bluuebunny/crossref_metadata_2025_split huggingface dataset:
Del Nido versus conventional blood cardioplegia in patients with combined aortic root surgery: A retrospective study
Authors: Huang Yingshan , Zhu Xiangni , Kong Jichang , Zhang Ling , Gui Wenting , Wang Jiao , Yang Yunling , Xie Yan , Wang Dongmei , Li Xinyue , Zhou Long , Song Yi , Wang Xiaoqi 
Published: October 2024

Objective This study aimed to compare the safety and efficacy of Del Nido cardioplegia (DNC) and conventional blood cardioplegia (CBC) in combined aortic surgery. Methods This retrospective study involved elective patients who underwent combined aortic root surgery between September 2017 and July 2023. Patients were divided into two groups: the DNC and the CBC group. The primary outcome was high-sensitivity cardiac troponin I and creatine kinase-MB levels at the 0, 1, 2, and three postoperative days. The secondary outcomes contained postoperative left ventricular ejection fraction, return to spontaneous rhythm after aortic de-clamping, postoperative myocardial infarction, new-onset atrial fibrillation, postoperative mechanical circulatory support, mechanical ventilation duration, intensive care unit stay, postoperative hospital stay, and the reduction of left ventricle end-diastolic diameter at 3 months after surgery. Results 223 patients were included and divided into the CBC ( n = 111) and the DNC group ( n = 112). There was no statistical difference in patients’ demographics and preoperative parameters between the two groups. No in-hospital mortality. The total cardioplegia volume [35.25 (30.30,43.65) ml/kg versus 21.43 (18.42,25.62) ml/kg, p < 0.001] and infusion times [2 (2,3) times versus 1 (1,2) times, p < 0.001] were less and the incidence of return to spontaneous rhythm after de-clamping was higher in the DNC group [59.5% versus 83%, p < 0.001]. Postoperative high-sensitivity cardiac troponin I and creatine kinase-MB levels were comparable between the two groups. DNC is related to a shorter duration of mechanical ventilation, intensive care unit stay, and hospital stay than CBC. The rate of return to spontaneous rhythm after aortic de-clamping seemed to decrease with the prolongation of aortic cross-clamping (ACC) duration, and there was no difference between the two groups when the time exceeded 120 min. Conclusions The safety and efficacy of using DNC were comparable to CBC in combined aortic surgery. The rate of return to spontaneous rhythm after aortic de-clamping seemed to decrease with the prolongation of ACC time. Further studies may be needed to fully elucidate the advantages of DNC in postoperative recovery and its long-term effects on patient outcomes.
Comparison of Clinical Diagnosis and Autopsy Findings of Early Neonatal Deaths: Diagnostic Challenges and the Value of Autopsy in Identifying Rare Pathologies
Authors: Suhren Jan-Theile , Hussein Kais , Kreipe Hans , Schaumann Nora 
Published: October 2024

Background: In a non-forensic hospital setting, neonatal death within the first week of life is often related to premature birth and/or lung diseases. Without post-mortem examination, the identification of the cause of death may be challenging. Autopsy can confirm the clinical diagnosis, uncover additional information or change the diagnosis. Our study aimed to assess the correlation between the clinical diagnosis and post-mortem findings in early neonatal deaths. Methods: The retrospective study included autopsy cases with neonatal deaths within the first 7 days of life (arbitrary time interval 2006-2021). Discrepancies between clinical and histopathological findings were classified into 3 groups: (i) full agreement, (ii) additional findings discovered by autopsy, or (iii) autopsy changed the diagnosis. Results: A cohort of 27 cases could be identified and lung pathologies were the most common finding (56%). Additional findings could be discovered in 48% of cases. Major discrepancies which changed the clinical diagnosis could be found in 11% (n = 3/27) of cases. Conclusion: Frequently, post-mortem examinations validate the clinical diagnosis while revealing crucial information in a few cases. In these discrepant cases, autopsy findings can provide information for genetic counselling and quality control of clinical management.
National waiting time monitoring in oral healthcare – The role of triage dental nurses
Authors: Söderlund Riitta 
Published: October 2024

