bluuebunny/crossref_metadata_2025_split huggingface dataset:
N06 The Introduction of Nurse Led Preconception and Pregnancy Education Clinics for patients with Inflammatory Bowel Disease
Authors: Gleeson S , Buckley P M , McCarthy D J , Moran D C , O'Sullivan C , O'Sullivan G , O'Grady D J , Sugrue K 
Published: January 2023

Abstract

Background
•The Inflammatory Bowel Disease Centre in the Mercy University Hospital ( MUH) has a patient population of approximately 4000 patients with IBD, of these roughly half are women and many are diagnosed during their reproductive years. • Caring for this patient cohort can be a challenge due to patient lack of knowledge surrounding IBD and pregnancy misinformation that can occur.
• The aim of this project was to identify the unmet education needs of patients in relation to pregnancy and IBD. Subsequent aims were to improve patient care through the establishment of IBD preconception and pregnancy education clinics

Methods
•An audit was carried out at the IBD infusion suite and Nurse led clinics over a 20-week period between April- August 2021. 448 patients between the ages of 18-45 were identified during this timeframe and asked to complete and IBD and pregnancy questionnaire. • The questions to assess education needs were Q1) Are you planning pregnancy in the next 2years? Q2 Has your diagnosis of IBD affected your family planning in any way? Q3) Do you feel well informed/prepared from an IBD perspective to start/continue your family? Q4) Do you have any questions or concerns regarding IBD and pregnancy e.g. Disease flare up impact on pregnancy, mediation queries/concerns, impact of pregnancy disease process Q5) What do you feel the percentage risk of your baby developing IBD would be ( 0-10%, 10-20%,20-40% or &gt;40%) Q6 Would you be interested in attending a pregnancy education clinic led by and Advanced Nurse Practitioner?

Results
•55% of respondents were women. • 89% of respondents felt they needed more education on IBD and pregnancy. • 70% of respondents were concerned about the impact of an IBD flare up on fetal health with 19% remaining voluntarily childless. • 95% of patients had questions/concerns about the effects of biologic drugs on pregnancy outcomes. • 90% of patients said they would attend IBD ANP led preconception and pregnancy education clinics. • 84% of patients overestimated the percentage risk of their offspring developing IBD, with 59% estimating the risk to be greater than 20%

Conclusion
•This audit identified the need for preconception and pregnancy education clinics for patients with IBD to improve patient education, care and outcomes.
ANP led preconception and pregnancy education clinics have been established since October 2021 & are ongoing. Currently between 8-12 patients attend exclusively for preconception counselling per month. Referrals are received from Consultants within the IBD Centre MUH
N29 Audit of Inflammatory Bowel Disease Telephone Advice Line
Authors: Walsh C 
Published: January 2023

Abstract

Background
Inflammatory Bowel Disease (IBD) is a chronic unpredictable condition of the gastrointestinal tract and advice lines for chronic disease are well established. Advice lines are a fundamental part of the Inflammatory Bowel Disease services. They offer advice and support for patients and have been shown that early intervention via an advice line can have a major impact in avoiding hospitalisation due to a flare up. Inflammatory Bowel Disease advice lines provide for multiple queries in relation to IBD and increasing demands were observed. The introduction and increased use of biologic medication (subcutaneous and oral) requires a repeat Hi Tech prescription and this has increased the workload through the IBD advice line.
The aim was establish if aspects of the IBD advice line was in accordance with IBD Standards UK and to highlight any deficiencies that would require corrective action

Methods
Data was collected on all telephone calls received by the ANP IBD advice line during the data period 17/01/2022 to 11/02/2022 (n=80). The average number of monthly calls to the service is 146. Prospective data was collected by ANP IBD and analysed by the Clinical Audit Facilitator using IBM SPSS Statistics v 24.
Criteria used to measure against:
Rapid access to specialist advice should be available to patients to guide early flare intervention, including access to a telephone/email advice line with response by the end of the next working day ( IBD Standards UK)

Results
The highest number of calls to the advice line was 23/80 (29%) for a Hi Tech prescription. Flare up calls consisted of 21.2% of the calls and results investigations was equal to this. Administration queries and medication queries consisted of 7.5% of the calls. Clinical related queries were almost 9% of the calls.
59% of calls were returned within 36 hours. Mean interval of time call was returned was 34.7 hours and a median interval of 28 hours.

