bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated identification of retinopathy of prematurity by image-based deep learning
Authors: Tong Yan , Lu Wei , Deng Qin-qin , Chen Changzheng , Shen Yin 
Published: August 2020

Abstract
Background
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide but can be a treatable retinal disease with appropriate and timely diagnosis. This study was performed to develop a robust intelligent system based on deep learning to automatically classify the severity of ROP from fundus images and detect the stage of ROP and presence of plus disease to enable automated diagnosis and further treatment.

Methods
A total of 36,231 fundus images were labeled by 13 licensed retinal experts. A 101-layer convolutional neural network (ResNet) and a faster region-based convolutional neural network (Faster-RCNN) were trained for image classification and identification. We applied a 10-fold cross-validation method to train and optimize our algorithms. The accuracy, sensitivity, and specificity were assessed in a four-degree classification task to evaluate the performance of the intelligent system. The performance of the system was compared with results obtained by two retinal experts. Moreover, the system was designed to detect the stage of ROP and presence of plus disease as well as to highlight lesion regions based on an object detection network using Faster-RCNN.

Results
The system achieved an accuracy of 0.903 for the ROP severity classification. Specifically, the accuracies in discriminating normal, mild, semi-urgent, and urgent were 0.883, 0.900, 0.957, and 0.870, respectively; the corresponding accuracies of the two experts were 0.902 and 0.898. Furthermore, our model achieved an accuracy of 0.957 for detecting the stage of ROP and 0.896 for detecting plus disease; the accuracies in discriminating stage I to stage V were 0.876, 0.942, 0.968, 0.998 and 0.999, respectively.

Conclusions
Our system was able to detect ROP and differentiate four-level classification fundus images with high accuracy and specificity. The performance of the system was comparable to or better than that of human experts, demonstrating that this system could be used to support clinical decisions.
Association of MYH9-rs3752462 polymorphisms with chronic kidney disease among clinically diagnosed hypertensive patients: a case-control study in a Ghanaian population
Authors: Owiredu William K. B. A. , Appiah Michael , Obirikorang Christian , Adu Evans Asamoah , Boima Vincent , Amos-Abanyie Ernestine Kubi , Akyaw Priscilla Abena , Owiredu Eddie-Williams , Acheampong Emmanuel 
Published: August 2020

Abstract
Background
Chronic kidney disease (CKD) is a significant comorbidity among hypertensive patients. Polymorphisms in the non-muscle myosin heavy chain 9 gene (MYH9) have been demonstrated to be significantly associated with CKD, among African- and European-derived populations. We investigated the spectrum of MYH9-associated CKD among Ghanaian hypertensive patients.

Methods
The study constituted a total of 264 hypertensive patients. Hypertensive patients with glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 (CKD-EPI formula) or clinically diagnosed were defined as case subjects (n = 132) while those with eGFR ≥60 ml/min/1.73m2 were classified as control subjects (n = 132). Demographic data were obtained with a questionnaire and anthropometric measurements were taken. Five (5) millilitres (ml) of venous blood was drawn from study subjects into gel and EDTA vacutainer tubes. Two (2) mL of EDTA anticoagulated blood was used for genomic DNA extraction while three (3) mL of blood was processed to obtain serum for biochemical measurements. Genotyping of MYH9 polymorphisms (rs3752462) was done employing Tetra primer Amplification Refractory Mutation System (T-ARMS) polymerase chain reaction (PCR). Spot urine samples were also collected for urinalysis. Hardy-Weinberg population was assessed. Logistic regression models were used to assess the associations between single nucleotide polymorphisms and CKD.

Results
The cases and control participants differed in terms of age, sex, family history, and duration of CKD (p-value < 0.001). The minor allele frequencies of rs3752462 SNP were 0.820 and 0.567 respectively among the control and case subjects. Patients with the heterozygote genotype of rs3752462 (CT) were more likely to develop CKD [aOR = 7.82 (3.81–16.04)] whereas those with homozygote recessive variant (TT) were protective [aOR = 0.12 (0.06–0.25)]. Single nucleotide polymorphism of rs3752462 (CT genotype) was associated with increased proteinuria, albuminuria, and reduced eGFR.

