bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol for an epidemiological study ‘Multimorbidity − identifying the most burdensome patterns, risk factors and potentials to reduce future burden (MOLTO)’ based on the Finnish health examination surveys and the ongoing register-based follow-up
Authors: Jääskeläinen Tuija , Koponen Päivikki , Lundqvist Annamari , Suvisaari Jaana , Järvelin Jutta , Koskinen Seppo 
Published: June 2022

IntroductionMultimorbidity, defined as the co-occurrence of two or more long-term medical conditions, is an increasing public health concern worldwide causing enormous burden to individuals, healthcare systems and societies. The most effective way of decreasing the burden caused by multimorbidity is to find tools for its successful prevention but gaps in research evidence limit capacities to develop prevention strategies. The aim of the MOLTO study (Multimorbidity - identifying the most burdensome patterns, risk factors and potentials to reduce future burden) is to provide novel evidence required for cost-effective prevention of multimorbidity by defining the multimorbidity patterns causing the greatest burden at the population level, by examining their risk and protective factors and by estimating the potentials to reduce the future burden.Methods and analysisThe MOLTO study is based on the data from the Finnish population-based cross-sectional (FINRISK 2002–2012, FinHealth 2017 the Migrant Health and Well-being Study 2010–2012) and longitudinal (Health 2000/2011) health examination surveys with individual-level link to administrative health registers, allowing register-based follow-up for the study participants. Both cross-sectional and longitudinal study designs will be used. Multimorbidity patterns will be defined using latent class analysis. The burden caused by multimorbidity as well as risk and protective factors for multimorbidity will be analysed by survival analysis methods such as Cox proportional hazards and Poisson regression models.Ethics and disseminationThe survey data have been collected following the legislation at the time of the survey. The ethics committee of the Hospital District of Helsinki and Uusimaa has approved the data collection and register linkages for each survey. The results will be published as peer-reviewed scientific publications.
Safety and effectiveness of appropriately and inappropriately dosed rivaroxaban or apixaban versus warfarin in patients with atrial fibrillation: a cohort study with nested case–control analyses from UK primary care
Authors: González-Pérez Antonio , Roberts Luke , Vora Pareen , Saez Maria Eugenia , Brobert Gunnar , Fatoba Samuel , García Rodríguez Luis Alberto 
Published: June 2022

ObjectivesTo investigate effects of appropriately and inappropriately dosed apixaban/rivaroxaban versus warfarin on effectiveness and safety outcomes in patients with non-valvular atrial fibrillation (NVAF).DesignCohort study with nested case–control analyses using primary care electronic health records (IQVIA Medical Research Data UK database).SettingUK primary care.ParticipantsPatients aged ≥18 years with NVAF newly prescribed apixaban (N=14 701), rivaroxaban (N=14 288) or warfarin (N=16 175) between 1 January 2012 and 30 June 2018, and followed up to 31 December 2018.Primary and secondary outcome measuresIncident cases of ischaemic stroke/systemic embolism (IS/SE) and intracranial bleeding (ICB). Cases were matched to controls on age, sex and OAC naïve status. Using logistic regression, adjusted ORs with 95% CIs were calculated for the outcomes comparing apixaban/rivaroxaban use (appropriate or inappropriate dosing based on the product label criteria) and warfarin.ResultsFor IS/SE, ORs (95% CIs) for apixaban versus warfarin were 1.19 (0.92–1.52) for appropriate dose and 1.01 (0.67–1.51) for inappropriate dose; for rivaroxaban versus warfarin, estimates were 1.07 (0.83–1.37) for appropriate dose and 1.21 (0.78–1.88) for inappropriate dose. For ICB, ORs (95% CIs) for apixaban versus warfarin were 0.67 (0.44–1.00) for appropriate dose and 0.45 (0.21–0.95) for inappropriate dose; for rivaroxaban versus warfarin, estimates were 0.81 (0.55–1.20) for appropriate dose and 1.14 (0.56–2.31) for inappropriate dose.ConclusionsDosing appropriateness in NVAF was not associated with a significant difference in IS/SE risk or increase in ICB risk versus warfarin. These findings may reflect residual confounding and biases that were difficult to control, as also seen in other observational studies. They should, therefore, be interpreted with caution, and prescribers should adhere to the dosing instructions in the respective Summary of Product Characteristics. Further studies on this topic from real-world populations are needed.
Gun violence restraining orders in California, 2016–2018: case details and respondent mortality
Authors: Pear Veronica A , Pallin Rocco , Schleimer Julia P , Tomsich Elizabeth , Kravitz-Wirtz Nicole , Shev Aaron B , Knoepke Christopher E , Wintemute Garen J 
Published: June 2022

