrial fibrillation (AF). We previously established that adverse atrial remodelling and AF susceptibility induced by intense exercise in mice require the mechanosensitive and pro-inflammatory cytokine tumour necrosis factor (TNF). The cellular and mechanistic basis for these TNF-mediated effects is unknown.

Methods and results

We studied the impact of Tnf excision, in either atrial cardiomyocytes or endothelial cells (using Cre-recombinase expression controlled by Nppa or Tie2 promoters, respectively), on the cardiac responses to six weeks of intense swim exercise training. TNF ablation, in either cell type, had no impact on the changes in heart rate, autonomic tone, or left ventricular structure and function induced by exercise training. Tnf excision in atrial cardiomyocytes did, however, prevent atrial hypertrophy, fibrosis, and macrophage infiltration as well as conduction slowing and increased AF susceptibility arising from exercise training. In contrast, endothelial-specific excision only reduced the training-induced atrial hypertrophy. Consistent with these cell-specific effects of Tnf excision, inducing TNF loss from atrial cardiomyocytes prevented activation of p38MAPKinase, a strain-dependent downstream mediator of TNF signalling, without affecting the atrial stretch as assessed by atrial pressures induced by exercise. Despite TNF’s established role in innate immune responses and inflammation, neither acute nor chronic exercise training caused measurable NLRP3 inflammasome activation.

Conclusions

Our findings demonstrate that adverse atrial remodelling and AF vulnerability induced by intense exercise require TNF in atrial cardiomyocytes whereas the impact of endothelial-derived TNF is limited to hypertrophy modulation. The implications of the cell autonomous effects of TNF and crosstalk between cells in the atria are discussed.
Validation of the IBD-Control Questionnaire across different sociodemographic and clinical subgroups: secondary analysis of a nationwide electronic survey
Authors: Gebeyehu Gerum G , Taylor Frederick , Dobson Liz , Cummings J R Fraser , Bloom Stuart , Kennedy Nicholas A , Christiansen Paul , Bodger Keith
Published: September 2023

Background

The IBD-Control Questionnaire is a simple, generic measure of patient-perceived disease control used increasingly in clinical practice and research. We aimed to address knowledge gaps in its psychometric performance, to ensure that it can be used with confidence in a variety of contexts.

Methods

We analysed 7341 responses to the IBD Registry COVID-19 survey, sent to 40 911 patients who completed an online self-assessment tool during the pandemic. Questions covered demographics, comorbidities, inflammatory bowel disease [IBD] sub-type, and IBD-Control Questionnaire and symptom scores [CD-PRO2 or UC-PRO2]. Psychometric properties of IBD-Control-8 were tested overall and within subgroups (Crohn’s disease [CD], ulcerative colitis [UC] and IBD unclassified; male and female; ≤65 and >65 years; number of co-morbidities; deprivation status).

Results

Internal consistency was very strong overall [α: 0.84, ω: 0.89] and for each subgroup [α range: 0.81–0.85; ω: 0.86–0.90]. Construct validity was demonstrated by moderate correlation of each item with global rating [VAS] [rs range: 0.47–0.65], strong correlation between IBD-Control-8 score and VAS [rs = 0.74], moderate-to-strong with PRO2 scores [CD: rs = −0.718; UC: rs = −0.602] and significantly higher IBD-Control-8 scores for PRO2-remission vs PRO2-active, consistent across subgroups. Exploratory and confirmatory factor analyses demonstrated a two-factor model (items loading onto ‘Health-related Quality of Life’ [HRQoL] or ‘Treatment’ domains). Extensive tests for factorial invariance confirmed consistency.

Conclusions

IBD-Control-8 is a psychometrically robust scale which can be used across a range of populations. It offers a quick, reliable, and valid method of assessing patient-perceived control. The construct of ‘control’ includes traditional HRQoL and a novel domain relating to treatment perception.
Temporary Faecal Diversion for Refractory Perianal and/or Distal Colonic Crohn’s Disease in the Biologic Era: An Updated Systematic Review with Meta-analysis
Authors: Jew Michael , Meserve Joseph , Eisenstein Samuel , Jairath Vipul , McCurdy Jeffrey , Singh Siddharth
Published: September 2023

Background and Aims

We evaluated short- and long-term outcomes of temporary faecal diversion [FD] for management of refractory Crohn’s disease [CD], focusing on outcomes in the biologic era.

