bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies to identify individuals with monogenic diabetes: results of an economic evaluation
Authors: Peters Jaime L , Anderson Rob , Shields Beverley , King Sophie , Hudson Michelle , Shepherd Maggie , McDonald Timothy James , Pearson Ewan , Hattersley Andrew , Hyde Chris 
Published: March 2020

ObjectivesTo evaluate and compare the lifetime costs associated with strategies to identify individuals with monogenic diabetes and change their treatment to more appropriate therapy.DesignA decision analytical model from the perspective of the National Health Service (NHS) in England and Wales was developed and analysed. The model was informed by the literature, routinely collected data and a clinical study conducted in parallel with the modelling.SettingSecondary care in the UK.ParticipantsSimulations based on characteristics of patients diagnosed with diabetes <30 years old.InterventionsFour test-treatment strategies to identify individuals with monogenic diabetes in a prevalent cohort of diabetics diagnosed under the age of 30 years were modelled: clinician-based genetic test referral, targeted genetic testing based on clinical prediction models, targeted genetic testing based on biomarkers, and blanket genetic testing. The results of the test-treatment strategies were compared with a strategy of no genetic testing.Primary and secondary outcome measuresDiscounted lifetime costs, proportion of cases of monogenic diabetes identified.ResultsBased on current evidence, strategies using clinical characteristics or biomarkers were estimated to save approximately £100–£200 per person with diabetes over a lifetime compared with no testing. Sensitivity analyses indicated that the prevalence of monogenic diabetes, the uptake of testing, and the frequency of home blood glucose monitoring had the largest impact on the results (ranging from savings of £400–£50 per person), but did not change the overall findings. The model is limited by many model inputs being based on very few individuals, and some long-term data informed by clinical opinion.ConclusionsCosts to the NHS could be saved with targeted genetic testing based on clinical characteristics or biomarkers. More research should focus on the economic case for the use of such strategies closer to the time of diabetes diagnosis.Trial registration numberNCT01238380.
Missed posterior shoulder fracture dislocations: a new protocol from a London major trauma centre
Authors: Magnussen Alex Peter , Watura Christopher , Torr Nicola , Walker Miny , Amiras Dimitri , Griffiths Dylan 
Published: March 2020

BackgroundA high incidence of missed posterior shoulder dislocations is widely recognised in the literature. Concern was raised by the upper limb multidisciplinary team at a London major trauma centre that these missed injuries were causing serious consequences due to the need for surgical intervention and poor functional outcome.ObjectiveTo identify factors contributing to missed diagnosis and propose solutions.MethodsA local quality improvement report was performed investigating time from admission to diagnosis of simple posterior dislocations and fracture dislocations over a 5-year period. Factors contributing to a delayed diagnosis were analysed.ResultsThe findings supported current evidence: a posterior shoulder dislocation was more often missed if there was concurrent fracture of the proximal humerus. Anteroposterior and scapular Y view radiographs were not always diagnostic for dislocation. Axial views were more reliable in assessment of the congruency of the joint and were associated with early diagnosis and appropriate treatment of the injury.DiscussionAs a result of these findings a new protocol was produced by the orthopaedic and radiology departments and distributed to our emergency department practitioners and radiography team. The protocol included routine axial or modified trauma axial view radiographs for all patients attending the emergency department with a shoulder injury, low clinical suspicion for dislocation and a low threshold for CT scan. Reaudit and ongoing data collection have shown significant increase in axial view radiographs and improved diagnosis.
Antibiotic prescribing in neonatal sepsis: an Australian nationwide survey
Authors: McMullan Brendan , Cooper Celia , Spotswood Naomi , James Rodney , Jones Cheryl , Konecny Pamela , Blyth Christopher , Karen Thursky 
Published: March 2020

