bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-invasive ventilation and chronic obstructive pulmonary disease
Authors: Ramsay Michelle , Polkey Mike 
Published: April 2017

Abstract
Non-invasive ventilation is one of the major advances in respiratory medicine over the last century. It can be lifesaving for patients in acute hypercapnic respiratory failure, improving gas exchange and pulmonary mechanics and reducing the need for endotracheal intubation. Adherence to therapy is key to its success, and many patients find this a significant challenge. This case report will examine the pitfalls of initiating non-invasive ventilation, provide a brief overview of the current British Thoracic Society non-invasive ventilation guidelines, and describe common causes of a chronic obstructive pulmonary disease patient ‘failing’ non-invasive ventilation and an approach to the long-term management of the frequently exacerbating chronic obstructive pulmonary disease patient.
Oxygen: risks as well as benefits
Authors: McDermott Rory , Davidson Craig 
Published: April 2017

Abstract
Oxygen administration is the most commonly used therapy in emergency medicine. It is given to 18,000 patients in the United Kingdom every day, and 14% of patients in hospital receive it at some time during their stay. Whilst some of this activity is helpful, or indeed lifesaving, in some patients, oxygen can lead to harm, or even death. The domiciliary use of oxygen is also an area in which there is the potential for both waste and harm. When appropriately used, it prolongs life and provides valuable symptom relief; yet, in up to 43% of the cases, such therapy was either not used by patients as directed or provided no clinical benefit. At an annual cost in excess of £110 million, this is a lot of waste. This chapter examines the use of oxygen in both the acute setting and the assessment for home oxygen, with a focus on the pathophysiology behind oxygen therapy and the potential dangers.
Water on the lung: a rare cause of a transudative effusion and new options for palliation
Authors: Schomberg Lucy , Maskell Nick 
Published: April 2017

Abstract
Pleural effusions are very common in clinical practice and can be notoriously difficult to diagnose and a real challenge to manage. There is a large amount of literature on malignant effusions, but no clear guidelines on managing refractory non-malignant pleural effusions. This case examines a rarer cause of a transudative effusion, focussing on the route to diagnosis. The emergence of thoracic ultrasound, in light of the National Patient Safety Agency report in 2008, and the increased safety are reviewed, and, in addition, the options for management are considered, including the tunnelled pleural catheter as a potential long-term solution in this challenging situation.
Pulmonary vasculature
Authors: Vergnaud Sophie , Dobarro David , Wort John 
Published: April 2017

Abstract
A 16-year-old girl with a diagnosis of diffuse cutaneous systemic sclerosis is referred to a specialist pulmonary hypertension centre with a history of progressive breathlessness, reduced exercise tolerance, and raised pulmonary pressures on transthoracic echocardiogram. She is found to have pulmonary arterial hypertension on right cardiac catheterization and is started on sildenafil, a phosphodiesterase-5 inhibitor, which stabilizes her condition. An endothelin receptor antagonist is added, which provides some initial symptomatic improvement. She continues to deteriorate over a period of 5 years, ultimately requiring intravenous prostanoids, the only treatment to provide a real symptomatic and haemodynamic improvement. This chapter explores the physiology and pathophysiology of pulmonary arterial hypertension, its classification, the means of investigation and diagnosis, who to refer to specialist centres, and the concepts behind current and future treatment strategies.
Sleep-disordered breathing in the obese
Authors: Mandal Swapna , Steier Joerg 
Published: April 2017

Abstract
Sleep-disordered breathing in the obese is not a small problem. Obesity-related sleep-disordered breathing is common and may include sleep apnoea or obesity hypoventilation syndrome. Patients present with symptoms of excessive daytime sleepiness, breathlessness, and, in severe cases, hypercapnic respiratory failure. In recent decades, the prevalence of obesity has increased exponentially. Although not exclusively responsible, obesity is directly linked to the development of sleep-disordered breathing due to high resistance in the upper airway, increased work of breathing, and high neural respiratory drive. Obese patients with sleep disorders are complicated with multiple metabolic, cardiovascular, and orthopaedic co-morbidities, frequently presenting at an advanced stage. This chapter reviews a common clinical presentation of an obese patient with a respiratory condition and the difficulties in their management. The chapter explains the complex underlying pathophysiology and the long-term management of these patients, and shows how sleep-disordered breathing may develop as a consequence of obesity.
Pulmonary sarcoidosis
Authors: Bloom Chloe , Donnelly Seamus 
Published: April 2017

