Aortic stenosis is a common valvular heart disease associated with substantial morbidity and mortality if left untreated. Surgical aortic valve replacement (SAVR), transcatheter aortic valve implantation (TAVI), and autologous pericardial aortic valve reconstruction (Ozaki procedure) represent alternative interventional strategies, but direct real-world comparisons remain limited. This study evaluated early clinical and 6-month hemodynamic outcomes following these 3 treatment approaches. This retrospective single-center observational study included 153 consecutive patients with severe aortic stenosis treated between December 2020 and March 2022 (SAVR, n = 67; Ozaki, n = 31; TAVI, n = 55). Early mortality was the primary clinical outcome, and 6-month mean transvalvular gradient was the primary echocardiographic outcome. Other clinical and echocardiographic outcomes were considered secondary or exploratory. Multivariable regression, analysis of covariance, and separate pairwise propensity-score matching models were used to account for baseline differences. Propensity scores were estimated using age, sex, EuroSCORE II, chronic kidney disease, and coronary artery disease. TAVI patients were older and had higher operative risk. No statistically significant differences were detected among the groups in early mortality, stroke, or postoperative dialysis. Permanent pacemaker implantation was more frequent after TAVI, while prolonged intensive care unit stay also differed among treatment groups. At 6 months, the Ozaki group showed favorable hemodynamic parameters, including lower mean transvalvular gradients and maximum transvalvular velocity. However, 6-month echocardiographic follow-up was incomplete, and these findings should be considered exploratory given the small Ozaki cohort, baseline differences, and observational study design. SAVR, Ozaki neocuspidization, and TAVI showed distinct early clinical and hemodynamic profiles in this real-world observational cohort. No statistically significant differences were detected in several major early clinical outcomes, although the study was not sufficiently powered to establish equivalent safety or exclude clinically meaningful differences. The favorable short-term hemodynamic findings observed with the Ozaki procedure should be considered hypothesis-generating. Larger prospective studies with longer follow-up are needed to further evaluate comparative clinical outcomes, hemodynamic performance, and durability.

Older adults with cardiovascular disease or hypertension have an elevated risk of depressive symptoms, which may adversely affect prognosis and quality of life. A practical prediction model could support early risk stratification and targeted screening. Data were obtained from the China Health and Retirement Longitudinal Study from 2011 to 2020. A time-based design was used for model development and temporal validation. The development cohort included 548 participants followed from 2011 to 2015, and the nonoverlapping temporal validation cohort included 523 participants followed from 2015 to 2020. The Boruta algorithm was used for predictor selection, 7 machine learning algorithms were compared, and Shapley additive explanations were used to interpret the selected model. Missing values were imputed using a random forest algorithm. Seven predictors were selected. Logistic regression showed the best overall performance, with an area under the receiver operating characteristic curve of 0.844 (95% confidence interval, 0.773-0.915) in the development cohort and 0.840 (95% confidence interval, 0.799-0.881) in the temporal validation cohort. The logistic regression model demonstrated good discrimination and calibration for predicting long-term depressive symptoms among older adults with cardiovascular disease or hypertension. Further independent and prospective validation is required before routine clinical implementation.

Chronic hepatitis B virus (HBV) infection is associated with both hepatic and extrahepatic complications. While liver-related outcomes are well characterized, the burden, demographic patterns, and survival associated with extrahepatic manifestations (EHMs) remain incompletely defined. This study aimed to evaluate the spectrum, incidence, and survival impact of EHMs in a large, geographically diverse cohort of patients with chronic HBV infection. We conducted a retrospective cohort study using the TriNetX Global Research Network, including 2,32,820 patients aged 0 to 90 years with chronic HBV infection. Demographic variables included age, sex, race, ethnicity, and geographic region. EHMs assessed comprised renal (glomerulonephritis), vasculitic (polyarteritis nodosa), musculoskeletal (arthralgia), hematologic (aplastic anemia), immunologic (cryoglobulinemia), and neurologic (polyneuropathy) conditions. Incidence proportions and incidence rates per person-day were calculated and stratified by demographic characteristics. Survival probabilities were estimated for each manifestation. The mean age of the cohort was 60 ± 14 years, and 56.9% were male. Racial distribution included Asian (34.4%), White (15.4%), Black or African American (12.1%), and unknown race (34.4%). Most patients were non-Hispanic (53.6%), with 44.1% reporting unknown ethnicity. Patients were represented across all US regions and internationally. Glomerulonephritis occurred in 1.26% of patients, with higher incidence in older adults, males, and Native Hawaiian/Other Pacific Islander and Hispanic/Latino populations. Polyarteritis nodosa was rare (0.04%) and predominated in older individuals, American Indian/Alaska Native, and Hispanic/Latino patients. Arthralgia was the most frequent EHM (13.76%), increasing with age and more common among females and Black or African American individuals. Cryoglobulinemia (0.10%) and aplastic anemia (0.12%) were uncommon. Polyneuropathy affected 3.27% of patients, with higher prevalence among older adults and males. Chronic HBV infection is associated with a wide spectrum of extrahepatic manifestations, with substantial variation by demographic factors. These findings underscore the need for comprehensive multisystem surveillance and targeted risk stratification in patients with chronic HBV infection.

