bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of intravascular ultrasound-guided percutaneous intervention in patients with acute coronary syndromes: a UK perspective
Authors: Sharp Andrew S P , Kinnaird Tim , Curzen Nick , Ayyub Ruba , Alfonso Jorge Emilio , Mamas Mamas A , Vanden Bavière Henri 
Published: December 2023

Abstract

Background
Use of intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI) is associated with improved clinical outcomes over angiography alone. Despite this, the adoption of IVUS in clinical practice remains low.

Aims
To examine the cost-effectiveness of IVUS-guided PCI compared to angiography alone in patients with acute coronary syndromes (ACS).

Methods and results
A 1-year decision tree and lifetime Markov model were constructed to compare the cost-effectiveness of IVUS-guided PCI to angiography alone for two hypothetical adult populations consisting of 1000 individuals: ST-elevation myocardial infarction (STEMI) and unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) patients undergoing drug-eluting stent (DES) implantation. The United Kingdom (UK) healthcare system perspective was applied using 2019/20 costs. All-cause death, myocardial infarction (MI), repeat PCI, lifetime costs, life expectancy, and quality-adjusted life-years (QALYs) were assessed. Over a lifetime horizon, IVUS-guided PCI was cost-effective compared to angiography alone in both populations, yielding an incremental cost-effectiveness ratio of £3649 and £5706 per-patient in STEMI and UA/NSTEMI patients, respectively.
In the 1-year time horizon, the model suggested that IVUS was associated with reductions in mortality, MI, and repeat PCI by 51%, 33%, and 52% in STEMI and by 50%, 29%, and 57% in UA/NSTEMI patients, respectively. Sensitivity analyses demonstrated the robustness of the model with IVUS being 100% cost-effective at a willingness to pay threshold of £20 000 per QALY-gained.

Conclusions
From a UK healthcare perspective, an IVUS-guided PCI strategy was highly cost-effective over angiography alone amongst ACS patients undergoing DES implantation due to the medium- and long-term reduction in repeat PCI, death, and MI.
Randomized double-blind placebo-controlled trial on levothyroxine and liothyronine combination therapy in totally thyroidectomized subjects: the LEVOLIO study
Authors: Brigante Giulia , Santi Daniele , Boselli Gisella , Margiotta Gianluca , Corleto Rossella , Monzani Maria Laura , Craparo Andrea , Locaso Michela , Sperduti Samantha , Roy Neena , Casarini Livio , Trenti Tommaso , Tagliavini Simonetta , De Santis Maria Cristina , Roli Laura , Rochira Vincenzo , Simoni Manuela 
Published: December 2023

Abstract

Objective
Despite having normal thyroid-stimulating hormone levels, many hypothyroid patients are dissatisfied with the treatment. The primary aim of this study was to evaluate the effect of twice-daily, combination therapy with levothyroxine (LT4) and liothyronine (LT3), at doses adapted according to TSH-level, on peripheral tissues as reflected by sex hormone binding globulin (SHBG) levels in totally thyroidectomized patients. Changes in other tissue markers and quality of life considering DIO2-rs225014 and MCT10-rs17606253 genetic variants were also assessed.

Design
Double-blind, randomized, placebo-controlled.

Methods
One hundred and forty-one subjects were randomized to LT4 + LT3 group (LT4 + LT3 in the morning and LT3 in the evening; n = 70) or placebo group (LT4 in the morning and placebo in the evening; n = 71). Pituitary-thyroid axis compensation was assessed after 6, 12, and 24 weeks. Clinical parameters, quality of life, and tissue markers (sex hormone binding globulin, serum lipids, bone markers) were evaluated at 12 and 24 weeks. DIO2 and MCT10 single nucleotide polymorphisms were genotyped.

Results
The LT4 + LT3 group was treated with mean daily LT3 doses of 5.00 µg, with a mean daily LT4 reduction of 15 µg. After 6 months of treatment, neither SHBG and other tissue markers nor quality of life differed significantly between groups. Combination treatment required greater dose adjustments than placebo (25% vs 54%, P &lt; .001), due to thyroid-stimulating hormone reduction, without hyperthyroidism signs or symptoms. At the end of treatment, the LT4 + placebo group had significantly lower fT3/fT4 compared to the LT4 + LT3 group (0.26 ± 0.05 vs 0.32 ± 0.08, P &lt; .001). No preference for combination therapy was found. Genetic variants did not influence any outcomes.

