bluuebunny/crossref_metadata_2025_split huggingface dataset:
The carbon footprint of future engineered wood construction in Montreal
Authors: Meyer Felicity , Elliot Thomas , Craig Salmaan , Goldstein Benjamin P 
Published: January 2024

Abstract
Engineered wood (EW) has the potential to reduce global carbon emissions from the building sector by substituting carbon-intensive concrete and steel for carbon-sequestering wood. However, studies accounting for material use and embodied carbon in buildings rarely analyse the city-scale or capture connections between the city and supplying hinterlands. This limits our knowledge of the effectiveness of decarbonising cities using EW and its potential adverse effects, such as deforestation. We address this gap by combining bottom-up material accounting of construction materials with life cycle assessment to analyse the carbon emissions and land occupation from future residential construction in Montreal, Canada. We compare material demand and environmental impacts of recent construction using concrete and steel to future construction using EW at the neighbourhood, urban scales under high- and low-density growth scenarios. We estimate that baseline embodied carbon per capita across the Agglomeration of Montreal is 3.2 tonnes per carbon dioxide equivalents (CO2eq.), but this ranges from 8.2 tonnes CO2eq. per capita in areas with large single-family housing to 2.0 tonnes CO2eq. per capita where smaller homes predominate. A Montreal-wide transition to EW may increase carbon footprint by up to 25% under certain scenarios, but this varies widely across the city and is tempered through urban densification. Likewise, a transition to EW results in less than 0.1% land transformation across Quebec’s timbershed. Moreover, sustainable logging practices that sequester carbon can actually produce a carbon-negative building stock in the future if carbon in the wood is not re-emitted when buildings are demolished or repurposed. To decarbonise future residential construction, Montreal should enact policies to simultaneously promote EW and denser settlement patterns in future construction and work with construction firms to ensure they source timber sustainably.
A stepped-wedge randomised controlled trial to assess efficacy and cost-effectiveness of a care-bundle to prevent falls in older hospitalised patients
Authors: Di Gennaro Gianfranco , Chamitava Liliya , Pertile Paolo , Ambrosi Elisa , Mosci Daniela , Fila Alice , Alemayohu Mulubirhan Assefa , Cazzoletti Lucia , Tardivo Stefano , Zanolin Maria Elisabetta 
Published: January 2024

Abstract

Background
Patient accidental falls in a hospital environment are a serious problem for patient safety, and for the additional costs due to associated medical interventions.

Objective
The endpoints of this study were the assessment of the fall incidence in the hospital before and after the implementation of a multidisciplinary care-bundle, along with a cost-effectiveness evaluation.

Design
A stepped-wedge trial was conducted between April 2015 and December 2016 in Bologna University Hospital.

Methods
Incidence rates (IRs) of falls in both the control and intervention periods were calculated. A multilevel mixed-effects generalised linear model with logit link function, adjusted for age, sex, cluster cross-over timing and patients’ clinical severity was used to estimate odds ratios (OR) of fall risk of patients of the intervention group respect to the controls.
Intervention costs associated with the introduction of the care-bundle intervention were spread between patients per cluster-period-group of exposure. Incremental cost-effectiveness ratio was evaluated using total costs in the intervention and control groups.

Results
IRs of falls in control and intervention periods were respectively 3.15 and 2.58 for 1,000 bed-days. After adjustment, the subjects receiving the intervention had a statistically significant reduced risk of falling with respect to those who did not (OR = 0.71, 95% confidence interval: 0.60–0.84). According to the cost-effectiveness analysis, the incremental cost per fall prevented was €873.92 considering all costs, and €1644.45 excluding costs related falls.

Conclusions
Care-bundle had a protective effect on patients, with a statistically significant reduction of the fall risk. This type of intervention appears cost-effective compared to routine practices.
Implementation and impact of the World Health Organization integrated care for older people (ICOPE) program in China: a randomised controlled trial
Authors: Yan Wang Ninie , Liu Xiaohong , Kong Xiangrong , Sumi Yuka , Chhetri Jagadish K , Hu Linlin , Zhu Minglei , Kang Lin , Liang Zhen , Ellis John W , Shi Leiyu 
Published: January 2024

Abstract

Background
Fragmentation of services increases health and social care burden as people live longer with higher prevalence of diseases, frailty and dependency. Local evidence for implementing person-centred integrated care is urgently needed to advance practice and policies to achieve healthy ageing.

