bluuebunny/crossref_metadata_2025_split huggingface dataset:
Length of stay and economic sustainability of virtual ward care in a medium-sized hospital of the UK: a retrospective longitudinal study
Authors: Jalilian Abdollah , Sedda Luigi , Unsworth Alison , Farrier Martin 
Published: January 2024

ObjectiveTo evaluate the length of stay difference and its economic implications between hospital patients and virtual ward patients.DesignRetrospective longitudinal study.SettingWrightington, Wigan and Leigh (WWL) Teaching Hospitals, National Health Service (NHS) Foundation Trust, a medium-sized NHS trust in the north-west of England.ParticipantsVirtual ward patients (n=318) were matched 1:1 to 1:4, depending on matching characteristics, to all hospital patients (n=350). All patients were admitted to the hospital during the calendar year 2022.Outcome measuresThe primary outcome is the length of stay as defined from the date of hospital admission to the date of discharge or death (hospital patients) and from the date of hospital admission to the date of admission in a virtual ward (virtual ward patients). The secondary outcome is the cost of a hospital bed day and the equivalent value of virtual ward savings in hospital bed days. Additional measures were 6-month readmission rates and survival rates at the follow-up date of 30 April 2023.Risk factorsAge, sex, comorbidities and the clinical frailty score (CFS) were used to evaluate the importance and effect of these factors on the main and secondary outcomes.MethodsStatistical analyses included logistic and binomial mixed models for the length of stay in the hospital and readmission rate outcomes, as well as a Cox proportional hazard model for the survival of the patients.ResultsThe virtual ward patients had a shorter stay in the hospital before being admitted to the virtual ward (2.89 days, 95% CI 2.1 to 3.9 days). Chronic kidney disease (CKD) and frailty were associated with a longer length of stay in the hospital (58%, 95% CI 22% to 100%) compared with patients without CKD, and 14% (95% CI 8% to 21%) compared with patients with one unit lower CFS. The frailty score was also associated with a higher rate of readmission within 6 months and lower survival. Being admitted to the virtual ward slightly improved survival, although when readmitted, survival deteriorated rapidly. The cost of a 24-hour period in a general hospital bed is £536. The cost of a day hospital saved by a virtual ward was £935.ConclusionThe use of a 40-bed virtual ward was clinically effective in terms of survival for patients not needing readmission and allowed for the freeing of three hospital beds per day. However, the cost for each day freed from hospital stay was three-quarters larger than the one for a single-day hospital bed. This raises concerns about the deployment of large-scale virtual wards without the existence of policies and plans for their cost-effective management.
Are there seasonal patterns for emergency department visits for head injuries in the USA? Findings from the National Electronic Injury Surveillance System-All Injury Program
Authors: Daugherty Jill , Yuan Keming , Sarmiento Kelly , Law Royal 
Published: January 2024

IntroductionPrevious international research suggests that the incidence of head injuries may follow seasonal patterns. However, there is limited information about how the numbers and rates of head injuries, particularly sports- and recreation-related head injuries, among adults and children evaluated in the emergency department (ED) vary by month in the USA. This information would provide the opportunity for tailored prevention strategies.MethodsWe analysed data from the National Electronic Injury Surveillance System-All Injury Program from 2016 to 2019 to examine both monthly variation of ED visit numbers and rates for head injuries overall and those due to sports and recreation.ResultsThe highest number of head injuries evaluated in the ED occurred in October while the lowest number occurred in February. Among males, children ages 0–4 years were responsible for the highest rates of head injury-related ED visits each year, while in females the highest rates were seen in both children ages 0–4 and adults ages 65 and older. The highest number of head injuries evaluated in the ED due to sports and recreation were seen in September and October. Head injury-related ED visits due to sports and recreation were much more common in individuals ages 5–17 than any other age group.ConclusionThis study showed that head injury-related ED visits for all mechanisms of injury, as well as those due to sports- and recreation-related activities, followed predictable patterns—peaking in the fall months. Public health professionals may use study findings to improve prevention efforts and to optimise the diagnosis and management of traumatic brain injury and other head injuries.
Genotype and phenotype correlation ofPHACTR1-related neurological disorders
Authors: Xu Zhao , Sadleir Lynette , Goel Himanshu , Jiao Xianru , Niu Yue , Zhou Zongpu , de Valles-Ibáñez Guillem , Poke Gemma , Hildebrand Michael , Lieffering Nico , Qin Jiong , Yang Zhixian 
Published: January 2024

