bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between baseline cardiac biomarkers and cardiovascular death or hospitalization for heart failure with and without sodium–glucose co‐transporter 2 inhibitor therapy in DECLARE‐TIMI 58
Authors: Zelniker Thomas A. , Morrow David A. , Mosenzon Ofri , Goodrich Erica L. , Jarolim Petr , Murphy Sabina A. , Bhatt Deepak L. , Leiter Lawrence A. , McGuire Darren K. , Wilding John , Bode Christoph , Lewis Basil S. , Gause‐Nilsson Ingrid , Langkilde Anna Maria , Fredriksson Martin , Raz Itamar , Sabatine Marc S. , Wiviott Stephen D. 
Published: December 2020

AimsDapagliflozin reduced the risk of the composite of cardiovascular (CV) death or hospitalization for heart failure (HHF) in patients with type 2 diabetes mellitus in DECLARE‐TIMI 58. We hypothesized that baseline N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) and high‐sensitivity troponin T (hsTnT) levels would help identify patients who are at higher baseline risk and we describe the treatment effects of dapagliflozin in patients according to their baseline NT‐proBNP and hsTnT levels.Methods and resultsThis was a pre‐specified biomarker study from DECLARE‐TIMI 58, a randomized, double‐blind, placebo‐controlled CV outcomes trial of dapagliflozin. Baseline NT‐proBNP and hsTnT levels were measured in the TIMI Clinical Trials Laboratory in 14 565 patients. Among the included patients, 9143 patients (62.8%) were male, 1464 (10.1%) had a history of heart failure and the mean age was 63.9 years. The median baseline NT‐proBNP and hsTnT levels were 75 pg/mL [interquartile range (IQR) 35–165] and 10.2 pg/mL (IQR 6.9–15.5), respectively. Patients with higher NT‐proBNP and hsTnT quartiles had higher rates of CV death/HHF (Q4 vs. Q1: NT‐proBNP: 4‐year Kaplan–Meier event rates 13.7% vs. 1.0%; hsTnT: 11.8% vs. 1.4%; P‐trend <0.001). Dapagliflozin consistently reduced the relative risk of CV death/HHF regardless of baseline NT‐proBNP (P‐interaction 0.72) or hsTnT quartiles (P‐interaction 0.93). Given their higher baseline risk, patients with NT‐proBNP and/or hsTnT levels above the median derived larger absolute risk reductions with dapagliflozin (NT‐proBNP 1.9% vs. 0%, P‐interaction 0.010; hsTnT 1.8% vs. 0.1%, P‐interaction 0.026).ConclusionPatients with type 2 diabetes mellitus and higher NT‐proBNP or hsTnT levels are at increased risk of CV death and HHF. Dapagliflozin reduced the relative risk of CV death/HHF irrespective of NT‐proBNP and hsTnT levels, with greater absolute risk reductions seen in patients with higher baseline biomarker levels.
Chewable Gelatin Emulsions for Oral Lipid Delivery: Elimination of Gastric Coalescence with κ‐Carrageenan
Authors: Dille Morten J. , Draget Kurt I. 
Published: December 2020

AbstractGelatin‐based chewable emulsions can be a convenient vehicle for oral delivery of oils or lipid soluble bioactive components. Gelatin‐stabilized emulsions do, however, rapidly flocculate and gradually coalesce in gastric fluids. This destabilization is caused by the combined action of pepsin and mucin and is most significant at pH 3, followed by pH 2, then pH 4. Through in vitro lipolysis experiments it is shown that this destabilization leads to a decrease in emulsion lipolysis rate after incubation in simulated gastric fluids (SGFs). In this paper a potential solution to this gastric instability is suggested: inclusion of 1 wt% sodium‐κ‐carrageenan (κ‐CGN) of intermediate Mw into the gelatin emulsions. The κ‐CGN used has minimal impact on gelatin gelled emulsion properties, preserving the soft elastic gelatin texture. When these gelled emulsions disintegrate in gastric fluids, electrostatic interactions between the gelatin and κ‐CGN occur. While these interactions lead to heavy flocculation, they also protect the gelatin from pepsin action, providing full stability against emulsion coalescence during at least 2 h in SGF at pH 2–4. When the pH is neutralized upon mixing with intestinal fluids, the emulsion fully deflocculates and the rate of in vitro lipolysis is not affected by gastric residence time.Practical applications: Avoiding gastric coalescence in gelatin emulsions may lead to more reliable oral delivery of lipids or lipophilic components in gelatin‐based chewable supplements or functional foods. Keeping the emulsion droplet size stable and small until reaching the intestine may lead to more rapid and efficient intestinal lipolysis, potentially advantageous in regards to bioavailability of slowly digested oils (e.g., omega‐3 concentrate) or for people suffering from impaired lipid digestion. These findings may also be applicable to emulsion systems stabilized by other proteins.
Morphometric analysis program: Detection of epileptic foci in young children using an adult normative database: Initial experience
Authors: Stecher Ximena , Schonstedt Valeria , Manterola Carla , Carreño Fernando , Zamorano Francisco , Velasquez Alvaro , Castillo Mauricio 
Published: December 2020

