bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential attainment in specialty training recruitment in the UK: an observational analysis of the impact of psychometric testing assessment in Public Health postgraduate selection
Authors: Pinder Richard J , Bury Fran , Sathyamoorthy Ganesh , Majeed Azeem , Rao Mala 
Published: March 2023

ObjectivesTo determine how current psychometric testing approaches used in selection of postgraduate training in UK Public Health are associated with socioeconomic and sociocultural background of applicants (including ethnicity).DesignObservational study using contemporaneous data collected during recruitment and psychometric test scores.SettingAssessment centre of UK national Public Health recruitment for postgraduate Public Health training. The assessment centre element of selection comprises three psychometric assessments: Rust Advanced Numerical Reasoning, Watson-Glaser Critical Thinking Assessment II and Public Health situational judgement test.Participants629 applicants completed the assessment centre in 2021. 219 (34.8%) were UK medical graduates, 73 (11.6%) were international medical graduates and 337 (53.6%) were from backgrounds other than medicine.Main outcome measureMultivariable-adjusted progression statistics in the form of adjusted OR (aOR), accounting for age, sex, ethnicity, professional background and surrogate measures of familial socioeconomic and sociocultural status.Results357 (56.8%) candidates passed all three psychometric tests. Candidate characteristics negatively associated with progression were black ethnicity (aOR 0.19, 0.08 to 0.44), Asian ethnicity (aOR 0.35, 0.16 to 0.71) and coming from a non-UK medical graduate background (aOR 0.05, 0.03 to 0.12); similar differential attainment was observed in each of the psychometric tests. Even within the UK-trained medical cohort, candidates from white British backgrounds were more likely to progress than those from ethnic minorities (89.2% vs 75.0%, p=0.003).ConclusionAlthough perceived to mitigate the risks of conscious and unconscious bias in selection to medical postgraduate training, these psychometric tests demonstrate unexplained variation that suggests differential attainment. Other specialties should enhance their data collection to evaluate the impact of differential attainment on current selection processes and take forward opportunities to mitigate differential attainment where possible.
Coupon coloring of Kneser graph K(n,2)
Authors: Shadravan Mehrnoosh , Borzooei Rajab Ali 
Published: March 2023

Chen et al. [On coupon coloring of graphs, Discrete Appl. Math. 193 (2015) 94–101] had introduced the concept of coupon coloring for any graph with no isolated vertex. A [Formula: see text]-coupon coloring of [Formula: see text] is an assignment of colors from [Formula: see text] to the vertices of [Formula: see text] such that the neighborhood of every vertex of [Formula: see text] contains vertices of all colors from [Formula: see text]. The maximum [Formula: see text] for which a [Formula: see text]-coupon coloring exists is called the coupon coloring number of [Formula: see text], and is denoted by [Formula: see text]. In this paper, we determine the coupon coloring number of Kneser graphs [Formula: see text].
Humanitarian Organizational Network and Effectiveness of Disaster Response — A Theoretical Review
Authors: Masaba Ayub Kutosi , Ntayi Joseph M. , Amooti Vincent Bagire 
Published: March 2023

In the humanitarian assistance sector, the primary objective of inter-organizational networks is to ensure that there are efficient and effective humanitarian response efforts that meet the needs of the affected population to the maximum extent possible (Drabek, 1987; Zhao et al., 2009). However, theoretical perspectives on humanitarian organizational networks and effective disaster response have remained relatively modest and confined to developing basic typologies of coordination arrangements and identifying the challenges encountered in the disaster management process. (Bennett, 1999) There also seems to be limited academic endeavor to use network, complexity, chaos and systems theories for disaster research not only for large-scale emergencies worldwide but also in developing countries. Most research works concentrate on an approach limited to a much smaller scale of nodes (organizational actors). In the preceding section, a review of relevant theories is presented in the context of humanitarian organizational network and disaster response.
Reservoir Characteristics and Gas Content of Black Shale of Wufeng-Longmaxi Formation in Qianjiang Area, Southeast Chongqing, China
Authors: Wu Bin 
Published: March 2023

