bluuebunny/crossref_metadata_2025_split huggingface dataset:
39 CAN CARE ROBOTS ASSIST OLDER PEOPLE AND LONG-TERM CARE SYSTEMS? KEY STAKEHOLDERS’ PERCEPTIONS IN HONG KONG SAR, CHINA AND IRELAND
Authors: Kodate N , Donnelly S , Cheung M-c , Maeda Y , Mannan H , Chan WC-h , O'Shea D 
Published: February 2023

Abstract

Background
Robotics is now seen as part of the solution to the ageing population internationally, and is deployed in care settings. Care robots are designed to enable active ageing as well as ageing in place, with support to older persons, their families, and care professionals. The aim of this study was to understand the perceptions of stakeholders in Hong Kong and Ireland regarding the current state of affairs surrounding the use of care robots in their jurisdictions.

Methods
Semi-structured, in-depth interviews were conducted with 30 experts (15 from each jurisdiction). The participants included care professionals, service providers, researchers, and advocacy group representatives and policymakers. The questions explored their knowledge of and perceptions regarding the current use of assistive technologies, long-term care systems, and their own future vision of care provision for old age.

Results
In both jurisdictions, the use of care robots is relatively new, although many respondents were familiar with the seal robot PARO and the humanoid robot Pepper. In Hong Kong, a gerontechnology-specific exposition has become an annual feature in recent years, and the government’s investment has stepped up. In Ireland, a more general ehealth agenda has been adopted within the government’s planned care reform (Sláintecare). Older people in Hong Kong and Ireland are believed to fall through the cracks in their respective two-tier care systems, and many respondents stated that care robots are most needed in order to fill the gaps (e.g. safety monitoring, mobility support). Concerns regarding the impact of using robots included a possible reduction in human-to-human contact and deskilling of older people themselves.

Conclusion
There was a sense of urgency in both jurisdictions that more smart and digital technologies should be utilised to ease the pressures on care professionals and systems. However, a degree of optimism was noted for technological leapfrogging after the pandemic.
43 REDUCED KIDNEY FUNCTION IS ASSOCIATED WITH POORER GLOBAL AND DOMAIN-SPECIFIC COGNITIVE PERFORMANCE IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Dyer A , Laird E , Hoey L , Hughes C , McNulty H , Ward M , Strain J J , Molloy A , Cunnningham C , Sexton D , McCarroll K 
Published: February 2023

Abstract

Background
Chronic Kidney Disease (CKD) is an important risk factor in the development of cognitive impairment. However, the association between reduced estimated Glomerular Filtration Rate (eGFR) and performance on domain-specific cognitive and neuropsychological assessments is less clear and may represent an important target in the promotion of optimal brain health in older adults.

Methods
Participants from the Trinity, Ulster and Department of Agriculture cohort study underwent detailed assessment of cognitive and neuropsychological function using the Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Repeatable Battery for Assessment of Neuropsychological Status (RBANS). Mixed-effects Poisson and linear regression was used to assess the relationship between eGFR strata and cognitive/neuropsychological test performance.

Results
4,887 participants were included (73.94 ± 8.25 years; 67.7% female). Reduced eGFR was associated with poorer performance on all three cognitive assessments, most pronounced in those with eGFR &lt;45 mL/mL/1.73m2 (IRR: 1.19; 95% CI: 1.09, 1.29; p &lt; 0.001 for MMSE/IRR: 1.14; 95% CI 1.04, 1.24; p &lt; 0.001 for the FAB/β: -3.23; 95% CI -5.18, −1.30; p = 0.001 for RBANS, fully adjusted). Reduced eGFR was associated with poorer performance on immediate memory, visual–spatial and attention RBANS domains. Associations were strongest in the youngest old (&lt;70 years) with no association observed in those aged &gt;80 years.

Conclusion
Reduced kidney function was associated with poorer global and domain-specific function in community-dwelling older adults. Associations were strongest for those with eGFR &lt;45 mL/min/1.73m2 and the youngest-old, suggesting that this group may be most at risk and may benefit from potential preventative interventions.
50 A COMPARISON OF FRAILTY SCREENING TOOLS WITHIN THE EMERGENCY DEPARTMENT
Authors: Loughlin K M , Lyons C , McGettigan L , Maloney P 
Published: February 2023

Abstract

Background
Increased awareness has been given to the value of identifying frail for risk stratification and to assist in providing frailty attuned care rather than disease specific input.
This increased awareness both nationally and internationally has led to many ED’s introducing the Clinical Frailty Scale (CFS) to triage however as a service we wanted to evaluate which tool would best meet our needs to screen appropriate patients and highlight the current level of frailty within the Emergency Department.

