bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding low acuity emergency department presentations in infancy: A cohort study
Authors: Mahmood Areeb‐Ud‐Deen , Adily Pejman , Francis Stephanie , Eastwood John , Bein Kendall , Chakar Bashir A , Montgomery Alicia 
Published: January 2024

AbstractObjectiveLow acuity presentations (LAPs) contribute to large numbers of ED presentations and carry numerous consequences. The present study sought to improve the understanding of regional infant LAPs by analysing temporal patterns of presentation, discharge diagnoses and potential predictive factors.MethodsThis retrospective observational study examined ED presentations among children less than 12 months old (infants) to the Royal Prince Alfred Hospital between 2017 and 2019. Descriptive statistics were used to identify temporal patterns of presentation and common discharge diagnoses among LAPs. Multivariable logistic regression was used to determine the association between early life, demographic and perinatal factors and low acuity presenters.ResultsOf 6881 infant ED presentations, 19.8% were LAPs, occurring disproportionately on weekdays (82.2%) and during hours of 08.00–17.00 (69.9%). Respiratory tract infections and gastrointestinal complaints were most common overall, though non‐allergic rash, feeding difficulties, eczema and developmental concerns contributed substantially among LAPs. Socio‐economic status (SES) (odds ratio [OR] 1.71), overseas maternal nationality (OR 1.25) and Medicare ineligible maternal financial class (OR 0.49) were associated with low acuity presenters. Low appearance, pulse, grimace, activity and respiration score (OR 3.53), low SES (OR 3.26), complicated delivery (OR 1.64), maternal multiparity (OR 0.50), maternal partner presence (OR 0.40) and obstetric complications (OR 0.37) were associated with repeat, multi‐low acuity presenters (multi‐LAPs).ConclusionA substantial minority of infant ED presentations are LAPs. Targeted interventions may benefit from focusing on families with a background of socioeconomic disadvantage, social isolation, cultural and linguistic diversity and perinatal complications, with a view to strengthening engagement with community‐based services among these groups.
Flexibility for equality: Examining the impact of flexible working time arrangements on women's convergence in working hours
Authors: Maraziotis Filippos 
Published: January 2024

AbstractDespite the rise in women's education and their increased participation in the workforce, there is still a lack of gender convergence in working hours. This study explores how flexible working time arrangements (FWTA) affect the convergence of women's working hours to those of men with similar job‐related characteristics. Using the German Socio‐Economic Panel and innovative methods to address endogeneity, the analysis suggests that FWTA, compared to fixed schedules, positively influence women's convergence. This is particularly pronounced among those working full‐time, the more educated, and those aged between 30 and 45. Transitioning to FWTA is associated with increased overtime and childcare hours but it is not related to more housework.
Risk factors for renal dysfunction after isolated intestinal transplantation
Authors: von Ahrens Dagny , Santeusanio Andrew D. , Weinberg Alan D. , Moon Jang , Iyer Kishore R. 
Published: January 2024

AbstractIntroductionKidney dysfunction is a known complication of intestinal transplantation; however, the rate of development and risk factors for chronic kidney disease (CKD) remain poorly defined.MethodsThis was a single‐center retrospective review of isolated adult intestinal allograft recipients from 2011 to 2019. Patients who died or experienced graft loss within 1‐year or had a prior transplant were excluded. Estimated glomerular filtration rate (eGFR) was calculated using the CKD‐EPI equation at 0‐, 6‐ and 12‐months post‐transplant, and multivariable linear regression was performed to identify variables associated with adjusted eGFR at 1‐year. Independent variables included age, ethnicity, BMI, history of diabetes/hypertension, vasopressor use, TPN and stoma days, urinary or bloodstream infections, intravenous contrast exposure, rejection, concomitant immunosuppression, and time above the therapeutic range of tacrolimus. Variables with a p < .1 in univariate analysis were considered for multivariable modeling.ResultsThirty‐three patients were included with a mean age of 43.9 ± 13.0. A mean 42.3% decline in eGFR was observed at 1‐year post‐transplant, with 15.2% of patients developing new stage 4/5 CKD. Factors associated with a greater decline in adjusted eGFR in the univariate model included increasing age, decreased BMI, stoma days, and vasopressor use. In the adjusted multivariable model patient age (β = –.77, p < .01) and stoma days (β = –.06, p < .01) remained significant. Tacrolimus and sirolimus exposure were not associated with decline in eGFR at 1 year.ConclusionsRenal dysfunction is common following intestinal transplantation. The need for stoma creation should be carefully considered, and reversal should be performed when feasible for renal protection.
Kidney transplantation using ipsilateral arterial and contralateral venous anastomosis in a patient with failing vascular access
Authors: Hogan Donnacha , Norton Sarah Marie , Davis Niall Francis , Mohan Ponnusamy 
Published: January 2024

