bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Older Patients with Acute Neuropsychological Symptoms Not Fulfilling Criteria of Delirium
Authors: Zipprich Hannah M. , Arends Marie‐Christine , Schumacher Ulrike , Bahr Viola , Scherag André , Kwetkat Anja , Wedding Ulrich , Brunkhorst Frank M. , Witte Otto W. , Prell Tino , Redecker Christoph 
Published: March 2020

OBJECTIVESAlthough delirium is often investigated, little is known about the outcomes of patients having acute neuropsychological changes at a single time point without fulfilling the criteria of full delirium. Our aim was to determine point prevalence, predictors, and long‐term outcomes of delirium and acute neuropsychological changes in patients aged 60 years and older across different departments of a university hospital with general inpatient care.DESIGNProspective observational study.SETTINGUniversity hospital excluding psychiatric wards.PARTICIPANTSAt baseline, 669 patients were assessed, and follow‐ups occurred at months 6, 12, 18, and 36.MEASUREMENTSMeasurements were obtained using the Confusion Assessment Method (CAM), comprehensive geriatric assessment, health‐related quality of life, functional state (month 6), and mortality rates (months 6, 12, 18, and 36). Subjects were classified into (1) patients with delirium according to the CAM, (2) patients with only two positive CAM items (2‐CAM state), and (3) patients without delirium.RESULTSDelirium was present in 10.8% and the 2‐CAM state in an additional 12.7% of patients. Highest prevalence of delirium was observed in medical and surgical intensive care units and neurosurgical wards. Cognitive restrictions, restricted mobility, electrolyte imbalance, the number of medications per day, any fixations, and the presence of a urinary catheter predicted the presence of delirium and 2‐CAM‐state. The mean Karnofsky Performance Score and EuroQol‐5D were comparable between delirium and the 2‐CAM state after 6 months. The 6‐, 12‐, 18‐, and 36‐month mortality rates of patients with delirium and the 2‐CAM state were comparable. The nurses’ evaluation of distinct patients showed high specificity (89%) but low sensitivity (53%) for the detection of delirium in wide‐awake patients.CONCLUSIONPatients with an acute change or fluctuation in mental status or inattention with one additional CAM symptom (ie, disorganized thinking or an altered level of consciousness) have a similar risk for a lower quality of life and death as patients with delirium. J Am Geriatr Soc 68:1469‐1475, 2020.
GABAergic mechanisms in the suprachiasmatic nucleus that influence circadian rhythm
Authors: Ono Daisuke , Honma Ken‐ichi , Honma Sato 
Published: March 2020

AbstractThe mammalian central circadian clock is located in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN contains multiple circadian oscillators which synchronize with each other via several neurotransmitters. Importantly, an inhibitory neurotransmitter, γ‐amino butyric acid (GABA), is expressed in almost all SCN neurons. In this review, we discuss how GABA influences circadian rhythms in the SCN. Excitatory and inhibitory effects of GABA may depend on intracellular Cl‐ concentration, in which several factors such as day‐length, time of day, development, and region in the SCN may be involved. GABA also mediates oscillatory coupling of the circadian rhythms in the SCN. Recent genetic approaches reveal that GABA refines circadian output rhythms, but not circadian oscillations in the SCN. Since several efferent projections of the SCN have been suggested, GABA might work downstream of neuronal pathways from the SCN which regulate the temporal order of physiology and behavior.
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A spectrophotometric approach for determining sporangium and zoospore viability of Plasmopara viticola
Authors: Hong Cheng‐Fang , Scherm Harald 
Published: March 2020

