bluuebunny/crossref_metadata_2025_split huggingface dataset:
Industry funding of patient organisations in the UK: a retrospective study of commercial determinants, funding concentration and disease prevalence
Authors: Gentilini Arianna , Parvanova Iva 
Published: June 2023

ObjectivesTo assess the relationship between UK-based patient organisation funding and companies’ commercial interests in rare and non-rare diseases in 2020.DesignRetrospective analysis of the value and volume of payments from pharmaceutical companies to patient organisations in the UK matched with data on the conditions supported by patient organisations and drugs in companies’ approved portfolios and research and development pipelines.SettingUK.Participants74 pharmaceutical companies making payments to 341 UK-based patient organisations.Main outcome measuresAlignment between the commercial interests of pharmaceutical companies and the disease area focus of patient organisations; difference in the volume and value of payments to patient organisations broken down by prevalence of conditions; industry funding concentration, measured as the number of companies funding each patient organisation, the share of overall industry funding coming from each contributing company and the share of industry funding of each organisation comprised by the single highest payments.Results1422 payments were made by 74 companies to 341 patient organisations. Almost all funds (90%) from pharmaceutical companies were directed to patient organisations that are aligned with companies’ approved drug portfolios and research and development pipelines. Despite rare diseases affecting less than 5% of the UK population, more than 20% of all payments were directed to patient organisations which target such conditions. Patient organisations focusing on rare diseases relied on payments from fewer companies (p value=0.0031) compared to organisations focusing on non-rare diseases.ConclusionsCompanies predominantly funded patient organisations operating in therapeutic areas relevant to companies’ portfolio or drug development pipeline. Patient organisations focusing on rare diseases received more funding relative to the number of patients affected by these conditions and relied more heavily on payments from fewer companies compared to organisations targeting non-rare diseases. Increased independence of patient organisations could help avoid conflicts of interest.
Applying an osteopathic intervention to improve mild to moderate mental health symptoms: a mixed-methods feasibility study protocol
Authors: Hope-Bell Josh , Draper-Rodi Jerry , Edwards Darren J 
Published: June 2023

IntroductionMental health services are stretched in the UK and are in need of support. One approach that could improve mental health symptoms is osteopathy. Research suggests that osteopathy influences psychophysiological factors, which could lead to improvements in mental health. The first objective of this protocol is to investigate the feasibility and acceptability of four osteopathic interventions. A secondary aim is to evaluate the interventions’ effectiveness for improving psychophysiological and mental health outcomes.Methods and analysisThis study will be an explanatory mixed-methods design. Participants will be 30 adults who have mild to moderate mental health symptoms and not experiencing any issues with pain. The feasibility and acceptability of the interventions will be the primary outcomes. Secondary outcomes will be physiological measures including heart rate variability, interoceptive accuracy and blood pressure. Psychological outcomes, collected preintervention and postintervention, will also be measured by five standardised questionnaires, which include: (1) the Depression, Anxiety and Stress Scale (DASS); (2) the International Positive and Negative Affect Schedule-Short-Form; (3) Acceptance and Action Questionnaire-II; (4) the Self as Context Scale and (5) and the Multidimensional Assessment of Interoceptive Awareness Version 2. Participants will be randomised to one of four intervention groups and receive a single intervention treatment session. These intervention groups are: (1) high-velocity and articulation techniques, (2) soft-tissue massage, (3) craniosacral techniques, and (4) a combination of these three approaches. Mixed design two (preintervention and postintervention) by the four interventions analysis of covariance models will be used to analyse the quantitative data for each quantitative measure. Participants will also be interviewed about their experiences of the study and interventions and a thematic analysis will be used to analyse this qualitative data. This will aid the assessment of the feasibility and acceptability of the study design.Ethics and disseminationThe protocol for this feasibility study has received ethical approval from the Department of Psychology Ethics Committee at Swansea University, ethical review reference number: 2022-5603-4810. Feasibility results from this protocol will be published in a peer review journal and presented at both national and international conferences.DiscussionThis study will assess the feasibility and acceptability of conducting osteopathic interventions for improving mental health outcomes. The results from this will help to inform the development of a future randomised controlled trial. The study will also produce original data which could provide preliminary evidence of whether osteopathic approaches are of benefit to individual’s mental health in the form of effect sizes, even if they are pain-free.Trial registration numberNCT05674071.
Effect of removing the 4-hour access standard in the ED: a retrospective observational study
Authors: Momesso Tomas , Gokpinar Bilal , Ibrahim Rouba , Boyle Adrian A 
Published: June 2023

