bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity, physical fitness and cardiometabolic risk amongst adults with moderate and severe haemophilia
Authors: Kennedy Megan , Roche Sheila , McGowan Mark , Singleton Evelyn , Elsheikh Einas , O'Donovan Mairead , Ryan Kevin , O'Connell Niamh M. , O'Mahony Brian , Lavin Michelle , O'Donnell James S. , Turecek Peter L. , Gormley John ,   the iPATH study group
Published: October 2022

AbstractAimThis study aimed to examine physical activity (PA), physical fitness and cardiometabolic risk amongst people with moderate and severe haemophilia (PwMSH).MethodsThe following domains were examined: PA (accelerometry); functional aerobic capacity (6‐Minute Walk Test); grip strength (dynamometry); balance (One Leg Stand Test); body composition (anthropometry and bioimpedance analysis); blood pressure; arterial stiffness; and cardiometabolic disorders.ResultsA total of 53 PwMSH (44 years) and 33 controls (43 years; p = .679) were recruited. Compared to controls, PwMSH were significantly less active in moderate and vigorous PA parameters (all p < .05), and less physically fit indicated by 6‐Minute Walk distance (p < .0005), grip strength (p = .040) and balance (p < .0005). PwMSH had higher rates of abdominal adiposity compared to controls measured by waist circumference indices (all p < .05). Resting blood pressure and arterial stiffness were not significantly different (p = .797 and .818, respectively). With respect to overall PA, World Health Organisation recommended targets for adults were achieved by the majority of both groups (haemophilia: 72.9% vs. controls: 90.0%; p = .069). Importantly, the number of PwMSH who achieved guideline recommended PA via longer, sustained bouts of moderate–vigorous PA was significantly lower compared to controls (18.8% vs. 56.7%; p = .001). Lastly, clinically diagnosed hypertension, insulin resistance and hyperlipidaemia were more prevalent amongst PwMSH compared to controls.ConclusionLow levels of PA and physical fitness, and significant rates of abdominal adiposity and hypertension may collectively influence the risk and severity of various cardiometabolic and/or musculoskeletal health issues amongst ageing PwMSH. Personalised multi‐disciplinary health interventions involving PA, dietary and health psychology input for PwMSH warrant future investigation.
Reducing delayed transfer of care in older people: A qualitative study of barriers and facilitators to shorter hospital stays
Authors: Smith Helen , Grindey Chloe , Hague Isabel , Newbould Louise , Brown Lesley , Clegg Andrew , Thompson Carl , Lawton Rebecca 
Published: October 2022

AbstractIntroductionGrowing numbers of older patients occupy hospital beds despite being ‘medically fit’ for discharge. These Delayed Transfers of Care amplify inefficiencies in care and can cause harm. Delayed transfer because of family or patient choice is common; yet, research on patient and family perspectives is scarce. To identify barriers to, and facilitators of, shorter hospital stays, we sought to understand older people's and caregivers' thoughts and feelings about the benefits and harms of being in hospital and the decisions made at discharge.MethodsA multimethod qualitative study was carried out. Content analysis was carried out of older people's experiences of health or care services submitted to the Care Opinion online website, followed by telephone and video interviews with older people and family members of older people experiencing a hospital stay in the previous 12 months.ResultsOnline accounts provide insight into how care was organized for older people in the hospital, including deficiencies in care organization, the discharge process and communication, as well as how care was experienced by older people and family members. Interview‐generated themes included shared meanings of hospitalization and discharge experiences and the context of discharge decisions including failure in communication systems, unwarranted variation and lack of confidence in care and lack of preparation for ongoing care.ConclusionPoor quality and availability of information, and poor communication, inhibit effective transfer of care. Communication is fundamental to patient‐centred care and even more important in discharge models characterized by limited assessments and quicker discharge. Interventions at the service level and targeted patient information about what to expect in discharge assessments and after discharge could help to address poor communication and support for improving discharge of older people from hospital.Patient or Public ContributionThe Frailty Oversight Group, a small group of older people providing oversight of the Community Aging Research 75+ study, provided feedback on the research topic and level of interest, the draft data collection tools and the feasibility of collecting data with older people during the COVID‐19 pandemic. The group also reviewed preliminary findings and provided feedback on our interpretation.
Effects of CD34+ cell dose on haematopoietic recovery in acute lymphoblastic leukaemia patients with positive pretransplant measurable residual disease
Authors: Wang Yuewen , Mo Xiaodong , Cheng Yifei , Chen Yuhong , Lv Meng , Wang Fengrong , Yan Chenhua , Han Wei , Chen Huan , Xu Lanping , Wang Yu , Zhang Xiaohui , Liu Kaiyan , Huang Xiaojun , Chang Yingjun 
Published: October 2022

