bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short‐term Prognosis and Current Management of Syncopal Patients at Intermediate Risk: Results from the IRiS (Intermediate‐Risk Syncope) Study
Authors: Numeroso Filippo , Mossini Gianluigi , Giovanelli Michela , Lippi Giuseppe , Cervellin Gianfranco 
Published: May 2016

AbstractObjectivesDespite guidelines, admission rates and expenditures for syncope remain high. This may be caused by an imprecise definition of cardiovascular disease considered at risk and an overestimation of the role of comorbidities and advanced age. In a cohort of patients with undetermined syncope, we prospectively compared the short‐term prognosis of patients at intermediate risk (i.e., with stable heart diseases or comorbidities, of any age) versus those at high risk for cardiogenic syncope and identified factors associated with serious events. Secondarily, we analyzed the current management of intermediate‐risk patients.MethodsIn a cohort of patients with undetermined syncope, we analyzed personal data, the presence of stable heart diseases or comorbidities, destination, length of hospitalization, incidence of serious events at 30 days, and costs.ResultsIn a 6‐month period, 347 patients (185 male and 162 female, age 72.8 years) with undetermined syncope were enrolled, 250 at intermediate risk and 97 at high risk. Intermediate‐risk patients were younger, with less frequent comorbidities and with a drastically lower incidence of serious events (0.8% vs. 27.8%, p < 0.001). Risk factors for cardiogenic syncope were the unique variable associated with serious events. Intermediate‐risk patients were mostly admitted (62.8%) in an ordinary ward or into an emergency department observation unit; in the case of ordinary admission we observed a mean prolonged hospitalization (8.8 days), elevated costs ($270,183), and a high rate of unexplained syncope (51%).ConclusionsAccording to the results of this study, the authors believe that intermediate‐risk patients could be safely discharged, with potentially significant costs saving. In prognostic stratification, priority is to seek risk factors for cardiogenic syncope while advanced age, stable heart diseases, or comorbidities likely lead to inappropriate hospitalization.
Tree species and position matter: the role of pests for survival of other insects
Authors: Hilszczański Jacek , Jaworski Tomasz , Plewa Radosław , Horák Jakub 
Published: May 2016

Abstract

We investigated insects overwintering in Norway spruce and Scots pine killed by cambium‐feeding beetles. The study was conducted in five large forests in north‐eastern Poland. Insects were reared from wood samples cut from the upper and lower parts of trees growing in both shaded and sun‐exposed conditions.
We found that the species richness of overwintering insects on killed trees was mainly driven by the position in the lower trunk strata rather than in crowns or along a sun–shade gradient. Even though pine and spruce shared almost the same species composition, spruce hosted a significantly higher number of species, including beneficial ones.
These results support the hypothesis that disturbance regimes change the spatial distribution of biodiversity, which is higher in low strata, as is known for abiotic disturbances that change the environment of the forest.
One of the most important messages emerging from the present study is that pest beetle disturbance during non‐outbreak periods creates habitats that are necessary for the survival of myriads of other insects. Thus, maintaining parts of the trees that were killed by bark and wood‐boring beetles, especially high stumps, would help to support biodiversity in managed forests.
Late Pleistocene and Holocene extreme hydrological event records from slackwater flood deposits of theAnkang east reach in the upperHanjiangRiver valley,China
Authors: Zhou Liang , Huang Chun Chang , Zhou Yali , Pang Jiangli , Zha Xiaochun , Xu Jie , Zhang Yuzhu , Guo Yongqiang 
Published: May 2016

