bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced cardiorespiratory fitness is a mediator of excess all-cause mortality in rheumatoid arthritis: the Trøndelag Health Study
Authors: Liff Marthe Halsan , Hoff Mari , Wisloff Ulrik , Videm Vibeke 
Published: March 2021

ObjectivesInvestigate if low cardiorespiratory fitness (CRF) was associated with and acted as a mediator of excess all-cause mortality rate in persons suffering from rheumatoid arthritis (RA) compared with the general population.MethodsAll-cause mortality was analysed using Cox regression modelling in patients with RA (n=348) and controls (n=60 938) who took part in the second (1995–1997) and third (2006–2008) waves of the longitudinal population-based Trøndelag Health Study in Norway. A mediation analysis was performed to investigate if excess relative risk of mortality in RA was mediated by low estimated CRF (eCRF).ResultsDuring the follow-up until 31 December 2018 (mean 19.3 years), the mortality rate among patients with RA (n=127, 36.5%) was higher than among controls (n=12 942, 21.2%) (p<0.001). Among controls and patients with RA, 51% and 26%, respectively, had eCRF above the median for their age and sex (p<0.001). The final Cox model included RA status and eCRF, adjusted for hypertension, body mass index, smoking, cholesterol, diabetes and creatinine. eCRF below median for sex and age category was associated with increased mortality (p<0.001). The total excess relative risk of mortality in patients with RA was 28% (95% CI 2% to 55%, p=0.035), in which RA itself contributed 5% and the direct and indirect contributions of low eCRF accounted for 23%.ConclusionsLow eCRF was an important mediator of the increased all-cause mortality rate found in RA. Our data indicate that patients with RA should be given advice to perform physical activity that increases CRF, along with optimised treatment with antirheumatic drugs, from the time of diagnosis.
A Diophantine Problem with Unlike Powers of Primes
Authors: Mu Quanwu , Xi Liyan 
Published: March 2021

Let

k

be an integer with

4
≤
k
≤
6

and

η

be any real number. Suppose that

λ

1

,

λ

2

,
…
,

λ

5

are nonzero real numbers, not all of them have the same sign, and

λ

1

/

λ

2

is irrational. It is proved that the inequality

λ

1

p

1

+

λ

2

p
2
2

+

λ

3

p
3
3

+

λ

4

p
4
4

+

λ

5

p
5
k

+
η

<

max

1
≤
j
≤
5

p

j

−
σ

k

has infinitely many solutions in prime variables

p

1

,

p

2

,

p

3

,

p

4

,
and

p

5

, where

0
<
σ

4

<
1
/

36

,
0
<
σ

5

<

4
/

189

, and

0
<
σ

6

<
1
/

54

. This gives an improvement of the recent results.
Association Between Increased Hospital Reimbursement for Cardiac Rehabilitation and Utilization of Cardiac Rehabilitation by Medicare Beneficiaries
Authors: Fletcher Dana R. , Grunwald Gary K. , Battaglia Catherine , Ho P. Michael , Lindrooth Richard C. , Peterson Pamela N. 
Published: March 2021

Background:
Although cardiac rehabilitation (CR) is a Class I Guideline recommendation, and has been shown to be a cost-effective intervention after a cardiac event, it has been reimbursed at levels insufficient to cover hospital operating costs. In January 2011, Medicare increased payment for CR in hospital outpatient settings by ≈180%. We evaluated the association between this payment increase and participation in CR of eligible Medicare beneficiaries to better understand the relationship between reimbursement policy and CR utilization.

Methods:
From a 5% Medicare claims sample, we identified patients with acute myocardial infarction, coronary artery bypass surgery, percutaneous coronary intervention, or cardiac valve surgery between January 1, 2009 and September 30, 2012, alive 30 days after their event, with continuous enrollment in Medicare fee-for-service, Part A/B for 4 months. Trends and changes in CR participation were estimated using an interrupted time series approach with a hierarchical logistic model, hospital random intercepts, adjusted for patient, hospital, market, and seasonality factors. Estimates were expressed using average marginal effects on a percent scale.

Results:
Among 76 695 eligible patients, average annual CR participation was 19.5% overall. In the period before payment increase, adjusted annual participation grew by 1.1 percentage points (95% CI, 0.48–2.4). No immediate change occurred in CR participation when the new payment was implemented. In the period after payment increase, on average, 20% of patients participated in CR annually. The annual growth rate in CR participation slowed in the post-period by 1.3 percentage points (95% CI, −2.4 to −0.12) compared with the prior period. Results were somewhat sensitive to time window variations.

