bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low food security is associated with frailty status and frailty components among people with HIV
Authors: Ruderman Stephanie A. , Willig Amanda L. , Cleveland John D. , Burkholder Greer , Davey Christine Horvat , Fleming Julia , Gripshover Barbara , Katundu Mari , Buford Thomas W. , Jones Raymond , Saag Michael S. , Delaney Joseph A.C. , Crane Heidi M. , Webel Allison R. 
Published: September 2024

Background:
Low food security is common among people with HIV (PWH) and is associated with poorer health outcomes. Frailty, an aging-related outcome that is increasingly prevalent among PWH, may be stimulated by low food security. We assessed associations between food security and frailty among PWH.

Methods:
The Impact of Physical Activity Routines and Dietary Intake on the Longitudinal Symptom Experience of People Living with HIV (PROSPER-HIV) study follows PWH to evaluate how diet and physical activity impact symptoms. We utilized food security and frailty data from PROSPER-HIV Year 1 visits (January 2019 to July 2022) to estimate associations. Food security was measured via the validated two-item Food Security Questionnaire and categorized as Food Secure, Low Food Security, or Very Low Food Security. Frailty was measured with the Fried frailty phenotype, and categorized as robust, prefrail, and frail. We used relative risk regression to estimate associations between food security and frailty status, adjusted for demographic characteristics.

Results:
Among 574 PWH, nearly one-quarter were women (22%), mean age was 52 years old, 8% were frail, and 46% prefrail. Low food security was reported among nearly one-third of PWH: 13% Low Food Security and 18% Very Low Food Security. Compared with being Food Secure, we found Low Food Security was associated with frailty [prevalence ratio: 4.06 (95% confidence interval (CI) 2.16–7.62] and Very Low Food Security was associated with both prefrailty [1.48 (1.23–1.78)] and frailty [5.61 (3.14–10.0)], as compared with robust status.

Conclusion:
Low food security was associated with increased frailty among PWH in this study, suggesting a potential intervention point to promote healthy aging.
Trends in Racial and Ethnic Differences in Declined Surgery for Resectable Malignancies in the United States
Authors: Patel Vishal R. , Liu Michael , Snyder Rebecca A. , Loehrer Andrew P. , Haynes Alex B. 
Published: September 2024

Objective:
To assess trends in patients’ decisions to decline cancer surgery in the United States by race and ethnicity.

Background:
Racial and ethnic differences in declining potentially curative cancer surgery are suggested to be due to systemic inequities in healthcare access and mistrust of healthcare systems, among other factors. Despite ongoing national efforts to address these inequities, it is unknown whether differences in rates of declined cancer surgery have improved.

Methods:
Using population-based data from the US Surveillance, Epidemiology, and End Results Program from 2000 to 2019, we studied individuals with non-metastatic cancer who were recommended surgery. Racial and ethnic differences in risk-adjusted rates of declined surgery were evaluated by year and cancer site using mixed-effects logistic regression.

Results:
Of 2,740,129 patients with resectable, non-metastatic cancer, Black patients had the highest rates of declined surgery (2.10% [95% CI, 1.91-2.31%]) while White patients had the lowest (1.04% [95% CI, 0.95-1.14%]). From 2000 to 2019, racial and ethnic differences in declined surgery did not change significantly, except for a decrease in the difference between Hispanic and White patients (difference-in-difference, −0.4% [95% CI, −0.71% to −0.09%]). When stratified by cancer site, Black-White differences in rates of declined surgery decreased significantly (but were not eliminated) for four of fifteen sites (esophageal, pancreatic, lung, and kidney) (P<0.001).

Conclusions:
Patients from racial and ethnic minority groups were more likely to decline surgical intervention for potentially curable malignancies and these differences have persisted over time. Further work is needed to understand the causes of these differences and identify opportunities for improvement.
Incidence of Dementia Among Medicare Beneficiaries With and Without Urinary Incontinence
Authors: High Rachel A. , Ford Cassie B. , Handa Victoria L. , Anger Jennifer 
Published: September 2024

Importance
Dementia and urinary incontinence (UI) have been associated in cross-sectional studies. The temporal relationship between these 2 conditions is not well understood.

Objective
The aim of the study was to investigate the risk of incident dementia in female adults with and without UI using the Medicare 5% Limited Data Set.

