bluuebunny/crossref_metadata_2025_split huggingface dataset:
Declining fitness and physical education lessons in UK adolescents
Authors: Weedon Benjamin David , Liu Francesca , Mahmoud Wala , Burden Samuel Joseph , Whaymand Luke , Esser Patrick , Collett Johnny , Izadi Hooshang , Joshi Shawn , Meaney Andy , Delextrat Anne , Kemp Steve , Jones Alexander , Dawes Helen 
Published: January 2022

ObjectivesThe objective was to determine recent cross-sectional trends in health-related fitness (HRF) in secondary school students by studying the 13–14 years old age group repeatedly over 6 years, considering parallel national trends in physical education (PE).MethodsHeight, weight, broad jump, grip strength, 20 m shuttle run and throwing and catching skills were measured by the same research team using standardised techniques from 2014 to 2019. Trends in these HRF measures were assessed by linear regression, adjusting for school, sex and height. Interactions with fitness and body mass index (BMI) were tested. The number of PE lessons reported in the UK Annual School Workforce Census between 2010 and 2019 for all state-funded secondary schools was analysed.ResultsGrip strength (B=−0.60, 95% CI −0.78 to –0.41), broad jump (B=−1.16, 95% CI −1.99 to –0.34), 20 m shuttle run (B=−1.85, 95% CI −2.58 to –1.12) and throwing and catching skills (B=−0.12, 95% CI −0.15 to –0.08) declined significantly over the study period. There was a greater reduction in broad jump and grip strength in adolescents with low fitness and a greater reduction in fitness and motor competence in adolescents with normal BMI. These declines coincided with a 16% reduction nationally in secondary school PE between 2010 (333 800 hours) and 2019 (280 725 hours).ConclusionAdolescent HRF has declined in recent years, in parallel with PE lessons. Declines were observed across all young people and particularly those of low fitness and normal BMI. To reach the majority of young people, policy makers could increase PE in schools to increase activity and prevent worsening fitness and health in future generations.
Ultrasound use to assess Crohn’s disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members
Authors: Radford Shellie Jean , Taylor Stuart , Moran Gordon 
Published: January 2022

BackgroundSmall bowel ultrasound has very good diagnostic accuracy for disease extent, presence and activity in Crohn’s Disease, is well tolerated by patients and is cheaper when compared with MRI. However, uptake of ultrasound in the UK is limited.MethodsAn online survey to assess the current usage of ultrasound throughout the UK was undertaken by BSG IBD group members between 9/06/2021- 25/06/2021. Responses were anonymous.Results103 responses were included in the data analysis. Responses came from 66 different NHS trusts from 14 different regions of the UK. All respondents reported that they currently have an MRI service for Crohn’s disease, whereas only 31 had an ultrasound service. Average time for results to be reported for MRI scans was reported as between 4– and 6 weeks, with a range of 2 days to 28 weeks. The average time for an ultrasound to be reported was stated as 1–4 weeks, with a range of 0–8 weeks. There was disparity between the reported confidence of clinicians making clinical decisions when using ultrasound compared to MRI. Of those respondents who did not have access to an ultrasound service, 72 stated that they would be interested in developing an ultrasound service.ConclusionThere is an appetite for the uptake of ultrasound in the UK for assessment of Crohn’s disease, however, there remains a significant number of UK centres with little or no access to an ultrasound service. Further research is necessary to understand why this is the case.
The national trauma triage protocol: how EMS perspective can inform the guideline revision
Authors: Fischer Peter E , Gestring Mark L , Sagraves Scott G , Michaels Holly N , Patel Bhavin , Dodd Jimm , Campion Eric M , VanderKolk Wayne E , Bulger Eileen M 
Published: January 2022

