bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-system trajectories and the incidence of heart failure in the Framingham Offspring Study
Authors: Guardino Cara E. , Pan Stephanie , Vasan Ramachandran S. , Xanthakis Vanessa 
Published: May 2022

Background
Heart failure is a multi-system disease, with non-cardiac systems playing a key role in disease pathogenesis.

Objective
Investigate whether longitudinal multi-system trajectories incrementally predict heart failure risk compared to single-occasion traits.

Methods
We evaluated 3,412 participants from the Framingham Heart Study Offspring cohort, free of heart failure, who attended examination cycle 5 and at least one examination between 1995–2008 (mean age 67 years, 54% women). We related trajectories for the following organ systems and metabolic functions to heart failure risk using Cox regression: kidney (estimated glomerular filtration rate), lung (forced vital capacity and the ratio of forced expiratory volume in one second/forced vital capacity), neuromotor (gait time), muscular (grip strength), cardiac (left ventricular mass index and heart rate), vascular function (pulse pressure), cholesterol (ratio of total/high-density lipoprotein), adiposity (body mass index), inflammation (C-reactive protein) and glucose homeostasis (hemoglobin A1c). Using traits selected via forward selection, we derived a trajectory risk score and related it to heart failure risk.

Results
We observed 276 heart failure events during a median follow up of 10 years. Participants with the ‘worst’ multi-system trajectory profile had the highest heart failure risk. A one-unit increase in the trajectory risk score was associated with a 2.72-fold increase in heart failure risk (95% CI 2.21–3.34; p<0.001). The mean c-statistics for models including the trajectory risk score and single-occasion traits were 0.87 (95% CI 0.83–0.91) and 0.83 (95% CI 0.80–0.86), respectively.

Conclusion
Incorporating multi-system trajectories reflective of the aging process may add incremental information to heart failure risk assessment when compared to using single-occasion traits.
Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): A dual-center, randomized controlled trial
Authors: Zhou Wendie , Yu Lili , Fan Yuying , Shi Baisheng , Wang Xiaohui , Chen Tianling , Yu Haixia , Liu Jie , Wang Xizhen , Liu Caihong , Zheng Huijia 
Published: May 2022

Aim
The study aimed to investigate the effect of early mobilization combined with early nutrition (EMN) on intensive care unit-acquired weakness (ICU-AW) in intensive care unit (ICU) settings compared with early mobilization (EM) or routine care.

Methods
A prospective, dual-center, randomized controlled trial was conducted. The control group underwent standard care without a pre-established routine for mobilization and nutrition. The EM group underwent early, individualized, progressive mobilization within 24 h of ICU admission. The EMN group underwent early mobilization, similar to the EM group plus guideline-based early nutrition (within 48 h of ICU admission). The primary outcome was the occurrence of ICU-AW at discharge from the ICU. Secondary outcomes included muscle strength, functional independence, organ failure, nutritional status, duration of mechanical ventilation (MV), length of ICU stay, and ICU mortality at ICU discharge.

Results
A total of 150 patients were enrolled and equally distributed into the three groups. Patients undergoing routine care only were more susceptible to ICU-AW upon ICU discharge than those in the EM or EMN groups (16% vs. 2%; p = 0.014 for both), and had a lower Barthel Index than others (control vs. EM/EMN: 57.5 vs 70.0; p = 0.022). The EMN group had improved muscle strength (p = 0.028) and better nutritional status than the control group (p = 0.031). Both interventions were associated with a lower ICU-AW (EM vs. control: p = 0.027, OR [95% CI] = 0.066 [0.006–0.739]; EMN vs. control: p = 0.016, OR [95% CI] = 0.065 [0.007–0.607]).

Conclusion
EM and EMN had positive effects. There was little difference between the effects of EM and EMN, except for muscle strength improvement. Both EM and EMN may lead to a lower occurrence of ICU-AW and better functional independence than standard care. EMN might benefit nutritional status more than usual care and promote improvement in muscle strength.
Glycemic control in newly insulin-initiated patients with type 2 diabetes mellitus: A retrospective follow-up study at a university hospital in Ethiopia
Authors: Sendekie Ashenafi Kibret , Teshale Achamyeleh Birhanu , Tefera Yonas Getaye 
Published: May 2022

Background
Though many trials had examined the effectiveness of taking insulin with or without oral agents, there are limited real-world data, particularly among patients with type 2 diabetes mellitus (T2DM) in the resource limited settings. This study aimed to examine level of glycemic control among patients with T2DM after initiation of insulin and factors associated with poor glycemic control.

