bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking associates with distinct clinical phenotypes in patients with systemic lupus erythematosus: a nationwide Danish cross-sectional study
Authors: Leffers Henrik Christian Bidstrup , Troldborg Anne , Voss Anne , Kristensen Salome , Lindhardsen Jesper , Kumar Prabhat , Linauskas Asta , Juul Lars , Krogh Niels Steen , Deleuran Bent , Dreyer Lene , Jacobsen Søren 
Published: April 2021

ObjectivesSLE displays large clinical heterogeneity that beyond genetic factors may be determined by environmental exposures. In this Danish nationwide study, we aimed to determine if clinical subsets of SLE were associated with smoking history.MethodsAt each of six participating centres, incident or prevalent inpatients and outpatients with SLE were consecutively included. Manifestations forming the basis of SLE classification were registered in an electronic chart system. Patients also provided questionnaire-based data on environmental exposures, including smoking history. Hierarchical cluster analysis was conducted to determine and characterise subsets of patients with similar traits of disease manifestations. Levels of smoking exposure by pack-years were correlated to the identified SLE subsets, as well as discrete SLE manifestations.ResultsThe cohort consisted of 485 patients (88% women and 92% Caucasian) with SLE of which 51% were ever smokers. Common disease manifestations comprised non-erosive arthritis (81%), malar rash (57%), lymphopenia (55%), photosensitivity (50%) and persistent proteinuria (41%). We identified three distinct phenotypic clusters characterised by their preponderance of (A) neurological, serosal and mucosal involvement; (B) renal, haematological and immunological disorders; and (C) acute and chronic skin manifestations. Cluster B was the youngest and had the lowest level of smoking exposure. Age-adjusted regression analyses showed that compared with never smokers a smoking history of >20 pack-years was associated with neurological disorder (OR=3.16), discoid rash (OR=2.22), photosensitivity (OR=2.19) and inversely with haematological disorder (OR=0.40), renal disorder (OR=0.40) and non-erosive arthritis (OR=0.45), p<0.05 for all.ConclusionsOur findings support that SLE presents in varying clinical phenotypes and suggest that they may have differentiated associations with smoking history.
Undiagnosed SARS-CoV-2 infection and outcome in patients with acute MI and no COVID-19 symptoms
Authors: Akhtar Zubair , Chowdhury Fahmida , Aleem Mohammad Abdul , Ghosh Probir Kumar , Rahman Mahmudur , Rahman Mustafizur , Hossain Mohammad Enayet , Sumiya Mariya Kibtiya , Islam A K M Monwarul , Uddin Mir Jamal , MacIntyre C Raina , Cajander Sara , Frobert Ole 
Published: April 2021

ObjectiveWe aimed to determine the prevalence and outcome of occult infection with SARS-CoV-2 and influenza in patients presenting with myocardial infarction (MI) without COVID-19 symptoms.MethodsWe conducted an observational study from 28 June to 11 August 2020, enrolling patients admitted to the National Institute of Cardiovascular Disease Hospital, Dhaka, Bangladesh, with ST-segment elevation MI (STEMI) or non-ST-segment elevation MI who did not meet WHO criteria for suspected COVID-19. Samples were collected by nasopharyngeal swab to test for SARS-CoV-2 and influenza virus by real-time reverse transcriptase PCR. We followed up patients at 3 months (13 weeks) postadmission to record adverse cardiovascular outcomes: all-cause death, new MI, heart failure and new percutaneous coronary intervention or stent thrombosis. Survival analysis was performed using the Kaplan-Meier method.ResultsWe enrolled 280 patients with MI, 79% male, mean age 54.5±11.8 years, 140 of whom were diagnosed with STEMI. We found 36 (13%) to be infected with SARS-CoV-2 and 1 with influenza. There was no significant difference between mortality rate observed among SARS-CoV-2 infected patients compared with non-infected (5 (14%) vs 26 (11%); p=0.564). A numerically shorter median time to a recurrent cardiovascular event was recorded among SARS-CoV-2 infected compared with non-infected patients (21 days, IQR: 8–46 vs 27 days, IQR: 7–44; p=0.378).ConclusionWe found a substantial rate of occult SARS-CoV-2 infection in the studied cohort, suggesting SARS-CoV-2 may precipitate MI. Asymptomatic patients with COVID-19 admitted with MI may contribute to disease transmission and warrants widespread testing of hospital admissions.
Impact of assessing patient-reported outcomes with mobile apps on patient–provider interaction
Authors: Shaw Yomei , Courvoisier Delphine S , Scherer Almut , Ciurea Adrian , Lehmann Thomas , Jaeger Veronika K , Walker Ulrich A , Finckh Axel 
Published: April 2021

