bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of the Advanced Clinical Practitioner (ACP) in triaging patients with Non ST-Elevation acute coronary syndromes (NSTE-ACS) patients for coronary angiographic procedures
Authors: Comer K 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
The introduction of the ACP role to a cardiology service with emphasis on measuring the effect of this role on improving the Inter-hospital transfer pathway for patients with ACS by improving patient outcomes
ACPs triage a large number (estimated n = 2500 per year) of cardiology IHT referrals from these hospitals and ensure effective transfer to our centre for ACS treatment whilst supporting staff in the care of those patients who do not meet our transfer criteria or are acutely unwell for transfer but cardiovascular stable
Patients are listed in order of presenting symptoms, presence or absence of chest pain on admission, relevant blood results such as infection markers, kidney function, and troponin a cardiac biomarkers, ECG findings, drug history , past medical history and arrival to hospital rather than clinical urgency .

Purpose
Therefore the purpose of this evaluation was to measure the patient outcomes of introduction of an ACP in triaging patients with NSTE-ACS)patients for coronary angiographic procedures.

Methods
Quantitative design approach with a specialist cardiology setting using a 2-year observational analysis of the data.The study population included all patients referred for angioplasty or PCI via the Inter-hospital transfer acute coronary syndrome network including all patients referred for PCI following NSTE-ACS. Results :
There were a total of n= 4976 patients referred for coronary angiogram +/-proceed procedures between Feb 2018 and Feb 2020.
Overall significant positive outcomes were noted across a consistent patient group based on presenting symptoms and patient characteristics when comparing data in the year preceding ACP led triage.
A 2-sided p-value &lt;0.05 defined statistical significance and to reject the null hypothesis.
There was a significant reduction in waiting time post introduction of ACP led triage (p &lt; 0.0001) equating to one day
Comparison from pre ACP to post ACP led triage and clinical cancellation rates was reduced significantly (p = 0.0062).
Rates of revascularisation were significantly higher post ACP led triage with a corresponding decrease in those managed medically (47.2% pre vs 43.1% post, p = 0.0037). These higher rates consisted of increased rates of both CABG (12.4% pre vs 13.5% post, p = 0.04) and PCI 40.4% vs 43.4%, p = 0.0216)

Conclusion
ACP led triage of ACS patients requiring urgent treatment demonstrates improved patient outcomes with economic benefits for healthcare providers, enhancing the service provided and opens up discussions for further quality improvement and implications to practice.
Evidence of the benefits of advanced practice and the role of the advanced clinical practitioner is demonstrated within the cardiology setting and for the clinical triage of a patient group.
Discharging patients; does it need to be done by a doctor?
Authors: Harrison S , Bellchambers J , Deane S , Dent N , Mackay N , Pottle A 
Published: July 2021

Abstract

Funding Acknowledgements
None

Background
Patients undergoing angiography and percutaneous coronary intervention (PCI) were historically reviewed post procedure by a member of the medical team who assesses the patient’s suitability for discharge and completes the discharge letter. Over the past 10 years, the number of patients admitted for these procedures as day cases has increased significantly. In addition, there has been an expansion in nursing roles in the UK with the development of a variety of clinical nurse specialist (CNS) posts which have taken over many of the traditional medical roles.
The majority of patients undergoing elective angiography and PCI are admitted to a day case unit at this tertiary cardiac centre. There is no designated medical cover for the unit and medical staff from the acute cardiac unit are called to review patients and complete their discharge paperwork in addition to their other duties. This frequently results in delayed discharge and patients going home without a discharge summary.
It was therefore proposed that suitably qualified CNSs could be trained to discharge these patients and others undergoing day case cardiology procedures. From June 2017, the CNS team took over the role of reviewing patients post procedure and completing the discharge letter.

Purpose
The aim of the study was to evaluate if CNSs were able to discharge patients and provide a timely and effective service following elective cardiology procedures and to obtain patient feedback.

