bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between care home residents’ characteristics and acute hospital admissions – a retrospective, register-based cross-sectional study
Authors: Kristensen Gitte Schultz , Kjeldgaard Anette Hvenegaard , Søndergaard Jens , Andersen-Ranberg Karen , Pedersen Andreas Kristian , Mogensen Christian Backer 
Published: April 2023

Abstract
Background
Care home residents are frail, multi-morbid, and have an increased risk of experiencing acute hospitalisations and adverse events. This study contributes to the discussion on preventing acute admissions from care homes. We aim to describe the residents’ health characteristics, survival after care home admission, contacts with the secondary health care system, patterns of admissions, and factors associated with acute hospital admissions.

Method
Data on all care home residents aged 65 + years living in Southern Jutland in 2018–2019 (n = 2601) was enriched with data from highly valid Danish national health registries to obtain information on characteristics and hospitalisations. Characteristics of care home residents were assessed by sex and age group. Factors associated with acute admissions were analysed using Cox Regression.

Results
Most care home residents were women (65.6%). Male residents were younger at the time of care home admission (mean 80.6 vs. 83.7 years), had a higher prevalence of morbidities, and shorter survival after care home admission. The 1-year survival was 60.8% and 72.3% for males and females, respectively. Median survival was 17.9 months and 25.9 months for males and females, respectively. The mean rate of acute hospitalisations was 0.56 per resident-year. One in four (24.4%) care home residents were discharged from the hospital within 24 h. The same proportion was readmitted within 30 days of discharge (24.6%). Admission-related mortality was 10.9% in-hospital and 13.0% 30 days post-discharge. Male sex was associated with acute hospital admissions, as was a medical history of various cardiovascular diseases, cancer, chronic obstructive pulmonary disease, and osteoporosis. In contrast, a medical history of dementia was associated with fewer acute admissions.

Conclusion
This study highlights some of the major characteristics of care home residents and their acute hospitalisations and contributes to the ongoing discussion on improving or preventing acute admissions from care homes.

Trial registration
Not relevant.
Should rapid antigen tests be first-line for COVID-19 testing? Results of a prospective urban cohort study
Authors: Hassoun Mohamad Rani , Kudlapur Nathan T. , Chen Grace M. , Green-Ross Jenna , Patel Ashlesha 
Published: April 2023

Abstract
Background
A highly accurate, rapid, and low-cost COVID-19 test is essential for guiding isolation measures. To date, the most widely used tests are either nucleic acid amplification tests or antigen tests. The objective of this study is to further assess the diagnostic performance of the Binax-CoV2 rapid antigen test in comparison to the current gold standard reverse transcription quantitative polymerase chain reaction (RT-qPCR), with additional analysis of symptomatology and cycle threshold utility.

Methods
This is a prospective cohort study performed between November and December 2020. Individuals who presented to COVID-19 testing events and received both RT-qPCR and a rapid antigent test were included. Testing occurred at the emergency department of an urban hospital and at a community mobile unit. No fees or appointments were required. Individuals self-reported the presence or absence of symptoms and history of positive COVID-19 test within the previous two weeks. Trained staff collected two subsequent nasopharyngeal swabs of both nares. One set of swabs underwent RT-qPCR and the other underwent Binax-CoV2 assay per manufacturer guidelines.

Results
A total of 390 patients were included, of which 302 were from the community site. Of these 302, 42 (14%) were RT-qPCR positive. Of the 42 RT-qPCR positive, 30 (71.4%) were also positive by Binax-CoV2. The Binax-CoV2 test had a sensitivity of 71.4% (95% CI: 55%–84%) and a specificity of 99.6% (95% CI: 98%–100%) in this population. Performance of the Binax-CoV2 test performed better in individuals with higher viral load. For symptomatic patients with cycle threshold < 20, sensitivity reached 100%.

