bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gambling Harms in Adult Social Care: Developing an ‘Introductory’ Question to Identify Gambling Harms Among Service Users
Authors: Forward Cat , Norrie Caroline , Bramley Stephanie , Riley Liz , Shearer James , Finch Emily , Stewart Glenn , Fletcher Paul , Manthorpe Jill , Wardle Heather 
Published: June 2023

Abstract
Gambling harms are disproportionately experienced among disadvantaged groups and as such, adult social care (ASC) practitioners are well-placed to identify and support affected individuals. There exists no evidence-based ‘introductory’ question for practitioners to identify those at risk of gambling harms, which includes family and friends (‘affected others’). To develop an ‘introductory’ question for use in English ASC, we conducted a scoping review that identified fifteen potential questions. Questions were refined through expert panel review groups (n = 13), cognitive interviewing (n = 18), test–retest reliability checks (n = 20) and validity testing (n = 2,100) against gold-standard measures of problem gambling behaviour. The question development process produced two questions suitable for testing in local authority (LA) ASC departments. These were (i) ‘Do you feel you are affected by any gambling, either your own or someone else’s?’ and (ii) ‘If you or someone close to you gambles, do you feel it is causing you any worries?’ Each had good face validity, strong test–retest reliability, correlated highly with well-being measures and performed reasonably against validated measures of problem gambling. These two questions are currently being piloted by ASC practitioners in three English LAs to assess their feasibility for adoption in practice.
CSF proteomics in autosomal dominant Alzheimer’s disease highlights parallels with sporadic disease
Authors: van der Ende Emma L , In ‘t Veld Sjors G J G , Hanskamp Iris , van der Lee Sven , Dijkstra Janna I R , Hok-A-Hin Yanaika S , Blujdea Elena R , van Swieten John C , Irwin David J , Chen-Plotkin Alice , Hu William T , Lemstra Afina W , Pijnenburg Yolande A L , van der Flier Wiesje M , del Campo Marta , Teunissen Charlotte E , Vermunt Lisa 
Published: June 2023

Abstract
Autosomal dominant Alzheimer’s disease (ADAD) offers a unique opportunity to study pathophysiological changes in a relatively young population with few comorbidities. A comprehensive investigation of proteome changes occurring in ADAD could provide valuable insights into AD-related biological mechanisms and uncover novel biomarkers and therapeutic targets. Furthermore, ADAD might serve as a model for sporadic AD, but in-depth proteome comparisons are lacking. We aimed to identify dysregulated CSF proteins in ADAD and determine the degree of overlap with sporadic AD. We measured 1472 proteins in CSF of PSEN1 or APP mutation carriers (n = 22) and age- and sex-matched controls (n = 20) from the Amsterdam Dementia Cohort using proximity extension-based immunoassays (PEA). We compared protein abundance between groups with two-sided t-tests and identified enriched biological pathways. Using the same protein panels in paired plasma samples, we investigated correlations between CSF proteins and their plasma counterparts. Finally, we compared our results with recently published PEA data from an international cohort of sporadic AD (n = 230) and non-AD dementias (n = 301). All statistical analyses were false discovery rate-corrected. We detected 66 differentially abundant CSF proteins (65 increased, 1 decreased) in ADAD compared to controls (q &lt; 0.05). The most strongly upregulated proteins (fold change &gt;1.8) were related to immunity (CHIT1, ITGB2, SMOC2), cytoskeletal structure (MAPT, NEFL) and tissue remodelling (TMSB10, MMP-10). Significant CSF-plasma correlations were found for the upregulated proteins SMOC2 and LILR1B. Of the 66 differentially expressed proteins, 36 had been measured previously in the sporadic dementias cohort, 34 of which (94%) were also significantly upregulated in sporadic AD, with a strong correlation between the fold changes of these proteins in both cohorts (rs = 0.730, P &lt; 0.001). Twenty-nine of the 36 proteins (81%) were also upregulated among non-AD patients with suspected AD co-pathology. This CSF proteomics study demonstrates substantial biochemical similarities between ADAD and sporadic AD, suggesting involvement of the same biological processes. Besides known AD-related proteins, we identified several relatively novel proteins, such as TMSB10, MMP-10 and SMOC2, which have potential as novel biomarkers. With shared pathophysiological CSF changes, ADAD study findings might be translatable to sporadic AD, which could greatly expedite therapy development.
Pleural Empyema Caused by Streptococcus intermedius and Fusobacterium nucleatum: A Distinct Entity of Pleural Infections
Authors: Dyrhovden Ruben , Eagan Tomas Mikal , Fløtten Øystein , Siljan William , Leegaard Truls Michael , Bø Bjørnar , Fardal Hilde , Grøvan Fredrik , Kildahl-Andersen Arne , Larssen Kjersti Wik , Tilseth Rune , Hjetland Reidar , Løes Sigbjørn , Lindemark Frode , Tellevik Marit , Breistein Rebecca , Kommedal Øyvind 
Published: June 2023

