bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Fat but powerful’ paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study
Authors: Alcazar Julian , Navarrete-Villanueva David , Mañas Asier , Gómez-Cabello Alba , Pedrero-Chamizo Raquel , Alegre Luis M , Villa Gerardo , Gusi Narcís , González-Gross Marcela , Casajús Jose Antonio , Vicente-Rodriguez German , Ara Ignacio 
Published: March 2021

ObjectivesTo assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the ‘fat but powerful’ (F+P) (or ‘fat but fit’) paradox in older adults.MethodsA total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated.ResultsAccording to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively).ConclusionPowerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.
Trends in obesity and adiposity measures by race or ethnicity among adults in the United States 2011-18: population based study
Authors: Liu Buyun , Du Yang , Wu Yuxiao , Snetselaar Linda G , Wallace Robert B , Bao Wei 
Published: March 2021

Abstract

Objective
To examine the trends in obesity and adiposity measures, including body mass index, waist circumference, body fat percentage, and lean mass, by race or ethnicity among adults in the United States from 2011 to 2018.

Design
Population based study.

Setting
National Health and Nutrition Examination Survey (NHANES), 2011-18.

Participants
A nationally representative sample of US adults aged 20 years or older.

Main outcome measures
Weight, height, and waist circumference among adults aged 20 years or older were measured by trained technicians using standardized protocols. Obesity was defined as body mass index of 30 or higher for non-Asians and 27.5 or higher for Asians. Abdominal obesity was defined as a waist circumference of 102 cm or larger for men and 88 cm or larger for women. Body fat percentage and lean mass were measured among adults aged 20-59 years by using dual energy x ray absorptiometry.

Results
This study included 21 399 adults from NHANES 2011-18. Body mass index was measured for 21 093 adults, waist circumference for 20 080 adults, and body fat percentage for 10 864 adults. For the overall population, age adjusted prevalence of general obesity increased from 35.4% (95% confidence interval 32.5% to 38.3%) in 2011-12 to 43.4% (39.8% to 47.0%) in 2017-18 (P for trend<0.001), and age adjusted prevalence of abdominal obesity increased from 54.5% (51.2% to 57.8%) in 2011-12 to 59.1% (55.6% to 62.7%) in 2017-18 (P for trend=0.02). Age adjusted mean body mass index increased from 28.7 (28.2 to 29.1) in 2011-12 to 29.8 (29.2 to 30.4) in 2017-18 (P for trend=0.001), and age adjusted mean waist circumference increased from 98.4 cm (97.4 to 99.5 cm) in 2011-12 to 100.5 cm (98.9 to 102.1 cm) in 2017-18 (P for trend=0.01). Significant increases were observed in body mass index and waist circumference among the Hispanic, non-Hispanic white, and non-Hispanic Asian groups (all P for trend<0.05), but not for the non-Hispanic black group. For body fat percentage, a significant increase was observed among non-Hispanic Asians (30.6%, 29.8% to 31.4% in 2011-12; 32.7%, 32.0% to 33.4% in 2017-18; P for trend=0.001), but not among other racial or ethnic groups. The age adjusted mean lean mass decreased in the non-Hispanic black group and increased in the non-Hispanic Asian group, but no statistically significant changes were found in other racial or ethnic groups.

Conclusions
Among US adults, an increasing trend was found in obesity and adiposity measures from 2011 to 2018, although disparities exist among racial or ethnic groups.
Occurrence and timely management of problems requiring prompt intervention among Indigenous compared with non-Indigenous Australian palliative care patients: a multijurisdictional cohort study
Authors: Woods John A , Katzenellenbogen Judith M , Murray Kevin , Johnson Claire E , Thompson Sandra C 
Published: March 2021

