bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Advocacy Approaches to Improving Care for Breast and Cervical Cancer in East and Southern Africa
Authors: Kizub Darya A. , Zujewski JoAnne , Gralow Julie R. , Ndoh Kingsley , Soko Udie , Dvaladze Allison L. 
Published: January 2020

PURPOSE Breast and cervical cancer are the most common cancers among women in East and Southern Africa, where mortality remains high because of late diagnosis and limited access to treatment. We explored local approaches to breast and cervical cancer advocacy to identify the most pressing issues and opportunities for increasing the impact of civil society activities in the region. METHODS Focus group discussions were conducted with participants of the 2016 Women’s Empowerment Cancer Advocacy Network (WE CAN) Summit in Nairobi, Kenya. Discussions were audio-recorded, transcribed, coded, and analyzed for emergent themes. Results were presented to participants of 2019 WE CAN summit for cross-validation. RESULTS Four focus group discussions were conducted with 50 participants. Thirty-six (70%) identified as advocates, 30 (59%) as cancer survivors, 14 (27%) as nongovernmental organization representatives, 13 (25%) as researchers, 4 (8%) as clinicians, and 6 (8%) as policymakers. Although most participants focused on cancer awareness and screening/early detection, some noted that treatment was often unavailable and advocated for a broader strategy to improving access to care. Challenges to designing and implementing such a strategy included knowledge gaps in addressing late diagnosis and access to care, difficulty collaborating with like-minded organizations, approaching policymakers, and addressing treatment financing. Cancer coalitions, although rare, were crucial to building collaborations with ministries of health, policymakers, and international organizations that advanced breast and cervical cancer care. CONCLUSION Participants indicated that they would benefit from additional training about resource-appropriate best practices for improving breast and cervical cancer care and outcomes. Coalition-building and collaborations, including with oncologists and other medical professionals involved in cancer care, were crucial to leveraging limited resources, sharing lessons learned, and developing local solutions to common challenges.
Frequency and Incidence of Carney Complex Manifestations: A Prospective Multicenter Study With a Three-Year Follow-Up
Authors: Espiard Stéphanie , Vantyghem Marie-Christine , Assié Guillaume , Cardot-Bauters Catherine , Raverot Gerald , Brucker-Davis Françoise , Archambeaud-Mouveroux Françoise , Lefebvre Hervé , Nunes Marie-Laure , Tabarin Antoine , Lienhardt Anne , Chabre Olivier , Houang Muriel , Bottineau Muriel , Stroër Sebastian , Groussin Lionel , Guignat Laurence , Cabanes Laure , Feydy Antoine , Bonnet Fidéline , North Marie Odile , Dupin Nicolas , Grabar Sophie , Duboc Denis , Bertherat Jérôme 
Published: January 2020

Abstract

Introduction
Carney Complex (CNC) is a rare multiple endocrine and nonendocrine neoplasia syndrome. Manifestations and genotype-phenotype correlations have been described by retrospective studies, but no prospective study evaluating the occurrence of the different manifestations has been available so far.

Methods
This multicenter national prospective study included patients with CNC, primary pigmented nodular adrenal disease (PPNAD), or a pathogenic PRKAR1A mutation; after a full initial workup, participants were followed for 3 years with annual standardized evaluation.

Results
The cohort included 70 patients (50 female/20 male, mean age 35.4 ± 16.7 years, 81% carrying PRKAR1A mutation). The initial investigations allowed identification of several manifestations. At the end of the 3-year follow-up, the newly diagnosed manifestations of the disease were subclinical acromegaly in 6 patients, bilateral testicular calcifications in 1 patient, and cardiac myxomas in 2 patients. Recurrences of cardiac myxomas were diagnosed in 4 patients during the 3-year follow-up study period. Asymptomatic abnormalities of the corticotroph and somatotroph axis that did not meet criteria of PPNAD and acromegaly were observed in 11.4% and 30% of the patients, respectively. Patients carrying the PRKAR1A c.709-7del6 mutation had a mild phenotype.