This paper reports an investigation into palaeoflooding along the upper reaches of the Hanjiang River valley, China. Based on the sedimentary evidence of the palaeohydrological regime, two bedsets of palaeoflood slackwater deposits (SWDs) were identified interbedded within the Holocene loess–soil sequence along the riverbanks of the Ankang east reach. Optical Stimulated Luminescence (OSL) dating and stratigraphical correlation with previously dated sites were used to reconstruct the chronology of the palaeoflood events. The results show that the palaeoflood events represented bySWD1 occurred between 13 000 and 12 400 a, coincident with the climatic transition from the Bølling–Allerød (BL+AL) stage to the Younger Dryas (YD) event. The palaeoflood events recorded bySWD2 were dated to 1000–800 a, corresponding to the later stages of the North Song Dynasty (AD960–1127) and the subsequent South Song Dynasty (AD1127–1279), which was a time of climatic decline according to historical documents. Palaeoflood discharges were estimated using the step‐backwater method, and the peak discharges were estimated to be in the range 35 200–47 400 m3 s−1. These results are of significance to our understanding of the regional hydrological response to global climatic change, the utilization of water resources, hydraulic engineering, flood control and disaster reduction.
8000 years of vegetation history in the northern Iberian Peninsula inferred from the palaeoenvironmental study of the Zalama ombrotrophic bog (Basque‐Cantabrian Mountains, Spain)
Authors: Pérez‐Díaz Sebastián , López‐Sáez José Antonio , Pontevedra‐Pombal Xabier , Souto‐Souto Martín , Galop Didier 
Published: May 2016

This paper focuses on pollen, spores, non‐pollen palynomorphs (NPPs) and certain geochemical elements from the ombrotrophic blanket bog of Zalama (Basque‐Cantabrian Mountains, northern Iberian Peninsula), with the support of a robust chronology based on 17 AMS 14C dates. The main results related to the last 8000 years show that, during the early middle Holocene, pines and deciduous forests were the most extensive tree formations. At the beginning of the succession, pines reach 44%, showing regional presence, whereas after 7600 cal. a BP, deciduous forests were particularly abundant. From c. 6500 cal. a BP the pollen diagram constructed from our samples shows the first anthropogenic evidence, linked with the new economic practices related to the Neolithic of the Basque‐Cantabrian Mountains. From 3300 cal. a BP the expansion of Fagus sylvatica is particularly clear, and has since then become one of the dominant forest species in this region. We also discuss the Holocene evolution of other noteworthy plant communities in southwestern Europe, such as Taxus baccata, Juglans and shrublands.
Comparative risk of major cardiovascular events associated with second‐line antidiabetic treatments: a retrospective cohort study using UK primary care data linked to hospitalization and mortality records
Authors: Zghebi S. S. , Steinke D. T. , Rutter M. K. , Emsley R. A. , Ashcroft D. M. 
Published: May 2016

AimsTo examine the risk of major cardiovascular events associated with second‐line diabetes therapies, in patients with type 2 diabetes, after adjusting for known cardiovascular risk factors.MethodsThis was a retrospective cohort study of patients prescribed second‐line regimens between 1998 and 2011 after first‐line metformin. The UK Clinical Practice Research Datalink, with linked national hospitalization and mortality data, for the period up to December 2013, was used. Inverse probability of treatment‐weighted time‐varying Cox regression models was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing a major cardiovascular event (cardiovascular death, myocardial infarction, stroke, acute coronary syndrome, unstable angina, or coronary revascularization) associated with second‐line therapies. Analyses adjusted for patient demographic characteristics, comorbidities, glycated haemoglobin, socio‐economic status, ethnicity, smoking status and concurrent medications.ResultsA total of 10 118 initiators of a second‐line add‐on to metformin of either a sulphonylurea (n = 6740), dipeptidyl peptidase‐4 (DPP‐4) inhibitor (n = 1030) or thiazolidinedione (n = 2348) were identified. After a mean (standard deviation) of 2.4 (1.9) years of follow‐up, 386, 36 and 95 major cardiovascular events occurred in sulphonylurea‐, DPP‐4 inhibitor‐ and thiazolidinedione‐initiators, respectively. In comparison with the metformin–sulphonylurea regimen, adjusted HRs were 0.78 (95% CI 0.55; 1.11) for the metformin–DPP‐4 inhibitor regimen and 0.68 (95% CI 0.54; 0.85) for the metformin–thiazolidinedione regimen.ConclusionsThiazolidinedione add‐on treatments to metformin were associated with lower risks of major cardiovascular disease or cardiovascular death compared with sulphonylurea add‐on treatment to metformin. Lower, but non‐statistically significant, risks were also found with DPP‐4 inhibitor add‐on therapies.
Adult Learning in Innovative Organisations
Authors: Sutherland Olsen Dorothy 
Published: May 2016

