bluuebunny/crossref_metadata_2025_split huggingface dataset:
1519 WELLBEING OF UNPAID CARERS OVER FIFTY: AN ANALYSIS OF DATA FROM ENGLISH LONGITUDINAL STUDY OF AGEING
Authors: Brack C , Makin S , Kynn M , Murchie P 
Published: July 2023

Abstract

Introduction
There is relatively little known about physical health of older people who are unpaid carers. The English Longitudinal Study of Ageing (ELSA) Wave 9 (2019) was used to examine the relationship between unpaid caring and health. This study contains information on frailty, caring, comorbidities and Instrumental Activities of Daily Living (IADL) from 8,736 participants 50 years and over.

Methods
We included participants who received a nurse visit in Wave 9 (n=3,047), 21 were excluded due to missing data. Frailty was calculated using the ELSA-Frailty Index (FI). Carers were those in receipt of Carers Allowance or self-reported unpaid caring.

Results
351 carers and 2675 non-carers were included. Carers were younger (64.5 (10.2) vs 66.7 (10.5), p&lt;0.001) and more likely to be married (78.1% vs 62.8%, p&lt;0.001). Carers had a lower median FI score (0.07 (0.04-0.14) vs 0.15 (0.12-0.21), p=0.000) however, 45/536(8%) of moderately and severely frail participants were carers. Of 966 non-frail (FI &lt;0.12) participants: 9/246(2.6%) carers experienced difficulties with IADLs, compared to 5/720(0.69%) non-carers; 79/246(31%) of carers had impaired mobility, compared to 39/720(5%) of non-carer; and 51/246(20%) had 2+ comorbidities, compared to 17/720(2.4%) non-carers. Of 1524 mildly frail (FI&gt;0.12-0.24) participants: 16/60(26.7%) carers experienced difficulties with IADLs, compared to 116/1464(0.69%) non-carers; 58/60(97%) of carers had impaired mobility, compared to 807/1464(55%) non-carers; and 42/60(70%) had 2+ comorbidities, compared to 607/1464(41.4%) non-carers. On frailty-adjusted multivariable analysis there was a strong association between carer status and comorbidities with Odds Ratio (OR)3.01 (95%CI 2.21-4.10); impaired mobility, OR 11.08 (95%CI7.52-16.32); and impaired IADLs, OR 5.44(95%CI3.48-8.48)

Conclusions
Carers are less likely to be frail but more likely to struggle with at least one IADL, experience comorbidity or mobility impairment than equivalently frail peers. This suggests that, in the over 50s, either caring contributes to impairment or the burden of care falls on the more impaired.
1651 VIDEO-RECORDING PATIENTS FOR DIRECT CARE PURPOSES: A SYSTEMATIC REVIEW WITH SPECIFIC FOCUS ON THE OLDER PATIENT
Authors: Ellis S , Lear R , Ollivierre-Harris T , Long S , Mayer E 
Published: July 2023

Abstract

Introduction
Video-recordings of patients may offer advantages over text-based documentation to supplement assessment and decision-making – particularly for older patients with complex needs. Our systematic review aimed to evaluate the application, acceptability, and impact of video-based records; here we highlight current evidence on using video-recordings to support direct care delivery for older patients.

Methods
Five electronic databases (Medline/Embase/PsycInfo/Cochrane/HMIC) were searched from 2012-2022. Studies involving videorecording patients aged ≥ 18 years for diagnosis, care, or treatment were identified. Study quality was assessed using published appraisal tools. Acceptability was evaluated through i) recruitment/retention rates, and ii) synthesis of patients’ and professionals’ perspectives and experiences. Sekhon’s Theoretical Framework of Acceptability (TFA), consisting of seven constructs (affective attitude/burden/ethicality/intervention coherence/opportunity costs/self-efficacy), underpinned the synthesis.

Results
Of 14,221 citations, 27 studies (mainly low-quality) met inclusion criteria. 10/27 studies recruited older patients including those with Parkinson’s Disease (PD), dementia, stroke, end-of-life care, average age was 69. Video-recording was used in diagnosis, management/monitoring, and rehabilitation of older patients. Mean recruitment rate was 58.8% (34.2%-73.7%): mean retention rate was 81.3% (73.4%-100%). Reasons for non-participation/withdrawal related to the video-recording intervention itself (privacy concerns/poor video quality) and other factors (patients lost to follow-up). Framework synthesis generated 17 sub-themes linked to the seven TFA constructs. Attitudes to video-based records were largely positive. Video-recordings were perceived to be helpful in facilitating diagnosis/treatment/care for patients with movement disorders (PD; high-risk fallers), including in dementia populations. Digital literacy, illness severity and cognitive impairment influenced patients’ capacity to consent to video-recording. Healthcare professionals were concerned about technical challenges but burden was minimised through using portable devices (e.g. iPad) for video capture.

