bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiopulmonary Exercise Testing and Prognosis in Hypertrophic Cardiomyopathy
Authors: Coats Caroline J. , Rantell Khadija , Bartnik Aleksandra , Patel Amour , Mist Bryan , McKenna William J. , Elliott Perry M. 
Published: September 2015

Background—
Exercise testing is performed in patients with hypertrophic cardiomyopathy to evaluate blood pressure response, a risk factor for sudden cardiac death. The prognostic role of exercise gas exchange variables is unknown.

Methods and Results—

Between 1998 and 2010, 1898 patients (age 47±15 years, range 16–86 years; 67% male) with hypertrophic cardiomyopathy underwent cardiopulmonary exercise testing. A total of 178 (9.4%) patients reached the primary end point of all-cause mortality or heart transplant (death/transplant) during a median follow-up of 5.6 years (interquartile range 2.6–8.9), giving an annual event rate of 1.6% per person year. Peak oxygen consumption (adjusted hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.77–0.88,
P
<0.001), ventilatory efficiency (adjusted HR 1.10, 95% CI 1.00–1.22,
P
=0.049), and ventilatory anaerobic threshold (adjusted HR 0.82, 95% CI 0.70–0.96,
P
=0.016) were predictors of the primary outcome after correction for age, sex, left atrial size, nonsustained ventricular tachycardia, and ejection fraction. The overall adjusted death/transplant estimates for patients in the lowest quartile with peak oxygen consumption ≤15.3 mL/kg/min were 14% at 5 years and 31% at 10 years. Peak oxygen consumption (HR 0.81, 95% CI 0.77–0.86,
P
<0.01) and ventilation to carbon dioxide production (HR 1.10, 95% CI 1.08–1.13,
P
<0.001) were predictors of death because of heart failure or transplantation but not sudden cardiac death or implantable cardioverter defibrillator shocks.

Conclusions—
Cardiopulmonary exercise testing provides prognostic information in patients with hypertrophic cardiomyopathy. Submaximal exercise parameters, such as ventilatory efficiency and anaerobic threshold, measured alone or in combination with peak oxygen consumption, predict death from heart failure.
Modulation of Land-Use Change Impacts on Temperature Extremes via Land–Atmosphere Coupling over Australia
Authors: Hirsch A L. , Pitman A. J. , Kala J. , Lorenz R. , Donat M. G. 
Published: September 2015

Abstract
The role of land–atmosphere coupling in modulating the impact of land-use change (LUC) on regional climate extremes remains uncertain. Using the Weather and Research Forecasting Model, this study combines the Global Land–Atmosphere Coupling Experiment with regional LUC to assess the combined impact of land–atmosphere coupling and LUC on simulated temperature extremes. The experiment is applied to an ensemble of planetary boundary layer (PBL) and cumulus parameterizations to determine the sensitivity of the results to model physics. Results show a consistent weakening in the soil moisture–maximum temperature coupling strength with LUC irrespective of the model physics. In contrast, temperature extremes show an asymmetric response to LUC dependent on the choice of PBL scheme, which is linked to differences in the parameterization of vertical transport. This influences convective precipitation, contributing a positive feedback on soil moisture and consequently on the partitioning of the surface turbulent fluxes. The results suggest that the impact of LUC on temperature extremes depends on the land–atmosphere coupling that in turn depends on the choice of PBL. Indeed, the sign of the temperature change in hot extremes resulting from LUC can be changed simply by altering the choice of PBL. The authors also note concerns over the metrics used to measure coupling strength that reflect changes in variance but may not respond to LUC-type perturbations.
A Thermodynamically Based Model for Actual Evapotranspiration of an Extensive Grass Field Close to FAO Reference, Suitable for Remote Sensing Application
Authors: de Bruin H. A. R. , Trigo I. F. , Bosveld F. C. , Meirink J. F. 
Published: September 2015