AbstractHerein, we describe our surgical technique and outcome of a kidney transplant in a patient with failing vascular access. A right donor kidney was transplanted into the right iliac fossa with an end‐to‐side arterial anastomosis to the ipsilateral right common iliac artery and end‐to‐side venous anastomosis to the contralateral left common iliac vein. The possibility of performing an ipsilateral arterial and contralateral venous anastomosis has been shown here to be successful. No post‐operative surgical complications were encountered.
Fatigue responses of metallic glass‐based stochastic network nanomaterial: Superior strain‐hardening ability
Authors: Zhang Yuhang , Li Jiejie , Hu Yiqun , Ding Suhang , Wu Wenwang , Xia Re 
Published: January 2024

AbstractEngineering materials commonly suffer from cumulative and irreversible damage during cyclic deformation, leading to fatigue failure. Developing materials with better fatigue resistance is imperative. This work reports a metallic glass network nanomaterial that possesses superior strain‐hardening ability. After a certain number of fatigue tests, the peak stress of the nanomaterial can even be up to four times its original value. This superior strain‐hardening ability originates from the unique plastic mechanism. During cyclic deformation, localized shear transformation zones form and develop, especially in the stress concentration regions. Ligaments crosslinked to these regions cannot sustain their original configurations and contract toward these plastic hinges, resulting in the collapse and coalescence of voids. This densification enhances the engineering stress during each cycle. The fatigue features can be altered by adjusting the cyclic frequency. Stronger strain‐hardening ability can be achieved at lower cyclic frequencies.
Fine sediment and the insecticide chlorantraniliprole inhibit organic‐matter decomposition in streams through different pathways
Authors: Mack Leoni , Buchner Dominik , Brasseur Marie V. , Kaijser Willem , Leese Florian , Piggott Jeremy J. , Tiegs Scott D. , Hering Daniel 
Published: January 2024

Abstract

Intensive agriculture drives an ongoing deterioration of stream biodiversity and ecosystem functioning across the planet. Key agricultural stressors include increased deposited fine sediment and insecticides flushed from adjacent land into streams. The individual and combined effects on aquatic biota are increasingly studied, but the functional consequences of biodiversity loss associated with agricultural stressors remain poorly understood. We addressed this knowledge gap by examining the effects of fine sediment and different concentrations of the insecticide chlorantraniliprole on organic‐matter decomposition.

We conducted an outdoor stream mesocosm experiment. Mesocosms contained a standardised organic‐matter assay (the cotton‐strip assay), which was used to assess organic‐matter decomposition rates (as tensile‐strength loss of the fabric) and microbial respiration of the cotton strips.

The decomposition rate of strips buried under fine sediment was inhibited, a result we attribute to the limited accessibility for invertebrate feeding and microbial activities, as well as the limited nutrient and dissolved oxygen exchange. The insecticide also inhibited decay rates, a finding we relate to reduced invertebrate grazing and associated excessive algal growth. In contrast to decomposition rates, we did not observe stressor effects on microbial respiration. An interaction between fine sediment and chlorantraniliprole was not identified.

Our results suggest that stressors induced by agriculture affect functions of stream ecosystems through a variety of pathways and operate by modifying habitats and biotic interactions.

