bluuebunny/crossref_metadata_2025_split huggingface dataset:
The course of readmission in frail older cardiac patients
Authors: Rijpkema Corinne J. , Verweij Lotte , Jepma Patricia , Latour Corine H. M. , Peters Ron J. G. , Scholte Op Reimer Wilma J. M. , Buurman Bianca M. 
Published: March 2021

AbstractAimThe aim of this study is to explore patients’ and (in)formal caregivers’ perspectives on their role(s) and contributing factors in the course of unplanned hospital readmission of older cardiac patients in the Cardiac Care Bridge (CCB) program.DesignThis study is a qualitative multiple case study alongside the CCB randomized trial, based on grounded theory principles.MethodsFive cases within the intervention group, with an unplanned hospital readmission within six months after randomization, were selected. In each case, semi‐structured interviews were held with patients (n = 4), informal caregivers (n = 5), physical therapists (n = 4), and community nurses (n = 5) between April and June 2019. Patients’ medical records were collected to reconstruct care processes before the readmission. Thematic analysis and the six‐step analysis of Strauss & Corbin have been used.ResultsThree main themes emerged. Patients experienced acute episodes of physical deterioration before unplanned hospital readmission. The involvement of (in)formal caregivers in adequate observation of patients’ health status is vital to prevent rehospitalization (theme 1). Patients and (in)formal caregivers’ perception of care needs did not always match, which resulted in hampering care support (theme 2). CCB caregivers experienced difficulties in providing care in some cases, resulting in limited care provision in addition to the existing care services (theme 3).ConclusionEarly detection of deteriorating health status that leads to readmission was often lacking, due to the acuteness of the deterioration. Empowerment of patients and their informal caregivers in the recognition of early signs of deterioration and adequate collaboration between caregivers could support early detection. Patients’ care needs and expectations should be prioritized to stimulate participation.Impact(In)formal caregivers may be able to prevent unplanned hospital readmission of older cardiac patients by ensuring: (1) early detection of health deterioration, (2) empowerment of patient and informal caregivers, and (3) clear understanding of patients’ care needs and expectations.
Using Holocene fossils to model the future: Distribution of climate suitability for tuatara, the last rhynchocephalian
Authors: Jarvie Scott , Worthy Trevor H. , Saltré Frédérik , Scofield R. Paul , Seddon Philip J. , Cree Alison 
Published: March 2021

AbstractAimCorrelative species distribution models (SDMs) are typically trained using only the contemporary distribution of species; however, recent records might reflect an incomplete description of a species' niche, limiting the reliability of predictions. SDMs linking fossil records have the potential to improve conservation decisions under human‐induced climate change. Here, we built SDMs using presence records from contemporary and Holocene records to enable estimations of climatically suitable area under current and future climate scenarios.LocationAotearoa New ZealandTaxonTuatara, Sphenodon punctatusMethodsFor an evolutionary relict found in Aotearoa New Zealand, the tuatara (Sphenodon punctatus), we built SDMs using presence records from contemporary and Holocene records to estimate climatically suitable area under current and future climate scenarios. We also use our detailed knowledge of the Holocene distribution and remnant populations to examine niche shifts following the arrival of humans and associated introduction of mammalian predators. To build SDMs, we use presence records from four sources: (a) remnant populations, (b) radiocarbon‐dated fossil deposits from the Holocene, (c) other fossil deposits containing tuatara bones of Holocene age and iv) islands from which tuatara are known or highly likely to have become extinct.ResultsWe found shifts in the niche of tuatara due to niche unfilling. Incorporating locations of Holocene deposits and/or all past locations in SDMs led to larger areas of climatically suitable area being identified compared to SDMs derived from remnant populations only. Using all presence records, under climate change projections for 2090, climatically suitable area increased slightly. However, many areas retain potential as translocation sites (e.g. northern South Island), some areas become unsuitable (e.g. inland Canterbury) and/or involve extrapolation into novel climates (e.g. Northland).Main ConclusionSDMs incorporating locations of Holocene deposits and/or all past locations identified areas of critical habitat for tuatara under current and future climate scenarios, that would not have been identified using contemporary occurrences only. Our results highlight the need to consider past locations when assessing habitat suitability for conservation translocations, both for tuatara and other relict species.
Wellbeing of CAMHS staff and changes in working practices during the COVID‐19 pandemic
Authors: Bentham Charlotte , Driver Katie , Stark Daniel 
Published: March 2021

