bluuebunny/crossref_metadata_2025_split huggingface dataset:
New guidelines for hospital-acquired pneumonia/ventilator-associated pneumonia: USA vs. Europe
Authors: Martin-Loeches Ignacio , Rodriguez Alejandro H. , Torres Antoni 
Published: August 2018

Purpose of review
The International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia were published in 2017 whilst the American guidelines for Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia were launched in 2016 by the Infectious Diseases Society of America/ATS. Both guidelines made updated recommendations based on the most recent evidence sharing not only some parallelisms but also important conceptual differences.

Recent findings
Contemporary therapy for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) emphasizes the importance of prompt and appropriate antimicrobial therapy. There is an implicit risk, when appropriate means broad spectrum, that liberal use of antimicrobial combinations will encourage the emergence of multidrug resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant bacteria (PDR) and generate untreatable infections, including carbapenemase resistant infections.

Summary
American and European guidelines have many areas of common agreement such as limiting antibiotic duration. Both guidelines were in favour of a close clinical assessment. Neither recommended a regular use of biomarkers but only in specific circumstances such as dealing with MDR and treatment failure. Risk factor prediction for MDR differed and whilst American guidelines focus on organ failure, the European ones did it in local ecology and septic shock.
Physical activity and weight maintenance: the utility of wearable devices and mobile health technology in research and clinical settings
Authors: Riffenburg Kaitlyn M. , Spartano Nicole L. 
Published: August 2018

Purpose of review
The integration of wearable devices and mobile health (mHealth) technology to facilitate behavior change has the potential to transform the efficacy of interventions and implementation programs for weight maintenance. The purpose of this review was to provide a comprehensive analysis of the overall utility of wearable devices for assessing and promoting weight maintenance in research and clinical settings.

Recent findings
Recent intervention trials using wearable devices have been successful in increasing physical activity and decreasing or maintaining body weight, but complex study designs involving multiple behavioral strategies make it difficult to assess whether wearable devices can independently influence weight status. The daily feedback that wearable devices and mHealth technology provide may assist in motivating higher levels of physical activity achievement. However, the integration of wearable devices into the healthcare setting and implementation of mHealth programs still need to be tested.

Summary
Recent studies add concrete implications for providers and researchers to better assess and promote physical activity in healthcare settings by identifying how wearable devices can be advantageous for physical activity and health promotion.
The potential of chronopharmacology for treatment of atherosclerosis
Authors: Winter Carla , Soehnlein Oliver 
Published: August 2018

Purpose of review
Development of atherosclerosis contributes to cardiovascular diseases that still are the leading cause of mortality worldwide. Successful strategies for treating inflammatory aspects of atherosclerotic lesion development are rare. Here, we review new insights into the impact of circadian rhythmicity on atherogenesis and their potential for innovative time-optimized pharmacological treatment strategies.

Recent findings
Studies on the circadian clock revealed an extensive influence on immune cell activity. Immune cell functionality and their recruitment to injured tissues exhibit circadian rhythmicity. Many indications that the circadian clock also modulates atherogenesis were given in the past. Transcriptome analysis of the aorta reveals a time-dependent expression profile. Furthermore, deficiency of the core clock proteins Bmal1 and Clock consistently accelerates atherosclerosis. Recent work provided new insights on time-dependent leukocyte recruitment to atherosclerotic lesions and its regulatory mechanisms through the CCR2-CCL2 axis. Based on timed CCR2-CCL2 signaling blockage, an effective chronopharmacological treatment strategy was established to reduce early lesion development with concomitant reduction of systemic side effects.