Abstract
A thermodynamically based model is presented to estimate daily actual evapotranspiration (ET) of a grass site closely resembling reference grass as defined by the Food and Agriculture Organization of the United Nations (FAO) under nonadvective conditions, from Meteosat Second Generation (MSG) imagery. The model presented here is derived from the thermodynamic theory by Schmidt combined with an atmospheric boundary layer model. Daily net radiation over the (reference) grass surface is parameterized as a function of global radiation, which can be estimated from MSG observations. It is then shown that ET over the grass area can be estimated using remotely sensed daily global radiation and air temperature as input only. The validation relied on observations gathered in Cabauw, a site closely resembling the reference grass, as defined by the FAO. The comparison with in situ data indicated a bias of 2.8 W m−2 and an RMSE of 7.7 W m−2. The possibility of using the approach developed here to provide reference crop evapotranspiration ETo is discussed. Because of the ambiguousness of ETo definition regarding local advection effects, it should be noted that explicitly advection-free conditions are dealt with. It is pointed out that in semiarid regions local advection cannot be ignored.
Efficacy of Warm Needle Moxibustion on Lumbar Disc Herniation
Authors: Li Xinhua , Han Yingchao , Cui Jian , Yuan Ping , Di Zhi , Li Lijun 
Published: September 2015

Background. Clinical studies on the efficacy of warm needle moxibustion to treat lumbar disc herniation are increasing, while studies on the assessment of its efficacy are still lacking. Objective. To assess the clinical effect of warm needle moxibustion on lumbar disc herniation. Methods. We searched relevant trials that compared warm needle moxibustion with other methods for lumbar disc herniation from 9 databases. Results. Warm needle moxibustion showed statistical significance efficiency rate compared with acupuncture and manipulation but had a similar rate with nonsteroidal anti-inflammatory drugs (NSAIDs). It showed a statistically significanty excellent rate when compared with acupuncture and manipulation but had a similar rate with NSAIDs. Regarding Japanese Orthopedic Association scores, it showed statistical significance with acupuncture and manipulation, but the rate was similar with Chinese medicine and NSAIDs. Regarding visual analog scale score, it demonstrated statistical significance when compared with acupuncture, manipulation, and NSAIDs but had a similar rate with Chinese medicine. Conclusion. Warm needle moxibustion is superior to acupuncture and manipulation in terms of efficiency rate, excellent rate, and controlling of pain for lumbar disc herniation, but it is similar when compared with NSAIDs and Chinese medicine.
Increased ventilatory response to carbon dioxide in COPD patients following vitamin C administration
Authors: Hartmann Sara E. , Kissel Christine K. , Szabo Lian , Walker Brandie L. , Leigh Richard , Anderson Todd J. , Poulin Marc J. 
Published: September 2015

Patients with chronic obstructive pulmonary disease (COPD) have decreased ventilatory and cerebrovascular responses to hypercapnia. Antioxidants increase the ventilatory response to hypercapnia in healthy humans. Cerebral blood flow is an important determinant of carbon dioxide/hydrogen ion concentration at the central chemoreceptors and may be affected by antioxidants. It is unknown whether antioxidants can improve the ventilatory and cerebral blood flow response in individuals in whom these are diminished. Thus, we aimed to determine the effect of vitamin C administration on the ventilatory and cerebrovascular responses to hypercapnia during healthy ageing and in COPD.Using transcranial Doppler ultrasound, we measured the ventilatory and cerebral blood flow responses to hyperoxic hypercapnia before and after an intravenous vitamin C infusion in healthy young (Younger) and older (Older) subjects and in moderate COPD.Vitamin C increased the ventilatory response in COPD patients (mean (95% CI) 1.1 (0.9–1.1)versus1.5 (1.1–2.0) L·min−1·mmHg−1, p<0.05) but not inYounger(2.5 (1.9–3.1)versus2.4 (1.9–2.9) L·min−1·mmHg−1, p>0.05) orOlder(1.3 (1.0–1.7)versus1.3 (1.0–1.7) L·min−1·mmHg−1, p>0.05) healthy subjects. Vitamin C did not affect the cerebral blood flow response in the young or older healthy subjects or COPD subjects (p>0.05).Vitamin C increases the ventilatory but not cerebrovascular response to hyperoxic hypercapnia in patients with moderate COPD.
Acute myocardial infarctionversusother cardiovascular events in community-acquired pneumonia
Authors: Aliberti Stefano , Ramirez Julio , Cosentini Roberto , Valenti Vincenzo , Voza Antonio , Rossi Paolo , Stolz Daiana , Legnani Delfino , Pesci Alberto , Richeldi Luca , Peyrani Paula , Massari Fernando Maria , Blasi Francesco 
Published: September 2015

