bluuebunny/crossref_metadata_2025_split huggingface dataset:
2535 Anticoagulation in atrial fibrillation
Authors: Saeed M 
Published: January 2025

Abstract

Introduction
A Clinical Audit was recommended by the ME following identification of potential safety signal because of possible non-compliance with guidelines on Anticoagulation in AF. The audit data collection tool was developed in discussion with the Chief Pharmacist and took account of up-to-date prescribing guidance from the Integrated Commissioning Board (ICB).

Aim
of the audit was to identify if, as per NICE guidelines patients had:

Objectives
To ensure that patients with new diagnosis of atrial fibrillation are assessed for stroke and bleeding and involved in discussion regarding anticoagulation which is prescribed as per national recommendations.

Method
This local audit was carried out by analysis of both electronic and paper-based patient records using an Excel spreadsheet for analysis. Data was then analysed with the help of the Senior Clinical Effectiveness Advisor.

Results and highlighted risks
It was observed that in most cases (82%), patients were not made aware about the condition and associated risk of stroke due to underlying AF. They were also not involved in discussion regarding commencing lifelong anticoagulation, and not explained the benefits and risks of anticoagulation. Omittance/Ignorance of anticoagulation upon new diagnosis of AF hence increasing the risk of stroke with lethal consequences of preventable death in 21% of patients.

Recommendations and Conclusion
Formulation of ‘AF Anticoagulation Checklist’ (based on NICE guidelines) ensuring every patient with a new diagnosis of AF has a repeat ECG for confirmation of diagnosis, CHA2DS2-VASc and ORBIT scores for risk assessment, their renal functions and coagulation profile checked, followed by discussion with patient regarding results of risk assessment and risk vs benefit of anticoagulation.
2795 Using the dynamics of the frailty index to assess population health across different countries
Authors: Drijver-Headley S , Godin J , Rockwood K , Hanlon P 
Published: January 2025

Abstract

Background
Worldwide population ageing is motivating how to measure the health of ageing populations. One approach is to compare dynamics of frailty, assessed by the cumulative-deficit frailty index, across different populations. We aim to compare the frailty distribution, mortality risk, and change in frailty over time between 18 countries.

Methods
Using data from five harmonised international surveys (HRS, SHARE, ELSA, CHARLS and MHAS) we assessed frailty with a 40-item frailty index (baseline, 2-, 4- and 6-year follow-up), along with mortality status. We constructed separate regression models for participants with the fewest baseline health deficits (‘zero-state’—assessing ambient health of the population) and the rest of the population (‘non-zero-state’). Using logistic and negative binomial, respectively, we assessed the odds of mortality and the rate of deficit accumulation (i.e. change in frailty index) between countries, adjusted for baseline frailty, age, and sex.

Results
Highest baseline frailty, mortality risk, and the most rapid increases in frailty were observed in Mexico, followed by China. Differences in mortality risk and deficit accumulation were similar regardless of baseline frailty. Lowest mortality risk and the slowest rates of deficit accumulation were observed in Scandinavian countries and in Switzerland. Differences between Central/Southern European countries, USA and UK varied when comparing zero-state with non- zero-state models. For example, mortality rates and deficit accumulation were relatively lower among the healthiest subset of the USA (and to a lesser extent UK) population. However, when modelling those with some degree of baseline frailty, mortality and deficit accumulation in the USA were relatively higher compared to European countries.

Conclusion
Dynamics of the frailty index can provide insights into population-level differences in health across different settings. For some, but not all, countries, findings are sensitive to the degree of frailty present at baseline, which may reflect inequalities in healthcare provision or access.
2821 The feasibility of delivering evidence-based fall prevention exercise in the voluntary sector—a mixed methods study
Authors: Whitney J , Belderbos K , Boyd T 
Published: January 2025

Abstract

Introduction
Highly challenging, regular strength and balance exercise classes (SBE) reduces fall risk but there are few options for long-term continuation. SBE could be delivered by the voluntary sector, but care is needed to ensure good fidelity. The feasibility of delivering evidence-based SBE outside the governance of health services is unclear. A voluntary sector-led weekly SBE class ‘Strong and Steady (S&S)’, led by a level 4 qualified postural stability and funded via grants and fees, was set up in December 2022 alongside an existing community coffee morning.

