bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing recruitment of individuals living with frailty, multimorbidity and cognitive impairment to Parkinson’s research: experiences from the PRIME-UK cross-sectional study
Authors: Tenison Emma , Smith Matthew D , Pendry-Brazier Danielle , Cullen Anisha , Lithander Fiona E , Ben-Shlomo Yoav , Henderson Emily J 
Published: May 2024

Abstract

Background and objectives
People with parkinsonism who are older, living in a care home, with frailty, multimorbidity or impaired capacity to consent are under-represented in research, limiting its generalisability. We aimed to evaluate more inclusive recruitment strategies.

Methods
From one UK centre, we invited people with parkinsonism to participate in a cross-sectional study. Postal invitations were followed by telephone reminders and additional support to facilitate participation. Personal consultees provided information on the views regarding research participation of adults with impaired capacity. These approaches were evaluated: (i) using external data from the Parkinson’s Real World Impact assesSMent (PRISM) study and Clinical Practice Research Datalink (CPRD), a sample of all cases in UK primary care, and (ii) comparing those recruited with or without intensive engagement.

Results
We approached 1,032 eligible patients, of whom 542 (53%) consented and 477 (46%) returned questionnaires. The gender ratio in PRIME-UK (65% male) closely matched CPRD (61% male), unlike in the PRISM sample (46%). Mean age of PRIME participants was 75.9 (SD 8.5) years, compared to 75.3 (9.5) and 65.4 (8.9) years for CPRD and PRISM, respectively. More intensive engagement enhanced recruitment of women (13.3%; 95% CI 3.8, 22.9%; P = 0.005), care home residents (6.2%; 1.1, 11.2%; P = 0.004), patients diagnosed with atypical parkinsonism (13.7%; 5.4, 19.9%; P &lt; 0.001), and those with a higher frailty score (mean score 0.2, 0.1, 0.2; P &lt; 0.001).

Conclusions
These recruitment strategies resulted in a less biased and more representative sample, with greater inclusion of older people with more complex parkinsonism.
The empty code cart: Drug shortages over time
Authors: Gentile Tyler , Snee Isabel , Heinrichs Dorothy , Hockstein Max A , Mazer-Amirshahi Maryann , Fox Erin R 
Published: May 2024

Abstract

Purpose
In high-acuity situations such as cardiac arrest, clinicians rely on prepared medications stocked in code carts to provide timely and accurate pharmacotherapy. We examined shortage trends for medications commonly used in code carts.

Methods
Drug shortage data from 2001 to 2022 were retrieved from the University of Utah Drug Information Service (UUDIS) to characterize shortages reported for commonly used code cart medications. Data extracted included the number of shortages, shortage duration, drug characteristics, and reason for the shortage.

Results
From 2001 to 2022, 71 drug shortages for code cart medications were reported. The number of new shortages peaked in 2010, and the number of total shortages peaked in 2010. At the end of the study period, 61 (84.7%) shortages had been resolved. For resolved shortages, the mean shortage duration was 18.2 months. The drug with the greatest number of reported shortages was dextrose (10 total), the drug with the longest resolved shortage was calcium chloride injection (116 months), and the drug with the longest active shortage was atropine injection (165 months at the end of the study period). Throughout the entire study period, only 2 suppliers provided commercially available prefilled syringes of dextrose for stocking on code carts. The most common reason for shortages, when reported, was manufacturing delays.

Conclusion
Medications commonly used in code carts were frequently impacted by drug shortages, which have the potential to impact patient care. Institutional protocols for mitigation and larger efforts to promote a more resilient drug supply chain are critical to ensure patient safety and quality care.
Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States
Authors: Matthews Timothy A , Liu Xinyue , Chen Liwei , Li Jian 
Published: May 2024

Abstract

Objectives
Leisure-time physical activity (LTPA) can reduce the risk of incident diabetes, whereas the role of occupational physical activity (OPA) in developing diabetes is still unclear due to conflicting evidence. Moreover, the joint associations of OPA and LTPA with incident diabetes among US workers have not yet been systematically examined. The objective of this study was to assess the independent and joint associations of OPA and LTPA with incident diabetes.