Conclusions
We have demonstrated that MYH9 polymorphisms exist among Ghanaian hypertensive patients and rs3752462 polymorphism of MYH9 is associated with CKD. This baseline indicates that further longitudinal and multi-institutional studies in larger cohorts in Ghana are warranted to evaluate MYH9 SNP as an independent predictor of CKD among hypertensive patients in Ghana.
Utilization of desktop 3D printer-fabricated “Cost-Effective” 3D models in orthognathic surgery
Authors: Narita Masato , Takaki Takashi , Shibahara Takahiko , Iwamoto Masashi , Yakushiji Takashi , Kamio Takashi 
Published: August 2020

Abstract
Background
In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the “in-house” fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes.

Review
We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups.

Conclusions
In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.
An improved WENO-Z scheme with symmetry-preserving mapping
Authors: Hong Zheng , Ye Zhengyin , Ye Kun 
Published: August 2020

AbstractSince the classical weighted essentially non-oscillatory (WENO) scheme is proposed, various improved versions have been developed, and a typical one is the WENO-Z scheme. Although better resolution is achieved, it is shown in this article that, the result of WENO-Z scheme suffers evident distortion in the long-time simulation of the linear advection equation. In order to fix the problem of WENO-Z, a symmetry-preserving mapping method is proposed in this article. In the original mapping method, the weight of each sub-stencil is used to map, which is demonstrated to cause asymmetric improvement about a discontinuity. This asymmetric improvement will lead to a distorted solution, more severe with longer output time. In the symmetry-preserving mapping method, a new variable related to the smoothness indicator is selected to map, which has the same ideal value for each sub-stencil. Using the new mapping method can not only fix the distortion problem of WENO-Z, but also improve the numerical resolution. Several benchmark problems are conducted to show the improved performance of the resultant scheme.
Five-year Estimated Glomerular Filtration Rate in Patients With Hypoparathyroidism Treated With and Without rhPTH(1–84)
Authors: Chen Kristina S , Gosmanova Elvira O , Curhan Gary C , Ketteler Markus , Rubin Mishaela , Swallow Elyse , Zhao Jing , Wang Jessie , Sherry Nicole , Krasner Alan , Bilezikian John P 
Published: August 2020

Abstract

Context
Chronic hypoparathyroidism (HypoPT) is conventionally managed with oral calcium and active vitamin D. Recombinant human parathyroid hormone (1–84) (rhPTH[1–84]) is a therapy targeting the pathophysiology of HypoPT by replacing parathyroid hormone.

Objective
To compare changes in the estimated glomerular filtration rate (eGFR) in patients with chronic HypoPT receiving or not receiving rhPTH(1–84) during a 5-year period.

Design/Setting
A retrospective analysis of patients with chronic HypoPT treated with or without rhPTH(1–84).

Patients
Sixty-nine patients with chronic HypoPT from 4 open-label, long-term trials (NCT00732615, NCT01268098, NCT01297309, and NCT02910466) composed the rhPTH(1–84) cohort and 53 patients with chronic HypoPT not receiving rhPTH(1–84) from the Geisinger Healthcare Database (01/2004–06/2016) composed the historical control cohort.

Interventions
The rhPTH(1–84) cohort (N = 69) received rhPTH(1–84) therapy; the historical control cohort (N = 53) did not receive rhPTH(1–84).

Main Outcome Measures
Changes in eGFR from baseline during a 5-year follow-up were examined in multivariate regression analyses.

Results
At baseline, demographic characteristics and eGFR were similar between cohorts, though the proportions with diabetes and cardiac disorders were lower in the rhPTH(1–84) cohort. At the end of follow-up, mean eGFR increased by 2.8 mL/min/1.73 m2 in the rhPTH(1–84) cohort, while mean eGFR fell by 8.0 mL/min/1.73 m2 in the control cohort. In the adjusted model, the difference in the annual eGFR change between the rhPTH(1–84) cohort and the control cohort was 1.7 mL/min/1.73 m2 per year (P = 0.009).

