bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost–Utility Analysis of Electroconvulsive Therapy and Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression in Ontario
Authors: Fitzgibbon Kyle P. , Plett Donna , Chan Brian C. F. , Hancock-Howard Rebecca , Coyte Peter C. , Blumberger Daniel M. 
Published: December 2019

Objectives: To evaluate the cost-effectiveness of repetitive transcranial magnetic stimulation (rTMS) and electroconvulsive therapy (ECT), and combining both treatments in a stepped care pathway for patients with treatment-resistant depression (TRD) in Ontario. Methods: A cost–utility analysis evaluated the lifetime costs and benefits to society of rTMS and ECT as first-line treatments for TRD using a Markov model, which simulates the costs and health benefits of patients over their lifetime. Health states included acute treatment, maintenance treatment, remission, and severe depression. Treatment efficacy and health utility data were extracted and synthesized from randomized controlled trials and meta-analyses evaluating these techniques. Direct costing data were obtained from national and provincial costing databases. Indirect costs were derived from government records. Scenario, threshold, and probabilistic sensitivity analyses were performed to test robustness of the results. Results: rTMS dominated ECT, as it was less costly and produced better health outcomes, measured in quality-adjusted life years (QALYs), in the base case scenario. rTMS patients gained an average of 0.96 additional QALYs (equivalent to approximately 1 year in perfect health) over their lifetime with costs that were $46,094 less than ECT. rTMS remained dominant in the majority of scenario and threshold analyses. However, results from scenarios in which the model’s maximum lifetime allowance of rTMS treatment courses was substantially limited, the dominance of rTMS over ECT was attenuated. The scenario that showed the highest QALY gain (1.19) and the greatest cost-savings ($46,614) was when rTMS nonresponders switched to ECT. Conclusion: From a societal perspective utilizing a lifetime horizon, rTMS is a cost-effective first-line treatment option for TRD relative to ECT, as it is less expensive and produces better health outcomes. The reduced side effect profile and greater patient acceptability of rTMS that allow it to be administered more times than ECT in a patient’s lifetime may contribute to its cost-effectiveness.
Determinants of (non-)attendance at the Dutch cancer screening programmes: A systematic review
Authors: Bongaerts Thomas HG , Büchner Frederike L , Middelkoop Barend JC , Guicherit Onno R , Numans Mattijs E 
Published: December 2019

Objective The Netherlands host three population-based cancer screening programmes: for cervical, breast, and colorectal cancer. For screening programmes to be effective, high participation rates are essential, but participation in the Netherlands’ programmes is starting to fall below the minimal effective rate. We aimed to produce a systematic overview of the current known determinants of (non-)attendance at the Dutch cancer screening programmes. Methods A literature search was conducted in the electronic databases Academic Search Premier, Cochrane Library, Embase, EMCare, PubMed, PsycINFO, Web of Science, and also in grey literature, including all articles published before February 2018. The I-Change model was used to categorize the identified determinants of cancer screening attendance. Results In total, 19/1232 identified studies and 6 grey literature reports were included. Fifteen studies reported on predisposing factors. Characteristics such as social economic status, country of birth, and residency were most often reported, and correlate with cancer screening attendance. Thirteen studies addressed information factors. Factors on awareness, motivation, ability, and barriers were less often studied. Conclusion Current studies tend to describe the general characteristics of (non-)attendance and (non-)attenders, but rarely provide in depth information on other factors of (non-)participation. The I-Change model proved to be a useful tool in mapping current knowledge on cancer screening attendance and revealed knowledge gaps regarding determinants of (non-)participation in the screening programmes. More research is needed to fully understand determinants of participation, in order to influence and optimize attendance rates over the long term.
Retinal arterial macroaneurysm associated with macular pucker
Authors: Rajabian Firuzeh , Arrigo Allesandro , Grazioli Allesio , Falcomatà Bruno , Bandello Francesco , Battaglia Parodi Maurizio 
Published: December 2019