Methods
Baseline measures and adherence were collected for all who commenced S&S. Two classes were observed using a standardised fidelity checklist. Interviews and focus groups were undertaken with class participants, a previous participant, the exercise instructor and lead volunteer.

Results
Since December 2022, 24 participants aged 59–95 (63% female) self-referred to S&S. Baseline measures, collected in 100% of assessments, (timed up and go, four-step balance scale and 60-second sit-to-stand) indicated performance slightly below age-matched norms with the exception of falls efficacy (FES-I). Three participants dropped out (1 died) and adherence was 67%. Fidelity in both observed classes was good (mean score 21/24). Four themes emerged from thematic analysis of all the interviews and focus groups:

Conclusion
Delivering SBE via the voluntary sector is feasible and can be delivered with good fidelity. The provision tends to attract people who have high levels of self-efficacy and motivation to exercise.
2671 A description of a patient navigator program for persons living with dementia in Canada
Authors: Jarrett P , MacNeil L , Luke A , Faig K , Gionet S , Doucet S 
Published: January 2025

Abstract

Introduction
Receiving a dementia diagnosis can be overwhelming for persons living with dementia (PLWD) and their carers. Accessing information and home supports can be challenging. Having access to a Patient Navigation (PN) program is one way that may assist PLWD and their carers.

Methods
This study used a mixed methods design and involved the implementation of a Patient Navigation (PN) program in 6 primary care settings in New Brunswick, Canada, between July 2022–July 2023. PLWD/carers living in their own homes were eligible to enrol.

Results
There were 150 PLWD with a mean age of 76.4 (SD = 9.4) years and 51.4% were male. The majority (60.7%) were living in rural communities. Most (50.7%) had been diagnosed within the past 2 years with 50.7% having seen a specialist, most commonly a geriatrician. Almost all (88.7%) had a primary care provider; however, only 25.2% were connected to the social care system, and 19.8% were connected to the home care system. The most common reasons for enrolling were gaining access to social programs and home supports and seeking dementia specific information. The average number of goals per PLWD/carer was 3.79 (SD = 1.7). The average time in the program was 121.7 days (SD = 100.0) and 76.6% achieved their goals. The majority (84.0%) were somewhat to very satisfied with the PN program. Carers stated that with increased knowledge, access, and support there was a decrease in social isolation as well as improved confidence, which allowed PLWD to remain in the community longer.

Conclusions
Most PLWD/carers were connected to the health system, but the minority were connected to social and home care programs. Through connection to the PN program, carers increased their confidence; improved their knowledge; and increased their access to home supports and other care programs, allowing PLWD to remain in the community longer.
2866 Clusters of multimorbidity and subjective cognitive decline (the ELSI-Brazil study)
Authors: Batista SRR , Leão NLG , Nogueira SCM , Melo SY , Silveira EA , Rodrigues RRD , Silva RR 
Published: January 2025

Abstract

Introduction
Subjective cognitive decline (SCD) is defined by cognitive complaints expressed by the individual, without evidence of cognitive impairment on objective neuropsychological tests. Studies have analysed SCD among patients with specific groups of diseases. An increased understanding of the association between disease patterns and subjective cognitive decline is essential to develop targeted interventions for these groups.

Method
Using data from the baseline of the Brazilian Longitudinal Study of Ageing (ELSI-Brazil), this cross-sectional study included 2508 participants. Subjective Cognitive Decline (SCD) was assessed using the Subjective Cognitive Decline Initiative Working Group’s criteria. Multimorbidity (MM) was defined as the presence of two or more of 14 self-reported health conditions. Clusters of MM were identified based on the most prevalent dyads and triads of diseases within the sample. Robust Poisson regression models were used to estimate adjusted prevalence ratios (PR) for the association between MM clusters and SCD, accounting for potential confounders.

