bluuebunny/crossref_metadata_2025_split huggingface dataset:
European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness
Authors: Kondziella D. , Bender A. , Diserens K. , van Erp W. , Estraneo A. , Formisano R. , Laureys S. , Naccache L. , Ozturk S. , Rohaut B. , Sitt J. D. , Stender J. , Tiainen M. , Rossetti A. O. , Gosseries O. , Chatelle C. ,   the EAN Panel on Coma, Disorders of Consciousness
Published: February 2020

Background and purposePatients with acquired brain injury and acute or prolonged disorders of consciousness (DoC) are challenging. Evidence to support diagnostic decisions on coma and other DoC is limited but accumulating. This guideline provides the state‐of‐the‐art evidence regarding the diagnosis of DoC, summarizing data from bedside examination techniques, functional neuroimaging and electroencephalography (EEG).MethodsSixteen members of the European Academy of Neurology (EAN) Scientific Panel on Coma and Chronic Disorders of Consciousness, representing 10 European countries, reviewed the scientific evidence for the evaluation of coma and other DoC using standard bibliographic measures. Recommendations followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The guideline was endorsed by the EAN.ResultsBesides a comprehensive neurological examination, the following suggestions are made: probe for voluntary eye movements using a mirror; repeat clinical assessments in the subacute and chronic setting, using the Coma Recovery Scale – Revised; use the Full Outline of Unresponsiveness score instead of the Glasgow Coma Scale in the acute setting; obtain clinical standard EEG; search for sleep patterns on EEG, particularly rapid eye movement sleep and slow‐wave sleep; and, whenever feasible, consider positron emission tomography, resting state functional magnetic resonance imaging (fMRI), active fMRI or EEG paradigms and quantitative analysis of high‐density EEG to complement behavioral assessment in patients without command following at the bedside.ConclusionsStandardized clinical evaluation, EEG‐based techniques and functional neuroimaging should be integrated for multimodal evaluation of patients with DoC. The state of consciousness should be classified according to the highest level revealed by any of these three approaches.
Decentralized central banks: Political ideology and the Federal Reserve System of regional banks
Authors: Ainsley Caitlin 
Published: February 2020

AbstractThis article examines the politics of the Federal Reserve System of regional banks. While regional banks have long lacked meaningful influence over monetary policy, their leadership stands to provide a base of elite support for the Federal Reserve. To serve this role effectively, however, regional bank leadership must reflect the ideological diversity of political elites. This article provides the first quantitative empirical analysis of the ideological composition of the regional banking system, introducing a novel data set of all regional bank directors serving from 1980 to 2015 and linking each individual to a measure of political ideology derived from campaign finance contributions. With these data, I examine the degree to which regional banks are ideologically aligned with the districts and industries they are assigned to represent. The results highlight a new function for the decentralized central banking system and opportunity to address declining levels of public confidence in the Fed.
Exploring women’s priorities for the potential consequences of a gestational diabetes diagnosis: A pilot community jury
Authors: Thomas Rae , Scott Anna Mae , Sims Rebecca , Craig Louise , Claase Leigh‐Anne , Lowe Julia , Heal Clare , Hardiman Leah , Glasziou Paul 
Published: February 2020

AbstractBackgroundThere is no international diagnostic agreement for gestational diabetes mellitus (GDM). In 2014, Australia adopted a new definition and testing procedure. Since then, significantly more women have been diagnosed with GDM but with little difference in health outcomes. We explored the priorities and preferences of women potentially impacted by a GDM diagnosis.MethodWe recruited 15 women from the Gold Coast, Australia, to participate in a pilot community jury (CJ). Over two days, the women deliberated on the following: (a) which important consequences of a diagnosis of GDM should be considered when defining GDM?; (b) what should Australian health practitioners call the condition known as GDM?ResultsEight women attended the pilot CJ, and their recommendations were a consensus. Women were surprised that the level of risk for physical harms was low but emotional harms were high. The final ranking of important consequences (high to low) was as follows: women's negative emotions; management burden of GDM; overmedicalized pregnancy; minimizing infant risks; improving lifestyle; and macrosomia. To describe the four different clinical states of GDM, the women chose three different labels. One was GDM.ConclusionsThe women from this pilot CJ prioritized the consequences of a diagnosis of GDM differently from clinicians. The current glucose threshold for GDM in Australia is set at a cut‐point for adverse risks including macrosomia and neonatal hyperinsulinaemia. Definitions and guideline panels often fail to ask the affected public about their values and preferences. Community voices impacted by health policies should be embedded in the decision‐making process.
Sin and the Limits of Theology: A Reflection in Conversation with Julian of Norwich and Martin Luther
Authors: McFarland Ian A. 
Published: February 2020