The aim of the present study was to define the prevalence, characteristics, risk factors and impact on clinical outcomes of acute myocardial infarction (AMI)versusother cardiovascular events (CVEs) in patients with community-acquired pneumonia (CAP).This was an international, multicentre, observational, prospective study of CAP patients hospitalised in eight hospitals in Italy and Switzerland. Three groups were identified: those without CVEs, those with AMI and those with other CVEs.Among 905 patients, 21 (2.3%) patients experienced at least one AMI, while 107 (11.7%) patients experienced at least one other CVE. Patients with CAP and either AMI or other CVEs showed a higher severity of the disease than patients with CAP alone. Female sex, liver disease and the presence of severe sepsis were independent predictors for the occurrence of AMI, while female sex, age >65 years, neurological disease and the presence of pleural effusion predicted other CVEs. In-hospital mortality was significantly higher among those who experienced AMI in comparison to those experiencing other CVEs (43%versus21%, p=0.039). The presence of AMI showed an adjusted odds ratio for in-hospital mortality of 3.57 (p=0.012) and for other CVEs of 2.63 (p=0.002).These findings on AMIversusother CVEs as complications of CAP may be important when planning interventional studies on cardioprotective medications.
Wide prevalence of hybridization in two sympatric grasshopper species may be shaped by their relative abundances
Authors: Rohde Katja , Hau Yvonne , Weyer Jessica , Hochkirch Axel 
Published: September 2015

AbstractBackgroundHybridization between species is of conservation concern as it might threaten the genetic integrity of species. Anthropogenic factors can alter hybridization dynamics by introducing new potentially hybridizing species or by diminishing barriers to hybridization. This may even affect sympatric species pairs through environmental change, which so far has received little attention. We studied hybridization prevalence and the underlying behavioral mechanisms in two sympatric grasshopper species, a rare specialist (Chorthippus montanus) and a common generalist (Chorthippus parallelus). We conducted a mate choice experiment with constant intraspecific density and varying heterospecific density, i.e. varying relative frequency of both species.ResultsMate choice was frequency-dependent in both species with a higher risk of cross-mating with increasing heterospecific frequency, while conspecific mating increased linearly with increasing conspecific density. This illustrates that reproductive barriers could be altered by environmental change, if the relative frequency of species pairs is affected. Moreover, we performed a microsatellite analysis to detect hybridization in twelve syntopic populations (and four allotopic populations). Hybrids were detected in nearly all syntopic populations with hybridization rates reaching up to 8.9 %. Genetic diversity increased for both species when hybrids were included in the data set, but only in the common species a positive correlation between hybridization rate and genetic diversity was detected.ConclusionOur study illustrates that the relative frequency of the two species strongly determines the effectiveness of reproductive barriers and that even the more choosy species (Ch. montanus) may face a higher risk of hybridization if population size decreases and its relative frequency becomes low compared to its sister species. The asymmetric mate preferences of both species may lead to quasi-unidirectional gene flow caused by unidirectional backcrossing. This might explain why genetic diversity increased only in the common species, but not in the rare one. Altogether, the hybridization rate was much higher than expected for a widely sympatric species pair.
Limited genomic divergence between intraspecific forms of Culex pipiens under different ecological pressures
Authors: Gomes Bruno , Wilding Craig S. , Weetman David , Sousa Carla A. , Novo Maria T. , Savage Harry M. , Almeida António P. G. , Pinto João , Donnelly Martin J. 
Published: September 2015

