bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Unique Subgroups of Individuals With Stroke Using Heart Rate and Steps to Characterize Physical Activity
Authors: Koffman Lily J. , Crainiceanu Ciprian M. , Roemmich Ryan T. , French Margaret A. 
Published: September 2023

Background
Low physical activity (PA) is associated with poor health outcomes after stroke. Step counts are a common metric of PA; however, other physiologic signals (eg, heart rate) may help to identify subgroups of individuals poststroke at varying levels of risk of poor health outcomes. Here, we aimed to identify clinically relevant subgroups of individuals poststroke based on PA profiles that leverage multiple data sources, including step count and heart rate data, from wearable devices.

Methods and Results
Seventy individuals poststroke participated. Participants wore a Fitbit Inspire 2 for 1 year and completed clinical assessments. We defined a group‐based steps‐per‐minute threshold and an individual heart rate threshold to categorize each minute of PA into 1 of 4 states: high steps/high heart rate, low steps/low heart rate, high steps/low heart rate, and low steps/high heart rate. We used the proportion of time spent in each state along with steps per day, sedentary time, mean steps among minutes with high steps and high heart rate, and resting heart rate in a k‐means clustering algorithm to identify subgroups and compared Activity Measure for Post‐Acute Care Mobility T Score, Stroke Impact Scale, and gait speed among subgroups. We identified 3 subgroups, Active (n=8), Sedentary (n=29), and Deconditioned (n=33), which differed significantly on all clustering variables except resting heart rate. We observed significant differences in Activity Measure for Post‐Acute Care Mobility T scores between subgroups, with the Deconditioned subgroup exhibiting the lowest score.

Conclusions
Quantifying PA with heart rate and step count using readily available wearable devices can identify clinically meaningful subgroups of individuals poststroke.
Use of the Wearable Cardioverter‐Defibrillator Among Patients With Myocarditis and Reduced Ejection Fraction or Ventricular Tachyarrhythmia: Data From a Multicenter Registry
Authors: El‐Battrawy Ibrahim , Koepsel Katharina , Tenbrink David , Kovacs Boldizsar , Dreher Tobias C. , Blockhaus Christian , Gotzmann Michael , Klein Norbert , Kuntz Thomas , Shin Dong‐In , Lapp Hendrik , Rosenkaimer Stephanie , Abumayyaleh Mohammad , Hamdani Nazha , Saguner Ardan Muammer , Kowitz Jacqueline , Erath Julia W. , Duru Firat , Mügge Andreas , Akin Ibrahim , Aweimer Assem , Beiert Thomas 
Published: September 2023

Background
Data on the use of the wearable cardioverter‐defibrillator (WCD) among patients with myocarditis remain sparse. Consequently, evidence for guideline recommendations in this patient population is lacking.

Methods and Results

In total, 1596 consecutive patients were included in a multicenter registry from 8 European centers, with 124 patients (8%) having received the WCD due to myocarditis and reduced left ventricular ejection fraction or prior ventricular tachyarrhythmia. The mean age was 51.6±16.3 years, with 74% being male. Patients were discharged after index hospitalization on heart failure medication: Angiotensin‐converting enzyme inhibitors (62.5%), angiotensin‐receptor‐neprilysin inhibitor (22.9%), aldosterone‐antagonists (51%), or beta blockers (91.4%). The initial median left ventricular ejection fraction was 30% (22%–45%) and increased to 48% (39%–55%) over long‐term follow‐up (
P
<0.001). The median BNP (brain natriuretic peptide) level at baseline was 1702 pg/mL (565–3748) and decreased to 188 pg/mL (26–348) over long‐term follow‐up (
P
=0.022). The mean wear time was 79.7±52.1 days and 21.0±4.9 hours per day. Arrhythmic event rates documented by the WCD were 9.7% for nonsustained ventricular tachycardia, 6.5% for sustained ventricular tachycardia, and 0% for ventricular fibrillation. Subsequently, 2.4% of patients experienced an appropriate WCD shock. The rate of inappropriate WCD shocks was 0.8%. All 3 patients with appropriate WCD shock had experienced ventricular tachycardia/ventricular fibrillation before WCD prescription, with only 1 patient showing a left ventricular ejection fraction <35%.

