bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting mortality and re-hospitalization for heart failure: a machine-learning and cluster analysis on frailty and comorbidity
Authors: Okoye Chukwuma , Mazzarone Tessa , Niccolai Filippo , Bencivenga Leonardo , Pescatore Giulia , Bianco Maria Giovanna , Guerrini Cinzia , Giusti Andrea , Guarino Daniela , Virdis Agostino 
Published: October 2023

Abstract
Background
Machine-learning techniques have been recently utilized to predict the probability of unfavorable outcomes among elderly patients suffering from heart failure (HF); yet none has integrated an assessment for frailty and comorbidity. This research seeks to determine which machine-learning-based phenogroups that incorporate frailty and comorbidity are most strongly correlated with death or readmission at hospital for HF within six months following discharge from hospital.

Methods
In this single-center, prospective study of a tertiary care center, we included all patients aged 65 and older discharged for acute decompensated heart failure. Random forest analysis and a Cox multivariable regression were performed to determine the predictors of the composite endpoint. By k-means and hierarchical clustering, those predictors were utilized to phenomapping the cohort in four different clusters.

Results
A total of 571 patients were included in the study. Cluster analysis identified four different clusters according to frailty, burden of comorbidities and BNP. As compared with Cluster 4, we found an increased 6-month risk of poor outcomes patients in Cluster 1 (very frail and comorbid; HR 3.53 [95% CI 2.30–5.39]), Cluster 2 (pre-frail with low levels of BNP; HR 2.59 [95% CI 1.66–4.07], and in Cluster 3 (pre-frail and comorbid with high levels of BNP; HR 3.75 [95% CI 2.25–6.27])).

Conclusions
In older patients discharged for ADHF, the cluster analysis identified four distinct phenotypes according to frailty degree, comorbidity, and BNP levels. Further studies are warranted to validate these phenogroups and to guide an appropriate selection of personalized, model of care.
A Novel Approach to Addiction Medicine Education for Undergraduate Medical Students
Authors: Malinowski Robert , Poland Cara , Alan Jamie K. , Walsh Madison O. 
Published: October 2023

AbstractA virtual addiction medicine elective was developed using interactive multimedia modules, active learning strategies, and patient-based cases. Student had opportunities for professional networking and interacting with physicians and patients. The elective was successful in boosting Year-1 medical students’ confidence to screen, manage, and treat patients with substance abuse disorder.
Multi-criteria decision support system for bridge construction system selection utilizing value engineering and TOPSIS
Authors: ElMarkaby Alaa , Sanad Abdelmonem , Elyamany Ahmed , Yehia Ebtisam 
Published: October 2023

AbstractWhen selecting the appropriate bridge deck construction system, it is essential to consider many criteria such as the span length, geographical location, construction speed, cost, site conditions, resource availability, technology, ease of construction, and service life. The objective of this study is to optimize the decision-making process for selecting a bridge deck construction system in the preliminary design and planning stage. The proposed model allows designers or decision-makers to make an informed choice of an appropriate construction system according to project criteria through a decision support system. The model employs value engineering methodology and a multi-criteria decision-making method and utilizes the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), a multi-criteria decision-making method. To gather modeling data from a focus group consisting of professional bridge engineers, a semi-structured interview and two questionnaires are conducted. When applying the proposed model to two active bridge construction projects in Egypt, it reveals that "Span by Span using launching girder" and "precast post tension girder" are better suited to cases one and two, respectively. The study makes a contribution by presenting a decision support system that combines value engineering methodology and a multi-criteria decision-making method (TOPSIS). This system empowers designers and decision-makers to make project decisions considering specific criteria and constraints.
The role of connection with nature in empirical studies with physiological measurements: a systematic literature review
Authors: Gál Vera , Dömötör Zsuzsanna 
Published: October 2023

AbstractIt is well described that exposure to nature reduces physiological stress, and connectedness to nature can have a moderating effect. However, few studies have so far examined the construction of the connection with nature in relation to physiological processes. In this systematic review, we collected studies that used a physiological measure and included a scale to measure connectedness to nature. Our aim was to assess the role of nature relatedness at the level of physiological processes and to summarize the results published so far. Our review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in 3 different databases (PubMed, ScienceDirect and Google Scholar). As keywords, we used all the different questionnaires that measure connectedness to nature, combined with terms related to physiological measures. After final screening, 28 articles met the inclusion criteria for the review. The studies were very diverse in terms of purpose, intervention and methods, so narrative synthesis was conducted without measures of effect. We found evidence for a mediating effect of nature connectedness on the associations between nature exposure and cognitive function, brain activity, blood pressure, cortisol level and mental health. Studies investigating nature relatedness as state-like characteristics have shown that exposure to nature increases the level of connection to nature. Eye-tracking studies have confirmed that this measurement method can be used to investigate nature relatedness at a physiological level, which could be a useful complement to self-report questionnaires in future studies.
Relationship Between Steroid Hormone Profile and Premenstrual Syndrome in Women Consulting for Infertility or Recurrent Miscarriage
Authors: Turner Joseph V. , McLindon Lucas A. , Turner Damien V. , Alefsen Yolaine , Ecochard René 
Published: October 2023

