bluuebunny/crossref_metadata_2025_split huggingface dataset:
Live dietary microbes and reduced prevalence of periodontitis: A cross‐sectional study
Authors: Lin Jie , Yang Hui , Lin Zhengshen , Xu Lingqiao 
Published: January 2024

AbstractObjectiveInvestigate the link between live dietary microbe consumption and the prevalence of periodontitis.Methods and MaterialsNational health and nutrition examination survey (2009–2014) data was used to assess the association among adults. Live dietary microbe intake was categorized as low or medium to high. Regression models were employed to assess this association, adjusting for demographic variables and other covariates. Examined dose–response relationship and conducted subgroup analyses by ethnicity, age and gender. Multiplicative interactions were evaluated using likelihood ratio tests.ResultsThe analysis included 8574 participants. After adjusting for various factors including age, gender, ethnicity, dietary habits, dietary inflammatory index, alcohol consumption, smoking status, hypertension, diabetes mellitus and oral health behaviors, individuals with daily intake of medium to high levels of live dietary microbes showed a significantly reduced risk of periodontitis compared to those who did not consume such microbes with a dose–response trend (p for trend <0.0001, p < 0.01). Significant differences in the impact of live microbe intake on periodontitis were also observed across different age groups in all Models (p for interaction ≤0.05).ConclusionMedium to high live dietary microbe consumption independently correlates with lower periodontitis risk, irrespective of traditional risk factors and demographics.
Single operator experience, learning curve, outcomes, and insights gained with conduction system pacing
Authors: Marion William , Schanz John D. , Patel Sonali , Co Michael Lawrenz , Pavri Behzad B. 
Published: January 2024

AbstractBackgroundConduction system pacing (CSP) is increasingly utilized to prevent and correct dyssynchrony. Barriers to CSP adoption include limited training, methodologic variability, laboratory slot allocation, and few data on learning curves. We report learning curves/clinical outcomes from a single experienced electrophysiologist who was new to CSP, and share gained insights.MethodsRetrospective analysis of all patients who underwent attempted CSP implantation (2016–2023). Patient characteristics, ECGs, echocardiograms, fluoroscopy/procedure times, lead data were recorded at implant and follow‐up.ResultsCSP leads were implanted successfully in 167/191(87.4%) patients with a follow‐up of 278 ± 378 days. His‐bundle pacing (HBP = 59) and left‐bundle‐area pacing (LBAP = 108) had similar procedure/fluoroscopy times, QRS duration decreases, and ejection fraction improvements (all p > NS). Eight HBP lead revisions were required for high capture thresholds LBAP demonstrated lower pacing thresholds, higher lead impedances, and greater R‐wave amplitudes at implant and follow‐up. After 25 HBP cases, implant pacing thresholds, fluoroscopy, procedural times did not decrease. After 25 LBAP cases, there were significant decreases in all these parameters (p < 0.05). A separate analysis in LBAP patients with recorded Purkinje signals showed no differences in paced ECG characteristics between patients with pre‐ QRS Purkinje signals versus patients with Purkinje signals post‐QRS onset.ConclusionsExperienced implanters who are new to CSP can achieve steady‐state procedural/fluoroscopy times after a learning curve of 25 implants. LBAP showed lower capture thresholds and higher success rates. Adequate depth of lead deployment (as determined by published parameters) does not require Purkinje potential to be pre‐QRS. Operators new to CSP.can forego HBP and directly implement LBAP.
A short RP tachycardia in congenitally corrected transposition. What is the mechanism?
Authors: Bhargav Anish , Sukumaran Suresh Kumar , Balaguru Sridhar , Selvaraj Raja J. 
Published: January 2024

AbstractA 51‐year‐old female with congenitally corrected transposition of great arteries (CCTGA), situs solitus, dextrocardia, atrial septal defect and persistent left superior vena cava underwent electrophysiology study for recurrent palpitations with documented narrow complex, short RP tachycardia. With a catheter in the region of the anterior mitral annulus, a His signal was recorded and HV interval was 35 msec. Tachycardia was induced with a ventricular extrastimulus. During the tachycardia there was 1:1 ventriculo‐atrial conduction and central atrial activation with a VA interval of 20 msec. The recorded His signal could be seen after the QRS. What is the mechanism of the tachycardia?
Protamine dosing and its impact in cardiac surgery transfusion practice—A retrospective bi‐institutional analysis
Authors: Mondal Samhati , Abuelkasem Ezeldeen , Vesselinov Roumen , Henderson Reney , Choi Seung , Mousa Ahmad , Zaza Khaled J. , Tanaka Kenichi A. 
Published: January 2024

