bluuebunny/crossref_metadata_2025_split huggingface dataset:
1308 VIRTUAL FRAILTY WARD - POST DISCHARGE FRAILTY SUPPORT
Authors: Teo A , Wright H 
Published: January 2023

Abstract

Background
In response to the COVID pandemic when new robust discharge criteria were introduced to facilitate early discharge to optimise hospital capacity, Virtual Frailty Ward (VFW) was established. VFW provides nurse-led telephone follow-up for patients discharged primarily from the Emergency Department (ED) and the Acute Frailty unit (AFU).

Objectives
We aim to provide continuity of care by following up frail elderly patients at home, reviewing their medical, functional and social progress post discharge and ensuring they received adequate support to avoid hospital re-admission.

Methods
The service is overseen by the Lead Frailty Practitioner, supported by Consultant Geriatricians. Calls are made Monday to Friday by a team of Advanced Specialist Nurses. The case load is split up into 3 categories with different levels of priorities – 1: at least weekly calls; 2: Fortnightly calls; 3: Monthly calls. This service engages closely with community partners such as community frailty service, social care, district nurses and general practitioners.

Results
In year 1 (1/4/2020-31/3/2021), we had 598 patients on this VFW. 93 patients were referred to therapy team for urgent equipment to maintain safety, 73 patients were referred to community frailty and 112 patients had urgent discussions with GP to avoid hospital admissions. The 30 days readmissions rate was 14%. 547 patients were discharged. In year 2 (1/4/2021 – 31/3/2022), we had 297 patients. 49 patients were referred to therapy team, 32 patients were referred to community frailty team, and 41 patients required input from GP. The 30-day readmission rate was 11%. 224 patients were discharged.

Conclusion
VFW is a cost- effective service that has helped to reduce length of stay of frail elderly patients in an acute hospital setting, maintaining patient safety and prevent hospital re-admission, co-ordinated with community services. Our service has been highlighted in the recent GIRFT report on improving clinical practice.
1230 PALLIATIVE CARE MOVEMENT DISORDERS MULTIDISCIPLINARY MEETING
Authors: Davies R , Wilson E , Richfield E , Mundy C , Wright B , Stratton E 
Published: January 2023

Abstract

Introduction
It is well recognised that patients with Parkinson’s disease (PD) have significant symptom burden in advanced stages of their disease. Integration of movement disorder and palliative care services has been limited by concerns about resource and sustainability. We present our experience of establishing a movement disorders palliative care multidisciplinary meeting.

Method
In 2019 we established a multidisciplinary virtual bimonthly meeting between movement disorders and palliative care specialists. Referrals were accepted from movement disorder specialists, community Parkinson’s practitioners and palliative care specialists. Referring clinicians all actively applied primary palliative care approaches within their existing services. Aims of the meeting were to facilitate holistic management of complex needs, support advance care planning (ACP) and consider referral to specialist palliative care services.

Result
37 patients in total were discussed over a 2-year period (although the service was limited for a time due to COVID pressures). On average 3 new patients were discussed per meeting. Reasons for referral included motor and non-motor symptoms, support with ACP, medication advice, caregiver concerns and emotional distress. Meeting outcomes included medication adjustments, expediting reviews, hospice support, carer support, and referral to other services. Since the meetings started 23 (62%) patients have died. Of these, 30% died in hospital compared with the national average of 43.4%. The average between discussion at the meeting and death was 139 days. The meeting has generated education opportunities, triggered joint assessments and a professionals’ framework for the palliative management of patients with a movement disorder.

Conclusions
We present the experience of an MDT embedded within an early integrated palliative care service for movement disorders. The MDT has strengthened partnership working and findings suggest that alongside active primary palliative care, specialist palliative care for PD can be sustainable and resource efficient in a UK setting.
1169 QUALITY IMPROVEMENT PROGRAMME ON NON-MEDICINAL MANAGEMENT OF POSTURAL HYPOTENSION AMONG MDT MEMBERS IN THE MEDICAL WARDS (COE)
Authors: Gujjar A , Kumar A , Zaheed A , Liaqat B 
Published: January 2023

Abstract

Introduction
Postural Hypotension is a very common presentation in the elderly population. Appropriate knowledge to record postural hypotension and non-medicinal management for this is very important among MDT members working in the care of the elderly wards.

