bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promotion of Para athlete well-being (the PROPEL studies): A cross-sectional study of sleep in Para athletes across two nations
Authors: Badenhorst Marelise , Brown James , Runciman Phoebe , Fliess Douer Osnat , Derman Wayne 
Published: July 2023

Abstract

Objectives
Limited research exists on the sleep profiles of South African Para athletes. The aim of this study was to describe sleep quality, day-time sleepiness and chronotype of South African Para athletes, and to compare the relationship between sleep-related outcomes and demographic factors to athletes from a higher resourced country.

Design
A descriptive, cross-sectional survey was conducted. Sleep-related characteristics were assessed with the Pittsburgh Sleep Quality Index, Epworth Sleepiness scale and Morningness-Eveningness Questionnaire. Multiple regression models were run with and without country as independent variable.

Results
124 South African athletes and 52 Israeli athletes were included. 30% of South African athletes presented with excessive daytime sleepiness, 35% slept 6 hours or less/night, and 52% reported poor sleep quality. 33% of Israeli athletes reported excessive daytime sleepiness, 29% slept 6 hours or less and 56% reported poor sleep quality. Chronotype was the only variable that differed significantly between countries (over-representation of morning types in South African athletes, and intermediate types in Israeli athletes). Intermediate chronotypes had significantly greater odds of excessive daytime sleepiness (p = 0.007) and poor sleep quality (p = 0.002) than morning types, irrespective of country.

Conclusion
The high prevalence of poor sleep among both South African and Israeli Para athletes warrants further investigation.
COMPARATIVE STUDY OF THE PAIN, FUNCTION AND BIOMARKERS OF JOINT DISEASE IN THE TRANSITION TO ADULTHOOD IN INDIVIDUALS WITH AND WITHOUT CEREBRAL PALSY
Authors: Hanaoka Chad , Gaebler-Spira Deborah , Pichika Rajeswari , Jayabalan Prakash 
Published: July 2023

ABSTRACT

Background
Biomarkers have potential to identify early signs of joint disease. This study compared joint pain and function in adolescents and young adults with CP compared to individuals without.

Methods
Cross-sectional study compared individuals with CP(n = 20), aged 13-30 with Gross Motor Function Classification System (GMFCS) I-III and age-matched individuals without CP(n = 20). Knee and hip joint pain measured using Numeric Pain Rating Scale (NPRS) and Knee injury and Osteoarthritis Outcome Score (KOOS) and Hip dysfunction and Osteoarthritis Outcome Score (HOOS) surveys. Objective strength and function were also measured. Biomarkers for tissue turnover (serum COMP, urinary CTX-II) and cartilage degradation (serum MMP-1, MMP-3) were measured in blood and urinary samples.

Findings
Individuals with CP had increased knee and hip joint pain, reduced leg strength, reduced walking and standing speeds, and ability to carry out activities of daily living(p < 0.005) compared to controls. They also had higher serum MMP-1(p < 0.001) and urinary CTX-II levels(p < 0.05). Individuals with CP who were GMFCS I and II demonstrated reduced hip joint pain(p = 0.02) and higher MMP-1 levels (p = 0.02) compared to GMFCS III.

Interpretation
Individuals with CP with less severe mobility deficits had higher MMP-1 levels likely due to more prolonged exposure to abnormal joint loading forces but experienced less joint pain.
Functional Reconstruction of Arches of the Foot With Vascularized Fibula Flap
Authors: Zor Fatih , Bayram Yalcin , Kulahci Yalcin 
Published: July 2023

Abstract
The skeletal integrity of the foot is as important as the soft tissue coverage of the foot. In this article, we present reconstruction of arches of foot with free fibula flap. Three patients with composite foot defects underwent reconstruction a with vascularized fibula flap. Free fibula flap was used to reconstruct the transverse arch in 2 cases and longitudinal arch in 1 case. The mean follow-up period was 3.2 years. Functional outcome was evaluated with 3-dimensional motion analyses at 12 months postoperatively. No early or late complications were encountered, and all patients were satisfied with both cosmetic appearance and functional aspects of their foot. Fibular bone showed a very healthy course without any fracture, resorption, extrusion, or migration. Three-dimensional motion analyses revealed acceptable gait capability in all cases showing successful restoration of the foot arches. As a conclusion, osteocutaneous free fibula flap can provide functional and durable reconstruction of longitudinal and transverse arches of the foot, especially if preservation of the length or the width of the foot is desired.
INVESTIGATION INTO P2Y RECEPTOR FUNCTION IN PLATELETS FROM PATIENTS WITH SEPSIS
Authors: Arkless Kate L. , Fish Matthew , Jennings Aislinn , Page Clive P. , Shankar-Hari Manu , Pitchford Simon C. 
Published: July 2023