To conduct a bibliometric analysis of stroke center-related research fields, both domestically and internationally, using CiteSpace, and to explore the current research status, hot topics, and development trends.

Using the China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, and the Web of Science Core Collection (WOSCC) as data sources, we performed visual analysis of annual publication volume, authors/institutions, and high-frequency keywords through CiteSpace.

A total of 3730 literature pieces were retrieved, including 3044 English articles and 686 Chinese articles. The overall research enthusiasm for stroke centers presents an upward trend. Current research hotspots mainly focus on Intravenous Thrombolysis (IVT), endovascular therapy, emergency green channels, and prognosis. The developmental frontiers chiefly involve machine learning (ML) and information system construction.

This study conducted cluster analysis on literature concerning stroke centers using CiteSpace software. It aims to explore hot topics and evolutionary trends within the field of stroke center research, broaden relevant research perspectives, and provide strategic references for clinical nursing practice and scholarly research.

Cardiovascular disease remains the leading cause of death in the United States, with heart failure (HF) and hyperlipidemia substantially contributing to mortality. This study aimed to examine national trends in HF-related mortality with coexisting hyperlipidemia from 1999 to 2024 and project future mortality patterns through 2035. Mortality data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Deaths were identified when heart failure and hyperlipidemia were listed on death certificates using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population and were stratified by sex, race/ethnicity, census region, and urbanization level. Temporal trends were evaluated using joinpoint regression analysis. Forecasts for 2025-2035 were generated using machine learning-based Seasonal Autoregressive Integrated Moving Average (SARIMA) time-series models. From 1999 to 2024, 283,161 deaths involving HF with hyperlipidemia were recorded on death certificates. The AAMR increased from 0.7 to 6.8 per 100,000 population, with a notable increase after 2018. Mortality rates were higher among men than women and were elevated in the non-Hispanic Black and American Indian/Alaska Native populations. Higher rates were also observed in nonmetropolitan counties and in the Midwest and West regions of the United States. Mortality involving HF with hyperlipidemia has increased over the past two decades, with persistent demographic and geographic differences. These findings highlight the importance of continued surveillance and targeted prevention strategies to address the cardiovascular health disparities in the United States.

Employees with hypertension face challenging job pressures that have a negative impact on their health, leading to ineffective and unsatisfactory work. Additionally, this can affect an organization's overall level of productivity. This study aimed to examine the effects of rational emotive behavior therapy (REBT) on stress among lecturers in tourism and hospitality management, educational scientists, and home economics and hospitality from state and federal universities who have hypertension, with a focus on the health and well-being of individual workers in specific university faculties.

A randomized controlled study was conducted, involving 93 staff members from private, state, and federal universities. Two dependent measures were assessed at Times 1, 2, and 3. A repeated measures statistical analysis was used to evaluate the participants' responses.

Participants' stress levels and illogical beliefs significantly decreased as a result of the REBT intervention. Before and after the REBT session, the participants' reactions to stress and irrational beliefs differed significantly. The follow-up study's findings confirm the long-lasting benefits of REBT and show the intervention's long-term influence.

The REBT intervention helps educators cultivate a positive mindset, decrease stress, and eliminate irrational beliefs.