Conclusion
The audit indicates the highest number of calls are for repeat Hi tech prescriptions for medications. A Quality Improvement Plan includes the establishment of a dedicated Hi Tech Prescription Telephone/Virtual Clinic. This will also ensure an improved quality and a safer standard of care for patients. .
The audit further identifies the number of calls and the effectiveness of the Inflammatory Bowel Disease advice line e.g. the number of calls (17/80) that dealt with a flare up that would have possibly attended the Emergency Department. It also highlights the time intervals for return of calls (33/80) calls were returned &gt; 36 hours. A new Clinical Nurse Specialist Inflammatory Bowel Disease would improve service outcomes.
Going under the bridge: unmasking ischaemia and endothelial dysfunction of myocardial bridging: a case report
Authors: Bhogal Sukhdeep , Waksman Ron , Hashim Hayder 
Published: January 2023

AbstractBackgroundPhysiological assessment of myocardial bridging prevents unnecessary interventions. Non-invasive workup or visual coronary artery compression may underestimate the underlying ischaemia associated with myocardial bridging in symptomatic patients.Case summaryA 74-year-old male presented to the outpatient clinic with chest pain and shortness of breath on exertion. He underwent coronary artery calcium scan showing an elevated calcium score of 404. On follow-up, he endorsed progressive worsening of symptoms with chest pain and decreased exercise tolerance. He was then referred for coronary angiography that revealed mid-left anterior descending myocardial bridging with initial normal resting full-cycle ratio of 0.92. Further workup after ruling out coronary microvascular disease demonstrated abnormal hyperaemic full-cycle ratio of 0.80 with a diffuse rise across the myocardial bridging segment on pullback. Our patient also had increased spastic response to hyperaemia on angiography, supporting the presence of underlying endothelial dysfunction and ischaemia, likely contributing to his exertional symptomology. The patient was started on beta-blocker therapy with improvement in symptoms and resolution of chest pain on follow-up.ConclusionOur case highlights the importance of thorough workup of myocardial bridging in symptomatic patients to better understand the underlying physiology and endothelial function after ruling out microvascular disease and consideration of hyperaemic testing if symptoms are suggestive of ischaemia.
Transcatheter aortic valve implantation for patient with non-calcified bicuspid aortic valve: a case report
Authors: Nonaka Hideaki , Asami Masahiko , Miura Sumio , Tanabe Kengo 
Published: January 2023

AbstractBackgroundNon-calcified aortic stenosis (AS) is rare and is associated with a high risk of transcatheter valve embolization and migration (TVEM) because aortic valve complex calcification is important for stable anchoring of the prosthesis. Therefore, transcatheter aortic valve implantation (TAVI) for non-calcified AS is not preferred. However, a universally accepted strategy for TAVI in such patients is not yet established.Case summaryA 69-year-old woman with symptomatic severe AS and a high surgical risk was admitted to our institution for TAVI. Pre-procedural computed tomography (CT) revealed a non-calcified bicuspid aortic valve. Implantation of a 23 mm self-expandable valve (SEV) was planned according to the manufacturer’s recommended optimal size based on CT measurements. Intraoperatively, the 23 mm SEV did not snugly fit at the aortic apparatus level. Thus, we deployed a 26 mm SEV with stable anchoring because of the stronger radial force. She was discharged without any complication. Echocardiography at 3 months follow-up showed a well-functioning transcatheter heart valve (THV) without migration or paravalvular leakage.DiscussionIn our patient with non-calcified bicuspid AS, an SEV that was one size larger than the optimal as measured on CT was successfully implanted without THV embolization. An upsized SEV may be considered when performing TAVI in patients with severe non-calcified AS.
Prasugrel dose de-escalation in diabetic patients with acute coronary syndrome receiving percutaneous coronary intervention: results from the HOST-REDUCE-POLYTECH-ACS trial
Authors: Lee Kyu-Sun , Park Keun-Ho , Park Kyung Woo , Rha Seung-Woon , Hwang Doyeon , Kang Jeehoon , Han Jung-Kyu , Yang Han-Mo , Kang Hyun-Jae , Koo Bon-Kwon , Lee Nam-ho , Rhew Jay Young , Chun Kook Jin , Lim Young-Hyo , Bong Jung Min , Bae Jang-Whan , Lee Bong Ki , Kim Seok-Yeon , Shin Won-Yong , Lim Hong-Seok , Park Kyungil , Kim Hyo-Soo 
Published: January 2023

