bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and cost-effectiveness of a web-based cardiac rehabilitation programme for people with chronic stable angina: protocol for the ACTIVATE (Angina Controlled Trial Investigating the Value of the ‘Activate your heart’ Therapeutic E-intervention) randomised controlled trial
Authors: Williams Nefyn H , Collins Brendan , Comerford Terence J , Dodd Susanna , Fisher Michael , Hardwick Ben , Hennessy Sophie , Jolly Kate , Jones Ian , Lane Deirdre , Lip Gregory Y H , Morgan Erica , Ralph Penelope , Thijssen Dick , Singh Sally J 
Published: March 2024

IntroductionChronic stable angina is common and disabling. Cardiac rehabilitation is routinely offered to people following myocardial infarction or revascularisation procedures and has the potential to help people with chronic stable angina. However, there is insufficient evidence of effectiveness and cost-effectiveness for its routine use in this patient group. The objectives of this study are to compare the effectiveness and cost-effectiveness of the ‘Activate Your Heart’ cardiac rehabilitation programme for people with chronic stable angina compared with usual care.Methods and analysisACTIVATE is a multicentre, parallel-group, two-arm, superiority, pragmatic randomised controlled trial, with recruitment from primary and secondary care centres in England and Wales and a target sample size of 518 (1:1 allocation; allocation sequence by minimisation programme with built-in random element). The study uses secure web-based allocation concealment. The two treatments will be optimal usual care (control) and optimal usual care plus the ‘Activate Your Heart’ web-based cardiac rehabilitation programme (intervention). Outcome assessment and statistical analysis will be performed blinded; participants will be unblinded. Outcomes will be measured at baseline and at 6 and 12 months’ follow-up. Primary outcome will be the UK version of Seattle Angina Questionnaire (SAQ-UK), physical limitations domain at 12 months’ follow-up. Secondary outcomes will be the remaining two domains of SAQ-UK, dyspnoea, anxiety and depression, health utility, self-efficacy, physical activity and the incremental shuttle walk test. All safety events will be recorded, and serious adverse events assessed to determine whether they are related to the intervention and expected. Concurrent economic evaluation will be cost–utility analysis from health service perspective. An embedded process evaluation will determine the mechanisms and processes that explain the implementation and impacts of the cardiac rehabilitation programme.Ethics and disseminationNorth of Scotland National Health Service Research Ethics Committee approval, reference 21/NS/0115. Participants will provide written informed consent. Results will be disseminated by peer-reviewed publication.Trial registration numberISRCTN10054455.
A rapid improvement event: progesterone prescribing in prevention of miscarriage
Authors: Bolger Lucy Anne , O'Riordan Nicola , Allen Cathy 
Published: March 2024

A rapid improvement event (RIE) is a standard operational excellence technique that uses team-based problem solving to improve processes. In this study, a RIE was undertaken to improve progesterone prescribing rates for those with a history of miscarriage experiencing vaginal bleeding in early pregnancy. This was on the basis of a recent change in guidelines regarding prescribing in these instances. NICE guidelines changed in November 2021 after Cochrane meta-analysis and the PRISM (Progesterone in Spontaneous Miscarriage) randomised control trial demonstrated a higher incidence of live births in those prescribed vaginal micronised progesterone for threatened miscarriage, when compared with those not prescribed it.A RIE involves a team approach and a standard sequence of events allowing analysis and improvement of a process. Analysis in the form of audit revealed a low progesterone prescribing rate for eligible patients in our unit. Dissection of this problem into its elements revealed a low level of staff knowledge regarding the change in guidelines and a lack of confidence in prescription of progesterone. A plan of actionable events to improve prescribing rates was devised. The updated guidance and local recommendations on appropriate micronised progesterone formulations were presented at hospital Grand Rounds with multidisciplinary attendance. Infographics were displayed in areas visible to stakeholders within the hospital and on the hospital’s social media pages. The validity of these educational measures to improve the process was reaudited after 3 months.Progesterone prescribing improved by 48%. Those comfortable with prescribing as per the new guidelines improved from 43% to 78%. A RIE proved to be an effective and efficient approach to collaboration, decision-making and action.
Implementation of the Infant-Toddler Checklist in Swedish child health services at 18 months: an observational study
Authors: Dahlberg Anton , Levin Anna , Fäldt Anna Erica 
Published: March 2024

