bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic disease in the elderly: back to the future of internal medicine
Authors: Fabbri L.M. , Ferrari R. 
Published: September 2016

Key pointsThe ageing of the population has increased the prevalence of chronic diseases, which represent a huge proportion of human illness.The two most important risk factors underlying the most frequent chronic diseases of the elderly are tobacco use and obesity.The most important comorbidities are cardiovascular diseases and chronic respiratory diseases, particularly COPD.Comorbidities may not only contribute to the severity of a patient's clinical manifestations, but they may also complicate its treatment, and they are therefore important to recognise and treat effectively.Educational aimsTo increase the interest of chest physicians in multiple chronic comorbidities in the elderly.To define the most important and frequent comorbidities in elderly patients, particularly those with COPD.To provide updated information on the most common chronic diseases present in the elderly.To emphasise the limitations of single disease-oriented clinical practice guidelines, and the need for a more comprehensive “internistic” approach to patients with multiple chronic comorbidities.To suggest that chronic inflammation might represent the common pathogenetic link between the different chronic diseases present in the elderly.SummaryElderly people are often affected by two or more chronic diseases, more frequently cardiovascular diseases, chronic respiratory diseases, metabolic syndrome and cancer. These most frequent chronic diseases share largely preventable risk factors, the most important being smoking and obesity, and may be linked to chronic systemic inflammation. Coexisting chronic diseases affect the course of the primary disease and alter the efficacy and safety of its management. Current clinical practice is dominated by the "singledisease" approach, which has major limitations, and there is increasing evidence that a patient-oriented approach that takes into account the several co-existing components of chronic disease is required. This "change of concept" implies the need for medical specialists to extend their expertise to broader diagnostic and treatment approaches that are traditionally the purview of internal medicine. This new approach also requires a different approach to clinical research and teaching, followed by extensive rewriting of medical textbooks and remodelling of teaching curricula to reflect the complexity of the patient affected by chronic diseases.
Problems of air travel for patients with lung disease: clinical criteria and regulations
Authors: Robson A.G. , Innes J.A. 
Published: September 2016

Key pointsCommercial aircraft have a hypoxic environment, equivalent to an altitude of 2,438 m (8,000 ft) above sea level.Normal subjects and the majority of respiratory patients can tolerate this without symptoms. In practice, medical diversions for respiratory problems are very rare.The tendency of individual patients to become hypoxic in these conditions cannot be predicted with accuracy from sea-level oxygen saturation or spirometry.Hypoxic challenge may be used to simulate the inflight environment, to predict hypoxaemia and to assess the effectiveness of inflight oxygen.Most airlines, with adequate warning, can provide oxygen at 2 or 4 litres per minute for respiratory patients.While it may be possible to predict hypoxia during flight, there are no means of predicting symptoms or actual risk of harm during air travel.Educational aimsTo identify the potential problems that patients with chronic respiratory conditions may encounter during air travel.To recognise that guidelines have been developed from a number of sources to assist doctors involved in assessing a patient who is considering air travel.To make clinicians aware of the different methods of hypoxic challenge that have been developed to help with the clinical assessment of patients.To highlight that many patients with chronic lung disease are capable of air travel without developing significant hypoxia, but to raise awareness about which patients are likely to be at risk.To discuss the potential difficulties that may arise for the patient when they are arranging inflight oxygen.SummaryDoctors are frequently asked by patients with chronic lung disease if they are fit to fly. As commercial flights are not pressurised to sea level, there is a reduction in partial pressure of oxygen (PO2), which may result in significant hypoxia in otherwise asymptomatic patients.A number of different assessment methods have been developed to assess flight fitness and several professional organisations have developed guidelines to help doctors give informed advice.Patients who become significantly hypoxic during a flight assessment may still be able to travel with supplemental oxygen. However, the provision of supplemental oxygen is dependent on individual airline policy and considerable variations in policy have been recorded.This review aims to give a brief overview of air travel for patients with lung disease, including physiology, guidelines, assessing fitness to fly and oxygen supplementation.
ERS School Course Basic principles of clinical exercise testing - Clinical exercise testing
Authors: Palange P. , Ward S.A. , Whipp B.J. 
Published: September 2016