Conclusion
Video-based records may be acceptable to older patients and professionals, providing valid consent is obtained and the potential benefits are recognised. Further research is needed to evaluate the acceptability, feasibility, and effectiveness.
1530 MEDIATION EFFECT OF CHILDHOOD HEALTH STATUS, LIFE ADVERSITIES, FINANCIAL CONDITION, AND NETWORK SATISFACTION ON SUICIDAL IDEATION
Authors: Ho-Ling Liu R , Chi-Pun Liu B 
Published: July 2023

Abstract

Introduction
The study is to explore how childhood health status (X), early life adversities (M1), financial condition (M2), and satisfaction with social networks (M3) are associated with the development of suicidal ideation (Y) over time among older adults in 13 European countries. Respondents were drawn from the Survey of Health, Ageing, Retirement, in Europe (SHARE) conducted in 2013 (Wave 5), 2015 (Wave 6), 2016 (Wave 7), and 2020 (Wave 8). 56.8% (n=10043) of respondents were female, and 43.2% (n=7642) were male. The mean age at Wave 8 was 72.35 (range 60-103).

Method
The conditional process analysis using the PROCESS macro (model 6), which can perform the same functions as structural equation modelling, was applied (Hayes, Montoya & Rockwood, 2017).

Results
A poor childhood health status (X) (coeff=.1222, p&lt;.001) was found to have a direct impact on suicidal ideation (Wave 8), but its effect was decreased after considering the mediation effect of the three mediators (coeff of M1=.1511, p&lt;.001, coeff of M2=.1931, p&lt;.001, and coeff of M3=-.1640, p&lt;.001) (Coeff of X to Y via M1, M2 and M3=.0428, p=.1913, Full competitive mediation).

Conclusion
Findings show that poor childhood health status contributed significantly to developing suicidal ideation over time. The cumulative risk of early life adversities and a worse financial situation than expected earlier in life positively mediated the impact of adverse childhood health status on developing suicidal ideation. However, a satisfied social network can eliminate the cumulated risk of adverse childhood health status, early life adversities, and a worse financial situation in the development of suicidal ideation. A higher level of satisfaction with social networks, especially since the outbreak of the COVID-19 pandemic, is a protective risk for suicidal ideation among older adults.
1565 PREVALENCE OF FRAILTY IN A TIA CLINIC AND ASSOCIATIONS WITH MORTALITY
Authors: Elliott A , Beishon L , Minhas J , Mistri A , Eveson D , Jones W , Quinn T , Robinson T 
Published: July 2023

Abstract

Background and aims
Frailty is a clinical syndrome of increased vulnerability to stressors, associated with adverse outcomes after stroke, but its impact on outcomes after transient ischaemic attack (TIA) remain unclear.

Methods
Retrospective analysis of 1185 patients referred by the emergency department (ED) who attended TIA clinic with a Clinical Frailty Scale (CFS) within two weeks. Records were combined from two routinely collected databases, and prevalence of frailty was determined. Frailty was classified as CFS score &gt;/=4. Data were collected on date of death, and hazard ratios (HR) were determined through cox proportional hazard regression, adjusted for prognostic factors.

Results
7945 patients were referred through the ED between 01/01/2016 and 12/03/2022. 1185 patients were included. 53.5% (n=634) had frailty. Patients with frailty tended to be older (median age 81 vs 74, p&lt;0.001) and female (53.9% vs 39.9% p&lt;0.001). TIA was diagnosed in 28.3% (n=335), 61.2% (n=205) of whom were frail. Stroke was diagnosed in 23.1% (n=274). 46.7% of these had frailty (n=128). In TIA patients and the whole cohort (WC), frailty (TIA: HR 2.69 [95%CI 1.23-5.87, p=0.013], WC: 2.58 [95%CI 1.64-4.08, p&lt;0.001]; and increasing age [HR 1.07 95% CI 1.04-1.12], were predictive of mortality. In stroke patients, only increasing age was predictive of death, (HR 1.11 [95%CI 1.04-1.19, p=0.003]).