Conclusions
Six months of combination therapy with twice-daily LT3 dose adapted according to TSH-level do not significantly change peripheral tissue response or quality of life, despite an increase in the fT3/fT4 ratio.
Coronary artery calcium and the risk of cardiovascular events and mortality in younger adults: a meta-analysis
Authors: Haq Ayman , Veerati Tejaswi , Walser-Kuntz Evan , Aldujeli Ali , Tang Michael , Miedema Michael 
Published: December 2023

Abstract

Aims
American College of Cardiology/American Heart Association 2019 prevention guidelines recommend utilizing coronary artery calcium (CAC) to stratify cardiovascular risk in selected cases. However, data regarding CAC and risk in younger adults are less robust due to the lower prevalence of CAC and lower incidence of events. The objective of this meta-analysis is to determine the ability of CAC to predict the risk of cardiovascular events and mortality in adults &lt;50.

Methods and results
PubMed and Cochrane CENTRAL databases were electronically searched through May 2022 for studies with a primary prevention cohort under age 55 who underwent CAC scoring. Six observational studies with a total of 45 919 individuals with an average age of 43.1 and mean follow-up of 12.1 years were included. The presence of CAC was associated with an increased risk of adverse events [pooled hazard ratio (HR) = 1.80, 95% confidence interval (CI) 1.26–2.56, P = 0.012, I2 = 65.5]. Compared with a CAC of 0, a CAC of 1–100 did carry an increased risk of cardiovascular events (pooled HR = 1.85, 95% CI 1.08–3.16, P = 0.0248, I2 = 50.3), but not mortality (pooled HR = 1.20, 95% CI 0.85–1.69, P = 0.2917), while a CAC &gt; 100 did carry an increased risk of cardiovascular events (pooled HR = 6.57, 95% CI 3.23–13.36, P &lt; 0.0001, I2 = 72.6) and mortality (pooled HR = 2.91, 95% CI 2.23–3.80, P &lt; 0.0001).

Conclusion
In a meta-analysis of younger adults undergoing CAC scoring, a CAC of 1–100 was associated with a higher likelihood of cardiovascular events, while a CAC &gt; 100 was associated with a higher likelihood of cardiovascular events and mortality.
Prevalence, virulence characteristics, and antimicrobial resistance of Vibrio parahaemolyticus isolates from raw seafood in a province in Northern Thailand
Authors: Siriphap Achiraya , Prapasawat Watsawan , Borthong Jednipit , Tanomsridachchai Wimonrat , Muangnapoh Chonchanok , Suthienkul Orasa , Chonsin Kaknokrat 
Published: December 2023

Abstract
Vibrio parahaemolyticus (V. parahaemolyticus) is commonly found in seawater and seafood products, but evidence is limited of its presence in seafood marketed in locations very distant from coastal sources. This study determined the prevalence and characterization of V. parahaemolyticus in seafood from markets in landlocked Phayao province, Northern Thailand. Among 120 samples, 26 (21.7%) were positive for V. parahaemolyticus, being highest in shrimp (43.3%), followed by shellfish (36.7%), and squid (6.7%), but was not found in fish. V. parahaemolyticus comprised 33 isolates that were non-pathogenic and non-pandemic. Almost all isolates from shrimp and shellfish samples were positive for T3SS1. Only five isolates (15.2%) showed two antimicrobial resistance patterns, namely, kanamycin-streptomycin (1) carrying sul2 and ampicillin-kanamycin-streptomycin (4) that carried tetA (2), tetA-sul2 (1), as well as one negative. Antimicrobial susceptible V. parahaemolyticus isolates possessing tetA (67.9%) and sul2 (3.5%) were also found. Six isolates positive for integron class 1 and/or class 2 were detected in 4 antimicrobial susceptible and 2 resistant isolates. While pathogenic V. parahaemolyticus was not detected, contamination of antimicrobial resistance V. parahaemolyticus in seafood in locations distant from coastal areas requires ongoing monitoring to improve food safety in the seafood supply chain.
Agtrevirus phage AV101 recognizes four different O-antigens infecting diverse E. coli
Authors: Sørensen Anders Nørgaard , Kalmár Dorottya , Lutz Veronika Theresa , Klein-Sousa Victor , Taylor Nicholas M I , Sørensen Martine C , Brøndsted Lone 
Published: December 2023