BackgroundGun violence restraining orders (GVROs), implemented in California in 2016, temporarily prohibit individuals at high risk of violence from purchasing or possessing firearms and ammunition. We sought to describe the circumstances giving rise to GVROs issued 2016–2018, provide details about the GVRO process and quantify mortality outcomes for individuals subject to these orders (‘respondents’).MethodsFor this cross-sectional description of GVRO respondents, 2016–2018, we abstracted case details from court files and used LexisNexis to link respondents to mortality data through August 2020.ResultsWe abstracted information for 201 respondents with accessible court records. Respondents were mostly white (61.2%) and men (93.5%). Fifty-four per cent of cases involved potential harm to others alone, 15.3% involved potential harm to self alone and 25.2% involved both. Mass shooting threats occurred in 28.7% of cases. Ninety-six and one half per cent of petitioners were law enforcement officers and one-in-three cases resulted in arrest on order service. One-year orders after a hearing (following 21-day emergency/temporary orders) were issued in 53.5% of cases. Most (84.2%) respondents owned at least one firearm, and firearms were removed in 55.9% of cases. Of the 379 respondents matched by LexisNexis, 7 (1.8%) died after the GVRO was issued: one from a self-inflicted firearm injury that was itself the reason for the GVRO and the others from causes unrelated to violence.ConclusionsGVROs were used most often by law enforcement officers to prevent firearm assault/homicide and post-GVRO firearm fatalities among respondents were rare. Future studies should investigate additional respondent outcomes and potential sources of heterogeneity.
Three-site screening for STIs in men who have sex with men using online self-testing in an English sexual health service
Authors: Charin Gideon , Symonds Ynez , Scholfield Clare , Graham Cynthia , Armstrong Heather 
Published: June 2022

ObjectivesAmong men who have sex with men (MSM) in the UK,Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) infections commonly occur asymptomatically at extragenital sites. Therefore, MSM seeking sexual health services are offered three-site (oropharyngeal, rectal and urogenital) STI screening. To increase access to screening, some UK sexual health services enable asymptomatic service users to order free STI screening kits online for self-sampling at home. We sought to assess prevalence of overall and extragenital CT/NG infection among asymptomatic MSM who used online self-testing in Hampshire, UK.MethodsWe assessed prevalence of CT/NG infections from non-pooled samples among asymptomatic cisgender MSM using an administrative database with results from 5601 STI screening kits returned between 20 December 2016 and 31 January 2020. We compared number of diagnoses of extragenital infection with urogenital results of the same individuals to determine prevalence of infection that would have been missed with urine testing alone.ResultsAmong 5051 valid CT and 5040 valid NG asymptomatic test results, overall prevalence was 5.9% (298/5051) and 4.5% (228/5040), respectively. Among MSM with asymptomatic CT, 71.8% (214/298) had extragenital infection only, χ2 (1, n=298)=56.71, p<0.001. Among those with asymptomatic NG, 89.9% (205/228) had extragenital infection only, χ2 (1, n=228)=145.281, p<0.001.ConclusionsOverall, most CT/NG infections among asymptomatic MSM who used online self-testing were extragenital. Given this and the likelihood of onward transmission from asymptomatic infection, it is recommended that three-site testing remain standard for MSM and free screening services be expanded in easily accessible ways.
Effects of increasing soil pH to near-neutral using lime on phosphorus saturation index and water-extractable phosphorus
Authors: Nyamaizi Sylvia , Messiga Aimé J. , Cornelis Jean-Thomas , Smukler Sean M. 
Published: June 2022

