bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease
Authors:   EUROPAR, the IPMDS Non Motor P.D. Study Group, Dafsari Haidar S. , Ray-Chaudhuri K. , Ashkan Keyoumars , Sachse Lena , Mahlstedt Picabo , Silverdale Monty , Rizos Alexandra , Strack Marian , Jost Stefanie T. , Reker Paul , Samuel Michael , Visser-Vandewalle Veerle , Evans Julian , Antonini Angelo , Martinez-Martin Pablo , Timmermann Lars 
Published: March 2020

Abstract
Background
Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson’s disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear.

Methods
In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size.

Results
Significant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up.

Conclusions
In this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.
Freiwilliger Verzicht auf Essen und Trinken – zur ethischen Lagebestimmung eines ambivalenten Begriffs
Authors: Starke Philipp 
Published: March 2020

ZusammenfassungWie ist der Freiwillige Verzicht auf Essen und Trinken und eine medizinische Begleitung dabei ethisch zu bewerten? Die ethische Bewertung des Freiwilligen Verzichts auf Essen und Trinken stellt Patienten und Angehörige, aber auch begleitende Ärzte und Pflegende vor erhebliche Schwierigkeiten. Basierend auf Ergebnissen eigener qualitativer Interviews mit Personen nach dem FVET ihrer Angehörigen legt dieser Artikel die bestehende Unklarheit und inhärente ethische Ambivalenz des Begriffs FVET frei, stellt aber in der Unterscheidung von FVET-Fällen – mit bzw. ohne terminale Erkrankung – einen Weg zur Lösung der Frage nach der ethischen Bewertung des „Sterbefastens“ und seiner medizinischen Begleitung vor: Ethisch wird der Freiwillige Verzicht auf Essen und Trinken und seine medizinische Begleitung erst in der Analyse von Situation und Intention der Handelnden beurteilbar. Ausgehend vom Konzept eines frei gewollten Verzichts auf Essen und Trinken bei einsichts- und einwilligungsfähigen Personen mit dem Bewusstsein, damit ihr Leben zu verkürzen oder zu beenden, wird mit der Philosophie Thomas von Aquins argumentiert, dass eine ethische Bewertung die Begleitumstände und beabsichtigten Ziele miteinschließen muss, ebenso wie die Auswirkungen auf Angehörige und die Implikationen von und für ein Behandlungsteam.
Time-resolved black carbon aerosol vertical distribution measurements using a 356-m meteorological tower in Shenzhen
Authors: Sun Tianlin , Wu Cheng , Wu Dui , Liu Ben , Sun Jia Yin , Mao Xia , Yang Honglong , Deng Tao , Song Lang , Li Mei , Li Yong Jie , Zhou Zhen 
Published: March 2020

AbstractBlack carbon (BC) is an essential climate forcer in the atmosphere. Large uncertainties remain in BC’s radiative forcing estimation by models, partially due to the limited measurements of BC vertical distributions near the surface layer. We conducted time-resolved vertical profiling of BC using a 356-m meteorological tower in Shenzhen, China. Five micro-aethalometers were deployed at different heights (2, 50, 100, 200, and 350 m) to explore the temporal dynamics of BC vertical profile in the highly urbanized areas. During the observation period (December 6–15, 2017), the average equivalent BC (eBC) concentrations were 6.6 ± 3.6, 5.4 ± 3.3, 5.9 ± 2.8, 5.2 ± 1.8, and 4.9 ± 1.4 μg m−3, from 2 to 350 m, respectively. eBC temporal variations at different heights were well correlated. eBC concentrations generally decreased with height. At all five heights, eBC diurnal variations exhibited a bimodal pattern, with peaks appearing at 09:00–10:00 and 19:00–21:00. The magnitudes of these diurnal peaks decreased with height, and the decrease was more pronounced for the evening peak. eBC episodes were largely initiated by low wind speeds, implying that wind speed played a key role in the observed eBC concentrations. eBC wind-rose analysis suggested that elevated eBC events at different heights originate from different directions, which suggested contributions from local primary emission plumes. Air masses from central China exhibited much higher eBC levels than the other three backward trajectory clusters found herein. The absorption Ångström exponent (AAE375–880) showed clear diurnal variations at 350 m and increased slightly with height.
Fate and stability of dissolved organic carbon in topsoils and subsoils under beech forests
Authors: Kalks Fabian , Liebmann Patrick , Wordell-Dietrich Patrick , Guggenberger Georg , Kalbitz Karsten , Mikutta Robert , Helfrich Mirjam , Don Axel 
Published: March 2020