Summary
Circadian rhythmicity impacts on the pathogenesis of atherosclerosis. Circadian oscillation in the expression of drug targets may license timed intervention strategies with improved efficacy and lower risk.
Anti‐Cytomegalovirus Activity in Human Milk and Colostrum From Mothers of Preterm Infants
Authors: Donalisio Manuela , Rittà Massimo , Tonetto Paola , Civra Andrea , Coscia Alessandra , Giribaldi Marzia , Cavallarin Laura , Moro Guido E. , Bertino Enrico , Lembo David 
Published: August 2018

ABSTRACTObjectives:This study aimed to investigate the anti‐human cytomegalovirus (CMV) activity of milk from seropositive and seronegative mothers of preterm infants and to analyze its changes throughout the different stages of lactation and after Holder pasteurization, a procedure adopted by donor human milk banks.Methods:Eighteen mothers of preterm infants were enrolled in the study. Colostrum, transitional milk, and mature milk samples were collected and tested for anti‐CMV activity. Depletion of immunoglobulins A from milk samples was carried out by jacalin resin. Pools of milk samples were pasteurized according to Holder technique.Results:All samples were endowed with anti‐CMV activity, although to a different extent. In CMV IgG‐positive mothers, colostra were significantly more active than the transitional milk and mature milk samples. Moreover, they were more potent than colostra from seronegative mothers. Immunoglobulins A depletion in colostra from IgG‐positive mothers resulted in a partial loss of anti‐CMV activity. Holder pasteurization significantly reduced the antiviral activity.Conclusions:Human milk is endowed with anti‐CMV activity and its potency may vary depending on the stage of lactation and the serological status of the mother. This biological property could partially neutralize CMV particles excreted in the milk of CMV IgG‐positive mothers thus reducing the risk of transmitting infectious viruses to the infant.
First Intracardiac Kaposiform Hemangioendothelioma in an Infant Resolved With Sirolimus: A Case Report
Authors: Zaidi Syed Javed , Shaik Shaista , Agrawal Caitlin , Cossor Waseem 
Published: August 2018

Introduction:
Kaposiform hemangioendothelioma (KHE) is a rare and aggressive vascular tumor that can be associated with a consumptive coagulopathy and thrombocytopenia (Kasabach-Merritt phenomenon). Only one case of an intracardiac KHE has been reported which was treated with surgical excision and then expectant management.

Case Presentation:
We present a patient with an intracardiac KHE which presented as a large mass surrounding the atria, pulmonary veins, superior vena cava, and infiltrating the atrial septum with moderate compression of the superior vena cava and mild compression of the pulmonary veins. This tumor clinically presented as persistent tachypnea and was unresponsive to conventional therapy with vincristine and steroids but responded dramatically to Sirolimus with almost complete regression on follow-up.

Conclusions:
None of the current treatments for KHE, alone or in combination therapy have been found to be effective in a uniform or reproducible manner. Well designed, preferably randomized trials are required for a better understanding of the appropriate dosage and duration as well as response to treatment and a consensus of first and second line therapies.
Retinal Thickness Changes throughout the Natural History of Drusen in Age-related Macular Degeneration
Authors: Nivison-Smith Lisa , Wang Henrietta , Assaad Nagi , Kalloniatis Michael 
Published: August 2018

SIGNIFICANCE
Drusen are associated with retinal thinning in age-related macular degeneration (AMD). These changes, however, have mostly been examined at single time points, ignoring the evolution of drusen from emergence to regression. Understanding the full breadth of retinal changes associated with drusen will improve understanding of disease pathogenesis.

PURPOSE
The purpose of this study was to assess how the natural history of drusen affects retinal thickness, focusing on the photoreceptor and retinal pigment epithelium (RPE) layers.

METHODS
Spectral domain optical coherence tomography of subjects with intermediate AMD (n = 50) who attended the Centre for Eye Health, Sydney, Australia, for two separate visits (476 ± 16 days between visits) was extracted. Scans were automatically segmented with manufacturer software then assessed for drusen that had emerged, grown, or regressed between visits. For each identified lesion, the thickness of each retinal layer at the drusen peak and at adjacent drusen-free areas (150 μm nasal and temporal to the druse) was compared between visits.