Abstract

Background
Many community-acquired pleural infections are caused by facultative and anaerobic bacteria from the human oral microbiota. The epidemiology, clinical characteristics, pathogenesis, and etiology of such infections are little studied. The aim of the present prospective multicenter cohort study was to provide a thorough microbiological and clinical characterization of such oral-type pleural infections and to improve our understanding of the underlying etiology and associated risk factors.

Methods
Over a 2-year period, we included 77 patients with community-acquired pleural infection, whereof 63 (82%) represented oral-type pleural infections. Clinical and anamnestic data were systematically collected, and patients were offered a dental assessment by an oral surgeon. Microbial characterizations were done using next-generation sequencing. Obtained bacterial profiles were compared with microbiology data from previous investigations on odontogenic infections, bacteremia after extraction of infected teeth, and community-acquired brain abscesses.

Results
From the oral-type pleural infections, we made 267 bacterial identifications representing 89 different species. Streptococcus intermedius and/or Fusobacterium nucleatum were identified as a dominant component in all infections. We found a high prevalence of dental infections among patients with oral-type pleural infection and demonstrate substantial similarities between the microbiology of such pleural infections and that of odontogenic infections, odontogenic bacteremia, and community-acquired brain abscesses.

Conclusions
Oral-type pleural infection is the most common type of community-acquired pleural infection. Current evidence supports hematogenous seeding of bacteria from a dental focus as the most important underlying etiology. Streptococcus intermedius and Fusobacterium nucleatum most likely represent key pathogens necessary for establishing the infection.
Repair of mitral prolapse: comparison of thoracoscopic minimally invasive and conventional approaches
Authors: Ascaso María , Sandoval Elena , Muro Anna , Barriuso Clemente , Quintana Eduard , Alcocer Jorge , Sitges Marta , Vidal Bàrbara , Pomar José-Luis , Castellà Manuel , García-Álvarez Ana , Pereda Daniel 
Published: June 2023

Abstract

OBJECTIVES
Surgical repair remains the best treatment for severe primary mitral regurgitation (MR). Minimally invasive mitral valve surgery is being increasingly performed, but there is a lack of solid evidence comparing thoracoscopic with conventional surgery. Our objective was to compare outcomes of both approaches for repair of leaflet prolapse.

METHODS
All consecutive patients undergoing surgery for severe MR due to mitral prolapse from 2012 to 2020 were evaluated according to the approach used. Freedom from mortality, reoperation and recurrent severe MR were evaluated by Kaplan–Meier method. Differences in baseline characteristics were adjusted with propensity score-matched analysis (1:1, nearest neighbour).

RESULTS
Three hundred patients met inclusion criteria and were divided into thoracoscopic (N = 188) and conventional (sternotomy; N = 112) groups. Unmatched patients in the thoracoscopic group were younger and had lower body mass index, New York Heart Association class and EuroSCORE II preoperatively. After matching, thoracoscopic group presented significantly shorter mechanical ventilation (9 vs 15 h), shorter intensive care unit stay (41 vs 65 h) and higher postoperative haemoglobin levels (11 vs 10.2 mg/dl) despite longer bypass and cross-clamp times (+30 and +17 min). There were no differences in mortality or MR grade at discharge between groups nor differences in survival, repair failures and reinterventions during follow-up.

CONCLUSIONS
Minimally invasive mitral repair can be performed in the majority of patients with mitral prolapse, without compromising outcomes, repair rate or durability, while providing shorter mechanical ventilation and intensive care unit stay and less blood loss.
Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium
Authors: Hamblin Ross , Fountas Athanasios , Lithgow Kirstie , Loughrey Paul Benjamin , Bonanos Efstathios , Shinwari Shah Khalid , Mitchell Kirsten , Shah Syed , Grixti Lydia , Matheou Mike , Isand Kristina , McLaren David S , Surya Ashutosh , Ullah Hafiz Zubair , Klaucane Katarina , Jayasuriya Anuradha , Bhatti Sumbal , Mavilakandy Akash , Ahsan Masato , Mathew Susan , Hussein Ziad , Jansz Thijs , Wunna Wunna , MacFarlane James , Ayuk John , Abraham Prakash , Drake William M , Gurnell Mark , Brooke Antonia , Baldeweg Stephanie E , Sam Amir H , Martin Niamh , Higham Claire , Reddy Narendra , Levy Miles J , Ahluwalia Rupa , Newell-Price John , Vamvakopoulos Joannis , Krishnan Amutha , Lansdown Andrew , Murray Robert D , Pal Aparna , Bradley Karin , Mamoojee Yaasir , Purewal Tejpal , Panicker Janki , Freel E Marie , Hasan Faisal , Kumar Mohit , Jose Biju , Hunter Steven J , Karavitaki Niki 
Published: June 2023