Abstract
This case of a young female with suspected pulmonary sarcoidosis demonstrates the difficulties in confirming the diagnosis and subsequently identifying the appropriate treatment. Current guidelines were developed in the 1990s, and there has been little change in the diagnostic pathway since then. However, there are new clinical tools to help differentiate from the common differential diagnosis of tuberculosis. The patient’s management can be complex, with a host of clinical parameters that can be potentially used to assess each patient’s disease activity, severity, and prognosis, and the decision to start immunosuppressive treatment is often difficult. The mainstay of treatment remains glucocorticoids, with a wide choice of possible steroid-sparing agents. However, the evidence for their use is limited. This case is particularly interesting, as the patient is a female with a young daughter who is planning imminently on continuing her family and has legitimate concerns about treatment side effects.
Nonlinear buckling behaviour of spherical shells: barriers and symmetry-breaking dimples
Authors: Hutchinson John W. , Thompson J. Michael T. 
Published: April 2017

The nonlinear axisymmetric post-buckling behaviour of perfect, thin, elastic spherical shells subject to external pressure and their asymmetric bifurcations are characterized, providing results for a structure/loading combination with an exceptionally nonlinear buckling response. Immediately after the onset of buckling, the buckling mode localizes into a dimple at the poles. The relations among the pressure, the dimple amplitude and the change in volume of the shell are determined over a large range of pole deflections. These results allow accurate evaluation of criteria such as the Maxwell condition for which the energies in the unbuckled and buckled states are the same and evaluation of the influences of pressure versus volume-controlled loadings. Non-axisymmetric bifurcation from the axisymmetric state, which occurs deep into the post-buckling regime in the form of multi-lobed dimples, is also established and discussed.
This article is part of the themed issue ‘Patterning through instabilities in complex media: theory and applications.’
Fluid dynamic instabilities: theory and application to pattern forming in complex media
Authors: Gallaire François , Brun P.-T. 
Published: April 2017

In this review article, we exemplify the use of stability analysis tools to rationalize pattern formation in complex media. Specifically, we focus on fluid flows, and show how the destabilization of their interface sets the blueprint of the patterns they eventually form. We review the potential use and limitations of the theoretical methods at the end, in terms of their applications to practical settings, e.g. as guidelines to design and fabricate structures while harnessing instabilities.
This article is part of the themed issue ‘Patterning through instabilities in complex media: theory and applications’.
Segmentation in cohesive systems constrained by elastic environments
Authors: Novak I. , Truskinovsky L. 
Published: April 2017

The complexity of fracture-induced segmentation in elastically constrained cohesive (fragile) systems originates from the presence of competing interactions. The role of discreteness in such phenomena is of interest in a variety of fields, from hierarchical self-assembly to developmental morphogenesis. In this paper, we study the analytically solvable example of segmentation in a breakable mass–spring chain elastically linked to a deformable lattice structure. We explicitly construct the complete set of local minima of the energy in this prototypical problem and identify among them the states corresponding to the global energy minima. We show that, even in the continuum limit, the dependence of the segmentation topology on the stretching/pre-stress parameter in this problem takes the form of a devil's type staircase. The peculiar nature of this staircase, characterized by locking in rational microstructures, is of particular importance for biological applications, where its structure may serve as an explanation of the robustness of stress-driven segmentation.
This article is part of the themed issue ‘Patterning through instabilities in complex media: theory and applications.’
Drying paint: from micro-scale dynamics to mechanical instabilities
Authors: Goehring Lucas , Li Joaquim , Kiatkirakajorn Pree-Cha 
Published: April 2017