RESULTS
Before drusen emergence, the RPE was significantly thicker at the drusen site (14.2 ± 2.6%) compared with neighboring drusen-free areas. There was a 71% sensitivity of RPE thickening predicting drusen emergence. Once drusen emerged, significant thinning of all outer retinal layers was observed, consistent with previous studies. Drusen growth was significantly correlated with thinning of the outer retina (r = −0.38, P < .001). Drusen regression resulted in outer retinal layers returning to thicknesses not significantly different from baseline.

CONCLUSIONS
The natural history of drusen is associated with RPE thickening before drusen emergence, thinning of the outer nuclear layer as well as photoreceptor and RPE layers proportional to drusen growth, and return to baseline thickness after drusen regression. These findings have useful clinical applications, providing a potential marker for predicting drusen emergence for AMD prognostic and intervention studies and highlighting that areas of normal retinal thickness in AMD may be former sites of regressed drusen.
Brief Report: Identification of Elite and Viremic Controllers From a Large Urban HIV Ambulatory Center in Kampala, Uganda
Authors: Kayongo Alex , Gonzalo-Gil Elena , Gümüşgöz Emrah , Niwaha Anxious J. , Semitala Fred , Kalyesubula Robert , Bagaya Bernard S. , Joloba Moses L. , Sutton Richard E. 
Published: August 2018

Background:
Throughout the world, there are antiretroviral therapy–naive HIV+ individuals who maintain elevated peripheral CD4+ T-cell counts, historically referred to as long-term nonprogressors (LTNPs). With recent improvements in viral load (VL) detection methods to levels as low as 20 copies per milliliter, 2 subsets of LTNPs have been defined: elite controllers (ECs), with undetectable VLs for at least 6–12 months, and viremic controllers (VCs), with VLs between 200 and 2000 copies per milliliter. ECs and VCs have been extensively studied in the developed world to determine underlying mechanisms responsible for virologic control. In sub-Saharan Africa, most studies have characterized LTNPs based on immunologic criteria making it difficult to compare findings with the Western cohorts, which use virologic criteria. Here, we describe a cohort of Uganda ECs and VCs attending a large HIV ambulatory center in Kampala, Uganda, based initially on CD4 counts and confirmed by repeated VL measurements.

Methods:
A cross-sectional study was conducted among 14,492 HIV-infected, antiretroviral therapy–naive individuals aged 18 years and older under care for at least 5 years with serial peripheral CD4 counts ≥500 cells/μL. Among those, we determined the frequency of individuals with VLs <2000 copies per milliliter for at least 6 months.

Results:
We report a prevalence of 0.26% (38/14,492) of HIV controllers in the clinic. We identified 36 ECs and 2 VCs. These individuals were middle-aged with an average CD4 count of 858 ± 172 (mean ± SD, 95% confidence interval: 795 to 921). Their average duration in HIV care was 7.4 ± 2.1 years (mean ± SD, 95% confidence interval: 6.6 to 8.1). The majority of EC/VCs were women (87%, 33/38), reflecting the demographics of the urban clinic.

Conclusions:
For the first time, this study demonstrates the frequency of EC/VCs in a large urban clinic in Uganda. Further study of these East African subjects may provide insights into how some individuals are able to control HIV in the absence of medications.
Lipofilling of Fingertips for Volume Defects after Fingertip Injuries
Authors: Cerny Michael K. , Moog Philipp , Bauer Anna-Theresa , Schmauss Daniel , Varga Laszlo , Aitzetmueller Matthias M. , Machens Hans-Günther , Duscher Dominik , Erne Holger 
Published: August 2018

Introduction
Regardless of the good outcomes of conservatively treated fingertip injuries, many patients complain about volume defects and hypoesthesia. Injection of autologous fat into the defect zone may resolve the volume problem and stimulate digital nerve regeneration by adipose derived stem cell transplantation.

