bluuebunny/crossref_metadata_2025_split huggingface dataset:
A copula‐based method of risk prediction for autonomous underwater gliders in dynamic environments
Authors: Chen Xi , Bose Neil , Brito Mario , Khan Faisal , Zou Ting 
Published: April 2023

ABSTRACTAutonomous underwater gliders (AUGs) are effective platforms for oceanic research and environmental monitoring. However, complex underwater environments with uncertainties could pose the risk of vehicle loss during their missions. It is therefore essential to conduct risk prediction to assist decision making for safer operations. The main limitation of current studies for AUGs is the lack of a tailored method for risk analysis considering both dynamic environments and potential functional failures of the vehicle. Hence, this study proposed a copula‐based approach for evaluating the risk of AUG loss in dynamic underwater environments. The developed copula Bayesian network (CBN) integrated copula functions into a traditional Bayesian belief network (BBN), aiming to handle nonlinear dependencies among environmental variables and inherent technical failures. Specifically, potential risk factors with causal effects were captured using the BBN. A Gaussian copula was then employed to measure correlated dependencies among identified risk factors. Furthermore, the dependence analysis and CBN inference were performed to assess the risk level of vehicle loss given various environmental observations. The effectiveness of the proposed method was demonstrated in a case study, which considered deploying a Slocum G1 Glider in a real water region. Risk mitigation measures were provided based on key findings. This study potentially contributes a tailored tool of risk prediction for AUGs in dynamic environments, which can enhance the safety performance of AUGs and assist in risk mitigation for decision makers.
A classification system for characterizing the integrity and quality of evidence in risk studies
Authors: Thekdi Shital , Aven Terje 
Published: April 2023

AbstractRisk management requires a balance between knowledge and values. Knowledge consists of justified beliefs and evidence, with evidence including data, assumptions, and models. While quality and integrity of evidence are valued in the sciences, risk science involves uncertainty, which suggests that evidence can be incomplete or imperfect. The use of inappropriate evidence can invalidate risk studies and contribute to misinformation and poor risk management decisions. Additionally, the interpretation of quality and integrity of evidence may vary by the risk study mission, decision‐maker values, and stakeholder needs. While risk science has developed standards for risk studies, there remains a lack of clarity for how to demonstrate quality and integrity of evidence, recognizing that evidence can be presented in many formats (e.g., data, ideas, and theories), be leveraged at various stages of a risk study (e.g., hypotheses, analyses, and communication), and involve differing expectations across stakeholders. This study develops and presents a classification system to evaluate quality and integrity of evidence that is based on current risk science guidance, best practices from non‐risk disciplines, and lessons learned from recent risk events. The classification system is demonstrated on a cyber‐security application. This study will be of interest to risk researchers, risk professionals, and data analysts.
Hemoglobin mass and performance responses during 4 weeks of normobaric “live high–train low and high”
Authors: Kettunen Oona , Leppävuori Antti , Mikkonen Ritva , Peltonen Juha E. , Nummela Ari , Wikström Bettina , Linnamo Vesa 
Published: April 2023