Methods
Over a 3 day period all patients over 75 who present during core hours were screened by a senior FITT member using a number of frailty tools (CFS, THINK frail, InterRai, PRIMSA 7 & compared against our own clinical reasoning if a FITT assessment was indicated).

Results
Total Patient’s over 75 screened by screener & FITT—48.
Average age: 82.
Sex: 51.62% male.
Discharges: 57% d/c’d.
Average CFS (Screener) = 5.
Average CFS (FITT) = 5.
28/48 CFS same = 58.33%.
15/48 CFS differ by 1 point = 31.25%.
Average THINK Frail (Screener): 3.
Average THINK Frail (FITT): 2.
17/47 THINK Frail same =36%.
21/47 THINK Frail differ by 1 point = 44%.
80.85% same or within 1 point difference.

Conclusion
The CFS score provided the most consistent when comparing scores by multiple disciplines/grades.
Although the majority of older adults who scored a CFS of 1–3 or deemed non frail at triage were unlikely to benefit from a CGA, those who presented with a new fall often did require FITT input.
This research has led us to move away from our current triage tool of THINK FRAIL to the CFS, whilst continuing to assess any new falls irrespective of score.
57 POTENTIALLY INAPPROPRIATE MEDICATION USE AND MORTALITY IN PATIENTS WITH COGNITIVE IMPAIRMENT
Authors: Buckley E , Jonsson A , Flood Z , Lavelle M , Nurdin N , Dowling P , Duggan E , O'Sullivan N , McGreevy C , Duggan J , Kyne L , McCabe J 
Published: February 2023

Abstract

Background
Potentially inappropriate medications (PIMs are associated with falls, hospitalisation, and cognitive decline. Few studies have investigated the association between PIMs related to cognitive impairment (PIMCog) and mortality in dementia or mild cognitive impairment (MCI).

Methods
This was a retrospective observational study. Patients diagnosed with MCI or dementia (DSM-IV criteria) presenting to a tertiary-referral memory clinic from 2013–2019 were eligible. The primary outcome was all-cause death. Secondary outcomes were vascular death and non-vascular death defined according to formal certification. The primary exposure variable of interest was PIMCog, defined as any medication in the Beers 2015 or STOPP criteria, classified as potentially inappropriate for patients with cognitive impairment. Anticholinergic burden was measured using the anticholinergic cognitive burden (ACB) scale. Polypharmacy was defined as ≥5 medications. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs).

Results
There were 418 patients included (n = 261 dementia, n = 157 MCI). The median age was 79 (interquartile range {IQR} 74–82) and median follow-up was 809 days (IQR 552–1,571). One or more PIMCog was prescribed in 141 patients (33.4%). PIMCog use was associated with all-cause mortality after adjustment for age, sex, dementia severity, Charlson Co-morbidity Index, chronic obstructive pulmonary disease, congestive cardiac failure, and peripheral vascular disease (HR 1.96, 95% CI 1.24–3.09). PIMCog use was associated with vascular death (HR 3.28, 95% CI 1.51–7.11) but not with non-vascular death (HR 1.40 95% CI: 0.78–2.52). Neither an ACB ≥3 (HR 0.87, 95% CI: 0.46–1.64) or polypharmacy (HR 1.87, 95% CI: 0.67–5.24) were associated with death.

Conclusion
The burden of PIMCog use in patients with cognitive impairment is high. PIMCog use is independently associated with all-cause mortality and vascular death. This is a potential modifiable risk factor for death in patients with neurocognitive disorders. Further research is required to independently validate this finding.
65 THE IMPACT OF SOCIAL ISOLATION DURING COVID-19 ON COGNITION IN OLDER ADULTS
Authors: McCormack R , McNally S , O'Shea D 
Published: February 2023

Abstract

Background
A correlation between social isolation and poorer cognitive function in later life has been increasingly implied in literature. Research indicates that maintaining a socially active lifestyle can enhance cognitive reserve and benefit cognitive function. Whereas social exclusion has been significantly associated with higher risks of cognitive impairment (Evans, et al., 2019).
Recent studies reviewed the consequences of restrictive living conditions during COVID-19, finding poorer cognitive performance (Ingram, et al., 2021). However, few services have investigated this. This study intended to explore the impact of social isolation on cognitive function of hospitalised older adults.

