bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Mixed-Methods Cohort Study Evaluating the Impact of a One-Day Well-Being Course for Anesthesia Providers Working in Low-Resource Settings
Authors: Bailey Jonathan G. , Mossenson Adam I. , Whynot Sara , Nyirigira Gaston , Gower Shelley , Livingston Patricia 
Published: February 2024

BACKGROUND:
Burnout, depression, and anxiety are increasingly recognized as common among health care providers. Risks for these conditions are exacerbated in low-resource settings by excessive workload, high disease burden, resource shortage, and stigma against mental health issues. Based on discussions and requests to learn more about burnout during the Vital Anaesthesia Simulation Training (VAST), our team developed VAST Wellbeing, a 1-day course for health care providers in low-resource settings to recognize and mitigate burnout and to promote personal and professional well-being.

METHODS:
This mixed-methods study used quantitative pre- and postcourse surveys using validated mental health measures and qualitative semistructured interviews to explore participants’ experience of VAST Wellbeing during and after the course. Quantitative outcomes included burnout and professional fulfillment as measured by the Professional Fulfillment Index and general well-being as measured by the Warwick–Edinburgh Mental Wellbeing Scale.

RESULTS:
Twenty-six participants from 9 countries completed the study. In the immediate postcourse survey, study participants rated the course overall as “very good” (60.7%) and “excellent” (28.6%). Quantitative analysis showed no statistical differences in levels of work exhaustion, interpersonal disengagement, burnout, professional fulfillment, or general mental well-being 2 months after the course. Five themes on the impact of VAST Wellbeing were identified during qualitative analysis: (1) raising awareness, breaking taboos; (2) not feeling alone; (3) permission and capacity for personal well-being; (4) workplace empowerment; and (5) VAST Wellbeing was relevant, authentic, and needed.

CONCLUSIONS:
Causes of burnout are complex and multidimensional. VAST Wellbeing did not change measures of burnout and fulfillment 2 months postcourse but did have a meaningful impact by raising awareness, reducing stigma, fostering connection, providing skills to prioritize personal well-being, and empowering people to seek workplace change.
Anterior vs Posterior Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network
Authors: Evaniew Nathan , Bailey Christopher S. , Rampersaud Y. Raja , Jacobs W. Bradley , Phan Philippe , Nataraj Andrew , Cadotte David W. , Weber Michael H. , Thomas Kenneth C. , Manson Neil , Attabib Najmedden , Paquet Jerome , Christie Sean D. , Wilson Jefferson R. , Hall Hamilton , Fisher Charles G. , McIntosh Greg , Dea Nicolas 
Published: February 2024

BACKGROUND AND OBJECTIVES:The advantages and disadvantages of anterior vs posterior surgical approaches for patients with progressive degenerative cervical myelopathy (DCM) remain uncertain. Our primary objective was to evaluate patient-reported disability at 1 year after surgery. Our secondary objectives were to evaluate differences in patient profiles selected for each approach in routine clinical practice and to compare neurological function, neck and arm pain, health-related quality of life, adverse events, and rates of reoperations.METHODS:We analyzed data from patients with DCM who were enrolled in an ongoing multicenter prospective observational cohort study. We controlled for differences in baseline characteristics and numbers of spinal levels treated using multivariable logistic regression. Adverse events were collected according to the Spinal Adverse Events Severity protocol.RESULTS:Among 559 patients, 261 (47%) underwent anterior surgery while 298 (53%) underwent posterior surgery. Patients treated posteriorly had significantly worse DCM severity and a greater number of vertebral levels involved. After adjusting for confounders, there was no significant difference between approaches for odds of achieving the minimum clinically important difference for the Neck Disability Index (odds ratio 1.23, 95% CI 0.82 to 1.86,P= .31). There was also no significant difference for change in modified Japanese Orthopedic Association scores, and differences in neck and arm pain and health-related quality of life did not exceed minimum clinically important differences. Patients treated anteriorly experienced greater rates of dysphagia, whereas patients treated posteriorly experienced greater rates of wound complications, neurological complications, and reoperations.CONCLUSION:Patients selected for posterior surgery had worse DCM and a greater number of vertebral levels involved. Despite this, anterior and posterior surgeries were associated with similar improvements in disability, neurological function, pain, and quality of life. Anterior surgery had a more favorable profile of adverse events, which suggests it might be a preferred option when feasible.
Novel Use of Bilateral Prone Transpsoas Approach for the Treatment of Transforaminal Interbody Fusion Pseudarthrosis and Interbody Cage Subsidence
Authors: Farber S. Harrison , Ehresman Jeff , Lee Bryan S. 
Published: February 2024

BACKGROUND AND OBJECTIVES:
Pseudarthrosis is a complication after transforaminal lumbar interbody fusion (TLIF) that leads to recurrent symptoms and potential revision surgery. Subsidence of the interbody adds to the complexity of surgical revision. In addition, we report a novel technique for the treatment of TLIF pseudarthrosis with subsidence and propose an approach algorithm for TLIF cage removal.

