bluuebunny/crossref_metadata_2025_split huggingface dataset:
MR 4D flow-based mean pulmonary arterial pressure tracking in pulmonary hypertension
Authors: Reiter Ursula , Kovacs Gabor , Reiter Clemens , Kräuter Corina , Nizhnikava Volha , Fuchsjäger Michael , Olschewski Horst , Reiter Gert 
Published: September 2020

Abstract
Objectives
Longitudinal hemodynamic follow-up is important in the management of pulmonary hypertension (PH). This study aimed to evaluate the potential of MR 4-dimensional (4D) flow imaging to predict changes in the mean pulmonary arterial pressure (mPAP) during serial investigations.

Methods
Forty-four adult patients with PH or at risk of developing PH repeatedly underwent routine right heart catheterization (RHC) and near-term MR 4D flow imaging of the main pulmonary artery. The duration of vortical blood flow along the main pulmonary artery was evaluated from MR 4D velocity fields using prototype software and converted to an MR 4D flow imaging-based mPAP estimate (mPAPMR) by a previously established model. The relationship of differences between RHC-derived baseline and follow-up mPAP values (ΔmPAP) to corresponding differences in mPAPMR (ΔmPAPMR) was analyzed by means of regression and Bland-Altman analysis; the diagnostic performance of ΔmPAPMR in predicting mPAP increases or decreases was investigated by ROC analysis.

Results
Areas under the curve for the prediction of mPAP increases and decreases were 0.92 and 0.93, respectively. With the natural cutoff ΔmPAPMR = 0 mmHg, mPAP increases (decreases) were predicted with an accuracy, sensitivity, and specificity of 91% (91%), 85% (89%), and 94% (92%), respectively. For patients in whom 4D flow allowed a point estimate of mPAP (mPAP > 16 mmHg), ΔmPAPMR correlated strongly with ΔmPAP (r = 0.91) and estimated ΔmPAP bias-free with a standard deviation of 5.1 mmHg.

Conclusions
MR 4D flow imaging allows accurate non-invasive prediction and quantification of mPAP changes in adult patients with PH or at risk of developing PH.

Trial registration
ClinicalTrials.gov identifier: NCT00575692 and NCT01725763

Key Points
• MR 4D flow imaging allows accurate non-invasive prediction of mean pulmonary arterial pressure increases and decreases in adult patients with or at risk of developing pulmonary hypertension.
• In adult patients with mean pulmonary arterial pressure > 16 mmHg, MR 4D flow imaging allows estimation of longitudinal mean pulmonary arterial pressure changes without bias with a standard deviation of 5.1 mmHg.
The impact of Hayward green kiwifruit on dietary protein digestion and protein metabolism
Authors: Park Sanghee , Church David D. , Starck Carlene , Schutzler Scott E. , Azhar Gohar , Kim Il-Young , Ferrando Arny A. , Moughan Paul J. , Wolfe Robert R. 
Published: September 2020

AbstractPurposeThe purpose of the study was to determine if an actinidin protease aids gastric digestion and the protein anabolic response to dietary protein.MethodsHayward green kiwifruit (containing an actinidin protease) and Hort 16A gold kiwifruit (devoid of actinidin protease) were given in conjunction with a beef meal to healthy older subjects. Twelve healthy older males (N = 6) and females (N = 6) were studied with a randomized, double-blinded, crossover design to assess muscle and whole-body protein metabolism before and after ingestion of kiwifruit and 100 g of ground beef. Subjects consumed 2 of each variety of kiwifruit daily for 14 d prior to each metabolic study, and again during each study with beef intake.ResultsHayward green kiwifruit consumption with beef resulted in a more rapid increase in peripheral plasma essential amino acid concentrations. There were significant time by kiwifruit intake interactions for plasma concentrations of EAAs, branched chain amino acids (BCAAs), and leucine (P < 0.01). However, there was no difference in the total amount of EAAs absorbed. As a result, there were no differences between kiwifruit in any of the measured parameters of protein kinetics.ConclusionConsumption of Hayward green kiwifruit, with a beef meal facilitates protein digestion and absorption of the constituent amino acids as compared to Hort 16A gold kiwifruit.Clinical trialNCT04356573, April 21, 2020 “retrospectively registered”.
Teaching middle ear anatomy using a novel three-dimensional papercraft model
Authors: Guy John , Muzaffar Jameel , Coulson Christopher 
Published: September 2020

