bluuebunny/crossref_metadata_2025_split huggingface dataset:
The presence of eccentric hyperpigmentation should raise the suspicion of melanoma
Authors: Borsari S. , Peccerillo F. , Pampena R. , Lai M. , Spadafora M. , Moscarella E. , Lallas A. , Pizzichetta M.A. , Zalaudek I. , Del Regno L. , Peris K. , Pellacani G , Longo C. 
Published: May 2020

AbstractBackgroundMelanocytic lesions with eccentric hyperpigmentation (EH), even though without other dermatoscopic features of melanoma, are often excised.ObjectiveAiming to understand whether the EH in a pigmented lesion is an accurate criterion of malignancy, we evaluated the capability of two evaluators, with different expertise, to correctly diagnose a melanoma when analysing a given lesion in toto versus a partial analysis, with only the EH or the non‐hyperpigmented portion (non‐EH) visible.MethodsDermatoscopic images of 240 lesions (107 melanomas and 133 nevi) typified by EH were selected. Facial, acral, mucosal lesions and lesions showing clear‐cut features of melanoma (except for atypical network) were excluded. Clinical and dermoscopic features (main pattern and numbers of colours) were described for all cases. Each image was split in two through a software so that only the EH or the non‐EH was visible. Two blinded evaluators examined three sets of images, two with customized images and one with the non‐modified ones: they were asked to give a dichotomous diagnosis (melanoma or nevus) for each image.ResultsMelanomas were significantly more frequently typified by colour variegation (3 colours in 44.8% and 4 colours in 41.1% of cases) and atypical network (88.1% in the EH). No significant differences in diagnostic accuracy emerged between the two evaluators. Sensitivity improved in the evaluation of the whole lesions (mean sensitivity 89.7%) in comparison with the evaluation of EH or non‐EH alone (72.7–62.6%). Specificity increased when evaluating the EH (54.1%). Positive predictive value (PPV) and likelihood ratio (LR+) of EH resulted 52.3% and 1.4, meaning that in one case out of two with EH is a melanoma.ConclusionsLesions with EH are challenging, regardless of dermoscopic experience. The EH is a robust criterion for malignancy, since the evaluation of the whole lesion, through an intralesional comparative approach, increases sensitivity.
Frailty Phenotype and Healthcare Costs and Utilization in Older Men
Authors: Ensrud Kristine E. , Kats Allyson M. , Schousboe John T. , Taylor Brent C. , Vo Tien N. , Cawthon Peggy M. , Hoffman Andrew R. , Langsetmo Lisa ,   for the Osteoporotic Fractures in Men Study (MrOS)
Published: May 2020

OBJECTIVESTo determine the association of the frailty phenotype with subsequent healthcare costs and utilization.DESIGNProspective cohort study (Osteoporotic Fracture in Men [MrOS]).SETTINGSix US sites.PARTICIPANTSA total of 1,514 community‐dwelling men (mean age = 79.3 years) participating in the MrOS Year 7 (Y7) examination linked with their Medicare claims data.MEASUREMENTSAt Y7, the frailty phenotype was operationalized using five components and categorized as robust, pre‐frail, or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims data. Functional limitations were assessed by asking about difficulty performing instrumental activities of daily living. Total direct healthcare costs and utilization were ascertained during 36 months following Y7.RESULTSMean of total annualized costs (2018 dollars) was $5,707 (standard deviation [SD] = 8,800) among robust, $8,964 (SD = 18,156) among pre‐frail, and $20,027 (SD = 27,419) among frail men. Compared with robust men, frail men (cost ratio [CR] = 2.35; 95% confidence interval [CI] = 1.88‐2.93) and pre‐frail men (CR = 1.28; 95% CI = 1.11‐1.48) incurred greater total costs after adjustment for demographics, multimorbidity, and cognitive function. Associations of phenotypic pre‐frailty and frailty with higher total costs were somewhat attenuated but persisted after further consideration of functional limitations and a claims‐based frailty indicator. Each individual frailty component was also associated with higher total costs. Frail vs robust men had higher odds of hospitalization (odds ratio [OR] = 2.62; 95% CI = 1.75‐3.91) and skilled nursing facility (SNF) stay (OR = 3.36; 95% CI = 1.83‐6.20). A smaller but significant effect of the pre‐frail category on SNF stay was present.CONCLUSIONPhenotypic pre‐frailty and frailty were associated with higher subsequent total healthcare costs in older community‐dwelling men after accounting for a claims‐based frailty indicator, functional limitations, multimorbidity, cognitive impairment, and demographics. Assessment of the frailty phenotype or individual components such as slowness may improve identification of older community‐dwelling adults at risk for costly extensive care.
Continuity of Hospital Care and Feeding Tube Use in Cognitively Impaired Hospitalized Persons
Authors: Teno Joan M. , Mitchell Susan , Bunker Jennifer , Meltzer David , Gozalo Pedro 
Published: May 2020

