bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiopoietin‐2 and angiopoietin‐like 4 protein provide prognostic information in patients with suspected acute coronary syndrome
Authors: Aarsetøy Reidun , Ueland Thor , Aukrust Pål , Michelsen Annika E. , de la Fuente Ricardo Leon , Pönitz Volker , Brügger‐Andersen Trygve , Grundt Heidi , Staines Harry , Nilsen Dennis W.T. 
Published: July 2021

AbstractBackgroundPlasma levels of angiopoietin‐2 (ANGPT2) and angiopoietin‐like 4 protein (ANGPTL4) reflect different pathophysiological aspects of cardiovascular disease. We evaluated their association with outcome in a hospitalized Norwegian patient cohort (n = 871) with suspected acute coronary syndrome (ACS) and validated our results in a similar Argentinean cohort (n = 982).MethodsA cox regression model, adjusting for traditional cardiovascular risk factors, was fitted for ANGPT2 and ANGPTL4, respectively, with all‐cause mortality and cardiac death within 24 months and all‐cause mortality within 60 months as the dependent variables.ResultsAt 24 months follow‐up, 138 (15.8%) of the Norwegian and 119 (12.1%) of the Argentinian cohort had died, of which 86 and 66 deaths, respectively, were classified as cardiac. At 60 months, a total of 259 (29.7%) and 173 (17.6%) patients, respectively, had died.ANGPT2 was independently associated with all‐cause mortality in both cohorts at 24 months [hazard ratio (HR) 1.27 (95% confidence interval (CI), 1.08–1.50) for Norway, and HR 1.57 (95% CI, 1.27–1.95) for Argentina], with similar results at 60 months [HR 1.19 (95% CI, 1.05–1.35) (Norway), and HR 1.56 (95% CI, 1.30–1.88) (Argentina)], and was also significantly associated with cardiac death [HR 1.51 (95% CI, 1.14–2.00)], in the Argentinean population.ANGPTL4 was significantly associated with all‐cause mortality in the Argentinean cohort at 24 months [HR 1.39 (95% CI, 1.15–1.68)] and at 60 months [HR 1.43 (95% CI, 1.23–1.67)], enforcing trends in the Norwegian population.ConclusionsANGPT2 and ANGPTL4 were significantly associated with outcome in similar ACS patient cohorts recruited on two continents.Clinical Trial RegistrationClinicalTrials.gov Identifier: NCT00521976.ClinicalTrials.gov Identifier: NCT01377402.
Genetics of coronary artery disease in the post‐GWAS era
Authors: Chen Zhifen , Schunkert Heribert 
Published: July 2021

AbstractDuring the past decade, genome‐wide association studies (GWAS) have transformed our understanding of many heritable traits. Three recent large‐scale GWAS meta‐analyses now further markedly expand the knowledge on coronary artery disease (CAD) genetics in doubling the number of loci with genome‐wide significant signals. Here, we review the unprecedented discoveries of CAD GWAS on low‐frequency variants, underrepresented populations, sex differences and integrated polygenic risk. We present the milestones of CAD GWAS and post‐GWAS studies from 2007 to 2021, and the trend in identification of variants with smaller odds ratio by year due to the increasing sample size. We compile the 321 CAD loci discovered thus far and classify candidate genes as well as distinct functional pathways on the road to indepth biological investigation and identification of novel treatment targets. We draw attention to systems genetics in integrating these loci into gene regulatory networks within and across tissues. We review the traits, biomarkers and diseases scrutinized by Mendelian randomization studies for CAD. Finally, we discuss the potentials and concerns of polygenic scores in predicting CAD risk in patient care as well as future directions of GWAS and post‐GWAS studies in the field of precision medicine.
US School‐Based Physical Fitness Assessments and Data Dissemination
Authors: Krochmal Patrick , Cooper Dan M. , Radom‐Aizik Shlomit , Lu Kim D. 
Published: July 2021

