bluuebunny/crossref_metadata_2025_split huggingface dataset:
“On the Border of Old Age”: An Entangled History of Eldercare in East Germany
Authors: Chappel James 
Published: May 2020

ABSTRACTHistorical research has turned in the last years more intensively toward entangled and transnational histories of biopolitics, the family, and the welfare state, but without renewed interest in aging and pension policy, a sphere of human experience that is often interrogated in parochial terms, if at all. An analysis of the culture and policies of old age in East Germany in the 1950s and 1960s shows the importance of a transnational history of this subject. The GDR, the Communist state with the greatest proportion of elderly citizens, needed to create a socialist model of aging. Neither the Communist tradition in Weimar Germany, nor the experience of the other states in the Communist bloc provided substantial guidance. East Germans looked instead for inspiration to West Germany, which was itself engaged in a debate about aging and pension policy. By grappling with the Western experience, including its perceived and real limitations, the GDR in the Ulbricht developed a vision of what it meant to age as a socialist.
Characteristics of disease progress in patients with coronavirus disease 2019 in Wuhan, China
Authors: Ji Mengyao , Yuan Lei , Shen Wei , Lv Junwei , Li Yong , Li Ming , Lu Xuefang , Hu Lanhua , Dong Weiguo 
Published: May 2020

Abstract
Coronavirus disease 2019 (COVID-19) patients were classified into four clinical stages (uncomplicated illness, mild, severe and critical pneumonia) depending on disease severity. We aim to investigate the corresponding clinical, radiological and laboratory characteristics between different clinical stages. A retrospective, single-centre study of 101 confirmed patients with COVID-19 at Renmin Hospital of Wuhan University from 2 January to 28 January 2020 was enrolled; follow-up endpoint was on 8 February 2020. Clinical data were collected and compared during the course of illness. The median age of the 101 patients was 51.0 years and 33.6% were medical staff. Fever (68%), cough (50%) and fatigue (23%) are the most common symptoms. About 26% patients underwent the mechanical ventilation and 98% patients were treated with antibiotics. Thirty-seven per cent patients were cured and 11 died. On admission, the number of patients with uncomplicated illness, mild, severe and critical pneumonia were 2 [2%], 86 [85%], 11 [11%] and 2 [2%]. Forty-four of the 86 mild pneumonia progressed to severe illness within 4 days, with nine patients worsened due to critical pneumonia within 4 days. Two of the 11 severe patients improved to mild condition while three others deteriorated. Significant differences were observed among groups of different clinical stages in numbers of influenced pulmonary segments (6 vs. 12 vs. 17, P < 0.001). A significantly upward trend was witnessed in ground-glass opacities overlapped with striped shadows (33% vs. 42% vs. 55% vs. 80%, P < 0.001), while pure ground-glass opacities gradually decreased as disease progressed (45% vs. 35% vs. 24% vs. 13%, P < 0.001) within 12 days. Lymphocytes, prealbumin and albumin showed a downtrend as disease progressed from mild to severe or critical condition, an uptrend was found in white blood cells, C-reactive protein, neutrophils and lactate dehydrogenase. The proportions of serum amyloid A > 300 mg/l in mild, severe and critical conditions were 18%, 46% and 71%, respectively.
Kawasaki disease with tsutsugamushi disease: two case reports
Authors: Hwang Hye Su , Kim Ye Jin , Song Min Seob 
Published: May 2020

AbstractA number of microorganisms were hypothesised as an aetiology of the Kawasaki disease. Unfortunately, no specific agent that provides reproducible evidence has yet been reported. We report two cases of extremely rare Kawasaki disease with tsutsugamushi disease. These case reports suggest that Kawasaki disease can rarely occur concurrently or immediately after a rickettsial illness such as tsutsugamushi disease.
Overcoming challenges in delivering integrated motivational interviewing and cognitive behavioural therapy for bipolar disorder with co-morbid alcohol use: therapist perspectives
Authors: Berry Katherine , Barrowclough Christine , Fitsimmons Mike , Hartwell Rosalyn , Hilton Claire , Riste Lisa , Wilson Ian , Jones Steven 
Published: May 2020