By examining a combination of stressors and responses that have not been addressed before, this study gives important insights into the effects of agricultural practices on streams. Understanding the effects of chlorantraniliprole is especially important since it is likely to become more widely used in future agricultural practice due to the increasing ban on neonicotinoid insecticides. Furthermore, most experimental studies address multiple stressor effects on biota. For a comprehensive understanding of complex stressor effects on ecosystems, ecosystem functions also need to be studied, such as the organic‐matter decomposition within streams.
Relationship between mortality and vitality in patients with mild cognitive impairment/dementia: An 8‐year retrospective study
Authors: Kuroda Yujiro , Sugimoto Taiki , Satoh Kenichi , Nakagawa Takeshi , Saito Tami , Noguchi Taiji , Komatsu Ayane , Uchida Kazuaki , Fujita Kosuke , Ono Rei , Arai Hidenori , Sakurai Takashi 
Published: January 2024

AimThe study aimed to investigate the association of vitality, as measured using the vitality index (Vix), with the survival outcomes of older adults with mild cognitive impairment (MCI) or dementia.MethodsWe analyzed data from 3731 patients in the National Center for Geriatrics and Gerontology – Life Stories of Individuals with Dementia cohort from July 2010 to September 2018. The main focus was to correlate Vix scores with the time from the initial visit to death. Vix was categorized into “moderately to severely impaired” (0–7 points), “mildly impaired” (8–9 points), and “normal” (10 points) groups. Survival outcomes were assessed using a Cox proportional hazards model, adjusted for various factors. We conducted a mediation analysis to evaluate the effect of body mass index (BMI), instrumental activities of daily living (IADL), and basic activities of daily living (BADL) on the association between vitality and mortality. Stratified analysis was also conducted for the Mini‐Mental State Examination groups.ResultsWe included 2740 patients with an average follow‐up of 1315 days. The mortality rate was 15.7%. The Vix distribution was 16% at 0–7 points; 40%, 8–9 points; and 44%, 10 points. Patients in the “moderately to severely impaired” category, characterized by lower Vix scores, exhibited notably higher mortality rates. Mediation effects emphasized the significant roles of BMI, IADL, and BADL in influencing survival outcomes.ConclusionsVitality significantly influences patient survival rates. The association between vitality and mortality seems to be mediated by IADL and BADL, which has significant clinical implications. Geriatr Gerontol Int 2024; 24: 221–228.
Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel
Authors: Laffan Mike , McLaughlin Paul , Motwani Jayashree , Alamelu Jayanthi , Austin Steve , Classey Stephen , Dolan Gerard , Eales Marie , Gooding Richard , Grainger John , Harrison Catherine , Jones April , Kelly Anne M. , Oyesiku Lara , Rodgers Ryan , Stephensen David , Talks Kate , Sonecha Shaneil , Danquah Andrew 
Published: January 2024

AbstractAimFor people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia‐related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript.MethodsFifteen HCPs experienced in the management of PwHA in the UK participated in a three‐round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert‐scale questions, and ≥70% selecting the same option for multiple‐ or single‐choice questions. Questions not reaching consensus were revised for the next round.Results26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20–30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50–150 IU/dL) FVIII levels.ConclusionThe panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs.
Evaluating patient participation in value‐based healthcare: Current state and lessons learned
Authors: Westerink Henrike J. , Garvelink Mirjam M. , van Uden‐Kraan Cornelia F. , Zouitni Ouisam , Bart Hans A. J. , van der Wees Philip J. , van der Nat Paul B. ,   the Santeon Patient Participation Study Group
Published: January 2024