Purpose: To describe a case of retinal arterial macroaneurysm associated with macular pucker with good response to subthreshold laser treatment. Presentation: Two-year follow-up of a patient with decreased vision in one eye for the past 6 months. Baseline best-corrected visual acuity was 20/40 in the affected eye. Multiple retinal arterial macroaneurysms were diagnosed on biomicroscopy fundus examination, with the presence of subretinal fluid and hard exudates on macula. Multimodal imaging including optical coherence tomography and fluorescein angiography confirmed the diagnosis and presence of macular pucker, which complicated the treatment choice. The largest retinal arterial macroaneurysm was treated 2 days after the diagnosis by means of subthreshold micropulse laser using an infrared diode laser with 1400 mW power, 200 ms exposure and 10% duty cycle. Results: Five months after the treatment, despite absorption of subretinal fluid, there were increased hard exudates at the posterior pole and best-corrected visual acuity was unchanged. Progressively, the exudates were absorbed and vision improved. Eighteen months after the treatment, best-corrected visual acuity was 20/25. Hard exudates were almost completely reabsorbed, with no evidence of fluid. Macular pucker was unchanged, with no retinal traction or complications related to conventional laser treatment. Conclusion: Subthreshold laser treatment could be the treatment of choice in complicated cases of retinal arterial macroaneurysm with macular pucker, as it is able to modify the vessel permeability, without any thermal negative effect.
The Underground Exchange of Diabetes Medications and Supplies: Donating, Trading, and Borrowing, Oh My!
Authors: Litchman Michelle L. , Oser Tamara K. , Wawrzynski Sarah E. , Walker Heather R. , Oser Sean 
Published: December 2019

Background: The cost of diabetes medications and supplies is rising, resulting in access challenges. This study assessed the prevalence of and factors predicting underground exchange activities—donating, trading, borrowing, and purchasing diabetes medications and supplies. Research Design and Methods: A convenience sample of people affected by diabetes was recruited online to complete a survey. Mixed method analysis was undertaken, including logistic regression to examine the relationship between self-reported difficulty purchasing diabetes medications and supplies and engagement in underground exchange activity. Thematic qualitative analysis was used to examine open-text responses. Results: Participants ( N = 159) self-reported engagement in underground exchange activities, including donating (56.6%), donation receiving (34.6%), trading (23.9%), purchasing (15.1%), and borrowing (22%). Such activity took place among a variety of individuals, including friends, family, coworkers, online acquaintances and strangers. Diabetes-specific financial stress predicted engagement in trading diabetes mediations or supplies (OR 6.3, 95% CI 2.2-18.5) and receiving donated medications or supplies (OR 2.8, 95% CI 1.1-7.2). One overarching theme, unmet needs, and three subthemes emerged: (1) factors influencing underground exchange activity, (2) perceived benefits of underground exchange activity, and (3) perceived consequences of underground exchange activity. Conclusion: Over half of the participants in this study engaged in underground exchange activities out of necessity. Providers must be aware about this underground exchange and inquire about safety and possible alternative resources. There is an urgent need to improve access to medications that are essential for life. Our study points to a failure in the US healthcare system since such underground exchanges may not be necessary if medications and supplies were accessible.
Pulmonary transit of contrast during exercise is related to improved cardio-pulmonary performance in highly trained endurance athletes
Authors: Sanz-de la Garza María , Vaquer-Seguí Antonia , Durán Karina , Blanco Isabel , Burgos Felip , Alsina Xavier , Prat-González Susanna , Bijnens Bart , Sitges Marta 
Published: December 2019