Conclusions
Patients with myocarditis and risk for occurrence of ventricular tachyarrhythmia may benefit from WCD use. Prior ventricular arrhythmia might appear as a better risk predictor than a reduced left ventricular ejection fraction <35% in this population.
Long‐Term Outcomes of Patients Undergoing Aortic Root Replacement With Mechanical Versus Bioprosthetic Valves: Meta‐Analysis of Reconstructed Time‐to‐Event Data
Authors: Sá Michel Pompeu , Tasoudis Panagiotis , Jacquemyn Xander , Van den Eynde Jef , Caranasos Thomas G. , Ikonomidis John S. , Chu Danny , Serna‐Gallegos Derek , Sultan Ibrahim 
Published: September 2023

Background
An aspect not so clear in the scenario of aortic surgery is how patients fare after composite aortic valve graft replacement (CAVGR) depending on the type of valve (bioprosthetic versus mechanical). We performed a study to evaluate the long‐term outcomes of both strategies comparatively.

Methods and Results

Pooled meta‐analysis of Kaplan‐Meier–derived time‐to‐event data from studies with follow‐up for overall survival (all‐cause death), event‐free survival (composite end point of cardiac death, valve‐related complications, stroke, bleeding, embolic events, and/or endocarditis), and freedom from reintervention. Twenty‐three studies met our eligibility criteria, including 11 428 patients (3786 patients with mechanical valves and 7642 patients with bioprosthetic valve). The overall population was mostly composed of men (mean age, 45.5–75.6 years). In comparison with patients who underwent CAVGR with bioprosthetic valves, patients undergoing CAVGR with mechanical valves presented no statistically significant difference in the risk of all‐cause death in the first 30 days after the procedure (hazard ratio [HR], 1.24 [95% CI, 0.95–1.60];
P
=0.109), but they had a significantly lower risk of all‐cause mortality after the 30‐day time point (HR, 0.89 [95% CI, 0.81–0.99];
P
=0.039) and lower risk of reintervention (HR, 0.33 [95% CI, 0.24–0.45];
P
<0.001). Despite its increased risk for the composite end point in the first 6 years of follow‐up (HR, 1.41 [95% CI, 1.09–1.82];
P
=0.009), CAVGR with mechanical valves is associated with a lower risk for the composite end point after the 6‐year time point (HR, 0.46 [95% CI, 0.31–0.67];
P
<0.001).

Conclusions
CAVGR with mechanical valves is associated with better long‐term outcomes in comparison with CAVGR with bioprosthetic valves.
The Necessity of Subsequent Dental Treatment for Odontogenic Sinusitis After Endoscopic Sinus Surgery
Authors: Zhao Xiaochang , Li Zufei , Liu Jinfeng 
Published: September 2023

Objective: To investigate the necessity of subsequent dental treatment for patients with odontogenic sinusitis (OS) after endoscopic sinus surgery (ESS). Methods: OS patients who received ESS from January 2018 to May 2022 were eligible. Demographic data, medical history, Lund–Mackay (LM) computed tomography (CT) score, Lund–Kennedy (LK) endoscopic score, and OS-specific CT score were recorded and analyzed. All patients were followed up for 6 months after surgery. Results: A total of 48 patients (30 males and 18 females) were enrolled. A total of 35 cases (72.9%) were caused by dental diseases (periapical periodontitis), and 13 cases (27.1%) were caused by iatrogenic factors (including tooth extraction or implantation). The overall treatment success rate was 97.9%, and the success rates in the dental disease OS group (97.1%) and the iatrogenic OS group (100%) were not significantly different (X2 = 0.329, P = .729). None of the patients in the dental disease group received treatment of the causative teeth within 6 months after the operation, except for one patient who received tooth extraction treatment 6 months after the operation. Conclusion: Without considering the impact of dental disease on patients’ oral health, OS can be completely alleviated by ESS alone, even if no dental treatment is carried out after surgery.
The Effect of Combining Hyaluronic Acid and Human Dermal Fibroblasts on Tendon Healing
Authors: Rhee Sung-Min , Jeon Saewha , Han Jikhyon , Kim Yun Hee , Jeong Hyeon Jang , Park Joo Hyun , Oh Joo Han 
Published: September 2023