Educational aimsTo provide a comprehensive introduction to the physiological basis of integrative exercise testing.To identify the indications and the protocols used in clinical settings.To discuss the clinical applications of exercise testing with special reference to lung and heart diseases.To understand the utility of exercise testing in the prescription and evaluation of therapeutic interventions and in rehabilitation.SummaryExercise intolerance is the hallmark of pulmonary and cardiac diseases. However, measurements of lung and cardiac function obtained at rest (e.g.forced expiratory volume in one second (FEV1), pulmonary diffusing capacity of the lung for carbon monoxide (DL,CO), left ventricular ejection fraction (EF)) are poorly predictive of the degree of exercise intolerance. Therefore, it is necessary to directly assess an individual's exercise intolerance and, where possible, establish its cause(s). The “gold standard” approach for this is cardiopulmonary exercise testing (CPET). CPET has also proven to be very useful in the following applications: prognostic evaluation of patients with chronic lung and heart diseases, such as chronic obstructive pulmonary diseases (COPD), interstitial lung diseases (ILD), cystic fibrosis (CF) and chronic heart failure (CHF); and evaluating the effects of interventions such as drug therapy, oxygen and heliox supplementation during exercise, and pulmonary rehabilitation based on exercise training.
Chronic cough: diagnosis, treatment and psychological consequences
Authors: Morice A.H. 
Published: September 2016

Educational aimsTo motivate the clinician to see chronic cough as a serious condition with extensive morbidity.To arm the clinician with the knowledge of the pathophysiology of chronic cough giving rise to the typical clinical history, enabling a firm diagnosis to be made.To suggest successful treatment strategies in patients with chronic cough.SummaryChronic cough is a common and disabling symptom leading to a marked decrement in a patient's quality of life. The vast majority of patients with chronic cough can be helped by making an accurate diagnosis, usually of either reflux disease or asthma.Reflux cough presents in a fashion markedly different from the classic symptoms of gastro-oesophageal reflux, such as heartburn. Indeed, <50% of patients with reflux cough suffer from heartburn. The correct diagnosis and correct treatment modality leads to amelioration of cough in the majority of cases.Where no diagnosis is obtained or there is a failure of therapy, non-specific cough suppression can dramatically improve the patient's quality of life.This overview provides information on the pathophysiology of the causes of chronic cough, hence enabling the reader to make an accurate clinical diagnosis and suggest therapy to improve even those with apparently intractable symptoms.
Causes and management of exacerbations of COPD
Authors: Vijayasaratha K. , Stockley R.A. 
Published: September 2016

Key pointsDiagnosis of exacerbations of COPD is based largely on key symptoms (increasing sputum purulence and volume, and breathlessness) and the severity depends on the level of healthcare resource utilisation.Aetiology is varied, although infection is the major causative factor. Neutrophilic inflammation is a major pathological event, but eosinophils are also implicated, suggesting an "asthmatic" aetiology.Airflow limitation and dynamic hyperinflation are the physiological changes, which can result in deterioration in gas exchange and respiratory failure.Antibiotics are reserved for purulent exacerbations, with the exception of the presence of pneumonia and prophylaxis during ventilation.Steroids are recommended for all hospitalised patients and outpatients with a significant increase in breathlessness.Controlled oxygen therapy is central to management and is guided by arterial blood gas measurements.Noninvasive ventilation is the preferred management for patients with acidotic respiratory failure when the arterial pH is 7.25–7.35 despite the standard initial therapy.Prevention of exacerbations is aided by influenza vaccination and the institution of regular inhaled long-acting bronchodilators and inhaled corticosteroids.Educational aimsTo understand the definition and burden of exacerbations.To understand the aetiology and varied pathophysiology.To understand the treatment and prevention of exacerbations.SummaryExacerbation of COPD is a common problem, which causes a considerable burden to the patient and the healthcare system. This article aims to give a structured overview of the different aspects of COPD exacerbations, including their classification, aetiology, pathophysiology, differential diagnosis, management and prevention.
Postgraduate Course ERS Munich 2006 - Paediatric respiratory medicine: allergy for paediatric pulmonologists; Management of paediatric anaphylaxis
Authors: Dubois A.E.J. 
Published: September 2016