PurposeTo investigate whether 4 weeks of normobaric “live high–train low and high” (LHTLH) causes different hematological, cardiorespiratory, and sea‐level performance changes compared to living and training in normoxia during a preparation season.MethodsNineteen (13 women, 6 men) cross‐country skiers competing at the national or international level completed a 28‐day period (∼18 h day−1) of LHTLH in normobaric hypoxia of ∼2400 m (LHTLH group) including two 1 h low‐intensity training sessions per week in normobaric hypoxia of 2500 m while continuing their normal training program in normoxia. Hemoglobin mass (Hbmass) was assessed using a carbon monoxide rebreathing method. Time to exhaustion (TTE) and maximal oxygen uptake (VO2max) were measured using an incremental treadmill test. Measurements were completed at baseline and within 3 days after LHTLH. The control group skiers (CON) (seven women, eight men) performed the same tests while living and training in normoxia with ∼4 weeks between the tests.ResultsHbmass in LHTLH increased 4.2 ± 1.7% from 772 ± 213 g (11.7 ± 1.4 g kg−1) to 805 ± 226 g (12.5 ± 1.6 g kg−1) (p < 0.001) while it was unchanged in CON (p = 0.21). TTE improved during the study regardless of the group (3.3 ± 3.4% in LHTLH; 4.3 ± 4.8% in CON, p < 0.001). VO2max did not increase in LHTLH (61.2 ± 8.7 mL kg−1 min−1 vs. 62.1 ± 7.6 mL kg−1 min−1, p = 0.36) while a significant increase was detected in CON (61.3 ± 8.0–64.0 ± 8.1 mL kg−1 min−1, p < 0.001).ConclusionsFour‐week normobaric LHTLH was beneficial for increasing Hbmass but did not support the short‐term development of maximal endurance performance and VO2max when compared to the athletes who lived and trained in normoxia.
Basal NAD(H) redox state permits hydrogen peroxide‐induced mesenteric artery dilatation
Authors: Raph Sean M. , Dwenger Marc M. , Hu Xuemei , Nystoriak Matthew A. 
Published: April 2023

AbstractSmooth muscle voltage‐gated K+ (Kv) channels in resistance arteries control vascular tone and contribute to the coupling of blood flow with local metabolic activity. Members of the Kv1 family are expressed in vascular smooth muscle and are modulated upon physiological elevation of local metabolites, including the glycolytic end‐product l‐lactate and superoxide‐derived hydrogen peroxide (H2O2). Here, we show that l‐lactate elicits vasodilatation of small‐diameter mesenteric arteries in a mechanism that requires lactate dehydrogenase (LDH). Using the inside‐out configuration of the patch clamp technique, we show that increases in NADH that reflect LDH‐mediated conversion of l‐lactate to pyruvate directly stimulate the activity of single Kv1 channels and significantly enhance the sensitivity of Kv1 activity to H2O2. Consistent with these findings, H2O2‐evoked vasodilatation was significantly greater in the presence of 10 mM l‐lactate relative to lactate‐free conditions, yet was abolished in the presence of 10 mM pyruvate, which shifts the LDH reaction towards the generation of NAD+. Moreover, the enhancement of H2O2‐induced vasodilatation was abolished in arteries from double transgenic mice with selective overexpression of the intracellular Kvβ1.1 subunit in smooth muscle cells. Together, our results indicate that the Kvβ complex of native vascular Kv1 channels serves as a nodal effector for multiple redox signals to precisely control channel activity and vascular tone in the face of dynamic tissue‐derived metabolic cues.
imageKey points
Vasodilatation of mesenteric arteries by elevated external l‐lactate requires its conversion by lactate dehydrogenase.
Application of either NADH or H2O2 potentiates single Kv channel currents in excised membrane patches from mesenteric artery smooth muscle cells.
The binding of NADH enhances the stimulatory effects of H2O2 on single Kv channel activity.
The vasodilatory response to H2O2 is differentially modified upon elevation of external l‐lactate or pyruvate.
The presence of l‐lactate enhances the vasodilatory response to H2O2 via the Kvβ subunit complex in smooth muscle.
“Living High-Training Low” for Olympic Medal Performance: What Have We Learned 25 Years After Implementation?
Authors: Girard Olivier , Levine Benjamin D. , Chapman Robert F. , Wilber Randall 
Published: April 2023