Objective
To test the feasibility and impact of World Health Organization's (WHO) Integrated Care for Older People (ICOPE) approach in China.

Design
A randomised controlled trial examining the feasibility of implementing ICOPE approach, evaluating its impact on health outcomes and health resource utilisation.

Setting
Primary care setting in urban and suburban communities of Chaoyang District, Beijing, China.

Subjects
Community-dwelling older adults screened as at-risk of functional declines and randomised into intervention (537) and control (1611) groups between September 2020 and February 2021.

Methods
A 6-month intervention program following WHO's ICOPE care pathways implemented by integrated care managers compared to standard available care.

Results
After 1 to 1 propensity score matching, participants in intervention and control groups (totally 938) had comparable baseline characteristics, demonstrated feasibility of implementing ICOPE with satisfaction by participants (97–99%) and providers (92–93%). All outcomes showed improvements after a 6-month intervention, while statistically significant least-squares mean differences (control-intervention) in vitality (Mini-Nutritional Assessment Short Form to measure vitality, −0.21, 95% CI, −0.40–0.02), mobility (Short Physical Performance Battery to measure mobility, −0.29, 95% CI, −0.44–0.14) and psychological health (Geriatric Depression Scale five items to measure psychological health, 0.09, 95% CI, 0.03–0.14) were observed (P &lt; 0.05).

Conclusions
It is feasible to localise and implement WHO’s ICOPE approach in regions with fragmented resources such as China. Preliminary evidence supports its acceptance among key stakeholders and impact on health outcomes.
Why to test for dementia: perspectives of patients, significant others and general practitioners
Authors: Linden Iris , Wolfs Claire , Hevink Maud , Dirksen Carmen , Ponds Rudolf , Perry Marieke 
Published: January 2024

Abstract

Background
This study aims to provide greater insight into the current decision-making process on diagnostic testing for dementia by exploring the expectations, needs and experiences of patients with memory complaints, significant others and general practitioners (GPs).

Methods
We performed semi-structured interviews with patients (&gt;60 years) who consulted their GP on memory complaints, significant others and GPs. Participants were recruited until data saturation was reached in thematic analysis of interview transcripts.

Results
We performed 51 interviews (patients n = 20, significant others n = 15, GPs n = 16). Thematic analysis revealed four themes: (i) ‘drivers to (not) testing’, i.e. need to act on symptoms, beliefs on the necessity and expected outcomes of diagnostic testing; (ii) ‘patient preferences and context are critical in the actual decision’, i.e. in the actual decision-making process interpretation of symptoms, GPs’ desire to meet patient preferences, social context and healthcare system dynamics guided the decision; (iii) ‘need for individualised communication in the decision-making process’, i.e. for patients feeling heard was a prerequisite for decision-making and GPs tailored communication strategies to individual patients and (iv) ‘GP practice and barriers to shared decision-making (SDM)’, i.e. although GPs value SDM in the decision on diagnostic testing for dementia, patients express limited awareness of the decision and options at stake.

Conclusions
Decision-making on diagnostic testing for dementia is a multifactorial and preference-guided process for all involved stakeholders, but decisions are often not explicitly jointly made. Development of patient decision aids could facilitate better involvement and more informed choices by patients.
Diagnostic test accuracy of serum creatinine and cystatin C-based index for sarcopenia: a systematic review and meta-analysis
Authors: Lin Taiping , Jiang Tingting , Huang Xiaotao , Xu Ping , Liang Rui , Song Quhong , Tu Xiangping , Zhao Yanli , Huang Li , Yue Jirong , Wu Chenkai 
Published: January 2024

Abstract

Background
Sarcopenia is an important prognostic factor, but its optimal screening methods remain challenging. Several new indices developed based on serum creatinine (Cr) and cystatin C (CysC) have been proposed to be diagnostic biomarkers for sarcopenia screening.

Objective
This review aimed to evaluate the diagnostic accuracy of serum Cr- and CysC-based indices for sarcopenia diagnosis.

