bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma biomarkers of endothelial function, inflammation and oxidative stress in individuals with non‐freezing cold injury
Authors: Eglin Clare M. , Wright Jennifer , Shepherd Anthony I. , Massey Heather , Hollis Sarah , Towse Jonathan , Young John S. , Maley Matthew J. , Bailey Stephen J. , Wilkinson Chris , Montgomery Hugh , Tipton Michael J. 
Published: February 2023

AbstractPlasma biomarkers of inflammation, oxidative stress, endothelial function and damage were examined in 16 individuals with chronic NFCI (NFCI) and matched control participants with (COLD, n = 17) or without (CON, n = 14) previous cold exposure. Venous blood samples were collected at baseline to assess plasma biomarkers of endothelial function (nitrate, nitrite and endothelin‐1), inflammation [interleukin‐6 (IL‐6), interleukin‐10 (IL‐10), tumour necrosis factor alpha and E‐selectin], oxidative stress [protein carbonyl, 4‐hydroxy‐2‐nonenal (4‐HNE), superoxide dismutase and nitrotyrosine) and endothelial damage [von Willebrand factor, syndecan‐1 and tissue type plasminogen activator (TTPA)]. Immediately after whole‐body heating and separately, foot cooling, blood samples were taken for measurement of plasma [nitrate], [nitrite], [endothelin‐1], [IL‐6], [4‐HNE] and [TTPA]. At baseline, [IL‐10] and [syndecan‐1] were increased in NFCI (P < 0.001 and P = 0.015, respectively) and COLD (P = 0.033 and P = 0.030, respectively) compared with CON participants. The [4‐HNE] was elevated in CON compared with both NFCI (P = 0.002) and COLD (P < 0.001). [Endothelin‐1] was elevated in NFCI compared with COLD (P < 0.001) post‐heating. The [4‐HNE] was lower in NFCI compared with CON post‐heating (P = 0.032) and lower than both COLD (P = 0.02) and CON (P = 0.015) post‐cooling. No between‐group differences were seen for the other biomarkers. Mild to moderate chronic NFCI does not appear to be associated with a pro‐inflammatory state or oxidative stress. Baseline [IL‐10] and [syndecan‐1] and post‐heating [endothelin‐1] are the most promising candidates for diagnosing NFCI, but it is likely that a combination of tests will be required.
Assessing Fatigue Damage in the Reuse of a Decommissioned Offshore Jacket Platform to Support a Wind Turbine
Authors: Heo Taemin , Liu Ding Peng , Manuel Lance , Correia José A.F.O. , Mendes Paulo 
Published: February 2023

AbstractAn offshore energy transition, even if only a gradual one, from carbon-emitting fossil fuel extraction to cleaner sources is recommended, if we are to slow the harmful impacts of climate change. The potential for sustainable reuse of decommissioned offshore jacket platforms to support wind turbines is being considered as an attractive proposition in such a transition. To maximize the benefits of such reuse of assets, what is needed is a rational optimization strategy that considers the remaining life of a repurposed platform, associated retrofit and construction costs, and a future period of gross renewable energy generation following installation of the wind turbine. We outline a study that employs a fatigue reliability-based framework, based on the global fatigue approach and Palmgren–Miner’s rule, to aid in such sustainable reuse planning and optimization. The framework proposed identifies an optimized reuse plan that incorporates metocean data analysis, structural analysis, life cycle evaluation, and revenue optimization. We employ a case study and sustainable reuse scenario for a site in the vicinity of Porto (Leixões), Portugal.
The Körperkoordinations Test Für Kinder for Iranian Youth: Factor Structure, Measurement Invariance, and Covariates
Authors: Salami Sedigheh , Ribeiro Bandeira Paulo Felipe , Martins Clarice , Hardy Louise L. , Shams Amir , Dehkordi Parvaneh Shamsipour 
Published: February 2023