Methods

Through a systematic literature review until March 15, 2023, we identified 33 studies [19 conducted in the biologic era] that evaluated 1578 patients with perianal and/or distal colonic CD who underwent temporary FD [with intent of restoring bowel continuity] and reported long-term outcomes [primary outcome: successful restoration of bowel continuity, defined as remaining ostomy-free after reconnection at a minimum of 6 months after diversion or at the end of follow-up]. We calculated pooled rates (with 95% confidence interval [CI]) using random effects meta-analysis, and examined factors associated with successful restoration of bowel continuity.

Results

Overall, 61% patients [95% CI, 52-68%; 50% in biologic era] experienced clinical improvement after FD. Stoma takedown was attempted in 34% patients [28–41%; 37% in biologic era], 6–18 months after diversion. Among patients where bowel restoration was attempted, 63% patients [54–71%] had successful restoration of bowel continuity, and 26% [20–34%] required re-diversion. Overall, 21% patients [17–27%; 24% in biologic era] who underwent FD were successfully restored; 34% patients [30–39%; 31% in biologic era] required proctectomy with permanent ostomy. On meta-regression, post-diversion biologic use and absence of proctitis was associated with successful bowel restoration after temporary FD in contemporary studies.

Conclusion

In the biologic era, temporary FD for refractory perianal and/or distal colonic CD improves symptoms in half the patients, and bowel continuity can be successfully restored in a quarter of patients.
Noninvasive assessment of left ventricular end-diastolic pressure using machine learning–derived phasic left atrial strain
Authors: Gruca Martin M , Slivnick Jeremy A , Singh Amita , Cotella Juan I , Subashchandran Varun , Prabhu David , Asch Federico M , Siddiki Mikail , Gupta Nikhil , Mor-Avi Victor , Su Jimmy L , Lang Roberto M
Published: September 2023

Aims

While transthoracic echocardiography (TTE) assessment of left ventricular end-diastolic pressure (LVEDP) is critically important, the current paradigm is subject to error and indeterminate classification. Recently, peak left atrial strain (LAS) was found to be associated with LVEDP. We aimed to test the hypothesis that integration of the entire LAS time curve into a single parameter could improve the accuracy of peak LAS in the noninvasive assessment of LVEDP with TTE.

Methods and results

We retrospectively identified 294 patients who underwent left heart catheterization and TTE within 24 h. LAS curves were trained using machine learning (100 patients) to detect LVEDP ≥ 15 mmHg, yielding the novel parameter LAS index (LASi). The accuracy of LASi was subsequently validated (194 patients), side by side with peak LAS and ASE/EACVI guidelines, against invasive filling pressures. Within the validation cohort, invasive LVEDP was elevated in 116 (59.8%) patients. The overall accuracy of LASi, peak LAS, and American Society of Echocardiography/European Association for Cardiovascular Imaging (ASE/EACVI) algorithm was 79, 75, and 76%, respectively (excluding 37 patients with indeterminate diastolic function by ASE/EACVI guidelines). When the number of LASi indeterminates (defined by near-zero LASi values) was matched to the ASE/EACVI guidelines (n = 37), the accuracy of LASi improved to 87%. Importantly, among the 37 patients with ASE/EACVI-indeterminate diastolic function, LASi had an accuracy of 81%, compared with 76% for peak LAS.

Conclusion

LASi allows the detection of elevated LVEDP using invasive measurements as a reference, at least as accurately as peak LAS and current diastolic function guideline algorithm, with the advantage of no indeterminate classifications in patients with measurable LAS.
Long-term comparison of the efficacy of manual versus powered tooth brushing in adolescent orthodontic patients: a single-centre, parallel design randomized clinical trial
Authors: Johal Ama , Shagmani Muftah , Alfuraih Omar , Arad Ian
Published: September 2023

Background and objectives

To-date, there is no evidence comparing the long-term efficacy of powered and manual toothbrushes in adolescents undergoing fixed appliance treatment. The trial compared the efficacy of manual versus powered toothbrush in controlling plaque and gingival health in patients undergoing fixed treatment in respect of both the short- and long-term.