BackgroundCommunication and language disorders are common conditions that emerge early and negatively impact quality of life across the life course. Early identification may be facilitated using a validated screening tool such as the Infant-Toddler Checklist (ITC). We introduced the ITC at the 18-month visit to child health services (CHS) in a Swedish county. Using the RE-AIM implementation framework, this study assessed the implementation of the ITC according to five key dimensions: reach, effectiveness, adoption, implementation and maintenance.MethodsThis observational study used medical records at CHS as data source. Data were collected from children who visited a child health nurse at 17–22 months. The sample included 2633 children with a mean age of 17.8 months, 1717 in the pre-implementation group and 916 in the post implementation group. We calculated the ITC completion rate (reach) and use at each site (adoption). We compared rates of referral to speech and language therapy (effectiveness) before and after implementation of the ITC using OR and 95% CIs. We described actions to facilitate implementation and maintenance of ITC screening over time.ResultsThe overall screening rate was 93% (reach) which increased from 80% initially to 94% at the end of the 2-year period (maintenance). All centres used the ITC (adoption). The ITC screen positive rate was 14%. Of children who had reached at least 24 months (n=2367), referral rate was 0.4% pre-implementation versus 6.9% post implementation (OR=18.17, 95% CI 8.15, 40.51, p<0.001) (effectiveness). Implementation strategies included training sessions, collaboration, written and automatic procedures and modifications to the medical records system.ConclusionThe implementation of the ITC was associated with high reach, higher referral rate, complete adoption, and sustained maintenance over time.
Nocturnal gastro-oesophageal reflux and respiratory symptoms are increased in sleep apnoea: comparison with the general population
Authors: Emilsson Össur Ingi , Aspelund Thor , Janson Christer , Benediktsdottir Bryndis , Juliusson Sigurdur , Maislin Greg , Pack Allan I , Keenan Brendan T , Gislason Thorarinn 
Published: March 2024

AimTo assess respiratory symptoms and nocturnal gastro-oesophageal reflux (nGER) among untreated obstructive sleep apnoea (OSA) patients, compared with the general population. Also, if nGER associates differently with respiratory symptoms among OSA patients.Methods2 study cohorts were included: 822 newly diagnosed subjects with moderate–severe OSA and 738 Icelandic general population study participants. All participants answered the same questionnaires. Those reporting nGER symptoms at least once per week were defined as ‘with nGER’; those without nGER symptoms and without nGER medication were defined as ‘no nGER’; and other participants were defined as having ‘possible nGER’. Propensity score-based weights were used to minimise confounding and selection bias and facilitate causal interpretations.ResultsThe prevalence of nGER among OSA patients was 14.1%, compared with 5.8% in the general population. This increased prevalence in OSA was not explained by differences in age, gender, body mass index, smoking, hypertension and diabetes (adjusted OR (95% CI)=3.79 (2.24 to 6.43)). OSA patients ‘with nGER’ and with ‘possible nGER’ reported more wheezing (44% and 44% vs 25%, respectively) and productive cough (47% and 42% vs 29%, respectively), compared with OSA patients with ‘no nGER’. The same pattern was seen in the general population, although with a generally lower prevalence. The effect of nGER on respiratory symptoms was similar between the two cohorts.ConclusionnGER was more often reported among untreated moderate–severe OSA patients than in the general population. Participants with nGER had more wheezing and productive cough, both among untreated OSA patients and in the general population.
Variant characterisation and clinical profile in a large cohort of patients with Ellis-van Creveld syndrome and a family with Weyers acrofacial dysostosis
Authors: Altunoglu Umut , Palencia-Campos Adrian , Güneş Nilay , Turgut Gozde Tutku , Nevado Julian , Lapunzina Pablo , Valencia Maria , Iturrate Asier , Otaify Ghada , Elhossini Rasha , Ashour Adel , K. Amin Asmaa , Elnahas Rania F , Fernandez-Nuñez Elisa , Flores Carmen-Lisset , Arias Pedro , Tenorio Jair , Chamorro Fernández Carlos Israel , Güven Yeliz , Özsu Elif , Eklioğlu Beray Selver , Ibarra-Ramirez Marisol , Diness Birgitte Rode , Burnyte Birute , Ajmi Houda , Yüksel Zafer , Yıldırım Ruken , Ünal Edip , Abdalla Ebtesam , Aglan Mona , Kayserili Hulya , Tuysuz Beyhan , Ruiz-Pérez Victor 
Published: March 2024