Charged colloidal dispersions make up the basis of a broad range of industrial and commercial products, from paints to coatings and additives in cosmetics. During drying, an initially liquid dispersion of such particles is slowly concentrated into a solid, displaying a range of mechanical instabilities in response to highly variable internal pressures. Here we summarize the current appreciation of this process by pairing an advection-diffusion model of particle motion with a Poisson–Boltzmann cell model of inter-particle interactions, to predict the concentration gradients in a drying colloidal film. We then test these predictions with osmotic compression experiments on colloidal silica, and small-angle X-ray scattering experiments on silica dispersions drying in Hele–Shaw cells. Finally, we use the details of the microscopic physics at play in these dispersions to explore how two macroscopic mechanical instabilities—shear-banding and fracture—can be controlled.
This article is part of the themed issue ‘Patterning through instabilities in complex media: theory and applications.’
Regimes of wrinkling in pressurized elastic shells
Authors: Taffetani Matteo , Vella Dominic 
Published: April 2017

We consider the point indentation of a pressurized elastic shell. It has previously been shown that such a shell is subject to a wrinkling instability as the indentation depth is quasi-statically increased. Here we present detailed analysis of this wrinkling instability using a combination of analytical techniques and finite-element simulations. In particular, we study how the number of wrinkles observed at the onset of instability grows with increasing pressurization. We also study how, for fixed pressurization, the number of wrinkles changes both spatially and with increasing indentation depth beyond onset. This ‘Far from threshold’ analysis exploits the largeness of the wrinkle wavenumber that is observed at high pressurization and leads to quantitative differences with the standard ‘Near threshold’ stability analysis.
This article is part of the themed issue ‘Patterning through instabilities in complex media: theory and applications.’
Estimating the extinction date of the thylacine accounting for unconfirmed sightings
Authors: Carlson Colin J. , Bond Alexander L. , Burgio Kevin R. 
Published: April 2017

ABSTRACTThe thylacine (Thylacinus cynocephalus), one of Australia’s most characteristic megafauna, was the largest marsupial carnivore until hunting, and potentially disease, drove them to extinction in 1936. Current knowledge suggests that thylacines became extinct on mainland Australia two millennia prior to their extirpation on Tasmania, but recent “plausible” sightings on the Cape York Peninsula have emerged, leading some to speculate the species may persist, undetected. Here we show that the continued survival of the thylacine is entirely implausible based on most current mathematical theories of extinction. We present a dataset including physical evidence, expert-validated sightings, and unconfirmed sightings leading up to the present day, and use a Bayesian framework that takes all three types of data into account by modelling them as independent processes, to evaluate the likelihood of the thylacine’s persistence. Although the last captive thylacine died in 1936, our model suggests the most likely extinction date would be 1940, or at the latest the 1950s. We validated this result by using other extinction estimator methods, all of which confirmed that the thylacine’s extinction likely fell between 1936 and 1943; even the most optimistic scenario suggests the species did not persist beyond 1956. The search for the thylacine, much like similar efforts to “rediscover” other recently extinct charismatic species, is likely to be fruitless, especially given that persistence on Tasmania would have been no guarantee the species could reappear in regions that had been unoccupied for millennia. The search for the thylacine may become a rallying point for conservation and wildlife biology, and could indirectly help fund and support critical research in understudied areas like Cape York. However, our results suggest that attempts to rediscover the thylacine will likely be unsuccessful.
Improved outcome and cost effectiveness in ablation of persistent atrial fibrillation under general anaesthetic
Authors: Martin Claire A , Curtain James P , Gajendragadkar Parag R , Begley David A , Fynn Simon P , Grace Andrew A , Heck Patrick M , Salaunkey Kiran , Virdee Munmohan S , Agarwal Sharad 
Published: April 2017

