bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nomogram for predicting echocardiogram prescription in outpatients: an analysis of the NAMCS database
Authors: Liu Yujian , Deng Yanhan , Wang Hongjie , Liu Wanjun , He Xingwei , Zeng Hesong 
Published: October 2023

Background and objectiveCardiovascular disease is the leading cause of morbidity and mortality globally. Echocardiography is a commonly used method for assessing the condition of patients with cardiovascular disease. However, little is known about the population characteristics of patients who are recommended for echocardiographic examinations.MethodsThe National Ambulatory Medical Care Survey was a cross-sectional survey previously undertaken in the USA. In this study, publicly accessible data from the National Ambulatory Medical Care Survey database (for 2007–2016 and 2018–2019; data for 2017 was not published) were utilized to create a nomogram based on significant risk predictors. The study was performed in accordance with the relevant guidelines and regulations stipulated in the National Ambulatory Medical Care Survey database. Patients were randomly assigned to one of two groups: training cohort or validation cohort. The latter was used to assess the reliability of the prediction nomogram. Decision curve analysis was performed to evaluate the net benefit. Propensity score matching analysis was used to evaluate the relevance of echocardiography to clinical decision-making.ResultsA total of 217,178 outpatients were enrolled. Multivariable logistic regression analysis demonstrated that hypertension, hyperlipidemia, coronary artery disease/ischemic heart disease/history of myocardial infarction, congestive heart failure, major reason for visit, metropolitan statistical area, cerebrovascular disease/history of stroke or transient ischemic attack, previously assessed, insurance, referred, diagnosis, and reason for visit were all predictors of echocardiogram prescription in outpatients. The reliability of the predictive nomogram was confirmed in the validation cohort. After propensity score matching, there was a significant difference in new cardiovascular agent prescriptions between the echocardiogram and no echocardiogram groups (P &lt; 0.01).ConclusionIn this cohort study, a nomogram based on the characteristics of outpatients was developed to predict the possibility of prescribing echocardiography. The echocardiogram group was more likely to be prescribed new cardiovascular agents. These findings may contribute to providing information about the gap between actual utilizations and guidelines and the actual outpatient practice, as well as meeting the needs of outpatients.
Isolated annuloplasty in elderly patients with secondary mitral valve regurgitation: short- and long-term outcomes with a less invasive approach
Authors: Oezpeker Ulvi Cenk , Hoefer Daniel , Barbieri Fabian , Gollmann-Tepekoeylue Can , Johannes Holfeld , Clemens Engler , Suat Ersahin , Adel Sakic , Sasa Rajsic , Mueller Ludwig , Grimm Michael , Bonaros Nikolaos 
Published: October 2023

BackgroundLong-term outcomes of elderly and frail patients with secondary mitral valve regurgitation (MR) are inconclusive. Especially in patients with co-morbidities such as atherosclerosis who are suffering from heart failure, optimal medical therapy (OMT) is the preferred therapy relative to surgical or percutaneous interventions. It remains challenging to identify the most successful therapy to improve symptoms and increase life expectancy. To reduce surgical trauma for these patients, minimally invasive mitral valve surgery (MIMVS) was developed; this has shown promising medium-term results, but there is still a lack of evidence regarding long-term results. The aim of this investigation was to describe the long-term outcomes of less invasive mitral valve surgery (MVS) in elderly patients.MethodsIn this longitudinal retrospective analysis, 67 patients (aged ≥70 years) with secondary MR who underwent MV repair ± tricuspid valve repair (TVR) were identified. MVS was performed via minithoracotomy (MT) in most cases (n = 54); in patients with contraindications for MIMVS, partial upper sternotomy (PS) was the preferred route for surgical access (n = 13). The appropriate access route was chosen according to the patient's clinical condition and comorbidities. We analyzed reoperation-free long-term survival, combined operative success (lack of residual MR, conversion to MV replacement, or larger thoracic incisions), and perioperative safety (at 30 days: mortality, re-thoracotomy, ECMO, pacemaker implantation, dialysis, longer ventilation, stroke, myocardial infarction). In a subgroup analysis, we compared long-term survival in MVS patients with and without TVR.ResultsThe median age of patients (62.7% female) was 74 years (interquartile range: 72–76 years), with a median EuroSCORE2 of 2.8% (1.5%–4.6%) and N-terminal pro-brain natriuretic peptide plasma levels of 1,434 ng/L (1035–2149 ng/L). The median follow-up period was 5.6 years (2.7–8.5 years). The reoperation-free long-term survival rate up to 10 years was 66.2%. Combined operative success and perioperative safety were achieved in 94% and 76% of patients, respectively. Additional TVR was performed in 56.7% of patients, without any significant difference in survival rates compared to the group without TVR (p = 0.417; HR 1.473, 95% CI 0.578–3.757).ConclusionLess invasive MV repair for secondary MR shows excellent operative success and safety in selected patients. Freedom from significant MR and from the need for reoperation indicates long-lasting efficacy. These results should be considered in heart team discussions regarding allocation of patients to surgical mitral procedures.
Changing relative intrinsic growth rates of species alter the stability of species communities
Authors: Löffler Thomas J. , Lischke Heike 
Published: October 2023

