bluuebunny/crossref_metadata_2025_split huggingface dataset:
ICU discharge screening for prediction of new‐onset physical disability—A multinational cohort study
Authors: Milton Anna , Schandl Anna , Soliman Iwo , Joelsson‐Alm Eva , van den Boogaard Mark , Wallin Ewa , Brorsson Camilla , Östberg Ulrika , Latocha Kristine , Savilampi Johanna , Paskins Stinne , Bottai Matteo , Sackey Peter 
Published: February 2020

BackgroundMethods to identify patients at risk for incomplete physical recovery after intensive care unit (ICU) stay are lacking. Our aim was to develop a method for prediction of new‐onset physical disability at ICU discharge.MethodsMultinational prospective cohort study in 10 general ICUs in Sweden, Denmark, and the Netherlands. Adult patients with an ICU stay ≥12 hours were eligible for inclusion. Sixteen candidate predictors were analyzed with logistic regression for associations with the primary outcome; new‐onset physical disability 3 months post‐ICU, defined as a ≥10 score reduction in the Barthel Index (BI) compared to baseline.ResultsOf the 572 included patients, follow‐up data are available on 78% of patients alive at follow‐up. The incidence of new‐onset physical disability was 19%. Univariable and multivariable modeling rendered one sole predictor for the outcome: physical status at ICU discharge, assessed with the five first items of the Chelsea critical care physical assessment tool (CPAx) (odds ratio 0.87, 95% confidence interval (CI) 0.81‐0.93), a higher score indicating a lower risk, with an area under the receiver operating characteristics curve of 0.68 (95% CI 0.61‐0.76). Negative predictive value for a low‐risk group (CPAx score >18) was 0.88, and positive predictive value for a high‐risk group (CPAx score ≤18) was 0.32.ConclusionThe ICU discharge assessment described in this study had a moderate AUC but may be useful to rule out patients unlikely to need physical interventions post‐ICU. For high‐risk patients, research to determine post‐ICU risk factors for an incomplete rehabilitation is mandated.
PR depression with multilead ST elevation and ST depression in aVR by left circumflex artery occlusion: How to differentiate from acute pericarditis
Authors: Zhan Zhong‐Qun , Nikus Kjell , Birnbaum Yochai 
Published: February 2020

AbstractPR‐segment depression with multilead ST‐segment elevation and ST‐segment depression in lead aVR are classic ECG manifestation of acute pericarditis. We present a patient, where the etiology of these ECG features was acute ST‐elevation myocardial infarction due to left circumflex artery occlusion. To avoid misdiagnosis, unnecessary examinations, and inappropriate therapeutic decisions, the possibility of ST‐segment elevation myocardial infarction should be kept in mind even when ECG changes typical for pericarditis are encountered in chest pain patients. Findings of QRS widening and QT interval shortening in leads with ST‐segment elevation could help to differentiate acute ST‐segment elevation myocardial infarction from acute pericarditis.
Short‐ and long‐term outcomes of percutaneous cholecystostomy in an Australian population
Authors: Corbetta Machado Maria Julia , Gray Andrew , Cerdeira Marisol P. , Gani Jon 
Published: February 2020