AbstractThe relationship between learning and innovation has been a central theme in studies of innovation (Fagerberg et al., 2005, Borras & Edquist, 2014, Lundvall & Johnsen, 1994). Studies of the workplace have also claimed a relationship between skills or training and a firm's ability to innovate (Toner, 2011). Recent studies of innovation in European firms (Arundalet al., 2007) included surveys on organisational contexts and suggested that some organisational forms were especially conducive to learning and innovation. Studies of the learning context or of training and skills development often refer to, or make assumptions about learning, without explaining who is learning or how this learning is occurring. This article supplements some of these earlier surveys by carrying out in‐depth qualitative studies of learners in innovative organisations in Norway. The organisation of activities and the learning environments are analysed. This is supplemented by information on local HRM practice and strategies for skills development and training. The data include information on formal and informal learning of participants working within product development. We then discuss how these workers draw upon their learning in their everyday work and how their everyday work provides the opportunity for new learning. By linking HRM and innovation, this article offers a novel way of studying adult learning in the workplace and adds to our understanding of how it contributes to economic success.
Fostering Entrepreneurial Learning On‐the‐Job: evidence from innovative small and medium‐sized companies in Europe
Authors: Baggen Yvette , Lans Thomas , Biemans Harm J. A. , Kampen Jarl , Mulder Martin 
Published: May 2016

AbstractAs economies become more innovation‐driven, the need for entrepreneurial behaviour amongst employees working for existing companies increases in order to enhance the organisations’ capacity to develop new ideas, products and services. Hence, entrepreneurial learning and the development of entrepreneurial competencies of employees on‐the‐job become more important. One of the most crucial competencies in this regard is the ability to identify potential business opportunities, referred to as opportunity identification competence (OIC). In this empirical study, antecedents of OIC were investigated in a small and medium‐sized business context. Based on the 3‐P (i.e. presage, process, product) model, specific learner, work environment, and process factors influencing OIC as an outcome variable were studied. More than 200 employees from 12 companies completed a questionnaire. Results of a backward regression analysis underline the importance of investing in programmes that focus on entrepreneurial learning at the shop floor level, trusting employees that they are capable of actively participating in the early stages of innovation and the crucial role of owner‐managers to support entrepreneurial employee activities.
Impact of neural cell adhesion molecule deletion on regeneration after mouse spinal cord injury
Authors: Saini Vedangana , Loers Gabriele , Kaur Gurcharan , Schachner Melitta , Jakovcevski Igor 
Published: May 2016

AbstractThe neural cell adhesion molecule (NCAM) plays important functional roles in development of the nervous system. We investigated the influence of a constitutive ablation of NCAM on the outcome of spinal cord injury. Transgenic mice lacking NCAM (NCAM−/−) were subjected to severe compression injury of the lower thoracic spinal cord using wild‐type (NCAM+/+) littermates as controls. According to the single‐frame motion analysis, the NCAM−/− mice showed reduced locomotor recovery in comparison to control mice at 3 and 6 weeks after injury, indicating an overall positive impact of NCAM on recovery after injury. Also the Basso Mouse Scale score was lower in NCAM−/− mice at 3 weeks after injury, whereas at 6 weeks after injury the difference between genotypes was not statistically significant. Worse locomotor function was associated with decreased monoaminergic and cholinergic innervation of the spinal cord caudal to the injury site and decreased axonal regrowth/sprouting at the site of injury. Astrocytic scar formation at the injury site, as assessed by immunohistology for glial fibrillary acidic protein at and around the lesion site was increased in NCAM−/− compared with NCAM+/+ mice. Migration of cultured monolayer astrocytes from NCAM−/− mice was reduced as assayed by scratch wounding. Numbers of Iba‐1 immunopositive microglia were not different between genotypes. We conclude that constitutive NCAM deletion in young adult mice reduces recovery after spinal cord injury, validating the hypothesized beneficial role of this molecule in recovery after injury.
Chronic pain disrupts the reward circuitry in multiple sclerosis
Authors: Seixas Daniela , Palace Jacqueline , Tracey Irene 
Published: May 2016