AbstractIntroductionA higher CD34+ cell dose in allografts is associated with faster haematopoietic recovery after allogeneic haematopoietic stem cell transplantation (allo‐HSCT). Leukaemia stem cells impair normal bone marrow (BM) niches and induce BM failure during leukemogenesis. However, whether measurable residual disease (MRD), known as the persistence of low‐level leukaemic cells, could influence the effects of CD34+ cell dose on haematopoietic recovery after transplantation in acute lymphoblastic leukaemia (ALL) patients is unknown.MethodsA total of 975 ALL patients were enrolled and classified into pre‐HSCT MRD‐positive and MRD‐negative subgroups. Cox proportional hazard regression models were built for time‐to‐event outcomes. Multivariate analysis was performed to determine independent influencing factors from the univariate analysis.ResultsAn appropriate CD34+ cell dose was positively associated with faster haematopoietic recovery in the total ALL population. More importantly, in pre‐HSCT MRD‐positive ALL patients, a higher CD34+ cell dose (≥2.76 × 106/kg) was related to faster neutrophil (HR 1.330, 95% CI 1.045–1.692, p = 0.021) and platelet engraftment (HR 1.808, 95% CI 1.412–2.316, p < 0.001) in multivariate analysis. CD34+ cell dose was a crucial factor associated with either engraftment or transplant outcomes, although we did not demonstrate direct correlations of CD34+ cell dose with relapse, TRM, LFS or OS after allo‐HSCT.ConclusionOur results indicated that no additional CD34+ stem and progenitor cell harvests were needed to ensure successful haematopoietic recovery in pre‐HSCT MRD‐positive patients compared to pre‐HSCT MRD‐negative patients.
Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy
Authors: De Luca Maia , D'Amore Carmen , Romani Lorenza , Tripiciano Costanza , Clemente Vitangelo , Mercadante Stefania , Perrotta Daniela , Nunziata Joseph , Cecchetti Corrado , Rossetti Emanuele , Bianchi Roberto , Perno Carlo Federico , Bernaschi Paola , Russo Cristina , Lancella Laura , Raponi Massimiliano , Ciofi degli Atti Marta Luisa 
Published: October 2022

AbstractBackgroundViral respiratory infections are one of the main causes of hospitalization in children. Even if mortality rate is low, 2% to 3% of the hospitalized children need mechanical ventilation. Risk factors for admission to the pediatric intensive care unit (PICU) are well known, while few studies have described risk factors for invasive ventilator support and prolonged hospitalization.MethodsA retrospective study including all patients aged between 2 and 18 months with a confirmed viral respiratory infection, requiring admission to PICU from September to March between 2015 and 2019, was conducted at Bambino Gesù Children's Hospital in Rome, Italy.ResultsOne hundred ninety patients were enrolled, with a median age of 2.7 months; 32.1% had at least one comorbidity, mainly prematurity. The most frequent isolated viruses were RSV‐B, rhinovirus, and RSV‐A; 38.4% needed mechanical ventilation. This subgroup of patients had lower median birth weight compared with patients not requiring mechanical ventilation (2800 g vs. 3180 g, p = 0.02); moreover, comorbidities were present in 43.8% of intubated patients and in 24.8% of patients treated with non‐invasive ventilation (p = 0.006). Viral coinfection did not result to be a risk factor for mechanical support, while virus–bacteria coinfection was significantly associated with mechanical ventilation (p < 0.001). Similar risk factors were identified for prolonged hospitalization.ConclusionsEarly identification of patients who could have a sudden respiratory deterioration and need of mechanical ventilation is crucial to reduce complications due to orotracheal intubation and prolonged hospitalization in PICU. Further studies are needed to define high‐risk group of patients and to design targeted interventions.
Loan Terms and Collateral: Evidence from the Bilateral Repo Market
Authors: AUH JUN KYUNG , LANDONI MATTIA 
Published: October 2022

