bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epidemiology of dying within 48 hours of presentation to emergency departments: a retrospective cohort study of older people across Australia and New Zealand
Authors: Sweeny Amy L , Alsaba Nemat , Grealish Laurie , Denny Kerina , Lukin Bill , Broadbent Andrew , Huang Ya-Ling , Ranse Jamie , Ranse Kristen , May Katya , Crilly Julia 
Published: April 2024

Abstract

Background
Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people.

Objectives
To estimate the need for ED end-of-life care for people aged ≥65 years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere.

Methods
We conducted a retrospective cohort study analysing data from 177 hospitals in Australia and New Zealand. Data on older people presenting to ED from January to December 2018, and those who died within 48 hours of ED presentation, were analysed using simple descriptive statistics and univariate logistic regression.

Results
From participating hospitals in Australia or New Zealand, 10,921 deaths in older people occurred. The 48-hour mortality rate was 6.43 per 1,000 ED presentations (95% confidence interval: 6.31–6.56). Just over a quarter (n = 3,067, 28.1%) died in ED. About one-quarter of the cohort (n = 2,887, 26.4%) was triaged into less urgent triage categories. Factors with an increased risk of dying in ED included age 65–74 years, ambulance arrival, most urgent triage categories, principal diagnosis of circulatory system disorder, and not identifying as an Aboriginal or Torres Strait Islander person. Of the 7,677 older people admitted, half (n = 3,836, 50.0%) had an encounter for palliative care prior to, or during, this presentation.

Conclusions
Our findings provide insight into the challenges of recognising the dying older patient and differentiating those appropriate for end-of-life care. We support recommendations for national advanced care planning registers and suggest a review of triage systems with an older person-focused lens.
Second Language Learning Difficulty of Chinese Grammar: A Rasch Analysis of Teachers’ Perceptions
Authors: Lin Jia , Lu Yuan 
Published: April 2024

Abstract
This study examined second language (L2) learning difficulty of 13 Chinese grammatical constructions on the basis of teachers’ perceptions and associated the L2 learning difficulty of Chinese grammatical constructions with teacher-perceived learner grammatical competence and with the instructional levels. A total of 77 experienced teachers were invited to rate the learning difficulty of 13 Chinese grammatical constructions with reference to L2 learners at four instructional levels at college. Utilizing the Rasch rating scale model, this study established an L2 Chinese grammar learning difficulty hierarchy and revealed that the learning difficulty hierarchy mostly overlapped with the acquisitional order of Chinese grammar found in L2 Chinese research and with the instructional order in a widely used Chinese textbook. This study enriches our understanding of the multifaceted nature of L2 learning difficulty and the idiosyncratic learning difficulty and pattern associated with each Chinese grammatical construction in L2 development. Implications for Chinese instruction, material development, and assessment are provided.
‘Valuable Lives to Save’ vs. ‘Babysitting These People While They Try to Kill Themselves’: Changing Police Attitudes Towards Safe Consumption Sites
Authors: McNeilly Rebekah , Berardi Luca , Haggerty Kevin D , Bucerius Sandra M , Krahn Harvey 
Published: April 2024

Abstract
North American police responses to the ‘drug issue’ have long been shaped by a crime control rather than a harm reduction imperative. Consequently, police officers’ responses to safe consumption sites (SCSs), where people who use illicit drugs can reduce personal health risks by administering previously obtained drugs in the presence of trained staff, were initially hostile. This paper draws on interview data from police officers in two western Canadian cities to highlight an apparent softening in attitudes, perhaps due to the current fentanyl-driven drug poisoning crisis. While some officers clearly recognized their public health benefits, others accepted SCSs, acknowledging the futility of a continued ‘war on drugs’. Some voiced reservations about SCSs, but not because of a generic ‘drugs are bad’ sentiment. Rather, they worried about specific downstream implications for communities and police work. These findings, reflecting apparent changes in police officers’ responses to SCSs, are discussed in the context of contemporary debates about police culture and the possibilities and desirability of pursuing police reform.
Impact of hospital volume on failure to rescue for complications requiring reoperation after elective colorectal surgery: multicentre propensity score–matched cohort study
Authors: Grönroos-Korhonen Marie T , Koskenvuo Laura E , Mentula Panu J , Nykänen Taina P , Koskensalo Selja K , Leppäniemi Ari K , Sallinen Ville J 
Published: April 2024

Abstract

Background
It has previously been reported that there are similar reoperation rates after elective colorectal surgery but higher failure-to-rescue (FTR) rates in low-volume hospitals (LVHs) versus high-volume hospitals (HVHs). This study assessed the effect of hospital volume on reoperation rate and FTR after reoperation following elective colorectal surgery in a matched cohort.