The shale gas exploration in Changning, Weiyuan, Fuling Jiaoshiba, and other areas has achieved great success in the Sichuan Basin, and the basin margin of the Sichuan Basin will be an important target in the future. In view of the lack of understanding of shale gas reservoir characteristics of the basin margin area of the Sichuan Basin, this paper conducts a study on reservoir characteristics and gas-bearing properties of this area using qualitative and quantitative techniques. The results show that the thickness of the black shale reservoir in the Qianjiang area is up to 33 m, the kerogen sapropelic type (I) is dominant, and Ro ranges from 2.2 wt% to 3.39 wt%. The mineral composition is relatively complex, mainly composed of quartz and clay minerals. Quartz content is in the range between 9.4 wt% and 79 wt% (

average
=
47.48

wt
%

), while clay content is in the range between 10.02 wt% and 43.6 wt% (

average
=
29.41

wt
%

). There are various types of reservoir spaces, mainly including organic pores dominated by matrix pores, intergranular and intragranular pores, intergranular and intragranular dissolution pores, secondary dissolution pores, and microfractures, among which organic pores are the main pore types. The pore volume of nanopores is 0.009897-0.017177 cm3/g (

average
=
0.01304

c

m

3

/
g

), and the specific surface area ranges from 12.1 m2/g to 35.1 m2/g (

average
=
20.47

m

2

/
g

). Micropores and mesopores are the main pore sizes for the development of organic pores. Quartz particles promote the development of reservoir space, while clay minerals are not conducive to the development of pores. The total gas content ranges from 0.5 m3/t to 4.43 m3/t (

average
=
1.69

m

3

/
t

). Its enrichment is controlled by many factors. The increase of organic matter abundance is the material basis for shale gas enrichment. The development of organic pores provides high-quality storage space for shale gas preservation. The development of different mineral components restricts the enrichment of shale gas.
Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Mortality in Patients With Cardiogenic Shock
Authors: Jentzer Jacob C. , Miller P. Elliott , Alviar Carlos , Yalamuri Suraj , Bohman J. Kyle , Tonna Joseph E. 
Published: March 2023

Background:
Exposure to hyperoxia, a high arterial partial pressure of oxygen (PaO2), may be associated with worse outcomes in patients receiving extracorporeal membrane oxygenator (ECMO) support. We examined hyperoxia in the Extracorporeal Life Support Organization Registry among patients receiving venoarterial ECMO for cardiogenic shock.

Methods:
We included Extracorporeal Life Support Organization Registry patients from 2010 to 2020 who received venoarterial ECMO for cardiogenic shock, excluding extracorporeal CPR. Patients were grouped based on PaO2 after 24 hours of ECMO: normoxia (PaO2 60–150 mmHg), mild hyperoxia (PaO2 151–300 mmHg), and severe hyperoxia (PaO2 >300 mmHg). In-hospital mortality was evaluated using multivariable logistic regression.

Results:

Among 9959 patients, 3005 (30.2%) patients had mild hyperoxia and 1972 (19.8%) had severe hyperoxia. In-hospital mortality increased across groups: normoxia, 47.8%; mild hyperoxia, 55.6% (adjusted odds ratio, 1.37 [95% CI, 1.23–1.53];
P
<0.001); severe hyperoxia, 65.4% (adjusted odds ratio, 2.20 [95% CI, 1.92–2.52];
P
<0.001). A higher PaO2 was incrementally associated with increased in-hospital mortality (adjusted odds ratio, 1.14 per 50 mmHg higher [95% CI, 1.12–1.16];
P
<0.001). Patients with a higher PaO2 had increased in-hospital mortality in each subgroup and when stratified by ventilator settings, airway pressures, acid-base status, and other clinical variables. In the random forest model, PaO2 was the second strongest predictor of in-hospital mortality, after older age.

Conclusions:
Exposure to hyperoxia during venoarterial ECMO support for cardiogenic shock is strongly associated with increased in-hospital mortality, independent from hemodynamic and ventilatory status. Until clinical trial data are available, we suggest targeting a normal PaO2 and avoiding hyperoxia in CS patients receiving venoarterial ECMO.
Practice Patterns and Outcomes Associated With Anticoagulation Use Following Sepsis Hospitalizations With New-Onset Atrial Fibrillation
Authors: Walkey Allan J. , Myers Laura C. , Thai Khanh K. , Kipnis Patricia , Desai Manisha , Go Alan S. , Lu Yun , Clancy Heather , Devis Ycar , Neugebauer Romain , Liu Vincent X. 
Published: March 2023

Background:
Practice patterns and outcomes associated with the use of oral anticoagulation for arterial thromboembolism prevention following a hospitalization with new-onset atrial fibrillation (AF) during sepsis are unclear.