Purpose: To examine the factor structure and measurement invariance of the Körperkoordinations Test Für Kinder (KTK) and covariates of motor competence in a sample of Iranian children aged 5–14 years. Methods: Participants were children aged 5–14 years (N = 432, 61% boys). Age, sex, and body mass index were collected. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure of KTK and multigroup CFA carried out to test measurement invariance across sexes and age groups. In addition, we calculated a model with covariates to identify the association between KTK items with age, sex, and body mass index z score. Results: CFA supported the construct validity of a one-factor model with an appropriate fit indices that the four subtests loaded on the same factor namely motor competence. Furthermore, according to the magnitude of changes in root mean square error of approximation and comparative fit index between nested models, the assumption of KTK measurement invariance across age-groups and sex were valid. Finally, adequate fit indices were found for the multigroup CFA path model of KTK with the covariates sex, age, and body mass index z score. Conclusion: The KTK is a valid, reliable, and valuable instrument for assessing motor competence of Iranian children and adolescents.
Accuracy of UK Rapid Test Consortium (UK-RTC) “AbC-19 Rapid Test” for
detection of previous SARS-CoV-2 infection in key workers: test accuracy
study
Authors: Mulchandani Ranya , Jones Hayley E , Taylor-Phillips Sian , Shute Justin , Perry Keith , Jamarani Shabnam , Brooks Tim , Charlett Andre , Hickman Matthew , Oliver Isabel , Kaptoge Stephen , Danesh John , Di Angelantonio Emanuele , Ades Anthony E , Wyllie David H 
Published: February 2023

Abstract

Objective
To assess the accuracy of the AbC-19 Rapid Test lateral flow
immunoassay for the detection of previous severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) infection.

Design
Test accuracy study.

Setting
Laboratory based evaluation.

Participants
2847 key workers (healthcare staff, fire and rescue officers, and
police officers) in England in June 2020 (268 with a previous polymerase
chain reaction (PCR) positive result (median 63 days previously), 2579
with unknown previous infection status); and 1995 pre-pandemic blood
donors.

Main outcome measures
AbC-19 sensitivity and specificity, estimated using known negative
(pre-pandemic) and known positive (PCR confirmed) samples as reference
standards and secondly using the Roche Elecsys anti-nucleoprotein assay,
a highly sensitive laboratory immunoassay, as a reference standard in
samples from key workers.

Results
Test result bands were often weak, with positive/negative
discordance by three trained laboratory staff for 3.9% of devices. Using
consensus readings, for known positive and negative samples sensitivity
was 92.5% (95% confidence interval 88.8% to 95.1%) and specificity was
97.9% (97.2% to 98.4%). Using an immunoassay reference standard,
sensitivity was 94.2% (90.7% to 96.5%) among PCR confirmed cases but
84.7% (80.6% to 88.1%) among other people with antibodies. This is
consistent with AbC-19 being more sensitive when antibody concentrations
are higher, as people with PCR confirmation tended to have more severe
disease whereas only 62% (218/354) of seropositive participants had had
symptoms. If 1 million key workers were tested with AbC-19 and 10% had
actually been previously infected, 84 700 true positive and 18 900 false
positive results would be projected. The probability that a positive
result was correct would be 81.7% (76.8% to 85.8%).

Conclusions
AbC-19 sensitivity was lower among unselected populations than among
PCR confirmed cases of SARS-CoV-2, highlighting the scope for
overestimation of assay performance in studies involving only PCR
confirmed cases, owing to “spectrum bias.” Assuming that 10% of the
tested population have had SARS-CoV-2 infection, around one in five key
workers testing positive with AbC-19 would be false positives.

Study registration
ISRCTN 56609224.
Early discontinuation and results reporting of robot-assisted surgery studies registered on ClinicalTrials.gov: a research on research study
Authors: Long Youlin , Hu Tengyue , Yang Zixin , Liu Liqin , Lin Yifei , Huang Jin , Du Liang 
Published: February 2023