AbstractBackgroundBleeding after cardiac surgery is common and continues to require 10–20% of the national blood supply. Transfusion of allogeneic blood is associated with increased morbidity and mortality. Excessive protamine in the absence of circulating heparin after weaning off CPB can cause anticoagulation and precipitate bleeding. Hence, adequate dose calculation of protamine is crucial yet under evaluated.Study DesignRetrospective cohort study.MethodsWe conducted a retrospective bi‐institutional analysis of cardiac surgical patients who underwent cardiopulmonary bypass (CPB)‐assisted cardiac surgery to assess the impact of protamine dosing in transfusion practice. Total 762 patients were identified from two institutions using electronic medical records and the Society of Thoracic Surgery (STS) database who underwent cardiac surgery using CPB. Patients were similar in demographics and other baseline characteristics. We divided patients into two groups based on mg of protamine administered to neutralize each 100 U of unfractionated heparin (UFH)—low‐ratio group (Protamine: UFH ≤ 0.8) and high‐ratio group (Protamine: UFH > 0.8).ResultsWe observed a higher rate of blood transfusion required in high‐ratio group (ratio >0.8) compared with low‐ratio group (ratio ≤0.8) (p < .001). The increased requirement was consistently demonstrated for intraoperative transfusions of red blood cells, plasma, platelets, and cryoprecipitate.ConclusionHigh protamine to heparin ratio may cause increased bleeding and transfusion in cardiac surgical patients. Protamine to heparin ratio of 0.8 or lower is sufficient to neutralize circulating heparin after weaning off cardiopulmonary bypass.
Phylogenetic relationships among horseshoe bats within the Rhinolophus ferrumequinum group (Mammalia, Chiroptera)
Authors: Uvizl Marek , Kotyková Varadínová Zuzana , Benda Petr 
Published: January 2024

AbstractThe horseshoe bats of the Rhinolophus ferrumequinum group form a well‐defined lineage within the Afro‐Palaearctic clade of the genus Rhinolophus. The group currently comprises four species widely distributed across the Palaearctic and Afrotropic regions: R. bocharicus (Central Asia), R. clivosus (from northern Africa and the Levant through Arabian Peninsula and eastern Africa to southern Africa), R. ferrumequinum (from western Europe and northern Africa through the Balkans and Middle East to Central Asia and India) and R. nippon (southern and central China, Korea, and Japan). The broad ranges and geographical variations within these species have led to the proposal of numerous subspecies. The phylogenetic relationships and intraspecific variation of the R. ferrumequinum group were investigated using a genetic approach. One mitochondrial marker and five nuclear markers were sequenced and supplemented with available sequences for all four species of the group. Our study revealed five major lineages within the R. ferrumequinum group, resulting in the recognition of four currently known species and identification of a new species. The prior name available for this lineage/species is R. acrotis. The relationships between the lineages varied depending on the chosen marker, leaving the interspecific relations within the ferrumequinum group unresolved. In addition, the results indicated that R. clivosus experienced historic introgression from northern Africa and the Levant, resulting in replacement of its mtDNA by that of R. ferrumequinum. Together, this study introduces a new Rhinolophus species, which increases the number of species in the ferrumequinum group to five.
Developing a Computational Model of Lungs for Patients With Acute Respiratory Distress Syndrome
Authors: Chavan Chinmay , Zainab Asma , Banerjee Debjyoti 
Published: January 2024

