bluuebunny/crossref_metadata_2025_split huggingface dataset:
Woody tissue photosynthesis increases radial stem growth of young poplar trees under ambient atmospheric CO2 but its contribution ceases under elevated CO2
Authors: De Roo Linus , Lauriks Fran , Salomón Roberto Luis , Oleksyn Jacek , Steppe Kathy 
Published: June 2020

Abstract
Woody tissue photosynthesis (Pwt) contributes to the tree carbon (C) budget and generally stimulates radial stem growth under ambient atmospheric CO2 concentration (aCO2). Moreover, Pwt has potential to enhance tree survival under changing climates by delaying negative effects of drought stress on tree hydraulic functioning. However, the relevance of Pwt on tree performance under elevated atmospheric CO2 concentration (eCO2) remains unexplored. To fill this knowledge gap, 1-year-old Populus tremula L. seedlings were grown in two treatment chambers at aCO2 and eCO2 (400 and 660 ppm, respectively), and woody tissues of half of the seedlings in each treatment chamber were light-excluded to prevent Pwt. Radial stem growth, sap flow, leaf photosynthesis and stomatal and canopy conductance were measured throughout the growing season, and the concentration of non-structural carbohydrates (NSC) in stem tissues was determined at the end of the experiment. Fuelled by eCO2, an increase in stem growth of 18 and 50% was observed in control and light-excluded trees, respectively. Woody tissue photosynthesis increased radial stem growth by 39% under aCO2, while, surprisingly, no impact of Pwt on stem growth was observed under eCO2. By the end of the growing season, eCO2 and Pwt had little effect on stem growth, leaf photosynthesis acclimated to eCO2, but stomatal conductance did not, and homeostatic stem NSC pools were observed among combined treatments. Our results highlight that eCO2 potentially fulfils plant C requirements, limiting the contribution of Pwt to stem growth as atmospheric [CO2] rises, and that radial stem growth in young developing trees was C (source) limited during early phenological stages but transitioned towards sink-driven control at the end of the growing season.
Predicting crash injury severity at unsignalized intersections using support vector machines and naïve Bayes classifiers
Authors: Arhin Stephen A , Gatiba Adam 
Published: June 2020

Abstract
The Washington, DC crash statistic report for the period from 2013 to 2015 shows that the city recorded about 41 789 crashes at unsignalized intersections, which resulted in 14 168 injuries and 51 fatalities. The economic cost of these fatalities has been estimated to be in the millions of dollars. It is therefore necessary to investigate the predictability of the occurrence of theses crashes, based on pertinent factors, in order to provide mitigating measures. This research focused on the development of models to predict the injury severity of crashes using support vector machines (SVMs) and Gaussian naïve Bayes classifiers (GNBCs). The models were developed based on 3307 crashes that occurred from 2008 to 2015. Eight SVM models and a GNBC model were developed. The most accurate model was the SVM with a radial basis kernel function. This model predicted the severity of an injury sustained in a crash with an accuracy of approximately 83.2%. The GNBC produced the worst-performing model with an accuracy of 48.5%. These models will enable transport officials to identify crash-prone unsignalized intersections to provide the necessary countermeasures beforehand.
Conflict Management in the ICU
Authors: Kayser Joshua B. , Kaplan Lewis J. 
Published: June 2020

Objectives:
To provide a concise review of data and literature pertaining to the etiologies of conflict in the ICU, as well as current approaches to conflict management.

Data Sources:
Detailed search strategy using PubMed and OVID Medline for English language articles describing conflict in the ICU as well as prevention and management strategies.

Study Selection:
Descriptive and interventional studies addressing conflict, bioethics, clinical ethics consultation, palliative care medicine, conflict management, and conflict mediation in critical care.

Data Extraction:
Relevant descriptions or studies were reviewed, and the following aspects of each manuscript were identified, abstracted, and analyzed: setting, study population, aims, methods, results, and relevant implications for critical care practice and training.