Methods
Quantitative measures were used. A retrospective review of cognitive results of individuals open to occupational therapy in an acute Care of the Older Person’s service in May 2018 (n = 23) were compared to cognitive results of individuals open to occupational therapy in the same acute Care of the Older Person’s service in May 2021 (n = 62).

Results
For the purpose of this study, cognitive results were compared by means of assessment results which indicated a mild, moderate or significant cognitive impairment. Of the patients seen in May 2021 (n = 62), 9.68% (n = 6) had a mild cognitive impairment, 25.81% (n = 16) had a moderate cognitive impairment and 32.26% (n = 20) presented with a significant cognitive impairment. Comparatively in May 2018 (n = 23), 30.43% (n = 7) had a mild cognitive impairment, 43.38% (n = 10) had a moderate cognitive impairment and just 4.35% (n = 1) presented with a significant cognitive impairment.

Conclusion
A substantial increase in the number of inpatients presenting with a significant cognitive impairment in an acute Care of the Older Person’s service was found between May 2018 (4.35%) and May 2021 (32.26%). This suggests that COVID-19 had a severe impact on cognitive functioning of older adults and implies that this cohort are at a high risk of cognitive decline caused by social isolation. These findings are preliminary and further research is recommended.
67 A BLENDED MODEL OF CARE USED IN THE ROLLOUT OF AN EARLY SUPPORTED DISCHARGE FOR STROKE SERVICE DURING COVID-19
Authors: Reilly E , Jana W , Dwyer S , Donohoe A , Crowley A , Foley S 
Published: February 2023

Abstract

Background
The Health and Social Care Professionals budget was augmented to develop rehabilitation services that facilitated hospital discharges. Early Supported discharge (ESD) for stroke is a proven model of best care for stroke patients with mild to moderate disability (Langhorne et al., 2005). A pilot was implemented with the team consisting of an Occupational Therapist, Speech and Language Therapist, Physiotherapist and Medical Social Worker.

Methods
The service facilitated an early discharge from the hospital with the delivery of specialist stroke rehabilitation in the home. Therapy is provided with the same intensity and expertise that would be received in hospital and is available for up to 8 weeks, it was provided using a blended model of domiciliary care and the introduction of telehealth in response to COVID 19.
Data was recorded for 100 service users using an excel spreadsheet. Data was recorded to measure number of new referrals, length of stay, bed days released back into the hospital system, mode of service delivery and functional outcomes. A cost analysis was completed. Service user experience was captured using questionnaires.

Results
From September 2020 to July 2021, 100 patients accessed ESD with a reduction of 7.2 days in hospital stay per patient. Improvements in pre- and post- rehabilitation scores on the FIM/FAM were evident. Very positive feedback regarding the rehabilitation experience was captured within the patient satisfaction questionnaire. Therapy delivery was 60% face to face, 37% via telehealth and 3% outpatient appointments. Telehealth received good compliance but with varying reports of experience in comparison to face to face.

Conclusion
ESD provided in the home environment facilitated earlier discharge from hospital with positive outcomes for the hospital and service users. Telehealth ensured that rehabilitation was maintained throughout the pandemic. Telehealth increased access for patients residing outside of the catchment area. However service user preference remains face to face.
75 EXPERIENCES OF HEALTH SERVICE USE FOR PEOPLE LIVING WITH PARKINSON’S DISEASE: A NATIONAL SURVEY
Authors: O'Shea E , Rukundo A , Timmons S 
Published: February 2023

Abstract

Background
Despite the growing prevalence of Parkinson’s disease (PD), and the need to plan for future health service provision, very little is known in the Irish context about PD patients’ experience of health services.

Methods
A cross-sectional survey design, with multiple formats, i.e. online, pen-and-paper, and telephone. Data were collected from May 2020–July 2021 using a multipronged recruitment strategy. It could be completed by a person with PD, or a support person on behalf of/with the person. Survey development was informed through literature review, and in consultation with the Parkinson’s Association of Ireland, and a patient advisory group (N = 10).