IntroductionIt is perplexing when species-rich ecosystems change abruptly and, for example, dominant or economically interesting species populations collapse. Although various aspects of such ecosystem regime shift at tipping points have been studied, little attention has been paid to the possible dependence of community stability on the intrinsic growth rates of their species. Intrinsic growth rates of species can vary, e.g., due to evolution, environmental changes or fluctuations, disturbances, or human influences such as exploitation of certain species.MethodsWe analyse theoretically and computationally the stability behaviour of the n-species Lotka–Volterra competition model.Results and discussionDepending on the competitive strengths of the species, changes in the relative intrinsic growth rates of competing species have a strong effect on community stability.
Preliminary study of donor volume changes after dual-graft liver transplantation in rats
Authors: Wang Dan , Ma Yanling , Gu Baohong , Li Xuemei , Yu Yang , Zhang Ying , Chen Hao 
Published: October 2023

Dual-graft liver transplantation (DGLT) expands the pool of donors, ensures the safety of the donors, and treats a potential small for size syndrome (SFSS). However, some of the recipient graft showed atrophy. The cause and mechanism of the unbalanced proliferation and atrophy of dual grafts after clinical DGLT have not been clarified. We established and optimized the rat model of DGLT to explore the causes of growth unbalance. Continuously and dynamically observed bilateral graft volume and portal vein blood flow change by magnetic resonance imaging (MRI) and ultrasound (US). We detected liver function indexes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL). Liver samples from receptors were obtained for morphology, and apoptosis was measured by RT-PCR and western blot. Optimization of the model improved the 7-day survival rate from former 58.3% to 87.5%, and the 30-day survival rate was 68.8%. The volume of the right graft gradually increased, and the left graft atrophied during the 30-day observation period. The portal blood flow of the left graft gradually decreased until the 30th day (0.13 ± 0.01 ml/s) compared with the sham group (0.63 ± 0.05 ml/s), and the right graft significantly increased on the 30th day (0.75 ± 0.11ml/s). The liver function initially increased and then recovered. The total volume (12.52 ± 1.60 ml vs 4.47 ± 0.08 ml) and weight (12.09 ± 1 g vs 4.91 ± 0.18 g) of the graft increased significantly compared to pre-transplantation and reached the level of the sham operation group on the 30th day. The volume and weight of the right graft increased more than those of the left graft (P &lt; 0.05). There was more inflammatory cell infiltration in the left graft, and the right graft had obvious proliferation of hepatocytes and mature bile duct cells. Left grafts were more prone to apoptosis than right grafts (P &lt; 0.05). In conclusion, growth of the right graft is superior to the left; after double liver transplantation, perfusion blood flow and apoptosis may be the reason contributing to the volume differences in dual grafts.
Efficacy and safety of adalimumab biosimilar (HS016) in inflammatory bowel disease from the real-world study
Authors: Wang Fang , Li Xiaofei , Shi Yanting , Zhou He , Yang Gang , Li Ruixia , Wu Tong , Liang Jie 
Published: October 2023