AbstractPain commonly affects multiple sclerosis (MS) patients, and has the potential to become chronic and burden an already damaged central nervous system. Imaging studies are providing insights into brain restructuring associated with chronic pain and different chronic pain conditions seem to evoke distinct plasticity patterns. Our objective was to study the structural and functional brain changes of chronic neuropathic pain of MS. Employing structural and resting functional magnetic resonance imaging we compared MS patients with chronic central pain with MS patients without pain matched with respect to age, gender, subtype and duration of MS and disability. Mean duration of pain was 7.6 years. Comparing the pain and no‐pain groups, brain functional default‐mode network differences were found. There was decreased coactivation in the caudate nucleus and nucleus accumbens bilaterally. Also, for the relapsing‐remitting subgroup of patients, grey matter thickness changes predominated in the pain group in the mesial region of the temporal lobes, caudate, putamen, thalami and the fronto‐parietal cortex; in the group without pain, changes predominated in the frontopolar and orbitofrontal cortices and in the occipital areas. A dysfunction in the reward system in chronic pain of MS was found, particularly in the brain areas involved in its motivational aspects, as such probably reflecting the maladaptive physiology of chronic pain, and possibly the signature of pain in MS, in a disease where reward impairment seems to be already one of its features.
Laminar analysis of the slow wave activity in the somatosensory cortex of anesthetized rats
Authors: Fiáth Richárd , Kerekes Bálint Péter , Wittner Lucia , Tóth Kinga , Beregszászi Patrícia , Horváth Domonkos , Ulbert István 
Published: May 2016

AbstractRhythmic slow waves characterize brain electrical activity during natural deep sleep and under anesthesia, reflecting the synchronous membrane potential fluctuations of neurons in the thalamocortical network. Strong evidence indicates that the neocortex plays an important role in the generation of slow wave activity (SWA), however, contributions of individual cortical layers to theSWAgeneration are still unclear. The anatomically correct laminar profiles ofSWAwere revealed under ketamine/xylazine anesthesia, with combined local field potential recordings, multiple‐unit activity (MUA), current source density (CSD) and time‐frequency analyses precisely co‐registered with histology. The up‐state related negative field potential wave showed the largest amplitude in layerIV, theCSDwas largest in layers I andIII, whereasMUAwas maximal in layer V, suggesting spatially dissociated firing and synaptic/transmembrane processes in the rat somatosensory cortex. Up‐state related firing could start in virtually any layers (III–VI) of the cortex, but were most frequently initiated in layer V. However, in a subset of experiments, layerIVwas considerably active in initiating up‐state relatedMUAeven in the absence of somatosensory stimulation. Somatosensory stimulation further strengthened up‐state initiation in layerIV. Our results confirm that cortical layer V firing may have a major contribution to the up‐state generation of ketamine/xylazine‐inducedSWA, however, thalamic influence through the thalamorecipient layerIVcan also play an initiating role, even in the absence of sensory stimulation.
Large‐scale impact of climate change vs. land‐use change on future biome shifts in Latin America
Authors: Boit Alice , Sakschewski Boris , Boysen Lena , Cano‐Crespo Ana , Clement Jan , Garcia‐alaniz Nashieli , Kok Kasper , Kolb Melanie , Langerwisch Fanny , Rammig Anja , Sachse René , van Eupen Michiel , von Bloh Werner , Clara Zemp Delphine , Thonicke Kirsten 
Published: May 2016