AbstractDissolved organic carbon (DOC) from Oa horizons has been proposed to be an important contributor for subsoil organic carbon stocks. We investigated the fate of DOC by directly injecting a DOC solution from 13C labelled litter into three soil depths at beech forest sites. Fate of injected DOC was quantified with deep drilling soil cores down to 2 m depth, 3 and 17 months after the injection. 27 ± 26% of the injected DOC was retained after 3 months and 17 ± 22% after 17 months. Retained DOC was to 70% found in the first 10 cm below the injection depth and on average higher in the topsoil than in the subsoil. After 17 months DOC in the topsoil was largely lost (− 19%) while DOC in the subsoil did not change much (− 4.4%). Data indicated a high stabilisation of injected DOC in the subsoils with no differences between the sites. Potential mineralisation as revealed by incubation experiments however, was not different between DOC injected in topsoil or subsoils underlining the importance of environmental factors in the subsoil for DOC stabilisation compared to topsoil. We conclude that stability of DOC in subsoil is primary driven by its spatial inaccessibility for microorganisms after matrix flow while site specific properties did not significantly affect stabilisation. Instead, a more fine-textured site promotes the vertical transport of DOC due to a higher abundance of preferential flow paths.
Ultrasound risk marker variability in symptomatic carotid plaque: impact on risk reclassification and association with temporal variation pattern
Authors: Stenudd Isak , Sjödin Elias , Nyman Emma , Wester Per , Johansson Elias , Grönlund Christer 
Published: March 2020

Abstract
Purpose
Ultrasound examinations of atherosclerotic carotid plaques can be used to calculate risk markers associated with plaque vulnerability. Recent studies demonstrate significant inter-frame variability in risk markers. Here, we investigate risk marker variability in symptomatic plaques and its impact on reclassification of plaque vulnerability, as well as its association with the shape of the temporal variation over the cardiac cycle.

Methods
56 patients with symptomatic carotid stenosis were included in this study. 88 plaques were identified and the plaque risk markers size (area), echogenicity (gray scale median, GSM) and heterogeneity (coarseness) were measured in all frames of ultrasound B-mode image sequences. Inter-frame variability was quantified using the coefficient of variation (CV).

Results
Inter-frame variabilities of the risk markers were area CV 5–8%; GSM CV 4–7%; coarseness CV 8–15% and was in general significantly lower in large as compared to smaller plaques. The variability in GSM risk marker caused a reclassification of vulnerability in 30 to 38% of the plaques. Temporal variations in GSM with a heart rate periodic or drift/trending pattern were found in smaller plaques (< 26 mm2), whereas random pattern was found in larger plaques. In addition, hypoechoic plaques (GSM < 25) were associated with cyclic variation pattern, independent of their size.

Conclusions
Risk marker variability causes substantial reclassification of plaque vulnerability in symptomatic patients. Inter-frame variation and its temporal pattern should be considered in the design of future studies related to risk markers.
Combining CSEM or gravity inversion with seismic AVO inversion, with application to monitoring of large-scale CO2 injection
Authors: Tveit Svenn , Mannseth Trond , Park Joonsang , Sauvin Guillaume , Agersborg Remy 
Published: March 2020