ABSTRACTBACKGROUNDLow physical fitness (PF) levels during childhood affect healthy growth and development, and increase the risk of cardiovascular diseases. Physical education standards exist for nearly all states in the United States, but evaluation of PF in youth has yet to be systematic, reproducible, and harmonized. The purpose of this project was to describe publicly available data of school‐based PF testing (SB‐PFT).METHODSA list of state‐mandated SB‐PFT programs published by SHAPE 2016 was confirmed by contacting appropriate authorities. SB‐PFT data were obtained through each state's department of education.RESULTSSixteen states mandate SB‐PFT, with 10 states providing publicly available data; 92% to 100% of states perform the pacer/mile, curl‐up, and push‐up; 54.2% to 78.5% of elementary and 44% to 66.5% of high‐school youth are in the “healthy fitness zone” for aerobic capacity.CONCLUSIONSSB‐PFT provided PF data in children across the United States. The variability and inconsistency in reporting and in the values, however, raises questions about the current status of SB‐PFT data and its utility in assessing PF in children. The critical nature of PF assessments is highlighted in the current COVID‐19 pandemic, during which physical education has been curtailed, and emerging data demonstrate worsening of the already low levels of PF in youth.
The minority or the misunderstood? A young man’s journey with anorexia nervosa
Authors: Corcoran Rachael , Trainor Gemma , Robinson Ben 
Published: July 2021

AbstractIntroductionDespite findings that 1 in 4 eating disorder sufferers are male (Beat, 2017), they continue to be known as “female” disorders, an association which delays diagnosis in males and prevents them from seeking the help that they need to recover.AimThe current paper aimed to challenge this misconception by enabling and supporting Ben, a young male diagnosed with Anorexia Nervosa aged 16, to share his experience of seeking and receiving treatment for the disorder.MethodIt achieved this by exploring how his disorder developed, his experience of a child and adolescent inpatient service and the events leading up to this, and his life post‐discharge, all in collaboration with Ben himself and using his own words.DiscussionThe paper concludes with some implications for future practice, including that eating disorders should not be skewed towards any gender, treatment programmes need to ensure full inclusivity of males, and more gender sensitive information is required to raise awareness of this population and thus reduce the stigma and isolation they experience at present. It is hoped that these, along with the rest of the paper, will be accessible to and utilized by both professionals and non‐professionals alike.Accessible summary

Around one quarter of people diagnosed with an eating disorder are male, yet they continue to be known as “female” disorders. Because of this, young males are often missed by the system and as a result, receive treatment later than they should. They are currently underrepresented in services.

This paper challenges the association above by supporting a young man who suffered with a type of eating disorder known as Anorexia Nervosa to share his journey from his personal perspective. It provides great insight into what it is like to be a male with an eating disorder, including how it felt to be the only male in an inpatient facility surrounded by females with the same disorder.

The paper also provides important information for professionals working in the area. For example, eating disorders, including Anorexia Nervosa, should not be associated with one specific gender, and treatment programmes for young people with eating disorders should ensure they are appropriate for both females and males. As a society, we need to challenge the stigma which exists for males in admitting when they are struggling and asking for help, and we need to do everything we can to ensure that young men are picked up earlier in the system, in order to give them the best chance of recovery.

It is hoped that Ben's story and the recommendations from it can go on to help other males who might be struggling.
Peripheral blood lymphocyte subtypes in dogs with different stages of myxomatous mitral valve disease
Authors: Druzhaeva Natalia , Nemec Svete Alenka , Ihan Alojz , Pohar Katka , Domanjko Petrič Aleksandra 
Published: July 2021

