bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of early enteral nutrition on pancreatic fistula and long-term prognosis after distal pancreatectomy or enucleation of pancreatic tumours in a major academic university hospital in China: protocol for a single-centre randomised controlled trial
Authors: Yuan Jingya , Xiu Dianrong 
Published: August 2023

IntroductionPostoperative pancreatic fistula (POPF) remains one of the main complications following pancreatic resection. Despite pancreatic fistula having a low postoperative mortality rate, the readmission and intervention rates in patients with pancreatic fistula are still considerable. Although there are several studies on pancreatic fistula development after pancreaticoduodenectomy, there are only a few studies on the feeding protocols applied after distal pancreatectomy or enucleation of pancreatic tumours. We designed this trial to test the hypothesis that early feeding does not increase the incidence of POPF and positively influences the long-term prognosis in patients who undergo distal pancreatectomy or enucleation of pancreatic tumours.Methods and analysisThis is a prospective randomised controlled trial that will be conducted in a single centre. A total of 106 patients undergoing distal pancreatectomy or enucleation of pancreatic tumours will be recruited after providing informed consent. They will be randomly assigned to either an early or late feeding group. The early feeding group will begin enteral nutrition on postoperative day (POD) 3, and the late feeding group will begin enteral nutrition on POD7. The primary outcome is the incidence of POPF. The secondary outcomes include the length of postoperative hospital stay, postoperative complications, and indicators of long-term prognosis.Ethics and disseminationPeking University Third Hospital Medical Science Research Ethics Committee approved the study (M2021395). Findings will be disseminated in a peer-reviewed journal and in national and/or international meetings to guide future practice.Trial registration numberChiCTR2100053978.
The STAIR OF KNOWLEDGE—a codesigned intervention to prevent pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes in Sweden: development of a complex intervention
Authors: Neziraj Merita , Axelsson Malin , Kumlien Christine , Hellman Peter , Andersson Magdalena 
Published: August 2023

ObjectivesTo describe the development of a codesigned complex intervention intended to prevent the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes.DesignA complex intervention development study. The development of the intervention was conducted in three phases. We established contact with stakeholders in the municipality, updated us of current status of the literature in this area and conducted studies in the local context (1). We codesigned the intervention in workshops together with end users (2). We codesigned the final outline of the intervention in an iterative process with stakeholders (3).Setting: Nursing homes in the municipality in southern Sweden.ParticipantsEnd users (n=16) in nursing homes (n=4) codesigned the intervention together with the research group in workshops (n=4) in March–April 2022. Additionally, stakeholders (n=17) who were considered to play an important role in developing the intervention participated throughout this process. Data were analysed using reflexive thematic analysis.ResultsFour workshops were conducted with end users (n=16) and 13 meetings with stakeholders (n=12) were held during the development process. The intervention aims to bridge the evidence-practice gap regarding the preventive care process of the risks of pressure ulcers, malnutrition, poor oral health and falls among older persons in nursing homes. The intervention is aimed at end users, lasts for 3 weeks and is divided into two parts. First, end users obtain knowledge on their own by following written instructions. Second, they meet, interact and discuss the knowledge acquired during part 1.ConclusionThe intervention is robustly developed and thoroughly described. The study highlights the extensive process that is necessary for developing tailored complex interventions. The description of the entire development process may enhance the replicability of this intervention. The intervention needs to be tested and evaluated in an upcoming feasibility study.Trial registration numberNCT05308862.
Are temporal trends in retained foreign object rates after surgery in Switzerland impacted by increasing coding intensity? A retrospective analysis of hospital routine data from 2000 to 2019
Authors: Schwappach David , Havranek Michael M 
Published: August 2023