ObjectiveTo explore the effect of apps measuring patient-reported outcomes (PROs) on patient–provider interaction in the rheumatic diseases in an observational setting.MethodsPatients in the Swiss Clinical Quality Management in Rheumatic Diseases Registry were offered mobile apps (iDialog and COmPASS) to track disease status between rheumatology visits using validated PROs (Rheumatoid Arthritis Disease Activity Index-5 score, Bath Ankylosing Spondylitis Disease Activity Index score, Routine Assessment of Patient Index Data-3 score and Visual Analogue Scale score for pain, disease activity and skin symptoms). We assessed two aspects of patient–provider interaction: shared decision making (SDM) and physician awareness of disease fluctuations. We used logistic regressions to compare outcomes among patients who (1) used an app and discussed app data with their physician (app+discussion group), (2) used an app without discussing the data (app-only group) or (3) did not use any app (non-app users).Results2111 patients were analysed, including 1799 non-app users, 150 app-only users and 162 app+discussion users (43% male; with 902 patients with rheumatoid arthritis, 766 patients with axial spondyloarthritis and 443 patients with psoriatic arthritis). App users were younger than non-app users (mean age of 47 vs 51 years, p<0.001). Compared with non-app users, the app+discussion group rated their rheumatologist more highly in SDM (OR 1.7, 95% CI 1.1 to 2.4) and physician awareness of disease fluctuations (OR 2.0, 95% CI 1.3 to 3.1). This improvement was absent in the app-only group.ConclusionApp users who discussed app data with their rheumatologist reported more favourably on patient–provider interactions than app users who did not and non-app users. Apps measuring PROs may contribute little to patient–provider interactions without integration of app data into care processes.
Species-specific vulnerability to angling and its size-selectivity in sympatric stream salmonids
Authors: Tsuboi Jun-ichi , Morita Kentaro , Sahashi Genki , Kuroki Mari , Baba Shinya , Arlinghaus Robert 
Published: April 2021

In mixed fisheries where multiple species are caught, to manage resources sustainably, knowledge about the species-specific vulnerability to fishing is equally or even more important than knowledge of size selectivity of the gear. We compared the vulnerability to bait recreational angling in four salmonid species in natural streams in Japan. The ranking of species-specific angling vulnerability was as follows (from highest to lowest): rainbow trout (Oncorhynchus mykiss), masu salmon (Oncorhynchus masou), white-spotted char (Salvelinus leucomaenis), and southern Asian Dolly Varden (Salvelinus curilus). In all species, larger individuals were more vulnerable to angling, but there were differences in the size dependence between species. In rainbow trout and Dolly Varden (which have a nonanadromous life history in the study area), the probability of being caught monotonically increased with body size, while the vulnerability to angling in masu salmon and white-spotted char (which have an anadromous life history in the study area) showed a domed-shaped pattern. We found that across the species the catch per unit effort showed a hyperstable relationship with population density. Therefore, diminishing local populations are prone to collapse, and this collapse would be hard to foresee based on catch rate data alone.
Holonomy and inverse-triad corrections in spherical models coupled to matter
Authors: Alonso-Bardaji Asier , Brizuela David 
Published: April 2021