Conclusions
Frailty is common in TIA and is predictive of mortality. Studies are required to investigate the effects of frailty on other outcomes after TIA, including: quality of life; progression to stroke; and how frailty impacts rehabilitation.
1664 ASSESSING FRAILTY AND ANTICHOLINERGIC BURDEN IN STROKE PATIENTS: A PROSPECTIVE, OBSERVATIONAL STUDY
Authors: Prescott D F , Drenan M , Quinn T 
Published: July 2023

Abstract

Introduction
Frailty assessment in stroke is not commonly integrated into clinical practice, despite current clinical recommendations. Pre-stroke frailty is associated with longer-term mortality, length of admission, and disability. Similarly, anticholinergic burden (ACB) is not routinely reviewed, even though it is associated with cognitive and physical impairment, increased hospital admissions, and higher mortality in older people. Healthcare Improvement Scotland-Frailty (HIS-Frailty) is a novel tool for the evaluation of frailty in older people. Our aim was to compare and correlate the identification and severity of frailty with HIS-Frailty to the Rockwood Clinical Frailty Scale (CFS) in stroke. We also used the ACB Score to determine if there was a difference in ACB between hospital admission and discharge in these patients.

Methods
We conducted a prospective, observational, single-centre study in a stroke unit. Patients with a cerebrovascular diagnosis were included. We compared frailty assessment through linear correlation and ACB through mean difference in scores.

Results
were considered statistically significant if p-value &lt; 0.05 and highly statistically significant if p-value &lt; 0.005. SPSS® 26.0 was used to perform data analysis. We included 145 patients. 110 (76%) were older than 60 years and 75 (52%) were male. Most admissions were due to ischemic stroke (67%), closely followed by TIA (14%). Forty-eight (32%) were classified as frail. There was a strong positive correlation between HIS-Frailty and the CFS (r = 0.95; p &lt;0.00001; R2 = 0.91). Seventy-nine (55%) patients had significant ACB. There was no significant difference between ACB at admission and discharge (MD = 0.010, CI 95% -0.52 to 0.54; p = 0.97).

Conclusion
HIS-Frailty may prove to be a consistent and easy tool for the systematic identification of frailty in stroke patients, in accordance with best clinical practice guidelines. We should identify and standardise measures to reduce ACB after admission for stroke.
Discovery of new functions of food proteins and their structural development for multifunctional applications
Authors: Ochiai Akihito 
Published: July 2023

ABSTRACT
Proteins and peptides derived from various food sources are used in a variety of applications, including functional foods, pharmaceuticals, and cosmetics. The three-dimensional structure of proteins provides useful insights into their functions and essential information for the creation of proteins with new functions. In this review, a series of functional conversion technologies based on protein structural information derived from foods traditionally consumed in Japan, such as natto (fermented soybeans) and rice, are introduced. For natto, we first identified 2 types of Bacillus subtilis-derived endolytic and exolytic enzymes with different modes of action on soybean cell wall polysaccharides and then focused on the technology used to create an endolytic enzyme from an exolytic enzyme. By applying this technology, a method for creating novel bioactive peptides from rice seed proteins was established. The modified peptides created could provide diverse options for the production of substances such as pharmaceuticals and cosmetic materials.
HNSPPI: a hybrid computational model combing network and sequence information for predicting protein–protein interaction
Authors: Xie Shijie , Xie Xiaojun , Zhao Xin , Liu Fei , Wang Yiming , Ping Jihui , Ji Zhiwei 
Published: July 2023

Abstract
Most life activities in organisms are regulated through protein complexes, which are mainly controlled via Protein–Protein Interactions (PPIs). Discovering new interactions between proteins and revealing their biological functions are of great significance for understanding the molecular mechanisms of biological processes and identifying the potential targets in drug discovery. Current experimental methods only capture stable protein interactions, which lead to limited coverage. In addition, expensive cost and time consuming are also the obvious shortcomings. In recent years, various computational methods have been successfully developed for predicting PPIs based only on protein homology, primary sequences of protein or gene ontology information. Computational efficiency and data complexity are still the main bottlenecks for the algorithm generalization. In this study, we proposed a novel computational framework, HNSPPI, to predict PPIs. As a hybrid supervised learning model, HNSPPI comprehensively characterizes the intrinsic relationship between two proteins by integrating amino acid sequence information and connection properties of PPI network. The experimental results show that HNSPPI works very well on six benchmark datasets. Moreover, the comparison analysis proved that our model significantly outperforms other five existing algorithms. Finally, we used the HNSPPI model to explore the SARS-CoV-2-Human interaction system and found several potential regulations. In summary, HNSPPI is a promising model for predicting new protein interactions from known PPI data.
Gambling Disorder, Financial Loss and Suicide—A Journey to the ‘Outer Reaches’ of the Common Law
Authors: O’Sullivan Janet 
Published: July 2023