Conclusions:
The 2011 increase in Medicare reimbursement for CR was not associated with an increase in participation. Future studies should evaluate whether payment did not reach a threshold to incentivize hospitals or if hospitals were not sensitive to reimbursement changes.
Associations of Serum Nonesterified Fatty Acids With Coronary Heart Disease Mortality and Nonfatal Myocardial Infarction: The CHS (Cardiovascular Health Study) Cohort
Authors: Huang Neil K. , Bůžková Petra , Matthan Nirupa R. , Djoussé Luc , Hirsch Calvin H. , Kizer Jorge R. , Longstreth W. T. , Mukamal Kenneth J. , Lichtenstein Alice H. 
Published: March 2021

Background

Significant associations have been reported between serum total nonesterified fatty acid (NEFA) concentrations and coronary heart disease (CHD) mortality and incident nonfatal myocardial infarction (MI) in some prospective cohort studies. Little is known about whether individual or subclasses (saturated, polyunsaturated [n‐6 and n‐3], and
trans
fatty acids) of serum NEFAs relate to CHD mortality and nonfatal MI.

Methods and Results

CHS (Cardiovascular Health Study) participants (N=1681) who had no history of MI, angina, or revascularization or were free of MI at baseline (1996–1997) were included. NEFAs were quantified using gas chromatography. Cox regression analysis was used to evaluate associations of 5 subclasses and individual NEFAs with CHD composite (CHD mortality and nonfatal MI), CHD mortality, and incident nonfatal MI. During a median follow‐up of 11.7 years, 266 cases of CHD death and 271 cases of nonfatal MI occurred. In the fully adjusted model, no significant associations were identified between individual NEFA and CHD composite. Exploratory analyses indicated that lauric acid (12:0) was negatively associated (hazard ratio [HR], 0.76; 95% CI, 0.59–0.98;
P
=0.0328) and dihomo‐γ‐linolenic acid (20:3n‐6) was positively associated with CHD mortality (HR, 1.34; 95% CI, 1.02–1.76;
P
=0.0351). Elaidic acid (18:1n‐7
t
) was positively associated with incident nonfatal MI (HR, 1.46; 95% CI, 1.01–2.12;
P
=0.0445). No significant associations were observed for NEFA subclass and any outcomes.

Conclusions
In CHS participants, 2 NEFAs, dihomo‐γ‐linolenic and elaidic acids, were positively associated with CHD mortality and nonfatal MI, respectively, suggesting potential susceptibility biomarkers for risks of CHD mortality and nonfatal MI.
Newly Diagnosed Atrial Fibrillation After Transient Ischemic Attack Versus Minor Ischemic Stroke in the POINT Trial
Authors: Kamel Hooman , Farrant Mary , Easton J. Donald , Sposato Luciano A. , Elm Jordan J. , Underwood Ellen , Johnston S. Claiborne 
Published: March 2021

Background
Atrial fibrillation/flutter (AF) after transient ischemic attack (TIA) has not been well studied. We compared the likelihood of new AF diagnosis after ischemic stroke versus TIA.

Methods and Results

The POINT (Platelet‐Oriented Inhibition in New TIA and Minor Ischemic Stroke) trial enrolled adults within 12 hours of minor ischemic stroke or high‐risk TIA. Our exposure was index event type (ischemic stroke versus TIA). The primary analysis used the original trial definition of TIA (resolution of symptoms/signs). In secondary analyses, TIA cases with infarction on neuroimaging were reclassified as strokes. Our primary outcome was a new AF diagnosis, ascertained from adverse event and treatment interruption/discontinuation reports. We calculated C‐statistics for variables associated with newly diagnosed AF. We used Kaplan‐Meier survival statistics and Cox models adjusted for demographics and vascular risk factors. Excluding 49 subjects with baseline AF, 2746 patients had index stroke and 2086 patients had index TIA. During the 90‐day follow‐up, 106 patients had newly diagnosed AF. Cumulative risks of AF were 2.7% (95% CI, 2.1%–3.4%) after stroke and 2.0% (95% CI, 1.5%–2.7%) after TIA (
P
=0.15). After reclassifying index events by neuroimaging, cumulative AF risk was higher after stroke (2.7%; 95% CI, 2.2%–3.4%) than TIA (1.8%; 95% CI, 1.3%–2.5%) (
P
=0.04). Index event type had negligible predictive utility (C‐statistic, 0.54).