Methods
We analyzed 5 volume defects resulting from conservatively treated fingertip injuries in 4 patients (male to female ratio, 2:2), 6 months after the injection of autologous abdominal fat into the defect zone retrospectively. The fat transplantation was performed after complete wound healing was achieved (2.5–13.5 months; mean, 6.5 months). Assessment of 2-point discrimination; finger pulp circumference; the Disability of the Arm, Shoulder, and Hand score; visual analog scale score; and a questionnaire regarding the treatment satisfaction were carried out both preoperatively and at a 6 month follow-up according to the standard of our clinic.

Results
In 3 patients, one session of lipofilling was sufficient to correct the contour, whereas 1 patient with 2 fingertip injuries was treated a second time. There was no significant change in finger pulp circumference, in the 2-point discrimination values and the Disability of the Arm, Shoulder, and Hand score results. There was a significant improvement in the visual analog scale scores in 4 of 5 cases, and all patients were very satisfied with the results of the procedure regarding the improvement in hand function in sports, at work and their daily routine.

Conclusions
Lipofilling can be performed with little operative risks, might alleviate the patient’s symptoms and reduce pain after conservative treatment of fingertip injuries.
Endoscopic Management of Spontaneous Cerebrospinal Fluid Fistula Caused by Clival Defect
Authors: Karli Rifat , Yildirim Ugur 
Published: August 2018

Abstract
Cerebrospinal fluid (CSF) rhinorrhea is that the fluid in subarachnoid space leaks into the nasal passage in any way as a transparent discharge. Cerebrospinal fluid fistulas generally develop as secondary to trauma. Only 3% of CSF fistulas develop spontaneously. Spontaneous CSF fistulas are mostly originated from ethmoid roof and cribriform plate; however, the development of spontaneous CSF fistula due to defect in clivus is very rare. To our knowledge, till date only 13 patients with spontaneous CSF fistulae due to Clivus defect have been reported in English literature. In this clinical report, the authors aimed to contribute to the literature by reporting a 56-year-old patient who has been treated in our clinic with spontaneous CSF fistula due to clivus defect.
Advances in management of Guillain–Barré syndrome
Authors: Doets Alex Y. , Jacobs Bart C. , van Doorn Pieter A. 
Published: August 2018

Purpose of reviewThe clinical presentation of Guillain–Barré syndrome (GBS) is highly variable, which can make the diagnosis challenging. Intravenous immunoglobulin (IVIg) and plasma exchange are the cornerstones of treatment since decades. But despite these treatments, 25% initially progress in muscle weakness, 25% require artificial ventilation, 20% is still not able to walk independently after 6 months, and 2–5% die, emphasizing the need for better treatment. We summarize new developments regarding the diagnosis, prognosis, and management of GBS.Recent findingsGBS is a clinical diagnosis that can be supported by cerebrospinal fluid examination and nerve conduction studies. Nerve ultrasound and MRI are potentially useful techniques to diagnose inflammatory neuropathies. Several novel infections have recently been associated to GBS. Evidence from experimental studies and recent phase 2 clinical trials suggests that complement inhibition combined with IVIg might improve outcome in GBS, but further studies are warranted. Prognostic models could guide the selection of patients with a relatively poor prognosis that might benefit most from additional IVIg or otherwise intensified treatment.SummaryNew diagnostic tools may help to have early and accurate diagnosis in difficult GBS cases. Increased knowledge on the pathophysiology of GBS forms the basis for development of new, targeted, and personalized treatments that hopefully improve outcome.
Trends and perspectives on the use of social network analysis in behavioural ecology: a bibliometric approach
Authors: Webber Quinn M.R. , Wal Eric Vander 
Published: August 2018