AbstractA spectrophotometric method for determining the viability of sporangia and zoospores of the oomycete Plasmopara viticola (causal agent of grapevine downy mildew) is described and evaluated to overcome the limitations of currently available methods for assessing propagule viability. Sporangia produced on leaf discs in the laboratory were harvested at different days after the initiation of sporulation (DAS) to yield differences in sporangium viability. Sporangia were suspended in sterile water, the suspensions were placed in a cuvette, and sporangium germination was monitored in a spectrophotometer (λ = 600 nm) at 2‐ to 3‐min intervals for 5 hr. Absorbance started to increase after sporangia were suspended in water for ~30–60 min followed by major peak(s) for younger sporangia (1–3 DAS), whereas low to no increase in absorbance was observed for senescent sporangia (>7 DAS). Microscopic observation confirmed that the increase in absorbance corresponded to the release and active swimming of zoospores, whereas absorbance decreased when zoospores encysted and settled. A positive correlation (r = .839, p = .0365) was observed when the time to the initial increase in absorbance was plotted against the age of sporangia. The time to the absorbance peak (marking the time of maximum zoospore movement) was shortest for immature sporangia (0 DAS), longest for young sporangia (2 DAS) and decreased for mature and senescent sporangia. A similar pattern was observed for the standardized area under the absorbance curve (indicating the overall quantity of zoospores released), for which values were lowest for immature and senescent sporangia, highest for young sporangia and intermediate for mature sporangia. Consistent patterns obtained across two independent experiments suggest that the method is reproducible and may be further developed for other zoospore‐releasing pathogens.
Trentepohlialean Algae (Trentepohliales, Ulvophyceae) Show Preference to Selected Mycobiont Lineages in Lichen Symbioses
Authors: Kosecka Magdalena , Jabłońska Agnieszka , Flakus Adam , Rodriguez‐Flakus Pamela , Kukwa Martin , Guzow‐Krzemińska Beata 
Published: March 2020

The main aims of this work were to assess phylogenetic relationships of the trentepohlialean photobionts in tropical, mainly sterile, lichens collected in Bolivia, to examine their genetic diversity, host specificity, and the impact of habitat factors on the occurrence of Trentepohliales. Based on rbcL marker analysis, we constructed a phylogenetic tree with eight major clades of Trentepohliales, of which seven free‐living species are intermingled with lichenized ones. Our analyses show that the studied photobionts are scattered across the phylogenetic tree and algae from temperate and tropical regions do not form monophyletic groups, except within one clade that seems to be restricted to the tropics. There is no significant occurrence pattern of lichenized Trentepohliaceae on a specific substratum, except Cephaleuros spp. and Phycopeltis spp., which are restricted to leaves, while some clades with lichenized algae may be specialized to tree bark and wood. Moreover, we found two patterns of associations: first, closely related algae can associate with distantly related mycobionts; second, some other trentepohlioid algae associate with selected lineages of fungi (e.g., Arthoniaceae or Graphidaceae). We also found that some lineages of photobionts are even more selective and associate exclusively with one species (e.g., Dichosporidium nigrocinctum, Diorygma antillarum) or closely related lichen‐forming fungi (Herpothallon spp.). Concluding, we found that occurrence of some trentepohlialean photobionts may correlate with the particular type of the mycobiont.
Temporal changes in clinical and radiographic variables in dogs with preclinical myxomatous mitral valve disease: The EPIC study
Authors: Boswood Adrian , Gordon Sonya G. , Häggström Jens , Vanselow Martin , Wess Gerhard , Stepien Rebecca L. , Oyama Mark A. , Keene Bruce W. , Bonagura John , MacDonald Kristin A. , Patteson Mark , Smith Sarah , Fox Philip R. , Sanderson Karen , Woolley Richard , Szatmári Viktor , Menaut Pierre , Church Whitney M. , O'Sullivan M. Lynne , Jaudon Jean‐Philippe , Kresken Jan‐Gerd , Rush John , Barrett Kirstie A. , Rosenthal Steven L. , Saunders Ashley B. , Ljungvall Ingrid , Deinert Michael , Bomassi Eric , Estrada Amara H. , Fernandez Del Palacio Maria J. , Moise N. Sydney , Abbott Jonathan A. , Fujii Yoko , Spier Alan , Luethy Michael W. , Santilli Roberto A. , Uechi Masami , Tidholm Anna , Schummer Christoph , Watson Philip 
Published: March 2020