AbstractIntroductionThe coronavirus disease 2019 pandemic has necessitated significant changes in working practices across healthcare services. The current study aimed to assess the wellbeing of health professionals and quantify the adaptations to working practices in a Child and Adolescent Mental Health Service (CAMHS) during the pandemic.MethodThe study was conducted in a UK CAMH team six weeks into lockdown measures. All clinicians were invited to complete a survey eliciting their experiences of working practices during the pandemic, degree of worry about the virus and mental wellbeing.ResultsClinicians had significantly lower levels of mental wellbeing during the pandemic than population normative data, to the extent that some clinicians were classified as at heightened risk of depression. A significant shift to remote working, reduction in face‐to‐face appointments, and decrease in clinicians' perceived ability to undertake clinical tasks was observed. Themes emerging from clinicians' experiences of working during the pandemic include being supported within the team, providing a service, working adaptations, and working as a team. A further theme highlights the needs of clinicians to complete their clinical role effectively.ConclusionCAMHS clinicians require additional support, training, and guidance during a pandemic to promote mental wellbeing and effectiveness in completing clinical tasks.
Non‐pharmacological management of hypertension
Authors: Verma Narsingh , Rastogi Smriti , Chia Yook‐Chin , Siddique Saulat , Turana Yuda , Cheng Hao‐min , Sogunuru Guru Prasad , Tay Jam Chin , Teo Boon Wee , Wang Tzung‐Dau , TSOI Kelvin Kam Fai , Kario Kazuomi 
Published: March 2021

AbstractHypertension is an insidious disease which predisposes to cardiovascular complications and if not treated properly can lead to various serious complications. Economic limitations, having additional benefits with few or almost no side effects have made non‐pharmacological management of hypertension an attractive approach for dealing with hypertension, in developed and developing countries alike. A MEDLINE search was done for relevant references with emphasis on original studies, randomized controlled trials, and meta‐analyses for this review paper. Lifestyle modifications including changes in the dietary pattern, adopting special diets with low sodium, saturated fat and high calcium, magnesium and potassium and trying the new methods like time restricted meal intake which work in tandem with the circadian rhythm are opening new vistas in the field of non‐pharmacological management of hypertension. Lifestyle modifications that effectively lower blood pressure are increased physical activity, weight loss, limited alcohol consumption, relaxation techniques of Yoga, Acupuncture, Tai chi, mindfulness‐based stress‐reduction program, and Transcendental Meditation. Air pollution of the surrounding air is linked with poor health outcomes and is a major contributor to the global burden of disease. Fine particulate matter <2.5 μm in diameter (PM2.5) is strongly associated with cardiovascular morbidity and mortality. Short‐term PM exposure (hours to weeks) increases the likelihood of adverse cardiovascular events including myocardial infarction, stroke, and heart failure, and longer‐term exposure multiplies that risk. Non‐pharmacological methods should be initiated early phase of disease and should be continued with medication.
Depicting the composition of gut microbiota in children with tic disorders: an exploratory study
Authors: Xi Wenjie , Gao Xuefeng , Zhao Huijun , Luo Xi , Li Jianfeng , Tan Xinjie , Wang Lei , Zhao Jian‐Bo , Wang Jing , Yang Guang , Liu Li‐Ying , Wang Yang‐Yang , Peng Lihua , Zou Li‐Ping , Yang Yunsheng 
Published: March 2021