ObjectivesIn this study, we aimed to investigate the characteristics of robot-assisted surgery studies registered on ClinicalTrials.gov and identify factors associated with early trial discontinuation and timely results reporting.DesignWe searched ClinicalTrials.gov to identify interventional studies on robot-assisted surgery on 24 May 2021. All structured information of the potential studies was downloaded and reviewed. A descriptive analysis was performed. Logistic and Cox regression analyses were respectively performed to determine the significance of the association of study characteristics with results reporting and early discontinuation.ResultsA total of 529 interventional studies on robot-assisted surgery were included, with 45 studies reporting results and 54 studies being stopped early. Of the 289 due studies, only 45 (16%) had submitted their results, and only 6 (2%) had submitted their results within the 1-year deadline. Funding source was associated with results reporting: academic funded were 63% less likely than industry to report results (OR=0.37, 95% CI: 0.16 to 0.83, p=0.02). Studies related to device feasibility were associated with greater risk of early discontinuation compared to treatment-related studies (HR=2.30, 95% CI: 1.08 to 4.89, p=0.03). Surprisingly, National Institutes of Health-funded studies were at greater hazard of discontinuation compared to industry-funded studies (HR=3.30, 95% CI: 1.09 to 10.00, p=0.04).ConclusionsThere was poor compliance with results reporting requirements for robot-assisted surgical studies. It is important that investigators remain informed about the regulatory requirements, and should be helped to develop a sense of responsibility for reporting results. Also, they need to ensure the careful design of the study protocol and adequate resources to reduce the risk of early discontinuation.
Screening tools for predicting mortality of adults with suspected sepsis: an international sepsis cohort validation study
Authors: Blair Paul W , Mehta Rittal , Oppong Chris Kwaku , Tin Som , Ko Emily , Tsalik Ephraim L , Chenoweth Josh , Rozo Michelle , Adams Nehkonti , Beckett Charmagne , Woods Christopher W , Striegel Deborah A , Salvador Mark G , Brandsma Joost , McKean Lauren , Mahle Rachael E , Hulsey William R , Krishnan Subramaniam , Prouty Michael , Letizia Andrew , Fox Anne , Faix Dennis , Lawler James V , Duplessis Chris , Gregory Michael G , Vantha Te , Owusu-Ofori Alex Kwame , Ansong Daniel , Oduro George , Schully Kevin L , Clark Danielle V 
Published: February 2023

ObjectivesWe evaluated the performance of commonly used sepsis screening tools across prospective sepsis cohorts in the USA, Cambodia and Ghana.DesignProspective cohort studies.Setting and participantsFrom 2014 to 2021, participants with two or more SIRS (Systemic Inflammatory Response Syndrome) criteria and suspected infection were enrolled in emergency departments and medical wards at hospitals in Cambodia and Ghana and hospitalised participants with suspected infection were enrolled in the USA. Cox proportional hazards regression was performed, and Harrell’s C-statistic calculated to determine 28-day mortality prediction performance of the quick Sequential Organ Failure Assessment (qSOFA) score ≥2, SIRS score ≥3, National Early Warning Score (NEWS) ≥5, Modified Early Warning Score (MEWS) ≥5 or Universal Vital Assessment (UVA) score ≥2. Screening tools were compared with baseline risk (age and sex) with the Wald test.ResultsThe cohorts included 567 participants (42.9% women) including 187 participants from Kumasi, Ghana, 200 participants from Takeo, Cambodia and 180 participants from Durham, North Carolina in the USA. The pooled mortality was 16.4% at 28 days. The mortality prediction accuracy increased from baseline risk with the MEWS (C-statistic: 0.63, 95% CI 0.58 to 0.68; p=0.002), NEWS (C-statistic: 0.68; 95% CI 0.64 to 0.73; p<0.001), qSOFA (C-statistic: 0.70, 95% CI 0.64 to 0.75; p<0.001), UVA score (C-statistic: 0.73, 95% CI 0.69 to 0.78; p<0.001), but not with SIRS (0.60; 95% CI 0.54 to 0.65; p=0.13). Within individual cohorts, only the UVA score in Ghana performed better than baseline risk (C-statistic: 0.77; 95% CI 0.71 to 0.83; p<0.001).ConclusionsAmong the cohorts, MEWS, NEWS, qSOFA and UVA scores performed better than baseline risk, largely driven by accuracy improvements in Ghana, while SIRS scores did not improve prognostication accuracy. Prognostication scores should be validated within the target population prior to clinical use.
Cohort study assessing the impact of COVID-19 on venous leg ulcer management and associated clinical outcomes in clinical practice in the UK
Authors: Guest Julian F , Fuller Graham W 
Published: February 2023