ObjectivesRetained foreign objects (RFOs) after surgery can cause harm to patients and negatively impact clinician and hospital reputation. RFO incidence based on administrative data is used as a metric of patient safety. However, it is unknown how differences in coding intensity across hospitals and years impact the number of reported RFO cases. The objective of this study is to investigate the temporal trend of RFO incidence at a national level and the impact of changes in coding practices across hospitals and years.DesignRetrospective study using administrative hospital data.Setting and participants21 805 005 hospitalisations at 354 Swiss acute-care hospital sitesPrimary and secondary outcome measuresRFO incidence over time, the distribution of RFOs across hospitals and the impact of differences in coding intensity across the hospitals and years.ResultsThe annual RFO rate more than doubled between 2000 and 2019 (from 4.6 to 11.8 with a peak of 17.0 in 2014) and coincided with increasing coding intensity (mean number of diagnoses: 3.4, SD 2.0 in 2000; 7.40, SD 5.2 in 2019). After adjusting for patient characteristics, two regression models confirmed that coding intensity was a significant predictor of both whether RFO cases were reported at the hospital level (OR: 12.94; 95% CI: 7.38 to 22.68) and the number of reported cases throughout the period at the national level (Incidence Rate Ratio (IRR): 5.95; 95% CI: 1.11 to 31.82).ConclusionsOur results raise concerns about the use of RFO incidence for comparing hospitals, countries and years. Utilising coding indices could be employed to mitigate the effects of coding intensity on RFO rates.
Biases in the collection of blood alcohol data for adult major trauma patients in Victoria, Australia
Authors: Lau Georgina , Gabbe Belinda , Mitra Biswadev , Dietze Paul , Reeder Sandra , Cameron Peter , Read David J , Symons Evan , Beck Ben 
Published: August 2023

BackgroundIn-hospital alcohol testing provides an opportunity to implement prevention strategies for patients with high risk of experiencing repeated alcohol-related injuries. However, barriers to alcohol testing in emergency settings can prevent patients from being tested. In this study, we aimed to understand potential biases in current data on the completion of blood alcohol tests for major trauma patients at hospitals in Victoria, Australia.MethodsVictorian State Trauma Registry data on all adult major trauma patients from 1 January 2018 to 31 December 2021 were used. Characteristics associated with having a blood alcohol test recorded in the registry were assessed using logistic regression models.ResultsThis study included 14 221 major trauma patients, of which 4563 (32.1%) had a blood alcohol test recorded. Having a blood alcohol test completed was significantly associated with age, socioeconomic disadvantage level, preferred language, having pre-existing mental health or substance use conditions, smoking status, presenting during times associated with heavy community alcohol consumption, injury cause and intent, and Glasgow Coma Scale scores (p<0.05). Restricting analyses to patients from a trauma centre where blood alcohol testing was part of routine clinical care mitigated most biases. However, relative to patients injured while driving a motor vehicle/motorcycle, lower odds of testing were still observed for patients with injuries from flames/scalds/contact burns (adjusted OR (aOR)=0.33, 95% CI 0.18 to 0.61) and low falls (aOR=0.17, 95% CI 0.12 to 0.25). Higher odds of testing were associated with pre-existing mental health (aOR=1.39, 95% CI 1.02 to 1.89) or substance use conditions (aOR=2.33, 95% CI to 1.47–3.70), and living in a more disadvantaged area (most disadvantaged quintile relative to least disadvantaged quintile: aOR=2.30, 95% CI 1.52 to 3.48).ConclusionBiases in the collection of blood alcohol data likely impact the surveillance of alcohol-related injuries. Routine alcohol testing after major trauma is needed to accurately inform epidemiology and the subsequent implementation of strategies for reducing alcohol-related injuries.
Longitudinal relationship between relative harm perceptions, beliefs about organic and additive-free tobacco, and cigarette brand switching among Natural American Spirit, Camel and Marlboro cigarette smokers
Authors: Pearson Jennifer , Gratale Stefanie Kristen , Ganz Ollie , Erinoso Olufemi A , Ohman-Strickland Pamela , Wackowski Olivia A 
Published: August 2023

Introduction
While previous research has examined misperceptions related to Natural American Spirit (NAS), a premium cigarette brand using ‘natural’-themed marketing, the longitudinal relationship between NAS-related harm beliefs and switching to NAS has not been established.

Methods
Using data from the PATH study, we modelled the longitudinal relationship between (1) brand switching and subsequent belief that one’s own brand might be less harmful than other brands (Waves 1–5); (2) belief that organic and/or additive-free tobacco products are less harmful and subsequent brand switching (Waves 3–5); and (3) belief that some types of cigarettes are less harmful and subsequent brand switching (Waves 3–5) for NAS and two leading comparator brands (Camel and Marlboro).