ObjectivesThe Field Triage Guidelines (FTG) support emergency medical service (EMS) decisions regarding the most appropriate transport destination for injured patients. While the components of the algorithm are largely evidenced-based, the stepwise approach was developed with limited input from EMS providers. FTG are only useful if they can easily be applied by the field practitioner. We sought to gather end-user input on the current guidelines from a broad group of EMS stakeholders to inform the next revision of the FTG.MethodsAn expert panel composed an end-user feedback tool. Data collected included: demographics, EMS agency type, geographic area of respondents, use of the current FTG, perceived utility, and importance of each step in the algorithm (1: physiologic, 2: anatomic, 3 mechanistic, 4: special populations). The American College of Surgeons Committee on Trauma (ACS COT), in partnership with several key organizations, distributed the tool to reach as many providers as possible.Results3958 responses were received (82% paramedics/emergency medical technicians, 9% physicians, 9% other). 94% responded directly to scene emergency calls and 4% were aeromedical providers. Steps 2 and 3 were used in 95% of local protocols, steps 1 and 4 in 90%. Step 3 was used equally in protocols across all demographics; however, step 1 was used significantly more in the air medical services than ground EMS (96% vs 88%, p<0.05). Geographic variation was demonstrated in FTG use based on the distance to a trauma center, but step 3 (not step 1) drove the majority of the decisions. This point was reinforced in the qualitative data with the comment, “I see the wreck before I see the patient.”ConclusionThe FTG are widely used by EMS in the USA. The stepwise approach is useful; however, mechanism (not physiological criteria) drives most of the decisions and is evaluated first . Revision of the FTG should consider the experience of the end-users.Level of evidenceV.
Multi-year investigation on the rate, timing, and use of surfactant for thinning apples with post-bloom applications of metamitron
Authors: Cline John A. , Bakker Catherine J. , Beneff Amanda 
Published: January 2022

Several experiments were conducted in Simcoe, Ontario, to evaluate the efficacy of metamitron (MET) as a post-bloom thinner for Ambrosia, Gala, and Honeycrisp apple trees. Trees were treated with rates of MET ranging from 165–480 mg·L−1, as well as different timings ranging from 5–22 mm fruit diameter. The effect of including a non-ionic surfactant on thinning efficacy with MET was also evaluated. Treatments were compared with untreated trees and industry standard sprays of carbaryl, 1-naphthalene acetic acid (NAA), 6-benzyladenine (6-BA), or combinations thereof. Response to MET varied by cultivar and season. In six of the seven experiments MET reduced fruit set, but only in four experiments did MET reduce the number of fruit per tree or crop load compared with the untreated control trees. Petal fall (5–7 mm) applications of MET were less effective than later timings. Thinning response increased with higher rates of MET in four of the seven studies. For Honeycrisp and Ambrosia, 175 mg·L−1 MET was effective in reducing fruit set and crop load, while rates at or above 263 mg·L−1 MET were required to thin Gala. MET improved fruit size distribution into larger categories and caused minimal leaf phytotoxicity with or without a non-ionic surfactant. Environmental factors such as nighttime temperature and solar radiation largely could not account for the seasonal or application timings in thinning response to MET. Greater understanding of the carbon balance and interplay of solar radiation, nighttime temperature, cultivar and fruitlet size on thinning response is required to improve the predictive thinning response of apple to MET.
(Invited) On the Role of Electrocatalysts in the Process of Light-Driven Water Splitting
Authors: Fiechter Sebastian , Xi Fanxing , Bozheyev Farabi , Abdi Fatwa Firdaus , Ellmer Klaus , Bogdanoff Peter , Kölbach Moritz 
Published: January 2022

Due to its high energy density, hydrogen could play an important role to store chemical energy in GW scale. To produce it in large quantities, “artificial leaf”-type structures can be used to convert solar light into hydrogen by photoelectrochemical splitting of water. Since this process is most efficiently working under acidic conditions, acid-stable semiconducting materials are required to efficiently absorb sunlight and generate electron-hole pairs, the energy of which must be high enough to split water. In addition, cheap and abundant electrocatalysts are needed to minimize the overvoltages at cathode and anode.
To replace costly platinum as well as RuO2 as efficient electrocatalysts for hydrogen and oxygen evolution, resp., alternative catalysts such as MoCo, (Mo,Co)Sx and (NH4)2Mo3S13 for pH <7 [1] and amorphous CoOxOHy, Mn2O3 for pH >7 [2] have been tested as hydrogen (HE) and oxygen evolution (OE) catalysts, respectively. The materials were first deposited on conductive glass by reactive magnetron sputtering, spin coating or electrochemical deposition techniques and investigated electrochemically. Highest activity as HE catalysts was found by depositing (NH4)2Mo3S13 on amorphous MoSx/FTO and alloys of MoCo, while porous layers of Mn2O3 deposited on FTO glass showed high activity as OE catalyst. Due to their remarkable behavior as dark catalysts (η(Mn2O3) = 340 mV and η(MoSx) = -170 mV at j = 10 mA/cm2), the materials were afterwards deposited on p- and n-type photosensitive transition metal chalcogenide layers to investigate their behavior under illumination.
Surprisingly, (NH4)2Mo3S13, deposited on highly 001-textured polycrystalline p-type WSe2 film, behaved as a photosensitive hydrogen evolving electrode. Here the deposited catalyst film operates as an electrocatalyst for hydrogen evolution, but also as a semiconductor at the catalyst-semiconductor interface forming a buried heterojunction.