Methods:
Retrospective, observational cohort study of patients ≥40 years of age discharged alive following hospitalization with new-onset AF during sepsis across 21 hospitals in the Kaiser Permanente Northern California health care delivery system, years 2011 to 2018. Primary outcomes were ischemic stroke/transient ischemic attack (TIA), with a safety outcome of major bleeding events, both within 1 year of discharge alive from sepsis hospitalization. Adjusted risk differences for outcomes between patients who did and did not receive oral anticoagulation within 30 days of discharge were estimated using marginal structural models fitted by inverse probability weighting using Super Learning within a target trial emulation framework.

Results:
Among 82 748 patients hospitalized with sepsis, 3992 (4.8%) had new-onset AF and survived to hospital discharge; mean age was 78±11 years, 53% were men, and 70% were White. Patients with new-onset AF during sepsis averaged 45±33% of telemetry monitoring entries with AF, and 27% had AF present on the day of hospital discharge. Within 1 year of hospital discharge, 89 (2.2%) patients experienced stroke/TIA, 225 (5.6%) had major bleeding, and 1011 (25%) died. Within 30 days of discharge, 807 (20%) patients filled oral anticoagulation prescriptions, which were associated with higher 1-year adjusted risks of ischemic stroke/TIA (5.69% versus 2.32%; risk difference, 3.37% [95% CI, 0.36–6.38]) and no significant difference in 1-year adjusted risks of major bleeding (6.51% versus 7.10%; risk difference, −0.59% [95% CI, −3.09 to 1.91]). Sensitivity analysis of ischemic stroke–only outcomes showed a risk difference of 0.15% (95% CI, −1.72 to 2.03).

Conclusions:
After hospitalization with new-onset AF during sepsis, oral anticoagulation use was uncommon and associated with potentially higher stroke/TIA risk. Further research to inform mechanisms of stroke and TIA and management of new-onset AF after sepsis is needed.
Eliminating Medication Copayments for Low-Income Older Adults at High Cardiovascular Risk: A Randomized Controlled Trial
Authors: Campbell David J.T. , Mitchell Chad , Hemmelgarn Brenda R. , Tonelli Marcello , Faris Peter , Zhang Jianguo , Tsuyuki Ross T. , Fletcher Jane , Au Flora , Klarenbach Scott , Exner Derek V. , Manns Braden J. ,   for the Interdisciplinary Chronic Disease Collaboration
Published: March 2023

Background:
One in eight people with heart disease has poor medication adherence that, in part, is related to copayment costs. This study tested whether eliminating copayments for high-value medications among low-income older adults at high cardiovascular risk would improve clinical outcomes.

Methods:
This randomized 2×2 factorial trial studied 2 distinct interventions in Alberta, Canada: eliminating copayments for high-value preventive medications and a self-management education and support program (reported separately). The findings for the first intervention, which waived the usual 30% copayment on 15 medication classes commonly used to reduce cardiovascular events, compared with usual copayment, is reported here. The primary outcome was the composite of death, myocardial infarction, stroke, coronary revascularization, and cardiovascular-related hospitalizations over a 3-year follow-up. Rates of the primary outcome and its components were compared using negative binomial regression. Secondary outcomes included quality of life (Euroqol 5-dimension index score), medication adherence, and overall health care costs.

Results:

A total of 4761 individuals were randomized and followed for a median of 36 months. There was no evidence of statistical interaction (
P
=0.99) or of a synergistic effect between the 2 interventions in the factorial trial with respect to the primary outcome, which allowed us to evaluate the effect of each intervention separately. The rate of the primary outcome was not reduced by copayment elimination, (521 versus 533 events, incidence rate ratio 0.84 [95% CI, 0.66–1.07],
P
=0.162). The incidence rate ratio for nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death (0.97 [95% CI, 0.67–1.39]), death (0.94 [95% CI, 0.80 to 1.11]), and cardiovascular-related hospitalizations (0.78 [95% CI, 0.57 to 1.06]) did not differ between groups. No significant between-group changes in quality of life over time were observed (mean difference, 0.012 [95% CI, –0.006 to 0.030],
P
=0.19). The proportion of participants who were adherent to statins was 0.72 versus 0.69 for the copayment elimination versus usual copayment groups, respectively (mean difference, 0.03 [95% CI, 0.006–0.06],
P
=0.016). Overall adjusted health care costs did not differ ($3575 [95% CI, –605 to 7168],
P
=0.098).