Abstract
Bacteriophages in the Agtrevirus genus are known for expressing multiple tail spike proteins (TSPs), but little is known about their genetic diversity and host recognition apart from their ability to infect diverse Enterobacteriaceae species. Here, we aim to determine the genetic differences that may account for the diverse host ranges of Agrevirus phages. We performed comparative genomics of 14 Agtrevirus and identified only a few genetic differences including genes involved in nucleotide metabolism. Most notably was the diversity of the tsp gene cluster, specifically in the receptor-binding domains that were unique among most of the phages. We further characterized agtrevirus AV101 infecting nine diverse Extended Spectrum β-lactamase (ESBL) Escherichia coli and demonstrated that this phage encoded four unique TSPs among Agtrevirus. Purified TSPs formed translucent zones and inhibited AV101 infection of specific hosts, demonstrating that TSP1, TSP2, TSP3, and TSP4 recognize O8, O82, O153, and O159 O-antigens of E. coli, respectively. BLASTp analysis showed that the receptor-binding domain of TSP1, TSP2, TSP3, and TSP4 are similar to TSPs encoded by E. coli prophages and distant related virulent phages. Thus, Agtrevirus may have gained their receptor-binding domains by recombining with prophages or virulent phages. Overall, combining bioinformatic and biological data expands the understanding of TSP host recognition of Agtrevirus and give new insight into the origin and acquisition of receptor-binding domains of Ackermannviridae phages.
Supporting Mealtime Participation Among People Living With Dementia at Home: Challenges and Strategies for Caregivers
Authors: Juckett Lisa A , Howard Mequeil L , Fields Beth E , Jarrott Shannon E , Mion Lorraine C , Thomas Kali S 
Published: December 2023

Abstract

Background and Objectives
Approximately 60% of people living with dementia at home are unable to routinely participate in mealtime activities (e.g., eating, safe food preparation), warranting assistance to ensure people with dementia meet their health and nutritional needs. The purpose of this study was to characterize these barriers to mealtime participation and identify potential caregiver-led strategies to enhance mealtime activities.

Research Design and Methods
We used a qualitative descriptive approach and obtained semistructured interview data from (a) allied health professionals and (b) community-based nutrition program providers who frequently serve people with dementia. Interview data were examined by means of directed content analysis and framework methodology until data saturation was reached. Codes from our analysis were categorized according to constructs drawn from the Socio-Ecological Model for Developing and Implementing Comprehensive Dementia Care.

Results
Data were obtained from 20 participants who attributed common mealtime participation barriers to: impairments in functional status, cognitive status deficits, a lack of caregiver knowledge and skills, and unsafe living conditions. Caregiver-led strategies to overcome these barriers included: reducing auditory and visual distractions, providing written cues to perform mealtime activities, eliminating clutter and fall risk hazards, and leveraging community-based nutrition program providers (e.g., home-delivered meal providers).

Discussion and Implications
People with dementia face several eating and mealtime participation obstacles. Caregiver-led strategies implemented by family, friends, or community-based nutrition program providers may enhance mealtime activities at home. Findings point to opportunities to develop decision-making tools and resources for caregivers to optimize the health and nutrition of people with dementia.
Comparison of social determinants of health in Medicaid vs commercial health plans
Authors: Gibbons Jason Brian , Cram Peter , Meiselbach Mark K , Anderson Gerard F , Bai Ge 
Published: December 2023

Abstract
Incorporating the measurement of social determinants of health (SDOH) into health care practice and US health policy reforms is a promising approach to improving population health nationwide. One way health care practitioners have started to incorporate consideration of SDOH in clinical care is by using International Classification of Diseases, Tenth Revision (ICD-10), Z-codes, a set of diagnosis codes spanning a range of social and economic circumstances. Our study summarizes Z-codes used by code type, setting, and patient demographics between Medicaid and commercial insurance to help identify strategies to optimize their use within each program and understand their differences. Overall, Z-code use was highly limited nationwide in Medicaid and commercial insurance between 2020 and 2021. Still, we found notable differences in the use of Z-codes between the programs; Medicaid beneficiaries were more likely to receive Z-codes related to financial and economic issues, while commercially insured beneficiaries were more likely to receive Z-codes indicating problems with social and familial relationships. Policy efforts focused on increasing the rate and ease of patient SDOH screening will potentially expand SDOH measurement and facilitate actions to address patient social needs.
Conversion from off-pump to on-pump coronary artery bypass grafting: impact of surgeon and anaesthetist experience
Authors: Ntinopoulos Vasileios , Haeussler Achim , Odavic Dragan , Papadopoulos Nestoras , Rings Laura , Dushaj Stak , Rodriguez Cetina Biefer Hector , Dzemali Omer 
Published: December 2023

