bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frailty trajectories in three longitudinal studies of aging: Is the level or the rate of change more predictive of mortality?
Authors: Bai Ge , Szwajda Agnieszka , Wang Yunzhang , Li Xia , Bower Hannah , Karlsson Ida K , Johansson Boo , Dahl Aslan Anna K , Pedersen Nancy L , Hägg Sara , Jylhävä Juulia 
Published: May 2021

Abstract

Background
frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.

Objectives
to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.

Methods
3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: &lt;70, 70–80, 80–90 and &gt;90 years. Generalised survival models were used in the survival analysis.

Results
the FI trajectories by age at death showed that those who died at &lt;70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47–1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.

Conclusions
Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.
Efficacy of exercise-based interventions in preventing falls among community-dwelling older persons with cognitive impairment: is there enough evidence? An updated systematic review and meta-analysis
Authors: Li Fuzhong , Harmer Peter , Eckstrom Elizabeth , Ainsworth Barbara E , Fitzgerald Kathleen , Voit Jan , Chou Li-Shan , Welker Fei Li , Needham Shana 
Published: May 2021

Abstract

Objective
Exercise prevents falls in the general older population, but evidence is inconclusive for older adults living with cognitive impairment. We performed an updated systematic review and meta-analysis to assess the potential effectiveness of interventions for reducing falls in older persons with cognitive impairment.

Methods
PubMed, EMBASE, CINAHL, Scopus, CENTRAL and PEDro were searched from inception to 10 November 2020. We included randomised controlled trials (RCTs) that evaluated the effects of physical training compared to a control condition (usual care, waitlist, education, placebo control) on reducing falls among community-dwelling older adults with cognitive impairment (i.e. any stage of Alzheimer’s disease and related dementias, mild cognitive impairment).

Results
We identified and meta-analysed nine studies, published between 2013 and 2020, that included 12 comparisons (N = 1,411; mean age = 78 years; 56% women). Overall, in comparison to control, interventions produced a statistically significant reduction of approximately 30% in the rate of falls (incidence rate ratio = 0.70; 95% CI, 0.52-0.95). There was significant between-trial heterogeneity (I2 = 74%), with most trials (n = 6 studies [eight comparisons]) showing no reductions on fall rates. Subgroup analyses showed no differences in the fall rates by trial-level characteristics. Exercise-based interventions had no impact on reducing the number of fallers (relative risk = 1.01; 95% CI, 0.90–1.14). Concerns about risk of bias in these RCTs were noted, and the quality of evidence was rated as low.

Conclusions
The positive statistical findings on reducing fall rate in this meta-analysis were driven by a few studies. Therefore, current evidence is insufficient to inform evidence-based recommendations or treatment decisions for clinical practice.
PROSPERO Registration number: CRD42020202094.
The definition of sexual selection
Authors: Shuker David M , Kvarnemo Charlotta 
Published: May 2021

AbstractSexual selection is a key component of evolutionary biology. However, from the very formulation of sexual selection by Darwin, the nature and extent of sexual selection have been controversial. Recently, such controversy has led back to the fundamental question of just what sexual selection is. This has included how we incorporate female-female reproductive competition into sexual or natural selection. In this review, we do four things. First, we examine what we want a definition to do. Second, we define sexual selection: sexual selection is any selection that arises from fitness differences associated with nonrandom success in the competition for access to gametes for fertilization. An important outcome of this is that as mates often also offer access to resources, when those resources are the targets of the competition, rather than their gametes, the process should be considered natural rather than sexual selection. We believe this definition encapsulates both much of Darwin’s original thinking about sexual selection, and much of how contemporary biologists use the concept of sexual selection. Third, we address alternative definitions, focusing in some detail on the role of female reproductive competition. Fourth, we challenge our definition with a number of scenarios, for instance where natural and sexual selection may align (as in some forms of endurance rivalry), or where differential allocation means teasing apart how fecundity and access to gametes influence fitness. In conclusion, we emphasize that whilst the ecological realities of sexual selection are likely to be complex, the definition of sexual selection is rather simple.
DetectIS: a pipeline to rapidly detect exogenous DNA integration sites using DNA or RNA paired-end sequencing data
Authors: Grassi Luigi , Harris Claire , Zhu Jie , Hardman Colin , Hatton Diane 
Published: May 2021

