bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to Secondary Preventative Medications One Year Post Stroke
Authors: D'Alton Maeve , Baby Maya , Donaghy Lisa , Hamad Mahmoud , Dolan Eamon , Sheehan Orla 
Published: September 2024

Abstract

Background
Adherence to secondary preventative medications is critical to reduce subsequent vascular events after ischaemic stroke. Many stroke risk factors are modifiable, but adherence is poor in up to 40% of stroke survivors. Guidelines recommend the use of antithrombotic, lipid lowering and antihypertensive medication. We examined adherence to these medications one year post stroke.

Methods
This was a retrospective cohort study of patients admitted to an Irish level 3 hospital with an acute stroke between July 2022 and June 2023. Stroke survivors were interviewed a year after stroke onset, either in clinic or in their home, and asked to show the interviewer all current medications. Adherence to three categories of secondary prevention medications and knowledge of their indication was assessed.

Results
172 stroke patients were contacted and 64% agreed to participate. The cohort included 62% males and average age was 69.9 years. The majority (72/110, 65%) had a modified Rankin score (mRS) of 0-2. The proportion of participants reporting full adherence to all prescribed medications was 81% (89/110) with adherence rates of 81% for lipid lowering agents and 88% for both antithrombotics and antihypertensives. Adherence was higher in participants who had an involved caregiver (85.9% vs 73.9%) and in those with mRS &gt;2 (94.9% vs 73.2%). There was no significant difference between age or gender subgroups. Knowledge of the indication was 62% for antithrombotics and 55% for lipid-lowering drugs.

Conclusion
Self-reported adherence to secondary preventative medications was high in this cohort but one in five stroke survivors reported poor adherence increasing their risk for recurrent stroke. Adherence was highest for antithrombotics and lowest for lipid-lowering drugs. Adherence is higher in more dependent individuals and helped by an involved caregiver. We observed a deficit in patient understanding of secondary prevention medications. Improving this knowledge gap could increase adherence to secondary prevention post stroke.
Incidence of Vestibular Dysfunction in Frail Older Adults Attending an Integrated Care Programme for Older Persons (ICPOP)
Authors: Hassett Patricia 
Published: September 2024

Abstract

Background
The World Falls Guidelines (2022) recommend a vestibular assessment as part of a multifactorial falls risk assessment in older adults. There is a possibility however, of vestibular dysfunction being overlooked because of no subjective complaints in older fallers i.e. vestibular agnosia. This study aimed to determine the prevalence of vestibular dysfunction in older adults presenting to physiotherapy in Integrated Care Programme for Older Persons (ICPOP) regardless of complaints of dizziness.

Methods
This was a retrospective observational study of frail older adults attending physiotherapy in ICPOP over a 4-month period. Patients with a falls history or indicators of vestibular dysfunction (e.g. dizziness, reduced balance on turning) were identified for vestibular assessment. Data was collected from a hospital clinical system using Microsoft Excel. This was a retrospective observational study of frail older adults attending physiotherapy in ICPOP over a 4-month period. Patients with a falls history or subjective indicators of vestibular dysfunction (e.g. dizziness, reduced balance on turning) were identified for vestibular assessment. Data was collected from a hospital clinical system using Microsoft Excel.

Results
A vestibular assessment was carried out on 69% (n=52) of physiotherapy patients with a mean age of 80.9 years and mean Clinical Frailty Score of 5. 75% of patients that underwent a vestibular assessment had vestibular dysfunction with the most prevalent diagnoses being Benign Paroxysmal Positional Vertigo (40%), Unilateral Vestibular Hypofunction (13%) & reduced gain of Vestibulo-Ocular Reflex (13%). 77% of those who tested positively for vestibular dysfunction had a fall within the last 12 months. 48% of those patients that had vestibular dysfunction did not complain of dizziness.