Background: The incidence of rotator cuff tears is rapidly increasing, and operative techniques for rotator cuff repair have been developed. However, the rates of postoperative retear remain high. Purpose/Hypothesis: The purpose was to determine the effects of human dermal fibroblasts (HDFs) with hyaluronic acid (HA) on tendon-to-bone healing in a rabbit model of chronic rotator cuff tear injury. It was hypothesized that HA would enhance HDF proliferation and that a combination of HA and HDFs would produce a synergistic effect on the healing of repaired rotator cuff tendons of rabbits. Study Design: Controlled laboratory study. Methods: For in vitro study, HDFs were plated on a 24-well plate. After 1 day, 2 wells were designated as the test group and treated with 0.75% HA in phenol red–free Dulbecco's modified Eagle medium (DMEM). An other 2 wells served as control groups and were treated with the same volume of phenol red–free DMEM without HA. Each group was duplicated, resulting in a total of 4 wells, with 2 wells in each group for replication purposes. The cells were incubated for 24 hours, followed by 72-hour cultivation. Absorbance ratios at 96 and 24 hours were compared to evaluate cell proliferation. For the in vivo study, a total of 24 rabbits were randomly allocated to groups A, B, and C (n = 8 each). Supraspinatus tendons were detached bilaterally and left for 6 weeks to establish a chronic rotator tear model. Torn tendons were subsequently repaired using the following injections: group A, 0.5 × 106 HDFs with HA; group B, HA only; and group C, saline only. At 12 weeks after repair, biomechanical tests and histological evaluation were performed. Results: In vitro study showed that HDF proliferation significantly increased with HA (HDFs with HA vs HDFs without HA; 3.96 ± 0.09 vs 2.53 ± 0.15; P < .01). In vivo, group A showed significantly higher load-to-failure values than the other groups (53.8 ± 6.9 N/kg for group A, 30.6 ± 6.4 N/kg for group B, and 24.3 ± 7.6 N/kg for group C; P < .001). Histological evaluation confirmed that group A showed higher collagen fiber density and better collagen fiber continuity, tendon-to-bone interface maturation, and nuclear shape than the other groups (all P < .05). Conclusion: This controlled laboratory study verified the potential of the combination of HDFs and HA in enhancing healing in a chronic rotator cuff tear rabbit model. Clinical Relevance: A potential synergistic effect on rotator cuff tendon healing may be expected from a combination of HDFs and HA.
Sociodemographic factors associated with acceptance of index case testing among newly diagnosed human immunodeficiency virus-positive clients in southern borno, Nigeria
Authors: Shallangwa Muktar Musa , Bello Hassan Muhammad , Musa Shuaibu Saidu , Iwenya Honesty Chukwudi , Hamid Raihanatu Mohammed , Hussaini Mohammed 
Published: September 2023

Background The study aimed to explore the sociodemographic factors associated with the acceptance of index case testing (ICT) among newly diagnosed people living with HIV (PLHIV) in Southern Borno, Nigeria. Methods The study involved four healthcare facilities providing antiretroviral therapy (ART) services in Southern Borno, Nigeria. Secondary data from the index case testing register were collected between April 2022 and April 2023. Categorical variables were analyzed using descriptive statistics, while bivariate and multiple logistic regression analyses was used to determine the factors associated with ICT acceptance, using a 95% confidence interval and significance level of p ≤ .05. Results Among the 302 index cases offered ICT, the acceptance rate was 69.5%. Individuals aged 25–49 years (AOR: 0.294, 95% CI: 0.098–0.775) and 50 years and above (AOR: 0.210, 95% CI: 0.046–0.862) were less likely to accept ICT compared to those aged 18–24 years. Married individuals were 38.86 times more likely to accept ICT than those who were single and never married (AOR: 38.856, 95% CI: 12.620–171.674). Conclusion The study shows high ICT acceptance among newly diagnosed PLHIV in Southern Borno, with age and marital status as significant factors. These findings can guide targeted interventions to enhance ICT acceptance and enhance HIV care and prevention strategies in the region.
Viral load and sexually transmitted infection testing among youth with HIV in a southern United States clinic
Authors: Budhwani Henna , Hao Jiaying , Maragh-Bass Allysha C. , Hill Samantha , Long Dustin M. , Simpson Tina 
Published: September 2023