AbstractLoop quantum gravity introduces two characteristic modifications in the classical constraints of general relativity: the holonomy and inverse-triad corrections. In this paper, a systematic construction of anomaly-free effective constraints encoding such corrections is developed for spherically symmetric spacetimes. The starting point of the analysis is a generic Hamiltonian constraint where free functions of the triad and curvature components as well as non-minimal couplings between geometric and matter degrees of freedom are considered. Then, the requirement of anomaly freedom is imposed in order to obtain a modified Hamiltonian that forms a first-class algebra. In this way, we construct a family of consistent deformations of spherical general relativity, which generalizes previous results in the literature. The discussed derivation is implemented for vacuum as well as for two matter models: dust and scalar field. Nonetheless, only the deformed vacuum model admits free functions of the connection components. Therefore, under the present assumptions, we conclude that holonomy corrections are not allowed in the presence of these matter fields.
Regular black hole interior spacetime supported by three-form field
Authors: Bouhmadi-López Mariam , Chen Che-Yu , Chew Xiao Yan , Ong Yen Chin , Yeom Dong-han 
Published: April 2021

AbstractIn this paper, we show that a minimally coupled 3-form endowed with a proper potential can support a regular black hole interior. By choosing an appropriate form for the metric function representing the radius of the 2-sphere, we solve for the 3-form field and its potential. Using the obtained solution, we construct an interior black hole spacetime which is everywhere regular. The singularity is replaced with a Nariai-type spacetime, whose topology is $$\text {dS}_2 \times \text {S}^2$$

dS
2

×

S
2

, in which the radius of the 2-sphere is constant. So long as the interior continues to expand indefinitely, the geometry becomes essentially compactified. The 2-dimensional de Sitter geometry appears despite the negative potential of the 3-form field. Such a dynamical compactification could shed some light on the origin of de Sitter geometry of our Universe, exacerbated by the Swampland conjecture. In addition, we show that the spacetime is geodesically complete. The geometry is singularity-free due to the violation of the null energy condition.
Aschenbach effect for spinning particles in Kerr–(A)dS spacetime
Authors: Vahedi Ali , Khodagholizadeh Jafar , Tursunov Arman 
Published: April 2021

AbstractA non-monotonic behavior of the velocity gradient of a test particle revolving around a rapidly rotating black hole in the locally non-rotating frame of reference is known as the Aschenbach effect. This effect can serve as a distinguishing signature of rapidly rotating black holes, being potentially useful for the measurements of the astrophysical black hole spins. This paper is the generalization of our previous research to the motion of spinning particles around a rotating black hole with non-zero cosmological constant. We show that both the particle’s spin s and the cosmological constant $$\Lambda $$
Λ
modify the critical value of the black hole spin $$a_c$$

a
c

, for which the Aschenbach effect can be observed; $$a_c$$

a
c

can increase or decrease depending on the signs of s and $$\Lambda $$
Λ
. We also found that the particle’s spin s can mimic the effect of the cosmological constant $$\Lambda $$
Λ
for a given $$a_c$$

a
c

, causing thus a discrepancy in the measurements of s, $$\Lambda $$
Λ
and $$a_c$$

a
c

in the Aschenbach effect.
Non-minimal energy–momentum squared gravity
Authors: Shahidi Shahab 
Published: April 2021

AbstractWe consider a gravitational theory with an additional non-minimal coupling between baryonic matter fields and geometry. The coupling is second order in the energy momentum tensor and can be seen as a generalization of the energy–momentum squared gravity model. We will add a constraint through a Lagrange multiplier to ensure the conservation of the energy–momentum tensor. Background cosmological implications together with its dynamical system analysis will be investigated in details. Also we will consider the growth of matter perturbations at first order, and estimate the model parameter from observations on H and also $$f\sigma _8$$

f

σ
8

. We will show that the model parameter should be small and positive in 2$$\sigma $$
σ
confidence interval. The theory is shown to be in a good agreement with observational data.
SHOULD ASEAN ANTITRUST LAWS EMULATE EUROPEAN COMPETITION POLICY?
Authors: AUER DIRK , MANNE GEOFFREY A. , BOWMAN SAM 
Published: April 2021