AbstractBackgroundPercutaneous cholecystostomy (PC) is a well‐recognized management option for the treatment of acute cholecystitis (AC) in high‐risk patients. Patient characteristics, efficacy and particularly the longer‐term outcomes for patients having PC across the Hunter New England Local Health District were analysed.MethodsA retrospective audit from January 2013 to September 2017 was undertaken. Patients were followed up until September 2019. All were retrospectively risk assessed using the P‐POSSUM risk assessment tool, complications and mortality were recorded. In addition to short‐term data, longer‐term outcomes including patient's living situation at 6 and 12 months were analysed.ResultsA total of 82 patients were assessed at ≥12 months post procedure or until death. Successful initial gallbladder drainage was achieved in 99% of cases. The mean P‐POSSUM score for mortality was 11%, confirming that this is a high‐risk group; 17% had inpatient complications recorded; 10% of these were major (Clavien‐Dindo ≥III). Outpatient complications were seen in 45%, 59% underwent further biliary tree intervention and 24% had recurrent AC. Thirty‐day mortality was 12% and 1‐year mortality was 22%. Functional capacity changed significantly for 41% of patients at 1 year, with 12% requiring a new admission to high‐level nursing home care.ConclusionOur series represents the largest reported Australasian series of PC for AC published to date. It confirms that PC is well‐established and safe in high‐risk patients. However, further intervention rates and recurrence rates of AC are high and escalation of dependency of care affects almost half of patients.
Opposition to Immigration and (Anti‐)Environmentalism: An Application and Extension of the Social Dominance‐Environmentalism Nexus with 21 Countries in Europe
Authors: Graça João 
Published: February 2020

The social dominance–environmentalism nexus proposes that orientations for inequality and domination are expressed both in human–human and human–nature relations. In two studies, the present work applies and extends this proposition to understand endorsement of environmental values, concern with climate change, support for climate policies, and responsibility for climate action. In study one, using a representative random sample from Portugal (N = 1270, 53.3% female; European Social Survey, ESS8), social dominance orientation showed unique associations with concern with climate change. Moreover, opposition to immigration (as expression of anti‐egalitarianism in intergroup relations) showed unique associations with all four measures of environmentalism. In study two, multi‐level analyses using representative random samples from 20 other countries in Europe (N = 38830, 51.5% female; ESS8) confirmed the associations between opposition to immigration and environmentalism, controlling for a set of sociodemographic covariates, political orientation, and nesting at the country level. However, there were differences in the strength and direction of these associations based on country levels of societal development (i.e., Human Development Index; HDI). These differences reinforce the notion that context or situational variables may shape the links between diverse expressions of (anti‐)egalitarianism and (anti‐)environmentalism. Inputs for applied research on hierarchy‐affirming tendencies toward others and the natural environment are proposed and discussed.
Nonparametric estimation of distributions and diagnostic accuracy based on group‐tested results with differential misclassification
Authors: Zhang Wei , Liu Aiyi , Li Qizhai , Albert Paul S. 
Published: February 2020

AbstractThis article concerns the problem of estimating a continuous distribution in a diseased or nondiseased population when only group‐based test results on the disease status are available. The problem is challenging in that individual disease statuses are not observed and testing results are often subject to misclassification, with further complication that the misclassification may be differential as the group size and the number of the diseased individuals in the group vary. We propose a method to construct nonparametric estimation of the distribution and obtain its asymptotic properties. The performance of the distribution estimator is evaluated under various design considerations concerning group sizes and classification errors. The method is exemplified with data from the National Health and Nutrition Examination Survey study to estimate the distribution and diagnostic accuracy of C‐reactive protein in blood samples in predicting chlamydia incidence.
Determinants of low‐quality warfarin anticoagulation in patients with mechanical prosthetic heart valves. The nationwide PLECTRUM study
Authors: Pastori Daniele , Lip Gregory Y. H. , Poli Daniela , Antonucci Emilia , Rubino Luca , Menichelli Danilo , Saliola Mirella , Violi Francesco , Palareti Gualtiero , Pignatelli Pasquale ,   the Italian Federation of Anticoagulation Clinics (FCSA)
Published: February 2020