METHODS:
Cases of reoperation for TLIF pseudarthrosis were reviewed. We report a novel technique using a bilateral prone transpsoas (PTP) approach to remove a subsided TLIF cage and place a new lateral cage. An approach algorithm was developed based on the experience of TLIF cage removal. The patient was placed in the prone position with somatosensory evoked potential and electromyography monitoring. A PTP retractor was placed using standard techniques on the ipsilateral side of the previous TLIF. After the discectomy, the subsided TLIF cage was visualized but unable to be removed. The initial dilator was closed, and a second PTP retractor was placed on the contralateral side. After annulotomy and discectomy to circumferentially isolate the subsided cage, a box cutter was used to push and mobilize the TLIF cage from this contralateral side, which could then be pulled out from the ipsilateral side. A standard lateral interbody cage was then placed.

RESULTS:
Retractor time was less than 10 minutes on each side. The patient's symptoms resolved postoperatively. We review illustrative cases of various approaches for TLIF cage removal spanning the lumbosacral spine and recommend an operative approach based on the lumbar level, degree of subsidence, and mobility of the interbody.

CONCLUSION:
Bilateral PTP retractors for TLIF cage removal may be effectively used in cases of pseudarthrosis with severe cage subsidence. Careful consideration of various factors, including patient surgical history, body habitus, and intraoperative findings, is essential in determining the appropriate treatment for these complex cases.
Blood Test–Based Age Acceleration Is Inversely Associated with High-Volume Sports Activity
Authors: JUHÁSZ VENCEL , ORSZÁG ANNA , BALLA DOROTTYA , SZABÓ LILIÁNA , SYDÓ NÓRA , KISS ORSOLYA , CSULAK EMESE , BABITY MÁTÉ , DOHY ZSÓFIA , SKODA RÉKA , BECKER DÁVID , MERKELY BÉLA , BENCZÚR ANDRÁS , VÁGÓ HAJNALKA , KEREPESI CSABA 
Published: February 2024

ABSTRACT

Purpose
We develop blood test–based aging clocks and examine how these clocks reflect high-volume sports activity.

Methods
We use blood tests and body metrics data of 421 Hungarian athletes and 283 age-matched controls (mean age, 24.1 and 23.9 yr, respectively), the latter selected from a group of healthy Caucasians of the National Health and Nutrition Examination Survey (NHANES) to represent the general population (n = 11,412). We train two age prediction models (i.e., aging clocks) using the NHANES dataset: the first model relies on blood test parameters only, whereas the second one additionally incorporates body measurements and sex.

Results
We find lower age acceleration among athletes compared with the age-matched controls with a median value of −1.7 and 1.4 yr, P < 0.0001. BMI is positively associated with age acceleration among the age-matched controls (r = 0.17, P < 0.01) and the unrestricted NHANES population (r = 0.11, P < 0.001). We find no association between BMI and age acceleration within the athlete dataset. Instead, age acceleration is positively associated with body fat percentage (r = 0.21, P < 0.05) and negatively associated with skeletal muscle mass (Pearson r = −0.18, P < 0.05) among athletes. The most important blood test features in age predictions were serum ferritin, mean cell volume, blood urea nitrogen, and albumin levels.

Conclusions
We develop and apply blood test–based aging clocks to adult athletes and healthy controls. The data suggest that high-volume sports activity is associated with slowed biological aging. Here, we propose an alternative, promising application of routine blood tests.
Immediate effects of circular trunk movements on reach distance and centre of pressure distance during a multidirectional seated reach task in participants with post-stroke hemiparesis: a non-randomised controlled trial
Authors: Nabeya Ryohei , Fujii Hiromi , Sato Toshiaki 
Published: February 2024