Data Synthesis:
Conflict frequently erupts in the ICU between patients and families and care teams, as well as within and between care teams. Conflict engenders a host of untoward consequences for patients, families, clinicians, and facilities rendering abrogating conflict a key priority for all. Conflict etiologies are diverse but understood in terms of a framework of triggers. Identifying and de-escalating conflict before it become intractable is a preferred approach. Approaches to conflict management include utilizing clinical ethics consultation, and palliative care medicine clinicians. Conflict Management is a new technique that all ICU clinicians may use to identify and manage conflict. Entrenched conflict appears to benefit from Bioethics Mediation, an approach that uses a neutral, unaligned mediator to guide parties to a mutually acceptable resolution.

Conclusions:
Conflict commonly occurs in the ICU around difficult and complex decision-making. Patients, families, clinicians, and institutions suffer undesirable consequences resulting from conflict, establishing conflict prevention and resolution as key priorities. A variety of approaches may successfully identify, manage, and prevent conflict including techniques that are utilizable by all team members in support of clinical excellence.
External Validation of an Acute Respiratory Distress Syndrome Prediction Model Using Radiology Reports
Authors: Mayampurath Anoop , Churpek Matthew M. , Su Xin , Shah Sameep , Munroe Elizabeth , Patel Bhakti , Dligach Dmitriy , Afshar Majid 
Published: June 2020

Objectives:
Acute respiratory distress syndrome is frequently under recognized and associated with increased mortality. Previously, we developed a model that used machine learning and natural language processing of text from radiology reports to identify acute respiratory distress syndrome. The model showed improved performance in diagnosing acute respiratory distress syndrome when compared to a rule-based method. In this study, our objective was to externally validate the natural language processing model in patients from an independent hospital setting.

Design:
Secondary analysis of data across five prospective clinical studies.

Setting:
An urban, tertiary care, academic hospital.

Patients:
Adult patients admitted to the medical ICU and at-risk for acute respiratory distress syndrome.

Interventions:
None.

Measurements and Main Results:
The natural language processing model was previously derived and internally validated in burn, trauma, and medical patients at Loyola University Medical Center. Two machine learning models were examined with the following text features from qualifying radiology reports: 1) word representations (n-grams) and 2) standardized clinical named entity mentions mapped from the National Library of Medicine Unified Medical Language System. The models were externally validated in a cohort of 235 patients at the University of Chicago Medicine, among which 110 (47%) were diagnosed with acute respiratory distress syndrome by expert annotation. During external validation, the n-gram model demonstrated good discrimination between acute respiratory distress syndrome and nonacute respiratory distress syndrome patients (C-statistic, 0.78; 95% CI, 0.72–0.84). The n-gram model had a higher discrimination for acute respiratory distress syndrome when compared with the standardized named entity model, although not statistically significant (C-statistic 0.78 vs 0.72; p = 0.09). The most important features in the model had good face validity for acute respiratory distress syndrome characteristics but differences in frequencies did occur between hospital settings.

Conclusions:
Our computable phenotype for acute respiratory distress syndrome had good discrimination in external validation and may be used by other health systems for case-identification. Discrepancies in feature representation are likely due to differences in characteristics of the patient cohorts.
A new algorithm for the evaluation of recurrent pregnancy loss redefining unexplained miscarriage: review of current guidelines
Authors: Papas Ralph S. , Kutteh William H. 
Published: June 2020

Purpose of review
Couples with recurrent pregnancy loss (RPL) are often referred to reproductive specialists to help determine the reason for their repeated losses. This review will help to develop a strategy that is effective in providing a diagnosis, efficient to administer, and cost-effective to the healthcare system.

Recent findings
International societies have published different recommendations for the evaluation of RPL, they consider it appropriate to initiate an evaluation after two (or three) clinical miscarriages. On the contrary, the clinician who follows these guidelines will only be able to offer a possible explanation to fewer than half of the couples being evaluated. Recently, genetic testing of miscarriage tissue using 24-chromosome microarray (CMA) analysis at the time of the second pregnancy loss coupled with testing based on society guidelines has been shown provide an explanation in more than 90% of cases.