AbstractTo determine the relationships between luteal-phase steroidal hormonal profile and PMS for a large number of women attending a dedicated fertility clinic. This was a retrospective cross-sectional study on women attending a hospital-based clinic for fertility concerns and/or recurrent miscarriage. All participants were assessed with a women’s health questionnaire which also included evaluation of premenstrual symptoms. Day of ovulation was identified based on the peak mucus symptom assessed by the woman after instruction in a fertility awareness-based method (FABM). This enabled reliable timing of luteal-phase serum hormone levels to be taken and analysed. Between 2011 and 2021, 894 of the 2666 women undertaking the women’s health assessment had at least one evaluable serum luteal hormone test. Serum progesterone levels were up to 10 nmol/L lower for symptomatic women compared with asymptomatic women. This difference was statistically significant (p < 0.05) for the majority of PMS symptoms at ≥ 9 days after the peak mucus symptom. A similar trend was observed for oestradiol but differences were generally not statistically significant. ROC curves demonstrated that steroid levels during the luteal phase were not discriminating in identifying the presence of PMS symptoms. Blood levels for progesterone were lower throughout the luteal phase in women with PMS, with the greatest effect seen late in the luteal phase.
Failure analysis of Incoloy 800 water immersion heating element
Authors: Ibrahim Abdulwahab , MacIntyre Scott 
Published: October 2023

AbstractDriven by regulations and restrictions of using fossil fuels and reducing carbon dioxide emissions, electrical heating is becoming a good choice for many domestic and industrial applications. High temperature oxidation along with corrosivity of the service environment bring many challenges to heating element designers and service engineers. Many factors, including design, overheating, sheath tube failure, corrosion, and overheating, cause heating elements to fail in use. Failure analysis is one method for enhancing a product's performance, reliability, and design.In this paper, a metallurgical failure analysis of Incoloy 800 water immersion heating element was conducted. Optical microscopy (OM), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), Vickers microhardness (Hv), and X-Ray radiography were used to analyze the different components of the failed item.Stress corrosion cracking (SCC) was identified as the cause of the failure. The chloride containing water caused the failure to begin by pitting on the Inconel 800 sheath material's outer surface, and then propagated as stress corrosion cracking (SCC).
Numerical modelling of Lamb wave propagation in 2D plate structures
Authors: Pollock L. , Wild G. 
Published: October 2023

AbstractLamb waves are a growing method for the Non-Destructive Testing and Evaluation (NDT&E) and structural health monitoring (SHM) of aerospace vehicles. These guided waves can propagate over large distances and have a strong tendency to interact with damage. Whilst several methods exist for the modelling of Lamb wave propagation, this paper is the first to introduce a first principles numerical model that can efficiently and accurately predict the behaviour of Lamb waves. The numerical model is easier to understand and implement compared with analytical solutions and significantly faster than discretised numerical methods. The numerical model is presented in detail for an isotropic and homogenous plate, along with validation against the industry accepted, WaveForm Revealer 3 (WFR3) software. The results show a mean correlation across all assessed parameters of 90.4% and 96.6% for the symmetric and antisymmetric modes, respectively. Further discussion is provided on future developments to the model, including on the topic of high temperature effects, anisotropic materials and edge reflections.
Sex Differences in Obstructive Sleep Apnea after Stroke
Authors: Dharmakulaseelan Laavanya , Black Sandra E. , Swartz Richard H. , Murray Brian J. , Boulos Mark I. 
Published: October 2023