AbstractBackground:Alcohol misuse is common in bipolar disorder and is associated with worse outcomes. A recent study evaluated integrated motivational interviewing and cognitive behavioural therapy for bipolar disorder and alcohol misuse with promising results in terms of the feasibility of delivering the therapy and the acceptability to participants.Aims:Here we present the experiences of the therapists and supervisors from the trial to identify the key challenges in working with this client group and how these might be overcome.Method:Four therapists and two supervisors participated in a focus group. Topic guides for the group were informed by a summary of challenges and obstacles that each therapist had completed at the end of therapy for each individual client. The audio recording of the focus group was transcribed and data were analysed using thematic analysis.Results:We identified five themes: addressing alcohol use versus other problems; impact of bipolar disorder on therapy; importance of avoidance and overcoming it; fine balance in relation to shame and normalising use; and ‘talking the talk’ versus ‘walking the walk’.Conclusions:Findings suggest that clients may be willing to explore motivations for using alcohol even if they are not ready to change their drinking, and they may want help with a range of mental health problems. Emotional and behavioural avoidance may be a key factor in maintaining alcohol use in this client group and therapists should be aware of a possible discrepancy between clients’ intentions to reduce misuse and their actual behaviour.
Disarmed principals: institutional resilience and the non-enforcement of delegation
Authors: Weiss Moritz , Heinkelmann-Wild Tim 
Published: May 2020

AbstractGovernments across the world increasingly rely on non-state agents for managing even the most sensitive tasks that range from running critical infrastructures to protecting citizens. While private agents frequently underperform, governments as principals tend nonethelessnotto enforce delegation contracts. Why? We suggest the mechanism of institutional resilience. A preexisting set of rules shapes non-enforcement through the combination of (i) itsstructural misfitwith the delegation contract and (ii)asymmetric interdependencethat favors the agent over time. To demonstrate the plausibility of our argument, we trace the political process behind Europe’s largest military transport aircraft, the A400M. Governments delegated the development and production of this complex program to a private firm, Airbus. They layered a ‘commercial approach’ onto traditionally state-run defense industries. Yet, resilience caused these new formal rules to fail and eventually disarmed principals. Our mechanism constitutes an innovative approach by theorizing an alternative path toward dynamic continuity.
Effect of antidepressants for cessation therapy in betel-quid use disorder: a randomised, double-blind, placebo-controlled trial
Authors: Hung Chung-Chieh , Lee Chien-Hung , Ko Albert Min-Shan , Lane Hsien-Yuan , Lee Chi-Pin , Ko Ying-Chin 
Published: May 2020

Abstract

Aims
More than one-half of betel-quid (BQ) chewers have betel-quid use disorder (BUD). However, no medication has been approved. We performed a randomised clinical trial to test the efficacy of taking escitalopram and moclobemide antidepressants on betel-quid chewing cessation (BQ-CC) treatment.

Methods
We enrolled 111 eligible male BUD patients. They were double-blinded, placebo-controlled and randomised into three treatment groups: escitalopram 10 mg/tab daily, moclobemide 150 mg/tab daily and placebo. Patients were followed-up every 2 weeks and the length of the trial was 8 weeks. The primary outcome was BQ-CC, defined as BUD patients who continuously stopped BQ use for ⩾6 weeks. The secondary outcomes were the frequency and amount of BQ intake, and two psychological rating scales. Several clinical adverse effects were measured during the 8-week treatment.

Results
Intention-to-treat analysis shows that after 8 weeks, two (5.4%), 13 (34.2%) and 12 (33.3%) of BUD patients continuously quit BQ chewing for ⩾6 weeks among placebo, escitalopram, moclobemide groups, respectively. The adjusted proportion ratio of BQ-CC was 6.3 (95% CI 1.5–26.1) and 6.8 (95% CI 1.6–28.0) for BUD patients who used escitalopram and moclobemide, respectively, as compared with those who used placebo. BUD patients with escitalopram and moclobemide treatments both exhibited a significantly lower frequency and amount of BQ intake at the 8th week than those with placebo.

