bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity and revision surgery, mortality, and patient-reported outcomes after primary knee replacement surgery in the National Joint Registry: A UK cohort study
Authors: Evans Jonathan Thomas , Mouchti Sofia , Blom Ashley William , Wilkinson Jeremy Mark , Whitehouse Michael Richard , Beswick Andrew , Judge Andrew 
Published: July 2021

Background
One in 10 people in the United Kingdom will need a total knee replacement (TKR) during their lifetime. Access to this life-changing operation has recently been restricted based on body mass index (BMI) due to belief that high BMI may lead to poorer outcomes. We investigated the associations between BMI and revision surgery, mortality, and pain/function using what we believe to be the world’s largest joint replacement registry.

Methods and findings
We analysed 493,710 TKRs in the National Joint Registry (NJR) for England, Wales, Northern Ireland, and the Isle of Man from 2005 to 2016 to investigate 90-day mortality and 10-year cumulative revision. Hospital Episodes Statistics (HES) and Patient Reported Outcome Measures (PROMs) databases were linked to the NJR to investigate change in Oxford Knee Score (OKS) 6 months postoperatively.
After adjustment for age, sex, American Society of Anaesthesiologists (ASA) grade, indication for operation, year of primary TKR, and fixation type, patients with high BMI were more likely to undergo revision surgery within 10 years compared to those with “normal” BMI (obese class II hazard ratio (HR) 1.21, 95% CI: 1.10, 1.32 (p < 0.001) and obese class III HR 1.13, 95% CI: 1.02, 1.26 (p = 0.026)). All BMI classes had revision estimates within the recognised 10-year benchmark of 5%. Overweight and obese class I patients had lower mortality than patients with “normal” BMI (HR 0.76, 95% CI: 0.65, 0.90 (p = 0.001) and HR 0.69, 95% CI: 0.58, 0.82 (p < 0.001)). All BMI categories saw absolute increases in OKS after 6 months (range 18–20 points). The relative improvement in OKS was lower in overweight and obese patients than those with “normal” BMI, but the difference was below the minimal detectable change (MDC; 4 points). The main limitations were missing BMI particularly in the early years of data collection and a potential selection bias effect of surgeons selecting the fitter patients with raised BMI for surgery.

Conclusions
Given revision estimates in all BMI groups below the recognised threshold, no evidence of increased mortality, and difference in change in OKS below the MDC, this large national registry shows no evidence of poorer outcomes in patients with high BMI. This study does not support rationing of TKR based on increased BMI.
Prehabilitation to prevent complications after cardiac surgery - A retrospective study with propensity score analysis
Authors: Hartog Johanneke , Mousavi Iman , Dijkstra Sandra , Fleer Joke , van der Woude Lucas H. V. , van der Harst Pim , Mariani Massimo A. 
Published: July 2021

Background
The rising prevalence of modifiable lifestyle-related risk factors (e.g. overweight and physical inactivity) suggests the need for effective and safe preoperative interventions to improve outcomes after cardiac surgery. This retrospective study explored potential short-term postoperative benefits and unintended consequences of a multidisciplinary prehabilitation program regarding in-hospital complications.

Methods
Data on patients who underwent elective cardiac surgery between January 2014 and April 2017 were analyzed retrospectively. Pearson’s chi-squared tests were used to compare patients who followed prehabilitation (three times per week, at a minimum of three weeks) during the waiting period with patients who received no prehabilitation. Sensitivity analyses were performed using propensity-score matching, in which the propensity score was based on the baseline variables that affected the outcomes.

Results
Of 1201 patients referred for elective cardiac surgery, 880 patients met the inclusion criteria, of whom 91 followed prehabilitation (53.8% ≥ 65 years, 78.0% male, median Euroscore II 1.3, IQR, 0.9–2.7) and 789 received no prehabilitation (60.7% ≥ 65 years, 69.6% male, median Euroscore II 1.6, IQR, 1.0–2.8). The incidence of atrial fibrillation (AF) was significantly lower in the prehabilitation group compared to the unmatched and matched standard care group (resp. 14.3% vs. 23.8%, P = 0.040 and 14.3% vs. 25.3%, P = 0.030). For the other complications, no between-group differences were found.