Method
Data on the number of patients reviewed by the CNSs from June 2017 to the end of December 2019, were prospectively collected in a dedicated database. A pilot study of patient experience was carried out in January 2020. Patients were given a questionnaire which asked about the explanation they received from the CNS regarding the procedure they had undergone, if their medication was reviewed and discussed with them, and if they received a discharge summary to take home.

Results
1287 patients were reviewed by the CNS team during the above period. 811 (63.0%) patients had undergone angiography and 423 (32.9%) PCI. Informal feedback from the staff working on the day case unit included that patients were discharged earlier, had improved knowledge about their procedure and that the discharge letter was more detailed when completed by the CNS team.
Eight patients completed the pilot questionnaire. Six were discharged by one of the CNS team, one by a doctor and one patient was not sure who did their discharge. All patients were very satisfied with the process and the information they were given.

Conclusion
Experienced CNSs can deliver high-quality, timely discharge of patients following cardiology procedures. This process is being used as a template to expand nurse-led discharge to other areas in cardiology. Patient experience will continue to be audited with a larger sample size in 2020.
Prognostic roles of obstructive sleep apnea syndrome and right ventricular dysfunction in heart failure patients with preserved ejection
Authors: Grakova E , Yakovlev AV , Shilov SN , Teplyakov AT , Yakovleva NF , Berezikova EN , Kopeva K 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Objective. To study the prognostic roles of obstructive sleep apnea syndrome (OSAS) and right ventricular dysfunction in the development of heart failure (HF) progression in patients with preserved ejection fraction (HFpEF) during the 12-month follow-up period. Methods. The severity of obstructive breathing disorders during sleep was assessed by the apnea/hypopnea index (AHI). A total of 86 men, median age of 62.0 (41.0; 78.0) years with moderate and severe OSAS (with AHI &gt; 15 per hour) and HF of NYHA class I-III with baseline LVEF of 60% [52; 65]% were enrolled in the study. All patients had the abdominal obesity (WC &gt; 92 cm), body mass index exceeded 30 kg/m2. Serum levels of NT-proBNP were measured using ELISA at baseline. Two-dimensional transthoracic echocardiography with assessment of right ventricular function and 6-minute walk test were performed at baseline and at 12 months. Results. At 12 months of follow-up period all patients were divided into 2 groups: group 1 (n = 33) comprised patients with HF progression, group 2 (n = 53) without it. The concentration of NT-proBNP at baseline was higher by 18% in group 1 than in group 2 (p = 0.024; 338 [168; 678] vs. 278 [177; 815] pg/mL, respectively). The median values of AHI (p &lt; 0.0001) were 46.0 [20.6; 85] per hour in group 1 and 24.0 [21.0; 28.0] per hour in group 2. In group 1 than in group 2 fractional change in the area of the right ventricle (ΔSRV) was less by 9.1% (p = 0.031; 40 [35; 47] vs. 44 [40; 47]%, respectively) and right ventricular myocardial function index (RVSWI, Tey index) was less by 8% (p = 0.022; 0.23 [0.22; 0.25] vs. 0.25 [0.24; 0.26], respectively). Based on ROC-analysis, AHI ≥33.5 episodes per hour (sensitivity 75.8%, specificity 67.9%, AUC = 0.732; p &lt; 0.0001), ΔSRV ≤18.6% (sensitivity 75.8%, specificity 54.7%, AUC = 0.62; p = 0.047) and NT-proBNP ≥311 pg/mL (sensitivity 63.6%, specificity 73.6%, AUC = 0.645; p &lt; 0.0001) were identified as a cut-off values predicting the development of HF progression. The combined evaluation of NT-proBNP and AHI increased the predictive value of the analysis (sensitivity of 82.6%, specificity of 77.1%, and AUС of 0.821; p &lt; 0.0001). Conclusion. Our data suggest that NT-proBNP, AHI and ΔSRV may be used as a diagnostic biomarker for HF progression in patients with preserved ejection fraction (HFpEF) during the 12-month follow-up period. The combined use of NT-proBNP and AHI demonstrated higher diagnostic sensitivity and specificity for prediction of unfavorable course of HF.
The effect of cardiorehabilitation on the quality of life by congestive heart failure patients
Authors: Labudova M , Hudak M , Zambojova I , Durinova E , Simonova M , Machackova B , Vaska E , Stanova J 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
To examine selected parameters of quality of life in patients with cardiac failure after cardiorehabilitation in outpatient and inpatient form and to compare the effect with each other.
Methods and methodology: The survey included 64 respondents without age restrictions with chronic heart failure NYHA I. - III. after undergoing inpatient or outpatient cardiorehabilitation, polymorbid, oncology and psychiatric patients were excluded. The questionnaire with 20 questions focused on 12 quality of life domains. Statistical processing: t-test, ANOVA, Chi-square test, Spearman correlation coefficient (p &lt;0.05).