AbstractAimsThe aim of this study was to evaluate the efficacy and safety of prasugrel dose de-escalation therapy in patients with diabetes mellitus (DM)–acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI).Methods and resultsThis was a post-hoc analysis of the HOST-REDUCE-POLYTECH-ACS (Harmonizing Optimal Strategy for Treatment of Coronary Artery Diseases—Comparison of Reduction of Prasugrel Dose or Polymer Technology in ACS Patients) randomized trial. The efficacy and safety of prasugrel dose de-escalation therapy (prasugrel 5 mg daily) were compared with conventional therapy (prasugrel 10 mg daily) in patients with DM. The primary endpoint was net adverse clinical events (NACE), defined as a composite of all-cause death, non-fatal myocardial infarction (MI), stent thrombosis (ST), clinically driven revascularization, stroke, and Bleeding Academic Research Consortium (BARC) class ≥2 bleeding events. The secondary ischaemic outcome was major adverse cardiovascular and cerebrovascular events, defined as the composite of cardiac death, non-fatal MI, ST, or ischaemic stroke. Of 2338 patients randomized, 990 had DM. The primary endpoint of NACE occurred in 38 patients (7.6%) receiving prasugrel dose de-escalation and in 53 patients (11.3%) receiving conventional therapy among patients with DM [hazard ratio (HR) 0.66; 95% confidence interval (CI) 0.43–0.99; P = 0.049]. Prasugrel dose de-escalation as compared with conventional therapy did not increase the risk of ischaemic events (HR 1.03; 95% CI 0.56–1.88; P = 0.927) but decreased BARC class ≥2 bleeding in patients with DM (HR 0.44; 95% CI 0.23–0.84; P = 0.012).ConclusionPrasugrel dose de-escalation compared with conventional therapy may reduce the risk of net clinical outcomes, mostly driven by a reduction in bleeding without an increase in ischaemic events in patients with DM.Trial Registration: HOST-REDUCE-POLYTECH-ACS, NCT02193971, https://clinicaltrials.gov/ct2/show/NCT02193971
LDL lowering effect of PCSK9 inhibition is reduced in women
Authors: Myasoedova Veronika A , Rimbert Antoine , Camera Marina , Le May Cedric , Capoulade Romain , Cariou Bertrand , Poggio Paolo 
Published: January 2023

Abstract

Aims
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of plasma low-density lipoprotein cholesterol (LDL-C) concentration, and its inhibition reduces the risk of atherosclerotic cardiovascular disease (ASCVD). We aimed to assess the sex-differential effect of either pharmacological or genetic inhibition of PCSK9 on LDL-C levels.

Methods and results
We meta-analyzed six real-life studies (1216 men and 641 women) that investigated the effects of PCSK9 monoclonal antibodies (mAbs) on LDL-C reduction in men and women. Despite higher LDL-C levels in women at baseline [mean difference (MD) = 17.4 mg/dL, P &lt; 0.0001, women = 175 mg/dL vs. men = 152 mg/dL], the LDL-C reduction under PCSK9 mAb treatment was significantly greater in men (MD = 7.6 mg/dL, 95% confidence interval: 2.7–12.4, P = 0.002) than in women.
We tested the sex-related association of the loss-of-function variant PCSK9-R46L with LDL-C plasma levels in 382 813 individuals (219 301 women and 163 512 men) free of lipid-lowering drugs from the UK Biobank general population cohort. The magnitude of LDL-C reduction was larger in men than in women (mean LDL-C difference: –35 mg/dL vs. –26 mg/dL, when comparing homozygous carriers with non-carriers in men and women, respectively). The relationship between PCSK9-R46L and LDL-C was significantly dependent on sex (P for interaction = 7.2e–04).