Objectives Our study analyzed dental nurses’ use and use behavior determinants of electronic patient IS modules in telephone triage. The modules were implemented in public oral healthcare organizations’ patient ISs to digitalize the national waiting time monitoring system. Methods For the cross-sectional survey, we collected data from dental nurses using convenience sampling and applied a modified UTAUT as the theoretical framework. Results The results indicate that using the module for different purposes varied, and the nurses used it sparsely in recording data for monitoring national waiting times. Using the module was laborious, and triage work was busy. Conclusion Dental nurses’ low system usage resulted in poor-quality data for waiting time monitoring. As healthcare data is increasingly used for purposes other than clinical decision making, we must ensure that healthcare professionals performing clinical tasks perceive data recording for non-clinical purposes as meaningful and have time for proper data entry.
Plasma metabolites, systolic blood pressure, lifestyle, and stroke risk: A prospective cohort study
Authors: Zhang Canjia , Li Mingxiao , Yang Miaomiao , Lin Jiaqi , Huang Jinyao , Lin Ying , Chen Xi , Liang Yongqiang , Yang Yuanhai , Yu Ziyuan , Hu Dongsheng , Zhang Ming , Hu Fulan 
Published: October 2024

Background: To estimate the associations of stroke risk with plasma metabolites, metabolic risk score (MRS), the combinations of MRS with hypertension or lifestyle, and lifestyle-related metabolic signature. To assess the improvement of the stroke risk prediction model through the incorporation of MRS. Methods: A total of 77,315 participants from the UK Biobank were included in this study. Xgboost and LASSO-Cox regression were used to select metabolites and construct MRS. Elastic net regression was utilized to construct the lifestyle-related metabolic signature. Multivariate Cox regression was used to estimate the associations between metabolites, MRS, the combinations of MRS with hypertension or lifestyle, lifestyle-related metabolic signature, and stroke risk. Results: We identified 48, 63, 39, and 4 metabolites associated with the risk of stroke, ischemic stroke (IS), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH), respectively. High MRS significantly increased the risk of stroke (HR = 2.65 (95% confidence interval (CI): 2.09−3.35)), IS (HR = 2.45 (95% CI: 1.89−3.17)), ICH (HR = 2.74 (95% CI: 1.55−4.85)), and SAH (HR = 4.64 (95% CI: 2.25−9.56)). In the combination analyses, compared with normal systolic blood pressure (SBP) and low MRS, normal/high SBP, and high MRS significantly increased stroke risk (HR = 5.80 (95% CI: 2.75–12.27)/6.37 (95% CI: 3.22−12.62)). A favorable/unfavorable lifestyle and high MRS also significantly increased stroke risk (HR = 2.38 (95% CI: 1.73–3.28)/3.86 (95% CI: 2.63−5.67)) compared with a favorable lifestyle and low MRS. Incorporating MRS into the 15-year stroke and IS risk prediction model increased the areas under the curves (AUCs) from 0.746 to 0.766 and from 0.771 to 0.811, respectively. The metabolic signature was correlated with adherence to a healthy lifestyle (r = 0.414; P = 2.22e−16) and inversely associated with stroke risk (HR = 0.80 (95% CI: 0.73–0.86)). Conclusions: Various metabolites and MRS were significantly associated with the risk of stroke, IS, ICH, and SAH. Individuals with a high MRS may face an elevated stroke risk among populations with high SBP or unhealthy lifestyle, even those with normal SBP or healthy lifestyle. MRS provided modest improvement to the stroke risk prediction model. The lifestyle-related metabolic signature could reduce 20% stroke risk.
New Multi-Channel VSMFxLMS Algorithm for Vibration Reduction of Gear Systems
Authors: Geng Zhibo , Chen Min , Wang Yingjian , Kong Yun , Xiao Ke 
Published: October 2024

AbstractAt present, the active control of gear vibration mostly relies on existing algorithms. In order to achieve effective vibration reduction of the gear system, particularly during the vibration process, this paper proposes a multi-channel VSMFxLMS algorithm based on the FxLMS algorithm. This novel approach takes into account the time-varying nature of the vibration signal during gear vibration. Adaptive filter power coefficients are updated in a skip-tongue variable-step manner using momentum factors. Firstly, the paper establishes the dynamics model of the gear system and analyzes the nonlinear dynamic characteristics of the system. It then examines the vibration damping effect of the FxLMS algorithm and analyzes its performance under different gear system motion states, considering different step lengths and momentum factors. Lastly, the proposed VSMFxLMS algorithm is compared with the FxLMS algorithm, highlighting the superiority of the former. Overall, this research highlights the potential of a multi-channel VSMFxLMS algorithm in reducing vibrations in gear systems. The study optimizes the performance of gear systems while using advanced control strategies.
Application of the world guidelines for falls prevention and management’s risk stratification algorithm to patients on a frailty intervention pathway and the potential utility of sensory impairment information
Authors: Katiri Roulla , Holman Jack A. , Magner Siobhán , O’Caheny Cian , Byrne Colm P. 
Published: October 2024