Results
A total of 1,504 individuals accessed the survey, with 1,402 meeting the eligibility criteria. Over half (53%) were male, and the distribution across Ireland’s provinces was: Leinster (46%); Munster (28%); Connaught (19%); and Ulster (7%). Approx. 5% were diagnosed with young-onset PD. A minority (6%) reported attending only their GP to manage their PD, with the rest attending a specialist outpatient clinic. The mean distance travelled each-way to outpatient clinics was 45.6 km (SD = 49.4, min 1 km, max. 300kms). Most were diagnosed by Neurologists (84%), followed by GPs (8%), and Geriatricians (7%); 1% indicated ‘other’. Of those diagnosed by a Neurologist or Geriatrician, most were diagnosed privately (68%); though 37% of these patients subsequently switched to the public system for ongoing management. The majority (97%) reported currently taking PD medications, but just 52% believed these were working effectively. Just over one-fifth (22%) had access to a PD nurse specialist. Access to the range of other health and social care professionals is also very poor for this patient group.

Conclusion
A number of significant gaps in PD care have been identified, which require urgent attention. A reconfigured model of PD care is necessary to accommodate the growing need for specialist, integrated care at the population level.
CLAIRE: contrastive learning-based batch correction framework for better balance between batch mixing and preservation of cellular heterogeneity
Authors: Yan Xuhua , Zheng Ruiqing , Wu Fangxiang , Li Min 
Published: February 2023

AbstractMotivationIntegration of growing single-cell RNA sequencing datasets helps better understand cellular identity and function. The major challenge for integration is removing batch effects while preserving biological heterogeneities. Advances in contrastive learning have inspired several contrastive learning-based batch correction methods. However, existing contrastive-learning-based methods exhibit noticeable ad hoc trade-off between batch mixing and preservation of cellular heterogeneities (mix-heterogeneity trade-off). Therefore, a deliberate mix-heterogeneity trade-off is expected to yield considerable improvements in scRNA-seq dataset integration.ResultsWe develop a novel contrastive learning-based batch correction framework, CIAIRE, which achieves superior mix-heterogeneity trade-off. The key contributions of CLAIRE are proposal of two complementary strategies: construction strategy and refinement strategy, to improve the appropriateness of positive pairs. Construction strategy dynamically generates positive pairs by augmenting inter-batch mutual nearest neighbors (MNN) with intra-batch k-nearest neighbors (KNN), which improves the coverage of positive pairs for the whole distribution of shared cell types between batches. Refinement strategy aims to automatically reduce the potential false positive pairs from the construction strategy, which resorts to the memory effect of deep neural networks. We demonstrate that CLAIRE possesses superior mix-heterogeneity trade-off over existing contrastive learning-based methods. Benchmark results on six real datasets also show that CLAIRE achieves the best integration performance against eight state-of-the-art methods. Finally, comprehensive experiments are conducted to validate the effectiveness of CLAIRE.Availability and implementationThe source code and data used in this study can be found in https://github.com/CSUBioGroup/CLAIRE-release.Supplementary informationSupplementary data are available at Bioinformatics online.
Optimal primary wound closure methods after thyroid and parathyroid surgery: network meta-analysis of randomized clinical trials
Authors: Davey Matthew G , Browne Ferdia , Davey Martin S , Walsh Stewart R , Kerin Michael J , Lowery Aoife J 
Published: February 2023

Abstract

Background
At present, there is no consensus on optimal neck wound closure methods after thyroid and parathyroid surgery. The aim of this study was to perform a systematic review and network meta-analysis of RCTs evaluating the optimal neck closure method after thyroid and parathyroid surgery.

Methods
A frequentist random-effects network meta-analysis was performed for RCTs comparing at least two closure methods according to PRISMA-network meta-analysis guidelines. Analysis was performed using R packages and Shiny.

Results
Eighteen RCTs evaluating six closure methods (that is adhesive (28.5 per cent, 404 patients), absorbable subcuticular suture (18.1 per cent, 257 patients), non-absorbable subcuticular suture (16.8 per cent, 238 patients), staples (26.3 per cent, 372 patients), steristrips (8.1 per cent, 115 patients), and conventional suture (2.1 per cent, 30 patients)) in 1416 patients were included. At network meta-analysis, there was no difference in complication, infection, dehiscence, or haematoma rates irrespective of closure method used. Staples reduced closure duration versus absorbable subcuticular suture (mean difference (MD) 8.50, 95 per cent c.i. 6.90 to 10.10) and non-absorbable subcuticular suture (MD 0.30, 95 per cent c.i. 0.23 to 0.37), whereas adhesives (MD −1.05, 95 per cent c.i. −1.31 to −0.79) reduced closure time relative to staples. Cosmesis was improved after non-absorbable subcuticular suture (odds ratio (OR) 3.41, 95 per cent c.i. 1.66 to 7.00) relative to staples. Staples reduced patient satisfaction (OR 0.04, 95 per cent c.i. 0.00 to 0.33) and ability to shower (OR 0.04, 95 per cent c.i. 0.00 to 0.33) relative to adhesives.