References:
[1] Jesse D. Benck, Sang Chul Lee, Kara D. Fong, Jakob Kibsgaard, Robert Sinclair, Thomas F. Jaramillo, Adv. Energy Mater. 4 (2014) 1400739-1400739.
[2] Bogdanoff P., Stellmach D., Gabriel O., Stannowski B., Schlatmann R., van de Krol R., Fiechter S, Energy Technology 4, (2016) 230–241, DOI:number:10.1002/ente.201500317
[3] Stellmach D., Bogdanoff P., Gabriel O., Stannowski B., Schlatmann R., van de Krol R, Fiechter S., Nanostructured MoS2 particles as a novel hydrogen evolving catalyst integrated in a PV-hybrid electrolyzer, Materials and Processes for Energy: Communicating, Current Research and Technological Developments, Vol. 1 (A. Méndez-Vilas, Ed.), FORMATEX 2013, 880-886.
[4] Moritz Kölbach, Sebastian Fiechter, Roel van de Krol, Peter Bogdanoff,
Catalysis Today, 290 (2017) 2–9, https://doi.org/10.1016/j.cattod.2017.03.030
[5] Ramírez A., Hillebrand, P., Stellmach D., May M.M., Bogdanoff P., Fiechter S.,Phys Chem. C, 118 (2014) 14073-14081 and SI.
Purification of Crocin-I from Gardenia Yellow by Macroporous Resin Columns In-Series and Its Antidepressant-Like Effect
Authors: Jiang Yu , Lin Susu , Li Qiaoqiao , Tong Yingpeng , Wang Ping 
Published: January 2022

In this study, the purification of crocin-I from Gardenia yellow by macroporous resin columns in-series was systematically investigated. The in-series macroporous adsorption resins consisting of XAD 4 and XAD 1600N resins were selected on the basis of the evaluation of performance and separation characteristics of 17 kinds of resins, including the adsorption capacities, desorption ratio, and separation degree. According to the analysis results, the optimum conditions were as follows: bed volume ratio of XAD 4 and XAD 1600N resins, sample volume, flow rate, and methanol concentration were 3 : 1, 5 BV, 15 BV/h, and 70%, respectively (BV was the bed volume of XAD 4 resin). After one run treatment, the separation degree of crocin-I at 254 nm and 440 nm decreased from 1.92 to 0.08 (

D

C
−
254

nm

) and from 0.71 to 0.36 (

D

C
−
440

nm

), respectively. The results showed that the in-series macroporous resins revealed a high capacity in the purification of crocin-I. Meanwhile, in the animal experiment, the forced swimming tests were regulated by crocin-I and Gardenia yellow, which demonstrated that crocin-I was the main constituent of Gardenia yellow and had potential antidepressant biological activities.
Chemotherapy Triggers T Cells to Remodel the Extracellular Matrix and Promote Metastasis
Authors: Kolonin Mikhail G. , Woodward Wendy A. 
Published: January 2022

Abstract
Chemotherapy can impede cancer progression and is a well-demonstrated component of curative care for some patients with nonmetastatic cancer. However, cancer often relapses in high-risk patients due to acquired chemoresistance and progression to an incurable metastatic stage. There is building evidence from mouse models suggesting a possible stimulatory effect of chemotherapy on metastasis. While clinical trial data from patients with cancer supports the benefits of chemotherapy, the potential adverse effects of chemotherapeutics in a yet unidentified subset of patients are important to consider. In a study by Haj-Shomaly and colleagues, the interaction between the immune system and extracellular matrix remodeling is investigated for its role in the process. The study sheds light on the role of lysyl oxidase secreted by CD8+ T cells in priming the lung microenvironment for metastatic cell seeding, which may represent a targetable axis to further enhance the efficacy of chemotherapy agents.
See related article by Haj-Shomaly et al., p. 278
ESMO Scale for Clinical Actionability of Molecular Targets Driving Targeted Treatment in Patients with Cholangiocarcinoma
Authors: Verdaguer Helena , Saurí Tamara , Acosta Daniel Alejandro , Guardiola Magdalena , Sierra Alexandre , Hernando Jorge , Nuciforo Paulo , Miquel Josep M. , Molero Cristina , Peiró Sandra , Serra-Camprubí Queralt , Villacampa Guillermo , Aguilar Susana , Vivancos Ana , Tabernero Josep , Dienstmann Rodrigo , Macarulla Teresa 
Published: January 2022

Abstract

Purpose:
Treatment options for advanced cholangiocarcinoma are limited and prognosis is poor. Cholangiocarcinomas are highly heterogeneous at the molecular level, with divergent patterns between intrahepatic and extrahepatic forms, intrahepatic being particularly rich in actionable alterations. We compared survival in patients with advanced cholangiocarcinoma harboring alterations matched to targeted drugs, with patients harboring nonactionable alterations.