Conclusion
Almost half of patients with vestibular dysfunction had no dizziness highlighting the incidence of vestibular agnosia. This study highlights the high prevalence of vestibular dysfunction amongst older adults and supports vestibular assessments in older fallers regardless of the presence of dizziness.
Employing Shared Decision Making (SDM) to reduce the Anti-Cholinergic Burden (ACB)
Authors: Kinahan Clare 
Published: September 2024

Abstract

Background
Anticholinergic medicines can cause a range of adverse drug reactions (ADRs) including urinary retention, dry mouth, constipation, tachycardia, blurred vision, sedation, dizziness, confusion and delirium. 10% of hospital admissions in those &gt;65 years of age are Adverse Drg Reaction (ADR) related, and approximately 70% of these can be avoided. Shared decision making (SDM) is a joint process in which a healthcare professional works with a person to reach a decision about their care. Medicines should be deprescribed, if a shared decision is reached that the risks outweigh the benefits for the individual.

Methods

Results
Thirty-eight patients, with a mean age of 76 years received a medication review. The mean number of regular medicines pre-review was 10.5 and post review was 9.3. The mean ACB score pre-review was 5.4 and post review was 3.5.
An ACB reduction was achieved in 25 patients (66%) patients. The total ACB score reduction achieved was 73. 90% of the total reduction was achieved by stopping urinary antispasmodics, amitriptyline, quetiapine, promethazine and lansoprazole.

Conclusion
Targeting future SDM interventions to patients on those anticholinergic medicines found to be amenable to deprescribing might be an efficient way to reduce anticholinergic burden and harm.
Unexpected Journeys: Investigating Urgent and Emergency Care Trends of Patients Attending a Community Specialist Team for Older Adults
Authors: Chan Kei Yen , Geoghegan James , McCleane Fiona , Fitzmaurice Cliodhna , Mannion Karen , Neachtain Maire Ni , Shiel Edel , Donohue Mary , Mulligan Des , Ramjohn Joshua , Lyne Maria Louise , Al Fazari Afrah , Reddin Catriona , McDermott Clodagh , Stankard Aidan , Burke Shona , Lynch Amy , Hanrahan Caoimhe , Higgins Meave , Memon Sajjan , Murphy Dearbhla Edwards , Conlon Chloe , Okon Mary , Cashen Aoife , Martin Niamh , Small Cliona , Robinson Stephanie , Costello Maria , Canavan Michelle 
Published: September 2024

Abstract

Background
Transitions of care for older people via ICPOP and Urgent and Emergency Care (UEC) pathways are becoming more complex. Demand for unscheduled care for older adults with complex care needs will increase with an ageing society, requiring proactive case management and practical realisation of integrated care pathways.

Methods
Retrospective analysis of UEC presentations of older patients attending a community specialist team (CST) who underwent Comprehensive Geriatric Assessment (CGA) between January-July 2023. Demographics and functional status [Clinical Frailty Score (CFS), Barthel Index (BI), Lawton-Brody Score (IADL), Montreal Cognitive Assessment (MOCA)] were extracted, along with UEC presentations post-CGA until March 2024.

Results
356 patients underwent CGA and 42% (n=148) had subsequent unscheduled care attendance(s). Of those with an UEC attendance 36% (n=54) lived alone. Median functional scores were: CFS 5, BI 17, IADL 3, MOCA 17. Median time to UEC presentation was 100 days since CGA. There were 283 UEC interactions in total. 39% (n=58) had &gt;1 interaction. 73% (n=206) of interactions resulted in acute hospital admissions, 21% (n=58) were ED visits, and 6% (n=19) were Pathfinder interactions. Falls (31%) and infection (19%) were the leading causes for presentation. Of 206 admissions, 61% were admitted under medical specialties, 26% under Geriatric Medicine, and 13% under Surgery. Average hospital stay was 13 days. 65% (n=134), were discharged home, 11% (n=22) to transitional care beds, 7% (n=15) to rehabilitation, 7% (n=14) to nursing home, 3% (n=5) transferred to other hospitals, 7%(n=15) died.

Conclusion
Over half of patients attending a CST had an UEC presentation, reflecting the complexity of this cohort and their level of healthcare utilisation. Case management roles that complement and pull together existing elements of the older persons pathway are lacking across healthcare settings and are fundamental to successful implementation of a patient-centred age friendly health system.
New developments in the diagnosis and management of motor neuron disease
Authors: O’Brien David , Shaw Pamela J 
Published: September 2024

Abstract

Introduction
Motor neuron disease (MND) is a devastating neurodegenerative disease characterized by progressive muscle weakness.