OBJECTIVESHospitalists are increasingly the attending physician for hospitalized patients, and the scheduling of their shifts can affect patient continuity. For dementia patients, the impact is unknown.DESIGNLongitudinal study using physician billing claims between 2000 and 2014 to examine the association of continuity of care with the insertion of a feeding tube (FT).SETTINGUS hospitals.PARTICIPANTSBetween 2000 and 2014, 166,056 hospitalizations of patients with a prior nursing home stay, advanced cognitive impairment, and impairments in four or more activities of daily living (mean age = 84.2 years; 30.4% male; 81.0% white).MEASUREMENTSContinuity of care measured at the hospital level with the Sequential Continuity Index (SECON; range = 0 to 100; higher score indicates higher continuity).RESULTSRates of a hospitalist acting as the attending physician increased from 9.6% in 2000 to 22.6% in 2010, whereas a primary care physician with a predominant outpatient focus acting as the attending physician decreased from 50.3% in 2000 to 12.6% in 2014. Post‐2010, a mixture of physician specialties increased from 55.5% to 66.4% with a reduction in hospitalists from 22.6% (2010) to 14.1% (2013). Continuity of care decreased over time with SECON dropping from 63.0 to 43.5. Adjusting for patient baseline risk factors, a nonlinear association was observed between SECON and FT insertion. Using cubic splines in the multivariate logistics regression model, the risk of FT insertion in hospitals where the SECON score dropped from 82 to 23 had an adjusted risk ratio (ARR) of FT insertion of 1.48 (95% confidence interval [CI] = 1.34‐1.63); hospitals in which SECON dropped from 51 to 23 had an ARR of FT insertion of 1.38 (95% CI = 1.27‐1.50).CONCLUSIONHospitalized dementia patients in hospitals in which continuity of care was lower had higher rates of FT insertions. Newer models of care are needed to enhance care continuity and thus ensure treatment consistent with likely outcomes of care and goals of care. J Am Geriatr Soc 68:1852‐1856, 2020.
Cosmetic camouflage as an adjuvant to vitiligo therapies: Effect on quality of life
Authors: Bassiouny Dalia , Hegazy Rehab , Esmat Samia , Gawdat Heba I. , Ahmed Ezzat Marwa , Tawfik Hebat‐Allah , Hegazy Amira Aly , Ibrahim Sarah 
Published: May 2020

AbstractBackgroundVitiligo is a pigmentary disorder associated with considerable psychological imbalance. Partial response to therapy and long duration for repigmentation are common. Meanwhile, camouflage may help through concealing vitiligo lesions and improving patient confidence and self‐esteem.AimTo assess the Dermatology Life Quality Index (DLQI) in vitiligo patients, and to determine the patients’ acceptance and willingness to utilize camouflage regularly and the impact of using camouflage as an adjuvant modality.Patients/MethodsThe study was carried out on 100 vitiligo patients who underwent thorough history taking, clinical examination, and DLQI assessment. Forty patients were randomly chosen, taught how to apply camouflage, and followed up over 1 month of regular application.ResultsDermatology Life Quality Index in the 100 vitiligo patients was found to be 12.2 ± 3.9, denoting the very large effect on quality of life vitiligo has. It was significantly worse in female patients, adolescents, students, and high‐socioeconomic level patients, in visible sites and genitalia, and in unstable cases. There was a significant positive correlation between the DLQI and disease duration (r = 0.75, P < .001) and VES (r = 0.79, P < .001). The 40 cases on camouflage showed a significant percent reduction in their DLQI when compared to noncamouflage users (P: .00).ConclusionsDermatology Life Quality Index is significantly affected by vitiligo. Camouflaging is a technique that needs to be taught to the patient to overcome the anticipated problems that drive them away from using it; especially, it significantly improves their DLQI in their devastating disease.
Fatherhood in Complex Families: Ties between Adult Children, Biological Fathers, and Stepfathers
Authors: Hornstra Maaike , Kalmijn Matthijs , Ivanova Katya 
Published: May 2020