ObjectiveModels of youth mental health help-seeking emphasize parents' central role in recognizing concerns, deciding to seek help, and accessing services. However, many parents who perceive a need for care do not access services. This study investigated whether parents' characteristics were related to parents' status in the youth mental health help-seeking pathway.MethodParents (N = 186; 25.8% Black or African American, 25.3% Hispanic or Latino, 15.6% Asian) completed online self-report questionnaires assessing sociodemographic characteristics and mental health-related knowledge, attitudes, and beliefs. Based on their responses to service use history and intentions to seek treatment, parents were classified as need perceivers, treatment intenders, or treatment utilizers.ResultsWhite parents were more likely than Black/African American and Asian parents to be treatment intenders or treatment utilizers rather than need perceivers. Parents were more likely to be treatment utilizers than need perceivers as parental self-efficacy increased and perceived irrelevance of treatment decreased.DiscussionFindings highlight potential parent-level and systemic factors relevant to youth mental health service use. Efforts to support access may benefit from addressing parents' confidence in seeking care, misconceptions about treatment relevance, and racial and ethnic inequities in the youth mental health help-seeking process.

Nursing students, as the reserve force of the nursing workforce, often experience transition shock during clinical internships, which negatively impacts their physical and mental health and may lead to presenteeism. Self-efficacy, a modifiable psychological resource, offers a key intervention target for improving this situation.

To examine self-efficacy's mediating role between transition shock and presenteeism in nursing students and to guide management.

This study adopted a descriptive cross-sectional design. A convenience sampling survey was conducted on 421 nursing students in Shenyang City, China. The questionnaire included demographic characteristics, the General Self-Efficacy Scale (GSES), the Transition Shock Scale for Undergraduate Nursing Students (UNSTS), and Stanford Presenteeism Scale (SPS-6). Descriptive statistics, correlation analysis, and multiple linear regression were performed using IBM SPSS 27.0. The structural equation model was used to test the mediating effect hypothesis of self-efficacy between transition shock and presenteeism, and AMOS 28.0 was used to estimate the path coefficients and evaluate the model fit.

The research found that the presenteeism, transition shock, and self-efficacy level of nursing students in Shenyang were all at a moderately high level. Transition shock showed statistically significant positive correlations with presenteeism (r = 0.646) and negative correlations with self-efficacy (r = -0.576), while self-efficacy was negatively correlated with presenteeism (r = -0.636). The SEM showed satisfactory model fit. The results indicated that self-efficacy played a partial mediating role between transition shock and presenteeism (effect = 0.212, [0.149.0.294], p < 0.001), accounting for 29.04% of the total effect (total effect = 0.73, [0.615.0.823], p < 0.001).

This study has confirmed that self-efficacy plays a mediating role between the transition shock and presenteeism among nursing students in Shenyang City, China.

This study offers nursing managers a new way to address presenteeism among nursing students and a reference for improving clinical internship quality and talent cultivation models.

Objective: Dementia caregiving is associated with elevated psychological distress, yet limited research has examined how caregiving demands shape mental health among East Asian American caregivers, a rapidly growing but understudied population. Guided by the stress process framework, this study examined three temporal dimensions of objective caregiving demands - time intensity, frequency, and chronicity - and their associations with subjective caregiving demands and depressive symptoms among older East Asian American caregivers of individuals living with Alzheimer's disease and related dementias (AD/ADRD).Design: Survey data were collected from 82 East Asian American caregivers aged 50 years or older who were providing care to individuals with dementia in the United States. Participants were recruited through community-based organizations and ethnic community settings. Ordinary least squares regression models were estimated to examine associations among temporal caregiving demands, subjective caregiving demands, and depressive symptoms. An exploratory post hoc structural equation model was also estimated to examine indirect associations.Result: Caregivers in this sample reported substantial caregiving involvement, averaging more than 10 hours of care per day, five days per week, over a period exceeding five years. In adjusted regression models, time intensity and chronicity were not directly associated with depressive symptoms, while caregiving frequency was negatively associated with depressive symptoms. Subjective caregiving demands were strongly and positively associated with depressive symptoms. Temporal caregiving demands were positively associated with subjective caregiving demands when examined separately. An exploratory post hoc analysis suggested that chronicity was indirectly associated with depressive symptoms through subjective caregiving demands.Conclusion: Findings suggest that the mental health implications of dementia caregiving may depend less on objective time exposure alone and more on caregivers' subjective appraisal of caregiving demands. Culturally and linguistically responsive interventions should address perceived caregiving burden, improve access to formal support, and attend to the long-term caregiving experiences of East Asian American dementia caregivers.