Sources of data
PubMed, MEDLINE, and Cochrane databases were searched for articles to March 2024. Searches involved the terms ‘motor neuron disease’ or ‘amyotrophic lateral sclerosis’ and ‘epidemiology’, ‘diagnosis’, ‘clinical’, ‘genetic’, ‘management’, ‘treatment’, or ‘trial’.

Areas of agreement
Evidence-based management involves riluzole, multidisciplinary care, provision of noninvasive ventilation and gastrostomy, and symptomatic treatments. Tofersen should be offered to treat SOD1-MND.

Areas of controversy
Edaravone and Relyvrio are approved treatments in the USA, but insufficient evidence was found to support approval in the UK and Europe.

Growing points
The discovery of neurofilaments as MND biomarkers, growth of platform trials and development of novel therapies provide optimism for more powerful neuroprotective therapies.

Areas timely for developing research
Further work should focus on the elucidation of environmental causes of MND, gene–environment interactions, and advanced cellular models of disease.
Towards an integrated network for DHSS
Authors: Spackman J W C 
Published: September 2024

Abstract
The Department of Health and Social Security, in awarding over £40 billion a year in benefits by means of more than 1,000 million separate payments to over 20 million claimants, faces an enormous operational task. In order to reduce the cost of this operation – which engages nearly 120,000 staff and costs more than £1.8 billion a year, while at the same time improving service to the public, the Operational Strategy was conceived. This is a plan for a network to connect the 500 or so Social Security local offices and the 1,000 or so Unemployment Benefit offices to the mainframe computers which will hold the claimant records. It is anticipated that there will be over 35,000 terminals online to this network by 1992.
The BCS OA Group
Authors: Levine Bente 
Published: September 2024

Abstract
I have been preaching the automated office gospel since the mid-70’s, and have watched attitudes change from reluctance to enthusiasm, from the spirited ‘we’ll try anything once’ approach to an increased specialisation in applications such as finance, database, graphics, and communications. The most spectacular changes appear to have taken place at opposite ends of the OA spectrum. The networks of large sophisticated organisations are becoming increasingly efficient with the improvements in international communication standards and the rapid growth of personal computers is turning everyone, from the senior managers to the post-room boy, into ‘instant’ experts. So why is there still a need for associations like the OA Specialist Group?
A strategy for office systems in large corporations
Authors: Kellett Geoff 
Published: September 2024

Abstract
Office systems are now being installed in many companies but very few maximise the benefits available to them. To do this, the information within the company needs to be shared, and a suitable strategy is required to do this effectively.
Looking back, the micro revolution seemed to start with the ready availability of spreadsheets. At about the same time came the dedicated word processors, taking advantage of the newly evolved micro-chip. Soon there was a proliferation of personal computers. For the first time, users had tools they could use immediately: no more two year wait, no overnight batch runs and error reports. Naturally, the salesmen took full advantage. There was no need to deal with the data processing manager, they could bypass him and go directly to the finance director, who was probably the man with the ready cash anyway. Who needs standards? Why should I communicate? I have all the data I need here, under my own control at last.
OA: bridging the language gap
Authors: Blaazer Caroline 
Published: September 2024

Abstract
Only Rip van Winkle can have missed the revolution in office communications of the last ten years. We can send memos, letters and reports to almost anyone, anywhere, any time, faster and more accurately: communication is cheaper, easier and more available than ever before. Yet it is a strange paradox to consider that the more technology is used, the less people seem to know about their colleagues, their organisations and what they are trying to achieve.
Telephone-based speech technologies
Authors: Wilson Nick 
Published: September 2024

Abstract
With competition within industry intensifying, more and more businesses are turning to the telephone as a means of interacting with their customers. Telesales departments are increasingly being used to supplement the efforts of mobile workforces -and in some cases, sales staff distributors and retailers are being replaced altogether with CallCentres manned by telephone agents. The fact that there are now upwards of 8,000 CallCentres established in Europe (a figure that is expected to increase to over 35,000 by 1998) bears testimony to this trend.
Automated computed tomography-derived fractional flow reserve model for diagnosing haemodynamically significant coronary artery disease: a prospective validation study
Authors: Bråten Anders T , Fossan Fredrik E , Muller Lucas O , Jørgensen Arve , Stensæth Knut H , Hellevik Leif R , Wiseth Rune 
Published: September 2024

Abstract

Aims
This study aims to assess the diagnostic performance of a novel computed tomography-derived fractional flow reserve (CT-FFR) algorithm and to compare its accuracy at three predefined sites: (i) at the location of invasive FFR measurements (CT-FFRatloc), (ii) at selected sites determined by an automated module integrated within the algorithm (CT-FFRauto), and (iii) distally in the vessel (CT-FFRdistal).