BackgroundSymptom improvement in children with tic disorder (TD) following fecal microbiota transplantation led us to investigate the gut microbiota in TD. This exploratory study aims to depict the gut microbial profile in patients with TD and explore the impact of dopamine receptor antagonist (DRA) drugs on the composition and metabolic function of the gut microbiota.MethodsThe gut microbiota were profiled in fecal samples of 49 children with TD and 50 matched healthy controls (HC) using shotgun metagenomic sequencing. A random forest (RF) model was constructed using the gut bacterial species to distinguish TD from HC. Associations between clinical metadata and microbial abundance or function were analyzed using MaAsLin2 and Spearman correlation.ResultsThe gut microbiota in children with TD was featured by higher abundances of Bacteroides plebeius and Ruminococcus lactaris (a potential pro‐inflammatory taxon) and lower abundances of Prevotella stercorea and Streptococcus lutetiensis compared to HC. The constructed RF model accurately distinguished TD from HC based on the gut microbiota profile, resulting in an AUC of 0.884. Significant correlations were observed between tic symptom severity and the abundances of multiple bacterial species and gut microbiota metabolic functions. Multivariate analysis identified an upregulation of 4‐aminobutanoate (GABA) degradation in the gut microbiota associated with TD status. The gut microbiota of DRA‐treated TD children showed a distinct gut microbiota compared to the treatment‐naïve group, represented by an increase in some potential enteric pathogens such as Escherichia coli, a decline in several species including Akkermansia muciniphila, and alterations in various metabolic functions.ConclusionsBacterial species promoting inflammatory responses and those modulating neurotransmitters such as GABA may be involved in the pathogenesis of TD. The use of DRA drugs is likely to induce overgrowth of some enteric pathogens and alter the gut microbiota metabolism.
Basal insulin requirement in patients with type 1 diabetes depends on the age and body mass index
Authors: Mitsui Yukari , Kuroda Akio , Ishizu Masashi , Mori Hiroyasu , Kurahashi Kiyoe , Kondo Takeshi , Yoshida Sumiko , Akehi Yuko , Aihara Ken‐ichi , Endo Itsuro , Abe Masahiro , Matsuhisa Munehide 
Published: March 2021

AbstractAims/IntroductionTo investigate the basal insulin requirement in patients with type 1 diabetes who are on multiple daily injections (MDI) and to assess the patient characteristics that affect the percent of total daily basal insulin dose to the total daily insulin dose (%TBD/TDD).Materials and MethodsThe subjects of this study were 67 inpatients with type 1 diabetes who were served diabetic meals of 25–30 kcal/kg standard body weight during several weeks of hospitalization. The basal insulin requirement was adjusted to keep the blood glucose level from bedtime to before breakfast within a 30 mg/dL difference. The bolus insulin dose before the meal was adjusted to keep the blood glucose level below 140 and 200 mg/dL before and 2 h after each meal, respectively. The total daily insulin dose (TDD), the percent of total daily basal insulin dose (TBD) to TDD (%TBD/TDD), and clinical characteristics were collected.ResultsThe median (Q1, Q3) of TDD was 33.0 (26.0, 49.0) units, and the %TBD/TDD was 24.1 ± 9.8%. The %TBD/TDD was positively correlated with the body mass index (BMI) and negatively correlated with the age at the onset and at the examination according to a univariate analysis. However, the %TBD/TDD was dependent on the BMI (β = 0.340, P = 0.004) and the age at examination (β = −0.288, P = 0.012) according to the multiple regression analysis.ConclusionsThe average %TBD/TDD in patients with type 1 diabetes on MDI was approximately 24% under inpatient conditions. The basal insulin requirement was dependent on the BMI and the age at examination.
On regulation and excess reserves: The case of Basel III
Authors: Miller Stephen Matteo , Hoarty Blake 
Published: March 2021

AbstractCommon explanations for the observed rise in excess bank reserves include payment of interest on reserves and liquidity regulations, but capital regulations may also matter. We show that a profit‐maximizing bank substitutes from higher risk‐weighted loans to lower risk‐weighted reserves and Treasuries if the risk‐based capital ratio, but not the leverage ratio, increases. Estimated treatment effects for “advanced approaches” bank holding companies, the focus of Basel III capital regulations, initially increased for reserves after the regulatory changes but later decreased when treatment effects for Treasuries increased as Treasury yields rose; treatment effects for loans became increasingly negative.
Manifestation of neuro‐fuzzy simulation environment for prognostication of water absorption kinetics of soybean grains in thermo‐ultrasonication‐assisted soaking process
Authors: Shafaei Seyed Mojtaba , Nourmohamadi‐Moghadami Arash , Kamgar Saadat 
Published: March 2021