Conclusions
Estimated glomerular filtration rate was preserved for over 5 years among patients with chronic HypoPT receiving rhPTH(1–84) treatment, contrasting with an eGFR decline among those not receiving rhPTH(1–84).
The Human TSHβ Subunit Proteins and Their Binding Sites on the TSH Receptor Using Molecular Dynamics Simulation
Authors: Mezei Mihaly , Baliram Ramkumarie , Ali M Rejwan , Zaidi Mone , Davies Terry F , Latif Rauf 
Published: August 2020

AbstractTo gain further insight into the binding of the normal and variant human TSHβ subunits (TSHβ and TSHβv), we modeled the 2 monomeric proteins and studied their interaction with the TSH receptor ectodomain (TSHR-ECD) using molecular dynamics simulation Furthermore, analyzed their bioactivity in vitro using recombinant proteins to confirm that such binding was physiologically relevant. Examining the interaction of TSHβ and TSHβv with the TSHR-ECD model using molecular dynamic simulation revealed strong binding of these proteins to the receptor ECD. The specificity of TSHβ and TSHβv binding to the TSHR-ECD was examined by analyzing the hydrogen-bonding residues of these subunits to the FSH receptor ECD, indicating the inability of these molecules to bind to the FSH receptors. Furthermore, the modelling suggests that TSHβ and TSHβv proteins clasped the concave surface of the leucine rich region of the TSHR ECD in a similar way to the native TSH using dynamic hydrogen bonding. These mutually exclusive stable interactions between the subunits and ECD residues included some high-affinity contact sites corresponding to binding models of native TSH. Furthermore, we cloned TSHβ and TSHβv proteins using the entire coding ORF and purified the flag-tagged proteins. The expressed TSHβ subunit proteins retained bioactivity both in a coculture system as well as with immune-purified proteins. In summary, we showed that such interactions can result in a functional outcome and may exert physiological or pathophysiological effects in immune cells.
Light and Hormones in Seasonal Regulation of Reproduction and Mood
Authors: Chen Junfeng , Okimura Kousuke , Yoshimura Takashi 
Published: August 2020

Abstract
Organisms that inhabit the temperate zone exhibit various seasonal adaptive behaviors, including reproduction, hibernation, molting, and migration. Day length, known as photoperiod, is the most noise-free and widely used environmental cue that enables animals to anticipate the oncoming seasons and adapt their physiologies accordingly. Although less clear, some human traits also exhibit seasonality, such as birthrate, mood, cognitive brain responses, and various diseases. However, the molecular basis for human seasonality is poorly understood. Herein, we first review the underlying mechanisms of seasonal adaptive strategies of animals, including seasonal reproduction and stress responses during the breeding season. We then briefly summarize our recent discovery of signaling pathways involved in the winter depression–like phenotype in medaka fish. We believe that exploring the regulation of seasonal traits in animal models will provide insight into human seasonality and aid in the understanding of human diseases such as seasonal affective disorder (SAD).
Traditional and New Perspectives on Youth Cardiorespiratory Fitness
Authors: ARMSTRONG NEIL , WELSMAN JO 
Published: August 2020

ABSTRACT

Purpose
This study aimed to review traditional and new perspectives in the interpretation of the development of youth cardiorespiratory fitness (CRF).

Methods
We analyzed data from (i) the literature which for 80 yr has been traditionally based on interpretations of peak oxygen uptake (V˙O2) in ratio with body mass (BM) and (ii) recent multilevel allometric models founded on 994 (475 from girls) determinations of 10- to 16-yr-olds’ peak V˙O2 with measures of age, maturity status, and morphological covariates (BM and fat-free mass), and from 10 to 13 yr, 110 peak V˙O2 determinations of maximum cardiovascular covariates (stroke volume, cardiac output, and arteriovenous oxygen difference).

Results
The application of ratio scaling of physiological variables requires satisfying specific statistical assumptions that are seldom met. In direct conflict with the ratio-scaled data interpretation of CRF, multilevel allometric modeling shows that with BM controlled, peak V˙O2 increases with age but the effect is smaller in girls than boys. Maturity status exerts a positive effect on peak V˙O2, in addition to those of age and BM. Changes in maximum cardiovascular covariates contribute to explaining the development of CRF, but fat-free mass (as a surrogate for active muscle mass) is the most powerful single influence. With age, maturity status, morphological covariates, and maximum cardiovascular covariates controlled, there remains an unexplained ~4% to ~9% sex difference in peak V˙O2.