AbstractBackgroundData on alterations in peripheral blood lymphocyte (PBL) subtypes in dogs with myxomatous mitral valve disease (MMVD) is lacking.ObjectivesTo investigate PBL subtypes and their correlation with parameters of inflammation and MMVD progression markers in dogs with different stages of MMVD.AnimalsSeventy‐eight client‐owned dogs: 65 with MMVD (American College of Veterinary Internal Medicine [ACVIM] classification stages B2, C, and D) and 13 healthy controls.MethodsProspective cross‐sectional study. Complete cardiac assessment, flow cytometry (T lymphocytes [CD3+], their subtypes [CD3+CD4+, CD3+CD8+, CD3+CD4+CD8+, CD3+CD4−CD8−], and B lymphocytes [CD45+CD21+]) and measurement of N‐terminal pro B‐type natriuretic peptide, cardiac troponin I, and C‐reactive protein concentrations were performed.ResultsThe percentage of CD3+CD4+ lymphocytes was significantly lower in stable ACVIM C patients (P = .01) and unstable ACVIM C and D patients (P = .003), the percentage of CD3+CD8+ lymphocytes was significantly higher in stable ACVIM C patients (P = .01) and unstable ACVIM C and D patients (P = .01), CD3+CD8+ lymphocyte concentration was significantly higher in unstable ACVIM C and D patients (P = .05), and the CD3+CD4+/CD3+CD8+ ratio was significantly lower in stable ACVIM C patients (P = .01) and unstable ACVIM C and D patients (P = .01) compared with healthy controls.Conclusions and Clinical ImportanceThe percentages of CD3+CD4+ and CD3+CD8+ PBL and CD4+/CD8+ ratio were altered in MMVD dogs with congestive heart failure (ACVIM C, D), but not in ACVIM B2, suggesting involvement of these PBL subtypes in the pathogenesis of congestive heart failure in dogs with MMVD.
Contract bundling considerations in urban road project scheduling
Authors: Miralinaghi Mohammad , Davatgari Amir , Seilabi Sania E. , Labi Samuel 
Published: July 2021

AbstractRoad project scheduling and contract bundling are two separate concepts that profoundly influence project delivery consequences to key stakeholders. Therefore, agencies espouse initiatives for contract bundling (to reduce project costs) and project scheduling (to reduce user delay costs). Bundling combined with scheduling could potentially yield benefits to both the agency and urban road users. This paper investigates the overall benefits (to the two stakeholders) of optimal schedules with bundling considerations, compared to the optimal schedules for unbundled contracts. The agency's objective is to make scheduling‐with‐bundling decisions that minimize system‐wide travel time and project costs, and the users’ objective is to minimize their travel times in the network with work zones. The problem is solved using the non‐dominated sorting genetic algorithm. The numerical experiments suggest that with well‐designed bundling, optimal scheduling can significantly reduce not only the project cost but also the total system cost (project and travel delay).
Democracy within, justice without: The duties of informal political representatives1
Authors: Salkin Wendy 
Published: July 2021

AbstractInformal political representation can be a political lifeline, particularly for oppressed and marginalized groups. Such representation can give these groups some say, however mediate, partial, and imperfect, in how things go for them. Coeval with the political goods such representation offers these groups are its particular dangers to them. Mindful of these dangers, skeptics challenge the practice for being, inter alia, unaccountable, unauthorized, inegalitarian, and oppressive. These challenges provide strong pro tanto reasons to think the practice morally impermissible. This paper considers the question: On what conditions is the informal political representation of oppressed and marginalized groups permissible? By responding to skeptics’ challenges, I develop a systematic account of moral constraints that, if adopted, would make such representation permissible. The account that emerges shows that informal political representatives (IPRs) must aim to fulfill two sets of sometimes conflicting duties to the represented: democracy within duties, which concern how the representative treats and relates to the represented, and justice without duties, which concern how the representative's actions advance the aims of the representation.
Warzone experiences and subsequent clinician suicide risk assessment in veterans
Authors: Bjork James M. , Perrin Paul B. , Redae Makda ,   VA Mid‐Atlantic MIRECC Workgroup, Tupler Larry A. 
Published: July 2021