SummaryQuality of warfarin therapy in patients with a mechanical prosthetic heart valve (MPHV) has been barely investigated. We analysed determinants of low time in the therapeutic range (TiTR <60%) in 2111 patients with MPHVs from the nationwide PLECTRUM study by the Italian Federation of Anticoagulation Clinics. Overall, 48·5% of patients had a TiTR of < 60%. At logistic regression analysis, arterial hypertension (odds ratio [OR] 1·502, P < 0·001), diabetes (OR 1·732, P < 0·001), heart failure (OR 1·484, P = 0·004), mitral site (vs. aortic) (OR 1·399, P = 0·006), international normalised ratio (INR) ranges of 2·5–3·5 (OR 2·575, P < 0·001) and 3·0–4·0 (OR 8·215, P < 0·001) associated with TiTR < 60%. TiTR is substantially suboptimal in MPHV patients, particularly in higher INR ranges.
The influence of conspiracy beliefs on conventional and unconventional forms of political participation: The mediating role of political efficacy
Authors: Ardèvol‐Abreu Alberto , Gil de Zúñiga Homero , Gámez Elena 
Published: February 2020

Recent approaches from social psychology lend support to conspiracy beliefs as a motivated form of social cognition, structured around and consistent with a higher‐order belief system, which may have an impact on the way people understand their political environment and respond to it. Building on these accounts, this study examines the influence of conspiracism on political efficacy and, indirectly, on conventional and unconventional forms of political participation. Drawing on two‐wave panel data collected in five democracies (United States, Japan, United Kingdom, Poland, and Estonia; n = 5,428), results suggest that individuals who hold conspiracy beliefs tend to regard the political system as less responsive to citizens’ demands – external dimension of political efficacy. We also found a less clear and country‐specific effect of conspiracy beliefs on perceptions of being less equipped to partake in the political process – internal efficacy. Furthermore, conspiratorial beliefs negatively affect conventional modes of political participation, indirectly through reduced external efficacy. We finally examine group differences by country that suggest that both individual‐ and contextual‐level factors may explain the observed pattern of influences. Our results emphasize the potential of currently widespread conspiratorial narratives to undermine attitudes and behaviours that lie at the heart of the democratic process.
Frequent homozygous deletion of Cdkn2a/2b in tremolite‐induced malignant mesothelioma in rats
Authors: Okazaki Yasumasa , Misawa Nobuaki , Akatsuka Shinya , Kohyama Norihiko , Sekido Yoshitaka , Takahashi Takashi , Toyokuni Shinya 
Published: February 2020

AbstractThe onset of malignant mesothelioma (MM) is linked to exposure to asbestos fibers. Asbestos fibers are classified as serpentine (chrysotile) or amphibole, which includes the crocidolite, amosite, anthophyllite, tremolite, and actinolite types. Although few studies have been undertaken, anthophyllite has been shown to be associated with mesothelioma, and tremolite, a contaminant in talc and chrysotile, is a risk factor for carcinogenicity. Here, after characterizing the length and width of these fibers by scanning electron microscopy, we explored the cytotoxicity induced by tremolite and anthophyllite in cells from an immortalized human mesothelial cell line (MeT5A), murine macrophages (RAW264.7), and in a rat model. Tremolite and short anthophyllite fibers were phagocytosed and localized to vacuoles, whereas the long anthophyllite fibers were caught on the pseudopod of the MeT5A and Raw 264.7 cells, according to transmission electron microscopy. The results from a 2‐day time‐lapse study revealed that tremolite was engulfed and damaged the MeT5A and RAW264.7 cells, but anthophyllite was not cytotoxic to these cells. Intraperitoneal injection of tremolite in rats induced diffuse serosal thickening, whereas anthophyllite formed focal fibrosis and granulomas on peritoneal serosal surfaces. Furthermore, the loss of Cdkn2a/2b, which are the most frequently lost foci in human MM, were observed in 8 cases of rat MM (homozygous deletion [5/8] and loss of heterozygosity [3/8]) by array‐based comparative genomic hybridization techniques. These results indicate that tremolite initiates mesothelial injury and persistently frustrates phagocytes, causing subsequent peritoneal fibrosis and MM. The possible mechanisms of carcinogenicity based on fiber diameter/length are discussed.
Identification of a predominant cognitive phenotype in patients with multiple sclerosis
Authors: Zurawski J. , Healy B. C. , Ratajska A. , Barker L. , Glanz B. I. , Houtchens M. 
Published: February 2020