We studied the effects of liming to increase soil pH from acidic to near-neutral on the degree of phosphorus saturation (DPS), the P saturation index (PSI), Mehlich-3 P ( PM3), and water-extractable P ( Pw). Soils collected from a long-term highbush blueberry experiment were incubated at 22.5 °C for 93 days after CaCO3 amendment to increase pH values from 4.1, 4.8, and 5.5 to 6 and from 5.8 to 6.5. Liming decreased PM3 by 8%, 6%, 10%, and 11% with increasing initial soil pH. The PM3 concentrations of all the studied soils belonged to the very high class with critical DPS > 25%, which are associated with increased environmental risk of P loss with runoff. For soils with initial pH values of 5.8, Pw was 3.65 mg kg–1, in line with critical DPS > 25%, but decreased to 2.74 mg kg–1 with CaCO3 addition. In contrast, soils with initial pH < 5.5 had lower Pw concentrations and CaCO3 did not significantly decrease Pw at the end of the incubation averaging 1.02, 1.11, and 1.43 mg kg–1 for initial pH 4.1, 4.8, and 5.5, respectively. The low Pw concentrations of soils with initial pH < 5.5 were in line with low PSI (5.2%–6.1%), but did not reflect DPS values > 25%. It is possible that high exchangeable aluminum (Al) (AlM3 > 2500 mg kg–1) enhanced the fixation of phosphate ions from the soil solution, thus reducing Pw. Our results suggest that using PM3 as a sole indicator of environmental risk likely underestimates potential P losses compared with Pw.
Spherical black holes with minimally coupled scalar cloud/hair in Einstein–Born–Infeld gravity
Authors: Zhang Shao-Jun 
Published: June 2022

AbstractPrevious studies showed that, in the presence of a simple and well-motivated self-interaction scalar potential, asymptotically flat and spherical black holes can carry minimally coupled and charged scalar cloud/hair in Einstein–Maxwell gravity. We extend these studies to Einstein–Born–Infeld gravity to consider the effect of nonlinearity of the electromagnetic field. Series of spherical cloudy/hairy black hole solutions are constructed numerically. Results show that increasing the Born–Infeld coupling constant b will make the domain of existence of the solution shrink or even disappear when b is large enough. This implies that, competing with the gravitation, nonlinearity of the electromagnetic field will make the formation of scalar cloud/hair harder or even impossible.
From Hyper-dimensional Structures to Linear Structures: Maintaining Deduplicated Data’s Locality
Authors: Zou Xiangyu , Yuan Jingsong , Shilane Philip , Xia Wen , Zhang Haijun , Wang Xuan 
Published: June 2022

Data deduplication is widely used to reduce the size of backup workloads, but it has the known disadvantage of causing poor data locality, also referred to as the fragmentation problem. This results from the gap between the hyper-dimensional structure of deduplicated data and the sequential nature of many storage devices, and this leads to poor restore and garbage collection (GC) performance. Current research has considered writing duplicates to maintain locality (e.g., rewriting) or caching data in memory or SSD, but fragmentation continues to lower restore and GC performance.
Investigating the locality issue, we design a method to flatten the hyper-dimensional structured deduplicated data to a one-dimensional format, which is based on classification of each chunk’s lifecycle, and this creates our proposed data layout. Furthermore, we present a novel management-friendly deduplication framework, called MFDedup, that applies our data layout and maintains locality as much as possible. Specifically, we use two key techniques in MFDedup: Neighbor-duplicate-focus indexing (NDF) and Across-version-aware Reorganization scheme (AVAR). NDF performs duplicate detection against a previous backup, then AVAR rearranges chunks with an offline and iterative algorithm into a compact, sequential layout, which nearly eliminates random I/O during file restores after deduplication.
Evaluation results with five backup datasets demonstrate that, compared with state-of-the-art techniques, MFDedup achieves deduplication ratios that are 1.12× to 2.19× higher and restore throughputs that are 1.92× to 10.02× faster due to the improved data layout. While the rearranging stage introduces overheads, it is more than offset by a nearly-zero overhead GC process. Moreover, the NDF index only requires indices for two backup versions, while the traditional index grows with the number of versions retained.
Analysis of Risk Factors for the Development of Gestational Diabetes Mellitus in a Group of Romanian Patients
Authors: Preda Agnesa , Stefan Adela Gabriela , Vladu Ionela Mihaela , Fortofoiu Mircea-Catalin , Clenciu Diana , Fortofoiu Maria , Gheorghe Ioan Ovidiu , Comanescu Alexandru Cristian , Mota Maria 
Published: June 2022