Conclusion
These results demonstrate by complementary approaches that the decrease in LDL-C mediated by PCSK9 inhibition is slightly, but significantly, less marked in women than in men. These data reinforce the need for specific studies to develop sex-specific recommendations for the management of ASCVD in women.
Conan Doyle and the rhetoric of genre
Authors: Kerr Douglas 
Published: January 2023

Abstract
Arthur Conan Doyle is recognized as a master of narrative. This essay argues that this mastery expresses itself in his management of genre, at a time when social and cultural changes had created a literary environment that saw the emergence of what is now called genre fiction. Crucial elements in the field of literary publishing which his stories served included the expansion of the monthly magazine market, the emergence of the short story as a popular form of fiction, and the appearance of a broad-based new reading public, well educated in the conventions of genre fiction and equipped with reading skills deriving from this ‘genre literacy’, which an author like Conan Doyle could foster and manipulate for rhetorical effect. I describe the conditions that created a taste for the popular genre fiction on which, somewhat to his chagrin, Conan Doyle’s reputation rested. He moved between genres with a versatility rivalled in his time only by Rudyard Kipling. But he also combined genres together in a single work, so as to satisfy or unsettle, disappoint, reward, or wrong-foot his readers pleasurably by playing on the expectations aroused by cues in the tales. Rather than the detective fiction which he made his own, I turn to his experiments in the genre of ‘imperial Gothic’ to illustrate this, and examine the rhetoric of three short stories with narrative tropes that depend for their effect on the genre literacy of the reading public to whom they were offered.
Hybridization in the absence of an ecotone favors hybrid success in woodrats (Neotomaspp.)
Authors: Klure Dylan M , Greenhalgh Robert , Parchman Thomas L , Matocq Marjorie D , Galland Lanie M , Shapiro Michael D , Dearing M Denise 
Published: January 2023

AbstractHybridization is a common process that has broadly impacted the evolution of multicellular eukaryotes; however, how ecological factors influence this process remains poorly understood. Here, we report the findings of a 3-year recapture study of the Bryant’s woodrat (Neotoma bryanti) and desert woodrat (Neotoma lepida), two species that hybridize within a creosote bush (Larrea tridentata) shrubland in Whitewater, CA, USA. We used a genotype-by-sequencing approach to characterize the ancestry distribution of individuals across this hybrid zone coupled with Cormack–Jolly–Seber modeling to describe demography. We identified a high frequency of hybridization at this site with ~40% of individuals possessing admixed ancestry, which is the result of multigenerational backcrossing and advanced hybrid-hybrid crossing. F1, F2, and advanced generation hybrids had apparent survival rates similar to parental N. bryanti, while parental and backcross N. lepida had lower apparent survival rates and were far less abundant. Compared to bimodal hybrid zones where hybrids are often rare and selected against, we find that hybrids at Whitewater are common and have comparable survival to the dominant parental species, N. bryanti. The frequency of hybridization at Whitewater is therefore likely limited by the abundance of the less common parental species, N. lepida, rather than selection against hybrids.
Weathering the Storm: Discordant Learning about Reputations for Reliability
Authors: Donahue Bailee , Crescenzi Mark J C 
Published: January 2023