Abstract

Objective
The optimal approach to the surveillance of non-functioning pituitary microadenomas (micro-NFPAs) is not clearly established. Our aim was to generate evidence on the natural history of micro-NFPAs to support patient care.

Design
Multi-centre, retrospective, cohort study involving 23 endocrine departments (UK NFPA consortium).

Methods
Clinical, imaging, and hormonal data of micro-NFPA cases between January, 1, 2008 and December, 21, 2021 were analysed.

Results
Data for 459 patients were retrieved [median age at detection 44 years (IQR 31-57)—152 males/307 females]. Four hundred and nineteen patients had more than two magnetic resonance imagings (MRIs) [median imaging monitoring 3.5 years (IQR 1.71-6.1)]. One case developed apoplexy. Cumulative probability of micro-NFPA growth was 7.8% (95% CI, 4.9%-8.1%) and 14.5% (95% CI, 10.2%-18.8%) at 3 and 5 years, respectively, and of reduction 14.1% (95% CI, 10.4%-17.8%) and 21.3% (95% CI, 16.4%-26.2%) at 3 and 5 years, respectively. Median tumour enlargement was 2 mm (IQR 1-3) and 49% of micro-NFPAs that grew became macroadenomas (nearly all &gt;5 mm at detection). Eight (1.9%) patients received surgery (only one had visual compromise with surgery required &gt;3 years after micro-NFPA detection). Sex, age, and size at baseline were not predictors of enlargement/reduction. At the time of detection, 7.2%, 1.7%, and 1.5% patients had secondary hypogonadism, hypothyroidism, and hypoadrenalism, respectively. Two (0.6%) developed hypopituitarism during follow-up (after progression to macroadenoma).

Conclusions
Probability of micro-NFPA growth is low, and the development of new hypopituitarism is rare. Delaying the first follow-up MRI to 3 years and avoiding hormonal re-evaluation in the absence of tumour growth or clinical manifestations is a safe approach for micro-NFPA surveillance.
Migraine and cardiovascular disease: what cardiologists should know
Authors: Kalkman Deborah N , Couturier Emile G M , El Bouziani Abdelhak , Dahdal Jorge , Neefs Jolien , Woudstra Janneke , Vogel Birgit , Trabattoni Daniela , MaassenVanDenBrink Antoinette , Mehran Roxana , de Winter Robbert J , Appelman Yolande 
Published: June 2023

AbstractMigraine is a chronic neurovascular disease with a complex, not fully understood pathophysiology with multiple causes. People with migraine suffer from recurrent moderate to severe headache attacks varying from 4 to 72 h. The prevalence of migraine is two to three times higher in women compared with men. Importantly, it is the most disabling disease in women &lt;50 years of age due to a high number of years lived with disability, resulting in a very high global socioeconomic burden. Robust evidence exists on the association between migraine with aura and increased incidence of cardiovascular disease (CVD), in particular ischaemic stroke. People with migraine with aura have an increased risk of atrial fibrillation, myocardial infarction, and cardiovascular death compared with those without migraine. Ongoing studies investigate the relation between migraine and angina with non-obstructive coronary arteries and migraine patients with patent foramen ovale. Medication for the treatment of migraine can be preventative medication, such as beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, antiepileptics, antidepressants, some of the long-acting calcitonin gene-related peptide receptor antagonists, or monoclonal antibodies against calcitonin gene-related peptide or its receptor, or acute medication, such as triptans and calcitonin gene-related peptide receptor antagonists. However, these medications might raise concerns when migraine patients also have CVD due to possible (coronary) side effects. Specifically, knowledge gaps remain for the contraindication to newer treatments for migraine. All cardiologists will encounter patients with CVD and migraine. This state-of-the-art review will outline the basic pathophysiology of migraine and the associations between migraine and CVD, discuss current therapies, and propose future directions for research.
New-onset atrial fibrillation prediction: the HARMS2-AF risk score
Authors: Segan Louise , Canovas Rodrigo , Nanayakkara Shane , Chieng David , Prabhu Sandeep , Voskoboinik Aleksandr , Sugumar Hariharan , Ling Liang-Han , Lee Geoff , Morton Joseph , LaGerche Andre , Kaye David M , Sanders Prashanthan , Kalman Jonathan M , Kistler Peter M 
Published: June 2023