Results
The following dyads of chronic conditions were associated with higher prevalence of SCD: ophthalmological problems/osteoporosis (RR: 1.497 p = 0.042), heart problems/stroke (RR: 2.33, p &lt; 0.001), and hypertension/asthma (RR: 3.309, p = 0.013). No triads had positive association with SCD, although the triads of ophthalmological problem/hypertension/osteoporosis (RR: 0.367, p &lt; 0.001) and hypertension/cardiac problems/dyslipidemia (RR: 0.545, p = 0.012) were negatively associated with the prevalence of SCD.

Conclusion
Our study demonstrated an association between SCD and MM clusters, which is important for developing and managing care for individuals with cognitive decline and/or those multimorbidity patterns. The results could also provide a foundation for future research exploring the causality between these variables.
2816 Decision-making experiences with older adults following a cancer diagnosis: a systematic review
Authors: Lewis L , Wagland R , Patel HP , Bridges J , Farrington N , Hunt K 
Published: January 2025

Abstract

Introduction
Little evidence exists about decision-making with older adults diagnosed with cancer (Bridges et al 2015). However, older age is associated with changes in physical, social, and psychological health domains in ways that influence treatment decisions potentially impacting on quality and quantity of life. We sought to explore the experiences of older adults, their significant others and healthcare professionals when decisions regarding cancer treatment and support are made.

Methods
Synonyms relating to search terms Cancer, Older People, Complexity and Qualitative research were used to search the databases CINAHL, Medline, Embase and PsychINFO. The Mixed Methods Appraisal Tool (MMAT) identified strengths and limitations of the evidence allowing concurrent appraisal of qualitative, quantitative, and mixed methods studies.

Results
Searches identified 534 articles: 37 studies underwent full text screening, and 15 of these were included. The synthesis identified six themes: Preconditions in decision-making; Identifying frailty and setting goals; Maintaining independence; Information provision; Support during the decision-making process/role distribution; Trust in physicians; Preferences and choice. Most included studies reported the views of the older person, or health care professionals (predominantly physicians/oncologists/surgeons). However, there is a paucity of evidence representing the views of the older adult’s significant other and a dearth of evidence exploring the efforts and contributions of all people involved in the process of decision-making.

Conclusions
Research is needed urgently to understand how and why decisions are made regarding cancer treatment and support, as well as how older adults are involved in these decisions throughout their cancer trajectory. Understanding this would assist healthcare professionals to prioritise individual’s healthcare preferences with the potential to positively influence service delivery and workforce development. This review has informed the research design for The CHOICES study which aims to understand how clinicians, older individuals and their significant others make decisions following a new diagnosis of cancer.
2815 Cross-cultural adaptation and psychometric properties of the Yoruba version of the clinical frailty scale
Authors: Adeniji T , Adebiyi ST , Okafor AC , Idowu O , Oyeyemi AY 
Published: January 2025

Abstract

Background
This cross-sectional study aimed to assess the socio-demographic, anthropometric, and patient characteristics of 94 Yoruba speakers aged 60 years and older, and to validate the Yoruba version of the Clinical Frailty Scale (CFS).

Methods
This study used a cross-sectional design with a purposive sampling technique and a sample size of 94 participants. This study also made use of the World Health Organisation methodologic guidelines on cultural adaptation of clinical scales. Convergent validity was assessed by evaluating the context that the Clinical frailty scale (CFS) relates to the Edmonton frailty scale, using the Spearman rank correlation coefficient. The known group validity was assessed using one-way ANOVA.

Results
The mean age of participants was 70.81 ± 8.11 years, with a mean BMI of 27.04 ± 5.61. The cohort included 38 males (44.4%) and 56 females (59.6%). Educational attainment varied, with 20.2% having no education and 9.6% holding postgraduate degrees. The validated CFS has excellent content validity (S-CVI/AVE = 0.96; S-CVI-UA = 0.78). Convergent validity demonstrated a moderate correlation between the CFS and the Edmonton Frail Scale (Spearman’s rho = 0.61, p &lt; 0.01). Known-group validity indicated significant associations between frailty, age (p = 0.02), and BMI (p = 0.007).