Background: Altitude training is often regarded as an indispensable tool for the success of elite endurance athletes. Historically, altitude training emerged as a key strategy to prepare for the 1968 Olympics, held at 2300 m in Mexico City, and was limited to the “Live High-Train High” method for endurance athletes aiming for performance gains through improved oxygen transport. This “classical” intervention was modified in 1997 by the “Live High-Train Low” (LHTL) model wherein athletes supplemented acclimatization to chronic hypoxia with high-intensity training at low altitude. Purpose: This review discusses important considerations for successful implementation of LHTL camps in elite athletes based on experiences, both published and unpublished, of the authors. Approach: The originality of our approach is to discuss 10 key “lessons learned,” since the seminal work by Levine and Stray-Gundersen was published in 1997, and focusing on (1) optimal dose, (2) individual responses, (3) iron status, (4) training-load monitoring, (5) wellness and well-being monitoring, (6) timing of the intervention, (7) use of natural versus simulated hypoxia, (8) robustness of adaptative mechanisms versus performance benefits, (9) application for a broad range of athletes, and (10) combination of methods. Successful LHTL strategies implemented by Team USA athletes for podium performance at Olympic Games and/or World Championships are presented. Conclusions: The evolution of the LHTL model represents an essential framework for sport science, in which field-driven questions about performance led to critical scientific investigation and subsequent practical implementation of a unique approach to altitude training.
Effect of exercise therapy versus surgery on mechanical symptoms in young patients with a meniscal tear: a secondary analysis of the DREAM trial
Authors: Damsted Camma , Thorlund Jonas Bloch , Hölmich Per , Lind Martin , Varnum Claus , Villumsen Martin Dalgaard , Hansen Mogens Strange , Skou Søren T 
Published: April 2023

ObjectiveTo compare the effect of early surgery versus exercise and education on mechanical symptoms and other patient-reported outcomes in patients aged 18–40 years with a meniscal tear and self-reported mechanical knee symptoms.MethodsIn a randomised controlled trial, 121 patients aged 18–40 years with a MRI-verified meniscal tear were randomised to surgery or 12-week supervised exercise and education. For this study, 63 patients (33 and 30 patients in the surgery and in the exercise group, respectively) reporting baseline mechanical symptoms were included. The main outcome was self-reported mechanical symptoms (yes/no) at 3, 6 and 12 months assessed using a single item from the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes were KOOS4and the 5 KOOS-subscales and the Western Ontario Meniscal Evaluation Tool (WOMET).ResultsIn total, 55/63 patients completed the 12-month follow-up. At 12 months, 9/26 (35%) in the surgery group and 20/29 (69%) in the exercise group reported mechanical symptoms. The risk difference and relative risk at any time point was 28.7% (95% CI 8.6% to 48.8%) and 1.83 (95% CI 0.98 to 2.70) of reporting mechanical symptoms in the exercise group compared with the surgery group. We did not detect any between-group differences in the secondary outcomes.ConclusionThe results from this secondary analysis suggest that early surgery is more effective than exercise and education for relieving self-reported mechanical knee symptoms, but not for improving pain, function and quality of life in young patients with a meniscal tear and mechanical symptoms.Trial registration numberNCT02995551.
Effect of a moderately carbohydrate-restricted diet on liver enzymes, steatosis and fibrosis in normal-weight individuals with non-alcoholic fatty liver disease: study protocol for a parallel randomised controlled clinical trial
Authors: Dashti Fatemeh , Alavian Seyed Moayed , Sohrabpour Amir Ali , Mousavi Sara Ebrahimi , Keshavarz Seyed-Ali , Esmaillzadeh Ahmad 
Published: April 2023