Methods
We systematically searched MEDLINE, EMBASE, SCIE and SCOPUS from inception to 2 April 2023. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random-effects model was used to synthesise the pooled sensitivity, specificity and area under the curves of the summary receiver operating characteristic (SROC-AUC).

Results
We retrieved 936 publications and included 16 studies with 5,566 participants (mean age ranged: 51.0–78.4 years, 50.2% men). The prevalence of sarcopenia ranged from 7.8 to 69.5%. All included studies presented a moderate to high risk of bias. The serum Cr- and CysC-based indices showed moderate diagnostic accuracy for sarcopenia (pooled sensitivity: 0.67, 95% CI 0.57–0.75; pooled specificity: 076, 95% CI 0.67–0.83; pooled SROC-AUC: 0.78, 95% CI 0.74–0.81). The Cr/CysC ratio is the most widely studied index, followed by the Cr × eGFRcys index. Overall, both indicators had satisfactory and comparable performance in screening sarcopenia.

Conclusion
Serum Cr- and CysC-based indices showed moderate diagnostic accuracy for sarcopenia. The most studied indices—the Cr/CysC ratio and Cr × eGFRcys index—had comparable diagnostic accuracy for evaluating sarcopenia and may serve as surrogate markers for sarcopenia. However, further validation is required to verify these findings.
Flowering time responses to warming drive reproductive fitness in a changing Arctic
Authors: Collins Courtney G , Angert Amy L , Clark Karin , Elmendorf Sarah C , Elphinstone Cassandra , Henry Greg H R 
Published: January 2024

Abstract

Background and Aims
The Arctic is warming at an alarming rate, leading to earlier spring conditions and plant phenology. It is often unclear to what degree changes in reproductive fitness (flower, fruit and seed production) are a direct response to warming versus an indirect response through shifting phenology. The aim of this study was to quantify the relative importance of these direct and indirect pathways and project the net effects of warming on plant phenology and reproductive fitness under current and future climate scenarios.

Methods
We used two long-term datasets on 12 tundra species in the Canadian Arctic as part of the International Tundra Experiment (ITEX). Phenology and reproductive fitness were recorded annually on tagged individual plants at both Daring Lake, Northwest Territories (64° 52' N, - 111° 35' W) and Alexandra Fiord, Nunavut (78° 49' N, - 75° 48' W). The plant species encompassed a wide taxonomic diversity across a range of plant functional types with circumpolar/boreal distributions. We used hierarchical Bayesian structural equation models to compare the direct and indirect effects of climate warming on phenology and reproductive fitness across species, sites and years.

Key Results
We found that warming, both experimental and ambient, drove earlier flowering across species, which led to higher numbers of flowers and fruits produced, reflecting directional phenotypic selection for earlier flowering phenology. Furthermore, this indirect effect of climate warming mediated through phenology was generally about two to three times stronger than the direct effect of climate on reproductive fitness. Under future climate predictions, individual plants showed a ~2- to 4.5-fold increase in their reproductive fitness (flower counts) with advanced flowering phenology.

Conclusions
Our results suggest that, on average, the benefits of early flowering, such as increased development time and subsequent enhanced reproductive fitness, might outweigh its risks. Overall, this work provides important insights into population-level consequences of phenological shifts in a warming Arctic over multi-decadal time scales.
Do patients benefit from omega-3 fatty acids?
Authors: Sherratt Samuel C R , Mason R Preston , Libby Peter , Steg Ph Gabriel , Bhatt Deepak L 
Published: January 2024