AbstractObjectiveWe examined adult children's concurrent ties to biological fathers and stepfathers. Three mechanisms potentially determining the strength of father‐child and stepfather‐child ties were tested, namely, investment, interdependence, and substitution.BackgroundAs most research studied father‐child and stepfather‐child ties separately, our knowledge about the potential substitution dynamics between the two ties is limited.MethodWe used the Dutch Ouders en Kinderen in Nederland (OKiN) survey, which features an oversample of individuals, aged 25–45, who did not live with their two biological parents when growing up (N = 1,183; Mage = 31.89 [SD = 5.13]; 56% female). OKiN includes information on adults' relationships to all parent figures in their lives. Non‐recursive structural equation models were applied to account for the bidirectional influence between children's ties to biological fathers and stepfathers.ResultsOur findings suggested that the quality of the two father‐child ties are interrelated, that is, we found a small substitution effect (i.e., adult children were more likely to “choose” one father in the presence of both). We also found that the quality of father‐child and stepfather‐child ties was associated with the length of the parental investment period (i.e., investment). In addition, bonds with stepfathers were positively associated with the attitudes of the two fathers toward each other, while bonds with both fathers were associated with the quality of the tie between the biological parents (i.e., interdependence).ConclusionOverall, the weak substitution dynamic that we found implied that a poor tie with one father can partly be substituted by being close to another father.
Genomic landscape of parallel domestication of upland rice and its implications
Authors: Wang Mei‐Xia , Jing Chun‐Yan , Wang Xiu‐Hua , Cai Zhe , Zhou Lian , Geng Mu‐Fan , Han Jing‐Dan , Guo Jie , Zhang Fu‐Min , Ge Song 
Published: May 2020

AbstractParallel domestication has been widely acknowledged but its genetic basis remains largely unclear. As an important rice ecotype, upland rice was assumedly domesticated multiple times in two rice subspecies (Indica and Japonica) and provides a feasible system to explore the genetic basis of parallel domestication. To uncover the genome‐wide pattern of genetic differentiation between upland and lowland rice and explore the parallelism of genetic changes during upland rice domestication, we obtained whole‐genome sequences of 95 rice landraces and yielded genome‐wide expression data for five tissues of representative accessions of upland and lowland rice. Our phylogenetic analyses confirmed multiple domestications of the upland ecotype in two rice subspecies. Genomic scans based on resequencing data identified substantial differentiation between the upland and lowland ecotypes with 11.4% and 14.8% of the genome diverged between the two ecotypes in Indica and Japonica, respectively. Further genome‐wide gene expression analyses found that 30% of effectively expressed genes were significantly differentiated between two ecotypes, indicating the importance of regulation changes in the domestication of upland rice. Importantly, we found that only 1.8% of differentiated genomes and 1.6% of differentially expressed genes were shared by upland Indica and upland Japonica, suggestive of largely unparallel genetic alterations during upland rice domestication. These findings not only provide new insights into the genetic basis of parallel domestication at the genome scale but could also facilitate genetic improvement and breeding of rice and crops in general.
How do microbiota associated with an invasive seaweed vary across scales?
Authors: Bonthond Guido , Bayer Till , Krueger‐Hadfield Stacy A. , Barboza Francisco Rafael , Nakaoka Masahiro , Valero Myriam , Wang Gaoge , Künzel Sven , Weinberger Florian 
Published: May 2020

AbstractCommunities are shaped by scale dependent processes. To study the diversity and variation of microbial communities across scales, the invasive and widespread seaweed Agarophyton vermiculophyllum presents a unique opportunity. We characterized pro‐ and eukaryotic communities associated with this holobiont across its known distribution range, which stretches over the northern hemisphere. Our data reveal that community composition and diversity in the holobiont vary at local but also larger geographic scales. While processes acting at the local scale (i.e., within population) are the main structuring drivers of associated microbial communities, changes in community composition also depend on processes acting at larger geographic scales. Interestingly, the largest analysed scale (i.e., native and non‐native ranges) explained variation in the prevalence of predicted functional groups, which could suggest a functional shift in microbiota occurred over the course of the invasion process. While high variability in microbiota at the local scale supports A. vermiculophyllum to be a generalist host, we also identified a number of core taxa. These geographically independent holobiont members imply that cointroduction of specific microbiota may have additionally promoted the invasion process.
On the relationship between sectorial and institutional structural changes
Authors: Bethencourt Carlos , Perera‐Tallo Fernando 
Published: May 2020