Abstract
Background
The middle ear is a complex anatomical space which is difficult to interpret from two-dimensional imagery. Appropriate surgical knowledge of the area is required to operate, yet current anatomical teaching methods are costly and hard to access for the trainee.

Methods
A papercraft 3D design involving anatomical elements added separately to a model was designed, and then peer-validated by medical students and junior doctors. Preliminary quantitative assessment was performed using an anatomical labelling questionnaire, with six students given a lecture to act as a control. Qualitative feedback was also gathered.

Results
18 participants were recruited for the study. A total of 12 models were constructed by 6 medical students and 6 junior doctors. 6 medical students received a lecture only. Qualitative feedback was positive and suggested the model improved knowledge and was useful, yet timing and complexity were issues. Students scored, on average, 37% higher after completing the model, with junior doctors also improving anatomical knowledge, though these differences were not significant (p > 0.05).

Conclusions
In this initial investigation, the model was shown to be an engaging way to learn anatomy, with the tactile and active nature of the process cited as benefits. Construction of the model improved anatomical knowledge to a greater extent than a classical lecture in this study, though this difference was not significant. Further design iterations are required to improve practical utility in the teaching environment, as well as a larger study.
Longitudinal prediction of falls and near falls frequencies in Parkinson’s disease: a prospective cohort study
Authors: Lindholm Beata , Brogårdh Christina , Odin Per , Hagell Peter 
Published: September 2020

Abstract
Introduction and objective
Several prediction models for falls/near falls in Parkinson’s disease (PD) have been proposed. However, longitudinal predictors of frequency of falls/near falls are poorly investigated. Therefore, we aimed to identify short- and long-term predictors of the number of falls/near falls in PD.

Methods
A prospective cohort of 58 persons with PD was assessed at baseline (mean age and PD duration, 65 and 3.2 years, respectively) and 3.5 years later. Potential predictors were history of falls and near falls, comfortable gait speed, freezing of gate, dyskinesia, retropulsion, tandem gait (TG), pain, and cognition (Mini-Mental State Exam, MMSE). After each assessment, the participants registered a number of falls/near falls during the following 6 months. Multivariate Poisson regression was used to identify short- and long-term predictors of a number of falls/near falls.

Results
Baseline median (q1–q3) motor (UPDRS) and MMSE scores were 10 (6.75–14) and 28.5 (27–29), respectively. History of falls was the only significant short-time predictor [incidence rate ratio (IRR), 15.17] for the number of falls/near falls during 6 months following baseline. Abnormal TG (IRR, 3.77) and lower MMSE scores (IRR, 1.17) were short-term predictors 3.5 years later. Abnormal TG (IRR, 7.79) and lower MMSE scores (IRR, 1.49) at baseline were long-term predictors of the number of falls/near falls 3.5 years later.

Conclusion
Abnormal TG and MMSE scores predict the number of falls/near falls in short and long term, and may be indicative of disease progression. Our observations provide important additions to the evidence base for clinical fall prediction in PD.
Secondary prevention for hepatocellular carcinoma in patients with chronic hepatitis B: are all the nucleos(t)ide analogues the same?
Authors: Yip Terry Cheuk-Fung , Lai Jimmy Che-To , Wong Grace Lai-Hung 
Published: September 2020