ObjectiveTo assess the impact of the COVID-19 pandemic on venous leg ulcer (VLU) management by the UK’s health services and associated outcomes.DesignRetrospective cohort analysis of the electronic records of patients from The Health Improvement Network database.SettingClinical practice in primary and secondary care.ParticipantsA cohort of 1946 patients of whom 1263, 1153 and 733 had a VLU in 2019, 2020 and 2021, respectively.Primary and secondary outcome measuresClinical outcomes and wound-related healthcare resource use.ResultsVLU healing rate in 2020 and 2021 decreased by 16% and 42%, respectively, compared with 2019 and time to heal increased by >85%. An estimated 3% of patients in 2020 and 2021 had a COVID-19 infection. Also, 1% of patients in both years had VLU-related sepsis, 0.1%–0.2% developed gangrene and 0.3% and 0.6% underwent an amputation on part of the foot or lower limb in 2020 and 2021 (of whom 57% had diabetes), respectively. The number of community-based face-to-face clinician visits decreased by >50% in both years and >35% fewer patients were referred to a hospital specialist. In 2020 and 2021, up to 20% of patients were prescribed dressings without compression compared with 5% in 2019. The total number of wound care products prescribed in 2020 and 2021 was >50% less than that prescribed in 2019, possibly due to the decreased frequency of dressing change from a mean of once every 11 days in 2019 to once every 21 days in 2020 and 2021.ConclusionsThere was a significant trend towards decreasing care during 2020 and 2021, which was outside the boundaries considered to be good care. This led to poorer outcomes including lower VLU healing rates and increased risk of amputation. Hence, the COVID-19 pandemic appears to have had a deleterious impact on the health of patients with a VLU.
Effectiveness of an oral health curriculum in reducing dental caries increment and improving oral hygiene behaviour among schoolchildren of Ernakulam district in Kerala, India: study protocol for a cluster randomised trial
Authors: Das Hindol , Janakiram Chandrashekar , Ramanarayanan Venkitachalam , Karuveettil Vineetha , Kumar Vijay , Balachandran Parvathy , Varma Balagopal , John Denny 
Published: February 2023

IntroductionChildren’s learning abilities suffer when their oral health is compromised. Inadequate oral health can harm children’s quality of life, academic performance, and future success and achievements. Oral health problems may result in appetite loss, depression, increased inattentiveness, and distractibility from play and schoolwork, all of which can lower self-esteem and contribute to academic failure. An oral health curriculum, in addition to the standard school curriculum, may instil preventive oral hygiene behaviour in school students, enabling them to retain good oral health for the rest of their lives. Because most children attend school, the school setting is the most effective for promoting behavioural change in children. A ‘health-promoting school’ actively promotes health by enhancing its ability to serve as a healthy place to live, learn and work, bringing health and education together. Making every school a health-promoting school is one of the joint objectives of the WHO and UNICEF. The primary objective of this proposed study is to assess the effectiveness of an oral health curriculum intervention in reducing dental caries incidence and improving oral hygiene behaviour among high school children in grades 8–10 of the Ernakulam district in Kerala, India. If found to be effective in changing children’s behaviour in a positive way, an oral health curriculum may eventually be incorporated into the school health curriculum in the future. Classroom interventions can serve as a cost-effective tool to increase children’s oral health awareness.Methods and analysisThis protocol presents a cluster randomised trial design. It is a parallel-group comparative trial with two arms having a 1:1 distribution—groups A and B with oral health curriculum intervention from a dental professional and a schoolteacher, respectively. High schools (grades 8–10) will be selected as clusters for the trial. The minimum cluster size is 20 students per school. The total sample size is 2000 high school children. Data will be collected at three time points, including baseline, after 1 year (mid-term) and 2 years (final), respectively. The outcome measures are Decayed, Missing and Filled Teeth Index; Oral Hygiene Index-Simplified; and knowledge, attitude and behaviour. Data collection will be done by clinical oral examination and questionnaire involving oral health-related knowledge, attitude and behaviour items.Ethics and disseminationEthical approval was obtained from the Institutional Ethics Committee of Amrita Institute of Medical Sciences and Research Centre (dated 19 July 2022, no: IEC-AIMS-2022-ASD-179).Trial registration numberClinical Trial Registry of India (CTRI/2022/09/045410).
Comparison of clinical characteristics and outcomes of critically ill adults with SARS-CoV-2 infection during Delta and Omicron variant predominance periods: a single-hospital retrospective cohort study
Authors: Sankar Keerthana , Modi Neil , Polyak Alexander , Directo Michael P , Johnson Lily R , Kho Norling , Isonaka Sharon K , Pedraza Isabel , Chen Peter , Modes Matthew E 
Published: February 2023