Abstract
Almost as soon as Briggs J opined in Calvert v William Hill Credit Ltd (2008) that ‘recognition of a common law duty to protect a problem gambler from self-inflicted gambling losses involves a journey to the outermost reaches of the tort of negligence, to the realm of the truly exceptional’, the legal and technological context of his dictum utterly transformed. The liberalising regime of the Gambling Act 2005 was not in force when the facts of Calvert occurred, and the legislation was itself out of date by the time it was implemented, with the arrival of highly addictive online gambling platforms, smartphones, sophisticated targeted marketing and ubiquitous advertising. Today, gambling disorder is a growing, devastating psychiatric disorder and a major public health problem, with far too many sufferers taking their own lives as a result, while gambling operators commit egregious breaches of licensing conditions and codes of practice intended to protect vulnerable customers. This article considers how the common law should respond, concluding that gambling disorder should no longer languish at the ‘outermost reaches’ of the tort of negligence.
The role of artificial intelligence in the endoscopic diagnosis of esophageal cancer: a systematic review and meta-analysis
Authors: Guidozzi Nadia , Menon Nainika , Chidambaram Swathikan , Markar Sheraz Rehan 
Published: July 2023

Abstract
Early detection of esophageal cancer is limited by accurate endoscopic diagnosis of subtle macroscopic lesions. Endoscopic interpretation is subject to expertise, diagnostic skill, and thus human error. Artificial intelligence (AI) in endoscopy is increasingly bridging this gap. This systematic review and meta-analysis consolidate the evidence on the use of AI in the endoscopic diagnosis of esophageal cancer. The systematic review was carried out using Pubmed, MEDLINE and Ovid EMBASE databases and articles on the role of AI in the endoscopic diagnosis of esophageal cancer management were included. A meta-analysis was also performed. Fourteen studies (1590 patients) assessed the use of AI in endoscopic diagnosis of esophageal squamous cell carcinoma—the pooled sensitivity and specificity were 91.2% (84.3–95.2%) and 80% (64.3–89.9%). Nine studies (478 patients) assessed AI capabilities of diagnosing esophageal adenocarcinoma with the pooled sensitivity and specificity of 93.1% (86.8–96.4) and 86.9% (81.7–90.7). The remaining studies formed the qualitative summary. AI technology, as an adjunct to endoscopy, can assist in accurate, early detection of esophageal malignancy. It has shown superior results to endoscopists alone in identifying early cancer and assessing depth of tumor invasion, with the added benefit of not requiring a specialized skill set. Despite promising results, the application in real-time endoscopy is limited, and further multicenter trials are required to accurately assess its use in routine practice.
Extracorporeal cardiopulmonary resuscitation for refractory OHCA: lessons from three randomized controlled trials—the trialists’ view
Authors: Ubben Johannes F H , Heuts Samuel , Delnoij Thijs S R , Suverein Martje M , van de Koolwijk Anina F , van der Horst Iwan C C , Maessen Jos G , Bartos Jason , Kavalkova Petra , Rob Daniel , Yannopoulos Demetris , Bělohlávek Jan , Lorusso Roberto , van de Poll Marcel C G 
Published: July 2023

Abstract
Extracorporeal cardiopulmonary resuscitation is a promising treatment for refractory out-of-hospital cardiac arrest. Three recent randomized trials (ARREST trial, Prague OHCA study, and INCEPTION trial) that addressed the clinical benefit of extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest yielded seemingly diverging results. The evidence for extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest, derived from three recent randomized controlled trials, is not contradictory but rather complementary. Excellent results can be achieved with a very high level of dedication, provided that strict selection criteria are applied. However, pragmatic implementation of extracorporeal cardiopulmonary resuscitation does not necessarily lead to improved outcome of refractory out-of-hospital cardiac arrest. Centres that are performing extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest or aspire to do so should critically evaluate whether they are able to meet the pre-requisites that are needed to conduct an effective extracorporeal cardiopulmonary resuscitation programme.
A rare case of cardiac myxoma with light bulb–like cystic morphology: a case report
Authors: Futami Shutaro , Hieda Michinari , Fukata Mitsuhiro , Shiose Akira 
Published: July 2023

Abstract

Background
Cystic myxomas are quite rare. Moreover, few reports have evaluated the causes that constituted them.