ObjectiveTo evaluate quality and variation in antibiotic prescribing for neonatal sepsis.DesignWe analysed prescribing in hospitalised neonates using the National Antimicrobial Prescribing Survey in Australian neonates from 1 January 2014 to 31 December 2018.SettingData from antibiotic point prevalence surveys performed in hospitals, ranging from rural hospitals to tertiary paediatric and maternity hospitals within Australia.PatientsAdmitted neonates <28 days of age from participating hospitals.Main outcome measuresVariation and appropriateness in prescribing for neonatal sepsis and variation in dosing for gentamicin and benzylpenicillin across hospitals.ResultsA total of 415 prescriptions among 214 neonates from 39 different hospitals were included. The majority of prescriptions (342, 82.4%) were for neonates <7 days of age. The most commonly prescribed antibiotics were gentamicin and benzylpenicillin, with 323 (77.8%) prescriptions. Dosing variability was substantial, with doses ranging from 2 to 8 mg/kg for gentamicin (median 5 mg/kg, IQR 4–5) and from 45 to 72 mg/kg for benzylpenicillin (median 60 mg/kg, IQR 50–60), although only 13 (3.2%) and 19 (4.6%) prescriptions were locally assessed as inappropriate or non-compliant with guidelines, respectively. At time of audit, 22% of antibiotics had been given for more than 48 hours and 9% more than 72 hours, although microbiologically confirmed infection was documented in only nine (4.2%) neonates.ConclusionsPrescribing for neonatal sepsis was dominated by use of benzylpenicillin and gentamicin with substantial variation in dosing. A small minority had culture-confirmed infection. Efforts to standardise antibiotic dosing and duration for suspected neonatal sepsis are recommended.
Asthma control is associated with economic outcomes, work productivity and health-related quality of life in patients with asthma
Authors: Lee Lulu K , Ramakrishnan Karthik , Safioti Guilherme , Ariely Rinat , Schatz Michael 
Published: March 2020

BackgroundThe objective of this analysis was to examine the association between asthma control (based on Asthma Control Test (ACT) responses) and healthcare resource utilisation (HRU), work productivity and health-related quality of life (HRQoL) among a nationwide sample of US adults with a self-reported diagnosis of asthma and without comorbid chronic obstructive pulmonary disease.MethodsData were obtained from the 2015 and 2016 self-administered, internet-based National Health and Wellness Surveys. Patients were grouped by ACT score (≤15: poorly controlled; 16–19: partly controlled; 20–25: well-controlled asthma). Study outcomes included HRU (patient-reported healthcare provider visits, emergency department visits and hospitalisations during the previous 6 months); work productivity, measured using the Work Productivity and Activity Impairment-General Health Scale; HRU-associated costs and work productivity loss and HRQoL, measured using EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) and the Short Form Health Survey-36V.2 (SF-36V.2). Incremental differences in outcomes between groups were assessed using generalised linear models adjusted for covariates.ResultsOf 7820 eligible adults, 17.4% had poorly controlled, 20.1% partly controlled and 62.5% well-controlled asthma. Well-controlled asthma was associated with significantly lower HRU (p<0.001) and lower mean direct costs ($6012 vs $8554 and $15 262, respectively; p<0.001); well-controlled asthma was also associated with significantly lower mean scores for work absenteeism, work presenteeism, overall work impairment and activity impairment (all p<0.001), and lower mean indirect costs ($6353 vs $10 448 and $14 764, respectively; p<0.001). Clinically meaningful differences favouring well-controlled asthma were seen for all HRQoL measures, with statistically significantly higher adjusted mean EQ-5D-5L index and SF-6D Health Utilities Index scores (derived from SF-36V.2) for patients with well-controlled asthma compared with partly controlled or poorly controlled asthma (p<0.001).ConclusionsThe study demonstrates a clear relationship between asthma control and its impact on HRU, costs, work productivity and HRQoL. This will allow for better identification and management of patients with poorly controlled asthma.
Early repolarisation among athletes
Authors: Claessen Femke M A P , Peeters Heidi A P , Sorgdrager Bastiaan J , van Veldhoven Peter L J 
Published: March 2020

ObjectivesTraditionally, early repolarisation (ER) is considered a benign ECG variant, predominantly found in youths and athletes. However, a limited number of studies have reported an association between ER and the incidental occurrence of ventricular fibrillation or sudden cardiac death. Yet definite, direct comparisons of the incidence of ER in unselected, contemporary populations in athletes as compared with non-athletes and across different sports are lacking. This study therefore aimed to investigate whether ER is more common among athletes as compared with non-athletes, and if ER patterns differ between sport disciplines based on static and dynamic intensity.MethodsTo assess ER we retrospectively analysed ECGs of 2241 adult subjects (2090 athletes, 151 non-athletes), who had a sports medical screening between 2010 and 2014 in an outpatient clinic. The outcome was tested for confounders in a multivariable logistic regression analysis.ResultsER was found in 502 athletes (24%). We found a 50% higher prevalence of ER in the athlete group compared with the control group (OR 1.5 (SE 0.34), adjusted 95% CI 1.0 to 2.4) in multivariable analysis. A 30% higher prevalence of ER in the inferior leads only (OR 1.3 (SE 0.38), adjusted 95% CI 0.74 to 2.3), a 120% higher prevalence of ER in the lateral leads only (OR 2.2 (SE 1.0), adjusted 95% CI 0.87 to 5.4), and a 20% higher prevalence of ER in the inferior and lateral leads (OR 1.2 (SE 0.49), adjusted 95% CI 0.55 to 2.7) was found in athletes.ConclusionAthletes had a 50% higher prevalence of ER and a 30% higher prevalence of ER in the inferior leads specifically. There was no association between training duration or sports discipline and ER.
Mental health screening: severity and cut-off point sensitivity of the Athlete Psychological Strain Questionnaire in male and female elite athletes
Authors: Rice Simon , Olive Lisa , Gouttebarge Vincent , Parker Alexandra G , Clifton Patrick , Harcourt Peter , Llyod Michael , Kountouris Alex , Smith Ben , Busch Beau , Purcell Rosemary 
Published: March 2020