BackgroundTime-based targets are used to improve patient flow and quality of care within EDs. While previous research often highlighted the benefits of these targets, some studies found negative consequences of their implementation. We study the consequences of removing the 4-hour access standard.MethodsWe conducted a before and after, retrospective, observational study using anonymised, routinely collected, patient-level data from a single English NHS ED between April 2018 and December 2019. The primary outcomes of interest were the proportion of admitted patients, that is, the admission rate, the length of stay in the ED and ambulance handover times. We used interrupted time series models to study and estimate the impact of removing the 4-hour access standard.ResultsA total of 169 916 attendances were included in the analysis. The interrupted time series models for the average daily admission rate indicate a drop from an estimated 35% to an estimated 31% (95% CI −4.1 to −3.9). This drop is only statistically significant for Majors (Ambulant) patients (from an estimated 38.3% to an estimated 31.4%) and, particularly, for short-stay admissions (from an estimated 18.1% to an estimated 12.8%). The models also show an increase in the average daily length of stay for admitted patients from an estimated 316 min to an estimated 387 min (95% CI 33.5 to 108.9), and an increase in the average daily length of stay for discharged patients from an estimated 222 min to an estimated 262 min (95% CI 6.9 to 40.4).ConclusionLifting the 4-hour access standard reporting was associated with a drop in short-stay admissions to the hospital. However, it was also associated with an increase in the average length of stay in the ED. Our study also suggests that the removal of the 4-hour standard does not impact all patients equally. While certain patient groups such as those Majors (Ambulant) patients with less severe issues might have benefited from the removal of the 4-hour access standard by avoiding short-stay hospital admissions, the average length of stay in the ED seemed to have increased across all groups, particularly for older and admitted patients.
Association of obesity with mild traumatic brain injury symptoms, inflammatory profile, quality of life and functional outcomes: a TRACK-TBI Study
Authors: Eagle Shawn R , Puccio Ava M , Nelson Lindsay D , McCrea Michael , Giacino Joseph , Diaz-Arrastia Ramon , Conkright William , Jain Sonia , Sun Xiaoying , Manley Geoffrey , Okonkwo David O 
Published: June 2023

AbstractObjectivesObesity is associated with chronic inflammation, which may impact recovery from mild traumatic brain injury (mTBI). The objective was to assess the role of obesity in recovery of symptoms, functional outcome and inflammatory blood biomarkers after mTBI.MethodsTRACK-TBI is a prospective study of patients with acute mTBI (Glasgow Coma Scale=13–15) who were enrolled ≤24 hours of injury at an emergency department of level 1 trauma centres and followed for 12 months. A total of 770 hospitalised patients who were either obese (body mass index (BMI) >30.0) or healthy mass (BMI=18.5–24.9) were enrolled. Blood concentrations of high-sensitivity C reactive protein (hsCRP), interleukin (IL) 6, IL-10, tumour necrosis factor alpha; Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Quality of Life After Brain Injury and Glasgow Outcome Score-Extended reflecting injury-related functional limitations at 6 and 12 months were collected.ResultsAfter adjusting for age and gender, obese participants had higher concentrations of hsCRP 1 day after injury (mean difference (MD)=0.65; 95% CI: 0.44 to 0.87, p<0.001), at 2 weeks (MD=0.99; 95% CI: 0.74 to 1.25, p<0.001) and at 6 months (MD=1.08; 95% CI: 0.79 to 1.37, p<0.001) compared with healthy mass participants. Obese participants had higher concentrations of IL-6 at 2 weeks (MD=0.37; 95% CI: 0.11 to 0.64, p=0.006) and 6 months (MD=0.42; 95% CI: 0.12 to 0.72, p=0.006). Obese participants had higher RPQ total score at 6 months (MD=2.79; p=0.02) and 12 months (MD=2.37; p=0.049).ConclusionsObesity is associated with higher symptomatology at 6 and 12 months and higher concentrations of blood inflammatory markers throughout recovery following mTBI.
Core elements of serious illness conversations: an integrative systematic review
Authors: Baxter Rebecca , Pusa Susanna , Andersson Sofia , Fromme Erik K , Paladino Joanna , Sandgren Anna 
Published: June 2023