Abstract

Motivation
Recombinant DNA technology is widely used for different applications in biology, medicine and bio-technology. Viral transduction and plasmid transfection are among the most frequently used techniques to generate recombinant cell lines. Many of these methods result in the random integration of the plasmid into the host genome. Rapid identification of the integration sites is highly desirable in order to characterize these engineered cell lines.

Results
We developed detectIS: a pipeline specifically designed to identify genomic integration sites of exogenous DNA, either a plasmid containing one or more transgenes or a virus. The pipeline is based on a Nextflow workflow combined with a Singularity image containing all the necessary software, ensuring high reproducibility and scalability of the analysis. We tested it on simulated datasets and RNA-seq data from a human sample infected with Hepatitis B virus. Comparisons with other state of the art tools show that our method can identify the integration site in different recombinant cell lines, with accurate results, lower computational demand and shorter execution times.

Availability and implementation
The Nextflow workflow, the Singularity image and a test dataset are available at https://github.com/AstraZeneca/detectIS.

Supplementary information
Supplementary data are available at Bioinformatics online.
‘All Watched Over by Machines of Loving Grace’1? Information technology, in-person relationships and normative regulation in an ‘integral cooperative’
Authors: Esteves Ana Margarida 
Published: May 2021

AbstractOn his study of the counterculture of the ‘60's and ’70's, Fred Turner argues that the application of systems-thinking and cybernetics to community-led initiatives (CLIs) makes them particularly vulnerable to internal factionalism and conflict, resulting from social and material pressures leading to the reproduction of mainstream norms and practices. Through the case study analysis of Cooperativa Integral Catalana (CIC) an “integral cooperative” for regional-level community development, this article explores how a governance strategy, combining online platforms for whole-system regulation and local nodes based on in-person relationships, promotes forms of normative regulation that contain factionalism and centrifugal tendencies in community-led initiatives (CLIs). Fieldwork evidence indicates that the use of online platforms and alternative currencies for overall network regulation does not prevent the accumulation of power by a core group of “professionalized activists”. The lack of processes of socialization aimed at building a common “habitus” among members of the cooperative with distinct identities, backgrounds and motivations creates difficulties to the development of relationships based on trust, as well as obstacles to the overall management of the cooperative. However, the in-person relationships of proximity build in regional-level nodes created “micro-public spheres” of praxis-based, co-constructed normative regulation that prevented the escalation of internal conflicts to reach a point of rupture. Such relationships provided a “cushion” of resilience that allowed CIC to begin, at the time of fieldwork, a process of decentralization and simplification of its structure.
Direct Interhemispheric Cortical Communication via Thalamic Commissures: A New White-Matter Pathway in the Rodent Brain
Authors: Szczupak Diego , Iack Pamela Meneses , Liu Cirong ,   IRC5 Consortium, Tovar-Moll Fernanda , Lent Roberto , Silva Afonso C 
Published: May 2021

