bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global pattern and drivers of nitrogen saturation threshold of grassland productivity
Authors: Peng Yunfeng , Chen Han Y. H. , Yang Yuanhe 
Published: June 2020

Abstract

Ecosystem productivity usually exhibits first increase and then saturated response to increasing nitrogen (N) additions, yet the broad‐scale pattern and potential drivers of the N saturation threshold are little investigated.

By synthesizing N addition experiments with at least four N‐input levels from the global grasslands, we applied the quadratic‐plus‐plateau model to fit the above‐ground net primary productivity (ANPP)–N rate relationship, and estimated the saturation threshold for N rate (critical N rate, NCR) and ANPP (maximum ANPP, ANPPmax) from the inflection point where ANPP no longer statistically increased with N rate for individual experiments. Based on these estimations, we investigated the spatial pattern and driving factors of NCR and ANPPmax.

The mean NCR and ANPPmax were 15.0 and 477.0 g m−2 year−1, respectively, but varied substantially among single‐site experiments. Management strategies (e.g. biomass harvest, different N forms and addition frequencies) minimally influenced both parameters. Structural equation models demonstrated that the spatial differences in NCR and ANPPmax were mainly explained by aridity index, and soil carbon (C)/N ratio also predicted the variation in NCR.

Given that grasslands are important not only for the trend and variability of the land C sink but also for the maintenance of pasture yield, the pattern and controls of NCR and ANPPmax, as revealed by the current study, are crucial for constructing robust predictions of C sink capacity and improving N fertilizer management in grasslands.
Age‐dependent plasticity in reproductive investment, regeneration capacity and survival in a partially clonal animal (Hydra oligactis)
Authors: Sebestyén Flóra , Miklós Máté , Iván Katalin , Tökölyi Jácint 
Published: June 2020

Abstract

Asexual reproduction diversifies life‐history priorities and is associated with unusual reproduction and somatic maintenance patterns, such as constant fertility with age, extensive regeneration ability and negligible senescence. While age‐dependent plasticity in relative allocation to sexual versus asexual reproductive modes is relatively well studied, the modulation of somatic maintenance traits in parallel with age‐dependent reproduction is much less well understood in clonal or partially clonal animals.

Here, we asked how age‐dependent investment into sexual and asexual reproduction co‐varies with somatic maintenance such as regeneration in a partially clonal freshwater cnidarian Hydra oligactis, a species with remarkable regeneration abilities and experimentally inducible sex.

We induced gametogenesis by lowering temperature at two ages, 1 or 4 weeks after detachment from an asexual parent, in animals of a male and a female clone. Then we measured phenotypically asexual and sexual reproductive traits (budding rate, start day and number of sexual organs) together with head regeneration rate, survival and the cellular background of these traits (number of reproductive and interstitial stem cells) for 2 or 5 months.

Younger animals had higher asexual reproduction while individuals in the older group had more intensive gametogenesis and reproductive cell production. In parallel with these age‐dependent reproductive differences, somatic maintenance of older individuals was also impacted: head regeneration, survival and interstitial stem cell numbers were reduced compared to younger polyps. Some of the traits investigated showed an ontogenetic effect, suggesting that age‐dependent plasticity and a fixed ontogenetic response might both contribute to differences between age groups.

We show that in H. oligactis asexual reproduction coupled with higher somatic maintenance is prioritized earlier in life, while sexual reproduction with higher maintenance costs occurs later if sex is induced. These findings confirm general life‐history theory predictions on resource allocation between somatic maintenance and sexual reproduction applying in a partially clonal species. At the same time, our study also highlights the age‐dependent integration of these resource allocation decisions with sexual/asexual strategies. Accounting for age‐related differences might enhance repeatability of research done with clonal individuals derived from mass cultures.
Japanese‐brand auto sales in China under the shadow of oppositional sentiments
Authors: Chen Zhao , Du Julan , Yang Hongli 
Published: June 2020