Trial design

This was a randomized, parallel, controlled single-blind clinical trial, undertaken in a hospital setting, for which the consolidated standards of reporting trials guidelines were followed.

Methods

Ninety-two adolescent participants planned to undergo fixed appliance therapy, were randomly assigned to either a manual or powered toothbrush, with allocation concealment. The outcome measures were plaque and gingival indices and bleeding on probing, assessed at baseline (prior to fixed appliance), one-, six- and 12-months.

Results

The final sample included 84 participants, aged 12-18 (M=14.1, SD=1.93) years, with 40 (47%) were using a manual and 44 (52%) a powered toothbrush. The intervention (powered vs. manual toothbrush) itself appeared insignificant with regards to the gingival index (GI) (95%CI −0.1 – 0.03; P=0.26), plaque index (PI) (95%CI −0.13 – 0.14; P=0.93) and bleeding on probing (BoP) (95%CI −0.03 – 0.03; P=0.98) at any of the time points assessed. However, periodontal health indicators and plaque control significantly worsened (p<0.01), over the 12-month follow-up period, following placement of the fixed appliances placement.

Conclusion

Whilst no differences were found between manual and powered toothbrushes in controlling plaque and gingival health, in participants undergoing fixed orthodontic treatment, both were suboptimal and highlighted the need for greater patient support and monitoring.

Trial registration details

https://doi.org/10.1186/ISRCTN74268923  Trial funding: Colgate-Palmolive (USA)
Optimizing patient selection for primary prevention implantable cardioverter-defibrillator implantation: utilizing multimodal machine learning to assess risk of implantable cardioverter-defibrillator non-benefit
Authors: Kolk Maarten Z H , Ruipérez-Campillo Samuel , Deb Brototo , Bekkers Erik J , Allaart Cornelis P , Rogers Albert J , Van Der Lingen Anne-Lotte C J , Alvarez Florez Laura , Isgum Ivana , De Vos Bob D , Clopton Paul , Wilde Arthur A M , Knops Reinoud E , Narayan Sanjiv M , Tjong Fleur V Y
Published: September 2023

Aims

Left ventricular ejection fraction (LVEF) is suboptimal as a sole marker for predicting sudden cardiac death (SCD). Machine learning (ML) provides new opportunities for personalized predictions using complex, multimodal data. This study aimed to determine if risk stratification for implantable cardioverter-defibrillator (ICD) implantation can be improved by ML models that combine clinical variables with 12-lead electrocardiograms (ECG) time-series features.

Methods and results

A multicentre study of 1010 patients (64.9 ± 10.8 years, 26.8% female) with ischaemic, dilated, or non-ischaemic cardiomyopathy, and LVEF ≤ 35% implanted with an ICD between 2007 and 2021 for primary prevention of SCD in two academic hospitals was performed. For each patient, a raw 12-lead, 10-s ECG was obtained within 90 days before ICD implantation, and clinical details were collected. Supervised ML models were trained and validated on a development cohort (n = 550) from Hospital A to predict ICD non-arrhythmic mortality at three-year follow-up (i.e. mortality without prior appropriate ICD-therapy). Model performance was evaluated on an external patient cohort from Hospital B (n = 460). At three-year follow-up, 16.0% of patients had died, with 72.8% meeting criteria for non-arrhythmic mortality. Extreme gradient boosting models identified patients with non-arrhythmic mortality with an area under the receiver operating characteristic curve (AUROC) of 0.90 [95% confidence intervals (CI) 0.80–1.00] during internal validation. In the external cohort, the AUROC was 0.79 (95% CI 0.75–0.84).