Conclusions
Prescribing a fixed dose of moclobemide and escitalopram to BUD patients over 8 weeks demonstrated treatment benefits to BQ-CC. Given a relatively small sample, this study provides preliminary evidence and requires replication in larger trials.
Poor implementation of the EU clinical trial regulation is a major threat for pragmatic trials in European countries
Authors: Ostuzzi Giovanni , Gastaldon Chiara , Petrini Carlo , Godman Brian , Barbui Corrado 
Published: May 2020

Abstract
The principle of pragmatism in clinical trials has been broadly recognised as a way to close the gap between research and practice. In this contribution, we argue that the conduct of pragmatic clinical trials in Europe may be hampered by poor implementation of current European Union's Clinical Trial Regulation No. 536/2014.
The Quasipersistent Feature of Highly Structured Field‐Aligned Currents in the Duskside Auroral Oval: Conjugate Observation Via Swarm Satellites and a Ground All‐Sky Imager
Authors: Yokoyama Y. , Taguchi S. , Iyemori T. , Hosokawa K. 
Published: May 2020

AbstractDuring northward interplanetary magnetic field (IMF), irregular magnetic perturbations were observed in the duskside aurora oval via Swarm satellites instead of large‐scale Region 1/2 magnetic perturbations. By taking advantage of Swarm constellation measurements, and their conjugate observations with an all‐sky imager on the ground, the features of the irregular magnetic perturbations were examined. Detailed analysis of the data from Swarm A and Swarm C for two events demonstrated that the irregular magnetic perturbations are a result of highly structured quasistatic field‐aligned currents (FACs), not dynamic Alfvén waves. The typical latitudinal size of the upward FACs is 20–30 km. In each region of the upward FACs, 630‐nm aurora emissions are relatively strong, indicating that the energy flux of precipitating electrons having energies of a few hundred electron volts is high in each of the upward FAC regions. The enhanced mesoscale auroras continued to exist for at least approximately 30 min. These indicate that the mesoscale FAC structures also have quasipersistent features. The precipitating particle data from the Defense Meteorological Satellite Program satellite, which passed through the field of view of the all‐sky imager, indicate that the source of the precipitating particles is the duskside low‐latitude boundary layer (LLBL). We suggest that the highly structured quasipersistent FACs flow along the magnetic field lines connected to the duskside LLBL where cold dense ions exist. The highly structured FACs in the duskside aurora oval are the phenomena that are pertinent to the magnetosphere for a northward IMF condition, not a simple remnant of the typical Region 1.
A Case Study of the Enhancements in Ionospheric Electron Density and Its Longitudinal Gradient at Chinese Low Latitudes
Authors: Liu Libo , Ding Zonghua , Zhang Ruilong , Chen Yiding , Le Huijun , Zhang Hui , Li Guozhu , Wu Jian , Wan Weixing 
Published: May 2020

AbstractThe day‐to‐day variability of the ionospheric electron density and its longitudinal gradient challenges our description and understanding of the ionosphere, which is also essential for reliable applications of the Global Navigation Satellite System (GNSS). In this paper we conduct a case study of the anomalous enhancements in ionospheric electron density and its longitudinal gradient to reveal the spatial extent and related drivers of the enhancements. The ionospheric data analyzed include the vertical total electron content (TEC) by the Global Navigation Satellite System receivers, peak electron density (NmF2) and height (hmF2) of the F layer by a chain of ionosondes, and electron density profiles recorded by the Qujing incoherent scatter radar (103.8°E, 25.6°N) during the period from 29 May to 2 June 2015. Electron density enhancements are found in the region around the northern crest of equatorial ionization anomaly on the first 2 days of June 2015. It is the first time to report that, during the anomalous enhancement, the increase in electron density over Qujing depends on altitude, being stronger at higher altitudes. Further, there are strong longitudinal gradients in vertical TEC in the regions during the course of the electron density enhancements. Low latitude hmF2 and especially the equatorial electrojet become much larger on the enhancement days, implying the important role of equatorial zonal electric fields in the formation of the electron density enhancements at low latitudes.
Revisited Reference Solar Proton Event of 23 February 1956: Assessment of the Cosmogenic‐Isotope Method Sensitivity to Extreme Solar Events
Authors: Usoskin Ilya G. , Koldobskiy Sergey A. , Kovaltsov Gennady A. , Rozanov Eugene V. , Sukhodolov Timofei V. , Mishev Alexander L. , Mironova Irina A. 
Published: May 2020