Results
Among people who did not think their prior brand might be less harmful, switching to NAS or maintaining NAS preference increased the odds of believing one’s own brand might be less harmful (aOR 19.4; 95% CI: 15.19, 24.8; aOR 6.1; 95% CI: 4.23, 8.67, respectively). Prior belief that organic and additive-free tobacco products were less harmful increased the odds of switching to (aOR 2.5; 95% CI: 1.68, 3.74) and decreased the odds of switching away (0.57; 955 CI: 0.36, 0.92) from NAS in the subsequent wave. Parallel analyses for Marlboro/Camel were largely null or in the opposite direction.

Conclusions
NAS use may maintain or shape new beliefs that the brand may be less harmful than other brands; holding pre-existing beliefs about the relative harm of some tobacco products may increase risk for NAS use.
Dynamic vegetation cover and decline in common eider breeding numbers in Nova Scotia, Canada
Authors: Tomlik Molly D. , Milton G. Randy , Parsons Glen J. , Mallory Mark L. 
Published: August 2023

The American common eider ( Somateria mollissima dresseri) is a colonially nesting sea duck breeding on islands in the coastal regions of Atlantic Canada. Declines in colony size have been pronounced in some parts of its range, notably in Nova Scotia, and may be attributable to a variety of interconnected factors including changes in habitat conditions. Using surveys collected two decades apart, we compared nesting habitat types, availability, and use by breeding eiders on 16 islands that supported >1600 eider nests in 1992–1993, but 830 nests in 2013. While general patterns of eider nesting habitat use remained consistent (e.g., nesting preferences exhibited for Low Shrubland and Grassland habitats, and avoidance of forest or beach habitats), overall vegetation cover declined, but relative habitat changes were inconsistent across islands. Three of the islands with the greatest change in vegetation had cormorant ( Phalacrocorax spp.) colonies in 2013 that were not there in the earlier years. We suggest that changes in vegetation, in some cases facilitated by cormorant colony formation, influenced susceptibility of nesting females to predators, and these interconnected factors may be contributing to local population declines.
Electron transport measurements in liquid xenon with Xenoscope, a large-scale DARWIN demonstrator
Authors: Baudis L. , Biondi Y. , Bismark A. , Cimental Chávez A. P. , Cuenca-García J. J. , Franchi J. , Galloway M. , Girard F. , Peres R. , Ramírez García D. , Sanchez-Lucas P. , Thieme K. , Wittweg C. 
Published: August 2023

AbstractThe DARWIN observatory is a proposed next-generation experiment with 40 tonnes of liquid xenon as an active target in a time projection chamber. To study challenges related to the construction and operation of a multi-tonne scale detector, we have designed and constructed a vertical, full-scale demonstrator for the DARWIN experiment at the University of Zurich. Here, we present the first results from a several-months run with $$343\,\hbox {kg}$$

343

kg

of xenon and electron drift lifetime and transport measurements with a $$53\,\hbox {cm}$$

53

cm

tall purity monitor immersed in the cryogenic liquid. After $$88\,\hbox {days}$$

88

days

of continuous purification, the electron lifetime reached a value of $$(664\,\pm \,23)\,\upmu \hbox {s}$$

(
664

±

23
)

μ
s

. We measured the drift velocity of electrons for electric fields in the range (25–75) V/cm, and found values consistent with previous measurements. We also calculated the longitudinal diffusion constant of the electron cloud in the same field range, and compared with previous data, as well as with predictions from an empirical model.
Amyloid Transthyretin Cardiomyopathy in Elderly Patients With Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation
Authors: Dobner Stephan , Pilgrim Thomas , Hagemeyer Daniel , Heg Dik , Lanz Jonas , Reusser Nicole , Gräni Christoph , Afshar‐Oromieh Ali , Rominger Axel , Langhammer Bettina , Reineke David , Windecker Stephan , Stortecky Stefan 
Published: August 2023

Background
The prevalence of calcific aortic stenosis and amyloid transthyretin cardiomyopathy (ATTR‐CM) increase with age, and they often coexist. The objective was to determine the prevalence of ATTR‐CM in patients with severe aortic stenosis and evaluate differences in presentations and outcomes of patients with concomitant ATTR‐CM undergoing transcatheter aortic valve implantation.

