bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gaps and discontinuation of statin treatment in Norway: potential for optimizing management of lipid lowering drugs
Authors: Engebretsen Ingrid , Munkhaugen John , Bugge Christoffer , Halvorsen Sigrun , Ødegaard Kristina Malene , Støvring Henrik , Kristiansen Ivar Sønbø 
Published: October 2022

Abstract

Aims
In clinical practice, many patients do not reach the recommended treatment targets for LDL-cholesterol levels. We aimed to examine treatment patterns and adherence for patients on lipid lowering drugs in Norway to inform future strategies to improve therapies.

Methods and results
We obtained information on all dispensed statins, ezetimibe, and proprotein convertase subtilisin/-kexin 9 (PCSK9) inhibitors 2010–2019 from the Norwegian Prescription Database. Treatment gaps were assessed assuming patients take one tablet per day and were defined to occur if a patient did not refill a prescription when the previous one should have been depleted. Treatment was defined as discontinued when the preceding prescription would have been used and no new subsequent prescription was filled. The mean proportion of days covered (PDC) was calculated by aggregating the total number of tablets dispensed during each calendar year and dividing by 365. Patients 80 years were excluded. A considerable proportion of statin users in Norway had long treatment gaps or discontinuation in treatment. The 19.6% of the patients had treatment gaps of 180 days or more, and 10.8% had gaps or greater than 365 days. Similar results were found for patients on antidiabetics and hypertensives. PDC ranged from 84.9% for simvastatin to 72.2% for ezetimibe (2019). The most common lipid lowering drugs in 2019 were atorvastatin, simvastatin, and ezetimibe.

Conclusion
There is a great potential for improving drug adherence and optimizing lipid lowering therapy by switching to more effective statins in greater doses, and more often add ezetimibe and PCSK9 inhibitors to treatment.
Social determinants of health and recurrence of atrial fibrillation after catheter ablation: a Danish nationwide cohort study
Authors: Vinter Nicklas , Calvert Peter , Kronborg Mads B , Cosedis-Nielsen Jens , Gupta Dhiraj , Ding Wern Y , Trinquart Ludovic , Johnsen Søren P , Frost Lars , Lip Gregory Y H 
Published: October 2022

Abstract

Aims
To examine the associations between three social determinants of health (SDOH) and recurrence of AF after ablation.

Methods and results
We selected patients who underwent a first ablation after an incident hospital diagnosis of AF between 2005 and 2018 from the entire Danish population. Educational attainment, family income, and whether the patient was living alone were assessed at the time of ablation. We used cause-specific proportional hazard models to estimate hazard ratios (HR) with 95% confidence interval (CI) adjusted for age and sex. In secondary analyses, we adjusted for comorbidities, antiarrhythmic medication, and prior electrical cardioversion.
We selected 9728 patients (mean age 61 years, 70% men), and 5881 patients had AF recurrence over an average of 1.37 years after ablation (recurrence rate 325.7 (95% CI 317.6–334.2) per 1000 person-years). Lower education (HR 1.09 [1.02–1.17] and 1.07 [1.01–1.14] for lower and medium vs. higher), lower income [HR 1.14 (1.06–1.22) and 1.09 (1.03–1.17) for lower and medium vs. higher], and living alone [HR 1.07 (1.00–1.13)] were associated with increased rates of recurrence of AF. We found no evidence of interaction between sex or prior HF with SDOH. The association between family income and AF recurrence was stronger among patients &lt; 65 years compared with those aged ≥ 65 years. The associations between SDOH and AF recurrence did not persist in the multivariable model.

Conclusion
AF was more likely to recur among patients with lower educational attainment, lower family income, or those living alone. Multidisciplinary efforts are needed to reduce socioeconomic inequity in the effect of ablation.
Coronary angiography after cardiac arrest without ST-elevation myocardial infarction: a network meta-analysis
Authors: Heyne Sebastian , Macherey Sascha , Meertens Max M , Braumann Simon , Nießen Franz S , Tichelbäcker Tobias , Baldus Stephan , Adler Christoph , Lee Samuel 
Published: October 2022