ObjectivesTo examine the sensitivity/specificity of the Athlete Psychological Strain Questionnaire (APSQ) in both male and female elite athletes, and also assess internal consistency and convergent/divergent validity, and determine discriminative validity relative to current injury status.MethodsData were provided by 1093 elite athletes (males n=1007; females n=84). Scale validity and reliability values were benchmarked against validated measures of general psychological distress and well-being. ROC curve analysis determined a range of optimal severity cut-points.ResultsBias-corrected area under curve (AUC) values supported three APSQ cut-points for moderate (AUC=0.901), high (AUC=0.944) and very high (AUC=0.951) categories. APSQ total score Cronbach coefficients exceeded those observed for the Kessler 10 (K-10). Gender ×injury status interactions were observed for the APSQ total score and K-10, whereby injured female athletes reported higher scores relative to males and non-injured female counterparts.ConclusionBy providing a range of cut-off scores identifying those scoring in the marginal and elevated ranges, the APSQ may better facilitate earlier identification for male and female elite athletes vulnerable to mental health symptoms and developing syndromes. Use of the APSQ may support sports medicine practitioners and allied health professionals to detect early mental ill health manifestations and facilitate timely management and ideally, remediation of symptoms.
GRACE score and cardiovascular outcomes prediction among the delayed coronary intervention after post-fibrinolytic STEMI patients in a limited PCI-capable hospital
Authors: Chotechuang Yotsawee , Phrommintikul Arintaya , Kuanprasert Srun , Muenpa Roungtiva , Ruengorn Chidchanok , Patumanond Jayanton , Chaichuen Tuanchai , Thanachaikun Noparat , Benjanuwatra Thanawat , Sukonthasarn Apichard 
Published: March 2020

BackgroundIn Thailand, due to limited availability of percutaneous coronary intervention (PCI)-capable hospitals, a number of patients with ST-elevation myocardial infarction (STEMI) after fibrinolytic therapy underwent the delayed coronary intervention (24 hours to 2 weeks). Existing tool such as the Global Registry of Acute Coronary Event (GRACE) to define patients at high risk of cardiovascular outcomes has been used widely, except for patients who had the delayed coronary intervention. We, therefore, evaluated the cardiovascular outcomes of STEMI patients who underwent the delayed coronary intervention.MethodsWe retrospectively analysed the data from the PCI-capable hospital (Maharaj Nakorn Chiang Mai Hospital) STEMI registry during the period 2007–2012. Patients who received fibrinolytic treatment (SK) and underwent the delayed coronary intervention were included. The outcomes of the study were 30-day and 6-month composite cardiovascular outcomes (including death, re-hospitalised with acute coronary syndrome, re-hospitalised with heart failure and stroke).ResultsOf all 341 patients included, 229 (67.2%) patients were in the low GRACE score group (<126 points) and 112 (32.8%) patients in the intermediate-high GRACE score group (≥126 points). At 30 days, the composite cardiovascular outcome occurred in 2.2% (n=5) in the low GRACE score group and 11.6% (n=13) in the intermediate-high GRACE score group (p value=0.001). At 6 months, the composite cardiovascular outcomes occurred in 3.9% (n=9) in the low GRACE score group and 13.4% (n=15) in the intermediate-high GRACE score group (p value=0.003). The area under the receiver operating characteristic curve of GRACE score for 6-month composite cardiovascular outcomes was 0.746 (95% CI 0.698 to 0.793).ConclusionIntermediate-high GRACE risk STEMI patients after fibrinolytic therapy in limited PCI-capable hospital who underwent the delayed coronary intervention increased 30-day and 6-month cardiovascular outcomes compared with the low GRACE risk patients. In limited available PCI-capable hospital, GRACE risk score can be helpful in guiding the cardiologists to select a proper time for coronary intervention in post-fibrinolytic STEMI patients.
Using point-of-sale data to examine tobacco pricing across neighbourhoods in Scotland
Authors: Shortt Niamh K , Tunstall Helena , Mitchell Richard , Coombes Emma , Jones Andy , Reid Garth , Pearce Jamie 
Published: March 2020