AbstractReducing the incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) is the key ultimate goal set in essentially all treatment guidelines. There has been solid evidence supporting the relationship between serum hepatitis B virus (HBV) DNA level and risk of HCC. Antiviral treatment with oral nucleos(t)ide analogues (NAs) leads to sustained viral suppression and hence is often adopted as the secondary prevention for HCC in CHB patients. The first-generation NA, lamivudine, reduced the risk of HCC at 3 years compared to placebo; yet, its high emergence of antiviral resistance has made it no longer recommended in the international guidelines. Recent heated debate is about the two current first-line NAs—entecavir and tenofovir disoproxil fumarate (TDF)—Are they just as good to reduce HCC risk in CHB patients? A handful of cohort studies show two different kinds of observations—TDF is better than entecavir in lowering HCC risk, or these two NAs have led to similarly low risk of HCC. Tenofovir alafenamide (TAF), a modified version of TDF higher rate of ALT normalization, would be another potent nucleotide analogue is the treatment of choice for secondary prevention for HCC.
Impact of ship operations aided by voyage optimization on a ship’s fatigue assessment
Authors: Lang Xiao , Wang Helong , Mao Wengang , Osawa Naoki 
Published: September 2020

AbstractIn this study, different operation factors affecting a ship’s wave statistics are studied, such as the slow steaming and voyage optimizations. Especially, the impact of various voyage optimization methods on the long-term wave statistics and corresponding fatigue damage during ship operations is investigated by comparing the encountered waves with the design wave scatter diagram. Three years of full-scale measurements from a container ship sailing in the North Atlantic are employed to study the impact, in addition to noon reports from two fleets of container ships and VLCCs. Furthermore, the benefits of using voyage optimizations for minimum fatigue damage accumulation during operation are discussed. The large difference of wave statistics is found when the ship follows routes generated by various optimization methods and the design diagram. For some westbound voyages, the voyage optimization methods can significantly decrease the ship’s fatigue damage accumulations, leading to longer fatigue life.
A cross-sectional study of sleep and depression in a rheumatoid arthritis population
Authors: Hughes Mark , Chalk Alan , Sharma Poonam , Dahiya Sandeep , Galloway James 
Published: September 2020

Abstract
Objectives
To assess the prevalence of impaired sleep quality and depression in a rheumatoid arthritis population and determine their correlation with Disease Activity Score (DAS) and its components.

Methods
In this single-centre observational cross-sectional study, data was collected by the assessing clinician for DAS28, age and gender in various treatment groups according to use of csDMARDs, biologics and long-term steroids. Presence of impaired sleep quality and depression was assessed by the Pittsburgh Sleep Quality Index (PSQI) and Public Health Questionnaire 9 (PHQ 9). Correlation for DAS and its components with the outcomes was determined by Pearson’s correlation coefficient. Multivariate analysis was performed by logistic regression.

Results
Two hundred patients were included. The prevalence across all subgroups of poor sleep quality and depression were 86.5% and 30%, respectively, with a correlation coefficient of 0.69 between the two and poor sleep quality amongst all RA patients with comorbid depression. Multivariate analysis found only subjective DAS components, tender joint count (TJC) and patient global health visual analogue score (VAS) to significantly correlate with both outcomes. Age inversely correlated with depression. Long-term steroid use was associated with poorer sleep quality, but there was no significant effect of csDMARDs or biologics. There was no significant difference in prevalence of depression amongst treatment subgroups.

Conclusion
Poor sleep quality and to a lesser extent depression are prevalent in the general rheumatoid arthritis population. Patients would benefit from clinicians measuring these outcomes routinely as they constitute a significant non-inflammatory burden of living with rheumatoid disease.

Key Points• Subjective components of DAS independently correlate with sleep quality and depression, while objective components do not.• Poor sleep quality is highly prevalent in RA and present in all those with comorbid depression.• Poor sleep quality and depression incidence in RA are much lower when DAS is low or remission.
Apararenone in patients with diabetic nephropathy: results of a randomized, double-blind, placebo-controlled phase 2 dose–response study and open-label extension study
Authors: Wada Takashi , Inagaki Masaya , Yoshinari Toru , Terata Ryuji , Totsuka Naoko , Gotou Miki , Hashimoto Gaia 
Published: September 2020

Abstract
Background
We investigated the efficacy and safety of apararenone (MT-3995), a non-steroidal compound with mineralocorticoid receptor agonist activity, in patients with stage 2 diabetic nephropathy (DN).