AbstractObjectiveTo determine in veterans whether severity of combat exposure was predictive of subsequently receiving a suicide risk assessment (SRA), and whether this relationship was meditated by depression symptomatology.MethodWe conducted an electronic medical records review for SRA ratings of 486 veterans who had completed Combat Exposure Scale (CES) and Beck Depression Inventory‐II (BDI‐II) assessments in a study of Post‐Deployment Mental Health (PDMH).ResultsHigher total scores on the CES and BDI‐II were characteristic of PDMH participants who subsequently (mean 29.2 months later) received an SRA from a Veterans Health Administration provider. Among participants with an SRA, those scoring at high risk had significantly greater CES and BDI‐II scores than those rated at low risk. Participants rated at low risk tended to have CES and BDI‐II scores higher than those of participants for whom no SRA was found. Relationships between combat exposures and both performance of an SRA and the SRA risk level were mediated by BDI‐II scores.ConclusionThese data extend previous findings of depression‐mediated linkages between warzone experiences and subsequent self‐reported suicide risk among veterans, by indicating chronicity of combat trauma‐related suicide risk and demonstrating a concordance between self‐reported and clinician‐reported suicidality as it relates to experiential and psychiatric factors.
Kinematics-Based Five-Axis Trochoidal Milling Process Planning for Deep and Curved Three-Dimensional Slots
Authors: Li Zhaoyu , He Dong , Xu Ke , Xie Fubao , Tang Kai 
Published: July 2021

Abstract
Trochoidal (TR) milling is a popular means for slotting operation. Attributing to its unique circular-shaped path pattern, TR milling avoids the full tool–workpiece engagement, which helps reduce the cutting heat accumulation and hence slow down the tool wear. While traditionally TR milling is only used for machining 2.5D cavities, it has now been extended to machining genuine 3D curved cavities under the realm of five-axis machining. However, since for a typical five-axis machine tool the rotary axes have a much larger moment of inertia than the three linear axes, to reduce both the total machining time and the consumed electric energy (for driving the machine tool), it is desirable to minimize the use of the two rotary axes (particularly the one with the larger moment of inertia) when planning a TR tool path for a given 3D cavity. Nevertheless, due to the newness of five-axis TR machining, there has no published reports on this subject. In this paper, we present a five-axis TR tool path planning algorithm for machining an arbitrary 3D curved cavity, which will consider the kinematical characteristics of the five-axis machine tool and try to minimize the use of the rotary axis with the largest moment of inertia, while tending to all the required constraints such as the threshold on the cutting force. Both computer simulation and physical cutting experiments of the proposed method have been conducted, and the results give a preliminary confirmation on the feasibility and advantages of the proposed method.
Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis
Authors: Cashin Aidan G , Folly Thiago , Bagg Matthew K , Wewege Michael A , Jones Matthew D , Ferraro Michael C , Leake Hayley B , Rizzo Rodrigo R N , Schabrun Siobhan M , Gustin Sylvia M , Day Richard , Williams Christopher M , McAuley James H 
Published: July 2021