Methods
An analysis of retrospective medical records of patients with T2DM who initiated insulin due to uncontrolled hyperglycemia by oral agents was conducted from 2015–2020 in the University of Gondar Comprehensive Specialized Hospital. Difference in median fasting plasma glucose (FPG) before and after insulin initiations was examined by a Wilcoxon signed-rank test. Kruskal Wallis test was performed to explore difference in the median level of FPG among treatment groups. A logistic regression model was also used to identify associated factors of poor glycemic control after insulin initiation. Statistical significance was declared at p < 0.05.

Results
Of 424 enrolled patients with T2DM, 54.7% were males and the mean age was 59.3±9.3 years. A Wilcoxon signed-rank test showed that there was significant deference in FPG before and after insulin initiation (P < 0.001). A declining trend of blood glucose was observed during the 1-year follow-up period of post-initiation. However, majority of the participants did not achieve target glucose levels. Participants who had higher FPG and systolic blood pressure (SBP) before insulin initiation were found more likely to have poor glycemic control after insulin initiation. Similarly, patients who received atorvastatin compared with simvastatin were found to have poor glycemic control in the post-period of initiation (P = 0.04). Premixed insulin was associated with a lower likelihood of poor glycemic control than neutral protamine Hagedorn (NPH) insulin (P < 0.001).

Conclusion
Following insulin initiation, a significant change in glycemic level and declining trend of FPG was observed during a 1-year follow-up period. However, the majority of patients still had a poorly controlled glycemic level. Appropriate management focusing on predictors of glycemic control would be of a great benefit to achieve glycemic control.
Perspectives of homeless service providers on their work, their clients, and the healthcare system
Authors: Qian Cindy Wu , Hauser Joshua 
Published: May 2022

Purpose
To describe the perspectives of homeless service providers who work for Chicago organizations that primarily serve persons experiencing homelessness.

Methods
A qualitative, cross-sectional study of Chicago homeless service providers (n = 17) consisting of a semi-structured interview and the Attitudes Toward the Homeless Inventory (ATHI). Interviews were analyzed for themes and patterns using inductive approach.

Results
Four categories of 16 themes describing homeless service providers’ perspectives and perceptions: 1) perspectives on work, 2) perspectives on the general population of those experiencing homelessness at large, 3) perceptions of the population of those experiencing homelessness based on client interactions, and 4) perceptions of hospitals and healthcare.

Conclusions
A richer understanding of the perspectives of homeless service may provide guidance in recruitment and training of workers in this area and offer insight into caring for persons experiencing homelessness in hospital settings.
Risk assessment of atherosclerotic cardiovascular diseases before statin therapy initiation: Knowledge, attitude, and practice of physicians in Yemen
Authors: Al-Ashwal Fahmi Y. , Sulaiman Syed Azhar Syed , Sheikh Ghadzi Siti Maisharah , Kubas Mohammed Abdullah , Halboup Abdulsalam 
Published: May 2022

Background
Risk evaluation of atherosclerotic cardiovascular disease (ASCVD) remains the cornerstone of primary prevention. The cardiovascular risk assessment can guide the decision-making on various preventive measures such as initiating or deferring statin therapy. Thus, our study aimed to assess the physicians’ knowledge, attitude, and practices regarding atherosclerotic cardiovascular diseases risk assessment. Also, we evaluated the physician-patient discussion and counseling practices before statin therapy initiation in concordance with recommendations from the latest clinical practice guideline.

Methods
A cross-sectional study was conducted between November 2020 and January 2021. A self-administered questionnaire was distributed to 350 physicians (GPs, residents, specialists, and consultants). Two trained pharmacists distributed the questionnaires in 5 major tertiary governmental hospitals and more than ten private hospitals. Also, private clinics were targeted so that we get a representative sample of physicians at different workplaces.

Results
A total of 270 physicians filled the questionnaire out of 350 physicians approached, with 14 being excluded due to high missing data, giving a final response rate of 73%. Participants had suboptimal knowledge and practices with a high positive attitude toward atherosclerotic cardiovascular diseases risk assessment. The knowledge and practices were higher among consultants, participants from the cardiology department, those with experience years of more than nine years, and those who reported following a specific guideline for cholesterol management or using a risk calculator in their practice. Notably, the risk assessment and counseling practices were lower among physicians who reported seeing more patients per day.