AbstractA sequential inversion methodology for combining geophysical data types of different resolutions is developed and applied to monitoring of large-scale CO2injection. The methodology is a two-step approach within the Bayesian framework where lower resolution data are inverted first, and subsequently used in the generation of the prior model for inversion of the higher resolution data. For the application of CO2monitoring, the first step is done with either controlled source electromagnetic (CSEM) or gravimetric data, while the second step is done with seismic amplitude-versus-offset (AVO) data. The Bayesian inverse problems are solved by sampling the posterior probability distributions using either the ensemble Kalman filter or ensemble smoother with multiple data assimilation. A model-based parameterization is used to represent the unknown geophysical parameters: electric conductivity, density, and seismic velocity. The parameterization is well suited for identification of CO2plume location and variation of geophysical parameters within the regions corresponding to inside and outside of the plume. The inversion methodology is applied to a synthetic monitoring test case where geophysical data are made from fluid-flow simulation of large-scale CO2sequestration in the Skade formation. The numerical experiments show that seismic AVO inversion results are improved with the sequential inversion methodology using prior information from either CSEM or gravimetric inversion.
Biomimicry design thinking education: a base-line exercise in preconceptions of biological analogies
Authors: Stevens Laura , Kopnina Helen , Mulder Karel , De Vries Marc 
Published: March 2020

AbstractPreliminary empirical research conducted by the leading author has shown that design students using biological analogies, or models across different contexts, often misinterpreted these, intentionally or unintentionally, during design. By copying shape or form without integrating the main function of the mimicked biological model, students failed to consider the process or system directing that function when attempting to solve the design need. This article considers the first step in the development of an applicable educational model using distant analogies from nature, by means of biomimicry thinking methodology. The analysis examines results from a base-line exercise taken by students in the Minor Design with Nature during the Spring semester of Industrial Design Engineering at The Hague University of Applied Sciences in 2019, verifying that students without biomimicry training use this hollow approach automatically. This research confirms the gap between where students are at the beginning of the semester and where they need to be as expert sustainable designers when they graduate. These findings provide a starting point for future interventions in biomimicry workshops to improve systematic design thinking through structural and scientifically based iterations of analogical reasoning.
Cell-laden alginate dialdehyde–gelatin hydrogels formed in 3D printed sacrificial gel
Authors: Dranseikiene Dalia , Schrüfer Stefan , Schubert Dirk W. , Reakasame Supachai , Boccaccini Aldo R. 
Published: March 2020

AbstractAlginate dialdehyde–gelatin (ADA–GEL) hydrogels have been reported to be suitable matrices for cell encapsulation. In general, application of ADA–GEL as bioink has been limited to planar structures due to its low viscosity. In this work, ring shaped constructs of ADA–GEL hydrogel were fabricated by casting the hydrogel into sacrificial molds which were 3D printed from 9% methylcellulose and 5% gelatin. Dissolution of the supporting structure was observed during the 1st week of sample incubation. In addition, the effect of different crosslinkers (Ba2+ and Ca2+) on the physicochemical properties of ADA–GEL and on the behavior of encapsulated MG-63 cells was investigated. It was found that Ba2+ crosslinked network had more than twice higher storage modulus, and mass decrease to 70% during incubation compared to 42% in case of hydrogels crosslinked with Ca2+. In addition, faster increase in cell viability during incubation and earlier cell network formation were observed after Ba2+ crosslinking. No negative effects on cell activity due to the use of sacrificial materials were observed. The approach presented here could be further developed for cell-laden ADA–GEL bioink printing into complex 3D structures.
Waiting time and queue length analysis of Markov-modulated fluid priority queues
Authors: Horváth Gábor 
Published: March 2020

AbstractThis paper considers a multi-type fluid queue with priority service. The input fluid rates are modulated by a Markov chain, which is common for all fluid types. The service rate of the queue is constant. Various performance measures are derived, including the Laplace–Stieltjes transform and the moments of the stationary waiting time of the fluid drops and the queue length distributions. An Erlangization-based numerical method is also provided to approximate the waiting time and the queue length distributions up to arbitrary precision. All performance measures are formulated as reward accumulation problems during busy periods of simple Markovian fluid flow models, for which efficient matrix-analytic solutions are provided, enabling us to solve large models with several hundred states.
Effect of lymphedema self-management group-based education compared with social network-based education on quality of life and fear of cancer recurrence in women with breast cancer: a randomized controlled clinical trial
Authors: Omidi Zahra , Kheirkhah Masoomeh , Abolghasemi Jamileh , Haghighat Shahpar 
Published: March 2020