Methods
This prospective cohort study included 1406 workers free from diabetes at baseline (2004–2006) from the national, population-based Mid-life in the United States (MIDUS) study. Associations of OPA and LTPA at baseline with incident diabetes during 9 years of follow-up were examined using Poisson regression models. High OPA was defined based on engagement in physical demands at work, and high LTPA was defined as participation in moderate or vigorous LTPA at least once per week.

Results
High OPA was associated with an increased risk of diabetes compared to low OPA (adjusted risk ratios and 95% confidence interval = 1.52 [1.04, 2.22]), while high LTPA was associated with a decreased risk of diabetes compared to low LTPA (0.66 [0.44, 0.97]). Diabetes risk was the highest among workers with high OPA and low LTPA (2.30 [1.30, 4.07]).

Conclusions
In a national, population-based prospective cohort study of US workers, high OPA was associated with an elevated risk of diabetes, while high LTPA was associated with a decreased diabetes risk. The combination of high OPA and low LTPA exhibited the greatest risk of diabetes.
A SARS-CoV-2 outbreak in a public order and safety training facility in England, June 2021
Authors: Gilham Ellie L , Raja Amber I , van Veldhoven Karin , Nicholls Gillian , Sandys Vince , Atkinson Barry , Spencer Antony , Nicholls Ian , Cooke Joan , Bennett Allan , Morgan Derek , Keen Chris , Fletcher Tony , Pearce Neil , Manley Petra , Brickley Elizabeth B , Chen Yiqun 
Published: May 2024

Abstract

Background
The public order and safety (POS) sector remains susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks, as workplace attendance is typically compulsory and close physical contact is often needed. Here, we report on a SARS-CoV-2 outbreak with an attack rate of 39% (9/23), which occurred between 19 and 29 June 2021 among a cohort of new POS recruits participating in a mandatory 18-week training programme in England.

Methods
The COVID-OUT (COVID-19 Outbreak investigation to Understand Transmission) study team undertook a multidisciplinary outbreak investigation, including viral surface sampling, workplace environmental assessment, participant viral and antibody testing, and questionnaires, at the two associated training facilities between 5 July and 24 August 2021.

Results
Environmental factors, such as ventilation, were deemed inadequate in some areas of the workplace, with carbon dioxide (CO2) levels exceeding 1,500 ppm on multiple occasions within naturally ventilated classrooms. Activities during safety training required close contact, with some necessitating physical contact, physical exertion, and shouting. Furthermore, most participants reported having physical contact with colleagues (67%) and more than one close work contact daily (97%).

Conclusions
Our investigation suggests that site- and activity-specific factors likely contributed to the transmission risks within the POS trainee cohort. Potential interventions for mitigating SARS-CoV-2 transmission in this POS training context could include implementing regular rapid lateral flow testing, optimizing natural ventilation, using portable air cleaning devices in classrooms, and expanding use of well-fitted FFP2/FFP3 respirators during activities where prolonged close physical contact is required.
Predmoter—cross-species prediction of plant promoter and enhancer regions
Authors: Kindel Felicitas , Triesch Sebastian , Schlüter Urte , Randarevitch Laura Alexandra , Reichel-Deland Vanessa , Weber Andreas P M , Denton Alisandra K 
Published: May 2024

Abstract

Motivation
Identifying cis-regulatory elements (CREs) is crucial for analyzing gene regulatory networks. Next generation sequencing methods were developed to identify CREs but represent a considerable expenditure for targeted analysis of few genomic loci. Thus, predicting the outputs of these methods would significantly cut costs and time investment.

Results
We present Predmoter, a deep neural network that predicts base-wise Assay for Transposase Accessible Chromatin using sequencing (ATAC-seq) and histone Chromatin immunoprecipitation DNA-sequencing (ChIP-seq) read coverage for plant genomes. Predmoter uses only the DNA sequence as input. We trained our final model on 21 species for 13 of which ATAC-seq data and for 17 of which ChIP-seq data was publicly available. We evaluated our models on Arabidopsis thaliana and Oryza sativa. Our best models showed accurate predictions in peak position and pattern for ATAC- and histone ChIP-seq. Annotating putatively accessible chromatin regions provides valuable input for the identification of CREs. In conjunction with other in silico data, this can significantly reduce the search space for experimentally verifiable DNA–protein interaction pairs.