AbstractIntroductionValue‐based healthcare (VBHC) focusses on increasing value for patients. Hospitals aim to implement VBHC via value improvement (VI) teams for medical conditions. To determine the patient's perspective on value, collective patient participation is important in these teams. We therefore evaluated the current state of patient participation in VI teams and share lessons learned.MethodsThis mixed‐methods study was conducted at seven collaborating hospitals in the Netherlands. A questionnaire (the public and patient engagement evaluation tool) was tailored to the study's context, completed by VI team members (n = 147 from 76 different VI teams) and analysed with descriptive statistics. In addition, 30 semistructured interviews were held with VI team members and analysed through thematic analysis. Data were collected between February 2022 and January 2023 and were triangulated by mapping the quantitative results to the interview themes.ResultsThirty‐eight of the 76 included VI teams reported using a form of patient participation. Many respondents (71%) indicated a lack of a clear strategy and goal for patient participation. Multiple VI team members believed that specific knowledge and skills are required for patients to participate in a VI team, but this led to concerns regarding the representativeness of participating patients. Furthermore, while patients indicated that they experienced some level of hierarchy, they also stated that they did not feel restricted hereby. Lastly, patients were satisfied with their participation and felt like equal VI team members (100%), but they did mention a lack of feedback from the VI team on their input.ConclusionThe results imply the lack of full implementation of patient participation within VI teams. Guidelines should be developed that provide information on how to include a representative group of patients, which methods to use, how to evaluate the impact of patient participation, and how to give feedback to participating patients.Patient and Public ContributionTwo patient advisors were part of the research team and attended the research team meetings. They were involved as research partners in all phases of the study, including drafting the protocol (e.g., drafting interview guides and selecting the measurement instrument), interpreting the results and writing this article.
Association between triglyceride glucose index and depression in hypertensive population
Authors: Zhang Xin , Zhao Dan , Guo Shanshan , Yang Jie , Liu Yang 
Published: January 2024

AbstractGrowing evidence suggests that hypertensive individuals have a greater risk of developing depression, and depression can also increase the incidence of hypertension. In the hypertensive population, the association between triglyceride glucose (TyG) index and depression remains unclear. This study aimed to assess the association between TyG index and depression in hypertensive people through the cross‐sectional study of the National Health and Nutrition Examination Survey (2007–2018). To assess the relationship between TyG index and depression in hypertensive population, we conducted weighted multiple logistic regression models and used a generalized additive model to probe for nonlinear correlations. In addition, we employed a recursive algorithm to determine the inflection point and established a two‐piece linear regression model. This study enrolled 5897 individuals. In the model adjusted for all covariates, the ORs (95% CI) for the relationship between TyG index and depression in hypertensive population were 1.32 (1.12–1.54). A nonlinear association was found between TyG index and depression, with an inflection point at 8.7. After the inflection point, the ORs (95% CI) were 1.44 (1.15–1.79). Only the interaction with the obese population was statistically significant. Our study highlighted a nonlinear association between TyG index and depression in American hypertensive adults.
Improving dose‐related adverse drug events among hospitalized older adults using a geriatric prescribing context
Authors: De Lima Bryanna , Nohner Mitchell , Drago Kathleen 
Published: January 2024

AbstractBackgroundAdverse drug events (ADEs) during hospitalization are a serious, yet preventable concern for older adults. Our institution designed a Geriatric Prescribing Context (GPC) to adjust doses for the older adult population but its impact on ADEs was unknown. The goal of this study was to assess any differences in rates of ADEs before and after its implementation in July 2017.MethodsWe used relevant ICD‐10 codes followed by confirmatory chart review to identify dose‐related ADEs from 10 commonly used medications at our institution. We assessed differences in the number of admissions with an ADE before and after the GPC implementation using a test of binomial proportions. The pre‐period was from July 2016 through June 2017 and the post‐period was from August 2017 through July 2018. We compared the rate of ADEs per 1000 patient days between periods with a Poisson rate test and further examined any differences in harm categories using a Fisher's exact test.ResultsThe proportion of admissions with any dose‐related ADEs significantly decreased from 0.0082 to 0.0037 after the GPC (p = 0.04). The rate of dose‐related ADEs also declined from 2.5 per 1000 patient days to 1.1 per 1000 patient days (p = 0.001). Harm categories did not change significantly between time points (p = 0.30).ConclusionsBased on our list of relevant ICD‐10 codes, the GPC was associated with lower dose‐related ADEs for our selected medications among hospitalized older adults.
The association of nursing home infection preventionists' training and credentialing with residentCOVID19 deaths
Authors: Kang Jung A. , Stone Patricia W. , Glance Laurent G. , Dick Andrew W. 
Published: January 2024