Abstract
Acute respiratory distress syndrome (ARDS) is a condition secondary to direct or indirect insult to lungs, leading to acute respiratory failure, and is associated with high mortality. Majority of the ARDS patients require mechanical ventilation, which acts as double-edged sword. Ventilator induced lung injury (VILI) is considered secondary to high inspiratory pressure and cyclical opening during inspiration, and collapse during expiration as suggested by ARDS network clinical trials. Other mechanism for VILI exist secondary to heterogeneous ventilation. To enumerate these mechanisms leading to VILI, a computational fluids dynamics (CFD) study was performed in this study to explore the flow patterns and the pressure distribution in a human tracheobronchial airway model from third to sixth generation branches. The authors validated the computational methodology and analyzed the results to obtain velocity profiles in the primary and secondary flow directions. The study investigated the role of various flow velocities corresponding to Reynolds number (Re) from 100 to 2000 on the pressure drops along branches and bifurcation zones. The identification of secondary flow patterns was critical in understanding the development of asymmetric velocity profiles in the triple bifurcation geometry. The observed patterns in pressure drops and velocity profiles over the laminar flow regime pave the path toward further development of a numerical model to aid treatment for patients with ARDS.
Controversies in the management of anti-TNF therapy in patients with Crohn’s disease: a Delphi consensus
Authors: González-Lama Yago , Ricart Elena , Carpio Daniel , Bastida Guillermo , Ceballos Daniel , Ginard Daniel , Marin-Jimenez Ignacio , Menchen Luis , Muñoz Fernando 
Published: January 2024

BackgroundDespite research, there are still controversial areas in the management of Crohn’s disease (CD).ObjectiveTo establish practical recommendations on using anti-tumour necrosis factor (TNF) drugs in patients with moderate-to-severe CD.MethodsClinical controversies in the management of CD using anti-TNF therapies were identified. A comprehensive literature review was performed, and a national survey was launched to examine current clinical practices when using anti-TNF therapies. Their results were discussed by expert gastroenterologists within a nominal group meeting, and a set of statements was proposed and tested in a Delphi process.ResultsQualitative study. The survey and Delphi process were sent to 244 CD-treating physicians (response rate: 58%). A total of 14 statements were generated. All but two achieved agreement. These statements cover: (1) use of first-line non-anti-TNF biological therapy; (2) role of HLA-DQA1*05 in daily practice; (3) attitudes in primary non-response and loss of response to anti-TNF therapy due to immunogenicity; (4) use of ustekinumab or vedolizumab if a change in action mechanism is warranted; (5) anti-TNF drug level monitoring; (6) combined therapy with an immunomodulator.ConclusionThis document sought to pull together the best evidence, experts’ opinions, and treating physicians’ attitudes when using anti-TNF therapies in patients with CD.
The symptom to assessment pathway for suspected chronic limb-threatening ischaemia (CLTI) affects quality of care: a process mapping exercise
Authors: Atkins Eleanor , Kellar Ian , Birmpili Panagiota , Waton Sam , Li Qiuju , Johal Amundeep S , Boyle Jon R , Pherwani Arun D , Chetter Ian , Cromwell David A 
Published: January 2024

BackgroundDelays in the pathway from first symptom to treatment of chronic limb-threatening ischaemia (CLTI) are associated with worse mortality and limb loss outcomes. This study examined the processes used by vascular services to provide urgent care to patients with suspected CLTI referred from the community.MethodsVascular surgery units from various regions in England were invited to participate in a process mapping exercise. Clinical and non-clinical staff at participating units were interviewed, and process maps were created that captured key staff and structures used to create processes for referral receipt, triage and assessment at the units.ResultsTwelve vascular units participated, and process maps were created after interviews with 45 participants. The units offered multiple points of access for urgent referrals from general practitioners and other community clinicians. Triage processes were varied, with units using different mixes of staff (including medical staff, podiatrists and s) and this led to processes of varying speed. The organisation of clinics to provide slots for ‘urgent’ patients was also varied, with some adopting hot clinics, while others used dedicated slots in routine clinics. Service organisation could be further complicated by separate processes for patients with and without diabetes, and because of the organisation of services regionally into vascular networks that had arterial and non-arterial centres.ConclusionsFor referred patients with symptoms of CLTI, the points of access, triage and assessment processes used by vascular units are diverse. This reflects the local context and ingenuity of vascular units but can lead to complex processes. It is likely that benefits might be gained from simplification.
Utility of Goal Attainment Scaling (GAS) in evaluating a multicomponent exercise programme for community-dwelling pre-frail older adults
Authors: Fang Juan , Ren Jianping , Wang Jinjing , Qiu Xiantao , Zhang Shiyan , Yuan Shuang , Wu Liangfeng , Xie Lin , Yu Le 
Published: January 2024