Summary
New guidelines for the complete evaluation of RPL should consider adding 24-CMA testing on the miscarriage tissue. Providing couples with an explanation for recurrent loss assists them in dealing with the loss and discourages the clinician from instituting unproven therapies. Truly unexplained pregnancy loss can be reduced to less than 10% with this new algorithm. Incorporation of these strategies will result in significant cost savings to the healthcare system.
Pediatric Resident Engagement With an Online Critical Care Curriculum During the Intensive Care Rotation*
Authors: Daniel Dennis A. , Poynter Sue E. , Landrigan Christopher P. , Czeisler Charles A. , Burns Jeffrey P. , Wolbrink Traci A. 
Published: June 2020

Objectives:
Residents are often assigned online learning materials as part of blended learning models, superimposed on other patient care and learning demands. Data that describe the time patterns of when residents interact with online learning materials during the ICU rotation are lacking. We describe resident engagement with assigned online curricula related to time of day and ICU clinical schedules, using website activity data.

Design:
Prospective cohort study examining curriculum completion data and cross-referencing timestamps for pre- and posttest attempts with resident schedules to determine the hours that they accessed the curriculum and whether or not they were scheduled for clinical duty. Residents at each site were cohorted based on two differing clinical schedules—extended duration (>24 hr) versus shorter (maximum 16 hr) shifts.

Setting:
Two large academic children’s hospitals.

Subjects:
Pediatric residents rotating in the PICU from July 2013 to June 2017.

Interventions:
None.

Measurements and Main Results:
One-hundred and fifty-seven pediatric residents participated in the study. The majority of residents (106/157; 68%) completed the curriculum, with no statistically significant association between overall curriculum completion and schedule cohort at either site. Residents made more test attempts at nighttime between 6 pm and 6 am (1,824/2,828; 64%) regardless of whether they were scheduled for clinical duty. Approximately two thirds of test attempts (1,785/2,828; 63%) occurred when residents were not scheduled to work, regardless of time of day. Forty-two percent of all test attempts (1,199/2,828) occurred between 6 pm and 6 am while off-duty, with 12% (342/2,828) occurring between midnight and 6 am.

Conclusions:
Residents rotating in the ICU completed online learning materials mainly during nighttime and off-duty hours, including usage between midnight and 6 am while off-duty. Increasing nighttime and off-duty workload may have implications for educational design and trainee wellness, particularly during busy, acute clinical rotations, and warrants further examination.
Reducing Point-of-care Blood Gas Testing in the Intensive Care Unit through Diagnostic Stewardship: A Value Improvement Project
Authors: Tchou Michael J. , May Sally , Holcomb John , Tanner-Edwards Ethan , Good Kathy , Frazier Matthew , Stalets Erika L. , Dewan Maya 
Published: June 2020

Introduction:
Overutilization of point-of-care (POC) testing may reduce the overall value of care due to high-cost cartridges, need for staff training, and quality assurance requirements.

Methods:
The Diagnostic Stewardship group at Cincinnati Children’s Hospital Medical Center assembled a multidisciplinary team to reduce the use of POC blood gas testing by 20% in the pediatric intensive care unit (PICU). Key drivers of test overutilization included poor knowledge of cost, concern with testing turnaround time, and a lack of a standard definition of when a POC test was appropriate. We calculated weekly the outcome measure of POC blood gas tests per PICU patient-day and a balancing measure of blood gas result turnaround time using data extracted from the electronic medical record. Interventions focused on staff education, the establishment of a standard practice guideline for the use of POC testing, and improving turnaround time for laboratory blood gas testing.

Results:
Over the baseline period starting July 2016, a median of 0.94 POC blood gas tests per PICU patient-day was ordered. After initial staff training, the rate was reduced to 0.60 tests per PICU patient-day and further reduced to 0.41 tests per PICU patient-day after a formal policy change was adopted. We have sustained this rate for 15 months through June 2018. Institutional direct cost savings were estimated to be $19,000 per year.