Conclusions
Among patients with cerebral ischemia, the distinction between TIA versus minor stroke did not stratify the risk of subsequent AF diagnosis, implying that patients with TIA should undergo similar heart‐rhythm monitoring strategies as patients with ischemic stroke.
Long‐Term Dipeptidyl Peptidase 4 Inhibition Worsens Hypertension and Renal and Cardiac Abnormalities in Obese Spontaneously Hypertensive Heart Failure Rats
Authors: Jackson Edwin K. , Mi Zaichuan , Gillespie Delbert G. , Cheng Dongmei , Tofovic Stevan P. 
Published: March 2021

Background
The long‐term effects of dipeptidyl peptidase 4 (DPP4) inhibitors on blood pressure and cardiovascular and renal health remain controversial. Herein, we investigated the extended (>182 days) effects of DPP4 inhibition in a model of spontaneous hypertension, heart failure, diabetes mellitus, obesity and hyperlipidemia.

Methods and Results

Adult obese spontaneously hypertensive heart failure rats (SHHF) were implanted with radio transmitters for measurement of arterial blood pressures. Two weeks later, SHHF were randomized to receive either a DPP4 inhibitor (sitagliptin, 80 mg/kg per day in drinking water) or placebo. At the end of the radiotelemetry measurements, renal and cardiac function and histology, as well as other relevant biochemical parameters, were assessed. For the first 25 days, mean arterial blood pressures were similar in sitagliptin‐treated versus control SHHF; afterwards, mean arterial blood pressures increased more in sitagliptin‐treated SHHF (
P
<0.000001). The time‐averaged mean arterial blood pressures from day 26 through 182 were 7.2 mm Hg higher in sitagliptin‐treated SHHF. Similar changes were observed for systolic (8.6 mm Hg) and diastolic (6.1 mm Hg) blood pressures, and sitagliptin augmented hypertension throughout the light‐dark cycle. Long‐term sitagliptin treatment also increased kidney weights, renal vascular resistances, the excretion of kidney injury molecule‐1 (indicates injury to proximal tubules), renal interstitial fibrosis, glomerulosclerosis, renal vascular hypertrophy, left ventricular dysfunction, right ventricular degeneration, and the ratios of collagen IV/collagen III and collagen IV/laminin in the right ventricle.

Conclusions
These findings indicate that, in some genetic backgrounds, long‐term DPP4 inhibitor treatment is harmful and identify an animal model to study mechanisms of, and test ways to prevent, DPP4 inhibitor–induced pathological conditions.
Water for the Saints of Baghdad: The Hydrology of a Sacred Ottoman Geography
Authors: Husain Faisal H. 
Published: March 2021

Abstract
Following the conquest of Baghdad in 1534, the Ottoman Empire pursued a wide range of policies to maintain the shrines of Muslim saints buried in the province, many of whom were revered by both the Sunni Ottomans and the Shiʿi Safavids. Ottoman endeavors entailed active management of the Tigris and Euphrates waters to provision inland shrines with water and guard those on the riverbanks from damaging floods. With a hydraulic infrastructure, the Ottomans appropriated the memories of the saints of Baghdad and reinforced their territorial claims to the province in the face of a rising Shiʿi power in Persia. The story highlights the political and religious dimensions of water control in a sacred geography as imperial conflicts within Islamdom and Christendom redrew the map of Eurasia.
Random Forest Model to Assess Predictor Importance and Nowcast Severe Storms using High-Resolution Radar–GOES Satellite–Lightning Observations
Authors: Mecikalski John R. , Sandmæl Thea N. , Murillo Elisa M. , Homeyer Cameron R. , Bedka Kristopher M. , Apke Jason M. , Jewett Chris P. 
Published: March 2021