AbstractSuccessful development processes involve not only ‘sectorial structural change’, shifts of factors between different productive sectors, but also, ‘institutional structural change’, shifts of factors from unproductive activities (predation) to productive ones. This paper analyzes the feedback process between the sectorial and the institutional structural changes in a model in which the labor share in agriculture is lower than in other sectors. Along the transition sectorial structural change emerges: employment in agriculture declines. Consequently, total labor share increases, raising the reward for working (while discouraging predation) and so, fostering institutional structural change. This, in turn, encourages capital accumulation, promoting sectorial structural change. This feedback mechanism widens differences in productivity and institutions among countries. Whereas zero‐cost policies aimed to build institutions have positive effects, costly policies have uncertain effects due to complex feedback mechanisms.
Visualisation of penetration of topical antifungal drug substances through mycosis‐infected nails by matrix‐assisted laser desorption ionisation mass spectrometry imaging
Authors: Endringer Pinto Fernanda , Bagger Charlotte , Kunze Gernot , Joly‐Tonetti Nicolas , Thénot Jean‐Paul , Osman‐Ponchet Hanan , Janfelt Christian 
Published: May 2020

AbstractBackgroundMatrix‐assisted laser desorption ionisation mass spectrometry imaging (MALDI‐MSI) is a mass spectrometry‐based technique, which can be applied for compound‐specific imaging of pharmaceuticals in tissues samples. MALDI‐MSI technology is widely used to visualise penetration and distribution profile through different tissues but has never been used with nail tissue.ObjectivesThis study used MALDI‐MSI technology to visualise distribution profile and penetration into ex vivo human mycosis‐infected toenails of three antifungal active ingredients amorolfine, ciclopirox and naftifine contained in topical onychomycosis nail treatment preparations, marketed as Loceryl®, Ciclopoli® and Exoderil®.MethodsThree mycosis‐infected toenails were used for each treatment condition. Six and twenty‐four hours after one single topical application of antifungal drugs, excess of formulation was removed, nails were cryo‐sectioned at a thickness of 20 μm, and MALDI matrix was deposited on each nail slice. Penetration and distribution profile of amorolfine, ciclopirox and naftifine in the nails were analysed by MALDI‐MSI.ResultsAll antifungal actives have been visualised in the nail by MALDI‐MSI. Ciclopirox and naftifine molecules showed a highly localised distribution in the uppermost layer of the nail plate. In comparison, amorolfine diffuses through the nail plate to the deep layers already 6 hours after application and keeps diffusing towards the lowest nail layers within 24 hours.ConclusionsThis study shows for the first‐time distribution and penetration of certain antifungal actives into human nails using MALDI‐MSI analysis. The results showed a more homogeneous distribution of amorolfine to nail and a better penetration through the infected nails than ciclopirox and naftifine.
The relationship between cognitive decline and motor dysfunction in Parkinson’s disease: A focused mini‐review on cognitive‐locomotor dual‐task interference
Authors: Mihara Masahito 
Published: May 2020

AbstractAccumulating evidence suggests that motor symptoms other than resting tremors are affected by coexisting cognitive decline in Parkinson's disease (PD). These cognitive and motor interactions are characterized by the extent to which a concurrent cognitive task affects motor task performance in a dual‐task paradigm. Many studies have investigated cognitive‐postural/locomotor dual‐task interference in PD. Consistent with the notion that bipedal locomotor control requires high cortical demand, previous studies observed greater “dual‐task cost” in patients with PD compared with healthy subjects. This suggests that a segregated cortico‐basal ganglia network is involved in cognitive‐motor dual‐tasking and that cortico‐basal ganglia dysfunction would increase dual‐task interference in patients with PD. In addition, cortico‐brainstem networks may also play an important role in cognitive‐locomotor dual‐task interference. Herein, we discuss possible theoretical models and neural underpinnings of dual‐task interference in PD and future clinical applications of the dual‐task paradigm.
Functional neuroimaging evidence supporting the dual syndrome hypothesis of cognitive impairment in Lewy body disease
Authors: Hirano Shigeki 
Published: May 2020