Methods
The study had two parts: a dose–response, parallel-group, randomized, double-blind, placebo-controlled, multicenter, phase 2, 24-week study and an open-label, uncontrolled, 28-week extension study. Primary and secondary endpoints were the 24-week percent change from baseline in urine albumin to creatine ratio (UACR) and 24- and 52-week UACR remission rates. Safety parameters were changes from baseline in estimated glomerular filtration rate (eGFR) and serum potassium at 24 and 52 weeks, and incidences of adverse events (AEs) and adverse drug reactions (ADRs).

Results
In the dose–response period, 73 patients received placebo and 73, 74, and 73 received apararenone 2.5 mg, 5 mg, and 10 mg, respectively. As a percentage of baseline, mean UACR decreased to 62.9%, 50.8%, and 46.5% in the 2.5 mg, 5 mg, and 10 mg apararenone groups, respectively, at week 24 (placebo: 113.7% at week 24; all P < 0.001 vs placebo). UACR remission rates at week 24 were 0.0%, 7.8%, 29.0%, and 28.1% in the placebo and apararenone 2.5 mg, 5 mg, and 10 mg groups, respectively. eGFR tended to decrease and serum potassium tended to increase, but these events were not clinically significant. AE incidence increased with dose while ADR incidence did not.

Conclusion
The UACR-lowering effect of apararenone administered once daily for 24 weeks in patients with stage 2 DN was confirmed, and the 52-week administration was safe and tolerable.

Clinical trial registration
NCT02517320 (dose–response study) and NCT02676401 (extension study)
Eternalism and Perspectival Realism About the ‘Now’
Authors: Slavov Matias 
Published: September 2020

AbstractEternalism is the view that all times are equally real. The relativity of simultaneity in special relativity backs this up. There is no cosmically extended, self-existing ‘now.’ This leads to a tricky problem. What makes statements about the present true? I shall approach the problem along the lines of perspectival realism and argue that the choice of the perspective does. To corroborate this point, the Lorentz transformations of special relativity are compared to the structurally similar equations of the Doppler effect. The ‘now’ is perspectivally real in the same way as a particular electromagnetic spectrum frequency. I also argue that the ontology of time licensed by perspectival realism is more credible in this context than its current alternative, the fragmentalist interpretation of special relativity.
Investigating the Effects of Mechanical Properties of Rocks on Specific Energy and Penetration Rate of Borehole Drilling
Authors: Kolapo Peter 
Published: September 2020

AbstractThis paper deals with the analysis of effects of mechanical properties of rock on penetration rate and specific energy. Five specimens were collected from the four locations in Federal capital territory, Abuja. These samples were subjected to laboratory point load strength index using point load testing machine. Results of the point load tests were used to estimate the uniaxial compressive strength of the rocks. The penetration rate and specific energy were determined using empirical equations. The results from the investigation showed that the rate of penetration decreases with increase in rock strength and the specific energy increases with increase in rock strength. Based on the investigation, a number of linear relationships that described the effects of mechanical properties on penetration rate in the drilling process were obtained with strong correlation coefficients.
Bauxite mining at Atewa Forest Reserve, Ghana: a political ecology of a conservation-exploitation conflict
Authors: Purwins Sebastian 
Published: September 2020