ABSTRACT
Key underlying pathological mechanisms contributing to sepsis are hemostatic dysfunction and overwhelming inflammation. Platelet aggregation is required for hemostasis, and platelets are also separately involved in inflammatory responses that require different functional attributes. Nevertheless, P2Y receptor activation of platelets is required for this dichotomy of function. The aim of this study was to elucidate whether P2YR-dependent hemostatic and inflammatory functions were altered in platelets isolated from sepsis patients, compared with patients with mild sterile inflammation. Platelets from patients undergoing elective cardiac surgery (20 patients, 3 female) or experiencing sepsis after community-acquired pneumonia (10 patients, 4 female) were obtained through the IMMunE dysfunction and Recovery from SEpsis-related critical illness in adults (IMMERSE) Observational Clinical Trial. In vitro aggregation and chemotaxis assays were performed with platelets after stimulation with ADP and compared with platelets isolated from healthy control subjects (7 donors, 5 female). Cardiac surgery and sepsis both induced a robust inflammatory response with increases in circulating neutrophil counts with a trend toward decreased circulating platelet counts being observed. The ability of platelets to aggregate in response to ex vivo ADP stimulation was preserved in all groups. However, platelets isolated from patients with sepsis lost the ability to undergo chemotaxis toward N-formylmethionyl-leucyl-phenylalanine, and this suppression was evident at admission through to and including discharge from hospital. Our results suggest that P2Y1-dependent inflammatory function in platelets is lost in patients with sepsis resulting from community-acquired pneumonia. Further studies will need to be undertaken to determine whether this is due to localized recruitment to the lungs of a platelet responsive population or loss of function as a result of dysregulation of the immune response.
CHRONIC ETHANOL USE WORSENS GUT PERMEABILITY AND ALTERS TIGHT JUNCTION EXPRESSION IN A MURINE SEPSIS MODEL
Authors: Oami Takehiko , Yumoto Tetsuya , Shimazui Takashi , Sarmiento Sofia , Klingensmith Nathan J. , Chen Ching-Wen , Otani Shunsuke , Liang Zhe , Burd Eileen M. , Mahdi Zaid K. , Ford Mandy L. , Coopersmith Craig M. 
Published: July 2023

ABSTRACT
Alcohol use disorder is associated with increased mortality in septic patients. Murine studies demonstrate that ethanol/sepsis is associated with changes in gut integrity. This study examined intestinal permeability after ethanol/sepsis and investigated mechanisms responsible for alterations in barrier function. Mice were randomized to drink either 20% ethanol or water for 12 weeks and then were subjected to either sham laparotomy or cecal ligation and puncture (CLP). Intestinal permeability was disproportionately increased in ethanol/septic mice via the pore, leak, and unrestricted pathways. Consistent with increased permeability in the leak pathway, jejunal myosin light chain (MLC) kinase (MLCK) expression and the ratio of phospho-MLC to total MLC were both increased in ethanol/CLP. Gut permeability was altered in MLCK−/− mice in water/CLP; however, permeability was not different between WT and MLCK−/− mice in ethanol/CLP. Similarly, jejunal IL-1β levels were decreased while systemic IL-6 levels were increased in MLCK−/− mice in water/CLP but no differences were identified in ethanol/CLP. While we have previously shown that mortality is improved in MLCK−/− mice after water/CLP, mortality was significantly worse in MLCK−/− mice after ethanol/CLP. Consistent with an increase in the pore pathway, claudin 4 levels were also selectively decreased in ethanol/CLP WT mice. Furthermore, mRNA expression of jejunal TNF and IFN-γ were both significantly increased in ethanol/CLP. The frequency of CD4+ cells expressing TNF and IL-17A and the frequency of CD8+ cells expressing IFN-γ in Peyer’s Patches were also increased in ethanol/CLP. Thus, there is an ethanol-specific worsening of gut barrier function after CLP that impacts all pathways of intestinal permeability, mediated, in part, via changes to the tight junction. Differences in the host response in the setting of chronic alcohol use may play a role in future precision medicine approaches toward the treatment of sepsis.
Event-related Potentials Corresponding to Decision-making Under Uncertain Conditions
Authors: Farrar Danielle C. , Killiany Ronald J. , Moss Mark B. , Fink Brandi , Budson Andrew E. 
Published: July 2023

Background:
Decision-making is essential to human functioning, and resolving uncertainty is an essential part of decision-making. Impaired decision-making is present in many pathological conditions, and identifying markers of decision-making under uncertainty will provide a measure of clinical impact in future studies of therapeutic intervention for impaired decision-making.