Conclusions
Prehabilitation might be beneficial to prevent postoperative AF. Patients participated safely in prehabilitation and were not at higher risk for postoperative complications. However, well-powered randomized controlled trials are needed to confirm and deepen these results.
Evaluation of neighborhood deprivation and store characteristics in relation to tobacco retail outlet sales violations
Authors: Wheeler David C. , Do Elizabeth K. , Hayes Rashelle B. , Hughes Colleen , Fuemmeler Bernard F. 
Published: July 2021

Introduction
Regulations of the sale of tobacco products to minors have been effective at reducing adolescent tobacco use overall. However, these efforts may not be uniformly enforced in all areas, creating uneven protection against adolescent smoking. Knowledge regarding factors associated with tobacco retail outlet (TRO) violations could help inform better enforcement strategies.

Methods
In this study, we used Bayesian index regression models to determine if tobacco sales to minors violations across Virginia (2012–2021) were related to store characteristics and neighborhood deprivation and identify geographic areas at significantly elevated risk for violations after adjusting for these factors.

Results
Results show that there were multiple factors associated with a higher likelihood of tobacco sales violations. Store type was an important factor, as grocery stores and pharmacies had significantly lowered likelihood of violations compared with convenience stores. Being located near another TRO was significantly associated with increased risk of sales to a minor. Neighborhood deprivation was also positively associated with TRO sales violations. Further, there were statistically higher likelihood of sales violations occurring in specific areas (e.g., southwest and southeast) of the state that were not explained by neighborhood deprivation and store attributes.

Conclusions
Together, results highlight the need to better understand where and why TRO sales violations are occurring in order to improve efforts aimed at monitoring and remediating TRO sales violations.
Geographic disparities and temporal changes of diabetes prevalence and diabetes self-management education program participation in Florida
Authors: Khan Md Marufuzzaman , Roberson Shamarial , Reid Keshia , Jordan Melissa , Odoi Agricola 
Published: July 2021

Background
Although Diabetes Self-Management Education (DSME) programs are recommended to help reduce the burden of diabetes and diabetes-related complications, Florida is one of the states with the lowest DSME participation rates. Moreover, there is evidence of geographic disparities of not only DSME participation rates but the burden of diabetes as well. Understanding these disparities is critical for guiding control programs geared at improving participation rates and diabetes outcomes. Therefore, the objectives of this study were to: (a) investigate geographic disparities of diabetes prevalence and DSME participation rates; and (b) identify predictors of the observed disparities in DSME participation rates.

Methods
Behavioral Risk Factor Surveillance System (BRFSS) data for 2007 and 2010 were obtained from the Florida Department of Health. Age-adjusted diabetes prevalence and DSME participation rates were computed at the county level and their geographic distributions visualized using choropleth maps. Significant changes in diabetes prevalence and DSME participation rates between 2007 and 2010 were assessed and counties showing significant changes were mapped. Clusters of high diabetes prevalence before and after adjusting for common risk factors and DSME participation rates were identified, using Tango’s flexible spatial scan statistics, and their geographic distribution displayed in maps. Determinants of the geographic distribution of DSME participation rates and predictors of the identified high rate clusters were identified using ordinary least squares and logistic regression models, respectively.

Results
County level age-adjusted diabetes prevalence varied from 4.7% to 17.8% while DSME participation rates varied from 26.6% to 81.2%. There were significant (p≤0.05) increases in both overall age-adjusted diabetes prevalence and DSME participation rates from 2007 to 2010 with diabetes prevalence increasing from 7.7% in 2007 to 8.6% in 2010 while DSME participation rates increased from 51.4% in 2007 to 55.1% in 2010. Generally, DSME participation rates decreased in rural areas while they increased in urban areas. High prevalence clusters of diabetes (both adjusted and unadjusted) were identified in northern and central Florida, while clusters of high DSME participation rates were identified in central Florida. Rural counties and those with high proportion of Hispanics tended to have low DSME participation rates.