Methods
Population-based retrospective multicentre cohort study of adult patients undergoing reoperation for a complication after an elective, non-centralized colorectal operation between 2006 and 2017 in 11 hospitals. Hospitals were divided into either HVHs (3 hospitals, median ≥126 resections per year) or LVHs (8 hospitals, &lt;126 resections per year). Patients were propensity score–matched (PSM) for baseline characteristics as well as indication and type of elective surgery. Primary outcome was FTR.

Results
A total of 6428 and 3020 elective colorectal resections were carried out in HVHs and LVHs, of which 217 (3.4%) and 165 (5.5%) underwent reoperation (P &lt; 0.001), respectively. After PSM, 142 patients undergoing reoperation remained in both HVH and LVH groups for final analyses. FTR rate was 7.7% in HVHs and 10.6% in LVHs (P = 0.410). The median Comprehensive Complication Index was 21.8 in HVHs and 29.6 in LVHs (P = 0.045). There was no difference in median ICU-free days, length of stay, the risk for permanent ostomy or overall survival between the groups.

Conclusion
The reoperation rate and postoperative complication burden was higher in LVHs with no significant difference in FTR compared with HVHs.
Narrow mycorrhizal specialization and its effect on early development in the Mediterranean orchid Orchis italica
Authors: Balducci Marco G , Calevo Jacopo , Duffy Karl J 
Published: April 2024

Abstract
The contribution of individual orchid mycorrhizal (OrM) fungi to orchid germination is poorly understood. We isolated Tulasnella OrM fungi from 11 populations representing nine Italian regions associated with the orchid Orchis italica. We performed in vitro germination experiments using both single and two OrM isolate combinations of Tulasnella and Ceratobasidium isolates found in O. italica and co-occurring orchids. We performed an in situ reciprocal translocation experiment of O. italica seeds in two populations and we experimentally planted seeds into two unoccupied sites to test whether the presence of suitable OrM may limit its distribution. In vitro, Tulasnella isolates initiated germination, but only two isolates resulted in seedling development, while seeds did not germinate in the presence of Ceratobasidium isolates. Combinations of two Tulasnella isolates had lower germination rates compared to single isolates. Reciprocal translocations revealed that seeds from the same population had higher germination rates. Protocorms developed in one unoccupied site, with the associated fungus identified as Tulasnella spp. These results suggest that Tulasnella vary in their efficacy in seed germination and O. italica has a narrow specialization on Tulasnella. Such information is important for understanding the range limits of orchids and their ecological dependency on OrM fungi.
The subcortical default mode network and Alzheimer’s disease: a systematic review and meta-analysis
Authors: Seoane Sara , van den Heuvel Martijn , Acebes Ángel , Janssen Niels 
Published: April 2024

AbstractThe default mode network is a central cortical brain network suggested to play a major role in several disorders and to be particularly vulnerable to the neuropathological hallmarks of Alzheimer’s disease. Subcortical involvement in the default mode network and its alteration in Alzheimer’s disease remains largely unknown. We performed a systematic review, meta-analysis and empirical validation of the subcortical default mode network in healthy adults, combined with a systematic review, meta-analysis and network analysis of the involvement of subcortical default mode areas in Alzheimer’s disease. Our results show that, besides the well-known cortical default mode network brain regions, the default mode network consistently includes subcortical regions, namely the thalamus, lobule and vermis IX and right Crus I/II of the cerebellum and the amygdala. Network analysis also suggests the involvement of the caudate nucleus. In Alzheimer’s disease, we observed a left-lateralized cluster of decrease in functional connectivity which covered the medial temporal lobe and amygdala and showed overlap with the default mode network in a portion covering parts of the left anterior hippocampus and left amygdala. We also found an increase in functional connectivity in the right anterior insula. These results confirm the consistency of subcortical contributions to the default mode network in healthy adults and highlight the relevance of the subcortical default mode network alteration in Alzheimer’s disease.
Bayesian modelling disentangles language versus executive control disruption in stroke
Authors: Hartwigsen Gesa , Lim Jae-Sung , Bae Hee-Joon , Yu Kyung-Ho , Kuijf Hugo J , Weaver Nick A , Biesbroek J Matthijs , Kopal Jakub , Bzdok Danilo 
Published: April 2024