ABSTRACT:Background and Objectives:Obstructive sleep apnea (OSA) is prevalent after stroke and associated with recurrent stroke, prolonged hospitalization, and decreased functional recovery. Sex differences in post-stroke OSA remain underexplored. The objective of this study was to evaluate sex differences in functional outcomes, stroke and OSA severity, and clinical manifestations of OSA in stroke patients with OSA.Methods:We retrospectively evaluated data from three previously conducted studies. Study patients had an imaging-confirmed stroke and had been found to have OSA (apnea–hypopnea index [AHI] ≥ 5) on either in-laboratory polysomnography or home sleep apnea testing performed within 1 year of their stroke. Linear regression models were used to evaluate study outcomes.Results:In total, 171 participants with post-stroke OSA (117 males [68.4%] and 54 females [31.6%]) were included. Female sex was an independent predictor for greater functional impairment (β = 0.37, 95% CI 0.029–0.71, p = 0.03), increased stroke severity (β = 1.009, 95% CI 0.032–1.99, p = 0.04), and greater post-stroke depressive symptoms (β = 3.73, 95% CI 0.16–7.29, p = 0.04). Female sex was associated with lower OSA severity, as measured by the AHI (β = –5.93, 95% CI –11.21– –0.66). Sex was not an independent predictor of specific symptoms of OSA such as daytime sleepiness, snoring, tiredness, and observed apneas.Conclusion:Females with post-stroke OSA had poorer functional outcomes and more severe strokes compared to males, despite having lower OSA severity. Females with post-stroke OSA also exhibited more depressive symptoms. Understanding sex differences in patients with post-stroke OSA will likely facilitate better recognition of OSA and potentially improve clinical outcomes.
The Foreign Trade of Tabriz: 1800-1900
Authors: Floor Willem 
Published: October 2023

AbstractUnder the early Qajars, Tabriz rose from being a provincial backwater in ruins to the foremost commercial entrepôt of Iran. Initially, its insignificant foreign trade was limited to Turkey (mostly raw Gilani silk), but, when the major commercial southern and western supply routes of Iran became unsafe and costly, trade moved to the northern route. Moreover, after Russia opened its territory to European goods in 1821, these also flowed via Tiflis to Tabriz. When ten years later Russia revoked this permission, the Tiflis trade moved to Tabriz via Trabzon, gradually replacing not only the Tiflis route but also the Istanbul-Erzerum route. This turned Trabzon into a quasi-“Iranian” port, as initially most of its imports were destined for or coming from Iran. Four-fifths of imports to Tabriz were European fabrics. Initially these had come from Russia, but, as of the 1820s, such were replaced by British, German, French, and Swiss fabrics. By mid-century, Manchester fabrics dominated the import trade of Tabriz. Thus, Great Britain took Russia's place as its primary trading partner, although by 1900 the tables had turned. During the majority of the nineteenth century, Caucasian Armenian merchants dominated Tabriz's foreign trade, with European merchants playing an important but limited role in the import of Manchester goods and the export of raw silk. After 1870, the importance of Tabriz as the commercial hub of N.W. Iran decreased, due to various reasons such as the outbreak of the Gilan silk disease, Russia stopping the transit of non-Russian goods, and the opening of the Suez Canal, but also because it became cheaper to import goods via Bushehr and Baghdad-Kermanshah. Nevertheless, even with a diminished role as a financial center and less foreign trade, Tabriz continued to be Iran's major commercial center until WW I.
Holocene hydroclimate and dust activity, as reconstructed from the sediments of Lake Bayanchagan, on the northern margin of the East Asian summer monsoon
Authors: Li Wubiao , Jiang Wenying , Yang Shiling , Lin Jie , Wang Yujie 
Published: October 2023

AbstractThe sediments of closed-basin lakes on the margin of the East Asian summer monsoon (EASM) are valuable archives of past changes in hydroclimate and dust activity and thus potentially can help us to understand future climate changes. We present high-resolution, well-dated records of the grain size and carbonate mineralogy from Lake Bayanchagan, northern China, spanning the last 11.5 ka. Grain-size endmember (EM) analysis distinguished four EMs, each linked to different sediment transport processes. EM1 (0.4–0.6 μm) and EM3 (14–102 μm) reflect the strength of regional dust activity, whereas EM2 (1.3–31 μm) represents variations in local hydrodynamic conditions related to lake-level changes and EM4 (68–500 μm) is associated with local dust activity. Our results show that a high lake level and weakened dust activity occurred during 10–5.8 ka, as indicated by increased EM2 and decreased EM3, respectively. After 5.8 ka, EM2 decreased as the three other EMs increased, and dolomite appeared in the sediments while calcite decreased—indicating both a decline in lake level and strengthened dust activity. The fluctuations in lake level and dust activity are in good agreement with precipitation variations reconstructed from other records, which are in turn correlated to movement of the EASM rainfall belt, in response to temperature changes.
Directors: Older and Wiser, or Too Old to Govern?
Authors: Masulis Ronald , Wang Cong , Xie Fei , Zhang Shuran 
Published: October 2023