AbstractAimsThis network meta-analysis aimed to assess the effect of early coronary angiography (CAG) compared with selective CAG (late and no CAG) for patients after out-of-hospital cardiac arrest without ST-elevation myocardial infarction (NSTE-OHCA).Methods and resultsA systematic literature search was performed using the EMBASE, MEDLINE and Web of Science databases without restrictions on publication date. The last search was performed on 15 July 2022. Randomized controlled trials (RCTs) and non-randomized studies (NRS) comparing the effect of early CAG to selective CAG after NSTE-OHCA on survival and/or neurological outcomes were included. Meta-analyses were performed based on a DerSimonian-Laird random effects model. A total of 18 studies were identified by the literature search. After the exclusion of two studies due to high risk of bias, 16 studies (six RCTs, ten NRS) were included in the final analyses. Meta-analyses showed a statistically significant increase in survival after early CAG compared with selective CAG in the overall analysis [OR: 1.40, 95% confidence interval (CI): (1.12–1.76), P &lt; 0.01, I2 = 68%]. This effect was lost in the subgroup analysis of RCTs [OR: 0.89, 95% CI: (0.73–1.10), P = 0.29, I2 = 0%]. Random effects model network meta-analysis of NRS based on a Bayesian method showed statistically significant increased survival after late compared with early CAG [OR: 4.20, 95% CI: (1.22, 20.91)].ConclusionThe previously reported superiority of early CAG after NSTE-OHCA is based on NRS at high risk of selection and survivorship bias. The meta-analysis of RCTs does not support routinely performing early CAG after NSTE-OHCA.
Physical activity volume, intensity, and incident cardiovascular disease
Authors: Dempsey Paddy C , Rowlands Alex V , Strain Tessa , Zaccardi Francesco , Dawkins Nathan , Razieh Cameron , Davies Melanie J , Khunti Kamlesh K , Edwardson Charlotte L , Wijndaele Katrien , Brage Soren , Yates Tom 
Published: October 2022

Abstract

Aims
The interplay between physical activity (PA) volume and intensity is poorly understood in relation to cardiovascular disease (CVD) risk. This study aimed to investigate the role of PA intensity, over and above volume, in relation to incident CVD.

Methods and results
Data were from 88 412 UK Biobank middle-aged adults (58% women) without prevalent CVD who wore accelerometers on their dominant wrist for 7 days, from which we estimated total PA energy expenditure (PAEE) using population-specific validation. Cox proportional hazards regressions modelled associations between PAEE (kJ/kg/day) and PA intensity (%MVPA; the fraction of PAEE accumulated from moderate-to-vigorous-intensity PA) with incident CVD (ischaemic heart disease or cerebrovascular disease), adjusted for potential confounders. There were 4068 CVD events during 584 568 person-years of follow-up (median 6.8 years). Higher PAEE and higher %MVPA (adjusted for PAEE) were associated with lower rates of incident CVD. In interaction analyses, CVD rates were 14% (95% confidence interval: 5–23%) lower when MVPA accounted for 20% rather than 10% of 15 kJ/kg/d PAEE; equivalent to converting a 14 min stroll into a brisk 7 min walk. CVD rates did not differ significantly between values of PAEE when the %MVPA was fixed at 10%. However, the lowest CVD rates were observed for combinations of both higher PAEE and %MVPA.

Conclusion
Reductions in CVD risk may be achievable through higher PA volume and intensity, with the role of moderately intense PA appearing particularly important. This supports multiple approaches or strategies to PA participation, some of which may be more practical or appealing to different individuals.
Activating the ‘peerness’ of youth leaders in a community sports programme throughtechneandphronesis
Authors: Christensen Julie H , Evans Adam B , Klinker Charlotte D , Staal Marie T , Bentsen Peter , Nielsen Glen 
Published: October 2022

SummaryPeer-to-peer approaches engage groups of people considered to share one or more characteristics that identify them as peers and draw on rationales of credibility, identification and role modelling in peer-to-peer interactions. Despite the popularity of the approach, the ways in which the peer leadership component specifically contributes to health promotion is not thoroughly understood. We suggest that a first step for making use of peer leader characteristics is to make explicit what the peer leadership component is expected to bring to a programme. To approach such an understanding, we investigated how peer leaders can be supported in activating their ‘peerness’ in health promotion programmes, using as a case the peer leader education of a youth-led, peer-to-peer community sports programme, implemented by the non-profit street sports organization, GAME. We analysed the peer leader training programme’s learning objectives and field notes from observations of the training programme. The empirical material was analysed using an abductive approach by drawing upon contemporary interpretations of two forms of knowledge originally proposed by Aristotle. In so doing, this article explores how the development of techne (practical knowledge) and phronesis (practical wisdom) was supported in a peer leader training programme for young people. Findings suggest that supporting the development of both these types of knowledge can strengthen programme planners’ attention to the contribution of peers. Concurrently, an emphasis on promoting phronesis in peer leader training can support and encourage peer leaders in activating their ‘peerness’ in peer-to-peer health promotion programmes.
‘Sheds for Life’: delivering a gender-transformative approach to health promotion in Men’s Sheds
Authors: McGrath Aisling , Murphy Niamh , Richardson Noel 
Published: October 2022