Results
35 men (54.7%) and 29 women (45.3%) were included, with a mean age of 58.07 years, with a mean duration of CHF treatment of 3.99 years, subgroups (internal 25, cardiology 21 and institute 18 probands) did not differ in age. We found that cardiorehabilitation has a positive effect on the quality of life of patients with CHF, if it is associated with social support, appropriate education and meets the conditions of a comprehensive approach. Patients rated their quality of life better compared to their quality of life a year ago. Outpatients are more satisfied with their health than patients in inpatient treatment, patients with a more severe manifestation of CHF have a greater anxiety from physical activity and therefore less motivation to move. All patients expressed dissatisfaction with their sex lives. Patients in outpatient treatment experience more depression. There were no differences between the subgroups in the evaluation of the degree of education by the nurse and the effect of the exercise on the subjective condition. All subgroups perceived the other person"s help more valuable than medical help. Patients from inpatient treatment have been more motivated to change their lifestyle on their own initiative and through the influence of information from healthcare professionals.

Conclusion
Comprehensive cardiovascular rehabilitation of patients with heart failure improves many of the prognostic indicators of heart failure, reduces mortality and the frequency of rehospitalizations, reduces treatment costs, improves quality of life. nevertheless, rehabilitation programs for chronic heart failure are being promoted only very slowly. The reason may be the absence of standard procedures, as well as organizational, economic and personnel demands.
Should I stay or should I go? An exploration of the decision-making behaviour of acute cardiac patients during the Covid-19 pandemic
Authors: Burton S , Hayes J , Scott-Morell N , Jones I , Sanders J , Walthall H , Wright J 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Liverpool John Moores University

Background
The Covid-19 pandemic has resulted in excess mortality. With efforts to reduce population movement and the spread of the disease, non-emergency patients are deterred from seeking help. Reduction in the number of patients presenting with acute cardiac conditions has dropped significantly, impacting initial and follow-up treatment. In a national survey, 71% reported they were afraid to visit hospital due to fear of being exposed to the virus, and 46% worried about putting pressure on the health service. Internet searches for chest pain symptoms increased following the announcement of lockdown and public health messages, suggesting an influence of government messaging on patient behaviour. Current work suggests that patients are turning to informal support networks to facilitate decision making, while more formalised networks are blocked.

Purpose
To qualitatively explore decision making of patients and their family members’ when faced with an acute cardiac event. This methodology provides insight into why patients made said decisions, and what factors influenced their decision making, during the Covid-19 pandemic.

Methods
A qualitative methodology was employed using purposive sampling of cardiac patients, who had attended hospital during a Covid-19 lockdown. Data was collected using semi-structured, digitally recorded, telephone or video call interviews. Interviews were transcribed verbatim and subjected to thematic analysis.

Results
Twenty-four participants were recruited, from three sites throughout England.