Abstract
Background
The 2022 world guidelines for falls prevention and management suggest measuring sensory function including dizziness, vision, and hearing. These variables are not included in the falls risk stratification algorithm. This study sought to investigate the utility of the guidelines and potential avenues for improvement. This study applied the falls risk stratification recommendations and reviewed the individual sensory impairment risk factor variables predictive of falls and falls risk grouping in those assessed by a frailty intervention team (FIT) based in an emergency department (ED).

Methods
Patients over 65 years old who attended the ED and had a comprehensive geriatric assessment carried out by FIT over a period of four months were included in this retrospective cross-sectional study. Patient characteristics, medication, physical and sensory function status data was retrieved and analysed with respect to falls and falls risk grouping.

Results
Data was gathered retrospectively from 392 patients. Excluding those with missing data, almost all attendees were in the high-risk of falls category (n = 170, 43.4%), or the low-risk category (n = 149, 38.0%). Few people were in the intermediate-risk category (n = 19, 4.8%). Hearing loss and dizziness were significantly associated with falls incidence, whereas vision and balance were not. Hearing loss, balance and dizziness were significantly associated with risk grouping, whereas vision was not.

Conclusions
Most older adults included in the analysis fell into the low- or high-risk categories, with a minority in the intermediate-risk category. This suggests that the inclusion criteria for the intermediate category could be altered for greater sensitivity. While impaired balance and vision were the most common impairments, hearing status, balance and dizziness were associated with risk group. These results, through a practical application of the world guidelines for falls to an acute clinical sample, raise the possibility of refining the falls risk stratification criteria, and highlight the capacity for additional sensory intervention to mitigate falls risk.
Examining concordance of sexual-related factors and PrEP eligibility with HIV risk perception among adolescent girls and young women: cross-sectional insights from DREAMS sites in Kenya, Malawi, and Zambia
Authors: Heck Craig J. , Reed Domonique M. , Okal Jerry , Chipeta Effie , Mbizvo Michael , Mathur Sanyukta 
Published: October 2024

Abstract
Background
HIV risk perception is an important cognition for prevention, theoretically engendering service-seeking and risk-reduction behaviors, but its composition remains poorly understood. We examined country-specific correlates of self-appraised HIV exposure risk among sexually active adolescent girls and young women (AGYW, aged 15–24 years) without HIV in Kenya, Malawi, and Zambia. We also explored overlaps between self-appraised HIV exposure risk and pre-exposure prophylaxis (PrEP) eligibility to identify engagement opportunities.

Methods
We analyzed cross-sectional data (2016/2017) to estimate sexual-related correlates of self-appraised HIV exposure risk (likely vs. not, temporally framed as “ever”) using log-Poisson models with robust standard errors. For sexual-related factors with an unadjusted p ≤ 0.10, individual adjusted models were fitted, controlling for sociodemographic and cognitive factors with an unadjusted p ≤ 0.10. PrEP eligibility was defined using national guidelines; since conditional criteria are in Malawi’s (age-disparate sex + ever-pregnant) and Zambia’s (multiple partners + condomless sex) guidelines, we also assessed PrEP eligibility after decoupling these factors.

Results
Few AGYW reported likely HIV exposures (Kenya [N = 746]: 15.7%, Malawi [N = 1348]: 46.2%, Zambia [N = 349]: 9.5%) despite ubiquitous HIV risk (98.7%, 99.8%, and 98.9% of Kenyan, Malawian, and Zambian AGYW reported ≥ 1 sexual-related factor). However, the adjusted models found some actual-perceived risk concordance. Positive correlates of self-appraised likely HIV exposures included partner(s)’ likely HIV exposure (all countries); partner(s)’ unknown HIV status and other partners (Kenya, Malawi); STI symptoms and partner(s) living outside the community (Kenya); non-partner sexual violence (Zambia); and transactional sex, multiple partners, pre-coital alcohol use, and physical/sexual intimate partner violence (Malawi). Per national guidelines, PrEP eligibility criteria differentially identified HIV risk (Kenya: 93.6%, Malawi: 53.3%, Zambia: 44.6%), and self-appraised likely HIV exposures were low among PrEP-eligible AGYW (Kenya: 16.5%, Malawi: 48.5%, Zambia: 18.8%). Decoupling Malawi’s and Zambia’s conditional PrEP criteria could increase risk identification to > 85% and potential engagement by ~ 70% and ~ 30%, respectively.

