bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between low levels of albuminuria and mortality among adults without major cardiovascular risk factors
Authors: Claudel Sophie E , Waikar Sushrut S , Schmidt Insa M , Vasan Ramachandran S , Verma Ashish 
Published: June 2024

Abstract

Aims
The aim of this study is to determine whether elevated levels of albuminuria within the low range [urinary albumin-to-creatinine ratio (UACR) &lt;30 mg/g] are linked to cardiovascular death in adults lacking major cardiovascular risk factors.

Methods and results
The association between UACR and cardiovascular mortality was investigated among 12 835 participants in the 1999–2014 National Health and Nutrition Examination Survey using Cox proportional hazard models and confounder-adjusted survival curves. We excluded participants with baseline cardiovascular disease, hypertension, diabetes, pre-diabetes, an estimated glomerular filtration rate &lt;60 mL/min/1.73 m2, currently pregnant, and those who received dialysis last year. Over a median follow-up of 12.3 years, 110 and 621 participants experienced cardiovascular and all-cause mortality. In multivariable-adjusted models, each doubling of UACR was associated with a 36% higher risk of cardiovascular death [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.02–1.82] and a 24% higher risk of all-cause mortality (HR 1.24, 95% CI 1.10–1.39). The 15-year adjusted cumulative incidences of cardiovascular mortality were 0.91, 0.99, and 2.1% for UACR levels of &lt;4.18, 4.18 to &lt;6.91, and ≥6.91 mg/g, respectively. The 15-year adjusted cumulative incidences of all-cause mortality were 5.1, 6.1, and 7.4% for UACR levels of &lt;4.18, 4.18 to &lt;6.91, and ≥6.91 mg/g, respectively.

Conclusion
Adults with elevated levels of albuminuria within the low range (UACR &lt;30 mg/g) and no major cardiovascular risk factors had elevated risks of cardiovascular and all-cause mortality. The risk increased linearly with higher albuminuria levels. This emphasizes a risk gradient across all albuminuria levels, even within the supposedly normal range, adding to the existing evidence.
“It’s like crystal gazing”: The Lived Experience of Anticipating End-of-Life Choices in Older Adults and Their Close Ones
Authors: Antonides Marte Fleur , van Wijngaarden Els 
Published: June 2024

Abstract

Background and Objectives
Nowadays people increasingly try to take control over the end of their lives by anticipating end-of-life choices. Explication of these choices is encouraged using advance care planning (ACP). We aim to deepen our understanding of how choice-making processes are lived in real life, exploring the experience of community-dwelling older adults and their close ones over time.

Research Design and Methods
A multiperspective and longitudinal approach grounded in phenomenology was chosen. Ten triads consisting of an older adult (75+) and 2 close ones (n = 30) were interviewed, twice individually and once as a group, over 20 months (=70 interviews). Data were thematically analyzed both longitudinally and from all 3 perspectives.

Results
The essential meaning of anticipatory choice-making processes was described as a dynamic and relationally entangled decisional process, to navigate between paradoxical choices for an opaque future. Three fields of tension were created due to ambivalence in these choice-making processes: navigation between having and losing control, between taking away and burdening with responsibility, and between expressing and holding back oneself.

Discussion and Implications
Anticipation of choices for hypothetical end-of-life scenarios turned out to be complex and ambivalent. Most older adults resisted ambivalence and ignored complexity in an attempt to stay in control over their end of life. The burdening impact of choices on close ones illuminated the relationality of choice-making processes. These aspects of end-of-life choice-making processes should be integrated into ACP in order to better understand and care for people and their close ones faced with these choices.
Why does the cost of employer-sponsored coverage keep rising?
Authors: Kanimian Salpy , Ho Vivian 
Published: June 2024