Method
We set out a questionnaire to assess the knowledge among MDT (multidisciplinary) members. An educational programme was initiated to improve the knowledge among MDT members. A complete audit cycle was done and the knowledge was reassessed with the same questionnaire based on the principles of the PDSA (Plan, Do, Studt and Act) cycle.

Results
It showed that the correct way of checking for postural blood pressure improved from 52.4% to 92% in recording the blood pressure. Correct identification of postural blood pressure improved from 33.3% to 88%. Self-rating of confidence to identify correctly postural blood pressure improved from 47.6% to 64% among the MDT Members. It was difficult to compare the answers about non-medicinal methods and exercises to help postural hypotension as there was heterogeneity in answers. It was also not possible to compare the impact of individual interventions on the alleviation of postural blood pressure.

Conclusion
Good improvement in the recording and non-medicinal management of Postural hypotension was observed in both the wards among the MDT Members. It is very important to have good knowledge and understanding in the management of this common condition as it helps in the identification and better management.
1291 DO PATIENTS UNDERSTAND THEIR RESPECT FORMS? A QI PROJECT REVIEWING PHRASES USED AND WHETHER THEY ARE MEANINGFUL TO PATIENTS
Authors: Mills H , O'Sullivan A , McCracken S , El Mabruk M 
Published: January 2023

Abstract

Background
Hospital based Quality Improvement Project focusing on adapting language used on Recommended Summary Plan for Emergency Treatment and Care (ReSPECT) forms to improve patient understanding.

Introduction
ReSPECT forms have been used to document patient wishes and appropriate escalation of treatment in our hospital since 2019. There continues to be a lack of understanding of phrases used amongst both patients and healthcare professionals; the hospital receives regular complaints. This project explored patients’ perceptions of language used and their thoughts on the ReSPECT discussion, to better guide discussions and documentation.

Methods
A questionnaire collecting qualitative and quantitative data was performed with 24 patients aged between 59-95 years old with ReSPECT forms on a medical ward (Geriatrics/ Endocrine).

Results
The phrases ‘DNACPR’ and ‘Not for ITU’ were understood by 5/24 patients (21%), ‘Ward based ceiling of care’ was understood by only 1/24 (4%) and ‘prioritising comfort care’ understood by 8/24 patients (34%). Only 6/24 (25%) of patients said they were a ‘little upset’ by their admission conversation about ReSPECT and no patients surveyed were ‘very upset’.

Conclusions
This first QI cycle found that overall, most patients did not understand the language commonly used on ReSPECT forms, particularly ‘ward-based ceiling of care’. The majority were not upset by the ReSPECT conversation, so a fear of upsetting the patient should not be a barrier to having a clear discussion. The next step in our QI work will be to explore phrases that are better understood by patients and then feedback findings so that we can develop a digital ReSPECT form with drop down options for phrases better understood by patients to describe ceilings of care.
1226 A MULTI-DISCIPLINARY APPROACH TO TRANSFORMING EYE CARE SERVICES FOR CARE HOME RESIDENTS
Authors: Ma N , Low S , Hasan S , Lawal A , Patel S , Nurse K , McNaughton G , Aggarwal R , Evans J , Koria R , Lam C , Chakravorty M , Stanley G , Banna S , Kalsi T 
Published: January 2023

Abstract

Introduction
Care home residents can have variable access to eye care services and treatments. We developed a collaborative approach between optometrists, care homes, and primary and secondary care to enable personalised patient-centred care.

Objective
To develop and evaluate an integrated model of eye care for care home residents.

Methods
Small scale plan-do-study-act (PDSA) service tests were completed in three care-homes in Southwark (2 residential, 1 nursing) between November 2021 to May 2022. Processes were compared to historical feedback and hospital-based ophthalmology clinic attendances (Mar 2019-2020). Hospital-like assessments were piloted at two care homes for feasibility and acceptability. Further piloting utilised usual domiciliary optometry-led assessment with multidisciplinary meeting access (including optometrist, GP, geriatrician, ophthalmologist and care home nurse) to reduce duplication of assessments and to evaluate MDM processes and referral rates.