ABSTRACTWe study secured lending contracts using a proprietary, loan‐level database of bilateral repurchase agreements containing groups of simultaneous loans backed by multiple tranches within a securitization. We show that lower‐quality loans (i.e., loans backed by lower‐rated collateral) have higher margins and spreads. We calibrate a model using collateral asset prices and find that lower‐quality loans are riskier despite the higher margins, yet cheaper for the borrower. This finding is consistent with a combination of lender optimism and reaching for yield. We also show that lower‐quality loans have longer maturity, consistent with models of rollover concerns with asymmetric information.
Survey of intrauterine red blood cell (RBC) transfusion practices in the United States
Authors: Bakhtary Sara , Panchalee Tachjaree , Crowe Elizabeth P. , Schwab Marisa E. , Zakieh Abdulhafiz , Josephson Cassandra D. , Sobhani Nasim C. , Gonzalez‐Velez Juan M. , Goel Ruchika 
Published: October 2022

AbstractBackgroundA paucity of data exists about the current practice of fetal red blood cell (RBC) transfusion in the United States (US). This investigation describes intrauterine transfusion (IUT) RBC product selection and processing practices at different US institutions.MethodsA transfusion medicine and maternal‐fetal medicine (MFM) team designed a survey to interrogate and characterize RBCs utilized for IUT. This survey was distributed to seventy US institutions with fetal treatment centers (October 2020–April 2021) identified through the NAFTNet (North American Fetal Therapy Network).ResultsThirty‐seven institutions responded (response rate 53%, 37/70), but five were excluded for not performing IUTs. Most (84%; 27/32) performed 1–24 IUTs annually; two performed >50 IUTs/year. Group O, Rh(D) negative RBC units were always used by 66% (21/32), and 75% (24/32) provided hemoconcentrated RBCs by washing (17/24) or dry packing (6/24). Overall, 66% (21/32) targeted a hematocrit ≥75%. Fifty percent provided both leukocyte‐reduced and CMV‐negative RBC units. Irradiation of RBC units was performed within 6 h of issue at 63% (20/32) of sites. Most (81%, 26/32) used RBC units at <7 days of age after collection, 56% (18/32) always provided washed RBC units, while 19% (6/32) issued washed RBC only if fresh units are unavailable. Implicated maternal RBC alloantibodies were matched for 78% (25/32) of the time. The transfused volume was universally determined by the MFMs.DiscussionHeterogeneity and lack of standardization exist in RBC product selection and special processing steps for IUTs in the US. Hence, the establishment of a consensus to standardize IUT protocols is needed.
Effectiveness of a 12‐week tele‐exercise training program on cardiorespiratory fitness and heart rate recovery in patients with cardiometabolic multimorbidity
Authors: Chiang Shang‐Lin , Shen Chien‐Lung , Lee Meei‐Shyuan , Lin Chueh‐Ho , Lin Chia‐Huei 
Published: October 2022

AbstractBackgroundExercise has positive impacts on cardiometabolic health. However, evidence regarding the effectiveness of tele‐exercise training on cardiorespiratory fitness and heart rate recovery in patients with cardiometabolic multimorbidity remains limited.AimsThe aim of this study was to assess whether an assumed increase in physical activity (PA) after a 12‐week tele‐exercise training program improved cardiorespiratory fitness and heart rate recovery of patients with cardiometabolic multimorbidity.MethodsA parallel‐group randomized controlled trial was conducted. Eligible patients with cardiometabolic multimorbidity (n = 83) were randomized 1:1 to either an experimental group (EG, received a 12‐week tele‐exercise training program with 3 sessions/week and 30 min/session and weekly remote monitoring for maintenance of exercise) or a control group (CG, usual care only). PA, cardiorespiratory fitness, and heart rate recovery were assessed at baseline and 12 weeks. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group.ResultsSixty‐eight participants (81.9%) completed the study, and 83 were included in the intention‐to‐treat analysis. The EG with higher vigorous‐intensity PA (β = 714, p = .037), walking behavior (β = 750, p = .0007), and total amount of PA (β = 1748, p = .001) after the intervention had significantly elevated cardiorespiratory fitness, including VO2peak (β = 3.9, p = .042), workload (β = 17.9, p = .034), and anaerobic threshold (β = 2.1, p = .041), and increased one‐min heart rate recovery (β = 5.3, p = .025), compared with the CG.Linking evidence to actionA 12‐week tele‐exercise training program was effective for increased PA, elevated cardiorespiratory fitness, and improved heart rate recovery for patients with cardiometabolic multimorbidity. These findings highlight the feasibility of better delivering lifestyle interventions for cardiometabolic health management.
Hierarchical genetic structure in a direct-developing whelk (Buccinum undatum) throughout the western North Atlantic
Authors: Sturch W.H. , D'Aloia C.C. 
Published: October 2022