Case summary
A 73-year-old Asian man presented for pre-operative examination of osteoarthritis, and transthoracic echocardiography (TTE) revealed an incidental intracardiac mass. Therefore, he was referred to our department for further evaluation. He had no specific symptoms or family history related to tumours and heart failure. The TTE showed a 32 × 24 mm spherical mass adherent to the left atrial septum. The upper part of the mass was cystic in formation and hypoechoic inside and resembled a light bulb. Transoesophageal echocardiography showed the feeding arteries flowing from the bottom into the cystic part. In addition, two jet strips drained from the cystic part in the direction of the mitral valve. Coronary angiography revealed the feeding arteries, which consisted mainly of the right coronary artery conus branch and the left circumflex branch, and the blood flowed into the saccular area from the feeding arteries and excreted towards the mitral valve. Surgical resection was performed due to the mobility, and the histopathology confirmed a cystic myxoma.

Discussion
We described the unique anatomical formation of a cystic myxoma, which consisted of an exquisite balance between the tumour-feeding arteries and the draining outlet vessels.
Entirely zero-contrast diagnosis and revascularization for bilateral stenotic iliac disease with advanced chronic kidney disease: a case report
Authors: Wakabayashi Kohei , Suzuki Toshiaki , Sato Chisato , Nishikura Tenjin 
Published: July 2023

Abstract

Background
Peripheral artery disease (PAD) is usually diagnosed with non-invasive arterial testing methods such as Doppler ultrasound or computed tomography angiography and treated with revascularization using contrast media, which increases the risk of contrast nephropathy and the need for subsequent renal replacement therapy, especially in patients with advanced chronic kidney disease (CKD). Therefore, it is important to identify a worthy alternative strategy for use in high-risk patients.

Case summary
We present the case of a 79-year-old man with bilateral claudication and advanced CKD. The patient had a high risk of sustained reduction in renal function and requirement of renal replacement therapy in the event that contrast media was used. Therefore, we planned a zero-contrast strategy for diagnosis and treatment. The case was diagnosed as bilateral stenotic iliac disease with non-contrast magnetic resonance angiography. Zero-contrast intervention was conducted successfully under magnetic resonance angiography and intra-vascular ultrasound guidance, resulting in an excellent clinical outcome and avoidance of worsening renal function.

Discussion
This zero-contrast strategy appears to be a viable alternative to angiography using contrast for diagnosis and treatment in patients with PAD and advanced CKD where contrast use is relatively contraindicated.
Characterizing atrial fibrillation symptom improvement following de novo catheter ablation
Authors: Reading Turchioe Meghan , Volodarskiy Alexander , Guo Winston , Taylor Brittany , Hobensack Mollie , Pathak Jyotishman , Slotwiner David 
Published: July 2023

Abstract

Aims
Atrial fibrillation (AF) symptom relief is a primary indication for catheter ablation, but AF symptom resolution is not well characterized. The study objective was to describe AF symptom documentation in electronic health records (EHRs) pre- and post-ablation and identify correlates of post-ablation symptoms.

Methods and results
We conducted a retrospective cohort study using EHRs of patients with AF (n = 1293), undergoing ablation in a large, urban health system from 2010 to 2020. We extracted symptom data from clinical notes using a natural language processing algorithm (F score: 0.81). We used Cochran’s Q tests with post-hoc McNemar’s tests to determine differences in symptom prevalence pre- and post-ablation. We used logistic regression models to estimate the adjusted odds of symptom resolution by personal or clinical characteristics at 6 and 12 months post-ablation. In fully adjusted models, at 12 months post-ablation patients, patients with heart failure had significantly lower odds of dyspnoea resolution [odds ratio (OR) 0.38, 95% confidence interval (CI) 0.25–0.57], oedema resolution (OR 0.37, 95% CI 0.25–0.56), and fatigue resolution (OR 0.54, 95% CI 0.34–0.85), but higher odds of palpitations resolution (OR 1.90, 95% CI 1.25–2.89) compared with those without heart failure. Age 65 and older, female sex, Black or African American race, smoking history, and antiarrhythmic use were also associated with lower odds of resolution of specific symptoms at 6 and 12 months.

Conclusion
The post-ablation symptom patterns are heterogeneous. Findings warrant confirmation with larger, more representative data sets, which may be informative for patients whose primary goal for undergoing an ablation is symptom relief.