Abstract
Stroke is the leading cause of long-term disability worldwide. Incurred brain damage can disrupt cognition, often with persisting deficits in language and executive capacities. Yet, despite their clinical relevance, the commonalities and differences between language versus executive control impairments remain under-specified. To fill this gap, we tailored a Bayesian hierarchical modelling solution in a largest-of-its-kind cohort (1080 patients with stroke) to deconvolve language and executive control with respect to the stroke topology. Cognitive function was assessed with a rich neuropsychological test battery including global cognitive function (tested with the Mini-Mental State Exam), language (assessed with a picture naming task), executive speech function (tested with verbal fluency tasks), executive control functions (Trail Making Test and Digit Symbol Coding Task), visuospatial functioning (Rey Complex Figure), as well as verbal learning and memory function (Soul Verbal Learning). Bayesian modelling predicted interindividual differences in eight cognitive outcome scores three months after stroke based on specific tissue lesion topologies. A multivariate factor analysis extracted four distinct cognitive factors that distinguish left- and right-hemispheric contributions to ischaemic tissue lesions. These factors were labelled according to the neuropsychological tests that had the strongest factor loadings: One factor delineated language and general cognitive performance and was mainly associated with damage to left-hemispheric brain regions in the frontal and temporal cortex. A factor for executive control summarized mental flexibility, task switching and visual-constructional abilities. This factor was strongly related to right-hemispheric brain damage of posterior regions in the occipital cortex. The interplay of language and executive control was reflected in two distinct factors that were labelled as executive speech functions and verbal memory. Impairments on both factors were mainly linked to left-hemispheric lesions. These findings shed light onto the causal implications of hemispheric specialization for cognition; and make steps towards subgroup-specific treatment protocols after stroke.
Ultra-Performance Liquid Chromatography–Tandem Mass Spectrometry Analysis of Urinary Oligosaccharides and Glycoamino Acids for the Diagnosis of Mucopolysaccharidosis and Glycoproteinosis
Authors: Wongkittichote Parith , Cho Se Hyun , Miller Artis , King Kaitlyn , Herbst Zackary M , Ren Zhimei , Gelb Michael H , Hong Xinying 
Published: April 2024

AbstractBackgroundMucopolysaccharidosis (MPS) and glycoproteinosis are 2 groups of heterogenous lysosomal storage disorders (LSDs) caused by defective degradation of glycosaminoglycans (GAGs) and glycoproteins, respectively. Oligosaccharides and glycoamino acids have been recognized as biomarkers for MPS and glycoproteinosis. Given that both groups of LSDs have overlapping clinical features, a multiplexed assay capable of unambiguous subtyping is desired for accurate diagnosis, and potentially for severity stratification and treatment monitoring.MethodsUrinary oligosaccharides were derivatized with 3-methyl-1-phenyl-2-pyrazoline-5-one (PMP) and analyzed by ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) together with the underivatized glycoamino acids. Novel biomarkers were identified with a semi-targeted approach with precursor mass scanning, the fragmentation pattern (if applicable), and the biochemical basis of the condition.ResultsA UPLC-MS/MS analysis with improved chromatographic separation was developed. Novel biomarkers for MPS-IIIA, IIIB, IIIC, and VII were identified and validated. A total of 28 oligosaccharides, 2 glycoamino acids, and 2 ratios were selected as key diagnostic biomarkers. Validation studies including linearity, lower limit of quantitation (LLOQ), and precision were carried out with the assay performance meeting the required criteria. Age-specific reference ranges were collected. In the 76 untreated patients, unambiguous diagnosis was achieved with 100% sensitivity and specificity. Additionally, the levels of disease-specific biomarkers were substantially reduced in the treated patients.ConclusionsA multiplexed UPLC-MS/MS assay for urinary oligosaccharides and glycoamino acids measurement was developed and validated. The assay is suitable for the accurate diagnosis and subtyping of MPS and glycoproteinosis, and potentially for severity stratification and monitoring response to treatment.
The influence of transcatheter aortic valve replacement on left atrial mechanics: a systematic review and meta-analysis
Authors: Meredith Thomas , Brown Lauren , Mohammed Farhan , Pomeroy Amy , Roy David , Muller David W M , Hayward Christopher , Feneley Michael , Namasivayam Mayooran 
Published: April 2024