Abstract
Over the past 25 years, the gap between the increase in health insurance costs and workers’ wages has significantly expanded. This trend has led to significant concerns about healthcare affordability, with surveys revealing conflicting opinions regarding whether hospitals or health insurance companies bear the blame for escalating costs. To better understand these dynamics, we examined consumer price indices for health insurance, hospital services, and professional services from 2006 to 2023 using Bureau of Labor Statistics data. Our analysis shows that the hospital price index rose steadily between 2006 and 2023, faster than insurance premiums or professional services. To examine whether differences in underlying costs are driving higher hospital price increases, we evaluated the profit margins of hospitals and health insurance companies using the National Academy for State Health Policy’'s Hospital Cost Tool and National Association of Insurance Commissioners Industry Reports. Our findings reveal that hospitals (for-profit and nonprofit) have consistently maintained higher profit margins than insurance companies. As health insurance costs continue to weigh heavily on working Americans, our analysis suggests that high hospital prices drive insurance premiums.
A novel tomato interspecific (Solanum lycopersicum var. cerasiforme and Solanum pimpinellifolium) MAGIC population facilitates trait association and candidate gene discovery in untapped exotic germplasm
Authors: Arrones Andrea , Antar Oussama , Pereira-Dias Leandro , Solana Andrea , Ferrante Paola , Aprea Giuseppe , Plazas Mariola , Prohens Jaime , Díez María José , Giuliano Giovanni , Gramazio Pietro , Vilanova Santiago 
Published: June 2024

Abstract
We developed a novel eight-way tomato multiparental advanced generation intercross (MAGIC) population to improve the accessibility of tomato relatives genetic resources to geneticists and breeders. The interspecific tomato MAGIC population (ToMAGIC) was obtained by intercrossing four accessions each of Solanum lycopersicum var. cerasiforme and Solanum pimpinellifolium, which are the weedy relative and the ancestor of cultivated tomato, respectively. The eight exotic ToMAGIC founders were selected based on a representation of the genetic diversity and geographical distribution of the two taxa. The resulting MAGIC population comprises 354 lines, which were genotyped using a new 12k tomato single primer enrichment technology panel and yielded 6488 high-quality single-nucleotide polymorphism (SNPs). The genotyping data revealed a high degree of homozygosity, an absence of genetic structure, and a balanced representation of the founder genomes. To evaluate the potential of the ToMAGIC population, a proof of concept was conducted by phenotyping it for fruit size, plant pigmentation, leaf morphology, and earliness. Genome-wide association studies identified strong associations for the studied traits, pinpointing both previously identified and novel candidate genes near or within the linkage disequilibrium blocks. Domesticated alleles for fruit size were recessive and were found, at low frequencies, in wild/ancestral populations. Our findings demonstrate that the newly developed ToMAGIC population is a valuable resource for genetic research in tomato, offering significant potential for identifying new genes that govern key traits in tomato. ToMAGIC lines displaying a pyramiding of traits of interest could have direct applicability for integration into breeding pipelines providing untapped variation for tomato breeding.
Ukraine and the opportunity costs of military aid
Authors: Glanville Luke , Pattison James 
Published: June 2024

Abstract
Western states have provided billions of dollars of military aid to Ukraine to help it in its war against Russia. Yet, despite numerous discussions of the ethical issues raised by the war, there has been little discussion of the opportunity costs of this military assistance. Is it right that the West has prioritized military assistance to Ukraine, when the conflict in Ukraine is just one of numerous challenges facing the world, from forced displacement to global poverty, preventable disease to climate change? This article offers the first detailed engagement with this issue, taking seriously the nonideal feasibility constraints that states face. It firsts set out the prima facie case against assisting Ukraine militarily due to the opportunity costs. It then explores—and largely rejects—two responses: that military assistance is required to protect Ukrainian self-determination and that it is needed to stop the march of authoritarianism. It argues that the opportunity costs objection has serious force and counts against much of the provision of military assistance to Ukraine (although not all). This argument has broader implications for the extent to which states should prioritize military aid over other means of addressing global challenges.
Predictors of long-term success after successful explantation of continuous flow left ventricular assist device support
Authors: Gyoten Takayuki , Amiya Eisuke , Saito Akihito , Ono Minoru 
Published: June 2024

Abstract

OBJECTIVES
Predictors and evaluations of continuous flow left ventricular assist device (cf-LVAD) explantation in recovered patients remain under discussion due to lack of evidence on long-term safety and efficacy. This study summarized our experiences regarding cf-LVAD explantation in non-ischaemic dilated cardiomyopathy patients and estimated a predictor for sufficient myocardial recovery allowing left ventricular assist device explant.