Abstract
Background
Breast cancer-related lymphedema (BCRL) and its associated symptoms harm the quality of life (QoL) of cancer survivors and can stimulate fear of cancer recurrence (FCR). Self-management education for lymphedema has been introduced as an effective method in controlling FCR. This study investigates the effect of lymphedema group-based education compared to the social network-based and control group on QoL and FCR in breast cancer patients.

Methods
This three-arm clinical trial studied 105 patients with breast cancer-related lymphedema referred to Seyed_Khandan rehabilitation center. Sampling was done by random allocation method in blocks of 3 with 35 subjects in each group. All subjects received routine lymphedema treatments. The group-based education (GE) and social network-based education (SNE) groups received self-management education in the clinic and Telegram™ messenger channel, respectively. Impairment in QoL and mean score of FCR were assessed before, immediately after, and three months after the intervention by using the Persian version of Lymphedema Life Impact Scale (LLIS) and Fear of Progression Questionnaire-Short Form (FoPQ-SF), respectively. Mixed-model ANOVA was applied for statistical analysis.

Results
There was a significant time effect on total LLIS (P = 0.007), psychosocial (P = 0.038) and functional (P = 0.024) subscale changes in three groups of study. Interaction between the main effect of group and time on psychosocial subscale changes was statistically significant (P = 0.017). The multicomparison results illustrated that the main effect of time, the main effect of group, and interaction of them on the mean score of FCR were P = 0.084, P = 0.380, and P = 0.568, respectively.

Conclusion
Despite no significant reduction in the FCR score, results showed the improvement of most QoL aspects after three months of intervention. Although the social network-based education method was effective, the group-based education method was more beneficial. Applying these educational methods in lymphedema treatment protocols needs cost-effectiveness studies.

Trial registration
This study was registered at the Iranian Registry of Clinical Trials (IRCT2017052834176N1).
Evolution of Electrocardiographic Repolarization Parameters During Antiandrogen Therapy in Patients with Prostate Cancer and Hypogonadism
Authors: Gheorghe Andrei Cristian Dan , Ciobanu Ana , Hodorogea Andreea Simona , Radavoi George Daniel , Jinga Viorel , Nanea Ioan Tiberiu , Gheorghe Gabriela Silvia 
Published: March 2020

AbstractWe assessed the effects of antiandrogen therapy on ECG parameters of ventricular repolarization related to arrhythmic risk in 35 patients aged 70.3 ± 7 years with advanced prostate cancer treated with degarelix associated with enzalutamide (group A, 26 patients) or degarelix monotherapy (group B, 9 patients). We analyzed Fridericia corrected Q-T interval (QTc), Q-T dispersion (QTd), J-Tpeak interval (JTp), mean and maximum Tpeak-Tend interval (Tpe) and Tpe/QT ratio, Tpeak-Tend dispersion (Tped), index of cardio-electrophysiological balance (iCEB) from ECG tracings, and occurrence of ventricular premature beats (VPB) recorded by Holter ECG, before initiation of medication (M0) and after 6 months of treatment (M1). The groups had similar demographics except for a higher prevalence of prior myocardial infarction in group B (p = 0.01). All patients had low serum testosterone at M1. Baseline QTc, QTd, maxTpe/QT, meanTpe, maxTpe, Tped values were higher in B compared to A. They had a significant prolongation at M1 only in A. 20 patients in A and 6 in B had a 10% prolongation or decrease of iCEB (p = 0.66). In 5 patients, VPB severity increased from non-complex to complex: 3 in A and 2 in B (p = 0.31), but no sustained ventricular arrhythmia was registered. In conclusion, after 6 months of treatment, patients with hypogonadism on degarelix associated with enzalutamide had significant prolongation of QTc, QTd, maxTpe, meanTpe/QT, maxTpe/QT, Tped compared to patients on degarelix alone. The proportion of patients with 10% iCEB variation was similar between groups. There was no record of severe arrhythmias during the first 6 months of treatment.
Responsibility for Increasing Mitigation Ambition in Light of the Right to Sustainable Development
Authors: Moellendorf Darrel 
Published: March 2020