Recent years have seen the Association of Southeast Asian Nations (ASEAN) members embark upon various initiatives that seek to harmonize their competition regimes. These ongoing efforts to modernize and harmonize ASEAN competition laws take place amid a longstanding effort by both the European Union (EU) and the United States (US) to export their respective competition laws throughout the world. This raises a critical question: Should the ASEAN countries attempt to mimic the competition regimes of other developed nations, notably those that are in force in the EU and the US? And, if so, which one of these regimes should they draw more inspiration from? This paper seeks to dispel the myth that the European model of competition enforcement would necessarily provide a superior blueprint. To the contrary, it shows that the evolutionary, common-law-like regime that has emerged in the US has many strengths that are often overlooked by contemporary competition policy scholarship, and which might provide a particularly good fit for the economic and political realities of the ASEAN member states. The paper proceeds as follows. Section 2 analyzes the high-level differences between the American and European approaches to competition policy. Section 3 shows that the US and Europe also differ substantially in terms of the conduct that may constitute an infringement of competition law — the EU system being significantly more restrictive. Section 4 turns to the thorny problem of digital platforms, in particular, and argues that while the European model might more readily facilitate intervention against digital platforms, the resulting cases may be detrimental to consumers and the economy more broadly. Section 5 posits that reducing economic concentration — sometimes cited as a byproduct of European-style competition enforcement — should not be a self-standing goal of antitrust policy. Finally, Section 6 argues that many of the economic and political characteristics of the ASEAN economy cut in favor of using the US model of competition enforcement as a blueprint for further development and harmonization of ASEAN competition law.
Expressing the largest eigenvalue of a singular beta F-matrix with heterogeneous hypergeometric functions
Authors: Shimizu Koki , Hashiguchi Hiroki 
Published: April 2021

In this paper, the exact distribution of the largest eigenvalue of a singular random matrix for multivariate analysis of variance (MANOVA) is discussed. The key to developing the distribution theory of eigenvalues of a singular random matrix is to use heterogeneous hypergeometric functions with two matrix arguments. In this study, we define the singular beta [Formula: see text]-matrix and extend the distributions of a nonsingular beta [Formula: see text]-matrix to the singular case. We also give the joint density of eigenvalues and the exact distribution of the largest eigenvalue in terms of heterogeneous hypergeometric functions.
Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander
Authors: Xiao Wang , Liu Siling , Lu Yanqin , Lei Lei , Liu Ning , Shen Xiaoping , He Yuhong , Liu Ousheng 
Published: April 2021

The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired

t

-test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from

35.75
±
2.48

mm and

54.20
±
3.17

mm to

37.87
±
2.26

mm (

P
<
0.05

) and

56.65
±
3.10

mm (

P
<
0.05

), respectively. The nasal cavity volume increased from

20320.00
±
3468.25

mm3 to

23134.70
±
3918.84

mm3 (

P
<
0.05

). The nasal pressure drop decreased from

36.34
±
3.99

Pa to

30.70
±
3.17

Pa (

P
<
0.05

), while the value of the maximum velocity decreased from

6.50
±
0.31

m/s to

5.85
±
0.37

m/s (

P
<
0.05

). Nasal resistance dropped remarkably from

0.16
±
0.14

Pa/ml/s to

0.08
±
0.06

Pa/ml/s (

P
<
0.05

). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.
Patient Experience of Interpersonal Processes of Care and Subsequent Utilization of Hormone Therapy for Non-Metastatic Breast Cancer
Authors: Poon BY , Kroenke CH , Hillyer GC , Lamerato LE , Stewart AL , Neugut AI , Hershman DL , Kushi LH 
Published: April 2021