Conclusion
This study underlines the importance of a systematic follow-up of the CNC manifestations, especially a biannual screening for cardiac myxoma. By contrast, regular screening for the other manifestations after a first extensive workup could be spread out, leading to a lighter and more acceptable follow-up schedule for patients. These are important results for recommendations for long-term management of CNC patients.
Fibroblast Growth Factor-21, Leptin, and Adiponectin Responses to Acute Cold-Induced Brown Adipose Tissue Activation
Authors: Sun Lijuan , Yan Jianhua , Goh Hui Jen , Govindharajulu Priya , Verma Sanjay , Michael Navin , Sadananthan Suresh Anand , Henry Christiani Jeyakumar , Velan S Sendhil , Leow Melvin Khee-Shing 
Published: January 2020

Abstract

Background
Adipocyte-derived hormones play a role in insulin sensitivity and energy homeostasis. However, the relationship between circulating fibroblast growth factor 21 (FGF21), adipocytokines and cold-induced supraclavicular brown adipose tissue (sBAT) activation is underexplored.

Objective
Our study aimed to investigate the relationships between cold-induced sBAT activity and plasma FGF21 and adipocytokines levels in healthy adults.

Design
Nineteen healthy participants underwent energy expenditure (EE) and supraclavicular infrared thermography (IRT) within a whole-body calorimeter at baseline and at 2 hours post-cold exposure. 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/magnetic resonance (PET/MR) imaging scans were performed post-cold exposure. PET sBAT mean standardized uptake value (SUV mean), MR supraclavicular fat fraction (sFF), anterior supraclavicular maximum temperature (Tscv max) and EE change (%) after cold exposure were used to quantify sBAT activity.

Main Outcome Measures
Plasma FGF21, leptin, adiponectin, and tumor necrosis factor alpha (TNFα) at baseline and 2 hours post-cold exposure. Body composition at baseline by dual-energy x-ray absorptiometry (DXA).

Results
Plasma FGF21 and adiponectin levels were significantly reduced after cold exposure in BAT-positive subjects but not in BAT-negative subjects. Leptin concentration was significantly reduced in both BAT-positive and BAT-negative participants after cold exposure. Adiponectin concentration at baseline was positively strongly associated with sBAT PET SUV mean (coefficient, 3269; P = 0.01) and IRT Tscv max (coefficient, 6801; P  = 0.03), and inversely correlated with MR sFF (coefficient, −404; P  = 0.02) after cold exposure in BAT-positive subjects but not in BAT-negative subjects.

Conclusion
Higher adiponectin concentrations at baseline indicate a greater cold-induced sBAT activity, which may be a novel predictor for sBAT activity in healthy BAT-positive adults.

Highlights
A higher adiponectin concentration at baseline was associated with higher cold-induced supraclavicular BAT PET SUV mean and IRT Tscv max, and lower MR supraclavicular FF. Adiponectin levels maybe a novel predictor for cold-induced sBAT activity.
Effect of the Age at Menarche and Menopause Status Interaction on Type 2 Diabetes: The Henan Rural Cohort Study
Authors: Zhang Lulu , Li Yuqian , Dong Xiaokang , Zhou Wen , Wang Chongjian , Mao Zhenxing , Yang Xiu , Fan Mengying , Han Shengna , Li Linlin 
Published: January 2020

Abstract

Purpose
The aims of this study were to evaluate the effect of age at menarche (AM) on type 2 diabetes mellitus (T2DM) and to assess whether the fasting plasma glucose (FPG) and homeostasis model assessment (HOMA) index responses to AM and menopause status interact in Chinese rural adults.

Methods
A cross-sectional, population-based study including 23 138 participants was performed. Logistic regression and multivariable linear regression were performed to investigate the relationship between AM and glucose status. Generalized linear model was used to calculate the interaction term of AM and menopause status on FPG and the HOMA index. Interaction plot was used to interpret the significant interaction effect.

Results
Women in the later menarche age group (≥18 years) had a 17.7% lower risk of T2DM (95% confidence interval [CI]: 0.712-0.951, P = .008), after adjusting for multiple variables. Further adjustment for body mass index (BMI) completely attenuated this association (odds ratio = 0.884, 95% CI: 0.764-1.024, P = .099). A significant interaction effect of AM and menopause status on T2DM (P = .004) was observed. The adverse effects of menopausal status on FPG and HOMA-2 of insulin resistance decreased with increasing menarche age, and the age ranges were limited to &lt;18 and 9 to 19 years, respectively.