Introduction. Gestational diabetes mellitus (GDM) is caused by numerous risk factors, the most common being old age, obesity, family history of diabetes mellitus, GDM, history of fetal macrosomia, history of polycystic ovary syndrome or treatment with particular drugs, multiple births, and certain races. The study proposed to analyze the risk factors causing GDM. Method. In the study, we included 97 pregnant women to whom there was an OGTT performed between weeks 24th and 28th of pregnancy, divided into two groups, with GDM and without GDM. The statistical analysis was performed with SPSS 26.0, the tests being statistically significant if

p

value < 0.05. Results. The favoring risk factors for the onset of GDM were analyzed, with statistically significant differences between the GDM group and the group without GDM related to the delivery age (

32.39
±
4.66

years old vs.

28.61
±
4.71

years old), history of fetal macrosomia (13.7% vs. 0%), presence of GDM during previous pregnancies (7.8% vs. 0%), HBP before pregnancy (9.8% vs. 0%), gestational HBP (17.6% vs. 0%), glycemia value at first medical visit (

79.37
±
9.34

mg
/
dl

vs.

71.39
±
9.16

mg
/
dl

), and weight gain during pregnancy (

14.61
±
4.47

kg

vs.

12.48
±
5.87

kg

). Conclusions. Identifying the risk factors for the GDM onset has a special importance, implying an early implementation of interventional measures in order to avoid the onset of GDM and associated maternal and fetal complications.
Epigenetic Regulation to Enhance Graft-versus-Leukemia Activity
Authors: Köhler Natalie , Zeiser Robert 
Published: June 2022

Summary:
Accumulating evidence supports that loss of HLA expression contributes to relapse after allogeneic hematopoietic cell transplantation (allo-HCT), but the mechanisms behind this evasion strategy are unclear. The groups of Luca Vago and Raffaella Di Micco identified the polycomb repressive complex 2 (PRC2) as a key epigenetic driver of immune escape after allo-HCT by reducing the chromatin accessibility of HLA class II molecules, which could be targeted by pharmacologic inhibition of PRC2 subunits.
See related article by Gambacorta et al., p. 1449 (10).
Perspectives on the Risk-Stratified Treatment of Multiple Myeloma
Authors: Davies Faith E. , Pawlyn Charlotte , Usmani Saad Z. , San-Miguel Jesus F. , Einsele Hermann , Boyle Eileen M. , Corre Jill , Auclair Daniel , Cho Hearn Jay , Lonial Sagar , Sonneveld Pieter , Stewart A. Keith , Bergsagel P. Leif , Kaiser Martin F. , Weisel Katja , Keats Jonathan J. , Mikhael Joseph R. , Morgan Kathryn E. , Ghobrial Irene M. , Orlowski Robert Z. , Landgren C. Ola , Gay Francesca , Caers Joseph , Chng Wee Joo , Chari Ajai , Walker Brian A. , Kumar Shaji K. , Costa Luciano J. , Anderson Kenneth C. , Morgan Gareth J. 
Published: June 2022

Summary:
The multiple myeloma treatment landscape has changed dramatically. This change, paralleled by an increase in scientific knowledge, has resulted in significant improvement in survival. However, heterogeneity remains in clinical outcomes, with a proportion of patients not benefiting from current approaches and continuing to have a poor prognosis. A significant proportion of the variability in outcome can be predicted on the basis of clinical and biochemical parameters and tumor-acquired genetic variants, allowing for risk stratification and a more personalized approach to therapy. This article discusses the principles that can enable the rational and effective development of therapeutic approaches for high-risk multiple myeloma.
The Evolving Role of Humans in Weather Prediction and Communication
Authors: Stuart Neil A. , Hartfield Gail , Schultz David M. , Wilson Katie , West Gregory , Hoffman Robert , Lackmann Gary , Brooks Harold , Roebber Paul , Bals-Elsholz Teresa , Obermeier Holly , Judt Falko , Market Patrick , Nietfeld Daniel , Telfeyan Bruce , DePodwin Dan , Fries Jeffrey , Abrams Elliot , Shields Jerry 
Published: June 2022