AbstractThe increased popularity and improved accessibility of social network analysis has improved our ability to test hypotheses about the complexity of animal social structure. To gain a deeper understanding of the use and application of social network analysis, we systematically surveyed the literature and extracted information on publication trends from articles using social network analysis. We synthesize trends in social network research over time and highlight variation in the use of different aspects of social network analysis. Our primary finding highlights the increase in use of social network analysis over time and from this finding, we observed an increase in the number of review and methods of social network analysis. We also found that most studies included a relatively small number (median = 15, range = 4–1406) of individuals to generate social networks, while the number and type of social network metrics calculated in a given study varied zero to nine (median = 2, range 0–9). The type of data collection or the software programs used to analyze social network data have changed; SOCPROG and UCINET have been replaced by various R packages over time. Finally, we found strong taxonomic and conservation bias in the species studied using social network analysis. Most species studied using social networks are mammals (111/201, 55%) or birds (47/201, 23%) and the majority tend to be species of least concern (119/201, 59%). We highlight emerging trends in social network research that may be valuable for distinct groups of social network researchers: students new to social network analysis, experienced behavioural ecologists interested in using social network analysis, and advanced social network users interested in trends of social network research. In summary we address the temporal trends in social network publication practices, highlight potential bias in some of the ways we employ social network analysis, and provide recommendations for future research based on our findings.
Approach direction prior to landing explains patterns of colour learning
Authors: Langridge Keri V. , Wilke Claudia , Riabinina Olena , Vorobyev Misha , de Ibarra Natalie Hempel 
Published: August 2018

SummaryGaze direction is closely coupled with body movement in insects and other animals. If movement patterns interfere with the acquisition of visual information, insects can actively adjust them to seek relevant cues. Alternatively, where multiple visual cues are available, an insect’s movements may influence how it perceives a scene. We show that the way a foraging bumblebee approaches a floral pattern could determine what it learns about the pattern. When trained to vertical bicoloured patterns, bumblebees consistently approached from below centre in order to land in the centre of the target where the reward was located. In subsequent tests, the bees preferred the colour of the lower half of the pattern that they predominantly faced during the approach and landing sequence. A predicted change of learning outcomes occurred when the contrast line was moved up or down off-centre: learned preferences again reflected relative frontal exposure to each colour during the approach, independent of the overall ratio of colours. This mechanism may underpin learning strategies in both simple and complex visual discriminations, highlighting that morphology and action patterns determines how animals solve sensory learning tasks. The deterministic effect of movement on visual learning may have substantially influenced the evolution of floral signals, particularly where plants depend on fine-scaled movements of pollinators on flowers.
Visual Long-term Memory Can Replace Active Maintenance in Visual Working Memory
Authors: Schurgin Mark W. , Cunningham Corbin A. , Egeth Howard E. , Brady Timothy F. 
Published: August 2018

AbstractHumans have remarkable visual long-term memory abilities, capable of storing thousands of objects with significant detail. However, it remains unknown how such memory is utilized during the short-term maintenance of information. Specifically, if people have a previously encoded memory for an item, how does this affect subsequent working memory for that same item? Here, we demonstrate people can quickly and accurately make use of visual long-term memories and therefore maintain less perceptual information actively in working memory. We assessed how much perceptual information is actively maintained in working memory by measuring neural activity during the delay period of a working memory task using electroencephalography. We find that despite maintaining less perceptual information in working memory when long-term memory representations are available, there is no decrement in memory performance. This suggests under certain circumstances people can dynamically disengage working memory maintenance and instead use long-term memories when available. However, this does not mean participants always utilize long-term memory. In a follow-up experiment, we introduced additional perceptual interference into working memory and found participants actively maintained items in working memory even when they had existing long-term memories available. These results clarify the kinds of conditions under which long-term and working memory operate. Specifically, working memory is engaged when new information is encountered or perceptual interference is high. Visual long-term memory may otherwise be rapidly accessed and utilized in lieu of active perceptual maintenance. These data demonstrate the interactions between working memory and long-term memory are more dynamic and fluid than previously thought.