SummaryResearch has highlighted the importance of gendered approaches to engage men with health. Sheds for Life (SFL) is a health and wellbeing initiative that utilizes evidence-based and gender-specific approaches to engage hard to reach men with health promotion directly in the Men’s Sheds (Sheds) setting. To understand the impact of SFL and how participants (Shedders) experienced SFL in practice, this qualitative study applied a framework of constructivism and aimed to explore how gendered approaches impacted engagement with SFL through Shedder’s own accounts of their attitudes, opinions and experiences. Qualitative methods incorporating ethnographical observations, focus groups (n = 8) and short semi-structured interviews (n = 19) were conducted with SFL participants in the Shed setting. Reflexive thematic analysis was used to analyse the data to faithfully capture Shedders’ experiences while acknowledging the reflexive influence of the researcher. Findings led to three key themes: Creating the ‘right environment’; Normalizing meaningful conversations; a legacy for ‘talking health’ with subthemes of creating safety and trust and strengthening of bonds; and transforming perceptions of how men ‘do health’ with subthemes of reaping the benefits of engaging with health and reframing attitudes towards health. This is first study to capture Shedders’ experiences of a structured health promotion initiative in the Shed setting. Findings highlight the value in utilizing the Shed setting to engage men with health and the importance of gender-specific strategies which encourage a gender-transformative approach to men’s health promotion.
Genistein improves renal disease in a mouse model of nephropathic cystinosis: a comparison study with cysteamine
Authors: De Leo Ester , Taranta Anna , Raso Roberto , Polishchuk Elena , D’Oria Valentina , Pezzullo Marco , Goffredo Bianca Maria , Cairoli Sara , Bellomo Francesco , Battafarano Giulia , Camassei Francesca Diomedi , Del Fattore Andrea , Polishchuk Roman , Emma Francesco , Rega Laura Rita 
Published: October 2022

AbstractCysteamine is currently the only therapy for nephropathic cystinosis. It significantly improves life expectancy and delays progression to end-stage kidney disease; however, it cannot prevent it. Unfortunately, compliance to therapy is often weak, particularly during adolescence. Therefore, finding better treatments is a priority in the field of cystinosis. Previously, we found that genistein, an isoflavone particularly enriched in soy, can revert part of the cystinotic cellular phenotype that is not sensitive to cysteamine in vitro. To test the effects of genistein in vivo, we fed 2-month-old wild-type and Ctns−/− female mice with either a control diet, a genistein-containing diet or a cysteamine-containing diet for 14 months. Genistein (160 mg/kg/day) did not affect the growth of the mice or hepatic functionality. Compared with untreated mice at 16 months, Ctns−/− mice fed with genistein had lower cystine concentrations in their kidneys, reduced formation of cystine crystals, a smaller number of LAMP1-positive structures and an overall better-preserved parenchymal architecture. Cysteamine (400 mg/kg/day) was efficient in reverting the lysosomal phenotype and in preventing the development of renal lesions. These preclinical data indicate that genistein ameliorates kidney injury resulting from cystinosis with no side effects. Genistein therapy represents a potential treatment to improve the outcome for patients with cystinosis.
Challenges in avoiding deep-water shark bycatch in Azorean hook-and-line fisheries
Authors: Fauconnet Laurence , Catarino Diana , Das Diya , Giacomello Eva , Gonzalez-Irusta José Manuel , Afonso Pedro , Morato Telmo 
Published: October 2022