Conclusion
The Yoruba version of the CFS is a valid tool for assessing frailty in elderly Yoruba-speaking populations.
2799 Exploring the physiotherapy and exercise needs and preferences of nursing home residents with dementia: a qualitative study
Authors: Boer D , Nibbering R , Schmidt C , Sterke S , Sizoo E , Vlieland TV 
Published: January 2025

Abstract

Introduction
Functional decline and restricted mobility are common issues among nursing home residents with dementia, resulting in frequent use of physiotherapy services. While these residents can typically articulate their therapy needs and preferences, these have not been investigated properly regarding physiotherapy and exercise, which may compromise therapy adherence. This study aims to explore the needs and preferences of nursing home residents with mild to moderate dementia in relation to physiotherapy and exercise interventions.

Methods
Semi-structured individual interviews were conducted with 15 nursing home residents diagnosed with mild to moderate dementia, who could understand and speak Dutch and were capable of providing informed consent. Thematic analysis was used to analyse interview data.

Results
From the interviews a total of 82 unique codes were identified, leading to four major themes: preferences regarding physiotherapeutic treatment, differences between physiotherapy and other exercises, preferences for unsupervised exercise, and communication and involvement preferences. Overall, residents wanted physiotherapy that included exercise and advice aimed at maintaining physical functioning and independence. Many participants indicated that a physiotherapist was not always required to supervise exercises as long as safety and quality were ensured. While residents wanted their family caregivers to stay informed about their therapy, they mostly preferred to exercise with someone other than a family caregiver.

Conclusions
Residents emphasised the importance of a physiotherapist providing information and understanding, and noted that sessions could be supervised by others if quality and safety are maintained. While residents preferred regular updates to their family, they did not want to exercise with them. A future coaching role for physiotherapists to oversee exercise interventions could enhance healthcare cost efficiency.
2785 Protocol for a feasibility randomised controlled trial of the OUTDOOR mobility intervention for older adults after hip fracture
Authors: Sheehan KJ , Bastas D , Lyczmanenko A , Guerra S , Creanor S , Hulme C , Lamb S , Martin FC , Sackley C , Smith T , Bell P , Hillsdon M , Pope S , Cook H , Godfrey E 
Published: January 2025

Abstract

Introduction
A high proportion of patients do not regain outdoor mobility after hip-fracture. Rehabilitation explicitly targeting outdoor mobility is needed to enable older adults to resume activities that they value most. The aim of this study is to determine the feasibility of a randomised, controlled trial intended to assess the clinical and cost-effectiveness of an intervention enabling recovery of outdoor mobility post hip-fracture (the OUTDOOR intervention).

Method
OUTDOOR is a multi-centre, parallel group, randomised, controlled, feasibility trial. Adults 60 years and older, admitted to hospital and planned discharge to home; with self-reported outdoor mobility three-months pre-fracture, surgically treated for hip fracture, who are able to consent and participate, are eligible. Individuals requiring two or more people to support mobility upon discharge are excluded. Screening and consent (or consent to contact) will take place in hospital. Baseline assessment and randomisation will follow discharge. Participants will receive usual care (physiotherapy, occupational therapy), or usual care plus the OUTDOOR intervention. OUTDOOR intervention includes a goal-orientated outdoor mobility programme, therapist-led motivational dialogue supported by a past-patient led videos sharing recovery experiences; and support to transition to independent recovery. Therapists delivering the OUTDOOR intervention will receive training in motivational interviewing, and behaviour change techniques. Patient reported outcome measures—health-related quality of life, daily activities, pain, community mobility, falls related self-efficacy, resource use, and readmission; will be collected at baseline, 6-weeks, 12-weeks, and 6-months (if enrolled early in the trial) post-randomisation. Exercise adherence and intervention acceptability will be collected. Subset of 20 participants will support accelerometery data collection for 10 days at each time point.
Trial received approval from East of England—Essex Research Ethics Committee (REF: 23/EE/0246) and the Health Research Authority. Findings will be disseminated to patients, the public, health professionals and researchers through publications, presentations, and social media.
Trial registered at ISRCTN16147125.
Innate numerosity perception and its roots in early vision
Authors: Harvey Ben 
Published: January 2025