Abstract

Aims
Lifestyle risk factors are a modifiable target in atrial fibrillation (AF) management. The relative contribution of individual lifestyle risk factors to AF development has not been described. Development and validation of an AF lifestyle risk score to identify individuals at risk of AF in the general population are the aims of the study.

Methods and results
The UK Biobank (UKB) and Framingham Heart Study (FHS) are large prospective cohorts with outcomes measured &gt;10 years. Incident AF was based on International Classification of Diseases version 10 coding. Prior AF was excluded. Cox proportional hazards regression identified independent AF predictors, which were evaluated in a multivariable model. A weighted score was developed in the UKB and externally validated in the FHS. Kaplan–Meier estimates ascertained the risk of AF development. Among 314 280 UKB participants, AF incidence was 5.7%, with median time to AF 7.6 years (interquartile range 4.5–10.2). Hypertension, age, body mass index, male sex, sleep apnoea, smoking, and alcohol were predictive variables (all P &lt; 0.001); physical inactivity [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.96–1.05, P = 0.80] and diabetes (HR 1.03, 95% CI 0.97–1.09, P = 0·38) were not significant. The HARMS2-AF score had similar predictive performance [area under the curve (AUC) 0.782] to the unweighted model (AUC 0.802) in the UKB. External validation in the FHS (AF incidence 6.0% of 7171 participants) demonstrated an AUC of 0.757 (95% CI 0.735–0.779). A higher HARMS2-AF score (≥5 points) was associated with a heightened AF risk (score 5–9: HR 12.79; score 10–14: HR 38.70). The HARMS2-AF risk model outperformed the Framingham-AF (AUC 0.568) and ARIC (AUC 0.713) risk models (both P &lt; 0.001) and was comparable to the CHARGE-AF risk score (AUC 0.754, P = 0.73).

Conclusion
The HARMS2-AF score is a novel lifestyle risk score which may help identify individuals at risk of AF in the general community and assist population screening.
Microvascular resistance reserve: diagnostic and prognostic performance in the ILIAS registry
Authors: Boerhout Coen K M , Lee Joo Myung , de Waard Guus A , Mejia-Renteria Hernan , Lee Seung Hun , Jung Ji-Hyun , Hoshino Masahiro , Echavarria-Pinto Mauro , Meuwissen Martijn , Matsuo Hitoshi , Madera-Cambero Maribel , Eftekhari Ashkan , Effat Mohamed A , Murai Tadashi , Marques Koen , Doh Joon-Hyung , Christiansen Evald H , Banerjee Rupak , Nam Chang-Wook , Niccoli Giampaolo , Nakayama Masafumi , Tanaka Nobuhiro , Shin Eun-Seok , Appelman Yolande , Beijk Marcel A M , van Royen Niels , Knaapen Paul , Escaned Javier , Kakuta Tsunekazu , Koo Bon Kwon , Piek Jan J , van de Hoef Tim P 
Published: June 2023

Abstract

Aims
The microvascular resistance reserve (MRR) was introduced as a means to characterize the vasodilator reserve capacity of the coronary microcirculation while accounting for the influence of concomitant epicardial disease and the impact of administration of potent vasodilators on aortic pressure. This study aimed to evaluate the diagnostic and prognostic performance of MRR.

Methods and results
A total of 1481 patients with stable symptoms and a clinical indication for coronary angiography were included from the global ILIAS Registry. MRR was derived as a function of the coronary flow reserve (CFR) divided by the fractional flow reserve (FFR) and corrected for driving pressure. The median MRR was 2.97 [Q1–Q3: 2.32–3.86] and the overall relationship between MRR and CFR was good [correlation coefficient (Rs) = 0.88, P &lt; 0.005]. The difference between CFR and MRR increased with decreasing FFR [coefficient of determination (R2) = 0.34; Coef.—2.88, 95% confidence interval (CI): -3.05–−2.73; P &lt; 0.005]. MRR was independently associated with major adverse cardiac events (MACE) at 5-year follow-up [hazard ratio (HR) 0.78; 95% CI 0.63–0.95; P = 0.024] and with target vessel failure (TVF) at 5-year follow-up (HR 0.83; 95% CI 0.76–0.97; P = 0.047). The optimal cut-off value of MRR was 3.0. Based on this cut-off value, only abnormal MRR was significantly associated with MACE and TVF at 5-year follow-up in vessels with functionally significant epicardial disease (FFR &lt;0.75).