Methods and Results

Prospective screening for ATTR‐CM with Technetium
99
‐3,3‐diphosphono‐1,2‐propanodicarboxylic acid bone scintigraphy was performed in 315 patients referred with severe aortic stenosis between August 2019 and August 2021. Myocardial Technetium
99
‐3,3‐diphosphono‐1,2‐propanodicarboxylic acid tracer uptake was detected in 34 patients (10.8%), leading to a diagnosis of ATTR‐CM in 30 patients (Perugini ≥2: 9.5%). Age (85.7±4.9 versus 82.8±4.5;
P
=0.001), male sex (82.4% versus 57.7%;
P
=0.005), and prior carpal tunnel surgery (17.6% versus 4.3%;
P
=0.007) were associated with coexisting ATTR‐CM, as were ECG (discordant QRS voltage to left ventricular wall thickness [42% versus 12%;
P
<0.001]), echocardiographic (left ventricular ejection fraction 48.8±12.8 versus 58.4±10.8;
P
<0.001; left ventricular mass index, 144.4±45.8 versus 117.2±34.4g/m
2
;
P
<0.001), and hemodynamic parameters (mean aortic valve gradient, 23.4±12.6 versus 35.5±16.6;
P
<0.001; mean pulmonary artery pressure, 29.5±9.7 versus 25.8±9.5;
P
=0.037). Periprocedural (cardiovascular death: hazard ratio [HR], 0.71 [95% CI, 0.04–12.53]; stroke: HR, 0.46 [95% CI, 0.03–7.77]; pacemaker implantation: HR, 1.54 [95% CI, 0.69–3.43]) and 1‐year clinical outcomes (cardiovascular death: HR, 1.04 [95% CI, 0.37–2.96]; stroke: HR, 0.34 [95% CI, 0.02–5.63]; pacemaker implantation: HR, 1.50 [95% CI, 0.67–3.34]) were similar between groups.

Conclusions
Coexisting ATTR‐CM was observed in every 10th elderly patient with severe aortic stenosis referred for therapy. While patients with coexisting pathologies differ in clinical presentation and echocardiographic and hemodynamic parameters, peri‐interventional risk and early clinical outcomes were comparable up to 1 year after transcatheter aortic valve implantation.

REGISTRATION

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT04061213.
Profiling Daily Life Performance Recovery in the Early Subacute Phase After Stroke Using a Graphical Modeling Approach
Authors: Veerbeek Janne M. , Hutter Clemens , Ottiger Beatrice , Micheletti Soel , Riedi Simone , Bianchi Enrico , Maaijwee Noortje , Vanbellingen Tim , Nyffeler Thomas 
Published: August 2023

Background
Laboratory‐based assessments have shown that stroke recovery is heterogeneous between patients and affected domains such as motor and language function. However, laboratory‐based assessments are not ecologically valid and do not necessarily reflect patients' daily life performance. Therefore, we aimed to give an innovative view on stroke recovery by profiling daily life performance recovery across domains in patients with early subacute stroke and determine their interrelatedness, taking stroke localization into account.

Methods and Results
Daily life performance was observed at neurorehabilitation admission and weekly thereafter until discharge, using a scale containing 7 daily life domains. Graphical modeling was applied to investigate the conditional independence between recovery of these domains depending on stroke localization. There were 592 patients analyzed. Four clusters of interrelated domains were identified within the first 6 weeks poststroke. The first cluster included recovery in learning and applying knowledge, general tasks and demands, and domestic life. The second cluster comprised recovery in self‐care and general tasks and demands. The third cluster included recovery in mobility and self‐care; it incorporated interpersonal interactions and relationships in left supratentorial stroke, and learning and applying knowledge in right supratentorial stroke. The final cluster included only communication recovery.

Conclusions
Daily life recovery dynamics early poststroke show that although impairments in body functions are anatomically determined, their impact on performance is comparable. Second, some, but by no means all, domains show an interrelated recovery. Domains requiring cognitive abilities are especially interrelated and seem to be essential for concomitant recovery in mobility and domestic life.
Association Between Prekallikrein and Stroke: A Mendelian Randomization Study
Authors: Wang Yinan , Jia Yiming , Xu Qingyun , Yang Pinni , Sun Lulu , Liu Yi , Chang Xinyue , He Yu , Shi Mengyao , Guo Daoxia , Zhang Yonghong , Zhu Zhengbao 
Published: August 2023

Background
High plasma prekallikrein was reported to be associated with increased risks of stroke, but the causality for these associations remains unclear. We aimed to investigate the associations of genetically predicted plasma prekallikrein concentrations with all‐cause stroke, ischemic stroke, 3 ischemic stroke subtypes, and intracerebral hemorrhage (ICH) using a 2‐sample Mendelian randomization approach.