METHODS
We retrospectively identified 135 adult patients with cf-LVAD therapy as bridge to heart transplant due to non-ischaemic dilated cardiomyopathy. Of those, 13 patients underwent device explantation (recovery group) after myocardial recovery. Twelve (92%) of the explanted patients were evaluated using our weaning protocol and underwent surgical explantation. Meanwhile, the remaining 122 continued with cf-LVAD therapy (non-recovery group).

RESULTS
Multivariate logistic regression analysis revealed time interval between the first heart failure event and cf-LVAD implantation as an independent predictor for successful explantation. The optimal time interval cutoff value to predict cf-LVAD explantation was 7 months, with a sensitivity of 91.0% and specificity of 84.6%. Echocardiography in patients with successful cf-LVAD explantation showed significant improvement of left ventricular function and dimensions at 6 months postoperatively. The 13 explanted patients are currently alive at a median of 30 (interquartile range; 18–58) months after explantation. The survival rate free from rehospitalization due to heart failure following explantation was 100%. Left ventricular function and remodelling after explantation were also preserved.

CONCLUSIONS
In non-ischaemic dilated cardiomyopathy patients with a short interval between the first heart failure event and cf-LVAD therapy, left ventricular myocardium may recover in an early phase after device implantation.
First experiences with automated annular suturing device in totally endoscopic aortic and mitral valve replacement
Authors: El-Sayed Ahmad Ali , Salamate Saad , Granov Nermir , Bayram Ali , Sirat Sami , Doss Mirko , Silaschi Miriam , Akhavuz Ömür , Bakhtiary Farhad 
Published: June 2024

Abstract

OBJECTIVES
To overcome some of the challenges of endoscopic minimally invasive valve surgery, an automated annular suturing device has been used in aortic and mitral valve replacement surgeries. The current study investigates early clinical outcomes of patients who received aortic or mitral valve replacement with the help of the RAM® device as first experiences in minimally invasive valve surgery.

METHODS
Between September 2020 and June 2023, 66 consecutive patients (mean age 61.8 ± 11 years) underwent endoscopic minimally invasive aortic or mitral valve replacement through right anterior mini-thoracotomy at 2 cardiac surgery referral centres in Germany. The RAM® device was used in all Patients. 3.5 and 5.0 sizes were used in 16.7% and 83.3% of patients, respectively. Aortic, mitral and double valve surgery was performed in 81.8%, 15.2% and 1.5% of patients, respectively. Clinical data were prospectively entered into our institutional database.

RESULTS
Cardiopulmonary bypass time and cross-clamping time were 97.9 ± 20.9 and 66 ± 15.7 min, respectively. Intensive care unit and hospital stays were 1 [1–2] and 9 [7–13] days, respectively. No paravalvular leak and no other intraoperative complications occurred. 30-day and in-hospital mortality were zero. Conversion to sternotomy occurred in 1 (1.5%) patient due to bleeding.

CONCLUSIONS
The usage of the RAM® device is a safe, feasible and effective approach to the endoscopic implantation of aortic or mitral valves and yield excellent early outcomes. Larger size studies are needed to evaluate the efficacy and safety of RAM® device.
Examining the effects of adopting early maturing crop varieties on agricultural productivity, climate change adaptation, and mitigation
Authors: Liang Zhihui , Ruiz-Menjivar Jorge , Zhang Lu , Zhang Junbiao , Shen Xue 
Published: June 2024