Conclusions
The findings confirm that geographic disparities in both diabetes prevalence and DSME participation rates exist. Specific attention is required to address these disparities especially in areas that have high diabetes prevalence but low DSME participation rates. Study findings are useful for guiding resource allocation geared at reducing disparities and improving diabetes outcomes.
Adaptation in the Age of Media Convergence, Johannes Fehrle and Werner Schäfke-Zell (eds) (2019)
Authors: Forlini Francesca 
Published: July 2021

Review of: Adaptation in the Age of Media Convergence, Johannes Fehrle and Werner Schäfke-Zell (eds) (2019)
Amsterdam: Amsterdam University Press, 232 pp.,
ISBN 978-9-46298-366-3, h/bk, €99.00
ISBN 978-9-04853-401-2, e/bk, €98.99
The Poincaré–Birkhoff Theorem for a Class of Degenerate Planar Hamiltonian Systems
Authors: López-Gómez Julián , Muñoz-Hernández Eduardo , Zanolin Fabio 
Published: July 2021

Abstract
In this paper, we investigate the problem of the existence and multiplicity of periodic solutions to the planar Hamiltonian system

x
′

=

-

λ
⁢
α
⁢

(
t
)

⁢
f
⁢

(
y
)

x^{\prime}=-\lambda\alpha(t)f(y)

,

y
′

=

λ
⁢
β
⁢

(
t
)

⁢
g
⁢

(
x
)

y^{\prime}=\lambda\beta(t)g(x)

, where

α
,
β

\alpha,\beta

are non-negative 𝑇-periodic coefficients and

λ
>
0

\lambda>0

. We focus our study to the so-called “degenerate” situation, namely when the set

Z
:=

supp
⁡
α

∩

supp
⁡
β

Z:=\operatorname{supp}\alpha\cap\operatorname{supp}\beta

has Lebesgue measure zero. It is known that, in this case, for some choices of 𝛼 and 𝛽, no nontrivial 𝑇-periodic solution exists. On the opposite, we show that, depending of some geometric configurations of 𝛼 and 𝛽, the existence of a large number of 𝑇-periodic solutions (as well as subharmonic solutions) is guaranteed (for

λ
>
0

\lambda>0

and large). Our proof is based on the Poincaré–Birkhoff twist theorem. Applications are given to Volterra’s predator-prey model with seasonal effects.
Periodic Solutions to Klein–Gordon Systems with Linear Couplings
Authors: Chen Jianyi , Zhang Zhitao , Chang Guijuan , Zhao Jing 
Published: July 2021

Abstract
In this paper, we study the nonlinear Klein–Gordon systems arising from relativistic physics and quantum field theories

{

u

t
⁢
t

-

u

x
⁢
x

+

b
⁢
u

+

ε
⁢
v

+

f
⁢

(
t
,
x
,
u
)

=
0

,

v

t
⁢
t

-

v

x
⁢
x

+

b
⁢
v

+

ε
⁢
u

+

g
⁢

(
t
,
x
,
v
)

=
0

,

\left\{\begin{aligned} \displaystyle{}u_{tt}-u_{xx}+bu+\varepsilon v+f(t,x,u)&\displaystyle=0,\\ \displaystyle v_{tt}-v_{xx}+bv+\varepsilon u+g(t,x,v)&\displaystyle=0,\end{aligned}\right.

where

u
,
v

u,v

satisfy the Dirichlet boundary conditions on spatial interval

[
0
,
π
]

[0,\pi]

,

b
>
0

b>0

and

f
,
g

f,g

are

2
⁢
π

2\pi

-periodic in 𝑡. We are concerned with the existence, regularity and asymptotic behavior of time-periodic solutions to the linearly coupled problem as 𝜀 goes to 0. Firstly, under some superlinear growth and monotonicity assumptions on 𝑓 and 𝑔, we obtain the solutions

(

u
ε

,

v
ε

)

(u_{\varepsilon},v_{\varepsilon})

with time period

2
⁢
π

2\pi

for the problem as the linear coupling constant 𝜀 is sufficiently small, by constructing critical points of an indefinite functional via variational methods. Secondly, we give a precise characterization for the asymptotic behavior of these solutions, and show that, as

ε
→
0

\varepsilon\to 0

,

(

u
ε

,

v
ε

)

(u_{\varepsilon},v_{\varepsilon})

converge to the solutions of the wave equations without the coupling terms. Finally, by careful analysis which is quite different from the elliptic regularity theory, we obtain some interesting results concerning the higher regularity of the periodic solutions.
Increased ammonium levels occurring during benthic algal blooms are potentially toxic to fucalean algae
Authors: Iveša Ljiljana , Djakovac Tamara , Bilajac Andrea , Gljušćić Edi , Devescovi Massimo 
Published: July 2021