Conclusions

ML models combining ECG time-series features and clinical variables were able to predict non-arrhythmic mortality within three years after device implantation in a primary prevention population, with robust performance in an independent cohort.
Interkingdom network analyses reveal microalgae and protostomes as keystone taxa involved in nutrient cycling in large freshwater lake sediment
Authors: Li Zhidan , Sun Liang , Liu Sijie , Lei Peng , Wang Rui , Li Sha , Gu Yian
Published: September 2023

Few studies have explored the role of interkingdom interactions between bacteria and microeukaryotes in nutrient cycling in lake ecosystems. We conducted sediment sampling from 40 locations covering Hongze Lake and analyzed their chemical properties. Intra- and interkingdom networks were constructed using 16S and 18S rRNA gene amplicon sequencing. Microeukaryotic intranetworks were more complex in spring than in autumn, while no clear variation in the complexity of bacterial intranetworks was found between autumn and spring. Larger and more complex bacterial–microeukaryotic bipartite networks emerged in spring than in autumn, correlated with lower carbon, nitrogen, and phosphorus levels in spring, likely resulting in intense microbial competition. Bacteria and microeukaryotes played different topological roles in interkingdom networks, with microeukaryotes contributing to the networks’ greater complexity. Seven keystone modules were identified in spring and autumn nutrient cycling. Importantly, keystone taxa in these modules belonged to photoautotrophic microalgae or predatory protostomes, indicating that these organisms are key drivers in lake sediment nutrient cycling. Our results suggested that nutrient content variation in autumn and spring changes interkingdom networks’ topological structure between bacteria and microeukaryotes. Microalgae and protostomes are essential in freshwater lake nutrient cycling and may be targeted to modulate nutrient cycling in large freshwater ecosystems.
Isolation of heavy metal-resistantStaphylococcus epidermidisstrainTWSL_22and evaluation of heavy metal bioremediation potential of recombinantE. colicloned with isolatedcadD
Authors: Dissanayake D M D C , Kumari W M N H , Chandrasekharan N V , Wijayarathna C D
Published: September 2023

A heavy metal-resistant bacterial strain, TWSL_22 was isolated from an industrial effluent sample and tested for heavy metal tolerance and resistance. The strain was molecularly characterized as Staphylococcus epidermidis based on 16S rDNA gene analysis and the sequence was deposited in the NCBI repository (accession number KT184893.1). Metal removal activity (P < .001) of TWSL_22 was 99.99 ± 0.001%, 74.43 ± 2.51%, and 51.16 ± 4.17% for Cd, Pb, and Cu, respectively. Highest MIC was observed for Cd. Antibiotic susceptibility assays revealed the strain TWSL_22 to be resistant to several antibiotics. The strain was screened for possible heavy metal-resistant genes and presence of cadA, copA, and cadD was confirmed by PCR. A DNA fragment containing complete sequence of cadD (618 bp) was isolated and cloned into pET 21a(+), transformed into E. coli BL21 and designated as E. coli/cadDET. E. coli/cadDET showed high metal tolerance capacity and could remove over 82% of heavy metals (Zn2+, Cd2+, Cu2+, and Cr3+) in the industrial effluent.
Genomic Mysteries of Giant Bacteria: Insights and Implications
Authors: Ionescu Danny , Volland Jean-Marie , Contarini Paul-Emile , Gros Olivier
Published: September 2023

Bacteria and Archaea are traditionally regarded as organisms with a simple morphology constrained to a size of 2–3 µm. Nevertheless, the history of microbial research is rich in the description of giant bacteria exceeding tens and even hundreds of micrometers in length or diameter already from its early days, for example, Beggiatoa spp., to the present, for example, Candidatus Thiomargarita magnifica. While some of these giants are still being studied, some were lost to science, with merely drawings and photomicrographs as evidence for their existence. The physiology and biogeochemical role of giant bacteria have been studied, with a large focus on those involved in the sulfur cycle. With the onset of the genomic era, no special emphasis has been given to this group, in an attempt to gain a novel, evolutionary, and molecular understanding of the phenomenon of bacterial gigantism. The few existing genomic studies reveal a mysterious world of hyperpolyploid bacteria with hundreds to hundreds of thousands of chromosomes that are, in some cases, identical and in others, extremely different. These studies on giant bacteria reveal novel organelles, cellular compartmentalization, and novel mechanisms to combat the accumulation of deleterious mutations in polyploid bacteria. In this perspective paper, we provide a brief overview of what is known about the genomics of giant bacteria and build on that to highlight a few burning questions that await to be addressed.
Worldwide Population Genomics Reveal Long-Term Stability of the Mitochondrial Genome Architecture in a Keystone Marine Plant
Authors: Khachaturyan Marina , Reusch Thorsten B H , Dagan Tal
Published: September 2023