AbstractWhile the confession of divine transcendence entails that all theological speech faces intrinsic limits, the problem of sin brings theology’s limits into focus in a very particular way. For while Christians confess that God has been uniquely and unsurpassably revealed in Jesus Christ, insofar as they do not claim that even this revelation explains the place of sin in the divine economy, the ongoing mystery of sin and evil presents the theologian with a stark alternative. On the one hand, if the grace of God revealed in Christ is emphasized, less attention will be given to the mystery of sin that remains hidden in God; on the other, if theologians emphasize what is hidden, the light of Christ will be obscured. This article explores the tension between these two alternatives with reference to the Showings of Julian of Norwich and Martin Luther’s Bondage of the Will.
Factors that predict glycaemic response to sodium‐glucose linked transporter (SGLT) inhibitors
Authors: Harding Amy L. , Bediaga Naiara , Galligan Anna , Colman Peter G. , Fourlanos Spiros , Wentworth John M. 
Published: February 2020

AbstractAimTo determine the clinical and biochemical variables associated with change in HbA1c in patients with type 2 diabetes who start sodium‐glucose linked transporter (SGLT) inhibitor therapy.MethodsWe performed a prospective cohort study (ACTRN12616000833460) of 48 adults (30 male, 18 female) with type 2 diabetes who attended a tertiary hospital diabetes clinic. Fasting serum and urine samples, collected during clinic visits prior to and at 1, 12 and 24 weeks after commencing SGLT inhibitor treatment, were analysed for HbA1c, electrolytes, urea, creatinine and glucose.ResultsAfter 12 weeks, SGLT inhibitor therapy was associated with respective median (97% CI) decreases in weight, blood pressure, HbA1c and urine albumin/creatinine ratio of 3.0 (1.7–3.4) kg, 8 (2–16)/4 (3–9) mmHg, 6 (3–14) mmol/mol and 0.69 (0.18–1.8) mg/mmol. These effects persisted to 24 weeks. Urinary frequency and genitourinary infection were common adverse effects. Baseline HbA1c and eGFR independently predicted ΔHbA1c at 12 weeks whereas only baseline HbA1c independently predicted ΔHbA1c at 24 weeks. Urinary fractional glucose excretion and change in fasting glucose 1 week after starting SGLT inhibitor did not contribute to prediction of glycaemic response.ConclusionsSGLT inhibitor therapy in a hospital clinic setting was associated with clinical improvements comparable to those observed in clinical trials but with higher incidence of genitourinary side‐effects. Baseline HbA1c and eGFR, but not urine fractional glucose excretion, predicted glycaemic response.
Waterbirth in low‐risk pregnancy: An exploration of women’s experiences
Authors: Carlsson Tommy , Ulfsdottir Hanna 
Published: February 2020