IntroductionNon-alcoholic fatty liver disease (NAFLD) is a hepatic condition that is considerably prevalent across the world. Dietary intakes, in which macronutrient composition is precisely planned, might be able to reduce inflammation, steatosis and fibrosis among patients with NAFLD. A moderately carbohydrate restricted diet with weight loss has been demonstrated to improve liver fat content among overweight or obese patients. However, there is no information about the appropriateness of such a restriction, without weight loss, in normal-weight patients. This randomised clinical trial will be aimed at assessing the effect of moderate carbohydrate restriction on liver enzymes, liver steatosis and fibrosis in normal-weight patients with NAFLD.Methods and analysisThis randomised controlled clinical trial will be conducted to evaluate the impact of a moderately carbohydrate restricted diet on liver enzymes, steatosis and fibrosis in 52 eligible normal-weight individuals with NAFLD. Transient elastography and controlled attenuation parameter with FibroScan will be applied to diagnose NAFLD. After individual matching based on body mass index, age and sex, patients will be randomly assigned to receive a moderately carbohydrate restricted diet or an isocaloric diet without carbohydrate restriction for 12 weeks. The primary and secondary outcomes in this study will be liver function indices, including liver steatosis and fibrosis, metabolic parameters and anthropometric measures. All these variables will be assessed at study baseline and postintervention.Ethics and disseminationThe present clinical trial study was accepted by the ethics committee of TUMS (Tehran University of Medical Sciences) (code: IR.TUMS.MEDICINE.REC.1400.116).Trial registration numberIRCT20210119050086N1.
Protocol for a bandit-based response adaptive trial to evaluate the effectiveness of brief self-guided digital interventions for reducing psychological distress in university students: the Vibe Up study
Authors: Huckvale Kit , Hoon Leonard , Stech Eileen , Newby Jill M , Zheng Wu Yi , Han Jin , Vasa Rajesh , Gupta Sunil , Barnett Scott , Senadeera Manisha , Cameron Stuart , Kurniawan Stefanus , Agarwal Akash , Kupper Joost Funke , Asbury Joshua , Willie David , Grant Alasdair , Cutler Henry , Parkinson Bonny , Ahumada-Canale Antonio , Beames Joanne R , Logothetis Rena , Bautista Marya , Rosenberg Jodie , Shvetcov Artur , Quinn Thomas , Mackinnon Andrew , Rana Santu , Tran Truyen , Rosenbaum Simon , Mouzakis Kon , Werner-Seidler Aliza , Whitton Alexis , Venkatesh Svetha , Christensen Helen 
Published: April 2023

IntroductionMeta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity.Methods and analysisThe Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions.Ethics and disseminationEthical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP).Trial registration numberACTRN12621001223820.
History of heart failure and chronic kidney disease and risk of all-cause death after COVID-19 during the first three waves of the pandemic in comparison with influenza outbreaks in Sweden: a registry-based, retrospective, case–control study
Authors: Ritsinger Viveca , Bodegård Johan , Kristofi Robin , Thuresson Marcus , Nathanson David , Nyström Thomas , Eriksson Jan , Norhammar Anna 
Published: April 2023

ObjectivesTo explore how cardiorenal disease (CRD; heart failure and/or chronic kidney disease) impacted mortality in men and women hospitalised for COVID-19 during the first three waves of the pandemic in Sweden in comparison to previous influenza outbreaks.DesignA registry-based, retrospective, case–control study.SettingHospital care in Sweden.ParticipantsAll patients in Sweden with a main hospital diagnosis of COVID‐19 (January 2020–September 2021) or influenza (January 2015–December 2019) with previous CRD were identified in registries and compared with a reference group free from CRD but with COVID-19 or influenza.Primary outcome measureAssociated risk of all-cause death during the first year was analysed using adjusted Cox proportional hazards models.ResultsIn COVID-19 patients with and without prior history of CRD (n=44 866), mean age was 79.8 years (SD 11.8) and 43% were women. In influenza patients (n=8897), mean age was 80.6 years (SD 11.5) and 45% were women. COVID-19 versus influenza was associated with higher mortality risk during the first two COVID-19 waves (HR 1.53; 95% CI 1.45 to 1.62, p<0.001 and HR 1.52; 95% CI 1.44 to 1.61, p<0.001), but not in the third wave (HR 1.07; 95% CI 0.99 to 1.14, p=0.072). CRD was an independent risk factor for all-cause death after COVID-19 in men and women (men: 1.37; 95% CI 1.31 to 1.44, p<0.001; women: 1.46; 95% CI 1.38 to 1.54, p<0.001). At ages <70 years, women with CRD had a similar mortality rate to men with CRD, while at ages ≥70 years, the mortality rate was higher in men.ConclusionsOutcome after COVID-19 is worse if CRD is present. In women at ages <70 years, the presence of CRD attenuates the protective effect of female sex. COVID-19 was associated with higher mortality risk than influenza during the first two pandemic waves.
UK physiotherapists delivering physical activity advice: what are the challenges and possible solutions? A qualitative study
Authors: Stead Alexandra , Vishnubala Dane , Marino Katherine Rose , Iqbal Adil , Pringle Andy , Nykjaer Camilla 
Published: April 2023