Educational aimsTo understand how to identify those patients at substantial risk of anaphylaxis who are likely to be encountered in everyday practice.To explain how to undertake initial preventive strategies to reduce risk and facilitate specialist care aimed at further risk reduction and treatment.To detail the prescription of an adrenaline self-administration device and provide instructions on its proper use.SummaryAnaphylaxis is a severe, systemic allergic reaction. It is also potentially life-threatening. Acute treatment depends on the administration of adrenaline. It is possible to identify those at greatest risk of anaphylaxis and to reduce the danger, by helping them to modify their behaviour and by prescribing them an adrenaline self-administration device. Education and prevention are vital.
Tuberculosis in children
Authors: Corrigan D.L. , Paton J.Y. 
Published: September 2016

Key pointsTuberculosis (TB) is a major cause of morbidity and mortality worldwide. Children with TB are markers of recent disease transmission, usually from infectious adults. The 1 million cases of TB in children registered each year is likely to be a gross underestimate.The diagnosis is challenging and often presumed rather than confirmed. Symptoms, if present, are nonspecific.TB infection occurs when a previously uninfected child inhales an infected aerosol droplet. At this stage, the child usually shows no symptoms, the infection passes undetected and the primary focus heals. In most cases the infection is controlled by the body's immune system and the organisms remain dormant. This is called latent TB. TB disease can develop either then or at a later stage when the organism multiplies, overpowering the host defences. At this stage, symptoms develop and there may be radiological or microbiological evidence of disease."More bugs require more drugs". In TB infection, the organism load is small and therefore drug-resistant mutations are rare: hence simpler drug regimes are effective. In TB disease, the number of organisms is greater, so a combination of ≥3 drugs is required. Increasing resistance worldwide has led to four drugs being recommended as standard in many areas.Poor adherence to drug therapy is the main barrier to cure. Although directly observed therapy (DOTS) and intermittent therapy may improve the outcome, neither is a panacea. Co-operation and other strategies are required.Bacille Calmette-Guérin (BCG) vaccination remains the most widely used preventative strategy. Its efficacy is uncertain and its use needs to be targeted to neonates in high-risk areas who are most likely to benefit. The development of new vaccines against pulmonary TB is an important global challenge.Educational aimsTo describe the epidemiology and natural history of TB in children, focusing on pulmonary TB.To explore the challenges of diagnosis and provide an up-to-date overview of the methods available.To outline the management and prevention of pulmonary TB in children.SummaryDespite advances in diagnosis, treatment and prevention, tuberculosis (TB) remains a major cause of mortality and morbidity worldwide. Diagnosis and treatment in children present a challenge, particularly in the face of growing drug resistance and coexistent disease such as HIV. New diagnostic methods have not yet been fully validated for use in children. No new drugs have become available in the past 30 years and many of the commercially available preparations are unsuitable for children. In 2006, a number of major documents and strategies were launched aimed at improving the care of children with TB, a previously neglected area.
General continuous-time Markov model of sequence evolution via insertions/deletions: local alignment probability computation
Authors: Ezawa Kiyoshi 
Published: September 2016

Abstract
Background
Insertions and deletions (indels) account for more nucleotide differences between two related DNA sequences than substitutions do, and thus it is imperative to develop a method to reliably calculate the occurrence probabilities of sequence alignments via evolutionary processes on an entire sequence. Previously, we presented a perturbative formulation that facilitates the ab initio calculation of alignment probabilities under a continuous-time Markov model, which describes the stochastic evolution of an entire sequence via indels with quite general rate parameters. And we demonstrated that, under some conditions, the ab initio probability of an alignment can be factorized into the product of an overall factor and contributions from regions (or local alignments) delimited by gapless columns.