Background: As compared to their older peers, youth with HIV (YWH) are less likely to attain viral suppression and have higher rates of sexually transmitted infections (STI). In this exploratory study, we examine the relationship between HIV viral suppression, STI testing, and STI diagnosis among YWH receiving care at a clinic in the southern United States. Methods: Data from 933 clinical visits (2017–2020) were aggregated into singular patient records for YWH aged 10–24 years in Alabama ( N = 139). Analyses included univariate generalized linear mixed models performed with the PROC GLIMMIX procedure approximating the marginal likelihood by using Laplace’s method. Results: Sample median age was 22 years at the index visit. Most YWH were 20–24 years old (69.1%), male (67.6%), and identified as Black (77%); 58.3% were virally unsuppressed at index visit. YWH who identified as White or of other races had 4.79 times higher odds of being virally suppressed as compared to Black YWH ( p < .01); STI testing behavior and STI positive diagnosis were associated with lower odds of being virally suppression. Conclusions: Findings suggest that among YWH, receiving STI testing and having an STI diagnosis is associated with a lack of viral suppression, suggesting that extra efforts may be necessary to support YWH who have an STI to attain suppression. Research is needed to examine individual behaviors, structural forces, and clinic features that could impact STI care engagement, specifically among unsuppressed YWH.
Construction of a New Index of Financial Inclusion
Authors: Yadav Ashutosh , Hazarika Ishan Kashyap , Yadav Deepshikha 
Published: September 2023

While we recognise that there exists no perfect method to construct indices in general, the problems with the widely used methods of constructing indices for financial inclusion (FI) stand out due to the peculiar nature of the variables of concern. First, FI is not unidimensional. It includes aspects of access, knowledge and usage of financial services at the least. Second, these different dimensions may not be perfect substitutes. Increasing financial literacy, for example, does not necessarily compensate for a lack of access due to the unavailability of bank branches nearby. Any index of FI thus must make sure that exceedingly good performance in one dimension should not be able to fully compensate for poor performance in another dimension in the index values. A discussion of how various researchers have tried to solve these problems in the past can be found in Sarma (2015) . We begin with a discussion of the Index of Financial Inclusion methodology proposed by Sarma (2015) and provide a new interpretation of what such indices may measure, based on a consideration of the distribution of the performances of various countries and the resulting entropy. Highlighting the unrealistic assumption of this methodology, we propose a new method to create sub-indices and the New Index of Financial Inclusion. JEL: C18, C40, G50, G59, O10
The Effect of Breast Milk Odor on Feeding Cues, Transition Time to Oral Feeding, and Abdominal Perfusion in Premature Newborns: A Randomised Controlled Trial
Authors: Yücel Adalet , Küçükoğlu Sibel , Soylu Hanifi 
Published: September 2023

Purpose: The present study was conducted to determine the effect of odor stimulation with breast milk (BM) applied to premature newborns before and during enteral feeding on feeding cues, transition time to oral feeding and abdominal perfusion. Design: This study was a parallel group pretest-post test randomised controlled trial (RCT). Methods: The study was conducted in the neonatal intensive care unit (NICU) in Türkiye. Study data were collected from 32 premature newborns between October 2020 and December 2021. Newborns were randomly assigned to either intervention ( n = 16) or control ( n = 16) groups. Odor stimulation with BM was applied to newborns in the intervention group (IG) before and during enteral feeding for 3 days. Data were collected with the Newborn Information Form, Abdominal Perfusion Follow-up Form, and Feeding Cues Follow-up Form. Yates corrected and Fisher chi-squared test, Mann-Whitney U test, Cohen Kappa statistics, Permanova analysis, and Wilcoxon test were used in the analysis. The study was registered in ClinicalTrials.gov (NCT04843293). Results: The frequency of feeding cues in newborns who were exposed to the odor of BM, was higher than in the control group (CG) ( p < .05). The transition times to oral feeding were similar in newborns in the IG and CG ( p > .05). Abdominal perfusion level of newborns in the IG was higher than the CG ( p < .05), and the level of abdominal perfusion showed a significant difference in terms of group*time interaction ( p < .05). Conclusion: Our findings suggest that odor stimulation with BM will be beneficial in improving the digestive functions of premature newborns.
Neurodevelopment of patients who received intravitreal bevacizumab or aflibercept for type 1 and aggressive retinopathy of prematurity
Authors: Baysal Senay Guven , Ekinci Dilbade Yildiz , Okur Nilufer 
Published: September 2023