IntroductionInitial reports suggest the B.1.1.529 (Omicron) variant of SARS-CoV-2 causes less severe disease compared with the B.1.617.2 (Delta) variant, though more widespread vaccination contributed to these findings. Little is known about clinical characteristics and outcomes of patients with SARS-CoV-2 infection requiring intensive care during periods of Delta and Omicron variant predominance.AimTo examine and compare characteristics of critically ill adults with SARS-CoV-2 infection during periods of Delta and Omicron variant predominance.MethodsWe conducted a retrospective cohort study of critically ill adults with SARS-CoV-2 infection at one academic hospital in Los Angeles during Delta (15 July 2021–23 September 2021) and Omicron (21 December 2021–27 January 2022) predominance. Patient characteristics were compared between Delta-period and Omicron-period hospitalisations, overall and stratified by vaccination status.Results79 adults required intensive care during the Delta predominance period and 116 during the Omicron predominance period. We found similar proportions of intensive care unit admissions occurring in fully vaccinated patients between the two periods, despite Los Angeles County data revealing an almost 60% increase in the proportion of SARS-CoV-2 hospitalisations occurring in fully vaccinated persons. There was no difference in the need for invasive mechanical ventilation (IMV). Among those who required IMV, the median duration of IMV was shorter overall (Delta=18 days; Omicron=8 days; p=0.006) and among unvaccinated persons (Delta=19 days; Omicron=8.5 days; p=0.018). Among unvaccinated persons, the median intensive care unit length of stay was shorter (Delta=12 days; Omicron=5 days; p=0.037) during Omicron predominance. There was no difference in the proportion of patients who died while hospitalised.ConclusionsIn this single-hospital study, critically ill patients with SARS-CoV-2 infection experienced less severe respiratory disease during Omicron predominance, likely due to reduced variant-specific virulence. Vaccination likely reduced development of critical illness in adults with SARS-CoV-2 infection during Omicron predominance.
Distinct phenotypes of kidney transplant recipients aged 80 years or older in the USA by machine learning consensus clustering
Authors: Thongprayoon Charat , Jadlowiec Caroline C , Mao Shennen A , Mao Michael A , Leeaphorn Napat , Kaewput Wisit , Pattharanitima Pattharawin , Nissaisorakarn Pitchaphon , Cooper Matthew , Cheungpasitporn Wisit 
Published: February 2023

ObjectivesThis study aimed to identify distinct clusters of very elderly kidney transplant recipients aged ≥80 and assess clinical outcomes among these unique clusters.DesignCohort study with machine learning (ML) consensus clustering approach.Setting and participantsAll very elderly (age ≥80 at time of transplant) kidney transplant recipients in the Organ Procurement and Transplantation Network/United Network for Organ Sharing database database from 2010 to 2019.Main outcome measuresDistinct clusters of very elderly kidney transplant recipients and their post-transplant outcomes including death-censored graft failure, overall mortality and acute allograft rejection among the assigned clusters.ResultsConsensus cluster analysis was performed in 419 very elderly kidney transplant and identified three distinct clusters that best represented the clinical characteristics of very elderly kidney transplant recipients. Recipients in cluster 1 received standard Kidney Donor Profile Index (KDPI) non-extended criteria donor (ECD) kidneys from deceased donors. Recipients in cluster 2 received kidneys from older, hypertensive ECD deceased donors with a KDPI score ≥85%. Kidneys for cluster 2 patients had longer cold ischaemia time and the highest use of machine perfusion. Recipients in clusters 1 and 2 were more likely to be on dialysis at the time of transplant (88.3%, 89.4%). Recipients in cluster 3 were more likely to be preemptive (39%) or had a dialysis duration less than 1 year (24%). These recipients received living donor kidney transplants. Cluster 3 had the most favourable post-transplant outcomes. Compared with cluster 3, cluster 1 had comparable survival but higher death-censored graft failure, while cluster 2 had lower patient survival, higher death-censored graft failure and more acute rejection.ConclusionsOur study used an unsupervised ML approach to cluster very elderly kidney transplant recipients into three clinically unique clusters with distinct post-transplant outcomes. These findings from an ML clustering approach provide additional understanding towards individualised medicine and opportunities to improve care for very elderly kidney transplant recipients.