Study Design
This retrospective cohort study matched females with UI to continent controls by index year, age, and dual Medicare/Medicaid eligibility. A 2-year look back period was used to exclude prevalent dementia and neurologic disorders. The 5-year cumulative incidence of dementia was estimated for women with UI and controls. Cox proportional hazard models assessed the association of variables with dementia, adjusting for age, dual Medicare/Medicaid eligibility, race, and comorbidities.

Results
A total of 8,651 female beneficiaries with UI (n = 8,651) were more likely than matched controls (n = 8,651) to report White race and several medical comorbidities. The 5-year cumulative incidence of dementia diagnosis was lower in the UI versus controls (8.8% vs 10.6%, P < 0.001). In multivariable analysis with adjustment for covariates, UI diagnosis was associated with a lower hazard of dementia diagnosis (hazard ratio 0.82 [0.74, 0.91], P < 0.001).

Conclusions
Among female Medicare beneficiaries without baseline neurologic disorders, having any UI diagnosis was associated with a lower risk of dementia diagnosis. Further studies assessing UI symptoms and dementia diagnosis with rigorous and valid assessment tools are needed to confirm this finding.
Scale at the interface of spatial and social ecology
Authors: Picardi Simona , Abrahms Briana L. , Merkle Jerod A. 
Published: September 2024

Animals simultaneously navigate spatial and social environments, and their decision-making with respect to those environments constitutes their spatial (e.g. habitat selection) and social (e.g. conspecific associations) phenotypes. The spatial–social interface is a recently introduced conceptual framework linking these components of spatial and social ecology. The spatial–social interface is inherently scale-dependent, yet it has not been integrated with the rich body of literature on ecological scale. Here, we develop a conceptual connection between the spatial–social interface and ecological scale. We propose three key innovations that incrementally build upon each other. First, the use–availability framework that underpins a large body of literature in behavioural ecology can be used in analogy to the phenotype–environment nomenclature and is transferable across the spatial and social realms. Second, both spatial and social phenotypes are hierarchical, with nested components that are linked via constraints—from the top down—or emergent properties—from the bottom up. Finally, in both the spatial and social realms, the definitions of environment and phenotype depend on the focal scale of inquiry. These conceptual innovations cast our understanding of the relationships between social and spatial dimensions of animal ecology in a new light, allowing a more holistic understanding and clearer hypothesis development for animal behaviour.
This article is part of the theme issue ‘The spatial–social interface: a theoretical and empirical integration’.
Faithful pals and familiar locales: differentiating social and spatial site fidelity during reproduction
Authors: Hendrix J. G. , Robitaille A. L. , Kusch J. M. , Webber Q. M. R. , Vander Wal E. 
Published: September 2024

Site fidelity—the tendency to reuse familiar spaces—is expected to improve fitness. Familiarity with the local environment is particularly crucial when resource demands or predation risk are high. Consequently, site fidelity often peaks during reproduction when energetic costs are high and offspring are vulnerable. For many species, the environment they experience is not solely a function of geography but also of the social environment. Social fidelity, the selection for familiar social environments, could constitute an independent or parallel strategy to spatial fidelity when considering behaviour at the spatial–social interface. Using global positioning system locations from caribou across Newfoundland, we tested whether females selected calving sites based on proximity to familiar conspecifics, in addition to geographical (spatial) fidelity. These strategies were synergistic, not alternative, and correlated across the population but more variable within individuals. We also tested whether either form of fidelity affected reproductive success. We failed to detect an effect of spatial or social fidelity on reproductive success in this population. Nevertheless, given the association between social and spatial fidelity and the demonstrated fitness consequences of site fidelity in other systems, familiar conspecifics and the potential benefits these social partners provide may be an underappreciated component driving site fidelity.
This article is part of the theme issue ‘The spatial–social interface: a theoretical and empirical integration’.
The CONSIDER Intervention Fidelity Framework for Complex Interventions in Healthcare: A “Best-Fit” Framework Synthesis
Authors: Páez Arsenio , Nunan David , McCulloch Peter , Beard David 
Published: September 2024