AbstractAimsOutcome of persistent atrial fibrillation (AF) ablation remains suboptimal. Techniques employed to reduce arrhythmia recurrence rate are more likely to be embraced if cost-effectiveness can be demonstrated. A single-centre observational study assessed whether use of general anaesthesia (GA) in persistent AF ablation improved outcome and was cost-effective.Methods292 patients undergoing first ablation procedures for persistent AF under conscious sedation or GA were followed. End points were freedom from listing for repeat ablation at 18 months and freedom from recurrence of atrial arrhythmia at one year.ResultsFreedom from atrial arrhythmia was higher in patients who underwent ablation under GA rather than sedation (63.9% vs 42.3%, HR 1.87, 95% CI: 1.23 to 2.86, p = 0.002). Significantly fewer GA patients were listed for repeat procedures (29.2% vs 42.7%, HR 1.62, 95% CI: 1.01 to 2.60, p = 0.044). Despite GA procedures costing slightly more, a saving of £177 can be made per patient in our centre for a maximum of 2 procedures if all persistent AF ablations are performed under GA.ConclusionsIn patients with persistent AF, it is both clinical and economically more effective to perform ablation under GA rather than sedation.What’s New?There is very little known regarding the clinical outcome of catheter ablation of AF under GA compared with sedation; to our knowledge there is one study only in paroxysmal AF and no studies examining cost effectiveness.This study shows that in patients with persistent AF, it is both clinical and economically more effective to perform ablation under GA rather than sedation.This study leads us to recommend the use of GA for the ablation of persistent AF. As PAF ablation is now increasingly being undertaken by single shot techniques which do not have the same requirements for analgesia and immobility, GA resources may be allocated for persistent AF ablation.
CiliaCarta: an integrated and validated compendium of ciliary genes
Authors: van Dam Teunis J. P. , Kennedy Julie , Lee Robin van der , Vrieze Erik de , Wunderlich Kirsten A. , Rix Suzanne , Dougherty Gerard W. , Lambacher Nils J. , Li Chunmei , Jensen Victor L. , Leroux Michel R. , Hjeij Rim , Horn Nicola , Texier Yves , Wissinger Yasmin , van Reeuwijk Jeroen , Wheway Gabrielle , Knapp Barbara , Scheel Jan F. , Franco Brunella , Mans Dorus A. , van Wijk Erwin , Képès François , Slaats Gisela G. , Toedt Grischa , Kremer Hannie , Omran Heymut , Szymanska Katarzyna , Koutroumpas Konstantinos , Ueffing Marius , Nguyen Thanh-Minh T. , Letteboer Stef J.F. , Oud Machteld M. , van Beersum Sylvia E. C. , Schmidts Miriam , Beales Philip L. , Lu Qianhao , Giles Rachel H. , Szklarczyk Radek , Russell Robert B. , Gibson Toby J. , Johnson Colin A. , Blacque Oliver E. , Wolfrum Uwe , Boldt Karsten , Roepman Ronald , Hernandez-Hernandez Victor , Huynen Martijn A. 
Published: April 2017

AbstractThe cilium is an essential organelle at the surface of most mammalian cells whose dysfunction causes a wide range of genetic diseases collectively called ciliopathies. The current rate at which new ciliopathy genes are identified suggests that many ciliary components remain undiscovered. We generated and rigorously analyzed genomic, proteomic, transcriptomic and evolutionary data and systematically integrated these using Bayesian statistics into a predictive score for ciliary function. This resulted in 285 candidate ciliary genes. We found experimental evidence of ciliary associations for 24 out of 36 analyzed candidate proteins. In addition, we show that OSCP1, which has previously been implicated in two distinct non-ciliary functions, causes a cilium dysfunction phenotype when depleted in zebrafish. The candidate list forms the basis of CiliaCarta, a comprehensive ciliary compendium covering 836 genes. The resource can be used to objectively prioritize candidate genes in whole exome or genome sequencing of ciliopathy patients and can be accessed athttp://bioinformatics.bio.uu.nl/john/syscilia/ciliacarta/.
Ablation of complex fractionated electrograms improves outcome in long standing persistent atrial fibrillation
Authors: Martin Claire A , Curtain James P , Gajendragadkar Parag R , Begley David A , Fynn Simon P , Grace Andrew A , Heck Patrick M , Virdee Munmohan S , Agarwal Sharad 
Published: April 2017