AbstractBackgroundThe Evaluation of pimobendan in dogs with cardiomegaly caused by preclinical myxomatous mitral valve disease (EPIC) study monitored dogs with myxomatous mitral valve disease (MMVD) as they developed congestive heart failure (CHF).ObjectivesTo describe the changes in clinical and radiographic variables occurring as dogs with MMVD and cardiomegaly develop CHF, compared to similar dogs that do not develop CHF.AnimalsOne hundred and thirty‐five, and 73 dogs that did or did not develop CHF, respectively.Materials and methodsThe following variables were evaluated in 2 groups of dogs (dogs that did or did not develop CHF): Heart rate (HR), clinic respiratory rate (RR), home‐measured resting respiratory rate (RRR), rectal temperature (RT), body weight (BW), and vertebral heart sum (VHS). Absolute value and rate of change of each variable were calculated for each day a dog was in study. Daily means were calculated and plotted against time. The onset of CHF or last visit before leaving the study were set as reference time points.ResultsThe most extreme values and rate of change occurred in variables immediately before onset of CHF. Vertebral heart sum increased earliest. Heart rate, RR, and RRR also increased. Rectal temperature and BW decreased. Increases in RR and RRR were most extreme and occurred immediately before CHF.Conclusions and Clinical ImportanceDogs with MMVD and cardiomegaly experience increases in HR, RR, RRR, and VHS, and decreases in BW and RT as they develop CHF. The variables with highest absolute change and rate of change were RR and RRR. These findings reinforce the value of RR and RRR as indicators of impending or incipient CHF.
Effect of feline characteristics on plasma N‐terminal‐prohormone B‐type natriuretic peptide concentration and comparison of a point‐of‐care test and an ELISA test
Authors: Hanås Sofia , Holst Bodil S. , Höglund Katja , Häggström Jens , Tidholm Anna , Ljungvall Ingrid 
Published: March 2020

AbstractBackgroundIncreased plasma concentration of N‐terminal‐prohormone B‐type natriuretic peptide (NT‐proBNP) can be detected in cats with cardiac disease. Potential effects of feline characteristics on NT‐proBNP concentration may influence clinical usefulness.ObjectivesTo evaluate potential effects of feline characteristics on NT‐proBNP plasma concentration and to compare NT‐proBNP plasma concentrations in healthy cats with results in hypertrophic cardiomyopathy (HCM) cats with or without left atrial enlargement (LAE) using an ELISA and a point‐of‐care test (POCT), and assess if POCT results reflect ELISA results.AnimalsOne hundred healthy cats of 3 breeds and 39 HCM cats were included.MethodsDiseases other than HCM were excluded by physical examination, blood pressure measurement, echocardiography, hematology, and serum biochemistry.ResultsHigher NT‐proBNP concentrations were found in males than in females in healthy (P = .005) and in HCM cats (P = .0021), but breed had no effect on NT‐proBNP concentrations. Using ≥100 pmol/L as a cutoff for abnormal samples, ELISA and POCT had similar sensitivity (SE; 72 and 74%) and specificity (SP; 97 and 98%) for detecting cats with HCM, cats with HCM and LAE (SE, both 100%; SP, 97 versus 98%), and cats with HCM without LAE (SE, both 69%; SP, 97 versus 98%), respectively, when compared to healthy cats.Conclusions and Clinical ImportanceBreed had no effect on plasma NT‐proBNP concentrations, but higher concentrations were found in male than in female cats. The ELISA and POCT had similar SE and SP for detecting HCM. Both tests could identify all HCM cats with LAE but not all HCM cats without LAE.
The influence of corporate governance and financial constraints on the speed of employment adjustment: An analysis using mixed‐effects models
Authors: Chen Ming‐Yuan , Kao Chun‐Lin 
Published: March 2020

AbstractThis paper proposes that the corporate governance structure and financial constraints determine the willingness and ability of firms to implement labor hoarding, and thus influence the speed of employment adjustment. Using Taiwanese manufacturing firms in the decade after the 2008 financial crisis as the sample and conducting a mixed‐effects analysis, our results confirm the presence of labor hoarding. The willingness of hoarding labor is higher for firms having a governance structure focusing less on shareholders’ interests, which leads to lower adjustment speeds. The ability of hoarding labor is stronger, so the adjustment is slower, for firms facing less pressure from financial constraints. Moreover, financial constraints have more impact than the governance structure, and impel firms to accelerate the adjustment throughout the decade. There is also evidence of asymmetric adjustment. The firms with job destruction have higher adjustment speeds than those with job creation, and the connections of adjustment speeds to corporate governance and financial constraints are more applicable to job destruction. We suggest that encouraging firms to adopt a governance structure of less shareholder concern, or more importantly helping them to obtain sufficient funds for retaining talent may be an effective policy to deal with brain drain in Taiwan.
Components of leaf‐trait variation along environmental gradients
Authors: Dong Ning , Prentice Iain Colin , Wright Ian J. , Evans Bradley J. , Togashi Henrique F. , Caddy‐Retalic Stefan , McInerney Francesca A. , Sparrow Ben , Leitch Emrys , Lowe Andrew J. 
Published: March 2020

Summary

Leaf area (LA), mass per area (LMA), nitrogen per unit area (Narea) and the leaf‐internal to ambient CO2 ratio (χ) are fundamental traits for plant functional ecology and vegetation modelling. Here we aimed to assess how their variation, within and between species, tracks environmental gradients.