ObjectivesThis study aimed to investigate the effectiveness of Goal Attainment Scaling (GAS) in assessing an intervention for pre-frail senior citizens. Additionally, the study aimed to explain how the GAS goals were established based on the International Classification of Functioning, Disability and Health (ICF) categories, including body function, activity and participation and environmental factors.MethodsIn this study, 220 pre-frail older adults were randomly selected to participate in a controlled trial. The intervention group engaged in multicomponent exercise three times a week, once at a community health service location and twice at home. The control group received advice on physical activity but did not have supervised exercise. Participants in both groups selected individualised GAS goals from 23 goals developed based on ICF by focus group discussion. The study used generalised estimating equations to analyse the differences between the groups.ResultsThe study included 144 participants, 72 in the exercise group and 72 in the control group. The top three individualised goals for all participants were vestibular functions (53.5%), pain management (43.1%) and lifting and carrying objects (31.9%). Both groups saw a significant increase in GAS scores at week 8 and week 24 of the intervention (p<0.05), but the exercise group showed a more significant improvement (p<0.05). The participants living alone were associated with lower postintervention improvements in the GAS scores. In contrast, the participants who were using a smartphone were likely to get higher postintervention improvements in the GAS scores.ConclusionsGAS can be a valuable tool for setting and evaluating individualised and meaningful goals in body functions, activity and participation and environmental factors. The multicomponent exercise interventions can help pre-frail older adults achieve their expected goals as measured by the GAS.
Trauma surgical skill sustainment at the University of Chicago AMEDD Military-Civilian Trauma Team Training Site: an observation report
Authors: Plackett Timothy P , Jaszczak Nicholas , Hampton David A , Prakash Priya , Cone Jennifer , Benjamin Andrew , Rogers Selwyn O , Wilson Kenneth 
Published: January 2024

BackgroundThe Army Medical Department (AMEDD) Military-Civilian Trauma Team Training (AMCT3) Program was developed to enhance the trauma competency and capability of the medical force by embedding providers at busy civilian trauma centers. Few reports have been published on the outcomes of this program since its implementation.MethodsThe medical and billing records for the two AMCT3 embedded trauma surgeons at the single medical center were retrospectively reviewed for care provided during August 2021 through July 2022. Abstracted data included tasks met under the Army’s Individual Critical Task List (ICTL) for general surgeons. The Knowledge, Skills, and Abilities (KSA) score was estimated based on previously reported point values for procedures. To assess for successful integration of the embedded surgeons, data were also abstracted for two newly hired civilian trauma surgeons.ResultsThe annual clinical activity for the first AMCT3 surgeon included 444 trauma evaluations and 185 operative cases. The operative cases included 80 laparotomies, 15 thoracotomies, and 15 vascular exposures. The operative volume resulted in a KSA score of 21 998 points. The annual clinical activity for the second AMCT3 surgeon included 424 trauma evaluations and 194 operative cases. The operative cases included 92 laparotomies, 8 thoracotomies, and 25 vascular exposures. The operative volume resulted in a KSA score of 22 799 points. The first civilian surgeon’s annual clinical activity included 453 trauma evaluations and 151 operative cases, resulting in a KSA score of 16 738 points. The second civilian surgeon’s annual clinical activity included 206 trauma evaluations and 96 operative cases, resulting in a KSA score of 11 156 points.ConclusionThe AMCT3 partnership at this single center greatly exceeds the minimum deployment readiness metrics established in the ICTLs and KSAs for deploying general surgeons. The AMEDD experience provided a deployment-relevant case mix with an emphasis on complex vascular injury repairs.
Can stepped collaborative care interventions improve post-traumatic stress disorder symptoms for racial and ethnic minority injury survivors?
Authors: Abu Khadija , Bedard-Gilligan Michelle , Moodliar Rddhi , Bulger Eileen M , Hernandez Alexandra , Knutzen Tanya , Shoyer Jake , Birk Navneet , Conde Cristina , Engstrom Allison , Ryan Paige , Wang Jin , Russo Joan , Zatzick Douglas F 
Published: January 2024