Abstract

Aims
The morphology and function of the left atrium (LA) are intimately tied to left ventricular loading conditions. Data pertaining to the effect of transcatheter aortic valve replacement (TAVR) on LA function and geometry are scarce. The aim of the study was to quantify associations between TAVR and LA remodelling by pooling available data from published observational studies.

Methods and results
A systematic review and meta-analysis were performed. Studies reporting serial LA speckle-tracking echocardiographic (STE) data, before and after TAVR, were included. Other outcome data included LA area and indexed volume (LAVi) and standard chamber measurements. Outcomes were stratified by timing of follow-up echocardiography: early (&lt;6 months) or late (≥6 months). Twelve studies were included, comprising 1066 patients. The mean reduction in LAVi was 2.72 mL/m2 [95% confidence interval (CI) 1.37–4.06, P &lt; 0.01]. LA reservoir function improved overall by a mean difference (MD) of 3.71% (95% CI 1.82–5.6, P &lt; 0.01), although there was significant heterogeneity within the pooled studies (I2 = 87.3%). Significant improvement in reservoir strain was seen in both early follow-up (MD 3.1%, P &lt; 0.01) and late follow-up studies (MD 4.48%, P = 0.03), but heterogeneity remained high (I2 = 65.23 and 94.4%, respectively). Six studies reported a change in LA contractile function, which recovered in the early follow-up studies (MD 2.26, P &lt; 0.01), but not in the late group (MD 1.41, P = 0.05). Pooled improvement in LA booster function was 1.96% (95% CI 1.11–2.8, P &lt; 0.01).

Conclusion
TAVR is associated with significant negative LA remodelling, and an improvement in LA mechanics, quantified by STE. The prognostic implications of these findings require further study.
A single-centre analysis of lung transplantation outcomes in recipients aged 70 or older
Authors: Kashem Mohammed Abul , Calvelli Hannah , Warnick Michael , Kehara Hiromu , Dulam Vipin , Zhao Huaqing , Yanigada Roh , Shigemura Norihisa , Toyoda Yoshiya 
Published: April 2024

Abstract

OBJECTIVES
As life expectancies continue to increase, a greater proportion of older patients will require lung transplants (LTs). However, there are no well-defined age cutoffs for which LT can be performed safely. At our high-volume LT centre, we explored outcomes for LT recipients ≥70 vs &lt;70 years old.

METHODS
This is a retrospective single-centre study of survival after LT among older recipients. Data were stratified by recipient age (≥70 vs &lt;70 years old) and procedure type (single versus double LT). Demographics and clinical variables were compared using Chi-square test and 2 sample t-test. Survival was assessed by Kaplan–Meier curves and compared by log-rank test with propensity score matching.

RESULTS
A total of 988 LTs were performed at our centre over 10 years, including 289 LTs in patients ≥70 years old and 699 LTs in patients &lt;70 years old. The recipient groups differed significantly by race (P &lt; 0.0001), sex (P = 0.003) and disease aetiology (P &lt; 0.0001). Older patients were less likely to receive a double LT compared to younger patients (P &lt; 0.0001) and had lower rates of intraoperative cardiopulmonary bypass (P = 0.019) and shorter length of stay (P = 0.001). Both groups had overall high 1-year survival (85.8% vs 89.1%, respectively). Survival did not differ between groups after propensity matching (P = 0.15).