Measurements were made on 705 species from 116 sites within a broad north–south transect from tropical to temperate Australia. Trait responses to environment were quantified using multiple regression; within‐ and between‐species responses were compared using analysis of covariance and trait‐gradient analysis.

Leaf area, the leaf economics spectrum (indexed by LMA and Narea) and χ (from stable carbon isotope ratios) varied almost independently among species. Across sites, however, χ and LA increased with mean growing‐season temperature (mGDD0) and decreased with vapour pressure deficit (mVPD0) and soil pH. LMA and Narea showed the reverse pattern. Climate responses agreed with expectations based on optimality principles. Within‐species variability contributed < 10% to geographical variation in LA but > 90% for χ, with LMA and Narea intermediate.

These findings support the hypothesis that acclimation within individuals, adaptation within species and selection among species combine to create predictable relationships between traits and environment. However, the contribution of acclimation/adaptation vs species selection differs among traits.
Diagnostics and treatment of nerve agent poisoning—current status and future developments
Authors: Amend Niko , Niessen Karin V. , Seeger Thomas , Wille Timo , Worek Franz , Thiermann Horst 
Published: March 2020

AbstractAlthough 193 states have committed to the Chemical Weapons Convention and 98% of the declared chemical weapons stockpiles have been destroyed so far, nerve agent poisoning remains a lingering threat. The recent dissemination of sarin in Syria, the assassination of Kim Jong‐Nam in Malaysia, and the assault on Sergei Skripal in the United Kingdom underline the need for effective treatment. The current therapeutic options of a muscarinic receptor antagonist, an oxime, and an anticonvulsant have been unchanged for decades. Therefore, new therapeutic strategies, for example, bioscavengers and receptor‐active substances, are promising concepts that have to be examined for their benefits and limitations. In order to facilitate rapid diagnosis in challenging clinical situations, point‐of‐care diagnostics and detection are of importance. Therapeutic guidance concerning the duration and success of the current oxime therapy via determination of the cholinesterase status can contribute to an optimal use of resources. In summary, the challenges of current and future therapies for nerve agent poisoning and key diagnostic devices will be discussed.
Noninvasive cardiac output measurement based optimization in nonresponders of cardiac resynchronization therapy
Authors: Yenerçağ Mustafa , Yüksel Serkan , Çoksevim Metin , Akçay Murat , Arslan Uğur 
Published: March 2020

AbstractBackgroundCardiac resynchronization therapy (CRT) is an important and effective therapy for end‐stage heart failure (HF). Nonresponse to CRT is one of the main obstacles to its application in clinical practice. Herein, we investigated the utilization of the optimization technique using noninvasive cardiac output measurement (NICOM) based Mobil‐O‐Graph device that measures several circulation parameters noninvasively.MethodsSeventy‐five CRT nonresponder HF patients with an implanted CRT device were included. Patients were randomized equally to 3 groups: NICOM, echocardiographic, and empirical optimization groups. After 3 months of optimization, changes in six minutes walk test (6‐MWT), cardiac output (CO), left ventricular ejection fraction (LVEF), and end‐systolic volume (LVESV) were measured. New York Heart Association (NYHA) class and hospitalization for HF were also determined.ResultsThere were no statistically significant differences among the three groups in terms of demographics, baseline characteristics. In the NICOM group, the 6‐MWT, LVEF, CO, and LVESV measurements showed significant improvements compared to baseline values (P < .05). There was no significant improvement in 6‐MWT, LVEF, CO, NYHA class, and LVESV in Echo and Empirical groups after 3 months (P > .05). 6‐MWT, CO, LVESV percentages, and hospitalization for HF were significantly different between the groups (P < .05). In post hoc analyzes, the percentages of the change in 6‐MWT, CO, LVESV, and hospitalization for HF were significantly higher in the NICOM group (P < .017).ConclusionsThis study suggests that Mobil‐O‐Graph device optimization according to CO measures does appear to have potential hemodynamic and clinical benefits in nonresponder CRT patients. Use of Mobil‐O‐Graph device as an option for optimization of CRT devices can be an attractive method of improving CRT outcomes.
Survival of patients with pacing‐induced cardiomyopathy upgraded to CRT does not depend on defibrillation therapy
Authors: Loboda Danuta , Gibinski Michal , Zietek Karolina , Wilczek Jacek , Gardas Rafal , Gladysz‐Wanha Sylwia , Golba Krzysztof S. 
Published: March 2020

AbstractBackgroundPermanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing‐induced cardiomyopathy (PICM) if upgraded to CRT.MethodsOne hundred fifteen patients, 75.0 years old (IQR 67.0–80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long‐term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the National Health System.ResultsThe prior percentage of RVP was 100.0% (IQR 97.0‐100.0), with a QRS duration of 180.0 ms (IQR 160.0‐200.0). LVEF at the time of the upgrade procedure was 27.0% (IQR 21.0‐32.75). The mean follow‐up was 980 ± 522 days. The primary endpoint, death from any cause, was met by 26 (22%) patients. Age > 82 years (HR 5.96; 95% CI 2.24‐15.89; P = .0004) and pre‐CRT implantation LVEF < 20% (HR 5.63; 95%CI 2.19‐14.47; P = .0003), but neither the cardioverter‐defibrillator (ICD) implantation (HR 1.00; 95%CI 0.45–2.22; P = 1.00), nor the presence of atrial fibrillation (HR 1.22; 95%CI 0.56–2.64; P = .62), were independently associated with all‐cause mortality.ConclusionAdvanced age and an extremely low LVEF, but neither the presence of atrial fibrillation nor implanting an additional high voltage lead, influence the all‐cause mortality in patients after long‐term RVP, when upgraded to CRT.
The enigma and challenges of vitiligo pathophysiology and treatment
Authors: Abdel‐Malek Zalfa A. , Jordan Christian , Ho Tina , Upadhyay Parth Rajendrakumar , Fleischer Alan , Hamzavi Iltefat 
Published: March 2020

AbstractVitiligo is the most common acquired pigmentary disorder, which afflicts 0.5%–1% of the world population, and is characterized by depigmented skin patches resulting from melanocyte loss. Vitiligo has a complex etiology and varies in its manifestations, progression, and response to treatment. It presents as an autoimmune disease, evidenced by circulating melanocyte‐specific antibodies, and association with other autoimmune diseases. However, autoimmunity may be secondary to the high oxidative stress in vitiligo skin and to intrinsic defects in melanocytes and their microenvironment, which contribute to aberrant stress response, neo‐antigenicity, and susceptibility of melanocytes to immune attack and apoptosis. There is also a genetic predisposition to vitiligo, which sensitizes melanocytes to environmental agents, such as phenolic compounds. Currently, there are different treatment modalities for re‐pigmenting vitiligo skin. However, when repigmentation is achieved, the major challenge is maintaining the pigmentation, which is lost in 40% of cases. In this review, we present an overview of the clinical aspects of vitiligo, its pathophysiology, the intrinsic defects in melanocytes and their microenvironment, and treatment strategies. Based on lessons from the biology of human melanocytes, we present our perspective of how repigmentation of vitiligo skin can be achieved and sustained.
Caterpillar dermatitis: A brief report
Authors: Jadoo Arvin S. , Treat James R. 
Published: March 2020

AbstractA 3 year‐old boy presented to our clinic with a 3‐day history of itchy rash involving the face and limbs and recent contact with a caterpillar. A diagnosis of caterpillar dermatitis was suspected. This condition has rarely been reported and may be underestimated in the pediatric population who may suffer more systemic symptoms associated with caterpillar contact.
Methylisothiazolinone in children’s nail polish
Authors: Kullberg Sara A. , Gupta Rachit , Warshaw Erin M. 
Published: March 2020

AbstractIsothiazolinones, preservatives including methylisothiazolinone (MI), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), benzisothiazolinone (BIT), and octylisothiazolinone (OIT), are notorious contact allergens. Pediatric dermatologists are familiar with these preservatives in personal care products, homemade slime recipes, and wet wipes. We present a novel source of MI declared in nail polish marketed to children.