ObjectivesDespite the known health benefits of physical activity (PA), PA levels are in decline. Healthcare professionals, including physiotherapists, have been identified as ideal conduits to promote PA, yet their knowledge and awareness of PA guidelines are poor. The aims of this study were to explore current knowledge of PA guidelines among UK physiotherapists and identify barriers and possible solutions to delivering PA advice.DesignA qualitative approach using semistructured interviews that took place between March and May 2021. Data were analysed with a thematic approach using Braun and Clarke’s six steps.SettingVarious inpatient and outpatient clinical settings across six UK regions.ParticipantsEighteen UK-based physiotherapists managing National Health Service patients were recruited through volunteer sampling in March 2021.ResultsFive themes and 16 subthemes (shown in parenthesis) were identified as barriers and solutions to delivering PA advice: physiotherapist intrinsic barriers (knowledge, fear/confidence); a lack of emphasis and priority given to PA (time constraints, minimal educational and staff training); patient barriers (compliance, expectations and fear of doing PA); increasing awareness of the PA guidelines (staff training, signposting awareness, use of social media and television campaigns); and optimising delivery (use of visual resources, good communication and approaches involving being individualised and gradual for patients with chronic conditions).ConclusionsIn this study, physiotherapist participants seemed to have limited awareness of the PA guidelines despite recent updates and were faced with similar barriers to those previously reported in the literature. The solutions suggested could guide strategies to support physiotherapists being able to deliver PA advice. Further research is needed to evaluate the efficiency of any implemented solutions supporting the delivery of PA advice.
Resting heart rate and risk of atrial fibrillation in Chinese general population: Kailuan prospective cohort study
Authors: Hou Ziwei , Zhao Mao Xiang , Sun Yizhen , Zhang Sijing , Yao Siyu , Wang Chi , Wang Miao , Yun Cuijuan , Xue Hao , Wu Shouling 
Published: April 2023

ObjectivePrevious research has shown an association of higher heart rate with an increased risk of atrial fibrillation (AF). However, the relationship between resting heart rate (RHR) and AF is unknown. The aim of this study was to investigate the association between RHR and AF in the general population of China.DesignProspective observational cohort study.SettingCommunity based.ParticipantsA total of 46 126 individuals from the Kailuan study who participated in the first three surveys (2006/2007, 2008/2009 and 2010/2011) and were followed up at 2-year intervals were enrolled.Primary outcome measuresThe association between RHR and risk of incident AF was evaluated using Cox proportional hazards regression and restricted cubic spline models.ResultsTwo hundred and forty-one individuals (0.52%) developed AF during 7.5 years of follow-up. After adjustment for age, sex, low-density and high-density lipoprotein, physical activity, alcohol consumption, smoking status, body mass index, mean systolic blood pressure, and history of diabetes and hypertension, the HRs were 2.32 (95% CI 1.45 to 3.72) for an RHR <60 beats/min and 2.80 (1.13 to 6.94) for an RHR ≥100 beats/min in comparison with an RHR of 70–80 beats/min. Restricted cubic spline models revealed a U-shaped relationship between RHR and incident AF.ConclusionThese findings indicate that RHR and incident AF have a U-shaped relationship in the Chinese general population. Both lower and higher RHRs were associated with an increased risk of AF.