Conclusions
AGYW's HIV risk perceptions were mostly influenced by factors beyond their locus of control. Conditional PrEP eligibility criteria may inhibit AGYW’s access and uptake in some settings: countries should consider decoupling these factors to minimize barriers. Intersections between autonomy, behaviors, and perceptions among AGYW in gender-inequitable settings warrants further investigation.
Implementing national care guidelines in local authorities in England and Wales: a theory-of-change
Authors: Bauer Annette , Boaz Annette , Breuer Erica , Hoomans Ties , Jasim Sarah , Knapp Martin , Camus Joaquín Mayorga , Malley Juliette 
Published: October 2024

Abstract
Background
The delivery of high-quality services in chronically underfunded social or long-term care systems is a major challenge internationally. National guidelines, developed by the National Institute for Health and Care Excellence, set out how local authorities in England and Wales should fund and provide care based on best available evidence. Theoretical and participatory approaches can usefully inform the design and evaluation of implementation strategies for guidelines. The aim of the study is to develop a Theory-of-Change for how the implementation of these guidelines is expected to lead to impacts from a local authority perspective.

Methods
As part of a comparative case study (The ‘Valuing Care Guidelines’ study; February 2022 to April 2024) with three local authority sites in England and Wales, we involved altogether 17 participants in two Theory-of-Change online workshops per site, each of 2 hours. Additional data gathered from the same participants as part of the overall study were used to conceptualise and enrich information from the workshops.

Results
Participants described the Theory-of-Change map as follows: A wide range of activities (categorised in stages of ‘pre-implementation’, ‘implementation’, ‘sustainment and scaling’) and skills were required to implement guidelines, and achieve long-term organisational sustainability and service delivery outcomes, leading to final impacts for service users and carers. Participants described a co-creation implementation model, led by ‘Implementation Support Practitioners’, who utilised relational skills to achieve motivation, trust, and confidence at different organisational levels, addressing contextual barriers such as inadequate staffing, lack of resources and of organisational support systems. Consistent use of guidelines by frontline staff could only be achieved if the value of guideline implementation was promoted widely, and if consideration was given to the roles of stakeholders, such as the inspection body, local health care providers, users and carers.

Conclusions
Our study is the first to investigate the implementation of national social care guidelines by local authorities in England and Wales. It generates insights that can guide implementation practice as well as inform the evaluation of future implementation strategies.
International Delphi consensus on the management of percutaneous choleystostomy in acute cholecystitis (E-AHPBA, ANS, WSES societies)
Authors: Ramia José M. , Serradilla-Martín Mario , Villodre Celia , Rubio Juan J. , Rotellar Fernando , Siriwardena Ajith K. , Wakabayashi Go , Catena Fausto ,   PERCHODEL Collaborative Study Group, Abe Tomoyuki , Abe Yuta , Abu-Zidan Fikri , López Cándido F. Alcázar , Amemiya Ryusuke , Andersson Bodil , Ansaloni Luca , Balakrishnan Anita , Balogh Zsolt J. , Carbonell-Morote Silvia , Coker Ahmet , Damaskos Dimitrios , De Simone Belinda , Devar Jonh , Frigerio Isabella , Fujita Yusuke , Hayatsu Sigheo , Hori Shutaro , Ibuki Sho , Kameyama Noriaki , Kawano Youichi , Kirkpatrick Andrew , Kleeff Jorg , Kluger Yoram , Latifi Rifat , Lopez-Ben Santiago , Malleo Giuseppe , Masuda Yuki , Minagawa Takuya , Mishima Kohei , Miyata Ryohei , Moore Ernest , Nishiyama Ryo , Ome Yusuke , Saito Junichi , Serrablo Alejandro , Shito Masaya , Soreide Kjetil , Strobel Oliver , Sugrue Michael , Suzuki Keiichi , Takigawa Yutaka , Tomikawa Moriaki , Urakami Hidejiro , Vallicelli Carlo , Wakawayashi Taiga , Weber Dieter 
Published: October 2024

Abstract
Background
There has been a progressive increase in the use of percutaneous cholecystostomy (PC) in acute cholecystitis (AC) over the last decades due to population aging, and the support of guidelines (Tokyo Guidelines (TG), World Society of Emergency Surgery (WSES) Guidelines) as a valid therapeutical option. However, there are many unanswered questions about the management of PCs. An international consensus on indications and PC management using Delphi methodology with contributions from experts from three surgical societies (EAHPBA, ANS, WSES) have been performed.