ObjectivesNo large-scale randomized clinical trial investigations have evaluated the potential differential effectiveness of early interventions for post-traumatic stress disorder (PTSD) among injured patients from racial and ethnic minority backgrounds. The current investigation assessed whether a stepped collaborative care intervention trial conducted at 25 level I trauma centers differentially improved PTSD symptoms for racial and ethnic minority injury survivors.MethodsThe investigation was a secondary analysis of a stepped wedge cluster randomized clinical trial. Patients endorsing high levels of distress on the PTSD Checklist (PCL-C) were randomized to enhanced usual care control or intervention conditions. Three hundred and fifty patients of the 635 randomized (55%) were from non-white and/or Hispanic backgrounds. The intervention included care management, cognitive behavioral therapy elements and, psychopharmacology addressing PTSD symptoms. The primary study outcome was PTSD symptoms assessed with the PCL-C at 3, 6, and 12 months postinjury. Mixed model regression analyses compared treatment effects for intervention and control group patients from non-white/Hispanic versus white/non-Hispanic backgrounds.ResultsThe investigation attained between 75% and 80% 3-month to 12-month follow-up. The intervention, on average, required 122 min (SD=132 min). Mixed model regression analyses revealed significant changes in PCL-C scores for non-white/Hispanic intervention patients at 6 months (adjusted difference −3.72 (95% CI −7.33 to –0.10) Effect Size =0.25, p<0.05) after the injury event. No significant differences were observed for white/non-Hispanic patients at the 6-month time point (adjusted difference −1.29 (95% CI −4.89 to 2.31) ES=0.10, p=ns).ConclusionIn this secondary analysis, a brief stepped collaborative care intervention was associated with greater 6-month reductions in PTSD symptoms for non-white/Hispanic patients when compared with white/non-Hispanic patients. If replicated, these findings could serve to inform future American College of Surgeon Committee on Trauma requirements for screening, intervention, and referral for PTSD and comorbidities.Level of evidenceLevel II, secondary analysis of randomized clinical trial data reporting a significant difference.Trial registration numberNCT02655354.
AMY Lorentz invariant parton cascade: the thermal equilibrium case
Authors: Kurkela Aleksi , Törnkvist Robin , Zapp Korinna 
Published: January 2024

AbstractWe introduce the parton cascade Alpaca, which evolves parton ensembles corresponding to single events according to the effective kinetic theory of QCD at high temperature formulated by Arnold, Moore and Yaffe by explicitly simulating elastic scattering, splitting and merging. By taking the ensemble average over many events the phase space density (as evolved by the Boltzmann equation) is recovered, but the parton cascade can go beyond the evolution of the mean because it can be turned into a complete event generator that produces fully exclusive final states including fluctuations and correlations. The parton cascade does not require the phase space density as input (except for the initial condition at the starting time). Rather, effective masses and temperature, which are functions of time and are defined as integrals over expressions involving the distribution function, are estimated in each event from just the parton ensemble of that event. We validate the framework by showing that ensembles sampled from a thermal distribution stay in thermal equilibrium even after running the simulation for a long time. This is a non-trivial result, because it requires all parts of the simulation to intertwine correctly.
Numerical and Scientific Investigation of Some Molecular Structures Based on the Criterion of Super Classical Average Assignments
Authors: Rajesh Kannan A. , Alessa Nazek , Loganathan K. , Pattanaik Balachandra 
Published: January 2024

Numbering a graph is a very practical and effective technique in science and engineering. Numerous graph assignment techniques, including distance-based labeling, topological indices, and spectral graph theory, can be used to investigate molecule structures. Consider the graph G, with the injection Ω from the node set to 1,2,…,∆, where ∆ is the sum of the number of nodes and links. Assume that the induced link assignment Ω∗ is the ceiling function of the average of root square, harmonic, geometric, and arithmetic means of the vertex labels of the end vertices of each edge. If the union of range of Ω of the node set and the range of Ω of the link set is the set 1,2,…,∆, then Ω is called a super classical average assignment (SCAA). This is known as the SCAA criterion. In this study, the graphical structures corresponding to chemical structures based on the SCAA criterion are demonstrated. The graphical depiction of chemical substances was first defined and second, the union of any number of cycles Cn, the tadpole graph, the graph extracted by identifying a line of any two cycles Cm and Cn, and the graph extracted by joining any two cycles by a path are all examined in this work.