Experimental Design:
Patients with cholangiocarcinoma treated between 2011 and 2020 at one institution, with available molecular analyses, were retrospectively reviewed. Genomic alteration actionability was classified according to the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT) and correlated with efficacy endpoints.

Results:
Of 327 patients included, 78.9% had intrahepatic cholangiocarcinoma, 97.9% had received chemotherapy for metastatic disease. Actionable molecular alterations per ESCAT were identified in 184 patients (56.3%), including IDH1 mutations and FGFR2 fusions (23.1% and 8.0% of patients with intrahepatic cholangiocarcinoma, respectively). Median overall survival in 50 patients with ESCAT I-IV alterations who received matched therapy (48 with intrahepatic cholangiocarcinoma) was 22.6 months [95% confidence interval (CI), 20.1–32.8], compared with 14.3 months (95% CI 11.9–18.1) in 130 patients without actionable ESCAT alterations (HR, 0.58; 95% CI, 0.40–0.85; P = 0.005). Among patients receiving matched targeted therapy, median progression-free survival was longer for patients with alterations classified as ESCAT I-II compared with ESCAT III-IV (5.0 vs. 1.9 months; HR, 0.36; 95% CI, 0.15–0.87; P = 0.02).

Conclusions:
ESCAT represents a tool to guide clinicians in fine-tuning use of molecular profiling data to choose matched targeted therapies. Our data demonstrate that targeted treatment administered per alteration actionability according to ESCAT is associated with improved survival in cholangiocarcinoma, particularly in ESCAT I-II intrahepatic cholangiocarcinoma.
Comfort Measures Only in Myocardial Infarction: Prevalence of This Status, Change Over Time, and Predictors From a Nationwide Study
Authors: Haghighat Leila , Reinhardt Samuel W. , Saly Danielle L. , Lu Di , Matsouaka Roland A. , Wang Tracy Y. , Desai Nihar R. 
Published: January 2022

Background:
Patients hospitalized with acute myocardial infarction (AMI) have a high mortality rate. Despite increasing recognition of the role for comfort focused care, little is known about the prevalence of comfort measures only (CMO) care among patients with AMI. The objective of this study was to investigate patient- and hospital-level patterns and predictors of CMO care among patients admitted with AMI.

Methods:
This retrospective cohort study used the National Cardiovascular Data Registry Chest Pain-MI Registry, which contains data on patients admitted with AMI. Data were analyzed in 6-month increments from January 2015 to June 2018.

Results:
Among 483 696 patients with AMI across 827 hospitals, 13 955 (2.9%) had CMO status at discharge (2.6% non–ST-segment–elevation myocardial infarction and 3.4% ST-segment–elevation myocardial infarction). There was a modest decline in CMO rates over time (3.0% to 2.8%). Independent patient characteristics associated with CMO status included male gender, White race, nonprivate insurance, frailty, and higher estimated bleeding and mortality risks. There was substantial variation in CMO rates across hospitals, with the proportion of CMO patients ranging from 0% to 17.1% and a median odds ratio of 1.59 (95% CI, 1.56–1.62). Among the 13 955 patients who were CMO by discharge, 8134 (58.3%) underwent diagnostic catheterization. This is despite significantly elevated risks predicted using precatheterization models, specifically the ACTION Registry GWTG in-hospital major bleeding and mortality risk scores. Patients who were initially managed invasively but later made CMO experienced high rates of procedural complications, including cardiogenic shock (38.3%), dialysis (10.1%), and bleeding (33.3%).

Conclusions:
Most patients with AMI who were CMO by discharge had aggressive initial management and became CMO following in-hospital complications of their care. Early identification of high-risk patients and appropriate transition of such patients to CMO, if aligned with their values, remain important areas for future quality programs in AMI.
Perks and Pitfalls of Performance-Linked Reimbursement for Novel Drugs: The Case of Sacubitril-Valsartan
Authors: Sandhu Alexander T. , Heidenreich Paul A. , Lin John , Parizo Justin , Bhattacharya Jay , Goldhaber-Fiebert Jeremy D. 
Published: January 2022

Background:
Rising drug costs have increased interest in performance-linked reimbursement (PLR) contracts that tie payment to patient outcomes. PLR is theoretically attractive to payers interested in reducing the risk of overpaying for expensive drugs, to manufacturers working to improve early drug adoption, and to patients seeking improved access. Multiple PLR contracts were developed for sacubitril-valsartan. We evaluated how the characteristics of a PLR contract influence its performance.