Conclusions
Later menarche was associated with a lower risk of T2DM, and the association appears to be mediated by BMI. More importantly, the adverse effect of menopause status on T2DM was decreased along with increasing menarche age.
PROP1-Dependent Retinoic Acid Signaling Regulates Developmental Pituitary Morphogenesis and Hormone Expression
Authors: Cheung Leonard Y M , Camper Sally A 
Published: January 2020

AbstractDietary vitamin A is metabolized into bioactive retinoic acid (RA) in vivo and regulates the development of many embryonic tissues. RA signaling is active in the oral ectoderm-derived tissues of the neuroendocrine system, but its role there has not yet been fully explored. We show here that RA signaling is active during pituitary organogenesis and dependent on the pituitary transcription factor Prop1. Prop1-mutant mice show reduced expression of the aldehyde dehydrogenase gene Aldh1a2, which metabolizes the vitamin A–intermediate retinaldehyde into RA. To elucidate the specific function of RA signaling during neuroendocrine development, we studied a conditional deletion of Aldh1a2 and a dominant-negative mouse model of inhibited RA signaling during pituitary organogenesis. These models partially phenocopy Prop1-mutant mice by exhibiting embryonic pituitary dysmorphology and reduced hormone expression, especially thyrotropin. These findings establish the role of RA in embryonic pituitary stem cell progression to differentiated hormone cells and raise the question of gene-by-environment interactions as contributors to pituitary development and disease.
JNK signaling is required for proper tangential migration and laminar allocation of cortical interneurons
Authors: Myers Abigail K. , Cunningham Jessica G. , Smith Skye E. , Snow John P. , Smoot Catherine A. , Tucker Eric S. 
Published: January 2020

ABSTRACT
The precise migration of cortical interneurons is essential for the formation and function of cortical circuits, and disruptions to this key developmental process are implicated in the etiology of complex neurodevelopmental disorders, including schizophrenia, autism and epilepsy. We have recently identified the Jun N-terminal kinase (JNK) pathway as an important mediator of cortical interneuron migration in mice, regulating the proper timing of interneuron arrival into the cortical rudiment. In the current study, we demonstrate a vital role for JNK signaling at later stages of corticogenesis, when interneurons transition from tangential to radial modes of migration. Pharmacological inhibition of JNK signaling in ex vivo slice cultures caused cortical interneurons to rapidly depart from migratory streams and prematurely enter the cortical plate. Similarly, genetic loss of JNK function led to precocious stream departure ex vivo, and stream disruption, morphological changes and abnormal allocation of cortical interneurons in vivo. These data suggest that JNK signaling facilitates the tangential migration and laminar deposition of cortical interneurons, and further implicates the JNK pathway as an important regulator of cortical development.
The Thoracic Spine in the Overhead Athlete
Authors: Ruiz Jeffrey , Feigenbaum Luis , Best Thomas M. 
Published: January 2020

Abstract
Overhead athletes are susceptible to many injuries, particularly in the shoulder and lumbar spine. Due to the heterogeneity of these two regional injuries, it is difficult to pinpoint the exact origin. A potential contributing factor that should be thoroughly evaluated is the thoracic spine. It can be challenging to quantify exactly how much thoracic spine mobility or lack thereof plays a role toward injury. Despite this, when examining mechanics of an overhead athlete, if neuromuscular control of the thorax is impaired, adjacent motion segments often take the brunt of the required movements. This article addresses the need to incorporate the thoracic spine when analyzing the entire kinetic chain. Clinical pearls regarding thoracic neuromuscular control and rehabilitation were explored, as well as a review of recent literature. Further investigation of thoracic spine therapeutic interventions should be considered when treating overhead athletes.
Association between Objective Activity Intensity and Heart Rate Variability: Cardiovascular Disease Risk Factor Mediation (CARDIA)
Authors: POPE ZACHARY C. , GABRIEL KELLEY PETTEE , WHITAKER KARA M. , CHEN LIN Y. , SCHREINER PAMELA J. , JACOBS DAVID R. , STERNFELD BARBARA , CARR J. JEFFREY , LLOYD-JONES DONALD M. , PEREIRA MARK A. 
Published: January 2020

ABSTRACT

Purpose
We evaluated the associations between accelerometer-estimated physical activity (PA) intensity and heart rate variability (HRV) and examined mediation of these associations by glycemic control indices and other cardiovascular disease risk factors.