Results
Examination was 100% successful at home (visual acuity and pressure measurement) compared to hospital outpatients (71.7% success visual acuity, 54.5% pressures). Examination was faster than in hospital settings (16 minutes vs 45 minutes-1 hour). Residents were away from usual activities for 32 minutes vs 6 hours for hospital visits including transport. Residents were less distressed with home-based assessments. Did-Not-Attend (DNA) rates reduced (26.7% to 0%), secondary care discharge rates improved (8.4% to 32%). Hospital eye service referral were indicated in 19% -23%, half of which were for consideration of cataract surgery. Alternative conservative plans were agreed at MDM for nursing home residents who were clinically too frail or would not have been able to comply with treatments avoiding 33% unnecessary referrals.

Conclusions
Home-based eye care assessments appear better tolerated and are more efficient for residents, health and care staff. Utilising an MDM for optometrists to discuss residents with ophthalmologists and wider MDT members enabled personalised patient-centred decision-making. Future work to test this borough wide is in progress.
SLGNN: synthetic lethality prediction in human cancers based on factor-aware knowledge graph neural network
Authors: Zhu Yan , Zhou Yuhuan , Liu Yang , Wang Xuan , Li Junyi 
Published: January 2023

Abstract

Motivation
Synthetic lethality (SL) is a form of genetic interaction that can selectively kill cancer cells without damaging normal cells. Exploiting this mechanism is gaining popularity in the field of targeted cancer therapy and anticancer drug development. Due to the limitations of identifying SL interactions from laboratory experiments, an increasing number of research groups are devising computational prediction methods to guide the discovery of potential SL pairs. Although existing methods have attempted to capture the underlying mechanisms of SL interactions, methods that have a deeper understanding of and attempt to explain SL mechanisms still need to be developed.

Results
In this work, we propose a novel SL prediction method, SLGNN. This method is based on the following assumption: SL interactions are caused by different molecular events or biological processes, which we define as SL-related factors that lead to SL interactions. SLGNN, apart from identifying SL interaction pairs, also models the preferences of genes for different SL-related factors, making the results more interpretable for biologists and clinicians. SLGNN consists of three steps: first, we model the combinations of relationships in the gene-related knowledge graph as the SL-related factors. Next, we derive initial embeddings of genes through an explicit message aggregation process of the knowledge graph. Finally, we derive the final gene embeddings through an SL graph, constructed using known SL gene pairs, utilizing factor-based message aggregation. At this stage, a supervised end-to-end training model is used for SL interaction prediction. Based on experimental results, the proposed SLGNN model outperforms all current state-of-the-art SL prediction methods and provides better interpretability.

Availability and implementation
SLGNN is freely available at https://github.com/zy972014452/SLGNN.
Cytoscape.js 2023 update: a graph theory library for visualization and analysis
Authors: Franz Max , Lopes Christian T , Fong Dylan , Kucera Mike , Cheung Manfred , Siper Metin Can , Huck Gerardo , Dong Yue , Sumer Onur , Bader Gary D 
Published: January 2023

AbstractSummaryCytoscape.js is an open-source JavaScript-based graph library. Its most common use case is as a visualization software component, so it can be used to render interactive graphs in a web browser. It also can be used in a headless manner, useful for graph operations on a server, such as Node.js. This update describes new features and enhancements introduced over many new versions from 2015 to 2022.Availability and implementationCytoscape.js is implemented in JavaScript. Documentation, downloads and source code are available at http://js.cytoscape.org.Supplementary informationSupplementary data are available at Bioinformatics online.
Discovering research articles containing evolutionary timetrees by machine learning
Authors: Stanojevic Marija , Andjelkovic Jovan , Kasprowicz Adrienne , Huuki Louise A , Chao Jennifer , Hedges S Blair , Kumar Sudhir , Obradovic Zoran 
Published: January 2023