AbstractClimate change and land‐use change are two major drivers of biome shifts causing habitat and biodiversity loss. What is missing is a continental‐scale future projection of the estimated relative impacts of both drivers on biome shifts over the course of this century. Here, we provide such a projection for the biodiverse region of Latin America under four socio‐economic development scenarios. We find that across all scenarios 5–6% of the total area will undergo biome shifts that can be attributed to climate change until 2099. The relative impact of climate change on biome shifts may overtake land‐use change even under an optimistic climate scenario, if land‐use expansion is halted by the mid‐century. We suggest that constraining land‐use change and preserving the remaining natural vegetation early during this century creates opportunities to mitigate climate‐change impacts during the second half of this century. Our results may guide the evaluation of socio‐economic scenarios in terms of their potential for biome conservation under global change.
Andean uplift drives diversification of the bothriurid scorpion genus Brachistosternus
Authors: Ceccarelli F. Sara , Ojanguren‐Affilastro Andrés A. , Ramírez Martín J. , Ochoa José A. , Mattoni Camilo I. , Prendini Lorenzo 
Published: May 2016

AbstractAimOne of the planet's most imposing geomorphological features, the Andes, played an important role in the evolution of South America's flora and fauna. The bothriurid scorpion genus Brachistosternus Pocock, 1893 comprises more than 40 species with high diversity and endemism in the Andes. The present contribution investigates the biogeographical history of this genus using molecular phylogenetics and dating, to determine the role of Andean uplift on the distribution and diversification of its species.LocationSouth America.MethodsA dated species tree was obtained for 55 putative species based on two nuclear and three mitochondrial gene loci. Ancestral ranges and biogeographical events were estimated on the species tree, diversification rates and rate shifts calculated, and areas with high phylogenetic diversity (PD) and evolutionary distinctiveness identified.ResultsBrachistosternus diversified at a steady rate during the main Andean uplift. The central Andean and western slope/Pacific coastal biogeographical provinces played important roles as ancestral areas. Coastal areas of central Chile and southern Peru exhibit high levels of PD in Brachistosternus, suggesting they experienced a relatively long period of ecological stability, while the Andes continued to rise.Main conclusionsAndean uplift created new habitats and climate regimes, favouring speciation in genera such as Brachistosternus. Coastal areas to the west of the Andes continued to harbour older lineages while accommodating more recently diverged lineages from the nearby Andes.
A consensus‐based practical and daily guide for the treatment of acne patients
Authors: Gollnick H.P. , Bettoli V. , Lambert J. , Araviiskaia E. , Binic I. , Dessinioti C. , Galadari I. , Ganceviciene R. , Ilter N. , Kaegi M. , Kemeny L. , López‐Estebaranz J.L. , Massa A. , Oprica C. , Sinclair W. , Szepietowski J.C. , Dréno B. 
Published: May 2016

AbstractBackgroundMany current guidelines provide detailed evidence‐based recommendations for acne treatment.ObjectiveTo create consensus‐based, simple, easy‐to‐use algorithms for clinical acne treatment in daily office‐based practice and to provide checklists to assist in determining why a patient may not have responded to treatment and what action to take.MethodsExisting treatment guidelines and consensus papers were reviewed. The information in them was extracted and simplified according to daily clinical practice needs using a consensus‐based approach and based on the authors' clinical expertise.ResultsAs outcomes, separate simple algorithms are presented for the treatment of predominant comedonal, predominant papulopustular and nodular/conglobate acne. Patients with predominant comedonal acne should initially be treated with a topical retinoid, azelaic acid or salicylic acid. Fixed combination topicals are recommended for patients with predominant papulopustular acne with treatment tailored according to the severity of disease. Treatment recommendations for nodular/conglobate acne include oral isotretinoin or fixed combinations plus oral antibiotics in men, and these options may be supplemented with oral anti‐androgenic hormonal therapy in women. Further decisions regarding treatment responses should be evaluated 8 weeks after treatment initiation in patients with predominant comedonal or papulopustular acne and 12 weeks after in those with nodular/conglobate acne. Maintenance therapy with a topical retinoid or azelaic acid should be commenced once a patient is clear or almost clear of their acne to prevent the disease from recurring. The principal explanations for lack of treatment response fall into 5 main categories: disease progression, non‐drug‐related reasons, drug‐related reasons, poor adherence, and adverse events.ConclusionThis practical guide provides dermatologists with treatment algorithms adapted to different clinical features of acne which are simple and easy to use in daily clinical practice. The checklists to establish the causes for a lack of treatment response and subsequent action to take will facilitate successful acne management.