Methods
A two-round Delphi consensus, which included 27 questions, was sent to key opinion leaders in AC. Participants were asked to indicate their ‘agreement/disagreement’ using a 5-point Likert scale. Survey items with less than 70% consensus were excluded from the second round. For inclusion in the final recommendations, each survey item had to have reached a group consensus (≥ 70% agreement) by the end of the two survey rounds.

Results
54 completed both rounds (82% of invitees). Six questions got > 70% and are included in consensus recommendations: In patients with acute cholecystitis, when there is a clear indication of PC, it is not necessary to wait 48 h to be carried out; Surgery is the first therapeutic option for the TG grade II acute cholecystitis in a patient suitable for surgery; Before PC removal a cholangiography should be done; There is no indication for PC in Tokyo Guidelines (TG) grade I patients; Transhepatic approach is the route of choice for PC; and after PC, laparoscopic cholecystectomy is the preferred approach (93.1%).

Conclusions
Only six statements about PC management after AC got an international consensus. An international guideline about the management of PCs are necessary.
Biological mechanisms of resilience to tau pathology in Alzheimer’s disease
Authors: Svenningsson Anna L. , Bocancea Diana I. , Stomrud Erik , van Loenhoud Anita , Barkhof Frederik , Mattsson-Carlgren Niklas , Palmqvist Sebastian , Hansson Oskar , Ossenkoppele Rik 
Published: October 2024

Abstract
Background
In Alzheimer’s disease (AD), the associations between tau pathology and brain atrophy and cognitive decline are well established, but imperfect. We investigate whether cerebrospinal fluid (CSF) biomarkers of biological processes (vascular, synaptic, and axonal integrity, neuroinflammation, neurotrophic factors) explain the disconnection between tau pathology and brain atrophy (brain resilience), and tau pathology and cognitive decline (cognitive resilience).

Methods
We included 428 amyloid positive participants (134 cognitively unimpaired (CU), 128 with mild cognitive impairment (MCI), 166 with AD dementia) from the BioFINDER-2 study. At baseline, participants underwent tau positron emission tomography (tau-PET), magnetic resonance imaging (MRI), cognitive testing, and lumbar puncture. Longitudinal data were available for MRI (mean (standard deviation) follow-up 26.4 (10.7) months) and cognition (25.2 (11.4) months). We analysed 18 pre-selected CSF proteins, reflecting vascular, synaptic, and axonal integrity, neuroinflammation, and neurotrophic factors. Stratifying by cognitive status, we performed linear mixed-effects models with cortical thickness (brain resilience) and global cognition (cognitive resilience) as dependent variables to assess whether the CSF biomarkers interacted with tau-PET levels in its effect on cortical atrophy and cognitive decline.

Results
Regarding brain resilience, interaction effects were observed in AD dementia, with vascular integrity biomarkers (VEGF-A (βinteraction = -0.009, pFDR = 0.047) and VEGF-B (βinteraction = -0.010, pFDR = 0.037)) negatively moderating the association between tau-PET signal and atrophy. In MCI, higher NfL levels were associated with more longitudinal cortical atrophy (β = -0.109, pFDR = 0.033) and lower baseline cortical thickness (β = -0.708, pFDR = 0.033) controlling for tau-PET signal. Cognitive resilience analyses in CU revealed interactions with tau-PET signal for inflammatory (GFAP, IL-15; βinteraction -0.073–-0.069, pFDR 0.001–0.045), vascular (VEGF-A, VEGF-D, PGF; βinteraction -0.099–-0.063, pFDR < 0.001–0.046), synaptic (14–3-3ζ/δ; βinteraction = -0.092, pFDR = 0.041), axonal (NfL; βinteraction = -0.079, pFDR < 0.001), and neurotrophic (NGF; βinteraction = 0.091, pFDR < 0.001) biomarkers. In MCI higher NfL levels (βmain = -0.690, pFDR = 0.025) were associated with faster cognitive decline independent of tau-PET signal.

Conclusions
Biomarkers of co-existing pathological processes, in particular vascular pathology and axonal degeneration, interact with levels of tau pathology on its association with the downstream effects of AD pathology (i.e. brain atrophy and cognitive decline). This indicates that vascular pathology and axonal degeneration could impact brain and cognitive resilience.