AbstractPurposeThere is controversy and sparse data on whether substrate based techniques in addition to pulmonary vein isolation (PVI) confer benefit in the catheter ablation of persistent atrial fibrillation (AF), especially if long standing. We performed an observational study to assess whether substrate based ablation improved freedom from atrial arrhythmia.Methods286 patients undergoing first ablation procedures for persistent AF with PVI only, PVI plus linear ablation, or PVI plus complex fractionated electrogram (CFAE) and linear ablation were followed. Primary end point was freedom from atrial arrhythmia at one year.ResultsMean duration of pre-procedure time in AF was 28+/-27 months. Freedom from atrial arrhythmia was higher with a PVI+CFAE+lines strategy then for PVI alone (HR 1.56, 95% CI: 1.04-2.34, p=0.032) but was not higher with PVI+lines. Benefit of substrate modification was conferred for pre-procedure times in AF of over 30 months. The occurrence of atrial tachycardia was higher when lines were added to the ablation strategy (HR 0.08, 95% CI: 0.01-0.59, p=0.014). Freedom from atrial arrhythmia at 1 year was higher with lower patient age, use of general anaesthetic (GA), normal or mildly dilated left atrium and decreasing time in AF.ConclusionsIn patients with long standing persistent AF of over 30 months duration, CFAE ablation resulted in improved freedom from atrial arrhythmia. Increased freedom from atrial arrhythmia occurs in patients who are younger and have smaller atria, and with GA procedures. Linear ablation did not improve outcome and resulted in a higher incidence of atrial tachycardia.
Limitation of dogwhelk consumption of mussels by crab cues depends on dogwhelk density and cue type
Authors: Boudreau Melanie L. , Scrosati Ricardo A. , Wong Melisa C. 
Published: April 2017

AbstractPredator nonconsumptive effects (NCEs) on prey activity are common in nature. Upon sensing predator cues, a common prey response is to reduce feeding to avoid being detected by predators. Using an aquatic system, this study investigated how prey density and predator cue type affect predator NCEs on prey feeding. Prey density was investigated because, as it increases, the individual risk of being preyed upon decreases, which may reduce NCEs if prey can detect conspecifics. Predator cue type was investigated because waterborne cues would trigger weaker NCEs than waterborne and tactile cues combined, as predation risk may be perceived by prey to be stronger in the second case. Specifically, a factorial experiment tested the hypotheses that (i) increasing dogwhelk (prey) density reduces the limitation that crab (predator) chemical cues can have on dogwhelk consumption of mussels and that (ii) chemical and tactile crab cues combined limit dogwhelk feeding more strongly than chemical crab cues alone. The results broadly supported these hypotheses. On the one hand, crab chemical cues limited the per-capita consumption of mussels by dogwhelks at a low dogwhelk density, but such NCEs disappeared at intermediate and high dogwhelk densities. On the other hand, the combination of chemical and tactile cues from crabs caused stronger NCEs, as dogwhelk consumption of mussels was negatively affected at all three dogwhelk densities. The structurally complex mussel beds may provide not only food for dogwhelks but a refuge from crab predation that allows dogwhelk density to limit crab NCEs when mediated by waterborne cues. Overall, this study suggests that prey evaluate conspecific density when assessing predation risk and that the type of cues prey are exposed to can affect their interpretation of risk.
Evolution of coprophagy and nutrient absorption in a cave salamander
Authors: Soares Daphne , Roenfeldt Rachel , Hammond Shea , Slay Michael E. , Fenolio Dante B. , Niemiller Matthew L. 
Published: April 2017

AbstractThe transition from carnivory to omnivory is poorly understood. The ability to feed at more than one trophic level theoretically increases an animal’s fitness in a novel environment. Because of the absence of light and photosynthesis, most subterranean ecosystems are characterized by very few trophic levels, such that food scarcity is a challenge in many subterranean habitats. One strategy against starvation is to expand diet breadth. Grotto salamanders (Eurycea spelaea) are known to ingest bat guano deliberately, challenging the general understanding that salamanders are strictly carnivorous. Here we tested the hypothesis that grotto salamanders have broadened their diet related to cave adaptation and found that, although coprophagous behavior is present, salamanders are unable to acquire sufficient nutrition from bat guano alone. Our results suggest that the coprophagic behavior has emerged prior to physiological or gut biome adaptations.