Conclusions
The Binax-CoV2 assay’s specificity and sensitivity in individuals with high viral load makes it a suitable first-line test for detecting COVID-19. However, given the assay’s measured sensitivity, a negative result on the Binax-CoV2 assay may warrant additional testing with more sensitive tests, such as the RT-qPCR. This is particularly the case with high clinical suspicion for an active SARS-CoV-2 infection even after a negative Binax-CoV2 result.
Evaluation of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Epidemiology, clinical characteristics, and outcomes in the older patients in a tertiary teaching hospital in Malaysia
Authors: Hasmukharay Kejal , Ngoi Soo Tein , Saedon Nor Izzati , Tan Kit Mun , Khor Hui Min , Chin Ai Vyrn , Tan Maw Pin , Kamarulzaman Adeeba , Idris Nuryana binti , Niek Wen Kiong , Teh Cindy Shuan Ju , Kamaruzzaman Shahrul Bahyah binti , Ponnampalavanar Sasheela Sri La Sri 
Published: April 2023

Abstract
Background
Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a major concern in the global healthcare system. However, data from Asian regions dealing with the singularity of this infection in older persons is lacking. We aimed to identify the differences in the clinical characteristics and outcomes of MRSA bacteremia between adults aged 18–64 and ≥ 65 years.

Methods
A retrospective study cohort was conducted at the University Malaya Medical Centre (UMMC) on cases of MRSA bacteremia from 2012 to 2016. Patient demographic and clinical data were collected for risk factors analyses.

Results
New cases of MRSA bacteremia showed a trend of increase from 0.12 to 100 admissions in 2012 to 0.17 per 100 admissions in 2016 but a drop was observed in 2014 (0.07 per 100 admissions). Out of the 275 patients with MRSA bacteremia, 139 (50.5%) patients were aged ≥ 65 years old. Co-morbidities and severity at presentation were significantly higher among older adults, including diabetes mellitus (p = 0.035), hypertension (p = 0.001), and ischemic heart disease (p < 0.001), as well as higher Charlson Comorbidity Index (p < 0.001) and Pitt bacteremia scores (p = 0.016). Central line-associated bloodstream infections were more common among younger patients (37.5% vs. 17.3% in older patients, p < 0.001), while skin and soft tissue infections are more frequent among older adults (20.9% vs. 10.3% in younger patients, p = 0.016). All-cause mortality and in-hospital mortality were significantly higher in older patients (82.7% and 56.1% vs. 63.2% and 28.7% in younger patients, p < 0.001). Multivariate analysis revealed age ≥ 65 years (adjusted odds ratio: 3.36; 95% confidence interval: 1.24–9.13), Pitt score ≥ 3 (2.15; 1.54–3.01), hospital (6.12; 1.81–20.72) and healthcare (3.19; 1.30–7.81) acquisition of MRSA, indwelling urinary catheters (5.43; 1.39–21.23), inappropriate targeted treatment (8.08; 1.15–56.86), lack of infectious disease team consultation (2.90; 1.04–8.11) and hypoalbuminemia (3.31; 1.25–8.79), were significant risk factors for 30-day mortality.

Conclusion
Older patients’ risk of mortality from MRSA bacteremia was three times higher than younger patients. Our data will contribute to developing and validating a robust scoring system for risk-stratifying patients to achieve better management and improved clinical outcomes.
Ectopic intrapulmonary thyroid masquerading as metastatic carcinoma of the lung: a rare case scenario
Authors: Zhuo Yuejian , Yu Han , Zhou Xingjian , Zhang Dongdong 
Published: April 2023

Abstract
Background
The intrapulmonary ectopic thyroid gland is exceedingly rare since the ectopic thyroid was discovered. Only eight cases have been reported in the worldwide literature. We present a case of multiple intrapulmonary ectopic thyroid glands with nodular goiter in a 10-year-old girl.

Case presentation
The girl was found with multiple intrapulmonary nodules in bilateral lungs during the treatment of nodular goiter. The intrapulmonary lesions were initially thought to be a high possibility of metastatic cancer. A computed tomography-guided percutaneous lung biopsy was performed, and the pathological examination confirmed that the diagnosis was ectopic intrapulmonary thyroid.

Conclusion
The ectopic intrapulmonary thyroid should be considered when children with nodular goiter presenting with suspected metastases in the lung.
The role of well-child visits in detecting developmental delay in preschool children
Authors: Moser M. , Müllner C. , Ferro P. , Albermann K. , Jenni O. G. , von Rhein M. 
Published: April 2023

Abstract
Background
Early detection of developmental delay (DD) in preschool children is crucial for counselling parents, initiating diagnostic work-up, and starting early intervention (EI).