Abstract

OBJECTIVES
Intraoperative conversion from off-pump to on-pump coronary artery bypass grafting (CABG) is associated with increased postoperative morbidity and mortality. The aim of this study is to assess the impact of surgeon and anaesthetist experience on the conversion rate.

METHODS
We performed a retrospective analysis of the data of all patients who underwent planned off-pump CABG in a single centre in 2007–2021, some of whom were non-electively converted to on-pump. Surgeon and anaesthetist experience were assessed by the number of off-pump bypass procedures per year. Multivariable logistic regression analysis was used to assess the impact of surgeon and anaesthetist experience on conversion rate.

RESULTS
A total of 2742 patients met the inclusion criteria. Ninety-four (3.4%) patients underwent non-elective conversion to on-pump surgery. Converted patients had significantly higher mortality [11 (11.7%) vs 35 (1.3%), P &lt; 0.0001] in comparison to non-converted patients. Anaesthetist experience was found to be a risk factor for conversion (P = 0.011). Surgeon experience did not significantly affect conversion rate (P = 0.51). Other risk factors for conversion were female gender [odds ratio 2.65 (95% confidence interval 1.65–4.26), P = 0.0001] and left ventricular ejection fraction ≤35% [odds ratio 1.91 (95% confidence interval 1.05–3.49), P = 0.040].

CONCLUSIONS
Conversion from off-pump to on-pump CABG is associated with worse postoperative outcomes. Limited experience of anaesthetists in off-pump bypass surgery is associated with a higher conversion rate.
Penicillin allergy de-labelling by non-allergists: a comparison of testing protocols
Authors: Powell Neil , Elkhalifa Shuayb , Sandoe Jonathan 
Published: December 2023

AbstractOptimizing penicillin allergy de-labelling (PADL) to ensure patients with an incorrect penicillin allergy record are de-labelled with minimal patient harm is important for antibiotic stewardship. The heterogeneity of inclusion and exclusion criteria in the published penicillin allergy testing protocols risks suboptimal delivery of PADL. We compared the similarities and the differences between non-allergist-delivered PADL testing protocols and make suggestions for harmonization.The observed variation in testing practice has two broad elements: (i) definitions and terminology; and (ii) differences in the acceptability of perceived risk. All direct drug provocation testing (DDPT) protocols included patients with benign delayed rash as eligible for testing, although the remoteness of the rash, and the terminology used to describe the rash, differed. Patients with features of potential IgE reactions were excluded from most DDPT protocols, but not all of them. There was differing advice on how to manage patients who had subsequently tolerated penicillin since the index reaction and differences in which patients were considered ineligible for DDPT due to acuity of illness, comorbidities and concomitant medications.Standardization of the terminology used in penicillin allergy testing protocols and consensus on inclusion and exclusion criteria are required for safe and efficient PADL delivery at scale by non-allergists.
Multi-strategy enhanced kernel search optimization and its application in economic emission dispatch problems
Authors: Dong Ruyi , Liu Yanan , Wang Siwen , Heidari Ali Asghar , Wang Mingjing , Chen Yi , Wang Shuihua , Chen Huiling , Zhang Yudong 
Published: December 2023

Abstract
The kernel search optimizer (KSO) is a recent metaheuristic optimization algorithm that is based on kernel theory, eliminating the need for hyper-parameter adjustments, and demonstrating excellent global search capabilities. However, the original KSO exhibits insufficient accuracy in local search, and there is a high probability that it may fail to achieve local optimization in complex tasks. Therefore, this paper proposes a multi-strategy enhanced KSO (MSKSO) to enhance the local search ability of the KSO. The MSKSO combines several control strategies, including chaotic initialization, chaotic local search mechanisms, the high-altitude walk strategy (HWS), and the Levy flight (LF), to effectively balance exploration and exploitation. The MSKSO is compared with ten well-known algorithms on 50 benchmark test functions to validate its performance, including single-peak, multi-peak, separable variable, and non-separable variable functions. Additionally, the MSKSO is applied to two real engineering economic emission dispatch (EED) problems in power systems. Experimental results demonstrate that the performance of the MSKSO nearly optimizes that of other well-known algorithms and achieves favorable results on the EED problem. These case studies verify that the MSKSO outperforms other algorithms and can serve as an effective optimization tool.
International law in the China–Russian energy partnership: mapping the partnership-based relational approach
Authors: Zhang Yuanyuan 
Published: December 2023