AbstractMotivationTimetrees depict evolutionary relationships between species and the geological times of their divergence. Hundreds of research articles containing timetrees are published in scientific journals every year. The TimeTree (TT) project has been manually locating, curating and synthesizing timetrees from these articles for almost two decades into a TimeTree of Life, delivered through a unique, user-friendly web interface (timetree.org). The manual process of finding articles containing timetrees is becoming increasingly expensive and time-consuming. So, we have explored the effectiveness of text-mining approaches and developed optimizations to find research articles containing timetrees automatically.ResultsWe have developed an optimized machine learning system to determine if a research article contains an evolutionary timetree appropriate for inclusion in the TT resource. We found that BERT classification fine-tuned on whole-text articles achieved an F1 score of 0.67, which we increased to 0.88 by text-mining article excerpts surrounding the mentioning of figures. The new method is implemented in the TimeTreeFinder (TTF) tool, which automatically processes millions of articles to discover timetree-containing articles. We estimate that the TTF tool would produce twice as many timetree-containing articles as those discovered manually, whose inclusion in the TT database would potentially double the knowledge accessible to a wider community. Manual inspection showed that the precision on out-of-distribution recently published articles is 87%. This automation will speed up the collection and curation of timetrees with much lower human and time costs.Availability and implementationhttps://github.com/marija-stanojevic/time-tree-classification.Supplementary informationSupplementary data are available at Bioinformatics online.
Shared and distinct patterns of dynamic functional connectivity variability of thalamo-cortical circuit in bipolar depression and major depressive disorder
Authors: Lu Fengmei , Chen Yanchi , Cui Qian , Guo Yuanhong , Pang Yajing , Luo Wei , Yu Yue , Chen Jiajia , Gao Jingjing , Sheng Wei , Tang Qin , Zeng Yuhong , Jiang Kexing , Gao Qing , He Zongling , Chen Huafu 
Published: January 2023

Abstract
Evidence has indicated abnormalities of thalamo-cortical functional connectivity (FC) in bipolar disorder during a depressive episode (BDD) and major depressive disorder (MDD). However, the dynamic FC (dFC) within this system is poorly understood. We explored the thalamo-cortical dFC pattern by dividing thalamus into 16 subregions and combining with a sliding-window approach. Correlation analysis was performed between altered dFC variability and clinical data. Classification analysis with a linear support vector machine model was conducted. Compared with healthy controls (HCs), both patients revealed increased dFC variability between thalamus subregions with hippocampus (HIP), angular gyrus and caudate, and only BDD showed increased dFC variability of the thalamus with superior frontal gyrus (SFG), HIP, insula, middle cingulate gyrus, and postcentral gyrus. Compared with MDD and HCs, only BDD exhibited enhanced dFC variability of the thalamus with SFG and superior temporal gyrus. Furthermore, the number of depressive episodes in MDD was significantly positively associated with altered dFC variability. Finally, the disrupted dFC variability could distinguish BDD from MDD with 83.44% classification accuracy. BDD and MDD shared common disrupted dFC variability in the thalamo-limbic and striatal-thalamic circuitries, whereas BDD exhibited more extensive and broader aberrant dFC variability, which may facilitate distinguish between these 2 mood disorders.
Initial Supplementary Dose of Dolutegravir in Second-Line Antiretroviral Therapy: A Noncomparative, Double-Blind, Randomized Placebo-Controlled Trial
Authors: Zhao Ying , Griesel Rulan , Omar Zaayid , Simmons Bryony , Hill Andrew , van Zyl Gert , Keene Claire , Maartens Gary , Meintjes Graeme 
Published: January 2023

Abstract

Background
Dolutegravir concentrations are reduced by efavirenz induction effect necessitating twice-daily dolutegravir dosing when coadministered. Efavirenz induction persists for several weeks after stopping, which could potentially select for dolutegravir resistance if switching occurred with unsuppressed human immunodeficiency virus type 1 (HIV-1) RNA levels and standard dolutegravir dosing. We evaluated the need for a lead-in supplementary dolutegravir dose in adults failing first-line tenofovir-emtricitabine-efavirenz (TEE).

Methods
We conducted a randomized, double-blind, placebo-controlled, phase 2 trial in Khayelitsha, South Africa. Eligible patients had virologic failure (2 consecutive HIV-1 RNA ≥1000 copies/mL) on first-line TEE. Participants were randomly assigned (1:1) to switch to tenofovir-lamivudine-dolutegravir (TLD) with a supplementary 50 mg dolutegravir dose or placebo taken 12 hours later for 14 days. Primary outcome was proportion with HIV-1 RNA &lt;50 copies/mL at week 24. This study was not powered to compare arms.