CONCLUSIONS
Our data showed high survival for older and younger LT recipients. There were no statistically significant differences observed in survival between the groups after propensity matching, however, a trend in favour of younger patients was observed.
Performance of left internal thoracic artery-left anterior descending artery anastomosis by residents versus attendings and coronary artery bypass grafting outcomes
Authors: Gikandi Ajami , Stock Eileen , DeMatt Ellen , Hirji Sameer , Awtry Jake , Quin Jacquelyn A , Tolis George , Biswas Kousick , Zenati Marco A 
Published: April 2024

Abstract

OBJECTIVES
Performance of a technically sound left internal thoracic artery to left anterior descending artery (LITA-LAD) anastomosis during coronary artery bypass grafting (CABG) is critically important. We used prospectively collected data from the multicentre, randomized REGROUP (Randomized Endograft Vein Perspective) trial to investigate CABG outcomes based on whether a resident or an attending surgeon performed the LITA-LAD anastomosis.

METHODS
This was a post hoc subanalysis of the REGROUP trial, which randomized veterans undergoing isolated on-pump CABG to endoscopic versus open vein harvest from 2014 through 2017. The primary end point was major cardiac adverse events, defined as the composite of all-cause deaths, nonfatal myocardial infarctions or repeat revascularizations.

RESULTS
Among 1,084 patients, 344 (31.8%) LITA-LAD anastomoses were performed by residents and 740 (68.2%), by attending surgeons. Residents (compared to attendings) operated on fewer patients with high tercile SYNTAX scores (22.1% vs 37.4%, P &lt; 0.001), performed fewer multiarterial CABGs (5.2% vs 14.6%, P &lt; 0.001) and performed more anastomoses to distal targets with diameters &gt; 2.0 mm (19.0% vs 10.9%, P &lt; 0.001) and non-calcified landing zones (25.1% vs 21.6%, P &lt; 0.001). During a median observation time of 4.7 years (interquartile range 3.84–5.45), major cardiac adverse events occurred in 77 patients (22.4%) in the group treated by residents and 169 patients (22.8%) in the group treated by attendings (unadjusted HR 1.00; 95% confidence interval, 0.76–1.33; P = 0.99). Outcomes persisted on adjusted analyses.

CONCLUSIONS
Based on this REGROUP trial subanalysis, under careful supervision and with appropriate patient selection, LITA-LAD anastomoses performed by the residents yielded clinical outcomes similar to those of the attendings.
‘Working me to life’: longitudinal perceptions from adults with heart failure with preserved ejection fraction enrolled in an exercise training clinical trial
Authors: Salahshurian Erin , Pozehl Bunny J , Lundgren Scott W , Bills Sara , Pandey Ambarish , Carbone Salvatore , Alonso Windy W 
Published: April 2024

Abstract

Aims
Adults with heart failure with preserved ejection fraction (HFpEF) responded more favourably to an exercise intervention compared with those with reduced ejection fraction. This study explores factors that contributed to this response, focusing on the qualitative perceptions of adults with HFpEF enrolled in an exercise intervention.

Methods and results
This qualitative descriptive study is a secondary analysis of longitudinal interviews collected at 3, 6, 12, and 18 months from participants with HFpEF enrolled in a randomized controlled trial testing an intervention to promote adherence to exercise. We included participants with at least two interviews. Interviews were examined across and within participants and time points using thematic analysis. Analyses included 67 interviews from 21 adults with HFpEF enrolled in the intervention arm. The sample consisted of 52% (11/21) males and over 47% (10/21) non-White participants. Mean age at enrolment was 63.7 ± 9.9 years. We identified four major themes: (1) overcoming negative attitudes, barriers, and injury, (2) motivations to exercise, (3) exercise—the panacea for HFpEF symptoms and quality of life, and (4) advice for others with HFpEF.

Conclusion
Our findings suggest that for many adults with HFpEF, initial hesitancy, fear, and negative attitudes about exercise can be overcome. Exercise coaching using social cognitive constructs, medical fitness centre memberships, and heart rate self-monitoring are successful strategies of engaging adults with HFpEF in long-term unsupervised exercise training.

Registration
ClinicalTrials.gov, NCT01658670.