Methods
Data were from 1668 participants (X̅
age = 45.9 ± 3.5 yr, 58.0% female, 39.9% black) who participated in year 20 (2005–2006) of the Coronary Artery Risk Development in Young Adults Fitness Study. The ActiGraph 7164 estimated participants’ mean minutes per day of vigorous-intensity PA (VPA), moderate-intensity PA (MPA), and light-intensity PA (LPA) over 7 d. Three sequential 10-s 12-lead ECG strips were used to derive standard deviation of all normal RR intervals (SDNN) and root mean square of all successive RR intervals (rMSSD) HRV. Mediators representing glycemic control indices included fasting glucose, fasting insulin, and 2-h oral glucose tolerance, with other mediators being traditional cardiovascular disease risk factors. Multiple linear regression assessed independent associations of PA intensity with HRV per 1-SD. Mediation analyses computed the proportion of the PA–HRV association attributable to physiological mediators.

Results
Participants averaged 2.7 ± 6.2 min·d−1, 33.0 ± 22.0 min·d−1, and 360.2 ± 83.8 min·d−1 of VPA, MPA, and LPA, respectively, with mean values for SDNN (32.6 ± 22.4 ms) and rMSSD (34.0 ± 24.8 ms) similar. After adjustment for demographic and lifestyle behaviors, VPA was associated with both HRV metrics (SDNN: std beta = 0.06 [0.03, 0.10]; rMSSD: std beta = 0.08 [0.05, 0.12]) and LPA with rMSSD only (std beta = 0.05 [0.01, 0.08]). Fasting insulin and glucose mediated 11.6% to 20.7% of the association of VPA and LPA with HRV, with triglycerides also potentially mediating these associations (range, 9.6%–13.4%).

Conclusions
Accelerometer-estimated VPA was associated with higher (i.e., improved) HRV. Light-intensity PA also demonstrated a positive association. Mediation analyses suggested these associations may be most attributable to glucose-insulin dynamics.
Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial
Authors: McMeekin Nicola , Geue Claudia , Briggs Andrew , Rombach Ines , Li Ho Kwong , Bejon Philip , McNally Martin , Atkins Bridget L. , Ferguson Jamie , Scarborough Matthew ,   OVIVA collaborators
Published: January 2020

Background: Bone and joint infections are becoming increasingly common and are usually treated with surgery and a course of intravenous antibiotics. However, there is no evidence to support the superiority of intravenous therapy and there is a growing body of literature showing that oral therapy is effective in treating these infections. Given this lack of evidence the clinical trial ‘Oral Versus Intravenous Antibiotics’ (OVIVA) was designed to assess the clinical and cost-effectiveness of intravenous versus oral antibiotics for the treatment of bone and joint infections, using a non-inferiority design. Clinical results from the trial indicate that oral antibiotics are non-inferior to intravenous antibiotics. The aim of this paper is to evaluate the cost-effectiveness of intravenous compared to oral antibiotics for treating bone and joint infections, using data from OVIVA. Methods: A cost-utility analysis was carried out, the main economic outcome measure was the quality adjusted life-year, measured using the EQ-5D-3L questionnaire, combined with costs to estimate cost-effectiveness over 12-months follow-up. Results: Results show that costs were significantly lower in the oral arm compared to the intravenous arm, a difference of £2,740 (95% confidence interval £1,488 to £3,992). Results of four sensitivity analyses were consistent with the base-case results. QALYs were marginally higher in the oral arm, however this difference was not statistically significant; -0.007 (95% confidence interval -0.045 to 0.031). Conclusions: Treating patients with bone and joint infections for the first six weeks of therapy with oral antibiotics is both less costly and does not result in detectable differences in quality of life compared to treatment with intravenous antibiotics. Adopting a practice of treating bone and joint infections with oral antibiotics early in the course of therapy could potentially save the UK National Health Service over £17 million annually.
Prospective Investigation of Markers of Elevated Delirium Risk (PRIMED Risk) study protocol: a prospective, observational cohort study investigating blood and cerebrospinal fluid biomarkers for delirium and cognitive dysfunction in older patients
Authors: Whitby Jonathan , Bampoe Sohail , Fullerton James N , Smaje Ashley , Hornby Joanna , Hajdu Bence , Schofield Nick , Stafford Ronnie , Zetterberg Henrik , McAuley Daniel F , Passmore Peter , Cunningham Emma , Whittle John , Walker David , Davis Daniel 
Published: January 2020