Mitochondrial genomes (mitogenomes) of flowering plants are composed of multiple chromosomes. Recombination within and between the mitochondrial chromosomes may generate diverse DNA molecules termed isoforms. The isoform copy number and composition can be dynamic within and among individual plants due to uneven replication and homologous recombination. Nonetheless, despite their functional importance, the level of mitogenome conservation within species remains understudied. Whether the ontogenetic variation translates to evolution of mitogenome composition over generations is currently unknown. Here we show that the mitogenome composition of the seagrass Zostera marina is conserved among worldwide populations that diverged ca. 350,000 years ago. Using long-read sequencing, we characterized the Z. marina mitochondrial genome and inferred the repertoire of recombination-induced configurations. To characterize the mitochondrial genome architecture worldwide and study its evolution, we examined the mitogenome in Z. marina meristematic region sampled in 16 populations from the Pacific and Atlantic oceans. Our results reveal a striking similarity in the isoform relative copy number, indicating a high conservation of the mitogenome composition among distantly related populations and within the plant germline, despite a notable variability during individual ontogenesis. Our study supplies a link between observations of dynamic mitogenomes at the level of plant individuals and long-term mitochondrial evolution.
Biomarkers of Alzheimer’s Disease and Cerebrovascular Disease in Relation to Depressive Symptomatology in Individuals With Subjective Cognitive Decline
Authors: Zapater-Fajarí Mariola , Diaz-Galvan Patricia , Cedres Nira , Rydberg Sterner Therese , Rydén Lina , Sacuiu Simona , Waern Margda , Zettergren Anna , Zetterberg Henrik , Blennow Kaj , Kern Silke , Hidalgo Vanesa , Salvador Alicia , Westman Eric , Skoog Ingmar , Ferreira Daniel
Published: September 2023

Background

Subjective cognitive decline (SCD) has gained recent interest as a potential harbinger of neurodegenerative diseases such as Alzheimer’s disease (AD) and cerebrovascular disease (CVD). In addition, SCD can be related to depressive symptomatology. However, the association between AD and CVD biomarkers, depressive symptomatology, and SCD is still unclear. We investigated the association of AD and CVD biomarkers and depressive symptomatology with SCD in individuals with subjective memory complaints (SCD-memory group) and individuals with subjective concentration complaints (SCD-concentration group).

Methods

We recruited a population-based cohort of 217 individuals (all aged 70 years, 53% female participants, 119 SCD-memory individuals, 23 SCD-concentration individuals, and 89 controls). AD and CVD were assessed through cerebrospinal fluid levels of the Aβ42/40 ratio and phosphorylated tau, and white matter signal abnormalities on magnetic resonance imaging, respectively. Associations between biomarkers, depressive symptomatology, and SCD were tested via logistic regression and correlation analyses.

Results

We found a significant association between depressive symptomatology with SCD-memory and SCD-concentration. Depressive symptomatology was not associated with AD and CVD biomarkers. Both the phosphorylated tau biomarker and depressive symptomatology predicted SCD-memory, and the Aβ42/40 ratio and depressive symptomatology predicted SCD-concentration.