Background

Ellis-van Creveld syndrome (EvC) is a recessive disorder characterised by acromesomelic limb shortening, postaxial polydactyly, nail-teeth dysplasia and congenital cardiac defects, primarily caused by pathogenic variants in
EVC
or
EVC2
. Weyers acrofacial dysostosis (WAD) is an ultra-rare dominant condition allelic to EvC. The present work aimed to enhance current knowledge on the clinical manifestations of EvC and WAD and broaden their mutational spectrum.

Methods
We conducted molecular studies in 46 individuals from 43 unrelated families with a preliminary clinical diagnosis of EvC and 3 affected individuals from a family with WAD and retrospectively analysed clinical data. The deleterious effect of selected variants of uncertain significance was evaluated by cellular assays.

Main results

We identified pathogenic variants in
EVC/EVC2
in affected individuals from 41 of the 43 families with EvC. Patients from each of the two remaining families were found with a homozygous splicing variant in
WDR35
and a de novo heterozygous frameshift variant in
GLI3
, respectively. The phenotype of these patients showed a remarkable overlap with EvC. A novel
EVC2
C-terminal truncating variant was identified in the family with WAD. Deep phenotyping of the cohort recapitulated ‘classical EvC findings’ in the literature and highlighted findings previously undescribed or rarely described as part of EvC.

Conclusions

This study presents the largest cohort of living patients with EvC to date, contributing to better understanding of the full clinical spectrum of EvC. We also provide comprehensive information on the
EVC
/
EVC2
mutational landscape and add
GLI3
to the list of genes associated with EvC-like phenotypes.
Bouncing and collapsing universes dual to late-time cosmological models
Authors: Mukherjee Dipayan , Jassal H. K. , Lochan Kinjalk 
Published: March 2024

AbstractWe use the Jordan frame–Einstein frame correspondence to explore dual universes with contrasting cosmological evolutions. We study the mapping between Einstein and Jordan frames where the Einstein frame universe describes the late-time evolution of the physical universe, which is driven by dark energy and non-relativistic matter. The Brans–Dicke theory of gravity is considered to be the dual scalar–tensor theory in the Jordan frame. We show that an Einstein frame universe, with cosmological evolution of the $$\Lambda $$
Λ
CDM model, always corresponds to a bouncing Jordan frame universe governed by a Brans–Dicke theory. On the other hand, quintessence models of dark energy with non-relativistic matter component are shown to be always dual to a Brans–Dicke Jordan frame with a turn-around, i.e., a bounce or a collapse. The evolution of the equation of state of the quintessence field determines whether the turn-around is a bounce or a collapse. The point of the Jordan frame turn-around for all the cases can be tuned anywhere by choosing an appropriate Brans–Dicke parameter. This essentially leads to alternative descriptions of the late-time evolution of the physical universe, in terms of bouncing or collapsing Brans–Dicke universes in the Jordan frame. Therefore, the effect of dark energy can equivalently be seen as collapse of space in a conformally connected universe. We further study the stability of such conformal maps against linear perturbations. The effective bouncing and collapsing descriptions of the current accelerating universe may have interesting implications for the evolutions of perturbations and quantum fluctuations in the cosmological background.
Online disinformation in the 2020 U.S. election: swing vs. safe states
Authors: Pratelli Manuel , Petrocchi Marinella , Saracco Fabio , De Nicola Rocco 
Published: March 2024

AbstractFor U.S. presidential elections, most states use the so-called winner-take-all system, in which the state’s presidential electors are awarded to the winning political party in the state after a popular vote phase, regardless of the actual margin of victory. Therefore, election campaigns are especially intense in states where there is no clear direction on which party will be the winning party. These states are often referred to as swing states. To measure the impact of such an election law on the campaigns, we analyze the Twitter activity surrounding the 2020 US preelection debate, with a particular focus on the spread of disinformation. We find that about 88% of the online traffic was associated with swing states. In addition, the sharing of links to unreliable news sources is significantly more prevalent in tweets associated with swing states: in this case, untrustworthy tweets are predominantly generated by automated accounts. Furthermore, we observe that the debate is mostly led by two main communities, one with a predominantly Republican affiliation and the other with accounts of different political orientations. Most of the disinformation comes from the former.
Efficient High-Quality Clustering for Large Bipartite Graphs
Authors: Yang Renchi , Shi Jieming 
Published: March 2024