Background The mechanisms underlying the high interindividual variability demonstrated for right-ventricular (RV) adaptation to exercise have not yet been identified, but different pulmonary vascular adaptations among individuals could be involved. Pulmonary transit of agitated saline (PTAS) during exercise has been demonstrated to be a good estimator of vascular reserve. Aim The aim of this study was to evaluate the presence of PTAS among endurance athletes (EAs) of both sexes and its influence on RV adaptation to exercise. Methods A total of 100 highly trained EAs performed a maximal cardiopulmonary exercise test. Bi-ventricular functional and structural characteristics as well as PTAS were evaluated at baseline and at peak exercise. Athletes were distributed between two groups based on the amount of PTAS during exercise as high (HTPAS; >12 bubbles) and low (LPTAS; ≤12 bubbles). Results Overall, 11 EAs exhibited an intra-cardiac shunt at rest and 1 met the criteria for chronic pulmonary disease and were excluded from the study. Among the remaining 88 EAs (51% women), 47 (53%) athletes were classified as HPTAS and 41 (47%) as LPTAS. HPTAS capability was associated with significantly larger RV contractile reserve, larger pulmonary vascular reserve and an enhanced maximal exercise capacity. On multivariate analysis, females were the only independent correlate of the HPTAS capability. Conclusion In highly trained endurance athletes, a HPTAS capability during exercise corresponded to an increase in pulmonary vascular and RV contractile reserves as well as an enhanced maximal exercise capacity. The long-term clinical or performance implications of the absence or presence of pulmonary shunting, and the subsequent RV afterload increase while performing exercise, remains to be determined.
Development of a stick-on hip protector: A multiple methods study to improve hip protector design for older adults in the acute care environment
Authors: Post E , Komisar V , Sims-Gould J , Korall AMB , Feldman F , Robinovitch SN 
Published: December 2019

Introduction Over 90% of hip fractures in older adults result from falls, and hospital patients are at especially high risk. Specific types of wearable hip protectors have been shown to reduce hip fracture risk during a fall by up to 80%, but user compliance has averaged less than 50%. We describe the development and evaluation of a “stick-on” hip protector (secured over the hip with a skin-friendly adhesive) for older patients in acute care. Methods An initial version of the product was evaluated with six female patients (aged 76–91) in a hospital ward, who were asked to wear it for one week. We subsequently refined the product through biomechanical testing and solicited feedback from 43 health professionals on a second prototype. Results The first prototype was worn by five of six patients for the full week or duration of their hospital stay. The second prototype (20 mm thick, surface area 19 × 15.5 cm) provided 36% force attenuation, more than common garment-based models (20–21%). Feedback from patients and health professionals highlighted usability, comfort, cost, and appearance. Conclusions Our results from biomechanical and user testing support the need for further work to determine the value of stick-on hip protectors in acute care.
Morphomolecular motifs of pulmonary neoangiogenesis in interstitial lung diseases
Authors: Ackermann Maximilian , Stark Helge , Neubert Lavinia , Schubert Stephanie , Borchert Paul , Linz Friedemann , Wagner Willi L. , Stiller Wolfram , Wielpütz Mark , Hoefer Anne , Haverich Axel , Mentzer Steven J. , Shah Harshit R. , Welte Tobias , Kuehnel Mark , Jonigk Danny 
Published: December 2019

The pathogenetic role of angiogenesis in interstitial lung diseases (ILDs) is controversial. This study represents the first investigation of the spatial complexity and molecular motifs of microvascular architecture in important subsets of human ILD. The aim of our study was to identify specific variants of neoangiogenesis in three common pulmonary injury patterns in human ILD.We performed comprehensive and compartment-specific analysis of 24 human lung explants with usual intersitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP) and alveolar fibroelastosis (AFE) using histopathology, microvascular corrosion casting, micro-comupted tomography based volumetry and gene expression analysis using Nanostring as well as immunohistochemistry to assess remodelling-associated angiogenesis.Morphometrical assessment of vessel diameters and intervascular distances showed significant differences in neoangiogenesis in characteristically remodelled areas of UIP, NSIP and AFE lungs. Likewise, gene expression analysis revealed distinct and specific angiogenic profiles in UIP, NSIP and AFE lungs.Whereas UIP lungs showed a higher density of upstream vascularity and lower density in perifocal blood vessels, NSIP and AFE lungs revealed densely packed alveolar septal blood vessels. Vascular remodelling in NSIP and AFE is characterised by a prominent intussusceptive neoangiogenesis, in contrast to UIP, in which sprouting of new vessels into the fibrotic areas is characteristic. The molecular analyses of the gene expression provide a foundation for understanding these fundamental differences between AFE and UIP and give insight into the cellular functions involved.
Acute air pollution exposure alters neutrophils in never-smokers and at-risk humans
Authors: Wooding Denise J. , Ryu Min Hyung , Li Hang , Alexis Neil E. , Pena Olga , Carlsten Chris 
Published: December 2019