Objective:
To describe EEG event-related potentials (ERPs) correlating with decision-making under uncertain conditions when compared with certain conditions.

Method:
We used a novel card-matching task based on the Wisconsin Card Sorting Test to describe the neural correlates of uncertainty, as measured by EEG, in a group of 27 neurotypical individuals. We evaluated 500-ms intervals in the 2 seconds after card presentation to identify ERPs that are associated with maximal uncertainty compared with maximal certainty.

Results:
After correcting for multiple comparisons, we identified an ERP in the 500–1000-ms time frame (certain > uncertain, max amplitude 12.73 µV, latency 914 ms) in the left posterior inferior region of the scalp. We also found a P300-like ERP in the left frontal and parietal regions in the 0–500-ms time frame when the individuals received correct versus incorrect feedback (incorrect feedback > correct feedback, max amplitude 1.625 µV, latency 339 ms).

Conclusion:
We identified an ERP in the 500–1000-ms time frame (certain > uncertain) that may reflect the resolution of uncertainty, as well as a P300-like ERP when feedback is presented (incorrect feedback > correct feedback). These findings can be used in future studies to improve decision-making and resolve uncertainty on the described markers.
Efficiency and novelty of using environmental swabs for dry surface biofilm recovery.
Authors: Watson Fergus , Wilks Sandra , Chewins John , Keevil Bill 
Published: July 2023

Studies on the epidemiology of dry surface biofilms within healthcare has shown an almost universal distribution across frequently touched items. Despite a growing body of evidence for dry surface biofilms in hospitals little attention has been paid to the recovery capacity of techniques used to detect these microbial communities. Biofilms are inherently difficult to remove from surfaces due to adhesive substances within their matrix and may act as sources of infection but to what extent is largely unknown. In this study we evaluate the recovery efficiencies of commonly used environmental swabs against dry surface biofilms containing 7.24-Log10 Acinetobacter baumannii/cm2, using a drip flow reactor and desiccation cycle. Biofilm presence was visually confirmed using episcopic differential interference contrast microscopy combined with epifluorescence and quantified using sonicated viable plate counts. The swab materials used comprised of foam, viscose and cotton, all of which were pre-moistened using a buffer solution. The surfaces were vigorously swabbed by each material type and the resultant microbe populations for both swabs and remaining dry surface biofilms were quantified. Our results found foam tipped swabs to be superior, detecting on average 30% of the original dry surface biofilm contamination; followed by viscose (6%) and cotton (3%). However, no distinct difference was revealed in the concentration of microbes remaining on the surface after swabbing for each swab type suggesting there is variation in the capacity for each swab to release biofilm associated microorganisms. We conclude whilst environmental swabs do possess the ability to detect biofilms on dry surfaces; the reduced efficiencies are likely to cause an underestimation of the microbes present and should be considered during clinical application.
Predicting non-response to ketamine for depression: a symptom-level analysis of real-world data
Authors: Miller Eric A. , Afshar Houtan Totonchi , Mishra Jyoti , Ramanathan Dhakshin 
Published: July 2023

AbstractBackgroundKetamine helps some patients with treatment resistant depression (TRD), but reliable methods for predicting which patients will, or will not, respond to treatment are lacking.MethodsThis is a retrospective analysis of PHQ-9 item response data from 120 military veterans with TRD who received repeated doses of intravenous racemic ketamine or intranasal eskatamine in a real-world clinic. Regression models were fit to individual patients’ symptom trajectories and model parameters were analyzed to characterize how different symptoms responded to treatment. Logistic regression classifiers were used to predict treatment response using patients’ baseline depression symptoms alone. Finally, by parametrically adjusting the classifier decision thresholds, the full space of models was searched to identify the best models for predicting non-response with very high negative predictive value.ResultsModel slopes indicated progressive improvement on all nine symptoms, but the symptom of depressed mood improved faster than the symptom of low energy. The first principal component (PC) represented a data-driven measurement of overall treatment response, while the second PC divided the symptoms into affective and somatic subdomains. Logistic regression classifiers predicted response better than chance using baseline symptoms, but these models achieved only 60.2% predictive value. Using threshold tuning, we identified models that can predict non-response with a negative predictive value of 96.4%, while retaining a specificity of 22.1%, suggesting we could successfully identify 22% of individuals who would not respond purely based on baseline symptom scores.ConclusionsWe developed an approach for identifying a subset of patients with TRD who will likely not respond to ketamine. This could inform rational treatment recommendations to avoid additional treatment failures.
Simultaneous Mapping of DNA Binding and Nucleosome Positioning with SpLiT-ChEC
Authors: Banks Orion G. B. , Harms Michael J. , McKnight Jeffrey. N. , McKnight Laura E. 
Published: July 2023