AbstractObjectiveTo report our initial experience using an adult‐template MAP in drug‐resistant focal epilepsy in five children with apparently normal MRI.MethodsPatients selected were highly suspicious of harboring focal structural lesions and had negative brain MRI studies. MAP was performed using a locally obtained adult database as a template. Results were reviewed by two neuroradiologists. Pertinence of MAP‐positive areas was confirmed by the focal epileptic hypothesis or by pathology when possible (J Neuroradiol, 39, 2012, 87). Visual analysis was performed using Mango Software. MRI studies were reanalyzed at the workstation with knowledge of the clinical suspicion to confirm or discard the possibility of FCD.ResultsFive patients aged 19‐48 months were studied, all with initial 3T MRI studies interpreted as normal. All had focal epileptic hypothesis with coherence of clinical seizure characterization and electroencephalographic findings. In two patients, histology showed type 1 FCD. Due to the age of our subjects, the junction map always highlighted the subcortical white matter in relationship to maturity differences. FCD was identified as asymmetric U‐shaped highlighted regions in the junction map.SignificanceFCD is the most frequent pathology reported in pediatric epilepsy surgery series (Epileptic Disord, 18, 2016, 240). Significant number of FCDs may be overlooked on MRIs, reducing the odds of seizure freedom after surgery (Epilepsy Res, 89, 2010, 310). MAP is an image postprocessing method for enhanced visualization of FCD; however, when using an adult template in developing brains, normal subcortical regions may be highlighted as pathological. Creating a pediatric template is difficult, due to the need for general anesthesia to acquire the MRI database. Here, we were able to show that MAP identified FCDs as asymmetric “U‐” shaped highlighted regions in the junction maps of all five patients, which may indicate that obtaining childhood databases for this purpose may not be necessary and that adult ones suffice for diagnosis of FCD.
Fuel cells as an advanced alternative energy source for the residential sector applications in Malaysia
Authors: Zakaria Zulfirdaus , Kamarudin Siti Kartom , Wahid Khairul Anuar Abd 
Published: December 2020

SummaryThe growth of the world's population has increased energy demand. Malaysia, as a developing country, also requires significant energy to drive economic development and address population demand. Malaysian conventional power generation system is highly dependent on natural gas, coal, and oil power systems that have had significant environmental impacts. This paper explores the energy status in Malaysia to highlight the advantages of fuel cells as an advanced alternative energy source. The discussion on energy status in Malaysia involves population situation, energy demand, energy sources, and energy policies. Then, the ability and type of fuel cells to provide this advanced alternative energy source in Malaysia are described. The prospects for introducing portable fuel cell devices and residential applications have been comprehensively described as the most relevant application for the residential sector to implement this technology in Malaysia.Highlights
A comprehensive review of fuel cell systems as a source of renewable energy for the residence sector in Malaysia is presented.
The introduction of fuel cell‐based portable devices and residential applications are the most relevant applications for the residence sector in Malaysia.
The prospects for the introduction of fuel cells are discussed, including costs and maintenance, the plan and strategy, and the availability of a research center in Malaysia.
Surface velocity fields of active rock glaciers and ice‐debris complexes in the Central Andes of Argentina
Authors: Blöthe Jan Henrik , Halla Christian , Schwalbe Ellen , Bottegal Estefania , Trombotto Liaudat Dario , Schrott Lothar 
Published: December 2020