BackgroundAriadne Labs’ Serious Illness Care Program (SICP), inclusive of the Serious Illness Conversation Guide (SICG), has been adapted for use in a variety of settings and among diverse population groups. Explicating the core elements of serious illness conversations could support the inclusion or exclusion of certain components in future iterations of the programme and the guide.AimThis integrative systematic review aimed to identify and describe core elements of serious illness conversations in relation to the SICP and/or SICG.DesignLiterature published between 1 January 2014 and 20 March 2023 was searched in MEDLINE, PsycINFO, CINAHL and PubMed. All articles were evaluated using the Joanna Briggs Institute Critical Appraisal Guidelines. Data were analysed with thematic synthesis.ResultsA total of 64 articles met the inclusion criteria. Three themes were revealed: (1) serious illness conversations serve different functions that are reflected in how they are conveyed; (2) serious illness conversations endeavour to discover what matters to patients and (3) serious illness conversations seek to align what patients want in their life and care.ConclusionsCore elements of serious illness conversations included explicating the intention, framing, expectations and directions for the conversation. This encompassed discussing current and possible trajectories with a view towards uncovering matters of importance to the patient as a person. Preferences and priorities could be used to inform future preparation and recommendations. Serious illness conversation elements could be adapted and altered depending on the intended purpose of the conversation.
Assisted suicide and capital punishment: a mirror image?
Authors: Doré Matthew 
Published: June 2023

ObjectivesTo outline the jurisprudential position in UK law regarding capital punishment, the death penalty and contrast this with proposed legislation for assisted dying and euthanasia (AD/E).MethodsA historical medico-legal jurisprudential research approach, focusing on investigating the case law which resulted in the eventual cessation of capital punishment and contrasting this with the arguments used in current proposed legislation for AD/E.ResultsAs a society, we are confronted with a similar choice in AD/E as we did in the 1960s with capital punishment, where it has demonstrated, despite a full judiciary process with a jury, that incorrect decisions have been made, resulting in death. In the context of two doctors making irrevocable decisions with prognosis uncertain, diagnostic errors and autonomy being relational—influenced by how others behave towards us—even campaigners for AD/E admit errors are inevitable. Some will have lethal drugs under a wrong diagnosis, an incorrect timespan or coercive pressures; is this cost acceptable?ConclusionIf the abolition of capital punishment is hard won, with the risk set that no one incorrectly should die, is this the standard that should be set for lethal drugs today? Is the right to choose so important that others’ lives lost are an acceptable cost to pay? If we do accept a radical individual autonomy ethos, what proportion of incorrect deaths is acceptable?
Higher Family Affluence is Associated With Multi-Sport Participation Among Irish Youth
Authors: Kearney Philip E. , Sherwin Ian , O’Brien Wesley , Nevill Alan M. , Ng Kwok 
Published: June 2023