AbstractBackgroundThe focus of clinical trials is typically interventions’ efficacy, or whether they attain their desired outcomes. Comparatively less attention is focused on understanding how or why interventions succeed, or fail to attain, those outcomes. This may be particularly important in trials of complex interventions such as surgery or physiotherapy, which are multifaceted and often tailored to individual participants, providers, or settings, increasing the potential for variations in intervention delivery and effects. The correspondence between the intervention that was planned and what was actually delivered in a trial is the intervention’s fidelity. Several benefits for high levels of intervention fidelity have been proposed. However, a lack of a uniform definition for fidelity and its key components may hinder intervention delivery in clinical trials and the translation of evidence-based interventions to clinical practice.MethodsIn this study, we undertook systematic review, and “Best-fit” framework synthesis to develop an empirically-based intervention fidelity framework for complex interventions in rehabilitation.ResultsThe resultingCONSIDER (Complex iNterventionS Design dElivery Recepit) frameworkis first integrated fidelity framework developed specifically for clinical trials of for complex interventions rehabiliation. CONSIDER consists of three main components, Design, Delivery and Receipt and the factors moderating them. Design encompasses the core elements of the intervention and the protocol for the clinical trial to evaluate its effectiveness. Delivery encompasses the actual implementation of the protocol and treatment integrity. It is focused primarily on the actions of the intervention providers. Receipt addresses the exposure of the trial participants to the intervention and their response to it.ConclusionsThis fidelity framework is the first designed suit the unique complexities and challenges presented by physical complex interventions. It can help promote transparency and reproducibility and helps researchers design clinical trials that reduce waste, enable uptake into clinical practice, and benefit the practice and evidencing of physiotherapy, surgery and other physical complex interventions.
Enhancing Interventional Cardiology Training: A Porcine Heart-Based Coronary Intervention Simulator
Authors: Reifart Joerg , Iaizzo Paul Anthony 
Published: September 2024

ABSTRACTIntroductionAccess to simulators for interventional cardiology is currently limited. High acuity, low occurrence procedures (HALO), such as coronary perforation or iatrogenic dissection, are not trained in currently available simulators. We developed a cost-effective coronary intervention simulator designed to enhance the training of both novice and experienced interventionalists.MethodsPorcine hearts from 6-month-old Yorkshire pigs (heart weight: 300-500g) were obtained from a large animal research laboratory. Guide catheters were inserted into the coronary artery ostia and secured with superglue. To maintain shape and rigidity, commercially available polyurethane insulation foam was injected into the ventricles. The guide catheter was then connected to a Tuohy valve linked to a 3-way stopcock. One connection led to a pressure infusion bag filled with tap water (inflated at > 300 mmHg); the other was used for contrast injection. The heart was set on a radiolucent box with a fluid collector underneath. Clinical scenarios were simulated using 3D-printed stenoses and occlusions, blood clots for occlusive myocardial infarction, balloon oversizing for dissections, and needle trauma for perforations.ResultsThe simulator was used to practice coronary angiography, managing perforations, bifurcations, dissections, and acute coronary occlusions.Assembly, set-up, and simulation time until refilling the perfusion bag was required were 50, 25, and 30 minutes, respectively. Intravascular imaging with Optical Coherence Tomography was successfully used to guide interventions. The simulator was frozen and reused more than three times without notable deterioration.ConclusionA wide range of clinical scenarios can be trained with our model. Its preparatory flexibility, including the ability to be frozen for on-demand training, enhances its utility. Limitations include the absence of pulsatile flow, heart movement, and the inability to train guide catheter intubation.
FACILITATORS AND BARRIERS TO UPTAKE OF CHILD-FRIENDLY 3 MONTHS OF ISONIAZID AND RIFAMPICIN (3HR) FIXED DRUG COMBINATION (FDC) FOR TUBERCULOSIS PREVENTIVE THERAPY (TPT) IN NIGERIA
Authors: Eneogu Rupert , Ihesie Austin , Daniel Olugbenga , Chukwuogo Ogoamaka , Nongo Debby , Agbaje Aderonke , Odume Bethrand , Kuye Joseph , Oyelaran Omosalewa , Egbule Daniel , Gemert Wayne Van , Mupfumi Lucy , D’auvergne Cleophas , Chijioke-Akaniro Obioma , Anyaike Chukwuma , Olarewaju Sunday 
Published: September 2024