Conclusions
The traditional interpretation of peak V˙O2 in ratio with BM is fallacious and leads to spurious correlations with other health-related variables. Studies of the development of CRF require analyses of sex-specific, concurrent changes in age- and maturation-driven morphological and maximum cardiovascular covariates. Multilevel allometric modeling provides a rigorous, flexible, and sensitive method of data analysis.
Bicarbonate Unlocks the Ergogenic Action of Ketone Monoester Intake in Endurance Exercise
Authors: POFFÉ CHIEL , RAMAEKERS MONIQUE , BOGAERTS STIJN , HESPEL PETER 
Published: August 2020

ABSTRACT

Purpose
We recently reported that oral ketone ester (KE) intake before and during the initial 30 min of a 3 h 15 min simulated cycling race (RACE) transiently decreased blood pH and bicarbonate without affecting maximal performance in the final quarter of the event. We hypothesized that acid–base disturbances due to KE overrules the ergogenic potential of exogenous ketosis in endurance exercise.

Methods
Nine well-trained male cyclists participated in a similar RACE consisting of 3 h submaximal intermittent cycling (IMT180′) followed by a 15-min time trial (TT15′) preceding an all-out sprint at 175% of lactate threshold (SPRINT). In a randomized crossover design, participants received (i) 65 g KE, (ii) 300 mg·kg−1 body weight NaHCO3 (BIC), (iii) KE + BIC, or (iv) a control drink (CON), together with consistent 60 g·h−1 carbohydrate intake.

Results
KE ingestion transiently elevated blood D-ß-hydroxybutyrate to ~2–3 mM during the initial 2 h of RACE (P < 0.001 vs CON). In KE, blood pH concomitantly dropped from 7.43 to 7.36 whereas bicarbonate decreased from 25.5 to 20.5 mM (both P < 0.001 vs CON). Additional BIC resulted in 0.5 to 0.8 mM higher blood D-ß-hydroxybutyrate during the first half of IMT180′ (P < 0.05 vs KE) and increased blood bicarbonate to 31.1 ± 1.8 mM and blood pH to 7.51 ± 0.03 by the end of IMT180′ (P < 0.001 vs KE). Mean power output during TT15′ was similar between KE, BIC, and CON at ~255 W but was 5% higher in KE + BIC (P = 0.02 vs CON). Time to exhaustion in the sprint was similar between all conditions at ~60 s (P = 0.88). Gastrointestinal symptoms were similar between groups.

Discussion
The coingestion of oral bicarbonate and KE enhances high-intensity performance at the end of an endurance exercise event without causing gastrointestinal distress.
The Effect of Preexercise Expiratory Muscle Loading on Exercise Tolerance in Healthy Men
Authors: HARDY TIM A. , HOW STEPHEN C. , TAYLOR BRYAN J. 
Published: August 2020

ABSTRACT

Purpose
Acute nonfatiguing inspiratory muscle loading transiently increases diaphragm excitability and global inspiratory muscle strength and may improve subsequent exercise performance. We investigated the effect of acute expiratory muscle loading on expiratory muscle function and exercise tolerance in healthy men.

Methods
Ten males cycled at 90% of peak power output to the limit of tolerance (T
LIM) after 1) 2 × 30 expiratory efforts against a pressure-threshold load of 40% maximal expiratory gastric pressure (PgaMAX) (EML-EX) and 2) 2 × 30 expiratory efforts against a pressure-threshold load of 10% PgaMAX (SHAM-EX). Changes in expiratory muscle function were assessed by measuring the mouth pressure (PEMAX) and PgaMAX responses to maximal expulsive efforts and magnetically evoked (1 Hz) gastric twitch pressure (Pgatw).

Results
Expiratory loading at 40% of PgaMAX increased PEMAX (10% ± 5%, P = 0.001) and PgaMAX (9% ± 5%, P = 0.004). Conversely, there was no change in PEMAX (166 ± 40 vs 165 ± 35 cm H2O, P = 1.000) or PgaMAX (196 ± 38 vs 192 ± 39 cm H2O, P = 0.215) from before to after expiratory loading at 10% of PgaMAX. Exercise time was not different in EML-EX versus SHAM-EX (7.91 ± 1.96 vs 8.09 ± 1.77 min, 95% CI = −1.02 to 0.67, P = 0.651). Similarly, exercise-induced expiratory muscle fatigue was not different in EML-EX versus SHAM-EX (−28% ± 12% vs −26% ± 7% reduction in Pgatw amplitude, P = 0.280). Perceptual ratings of dyspnea and leg discomfort were not different during EML-EX versus SHAM-EX.