Methods and Results

Seven independent prekallikrein‐related single‐nucleotide polymorphisms were identified as genetic instruments for prekallikrein based on a genome‐wide association study with 1000 European individuals. The summary statistics for all‐cause stroke, ischemic stroke, and ischemic stroke subtypes were obtained from the Multiancestry Genome‐wide Association Study of Stroke Consortium with 40 585 cases and 406 111 controls of European ancestry. The summary statistics for ICH were obtained from the ISGC (International Stroke Genetics Consortium) with 1545 ICH cases and 1481 controls of European ancestry. In the main analysis, the inverse‐variance weighted method was applied to estimate the associations of plasma prekallikrein concentrations with all‐cause stroke, ischemic stroke, ischemic stroke subtypes, and ICH. Genetically predicted high plasma prekallikrein levels were significantly associated with elevated risks of all‐cause stroke (odds ratio [OR] per SD increase, 1.04 [95% CI, 1.02–1.06];
P
=5.44×10
−5
), ischemic stroke (OR per SD increase, 1.05 [95% CI, 1.03–1.07];
P
=1.42×10
−5
), cardioembolic stroke (OR per SD increase, 1.08 [95% CI, 1.03–1.12];
P
=3.75×10
−4
), and small vessel stroke (OR per SD increase, 1.11 [95% CI, 1.06–1.17];
P
=3.02×10
−5
). However, no significant associations were observed for genetically predicted prekallikrein concentrations with large artery stroke and ICH.

Conclusions
This Mendelian randomization study found that genetically predicted high plasma prekallikrein concentrations were associated with increased risks of all‐cause stroke, ischemic stroke, cardioembolic stroke, and small vessel stroke, indicating that prekallikrein might have a critical role in the development of stroke.
Real‐World Evidence on Disparities on the Initiation of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome
Authors: Yildirim Mustafa , Mueller‐Hennessen Matthias , Milles Barbara Ruth , Biener Moritz , Hund Hauke , Frey Norbert , Giannitsis Evangelos , Salbach Christian 
Published: August 2023

Background

Management of patients with non–ST‐segment–elevation acute coronary syndrome (NSTE‐ACS) is based on 2020 European Society of Cardiology guidelines, which recommend the preferential use of prasugrel over ticagrelor. Because the selection of the respective P
2
Y
12
inhibitor has to consider label restrictions, we sought to evaluate the proportion of patients qualifying for either ticagrelor or prasugrel and reasons for noneligibility in an unselected cohort of patients with acute coronary syndrome.

Methods and Results

In this retrospective observational study, patients with ST‐segment–elevation myocardial infarction (STEMI) or NSTE‐ACS presenting consecutively during a 24‐month period were enrolled. The eligibility of patients for a dual antiplatelet therapy option was assessed retrospectively. A total of 1502 patients had confirmed acute coronary syndrome (287 STEMI and 1215 NSTE‐ACS). Eligibility for ticagrelor and full‐dose prasugrel differed significantly for STEMI and NSTE‐ACS (93% versus 51%,
P
<0.0001 versus 80% versus 31%,
P
<0.0001). Eligibility remained significantly lower (STEMI 78% versus NSTE‐ACS 52%) if low‐dose prasugrel was considered. Patients eligible for full‐dose prasugrel had lower ischemic risk per GRACE (Global Registry of Acute Coronary Events) score (109 points [90–129 points] versus 121 points [98–146 points],
P
<0.0001) and lower bleeding risk (14 points [13–15 points] versus 20 points [12–29 points],
P
<0.0001) per PRECISE‐DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy) score.

Conclusions
In real life, eligibility for prasugrel in patients requiring dual antiplatelet therapy is considerably lower than for ticagrelor, even in a cohort with high rates of coronary angiography and percutaneous coronary interventions. The recommended use of prasugrel over ticagrelor in current acute coronary syndrome guidelines contrasts with our observations of a substantial disparity on the eligibility. This important aspect has not received appropriate attention yet.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05774431.