AbstractFew studies have assessed combined satellite, lightning, and radar databases to diagnose severe storm potential. The research goal here is to evaluate next-generation, 60-second update frequency geostationary satellite and lightning information with ground-based radar to isolate which variables, when used in concert, provide skillful discriminatory information for identifying severe (hail ≥2.5 cm in diameter, winds ≥25 m s–1, tornadoes) versus non-severe storms. The focus of this study is predicting severe thunderstorm and tornado warnings. A total of 2,004 storms in 2014–2015 were objectively tracked with 49 potential predictor fields related to May, daytime Great Plains convective storms. All storms occurred when 1-min Geostationary Operational Environmental Satellite (GOES)–14 “super rapid scan” data were available. The study used three importance methods to assess predictor importance related to severe warnings, and random forests to provide a model and skill evaluation measuring the ability to predict severe storms. Three predictor importance methods show that GOES mesoscale atmospheric motion vector derived cloud-top divergence and above anvil cirrus plume presence provide the most satellite-based discriminatory power for diagnosing severe warnings. Other important fields include Earth Networks Total Lightning flash density, GOES estimated cloud-top vorticity, and overshooting-top presence. Severe warning predictions are significantly improved at the 95% confidence level when a few important satellite and lightning fields are combined with radar fields, versus when only radar data are used in the random forests model. This study provides a basis for including satellite and lightning fields within machine-learning models to help forecast severe weather.
A systematic review and meta-analysis on adoption of WHO-recommended infant feeding practices among HIV positive mothers in Ethiopia
Authors: Dagnew Amare Belachew , Teferi Mulat Dagnew 
Published: March 2021

Abstract
Background
The prevalence of the World Health Organization (WHO) recommended infant feeding practices for HIV exposed infants is low in developing countries. There is no nationwide representative study was done in Ethiopia. Therefore, this study aimed to assess the pooled prevalence of WHO-recommended infant feeding practices among HIV-positive mothers in Ethiopia.

Methods
EMBASE, PubMed, Google Scholar, CINHAL, Web of Science, Cochrane library, and hand searches of references were extensively searched to find out the primary articles. This study was included in all primary articles published in peer review journals regarding the recommended infant feeding practices in Ethiopia. Reviewers were used a standardized Microsoft Excel format to extract the data and analyzed it with Stata 11 version software. The pooled prevalence of recommended infant feeding practices among HIV exposed infants was estimated by a random-effect model. The sources of variation between the studies were identified by the I2 statistics test. Furthermore, the source of heterogeneity was checked by subgroup and meta-regression analyses. Sensitivity analysis was also carried out for included articles to identify extreme values that affect the outcome of pooled results.

Results
A total of twenty-one articles were included in this study. The random effect pooled prevalence of WHO-recommended infant feeding practices in Ethiopia was 82.76% (95% Confidence Interval [CI]: 75.4, 90.11) with the heterogeneity of I2 = 93.7 with a value of p < 0.001. The subgroup analysis result showed that the highest prevalence of WHO-recommended infant feeding practices was observed in the retrospective cohort study design, 89.45%, and the lowest prevalence was found in cross-sectional studies, 80.67%. Mothers who disclosed their HIV serostatus to their spouses OR = 2.88(2.27, 3.66) and attended antenatal care visits OR = 4.62(3.13, 6.83) were more likely to follow the WHO-recommended infant feeding practices than their counterparts.

Conclusion
Two out of ten HIV exposed infants received mixed feeding in Ethiopia. Health professionals should support and counsel HIV positive mothers to disclose their HIV serostatus to their spouses and advertisements in general or community health workers can get this message out to encourage using antenatal care services during the pregnancy period were recommended to increase the adoption of WHO recommended infant feeding practices and decrease their infant’s risk of morbidity, including HIV infection.
Progress towards reduced-crude protein diets for broiler chickens and sustainable chicken-meat production
Authors: Liu Sonia Yun , Macelline Shemil P. , Chrystal Peter V. , Selle Peter H. 
Published: March 2021