AbstractRock glaciers and transitional ice‐debris complexes predominate the Central Andean landform assemblage, yet regional studies on their state of activity and their kinematics remain sparse. Here we utilize the national glacier inventory of Argentina to quantify surface velocity fields of 244 rock glaciers and 51 ice‐debris complexes, located in the Cordón del Plata range, Argentina. Applying a feature‐tracking approach to repeated RapidEye satellite imagery acquired between 2010 and 2017/18, we find mean displacement rates between 0.37 and 2.61 m year−1 for 149 landforms, while for the remaining 146 features, surface movement remains below our level of detection. We compare our satellite‐derived velocity fields with ground‐truth data from two local field sites and find closely matching results in magnitude and spatial distribution. With average displacement of one‐third of the active rock glaciers and ice‐debris complexes exceeding 1 m year−1, the region hosts an exceptional number of fast‐flowing periglacial landforms, compared to other mountain belts. Using a random forest model, we test the predictive power of 25 morphometric and topoclimatic candidate predictors for modelling the state of activity of rock glaciers and ice‐debris complexes on two different scales. For entire landforms and individual landform segments, constructed along displacement centrelines, we can predict the state of activity with overall accuracies of 70.08% (mean AUROC = 0.785) and 74.86% (mean AUROC = 0.753), respectively. While topoclimatic parameters such as solar radiation and elevation are most important for entire landforms, geometric parameters become more important at the scale of landform segments. Despite tentative correlations between local slope and surface kinematics, our results point to factors integrating slope and distance to the source to govern local deformation. We conclude that feature tracking in optical imagery is feasible for regional studies in remote regions and provides valuable insight into the current state of the Andean cryosphere. © 2020 The Authors. Earth Surface Processes and Landforms published by John Wiley & Sons Ltd
Energy efficient optimal parent selection based routing protocol for Internet of Things using firefly optimization algorithm
Authors: Sennan Sankar , Somula Ramasubbareddy , Luhach Ashish K. , Deverajan Ganesh Gopal , Alnumay Waleed , Jhanjhi N. Z. , Ghosh Uttam , Sharma Pradip 
Published: December 2020

AbstractEnergy conservation is a major challenge in the Internet of Things (IoT) as the number of resource‐constrained devices is connected to the network. Routing plays a vital role in IoT to extend the lifespan of the network. Routing protocol for low‐power and lossy networks (RPL) is a standard routing protocol in IoT. The parent selection is a crucial role in the routing process to exchange the data. In RPL, the researchers have introduced a single metric, composite metric, and multiobjective optimization algorithm for parent selection. However, the improper parent selection causes the packet losses, congestion among the network nodes, depletes more energy, and increases the convergence time. To overcome these issues, this article proposes energy efficient optimal parent selection in RPL (EEOPS‐RPL) using firefly optimization algorithm to extend the lifespan of the IoT network. In EEOPS‐RPL, each node in the network is considered to be firefly and also calculates the current location of firefly, attraction of the fireflies, random function, velocity, and the global best values in the network. Residual energy and expected transmission count are attractiveness parameters and distance is a movement parameter to choose the optimum parent in the destination‐oriented directed acyclic graph for data transmission. The simulation is conducted using COOJA. The EEOPS‐RPL provides better performance in comparison to the efficient parent selection for RPL (EPC‐RPL) and the E‐RPL. The EEOPS‐RPL improves the packet transmission ratio and lifespan of the network by 2% to 5%, and 5% to 10%, respectively, compared with EPC‐RPL and E‐RPL.In EEOPS‐RPL, each participant node applies the firefly algorithm over the parent node information such as distance, residual energy, and expected transmission count through DODAG information object control message to pick the best parent node in the DODAG. The firefly algorithm provides the fast convergence that able to choose the optimal parent quickly. Thus, it avoids the packet loss during the route establishment in network. Thus, EEOPS‐RPL extends the lifespan of the network and reduces the convergence time.
Generalized self‐tuning system for adaptive threshold estimators in cognitive radio systems using swarm and evolutionary‐based approaches
Authors: Onumanyi Adeiza J. , Abu‐Mahfouz Adnan M. , Hancke Gerhard P. 
Published: December 2020