Three themes were generated from the study
Reliance on informal support network, including disclosing their symptoms to family and friends, in turn leading to displaced or co-decision making. Secondly, a lack of awareness of cardiac symptoms leading to delayed help-seeking. Finally, an indirect Covid-19 effect, in which patients suggest that Covid-19 did not influence their decisions, yet a perception that their condition was non-urgent combined with a belief that GP services were limited resulted in delayed help-seeking

Conclusions
Patients have turned to informal health support networks, especially when the cause of symptoms are unknown. While the presence of Covid-19 is not explicitly noted as being influential, indirect effects are noted. Findings highlight the need for informed public health messages, that allow those in need of treatment to access care as and when they need.
Decolonising Copyright: Reconsidering Copyright Exclusivity and the Role of the Public Interest in International Intellectual Property Frameworks
Authors: Kouletakis Jade 
Published: July 2021

Abstract
International intellectual property frameworks conceive of copyright exclusivity as a largely individualistic, westernised and capitalistic benefit which must be balanced against and limited by the non-commercial, competing public interest. This is expressed primarily by way of limitations to and exceptions from the norm of exclusivity recognised within these frameworks. This article argues for an alternative interpretation of copyright exclusivity as being justified by the public interest. However, unlike the works of Geiger et al., this interpretation is not premised upon the constitutional and quasi-constitutional patterns accounting for the public interest foundations of IP. Instead, it is premised upon the conceptualisations of indigenous communities within the Global South relating to exclusivity over intangible property for the communal benefit. This article argues that a paradigm shift in the international community at a supranational level, such as the removal of the TRIPS Agreement from the WTO, is needed in order to better reflect the norms and values of the Global South. By reassessing the nature of copyright exclusivity rather than delegating conversations about non-commercial communal needs to limitations and exceptions, the Global South is no longer seen as mere passive receptors of Western norms and values, but as active participants with inherent value in the creation of a truly global IP framework.
A visualizing analysis of Chinese character processing in the past 40 years (1981–2020)
Authors: Cheng Heben , Shinnick Elizabeth , Wang Xiaolu 
Published: July 2021

Abstract
The article uses CiteSpace to analyze the research of Chinese character processing through two analyses. A document co-citation analysis of the research in the past 40 years has found ten obvious clusters and described their transitional pattern by timeline visualization and betweenness centrality measurement. Additionally, an emerging trend analysis has also been carried out to describe the current directions of research in the field within the past 5 years, from which we found that multi-method research and acquisition of Chinese literacy are the most productive domains. By converging the results of the two analyses, we came up with a framework of combination between cognitive processes and anatomical structure, as well as a framework of development trajectory for Chinese character awareness. The two frameworks can be used to make predictions and show future directions in these two domains and other related domains, such as the research of Chinese character processing by Chinese foreign language learners.
Asteroseismology of overmassive, undermassive, and potential past members of the open cluster NGC 6791
Authors: Brogaard K , Arentoft T , Jessen-Hansen J , Miglio A 
Published: July 2021

ABSTRACT
We perform an asteroseismic investigation of giant stars in the field of NGC 6791 with previous indications of atypical evolution. The analysis uses observations from Kepler and Gaia in combination with ground-based photometry, a literature radial-velocity study, and measurements of eclipsing binaries in the cluster. We derive mass, radius, effective temperature, evolutionary stage, and apparent distance modulus of each target. Among the investigated cluster giants we find clear evidence of overmassive and undermassive members, and non-members with strong hints of potential past membership. Our results indicate that about 10 per cent of the red giants in the cluster have experienced mass transfer or a merger. High-resolution high-S/N spectroscopic follow-up could confirm potential past membership of the non-members, and reveal whether certain element abundances might expose the non-standard evolution of overmassive and undermassive stars. If so, field stars of similar type could be identified as what they are, i.e. overmassive or undermassive stars, and not mistakenly classified as younger or older than they are.
Constraining properties of GRB central engines with X-ray flares
Authors: Yi Shuang-Xi , Xie Wei , Ma Shuai-Bing , Lei Wei-Hua , Du Mei 
Published: July 2021