AbstractThis study uses the interstate political conflict in 2010 to study the impacts of oppositional sentiment on product sales of Japanese‐brand automobiles in China. By using the nationwide automobile registration data in China, we conduct difference‐in‐differences analysis and find direct evidence on Chinese consumers’ boycott of Japanese‐brand autos. It is individual buyers rather than business or government entity buyers that boycotted Japanese cars significantly. War memory, nationalist education, and protests contributed to the intensity of boycott activities, and the boycott effect was long‐lasting. Older‐generation buyers boycotted Japanese cars more significantly, but younger‐generation buyers living in cities with historical war experience or patriotic education bases boycotted Japanese cars more actively than their counterparts in other cities.
Fatigue and associated factors in a multi‐ethnic cohort of rheumatoid arthritis patients
Authors: Lee Hwai Jien , Pok Lydia Say Lee , Ng Choung Min , Yahya Fariz , Sockalingam Sargunan , Tee Ying Chew , Raja Jasmin 
Published: June 2020

AbstractIntroductionFatigue is an important yet infrequently evaluated component in patients with rheumatoid arthritis (RA) and may have a major impact on quality of life.ObjectivesTo evaluate fatigue, identify factors associated with fatigue and assess the effect of fatigue on health‐related quality of life (HRQoL) in a multi‐ethnic cohort of RA patients.MethodsA cross‐sectional study was performed in patients who fulfilled European League Against Rheumatism/ American College of Rheumatology 2010 criteria for RA. Functional Assessment of Chronic Illness Therapy ‐ Fatigue (FACIT‐F) questionnaire was used to assess fatigue. Potential factors for fatigue were categorized into RA‐related (gender, seropositivity [rheumatoid factor and/or anti‐citrullinated protein antibody], disease duration, visual analog scale pain score, Disease Activity Score of 28 joints – erythrocyte sedimentation rate [DAS28‐ESR], ESR, hemoglobin level, functional disability [Health Assessment Questionnaire ‐ Disability Index, HAQ‐DI score], EQ‐5D‐3L, concomitant prednisolone use and number of conventional synthetic disease‐modifying anti‐rheumatic drugs [csDMARDs] used) and non‐RA‐related (age, body mass index, ethnicity and number of co‐morbidities).ResultsA total of 214 patients (86.9% female) were included; the median age was 62 (25‐91) years and 67.3% were seropositive. Seventy‐six (33.5%) patients had moderate disease activity, 12 (5.6%) had high disease activity and 152 (71%) patients had mild difficulties to moderate disability HAQ‐DI scores. Median of total FACIT‐F score was 113.2 (36.3‐160.0). Joint factors of younger age, longer disease duration, higher HAQ score (increased functional disability), and lower EQ‐5D (poorer HRQoL) were significantly associated with higher levels of fatigue (all P < .02).ConclusionFatigue was associated with functional disability and has a significant impact on HRQoL in RA. Fatigue assessment should be considered in routine clinical practice for RA patients.
Automated Retrospective Calculation of the EDACS and HEART Scores in a Multicenter Prospective Cohort of Emergency Department Chest Pain Patients
Authors: Mark Dustin G. , Huang Jie , Kene Mamata V. , Sax Dana R. , Cotton Dale M. , Lin James S. , Bouvet Sean C. , Chettipally Uli K. , Anderson Megan L. , McLachlan Ian D. , Simon Laura E. , Shan Judy , Rauchwerger Adina S. , Vinson David R. , Ballard Dustin W. , Reed Mary E. ,   for the Kaiser Permanente CREST Network Investigators
Published: June 2020

AbstractObjectivesCoronary risk scores are commonly applied to emergency department patients with undifferentiated chest pain. Two prominent risk score–based protocols are the Emergency Department Assessment of Chest pain Score Accelerated Diagnostic Protocol (EDACS‐ADP) and the History, ECG, Age, Risk factors, and Troponin (HEART) pathway. Since prospective documentation of these risk determinations can be challenging to obtain, quality improvement projects could benefit from automated retrospective risk score classification methodologies.MethodsEDACS‐ADP and HEART pathway data elements were prospectively collected using a Web‐based electronic clinical decision support (eCDS) tool over a 24‐month period (2018–2019) among patients presenting with chest pain to 13 EDs within an integrated health system. Data elements were also extracted and processed electronically (retrospectively) from the electronic health record (EHR) for the same patients. The primary outcome was agreement between the prospective/eCDS and retrospective/EHR data sets on dichotomous risk protocol classification, as assessed by kappa statistics (ĸ).ResultsThere were 12,110 eligible eCDS uses during the study period, of which 66 and 47% were low‐risk encounters by EDACS‐ADP and HEART pathway, respectively. Agreement on low‐risk status was acceptable for EDACS‐ADP (ĸ = 0.73, 95% confidence interval [CI] = 0.72 to 0.75) and HEART pathway (ĸ = 0.69, 95% CI = 0.68 to 0.70) and for the continuous scores (interclass correlation coefficients = 0.87 and 0.84 for EDACS and HEART, respectively).ConclusionsAutomated retrospective determination of low risk status by either the EDACS‐ADP or the HEART pathway provides acceptable agreement compared to prospective score calculations, providing a feasible risk adjustment option for use in large data set analyses.
What makes community‐based physical activity programs for culturally and linguistically diverse older adults effective? A systematic review
Authors: Montayre Jed , Neville Stephen , Dunn Ihaka , Shrestha‐Ranjit Jagamaya , Wright‐St. Clair Valerie 
Published: June 2020