Methods
We conducted a register study of all preschool children referred for EI in the Canton of Zurich, Switzerland, in 2017 (N = 1,785) and used an online survey among primary care physicians (PCPs, N = 271) to evaluate the care service of DD children.

Results
PCPs accounted for 79.5% of all referrals by physicians and had correctly referred over 90% of the children in need of EI at an average age of 39.3 months (SD 8.9). In the survey, which represents 59.2% of all pediatricians and 11.3% of all general practitioners in the Canton, PCPs reported performing a mean of 13.5 (range 0–50, SD 10.7) well-child visits per week to preschool children and estimated well-child visits to be the most frequent type of consultation (66.7%) for the identification of DD. Parents’ hesitancy in accepting further evaluation or support were reported by 88.7%.

Conclusions
Most preschool children with DD are identified in well-child visits. These visits represent an ideal opportunity for early detection of developmental impairment and initiation of EI. Carefully addressing parents’ reservations could reduce the rate of refusal, thus improving early support for children with DD.
Assessing reliability and validity of the Chinese version of the Crown-Crisp Experience Index and its application in pneumoconiosis patients
Authors: Cai Fulin , Xue Sheng , Zhang Mei , Chen Xiufeng , Zhang Jing , Bao Yi , Li Yaqiang 
Published: April 2023

AbstractIn China, among all patients with occupational diseases, 90% have pneumoconiosis. The disease, which leads to psychological problems, seriously affects patients’ lives. The Crown-Crisp Experience Index (CCEI) is a multidimensional questionnaire to assess patients’ psychological conditions. Yet there is no Chinese version of CCEI. This study, therefore, aims to develop a Chinese CCEI, in line with standard localization procedures, by translating, back-translating, and culturally adapting the original English version. The final Chinese version comprises 47 items in six dimensions. The reliability and validity of the Chinese CCEI were tested by analyzing the data collected from 1,000 pneumoconiosis patients from an occupational disease prevention and treatment hospital. A rank sum test was carried out to compare the phobic anxiety (PHO) between pneumoconiosis patients and retired miners. The results of exploratory factor analysis show six principal components, which explain a total of 78.246% variances. Confirmatory factor analysis shows that the Chi-square freedom ratio (χ2/df) were less than 3, the root mean square error approximation (RMSEA) were less than 0.05, comparative fit Index(CFI) and incremental fit index (IFI) were greater than 0.9, average variance extracted(AVE) in six dimensions were less than 0.5, residual variances(CR) were greater than 0.8, Cronbach’s alpha coefficient 0.839, Omega ω coefficient 0.889, and S-CVI 0.88. The PHO of pneumoconiosis patients was significantly higher than that of retired miners exemplified by a statistical difference (P < 0.05). The study shows that the Chinese version of CCEI enjoys a high degree of reliability and validity and thus can be used as a screening tool for measuring patients’ anxiety and fear levels.
Construction and validation of cognitive frailty risk prediction model for elderly patients with multimorbidity in Chinese community based on non-traditional factors
Authors: Peng Shuzhi , Zhou Juan , Xiong Shuzhen , Liu Xingyue , Pei Mengyun , Wang Ying , Wang Xiaodong , Zhang Peng 
Published: April 2023

AbstractBackground and objectivesEarly identification of risk factors and timely intervention can reduce the occurrence of cognitive frailty in elderly patients with multimorbidity and improve their quality of life. To explore the risk factors, a risk prediction model is established to provide a reference for early screening and intervention of cognitive frailty in elderly patients with multimorbidity.MethodsNine communities were selected based on multi-stage stratified random sampling from May–June 2022. A self-designed questionnaire and three cognitive frailty rating tools [Frailty Phenotype (FP), Montreal Cognitive Assessment (MoCA), and Clinical Qualitative Rating (CDR)] were used to collect data for elderly patients with multimorbidity in the community. The nomogram prediction model for the risk of cognitive frailty was established using Stata15.0.ResultsA total of 1200 questionnaires were distributed in this survey, and 1182 valid questionnaires were collected, 26 non-traditional risk factors were included. According to the characteristics of community health services and patient access and the logistic regression results, 9 non-traditional risk factors were screened out. Among them, age OR = 4.499 (95%CI:3.26–6.208), marital status OR = 3.709 (95%CI:2.748–5.005), living alone OR = 4.008 (95%CI:2.873–5.005), and sleep quality OR = 3.71(95%CI:2.730–5.042). The AUC values for the modeling and validation sets in the model were 0. 9908 and 0.9897. Hosmer and Lemeshow test values for the modeling set were χ2 = 3.857,p = 0.870 and for the validation set were χ2 = 2.875,p = 0.942.ConclusionThe prediction model could help the community health service personnel and elderly patients with multimorbidity and their families in making early judgments and interventions on the risk of cognitive frailty.
Identification of a m6A-related ferroptosis signature as a potential predictive biomarker for lung adenocarcinoma
Authors: Li Dongdong , Chen Ting , Li Qiu-Gen 
Published: April 2023