AbstractElucidating the pathophysiology of cognitive impairment in Lewy body disease is important but complex because of its heterogeneous cause. This review gives an overview of the recent functional neuroimaging findings of dopaminergic image and perfusion/metabolism image studies in Parkinson's disease with dementia and dementia with Lewy bodies. Image results of cognitively impaired Lewy body disease, compared with healthy subjects or patients with Parkinson's disease without cognitive impairment, are addressed, and the predictive role of neuroimaging is discussed. Additionally, the association between cognition and striatal dopaminergic function in healthy subjects and perfusion changes due to cholinesterase inhibitors in Lewy body disease are described. The caudate dopaminergic system is a hub region for fronto‐striatal circuits that are associated with verbal memory and executive function. In contrast, the posterior brain region controls visuospatial and memory functions that are primarily regulated by the cholinergic system and, in some cases, may have concomitant Alzheimer's disease pathology. To segregate the anterior and posterior (dual) brain system, cumulative evidence from functional neuroimages is provided and discussed. The dual syndrome hypothesis is a pivotal concept for understanding the underlying mechanisms of cognitive impairment in Lewy body disease, especially in regard to neurotransmitters.
Characteristics and trends of flash droughts in Spain, 1961–2018
Authors: Noguera Iván , Domínguez‐Castro Fernando , Vicente‐Serrano Sergio M. 
Published: May 2020

AbstractFlash droughts are characterized by rapid onset and intensification, as well as major environmental and agricultural impacts. In this study, we developed an objective method for identifying flash droughts using the standardized evaporation precipitation index (SPEI) based on a short time scale (1‐month) and high‐frequency data (weekly). The identification of flash droughts was focused on the development phase, anomalous decreases in index values in a short time period (4 weeks), and the magnitude of the events. The method was applied to mainland Spain and the Balearic Islands using a high spatial resolution gridded dataset for the period 1961–2018. For this period of 58 years, we characterized the occurrence of flash droughts and showed that for Spain, there was a large spatial and temporal variability in their frequency, with more occurring in the northwest than in the central and southern regions. The northern regions, where a higher frequency of flash droughts was found, showed negative trends in the frequency of flash droughts, while the regions subject to fewer flash drought events showed generally positive trends. We investigated the relative frequency of flash droughts affecting the study regions and found that they are a common phenomenon, as 40% of all droughts were characterized by rapid development. The findings of this study have important implications for drought assessment, monitoring, and mitigation.
Acute cytotoxicity and increased vascular endothelial growth factor after in vitro nitrogen mustard vapor exposure
Authors: McGraw Matthew D. , Kim So‐Young , White Carl W. , Veress Livia A. 
Published: May 2020

AbstractNitrogen mustard (NM) is a highly toxic alkylating agent. Inhalation exposure can cause acute and chronic lung injury. This study's aims were to develop an in vitro coculture model of mustard‐induced airway injury and to identify growth factors contributing to airway pathology. Primary human bronchial epithelial cells cultured with pulmonary endothelial cells were exposed to NM (25, 50, 100, 250, or 500 μM) or PBS (control) for 1 hour. Lactate dehydrogenase (LDH) and transepithelial electrical resistance (TEER) were measured before and 24 h after NM exposure. Fixed cultures were stained for hematoxylin and eosin or live/dead staining. Culture media were analyzed for 11 growth factors. A 1‐h vapor exposure to greater than or equal to 50 μM NM increased supernatant LDH, decreased TEER, and caused airway epithelial cell detachment. Endothelial cell death occurred at 500 μM NM. Vascular endothelial growth factor A (VEGF‐A) and placental growth factor (PlGF) expression increased in 500 μM NM−exposed cultures compared with PBS‐exposed control cultures. NM vapor exposure causes differential cytotoxicity to airway epithelial and endothelial injury in culture. Increased VEGF‐A and PlGF expression occurred acutely in airway cocultures. Future studies are required to validate the role of VEGF signaling in mustard‐induced airway pathology.