Direct-developing marine species lack a pelagic larval phase and are therefore predicted to have limited dispersal capacity and exhibit strong genetic structure over small spatial scales. Nevertheless, empirical work suggests that developmental mode, alone, cannot always explain realized connectivity patterns. We characterized spatial genetic structure within the western North Atlantic lineage of the waved whelk ( Buccinum undatum) , a direct-developing gastropod that is the target of an emerging fishery. We genotyped individuals throughout Atlantic Canada using 1052 single nucleotide polymorphisms, documenting strong hierarchical genetic structuring throughout this region. Overall, pairwise genetic structure estimates were high, with two major genetic clusters separating southwestern and northeastern sites. But more complex patterns emerged at smaller spatial scales. Notably, pairs of sites on deeper offshore habitat exhibited panmixia, despite being separated by up to 100 km, whereas inshore and intertidal populations spaced at comparable distances were strongly genetically divergent. Collectively, our multi-scale analyses revealed that direct developers can exhibit genetic patterns that do not conform to simple geographic expectations. Future exploration of potential depth-variable connectivity is warranted, especially among harvested populations.
Metabolic and Nonmetabolic Functions of PSAT1 Coordinate Signaling Cascades to Confer EGFR Inhibitor Resistance and Drive Progression in Lung Adenocarcinoma
Authors: Luo Ming-Yu , Zhou Ye , Gu Wei-Ming , Wang Cheng , Shen Ning-Xiang , Dong Jiang-Kai , Lei Hui-Min , Tang Ya-Bin , Liang Qian , Zou Jing-Hua , Xu Lu , Ma Pengfei , Zhuang Guanglei , Bi Ling , Xu Ling , Zhu Liang , Chen Hong-Zhuan , Shen Ying 
Published: October 2022

AbstractEmerging evidence demonstrates that the dysregulated metabolic enzymes can accelerate tumorigenesis and progression via both metabolic and nonmetabolic functions. Further elucidation of the role of metabolic enzymes in EGFR inhibitor resistance and metastasis, two of the leading causes of death in lung adenocarcinoma, could help improve patient outcomes. Here, we found that aberrant upregulation of phosphoserine aminotransferase 1 (PSAT1) confers erlotinib resistance and tumor metastasis in lung adenocarcinoma. Depletion of PSAT1 restored sensitivity to erlotinib and synergistically augmented the tumoricidal effect. Mechanistically, inhibition of PSAT1 activated the ROS-dependent JNK/c-Jun pathway to induce cell apoptosis. In addition, PSAT1 interacted with IQGAP1, subsequently activating STAT3-mediated cell migration independent of its metabolic activity. Clinical analyses showed that PSAT1 expression positively correlated with the progression of human lung adenocarcinoma. Collectively, these findings reveal the multifunctionality of PSAT1 in promoting tumor malignancy through its metabolic and nonmetabolic activities.Significance:Metabolic and nonmetabolic functions of PSAT1 confer EGFR inhibitor resistance and promote metastasis in lung adenocarcinoma, suggesting therapeutic targeting of PSAT1 may attenuate the malignant features of lung cancer.
Patient and Provider Web-Based Decision Support for Breast Cancer Chemoprevention: A Randomized Controlled Trial
Authors: Crew Katherine D. , Bhatkhande Gauri , Silverman Thomas , Amenta Jacquelyn , Jones Tarsha , McGuinness Julia E. , Mata Jennie , Guzman Ashlee , He Ting , Dimond Jill , Tsai Wei-Yann , Kukafka Rita 
Published: October 2022