Results
One hundred thirty participants were randomized (65 to each arm). Median baseline HIV-1 RNA was 4.0 log10 copies/mL and 76% had baseline resistance to both tenofovir and lamivudine. One participant died and 2 were lost to follow-up. At week 24, 55 of 64 (86% [95% confidence interval {CI}: 75%–93%]) in the supplementary dolutegravir arm and 53 of 65 (82% [95% CI: 70%–90%]) in the placebo arm had HIV-1 RNA &lt;50 copies/mL. Grade 3 or 4 adverse events were similar in frequency between arms. None of 6 participants (3 in each arm) eligible for resistance testing by 24 weeks developed dolutegravir resistance.

Conclusions
Our findings do not support the need for initial dolutegravir dose adjustment in patients switching to TLD who failed first-line TEE.

Clinical Trials Registration
NCT03991013.
Drosophila postembryonic nervous system development: a model for the endocrine control of development
Authors: Truman James W , Riddiford Lynn M 
Published: January 2023

Abstract
During postembryonic life, hormones, including ecdysteroids, juvenile hormones, insulin-like peptides, and activin/TGFβ ligands act to transform the larval nervous system into an adult version, which is a fine-grained mosaic of recycled larval neurons and adult-specific neurons. Hormones provide both instructional signals that make cells competent to undergo developmental change and timing cues to evoke these changes across the nervous system. While touching on all the above hormones, our emphasis is on the ecdysteroids, ecdysone and 20-hydroxyecdysone (20E). These are the prime movers of insect molting and metamorphosis and are involved in all phases of nervous system development, including neurogenesis, pruning, arbor outgrowth, and cell death. Ecdysteroids appear as a series of steroid peaks that coordinate the larval molts and the different phases of metamorphosis. Each peak directs a stereotyped cascade of transcription factor expression. The cascade components then direct temporal programs of effector gene expression, but the latter vary markedly according to tissue and life stage. The neurons read the ecdysteroid titer through various isoforms of the ecdysone receptor, a nuclear hormone receptor. For example, at metamorphosis the pruning of larval neurons is mediated through the B isoforms, which have strong activation functions, whereas subsequent outgrowth is mediated through the A isoform through which ecdysteroids play a permissive role to allow local tissue interactions to direct outgrowth. The major circulating ecdysteroid can also change through development. During adult development ecdysone promotes early adult patterning and differentiation while its metabolite, 20E, later evokes terminal adult differentiation.
Geodetic modelling of the 2022Mw 6.6 Menyuan earthquake: insight into the strain-partitioned northern Qilian Shan fault system and implications for regional tectonics and seismic hazards
Authors: Zhang Yingfeng , Chen Jie , Gong Wenyu , Han Nana , Liu Yunhua , Shan Xinjian 
Published: January 2023

SUMMARYStrain partitioning between strike-slip faults in mountains and thrust faults in the foreland is a typical mountain building process to accommodate oblique plate convergence. Studying the geometry and movement of such strain-partitioned fault systems is key to understanding the mountain building process and related seismic hazards. The 2022 Mw 6.6 Menyuan earthquake is the largest strike-slip earthquake to have ruptured the northern Qilian Shan fault system in the modern geodetic era. We combined satellite and field observations to determine the fault geometry and coseismic slip distribution in the Menyuan earthquake, and link the distribution of coseismic slip with the pattern of interseismic strain accumulation within the northern Qilian Shan from our geodetic slip model. We find that the Menyuan earthquake ruptured a 25 km-long section of the left-lateral Longlongling Fault between the surface and 7 km depth. The maximum slip was 4 m at 3–4 km depth. Damage to a high-speed railway tunnel recorded a fault offset of 2.7 m at a depth of 200 m compared to 2.5–3.0 m on the surface, suggesting that dispersion of the rupture through unconsolidated shallow sediments was limited, at least at the tunnel site. We also determined the pattern of interseismic deformation prior to the earthquake using Interferometric Synthetic Aperture Radar and Global Navigation Satellite System data. We found the interseismic geodetic data can be explained by the oblique movement of a low-angle décollement beneath the Qilian Shan rather than a strain partitioning fault system. We suggested that the strike-slip faults and foreland thrusts are separated by a creeping décollement, which would act as a barrier to stop the cascading rupture of the strike-slip and thrust fault.