AbstractParameter‐based adaptive threshold estimators (ATEs) are widely used for signal detection in cognitive radio (CR) systems. However, their performance deteriorates under dynamic spectra conditions owing to a lack of valid methods to accurately self‐tune the different parameters of such ATEs. In this article, we address this limitation by proposing a generalized system for self‐tuning the parameters of any ATE based only on the input signal measured per time. We adopt swarm and evolutionary‐based metaheuristic optimization techniques to effectively search for the optimal parameter values of any ATE. Our system controls the search process by applying the between‐class variance function adapted from Otsu's algorithm as the objective function. We tested the system using five different metaheuristic optimization algorithms (MOAs) to self‐tune two different ATEs, namely the recursive one‐sided hypothesis testing (ROHT) technique and the histogram partitioning algorithm under Rayleigh and Rician fading channels, as well as under different modulation schemes, including the 4‐quadrature amplitude modulation and 4‐phase shift keying schemes. Our findings suggest that our proposed system yields generally a small error rate irrespective of the MOA used. In addition, the ROHT‐cuckoo search optimization configuration yielded a reasonably high and low probability of detection and probability of false alarm, respectively, as a function of the signal‐to‐noise‐ratio of the input signal at a fast average processing time of 0.0699 seconds. We concluded that our system presents an effective mechanism that can be used to automatically tune the parameters of any ATE for useful signal detection in CR.
The Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention: A goal attainment scaling approach to promote self‐management
Authors: Chester Helen , Beresford Rebecca , Clarkson Paul , Entwistle Charlotte , Gillan Vincent , Hughes Jane , Orrell Martin , Pitts Rosa , Russell Ian , Symonds Eileen , Challis David ,   Members of the HoSt‐D (Home Support in Dementia) Programme Management Group
Published: December 2020

AbstractObjectivesThis study investigated goals identified by people with dementia and their carers to promote the self‐management of symptoms and abilities; measured achievement using goal attainment scaling (GAS); and explored the reflections of Dementia Support Practitioners (DSPs) facilitating it.Methods and designWithin this pragmatic randomised trial, DSPs gave memory aids, training and support to people with mild to moderate dementia and their carers at home. Data were collected across seven NHS Trusts in England and Wales (2016–2018) and abstracted from intervention records and semi‐structured interviews with DSPs delivering the intervention, supplemented by a subset of the trial dataset. Measures were created to permit quantification and descriptive analysis and interview data thematically analysed. A GAS measure for this intervention in this client group was derived.ResultsEngagement was high across the 117 participants and 293 goals were identified. These reflected individual circumstances and needs and enabled classification and assessment of their attainment. Seventeen goal types were identified across six domains: self‐care, household tasks, daily occupation, orientation, communication, and well‐being and safety. On average participants achieved nominally significant improvement regarding the specified goals of 1.4 with standard deviation of 0.6. Five interviews suggested that DSPs' experiences of goal setting were also positive.ConclusionsGAS is useful for assessing psychosocial interventions for people with early‐stage dementia. It has a utility in identifying goals, promoting self‐management and providing a personalised outcome measure. There is a strong case for exploring whether these clear benefits translate to other interventions in other populations in other places.
Preliminary development and validation of a measure of fear of swallowing and swallowing‐related movement injury in head and neck cancer: Swallowing Kinesiophobia Scale
Authors: Carnaby Giselle D. , Chhabria Karishma 
Published: December 2020

AbstractBackgroundFear is an under‐recognized issue in intervention adherence in head and neck cancer (HNC). We developed and validated a patient reported outcome for swallowing fear in HNC patients.MethodsItems were adapted from the Tampa Scale for Kinesiophobia to swallowing function. A beta version was completed by 51 HNC patients undergoing chemo +/− radiotherapy at baseline and post‐treatment. Psychometric and factor structure analyses were applied.ResultsSwallowing Kinesiophobia Scale (SWKS) demonstrated strong face and content validity, internal consistency, and test‐retest reliability. Factor analysis revealed three‐factors: somatic factor, swallow avoidance, and fear of harm. Factors correlated positively with depression score, worry scale, and anxiety and pain scales. Score differences between patient subgroups (dysphagic vs nondysphagic) confirmed discriminative validity.ConclusionThe SWKS is a psychometrically valid tool to identify patients with fear of swallowing and swallowing‐related movement. It can help identify patients early in treatment who may need additional support.
Molecular Profiling of Decompensated Cirrhosis by a Novel MicroRNA Signature
Authors: Garcia de Paredes Ana Garcia , Manicardi Nicolo , Tellez Luis , Ibañez Luis , Royo Felix , Bermejo Javier , Blanco Carolina , Fondevila Constantino , Lanza Val Fernandez , Garcia-Bermejo Laura , Falcon-Perez Juan Manuel , Bañares Rafael , Gracia-Sancho Jordi , Albillos Agustin 
Published: December 2020