ABSTRACT
X-ray flares in gamma-ray bursts (GRBs) are believed to be generated by the late activities of central engine, and thus provide an useful tool to diagnose the properties of central objects. In this paper, we work on a GRB X-ray flare sample whose bulk Lorentz factors are constrained by two different methods and the jet opening angles are determined by the jet breaks in afterglow light curves. Considering a hyperaccreting stellar-mass black hole (BH) as the central engine of GRBs and the Blandford & Znajek process (BZ) as the jet production mechanism, we constrain the parameters of central engine by using the X-ray flare data. We find that the BZ mechanism is so powerful making it possible to interpret both GRB prompt emissions and bright X-ray flares. The wind parameter (p) and accreted mass (Md) fall into reasonable ranges. Our result is also applied to GRB 170817A. The late X-ray flare in GRB 170817A, if it is true, might not be a BH origin.
The origin of the dust extinction curve in milky way-like galaxies
Authors: Li Qi , Narayanan Desika , Torrey Paul , Davé Romeel , Vogelsberger Mark 
Published: July 2021

ABSTRACT
We develop a cosmological model for the evolution of dust grains in galaxies with a distribution of sizes in order to understand the origin of the Milky Way dust extinction curve. Our model considers the formation of active dust in evolved stars, growth by accretion and coagulation, and destruction processes via shattering, sputtering, and astration in the ISM of galaxies over cosmic time. Our main results follow. Galaxies in our cosmological model with masses comparable to the Milky Way’s at z ∼ 0 exhibit a diverse range of extinction laws, though with slopes and bump strengths comparable to the range observed in the Galaxy. The progenitors of the Milky Way have steeper slopes, and only flatten to slopes comparable to the Galaxy at z ∼ 1. This owes to increased grain growth rates at late times/in high-metallicity environments driving up the ratio of large to small grains, with a secondary dependence on the graphite-to-silicate ratio evolution. The UV bump strengths depend primarily on the graphite-to-silicate ratio, and remain broadly constant in MW-like galaxies between z = 3 and z = 0, though show slight variability. Our models span comparable regions of bump-slope space as sightlines in the Galaxy do, though there is a lack of clear relationship between the model slopes and bump strengths owing to variations among galaxies in the graphite-to-silicate ratio. Our model provides a novel framework to study the origins and variations of dust extinction curves in galaxies over cosmic time.
A joint 2- and 3-point clustering analysis of the VIPERS PDR2 catalogue at z ∼ 1: breaking the degeneracy of cosmological parameters
Authors: Veropalumbo Alfonso , Sáez Casares Iñigo , Branchini Enzo , Granett Benjamin R , Guzzo Luigi , Marulli Federico , Moresco Michele , Moscardini Lauro , Pezzotta Andrea , de la Torre Sylvain 
Published: July 2021

ABSTRACT
We measure the galaxy two- and three-point correlation functions at z = [0.5, 0.7] and z = [0.7, 0.9], from the Public Data Release 2 (PDR2) of the VIMOS Public Extragalactic Redshift Survey (VIPERS). We model the two statistics including a non-linear one-loop model for the two-point function and a tree-level model for the three-point function, and perform a joint likelihood analysis. The entire process and non-linear corrections are tested and validated through the use of the 153 highly realistic VIPERS mock catalogues, showing that they are robust down to scales as small as 10 $h^{-1} \, \mathrm{Mpc}$. The mocks are also adopted to compute the covariance matrix that we use for the joint two- and three-point analysis. Despite the limited statistics of the two (volume-limited) subsamples analysed, we demonstrate that such a combination successfully breaks the degeneracy existing at two-point level between clustering amplitude σ8, linear bias b1, and the linear growth rate of fluctuations f. For the latter, in particular, we measure $f(z=0.61)=0.64^{+0.55}_{-0.37}$ and f(z = 0.8) = 1.0 ± 1.0, while the amplitude of clustering is found to be σ8(z = 0.61) = 0.50 ± 0.12 and $\sigma _8(z=0.8)=0.39^{+0.11}_{-0.13}$. These values are in excellent agreement with the extrapolation of a Planck cosmology.