A bipartite graph contains inter-set edges between two disjoint vertex sets, and is widely used to model real-world data, such as user-item purchase records, author-article publications, and biological interactions between drugs and proteins. k-Bipartite Graph Clustering (k-BGC) is to partition the target vertex set in a bipartite graph into k disjoint clusters. The clustering quality is important to the utility of k-BGC in various applications like social network analysis, recommendation systems, text mining, and bioinformatics, to name a few. Existing approaches to k-BGC either output clustering results with compromised quality due to inadequate exploitation of high-order information between vertices, or fail to handle sizable bipartite graphs with billions of edges.
Motivated by this, this paper presents two efficient k-BGC solutions, HOPE and HOPE+, which achieve state-of-the-art performance on large-scale bipartite graphs. HOPE obtains high scalability and effectiveness through a new k-BGC problem formulation based on the novel notion of high-order perspective (HOP) vectors and an efficient technique for low-rank approximation of HOP vectors. HOPE+ further elevates the k-BGC performance to another level with a judicious problem transformation and a highly efficient two-stage optimization framework. Two variants, HOPE+ (FNEM) and HOPE+ (SNEM) are designed when either the Frobenius norm or spectral norm is applied in the transformation. Extensive experiments, comparing HOPE and HOPE+ against 13 competitors on 10 real-world datasets, exhibit that our solutions, especially HOPE+, are superior to existing methods in terms of result quality, while being up to orders of magnitude faster. On the largest dataset MAG with 1.1 billion edges, HOPE+ is able to produce clusters with the highest clustering accuracy within 31 minutes, which is unmatched by any existing solution for k-BGC.
LST-Bench: Benchmarking Log-Structured Tables in the Cloud
Authors: Camacho-Rodríguez Jesús , Agrawal Ashvin , Gruenheid Anja , Gosalia Ashit , Petculescu Cristian , Aguilar-Saborit Josep , Floratou Avrilia , Curino Carlo , Ramakrishnan Raghu 
Published: March 2024

Data processing engines increasingly leverage distributed file systems for scalable, cost-effective storage. While the Apache Parquet columnar format has become a popular choice for data storage and retrieval, the immutability of Parquet files renders it impractical to meet the demands of frequent updates in contemporary analytical workloads. Log-Structured Tables (LSTs), such as Delta Lake, Apache Iceberg, and Apache Hudi, offer an alternative for scenarios requiring data mutability, providing a balance between efficient updates and the benefits of columnar storage. They provide features like transactions, time-travel, and schema evolution, enhancing usability and enabling access from multiple engines. Moreover, engines like Apache Spark and Trino can be configured to leverage the optimizations and controls offered by LSTs to meet specific business needs. Conventional benchmarks and tools are inadequate for evaluating the transformative changes in the storage layer resulting from these advancements, as they do not allow us to measure the impact of design and optimization choices in this new setting.
In this paper, we propose a novel benchmarking approach and metrics that build upon existing benchmarks, aiming to systematically assess LSTs. We develop a framework, LST-Bench, which facilitates effective exploration and evaluation of the collaborative functioning of LSTs and data processing engines through tailored benchmark packages. A package is a mix of use patterns reflecting a target workload; LST-Bench makes it easy to define a wide range of use patterns and combine them into a package, and we include a baseline package for completeness. Our assessment demonstrates the effectiveness of our framework and benchmark packages in extracting valuable insights across diverse environments. The code for LST-Bench is open source and is available at https://github.com/microsoft/lst-bench/.
Ultrasensitive Response Explains the Benefit of Combination Chemotherapy Despite Drug Antagonism
Authors: Patterson Sarah C. , Pomeroy Amy E. , Palmer Adam C. 
Published: March 2024