Abstract
Omega-3 fatty acids (O3FAs) possess beneficial properties for cardiovascular (CV) health and elevated O3FA levels are associated with lower incident risk for CV disease (CVD.) Yet, treatment of at-risk patients with various O3FA formulations has produced disparate results in large, well-controlled and well-conducted clinical trials. Prescription formulations and fish oil supplements containing low-dose mixtures of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have routinely failed to prevent CV events in primary and secondary prevention settings when added to contemporary care, as shown most recently in the STRENGTH and OMEMI trials. However, as observed in JELIS, REDUCE-IT, and RESPECT-EPA, EPA-only formulations significantly reduce CVD events in high-risk patients. The CV mechanism of action of EPA, while certainly multifaceted, does not depend solely on reductions of circulating lipids, including triglycerides (TG) and LDL, and event reduction appears related to achieved EPA levels suggesting that the particular chemical and biological properties of EPA, as compared to DHA and other O3FAs, may contribute to its distinct clinical efficacy. In vitro and in vivo studies have shown different effects of EPA compared with DHA alone or EPA/DHA combination treatments, on atherosclerotic plaque morphology, LDL and membrane oxidation, cholesterol distribution, membrane lipid dynamics, glucose homeostasis, endothelial function, and downstream lipid metabolite function. These findings indicate that prescription-grade, EPA-only formulations provide greater benefit than other O3FAs formulations tested. This review summarizes the clinical findings associated with various O3FA formulations, their efficacy in treating CV disease, and their underlying mechanisms of action.
Carney complex predisposes to breast cancer: prospective study of 50 women
Authors: Vaduva Patricia , Violon Florian , Jouinot Anne , Bouys Lucas , Espiard Stéphanie , Bonnet-Serrano Fidéline , North Marie Odile , Cardot-Bauters Catherine , Raverot Gerald , Hieronimus Sylvie , Lefebvre Hervé , Nunes Marie-Laure , Tabarin Antoine , Groussin Lionel , Assié Guillaume , Sibony Mathilde , Vantyghem Marie-Christine , Pasmant Eric , Bertherat Jérôme 
Published: January 2024

Abstract

Objective
Carney complex (CNC) is a rare genetic syndrome, mostly due to germline loss-of-function pathogenic variants in PRKAR1A. Carney complex includes pigmented skin lesions, cardiac myxomas, primary pigmented nodular adrenocortical dysplasia, and various breast benign tumors.

Design
The present study was designed to describe the characteristics of breast lesions in CNC patients and their association with other manifestations of CNC and PRKAR1A genotype.

Methods
A 3-year follow-up multicenter French prospective study of CNC patients included 50 women who were analyzed for CNC manifestations and particularly breast lesions, with breast imaging, genotyping, and hormonal settings.

Results
Among the 38 women with breast imaging, 14 (39%) had breast lesions, half of them bilateral. Ten women (26%) presented with benign lesions and six with breast carcinomas (16%): one had ductal carcinoma in situ at 54, and five had invasive cancer before 50 years old, whom one with contralateral breast cancer during follow-up. The occurrence of breast cancer was more frequent in women with PRKAR1A pathogenic variant odds ratio = 6.34 (1.63-17.91) than in general population of same age. The mean age at breast cancer diagnosis was 44.7 years old: 17 years younger than in the general population. Breast cancer patients had good prognosis factors. All breast carcinomas occurred in individuals with familial CNC and PRKAR1A pathogenic variants. Loss of heterozygosity at the PRKAR1A locus in the 2 invasive breast carcinomas analyzed suggested a driver role of this tumor suppressor gene.

Conclusions
As CNC could predispose to breast carcinoma, an adequate screening strategy and follow-up should be discussed in affected women.

Clinical Trial Registration
ClinicalTrial.gov NCT00668291.
The evolution of multi-component weapons in the superfamily of leaf-footed bugs
Authors: Miller Christine W , Kimball Rebecca T , Forthman Michael 
Published: January 2024

Abstract
Sexually selected weapons, such as the antlers of deer, claws of crabs, and tusks of beaked whales, are strikingly diverse across taxa and even within groups of closely related species. Phylogenetic comparative studies have typically taken a simplified approach to investigate the evolution of weapon diversity, examining the gains and losses of entire weapons, major shifts in size or type, or changes in location. Less understood is how individual weapon components evolve and assemble into a complete weapon. We addressed this question by examining weapon evolution in the diverse, multi-component hind-leg and body weapons of leaf-footed bugs, superfamily Coreoidea (Hemiptera: Heteroptera). Male leaf-footed bugs use their morphological weapons to fight for access to mating territories. We used a large multilocus dataset comprised of ultraconserved element loci for 248 species and inferred evolutionary transitions among component states using ancestral state estimation. Our results suggest that weapons added components over time with some evidence of a cyclical evolutionary pattern—gains of components followed by losses and then gains again. Furthermore, our best estimate indicated that certain trait combinations evolved repeatedly across the phylogeny, suggesting that they function together in battle or that they are genetically correlated. This work reveals the remarkable and dynamic evolution of weapon form in the leaf-footed bugs and provides insights into weapon assembly and disassembly over evolutionary time.
Improving compliance with personal protective equipment among anaesthetists through behaviour-changing interventions during the coronavirus disease 2019(COVID-19) pandemic
Authors: Chia Pamela , Tang Leonard , Tse Gerald , How Molly , Wong Loong Tat , Mok May , Chong Shin Yuet 
Published: January 2024