Background/Aims Sitting balance training is an important therapeutic tool used by physical and occupational therapists who work with patients with hemiparesis, many of whom have difficulty shifting their weight while sitting. This study assessed the immediate effects of circular trunk movements on the maximum reach distance and the centre of pressure distance that could be achieved during a multidirectional reach task in participants with post-stroke hemiparesis and healthy individuals as a control group. Methods This non-randomised controlled study included 26 participants with hemiparesis and 10 age-matched control participants. A functional reach apparatus, body pressure distribution measuring system and digital video camera were used to measure multidirectional reach, centre of pressure trajectories and circular trunk movements. The participants completed the assessments in the following order: multidirectional reach, circular trunk movements and repeat multidirectional reach. The authors classified the centre of pressure trajectories into type A (oval) and type B (non-oval) tracings according to the shape displayed by the circular trunk movements, which corresponded to the level of trunk function. The reach distance and centre of pressure distance before and after the circular trunk movements were compared. Results The reach distance and centre of pressure distance values in the front direction of participants with hemiparesis who exhibited type A tracings and had higher trunk function were significantly greater after completing circular trunk movements. In contrast, the reach distance and centre of pressure distance values of participants in all directions who exhibited type B tracings and had lower trunk function were significantly greater after completing circular trunk movements. Conclusions Circular trunk movements appeared to affect both reach distance and centre of pressure distance, particularly in participants with hemiparesis with type B tracings and lower trunk function. Implications for practice Physical and occupational therapists could incorporate circular trunk movements into rehabilitation programmes to help individuals with post-stroke hemiparesis improve their reach distance, trunk function and ability to shift their weight while sitting.
Clinical risk factors of recurrent kidney stone disease: a cohort retrospective study in a tertiary referral hospital
Authors: Atmoko Widi , Febriyani  , Savitri Ary Indriana , Uiterwaal Cuno , Setiati Siti , Hamid Agus Rizal Ardy Hariandy , Birowo Ponco , Rasyid Nur 
Published: February 2024

BACKGROUND Nephrolithiasis or kidney stone disease (KSD) is common worldwide. Despite various effective treatment strategies, KSD recurrence remains a problem. This study aimed to investigate the risk factors of KSD recurrence.
METHODS This retrospective cohort study used medical records of all patients who came to the Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, from January 2014 to December 2019, with asymptomatic and symptomatic KSD. Demographic information, clinical data, exposure to risk factors, and recurrent KSD diagnosis were collected. Univariate and multivariate analyses using logistic regression were performed to determine the significant risk factors.
RESULTS We reported 325 patients with a median age of 52 years. More than half of the patients were males and from Java. Staghorn stone dominated the KSD types found in 181 patients (55.7%). After undergoing percutaneous nephrolithotomy, 214 patients (65.8%) became stone-free. However, about 40.6% of them later developed recurrent KSD. The adjusted odds ratio in recurrent KSD were 1.46 (95% confidence interval [CI] 1.33–1.59) for younger age, 1.86 (95% CI 1.61–2.07) for overweight–obese, 2.13 (95% CI 1.89–2.31) for less fluid intake, 1.81 (95% CI 0.97–2.12) for routine tea consumption, 1.24 (95% CI 1.06–1.84) for routine vegetables consumption, 2.27 (95% CI 1.83–2.84) for a family history of KSD, and 2.08 (95% CI 1.77–2.39) for diabetes mellitus (DM).
CONCLUSIONS Most patients with recurrent KSD were younger, overweight/obese, had less fluid intake, a family history of KSD, and DM. Modifying a healthy lifestyle and a balanced diet is important to prevent KSD recurrence.
Left ventricle function and post-transcriptional events with exercise training in pigs
Authors: Samani Stephanie L. , Barlow Shayne C. , Freeburg Lisa A. , Jones Traci L. , Poole Marlee , Sarzynski Mark A. , Zile Michael R. , Shazly Tarek , Spinale Francis G. 
Published: February 2024

Background
Standardized exercise protocols have been shown to improve overall cardiovascular fitness, but direct effects on left ventricular (LV) function, particularly diastolic function and relation to post-transcriptional molecular pathways (microRNAs (miRs)) are poorly understood. This project tested the central hypothesis that adaptive LV remodeling resulting from a large animal exercise training protocol, would be directly associated with specific miRs responsible for regulating pathways relevant to LV myocardial stiffness and geometry.