Results
Here, using our formulation, we attempt to approximately calculate the probabilities of local alignments under space-homogeneous cases. First, for each of all types of local pairwise alignments (PWAs) and some typical types of local multiple sequence alignments (MSAs), we numerically computed the total contribution from all parsimonious indel histories and that from all next-parsimonious histories, and compared them. Second, for some common types of local PWAs, we derived two integral equation systems that can be numerically solved to give practically exact solutions. We compared the total parsimonious contribution with the practically exact solution for each such local PWA. Third, we developed an algorithm that calculates the first-approximate MSA probability by multiplying total parsimonious contributions from all local MSAs. Then we compared the first-approximate probability of each local MSA with its absolute frequency in the MSAs created via a genuine sequence evolution simulator, Dawg. In all these analyses, the total parsimonious contributions approximated the multiplication factors fairly well, as long as gap sizes and branch lengths are at most moderate. Examination of the accuracy of another indel probabilistic model in the light of our formulation indicated some modifications necessary for the model’s accuracy improvement.

Conclusions
At least under moderate conditions, the approximate methods can quite accurately calculate ab initio alignment probabilities under biologically more realistic models than before. Thus, our formulation will provide other indel probabilistic models with a sound reference point.
On multiplicative metric spaces: survey
Authors: Došenović Tatjana , Postolache Mihai , Radenović Stojan 
Published: September 2016

AbstractThe purpose of this survey is to prove that the fixed point results for various multiplicative contractions are in fact equivalent to the corresponding fixed point results in (standard) metric spaces. For example, such are recent results established by He et al. (Fixed Point Theory Appl. 2014:48, 2014), Mongkolkeha and Sintunavarat (J. Nonlinear Sci. Appl. 8:1134-1140, 2015) and Abdou (J. Nonlinear Sci. Appl. 9:2347-2363, 2016) and all others from the list of references. Our results here generalize, complement, and improve recent ones from existing literature.
RETRACTED ARTICLE: An algebra of reversible computation
Authors: Wang Yong 
Published: September 2016

AbstractWe design an axiomatization for reversible computation called reversible ACP (RACP). It has four extendible modules: basic reversible processes algebra, algebra of reversible communicating processes, recursion and abstraction. Just like process algebra ACP in classical computing, RACP can be treated as an axiomatization foundation for reversible computation.
Complete genome sequence of Pseudomonas citronellolis P3B5, a candidate for microbial phyllo-remediation of hydrocarbon-contaminated sites
Authors: Remus-Emsermann Mitja N.P. , Schmid Michael , Gekenidis Maria-Theresia , Pelludat Cosima , Frey Jürg E. , Ahrens Christian H. , Drissner David 
Published: September 2016

AbstractPseudomonas citronellolis is a Gram negative, motile gammaproteobacterium belonging to the order Pseudomonadales and the family Pseudomonadaceae. We isolated strain P3B5 from the phyllosphere of basil plants (Ocimum basilicum L.). Here we describe the physiology of this microorganism, its full genome sequence, and detailed annotation. The 6.95 Mbp genome contains 6071 predicted protein coding sequences and 96 RNA coding sequences. P. citronellolis has been the subject of many studies including the investigation of long-chain aliphatic compounds and terpene degradation. Plant leaves are covered by long-chain aliphates making up a waxy layer that is associated with the leaf cuticle. In addition, basil leaves are known to contain high amounts of terpenoid substances, hinting to a potential nutrient niche that might be exploited by P. citronellolis. Furthermore, the isolated strain exhibited resistance to several antibiotics. To evaluate the potential of this strain as source of transferable antibiotic resistance genes on raw consumed herbs we therefore investigated if those resistances are encoded on mobile genetic elements. The availability of the genome will be helpful for comparative genomics of the phylogenetically broad pseudomonads, in particular with the sequence of the P. citronellolis type strain PRJDB205 not yet publicly available. The genome is discussed with respect to a phyllosphere related lifestyle, aliphate and terpenoid degradation, and antibiotic resistance.
Frontline Science: Defects in immune function in patients with sepsis are associated with PD-1 or PD-L1 expression and can be restored by antibodies targeting PD-1 or PD-L1
Authors: Patera Andriani C , Drewry Anne M , Chang Katherine , Beiter Evan R , Osborne Dale , Hotchkiss Richard S 
Published: September 2016