BackgroundPHACTR1 (phosphatase and actin regulators) plays a key role in cortical migration and synaptic activity by binding and regulating G-actin and PPP1CA. This study aimed to expand the genotype and phenotype of patients withde novovariants inPHACTR1and analyse the impact of variants on protein–protein interaction.MethodsWe identified seven patients withPHACTR1variants by trio-based whole-exome sequencing. Additional two subjects were ascertained from two centres through GeneMatcher. The genotype–phenotype correlation was determined, and AlphaFold-Multimer was used to predict protein–protein interactions and interfaces.ResultsEight individuals carried missense variants and one had CNV in thePHACTR1. Infantile epileptic spasms syndrome (IESS) was the unifying phenotype in eight patients with missense variants ofPHACTR1. They could present with other types of seizures and often exhibit drug-resistant epilepsy with a poor prognosis. One patient with CNV displayed a developmental encephalopathy phenotype. Using AlphaFold-Multimer, our findings indicate that PHACTR1 and G-actin-binding sequences overlap with PPP1CA at the RPEL3 domain, which suggests possible competition between PPP1CA and G-actin for binding to PHACTR1 through a similar polymerisation interface. In addition, patients carrying missense variants located at the PHACTR1–PPP1CA or PHACTR1–G-actin interfaces consistently exhibit the IESS phenotype. These missense variants are mostly concentrated in the overlapping sequence (RPEL3 domain).ConclusionsPatients with variants inPHACTR1can have a phenotype of developmental encephalopathy in addition to IESS. Moreover, our study confirmed that the variants affect the binding of PHACTR1 to G-actin or PPP1CA, resulting in neurological disorders in patients.
Morphodynamics of macrotidal channels in Korean tidal flats: implications for the role of monsoon precipitation and the stratigraphic architecture of tidal point bars
Authors: Choi K. S. , Jo J. H. , Kim D. H. , Sohn S. Y. , Bang S. H. 
Published: January 2024

Abstract
Tidal channels exert a crucial control on sediment transport and drive geomorphic changes in the tidal environment. Despite their ubiquitous occurrence, long-term morphodynamics and processes driving the morphologic changes remain less well understood than fluvial counterparts. Spanning from straight to dendritic, Korean tidal channels become more sinuous and densely populated with elevation due to higher mud content. Mutually evasive current patterns resulted in a cuspate meander bend, where a flood barb develops at the seaward side of the bend. Multiannual observation revealed that tidal channels migrate from up to 80 m per year in the lower intertidal zone of open-coast sandy tidal flats to nearly stationary for several years in the upper intertidal zone of protected muddy tidal flats. Migration rates are temporarily pronounced during the summer monsoon, when heavy rainfall-induced surface runoff intensifies ebb tidal asymmetry and promotes headward erosion. Meander bends are mostly landward-skewed and shift downstream, implying that ebb currents primarily drive the long-term channel morphodynamics. Tidal point bars commonly display ebbward dipping, inclined heterolithic stratification (IHS) dominated by bedforms formed by subordinate flood tidal currents. An overall ebb dominance and mutually evasive current patterns account for the counterintuitive stratigraphic architecture of point bars in Korean tidal channels.
Prostanoids in Cardiac and Vascular Remodeling
Authors: Ricciotti Emanuela , Haines Philip G. , Chai William , FitzGerald Garret A. 
Published: January 2024

Prostanoids are biologically active lipids generated from arachidonic acid by the action of the COX (cyclooxygenase) isozymes. NSAIDs, which reduce the biosynthesis of prostanoids by inhibiting COX activity, are effective anti-inflammatory, antipyretic, and analgesic drugs. However, their use is limited by cardiovascular adverse effects, including myocardial infarction, stroke, hypertension, and heart failure. While it is well established that NSAIDs increase the risk of atherothrombotic events and hypertension by suppressing vasoprotective prostanoids, less is known about the link between NSAIDs and heart failure risk. Current evidence indicates that NSAIDs may increase the risk for heart failure by promoting adverse myocardial and vascular remodeling. Indeed, prostanoids play an important role in modulating structural and functional changes occurring in the myocardium and in the vasculature in response to physiological and pathological stimuli.
This review will summarize current knowledge of the role of the different prostanoids in myocardial and vascular remodeling and explore how maladaptive remodeling can be counteracted by targeting specific prostanoids.
Detection of respiration-induced field modulations in fMRI: A concurrent and navigator-free approach
Authors: Jaffray Alexander , Kames Christian , Medina Michelle , Graf Christina , Clansey Adam , Rauscher Alexander 
Published: January 2024