ObjectivesTo assess the geographical variation in tobacco price (cigarettes and roll-your-own (RYO) tobacco) in convenience stores across Scotland and how this relates to neighbourhood income deprivation, tobacco retail outlet density and urban/rural status.MethodsTobacco price data from 124 566 shopping baskets purchased in 274 convenience stores during 1 week in April 2018 were obtained through an electronic point-of-sale system. These data were combined with neighbourhood-level measures of income deprivation, tobacco retail outlet density and urban/rural status. We examined brand price for 12 of the most popular cigarette brands and 3 RYO brands and variations in purchases by price segment; multivariable regression analysis assessed associations between area variables and tobacco price.ResultsMost stores sold tobacco in all price segments. The lowest priced subvalue brands were the most popular in all neighbourhoods but were most dominant in shops in more deprived neighbourhoods. When total sales were assessed, overall purchase price varied significantly by neighbourhood income deprivation; packets of 20 cigarettes were 50 pence (5.6%) lower and RYO 34 pence (2.7%) lower among shops in the two highest income deprivation quintiles relative to the lowest. Analysis of individual brands showed that for 3 of the 12 cigarette brands considered, average prices were 12–17 pence lower in more deprived neighbourhoods with the most popular RYO brand 15 pence lower. There was limited evidence of a relationship with tobacco retail outlet density.ConclusionAcross Scottish convenience stores, the purchase price of cigarettes and RYO was lower in more income-deprived neighbourhoods. The lower prices primarily reflect greater sales of cheap brands in these areas, rather than retailers reducing the prices of individual brands.
Projecting the future impact of past accomplishments in tobacco control
Authors: Maciosek Michael V , St Claire Ann W , Keller Paula A , LaFrance Amy B , Xu Zack , Schillo Barbara 
Published: March 2020

BackgroundThe benefits to adults who quit smoking increase over time as former smokers live longer, healthier lives. Youth who never smoke will benefit for decades. Thus, the long-term population effects of tobacco prevention and control policies may be substantial. Yet they are rarely quantified in evaluations of state tobacco control programmes.MethodsUsing a microsimulation model, we predicted the benefits to Minnesotans from 2018 to 2037 of having reduced cigarette smoking prevalence from 1998 to 2017. We first simulated the health and economic harms of tobacco that would have occurred had smoking prevalence stayed at 1997 levels. The harms produced by that scenario were then compared with harms in scenarios with smoking declining at observed rates from 1998 to 2017 and either expected declines from 2018 to 2037 or a greater decline to 5% prevalence in 2037.ResultsWith expected smoking prevalence decreases from 2018 to 2037, Minnesotans will experience 12 298 fewer cancers, 72 208 fewer hospitalisations for cardiovascular disease and diabetes, 31 913 fewer respiratory disease hospitalisations, 14 063 fewer smoking-attributable deaths, $10.2 billion less in smoking-attributable medical expenditures and $9.4 billion in productivity gains than if prevalence had stayed at 1997 levels. These gains are two to four times greater than for the previous 20 years, and would be about 15% higher if Minnesota achieves a 5% adult prevalence rate by 2037.ConclusionsThe tobacco control measures implemented from 1998 to 2017 will produce accelerated benefits during 2018–2037 if modest progress in tobacco prevalence rates is maintained.
Hyperon–nucleon interaction within chiral effective field theory revisited
Authors: Haidenbauer J. , Meißner U.-G. , Nogga A. 
Published: March 2020