Background and purposeCognitive impairment occurs frequently in multiple sclerosis (MS). However, the prevalence and clinical characteristics of cognitive MS phenotype are not well established. The aim of the study was to characterize the clinical course and neurocognitive impairment of patients with MS meeting an Expanded Disability Status Scale (EDSS)‐defined cognitive phenotype.MethodsA total of 2302 patients from the Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women’s Hospital (CLIMB) study were studied. Predominant cognitive MS phenotype was defined as EDSS Cerebral Functional System (FS) subscore ≥3 and remaining EDSS FS subscores ≤2 on at least one clinical visit. Demographic/clinical characteristics, phenotype stability and neurocognitive domain impairment of these subjects were assessed.ResultsA total of 60 of 2302 (2.6%) patients (age 52.8 ± 10.8 years, 68% female, 82% relapsing MS) met criteria for phenotype designation. A total of 29 of 60 (48%) were designated within 10 years of their presenting MS symptom. The mean cohort annualized relapse rate was 0.38 and EDSS score at last clinical assessment was 3.2 ± 1.3. Cognitive phenotype status was poorly sustained, with only 27% of subjects maintaining Cerebral FS score ≥2 throughout all follow‐up. However, predominant cognitive phenotype subjects with clinical neuropsychiatric testing [n = 39/60 (65%)] frequently had cognitive impairment (1.5 SD below mean) in ≥1 domain [n = 30/39 (77%) of subjects] affecting memory, attention/executive function and processing speed. A total of 11 of 39 (28%) patients had severe‐range cognitive impairment (3.0 SD below mean). Cognitive phenotype designation was associated with low rate of employment at last clinical assessment.ConclusionPredominant cognitive MS phenotype is rare, although an EDSS‐based definition identifies patients with multidomain cognitive impairment and may serve as a practical screen for identification of patients who might warrant close monitoring of neurocognitive status.
Species–area relationships on small islands differ among plant growth forms
Authors: Schrader Julian , König Christian , Triantis Kostas A. , Trigas Panayiotis , Kreft Holger , Weigelt Patrick 
Published: February 2020

AbstractAimWe tested whether species–area relationships of small islands differ among plant growth forms and whether this influences the prevalence of the small‐island effect (SIE). The SIE states that species richness on small islands is independent of island area or relates to area in a different way compared with larger islands. We investigated whether island isolation affects the limits of the SIE and which environmental factors drive species richness on small islands.LocationSeven hundred islands (< 100 km2) worldwide belonging to 17 archipelagos.Major taxa studiedAngiosperms.MethodsWe applied linear and breakpoint species–area models for angiosperm species richness and for herb, shrub and tree species richness per archipelago separately, to test for the existence of SIEs. For archipelagos featuring the SIE, we calculated the island area at which the breakpoints occurred (breakpoint area) and used linear models to test whether the breakpoint areas varied with isolation. We used linear mixed‐effect models to discern the effects of seven environmental variables related to island area, isolation and other environmental factors on the species richness of each growth form for islands smaller than the breakpoint area.ResultsFor 71% of all archipelagos, we found an SIE for total and herb species richness, and for 59% for shrub species richness and 53% for tree species richness. Shrub and tree species richness showed larger breakpoint areas than total and herb species richness. The breakpoint area was significantly positively affected by the isolation of islands within an archipelago for total and shrub species richness. Species richness on islands within the range of the SIE was differentially affected by environmental factors across growth forms.Main conclusionThe SIE is a widespread phenomenon that is more complex than generally described. Different functional groups have different environmental requirements that shape their biogeographical patterns and affect species–area and, more generally, richness–environment relationships. The complexity of these patterns cannot be revealed when measuring overall plant species richness.
Abscisic acid response to water status in Dactylis glomerata differs with expression of summer dormancy
Authors: Norton Mark R. , Xian Lisa , Kalic Jesse N. , Hughes Trijntje , Gubler Frank 
Published: February 2020