Abstract
Functional Magnetic Resonance Imaging (fMRI) is typically acquired using gradient-echo sequences with a long echo time at high temporal resolution. Gradient-echo sequences inherently encode information about the magnetic field in the often discarded image phase. We demonstrate a method for processing the phase of reconstructed fMRI data to isolate temporal fluctuations in the harmonic fields associated with respiration by solving a blind source separation problem. The fMRI-derived field fluctuations are shown to be in strong agreement with breathing belt data acquired during the same scan. This work presents a concurrent, hardware-free measurement of respiration-induced field fluctuations, providing a respiratory regressor for fMRI analysis which is independent of local contrast changes, and with potential applications in image reconstruction and fMRI analysis.
How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?
Authors: Pound Megan , Massey Heather , Roseneil Sasha , Williamson Ruth , Harper C Mark , Tipton Mike , Shawe Jill , Felton Malika , Harper Joyce C 
Published: January 2024

Objective This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms. Study design An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed. Main outcome measures Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms. Results 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement. Conclusion Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings.
RETRACTED ARTICLE: Tumor microenvironment and immune system preservation in early-stage breast cancer: routes for early recurrence after mastectomy and treatment for lobular and ductal forms of disease
Authors: Saad Hassan A. , Baz Azza , Riad Mohamed , Eraky Mohamed E. , El-Taher Ahmed , Farid Mohamed I. , Sharaf Khaled , Said Huda E. M. , Ibrahim Lotfy A. 
Published: January 2024

Abstract
Background
Intra-ductal cancer (IDC) is the most common type of breast cancer, with intra-lobular cancer (ILC) coming in second. Surgery is the primary treatment for early stage breast cancer. There are now irrefutable data demonstrating that the immune context of breast tumors can influence growth and metastasis. Adjuvant chemotherapy may be administered in patients who are at a high risk of recurrence. Our goal was to identify the processes underlying both types of early local recurrences.

Methods
This was a case-control observational study. Within 2 years of receiving adjuvant taxan and anthracycline-based chemotherapy, as well as modified radical mastectomy (MRM), early stage IDC and ILC recurred. Vimentin, α-smooth muscle actin (SMA), platelet-derived growth factor (PDGF), matrix metalloproteinase (MMP1), and clustered differentiation (CD95) were investigated.

Results
Of the samples in the ductal type group, 25 showed local recurrence, and 25 did not. Six individuals in the lobular-type group did not experience recurrence, whereas seven did. Vimentin (p = 0.000 and 0.021), PDGF (p = 0.000 and 0.002), and CD95 (p = 0.000 and 0.045) expressions were significantly different in ductal and lobular carcinoma types, respectively. Measurement of ductal type was the sole significant difference found in MMP1 (p = 0.000) and α-SMA (p = 0.000). α-SMA and CD95 were two variables that helped the recurrence mechanism in the ductal type according to the pathway analysis. In contrast, the CD95 route is a recurrent mechanism for the lobular form.

Conclusions
While the immune system plays a larger role in ILC, the tumor microenvironment and immune system both influence the recurrence of IDC. According to this study, improving the immune system may be a viable cancer treatment option.
Genomic and cytogenetic analyses reveal satellite repeat signature in allotetraploid okra (Abelmoschus esculentus)
Authors: Liu Jiarui , Lin Xinyi , Wang Xiaojie , Feng Liqing , Zhu Shixin , Tian Runmeng , Fang Jingping , Tao Aifen , Fang Pingping , Qi Jianmin , Zhang Liwu , Huang Yongji , Xu Jiantang 
Published: January 2024

Abstract
Background
Satellite repeats are one of the most rapidly evolving components in eukaryotic genomes and play vital roles in genome regulation, genome evolution, and speciation. As a consequence, the composition, abundance and chromosome distribution of satellite repeats often exhibit variability across various species, genome, and even individual chromosomes. However, we know little about the satellite repeat evolution in allopolyploid genomes.

Results
In this study, we investigated the satellite repeat signature in five okra (Abelmoschus esculentus) accessions using genomic and cytogenetic methods. In each of the five accessions, we identified eight satellite repeats, which exhibited a significant level of intraspecific conservation. Through fluorescence in situ hybridization (FISH) experiments, we observed that the satellite repeats generated multiple signals and exhibited variations in copy number across chromosomes. Intriguingly, we found that five satellite repeats were interspersed with centromeric retrotransposons, signifying their involvement in centromeric satellite repeat identity. We confirmed subgenome-biased amplification patterns of these satellite repeats through existing genome assemblies or dual-color FISH, indicating their distinct dynamic evolution in the allotetraploid okra subgenome. Moreover, we observed the presence of multiple chromosomes harboring the 35 S rDNA loci, alongside another chromosomal pair carrying the 5 S rDNA loci in okra using FISH assay. Remarkably, the intensity of 35 S rDNA hybridization signals varied among chromosomes, with the signals predominantly localized within regions of relatively weak DAPI staining, associated with GC-rich heterochromatin regions. Finally, we observed a similar localization pattern between 35 S rDNA and three satellite repeats with high GC content and confirmed their origin in the intergenic spacer region of the 35 S rDNA.