AbstractThe uptake of TB preventive therapy (TPT) for child and adult contacts of index TB patients in Nigeria has been suboptimal. Nigeria introduced the 3-month isoniazid-rifampicin (3HR) shorter regimen TPT for all eligible contacts through the USAID-funded Stop TB Partnership introducing New Tools Project (iNTP). This study assesses the facilitators and barriers to the uptake of the newly introduced child-friendly 3HR TPT for child contacts of TB patients in Nigeria.This was a cross-sectional descriptive study using mixed methods. In-depth interviews were conducted among 36 purposely selected Healthcare Workers (HCWs) and 36 caregivers of child contacts. Records of TPT-eligible child contacts (0–14 years) from April to September 2022 were retrospectively extracted. Study data were analyzed using appropriate statistical tools for qualitative and quantitative techniques.There were 7,906 child contacts identified, of which 7,902 (99.9%) contacts were screened for TB, 1,704 (21.5%) were presumptive, 264 (15.5%) diagnosed with TB, and 6,994 were eligible for TB Preventive Therapy. Additionally, out of 6,994 eligible child contacts, 3984 (57%) were initiated on TPT with 2,982 (74,8%) enrolled on 3HR and 1,002 (25%) on 6H. Of the clients placed on 3HR, 2,499 (85%) completed treatment, 309 (10.5%) lost to follow-up, 27(0.92%) developed Tuberculosis while 48 (1.6%) interrupted treatment.The key drivers of 3HR TPT uptake among child contacts were TPT-related health education and counseling. Access barriers to 3HR TPT elicited included stigma, poverty, transportation cost, stock out, ineffective monitoring and management of side effects issues of 3HR TPT, subpar Government funding and commitment to addressing TPT implementation challenges and inadequate knowledge among HCWs and caregivers.In conclusion, 3HR-TPT uptake among child contacts of index TB patients was high. Enhanced provider training and intensive community health education should be sustained while identified individual, structural, and institutional barriers should be addressed to improve implementation.
CRISPR-CAS9 MEDIATED EDITING OF THELACZGENE FOR OPTIMIZING LIPASE PRODUCTION AND CHARACTERIZATION IN ENGINEEREDESCHERICHIA COLIUSING POTATO PEEL AS A GLUCOSE SOURCE
Authors: Minari Joseph Bamidele , Dada Idowu Samuel , Abdulazeez Dhikrullah Oluwatope , Nwosu Gift E. 
Published: September 2024

ABSTRACTImproper disposal of potato peels harms the environment, wasting nutrient-rich resources that could be used for beneficial enzyme production like lipase. This study aimed to edit thelacZ geneinEscherichiacoli using utilizing the CRISPR Cas9 technology. Both edited and uneditedE. coliwere used for submerged fermentation of potato peels to produce and characterize lipase. ThelacZgene was edited using the CRISPR Cas9 technology, and the efficiency was measured using multiplex PCR and gel electrophoresis. To measure lipolytic activity, olive oil screening was performed. The temperature and pH of the lipase were used to characterize it after partial purification and submerged fermentation at 10°C, 30°C, and 45°C. Blue colonies indicated thelacZ genewas unedited,lacZgene editing and repair was demonstrated by white colonies, and no colonies demonstrated the editing but not repair of thelacZgene. Bands at 1,100 bp indicated uneditedlacZ gene, while 650 bp showed editedlacZ gene. Increased cell mass was observed at 10°C. CRISPR Cas9 editedE. colishowed a clearer zone than the unedited in the lipase medium. The highest lipase activity from both edited and uneditedE. coliwas at 35°C, and the lowest at 65°C. Optimal pH was 7, with lowest activity at pH 4. The CRISPR Cas9 editedE. colidemonstrated significantly higher enzyme activities (p<0.05). This study concluded that CRISPR Cas9-mediatedlacZ geneediting inE. colienhances its ability to utilize potato peels, increasing lipase production.
Development of a national osteopathic practice-based research network: the NCOR Research Network
Authors: Draper-Rodi Jerry , Fawkes Carol , Bailey Daniel 
Published: September 2024