Purpose We aimed to compare the neurodevelopment of patients who received intravitreal bevacizumab (IVB) and intravitreal aflibercept (IVA) for type 1 retinopathy of prematurity (ROP) and aggressive ROP (A-ROP) using the Ages and Stages Questionnaire (ASQ-3) test. Methods Patients who underwent IVB (group 1), IVA (group 2), and patients who did not receive treatment (group 3) were included in the prospective-controlled study. The patients were grouped as low-intermediate-high risk according to the high-risk infant follow-up guide. With the ASQ-3 test, fine and gross motor movements, communication, problem solving, and personal-social developments of the patients were compared. Results The gender distribution, birth weight (BW), and neonatal risk category of the groups were similar. Gestational age (GA) of group 1 was found to be lower compared to group 3. There was no difference between the groups in the development of gross and fine motor movements, communication and problem solving. The personal and social development of group 1 and group 2 was found to be retarded compared to the control group. Discussion As a result, the detection of retardation in the personal and social areas in the treated patients, and the detection of retardation in other areas, although not significant, reveals the necessity of following the development of these patient groups and providing the necessary support in the areas where retardation is detected.
Clinacanthus nutans L Extracts Reduce the Serum Tumor Necrosis Factor-α, Malondialdehyde, and Interleukin-6 Levels and Improve the Langerhans Islet Area in Diabetic Rat Models
Authors: Mustika Arifa , Fatimah Nurmawati , Safitri Indri , Susanti Nurlaili , Noor Nurul Shahfiza 
Published: September 2023

Background: Diabetes mellitus-induced hyperglycemia increases oxidative stress and inflammatory cytokine production, which play a significant role in the damage and apoptosis of pancreatic β cells. Therefore, the administration of medications that can reduce oxidative stress and inflammation plays an important role in diabetes treatment. Objective: To probe the Clinacanthus nutans leaf extract effect on oxidative stress and inflammatory markers and the Langerhans islet area in diabetic rat models. Design: An experimental laboratory in the animal model. Methods: Twenty-five diabetic rat models were randomly assigned into 5 clusters. Clusters 1, 2, and 3 were administered with C. nutans leaf extract in aqueous suspension with vehicle 1% Na-CMC at 75 mg/kg body weight (BW), 150 mg/kg BW, and 300 mg/kg BW, respectively. Cluster 4 was diabetic control rats administered with metformin at a 21 mg/rat dose. Cluster 5 was a control diabetic rat only administered with 1% Na-CMC suspension. Treatment was administered orally for 14 days. On the 15th day, the rats were sacrificed to obtain blood samples and pancreatic tissues. Serum interleukin (IL)-6, malondialdehyde (MDA), and tumor necrosis factor (TNF-α) were measured using the enzyme-linked immunosorbent assay (ELISA) method. Histopathological examination was performed by counting the Langerhans islet areas. Results: The average IL-6, MDA, and TNF-α levels declined in the cluster receiving C. nutans extract and were significantly different from the untreated cluster ( P < .05). Histopathological examination revealed a significant upsurge in the Langerhans islets area in diabetic rats receiving C. nutans extract at doses of 75 and 150 mg/kg ( P < .05). Conclusion: C. nutans leaf extract reduced the serum MDA, TNF-α, and IL-6 levels, and increased the Langerhans islets area in a diabetic rat model.