Abstract
The corpus callosum (CC), the anterior (AC), and the posterior (PC) commissures are the principal axonal fiber bundle pathways that allow bidirectional communication between the brain hemispheres. Here, we used the Allen mouse brain connectivity atlas and high-resolution diffusion-weighted MRI (DWI) to investigate interhemispheric fiber bundles in C57bl6/J mice, the most commonly used wild-type mouse model in biomedical research. We identified 1) commissural projections from the primary motor area through the AC to the contralateral hemisphere; and 2) intrathalamic interhemispheric fiber bundles from multiple regions in the frontal cortex to the contralateral thalamus. This is the first description of direct interhemispheric corticothalamic connectivity from the orbital cortex. We named these newly identified crossing points thalamic commissures. We also analyzed interhemispheric connectivity in the Balb/c mouse model of dysgenesis of the corpus callosum (CCD). Relative to C57bl6/J, Balb/c presented an atypical and smaller AC and weaker interhemispheric corticothalamic communication. These results redefine our understanding of interhemispheric brain communication. Specifically, they establish the thalamus as a regular hub for interhemispheric connectivity and encourage us to reinterpret brain plasticity in CCD as an altered balance between axonal reinforcement and pruning.
The SWEDEHEART secondary prevention and cardiac rehabilitation registry (SWEDEHEART CR registry)
Authors: Bäck Maria , Leosdottir Margret , Hagström Emil , Norhammar Anna , Hag Emma , Jernberg Tomas , Wallentin Lars , Lindahl Bertil , Hambraeus Kristina ,   for the SWEDEHEART study group
Published: May 2021

Abstract

Aims
The quality registry SWEDEHEART covers data across the patient pathway after an acute myocardial infarction (MI), from hospital care to secondary prevention. Although cardiac rehabilitation (CR) is strongly recommended after an MI, there is still heterogeneity regarding standards, uptake, and adherence rates. The aim of the SWEDEHEART-CR registry is to provide continuous information on secondary prevention and CR performance to support the audit and development of evidence-based practice. To facilitate quality improvement and research initiatives, a description of the characteristics and development of the SWEDEHEART-CR registry is needed.

Methods and results
The SWEDEHEART-CR registry starts with data obtained during hospital care and then collects data at out-patient visits 2 months and 1-year after discharge, and at start and end of an exercise-based CR programme. The registry data covers comorbidities, biochemistry, blood pressure, anthropometric variables, medication, psychosocial- and lifestyle variables, readmissions, patient-reported outcome measures, attendance in CR-related programmes, and physical fitness variables. Over 100 000 patients with MI have been included in the SWEDEHEART-CR registry since its start in 2005. From initially covering 35 centres (47%) and 2200 patients annually (27%), SWEDEHEART-CR has developed to a nation-wide registry with 75 centres (100%) and 8800 patients annually (80%) in 2020.