AbstractObjectivesTo describe the development of the NCOR Research Network, the first osteopathic Practice-Based Research Network (PBRN) in the UK, and provide data on its members’ characteristics, clinical practices, and patient demographics.DesignCross-sectional survey study.SettingOnline survey of osteopaths practising in the United Kingdom.Participants570 osteopaths registered with the General Osteopathic Council who consented to participate in the NCOR Research Network.Primary and secondary outcome measuresDemographic characteristics of osteopaths, details of their clinical practice, patient demographics, common presenting complaints, treatment approaches, and attitudes towards evidence-based practice.ResultsThe median age bracket of participants was 50-59 years, with 55% identifying as women. Participants had a median of 17 years of clinical experience. Most worked in private practice (71% as principals, 32% as associates), seeing 20-39 hours of patients per week. The majority (87%) regularly treated adults aged 65 or older. Low back pain was the most common complaint seen daily (56%). Spinal articulation/mobilization (79%) and soft tissue massage (78%) were the most frequently used techniques. Participants reported positive views towards evidence-based practice but cited lack of research skills and time as barriers to engagement.ConclusionsThe NCOR Research Network provides a foundation for future osteopathic research in the UK. While the sample was not fully representative of UK osteopaths, it offers insights into current osteopathic practice. The network aims to foster collaboration between clinicians and academics, potentially bridging the gap between research and practice in osteopathy.Protocol registrationhttps://doi.org/10.17605/OSF.IO/HPWG4Article summaryStrengths and limitations of this study:This study establishes the first osteopathic Practice-Based Research Network (PBRN) in the UK, providing a novel infrastructure for collaborative research in osteopathy.The survey was developed based on previous PBRN studies and existing UK osteopathic datasets, allowing for comparability of data across different research initiatives.A diverse recruitment strategy was employed, including various channels such as the regulatory body, professional organisations, and both face-to-face and online presentations, to reach a wide range of osteopaths.The sample in this study is not fully representative of the UK osteopathic profession when compared to the General Osteopathic Council registrant data, which may limit the generalisability of the findings.As the survey data were self-reported by osteopaths, the findings may be subject to recall or social desirability biases.
Feasibility study of the application of Magnetic Resonance Elastography (MRE) to diagnose adenomyosis
Authors: Jain V , Hojo E , McKillop G , Oniscu A , Le Y , Chen J , Ehman R , Roberts N , Critchley HOD 
Published: September 2024

Structured AbstractIntroductionAdenomyosis is an under-recognised condition in which definitive diagnosis is only possible via histology after hysterectomy, an unacceptable option for those wishing to preserve fertility. Recent cellular/molecular studies indicate adenomyotic lesions may be fibrotic leading to increased uterine tissue stiffness. 3D Magnetic Resonance Elastography (MRE) is a novel imaging technique that allows in vivo measurement of tissue stiffness (via elastograms). 3D MRE has not been reported to study adenomyosis. The feasibility study aimed to utilise a novel 3D MRE protocol to measure global uterine stiffness and to investigate its potential application for non-invasive in vivo diagnosis of adenomyosis.Materials and Methods3D MRE protocol was conducted on one healthy volunteer (control) and four patients with suspected adenomyosis and heavy menstrual bleeding (HMB), diagnosed via transvaginal ultrasound and clinical history (REC:20/SS/0123 and 19/SS/0102). Two patients underwent hysterectomy, and representative uterine tissue samples were assessed for (i) histological presence of adenomyosis via H&E staining; (ii) cellular/molecular measures of tissue stiffness (collagen [picrosirius red], α-smooth muscle actin, e-cadherin); (iii) relationship between in vivo assessment of the uterus via MRI images and 3D MRE findings with in vitro uterine tissue histology from the same individuals.Results3D MRE was successfully used to acquire elastograms for four patients with adenomyosis (diffuse n=3, focal n=1) and one healthy volunteer. Calculated global uterine stiffness was higher in women with adenomyosis (2.93kPa; range 2.34 – 3.39kPa) compared to a healthy volunteer (2.04kPa). Areas of stiffness on 3D elastograms reflected adenomyotic changes visualised via conventional MRI, with the added benefit of also correlating with histology/immunohistochemical assessment for markers of tissue stiffness.DiscussionA novel 3D MRE protocol has been applied to obtain the global uterine stiffness in four women with HMB and suspected adenomyosis, and one healthy volunteer. 3D MRE has the potential to provide superior non-invasive tissue characterisation in vivo when compared to conventional MRI in the assessment of adenomyosis due to the correlation of imaging and tissue findings. Further studies are now needed to confirm the above exploratory findings, prior to performing a potential clinical trial.