| 1. |
- Ruilope, LM, et al.
(author)
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Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
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In: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
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Journal article (peer-reviewed)abstract
- <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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| 2. |
- Emery, Carolyn A, et al.
(author)
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Establishing outcome measures in early knee osteoarthritis
- 2019
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In: Nature Reviews Rheumatology. - : Springer Science and Business Media LLC. - 1759-4804 .- 1759-4790. ; 15:7, s. 438-448
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Research review (peer-reviewed)abstract
- The classification and monitoring of individuals with early knee osteoarthritis (OA) are important considerations for the design and evaluation of therapeutic interventions and require the identification of appropriate outcome measures. Potential outcome domains to assess for early OA include patient-reported outcomes (such as pain, function and quality of life), features of clinical examination (such as joint line tenderness and crepitus), objective measures of physical function, levels of physical activity, features of imaging modalities (such as of magnetic resonance imaging) and biochemical markers in body fluid. Patient characteristics such as adiposity and biomechanics of the knee could also have relevance to the assessment of early OA. Importantly, research is needed to enable the selection of outcome measures that are feasible, reliable and validated in individuals at risk of knee OA or with early knee OA. In this Perspectives article, potential outcome measures for early symptomatic knee OA are discussed, including those measures that could be of use in clinical practice and/or the research setting.
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| 3. |
- Helmens, Karin F., et al.
(author)
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Warm summers and rich biotic communities during N-Hemisphere deglaciation
- 2018
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In: Global and Planetary Change. - : Elsevier BV. - 0921-8181 .- 1872-6364. ; 167, s. 61-73
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Journal article (peer-reviewed)abstract
- Detailed studies on fossil remains of plants or animals in glacial lake sediments are rare. As a result, environmental conditions right at the moment of deglaciation of the large N-Hemisphere ice-sheets remain largely unknown. Here we study three deglacial phases of the Fennoscandian Ice Sheet as a unique, repeated element in a long sediment record preserved at Soldl in northern Finland. We summarize extensive multi-proxy data (diatoms, phytoliths, chironomids, pollen, spores, non-pollen palynomorphs, macrofossils, lithology, loss-on-ignition, C/N) obtained on glacial lake sediments dated to the early Holocene (ca. 10 kyr BP), early MIS 3 (ca. 50 kyr BP) and early MIS 5a (ca. 80 kyr BP). In contrast to the common view of an unproductive ice-marginal environment, our study reconstructs rich ecosystems both in the glacial lake and along the shores with forest on recently deglaciated land. Higher than present-day summer temperatures are reconstructed based on a large variety of aquatic taxa. Rich biota developed due to the insolation-induced postglacial warming and high nutrient levels, the latter resulting from erosion of fresh bedrock and sediment, leaching of surface soils, decay of plant material under shallow water conditions, and sudden decreases in lake volume. Aquatic communities responded quickly to deglaciation and warm summers and reflect boreal conditions, in contrast to the terrestrial ecosystem which responded with some delay probably due to time required for slow soil formation processes. Birch forest is reconstructed upon deglaciation of the large LGM ice-sheet and shrub tundra following the probably faster melting smaller MIS 4 and MIS 5b ice-sheets. Our study shows that glacial lake sediments can provide valuable palaeo-environmental data, that aquatic biota and terrestrial vegetation rapidly accommodated to new environmental conditions during deglaciation, and that glacial lake ecosystems, and the carbon stored in their sediments, should be included in earth system modeling.
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| 4. |
- Higgins, Lindsey, et al.
(author)
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Surface Area Variability of a North-Central Tanzanian Crater Lake
- 2016
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In: Geosciences. - : MDPI AG. - 2076-3263. ; 6:2
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Journal article (peer-reviewed)abstract
- A history of modern (1973–2015) surface area variability for Lake Basotu in north-central Tanzania has been reconstructed using archived Landsat images from the dry season between June and October. This record was compared to local weather data as well as larger scale weather patterns. The lake has been in a state of decline interrupted by major flood events since the beginning of the satellite record. From 1973 to 1997, the lake area was between 0.97 km2 and 4.28 km2. Lake extent abruptly increased to 13.86 km2 in 1998, when a co-occurrence of El Niño and a positive Indian Ocean Dipole led to extensive flooding. It is hypothesized that local agricultural practices leading to soil erosion and subsequent basin sedimentation have most likely increased the sensitivity of Lake Basotuto climatic fluctuations.
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| 5. |
- Plikk, Anna, et al.
(author)
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Development of an Eemian (MIS 5e) Interglacial palaeolake at Sokli (N Finland) inferred using multiple proxies
- 2016
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In: Palaeogeography, Palaeoclimatology, Palaeoecology. - : Elsevier BV. - 0031-0182 .- 1872-616X. ; 463, s. 11-26
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Journal article (peer-reviewed)abstract
- A 12 m long lacustrine record from Sokli, N Finland, was analyzed for diatoms, non-pollen palynomorphs, macrofossils, pollen and geochemistry in order to reconstruct the development of a high-latitude Eemian lake and investigate the influence of climatic and environmental changes on the lake ecosystem. Based on this multi-proxy dataset we distinguished five major lake phases in the lake's evolution. An initial minerogenic, glacio-lacustrine phase was followed by an organic-rich early Eemian lake phase characterized by anoxic bottom waters, high seasonality and rising nutrient levels. A long open water season, pronounced summer stratification and high productivity characterized the following early mid-Eemian lake phase, corresponding to the Eemian thermal maximum. During the late mid-Eemian lake phase decreasing water depths due to infilling and extensive mixing of the water column resulted in less stable summer stratification and decreased anoxia. The late-Eemian lake phase was characterized by shallow and dynamic conditions and a cooling climate. Superimposed on these general trends are two events characterized by colder and more arid conditions, that possibly match cold and arid events registered in palaeolimnological records on the European continent. In general, the multi-proxy record reflects a nutrient rich lake, where changes in mixing regime associated with climatic forcing and lake level changes asserted a major impact on the aquatic assemblages. The changes in the aquatic assemblages reflect the major patterns of climate change that took place during the Eemian in northern Europe; i.e. a rapid warming and high seasonality during the early Eemian, decreased seasonality during the mid Eemian and a cooling late Eemian with increased seasonality. The high latitude Sokli Eemian palaeolake record lengthens the latitudinal extent of Eemian terrestrial records across Europe, adding to the understanding of climatic gradients and drivers over Europe.
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| 6. |
- Risberg, Daniel, et al.
(author)
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Computational fluid dynamics simulation of indoor climate in low energy buildings computational set up
- 2017
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In: Thermal Science. - : VINČA Institute of Nuclear Sciences. - 0354-9836 .- 2334-7163. ; 21:5, s. 1985-1998
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Journal article (peer-reviewed)abstract
- In this paper CFD was used for simulation of the indoor climate in a part of a low energy building. The focus of the work was on investigating the computational set up, such as grid size and boundary conditions in order to solve the indoor climate problems in an accurate way. Future work is to model a complete building, with reasonable calculation time and accuracy. A limited number of grid elements and knowledge of boundary settings are therefore essential. An accurate grid edge size of around 0.1 m was enough to predict the climate according to a grid independency study. Different turbulence models were compared with only small differences in the indoor air velocities and temperatures. The models show that radiation between building surfaces has a large impact on the temperature field inside the building, with the largest differences at the floor level. Simpling the simulations by modelling the radiator as a surface in the outer wall of the room is appropriate for the calculations. The overall indoor climate is finally compared between three different cases for the outdoor air temperature. The results show a good indoor climate for a low energy building all around the year.
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