AbstractDeep-water sharks are highly diverse, vulnerable, and understudied as a group, despite the increasing pressures on their populations. Twenty-five species of deep-water sharks have been recorded in the Azores, an oceanic archipelago in the mid-North Atlantic, that are regularly caught as bycatch in hook-and-line fisheries. Avoiding the bycatch of deep-water sharks presents multiple challenges due to their high catchability, difficulties in correctly identifying species, and the general lack of data on these species. This review summarizes the findings of recent studies from the region, providing an up-to-date science-based framework for mitigating bycatch effects of Azorean hook-and-line fisheries. Several depth-based, area-based, and gear-based measures have been studied that demonstrate the potential to either avoid or increase the survival of deep-water shark bycatch. However, these measures may have limited efficacy for some species (e.g. highly mobile species) and thus, limited widespread applicability. Convincing fishers to avoid deep-water shark bycatch is also a challenge given the antagonistic interactions with sharks damaging the catch and fishing gear, while simultaneously a market incentive for shark liver oil remains. It highlights the need to proactively engage fishers and incentivize the mitigation of bycatch of deep-water sharks in Azorean waters.
Risks and adaptation options for the Mediterranean fisheries in the face of multiple climate change drivers and impacts
Authors: Hidalgo M , El-Haweet A E , Tsikliras A C , Tirasin E M , Fortibuoni T , Ronchi F , Lauria V , Ben Abdallah O , Arneri E , Ceriola L , Milone N , Lelli S , Hernández P , Bernal M , Vasconcellos M 
Published: October 2022

Abstract
The Mediterranean Sea is among the most vulnerable semi-enclosed seas to climate change. Multiple oceanic changes occur besides warming that can generate numerous ecological, social, and economic risks, challenging fisheries management at various spatial scales—from local to international. In this study, we applied a semi-quantitative climate risk assessment (CRA) to the Mediterranean small pelagic and demersal fisheries in relation to a diversity of climate-related drivers and impacts. We assessed the risks of climate change effects on demersal and small pelagic fisheries resources, fishing operations, livelihoods, and wider social and economic implications in seven sub-regions of the Mediterranean Sea. Ocean warming, an increase in extreme weather events, and changes in vertical stratification resulted in the most important climate drivers. Overall, climate drivers present higher risks to fishing resources and livelihoods than to fishing operations and wider social and economic impacts. The study puts into evidence geographic differences in terms of the drivers and impacts, with the south-eastern Mediterranean being the sub-region with higher risk levels for both fisheries, while the north-central Mediterranean also showed important risk levels for the demersal fisheries. The study furthermore discusses the most plausible adaptive measures in management, policy, research, and livelihoods to be potentially applied to address high priority risks, as well as various implementation concerns and technical effectiveness issues. Enhancing adaptive fisheries management needs to be the primary strategy for this region to reverse the high number of overfished stocks and build resilience to climate change.
A qualitative study exploring challenges and solutions to negotiating goals of care at the end of life in hospital settings
Authors: Devery Kim , Winsall Megan , Rawlings Deb 
Published: October 2022

Abstract

Background
Negotiating goals of care (GoC) with patients is an essential skill for all health-care professionals (HCPs) in hospitals. End-of-Life Essentials (EOLE) is a Commonwealth-funded project that delivers free, peer-reviewed, evidence-based, online education and practice change resources. To date, around 26 000 doctors, nurses and allied health professionals have registered to access the education. ‘Planning End-of-Life Care—Goals of Care’ features in the suite of EOLE modules and includes education around negotiating GoC with patients and families.

Objective
The aim of the study was to explore the views of module learners (HCPs) on challenges they have faced when negotiating GoC at the EOL with patients and families.

Methods
Participants were learners (HCPs) who registered to the EOLE website and engaged with the GoC module. Learners’ responses to the question posed at the end of the module ‘What are the hardest or most challenging things about negotiating GoC with patients and families?’ were extracted for a 12-month period. Qualitative data were analysed thematically in NVivo V.12, guided by the theoretical framework of pragmatism. An open, inductive approach was used to code the data, with axial coding used to refine and organize themes and subthemes.

Results
A total of 451 learner statements were analysed. Five themes emerged from the data: (i) differing views and opinions; (ii) challenges to understanding; (iii) managing emotions; (iv) initiating the EOL conversation and (v) lack of professional knowledge or capacity. Five subthemes were also organized under the theme ‘differing views and opinions’.

Conclusion
Planning EOL care demands high-level, compassionately skilful and sensitive care and services, which are in line with the patient’s and family’s wishes. In practice, however, there are many challenges to this, such as ensuring that patients, families, and HCPs are aware of different expectations regarding future health-care possibilities, and that HCPs are prepared for negotiating GoC to achieve quality and safe EOL care in hospitals.
Entomopathogenic Fungi, Isolated From Soils andBemisia tabaci(Hemiptera: Aleyrodidae) Adults, to Manage theEucalyptusRed Gum Lerp PsyllidGlycaspis brimblecombei(Hemiptera: Aphalaridae)
Authors: Domingues Maurício Magalhães , dos Santos Paula Leite , Gêa Bianca Cristina Costa , de Carvalho Vanessa Rafaela , de Oliveira Fabricio Naka , Soliman Everton Pires , Serrão José Eduardo , Zanuncio José Cola , Zanetti Ronald , Wilcken Carlos Frederico 
Published: October 2022