ABSTRACTNeuro‐fuzzy simulation of food engineering phenomena can be a supportive manner for integrated realization of compound trends of involved parameters. This article is aimed to manifest neuro‐fuzzy simulation environment for prognostication of water absorption kinetics of soybean grains in thermo‐ultrasonication‐assisted soaking process. The simulation environment was developed based on various types and numbers of input membership functions, defuzzification methods, types of output membership functions, and numbers of training cycles. Promising performance of the prominent environment guaranteed its reliability for prognostication of water absorption kinetics on the basis of numeral variables of soaking time and temperature (20, 30, 40, 50 and 60°C), and nominal variable of soaking strategy (thermic and ultrasonication [25 kHz and 360 W]). The simulation results divulged that applying both strategies of thermic and ultrasonication (thermo‐ultrasonication strategy) was more effective than individual strategy of thermic and ultrasonication in order to proliferate water absorption into the grains. However, contributory influence of the ultrasonication on water absorption was less apparent at higher soaking temperatures and it was more dominant, when soaking time augmented.Practical ApplicationsIt can be asserted that the neuro‐fuzzy simulation environment manifested and verified in this study can be practically utilized in oil extraction and seed priming process, and industrial production of some popular soybean food products (Soymilk, Okara, Tofu, Shoyu, Miso, and Natto).
Systematic review of coexistent epileptic seizures and Alzheimer's disease: Incidence and prevalence
Authors: Xu Ying , Lavrencic Louise , Radford Kylie , Booth Andrew , Yoshimura Sohei , Anstey Kaarin J. , Anderson Craig S. , Peters Ruth 
Published: March 2021

AbstractBackground/ObjectivesCoexistent seizures add complexity to the burden of Alzheimer's disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics.DesignA systematic review and meta‐analysis (PROSPERO protocol registration CRD42020150479).SettingPopulation‐, community‐, hospital‐, or nursing home‐based.Participants and measurementsThirty‐nine studies reporting on seizure incidence and prevalence in 21,198 and 380,777 participants with AD, respectively, and AD prevalence in 727,446 participants with seizures. When statistical heterogeneity and inconsistency (assessed by Q statistic and I2) were not shown, rates were synthesized using random effect.ResultsStudies were conducted in Australia, Brazil, Finland, France, Ireland, Italy, Japan, Netherlands, Portugal, Sweden, Taiwan, United Kingdom, and United States. The incidence of seizures among people with clinically diagnosed AD ranged from 4.2 to 31.5 per 1000 person‐years. Prevalence of seizures among people with clinically diagnosed AD ranged from 1.5% to 12.7% generally, but it rose to the highest (49.5% of those with early‐onset AD) in one study. Meta‐analysis reported a combined seizure prevalence rate among people with pathologically verified AD at 16% (95% confidence interval [CI] 14–19). Prevalence of seizure in autosomal dominant AD (ADAD) ranged from 2.8% to 41.7%. Being younger was associated with higher risk of seizure occurrence. Eleven percent of people with adult‐onset seizures had AD (95%CI, 7‐14).ConclusionSeizures are common in those with AD, and seizure monitoring may be particularly important for younger adults and those with ADAD.
Mental ill‐health in mothers of people with intellectual disabilities compared with mothers of typically developing people: a systematic review and meta‐analysis
Authors: Rydzewska E. , Dunn K. , Cooper S.‐A. , Kinnear D. 
Published: March 2021

AbstractBackgroundMothers of people with intellectual disabilities (IDs) face exceptional challenges and may be more prone to experiencing mental ill‐health compared with mothers of typically developing people. These mental ill‐health problems may differ at different stages of the caregiving trajectory. However, there is no evidence synthesis on this topic. We aimed to systematically review evidence in this area and identify gaps in the existing literature.MethodProspero registration: CRD42018088197. Medline, Embase, CINAHL and PsycINFO databases were searched. No time limits were applied. Studies were limited to English language. Inclusion criteria were studies of mothers of people with IDs that also included a comparison group of mothers of typically developing/developed children. Data were extracted from selected studies using a structured database. Study selection and quality appraisal were double rated. Where possible, meta‐analyses were performed.ResultsOf the retrieved articles, 32/3089 were included, of which 10 reported on anxiety, 21 on depression and 23 on other indicators of mental ill‐health. Overall, previous studies reported that mothers of people with IDs experienced poorer mental health as compared with mothers of typically developing people. Meta‐analyses revealed significant findings for anxiety, depression, parenting stress, emotional burden and common mental disorders, but not for somatic symptoms. However, there was a considerable heterogeneity; hence, interpretation of results should be cautious. Identified gaps included scarce research on mental ill‐health of mothers of adults with IDs at different stages of the caregiving trajectory.ConclusionsThere is evidence of poorer mental ill‐health in mothers of people with IDs compared with mothers of typically developing people, but lack of focus on different stages of the caregiving trajectory, methodological inconsistencies between studies and lack of robust studies pose limitations. This highlights the need both for improved support for mothers of people with IDs and for further methodologically robust research.
Racial‐ethnic differences in educational trajectories for individuals with intellectual disability
Authors: Bisesti E. , Landes S. D. 
Published: March 2021