Conclusion
Physicians had overall low knowledge, suboptimal practices, and a high positive attitude toward cardiovascular risk assessment. Therefore, physicians’ training and continuing medical education regarding cholesterol management and primary prevention clinical practice guidelines are recommended. Also, the importance of adherence to clinical practice guidelines and their impact on clinical outcomes should be emphasized.
The Golden Age of British Short Stories: 1890–1914, Philip Hensher (ed.) (2020)
Authors: Ue Tom 
Published: May 2022

Review of: The Golden Age of British Short Stories: 1890–1914, Philip Hensher (ed.) (2020)
London: Penguin, 640 pp.,
ISBN: 978-0-14199-220-4, h/bk, £25;
ISBN 978-0-24143-431-4, p/bk, £12.99
Devoción, propiedad y posición social. En torno a una capellanía: Albacete, 1486
Authors: Ayllón Gutiérrez Carlos 
Published: May 2022

El artículo analiza las circunstancias que rodean la creación de la capellanía fundada en la villa de Albacete a finales de la Edad Media por María Gómez de Molina, revisa la taxonomía de este tipo de fundaciones y ofrece un modelo de análisis de las mismas. Todo ello permite verificar no sólo los pormenores de los oficios religiosos relacionados con la fundación y algunos aspectos relativos a la mentalidad de la época, sino también la estructura económica de la comarca, las relaciones intrafamiliares y la posición de los fundadores en la sociedad marco. Como principal aportación, este estudio revela cómo una fundación piadosa nos permite trascender los aspectos de espiritualidad y conocer la naturaleza de los bienes inmuebles urbanos de una población del bajo Medievo y las explotaciones agrarias a través del análisis de los bienes vinculados a la capellanía. Asimismo, se evidencia que la creación del culto refuerza las relaciones entre el linaje promotor y la Iglesia, genera oficios clericales, acrecienta la fisionomía parroquial y genera vínculos mercantiles en torno a la provisión de la capilla, contribuyendo a la vitalidad material de la población. Así, se configura todo un conglomerado de relaciones económicas y sociales que trascienden el mero contrato entre la Iglesia y los fundadores, como es común en las poblaciones castellanas del bajo Medievo y de toda la Edad Moderna. De este modo se subraya la importancia del análisis de las capellanías para los estudios sociales de la población y al mismo tiempo se justifica la investigación de este tipo de fundaciones como medio para un mejor conocimiento de la propiedad de la tierra en la Castilla de los Reyes Católicos. Con este trabajo se aportan, pues, elementos inéditos para un mejor conocimiento de la realidad material de una villa en proceso de incuestionable progreso.
Association of serum and fecal bile acid patterns with liver fibrosis in biopsy-proven nonalcoholic fatty liver disease: An observational study
Authors: Kasai Yuki , Kessoku Takaomi , Tanaka Kosuke , Yamamoto Atsushi , Takahashi Kota , Kobayashi Takashi , Iwaki Michihiro , Ozaki Anna , Nogami Asako , Honda Yasushi , Ogawa Yuji , Kato Shingo , Imajo Kento , Higurashi Takuma , Hosono Kunihiro , Yoneda Masato , Usuda Haruki , Wada Koichiro , Kawanaka Miwa , Kawaguchi Takumi , Torimura Takuji , Kage Masayoshi , Hyogo Hideyuki , Takahashi Hirokazu , Eguchi Yuichiro , Aishima Shinichi , Kobayashi Noritoshi , Sumida Yoshio , Honda Akira , Oyamada Shunsuke , Shinoda Satoru , Saito Satoru , Nakajima Atsushi 
Published: May 2022

Abstract

Introduction:
No reports on both blood and fecal bile acids (BAs) in patients with nonalcoholic fatty liver disease (NAFLD) exist. We simultaneously assessed the serum and fecal BA patterns in healthy participants and those with NAFLD.

Methods:
We collected stools samples from 287 participants from 5 hospitals in Japan, (healthy control [HC]: n = 88, mild fibrosis: n = 104, advanced fibrosis group: n = 95). Blood samples were collected and analyzed for serum BAs and 7α-hydroxy-4-cholesten-3-one (C4)—a surrogate marker for BA synthesis ability—from 141 patients. Concentrations of BAs, including cholic acid (CA), deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), and lithocholic acid (LCA), were measured using liquid chromatography-mass spectrometry.