Conclusion
MRR seems a robust indicator of the microvascular vasodilator reserve capacity. Moreover, in line with its theoretical background, this study suggests a diagnostic advantage of MRR over other indices of vasodilatory capacity in patients with hemodynamically significant epicardial coronary artery disease.
Procedure, management, and outcome of subcutaneous implantable cardioverter–defibrillator extraction in clinical practice
Authors: De Filippo Paolo , Migliore Federico , Palmisano Pietro , Nigro Gerardo , Ziacchi Matteo , Rordorf Roberto , Pieragnoli Paolo , Di Grazia Angelo , Ottaviano Luca , Francia Pietro , Pisanò Ennio , Tola Gianfranco , Giammaria Massimo , D’Onofrio Antonio , Botto Giovanni Luca , Zucchelli Giulio , Ferrari Paola , Lovecchio Mariolina , Valsecchi Sergio , Viani Stefano 
Published: June 2023

Abstract

Aims
Subcutaneous implantable cardioverter–defibrillator (S-ICD) therapy is expanding rapidly. However, there are few data on the S-ICD extraction procedure and subsequent patient management. The aim of this analysis was to describe the procedure, management, and outcome of S-ICD extractions in clinical practice.

Methods and results
We enrolled consecutive patients who required complete S-ICD extraction at 66 Italian centres. From 2013 to 2022, 2718 patients undergoing de novo implantation of an S-ICD were enrolled. Of these, 71 required complete S-ICD system extraction (17 owing to infection). The S-ICD system was successfully extracted in all patients, and no complications were reported; the median procedure duration was 40 (25th–75th percentile: 20–55) min. Simple manual traction was sufficient to remove the lead in 59 (84%) patients, in whom lead-dwelling time was shorter [20 (9–32) months vs. 30 (22–41) months; P = 0.032]. Hospitalization time was short in the case of both non-infectious [2 (1–2) days] and infectious indications [3 (1–6) days]. In the case of infection, no patients required post-extraction intravenous antibiotics, the median duration of any antibiotic therapy was 10 (10–14) days, and the re-implantation was performed during the same procedure in 29% of cases. No complications arose over a median of 21 months.

Conclusion
The S-ICD extraction was safe and easy to perform, with no complications. Simple traction of the lead was successful in most patients, but specific tools could be needed for systems implanted for a longer time. The peri- and post-procedural management of S-ICD extraction was free from complications and not burdensome for patients and healthcare system.

Clinical Trial Registration
URL: http://clinicaltrials.gov/Identifier: NCT02275637.
The influence of atrial high-rate episodes on stroke and cardiovascular death: an update
Authors: Toennis Tobias , Bertaglia Emanuele , Brandes Axel , Dichtl Wolfgang , Fluschnik Nina , de Groot Joris R , Marijon Eloi , Mont Lluis , Lundqvist Carina Blomström , Cabanelas Nuno , Dan G Andrei , Lubinski Andrzej , Merkely Béla , Rajappan Kim , Sarkozy Andrea , Velchev Vasil , Wichterle Dan , Kirchhof Paulus 
Published: June 2023

Abstract
Atrial high-rate episodes (AHRE) are atrial tachyarrhythmias detected by continuous rhythm monitoring by pacemakers, defibrillators, or implantable cardiac monitors. Atrial high-rate episodes occur in 10–30% of elderly patients without atrial fibrillation. However, it remains unclear whether the presence of these arrhythmias has therapeutic consequences. The presence of AHRE increases the risk of stroke compared with patients without AHRE. Oral anticoagulation would have the potential to reduce the risk of stroke in patients with AHRE but is also associated with a rate of major bleeding of ∼2%/year. The stroke rate in patients with AHRE appears to be lower than the stroke rate in patients with atrial fibrillation. Wearables like smart-watches will increase the absolute number of patients in whom atrial arrhythmias are detected. It remains unclear whether anticoagulation is effective and, equally important, safe in patients with AHRE. Two randomized clinical trials, NOAH-AFNET6 and ARTESiA, are expected to report soon. They will provide much-needed information on the efficacy and safety of oral anticoagulation in patients with AHRE.