Conclusions

The role of depressive symptomatology in SCD may differ depending on the stage within the spectrum of preclinical AD (as determined by amyloid-beta and tau positivity), and does not seem to reflect AD pathology. Our findings contribute to the emerging field of subclinical depressive symptomatology in SCD and clarify the association of different types of subjective complaints with distinct syndromic and biomarker profiles.
Reduced Activity of Glutamatergic Neurons in the Prelimbic Medial Prefrontal Cortex Underlies the Inherent Aging-Related Physiological Reduction in Social Dominance
Authors: Shan Qiang , Lin Xiaoli , Yu Xiaoxuan , Guo Wenye , Tian Yao
Published: September 2023

Human society is aging, and the percentage of the population of older adults is increasing at an unprecedented rate. It is increasingly appreciated that social behaviors change with aging. One such example is the possible aging-related reduction in dominance status. This change has been thought to underlie older adults’ peculiar vulnerability to fraud, which has become a major challenge in the present aging society. However, whether this change is an inherent physiological process, and, if so, its underlying microscopic physiological mechanism, is not known. This study used groups of mice in a design that minimized effects that could confound any inherent process of dominance and verified that social dominance does inherently reduce with aging. This study further identified an aging-related microscopic functional alteration, that is, a reduction in the activity of glutamatergic pyramidal neurons in the prelimbic medial prefrontal cortex; and established that this reduction in neuronal activity serves as an intrinsic physiological mechanism underlying the macroscopic aging-related reduction in dominance. This study, by exploiting modern neurobiological techniques, sheds light on our understanding of human social behaviors during aging and may help develop strategies to counter related social challenges among the older adults population.
Marketing Principles and Practice
Authors: Paul Baines , Sara Rosengren , Paolo Antonetti
Published: September 2023

This chapter introduces the concept of marketing principles and practices. It identifies the major contexts of marketing: consumer goods, business-to-business, and services marketing. Marketing is a process of mutual exchange wherein organizations anticipate and satisfy their customers' needs for both parties' benefit. Moreover, marketing is a systematic organizational activity based on market research insights, customer analytics, and sophisticated promotional activity, which result in companies and organizations to behave responsibly concerning society. The chapter then explains how organizations deploy their marketing programmes via the marketing mix, which comprises product, place, price, and promotion. The chapter then considers the positive contribution that marketing makes to society, such as improving the standard of living for people across the world.
Marketing Research and Analytics
Authors: Baines Paul , Rosengren Sara , Antonetti Paolo
Published: September 2023

This chapter expounds on the concept of market research, which is a key sub-discipline of marketing practice and a fundamental component of the marketing philosophy. It highlights the importance of understanding customer insights and marketing research in the decision-making process. Contemporary marketing research is very much affected by technology as digitalization resulted in a proliferation of information and data available to marketers. Thus, many digital environments produce vast data streams on how consumers search and use products. The chapter explains that marketing research should be conducted with ethics, regardless if the research is done online or offline, since the privacy of consumers and customers needs to be protected.
Not-for-Profit and Social Marketing
Authors: Paul Baines , Sara Rosengren , Paolo Antonetti
Published: September 2023

This chapter looks at the characteristics of not-for-profit organizations and social marketing. The types of not-for-profit organizations range between charities, social enterprise secretaries, public sector, political parties, and campaigning organizations. Political marketing can be seen as a marketing–propaganda hybrid since marketing is commonly used in government social marketing campaigns to drive positive behavioural change, improve citizens' well-being, or gain support and votes. The chapter mentions how not-for-profit organizations do not always value their customers. It explains that a cause marketing campaign occurs when companies and non-profit organizations form marketing alliances, which are then focused on sales promotions developed for mutual benefit.
The global context of strategic human resource management
Authors: Bailey Catherine , Mankin David , Kelliher Clare , Garavan Thomas
Published: September 2023

This chapter provides an overview of important global trends and their impact on organizations, the nature of work, and SHRM. It begins with a discussion of the concept of globalization and how emotive and contentious it has become. The chapter also evaluates different perspectives and levels of globalization and considers both positive and negative attitudes towards globalization. The last part discusses the implications of globalization for organizations, the nature of work, and SHRM. Attention is likewise given to important SHRM issues including employer branding, global talent management, managing an international workforce, and the use of technology to deliver SHRM.
Human resource strategy
Authors: Bailey Catherine , Mankin David , Kelliher Clare , Garavan Thomas
Published: September 2023