ObjectivesAnticipation and prompt relief of symptoms among patients with a life-limiting illness is a core element of palliative care. Indigenous Australians commonly encounter cultural barriers in healthcare that may impair outcomes. The Palliative Care Outcomes Collaboration collects patient care data for the purposes of continuous quality improvement and benchmarking, with each recorded care episode divided into phases that reflect a patient’s condition. We aimed to investigate differences between Indigenous and non-Indigenous patients in the occurrence and duration of ‘unstable’ phases (which indicate unanticipated deterioration in a patient’s condition or circumstances), and determine attainment of the relevant benchmark (resolution of unstable phases in ≤3 days in 90% of cases) for both groups.DesignCohort study.SettingAustralia-wide hospital-based and community-based specialist palliative care (1 January 2010 to 30 June 2015).Participants139 556 (1502 Indigenous and 138 054 non-Indigenous) adult patients.Outcome measuresIndigenous and non-Indigenous patients were compared on (1) the risk of a phase being categorised as unstable, (2) the duration of unstable phases, and (3) the risk of unstable phases being prolonged (>3 days). Crude and adjusted estimates were produced from three-level robust Poisson regression and complementary log-log discrete time survival models.ResultsUnstable phases occurred with similar frequency overall among Indigenous and non-Indigenous patients (adjusted relative risks 1.06; 95% CI 1.00 to 1.11; not significant after correction for multiple comparisons). The duration and risk of prolongation of unstable phases were similar in both patient groups, with no significant differences evident among subgroups. The benchmark was not met for either Indigenous or non-Indigenous patients (unstable phase duration >3 days in 24.3% vs 25.5%; p=0.398).ConclusionsDespite well-documented shortcomings of healthcare for Indigenous Australians, there is no clear evidence of greater occurrence or prolongation of unanticipated problems among Indigenous patients accessing specialist palliative care services in hospital or the community.
Impact of a videoconferencing educational programme for the management of concurrent disorders on nurses’ competency development and clinical practice: protocol for a convergent mixed methods study
Authors: Chicoine Gabrielle , Côté José , Pepin Jacinthe , Pluye Pierre , Boyer Louise , Fontaine Guillaume , Rouleau Geneviève , Dubreucq Simon , Jutras-Aswad Didier 
Published: March 2021

IntroductionExtension for Community Healthcare Outcomes (Project ECHO©) is an innovative model for continuing professional development that uses videoconferencing technology to support and train general practitioners remotely. The model has been replicated to a variety of settings and locations for capacity building in healthcare professionals caring for patients with chronic and complex health conditions. Limited research has been conducted so far on the impact of ECHO in the field of concurrent mental health and substance use disorders (ie, concurrent disorders (CDs)). Therefore, this mixed methods study aims to develop a comprehensive understanding of an ECHO programme impact for CD management on nurses’ competency development and clinical practice.Methods and analysisThe proposed mixed methods study, based on a convergent parallel design, will be conducted in the province of Quebec, Canada, to collect, analyse and interpret quantitative (QUAN) and qualitative (QUAL) data from a specific ECHO Program on CDs. In the QUAN component, an observational prospective cohort study will be conducted over a 12-month period. All nurses who participated in the programme between 2018 and 2020 and who consent to research will be recruited to collect data on the extent of their learning and practice outcomes at three time points. Alongside the surveys, nurses will be invited to participate in individual semistructured interviews. In-depth QUAL data will be subjected to a thematic analysis and will assist in exploring how and in which conditions nurses developed and mobilised their competencies in clinical practice. A comparison-of-results strategy will be used in the final integration component of the study.Ethics and disseminationThis study protocol was approved by the Ethics Committee of the Université de Montréal Hospital Center (#19.295) and the Université de Montréal Ethics Committee (CERSES-20–017 R). We aim to disseminate the findings through international academic conferences, international peer-reviewed journals and professional media.
Timing of evidence-based non-surgical interventions as part of multimodal treatment guidelines for the management of cervical radiculopathy: a Delphi study protocol
Authors: Thoomes Erik , Thoomes-de Graaf Marloes , Cleland Joshua , Gallina Alessio , Falla Deborah 
Published: March 2021

IntroductionCervical radiculopathy (CR) is a clinical condition whereby motor, reflex and/or sensory changes such as radicular pain, paraesthaesia or numbness can exist. Conservative management is a preferred first treatment option as the risk–benefit ratio for surgery is less favourable. Systematic reviews and treatment guidelines gather evidence on the effectiveness of non-surgical management of patients with CR from randomised controlled trials, which do not consider the natural course of recovery to modify the management strategy accordingly. The aim of this study is to establish consensus on effective non-surgical treatment modalities for patients in different stages (acute, subacute and chronic) of CR, using the Delphi method approach.Methods and analysisThrough an iterative multistage process, experts within the field will rate their agreement with a list of proposed treatment modalities and suggest any missing treatment modalities during each round. Agreement will be measured using a five-point Likert scale. Descriptive statistics will be used to measure agreement (median, IQR and percentage of agreement). Consensus criteria will be defined a priori for each round. Data analysis at the end of round three will produce a consensus list of effective treatment modalities for the management of patients with CR in different stages of recovery.Ethics and disseminationEthical approval has been granted from the University of Birmingham ethics committee under ERN_20-1121. The study findings will be submitted to a peer-reviewed journal and to relevant conferences for dissemination of the study results.
Beyond the European Union Tobacco Products Directive: smokers’ and recent quitters’ support for further tobacco control measures (2016–2018)
Authors: Nogueira Sarah O , Driezen Pete , Fu Marcela , Hitchman Sara C , Tigova Olena , Castellano Yolanda , Kyriakos Christina N , Zatoński Mateusz Zygmunt , Mons Ute , Quah Anne C K , Demjén Tibor , Trofor Antigona Carmen , Przewozniak Krzysztof , Katsaounou Paraskevi , Fong Geoffrey , Vardavas Constantine I , Fernández Esteve 
Published: March 2021