AbstractThe$$\varLambda N$$ΛNand$$\varSigma N$$ΣNinteractions are considered at next-to-leading order in SU(3) chiral effective field theory. Different options for the low-energy constants that determine the strength of the contact interactions are explored. Two variants are analysed in detail which yield equivalent results for$$\varLambda N$$ΛNand$$\varSigma N$$ΣNscattering observables but differ in the strength of the$$\varLambda N \rightarrow \varSigma N$$ΛN→ΣNtransition potential. The influence of this difference on predictions for light hypernuclei and on the properties of the$$\varLambda $$Λand$$\varSigma $$Σhyperons in nuclear matter is investigated and discussed. The effect of the variation in the potential strength of the$$\varLambda N$$ΛN-$$\varSigma N$$ΣNcoupling (also called$$\varLambda -\varSigma $$Λ-Σconversion) is found to be moderate for the considered$$^3_\varLambda {{\mathrm{H}}}$$Λ3Hand$$^4_\varLambda \mathrm{He}$$Λ4Hehypernuclei but sizable in case of the matter properties. Further, the size of three-body forces and their relation to different approaches to hypernuclear interactions is discussed.
The $$q_T$$ subtraction method: electroweak corrections and power suppressed contributions
Authors: Buonocore Luca , Grazzini Massimiliano , Tramontano Francesco 
Published: March 2020

AbstractBuilding upon the formulation of transverse-momentum resummation for heavy-quark hadroproduction, we present the first application of the $$q_T$$qT subtraction formalism to the computation of electroweak corrections to massive lepton pairs through the Drell–Yan mechanism. We then study the power suppressed contributions to the $$q_T$$qT subtraction formula in the parameter $$r_{\mathrm{cut}}$$rcut, defined as the minimum transverse momentum of the lepton pair normalised to its invariant mass. We analytically compute the leading power correction from initial and final-state radiation to the inclusive cross section. In the case of initial-state radiation the power correction is quadratic in $$r_{\mathrm{cut}}$$rcut and our analytic result is consistent with results previously obtained in the literature. Final-state radiation produces linear contributions in $$r_{\mathrm{cut}}$$rcut that may challenge the efficiency of the $$q_T$$qT subtraction procedure. We explicitly compute the linear power correction in the case of the inclusive cross section and we discuss the extension of our calculation to differential distributions.
Partial Inhibition of Glycolysis Reduces Atherogenesis Independent of Intraplaque Neovascularization in Mice
Authors: Perrotta Paola , Van der Veken Bieke , Van Der Veken Pieter , Pintelon Isabel , Roosens Laurence , Adriaenssens Elias , Timmerman Vincent , Guns Pieter-Jan , De Meyer Guido R.Y. , Martinet Wim 
Published: March 2020

Objective:
Intraplaque neovascularization is an important feature of unstable human atherosclerotic plaques. However, its impact on plaque formation and stability is poorly studied. Because proliferating endothelial cells generate up to 85% of their ATP from glycolysis, we investigated whether pharmacological inhibition of glycolytic flux by the small-molecule 3PO (3-[3-pyridinyl]-1-[4-pyridinyl]-2-propen-1-one) could have beneficial effects on plaque formation and composition.

Approach and Results:

ApoE
−/
−
(apolipoprotein E deficient) mice treated with 3PO (50 µg/g, ip; 4×/wk, 4 weeks) showed a metabolic switch toward ketone body formation. Treatment of ApoE
−/−
Fbn1
C1039G+/−
mice with 3PO (50 µg/g, ip) either after 4 (preventive, twice/wk, 10 weeks) or 16 weeks of Western diet (curative, 4×/wk, 4 weeks) inhibited intraplaque neovascularization by 50% and 38%, respectively. Plaque formation was significantly reduced in all 3PO-treated animals. This effect was independent of intraplaque neovascularization. In vitro experiments showed that 3PO favors an anti-inflammatory M2 macrophage subtype and suppresses an M1 proinflammatory phenotype. Moreover, 3PO induced autophagy, which in turn impaired NF-κB (nuclear factor-kappa B) signaling and inhibited TNF-α (tumor necrosis factor-alpha)–mediated VCAM-1 (vascular cell adhesion molecule-1) and ICAM-1 (intercellular adhesion molecule-1) upregulation. Consistently, a preventive 3PO regimen reduced endothelial VCAM-1 expression in vivo. Furthermore, 3PO improved cardiac function in ApoE
−/−
Fbn1
C1039G+/−
mice after 10 weeks of treatment.

Conclusions:
Partial inhibition of glycolysis restrained intraplaque angiogenesis without affecting plaque composition. However, less plaques were formed, which was accompanied by downregulation of endothelial adhesion molecules—an event that depends on autophagy induction. Inhibition of coronary plaque formation by 3PO resulted in an overall improved cardiac function.