AbstractObjectiveThis integrative review aimed to determine the features of effective physical activity programs for culturally and linguistically diverse (CALD) older adults.MethodsWe searched for relevant articles in MEDLINE, PubMed, Google Scholar, Scopus and CINAHL. Articles were selected for evaluation if they included CALD older adults and implemented physical activity programs with culturally specific design features. Consistent with the Whittemore and Knafl integrative review methodology, we used the Downs and Black Checklist, Mixed Methods Appraisal Tool and the McMaster University appraisal tool for quantitative studies to assess the quality of included articles.ResultsSeven articles were included in this review. Effective community‐based exercise or physical activity programs for CALD populations commonly featured close‐to‐home delivery, native language instruction and adaptations of culturally familiar activities.ConclusionThe provision of culturally appropriate community‐based physical activity programs appears to support and encourage engagement among CALD older adults.
Juvenile gangrenous vasculitis of the scrotum: A rare cause of genital ulcer
Authors: Marcos‐Pinto Ana , Lemos Almeida João , Soares‐de‐Almeida Luís , Filipe Paulo 
Published: June 2020

AbstractJuvenile gangrenous vasculitis of the scrotum is a rare entity of unknown aetiology which should be considered in the differential diagnosis of genital ulcers, mainly with those caused by sexually transmitted infections. The authors report a case of a 23‐year‐old patient who presented a single painful scrotal ulcer developing shortly after an episode of pharyngotonsillitis. The ulcer was treated with oral corticosteroids with total healing and no relapse in over two years of follow‐up.
Labor Unions and White Racial Politics
Authors: Frymer Paul , Grumbach Jacob M. 
Published: June 2020

AbstractScholars and political observers point to declining labor unions, on the one hand, and rising white identity politics, on the other, as profound changes in American politics. However, there has been little attention given to the potential feedback between these forces. In this article, we investigate the role of union membership in shaping white racial attitudes. We draw upon research in history and American political development to generate a theory of interracial labor politics, in which union membership reduces racial resentment. Cross‐sectional analyses consistently show that white union members have lower racial resentment and greater support for policies that benefit African Americans. More importantly, our panel analysis suggests that gaining union membership between 2010 and 2016 reduced racial resentment among white workers. The findings highlight the important role of labor unions in mass politics and, more broadly, the importance of organizational membership for political attitudes and behavior.
Clinical assessment for high‐risk patients with non‐alcoholic fatty liver disease in primary care and diabetology practices
Authors: Younossi Zobair M. , Corey Kathleen E. , Alkhouri Naim , Noureddin Mazen , Jacobson Ira , Lam Brian , Clement Stephen , Basu Rita , Gordon Stuart C. , Ravendhra Natarajan , Puri Puneet , Rinella Mary , Scudera Peter , Singal Ashwani K. , Henry Linda ,   the US Members of the Global Nash Council
Published: June 2020