Abstract
Most aggressive lymphomas are treated with combination chemotherapy, commonly as multiple cycles of concurrent drug administration. Concurrent administration is in theory optimal when combination therapies have synergistic (more than additive) drug interactions. We investigated pharmacodynamic interactions in the standard 4-drug “CHOP” regimen in peripheral T-cell lymphoma (PTCL) cell lines and found that CHOP consistently exhibits antagonism and not synergy. We tested whether staggered treatment schedules could improve tumor cell kill by avoiding antagonism, using in vitro models of concurrent or staggered treatments. Surprisingly, we observed that tumor cell kill is maximized by concurrent drug administration despite antagonistic drug–drug interactions. We propose that an ultrasensitive dose response, as described in radiology by the linear–quadratic (LQ) model, can reconcile these seemingly contradictory experimental observations. The LQ model describes the relationship between cell survival and dose, and in radiology has identified scenarios favoring hypofractionated radiotherapy—the administration of fewer large doses rather than multiple smaller doses. Specifically, hypofractionated treatment can be favored when cells require an accumulation of DNA damage, rather than a “single hit,” to die. By adapting the LQ model to combination chemotherapy and accounting for tumor heterogeneity, we find that tumor cell kill is maximized by concurrent administration of multiple drugs, even when chemotherapies have antagonistic interactions. Thus, our study identifies a new mechanism by which combination chemotherapy can be clinically beneficial that is not contingent on positive drug–drug interactions.
ACURATE neo2 Versus SAPIEN 3 Ultra Transcatheter Heart Valve in Severe Aortic Valve Calcification: A Propensity-Matched Analysis
Authors: Eckel Clemens , Kim Won-Keun , Sötemann Dagmar , Grothusen Christina , Tiyerili Vedat , Dohmen Guido , Renker Matthias , Charitos Efstratios I. , Hamm Christian W. , Choi Yeong-Hoon , Elsässer Albrecht , Möllmann Helge , Blumenstein Johannes 
Published: March 2024

BACKGROUND:
Comparative data on transcatheter self-expanding ACURATE neo2 (NEO2) and balloon-expandable SAPIEN 3 Ultra prostheses in technically challenging anatomy of severe aortic valve calcified aortic annuli are scarce.

METHODS:

A total of 1987 patients with severe native aortic stenosis treated with the self-expanding NEO2 (n=1457) or balloon-expandable SAPIEN 3 Ultra (n=530) from January 2017 to April 2023 were evaluated. The primary end point was procedural outcome according to the Valve Academic Research Consortium 3 definitions. Propensity matching defined 219 pairs with severe calcification (calcium density cutoff, 758 AU/cm
2
) of the native aortic valve.

RESULTS:

Technical success (90.4% versus 91.8%; risk difference, 1.4% [95% CI, −4.4 to −7.2];
P
=0.737) and device success at 30 days (80.8% versus 75.8%; risk difference, −5.0% [95% CI, −13.2 to 3.1];
P
=0.246) were comparable between NEO2 and SAPIEN 3 Ultra. The rate of severe prosthesis-patient mismatch (1.1% versus 10.1%; risk difference, 10.0% [95% CI, 4.0–13.9];
P
<0.001) and mean transvalvular gradient ≥20 mm Hg (2.8% versus 14.3%; risk difference, 11.5% [95% CI, 5.8–17.1];
P
<0.001) was lower with NEO2. The rate of more-than-mild paravalvular leakage or valve-in-valve due to paravalvular leakage was significantly higher (6.2% versus 0.0%; risk difference, 6.2% [95% CI, −10.1 to −2.7];
P
=0.002), and there was a tendency for a higher rate of device embolization or migration (1.8% versus 0.0%; risk difference, −1.8% [95% CI, −4.1 to 0.4];
P
=0.123) with NEO2. Multivarate regression revealed no independent impact of transcatheter heart valve selection on device success (odds ratio, 0.93 [95% CI, 0.48–1.77];
P
=0.817).

CONCLUSIONS:
In patients with severely calcified annuli, supraannular implantation of NEO2 showed hemodynamic advantages. Nevertheless, NEO2 was associated with a higher incidence of relevant paravalvular leakage and a numerically higher rate of device embolization than SAPIEN 3 Ultra in this particular patient group.