AbstractAimsTo explore retrospective descriptions about benefits, negative experiences and preparatory information related to waterbirths.DesignA qualitative study.MethodsWomen who gave birth in water with healthy pregnancies and low‐risk births were consecutively recruited between December 2015–October 2018 from two birthing units in Sweden. All who gave birth in water during the recruitment period were included (N = 155) and 111 responded to the survey. Women were emailed a web‐based survey six weeks postpartum. Open‐ended questions were analysed with qualitative content analysis.ResultsTwo themes were identified related to benefits: (a) physical benefits: the water eases labour progression while offering buoyancy and pain relief; and (b) psychological benefits: improved relaxation and control in a demedicalized and safe setting. Two themes were identified related to negative experiences: (a) equipment‐related issues due to the construction of the tub and issues related to being immersed in water; and (b) fears and worries related to waterbirth. In regard to preparatory information, respondents reported a lack of general and specific information related to waterbirths, even after they contacted birthing units to ask questions. Supplemental web‐based information was sought, but the trustworthiness of these sources was questioned and a need for trustworthy web‐based information was articulated.ConclusionWomen who give birth in water experience physical and psychological benefits, but need better equipment and sufficient information. There is room for improvement with regard to prenatal and intrapartum care of women who give birth in water.ImpactJudging from women's recounts, midwives and nurses should continue advocating waterbirth in low‐risk pregnancies. The lack of adequate equipment in Swedish birthing units articulated by women challenge current routines and resources. The findings illustrate unfulfilled needs for preparatory information about waterbirth, further strengthening that midwives should discuss the possibility of waterbirth when meeting expectant parents in the antenatal setting.
Revisiting the prevalence and diversity of localized thinning of the left ventricular apex
Authors: Yamamoto Kyoko , Mori Shumpei , Fukuzawa Koji , Miyamoto Koji , Toba Takayoshi , Izawa Yu , Tanaka Hidekazu , Kono Atsushi K. , Hirata Ken‐ichi 
Published: February 2020

AbstractBackgroundThe left ventricular apex commonly has a paper‐thin structure. However, available data about its structure are limited to variable samples, methodologies, and results.ObjectiveTo investigate the structural anatomy of the left ventricular apex using living heart datasets with the latest computed tomography scanner.MethodsOne hundred thirty‐one consecutive patients (median age, 73 years; 58% men) who underwent cardiac computed tomography were retrospectively analyzed. Patients with severe aortic stenosis were analyzed separately. Thickness and diameters of the thinnest part of the left ventricular apex during mid‐diastole were measured using orthogonal multiplanar reconstruction images. The area of thinning was estimated using the formula for the ellipse.ResultsIn 88 patients without severe aortic stenosis, the median thickness of the thinnest area of the left ventricular apex was only 0.9 mm. Among them, 74%, 99%, and 100% of cases displayed a left ventricular apex thinner than 1.0, 3.0, and 5.0 mm, respectively. The median area of the thinnest region was 5.6 mm2. In 43 patients with severe aortic stenosis, the median thickness of the thinnest area of the left ventricular apex was 1.2 mm. Among them, 51%, 93%, and 100% of cases displayed a left ventricular apex thinner than 1.0, 3.0, and 5.0 mm, respectively. The median area of the thinnest region was 3.9 mm2.ConclusionsLocalized thinning of the left ventricular apex is unexceptional, regardless of aortic stenosis with concentric left ventricular hypertrophy, thus highlighting the need for a reappreciation of this feature to avoid inadvertent catastrophic complications.
Patterns of hypertension management in France in 2015: The ESTEBAN survey
Authors: Vallée Alexandre , Gabet Amélie , Grave Clémence , Sorbets Emmanuel , Blacher Jacques , Olié Valérie 
Published: February 2020

AbstractThe purposes of this study were to describe the hypertensive population and therapeutic management of hypertension in adults between 18 and 74 years of age in France in 2015. Esteban survey is a cross‐sectional survey with a clinical examination conducted in a representative sample of French adults aged 18‐74 years between 2014 and 2016. Esteban was entirely public‐funded. Blood pressure (BP) was measured during clinical examination with a standardized protocol, and pharmacological treatment was collected through the exhaustive Système National des Données de Santé (SNDS) database. Hypertension was defined by systolic BP (SBP)> 140 mm Hg, diastolic BP (DBP)> 90 mm Hg or treatment with BP‐lowering drugs. The therapeutic control of treated hypertensive patients was defined by SBP < 140 mm Hg and DBP < 90 mm Hg. Adherence to drug treatment was defined as more than 80% of days covered by BP‐lowering drug per year. The prevalence of hypertension was 31.3%. 74.7% of aware hypertensive participants taking an antihypertensive drug, and 57.7% of them were treated with a single antihypertensive pharmacological class. Overall, among hypertensives, 24.3% had a satisfactory BP control. Only 49.7% of treated hypertensives participants were controlled, and 33.6% of them were adherent to their drug treatment. The prevalence of hypertension in France remains high, with only 74.7% of the aware hypertensive participants receiving pharmacological therapy and only 48.9% of aware hypertensives with a BP at goal. More effective measures are needed to improve clinical management of hypertension in France.
Strategic shirking in competitive labor markets: A general model of multi‐task promotion tournaments with employer learning
Authors: DeVaro Jed , Gürtler Oliver 
Published: February 2020