AbstractBackgroundRacial‐ethnic differences in educational attainment have not been explored among adults with intellectual disability (ID). Because adults with ID and racial‐ethnic minority groups have been historically marginalised from educational pathways through life, they have likely experienced cumulative disadvantage. Therefore, investigating the intersection of ID and race‐ethnicity is necessary to increase understanding of educational attainment among adults with ID.MethodsUsing 1986–2017 National Health Interview Survey data, we examined the educational trajectories of adults with ID, stratified by race‐ethnicity (N = 4610). Generalised ordered logistic regression models were utilised to estimate the effect of birth cohort on educational attainment by race‐ethnicity among adults with ID.ResultsResults support prior findings that educational attainment increased for adults with ID around the 1950–1959 birth cohort; however, this was only the case for non‐Hispanic Whites. For racial‐ethnic minority groups, the probability of attaining a high school degree did not increase until comparatively later birth cohorts: non‐Hispanic Black adults did not have their largest gains in educational attainment until the 1960–1969 birth cohort; Hispanic adults did not have their largest gains in attainment until the 1980–1999 birth cohort.ConclusionThis study provides evidence of improvements in educational attainment for all adults with ID across birth cohorts. However, racial‐ethnic disparities were also present – educational attainment levels for non‐Hispanic Blacks remained lower than for non‐Hispanic Whites across all birth cohorts in the study. Hispanics were able to catch up to and surpass both non‐Hispanic Whites and non‐Hispanic Blacks by the end of the study period, despite lower levels of education in the early birth cohorts. Results from this study highlight the need to attend to race‐ethnicity when examining educational outcomes among adults with ID.
Diagnostic yield of whole‐exome sequencing in non‐syndromic intellectual disability
Authors: Taşkıran E. Z. , Karaosmanoğlu B. , Koşukcu C. , Ürel‐Demir G. , Akgün‐Doğan Ö. , Şimşek‐Kiper P. Ö. , Alikaşifoğlu M. , Boduroğlu K. , Utine G. E. 
Published: March 2021

AbstractBackgroundAetiological diagnosis in non‐syndromic intellectual disability (NSID) still poses a diagnostic challenge to clinicians.MethodsScreening is currently achieved by chromosomal microarrays followed by whole‐exome sequencing (WES). In search for the aetiological yield of WES in patients with NSID, 59 unrelated patients were studied.ResultsAmong the 59 patients, 44 (74.6%) were from consanguineous unions. Epilepsy was present in 11 (37.9%), behavioural problems in 12 (41.4%) and autistic features in 14 (48.3%). WES analysis resulted in molecular diagnosis in 29 patients (49.2%). Some of the genes were specific for nervous system functioning, like HERC1, TBC1D7, LINS, HECW2, DEAF1, HNMT, DLG3, NRXN1 and HUWE1. Others were ubiquitously expressed genes involved in fundamental cellular processes, like IARS, UBE3A, COQ4, TAF1, SETBP1, ARV1, ZC4H2, KAT6A, ASXL3, THOC6, HNRNPH2, TUBA8 and KIF1A. Twenty‐two (75.8%) were consanguineously married; however, only 12 (41.4%) of the detected genes caused autosomal recessive phenotypes.ConclusionsThis cohort suggests that recessive genes probably represent an actually smaller subgroup of NSID, even among families with consanguinity. Although in societies with high consanguinity rates, considering the recessive inheritance first seems to be an advantageous strategy, de novo mutations in autosomal dominantly expressed genes represent the major aetiological group in patients with NSID, even among those patients from consanguineous families.