Abstract
Sepsis is a heterogeneous syndrome comprising a highly diverse and dynamic mixture of hyperinflammatory and compensatory anti-inflammatory immune responses. This immune phenotypic diversity highlights the importance of proper patient selection for treatment with the immunomodulatory drugs that are entering clinical trials. To better understand the serial changes in immunity of critically ill patients and to evaluate the potential efficacy of blocking key inhibitory pathways in sepsis, we undertook a broad phenotypic and functional analysis of innate and acquired immunity in the same aliquot of blood from septic, critically ill nonseptic, and healthy donors. We also tested the ability of blocking the checkpoint inhibitors programmed death receptor-1 (PD-1) and its ligand (PD-L1) to restore the function of innate and acquired immune cells. Neutrophil and monocyte function (phagocytosis, CD163, cytokine expression) were progressively diminished as sepsis persisted. An increasing frequency in PD-L1+-suppressor phenotype neutrophils [low-density neutrophils (LDNs)] was also noted. PD-L1+ LDNs and defective neutrophil function correlated with disease severity, consistent with the potential importance of suppressive neutrophil populations in sepsis. Reduced neutrophil and monocyte function correlated both with their own PD-L1 expression and with PD-1 expression on CD8+ T cells and NK cells. Conversely, reduced CD8+ T cell and NK cell functions (IFN-γ production, granzyme B, and CD107a expression) correlated with elevated PD-L1+ LDNs. Importantly, addition of antibodies against PD-1 or PD-L1 restored function in neutrophil, monocyte, T cells, and NK cells, underlining the impact of the PD-1:PD-L1 axis in sepsis-immune suppression and the ability to treat multiple deficits with a single immunomodulatory agent.
Incentive-Based Capital Requirements
Authors: Eufinger Christian , Gill Andrej 
Published: September 2016

This paper proposes a new regulatory approach that implements capital requirements contingent on executive incentive schemes. We argue that excessive risk taking in the financial sector originates from the shareholder moral hazard created by government guarantees rather than from corporate governance failures within banks. The idea behind the proposed regulatory approach is thus that the more the compensation structure decouples the interests of bank managers from those of shareholders by curbing risk-taking incentives, the higher the leverage the bank is permitted to take on. Consequently, the risk-shifting incentives caused by government guarantees and the risk-mitigating incentives created by the compensation structure offset each other such that the manager chooses the socially efficient investment policy. This paper was accepted by Amit Seru, finance.
Sibling Caregivers of People With Intellectual and Developmental Disabilities: Sociodemographic Characteristics and Material Hardship Prevalence
Authors: Sonik Rajan A. , Parish Susan L. , Rosenthal Eliana S. 
Published: September 2016

Abstract
In growing numbers, people with intellectual and developmental disabilities are outliving their parents, or at least their parents' ability to care for them. Consequently, adult siblings without intellectual and developmental disabilities are increasingly taking on primary caregiving responsibilities. However, adult siblings have received little study generally, and sibling caregivers have received even less. We used nationally representative data from the Survey of Income and Program Participation (SIPP) to describe the social characteristics and material hardship levels of sibling caregivers, in comparison to the general working age adult population. This study finds moderate material hardship to be pervasive among sibling caregivers, though extreme levels of hardship are possibly being abated somewhat through public benefit programs. Implications for greater service needs are discussed.