Objective: Adalimumab (ADA) is an effective treatment for inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn’s disease (CD). The equal effect between the original ADA and biosimilars from Europe and the United States has been shown. However, the biosimilar of ADA is different in China. The effectiveness and safety data of ADA biosimilar (HS016) in China have yet to be discovered.Patients and methods: 91 patients (75 CD, 16 UC) received HS016 treatment and were enrolled in this study. Therapeutic response and safety profiles were analyzed. Therapeutic drug monitoring (TDM) was also carried out among nonresponse patients. After being considered as “nonresponse” (after three or 6 months of treatment), 20 patients’ serum TNFα concentrations were measured and correlated to their disease severity.Results: Among active CD patients (n = 61), 75.4% (46/61) at 12 w, 73.8% (45/61) at 26 w, 50.8% (31/61) at 52 w achieved the clinical response, respectively; 55.7% (34/61) at 12 w, 65.6% (40/61) at 26 w, and 45.9% (28/61) at 52 w achieved clinical remission. The maintained remission rates of CD (n = 14) in clinical remission were 100% (14/14) at 12 w, 78.6% (11/14) at 26 w, and 63.6% (7/11) at 52 w, respectively. Among active UC patients, 37.5% (6/16) at 12 w and 50% (8/16) at 26 w achieved clinical response. Total adverse event rates were 5.5% (5/91) during 52-week visits. Due to the inadequate serum drug concentration, 30.4% (7/23) of patients had poor clinical responses. Elevations of serum anti-drug antibodies occurred in one additional patient (4.3%).Conclusion: ADA biosimilar HS016 had good efficacy and safety in Chinese IBD patients.
Auricular acupressure for constipation in adults: a systematic review and meta-analysis
Authors: Jiang Ze-Fei , Liu Guang , Sun Xiao-Xiang , Zhi Na , Li Xue-Mei , Sun Ran , Zhang Hong 
Published: October 2023

Introduction: Auricular acupressure (AA) has been widely utilized in the management of constipation, with several studies suggesting its efficacy in treating constipation patients. However, the safety and effectiveness of AA in constipation remain uncertain. Hence, the aim of this study was to assess the effectiveness and safety of AA for constipation.Methods and analysis: A total of eight electronic databases and three clinical trial registration platforms were searched from their inception to April 2023 for randomized controlled trials (RCTs) of AA for constipation. The included studies were appraised for quality using the Cochrane Collaboration’s Risk of Bias Assessment tool. The quality of evidence was assessed by two independent reviewers employing the Grading of Recommendations Assessment, Development, and Evaluation System (GRADE) evaluation tool. Meta-analysis of data and assessment of publication bias were performed using RevMan 5.4 and STATA 13.0 software, respectively.Results: This review included 34 randomized controlled trials conducted between 2007 and 2023, involving 2,465 participants. The findings of the study indicate that overall, AA is significantly associated with improved CSBMs (MD = 1.22, 95% CI [0.68, 1.77], p &lt; 0.0001, I2 = 0%), BSF (MD = 0.72, 95%CI: [0.15,1.28], p = 0.01, I2 = 82%), CAS (MD = -3.28, 95%CI: [−5.95, −0.60], p = 0.02, I2 = 80%), responder rate (RR = 1.27, 95%CI: [1.16, 1.38], p &lt; 0.00001, I2 = 79%), cure rate (RR = 1.84, 95% CI [1.56, 2.15], p &lt; 0.00001, I2 = 0%), and PAC-QOL (MD = −2.73, 95% CI: [−3.41, −2.04], p &lt; 0.00001, I2 = 98%) compared to the control group. However, no difference in PAC-SYM (MD = −0.15, 95%CI: [−0.38,0.07], p = 0.19, I2 = 67%) was found between the two groups. Additionally, there was no significant difference in adverse events (RR = 0.53, 95% CI: [0.24, 1.21], p = 0.13, I2 = 38%).Conclusion: Based on the available evidence, auricular acupressure appears to be a potentially safe and effective intervention for managing constipation in adults. Nonetheless, the overall quality of evidence for the identified outcomes was assessed as low to very low, highlighting the need for additional high-quality randomized controlled trials to further validate these findings.Systematic Review Registration:https://www.crd.york.ac.uk/prospero, identifier CRD42023425033.
Seasonal changes in free 25-(OH)D and vitamin D metabolite ratios and their relationship with psychophysical stress markers in male professional football players
Authors: Książek Anna , Zagrodna Aleksandra , Lombardi Giovanni , Słowińska-Lisowska Małgorzata 
Published: October 2023