Refractory ascites is characterized by severe circulatory dysfunction and increased sensitivity to renal impairment by non-selective beta-blockers (NSBB). A novel serum microRNA signature, identified in the secretome of human cirrhotic hepatocytes, allows for the molecular characterization of patients with decompensated cirrhosis more prone to develop significant cardiac impairment after NSBB, as well as those more likely to respond to NSBB in terms of HVPG reduction.
Noninvasive staging of decompensated cirrhosis is an unmet clinical need. The aims of this study were to characterize and validate a novel microRNA (miRNA) signature to stage decompensated cirrhosis and predict the portal pressure and systolic cardiac response to nonselective beta-blockers (NSBBs). Serum samples from patients with decompensated cirrhosis (n = 36) and healthy controls (n = 36) were tested for a novel signature of five miRNAs (miR-452-5p, miR-429, miR-885-5p, miR-181b-5p, and miR-122-5p) identified in the secretome of primary human hepatocytes and for three miRNAs (miR-192-5p, miR-34a-5p, and miR-29a-5p) previously discovered as biomarkers of chronic liver disease. All patients had ascites, which was refractory in 18 (50%), and were placed on NSBBs for variceal bleeding prophylaxis. In all patients, serum miRNAs, hepatic venous pressure gradient, and an echocardiogram study were performed before and 1 month after NSBBs. Patients with cirrhosis had lower serum levels of miR-429, miR-885-5p, miR-181b-5p, miR-122-5p, miR-192-5p, and miR-29a-5p (P < 0.05). Baseline serum miR-452-5p and miR-429 levels were lower in NSBB responders (P = 0.006). miR-181b-5p levels were greater in refractory ascites than in diuretic-sensitive ascites (P = 0.008) and correlated with serum creatinine. miR-452-5p and miR-885-5p were inversely correlated with baseline systemic vascular resistance (ρ = −0.46, P = 0.007; and ρ = −0.41, P = 0.01, respectively) and with diminished systolic contractility (ρ = −0.55, P = 0.02; and ρ = −0.55, P = 0.02, respectively) in patients with refractory ascites after NSBBs. Conclusion: Analysis of a miRNA signature in serum discriminates between patients with decompensated cirrhosis who show more severe systemic circulatory dysfunction and compromised systolic function after beta-blockade and those more likely to benefit from NSBBs.
Problem‐solving strategies used in anatomical multiple‐choice questions
Authors: Kolomitro Klodiana , MacKenzie Leslie W. , Lockridge Mackenzie , Clohosey Diandra 
Published: December 2020

AbstractBackground and AimsMultiple‐choice questions (MCQ) in the anatomical sciences are often perceived to be targeting recall of facts and regurgitation of trivial details. Moving away from this assumption requires the design of purposeful multiple‐choice questions that focus on higher‐order cognitive functions as opposed to rote memorization. In order to develop such questions, it was important to first understand the strategies that students use in solving multiple‐choice questions. Using the think‐aloud protocol, this study seeks to understand strategies students use in solving multiple‐choice questions. Specifically, it seeks to uncover patterns in the reasoning process and tactics used when solving higher and lower order MCQ in anatomy. The research also provides insights onto how these strategies influence the student's probability of answering questions correctly.MethodsMultiple‐choice questions were created at three levels of cognitive functioning based on the ideas, connections, extensions (ICE) learning framework. The think‐aloud protocol was used to unravel problem‐solving strategies used by 92 undergraduate anatomy students as they solved multiple‐choice questions.ResultsSixteen strategies were identified through the oral and written think‐alouds that students used to solve MCQ. Eleven of these have been described and supported by the literature, while the rest were utilized by our students when solving MCQ in anatomy. Domain‐specific strategies of visualizing and recalling had the highest use. Personal connection was a strategy that allowed students to achieve success in all ICE levels in the oral think‐alouds and in the I and E levels in the written think‐alouds.ConclusionsThis research argues that it is upon us as educators to make learning visible to our students, specifically through the use of think‐alouds. It also raises awareness that when educators facilitate the process of students making personal connections, it aids students in new knowledge being integrated effectively and retrieved accurately.