AbstractAtewa Forest Reserve in the Eastern Region of Ghana represents one of only two reserves with upland evergreen forests in Ghana but is also a possible site for bauxite mining. The Government of Ghana deployed an infrastructure in anticipation for a refined bauxite agreement with China. Ghana’s Government seeks to develop an integrated Bauxite-Aluminum Industry; however, several NGOs try to protect the Atewa Forest and propose that the area should be upgraded to a National Park. In this study, this conservation-exploitation conflict is analyzed from a political ecology perspective elaborating on who are the involved key actors, their relations and what strategies are used. Political ecology is about recognizing the power that actors have at the moment of deciding what, how, and where to conserve nature. Based on interviews done during fieldtrips in 2018, 2019 and 2020 complemented by an analysis of political documents, the identified strategies the NGOs are using in this conflict, can be described as demonstration and upscaling. The aim of this paper is to draw attention on the politicization of nature, in particular Atewa forest reserve and its bauxite resources.
Simulating spatial complexity in dry conifer forest restoration: implications for conservation prioritization and scenario evaluation
Authors: Cannon Jeffery B. , Gannon Benjamin M. , Feinstein Jonas A. , Padley Eunice A. , Metz Loretta J. 
Published: September 2020

AbstractContextSeveral initiatives seek to increase the pace and scale of dry forest restoration and fuels reduction to enhance forest resilience to wildfire and other stressors while improving the quality and reliability of key ecosystem services. Ecological effects models are increasingly used to prioritize these efforts at the landscape-scale based on simulated treatment outcomes.ObjectivesTreatments are often simulated using uniform post-treatment target conditions or proportional changes to baseline forest structure variables, but do not account for the common objective of restoration to mimic the complex forest structure that was present historically which is thought to provide an example of structural conditions that contributed to ecosystem diversity and resilience.MethodsWe simulate spatially homogenous fire hazard reduction treatments along with heterogeneous restoration treatments in dry conifer forests to investigate how spatial complexity affects ecological indicators of (1) forest structural heterogeneity, (2) forest and watershed vulnerability to high-severity fire, and (3) feasibility of future prescribed fire use.ResultsOur results suggest that spatially explicit restoration treatments should produce similar wildfire and prescribed fire outcomes as homogeneous fuels reduction treatments, but with greater forest structural heterogeneity. The lack of strong tradeoffs between ecological objectives suggests the primary benefit of spatially complex treatments is to increase forest structural heterogeneity which may promote biodiversity.ConclusionsWe show that landscape-scale prioritization to maximize ecological benefits can change when spatially complex restoration treatments are modeled. Coupling landscape-scale management simulations and ecological effects models offers flexible decision support for conservation assessment, prioritization, and planning.
Surrounding landscape structures, rather than habitat age, drive genetic variation of typical calcareous grassland plant species
Authors: Lehmair Theresa Anna , Pagel Ellen , Poschlod Peter , Reisch Christoph 
Published: September 2020

AbstractContextLand use change reduced calcareous grasslands throughout Europe during the last decades. Subsequent fragmentation and habitat deterioration led, moreover, to a massive biodiversity decline. To counteract this alarming development, a clear understanding of genetic variation patterns, as fundamental level of biodiversity, becomes inevitable.ObjectivesThe aim of our study was to identify the drivers of genetic variation in common calcareous grassland plant species. More specifically, we tested whether genetic diversity or differentiation ofAsperula cynanchica,Campanula rotundifolia, andLinum catharticumdepend on habitat age, landscape structure, habitat quality, and/or population size.MethodsWe investigated 912 individuals, 304 per study species, from 19 calcareous grasslands across the Swabian Alb in Baden-Württemberg (Germany) using AFLP analyses.ResultsWe observed no significant influence of habitat age on genetic diversity and differentiation. Habitat quality also had no impact on genetic diversity and population size only showed weak effects. However, genetic diversity strongly depended on landscape structure represented by distance to the nearest settlement, total area of surrounding calcareous grasslands, and their connectivity.ConclusionsMigratory sheep herding is considered as main land use in calcareous grasslands on the Swabian Alb and thus, landscape structures in the study region may describe movement patterns of grazing livestock. In this study, genetic variation in calcareous grassland populations was strongly affected by surrounding landscape structures and subsequent grazing patterns. Therefore, we assume that moderate grazing intensities over the long term may increase levels of genetic diversity, whereas periods of overgrazing or abandonment could lower genetic diversity.