AbstractObjectiveTo investigate the efficacy, acceptability, and safety of muscle relaxants for low back pain.DesignSystematic review and meta-analysis of randomised controlled trials.Data sourcesMedline, Embase, CINAHL, CENTRAL, ClinicalTrials.gov, clinicialtrialsregister.eu, and WHO ICTRP from inception to 23 February 2021.Eligibility criteria for study selectionRandomised controlled trials of muscle relaxants compared with placebo, usual care, waiting list, or no treatment in adults (≥18 years) reporting non-specific low back pain.Data extraction and synthesisTwo reviewers independently identified studies, extracted data, and assessed the risk of bias and certainty of the evidence using the Cochrane risk-of-bias tool and Grading of Recommendations, Assessment, Development and Evaluations, respectively. Random effects meta-analytical models through restricted maximum likelihood estimation were used to estimate pooled effects and corresponding 95% confidence intervals. Outcomes included pain intensity (measured on a 0-100 point scale), disability (0-100 point scale), acceptability (discontinuation of the drug for any reason during treatment), and safety (adverse events, serious adverse events, and number of participants who withdrew from the trial because of an adverse event).Results49 trials were included in the review, of which 31, sampling 6505 participants, were quantitatively analysed. For acute low back pain, very low certainty evidence showed that at two weeks or less non-benzodiazepine antispasmodics were associated with a reduction in pain intensity compared with control (mean difference −7.7, 95% confidence interval−12.1 to−3.3) but not a reduction in disability (−3.3, −7.3 to 0.7). Low and very low certainty evidence showed that non-benzodiazepine antispasmodics might increase the risk of an adverse event (relative risk 1.6, 1.2 to 2.0) and might have little to no effect on acceptability (0.8, 0.6 to 1.1) compared with control for acute low back pain, respectively. The number of trials investigating other muscle relaxants and different durations of low back pain were small and the certainty of evidence was reduced because most trials were at high risk of bias.ConclusionsConsiderable uncertainty exists about the clinical efficacy and safety of muscle relaxants. Very low and low certainty evidence shows that non-benzodiazepine antispasmodics might provide small but not clinically important reductions in pain intensity at or before two weeks and might increase the risk of an adverse event in acute low back pain, respectively. Large, high quality, placebo controlled trials are urgently needed to resolve uncertainty.Systematic review registrationPROSPERO CRD42019126820 and Open Science Frameworkhttps://osf.io/mu2f5/.
Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population
Authors: Yap Jonathan , Anbalakan Kamalesh , Tay Wan Ting , Ting Daniel , Cheung Carol Yim , Sabanayagam Charumathi , Cheng Ching-Yu , Wong Tien-Yin , Yeo Khung Keong 
Published: July 2021

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.
Cost-effectiveness modelling of use of urea breath test for the management ofHelicobacter pylori-related dyspepsia and peptic ulcer in the UK
Authors: Pritchard D. Mark , Bornschein Jan , Beales Ian , Beresniak Ariel , Salhi Hocine , Malfertheiner Peter 
Published: July 2021

ObjectiveClinical data comparing diagnostic strategies in the management ofHelicobacter pylori-associated diseases are limited. Invasive and noninvasive diagnostic tests for detectingH. pyloriinfection are used in the clinical care of patients with dyspeptic symptoms. Modelling studies might help to identify the most cost-effective strategies. The objective of the study is to assess the cost-effectiveness of a ‘test-and-treat’ strategy with the urea breath test (UBT) compared with other strategies, in managing patients withH. pylori-associated dyspepsia and preventing peptic ulcer in the UK.DesignCost-effectiveness models compared four strategies: ‘test-and-treat’ with either UBT or faecal antigen test (FAT), ‘endoscopy-based strategy’ and ‘symptomatic treatment’. A probabilistic cost-effectiveness analysis was performed using a simulation model in order to identify probabilities and costs associated with relief of dyspepsia symptoms (over a 4-week time horizon) and with prevention of peptic ulcers (over a 10-year time horizon). Clinical and cost inputs to the model were derived from routine medical practice in the UK.ResultsFor relief of dyspepsia symptoms, ‘test-and-treat’ strategies with either UBT (€526/success) and FAT (€518/success) were the most cost-effective strategies compared with ‘endoscopy-based strategy’ (€1317/success) and ‘symptomatic treatment’ (€1 029/success). For the prevention of peptic ulcers, ‘test-and-treat’ strategies with either UBT (€208/ulcer avoided/year) or FAT (€191/ulcer avoided/year) were the most cost-effective strategies compared with ‘endoscopy-based strategy’ (€717/ulcer avoided/year) and ‘symptomatic treatment’ (€651/ulcer avoided/year) (1 EUR=0,871487 GBP at the time of the study).Conclusion‘Test-and-treat’ strategies with either UBT or FAT are the most cost-effective medical approaches for the management ofH. pylori-associated dyspepsia and the prevention of peptic ulcer in the UK. A ‘test-and-treat’ strategy with UBT has comparable cost-effectiveness outcomes to the current standard of care using FAT in the UK.