AbstractThe parasitoid Psyllaephagus bliteus Riek (Hymenoptera: Encyrtidae), entomopathogenic fungi, and chemical insecticides are the main strategies to manage the eucalypts pest Glycaspis brimblecombei Moore. The objective of this study was to isolate and to identify entomopathogenic fungi, collected from Bemisia tabaci Gennadius adults in soybean and tomato crops, and from soil samples in eucalypts, soybean, and native forest areas to evaluate their potential to manage G. brimblecombei. Twelve Beauveria and Cordyceps isolates were selected and compared with the commercial products Boveril Beauveria bassiana Bals. (Hypocreales: Cordycipitaceae), Metarril Metarhizium anisopliae Metschn. (Hypocreales: Clavicipitaceae), and Octane Cordyceps fumosorosea Wize (Hypocreales: Cordycipitaceae) and their respective strains. The fungal isolates were diluted in 0.1% aqueous Tween 80 at a concentration of 1.0 × 108 conidia/ml and sprayed on the G. brimblecombei nymphs with or without lerps. Pest mortality was higher and the TL50 and TL90 lower with the isolates LCBPF 11 C. javanica Frieder. & Bally (Hypocreales: Cordycipitaceae), LCBPF 12 (C. fumosorosea), and LCBPF 67 (C. fumosorosea) from B. tabaci adults. Fungi of the genera Beauveria and Cordyceps developed and caused high mortality of G. brimblecombei nymphs with lerps. The B. bassiana, C. cateniannulata Liang (Hypocreales: Cordycipitaceae), C. fumosorosea, C. javanica, and M. anisopliae isolates showed potential to manage G. brimblecombei. The lerp of this insect enhances entomopathogenic fungus development as a source of inoculum accelerating G. brimblecombei nymph mortality. Entomopathogenic fungi isolated from insects and soils are effective against G. brimblecombei and the presence of the lerp of this insect increases the effectiveness of its control.
Adjuvant nivolumab versus placebo following radical surgery for high-risk muscle-invasive urothelial carcinoma: a subgroup analysis of Japanese patients enrolled in the phase 3 CheckMate 274 trial
Authors: Tomita Yoshihiko , Kobayashi Ko , Kimura Go , Oya Mototsugu , Uemura Hirotsugu , Nishiyama Hiroyuki , Galsky Matthew D , Nasroulah Federico , Collette Sandra , Broughton Edward , Ünsal-Kaçmaz Keziban , Kamisuki Yukinori , Bajorin Dean F 
Published: October 2022

Abstract

Background
The phase 3 CheckMate 274 trial demonstrated superiority of adjuvant nivolumab over placebo after radical surgery in patients with high-risk muscle-invasive urothelial carcinoma. However, the efficacy and safety of adjuvant nivolumab in Japanese patients with muscle-invasive urothelial carcinoma have not been clarified.

Methods
Patients with muscle-invasive urothelial carcinoma were randomized to adjuvant nivolumab 240 mg or placebo (every 2 weeks via intravenous infusion) up to 120 days after radical surgery in CheckMate 274.

Results
Of 49 patients in the Japanese subgroup, 27 and 22 patients were randomized to nivolumab and placebo, respectively. Eleven and 8 patients, respectively, had tumor PD-L1 expression level of 1% or more. The median disease-free survival times in the nivolumab and placebo groups were 29.67 months (95% confidence interval 7.79–not reached) and 9.72 months (95% confidence interval 4.73–not reached), respectively (hazard ratio 0.77, 95% confidence interval 0.35–1.69). The corresponding values in patients with tumor PD-L1 expression level of 1% or more were 29.67 months (95% confidence interval 2.63–not reached) and 25.95 months (95% confidence interval 5.59–not reached) (hazard ratio 1.10, 95% confidence interval 0.31–3.92), respectively. Treatment-related adverse events of Grade 3–4 occurred in 25.9 and 13.6% of patients in the nivolumab and placebo groups, respectively. The most common treatment-related adverse events in the nivolumab group were lipase increased, amylase increased and diarrhea. The changes in quality of life scores from baseline over time were similar in both groups.

Conclusions
The efficacy and safety results in the Japanese subgroup were consistent with the overall population of CheckMate 274.