AbstractBackgroundDivergent selection can be a major driver of ecological speciation. In insects of medical importance, understanding the speciation process is both of academic interest and public health importance. In the West Nile virus vectorCulex pipiens, intraspecific pipiens and molestus forms vary in ecological and physiological traits. Populations of each form appear to share recent common ancestry but patterns of genetic differentiation across the genome remain unknown. Here, we undertook an AFLP genome scan on samples collected from both sympatric and allopatric populations from Europe and the USA to quantify the extent of genomic differentiation between the two forms.ResultsThe forms were clearly differentiated but each exhibited major population sub-structuring between continents. Divergence between pipiens and molestus forms from USA was higher than in both inter- and intra-continental comparisons with European samples. The proportion of outlier loci between pipiens and molestus (≈3 %) was low but consistent in both continents, and similar to those observed between sibling species of other mosquito species which exhibit contemporary gene flow. Only two of the outlier loci were shared between inter-form comparisons made within Europe and USA.ConclusionThis study supports the molestus and pipiens status as distinct evolutionary entities with low genomic divergence. The low number of shared divergent loci between continents suggests a relatively limited number of genomic regions determining key typological traits likely to be driving incipient speciation and/or adaptation of molestus to anthropogenic habitats.
Neurospora discreta as a model to assess adaptation of soil fungi to warming
Authors: Romero-Olivares Adriana L. , Taylor John W. , Treseder Kathleen K. 
Published: September 2015

Abstract
Background
Short-term experiments have indicated that warmer temperatures can alter fungal biomass production and CO2 respiration, with potential consequences for soil C storage. However, we know little about the capacity of fungi to adapt to warming in ways that may alter C dynamics. Thus, we exposed Neurospora discreta to moderately warm (16 °C) and warm (28 °C) selective temperatures for 1500 mitotic generations, and then examined changes in mycelial growth rate, biomass, spore production, and CO2 respiration. We tested the hypothesis that strains will adapt to its selective temperature. Specifically, we expected that adapted strains would grow faster, and produce more spores per unit biomass (i.e., relative spore production). In contrast, they should generate less CO2 per unit biomass due to higher efficiency in carbon use metabolism (i.e., lower mass specific respiration, MSR).

Results
Indeed, N. discreta adapted to warm temperatures, based on patterns of relative spore production. Adapted strains produced more spores per unit biomass than parental strains in the selective temperature. Contrary to our expectations, this increase in relative spore production was accompanied by an increase in MSR and a reduction in mycelial growth rate and biomass, compared to parental strains.

Conclusions
Adaptation of N. discreta to warm temperatures may have elicited a tradeoff between biomass production and relative spore production, possibly because relative spore production required higher MSR rates. Therefore, our results do not support the idea that adaptation to warm temperatures will lead to a more efficient carbon use metabolism. Our data might help improve climate change model simulations and provide more concise predictions of decomposition processes and carbon feedbacks to the atmosphere.
An action research approach to facilitating the adoption of a foot health assessment tool in India
Authors: Harrison‐Blount Michael , Cullen Michelle , Nester Christopher J. , Williams Anita E. 
Published: September 2015