AbstractThe organization of chromatin – including the positions of nucleosomes and the binding of other proteins to DNA – helps define transcriptional profiles in eukaryotic organisms. While techniques like ChIP-Seq and MNase-Seq can map protein-DNA and nucleosome localization separately, assays designed to simultaneously capture nucleosome positions and protein-DNA interactions can produce a detailed picture of the chromatin landscape. Most assays that monitor chromatin organization and protein binding rely on antibodies, which often exhibit nonspecific binding, and/or the addition of bulky adducts to the DNA-binding protein being studied, which can affect their expression and activity. Here, we describe SpyCatcher Linked Targeting of Chromatin Endogenous Cleavage (SpLiT-ChEC), where a 13-amino acid SpyTag peptide, appended to a protein of interest, serves as a highly-specific targeting moiety for in situ enzymatic digestion. The SpyTag/SpyCatcher system forms a covalent bond, linking the target protein and a co-expressed MNase-SpyCatcher fusion construct. SpyTagged proteins are expressed from endogenous loci, whereas MNase-SpyCatcher expression is induced immediately before harvesting cultures. MNase is activated with high concentrations of calcium, which primarily digests DNA near target protein binding sites. By sequencing the DNA fragments released by targeted MNase digestion, we found that this method recovers information on protein binding and proximal nucleosome positioning. SpLiT-ChEC provides precise temporal control that we anticipate can be used to monitor chromatin under various conditions and at distinct points in the cell cycle.
Artificial Intelligence for Anatomical Structure Identification on Ultrasound in Regional Anaesthesia: A Scoping Review Protocol
Authors: Bowness James S , Metcalfe David , El-Boghdadly Kariem , Thurley Neal , Noble J Alison , Higham Helen 
Published: July 2023

AbstractBackgroundUltrasound is the most common form of guidance for regional anaesthesia. There is increasing interest in developing supporting technology, particularly in the form of artificial intelligence (AI), to aid in the acquisition and interpretation of optimal ultrasound views for these procedures. However, this is a broad field, with academia, clinical practice, and industry all providing disparate contributions. We will undertake a scoping review of publicly-available data, to assess methods of evaluation for accuracy and utility of such systems.MethodsWe will perform searches in multiple databases, including ACM Digital Library, CINAHL, EMBASE, IEEE Explore, and OVID MEDLINE. We will search the International Committee of Medical Journal Editors approved clinical trial registries and the World Health Organisation (WHO) clinical trials registry for studies registered in this field. Grey literature will be searched through the online library of doctoral theses (http://ethos.bl.uk/Home.do), regulatory authority registries and competent authority websites of North America and the UK, the websites of international learned societies in regional anaesthesia, and material from commercial organisations with products in the field.The primary goal is to summarise the approaches used to evaluate accuracy and utility of these devices. A secondary goal is to assess the standardisation of reporting in this field, with particular reference to whether reporting guidelines have been followed.DiscussionTo the best of our knowledge, this is the first scoping review of this type. Synthesis of the available evidence will enable us to make recommendations on standardised evaluation approaches of assessment, to allow robust and relevant evaluation which can be compared to similar evaluations of other devices.
Polygenic risk score analysis reveals shared genetic burden between epilepsy and psychiatric comorbidities
Authors: Campbell C. , Lewis-Smith D. , Leu C. , Martins H. , Wolking S. , Krause R. , O’Brien T. , Sill G. , Zara F. , Koeleman B. , Depondt C. , Marson A. , Stefánnson H. , Stefánnson K. , Craig J. , Johnson MR. , Striano P. , Jorgensen A. , Lerche H. , Delanty N. ,   The EpiPGX Consortium, Sisodiya S.M. , Thomas R. H. , Cavalleri G. L. 
Published: July 2023