Results:
Total fecal BA concentration was significantly higher in the NAFLD group with worsening of fibrosis than in the HC group. Most of the fecal BAs were secondary and unconjugated. In the fecal BA fraction, CA, DCA, CDCA, UDCA, and LCA were significantly higher in the NAFLD than in the HC group. The total serum BA concentration was higher in the NAFLD group with worsening of fibrosis than in the HC group. In the serum BA fraction, CA, LCA, and C4 concentrations were significantly higher in the NAFLD than in the HC group.

Discussion:
Fecal and serum BA and C4 concentrations were high in patients with NAFLD with worsening of fibrosis, suggesting involvement of abnormal BA metabolism in NAFLD with fibrosis progression. Abnormalities in BA metabolism may be a therapeutic target in NAFLD with fibrosis.
Improvement of the Constructive A Priori Error Estimates for a Fully Discretized Periodic Solution of Heat Equation
Authors: Kimura Takuma , Minamoto Teruya , Nakao Mitsuhiro T. 
Published: May 2022

Abstract
In this study, we present new sharper constructive a priori error estimates for a full-discrete numerical solution of the heat equation that refines our previous work. The full discretization is given using the finite element method in space and linear interpolation in time, similar to that in the previous work. In particular, we adopt an approach based on the effective use of the properties both for exact and discretized time-periodic solutions to establish the error estimates simpler and sharper than the previous work. Furthermore, we derive some time-stepwise error estimates in the space direction. Finally, we present several numerical examples that confirm the actual refinements of the convergence.
Follow the Leader? A Comparative Law Study of the EU’s General Data Protection Regulation’s Impact in Latin America
Authors: Carrillo Arturo J , Jackson Matías 
Published: May 2022

Abstract
In May 2018, the General Data Protection Regulation (GDPR) entered into force in the European Union. As is widely recognized, its impact goes beyond the borders of the old continent, permeating through the regulatory processes of countries all over the world. Nowhere is this more evident than in Latin America, where governments have long emulated European data protection standards. Professor Anu Bradford has famously characterized this phenomenon as a prominent example of ‘the Brussels Effect,’ defined as Europe’s unilateral power to regulate global markets. Other scholars see a more complex dynamic at play. This is especially true in the data privacy context in which the EU has benefited from a highly transplantable legal model and normative innovations that have proved successful in a global marketplace of ideas. This Article joins the debate around the EU’s transnational influence on the regulation of personal data by evaluating the de jure impact that the GDPR has had in Latin America to date. To this end, the Article addresses three main questions. First, what is the panorama of data privacy legislation across Latin America since the 2016 adoption of the GDPR? Second, how have those countries in the region that have moved first to reform or enact data privacy legislation in light of the GDPR’s key innovations done so? And finally, what lessons can be learned from the Latin American experience based on the responses to these questions? In responding, the Article looks first at which countries in the region have introduced or proposed changes to their legislation in the wake of the GDPR’s enactment in 2016. It then evaluates the experience of key jurisdictions in greater detail, namely Brazil, Mexico, Chile and Uruguay, to determine what lessons can be drawn from their efforts. By pursuing these inquiries, the authors shed new light on the debate surrounding the nature of the de jure dimension of ‘the Brussels Effect’ in the region.
Hybrid material performance assessment for rocket propulsion
Authors: AL-Oqla Faris M. , Hayajneh Mohammed T. 
Published: May 2022

Abstract
Fuel based on hybrid green material is of paramount importance for various military and civilian purposes. This work presents a novel expert-based multi-criteria hierarchy and decision-making model to evaluate various chemical rocket propulsion technologies with different fuel material types under an uncertain environment. This helps select the most appropriate fuel material types according to the performance requirements considering various evaluation criteria toward achieving better performance economic benefits of the sustainable hybrid green material-based fuel for various applications. Here, the analytical hierarchy process model was utilized to enhance more informative decisions from both numerical and linguistics information regarding the performance of the fuel based on hybrid green material under an uncertain environment. The model considers various simultaneous evaluations and conflicting criteria to practically demonstrate economic, technical, and sustainable issues for the decision makers in this field. Results demonstrate that cost and size criteria are the most important in the evaluation process from experts’ points of view for the rocket propulsion technology. The fuel based on hybrid green material has the highest priority regarding the whole evaluation criteria. The sensitivity analysis illustrates the robustness of the model as well as the reliability of the drawn decisions.
The effect of 150 and 80 mg doses of aspirin on preventing preterm birth in high-risk pregnant women
Authors: Kasraeian Maryam , Asadi Nasrin , Vafaei Homeira , Tazang Mahin , Azam Faraji  , Rahimirad Neda , Yousofi Sedighe , Khaleghi Seyedeh Fatemeh , Zare Marjan 
Published: May 2022