Abstract
Background
Both N6-methyladenosine (m6A) and ferroptosis-related genes are associated with the prognosis of lung adenocarcinoma. However, the predictive value of m6A-related ferroptosis genes remains unclear. Here, we aimed to identify the prognostic value of m6A-related ferroptosis genes in lung adenocarcinoma.

Methods
Lung adenocarcinoma sample data were downloaded from the University of California Santa Cruz Xena and Gene Expression Omnibus databases. Spearman’s correlation analysis was used to screen for m6A-related ferroptosis genes. Univariate Cox regression, Kaplan–Meier, and Lasso analyses were conducted to identify prognostic m6A-related ferroptosis genes, and stepwise regression was used to construct a prognostic gene signature. The predictive value of the gene signature was assessed using a multivariate Cox analysis. In the validation cohort, survival analysis was performed to verify gene signature stability. The training cohort was divided into high- and low-risk groups according to the median risk score to assess differences between the two groups in terms of gene set variation analysis, somatic mutations, and tumor immune infiltration cells.

Results
Six m6A-related ferroptosis genes were used to construct a gene signature in the training cohort and a multivariate Cox analysis was conducted to determine the independent prognostic value of these genes in lung adenocarcinoma. In the validation cohort, Kaplan–Meier and receiver operating characteristic analyses confirmed the strong predictive power of this signature for the prognosis of lung adenocarcinoma. Gene set variation analysis showed that the low-risk group was mainly related to immunity, and the high-risk group was mainly related to DNA replication. Somatic mutation analysis revealed that the TP53 gene had the highest mutation rate in the high-risk group. Tumor immune infiltration cell analysis showed that the low-risk group had higher levels of resting CD4 memory T cells and lower levels of M0 macrophages.

Conclusion
Our study identified a novel m6A-related ferroptosis-associated six-gene signature (comprising SLC2A1, HERPUD1, EIF2S1, ACSL3, NCOA4, and CISD1) for predicting lung adenocarcinoma prognosis, yielding a useful prognostic biomarker and potential therapeutic target.
Protoscolicidal effects of curcumin nanoemulsion against protoscoleces of Echinococcus granulosus
Authors: Teimouri Aref , Jafarpour Azami Sanaz , Hashemi Hafshejani Saeedeh , Ghanimatdan Mohammad , Bahreini Mohammad Saleh , Alimi Rasoul , Sadjjadi Seyed Mahmoud 
Published: April 2023