AbstractIn a multitask, market‐based promotion tournament model, under different environments concerning employer learning about worker ability, it is shown that: (a) asymmetric learning in multitask jobs is a necessary condition for “strategic shirking” (i.e., underperforming on certain tasks to increase the promotion probability); (b) when learning becomes increasingly symmetric on one task, the effort allocated to that task could increase or decrease, but effort on the other task increases; (c) strategic shirking does not occur in equilibrium in single‐task models; and (d) promotions signal worker ability even when there is symmetric learning on one task, if learning is asymmetric on another.
Life cycle assessment of side stream removal and recovery of nitrogen from wastewater treatment plants
Authors: van Zelm Rosalie , Seroa da Motta Raquel de Paiva , Lam Wan Yee , Menkveld Wilbert , Broeders Eddie 
Published: February 2020

AbstractIn the light of a circular economy, the Nijhuis Ammonia Recovery system (AECO‐NAR) was developed to not only remove nitrogen from wastewater streams, but also produce ammonium sulfate (AS), used as fertilizer, in a single plant. The goal of this paper was to quantify the environmental impacts of side stream ammonia recovery with the AECO‐NAR system and compares them with the impacts of side stream nitrogen removal combined SHARON (partly nitrification)‐anammox plant. For this, an environmental life cycle assessment was performed with a functional unit (FU) of the treatment of 1 kg of total dissolved nitrogen inflow. Since AS obtained by the AECO‐NAR is a by‐product of the ammonia removal process, allocation was based on system expansion. Foreground inventory data were obtained from a full‐scale plant. ReCiPe2016 was used to determine human health and biodiversity impacts. Results show that due to the production of AS in an integrated water treatment and production system, the AECO‐NAR avoids impacts of current AS production, leading to negative impact scores. Impacts per FU decrease with increasing inflow concentrations of ammonia. Main improvement options are the use of renewable energy and the replacement of the cleaning chemical citric acid with a sustainable alternative. Total impacts of the AECO‐NAR system diminish when comparing the system to the biological SHARON‐Anammox system, due to production of AS fertilizer product. Due to the fertilizer production step being integrated in the side stream treatment, the complete system is beneficial over ammonia recovery and wastewater treatment as separate systems.
Ameliorative effects of quercetin on the preimplantation embryos development in diabetic pregnant mice
Authors: Bolouki Ayeh , Zal Fatemeh , Alaee Sanaz 
Published: February 2020

AbstractAimMaternal diabetes adversely retards the development of preimplantation embryos. Quercetin is a flavonoid belonging to phytoestrogens family and may be useful in treatment of reproductive disorders. The aim of this study was investigation of the ameliorative effects of quercetin administration on preimplantation embryo development in diabetic pregnancy.MethodsDiabetic and healthy female mice were treated with 30 mg/kg/day quercetin 4 weeks before conception. Blastocysts were recovered at the 4th day of pregnancy for protein and mRNA expression changes. Plasma sex‐steroid levels were also analyzed.ResultsQuercetin significantly decreased blood glucose levels in diabetic mice. Embryos retrieved from diabetic mice exhibited a considerable delay in morphological development. In diabetic mice with quercetin treatment, morphological distribution was shifted considerably to the well‐developed stages. Serum estradiol level reduced in diabetic mice but, treatment with quercetin significantly increased serum estradiol level. While IGF1R, integrin αvβ3, and Cox2 mRNA expression in the blastocyst of diabetic mice decreased significantly, quercetin treatment caused increasing expression levels of these genes. Expression of the Caspase3 gene increased dramatically in the collected blastocysts from diabetic mice and reduced following quercetin treatment. Besides, the inactive β‐catenin protein level in the blastocysts of diabetic mice was higher than that in normal mice, while treatment with quercetin decreased the level of inactive β‐catenin protein in the blastocyst of diabetic mice.ConclusionQuercetin protects preimplantation embryos from destructive effects of diabetes. The amelioration of sex hormones disturbance in early pregnancy may help to treat reproductive disorders in diabetic women. Quercetin can be considered as a novel solution to the improvement of reproductive disorders in the diabetic females.
Do spotted hyaenas outcompete the big cats in a small, enclosed system in South Africa?
Authors: Comley J. , Joubert C. J. , Mgqatsa N. , Parker D. M. 
Published: February 2020