Conclusions:
In low-income adults at high cardiovascular risk, eliminating copayments (average, $35/mo) did not improve clinical outcomes or reduce health care costs, despite a modest improvement in adherence to medications.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02579655.
NLRP3 Inflammasome Activation in Peripheral Arterial Disease
Authors: Bartoli‐Leonard Francesca , Zimmer Jonas , Sonawane Abhijeet R. , Perez Katelyn , Turner Mandy E. , Kuraoka Shiori , Pham Tan , Li Feifei , Aikawa Masanori , Singh Sasha , Brewster Luke , Aikawa Elena 
Published: March 2023

Background
Peripheral arterial disease (PAD) is estimated to affect 7% of the adult population in the United States; however, there is currently little understanding of the key cellular and molecular pathways at play. With PAD characterized by vascular inflammation and associated calcification, the current study set out to elucidate the role of NLRP3 (nucleotide oligomerization domain‐like receptor family, pyrin domain containing 3) inflammasome activation in the current cohort.

Methods and Results
Global proteomics of human vessels with and without PAD from a total of 14 donors revealed an increase of proinflammatory associated ontologies, specifically acute phase and innate immunity. Targeted mass spectrometry showed a significant increase in NLRP3, confirmed by NLRP3 ELISA. Histological analysis from the same patients demonstrated expression of NLRP3, colocalizing in immunoreactive CD68 (cluster of differentiation 68) and CD209 (cluster of differentiation 209) macrophages. Moreover, transmission electron microscopy showed the locality of macrophage‐like cells in the presence of calcification, with confocal microscopy further validating the localization of CD68, NLRP3, and calcification via near‐infrared calcium tracer. Systemic inflammation and the presence of the NLRP3 inflammasome was assessed via flow cytometry and ELISA, respectively. Compared with patients without PAD, NLRP3 expression was significantly increased in serum. In addition, proinflammatory cytokine presence was significantly increased in disease versus control, with IL (interleukin)‐1β, TNF‐α (tumor necrosis factor α), and IL‐33 demonstrating the greatest disparity, correlating with NLRP3 activation.

Conclusions
The current findings demonstrate a link between NLRP3, macrophage accumulation, and calcification in arteries of patients with PAD, suggesting an association or possible driver of PAD in these patients.
Implementation of Ticagrelor Reduced Mortality in Routine Clinical Care: Evidence From a Natural Experiment Including 109 995 Patients With Myocardial Infarction in Sweden
Authors: Johannesen Kasper , Siverskog Jonathan , Henriksson Martin , Janzon Magnus , Lindahl Bertil , Grönqvist Erik 
Published: March 2023

Background
Effectiveness estimates from observational studies on ticagrelor use in routine clinical care are conflicting, with some contrary to the results of the pivotal randomized controlled trial of ticagrelor in acute coronary syndrome. The aim of this study was to estimate the effect of implementing and using ticagrelor in routine clinical care in patients with myocardial infarction using a natural experimental approach.

Methods and Results
This is a retrospective cohort study including patients hospitalized for myocardial infarction in Sweden between 2009 and 2015. The study exploited differences in the timing and speed of ticagrelor implementation between treatment centers as a source of random treatment assignment. The effect of implementing and using ticagrelor was estimated based on the admitting center's likelihood of treating patients with ticagrelor, measured as the proportion of patients treated in the 90 days before patient admission. The main outcome was 12‐month mortality. The study included 109 955 patients, of whom 30 773 were treated with ticagrelor. Being admitted to a treatment center with higher past ticagrelor use was associated with a reduction in 12‐month mortality (2.5 percentage points for 100% versus 0% past use [95% CI, 0.2–4.8]). The results are in line with the findings from the ticagrelor pivotal trial.