Methods:
We used a published cost-effectiveness model of sacubitril-valsartan. We evaluated hypothetical PLR contracts that adjusted drug payment based on observed therapy effectiveness. Ideally, these contracts reduce the uncertainty around the value obtained with purchasing sacubitril-valsartan. By reducing the financial risk in covering an ineffective therapy, PLR incentivizes insurers to increase patient access. We measured the uncertainty in value as the SD of the incremental net monetary benefit (INMB), an estimate of therapy value incorporating costs and clinical benefits. We evaluated the change in INMB SD under a variety of different assumptions regarding contract design, therapy effectiveness, and population characteristics.

Results:
Over 2 years, sacubitril-valsartan led to 0.042 additional quality-adjusted life-years at an incremental cost of $4916. Using a willingness-to-pay of $150 000 per quality-adjusted life-year, this led to a mean INMB across simulations of $1416 (SD, $1720). A PLR contract that adjusted payment based on cardiovascular mortality reduced the INMB SD moderately by 20.7% while a contract based on all-cause mortality was more effective (INMB SD reduction of 27.3%). A contract based on heart failure hospitalization reduction was ineffective. PLR effectiveness increased with greater uncertainty regarding therapy effectiveness or in sicker cohorts (eg, New York Heart Association Class III/IV heart failure). Contracts required precise estimates of treatment effect in addition to trust or verifiability between manufacturers and payers concerning patient selection.

Conclusions:
The development of accurate prospective estimates of treatment effectiveness using actual enrollee characteristics will be critical for successful PLR. If able to meet these requirements, PLRs could incentivize insurers to expand access to expensive treatments by reducing financial risk.
Association of State Medicaid Expansion Status With Hypertensive Disorders of Pregnancy in a Singleton First Live Birth
Authors: Everitt Ian K. , Freaney Priya M. , Wang Michael C. , Grobman William A. , O’Brien Matthew J. , Pool Lindsay R. , Khan Sadiya S. 
Published: January 2022

Background:
Incidence of hypertensive disorders of pregnancy is increasing in the United States. Early detection is important to prevent adverse maternal and offspring outcomes. This ecological study evaluated changes in rates of hypertensive disorders of pregnancy among states that expanded Medicaid compared with states that did not expand Medicaid.

Methods:
A quasi-experimental analysis using difference-in-differences models compared changes in rates of hypertensive disorders of pregnancy in Medicaid expansion states relative to non-Medicaid expansion states from 2012 to 2019. Maternal data from singleton first live births to individuals aged 20 to 39 years were obtained from the National Center for Health Statistics. Outcomes of interest included age-adjusted rates of de novo hypertension in pregnancy (gestational hypertension or preeclampsia) and prepregnancy hypertension.

Results:
Data from 7 764 965 individuals with a singleton first live birth were analyzed from 17 states and Washington, DC that expanded Medicaid and 15 states that did not. Rates of de novo hypertension in pregnancy increased over the study period in both expansion (54.34 [95% CI, 48.25–60.43] to 74.87 [95% CI, 71.20–78.55] per 1000 births) and nonexpansion states (68.32 [95% CI, 61.02–75.62] to 84.79 [95% CI, 80.67–88.91] per 1000 births). In adjusted difference-in-differences analyses, expansion status was associated with a greater increase in rates of de novo hypertension in pregnancy (difference-in-differences coefficient, +8.18 [95% CI, 4.00–12.36] per 1000 live births) but a decline in rates of de novo hypertension in pregnancy complicated by low birth weight (−7.20 [95% CI, −13.71 to −0.70] per 1000 births with hypertensive disorders of pregnancy). In adjusted difference-in-differences analyses, there were no significant changes in rates of prepregnancy hypertension in expansion relative to nonexpansion states (+1.13 [95% CI, −0.09 to +2.35] per 1000 live births).

Conclusions:
Between 2012 and 2019, states that expanded Medicaid had a significantly greater increase in rates of de novo hypertension, with some evidence of better outcomes among those with de novo hypertension diagnosed in pregnancy.