bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcatheter Aortic Valve Replacement in Large Annuli Valves With the Supra-Annular, Self-Expandable Evolut Platform in a Real-World Registry
Authors: Dallan Luis Augusto P. , Tang Gilbert , Forrest John K. , Reardon Michael J. , Szeto Wilson Y. , Kodali Susheel K. , Baeza Cristian , Eisenberg Ruth , Attizzani Guilherme F. 
Published: April 2024

Background:
Transcatheter aortic valve replacement is approved for treatment of patients with severe aortic stenosis across the spectrum of risk. While considering broader indications for use, transcatheter aortic valve replacement in large native annuli has become increasingly important.

Methods:
Patients with tricuspid aortic stenosis undergoing transcatheter aortic valve replacement using the Evolut R or Evolut PRO+ 34 mm valves (Medtronic, Minneapolis, MN) in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry between October 2016 and September 2020 were stratified according to in range (>12%) device oversizing and below range (0%–12%) device oversizing. Patients undergoing valve-in-valve procedures, having a baseline annulus size <26 or ≥34 mm, or without computed tomography angiography measured annulus size were excluded. Percentage of oversizing was calculated as [(valve diameter−annulus diameter)×100/annulus diameter].

Results:

Transcatheter aortic valve replacement in patients with large annuli was performed in 8017 patients with a mean (±SD) age 79.3±7.9 years and 94% were male. Below range (n=1096) was less common than in range oversizing (n=6921). At 1-year follow-up, mortality (19.6% versus 14.9%;
P
=0.001), aortic valve reintervention (2.1% versus 0.6%;
P
<0.001) and valve-related readmission rates (3.2% versus 2.0%;
P
=0.014) were higher in the below range device oversizing group versus in range group respectively. In a multivariable Cox proportional hazards regression model, when controlling for clinically relevant covariates, below range device oversizing was associated with higher 1-year all-cause mortality (HR, 1.28 [CI, 1.07–1.51];
P
=0.005).

Conclusions:
Results from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry in patients with large annuli valves using 34mm Evolut R/PRO+ valves suggest that in range (>12%) device oversizing delivered better clinical outcomes than implantation with below range (0%–12%) device oversizing.
Understanding Meaning through Human Evolution
Authors: Faye Jan 
Published: April 2024

Abstract
I argue that meaning is a result of our biological evolution, and that language evolved from primates’ ability to grasp conceptually the most important features of their environment. I hold that natural selection and adaptation ensure that primates both sense and conceptualize their world similarly, and that they therefore think similarly, whenever they receive the same sense impressions. This cognitive similarity enabled our predecessors to learn and develop a language because of the regular association of a particular sound and a particular image. The evolutionary pressure on our predecessors to develop a language was the advantage that such a language had for cooperation and survival. Finally, I argue that the old, but in wider circles frowned-upon theory of meaning, the expressive theory of language, provides the best explanation of the relationship between thought, meaning, and words, because it operates with words and not sentences as the basic semantic unit.
A systematic review of cardiac surgery clinical prediction models that include intra-operative variables
Authors: Jones Ceri , Taylor Marcus , Sperrin Matthew , Grant Stuart W. 
Published: April 2024

Background Most cardiac surgery clinical prediction models (CPMs) are developed using pre-operative variables to predict post-operative outcomes. Some CPMs are developed with intra-operative variables, but none are widely used. The objective of this systematic review was to identify CPMs with intra-operative variables that predict short-term outcomes following adult cardiac surgery. Methods Ovid MEDLINE and EMBASE databases were searched from inception to December 2022, for studies developing a CPM with at least one intra-operative variable. Data were extracted using a critical appraisal framework and bias assessment tool. Model performance was analysed using discrimination and calibration measures. Results A total of 24 models were identified. Frequent predicted outcomes were acute kidney injury (9/24 studies) and peri-operative mortality (6/24 studies). Frequent pre-operative variables were age (18/24 studies) and creatinine/eGFR (18/24 studies). Common intra-operative variables were cardiopulmonary bypass time (16/24 studies) and transfusion (13/24 studies). Model discrimination was acceptable for all internally validated models (AUC 0.69-0.91). Calibration was poor (15/24 studies) or unreported (8/24 studies). Most CPMs were at a high or indeterminate risk of bias (23/24 models). The added value of intra-operative variables was assessed in six studies with statistically significantly improved discrimination demonstrated in two. Conclusion Weak reporting and methodological limitations may restrict wider applicability and adoption of existing CPMs that include intra-operative variables. There is some evidence that CPM discrimination is improved with the addition of intra-operative variables. Further work is required to understand the role of intra-operative CPMs in the management of cardiac surgery patients.
Sonographic Evaluation of Doppler Parameters Within the Central Retinal Artery: A Cohort Study
Authors: Paulinus Samson Omini , Ijever Andrew Wueseter , Akwa Egom Erim , Archibong Bassey Eyo , Akintomide Akintunde Olusijibomi , Eru Eru Mba , Egbe Nneoyi Onen , Okoro Ulu Ulu 
Published: April 2024