Abstract

Significant underutilization of breast cancer chemoprevention remains, despite guidelines stating that physicians should recommend chemoprevention with antiestrogen therapy to high-risk women. We randomized women, ages 35 to 75 years, who met high-risk criteria for breast cancer, without a personal history of breast cancer or prior chemoprevention use, to standard educational materials alone or combined with a web-based decision aid. All healthcare providers, including primary care providers and breast specialists, were given access to a web-based decision support tool. The primary endpoint was chemoprevention uptake at 6 months. Secondary outcomes included decision antecedents (perceived breast cancer risk/worry, chemoprevention knowledge, self-efficacy) and decision quality (decision conflict, chemoprevention informed choice) based upon patient surveys administered at baseline, 1 and 6 months after randomization. Among 282 evaluable high-risk women enrolled from November 2016 to March 2020, mean age was 57 years (SD, 9.9) and mean 5-year invasive breast cancer risk was 2.98% (SD, 1.42). There was no significant difference in chemoprevention uptake at 6 months between the intervention and control groups (2.1% vs. 3.5%). Comparing the intervention and control arms at 1 month, there were significant differences among high-risk women in accurate breast cancer risk perceptions (56% vs. 39%, P = 0.017), adequate chemoprevention knowledge (49% vs. 27%, P &lt; 0.001), mean decision conflict (34.0 vs. 47.0, P &lt; 0.001), and informed choice (41% vs. 23%, P = 0.003). These differences were no longer significant at 6 months. Although our decision support tools did not result in a significant increase in chemoprevention uptake, we did observe improvements in decision antecedents and decision quality measures.

Prevention Relevance:
In this randomized controlled trial of decision support for 300 high-risk women and 50 healthcare providers, we did not observe a significant increase in chemoprevention uptake, which remained low at under 5%. However, these decision support tools may increase knowledge and informed choice about breast cancer chemoprevention.
Targeting the Leukotriene Pathway for Colon Cancer Interception
Authors: Mohammed Altaf , Shoemaker Robert H. 
Published: October 2022

AbstractThe role of chronic inflammation and arachidonic acid (AA) metabolism in tumor progression has been well characterized for variety of cancers, with compelling data for colon cancer. Several preclinical and clinical studies primarily focused on inhibiting the cyclooxygenase pathways using NSAIDs and aspirin for colon cancer prevention. However, emerging evidence clearly supports the pro-tumorigenic role of 5-lipoxygenase and its downstream leukotriene pathway within AA metabolism. As discussed in the current issue, targeting the leukotriene pathway by cysteinyl leukotriene receptor antagonist (LTRA) montelukast suppressed formation of aberrant crypt foci (ACF) and cell proliferation in colonic epithelium, suggesting the potential of LTRAs for colon cancer prevention. Although this is a short clinical chemoprevention trial to explore the effects of LTRAs against ACF development, it is a significant and timely study opening avenues to further explore the possibilities of using LTRAs in other inflammation-associated precancerous lesions as well. In this spotlight commentary, we highlight the implications of their data and the opportunities for developing LTRAs as potential candidates for colorectal cancer interception.See related article by Higurashi et al., p. 661
One Barrier to Colorectal Cancer Screening Eliminated: On to the Next
Authors: Wender Richard C. , Rendle Katharine A. 
Published: October 2022

AbstractColorectal cancer screening is one of the best proven and most cost-effective of all preventive interventions. Screening lowers both incidence and mortality. Bearing some of the costs of colonoscopy, also known as cost-sharing, has been a barrier to completion of colonoscopy, both as a primary screen and as a second test to complete screening after an abnormal initial stool or radiologic screening test. While a newly published model concludes that eliminating cost-sharing for colonoscopy after an initial screen is cost-effective, the desired outcome has already been achieved. The Centers for Medicaid and Medicare Services has announced the plan to eliminate this final out of pocket expense starting in 2023. While this is an important step, many barriers to screening for colorectal cancer and all other cancers remain. Eliminating downstream costs that result from an abnormal screen is a difficult to achieve but important goal.See related article by Fendrick et al., p. 653