Abstract
Climate-smart agriculture is guided by three main goals: increased productivity, enhanced resilience (climate change adaptation), and reduced emissions (climate change mitigation). Early mature crop varieties have been promoted to minimize the impact of climate change and extreme weather events on farming activities. This study examined the effects of adopting early mature rice varieties on agricultural productivity, climate change adaptation, and mitigation. Data came from a cross-sectional sample of 1396 rice farmers in Hubei, China. Productivity was measured via mean rice yield. Production risk (variance of yield) and downside risk (skewness of rice yield) were used as proxies for adaptation. Life cycle assessment was used to calculate the greenhouse gas emissions of rice production. Results indicated that adopting early maturing varieties significantly increased mean rice yield and reduced production risk, downside risk, and greenhouse gas emissions. Altogether, this study provided evidence that using early maturing varieties positively contributed to the three goals of climate-smart agriculture. Our findings provide insight into formulating future policies and programs promoting agricultural sustainability and climate resilience in China and other developing nations in the region.
Space-time error estimates for approximations of linear parabolic problems with generalized time boundary conditions
Authors: Arendt W , Chalendar I , Eymard R 
Published: June 2024

Abstract
We first give a general error estimate for the nonconforming approximation of a problem for which a Banach–Nečas–Babuška (BNB) inequality holds. This framework covers parabolic problems with general conditions in time (initial value problems as well as periodic problems) under minimal regularity assumptions. We consider approximations by two types of space-time discretizations, both based on a conforming Galerkin method in space. The first one is the Euler $\theta -$scheme. In this case, we show that the BNB inequality is always satisfied, and may require an extra condition on the time step for $\theta \le \frac 1 2$. The second one is the time discontinuous Galerkin method, where the BNB condition holds without any additional condition.
Cytokine Biomarkers of Exacerbations in Sputum From Patients With Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study
Authors: Budroni Sonia , Taccone Marianna , Stella Maria , Aprea Susanna , Schiavetti Francesca , Bardelli Monia , Lambert Christophe , Rondini Simona , Weynants Vincent , Contorni Mario , Wilkinson Tom M A , Brazzoli Michela , Rossi Paccani Silvia 
Published: June 2024

Abstract

Background
We determined the relationships between cytokine expression in sputum and clinical data to characterize and understand chronic obstructive pulmonary disease (COPD) exacerbations in people with COPD.

Methods
We measured 30 cytokines in 936 sputum samples, collected at stable state and exacerbation visits from 99 participants in the Acute Exacerbation and Respiratory InfectionS in COPD (AERIS) study (ClinicalTrials.gov NCT01360398). We determined their longitudinal expression and examined differential expression based on disease status or exacerbation type.

Results
Of the cytokines, 17 were suitable for analysis. As for disease states, in exacerbation sputum samples, interleukin (IL) 17A, tumor necrosis factor alpha (TNF-α), IL-1β, and IL-10 were significantly increased compared to stable state sputum samples, but a logistic mixed model could not predict disease state. As for exacerbation types, bacteria-associated exacerbations showed higher expression of IL-17A, TNF-α, IL-1β, and IL-1α. IL-1α, IL-1β, and TNF-α were identified as suitable biomarkers for bacteria-associated exacerbation. Bacteria-associated exacerbations also formed a cluster separate from other exacerbation types in principal component analysis.

Conclusions
Measurement of cytokines in sputum from COPD patients could help identify bacteria-associated exacerbations based on increased concentrations of IL-1α, IL-1β, or TNF-α. This finding may provide a point-of-care assessment to distinguish a bacterial exacerbation of COPD from other exacerbation types.
A multi-tissue genome-scale model of Populus trichocarpa elucidates overexpression targets for improving drought tolerance
Authors: Simas Coutinho Barbosa Juliana , Schroeder Wheaton L , Suthers Patrick F , Jawdy Sara S , Chen Jin-Gui , Muchero Wellington , Maranas Costas D 
Published: June 2024