Objective: The objective of this study was to assess the Doppler parameters, associated within the central retinal artery (CRA), based on a cohort of Nigerian participants. Materials and Methods: A total of 66 participants were recruited and consented at a medical clinic in Calabar, Nigeria, and presented from August 2019 to December 2023. The diagnostic data points recorded on this cohort were their fasting blood glucose (FBG) (mmol/L), CRA peak systolic velocity (PSV), CRA end-diastolic velocity (EDV), the resistive index (RI), and pulsatility index (PI). The data analysis was completed to provide descriptive information, as well as correlations. The statistical significance was set at P < .05. Results: In this cohort, the women demonstrated a higher PSV and EDV, based on the vascular flow within the right CRA (Rt. PSV [20.8 ± 6.0 SD] and Rt. EDV [5.8 ±2.1 SD]), as well as the left CRA (Lt. PSV [20. 6 ± 4.4 SD] and Lt. EDV [6.2 ± 2.0 SD]). This was compared to the men’s data taken on the vascular flow within the right CRA (Rt. PSV [19.6 ± 5.3 SD] and Rt. EDV [5.2 ± 1.8 SD]), as well as their left CRA (Lt. PSV [19.2± 4.7 SD] and Lt. EDV [5.3 ± 1.3 SD]). The participants’ FBG levels did not correlate with their respective Doppler parameters. The Doppler parameters, based on the flow within the right CRA, showed moderate to weak positive correlations compared with the left CRA. The PSV recorded in the right CRA was varied across the specific participant age groups of 17 to 25 and 26 to 34 years. Conclusion: Potential sex and age-related variations in the Doppler velocities, recorded within the CRA, were specific to this cohort, and the sample size may have compromised the overall study’s statistical power. A replication of this research is needed, and data from a larger cohort of participants are needed.
Exertional heat stroke-induced changes in gut microbiota cause cognitive impairment in mice
Authors: Xie Jiangang , Wang Linxiao , Xu Yunyun , Ma Yuexiang , Zhang Lingqin , Yin Wen , Huang Yang 
Published: April 2024

Abstract
Background
The incidence of exertional heat stroke (EHS) escalates during periods of elevated temperatures, potentially leading to persistent cognitive impairment postrecovery. Currently, effective prophylactic or therapeutic measures against EHS are nonexistent.

Methods
The selection of days 14 and 23 postinduction for detailed examination was guided by TEM of neuronal cells and HE staining of intestinal villi and the hippocampal regions. Fecal specimens from the ileum and cecum at these designated times were analyzed for changes in gut microbiota and metabolic products. Bioinformatic analyses facilitated the identification of pivotal microbial species and metabolites. The influence of supplementing these identified microorganisms on behavioral outcomes and the expression of functional proteins within the hippocampus was subsequently assessed.

Results
TEM analyses of neurons, coupled with HE staining of intestinal villi and the hippocampal region, indicated substantial recovery in intestinal morphology and neuronal injury on Day 14, indicating this time point for subsequent microbial and metabolomic analyses. Notably, a reduction in the Lactobacillaceae family, particularly Lactobacillus murinus, was observed. Functional annotation of 16S rDNA sequences suggested diminished lipid metabolism and glycan biosynthesis and metabolism in EHS models. Mice receiving this intervention (EHS + probiotics group) exhibited markedly reduced cognitive impairment and increased expression of BDNF/TrKB pathway molecules in the hippocampus during behavioral assessment on Day 28.

Conclusion
Probiotic supplementation, specifically with Lactobacillus spp., appears to mitigate EHS-induced cognitive impairment, potentially through the modulation of the BDNF/TrKB signaling pathway within the hippocampus, illustrating the therapeutic potential of targeting the gut-brain axis.
A case report of ventricular fibrillation following Shockwave intravascular lithotripsy during percutaneous coronary intervention
Authors: Jakobsen Lars , Christiansen Evald Høj , Thim Troels 
Published: April 2024

Abstract
Background
Shockwave intravascular lithotripsy (S-IVL) is widely used during percutaneous coronary intervention (PCI) of calcified coronary arteries. Ventricular capture beats during S-IVL are common but arrhythmias are rare.

Case presentation
A 75-year-old woman was scheduled for PCI to a short, heavily calcified chronic total occlusion of the right coronary artery. After wiring of the occlusion, S-IVL was used to predilated the calcified stenosis. During S-IVL, the patient developed ventricular fibrillation twice.