BackgroundSeveral measures recommended by the WHO Framework Convention on Tobacco Control have not been implemented in the European Union, despite changes in the legislation such as the Tobacco Products Directive (TPD). This study aims to understand smokers’ and recent quitters’ levels of support for tobacco control measures that go beyond the TPD during and after its implementation.MethodsData from wave 1 (2016, n=6011) and wave 2 (2018, n=6027) of the EUREST-PLUS International Tobacco Control Policy Evaluation Project Six European Countries Survey, a cohort of adult smokers in Germany, Greece, Hungary, Poland, Romania, Spain were used to estimate the level of support for seven different tobacco control measures, overall and by country.ResultsIn 2018, the highest support was for implementing measures to further regulate tobacco products (50.5%) and for holding tobacco companies accountable for the harm caused by smoking (48.8%). Additionally, in 2018, 40% of smokers and recent quitters supported a total ban on cigarettes and other tobacco products within ten years, if assistance to quit smoking is provided. Overall, support for tobacco control measures among smokers and recent quitters after the implementation of the TPD remained stable over time.ConclusionThere is considerable support among smokers and recent quitters for tobacco control measures that go beyond the current measures implemented. A significant percentage of smokers would support a ban on tobacco products in the future if the government provided assistance to quit smoking. This highlights the importance of implementing measures to increase smoking cessation in conjunction with other policies.
The influence of exercise intensity and exercise mode on gastrointestinal damage
Authors: Edwards Kate H. , Ahuja Kiran D. , Watson Greig , Dowling Courtney , Musgrave Harrison , Reyes Jessica , Cherry James , Kitic Cecilia M. 
Published: March 2021

Strenuous exercise increases gastrointestinal damage, but the dose–response relationship is yet to be elucidated. It is also commonly believed that running causes greater gastrointestinal damage than cycling. Two randomised, crossover studies aimed to 1) quantify gastrointestinal damage with increasing exercise intensity, and 2) determine if running was associated with greater gastrointestinal damage than cycling. Following a maximal oxygen uptake (V̇O2max) test, participants completed 3 cycling trials at different intensities (60 min at 40%, 60% and 80% V̇O2max; n = 10 (5 female, 5 male)) (INTENSITY), or 1 running and 1 cycling trial (45 min at 70% V̇O2max; n = 11 (3 female, 8 male)) (MODE). Venous blood samples were collected pre- and post-exercise to measure gastrointestinal damage via intestinal fatty acid binding protein (I-FABP). In INTENSITY, I-FABP magnitude of change was greater at 80% V̇O2max than 40% V̇O2max (p < 0.01). In MODE, I-FABP magnitude of change was greater with cycling (mean (SD)) (84.7 (133.2)% d = 1.07) compared with running (19.3 (33.1)%, d = 0.65) with a moderate effect (d = 0.68, p = 0.024). Rating of perceived exertion (RPE) and heart rate (HR) were higher during cycling (RPE p < 0.0001; HR p < 0.0001) but rectal temperature was not different between modes (p = 0.94). While gastrointestinal damage increases with increasing exercise intensity, running was not associated with greater gastrointestinal damage than cycling. Novelty: A fraction of the anaerobic threshold, rather than a fraction of V̇O2max, may be more predictive of intensity that results in exercise induced gastrointestinal damage. The mode of exercise may not be as important as intensity for inducing gastrointestinal damage. Improving anaerobic threshold may reduce susceptibility to gastrointestinal damage when exercising at high intensities.
Review of Algorithmic Aspects of Machine Learning By Ankur Moitra
Authors: Upadhyay Sarvagya 
Published: March 2021

Over the past two decades, machine learning has seen tremendous development in practice. Technological advancement and increased computational resources have enabled several learning algorithms to become quite useful in practice. Although many families of learning algorithms are heuristic in nature, their usefulness cannot be understated. Empirical observations coupled with abundance of new datasets have led to development of novel algorithmic techniques that aim to accomplish a variety of learning tasks efficiently on real-world problems.
But what makes these algorithms work on such real-world problems? Clearly, producing correct solutions is one aspect of it. The other aspect is efficiency. While many of these algorithms solve hard problems and cannot be theoretically efficient (under plausible complexity-theoretic assumptions), they seemingly do work on real-world problems. It begets the question: are there conditions under which these algorithms become tractable? Having an answer to this fundamental question sheds light on the power and limitations of these algorithmic techniques.
This book focuses on different learning models and problems, and sets out to capture the assumptions that make certain algorithms tractable. The emphasis is on models and algorithmic techniques that make learning an efficient endeavor.
Three-Dimensional Modelling of Desorbed Gas Volume and Comparison to Gas Production Rate in the Montney Plays, Western Canadian Sedimentary Basin
Authors: Song Gihun , Lee Hyun Suk , Shin Hyundon 
Published: March 2021