SummaryBackgroundPrimary care practitioners (PCPs) and diabetologists are at the frontline of potentially encountering patients with NASH. Identification of those at high risk for adverse outcomes is important.AimTo provide practical guidance to providers on how to identify these patients and link them to specialty care.MethodsUS members of the Global Council on NASH evaluated the evidence about NASH and non‐invasive tests and developed a simple algorithm to identify high‐risk NASH patients for diabetologists and primary care providers. These tools can assist frontline providers in decision‐making and referral to gastroenterology/hepatology practices for additional assessments.ResultsThe presence of NASH‐related advanced fibrosis is an independent predictor of adverse outcomes. These patients with NASH are considered high risk and referral to specialists is warranted. Given that staging of fibrosis requires a liver biopsy, non‐invasive tests for fibrosis would be preferred. Consensus recommendation from the group is to risk‐stratify patients based on metabolic risk factors using the FIB‐4 as the initial non‐invasive test due to its simplicity and ease of use. A FIB‐4 score ≥1.3 can be used for further assessment and linkage to specialty care where additional technology to assess liver stiffness or serum fibrosis test will be available.ConclusionDue to the growing burden of NAFLD and NASH, PCPs and diabetologists are faced with increased patient encounters in their clinical practices necessitating referral decisions. To assist in identifying high‐risk NASH patients requiring specialty care, we provide a simple and easy to use algorithm.
Sex disparities in presentation and prognosis of 1110 patients with hepatocellular carcinoma
Authors: Rich Nicole E. , Murphy Caitlin C. , Yopp Adam C. , Tiro Jasmin , Marrero Jorge A. , Singal Amit G. 
Published: June 2020

SummaryBackgroundAlthough sex disparities in hepatocellular carcinoma (HCC) incidence have been well described, there are limited data examining sex disparities in HCC prognosis.AimTo characterise sex differences in HCC presentation and prognosis.MethodsWe performed a retrospective study of consecutive patients (n = 1110, 23.5% women) diagnosed with HCC between 2008 and 2017 at two US health systems. We used Cox proportional hazard and multivariable logistic regression models to identify factors associated with overall survival, early tumour detection and response to HCC treatment (per the modified Response Evaluation Criteria in Solid Tumors [mRECIST] criteria).ResultsWomen were older at HCC diagnosis (mean 62.5 vs 59.2 years, P < 0.001) and had a higher proportion of early‐stage tumours (53.1% vs 43.7% Barcelona Clinic Liver Cancer [BCLC] stage 0/A, P = 0.04), but similar liver function compared to men (49.2% vs 47.1% Child Pugh A, P = 0.27). In univariable analysis, women had significantly better overall survival than men (median 17.1 vs 12.0 months, P = 0.02). When stratified by age, younger (<65 years) women had better overall survival than men (18.3 vs 11.2 months, P = 0.02); however, older (≥65 years) women and men had similar overall survival (15.5 vs 15.7 months, P = 0.45). In multivariable analysis, female sex was independently associated with lower mortality after adjusting for age, race/ethnicity, alpha‐fetoprotein, BCLC stage, Albumin‐Bilirubin grade and Child Pugh score (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.68‐0.98). In secondary analyses, female sex was independently associated with early tumour detection (odds ratio [OR] 1.46, 95% CI 1.05‐2.02) and response to first HCC treatment (OR 1.72, 95% CI 1.18‐2.53) after adjusting for the same covariates.ConclusionIn a large cohort of patients with HCC, women had significantly better prognosis than men.
Candidates registered for reasonable adjustments underperform compared to other candidates in the national undergraduate Prescribing Safety Assessment: Retrospective cohort analysis (2014–2018)
Authors: Hutchinson Kate , Ricketts William M. , Maxwell Simon , Ng Fu Liang 
Published: June 2020