Conclusions
Using a natural experiment, this study finds that the implementation and use of ticagrelor in routine clinical care has reduced 12‐month mortality in patients admitted to the hospital with myocardial infarction in Sweden and supports the external validity of randomized evidence on ticagrelor effectiveness.
Variability in Lipid Levels and Risk for Cardiovascular Disease: An Electronic Health Record–Based Population Cohort Study
Authors: Manemann Sheila M. , Bielinski Suzette J. , Moser Ethan D. , St. Sauver Jennifer L. , Takahashi Paul Y. , Roger Véronique L. , Olson Janet E. , Chamberlain Alanna M. , Remaley Alan T. , Decker Paul A. , Killian Jill M. , Larson Nicholas B. 
Published: March 2023

Background
Larger within‐patient variability of lipid levels has been associated with increased risk of cardiovascular disease (CVD); however, measures of lipid variability require ≥3 measurements and are not currently used clinically. We investigated the feasibility of calculating lipid variability within a large electronic health record–based population cohort and assessed associations with incident CVD.

Methods and Results
We identified all individuals ≥40 years of age who resided in Olmsted County, MN, on January 1, 2006 (index date), without prior CVD, defined as myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, or CVD death. Patients with ≥3 measurements of total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, or triglycerides during the 5 years before the index date were retained. Lipid variability was calculated using variability independent of the mean. Patients were followed through December 31, 2020 for incident CVD. We identified 19 652 individuals (mean age 61 years; 55% female), who were CVD‐free and had variability independent of the mean calculated for at least 1 lipid type. After adjustment, those with highest total cholesterol variability had a 20% increased risk of CVD (Q5 versus Q1 hazard ratio, 1.20 [95% CI, 1.06–1.37]). Results were similar for low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol.

Conclusions
In a large electronic health record–based population cohort, high variability in total cholesterol, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol was associated with an increased risk of CVD, independent of traditional risk factors, suggesting it may be a possible risk marker and target for intervention. Lipid variability can be calculated in the electronic health record environment, but more research is needed to determine its clinical utility.
Preferences of Patients With Chronic Kidney Disease for Invasive Versus Conservative Treatment of Acute Coronary Syndrome: A Discrete Choice Experiment
Authors: Wilson Todd A. , Hazlewood Glen S. , Sajobi Tolulope T. , Wilton Stephen B. , Pearson Winnie E. , Connolly Carol , Javaheri Pantea A. , Finlay Juli L. , Levin Adeera , Graham Michelle M. , Tonelli Marcello , James Matthew T. 
Published: March 2023

Background
Patients with chronic kidney disease (CKD) can experience acute coronary syndromes (ACS) with high morbidity and mortality. Early invasive management of ACS is recommended for most high‐risk patients; however, choosing between an early invasive versus conservative management approach may be influenced by the unique risk of kidney failure for patients with CKD.

Methods and Results

This discrete choice experiment measured the preferences of patients with CKD for future cardiovascular events versus acute kidney injury and kidney failure following invasive heart procedures for ACS. The discrete choice experiment, consisting of 8 choice tasks, was administered to adult patients attending 2 CKD clinics in Calgary, Alberta. The part‐worth utilities of each attribute were determined using multinomial logit models, and preference heterogeneity was explored using latent class analysis. A total of 140 patients completed the discrete choice experiment. The mean age of patients was 64 years, 52% were male, and mean estimated glomerular filtration rate was 37 mL/min per 1.73 m
2
. Across the range of levels, risk of mortality was the most important attribute, followed by risk of end‐stage kidney disease and risk of recurrent myocardial infarction. Latent class analysis identified 2 distinct preference groups. The largest group included 115 (83%) patients, who placed the greatest value on treatment benefits and expressed the strongest preference for reducing mortality. A second group of 25 (17%) patients was identified who were procedure averse and had a strong preference toward conservative management of ACS and avoiding acute kidney injury requiring dialysis.

Conclusions
The preferences of most patients with CKD for management of ACS were most influenced by lowering mortality. However, a distinct subgroup of patients was strongly averse to invasive management. This highlights the importance of clarifying patient preferences to ensure treatment decisions are aligned with patient values.