AbstractSummer dormancy confers superior drought survival in cool‐season perennial grasses and is likely to be of increasing importance as climate change proceeds although relatively little is known about this trait. This paper explores the relationship between the level of abscisic acid (ABA), the expression of summer dormancy and the onset and relief of water deficit in cool‐season perennial grasses. Three cultivars of Dactylis glomerata L. (cocksfoot) known to differ in expression of summer dormancy were grown in the field over summer and in the glasshouse over winter under water deficit or full irrigation. Hydration and osmotic potentials of basal tissues were measured to assess the level of water deficit, and endogenous ABA was determined in the tissues by monoclonal immunoassay analysis. In a winter trial, higher contents of ABA were present when plant water deficits became greater so that there were no differences between the cultivars in the concentrations of ABA observed. In a summer trial a short period of waterlogging caused water status to increase in all cultivars, although in the maritime cultivar Oasis this was also associated with a rise in ABA contents. In contrast, in the summer‐dormant cultivar Kasbah, only low ABA concentrations were observed throughout the entire period whether waterlogged or in drying soil. Heightened ABA levels are not induced by water deficit when summer dormancy is expressed in Dactylis glomerata. This contrasted with those cultivars unable to express summer dormancy where particularly in early summer severe water deficit was associated with heightened ABA levels.
Harvest interval affects lucerne (Medicago sativa L.) taproot total yield, starch, nitrogen and water‐soluble carbohydrates
Authors: Mitchell Meredith L. , Clark Stephen G. , Butler Kym L. , Nie Zhongnan , Burnett Vivianne F. , Meyer Richard , Zollinger Reto , Seymour Gregory R. 
Published: February 2020

AbstractLucerne (Medicago sativa L.) has a large taproot to store and release starch, carbohydrates and nutrients during the plant's growth. Recommended management of the lucerne crop aims to keep the taproot stable subject to the demands for feed provision and stand longevity. Field experiments were conducted in Victoria, Australia, to examine the effects of recovery period on taproot mass and nutritive status. Both experiments used established SARDI Seven lucerne crops and were either cut every 21 days (short recovery SR) or every 42 days (long recovery LR). At each defoliation, taproots were extracted for determination of DM yield and starch, water‐soluble carbohydrate (WSC) and nitrogen (N) concentration and DM yield. At both sites, WSC and N DM yields along with total taproot DM yield did not change greatly as the experiment progressed. Starch was responsive to herbage accumulation with both concentration and DM yield, increasing when herbage accumulation rates were high and decreasing when herbage accumulation rates were low. At both sites, LR taproots had starch levels equal to or higher than those of SR taproots. We conclude that short intervals between defoliations disrupt the energy cycling between shoots and roots. This is likely to reduce lucerne productivity, particularly during periods of rapid growth.
Studying the effectiveness of an online argumentation model for improving undergraduate students' argumentation ability
Authors: Fan Ya‐Ching , Wang Tzu‐Hua , Wang Kuo‐Hua 
Published: February 2020

AbstractThis research develops a web‐based model, entitled the “intuitive claim, peer‐assessment, discussion, and elaborate claim argumentation training” (IPadE) model, and embeds with a Web‐based Interactive Argumentation System to enhance undergraduate students' socioscientific argumentation abilities. This research adopts a quasi‐experimental research design; the sample comprised 131 undergraduate students from two classes (69 in the experimental group and 62 in the control group). The socioscientific issue discussed were related to global health. This study collected and analysed quantitative and qualitative data, including the pretest and posttest of students' knowledge test scores and argumentation abilities questionnaire. The results generally confirmed the effectiveness of the IPadE model. First, in a comparison of the content knowledge and argumentation skills, the experimental group have statistically significantly improved than the control group. Second, regarding the number of reasoning modes proposed, the experimental group could propose multiple reasoning modes and reasoning levels on rebuttals increased after training.