Abstract
Populus trichocarpa (poplar) is a fast-growing model tree whose lignocellulosic biomass is a promising biofuel feedstock. Enhancing its viability and yield in non-arable drought-prone lands can reduce biomass costs and accelerate adoption as a biofuel crop. Data from extensive -omics and phenotypic studies were leveraged herein to reconstruct a multi-tissue (root, stem and leaf) genome-scale model (GSM) of poplar, iPotri3463, encompassing 14 360 reactions, 12 402 metabolites and 3463 genes. Two condition-specific GSMs were extracted from iPotri3463: iPotri3016C (control) and iPotri2999D (drought), supported by condition-specific transcript levels and reaction essentiality for growth. Physiological constraints consistent with experimental measurements of drought-stressed plants were imposed on growth, photorespiration and carbon assimilation rates. Calculated increased flux capacity through the violaxanthin cycle and GABA biosynthetic pathways agree with established key strategies for improving drought tolerance. Differential gene expression analysis was performed on existing transcriptomes of poplar under different watering regimes. Computational flux knockdown was applied to reactions with increased flux capacity under drought that were associated with at least one downregulated gene. Several such reactions were essential for maintaining observed biomass yield and their associated genes are candidates for overexpression to improve drought tolerance. Glutamine synthetase is one whose overexpression in poplar confirms in silico predictions. However, the two most promising candidates are genes encoding ferulate-5-hydroxylase, Potri.007G016400 and Potri.005G117500, as their overexpression in other plant species led to demonstrably improved drought tolerance while previous overexpression in poplar reduced biomass recalcitrance. iPotri3463 is the first poplar-specific whole-plant GSM and the second one available for a woody plant.
Designing for Autonomy: A Process-Oriented Approach Based on Organismic Integration Theory
Authors: Gerstenberg Rebecca , Hassenzahl Marc , Laschke Matthias 
Published: June 2024

Abstract
In human–computer interaction, self-determination theory (SDT) is best known for its concepts of intrinsic motivation and need fulfillment. In the field of behavior change technologies (BCTs), the need for autonomy, i.e. to act according to one’s own goals and values, has become increasingly important due to its strong positive impact on maintaining behavior change. Still, designers struggle with taking autonomy into account. We believe that organismic integration theory (OIT), an underutilized sub-theory of SDT, is a valuable addition as it allows for a process-oriented view on autonomy. OIT introduces different types of extrinsic motivation (external, introjected, identified and integrated) along a continuum of autonomy. It offers new ways to talk about people's experiences of using BCTs and calls for individualized design strategies. We propose a design approach based on OIT, which understands BCTs as active facilitators to progressively move people along the continuum from external to integrated motivation.
Fine-tuning large language models for rare disease concept normalization
Authors: Wang Andy , Liu Cong , Yang Jingye , Weng Chunhua 
Published: June 2024

Abstract

Objective
We aim to develop a novel method for rare disease concept normalization by fine-tuning Llama 2, an open-source large language model (LLM), using a domain-specific corpus sourced from the Human Phenotype Ontology (HPO).

Methods
We developed an in-house template-based script to generate two corpora for fine-tuning. The first (NAME) contains standardized HPO names, sourced from the HPO vocabularies, along with their corresponding identifiers. The second (NAME+SYN) includes HPO names and half of the concept’s synonyms as well as identifiers. Subsequently, we fine-tuned Llama 2 (Llama2-7B) for each sentence set and conducted an evaluation using a range of sentence prompts and various phenotype terms.

Results
When the phenotype terms for normalization were included in the fine-tuning corpora, both models demonstrated nearly perfect performance, averaging over 99% accuracy. In comparison, ChatGPT-3.5 has only ∼20% accuracy in identifying HPO IDs for phenotype terms. When single-character typos were introduced in the phenotype terms, the accuracy of NAME and NAME+SYN is 10.2% and 36.1%, respectively, but increases to 61.8% (NAME+SYN) with additional typo-specific fine-tuning. For terms sourced from HPO vocabularies as unseen synonyms, the NAME model achieved 11.2% accuracy, while the NAME+SYN model achieved 92.7% accuracy.

Conclusion
Our fine-tuned models demonstrate ability to normalize phenotype terms unseen in the fine-tuning corpus, including misspellings, synonyms, terms from other ontologies, and laymen’s terms. Our approach provides a solution for the use of LLMs to identify named medical entities from clinical narratives, while successfully normalizing them to standard concepts in a controlled vocabulary.