Methods and results
We prospectively recruited 108 consecutive patients with stable symptoms of coronary artery disease and at least one suspected obstructive lesion on coronary computed tomography angiography (CCTA). CT-FFR was validated against invasive FFR as gold standard using FFR ≤ 0.80 to define myocardial ischaemia. CT-FFRatloc showed good correlation with invasive FFR (r = 0.67) and improved the ability to detect myocardial ischaemia compared with CCTA at both lesion [area under the curve (AUC) 0.83 vs. 0.65, P &lt; 0.001] and patient level (AUC 0.87 vs. 0.74, P = 0.007). CT-FFRauto demonstrated similar diagnostic accuracy to CT-FFRatloc and significantly improved specificity compared with CT-FFRdistal (86% vs. 49%, P &lt; 0.001). High end CT quality improved the diagnostic performance of CT-FFRauto, demonstrating an AUC of 0.92; similarly, the performance was improved in patients with low-to-intermediate coronary artery calcium score with an AUC of 0.88.

Conclusion
Implementing an automated module to determine the site of CT-FFR evaluations was feasible, and CT-FFRauto demonstrated comparable diagnostic accuracy to CT-FFRatloc when assessed against invasive FFR. Both CT-FFRatloc and CT-FFRauto improved the diagnostic performance compared with CCTA and improved specificity compared with CT-FFRdistal. High end CT quality and low-to-intermediate calcium burden improved the diagnostic performance of our algorithm.

ClinicalTrials.gov Identifier
NCT03045601
Mechanisms in endocrinology: hypogonadism and metabolic health in men—novel insights into pathophysiology
Authors: Miller Clare , Madden-Doyle Lauren , Jayasena Channa , McIlroy Marie , Sherlock Mark , O’Reilly Michael W 
Published: September 2024

Abstract
Hypogonadism in men is associated with an adverse metabolic phenotype and increased mortality. Reciprocally, obesity and insulin resistance can suppress the hypothalamic–pituitary–gonadal axis in the absence of structural organic disease, further perpetuating a cycle of metabolic dysfunction and low testosterone. The mechanisms underpinning this bidirectional association are complex as hypogonadism is a heterogenous syndrome, and obesity is associated with metabolic perturbations in glucose and lipid metabolism even in the presence of normal testicular function. However, distinct molecular defects specific to testosterone deficiency have been identified in pathways relating to glucose and lipid metabolism in target metabolic depots such as adipose tissue and skeletal muscle. This review discusses the etiology and prevalence of metabolic disease in male hypogonadism, with a specific focus on both disease mechanisms and novel potential approaches to enhance our understanding.
Neuropeptide signaling network of Caenorhabditis elegans: from structure to behavior
Authors: Watteyne Jan , Chudinova Aleksandra , Ripoll-Sánchez Lidia , Schafer William R , Beets Isabel 
Published: September 2024

Abstract
Neuropeptides are abundant signaling molecules that control neuronal activity and behavior in all animals. Owing in part to its well-defined and compact nervous system, Caenorhabditis elegans has been one of the primary model organisms used to investigate how neuropeptide signaling networks are organized and how these neurochemicals regulate behavior. We here review recent work that has expanded our understanding of the neuropeptidergic signaling network in C. elegans by mapping the evolutionary conservation, the molecular expression, the receptor–ligand interactions, and the system-wide organization of neuropeptide pathways in the C. elegans nervous system. We also describe general insights into neuropeptidergic circuit motifs and the spatiotemporal range of peptidergic transmission that have emerged from in vivo studies on neuropeptide signaling. With efforts ongoing to chart peptide signaling networks in other organisms, the C. elegans neuropeptidergic connectome can serve as a prototype to further understand the organization and the signaling dynamics of these networks at organismal level.
The extraordinary Atlantic silverside and me
Authors: Conover David O 
Published: September 2024