Abstract
Purpose: We examined the association between patient experience of care and utilization of hormone therapy (HT) in the treatment of non-metastatic hormone-receptor positive (HR+) breast cancer. Methods: Patients newly diagnosed with non-metastatic breast cancer were recruited from 2006 to 2010 for a longitudinal multisite cohort study in New York, NY, Detroit, MI, and Northern California. Of 1,145 patients surveyed, 797 had HR+ tumors eligible for HT and all necessary data. We assessed patient experience 4 to 8 weeks after recruitment using 6 subscales of the Interpersonal Processes of Care (IPC) survey: compassion, discrimination, and hurriedness in communication, as well as concern elicitation, result explanation, and patient-centered decision-making. Subscales ranged from 1 to 5 where higher values indicated better experiences. HT for 5 years is standard care for HR+ breast cancer so utilization was defined as time from diagnosis to HT initiation and time from HT initiation to early discontinuation before 5 years as calculated from follow-up survey responses. We evaluated the relationship between patient experience and utilization using Cox proportional hazard models, controlling for education, income, insurance, marital status, social support, site of care, age at diagnosis, stage, grade, tumor size, Charlson comorbidity index, and chemotherapy. Results: Median age at diagnosis was 59 years (interquartile range 51–66) with the majority diagnosed at clinical stage 1 (54%) and with low or moderate grade disease (78%). Less hurried communication was associated with increased probability of HT initiation (Hazards Ratio (HR) 1.15; 95% Confidence Interval (CI) 1.03, 1.30; p = 0.018). Conversely, more patient-centered decision-making was associated with increased probability of early discontinuation (HR 1.29; CI, 1.03, 1.63; p = 0.028). All other associations were null. Conclusion: While unhurried communication was associated with initiation of hormone therapy, patient-centered decision-making was associated with early discontinuation. Different aspects of patient experience may have vastly different relationships with patient utilization of health services. Actionable assessments of patient experience may require measurement along multiple dimensions.
Recommending Inequality? Patterns of US Healthcare Providers' HPV Vaccine Recommendations
Authors: Kong WY , Bustamante G , Margolis M , McRee AL , Pallotto IK , Gilkey MB 
Published: April 2021

Abstract
Purpose: Infrequent provider recommendations continue to be a key barrier to human papillomavirus (HPV) vaccination, including among adolescents at higher risk for future HPV cancers. To inform future provider- training programs, our study sought to synthesize the findings of existing studies of disparities in provider recommendation of HPV vaccination among adolescents. Methods: We conducted a systematic review of studies that quantitatively assessed the prevalence of provider recommendation of HPV vaccination among US parents of adolescents aged 9–17. We excluded studies that were not empirical, not peer-reviewed, or collected data before 2012. Following PRISMA guidelines, two independent coders extracted and screened 3,158 unique titles and abstracts from multiple databases. Next, two independent coders reviewed the full text of eligible studies, systematically collecting data using a standardized abstraction form. We resolved coding disagreements via discussion with the whole team. Results: Fifty-four of 252 reviewed studies met eligibility criteria, including 33 studies of parents and 21 studies of providers. Parental report of receiving a provider recommendation for HPV vaccination ranged from 22% to 78%. These studies most often assessed disparities by adolescents' sex, with almost all finding that provider recommendations were less common for boys vs. girls. Most studies of provider reports confirmed disparate recommendations by sex. Fewer studies stratified recommendation disparities by income or race/ethnicity; these studies found that recommendations were less common among lower-income households, but reported mixed findings by race/ethnicity. Geographic assessments found variation across states and urbanicity, with recommendations being lower including in some Southern states and in rural areas. Conclusion: Findings suggest differences in provider recommendation by sex, household income, geography, and possibly race/ethnicity, in spite of national guidelines for routine HPV vaccination. National efforts to improve provider communication about HPV vaccination should focus on improving recommendation consistency, especially for populations such as lower-income and rural adolescents who are at higher risk for future HPV cancers.