AimsCandidates with disabilities are eligible for reasonable adjustments (RA) while undertaking the national Prescribing Safety Assessment (PSA). The PSA is a novel open‐book, time‐constrained, multiformat assessment that may pose challenges to candidates with dyslexia and other disabilities.MethodsRetrospective cohort analysis of 36 140 UK candidates undertaking first‐sitting of the PSA (2014–2018).ResultsOf the 36 140 candidates, 9.1% (3284) were registered for RA. The RA group had lower pass rates (absolute difference 1.94%, 95% confidence interval 1.01–2.87%; P < .001) and assessment scores (1.16 percentage marks, 95% confidence interval 0.83–1.48; P < .001) compared with the non‐RA group. This absolute difference is small relative to overall variability. This difference persists after adjusting for confounding factors (medical school and paper), and was present for all 8 different question types. The attainment gap within each medical school is negatively correlated with the school's overall performance, both in terms of pass rate (P < .001) and scores (P = .01). The RA group were also less likely to perceive the PSA as an appropriate test, having easy to follow layout/presentation or clear/unambiguous questions, even after adjusting for candidate performance.ConclusionThis analysis identifies slight differences in academic performance of candidates requiring RA in a national undergraduate assessment. The study is limited by the unavailability of data on ethnicity, sex, age, diagnosis and time of diagnosis. While further research is required to determine the cause of the attainment gap, this study emphasises the need to maintain a careful review on the fairness and validity of all aspects of the assessment.
The role of novel minimally invasive treatments for lower urinary tract symptoms associated with benign prostatic hyperplasia
Authors: Madersbacher Stephan , Roehrborn Claus G. , Oelke Matthias 
Published: June 2020

ObjectivesTo provide an update on novel minimally invasive lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) treatments in a non‐systematic review. To define potential target populations for the various new minimally invasive treatments.MethodsRecent literature, meta‐analyses and guideline recommendations for aquablation (AquaBeam®; PROCEPT BioRobotics, Redwood City, CA, USA), water vapour thermal therapy (Rezūm®; Boston Scientific, Natick, MA, USA), prostate artery embolisation (PAE), prostatic urethral lift (UroLift®; NeoTract‐Teleflex, Pleasanton, CA, USA) and the temporary implantable nitinol device [i‐TIND® (nitinol butterfly‐like stent ); Medi‐Tate Ltd., Or‐Akiva, Israel] were reviewed.ResultsProcedures that can be performed on an outpatient basis (Rezūm, PAE, UroLift and i‐TIND) are not an alternative for the standard patient requiring BPH surgery. Their effect on urinary flow, post‐void residual urine volume or bladder outlet obstruction is less pronounced than that of transurethral resection of the prostate (TURP). Yet, these options appear to be valuable for those patients unfit for surgery, men who want to avoid medical therapy in general, or those who want to avoid sexual side‐effects associated with medical therapy or standard BPH surgery (e.g. TURP). Aquablation is the first successfully operationalised robotic resection system, especially for patients with prostates >50 g. Nevertheless, long‐term data are necessary for all novel, minimally invasive treatments.ConclusionsBetter designed clinical trials, a clearer definition of target populations and a more realistic marketing allow a better characterisation of novel minimally invasive therapies for LUTS/BPH. It is hoped that some of these novel devices will stand the test of time, in contrast to the vast majority of their predecessors.
Ethnic and socio‐economic disparities in prostate cancer screening: lessons from New Zealand
Authors: Matti Bashar , Lyndon Mataroria , Zargar‐Shoshtari Kamran 
Published: June 2020

ObjectivesTo investigate the presence of ethnic and socio‐economic disparities in prostate cancer (PCa) screening and identify its impact on cancer outcomes.Materials and MethodsFrom January 2008 to December 2017, all men in the Northern region of New Zealand who had a prostate‐specific antigen (PSA) test performed in the community were identified from the electronic laboratory reports database. Asymptomatic men, with no known diagnosis of PCa, were included. Variables collected were age, ethnicity, social deprivation, medical therapy, PSA test information and cancer data. Disparities were investigated by comparing the frequency of PSA testing, proportions of men screened, and rates of cancer detection, between Māori (indigenous) and non‐Māori ethnic groups.ResultsThe study cohort included 248 491 men, who each received approximately 3.45 PSA tests over the 10‐year study period. Māori men were less likely to be tested compared to non‐Māori men (25.4% vs 46.1% of the total aged‐matched region population; P < 0.001). Moreover, they received less frequent PSA testing irrespective of their deprivation status (mean difference of 0.97 PSA tests per person; P < 0.001). The higher testing frequency in non‐Māori men was associated with increased PCa diagnosis rates. Nevertheless, cancers detected in Māori men were 73% more likely to be of high grade (Gleason 8 or above), compared to those in non‐Māori men.ConclusionThere were significant ethnic disparities in PCa screening rates in the Northern region of New Zealand. Māori men, regardless of other demographic factors, were disproportionately affected. The difference in the rates of screening by ethnicity had influenced the incidence and clinical significance of the diagnosed cancers.