Abstract
Over the past decades, the China–Russian energy partnership has become firmly established. Significant milestones such as the 2009 oil and the 2014 gas deals demonstrate the geopolitical impact of this partnership. The article finds that the China–Russian energy cooperation uses a partnership-based relational approach that eschews rulemaking by treaty. Instead, the legal framework of this partnership is multi-layered and has distinct features. It relies heavily on bilateralism, pragmatic cooperation, and non-binding commitments. A range of instruments applies at the bilateral level, including a bilateral investment treaty, energy cooperation agreements, intergovernmental agreements on significant energy deals, and many joint communiques and statements of a soft law nature. Regarding regional energy governance, China and Russia prefer different approaches, as reflected in their participation in the Shanghai Cooperation Organization, the Eurasian Economic Union, and the Belt and Road Initiative. While these regional mechanisms contribute to the energy partnership, their impact on the legal framework is limited.
A cucumber protein, Phloem Phosphate Stress-Repressed 1, rapidly degrades in response to a phosphate stress condition
Authors: Chen Jieyu , Ham Byung-Kook , Kochian Leon V , Lucas William J 
Published: December 2023

Abstract
Under depleted external phosphate (Pi), many plant species adapt to this stress by initiating downstream signaling cascades. In plants, the vascular system delivers nutrients and signaling agents to control physiological and developmental processes. Currently, limited information is available regarding the direct role of phloem-borne long-distance signals in plant growth and development under Pi stress conditions. Here, we report on the identification and characterization of a cucumber protein, Cucumis sativus Phloem Phosphate Stress-Repressed 1 (CsPPSR1), whose level in the phloem translocation stream rapidly responds to imposed Pi-limiting conditions. CsPPSR1 degradation is mediated by the 26S proteasome; under Pi-sufficient conditions, CsPPSR1 is stabilized by its phosphorylation within the sieve tube system through the action of CsPPSR1 kinase. Further, we discovered that CsPPSR1 kinase was susceptible to Pi starvation-induced degradation in the sieve tube system. Our findings offer insight into a molecular mechanism underlying the response of phloem-borne proteins to Pi-limited stress conditions.
Protostellar discs fed by dense collapsing gravomagneto sheetlets
Authors: Tu Yisheng , Li Zhi-Yun , Lam Ka Ho , Tomida Kengo , Hsu Chun-Yen 
Published: December 2023

ABSTRACT
Stars form from the gravitational collapse of turbulent, magnetized molecular cloud cores. Our non-ideal MHD simulations reveal that the intrinsically anisotropic magnetic resistance to gravity during the core collapse naturally generates dense gravomagneto sheetlets within inner protostellar envelopes – disrupted versions of classical sheet-like pseudo-discs. They are embedded in a magnetically dominant background, where less dense materials flow along the local magnetic field lines and accumulate in the dense sheetlets. The sheetlets, which feed the disc predominantly through its upper and lower surfaces, are the primary channels for mass and angular momentum transfer from the envelope to the disc. The protostellar disc inherits a small fraction (up to 10 per cent) of the magnetic flux from the envelope, resulting in a disc-averaged net vertical field strength of 1–10 mG and a somewhat stronger toroidal field, potentially detectable through ALMA Zeeman observations. The inherited magnetic field from the envelope plays a dominant role in disc angular momentum evolution, enabling the formation of gravitationally stable discs in cases where the disc field is relatively well-coupled to the gas. Its influence remains significant even in marginally gravitationally unstable discs formed in the more magnetically diffusive cases, removing angular momentum at a rate comparable to or greater than that caused by spiral arms. The magnetically driven disc evolution is consistent with the apparent scarcity of prominent spirals capable of driving rapid accretion in deeply embedded protostellar discs. The dense gravomagneto sheetlets observed in our simulations may correspond to the ‘accretion streamers’ increasingly detected around protostars.