AbstractOur direct knowledge of solar eruptive events is limited to several decades and does not include extreme events, which can only be studied by the indirect proxy method over millennia, or by a large number of Sun‐like stars. There is a gap, spanning 1–2 orders of magnitude, in the strength of events between directly observed and reconstructed ones. Here, we study the proxy method sensitivity to identify extreme solar particle events (SPEs). First, the strongest directly observed SPE (23 February 1956), used as a reference for proxy‐based reconstructions, was revisited using the newly developed method. Next, sensitivity of the cosmogenic‐isotope method to detect a reference SPE was assessed against the precision and number of individual isotopic records, showing that it is too weak by a factor ≈30 to be reliably identified in a single record. Uncertainties of 10Be and 14C data are shown to be dominated by local/regional patterns and measurement errors, respectively. By combining several proxy records, a SPE 4–5 times stronger than the reference one can be potentially detected, increasing the present‐day sensitivity by an order of magnitude. This will allow filling the observational gap in SPE strength distribution, thus enriching statistics of extreme events from 3–4 presently known ones to several tens. This will provide a solid basis for research in the field of extreme events, both for fundamental science, namely solar and stellar physics, and practical applications, such as the risk assessments of severe space‐based hazards for modern technological society.
The role of bone marrow biopsy in patients with plasma cell disorders: should all patients with a monoclonal protein be biopsied?
Authors: Sidiqi M. Hasib , Aljama Mohammed , Kumar Shaji K. , Jevremovic Dragan , Buadi Francis K. , Warsame Rahma , Lacy Martha Q. , Dingli David , Gonsalves Wilson I. , Fonder Amie L. , Hobbs Miriam A. , Hwa Yi Lisa , Kapoor Prashant , Kourelis Taxiarchis , Leung Nelson , Muchtar Eli , Lust John A. , Kyle Robert A. , Go Ronald S. , Rajkumar Vincent S. , Gertz Morie A. , Dispenzieri Angela 
Published: May 2020

AbstractWe conducted a retrospective review of multiple myeloma (MM), smoldering multiple myeloma (SMM), and monoclonal gammopathy of undetermined significance (MGUS) patients seen at Mayo Clinic to determine whether a bone marrow biopsy (BM) is necessary in all patients diagnosed with a monoclonal protein. A total of 2254 MM, 397 SMM, and 5836 MGUS patients were included in the study. A total of 29 (1.3%) MM patients “without CRAB/FLC” were identified where BM or advanced imaging was critical for diagnosis, 8 (0.3% MM cohort) of whom were diagnosed with MM solely on BM findings (plasma cells > 60%). Without BM or advanced imaging none of these patients would be classified low-risk MGUS. A total of 314 (79%) MGUS-like SMM patients were identified where classification of SMM was based on BM findings. Without BM 97 would be classified as low/low-intermediate-risk MGUS and 151 intermediate or high-risk MGUS; 66 had missing information precluding classification. Only three (<1% SMM cohort) were low-risk MGUS without abnormalities in hemoglobin, calcium, and renal function. In patients presenting with low-risk MGUS and normal hemoglobin, calcium, and renal function, the risk of missing a diagnosis of SMM and MM by omitting BM is <1%. BM should be deferred in these patients in preference to clinical and laboratory monitoring.
Innate lymphoid cells control signaling circuits to regulate tissue-specific immunity
Authors: Klose Christoph S. N. , Artis David 
Published: May 2020