Abstract
During the spring of 2016, benthic blooms of Acinetospora crinita (Ectocarpales, Phaeophyceae) producing voluminous mucilaginous aggregates frequently occurred at surveyed locations of the west Istrian Coast (northern Adriatic Sea, Croatia). In mucilage-affected macroalgal assemblages, the concentration of ammonium ranged from 50 to 300 μM. To investigate whether ammonium has the potential to harm fucalean species, a selected taxon, Cystoseira compressa was exposed to increased ammonium concentrations in laboratory conditions. Experiments revealed that exposure to 50 μM ammonium severely damaged the thalli while exposure to 300 μM caused complete necrosis of thalli in 2 days. These findings suggest that benthic algal blooms, enhanced by climate change and eutrophication, can negatively affect the populations of fucalean species due to production of ammonium during the decay of mucilaginous aggregates, causing thallus necrosis.
Notification of biochemistry critical results and its clinical impact on outpatient care: experience in a Spanish tertiary hospital
Authors: Laguna Javier , Macias-Muñoz Laura , Bedini José Luis , Rico Naira 
Published: July 2021

Abstract

Objectives
The communication of critical results (CR) is considered an essential role in clinical laboratories to ensure patient safety. This is especially relevant to outpatients, who are non-hospitalized and more difficult to locate. In our laboratory, there is a specific protocol for CR management that sets up the communication pathway to adequately provide these results to clinicians. The aim of this study is to evaluate the impact of CR reporting on outpatient care.

Methods
This is a retrospective study focused on CR for biochemistry parameters in a clinical laboratory of a Spanish tertiary hospital during 2019. A total of 156 CR were determined and properly provided to clinicians. We collected CR, age, gender, and the requesting department. We also collected the medical action data resulting from the communication of the CR.

Results
Seventy-six outpatients (49%) were properly treated because of effective CR communication. Hypoglycemia was the most frequent event (33%), however, the greatest clinical impact was observed for patients with hyponatremia (100%), hyperkalemia (62%), hypokalemia (60%), and hypercalcemia (57%). Based on these findings, we evaluated new glucose alert thresholds depending on whether or not the outpatient was diabetic (1.7 and 2.2 mmol/L, respectively). Based on these new thresholds, we established a CR reporting protocol with 69% effectiveness in outpatients.

Conclusions
We demonstrate that CR communication in outpatients has a significant clinical impact. To increase the effectiveness of the CR reporting protocol, we propose to adjust alert thresholds according to pathology, department, and patient population.
Analysis of Backward Euler Primal DPG Methods
Authors: Führer Thomas , Heuer Norbert , Karkulik Michael 
Published: July 2021

Abstract
We analyze backward Euler time stepping schemes for a primal DPG formulation of a class of parabolic problems.
Optimal error estimates are shown in a natural norm and in the

L
2

{L^{2}}

norm of the field variable.
For the heat equation the solution of our primal DPG formulation equals the solution of a standard Galerkin scheme and, thus, optimal error bounds are found in the literature.
In the presence of advection and reaction terms, however, the latter identity is not valid anymore and the analysis of optimal error bounds requires to resort to elliptic projection operators.
It is essential that these operators be projections with respect to the spatial part of the PDE, as in standard Galerkin schemes, and not with respect to the full PDE at a time step, as done previously.
Variations in heartwood formation and wood density as a function of age and plant spacing in a fast-growing eucalyptus plantation
Authors: Santos Lourdes Maria Hilgert , Almeida Maria Naruna Felix de , Silva João Gabriel Missia da , Vidaurre Graziela Baptista , Hein Paulo Ricardo Gherardi , Silva Gilson Fernandes da , Zanuncio Antonio José Vinha , Fraga Filho Clayton Vieira , Campinhos Eduardo Nogueira , Mafia Reginaldo Goncalves , Arantes Marina Donária Chaves , Tomazello-Filho Mario , Oliveira Michel Picanço , Rocha Quinny Soares , Minini Daniela , Melo Alexa Barglini de , Amorim Gabriela Aguiar 
Published: July 2021