Availability and implementation
The source code for Predmoter is available at: https://github.com/weberlab-hhu/Predmoter. Predmoter takes a fasta file as input and outputs h5, and optionally bigWig and bedGraph files.
Total mesorectal excision in MRI-defined low rectal cancer: multicentre study comparing oncological outcomes of robotic, laparoscopic and transanal total mesorectal excision in high-volume centres
Authors: Rutgers Marieke L , Burghgraef Thijs A , Hol Jeroen C , Crolla Rogier M , van Geloven Nanette A , Leijtens Jeroen W , Polat Fatih , Pronk Apollo , Smits Anke B , Tuyman Jurriaan B , Verdaasdonk Emiel G , Sietses Colin , Consten Esther C , Hompes Roel 
Published: May 2024

Abstract

Background
The routine use of MRI in rectal cancer treatment allows the use of a strict definition for low rectal cancer. This study aimed to compare minimally invasive total mesorectal excision in MRI-defined low rectal cancer in expert laparoscopic, transanal and robotic high-volume centres.

Methods
All MRI-defined low rectal cancer operated on between 2015 and 2017 in 11 Dutch centres were included. Primary outcomes were: R1 rate, total mesorectal excision quality and 3-year local recurrence and survivals (overall and disease free). Secondary outcomes included conversion rate, complications and whether there was a perioperative change in the preoperative treatment plan.

Results
Of 1071 eligible rectal cancers, 633 patients with low rectal cancer were identified. Quality of the total mesorectal excision specimen (P = 0.337), R1 rate (P = 0.107), conversion (P = 0.344), anastomotic leakage rate (P = 0.942), local recurrence (P = 0.809), overall survival (P = 0.436) and disease-free survival (P = 0.347) were comparable among the centres. The laparoscopic centre group had the highest rate of perioperative change in the preoperative treatment plan (10.4%), compared with robotic expert centres (5.2%) and transanal centres (2.1%), P = 0.004. The main reason for this change was stapling difficulty (43%), followed by low tumour location (29%). Multivariable analysis showed that laparoscopic surgery was the only independent risk factor for a change in the preoperative planned procedure, P = 0.024.

Conclusion
Centres with expertise in all three minimally invasive total mesorectal excision techniques can achieve good oncological resection in the treatment of MRI-defined low rectal cancer. However, compared with robotic expert centres and transanal centres, patients treated in laparoscopic centres have an increased risk of a change in the preoperative intended procedure due to technical limitations.
Impact of clinical frailty on surgical and non-surgical complications after major emergency abdominal surgery
Authors: Snitkjær Christian , Rehné Jensen Lasse , í Soylu Liv , Hauge Camilla , Kvist Madeline , Jensen Thomas K , Kokotovic Dunja , Burcharth Jakob 
Published: May 2024

Abstract

Background
Major emergency abdominal surgery is associated with a high risk of morbidity and mortality. Given the ageing and increasingly frail population, understanding the impact of frailty on complication patterns after surgery is crucial. The aim of this study was to evaluate the association between clinical frailty and organ-specific postoperative complications after major emergency abdominal surgery.

Methods
A prospective cohort study including all patients undergoing major emergency abdominal surgery at Copenhagen University Hospital Herlev, Denmark, from 1 October 2020 to 1 August 2022, was performed. Clinical frailty scale scores were determined for all patients upon admission and patients were then analysed according to clinical frailty scale groups (scores of 1–3, 4–6, or 7–9). Postoperative complications were registered until discharge.

Results
A total of 520 patients were identified. Patients with a low clinical frailty scale score (1–3) experienced fewer total complications (120 complications per 100 patients) compared with patients with clinical frailty scale scores of 4–6 (250 complications per 100 patients) and 7–9 (277 complications per 100 patients) (P &lt; 0.001). A high clinical frailty scale score was associated with a high risk of pneumonia (P = 0.009), delirium (P &lt; 0.001), atrial fibrillation (P = 0.020), and infectious complications in general (P &lt; 0.001). Patients with severe frailty (clinical frailty scale score of 7–9) suffered from more surgical complications (P = 0.001) compared with the rest of the cohort. Severe frailty was associated with a high risk of 30-day mortality (33% for patients with a clinical frailty scale score of 7–9 versus 3.6% for patients with a clinical frailty scale score of 1–3, P &lt; 0.001). In a multivariate analysis, an increasing degree of clinical frailty was found to be significantly associated with developing at least one complication.