Conclusion
Despite staples decreasing closure times, this advantage is offset by reduced patient satisfaction, ability to shower, and cosmesis compared with patients with wounds closed using adhesives, absorbable subcuticular suture, and non-absorbable subcuticular suture. Therefore, these closure methods are favourable for closing neck wounds due to more acceptable patient-reported outcomes, without compromising the safety of the procedure.
Metabolic and microbial changes in light-vented bulbul during recent northward range expansion
Authors: Wu Yun , Xiong Ying , Ji Yanzhu , Cheng Yalin , Zhu Qianghui , Jiao Xiaolu , Chang Yongbin , Zhao Na , Yang Jing , Lei Fumin , Song Gang 
Published: February 2023

Abstract
Endotherms recently expanding to cold environments generally exhibit strong physiological acclimation to sustain high body temperature. During this process, gut microbes likely play a considerable role in host physiological functions, including digestion and thermogenesis. The light-vented bulbul Pycnonotus sinensis represents one such species. It used to be restricted to the Oriental realm but expanded its distribution range north to the Palearctic areas during the past few decades. Here, we explored the seasonal dynamics of the resting metabolic rate (RMR) and microbiota for local and newly colonized populations of the species. Our results showed that the mass-adjusted RMR and body mass were positively correlated with latitude variations in both seasons. Consistently, the gut microbiota showed a corresponding variation to the northern cold environments. In the two northern populations, the alpha diversity decreased compared with those of the two southern populations. Significant differences were detected in dominant phyla, such as Firmicutes, Bacteroidetes, Proteobacteria, and Desulfobacterota in both seasons. The core microbiota showed geographic differences in the winter, including the elevated relative abundance of 5 species in northern populations. Finally, to explore the link between microbial communities and host metabolic thermogenesis, we conducted a correlation analysis between microbiota and mass-adjusted RMR. We found that more genera were significantly correlated with mass-adjusted RMR in the wintering season compared to the breeding season (71 vs. 23). These results suggest that microbiota of the lighted-vented bulbul linked with thermogenesis in diversity and abundance under northward expansion.
Non-hepatic Solid Organ Transplant in Patients with Inflammatory Bowel Disease: An ECCO CONFER Multicentre Case Series
Authors: Ribaldone Davide Giuseppe , Vieujean Sophie , Julsgaard Mette , Armandi Angelo , Zingone Fabiana , Savarino Edoardo , Cañete Fiorella , Aratari Annalisa , Imperatore Nicola , Ramos Laura , Plaza Rocio , Pugliese Daniela , Barberio Brigida , Drobne David , Chaparro María 
Published: February 2023

Abstract

Background and Aims
Solid organ transplantation, with the exception of liver, has rarely been reported in patients affected by inflammatory bowel diseases [IBD].

Methods
This is an ECCO-CONFER project collecting cases of solid organ transplants [with the exclusion of liver] that were performed in IBD patients. We evaluated the change in the IBD therapy, need for bowel resection due to medically refractory IBD, or need for hospitalisation due to IBD relapse [‘severe IBD course’] before and after transplantation.

Results
in total, 34 organ transplantations [28 kidney, five heart, one lung] in 33 IBD patients were collected [67% male, 55% Crohn’s disease, mean age 53 ± 16 years]. The median follow-up was 4.3 years (interquartile range [IQR] 3.2–10.7); 29 patients [87.9%] were treated with tacrolimus, 25 [76%] with systemic steroids, 22 [67%] with mycophenolate mofetil, 11 [33%] with everolimus, six with cyclosporine [18%]. One patient was treated with infliximab, two patients with adalimumab, two patients with vedolizumab, one patient with ustekinumab. Overall, a severe IBD course was observed in three [9.3%] patients before transplantation and in four [11.7%] in the post-transplant setting [p = 0.26]. Three cases of cancer [excluding skin non-melanoma] [9.1%] were recorded in the post-transplantation period versus two in the pre-transplantation period [6.1%, p = 0.04]. Six patients [18.2%] died during the period of observation. No deaths were associated with IBD or complications of the transplant.

Conclusions
In IBD patients, solid organ transplantation does not seem to impact on the IBD severity. However, the risk of malignancy needs further investigation.