Conclusions
Our findings uncover a unique satellite repeat signature in the allotetraploid okra, contributing to our understanding of the composition, abundance, and chromosomal distribution of satellite repeats in allopolyploid genomes, further enriching our understanding of their evolutionary dynamics in complex allopolyploid genomes.
Factors associated with serious abdominal conditions in geriatric patients visiting the emergency department
Authors: Dadeh Ar-aishah , Uppakarnnuntakul Wasitthee 
Published: January 2024

Abstract
Background
Abdominal pain occurs in 20% of geriatric patients who visit the emergency department (ED). Geriatric patients usually have more severe conditions and a higher mortality rate. We aimed to determine the factors associated with serious abdominal conditions in geriatric patients who visit the ED with abdominal pain.

Methods
This retrospective cohort study was conducted from January 1, 2017 to June 30, 2021. The inclusion criteria were patients aged ≥ 65 years and presented at the ED with acute abdominal pain. Significantly associated factors for serious abdominal conditions were examined using univariate and multivariate logistic regression analyses.

Results
A total of 1221 patients were included in this study. Multivariate logistic regression analysis showed that the significant factors associated with serious abdominal conditions were male (adjusted odds ratio [AOR] 2.29, 95% CI:1.3–4.04; p = 0.004), anorexia (AOR 2.16, 95% CI:1.08–4.32; p = 0.03), NEWS 5–6 (AOR 2.96, 95% CI:1.35–6.49; p = 0.007), SBP 100–125 mmHg (AOR 1.5, 95% CI:0.75–2.99; p ≤ 0.001), guarding (AOR 6.92, 95% CI:3.39–14.12; p ≤ 0.001), WBC ≥ 14,000 cells/mm3 (AOR 2.08, 95% CI:1.06–4.09; p = 0.034), ED length of stay (EDLOS) 4–8 h (AOR 2.17, 95% CI:1.08–4.36; p = 0.03), and EDLOS ≥ 8 h (AOR 3.22, 95% CI:1.15–9; p = 0.025).

Conclusions
The statistically significant factors associated with serious abdominal conditions in geriatric patients were male, anorexia, NEWS 5–6, SBP 100–125 mmHg, guarding, WBC ≥ 14,000 cells/mm3, EDLOS 4–8 h, and EDLOS ≥ 8 h.
Place of care in the last three years of life for Medicare beneficiaries
Authors: Lin Haiqun , Grafova Irina B. , Zafar Anum , Setoguchi Soko , Roy Jason , Kobylarz Fred A. , Halm Ethan A. , Jarrín Olga F. 
Published: January 2024

Abstract
Background
Most older adults prefer aging in place; however, patients with advanced illness often need institutional care. Understanding place of care trajectory patterns may inform patient-centered care planning and health policy decisions. The purpose of this study was to characterize place of care trajectories during the last three years of life.

Methods
Linked administrative, claims, and assessment data were analyzed for a 10% random sample cohort of US Medicare beneficiaries who died in 2018, aged fifty or older, and continuously enrolled in Medicare during their last five years of life. A group-based trajectory modeling approach was used to classify beneficiaries based on the proportion of days of institutional care (hospital inpatient or skilled nursing facility) and skilled home care (home health care and home hospice) used in each quarter of the last three years of life. Associations between group membership and sociodemographic and clinical predictors were evaluated.

Results
The analytic cohort included 199,828 Medicare beneficiaries. Nine place of care trajectory groups were identified, which were categorized into three clusters: home, skilled home care, and institutional care. Over half (59%) of the beneficiaries were in the home cluster, spending their last three years mostly at home, with skilled home care and institutional care use concentrated in the final quarter of life. One-quarter (27%) of beneficiaries were in the skilled home care cluster, with heavy use of skilled home health care and home hospice; the remaining 14% were in the institutional cluster, with heavy use of nursing home and inpatient care. Factors associated with both the skilled home care and institutional care clusters were female sex, Black race, a diagnosis of dementia, and Medicaid insurance. Extended use of skilled home care was more prevalent in southern states, and extended institutional care was more prevalent in midwestern states.

Conclusions
This study identified distinct patterns of place of care trajectories that varied in the timing and duration of institutional and skilled home care use during the last three years of life. Clinical, socioregional, and health policy factors influenced where patients received care. Our findings can help to inform personal and societal care planning.