AbstractBackgroundOne in three people with epilepsy experiences psychiatric comorbidity, with higher rates in people with drug-resistant epilepsy. Despite their high heritabilities, finding genetic links between epilepsy and psychiatric disorders has proven difficult. We used polygenic risk scoring (PRS) to test whether people with epilepsy have an increased polygenic burden of common genetic variants for depression, anxiety, psychosis, and attention deficit/hyperactivity disorder (ADHD), and examined whether such polygenic burden influences the response to pharmacological treatment of epilepsy.MethodsPhenotype data in the UK Biobank were assessed to identify people with 1) epilepsy (n=8 488), 2) depression (n=143 440), 3) psychosis (n=2 357), 4) ADHD (n=89), and 5) anxiety (n=18 222. Using genotype data and restricting to Caucasian-ancestry samples (n=409 634), PRS for each psychiatric trait were calculated and multinomial regression was used to compare 1) population controls, 2) people with epilepsy and no psychiatric illness, 3) people with epilepsy and the psychiatric trait of interest, and 4) people with the psychiatric trait of interest and no epilepsy. Fixed-effect meta-analysis was used to compare psychiatric PRS in drug-resistant and drug-responsive epilepsy samples from the UK Biobank (n=1 640) and the EpiPGX consortium (n=3 449).ResultsAfter correction for multiple testing, people with epilepsy showed elevated PRS for depression (p<2 x10−16), psychosis (p=0.04) and ADHD (p<0.001). Patients with drug-resistant epilepsy had an increased PRS for psychosis (p=0.002) and depression (p=0.0004) relative to responsive cases.ConclusionWe present evidence that the common genetic basis of epilepsy overlaps with that of psychiatric conditions which are frequently comorbid in people with epilepsy. Common genetic variants that drive psychiatric illness are enriched in people with drug-resistant epilepsy. These results further our understanding of the genetic architecture of epilepsy and suggest a potential future role for polygenic interpretation of common variants in prognostic stratification, both for seizure-treatment outcomes and non-seizure comorbidities.
Feasibility, acceptability, and cognitive benefits of a theory-informed intervention to increase Mediterranean diet adherence and physical activity in older adults at risk of dementia: the MedEx-UK randomised controlled trial
Authors: Jennings A , Shannon OM , Gillings R , Lee V , Elsworthy R , Rao G , Hanson S , Hardeman W , Paddick S-M , Siervo M , Aldred S , Mathers JC , Hornberger M , Minihane AM 
Published: July 2023

AbstractBackgroundDespite an urgent need for multi-domain lifestyle interventions to reduce dementia risk there is a lack of interventions which are informed by theory- and evidence- based behaviour change strategies and no interventions in this domain have investigated the feasibility or effectiveness of behaviour change maintenance.ObjectivesWe tested the feasibility, acceptability, and cognitive effects of MedEx-UK, a personalised theory-based 24-week intervention to improve Mediterranean-diet (MD) adherence alone, or in combination with physical activity (PA), in older-adults at risk of dementia, defined using a cardiovascular risk-score of >10%.Design104 participants (74% female, 57–76 years) were randomised to three parallel intervention arms: 1) control, 2) MD, or 3) MD+PA for 24-weeks and invited to an additional 24-week follow-up period with no active intervention. Behaviour change was supported using personalised targets, a web-based intervention, group sessions and food provision.ResultsThe intervention was feasible and acceptable with the intended number of ‘at risk’ participants completing the study. Participant engagement with group sessions and food provision components was high. There was improved MD adherence in the two MD groups compared with control at 24-weeks (3.7 points on a 14-point scale (95% CI 2.9, 4.5, p <0.01) and 48-weeks (2.7 points (95% CI 1.6, 3.7) p<0.01). Intervention did not change objectively measured PA. Improvements in general cognition (0.22 (95% CI 0.05, 0.35, p =0.01), memory (0.31 (95% CI 0.10, 0.51, p <0.01), and select cardiovascular outcomes captured as underpinning physiological mechanisms were observed in the MD groups at 24-weeks.ConclusionThe intervention was successful in initiating and maintaining dietary behaviour change for up to 12-months, which was likely due to the intense early support provided which resulted in cognitive benefits. These results will inform larger-scale complex behaviour change interventions with health and well-being endpoints.