AbstractBackgroundThe aim of the present study was to assess in vitro protoscolicidal effects of curcumin nanoemulsion (CUR-NE) against protoscoleces of cystic echinococcosis (CE)/hydatid cysts.MethodsThe CUR-NE was prepared via spontaneous emulsification of soybean as the oil phase, a mixture of Tween 80 and Tween 85 as the surfactant, ethanol as the co-surfactant and distilled water. Various concentrations of CUR-NE (156, 312, 625 and 1250 µg/ml) were exposed to collected protoscoleces of infected sheep liver hydatid cysts for 10, 20, 30, 60 and 120 min. Viability of the protoscoleces were assessed using eosin exclusion test. Morphological changes of the protoscoleces were observed using differential interference contrast (DIC) microscopy.ResultsThe mean particle size and zeta potential of CUR-NE included 60.4 ± 14.8 nm and − 16.1 ± 1.1 mV, respectively. Results showed that the viability of the protoscoleces decreased significantly with increases in CUR-NE concentrations (p < 0.001). The mortality rates of protoscoleces with exposure to concentrations of 1250 and 625 µg/ml of CUR-NE for 60 min were 94 and 73.33%, respectively. Mortality of the protoscoleces was 100% after 120 min of exposure to 1250 and 625 µg/ml concentrations of CUR-NE. Using NIC microscopy, extensively altered tegumental surface protoscoleces was observed after protoscoleces exposure to CUR-NE.ConclusionThe findings of the present study revealed the in vitro protoscolicidal potential of CUR-NE. Therefore, CUR-NEs are addressed as novel protoscolicidal agents, which can be used as an alternative natural medicine to kill the protoscoleces, owing to their low toxicity and significant inhibition potency. However, further studies are necessary to investigate pharmacologic and pharmacokinetics of CUR-NEs.
Experience of pediatric nurses in nursing dying children - a qualitative study
Authors: Bian Weina , Cheng Junxiang , Dong Yue , Xue Ying , Zhang Qian , Zheng Qinghua , Song Rui , Yang Hongwei 
Published: April 2023

AbstractPurposeTo explore pediatric nurses’ challenges and effective coping strategies in caring for dying children.MethodsA descriptive qualitative study was adopted. Data were collected using a semi-structured interview with ten nurses from the pediatric, pediatric emergency, and neonatology departments.ResultsThree themes were generated: stressors, consequences, and coping strategies. Ten sub-themes were generalized: negative emotions; helplessness; questioning rescue behavior; fear of communication; lack of workforce for night rescue; compassion fatigue; burnout; changes in life attitudes; self-regulation; leadership approval and no accountability.ConclusionsThrough qualitative research, nurses’ challenges and effective coping strategies in caring for dying children were found, which provides information for nurses’ career development and related policy formulation in China.Clinical relevanceWhile there are many articles in China on hospice care, there is little research on the nurses’ experience of caring for dying children. Many studies have mentioned the adverse consequences of caring for dying children in foreign countries, leading to post-traumatic stress disorder (PTSD). However, domestic discussion of such problems is rare, and no corresponding coping strategies exist. This study explores pediatric nurses’ challenges and effective coping strategies in caring for dying children.
Description of the nationally implemented National Health Service digital diabetes prevention programme and rationale for its development: mixed methods study
Authors: Miles Lisa M , Hawkes Rhiannon E , French David P 
Published: April 2023

Abstract
Background
The National Health Service (NHS) Digital Diabetes Prevention Programme (DDPP) is a behaviour change programme for adults in England who are at high risk of developing type 2 diabetes. Four independent providers deliver the NHS-DDPP following a competitive tendering process. Although providers work to a single service specification, there is potential for some variation in the service across providers. This study (1) assesses fidelity of the structural features of the design of the NHS-DDPP compared to the service specification, (2) describes the structural features of delivery of the NHS-DDPP as implemented (3) reports developers’ views on how the structural components of the NHS-DDPP were developed and why changes were made following implementation.

Methods
Using mixed methods, we conducted a document review of providers’ NHS-DDPP design and delivery documentation, and extracted information using the Template for Intervention Description and Replication checklist, which was adapted to capture features of digital delivery. Documentation was supplemented by content analysis of interviews with 12 health coaches involved in delivering the NHS-DDPP. Semi-structured interviews were also conducted with 6 programme developers employed by the digital providers.

Results
Provider plans for the NHS-DDPP show relatively high fidelity to the NHS service specification. Despite this, there was wide variation in structural features of delivery of the NHS-DDPP across providers, particularly for delivery of ‘support’ (e.g. use, dose and scheduling of health coaching and/or group support). Interviews with developers of the programmes showed that much of this variation is likely to be attributable to the origin of each provider’s programme, which was usually a pre-existing programme that was adapted to conform to the NHS-DDPP service specification. The NHS-DDPP is continually improved and developed based on user experience feedback and research conducted by the providers.

Conclusion
Indirect evidence suggests that variation in delivery of support could affect effectiveness of the NHS-DDPP. A priority for future research is ascertaining whether the variation in delivery of the NHS-DDPP across providers is related to any differences in health outcomes. It is recommended that future rounds of commissioning the NHS-DDPP pre-specify the type of support participants should receive, including expected dose and scheduling.