Introduction: Novel markers of vitamin D status are currently being investigated, including free 25-(OH)D (25-(OH)DF) and the vitamin D metabolite ratio (24,25-(OH)2D3:25-(OH)D3; VMR). The VMR may provide additional functional information on vitamin D metabolism in athletes. Therefore, the main objective of the current study was to evaluate 25-(OH)DF, bioavailable 25-(OH)D (25-(OH)DB), VMR, and psychophysical stress markers during different training periods over a half-season. The second aim was to assess the association between vitamin D binding protein (VDBP), total and free 25-(OH)D, VMRs, and psychophysical stress markers in professional football players. Moreover, we examined the relationship between 25-(OH)D3 and vitamin D metabolites (24,25-(OH)2D3, 3-epi-25-(OH)D3) to determine if training loads in different training periods influenced the vitamin D metabolome.Methods: Twenty professional football players were tested at six different time points across half a year (V1—June; V2—July; V3—August; V4—October; V5—December; V6—January).Results: Analyses indicated a significant seasonal rhythm for VDBP, and total 25-(OH)D (25-(OH)DT), 25-(OH)DB, 24,25-(OH)2D3, 3-epi-25-(OH)D3, 25-(OH)D3:24,25-(OH)2D3, and 24,25-(OH)2D3:25-(OH)D3 VMRs throughout the training period. No correlation was detected between 25-(OH)DT, 25-(OH)DB, 25-(OH)DF, vitamin D metabolites, VMRs, VDBP, and ferritin, liver enzymes (aspartate transaminase [AST] and alanine transaminase [ALT]), creatine kinase (CK), cortisol, testosterone, and testosterone-to-cortisol ratio (T/C) in each period (V1-V6). However, there was a strong statistically significant correlation between 25-(OH)D3 and 24,25-(OH)D3 in each training period.Conclusion: In conclusion, a seasonal rhythm was present for VDBP, 25-(OH)DT, 25-(OH)DB, vitamin D metabolites (24,25-(OH)2D3, 3-epi-25-(OH)D3), and VMRs (25-(OH)D3:24,25-(OH)2D3, 25-(OH)D3:3-epi-25-(OH)D3). However, no rhythm was detected for 25-(OH)DF and markers of psychophysical stress (ferritin, liver enzymes, CK, testosterone, cortisol, and T/C ratio). Moreover, the relationships between free and total 25-(OH)D with psychophysical stress markers did not demonstrate the superiority of free over total measurements. Furthermore, training loads in different training periods did not affect resting vitamin D metabolite concentrations in football players.
Impact of the number of players on the emergence of creative movements in small-sided soccer games: a systematic review emphasizing deliberate practice
Authors: Ueda Lucas Shoiti Carvalho , Milistetd Michel , Praça Gibson Moreira , da Maia Gabriel Silveira Guedes , da Silva Juliano Fernandes , Borges Paulo Henrique 
Published: October 2023