Abstract
My career is inextricably linked to the remarkable characteristics and astonishing insights provided by a simple yet elegant species, the Atlantic silverside, Menidia menidia. My initial field and laboratory studies provided the first demonstration of temperature-dependent sex determination (TSD) and its adaptive significance in fish, as well as the first empirical confirmation of frequency-dependent sex ratio selection. This early work then led to the discovery of countergradient variation in growth, evolutionary trade-offs associated with growth, pioneered the study of fisheries-induced evolution, and furthered our understanding of the spatial scale of local adaptation in marine species. Most of these topics are now vigorous areas of research encompassing numerous species and systems. Here I describe how these unforeseen discoveries were made and led to other findings on bluefish (Pomatomus saltatrix) and striped bass (Morone saxatilis). An interest in leadership during my early years was later rekindled as I took on administrative roles. It all began with an intriguing observation stemming from my MS thesis that I was compelled to follow. My career illustrates the value of exploring deeply the natural history of lesser-known yet easy-to-study species and to follow unexpected observations even if peripheral to a preconceived plan of research.
Quantum K-Theory of IG(2,2n)
Authors: Benedetti V , Perrin N , Xu W 
Published: September 2024

Abstract
We prove that the Schubert structure constants of the quantum $K$-theory rings of symplectic Grassmannians of lines have signs that alternate with codimension and vanish for degrees at least 3. We also give closed formulas that characterize the multiplicative structure of these rings, including the Seidel representation and a Chevalley formula.
Effects of a veterinary gastrointestinal low-fat diet on fecal characteristics, metabolites, and microbiota concentrations of adult dogs treated with metronidazole
Authors: Belchik Sara E , Oba Patricia M , Lin Ching-Yen , Swanson Kelly S 
Published: September 2024

Abstract
Antibiotics are known to cause loose stools, disrupt the fecal microbiota, and alter fecal bile acid (BA) profiles of dogs. Recovery may be aided by diet, but little research has been conducted. The objective of this study was to determine how a veterinary low-fat diet affected the fecal characteristics, metabolites, BA, and microbiota of dogs receiving antibiotics. Twenty-four healthy adult dogs [7.38 ± 1.95 yr; 7.67 ± 0.76 kg body weight (BW)] were used in an 8-wk completely randomized design study. During a 2-wk baseline, all dogs were fed a leading grocery brand diet (GBD). Over the next 2 wk, dogs were fed GBD and received metronidazole orally (20 mg/kg BW twice daily). At week 4, dogs were randomly allotted to one of two treatments [GBD or Blue Buffalo Natural Veterinary Diet GI Gastrointestinal Support Low-Fat (BB)] and fed for 4 wk. Fecal scores were recorded daily and fresh fecal samples were collected at weeks 2, 4, 5, 6, 7, and 8 for measurement of pH, dry matter content, and metabolite and BA concentrations. Fecal microbiota populations were analyzed using 16S rRNA gene amplicon sequencing and qPCR-based dysbiosis index (DI). All data were analyzed as repeated measures using the Mixed Models procedure of SAS 9.4, testing for effects of treatment, time, and treatment*time and significance set at P &lt; 0.05. Metronidazole increased (P &lt; 0.0001) fecal scores (looser stools), reduced fecal short-chain fatty acid, branched-chain fatty acid, phenol, and indole concentrations, increased primary BA concentrations, and decreased secondary BA concentrations. Metronidazole also reduced fecal bacterial alpha diversity, altered the abundance of 58 bacterial genera, and increased DI. During antibiotic recovery, changes in fecal pH, dry matter percentage, and metabolite and immunoglobulin A concentrations were altered (P &lt; 0.05) by diet. Fecal BA concentrations recovered quickly for all dogs. Change in lithocholic acid was affected (P &lt; 0.0001) by diet, but other BA were not. Recovery of over 25 bacterial genera was impacted by diet (P &lt; 0.05). While many bacterial taxa returned to baseline levels after 4 wk, others did not fully recover. DI and bacterial alpha diversity measures recovered quickly for all dogs but were not impacted by diet. In conclusion, metronidazole drastically altered the fecal microbiota and metabolites of dogs. While most variables returned to baseline by week 8, diet may be used to aid in recovery.