AbstractBackgroundIndia has a diabetes population that is growing and alongside this, the incidence of limb threatening foot problems is increasing. Foot health care provision does not yet meet this demand. In one locality in India, clinicians had an unstructured approach to foot health assessments resulting in poor adoption of evidence based guidelines from the West and a persistence of serious foot complications. There was the perception that existing assessment tools did not take into account the local cultural, organizational and professional needs and there was a lack of ownership of any potential solution to the problem. Therefore, the aim of this work was to facilitate the ownership and development of a foot health assessment tool for use in the Indian context. In order to achieve this an action research approach was chosen.MethodsParticipants were facilitated through the action and implementation phases of the action research cycle by the researchers. The action phase included generating a list of potential items for inclusion in the tool from a review of the literature to provide an evidence based foundation for the foot health assessment tool. A modified Delphi method was used to further refine the contents of the tool. Members of the Delphi Panel (n = 8) were experts in their field of medicine and experts in delivering health care within services in India.ResultsThe outcome of the study was the adoption of a locally developed foot health assessment tool (Salford Indian Foot Health Assessment Tool, SIFT). It contains thirteen sections, which reflect the risk factors identified for assessing foot health agreed by the participants to fit the Indian context. The SIFT is supported with evidence based guidelines from the West and a training program was delivered by the researchers in order to support its implementation into clinical practice.ConclusionAn action research approach has facilitated the development and implementation of a locally created and owned foot health assessment tool. This in turn has resulted in the integration of evidence‐based guidelines from the West with consideration to local cultural, organizational and professional needs and ultimately the needs of their patients. Further work is underway evaluating the outcomes of the SIFT in practice.
Role of Notch signaling during lipopolysaccharide-induced preterm labor
Authors: Agrawal Varkha , Jaiswal Mukesh K , Pamarthy Sahithi , Katara Gajendra K , Kulshrestha Arpita , Gilman-Sachs Alice , Hirsch Emmet , Beaman Kenneth D 
Published: September 2015

AbstractNotch signaling pathways exert effects throughout pregnancy and are activated in response to TLR ligands. To investigate the role of Notch signaling in preterm labor, Notch receptors (Notch1–4), its ligand Delta-like protein-1, transcriptional repressor hairy and enhancer of split-1, and Notch deregulator Numb were assessed. Preterm labor was initiated on gestation d 14.5 by 1 of 2 methods: 1) inflammation-induced preterm labor: intrauterine injection of LPS (a TLR4 agonist) and 2) hormonally induced preterm labor: subcutaneous injection of mifepristone. Delta-like protein-1, Notch1, and hairy and enhancer of split-1 were elevated significantly, and Numb was decreased in the uterus and placenta of inflammation-induced preterm labor mice but remained unchanged in hormonally induced preterm labor compared with their respective controls. F4/80+ macrophage polarization was skewed in the uterus of inflammation-induced preterm labor toward M1-positive (CD11c+) and double-positive [CD11c+ (M1) and CD206+ (M2)] cells. This process is dependent on activation of Notch signaling, as shown by suppression of M1 and M2 macrophage-associated cytokines in decidual macrophages in response to γ-secretase inhibitor (an inhibitor of Notch receptor processing) treatment ex vivo. γ-Secretase inhibitor treatment also diminished the LPS-induced secretion of proinflammatory cytokines and chemokines in decidual and placental cells cultured ex vivo. Furthermore, treatment with recombinant Delta-like protein-1 ligand enhanced the LPS-induced proinflammatory response. Notch ligands (Jagged 1 and 2 and Delta-like protein-4) and vascular endothelial growth factor and its receptor involved in angiogenesis were reduced significantly in the uterus and placenta during inflammation-induced preterm labor. These results suggest that up-regulation of Notch-related inflammation and down-regulation of angiogenesis factors may be associated with inflammation-induced preterm labor but not with hormonally induced preterm labor.
Health Care Cost Containment in West Germany
Authors: Stone Deborah A. 
Published: September 2015

The West German health care system has experienced a serious escalation of expenditures since about 1970. For a variety of reasons, many features of the national health insurance program that might have provided restraints on costs were gradually eliminated. Most notably, some restrictions on the supply of physicians and hospital facilities were ended, as was an earlier system of fixed budgeting for ambulatory care services. In addition, legislative and judicial decisions have continually expanded both the benefits and the standard of care that must be provided to publicly insured patients.
In 1977, the government passed a Health Care Cost Containment Act which ordered several measures to curb costs: prospectively negotiated ceilings on expenditures for physicians' services, dentists' services and prescription drugs; strengthening of utilization review; composition of a unified fee schedule; small increases in cost sharing and limitations on insurance benefits; and some changes in financing. The reform efforts seem to have had a significant effect, though it is still too early to tell exactly what caused the declining growth rate of health expenditures, and whether the new trend will persist.