Background: Delirium is a common post-operative complication, particularly in older adults undergoing major or emergency procedures. It is associated with increased length of intensive care and hospital stay, post-operative mortality and subsequent dementia risk. Current methods of predicting delirium incidence, duration and severity have limitations. Investigation of blood and cerebrospinal fluid (CSF) biomarkers linked to delirium may improve understanding of the underlying pathophysiology, particularly with regard to the extent this is shared or distinct with underlying dementia. Together, these have the potential for development of better risk stratification tools and perioperative interventions. Methods: 200 patients over the age of 70 scheduled for surgery with routine spinal anaesthetic will be recruited from UK hospitals. Their cognitive and functional baseline status will be assessed pre-operatively by telephone. Time-matched CSF and blood samples will be taken at the time of surgery and analysed for known biomarkers of neurodegeneration and neuroinflammation. Patients will be assessed daily for delirium until hospital discharge and will have regular cognitive follow-up for two years. Primary outcomes will be change in modified Telephone Interview for Cognitive Status (TICS-m) score at 12 months and rate of change of TICS-m score. Delirium severity, duration and biomarker levels will be treated as exposures in a random effects linear regression models. PRIMED Risk has received regulatory approvals from Health Research Authority and London – South East Research Ethics Committee. Discussion: The main anticipated output from this study will be the quantification of biomarkers of acute and chronic contributors to cognitive impairment after surgery. In addition, we aim to develop better risk prediction models for adverse cognitive outcomes.
Efficiently Evaluating Targeting Policies: Improving on Champion vs. Challenger Experiments
Authors: Simester Duncan , Timoshenko Artem , Zoumpoulis Spyros I. 
Published: January 2020

Champion versus challenger field experiments are widely used to compare the performance of different targeting policies. These experiments randomly assign customers to receive marketing actions recommended by either the existing (champion) policy or the new (challenger) policy, and then compare the aggregate outcomes. We recommend an alternative experimental design and propose an alternative estimation approach to improve the evaluation of targeting policies. The recommended experimental design randomly assigns customers to marketing actions. This allows evaluation of any targeting policy without requiring an additional experiment, including policies designed after the experiment is implemented. The proposed estimation approach identifies customers for whom different policies recommend the same action and recognizes that for these customers there is no difference in performance. This allows for a more precise comparison of the policies. We illustrate the advantages of the experimental design and estimation approach using data from an actual field experiment. We also demonstrate that the grouping of customers, which is the foundation of our estimation approach, can help to improve the training of new targeting policies. This paper was accepted by Matthew Shum, marketing.
O controle das emoções na escrita acadêmica e seu impacto na relação do indivíduo com o trabalho intelectual
Authors: Ribeiro de Almeida Rezende Camila , Fayet Sallas Ana Luisa 
Published: January 2020

O trabalho intelectual é fomentado por meio da escrita acadêmica, que é tanto permeada por questões subjetivas – distintas e singulares para cada indivíduo – quanto por questões socialmente compartilhadas – imaginários coletivos de significação e interpretações do campo acadêmico que a constrói. No atual contexto brasileiro, o aumento da cobrança por produtividade tem intensificado o status da escrita como moeda de troca e afetado a relação entre trabalho e emoções na produção intelectual. Em resposta a esse panorama social, algumas universidades têm buscado saídas para lidar com a problemática da produtividade acadêmica. Assim, este artigo busca compartilhar um estudo de caso feito na Universidade Federal do Paraná (UFPR), que, em 2016, inaugurou o Centro de Assessoria de Publicação Acadêmica (CAPA), o primeiro writing center brasileiro. Por meio da observação participante como assessora de escrita acadêmica de diferentes estudantes de pós-graduação nesse centro e de respostas coletadas por meio de questionários aplicados nas assessorias, buscamos refletir sobre o controle das emoções na escrita acadêmica e seu impacto na relação do indivíduo com o trabalho intelectual. O embasamento teórico é apoiado nas intersecções entre a sociologia das emoções, do corpo e da arte, o que permite compreender como a regulação da escrita no meio acadêmico opera tanto no âmbito estético/gramatical quanto no controle da emotividade do indivíduo no texto, sedimentando e perpetuando as dicotomias corpo/mente, arte/ciência, emoção/razão, e influenciando, assim, as construções epistemológicas.