Conclusion
Patients with frailty have a significantly increased risk of postoperative complications after major emergency abdominal surgery, especially atrial fibrillation, delirium, and pneumonia. Likewise, patients with frailty have an increased risk of mortality within 90 days. Thus, frailty is a significant predictor for adverse events after major emergency abdominal surgery and should be considered in all patients undergoing major emergency abdominal surgery.
Intervention Pathways following a Social Work Assessment: An Analysis of National Administrative Data for Children’s Social Care in England
Authors: Hood Rick , Goldacre Allie , Jones Ed , Martin Emma , Clements Keith , Webb Calum 
Published: May 2024

Abstract
The majority of children referred to social care services in England go on to receive a statutory assessment by a social worker. Research has identified consistent categories of demand based on the needs identified in assessments. However, little is known about the relationship between children’s assessed needs and their subsequent intervention pathways. To explore this relationship, secondary analysis was undertaken of a national administrative data-set including all children who received a social work assessment in England from 2015 to 2020 (n = 3.6 m). Children’s characteristics, assessed needs and intervention pathways were compared for each episode of CSC involvement. Regression analysis then explored how the proportion of children receiving different types of provision varied according to their needs as well as intersections of gender, age and ethnicity. The findings showed significant differences across twelve categories of demand, pointing to variation in the assessment and response to similar types of presenting needs. Implications are discussed for the planning and design of services.
Personality and quality-of-life improvement after apomorphine infusion in Parkinson’s disease
Authors: Boussac Mathilde , Harroch Estelle , Barthelemy Christel , Ory-Magne Fabienne , Leung Clémence , Fabbri Margherita , Arbus Christophe , Brefel-Courbon Christine 
Published: May 2024

Abstract
People with Parkinson’s disease with motor fluctuations can be treated by continuous subcutaneous apomorphine infusion (CSAI) to reduce their symptoms. Nonetheless, factors are lacking to predict patients’ quality-of-life amelioration after CSAI. This pilot study aimed to evaluate associations between personality dimensions and quality-of-life improvement after 6 months of CSAI.
Thirty-nine people with Parkinson’s disease awaiting CSAI were included. Linear regression models between ‘Temperament and Character Inventory’ personality dimensions at baseline and percentage of change in Parkinson’s Disease Questionnaire-39 scores after 6 months of CSAI were realized (n = 35). The Temperament and Character Inventory was also compared between patients awaiting CSAI and patients awaiting deep brain stimulation of the sub-thalamic nucleus (n = 39 from the PREDI-STIM study).
Higher reward dependence scores were associated with a better quality-of-life outcome after 6 months of CSAI, while self-directedness scores were associated with a better quality of life before CSAI (as opposed to harm avoidance, reward dependence and self-transcendence scores associated with a worse quality of life). Moreover, people with Parkinson’s disease awaiting deep brain stimulation of the sub-thalamic nucleus had similar Temperament and Character Inventory dimensions compared to patients awaiting CSAI.
People with Parkinson’s disease with higher reward dependence scores at baseline had the best quality-of-life improvement after 6 months of CSAI. This finding could be used to better prepare and accompany people with Parkinson’s disease during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.
Does Adjunctive Clindamycin Have a Role in Staphylococcus aureus Bacteremia? A Protocol for the Adjunctive Treatment Domain of the Staphylococcus aureus Network Adaptive Platform (SNAP) Randomized Controlled Trial
Authors: Anpalagan Keerthi , Dotel Ravindra , MacFadden Derek R , Smith Simon , Voss Lesley , Petersiel Neta , Marks Michael , Marsh Julie , Mahar Robert K , McGlothlin Anna , Lee Todd C , Goodman Anna , Morpeth Susan , Davis Joshua S , Tong Steven Y C , Bowen Asha C ,   the Adjunctive Clindamycin Domain-Specific Working Group for the Staphylococcus aureus Network Adaptive Platform (SNAP) Trial Group, Anpalagan Keerthi , Dotel Ravindra , MacFadden Derek R , Smith Simon , Voss Lesley , Petersiel Neta , Marks Michael , Davis Joshua S , Bowen Asha C , Bonten Marc , Bowen Asha C , Daneman Nick , van Hal Sebastiaan J , Heriot George S , Lewis Roger J , Lye David C , McQuilten Zoe , Paterson David L , Robinson J Owen , Roberts Jason A , Scarborough Matthew , Webb Steve A , Whiteway Lynda , Walls Genevieve , Lee Todd C , Yahav Dafna , Hensgens Marjolein , Cheng Matthew P , Morpeth Susan , Tong Steven Y C , Davis Joshua S 
Published: May 2024