This chapter examines the HR strategy from the perspectives of content, process, and implementation. From a content perspective, it considers the range of choices available to HR professionals when developing an HR strategy. It also introduces the construct of the HR architecture. Second, from the process perspective, it analyses some of the propositions that have been put forward to explain the process by which HR strategies can be developed and the critical role that line managers play. Finally, it explores issues of implementation.
Strategic human resource management and performance
Authors: Bailey Catherine , Mankin David , Kelliher Clare , Garavan Thomas
Published: September 2023

This chapter discusses the circumstances in which HRM might be associated with improved performance outcomes. First, it considers some of the key findings arising out of research on the topic, differentiating between outcomes at the individual, unit, and organizational levels. Second, it evaluates the theoretical frameworks that have been used to explain the mechanisms underpinning the HRM–performance linkage and explain the process by which interventions in the-HRM arena are expected to give rise to outcomes. It then explores some of the critiques relating to this body of research, before considering recent calls for sustainable approaches to HRM that go beyond narrow considerations of firm performance. Finally, the chapter examines some of the methodologies used by human resource practitioners to evaluate and measure the contribution of the HR department to organizational performance.
Strategic human resource management and change management
Authors: Bailey Catherine , Mankin David , Kelliher Clare , Garavan Thomas
Published: September 2023

This chapter explores the nature and meaning of ‘change management’ focusing on ‘planned’ approaches to change. It examines several change management models and frameworks to give an overview of the main approaches to managing change. Then it explains the principal stages of planned change programs, as well as the impact of change on individuals. It then moves on to analyse aspects of change management in which HR departments have the most involvement. Finally, it considers managing individual-level change, communication, and designing human resource management (HRM) practices in support of change.
Operations Strategy and International Operations
Authors: Jones Peter , Robinson Peter
Published: September 2023

This chapter explores operations strategy and international operations. It notes the relationship between corporate, business, and operations strategy in line with the relationship between operations, marketing, human resource, and finance strategies. The chapter also includes the comparison between market-driven and the resource-based view of operations strategy. It discusses the concept of business models as well. Next, the chapter looks into the internationalization and globalization of markets while identifying the challenges and alternative approaches in manning an international operation. It then cites the difference between contemporary operations strategies and how it is used to achieve order winners.
Measuring Economic Activity
Authors: Hayley Simon , Chrystal Alec
Published: September 2023

This chapter explains what economic activity is and how it can be measured. It introduces the concept of gross domestic product (GDP), which is defined as the total amount of goods and services that the economy produces in a year. GDP is measured by the following methods: adding up all the final goods and services produced by a country–s economy; summing the value added by each firm; and totalling the wages earned by every employee and profits earned by the owners of firms. The chapter illustrates that money spent on final goods and services in the economy ultimately ends up being someone–s income. It also highlights that GDP is an important economic indicator and a useful measure to help governments learn how to reduce the size of booms and recessions.
Introducing corporate social responsibility
Authors: Blowfield Michael , Murray Alan
Published: September 2023

This chapter establishes the concept of corporate social responsibility (CSR). It explores the context within which contemporary CSR has flourished. It also considers the different perspectives on, and definitions of, CSR. The chapter also delves into the values that companies are being asked to uphold. Finally, it discusses the main issues with which contemporary CSR is wrestling.
Corporate social responsibility in developing economies
Authors: Blowfield Michael , Murray Alan
Published: September 2023

This chapter examines the role of business in developing economies, and whether and how business can be an agent of poverty reduction. It studies the role of business in social and economic development. In addition, it considers what it means for business to be an agent of development. The chapter also explores the circumstances under which business takes on a developmental role. Lastly, the limitations of business as a force for development are discussed.
Globalization and corporate social responsibility
Authors: Blowfield Michael , Murray Alan
Published: September 2023

This chapter studies the importance of globalization for corporate social responsibility (CSR), and how it accounts for some of the ways that CSR has evolved. It delves into the different meanings of globalization and identifies the main areas in which globalization has had an impact. It also talks about the ways in which globalization has altered employment, trade, production, and investment. How globalization influences governance and the implications of this for CSR is likewise discussed. The chapter then expounds on CSR as a business response to the challenges of globalization, identifying what it addresses. The chapter examinines why some feel it is inadequate. Lastly, it looks into the industry responses to aspects of globalization.