Abstract
The heartwood formation process is little known in fast growing plantation woods. Therefore, the aims of this study were to determine how planting spacing and tree age affect the formation and proportion of heartwood and sapwood, as well as the density of eucalyptus wood. Trees from a eucalyptus clonal plantation (Eucalyptus grandis × E. urophylla hybrid) cultivated in three spacings (3 × 1, 3 × 2 and 3 × 3 m) were sampled at 14, 27, 32, 53, 64 and 76 months of age. Heartwood percentage was quantified with Dimethyl yellow indicator, while the wood density was determined by X-ray densitometry. The heartwood percentage, wood volume, heartwood density and wood density were correlated with the different growth rates. The heartwood formation process started between 32 and 53 months, regardless of spacing. The heartwood proportion doubled with increasing age in the widest spacing and increased about four times in 3 × 1 and 3 × 2 m spacing. The planting spacing influenced the growth rates of the trees, but did not affect the heartwood and sapwood percentage or density. The greatest increase in density values occurred between the first year of growth (14 months) and the beginning of heartwood formation (53 months).
Two families of pro-𝑝 groups that are not absolute Galois groups
Authors: Quadrelli Claudio 
Published: July 2021

AbstractLet 𝑝 be a prime. We produce two new families of pro-𝑝 groups which are not realizable as absolute Galois groups of fields. To prove this, we use the 1-smoothness property of absolute Galois pro-𝑝 groups. Moreover, we show in these families, one has several pro-𝑝 groups which may not be ruled out as absolute Galois groups employing the quadraticity of Galois cohomology (a consequence of the norm residue theorem), or the vanishing of Massey products in Galois cohomology.
Research on QR image code recognition system based on artificial intelligence algorithm
Authors: Huo Lina , Zhu Jianxing , Singh Pradeep Kumar , Pavlovich Pljonkin Anton 
Published: July 2021

Abstract
The QR code recognition often faces the challenges of uneven background fluctuations, inadequate illuminations, and distortions due to the improper image acquisition method. This makes the identification of QR codes difficult, and therefore, to deal with this problem, artificial intelligence-based systems came into existence. To improve the recognition rate of QR image codes, this article adopts an improved adaptive median filter algorithm and a QR code distortion correction method based on backpropagation (BP) neural networks. This combination of artificial intelligence algorithms is capable of fitting the distorted QR image into the geometric deformation pattern, and QR code recognition is accomplished. The two-dimensional code distortion is addressed in this study, which was a serious research issue in the existing software systems. The research outcomes obtained after emphasizing on the preprocessing stage of the image revealed that a significant improvement of 14% is observed for the reading rate of QR image code, after processing by the system algorithm in this article. The artificial intelligence algorithm adopted has a certain effect in improving the recognition rate of the two-dimensional code image.
Partial remission in children and adolescents with type 1 diabetes: an analysis based on the insulin dose-adjusted hemoglobin A1c
Authors: Cimbek Emine Ayça , Bozkır Aydın , Usta Deniz , Beyhun Nazım Ercüment , Ökten Ayşenur , Karagüzel Gülay 
Published: July 2021

Abstract

Objectives
Most patients with type 1 diabetes (T1D) experience a transient phase of partial remission (PR). This study aimed to identify the demographic and clinical factors associated with PR.

Methods
This was a longitudinal retrospective cohort study of 133 children and adolescents with T1D. PR was defined by the gold standard insulin dose-adjusted hemoglobin A1c (HbA1c) (IDAA1c) of ≤9.

Results
Remission was observed in 77 (57.9%) patients. At diagnosis, remitters had significantly higher pH (7.3 ± 0.12 vs. 7.23 ± 0.15, p=0.003), higher C-peptide levels (0.45 ± 0.31 ng/mL vs. 0.3 ± 0.22, p=0.003), and they were significantly older (9.3 ± 3.6 years vs. 7.3 ± 4.2, p=0.008) compared with non-remitters. PR developed more frequently in patients without diabetic ketoacidosis (DKA) (p=0.026) and with disease onset after age 5 (p=0.001). Patients using multiple daily insulin regimen were more likely to experience PR than those treated with a twice daily regimen (63.9 vs. 32%, p=0.004). Only age at onset was an independent predictor of PR (OR: 1.12, 95% CI: 1-1.25; p=0.044). Remitters had lower HbA1c levels and daily insulin requirement from diagnosis until one year after diagnosis (p<0.001). PR recurred in 7 (9%) patients. The daily insulin requirement at three months was lower in remitters with PR recurrence compared to those without (0.23 ± 0.14 vs. 0.4 ± 0.17 U/kg/day, p=0.014).

Conclusions
Addressing factors associated with the occurrence of PR could provide a better comprehension of metabolic control in T1D. The lack of DKA and higher C-peptide levels may influence PR, but the main factor associated with PR presence was older age at onset. PR may recur in a small proportion of patients.