Abstract

Background
The use of adjunctive antibiotics directed against exotoxin production in Staphylococcus aureus bacteremia (SAB) is widespread, and it is recommended in many guidelines, but this is based on limited evidence. Existing guidelines are based on the theoretical premise of toxin suppression, as many strains of S. aureus produce toxins such as leukocidins (eg, Panton-Valentine leukocidin, toxic shock syndrome toxin 1, exfoliative toxins, and various enterotoxins). Many clinicians therefore believe that limiting exotoxin production release by S. aureus could reduce its virulence and improve clinical outcomes. Clindamycin, a protein synthesis inhibitor antibiotic, is commonly used for this purpose. We report the domain-specific protocol, embedded in a large adaptive, platform trial, seeking to definitively answer this question.

Methods and Analysis
The Staphylococcus aureus Network Adaptive Platform (SNAP) trial is a pragmatic, randomized, multicenter adaptive platform trial that aims to compare different SAB therapies, simultaneously, for 90-day mortality rates. The adjunctive treatment domain aims to test the effectiveness of adjunctive antibiotics, initially comparing clindamycin to no adjunctive antibiotic, but future adaptations may include other agents. Individuals will be randomized to receive either 5 days of adjunctive clindamycin (or lincomycin) or no adjunctive antibiotic therapy alongside standard-of-care antibiotics. Most participants with SAB (within 72 hours of index blood culture and with no contraindications) will be eligible to participate in this domain. Prespecified analyses are defined in the statistical appendix to the core protocol, and domain-specific secondary analyses will be adjusted for resistance to clindamycin, disease phenotype (complicated or uncomplicated SAB) and Panton-Valentine leukocidin–positive isolate.
Serial cardiopulmonary exercise testing in young patients after one-and-half ventricle repair and Fontan procedure: a comparative study
Authors: Vecchiato Marco , Mazzucato Barbara , Battista Francesca , Neunhaeuserer Daniel , Quinto Giulia , Aghi Andrea , Varnier Maurizio , Gasperetti Andrea , Di Salvo Giovanni , Vida Vladimiro , Padalino Massimo Antonio , Ermolao Andrea 
Published: May 2024

Abstract

Aim
The Fontan procedure is a palliative surgical treatment for different congenital heart diseases with a univentricular heart, but it has been associated with decreased exercise capacity, cardiovascular morbidity, and premature mortality. The one-and-half ventricle repair (1.5VR) was introduced as an alternative to the Fontan procedure, specifically for selected patients with borderline hypoplastic right ventricle (HRV), aiming for a more physiological circulation. Despite these efforts, the benefit of 1.5VR over Fontan circulation comparison on clinical and functional outcomes remains unclear. The aim of this study was to investigate and compare young patients with HRV after 1.5VR with those with functional single right or left ventricles (FSRV or FSLV) after Fontan palliation over a 10-year follow-up period.

Methods and results
In this retrospective observational study, serial cardiopulmonary exercise tests (CPETs) performed in patients with 1.5VR and Fontan circulation between September 2002 and March 2024 have been analysed. Only patients with at least 10 years of follow-up were considered. A total of 43 patients were included (age at baseline 8.6 ± 2.6 years): 21 with FSLV, 12 with FSRV, and 10 with 1.5VR. No differences in cardiorespiratory fitness and efficiency were shown at the first CPET assessment among the three groups. At 10-year follow-up, 1.5VR had higher cardiorespiratory fitness and efficiency compared to FSLV and FSRV patients.

Conclusion
These findings suggest that the 1.5VR may provide superior long-term functional outcomes than the Fontan procedure in patients with borderline HRV. Further studies are needed to evaluate the impact on hard clinical endpoints.