Abstract
An unintended consequence of recent governance reforms in the United States is firms’ greater reliance on older director candidates, resulting in noticeable board aging. We investigate this phenomenon’s implications for corporate governance. We document that older independent directors exhibit poorer board meeting attendance, are less likely to serve on or chair key board committees, and receive less shareholder support in annual elections. These directors are associated with weaker board oversight in acquisitions, CEO turnovers, executive compensation, and financial reporting. However, they can also provide particularly valuable advice when they have specialized experience or when firms have greater advisory needs.
Care home co-worker relationships: a key ingredient for care home quality
Authors: Haunch Kirsty , Spilsbury Karen 
Published: October 2023

Abstract
The relationships that care home staff have with their co-workers are a key influence on the way they feel about their work and how they perform in their roles. This has a direct influence on quality of care and life as experienced by residents. However, care home providers face a challenge to promote co-worker relationships because: (a) the care home workforce often lack human resource oversight; (b) registered managers (and nurses), who often lack leadership training, are tasked with managing the working relationships of staff, the majority of whom are care workers of different ages, ethnicity and cultural beliefs; and (c) most (care workers) do not have any formal qualifications and are not routinely provided with the communication skills to facilitate collaborative working in dynamic and pressured climates. In this forum article, we consider these challenges and their implications for collaborative co-worker relationships, before highlighting opportunities for research, policy and practice. An important starting point is to focus on developing the leadership skills of staff at all levels and provide care workers with the skills they require to manage their working relationships and support them in their everyday work for the benefit of residents.
Phenotypes and genotypes in a cohort of children with single-ventricle CHD
Authors: Baker Elizabeth K. , Shikany Amy , Winlaw David S. , Weaver K. Nicole 
Published: October 2023

AbstractObjective:CHD is known to be associated with increased risk for neurodevelopmental disorders. The combination of CHD with neurodevelopmental disorders and/or extra-cardiac anomalies increases the chance for an underlying genetic diagnosis. Over the last 15 years, there has been a dramatic increase in the use of broad-scale genetic testing. We sought to determine if neurodevelopmental disorders in children with single-ventricle CHD born prior to the genetic testing revolution are associated with genetic diagnosis.Methods:We identified 74 5–12-year-old patients with single-ventricle CHD post-Fontan procedure. We retrospectively evaluated genetic testing performed and neurodevelopmental status of these patients.Results:In this cohort, there was an overall higher rate of neurodevelopmental disorders (80%) compared to the literature (50%). More of the younger (5–7-year-old) patients were seen by genetic counsellors compared to the older (8–12-year-old) cohort (46% versus 19% p value = 0.01). In the younger cohort, the average age of initial consultation was 7.7 days compared to 251 days in the older cohort. The overall rate of achieving a molecular diagnosis was 12% and 8% in the younger and older cohorts, respectively; however, the vast majority of did not have broad genetic testing.Conclusion:The minority of patients in our cohort achieved a genetic diagnosis. Given a large increase in the number of genes associated with monogenic CHD and neurodevelopmental disorders in the last decade, comprehensive testing and consultation with clinical genetics should be considered in this age range, since current testing standards did not exist during their infancy.
The interaction between the community food environment and cooking skills in association with diet-related outcomes in Dutch adults
Authors: Siddiqui Noreen Z , Pinho Maria GM , Rutters Femke , Beulens Joline WJ , Mackenbach Joreintje D 
Published: October 2023

AbstractObjective:We examined whether associations between the food environment, frequency of home cooking, diet quality and BMI were modified by the level of cooking skills.Design:Cross-sectional study using linear and modified Poisson regression models adjusted for age, sex, energy intake, education, income, household size and urbanisation. The frequency of home cooking was categorised into <6 and 6–7 d. Diet quality was based on a validated Dutch healthy diet index (0–150 points). Count of restaurants and food stores were determined by their count in a 1000m buffer around home and work. Cooking skills (score 1–5) were assessed using a validated questionnaire and added as interaction term.Setting:The Netherlands.Participants:1461 adults aged 18–65 years.Results:Count of restaurants and food stores were not associated with the frequency of home cooking. A 10-unit higher count of food stores was associated with a higher diet quality (β: 0·58 (95 % CI (0·04, 1·12)), and a 10-unit higher count of restaurants was associated with a lower BMI kg/m2 (β: −0·02 (95 % CI (-0·04, −0·004)). Better cooking skills were associated with a higher likelihood of cooking 6–7 d compared with <6 d (risk ratio: 1·24 (95 % CI (1·16, 1·31)) and a higher diet quality (β: 4·45 (95 % CI (3·27, 5·63)) but not with BMI. We observed no interaction between the food environment and cooking skills (P-for-interaction > 0·1).Conclusions:Exposure to food stores was associated with a higher diet quality and exposure to restaurants with a lower BMI. Better cooking skills were associated with a higher frequency of home cooking and better diet quality but did not modify associations with the food environment. Future studies should explore different approaches to understand how individuals interact with their food environment.