AbstractThe prime purpose of this review is to explore the pathways whereby progress towards reduced-crude protein (CP) diets and sustainable chicken-meat production may be best achieved. Reduced-CP broiler diets have the potential to attenuate environmental pollution from nitrogen and ammonia emissions; moreover, they have the capacity to diminish the global chicken-meat industry’s dependence on soybean meal to tangible extents. The variable impacts of reduced-CP broiler diets on apparent amino acid digestibility coefficients are addressed. The more accurate identification of amino acid requirements for broiler chickens offered reduced-CP diets is essential as this would diminish amino acid imbalances and the deamination of surplus amino acids. Deamination of amino acids increases the synthesis and excretion of uric acid for which there is a requirement for glycine, this emphasises the value of so-called “non-essential” amino acids. Starch digestive dynamics and their possible impact of glucose on pancreatic secretions of insulin are discussed, although the functions of insulin in avian species require clarification. Maize is probably a superior feed grain to wheat as the basis of reduced-CP diets; if so, the identification of the underlying reasons for this difference should be instructive. Moderating increases in starch concentrations and condensing dietary starch:protein ratios in reduced-CP diets may prove to be advantageous as expanding ratios appear to be aligned to inferior broiler performance. Threonine is specifically examined because elevated free threonine plasma concentrations in birds offered reduced-CP diets may be indicative of compromised performance. If progress in these directions can be realised, then the prospects of reduced-CP diets contributing to sustainable chicken-meat production are promising.
Safety-enhanced control strategy of a power soft robot driven by hydraulic artificial muscles
Authors: Feng Yunhao , Ide Tohru , Nabae Hiroyuki , Endo Gen , Sakurai Ryo , Ohno Shingo , Suzumori Koichi 
Published: March 2021

AbstractPower soft robots—defined as novel robots driven by powerful soft actuators, achieving both powerfulness and softness—are potentially suitable for complex collaborative tasks, and an approach to actuating a power soft robot is the McKibben artificial muscle. This study aims to show the potential of hydraulic artificial muscles to be implemented in a power soft robot with high safety, including higher stability against sudden load separation or impact disturbance, and appropriate dynamic compliance. The stability of a manipulator arm driven by hydraulic muscle actuators is experimentally proven to be higher than that of pneumatic muscle actuators when the stored elastic energy is instantaneously released. Therefore, the hydraulic muscle actuator is a better candidate for actuating a power soft robot. By taking advantage of the incompressible liquid medium and the compliant structure of a hydraulic muscle, a second-order impedance control strategy with a braking method is proposed to improve dynamic compliance without sacrificing the safety features of hydraulic muscles. The results show that the manipulator can be easily shifted by a several-kilogram-level external force and react safely against sudden load change with low angular velocity by the proposed impedance control.
Improved PET/MRI accuracy by use of static transmission source in empirically derived hardware attenuation correction
Authors: Farag Adam , Thompson R. Terry , Thiessen Jonathan D. , Prato Frank S. , Théberge Jean 
Published: March 2021

Abstract
Background
Accurate quantification of radioactivity, measured by an integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) system, is still a challenge. One aspect of such a challenge is to correct for the hardware attenuation, such as the patient table and radio frequency (RF) resonators. For PET/MRI systems, computed tomography (CT) is commonly used to produce hardware attenuation correction (AC) maps, by converting Hounsfield units (HU) to a linear attenuation coefficients (LAC) map at the PET energy level 511 keV, using a bilinear model. The model does not address beam hardening, nor higher density materials, which can lead to inaccurate corrections.

Purpose
In this study, we introduce a transmission-based (TX-based) AC technique with a static Germanium-68 (Ge-68) transmission source to generate hardware AC maps using the PET/MRI system itself, without the need for PET or medical CT scanners. The AC TX-based maps were generated for a homogeneous cylinder, made of acrylic as a validator. The technique thereafter was applied to the patient table and posterior part of an RF-phased array used in cardiovascular PET/MRI imaging. The proposed TX-based, and the CT-based, hardware maps were used in reconstructing PET images of one cardiac patient, and the results were analysed and compared.

Results
The LAC derived by the TX-based method for the acrylic cylinder is estimated to be 0.10851 ± 0.00380 cm−1 compared to the 0.10698 ± 0.00321 cm−1 theoretical value reported in the literature. The PET photon counts were reduced by 8.7 ± 1.1% with the patient table, at the region used in cardiac scans, while the CT-based map, used for correction, over-estimated counts by 4.3 ± 1.3%. Reconstructed in vivo images using TX-based AC hardware maps have shown 4.1 ± 0.9% mean difference compared to those reconstructed images using CT-based AC.

Conclusions
The LAC of the acrylic cylinder measurements using the TX-based technique was in agreement with those in the literature confirming the validity of the technique. The over-estimation of photon counts caused by the CT-based model used for the patient table was improved by the TX-based technique. Therefore, TX-based AC of hardware using the PET/MRI system itself is possible and can produce more accurate images when compared to the CT-based hardware AC in cardiac PET images.