AbstractBackgroundNursing home (NH) residents' vulnerability to COVID‐19 underscores the importance of infection preventionists (IPs) within NHs. Our study aimed to determine whether training and credentialing of NH IPs were associated with resident COVID‐19 deaths.MethodsThis retrospective observational study utilized data from the Centers for Disease Control and Prevention's National Healthcare Safety Network NH COVID‐19 Module and USAFacts, from May 2020 to February 2021, linked to a 2018 national NH survey. We categorized IP personnel training and credentialing into four groups: (1) LPN without training; (2) RN/advanced clinician without training; (3) LPN with training; and (4) RN/advanced clinician with training. Multivariable linear regression models of facility‐level weekly deaths per 1000 residents as a function of facility characteristics, and county‐level COVID‐19 burden (i.e., weekly cases or deaths per 10,000 population) were estimated.ResultsOur study included 857 NHs (weightedn = 14,840) across 489 counties and 50 states. Most NHs had over 100 beds, were for profit, part of chain organizations, and located in urban areas. Approximately 53% of NH IPs had infection control training and 82% were RNs/advanced clinicians. Compared with NHs employing IPs who were LPNs without training, NHs employing IPs who were RNs/advanced clinicians without training had lower weekly COVID‐19 death rates (−1.04 deaths per 1000 residents; 95% CI −1.90, −0.18), and NHs employing IPs who were LPNs with training had lower COVID‐19 death rates (−1.09 deaths per 1000 residents; 95% CI −2.07, −0.11) in adjusted models.ConclusionsNHs with LPN IPs without training in infection control had higher death rates than NHs with LPN IPs with training in infection control, or NHs with RN/advanced clinicians in the IP role, regardless of IP training. IP training of RN/advanced clinician IPs was not associated with death rates. These findings suggest that efforts to standardize and improve IP training may be warranted.
Loneliness in older primary care patients and its relationship to physical and mental health‐related quality of life
Authors: Williams‐Farrelly Monica M. , Schroeder Matthew W. , Li Claudia , Perkins Anthony J. , Bakas Tamilyn , Head Katharine J. , Boustani Malaz , Fowler Nicole R. 
Published: January 2024

AbstractBackgroundLoneliness is a significant public health challenge in the United States, especially among older adults. The epidemiology of loneliness among older adults in primary care is lacking, and specific research is needed on how loneliness impacts older primary patients' physical, mental, and cognitive health. A large sample of older primary care patients were recruited for a trial during the COVID‐19 pandemic to measure the relationship between loneliness and physical and mental quality of life (QOL).MethodsBaseline data come from the Caregiver Outcomes of Alzheimer's Disease Screening (COADS) study, an ongoing randomized controlled trial evaluating benefits and risks of Alzheimer's disease and related dementias screening among primary care patients ages 65 and older, collected April 2020 to September 2021. Loneliness was measured with the 5‐item, Loneliness Fixed Form Ages 18+ from The NIH Toolbox Emotion Battery, physical and mental health‐related QOL was measured with the SF‐36v2, and depression and anxiety severity were measured with the PHQ‐9 and GAD‐7, respectively.ResultsSpearman correlation analyses revealed that loneliness was moderately correlated with mental health QOL (r[601] = −0.43, p < 0.001), anxiety severity (r[601] = 0.44, p < 0.001), and depression severity (r[601] = 0.42, p < 0.001), while weakly correlated with physical health QOL (r[601] = −0.15, p < 0.001). After conducting unadjusted and adjusted linear regression models, we found that loneliness was significantly associated with both lower mental (p < 0.001) and physical (p < 0.001) QOL. Furthermore, loneliness remained significantly associated with worse mental QOL after adjusting for age, gender, race, ethnicity, educational level, perceived income status, neighborhood disadvantage, severity of comorbidities, and comorbid depression and anxiety.ConclusionPrimary care providers should discuss loneliness with their older adult patients and provide resources to help patients develop and maintain meaningful social relationships.