Abstract
Since 2020, the coronavirus disease 2019 (COVID-19) pandemic has seen many changes in our daily infection prevention behaviours so as to reduce healthcare-associated transmission of COVID-19 in patients and healthcare workers. In the early phases of the COVID-19 pandemic of 2020, there was much emphasis on compliant personal protective equipment utilization in the operating theatres (OTs) for COVID-19-positive patients. However, during this period, there was a lack of international validated protocols on the appropriate handling and subsequent storage of personal protective equipment in the context of aerosol-generating procedures in OTs for asymptomatic antigen rapid test (ART)-negative patients. Given the potential for transmission even with a negative ART due to the incubation period, our team developed a checklist of eye protection (e.g. goggles/face shield) and N95 mask handling and storage in non-isolation OTs for these patients. We sought to improve the compliance of best practices from 20% to 80% amongst junior anaesthetists in Singapore General Hospital so as to prevent infection transmission and cross-contamination in the OT through education and behaviour-changing interventions. This quality improvement project took place over 19 weeks from June to October 2020 by our team of anaesthetists and nurse clinicians in the non-isolation OT setting. To analyse the problem, we performed a root cause analysis to understand attitudes and beliefs driving their behaviour. The top 80% of cited root causes for non-compliance then guided prioritization of resources for subsequent behaviour-changing interventions. Using the comprehensive infection control checklist, we conducted several plan-do-study-act cycles while implementing this new checklist amongst junior anaesthetists. A total of 227 assessments of junior anaesthetists were made in the care of asymptomatic ART-negative patients. Compliance with correctly handling goggles post-intubation started out as 33.3% in Week 1, which improved to 78.5% by Week 19. Compliance with goggle storage and face shield disposal started out at 13.6% in Week 1 and increased to 78.6% by Week 19. We attributed this improvement to education and behaviour-changing interventions. This quality improvement project focusing on improving compliance with personal protective equipment utilization during the COVID-19 pandemic in the management of asymptomatic ART-negative patients in non-isolation OTs demonstrated the importance of interventions of education, persuasion, modelling, and training in effecting and sustaining organizational behaviour change in physicians and other healthcare personnel.
Genetic mixing and demixing on expanding spherical frontiers
Authors: García Vázquez Alba , Mitarai Namiko , Jauffred Liselotte 
Published: January 2024

Abstract
Genetic fluctuation during range expansion is a key process driving evolution. When a bacterial population is expanding on a 2D surface, random fluctuations in the growth of the pioneers at the front line cause a strong demixing of genotypes. Even when there is no selective advantage, sectors of low genetic diversity are formed. Experimental studies of range expansions in surface-attached colonies of fluorescently labelled micro-organisms have contributed significantly to our understanding of fundamental evolutionary dynamics. However, experimental studies on genetic fluctuations in 3D range expansions have been sparse, despite their importance for tumour or biofilm development. We encapsulated populations of two fluorescent Escherichia coli strains in inoculation droplets (volumes $\sim 0.1$ nl). The confined ensemble of cells grew when embedded in a hydrogel—with nutrients—and developed 3D colonies with well-defined, sector-like regions. Using confocal laser scanning microscopy, we imaged the development of 3D colonies and the emergence of sectors. We characterized how cell concentration in the inoculation droplet controls sectors, growth rate, and the transition from branched colonies to quasi-spherical colonies. We further analysed how sectors on the surface change over time. We complement these experimental results with a modified 3D Eden growth model. The model in 3D spherical growth predicts a phase, where sectors are merging, followed by a steady increase (constant rate), and the experimentally analysed sectors were consistent with this prediction. Therefore, our results demonstrate qualitative differences between radial (2D) and spherical (3D) range expansions and their importance in gene fixation processes.