Abstract
It is well established that state reputations impact international politics, but less is known about how these reputations change. We investigate one form of change by examining how individuals process new information. Using a logic of discordant learning, we expect good reputations to survive new and incongruent information that counters expectations. Good reputations can help states “weather the storm” in times of crisis. Such buffers have their limits, however, as strong incongruent signals can trigger large corrections in a state’s reputation. To analyze these expectations, we focus on alliance reliability. Using a pair of survey experiments, we find that individuals alter their perceptions of a state’s reputation when observing signals that deviate from the state’s prior reputation, and that good reputations are able to “weather the storm”. We also find that strongly incongruent signals affect good reputations more than others, suggesting “the bigger they are, the harder they fall” may also apply. Even in these large corrections, however, a reputation for reliability has lasting benefits. The analysis helps us understand when to expect changes in reputations for alliance reliability, which in turn may inform when reputation loss can influence alliance politics.
Sucrose enhances the chromogenic ability ofStaphylococcus xylosusby improving nitric oxide synthase activity
Authors: Xu Zhiqiang , Zheng Wenbin , Zhao Shang , Chen Yong , Yang Qingli , Zhu Yinglian 
Published: January 2023

AbstractIn this paper, the effect of different concentrations of sucrose stress on color formation of the Staphylococcus xylosus was investigated. The results showed that the highest a* value and the best coloring effect similar to those of nitrite were observed after the addition of 0.05 g/mL sucrose to stress the S. xylosus. UV-Vis and electron spin resonance spectra analysis showed that production of coloring product Mb-NO was significantly enhanced after 0.05 g/mL sucrose stress. The growth curve, reactive oxygen content, cell cycle, nitric oxide synthase (NOS) activity, zeta potential, cell size, and protein composition of S. xylosus were investigated to reveal the mechanism of sucrose stress to enhance the coloring effect of the strain. The result showed that sucrose inhibited the growth of S. xylosus, which changed the physiological state by activating the oxidative stress response. The stress altered the rate of intracellular metabolism of S. xylosus by delaying the cell cycle and increasing cell surface zeta potential and cell particle size. These changes altered the protein composition of the cells and significantly enhanced the activity of intracellular NOS, which could improve the chromogenic ability of S. xylosus. This study will provide theoretical support for sucrose stress on S. xylosus to enhance its coloring effect, and sucrose stress for S. xylosus might be a promising biological alternative to nitrite in meat products.
Dual Roles of Cardiorespiratory Fitness and Fatigability in the Life-Space Mobility of Older Adults: The Study of Muscle, Mobility and Aging (SOMMA)
Authors: Moored Kyle D , Qiao Yujia (Susanna) , Rosso Andrea L , Toledo Frederico G S , Cawthon Peggy M , Cummings Steven R , Goodpaster Bret H , Kritchevsky Stephen B , Glynn Nancy W 
Published: January 2023

Abstract

Background
Cardiorespiratory fitness and perceived fatigability are interrelated components of physical capacity that may jointly influence movement within one’s living environment (life-space mobility). We examined whether fitness and fatigability were associated with life-space mobility in community-dwelling older adults, and whether the association of fitness with life-space varied by the level of perceived fatigability.

Methods
Participants were from the Study of Muscle, Mobility and Aging (SOMMA) baseline cohort (N = 775, mean age 76.1 years). Life Space Assessment scores incorporated level, frequency, and assistance used (personal, devices) for life-space mobility. Fitness was measured as VO2peak from symptom-limited treadmill testing. Fatigability cut-points included: (i) Borg Rating of Perceived Exertion (RPE) ≥ 10 after a fixed-speed (1.5 mph) treadmill test, (ii) the Pittsburgh Fatigability Scale (PFS) Physical ≥ 15, and (iii) PFS Mental ≥ 13. The total count of cut-points was used as a composite fatigability measure (range: 0–3). Linear regressions were adjusted for demographic, lifestyle, and health confounders.

Results
Better fitness was associated with greater life-space, but the association plateaued at higher fitness levels (VO2peak &gt; 18). Life-space was significantly lower for individuals meeting ≥2 fatigability criteria (vs none), attributable mainly to more severe physical, but not mental, fatigability. In moderation analyses, the fitness–life-space association was significant only for those with RPE ≥ 10 but did not differ by PFS.

Conclusion
Fitness below a critically low threshold was associated with limited life-space mobility, suggesting that certain older individuals may need to operate close to their maximum aerobic capacity to traverse daily environments; these associations were driven by those with more severe physical fatigability.