Conclusion
The SWEDEHEART-CR registry includes a high proportion of the national MI population entering a CR programme and is a powerful tool for quality audit, improvement, and research. The registry provides insights into the characteristics, treatment, and outcomes of evidence-based secondary preventive practice, ultimately leading to better cardiovascular health.
Comparison and risk stratification of patients presenting with syncope in emergency department
Authors: Maqsood H , Younus S , Qazi S , Mazhar S , Ghaffar U , Basit A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction :
Syncope is the sudden loss of consciousness, associated with an inability to maintain postural tone, with immediate and spontaneous recovery without requiring electrical or chemical cardioversion. It is a common condition associated with frequent hospitalization or visits to the emergency department. It has a prevalence of 40%, considering a lifetime of 70 years and an annual incidence of 6%. The prognosis after syncope ranges from relatively benign for vasovagal to poor for ventricular tachyarrhythmia, but invariably creates anxiety and potentially life-changing disruption demanding timely resolution Overall, morbidity and mortality in syncope patients are low, but 1-year mortality can reach significantly higher in certain subgroups.
Purpose :
To compare the mortality rates in men and women so that management of the disease and comorbidities can be done accordingly.
Methods :
Anyone who presented to the ED with transient loss of consciousness (TLOC) between 2015 and 2018 (n = 11,718) underwent evaluation for syncope. Initial evaluation included history, physical exam, orthostatic blood pressure, heart rate measurement and a 12-lead ECG with or without echocardiogram. All patients were followed up from their initial ED visit until either April 30, 2019, or death, whichever occurred first.
Results :
Among the patients who presented to the ED, 1,011 (8.62%) females and 1,391 (11.87%) males were admitted to inpatient facilities. The median age of females at the time of diagnosis was 49 years as compared to 54 years for males. Moreover, females had fewer comorbidities (67.9% with Charlson/Deyo comorbidity score of 0) as compared to males (61.8% with Charlson/Deyo comorbidity score of 0). At 30 days, among those admitted, females had a mortality rate of 2.2% vs. 5.1% for males, and among those discharged, females had a mortality rate of 0.1% vs. 0.6% for males (P &lt; .001 for both). At 1 year, among those admitted, females had a mortality rate of 10.9% vs. 15.6% for males, and among those discharged, females had a mortality rate of 1.8% vs. 3.2% for males (P &lt; .001 for both). All data were analyzed on SPSS version 20 and it was found that males had a 1.2 fold greater risk for death at 1 year compared to females.
Conclusion : By comparing the mortality rates of males and females presenting in the emergency department with syncope, we concluded that the mortality rate is higher in males. This finding will help us to manage the high-risk patients of syncope accordingly.
ECG markers of malignant arrhythmias risk in patients with arterial hypertension hospitalized for COVID-19 pneumonia
Authors: Novitskiy A , Popov K , Smirnova A , Shvarts Y 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction. Changes in the myocardium in patients with arterial hypertension (AH) can cause fatal arrhythmias. The effects of inflammation and drugs on the heart in COVID-19 pneumonia can also increase the risk of sudden arrhythmic death.
The aim of the paper is to study interrelationship of ECG markers of malignant arrhythmias and clinical and laboratory findings in patients with AH and COVID-19 pneumonia.
Methods. 48 patients with AH hospitalized for COVID-19 pneumonia (32 women aged 34 to 83, 16 men aged 48-80) were included in the study in October-November 2020. Exclusion criteria: congestive heart failure, previous myocardial infarction, reduced ejection fraction, valvular disease, life-threatening COVID-19 and other serious diseases. Main clinical characteristics and recommended laboratory findings were taken into account. Corrected QT and Tpeak-Tend were analyzed.
Results. The QTc fluctuations were from 353 ms to 494 ms. The QTc values were higher than normal in 28%. The QTc duration correlated with C-reactive protein level (Kendall R = 0.59) and NYHA class (Gamma = 0.48). The Tpeak-Tend value correlated with coronary heart disease (Gamma 0.65), C-reactive protein (Kendall R = 0.57) and taking dexamethasone (Gamma 0.44) and fluoroquinolones (Gamma 0.58). Multivariate analysis has showed that high level of C-reactive protein (Wald = 7.4) and the presence of heart failure (Wald = 5.2) were independent predictors of QTc increase. Coronary heart disease (Wald = 4,8) and taking respiratory fluoroquinolones (Wald= 3.7) were independent predictors of Tpeak-Tend increase. Age, SatO2, taking betablockers and other analyzed indicators were not significantly related to QTc and Tpeak-Tend.
Conclusion. Systemic inflammatory response, heart diseases and taking respiratory fluoroquinolones can adversely affect the myocardial repolarization indicators associated with the risk of sudden death in patients with AH hospitalized for COVID-19 pneumonia.
Sleep disorders in patients with overweight and acute and exacerbated chronic heart failure
Authors: Kalidjiev PK , Kinova E , Somleva D , Goudev A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Medical University - Sofia University Hospital "Tsaritsa Yoanna – ISUL”

Background
Often accompanying comorbidity in patients with heart failure and overweight is sleep disorders. Detection and treatment of sleep apnea will be helpful in these patients.

Purpose
To determine the phenotypic characteristics of sleep apnea in these patients. To determine whether there is a link between forms of sleep apnea and type of heart failure.

Methods
Hospitalized 46 patients with acute and exacerbate heart failure. Measuring of NT proBNP. Sleep apnea screening with ApneaLink™. Echocardiographic assessment of left ventricular ejection fraction (LVEF) and the E/e‘ ratio. Statistical methods to compare independent samples and correlation analysis for linear dependence.