IntroductionCreativity is a recognized quality in various areas, including sports. Within the training processes, various modifications to objectives, game configurations, rules, among other factors, can be considered to favor creative solutions to the tactical problems inherent to soccer. This systematic review aimed to identify the impact of the number of players on the emergence of creative movements in small-sided soccer games, emphasizing deliberate practice.MethodsA systematic review of Scopus, PubMed, Scielo, PsycInfo, SportDiscus and Lilacs databases was performed according to PRISMA guidelines. Eligibility criteria were defined based on the elements of population, context and concept. Only full articles published in scientific journals written in English were included. No period restriction was applied.ResultsFive papers were included and the results of studies indicate greater number of actions, variability, and creativity in small-sided games compared to formal soccer matches. When comparing different small-sided game formats, 5 v 5 showed higher values in terms of total number of actions compared to 7 v 7, and the absolute number of original and creative actions tended to decrease as the game format increased. Imbalanced small-sided games format can promote increased exploratory behavior. Structural manipulation in goal positioning in 5 v 5 games may also influence the originality of tactical behaviors, while the use of different ball types in 4 v 4 games appears to decrease fluency values. In 6 v 6 games, fluency and versatility are negatively impacted.ConclusionReduced game formats with fewer players and in smaller field dimensions provide more suggestive environment for exploratory behavior, variability and original and creative actions. The protocol was registered on the Open Science Framework (OSF) on 2 December 2022 (DOI: 10.17605/OSF.IO/VN6YZ).Systematic review registration[https://osf.io/jmf4k/].
Odor familiarity and improvement of olfactory identification test in Chinese population
Authors: Zhang Hao , Wang Mingyao , Qian Meiyu , Wei Hongquan 
Published: October 2023

AimsThis study aimed to design the Chinese Modified Olfactory Identification (CMOI) test based on the Sniffin' Sticks Olfactory Identification (SSOI) test by changing unfamiliar distractors and odors for more familiar ones for the Chinese population.Materials and methodsWe recruited 200 healthy volunteers (103 males and 97 females, aged 18–65 years, mean age 35.04 years, SD 10.96); in a survey, 100 volunteers rated their familiarity with 121 odors, including all the SSOI test odor descriptors and common odors in Chinese daily life. The SSOI test was modified according to the survey results. The other 100 volunteers were tested three times using the SSOI test, the Modified Distractors Olfactory Identification (MDOI) test established by modifying distractors in the SSOI test, and the CMOI test developed by using familiar unpleasant odors to displace the odors with low correct recognition rates in the MDOI test. We compared the test scores of the volunteers during the modification process.ResultsVolunteers were unfamiliar with 31 odor descriptors in the SSOI test; 23 distractors with low familiarity were displaced with more familiar distractors. The three odors with the lowest correct recognition rate in the MDOI test (apple, leather, and pineapple) were displaced with familiar unpleasant odors. The test scores were significantly higher in the CMOI test than in others (p &lt; 0.0001); the correct recognition rate in the CMOI test was significantly higher than in the SSOI test (p &lt; 0.01).ConclusionThe test scores in the CMOI test were significantly improved; it prevented choosing wrongly due to unfamiliarity with an odor and its distractors.
It’s not in my head: a qualitative analysis of experiences of discrimination in people with mental health and substance use conditions seeking physical healthcare
Authors: Cunningham Ruth , Imlach Fiona , Haitana Tracy , Every-Palmer Susanna , Lacey Cameron , Lockett Helen , Peterson Debbie 
Published: October 2023

IntroductionClinician bias contributes to lower quality healthcare and poorer health outcomes in people with mental health and substance use conditions (MHSUC). Discrimination can lead to physical conditions being overlooked (diagnostic overshadowing) or substandard treatment being offered to people with MHSUC. This research aimed to utilise experiences of people with MHSUC to identify discrimination by clinicians, including the role of clinician’s beliefs and assumptions in physical health service provision.MethodsWe surveyed people with MHSUC who accessed physical healthcare services. Of 354 eligible participants, 253 responded to open-ended questions about experiences of those services. Thematic descriptive analysis of survey responses was completed using existing stigma frameworks and inductive coding.ResultsOne dominant theme from survey responses was that diagnostic overshadowing by clinicians was driven by clinician mistrust. Another theme was that clinicians assumed respondent’s physical symptoms, including pain, were caused by MHSUC. This influenced decisions not to initiate investigations or treatment. Respondents perceived that clinicians focused on mental health over physical health, contributing to suboptimal care.DiscussionDiscrimination based on MHSUC leads to poor quality care. Health systems and clinicians need to focus quality improvement processes on access to and delivery of equitable physical healthcare to people with MHSUC, address stereotypes about people with MHSUC and improve integration of mental and physical healthcare.