Conclusions:
Our improvement initiative was associated with a significant and rapid reduction in the use of POC testing in the PICU. Interventions focused on cost awareness, and a formal guideline helped establish a consensus around appropriate utilization.
Genetic diversity increases food-web persistence in the face of climate warming
Authors: Barbour Matthew A. , Kliebenstein Daniel J. , Bascompte Jordi 
Published: June 2020

Genetic diversity provides the raw material for species to adapt and persist in the face of climate change. Yet, the extent to which these genetic effects scale at the level of ecological communities remains unclear. Here we experimentally test the effect of plant genetic diversity on the persistence of an insect food web under a current and future warming scenario. We found that plant genetic diversity increased food-web persistence by increasing the intrinsic growth rates of species across multiple trophic levels. This positive effect was robust to a 3°C warming scenario and resulted from allelic variation at two genes that control the biosynthesis of chemical defenses. Our results suggest that the ongoing loss of genetic diversity may undermine the persistence and functioning of ecosystems in a changing world.One Sentence SummaryThe loss of genetic diversity accelerates the extinction of inter-connected species from an experimental food web.
Nutrient sensing in the nucleus of the solitary tract mediates non-aversive suppression of feeding via inhibition of AgRP neurons
Authors: Tsang Anthony H. , Nuzacci Danae , Darwish Tamana , Samudrala Havish , Blouet Clémence 
Published: June 2020

SummaryThe nucleus of the solitary tract (NTS) is emerging as a major site of action for the appetite-suppressive effects of leading pharmacotherapies currently investigated for the treatment of obesity. However, our understanding of how NTS neurons regulate appetite remains incomplete. Here we used NTS nutrient sensing as an entry point to characterize stimulus-defined neuronal ensembles engaged by the NTS to produce physiological satiety. Using activity-dependent expression of genetically-encoded circuit analysis tools, we found that NTS detection of leucine engages NTS prolactin-releasing peptide (PrRP) neurons to inhibit AgRP neurons via a population of leptin-receptor-expressing neurons in the dorsomedial hypothalamus. This circuit is necessary for the anorectic response to NTS leucine, the appetite-suppressive effect of high protein diets, and the long-term control of energy balance. These results extends the integrative capability of AgRP neurons to include brainstem nutrient sensing inputs.
Visualizing dendritic characteristics of corticotropin-releasing hormone neurons at single-cell resolution in the whole mouse brain
Authors: Wang Yu , Hu Pu , Shan Qinghong , Huang Chuan , Huang Zhaohuan , Chen Peng , Li Anan , Gong Hui , Zhou Jiang-Ning 
Published: June 2020

AbstractCorticotropin-releasing hormone (CRH) is an important neuromodulator with wide distribution in the brain. Here, we screened the CRH-IRES-Cre;Ai32 mouse line to reveal the morphologies of individual CRH neurons throughout the mouse brain by using fluorescence micro-optical sectioning tomography (fMOST) system. Diverse dendritic morphologies and projection fibers were found in various brain regions. Reconstructions showed hypothalamic CRH neurons had the smallest somatic volumes and simplest dendritic branches, and CRH neurons in several regions shared a bipolar morphology. Further investigations in the medial prefrontal cortex unveiled somatic depth-dependent morphologies that exhibited three types of connections and CRH neurons in the anterior parvicellular area of hypothalamus had fewer and smaller Herring bodies whereas in the periventricular area had more and larger Herring bodies that were present within fibers projecting to the third ventricle. Our findings provide the most comprehensive intact morphologies of CRH neurons throughout the mouse brain that is currently available.
Presence of endogenous viral elements negatively correlates with FeLV susceptibility in puma and domestic cat cells
Authors: Chiu Elliott S. , VandeWoude Sue 
Published: June 2020