The impact of early single sport participation among young people has received much attention, with both sport leaders and pediatricians advocating multi-sport participation at least until early adolescence. In this study we explored the association between family socioeconomic status and level of Irish youth specialization in sport. We relied on data from the Children’s Sport Participation and Physical Activity (CSPPA) study, involving a representative sample of 3499 Irish children and adolescents aged 10–15 years. We analyzed data from questions related to the number of sports played, the number of days per week the youth were engaged in sport, and family affluence (as a proxy measure for socioeconomic status). Youth sport specialization before 12 years of age (males 5.7%; females 4.2%) and even between 13–15 years of age (males, 7.8%; females, 5.8%) was uncommon. However, lower levels of specialization were associated with higher socioeconomic status in that more children with high family affluence participated in multiple sports. Careful consideration should be given to whether low socioeconomic status may act as a barrier to participation in multiple sports.
Long noncoding RNA long intergenic non-protein-coding RNA 173 contributes to nasopharyngeal carcinoma progression by regulating microRNA-765/Gremlin 1 pathway
Authors: Wang Dan , Jiang Heng 
Published: June 2023

Background Long intergenic non-protein-coding RNA 173 (LINC00173) executes vital functions in various cancers. Nevertheless, its role and expression in nasopharyngeal carcinoma (NPC) have yet to be investigated. Here, we investigated its effects on the malignancy characteristics of NPC and elucidated the potential molecular mechanism of LINC00173 in NPC progression. Methods Quantitative real-time reverse transcription-PCR (qRT-PCR) and immunoblotting were conducted to estimate the LINC00173, microRNA-765 (miR-765), and Gremlin 1 (GREM1) expressions in NPC cells and tissues. Cell counting kit-8 (CCK8), colony formation, and wound healing experiments were done to evaluate the proliferation, growth, and migration of NPC cells, respectively. The tumorous growth of NPC cells in vivo was assessed through the xenograft tumor experiment. Furthermore, the interactions among miR-765, LINC00173, and GREM1 were investigated through bioinformatics analyses, luciferase reporter and RNA immunoprecipitation chip assays. Results An upregulated LINC00173 expression was found in NPC cell lines and tissues. The functional experiments uncovered that its downregulation repressed NPC cell proliferation, growth, and migration. In addition, LINC00173 knockdown hampered the NPC cells’ tumorous growth in vivo. These effects could partially be reversed by downregulating miR-765. GREM1 is a downstream target of miR-765. GREM1 knockdown could repress the proliferation, growth, and migration of NPC cells. Nonetheless, these anti-tumor effects could be abolished by miR-765 downregulation. Mechanistically, LINC00173 increased the expression of GREM1 by binding with miR-765. Conclusions LINC00173 functions as an oncogenic factor by binding with miR-765 to promote the progression of NPC via GREM1 upregulation. This study provides a novel insight into the molecular mechanisms involved in NPC progression.
The Use of Machine Learning Techniques to Predict Deep Vein Thrombosis in Rehabilitation Inpatients
Authors: Hou Tingting , Qiao Wei , Song Sijin , Guan Yingchao , Zhu Chunyang , Yang Qing , Gu Qi , Sun Li , Liu Su 
Published: June 2023