Shale reservoir has been focused among unconventional resources since the first extraction of free and adsorbed gas from the low-permeable Barnett Shale via horizontal drilling and hydraulic fracturing. In the beginning of production, free gas was rapidly recovered through an artificial fracture system, and then, desorbed gas followed at the final stage due to a decrease of reservoir pressure. This desorbed gas volume commonly occupies 10 to 40% of total gas production in shale gas play although it shows wide variety in cumulative gas volume and production time. The largest gas production in Canada is recovered from either tight sandstone or shale reservoirs. The Montney play in Western Canadian Sedimentary Basin (WCSB) has produced up to 80% of Canadian natural gas production. The desorbed gas production from this play has been reported up to 10% of total produced gas. The distribution and productivity of the desorbed gas have not been fully studied. Therefore, we focus to understand the distribution of the desorbed gas volume of eastern, middle, and northwestern areas in the Montney play. The desorbed gas volume within these areas was estimated from the relationship among canister, illite, and shale volumes in core samples and well logs. The average shale volume fraction in eastern area is 0.38

v
/
v

, the average illite mineral volume fraction is 0.25

v
/
v

, and the average desorbed gas volume refers to 8.52 scf/ton. In middle area, calculated volume represents 0.34

v
/
v

, 0.216

v
/
v

, and 8.15 scf/ton as listed above. The northwestern area also shows 0.65

v
/
v

, 0.4

v
/
v

, and 9.78 scf/ton, respectively. 3D models of each area indicated relatively rich and lack parts of desorbed gas volume. These estimated desorbed gas volume and gas production history were compared in order to understand when and how the desorbed gas would affect to gas production. It shows strong positive relationship, gradually increasing correlation to the later stage (from 24-44 months to 36-44 months) of gas production in the entire areas. This result implies that the estimation of later stage gas productivity is able from the estimated volume of desorbed gas, and also, the total gas production can be forecast in shale gas reservoir. Northwestern area in Montney play preserves relatively abundant desorbed gas volume, which will be dominant after 24 months of production.
Elevated Plasma Soluble Triggering Receptor Expressed on Myeloid Cells-1 Level in Patients with Acute Coronary Syndrome (ACS): A Biomarker of Disease Severity and Outcome
Authors: Shiber Shachaf , Kliminski Vitaly , Orvin Katia , Sagy Iftach , Vaturi Mordehay , Kornowski Ran , Drescher Michael , Molad Yair 
Published: March 2021

Background and Aims. Plasma levels of soluble triggering receptor expressed on myeloid cells (sTREM-1) reflect innate immune cell activation. We sought to evaluate sTREM-1 levels in patients with acute coronary syndrome (ACS) and their predictive value for disease severity and outcome. Methods. Plasma sTREM-1 levels were prospectively measured by ELISA in 121 consecutive patients with new-onset (≤24 h) chest pain at arrival to the emergency department (ED) and 73 healthy controls. Secondary endpoints were the association of plasma levels of sTREM-1 with day 30 and month 6 major adverse cardiovascular events (MACE) defined as death, ACS, stroke, and need for coronary revascularization, as well as with CAD severity. The primary endpoint of the study was the association of plasma sTREM-1 level at the time of admission to the ED with a diagnosis of ACS at day 30. Results. Fifty-nine patients (48.7%) were diagnosed with ACS and 62 (51.3%) with nonspecific chest pain (NSCP). Median plasma sTREM-1 level at admission was significantly higher in the ACS group than the NSCP group and the control group (

539.4
±
330.3

pg/ml vs.

432.5
±
196.4

pg/ml vs.

230.1
±
85.5

pg/ml, respectively;

P
<
0.001

) and positively correlated with the number of stenosed/occluded coronary arteries on angiography (

P
<
0.001

). On logistic regression analysis, higher sTREM-1 levels predicted definite ACS vs. NSCP determined on day 30 (OR 1.29, 95% CI 1.07-1.54,

P
=
0.01

) as well as with recurrent ACS (

P
=
0.04

) and stroke (

P
=
0.02

) at 6 months. Conclusions. Plasma sTREM-1 levels are significantly elevated in patients with ACS and might serve as a biomarker differentiating ACS from NSCP in the ED as well as an inflammatory biomarker for coronary artery disease severity and outcome.