Abstract

Objectives
Preterm birth (PTB) is the common cause of neonatal mortality nationwide. The present study aimed to evaluate the efficacy of different doses of aspirin in preventing PTB in high-risk pregnant women. As secondary outcomes, other perinatal complications were compared.

Methods
This double-blind randomized clinical trial was conducted on high-risk pregnant women with impaired placental perfusion diagnosed in the first trimester of pregnancy referring to the perinatal centers affiliated to Shiraz university of Medical Sciences between February 2020 and March 2021. The subjects were randomly divided in two groups administered with 150 or 80 mg aspirin every night from 11 to 13+6 weeks until 36 weeks or delivery. This study is registered in the Iranian Registry of Clinical Trials (IRCT20140317017035N6; http://www.irct.ir/). Univariate and multiple logistic regressions were applied using SPSS 22.

Results
A total of 101 subjects received 80 mg aspirin and 89 ones received 150 mg aspirin. The results of multiple analysis revealed a significantly lower odds of PTB (OR 0.4 (0.19, 0.99)) in the 150 mg group compared to the 80 mg group. As secondary outcomes, preeclampsia (PEC) and PEC with severe features (PECsf) were lower (OR 0.2 (0.06, 0.82) and 0.1 (0.01, 0.92), respectively); however, fetal age and neonatal weight were higher in the 150 mg group (OR 1.2 (1.04, 1.33) and 1.001 (1–1.001), respectively).

Conclusions
The study findings indicated that, compared with 80 mg of aspirin, taking 150 mg of aspirin reduced PTB and perinatal complications in high risk pregnant women.
Multimodality in liquid biopsy: does a combination uncover insights undetectable in individual blood analytes?
Authors: Keup Corinna , Kimmig Rainer , Kasimir-Bauer Sabine 
Published: May 2022

Abstract
The heterogeneity of each individual oncologic disease can be mirrored by molecular analysis of a simple blood draw in real time. Liquid biopsy testing has been shown useable for cancer detection, proof of minimal residual disease, therapy decision making and monitoring. However, an individual blood analyte does not present a comprehensive picture of the disease. It was recently shown that multi-modal/multi-parametric/multi-analyte liquid biopsy testing has the advantage of generating a high-resolution snapshot of the disease complexity. The different blood analytes such as circulating tumor cells, circulating immune cells, tumor-educated platelets, extracellular vesicles, cell-free DNA, cell-free RNA and circulating proteins complement each other and have additive value for clinical cancer management. We, here, like to review the studies leading to these promising conclusions and like to, at the end, mention that many challenges lie ahead before the translation into the clinic can be accomplished, including issues concerning clinical utility, method standardization, cost reimbursement and data management.
Numerical investigation of heat transfer in the nanofluids under the impact of length and radius of carbon nanotubes
Authors: Adnan  , Khan Umar , Ahmed Naveed , Basha D. Baba , Mohyud-Din Syed Tauseef , Mahmoud Omar , Khan Ilyas 
Published: May 2022

Abstract
The investigation of thermal transport in the nanofluid over a curved Riga surface is significant and extensively used in many industries as well as in engineering. Therefore, the study is conducted to analyze the thermal transport rate in H2O composed of nanomaterial, namely, carbon nanotubes (CNTs). To improve the thermal conductance, a thermal conductivity correlation based on the length and radius of CNTs is plugged in the energy equation. After that, the flow model was reduced into a self-similar form via feasible transformations and tackled numerically. From the plotted results, it is experienced that the nanofluid velocity drops against a more curved surface. The momentum boundary layer intensifies against larger curvature. An enhanced temperature is experienced in the nanofluid due to varying the parameters. Further, thermal conductivity of the nanofluids rises due to the high volume fraction factor, which plays a significant role in thermal transport. Moreover, the local thermal performance rises linearly against M.