AbstractThe international community is currently in the midst of a facilitative dialogue about how to increase mitigation ambition under the terms of Paris Agreement. This dialogue concerns centrally considerations of equity, which includes matters of both justice and responsibility. I defend the importance of the right to sustainable development in this regard. I argue that if the right of states to pursue poverty eradicating human development is to be respected, then there is plausible interpretation of responsibility for mitigation in which a state’s ability to pay is the central consideration, where that ability is measured by its human development level. That conception of responsibility should be applied to considerations of how increase mitigation ambition.
An analysis of stakeholder networks to support the breastfeeding scale-up environment in Mexico
Authors: Buccini Gabriela , Harding Kassandra L. , Ferré Eguiluz Isabel , Safon Cara B. , Hromi-Fielder Amber , González de Cosío Teresita , Pérez-Escamilla Rafael 
Published: March 2020

AbstractLittle information exists on how to garner political commitment to strengthen large-scale breastfeeding policies and programmes by targeting key decision makers. The present study aims to map and describe the influence of stakeholders involved in breastfeeding policy and programming and identify opportunities to strengthen the breastfeeding-friendly environment in Mexico. A total of nine key informants from seventeen stakeholder organisations were selected based on their in-depth knowledge of the breastfeeding environment in Mexico and were individually interviewed using Net-Map methodology. This participatory interview technique combines stakeholder mapping, social network analysis and influence mapping to identify relevant stakeholders. Participants identified a total of fifty-five stakeholders shaping breastfeeding programmes and policies through four domains of influence: commands (n32 stakeholders), dissemination (n40), funding (n35) and technical assistance (n37). The Federal Ministry of Health emerged as the most influential stakeholder of breastfeeding policy and programming decisions in Mexico among all domains of influence. The Ministry of Finance and Public Credit as well as the National Institute of Public Health were identified as additional key stakeholders providing funding and technical assistance to the Federal Ministry of Health, respectively. Engaging identified key stakeholders can generate a multisectoral commitment to breastfeeding and strengthen the breastfeeding-friendly environment in Mexico.
Provider perspective on the role of palliative care in hypoplastic left heart syndrome
Authors: Lowenstein Sarah , Macauley Robert , Perko Kathleen , Ronai Christina 
Published: March 2020

AbstractObjective:Hypoplastic left heart syndrome is a single ventricle defect. While staged surgical palliative treatments have revolutionised care, patients with hypoplastic left heart syndrome continue to have significant morbidity and mortality. In 2017, the National Pediatric Cardiology Quality Improvement Collaborative recommended all single ventricle patients to receive a prenatal palliative care consult. This study aimed to elucidate provider perspectives on the implementation of prenatal palliative care consults for families expecting a child with hypoplastic left heart syndrome.Methods:An online survey was administered to obstetric and paediatric providers of relevant disciplines to assess their experience with palliative care involvement in hypoplastic left heart syndrome cases.Results:Nearly, all physicians (97%) and most registered nurses (79%) agreed that the initial palliative care consult for patients with hypoplastic left heart syndrome should occur during the prenatal period. Respondents also indicated that prenatal palliative care consults should also be offered in a variety of other CHD conditions. Participants believed positive aspects of this new referral protocol included an expanded support network for families, decreased family stress during the postnatal period, increased patient education about what to expect during the postnatal period, and continuity of care.Conclusion:Multidisciplinary healthcare professionals believe that prenatal palliative care consults provide a variety of benefits for patients and families with hypoplastic left heart syndrome. Additional, multi-centre research is necessary to evaluate whether prenatal palliative care consults should become standard of care for families expecting a child with a single ventricle defect.