Background Rehabilitation is crucial to recovering patients’ dysfunction, improving their life quality, and promoting an early return to their family and society. In China, most patients in rehabilitation units are patients transferred from neurology, neurosurgery, and orthopedics, and most of these patients face problems such as continuously bedridden or varying degrees of limb dysfunction, all of which are risk factors for deep venous thrombosis. The formation of deep venous thrombosis can delay the recovery process and result in significant morbidity, mortality, and higher healthcare costs, so early detection and individualized treatment are needed. Machine learning algorithms can help develop more precise prognostic models, which can be of great significance in the development of rehabilitation training programs. In this study, we aimed to develop a model of deep venous thrombosis for inpatients in the Department of Rehabilitation Medicine at the Affiliated Hospital of Nantong University using machine learning methods. Methods We analyzed and compared 801 patients in the Department of Rehabilitation Medicine using machine learning. Support vector machine, logistic regression, decision tree, random forest classifier, and artificial neural network were used to build models. Results Artificial neural network was the better predictor than other traditional machine learnings. D-dimer levels, bedridden time, Barthel Index, and fibrinogen degradation products were common predictors of adverse outcomes in these models. Conclusions Risk stratification can help healthcare practitioners to achieve improvements in clinical efficiency and specify appropriate rehabilitation training programs.
“It’s Another Feather in My Hat”-Exploring Factors Influencing the Adoption of Apps With People Living With Dementia
Authors: Conway Aoife , Ryan Assumpta , Harkin Deirdre , Mc Cauley Claire 
Published: June 2023

Introduction With the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing adoption of mobile applications for people living with dementia. Methods The recruitment of participants was facilitated through a dementia advocacy group of people living with dementia. A focus group design was applied to elicit discussion and to explore divergent views on the topic. The data was analysed using thematic analysis. Findings The 15 individuals who participated in this study comprised of seven women and eight men within the age range of 60-90 years. This study reports key findings pertaining to the views and experiences of using mobile apps. Data analysis revealed the following four distinct themes; (Theme 1: Living with dementia)-“That’s the difficulty there even with apps or anything else.” (Theme 2: Motivation)- “It makes me feel good. I feel a little with it [laughs], that its not all gone in there” (Theme 3: Fears and Concerns)- “Can somebody else get into your personal memories?” (Theme 4- Support)– “So it’s important that we have that support”. Together these themes encapsulate the most influential aspects, as highlighted by the participants influencing the acceptance and adoption of apps. Conclusion This paper explores the barriers and facilitators to app acceptance and adoption. This includes the importance of “feel good moments” and positive experiences, challenges associated with living with dementia, the importance of ongoing support, and security of the user’s information. This study adds to what is already known by capturing the views and experiences of people living with dementia in relation to the factors influencing the adoption of apps.
Long-Term Outcome of Carotid-Subclavian Bypass in the Management of Coronary-Subclavian Steal Syndrome
Authors: Wenkel Martin , Halloum Nancy , Izzat Mohammad Bashar , Ali-Hasan-Al-Saegh Sadeq , Duerr Georg Daniel , Kriege Marc , Stamenovic Davor , Treede Hendrik , El Beyrouti Hazem 
Published: June 2023

Objective The presence of a significant left subclavian artery stenosis may occasionally lead to blood flow reversal through a LIMA-to-coronary artery bypass graft during left arm exertion; with “stealing” of myocardial blood supply. The aim of this study was to review our experience with carotid-subclavian bypass in patients with post-CABG coronary-subclavian steal syndrome. Methods This is a retrospective review of all patients who underwent carotid-subclavian bypass grafting for post-CABG coronary-subclavian steal syndrome at Mainz University Hospital between 2006 and 2015. Cases were identified in our institutional database, and data were retrieved from surgical records, imaging studies, and follow-up records. Results Nine patients (all males, mean age of 69.1 years) underwent surgical treatment for post-CABG coronary-subclavian steal syndrome. Medium interval between original CABG and carotid-subclavian bypass grafting was 86.1 months. There were no perioperative deaths, strokes or myocardial infarctions. At a mean follow-up period of 79.9 months, all patients remained asymptomatic and all carotid-subclavian bypass grafts remained patent. One patient required stenting of a common carotid artery stenosis proximal to the graft anastomosis site, and coronary artery stenting was required in four patients in regions other than those supplied by the patent LIMA graft. Conclusion Carotid-subclavian bypass surgery is a safe treatment option even in patients with multivessel disease and severe comorbidities and should be taken into consideration in patients who are deemed fit for surgery and those who would benefit from the excellent long-term patency rates.