Methods and results
Pigs (n = 9; 25 Kg) underwent a 4 week exercise training protocol (10 degrees elevation, 2.5 mph, 10 min, 5 days/week) whereby LV chamber stiffness (KC) and regional myocardial stiffness (rKm) were measured by Doppler/speckle tracking echocardiography. Age and weight matched non-exercise pigs (n = 6) served as controls. LV KC fell by approximately 50% and rKm by 30% following exercise (both p < 0.05). Using an 84 miR array, 34 (40%) miRs changed with exercise, whereby 8 of the changed miRs (miR-19a, miR-22, miR-30e, miR-99a, miR-142, miR-144, miR-199a, and miR-497) were correlated to the change in KC (r ≥ 0.5 p < 0.05) and mapped to matrix and calcium handling processes. Additionally, miR-22 and miR-30e decreased with exercise and mapped to a localized inflammatory process, the inflammasome (NLRP-3, whereby a 2-fold decrease in NLRP-3 mRNA occurred with exercise (p < 0.05).

Conclusion
Chronic exercise reduced LV chamber and myocardial stiffness and was correlated to miRs that map to myocardial relaxation processes as well as local inflammatory pathways. These unique findings set the stage for utilization of myocardial miR profiling to identify underlying mechanisms by which exercise causes changes in LV myocardial structure and function.
Ultra-Processed Food, Disease Activity, and Inflammation in Ulcerative Colitis: The Manitoba Living With IBD Study
Authors: Vagianos Kathy , Dolovich Casandra , Witges Kelcie , Graff Lesley A. , Bernstein Charles N. 
Published: February 2024

INTRODUCTION:
The purpose of this study was to investigate the relationship between ultra-processed food (UPF) consumption and (i) symptomatic disease and (ii) intestinal inflammation among adults with inflammatory bowel disease (IBD).

METHODS:
We identified participants (Crohn's disease [CD] and ulcerative colitis [UC]) from the Manitoba Living with IBD study. Active disease was defined using the IBD Symptom Inventory (score >14 for CD; >13 for UC); fecal calprotectin was measured for intestinal inflammation (>250 μg/g). Diet data were collected using the Harvard Food Frequency Questionnaire. UPF consumption was determined by the NOVA classification system. Percentage of energy consumption from UPFs was calculated and divided into 3 tertiles (T1 = low; T3 = high). Multiple linear regression analysis was used for active disease and inflammation predicted by UPF consumption.

RESULTS:
Among 135 participants (65% with CD), mean number of episodes of active disease (14.2 vs 6.21) and active inflammation (1.6 vs 0.6) was significantly higher among participants with UC in T3 compared with T1 of UPF consumption (P < 0.05). When adjusting for age, sex, disease type, and duration, number of episodes of active disease was lower in T1 compared with T3 (β = −7.11, P = 0.02); similarly, number of episodes of intestinal inflammation was lower in T1 (β = −0.95, P = 0.03). No significant differences were observed among participants with CD.

DISCUSSION:
UPF consumption may be a predictor of active symptomatic disease and inflammation among participants with UC. Reducing UPF consumption is a dietary strategy that can be suggested for minimizing symptoms and inflammation among people living with IBD.
Rates of Adverse Events in Patients With Ulcerative Colitis Undergoing Colectomy During Treatment With Tofacitinib vs Biologics: A Multicenter Observational Study
Authors: Dragoni Gabriele , Innocenti Tommaso , Amiot Aurelién , Castiglione Fabiana , Melotti Laura , Festa Stefano , Savarino Edoardo Vincenzo , Truyens Marie , Argyriou Konstantinos , Noviello Daniele , Molnar Tamas , Bouillon Vincent , Bezzio Cristina , Eder Piotr , Fernandes Samuel , Kagramanova Anna , Armuzzi Alessandro , Oliveira Raquel , Viola Anna , Ribaldone Davide Giuseppe , Drygiannakis Ioannis , Viganò Chiara , Calella Francesca , Gravina Antonietta Gerarda , Pugliese Daniela , Chaparro María , Ellul Pierre , Vieujean Sophie , Milla Monica ,   the “TOFA-poSTOP” Study Group, Caprioli Flavio 
Published: February 2024

INTRODUCTION:
Patients with ulcerative colitis (UC) receiving immunosuppressive drugs are at substantial risk of colectomy. We aimed to assess the risk of postoperative complications of tofacitinib exposure before colectomy in comparison with biologics.

METHODS:
A multicenter, retrospective, observational study was conducted in patients with UC who underwent total colectomy for medically refractory disease, exposed to tofacitinib or a biologic before surgery. Primary outcome was the occurrence of any complication within 30 (early) and 90 (late) days after surgery. Secondary outcomes were the occurrence of infections, sepsis, surgical site complications, venous thromboembolic events (VTE), hospital readmissions, and redo surgery within the same timepoints.