AbstractCarnivores are adapted to kill, meaning sympatric carnivores can have particularly aggressive and harmful competitive interactions. The co‐existence of multiple carnivores in an ecosystem could be restricted by their similarity in ecological niches (e.g. dietary overlap); however, high prey abundances could facilitate their co‐existence. Although the development of small, enclosed reserves (<400 km2) in South Africa has reduced human–carnivore conflict, these systems may increase the likelihood of carnivore intra‐guild competition due to the clumping of competing carnivores into these restricted spaces. Using carnivore scat and kill site analyses, we determined the dietary preferences and overlap of sympatric large carnivores in a small, enclosed reserve, Selati Game Reserve (Selati). Large carnivores in Selati (lions (Panthera leo), spotted hyaenas (Crocuta crocuta) and leopards (Panthera pardus)) preferentially selected for varying combinations of prey size classes. Lions selected for large prey, leopards selected for small prey and spotted hyaenas did not prefer any particular prey size. Additionally, lions had the largest dietary breadth and the diet of leopards and spotted hyaenas overlapped considerably. Coupled with high prey densities in Selati, the predation strategies of the large carnivores could be facilitating their co‐existence. On the other hand, the high degree of dietary overlap among large carnivores suggests that there is strong potential for exploitation competition, particularly between spotted hyaenas and leopards as their diet overlapped extensively (91% and 93% for prey species and size class, respectively). Although spotted hyaenas are potentially outcompeting leopards in Selati, lions were the most dominant large carnivore. Our study reiterates the complexity of carnivore guild interactions and emphasizes how these interactions are subject to variation due to site‐specific circumstances (e.g. composition of prey and carnivore populations). We therefore encourage site‐specific, multi‐carnivore research throughout protected areas in southern Africa.
Midfacial pain
Authors: Lukic N. , Ettlin D. 
Published: February 2020

AbstractThe midface anatomy includes a variety of structures and pain may therefore originate from different tissues. Several medical specialties are often involved in its management. Criteria that define a specific pathology guide the diagnostic process. Namely, reported symptoms require careful verification by the clinical examination. Where appropriate, imaging can offer supplemental information. However, there is mostly no image correlate for myogenic and neuropathic pain. Hence, the medical images need to be interpreted with caution to avoid an inadequate attribution of pain aetiology. The mnemonic “DAMN‐ODD” may serve for remembering the more common differential diagnoses. Specific entities such as migraine, cluster headache, nose and sinus disorders, and cardiovascular disorders are discussed.
Polyploidization‐driven differentiation of freezing tolerance in Solidago canadensis
Authors: Lu Huan , Xue Lifang , Cheng Jiliang , Yang Xianghong , Xie Hongjie , Song Xiaoling , Qiang Sheng 
Published: February 2020

AbstractSolidago canadensis, originating from the temperate region of North America, has expanded southward to subtropical regions through polyploidization. Here we investigated whether freezing tolerance of S. canadensis was weakened during expansion. Measurement of the temperature causing 50% ruptured cells (LT50) in 35 S. canadensis populations revealed ploidy‐related differentiation in freezing tolerance. Freezing tolerance was found to decrease with increasing ploidy. The polyploid populations of S. canadensis had lower ScICE1 gene expression levels but more ScICE1 gene copies than the diploids. Furthermore, more DNA methylation sites in the ScICE1 gene promoter were detected in the polyploids than in the diploids. The results suggest that promoter methylation represses the expression of multi‐copy ScICE1 genes, leading to weaker freezing tolerance in polyploid S. canadensis compared to the diploids. The study provides empirical evidence that DNA methylation regulates expression of the gene copies and supports polyploidization‐driven adaptation to new environments.