Results
Of the 46 overweight patients with acute and exacerbated chronic heart failure, sleep apnea was diagnosed in 36 patients (78.2%). Of these, 83.3% (n = 30) have оbstructive sleep apnea (OSA) and 16.7% (n = 6) have central sleep apnea (CSA). There was a statistically significant difference in LVEF for the group with CSA (n = 6) vs group with OSA (n = 30) (41.67 ± 13.88 vs. 50.57 ± 8.16, p = 0.038). For diastolic function didn"t reach statistical significance for E/e" ratio (20,33 ± 5,00 vs. 17,06 ± 4,02, p = 0,089). Regarding NTproBNP, there is no significant difference between the groups with OSA and those with CSA (2978.5 ± 2664.1 vs. 2063.36 ± 1877.27 pg/ml, p = 0.316). There is a moderate negative correlation with LVEF and number of central sleep apnea events (r=-0,334, p = 0,047).

Conclusions
With greater frequency occurs obstructive sleep apnea. Left ventricular systolic function is lower in patients with central sleep apnea. There is a reverse correlation between ejection fraction and number of central apnea.
Impact of a cardiovascular rehabilitation program on frailty indicators in elderly patients with heart disease
Authors: Fonteles Ritt L , Matos E Oliveira F , Santos Pereira Ramos JV , Braga Linhares De Albuquerque R , Borges De Oliveira Q , Amoedo Da Costa Pinto D , Costa Claro T , Miura Feitosa C , Santos Gramacho M , Freitas Feitosa G , Sahade Darze E 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): Hospital Cardio Pulmonar

INTRODUCTION
Frailty has been considered an important predictor of morbidity and mortality in elderly patients with cardiovascular disease. Cardiovascular Rehabilitation (CVR) has a direct and unequivocal effect on improving functional capacity in patients with heart disease, however, the effect of CVR on frailty indicators has not yet been well established. PURPOSE: To evaluate the association of the CVR program with frailty indicators in elderly patients with heart disease referred to a cardiovascular rehabilitation program and to identify possible predictors of improvement in frailty in this population. METHODS: Retrospective cohort with patients over 65 years old referred to an CVR program in Salvador-BA, Brazil from August / 2017 to March / 2020. Frailty was assessed using the Edmonton Frail Scale (EFS) at baseline and at least 3 months after the start of the program. Student"s t and Chi-square tests were used to compare continuous and categorical variables, respectively, logistic regression to analyze independent predictors of improvement in frailty and p &lt;0.05 adopted as statistically significant. RESULTS: 51 patients were included, with a mean age of 75 ± 6 years, 65% men, 39 (77%) with coronary artery disease, 23 (50%) with heart failure, 21 (41%) with diabetes, 34 (67%) with hypertension and 41 (80%) dyslipidemia. According to the American Heart Association (AHA) risk stratification for exercise, 21 (49%) were risk B and 22 (51%) risk C. Regarding functional capacity, 12 (31%) were class I, 21 (41%) class II, 5 (13%) class III and 1 (3%) class IV according to the New York Heart Association (NYHA). The average initial ejection fraction was 53 ± 16%. The mean time between the two assessments was 5 ± 2 months and the improvement observed in maximum oxygen consumption (VO2 max) was from 15 ± 4 to 16 ± 4 mL.Kg-1.min-1 (p = 0.001). Regarding frailty, there was an improvement from 5.4 ± 2.0 to 4.8 ± 1.9 in the average of the EFS score (p = 0.034), with 25 patients (49%) being considered responders. This group was predominantly formed by men, non-diabetics, using statins, at risk B (AHA) and with a higher score on the quality of life score and on the EFS. However, in the multivariate analysis, only the highest score on the EFS (OR 1.8 CI 95% 1.06-3.3; p &lt;0.05) and the lowest risk on the AHA scale (OR 0.18 CI 95% 0.03-0.97; p &lt;0.05) remained as independent predictors of response. CONCLUSIONS: There was a significant improvement in the frailty of elderly patients referred for CVR, the higher the baseline frailty score, the greater the chance of response.