Abstract
A series of webinars and panel discussions were conducted on the topic of the evolving role of humans in weather prediction and communication, in recognition of the 100th anniversary of the founding of the AMS. One main theme that arose was the inevitability that new tools using artificial intelligence will improve data analysis, forecasting, and communication. We discussed what tools are being created, how they are being created, and how the tools will potentially affect various duties for operational meteorologists in multiple sectors of the profession. Even as artificial intelligence increases automation, humans will remain a vital part of the forecast process as that process changes over time. Additionally, both university training and professional development must be revised to accommodate the evolving forecasting process, including addressing the need for computing and data skills (including artificial intelligence and visualization), probabilistic and ensemble forecasting, decision support, and communication skills. These changing skill sets necessitate that both the U.S. Government’s Meteorologist General Schedule 1340 requirements and the AMS standards for a bachelor’s degree need to be revised. Seven recommendations are presented for student and forecaster preparation and career planning, highlighting the need for students and operational meteorologists to be flexible lifelong learners, acquire new skills, and be engaged in the changes to forecast technology in order to best serve the user community throughout their careers. The article closes with our vision for the ways that humans can maintain an essential role in weather prediction and communication, highlighting the interdependent relationship between computers and humans.
The Influence of Shear on Deep Convection Initiation. Part I: Theory
Authors: Peters John M. , Morrison Hugh , Nelson T. Connor , Marquis James N. , Mulholland Jake P. , Nowotarski Christopher J. 
Published: June 2022

Abstract
This article introduces a novel hypothesis for the role of vertical wind shear (“shear”) in deep convection initiation (DCI). In this hypothesis, initial moist updrafts that exceed a width and shear threshold will “root” within a progressively deeper steering current with time, increase their low-level cloud-relative flow and inflow, widen, and subsequently reduce their susceptibility to entrainment-driven dilution, evolving toward a quasi-steady self-sustaining state. In contrast, initial updrafts that do not exceed the aforementioned thresholds experience suppressed growth by shear-induced downward pressure gradient accelerations, will not root in a deep-enough steering current to increase their inflow, will narrow with time, and will succumb to entrainment-driven dilution. In the latter case, an externally driven lifting mechanism is required to sustain deep convection, and deep convection will not persist in the absence of such lifting mechanism. A theoretical model is developed from the equations of motion to further explore this hypothesis. The model indicates that shear generally suppresses DCI, raising the initial subcloud updraft width that is necessary for it to occur. However, there is a pronounced bifurcation in updraft growth in the model after the onset of convection. Sufficiently wide initial updrafts grow and eventually achieve a steady state. In contrast, insufficiently wide initial updrafts shrink with time and eventually decay completely without external support. A sharp initial updraft radius threshold discriminates between these two outcomes. Thus, consistent with our hypothesis and observations, shear inhibits DCI in some situations, but facilitates it in others.
Exploring Optimal Objective Function Weightings to Predict Lifting Postures Under Unfatigued and Fatigued States
Authors: Davidson Justin B. , Cashaback Joshua G. A. , Fischer Steven L. 
Published: June 2022

Objective To explore whether the optimal objective function weightings change when using a digital human model (DHM) to predict origin and destination lifting postures under unfatigued and fatigued states. Background The ability to predict human postures can depend on state-based influences (e.g., fatigue). Altering objective function weightings within a predictive DHM could improve the ability to predict tasks specific lifting postures under unique fatigue states. Method A multi-objective optimization-based DHM was used to predict origin and destination lifting postures for ten anthropometrically scaled avatars by using different objective functions weighting combinations. Predicted and measured postures were compared to determine the root mean squared error. A response surface methodology was used to identify the optimal objective function weightings, which was found by generating the posture that minimized error between measured and predicted lifting postures. The resultant weightings were compared to determine if the optimal objective function weightings changed for different lifting postures or fatigue states. Results Discomfort and total joint torque weightings were affected by posture (origin/destination) and fatigue state (unfatigued/fatigued); however, post-hoc differences between fatigue states and lifting postures were not sufficiently large to be detected. Weighting the discomfort objective function alone tended to predict postures that generalized well to both postures and fatigue states. Conclusion Lift postures were optimal predicted using the minimization of discomfort objective function regardless of fatigue state. Application Weighting the discomfort objective can predict unfatigued postures, but more research is needed to understand the optimal objective function weightings to predict postures during a fatigued state.