AbstractThe multifaceted organization of the immune system involves not only patrolling lymphocytes that constantly monitor antigen-presenting cells in secondary lymphoid organs but also immune cells that establish permanent tissue-residency. The integration in the respective tissue and the adaption to the organ milieu enable tissue-resident cells to establish signaling circuits with parenchymal cells to coordinate immune responses and maintain tissue homeostasis. Innate lymphoid cells (ILCs) are tissue-resident innate immune cells that have a similar functional diversity to T cells including lineage-specifying transcription factors that drive certain effector programs. Since their formal discovery 10 years ago, it has become clear that ILCs are present in almost every tissue but strongly enriched at barrier surfaces, where they regulate immunity to infection, chronic inflammation, and tissue maintenance. In this context, recent research has identified ILCs as key in orchestrating tissue homeostasis through their ability to sustain bidirectional interactions with epithelial cells, neurons, stromal cells, adipocytes, and many other tissue-resident cells. In this review, we provide a comprehensive discussion of recent studies that define the development and heterogeneity of ILC populations and their impact on innate and adaptive immunity. Further, we discuss emerging research on the influence of the nervous system, circadian rhythm, and developmental plasticity on ILC function. Uncovering the signaling circuits that control development and function of ILCs will provide an integrated view on how immune responses in tissues are synchronized with functional relevance far beyond the classical view of the role of the immune system in discrimination between self/non-self and host defense.
The role of calcium in regulating marine phosphorus burial and atmospheric oxygenation
Authors: Zhao Mingyu , Zhang Shuang , Tarhan Lidya G. , Reinhard Christopher T. , Planavsky Noah 
Published: May 2020

AbstractThe marine phosphorus cycle plays a critical role in controlling the extent of global primary productivity and thus atmospheric pO2 on geologic time scales. However, previous attempts to model carbon–phosphorus-oxygen feedbacks have neglected key parameters that could shape the global P cycle. Here we present new diagenetic models to fully parameterize marine P burial. We have also coupled this diagenetic framework to a global carbon cycle model. We find that seawater calcium concentration, by strongly influencing carbonate fluorapatite (CFA) formation, is a key factor controlling global phosphorus cycling, and therefore plays a critical role in shaping the global oxygen cycle. A compilation of Cenozoic deep-sea sedimentary phosphorus speciation data provides empirical support for the idea that CFA formation is strongly influenced by marine Ca concentrations. Therefore, we propose a previously overlooked coupling between Phanerozoic tectonic cycles, the major-element composition of seawater, the marine phosphorus cycle, and atmospheric pO2.
Symptom-based screening tool for asthma syndrome among young children in Uganda
Authors: Nantanda Rebecca , Siersma Volkert , Ndeezi Grace , Tumwine James K. , Østergaard Marianne S. 
Published: May 2020

AbstractUnder-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensus diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
The Lipocalin2 Gene is Regulated in Mammary Epithelial Cells by NFκB and C/EBP In Response to Mycoplasma
Authors: Zhao Wei , Bendickson Lee , Nilsen-Hamilton Marit 
Published: May 2020

AbstractLcn2 gene expression increases in response to cell stress signals, particularly in cells involved in the innate immune response. Human Lcn2 (NGAL) is increased in the blood and tissues in response to many stressors including microbial infection and in response to LPS in myeloid and epithelial cells. Here we extend the microbial activators of Lcn2 to mycoplasma and describe studies in which the mechanism of Lcn2 gene regulation by MALP-2 and mycoplasma infection was investigated in mouse mammary epithelial cells. As for the LPS response of myeloid cells, Lcn2 expression in epithelial cells is preceded by increased TNFα, IL-6 and IκBζ expression and selective reduction of IκBζ reduces Lcn2 promoter activity. Lcn2 promoter activation remains elevated well beyond the period of exposure to MALP-2 and is persistently elevated in mycoplasma infected cells. Activation of either the human or the mouse Lcn2 promoter requires both NFκB and C/EBP for activation. Thus, Lcn2 is strongly and enduringly activated by mycoplasma components that stimulate the innate immune response with the same basic regulatory mechanism for the human and mouse genes.