Conclusion
To our knowledge, this is only the second reported case of VF during S-IVL. Although very rare, it is important to be aware of this potential and serious complication.
An important issue of burnout among pre-hospital emergency medical personnel in Chengdu: a cross-sectional study
Authors: Liu ZhiJiang , Luo Li , Dai Hang , Zhang Bihua , Ma Lin , Xiang Tao 
Published: April 2024

Abstract
Objective
This survey aims to comprehensively understand occupational burnout among pre-hospital emergency medical personnel and explore associated risk factors.

Methods
A cross-sectional online survey using a census method was conducted between 15 July, 2023, and ends on 14 August, 2023, in Chengdu, SiChuan province, China. The questionnaire included general demographic information, the Maslach Burnout Inventory-General Survey (MBI-GS) with 15 items, and the Fatigue Scale-14 (FS-14) with 14 items. Univariate analysis was conducted on all variables, followed by multivariate logistic regression models to examine the associations between occupational burnout and the risk factors.

Results
A total of 2,299 participants,99.57% completed the survey effectively The participants were from 166 medical institutions in Chengdu, comprising 1,420 nurses (61.50%) and 889 clinical doctors (38.50%). A total of 33.36% participants experienced burnout, predominantly mild (30.27%), followed by moderate (2.78%) and severe (0.3%). Physicians, higher fatigue scores, age, work experience appeared to be related to burnout. Logistic regression models revealed that individuals aged over 50 were less prone to experience burnout compared to medical staff aged 18–30 (OR: 0.269, 95% CI: 0.115–0.627, p = 0.002). Physicians were more prone to experience burnout compared to nursing staff (OR: 0.690, 95% CI: 0.531–0.898, p = 0.006). Those with 0–5 years of experience were more prone to experience burnout compared to those with 6–10 years or over 15 years of experience (OR: 0.734, 95% CI: 0.547–0.986, p = 0.040; OR: 0.559, 95% CI: 0.339–0.924, p = 0.023). Additionally, for each 1-point increase in the fatigue score, the likelihood of burnout in medical staff increased by 1.367 times (OR: 1.367, 95% CI: 1.323–1.412, p < 0.0001).

Conclusion
Pre-hospital emergency medical personnel demonstrate a notable prevalence of mild job burnout. These results provide a groundwork for future focus on the various stages of job burnout within pre-hospital emergency staff, alerting hospital and departmental managers to promptly address the mental well-being of their personnel and intervene as needed.
Realization path and connotation of the Healthy China strategy: macroscopic perspective of dietary structure and the entry of individual health consciousness
Authors: Zhu Xiaohua , Zhang Yan , Zhu Yuanyuan , Guo Youhua , Zhang Yunjin , Wen Bin 
Published: April 2024

Abstract
Background
Dietary rationality and health concept have certain influence on individual health level. This study aims to explore the characteristics and existing problems of Chinese residents’ health behaviors from both macro and micro perspectives, and explore the feasibility and realization path of Healthy China strategy.

Methods
We utilized regression models to evaluate the correlation between diet and the risk of disease causes of death. By use of the linear regression analysis model, we distinguished the impact of each dimension on health literacy index at the individual level. Then, we explored the influential factors of the diet health index using the binary logit regression model.

Results
Increased consumption of animal-derived foods in China has contributed to the burden of non-communicable diseases. The individuals’ health awareness is still weak, and the health literacy index is greatly affected by the diet, while the individual gender and age are positively correlated with the diet health index, and the individual body mass index (BMI) level is negatively correlated with the diet health index.

Conclusions
This study provided a comprehensive understanding of existing problems of Chinese residents’ health behaviors. We have proposed a path model for the implementation of the Healthy China strategy from the perspectives of “diet health, physical health, conceptual health and environmental health,” which is also a great contribution to the world.
The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey
Authors: Yıldız Nadire Gülçin , Aydin Halide Z. , Sambo Grace , Aydın Kemal , Yıldız Hatice , Santri Ichtiarini Nurullita , Wardani Yuniar , Mwamulima Bwanalori , Isni Khoiriyah , Phiri Yohane V. A. 
Published: April 2024

Abstract
Background
Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70–84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability.

Methods
This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender.

Results
We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45–1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61–2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23–2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67–20.10)] of the association between women having a higher likelihood of low back pain compared to men.