Conclusion
Acute expiratory muscle loading enhances expiratory muscle function but does not improve subsequent severe-intensity exercise tolerance in healthy men.
Dietary Nitrate and Nitric Oxide Metabolism: Mouth, Circulation, Skeletal Muscle, and Exercise Performance
Authors: Jones Andrew M. , Vanhatalo Anni , Seals Douglas R. , Rossman Matthew J. , Piknova Barbora , Jonvik Kristin L. 
Published: August 2020

ABSTRACT

Nitric oxide (NO) is a gaseous signaling molecule that plays an important role in myriad physiological processes, including the regulation of vascular tone, neurotransmission, mitochondrial respiration, and skeletal muscle contractile function. NO may be produced via the canonical NO synthase–catalyzed oxidation of l-arginine and also by the sequential reduction of nitrate to nitrite and then NO. The body’s nitrate stores can be augmented by the ingestion of nitrate-rich foods (primarily green leafy vegetables). NO bioavailability is greatly enhanced by the activity of bacteria residing in the mouth, which reduce nitrate to nitrite, thereby increasing the concentration of circulating nitrite, which can be reduced further to NO in regions of low oxygen availability. Recent investigations have focused on promoting this nitrate–nitrite–NO pathway to positively affect indices of cardiovascular health and exercise tolerance. It has been reported that dietary nitrate supplementation with beetroot juice lowers blood pressure in hypertensive patients, and sodium nitrite supplementation improves vascular endothelial function and reduces the stiffening of large elastic arteries in older humans. Nitrate supplementation has also been shown to enhance skeletal muscle function and to improve exercise performance in some circumstances. Recently, it has been established that nitrate concentration in skeletal muscle is much higher than that in blood and that muscle nitrate stores are exquisitely sensitive to dietary nitrate supplementation and deprivation. In this review, we consider the possibility that nitrate represents an essential storage form of NO and discuss the integrated function of the oral microbiome, circulation, and skeletal muscle in nitrate–nitrite–NO metabolism, as well as the practical relevance for health and performance.
Multidirectional Walking in Hematopoietic Stem Cell Transplant Patients
Authors: Potiaumpai Melanie , Cutrono Stacy , Medina Tamia , Koeppel Maximillian , Pereira Denise L. , Pirl William F. , Jacobs Kevin A. , Eltoukhy Moataz , Signorile Joseph F. 
Published: August 2020

ABSTRACT

Background
The effect of a peritransplant multidirectional walking intervention to target losses in physical function and quality of life (QOL) has not been investigated.

Purpose
This study examined the effects of a novel multidirectional walking program on physical function and QOL in adults receiving a hematopoietic stem cell transplant (HSCT).

Methods
Thirty-five adults receiving an autologous or allogeneic HSCT were randomized to a multidirectional walking (WALK) or usual care (CONT) group. The WALK group received supervised training during hospitalization; the CONT group received usual care. Patients were assessed at admission (t
0), 3 to 5 d post-HSCT (t
1), and 30 d post-HSCT (t
2). Physical function measures included the 6-min walk test (6MWT), the Physical Performance Test, and the Timed Up and Go test. Health-related QOL was collected using the Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT-BMT) questionnaire.

Results
There were no significant between-group changes for physical function or QOL. However, after the intervention (t
1 to t
2), the WALK group showed significant improvement in aerobic capacity (6MWT, P = 0.01), physical (P < 0.01) and functional well-being (P = 0.04), and overall QOL scores (P < 0.01). The CONT group saw no significant changes in physical function or QOL. Effect sizes showed the WALK group had a larger positive effect on physical function and QOL. Minimal clinically important differences in the 6MWT and FACT-BMT were exceeded in the WALK group.

Conclusion
A multidirectional walking program during the transplant period may be effective at increasing aerobic capacity and QOL for patients receiving HSCT compared with no structured exercise.