Abstract
In the current issue of Cerebral Cortex, Lorenzi et al. (2025) discuss evidence for an innate sense of object number (numerosity) in the brains of many species, without the need for visual experience. This commentary discusses how numerosity processing can be understood as an innate property of vision, derived from the spatial frequency-based representation of images in the visual systems of many animals.
Who is afraid of innate knowledge?
Authors: Berent Iris 
Published: January 2025

Abstract
The fascinating results of Lorenzi et al. (2025) suggest that the number sense is innate. Many readers might find this conclusion disturbing. Here, I explore the deep cognitive origins of this sentiment. Empiricism, I suggest, is deeply grounded in human nature. This conclusion obviously does not license us to assume that knowledge is innate, but it does suggest caution against heeding our skeptical gut reaction.
Clinical Features of Thiopurine-Induced Acute Pancreatitis: Comparison Between Patients With and Without Inflammatory Bowel Disease
Authors: Oizumi Tomofumi , Toya Yosuke , Yanai Shunichi , Matsumoto Takayuki 
Published: January 2025

Abstract

Background and Aims
Patients with inflammatory bowel disease (IBD) are at increased risk of developing acute pancreatitis (AP). Thiopurines (TP) are a well-known cause of AP. The aims of this study were to compare the incidence of AP and TP-induced AP (TIP) between patients with and without IBD under the use of TP and to assess for risk factors of TIP.

Methods
We examined a retrospective cohort of 664 patients treated with TP from 2016 to 2021 at our institution. AP was defined as pancreatitis confirmed by symptoms, serum tests, and radiology, and TIP as AP occurring shortly after starting TP and improving after withdrawal. We compared the incidence of AP and TIP between patients with and without IBD and reviewed the clinical features of TIP patients in detail.

Results
There were 366 IBD patients and 298 without IBD. IBD patients included 249 males (52.4%) with a median age of 39 years. Among them, 211 had ulcerative colitis (UC) and 155 had Crohn’s disease (CD). Azathioprine was administered to 560 patients, and 6-mercaptopurine to 104. AP occurred in 13 IBD patients but in none without IBD, with a significantly higher incidence in IBD patients (1.9% vs. 0%, P = .009). Seven of 13 patients with AP satisfied the criteria for TIP. Furthermore, 5 of the 7 TIP patients had a prior history of 5-aminosalicylic acid (5-ASA) intolerance.

Conclusions
TIP may be a condition specific to IBD. IBD patients with 5-ASA intolerance are prone to TIP.
Association between Life’s Essential 8 and risk of heart failure: findings from the Kailuan study
Authors: Liu Yang , Zhao Maoxiang , Jiang Jinguo , Peng Xinyi , Luo Donglei , Chen Shuohua , Wu Shouling , Qin Xueying 
Published: January 2025

Abstract

Aims
The impact of Life’s Essential 8 (LE8) on heart failure (HF) remains poorly understood. We examined the associations between three forms of LE8 measurements and HF.

Methods and results
A total of 35 896 participants without a prior history of HF from the Kailuan community were included. The LE8 status was measured in 2014. A latent mixture model was employed to identify the trajectories of LE8 during 2006 to 2014. The LE8 annual change rate was defined as the slope of the linear regression equation fitted by five LE8 measurements. Cox proportional hazards models were used to assess the risk of HF associated with LE8, after adjusting for potential confounding variables. The predictive performance was quantified and compared using the C-index. Five distinct LE8 trajectories were identified. 461 HF events documented during follow-up. The LE8 trajectories presenting an upward trend in LE8 were associated with a reduced risk of HF, even when the initial LE8 level was low [HR (95% confidence interval) for moderate-increasing vs. moderate-decreasing trajectory was 0.43 (0.34, 0.55)]. The LE8 status was inversely associated with HF risk. A higher LE8 annual increase was associated with a lower risk of HF. The LE8 trajectory was more accurate in predicting the risk of HF compared with LE8 status.

Conclusion
LE8 was inversely associated with HF risk. Individuals with initially low LE8 levels experienced a reversal in HF risk upon improvement. Both LE8 trajectories and status are practicable in identifying individuals at high risk of HF, LE8 trajectories may provide added prognostic information.