Conclusion
We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.
Association between area-level walkability and glycated haemoglobin: a Portuguese population-based study
Authors: Sá Regina , Roquette Rita , Rebecchi Andrea , Matias Judite , Rocha Jorge , Buffoli Maddalena , Capolongo Stefano , Ribeiro Ana Isabel , Nunes Baltazar , Dias Carlos , Sousa Uva Mafalda 
Published: April 2024

AbstractDiabetes poses a substantial disease burden, prompting preventive interventions. Physical inactivity, a major risk factor for type 2 diabetes, can potentially be mitigated by enhancing area-level walkability. Despite this, limited population-based studies have investigated the link between walkability and objective diabetes measures. Our study aims to estimate the association between area-level walkability and individual glycated haemoglobin levels in the Portuguese adult population without the diagnosis of diabetes. Data from the 2011 census and an updated street map were obtained to construct a walkability index based on residential density, land-use mix, and street connectivity. Individual health data were sourced from The National Health Examination Survey (INSEF) 2015, a representative survey of the Portuguese adult population. Gamma regression was employed for estimation of the main associations, revealing that residing in moderately walkable areas significantly reduced average glycated haemoglobin levels (Exp(β) = 0.906; 95% CI: 0.821, 0.999) compared to the least walkable areas. The association was less pronounced and not statistically significant for the third tertile of walkability (Exp(β) = 0.919; 95% CI: 0.822, 1.028). Our findings highlight a nonlinear protective association between walkability and glycated haemoglobin, emphasizing the potential policy implications for urban planning, diabetes prevention, and health promotion.
Investigating and analyzing the current situation and factors influencing chronic neck, shoulder, and lumbar back pain among medical personnel after the epidemic
Authors: Wang Ansu , Zhou Yufeng , Li Xuyan , Wang Weiqun , Zhao Xu , Chen Ping , Liao Wenbo 
Published: April 2024

Abstract
Background
Chronic shoulder and neck pain is one of the most common chronic occupational disorders, with an average incidence rate of 48.5%, severely affecting patients’ quality of life and ability to work. According to epidemiological research, the prevalence of chronic neck, shoulder, and low back pain in adults over the age of 45 ranges from 40 to 80%. According to reports, medical staff have a higher incidence rate than other populations, and there is a positive correlation between the grade of the medical institution and the incidence rate, making medical staff a priority group for the prevention of chronic neck, shoulder, and low back pain. By the end of 2022, China has been fully opened to epidemic prevention and control, the total number of patients in domestic hospitals has increased significantly, and resulting in medical personnel shoulting great pressure, which seriously affects the physical and mental health of medical personnel. The aim of this study was to explore the risk factors of chronic neck, shoulder and lumbar back pain in medical staff. To provide guidelines for medical staff to improve cervical and lumbar subacute pain and reduce the emergence of spinal lesions.

Methods
From January to February 2023, 602 staff members of a third-grade hospital in Zunyi City were studied by Questionnaire star. Univariate and multivariate Logistic regression were used to analyze the independent risk factors of chronic neck, shoulder and lumbar back pain in medical staff, with stepwise regression utilized to choose the optimum model. The model was selected using Akaike’s information criterion (AIC) and the Hosmer-Lemeshow goodness-of-fit test.

Results
A total of 602 medical staff were polled, and the findings revealed that 588 cases of chronic neck, shoulder, and low back pain of varied severity had occurred in the previous 1 to 2 years, with a 97.7% incidence rate; logistic regression analysis revealed that anxiety level, frequency of bending over in the previous 1 to 2 years, whether related preventive measures were taken at work, gender, positive senior title, daily ambulation time, and whether the department they worked in organized independent influencing factors.

Conclusion
The incidence of chronic neck, shoulder, and lumbar back pain among medical staff is high; its influencing factors are different and have not been systematically identified. Hospitals should take effective measures tailored to local conditions to improve the physical and mental health of medical staff.
The effectiveness of instrument-assisted soft tissue mobilization on range of motion: a meta-analysis
Authors: Tang Sien , Sheng Li , Xia Jinming , Xu Bing , Jin Peiyong 
Published: April 2024

Abstract
Background
To evaluate the effectiveness of instrument-assisted soft tissue mobilization (IASTM) on range of motion (ROM).

Methods
We performed a literature search of the PubMed, Embase, Web of Science, and Cochrane Library databases from inception to December 23, 2023. Randomized controlled trials that compared treatment groups receiving IASTM to controls or IASTM plus another treatment(s) to other treatment(s) among healthy individuals with or without ROM deficits, or patients with musculoskeletal disorders were included. The Cochrane risk of bias tool was used to assess the risk of bias.

Results
Nine trials including 450 participants were included in the quantitative analysis. The IASTM was effective in improving ROM in degree in healthy individuals with ROM deficits and patients with musculoskeletal disorders (n=4) (MD = 4.94, 95% CI: 3.29 to 6.60), and in healthy individuals without ROM deficits (n=4) (MD = 2.32, 95% CI: 1.30 to 3.34), but failed to improve ROM in centimeter in healthy individuals with ROM deficits (n=1) (MD = 0.39, 95% CI: -1.34 to 2.11, p=0.66, I2 = 88%).

Conclusions
IASTM can improve ROM in degree in healthy individuals with or without ROM deficits, or in patients with musculoskeletal disorders (with very low to low certainty).

Trial registration
The PROSPERO registration ID is CRD42023425200.