AbstractWhile feline leukemia virus (FeLV) has been shown to infect felid species other than the endemic domestic cat host, differences in FeLV susceptibility among species has not been evaluated. Previous reports have noted a negative correlation between enFeLV copy number and exogenous FeLV infection outcomes in domestic cats. Since felids outside the genusFelisdo not harbor enFeLV genomes, we hypothesized absence of enFeLV results in more severe disease consequences in felid species lacking these genomic elements. We infected primary fibroblasts isolated from domestic cats (Felis catus) and pumas (Puma concolor) with FeLV and quantitated proviral and viral antigen loads. Domestic cat enFeLVenvand LTR copy numbers were determined for each individual and compared to FeLV viral outcomes. FeLV proviral and antigen levels were also measured in 6 naturally infected domestic cats and 11 naturally infected Florida panthers (P. concolor coryi). We demonstrated that puma fibroblasts are more permissive to FeLV than domestic cat cells, and domestic cat FeLV restriction was highly related to enFeLV LTR copy number. Terminal tissues from FeLV-infected Florida panthers and domestic cats had similar exFeLV proviral copy numbers, but Florida panther tissues have higher FeLV antigen loads. Our work indicates enFeLV LTR elements negatively regulate exogenous FeLV replication. Further,Puma concolorlacking enFeLV are more permissive to FeLV infection than domestic cats, suggesting endogenization can play a beneficial role in mitigating exogenous retroviral infections. Conversely, presence of endogenous retroelements may relate to new host susceptibility during viral spillover events.ImportanceFeline leukemia virus (FeLV) can infect a variety of felid species. Only the primary domestic cat host and related small cat species harbor a related endogenous virus in their genomes. Previous studies noted a negative association between the endogenous virus copy number and exogenous virus infection in domestic cats. This report shows that puma cells, which lack endogenous FeLV, produce more virus more rapidly than domestic cat fibroblasts following cell culture challenge. We document a strong association between domestic cat cell susceptibility and FeLV long terminal repeat (LTR) copy number, similar to observations in natural FeLV infections. Viral replication does not, however, correlate with FeLVenvcopy number, suggesting this effect is specific to FeLV LTR elements. This discovery indicates a protective capacity of the endogenous virus against the exogenous form, either via direct interference or indirectly via gene regulation, and may suggest evolutionary outcomes of retroviral endogenization.
Structural determinants within the adenovirus early region 1A protein spacer region necessary for tumourigenesis
Authors: Molloy David P , Grand Roger J 
Published: June 2020

AbstractIt has long been established that group-A adenoviruses (HAdV-A12, -A18 and -A31) can cause tumours in new-born rodents with tumourigenicity related to the presence of a unique spacer region located between conserved regions 2 and 3 within the Ad12E1A protein. Group B adenoviruses are weakly oncogenic whereas most of the remaining human adenoviruses are non-oncogenic. In order to understand better the relationship between the structure of the AdE1A spacer region and oncogenicity of HAdVs the structure of synthetic peptides identical or very similar to the adenovirus12 E1A spacer region have been determined to be α-helical using NMR spectroscopy. This contrasts significantly with some previous suggestions that this region is unstructured. Using available predictive algorithms, the structures of spacer regions from other E1As were also examined and the extent of predicted α-helix was found to correlate reasonably well with the tumorigenicity of the respective viruses.ImportanceThis research analysed small peptides equivalent to a region within the human adenovirus early region 1A protein that confers, in part, tumour inducing properties to varying degrees on several viral strains in rats and mice. The oncogenic spacer region is alpha-helical, which contrasts with previous suggestions that this region is unstructured. The helix is characterised by a stretch of amino acids rich in alanine residues that are organised into a hydrophobic or ‘water-hating’ surface that is considered to form a major site of interaction with cellular protein targets that mediate tumour formation. The extent of alpha-helix in E1A from other adenovirus species can be correlated to a limited degree to the tumourigenicity of that virus. Some serotypes show significant differences in predicted structural propensity suggesting the amino acid type and physicochemical properties are also of importance.