RESULTS:
Three hundred one patients (64 tofacitinib, 162 anti-tumor necrosis factor-α agents, 54 vedolizumab, and 21 ustekinumab) were included. No significant differences were reported in any outcome, except for a higher rate of early VTE with anti-tumor necrosis factor-α agents (P = 0.047) and of late VTE with vedolizumab (P = 0.03). In the multivariate analysis, drug class was not associated with a higher risk of any early and late complications. Urgent colectomy increased the risk of any early (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.06–3.48) complications, early hospital readmission (OR 4.79, 95% CI 1.12–20.58), and early redo surgery (OR 7.49, 95% CI 1.17–47.85). A high steroid dose increased the risk of any early complications (OR 1.96, 95% CI 1.08–3.57), early surgical site complications (OR 2.03, 95% CI 1.01–4.09), and early redo surgery (OR 7.52, 95% CI 1.42–39.82). Laparoscopic surgery decreased the risk of any early complications (OR 0.54, 95% CI 0.29–1.00), early infections (OR 0.39, 95% CI 0.18–0.85), and late hospital readmissions (OR 0.34, 95% CI 0.12–1.00).

DISCUSSION:
Preoperative tofacitinib treatment demonstrated a postoperative safety profile comparable with biologics in patients with UC undergoing colectomy.
Levels and types of physical activity in Russia according to the ESSE-RF study: is there a trace of the COVID-19 pandemic?
Authors: Kotova M. B. , Maksimov S. A. , Shalnova S. A. , Kontsevaya A. V. , Balanova Yu. A. , Imaeva A. E. , Kutsenko V. A. , Muromtseva G. A. , Karamnova N. S. , Evstifeeva S. E. , Kapustina A. V. , Litinskaya O. A. , Pokrovskaya M. S. , Yarovaya E. B. , Repkina T. V. , Gonoshilova T. O. , Kudryavtsev A. V. , Belova N. I. , Shagrov L. L. , Samotrueva M. A. , Yasenyavskaya A. L. , Chernysheva E. N. , Glukhovskaya S. V. , Levina I. A. , Shirshova E. A. , Dorzhieva E. B. , Urbanova E. Z. , Borovkova N. Yu. , Kurashin V. K. , Tokareva A. D. , Ragino Yu. I. , Simonova G. I. , Khudyakova A. D. , Nikulin V. N. , Aslyamov O. R. , Khokhlova G. V. , Solovyova A. V. , Rodionov A. A. , Kryachkova O. V. , Shamurova Yu. Yu. , Tantsyreva I. V. , Baryshnikova I. N. , Ataev M. G. , Radjabov M. O. , Isakhanova M. M. , Umetov M. A. , Elgarova L. V. , Khakuasheva I. A. , Yamashkina E. I. , Esina M. V. , Kunyaeva T. A. , Nikitina A. M. , Savvina N. V. , Spiridonova Yu. E. , Naumova E. A. , Keskinov A. A. , Yudin V. S. , Yudin S. M. , Drapkina O. M. 
Published: February 2024

Aim. To study levels and types of physical activity, as well as its individual socio-demographic and seasonal determinants in the Russian population according to the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study.Material and methods. Data from the ESSE-RF2 (2017) and ESSERF3 (2020-2022) was used. The sample included 28731 men and women aged 35-74 from 15 regions. The level of physical activity was assessed using the Global physical activity questionnaire (GPAQ). The following socio-economic and demographic characteristics were taken as covariates: sex, age, place of residence (urban and rural), level of education, marital status, work characteristics, income level, season of the year. Statistical analysis was performed using SPSS version 22 (IBM Corp. USA).Results. The study showed that 27,4% of the sample have insufficient physical activity. Among the low physical activity category, there are more women than men (28,12 vs 26,7%, p<0,001); among men, high physical activity was more often identified (24,1 vs 18,3%, p<0,001). Compared to the urban population, rural residents have higher physical activity rates (23,9 vs 20,3%, p<0,001). The proportion of people with high physical activity is also higher among people with higher income levels (p<0,001). General physical activity in men is higher compared to women, due to work and recreational activity, but transport-related physical activity is significantly higher in women. From 2017 to 20202022, the population level of physical activity decreased.Conclusion. This study provides the most complete description of Russian patterns of physical activity and shows the areas of necessary intervention for the development of measures and programs aimed at increasing physical activity of Russian population.