Outdoor air pollution exposure increases chronic obstructive pulmonary disease (COPD) hospitalisations, and may contribute to COPD development. The mechanisms of harm, and the extent to which at-risk populations are more susceptible are not fully understood. Neutrophils are recruited to the lung following diesel exhaust exposure, a model of traffic-related air pollution (TRAP), but their functional role in this response is unknown. The purpose of this controlled human-exposure crossover study was to assess the effects of acute diesel exhaust exposure on neutrophil function in never-smokers and at-risk populations, with support from additionalin vitrostudies.18 participants, including never-smokers (n=7), ex-smokers (n=4) and mild–moderate COPD patients (n=7), were exposed to diesel exhaust and filtered air for 2 h on separate occasions, and neutrophil function in blood (0 h and 24 h post-exposure) and bronchoalveolar lavage (24 h post-exposure) was assessed.Compared to filtered air, diesel exhaust exposure reduced the proportion of circulating band cells at 0 h, which was exaggerated in COPD patients. Diesel exhaust exposure increased the amount of neutrophil extracellular traps (NETs) in the lung across participants. COPD patients had increased peripheral neutrophil activation following diesel exhaust exposure.In vitro, suspended diesel exhaust particles increased the amount of NETs measured in isolated neutrophils. We propose NET formation as a possible mechanism through which TRAP exposure affects airway pathophysiology. In addition, COPD patients may be more prone to an activated inflammatory state following exposure.This is the first controlled human TRAP exposure study directly comparing at-risk phenotypes (COPD and ex-smokers) with lower-risk (never-smokers) participants, elucidating the human susceptibility spectrum.
Enhanced Light-Induced Transverse Thermoelectric Effect in Tilted BiCuSeO Film via the Ultra-thin AuNPs Layer
Authors: Yu Weiyuan , Yan Guoying , Xue Yuli , Zhang Yuejiao , Wang Jianglong , Fu Guangsheng , Wang Shufang 
Published: December 2019

AbstractSignificant enhancement of light-induced transverse thermoelectric (LITT) effect in tilted BiCuSeO film has been achieved via introduction of an ultra-thin layer of gold nanoparticles (AuNPs) with the thickness of a few nanometers. In both cases of pulsed and continuous light irradiation, about two times increment in the LITT voltage sensitivity is observed for the BiCuSeO film coated with 4-nm-thick AuNPs layer. This can be ascribed to the increased photo-thermal conversion efficiency in the LITT effect owing to the efficient usage of the incident light of AuNPs layer. Thicker AuNPs layer will suppress the voltage sensitivity increment due to the electrical connectivity effect. This work provides an effective strategy for optimizing the performance of thermal-type optical detectors based on the LITT effect.
A Transient-Enhanced Voltage Regulator with Stability and Power-Supply-Rejection Boosting
Authors: Shi Yue , Wang Anqi , Cao Jianwen , Zhou Zekun 
Published: December 2019

AbstractA high-stability voltage regulator (VR) is proposed in this paper, which integrates transient enhancement and overcurrent protection (OCP). Taken into consideration the performance and area advantages of low-voltage devices, most control parts of proposed VR are supplied by the regulated output voltage, which forms self-power technique (SPT) with power supply rejection (PSR) boosting. Besides, the stability and transient response are enhanced by dynamic load technique (DLT). An embedded overcurrent feedback loop is also adopted to protect the presented VR from damage under overload situations. The proposed VR is implemented in a standard 350 nm BCD technology, whose results indicate the VR can steadily work with 5.5–30 V input voltage, 0–30 mA load range, and 0.1–3.3 μF output capacitor. A 2.98 μV/V line regulation and a 0.233 mV/mA load regulation are achieved with a 40 mA current limiting. The PSR is better than − 64 dB up to 10 MHz with a 0.1 μF output capacitor.
Industrial policy, structural transformation and economic growth: evidence from China
Authors: Chen Jinran , Xie Lijuan 
Published: December 2019

AbstractIndustrial policy is an important means for governments to promote industrial development and accelerate economic growth. This paper mainly uses the Chinese Law and Regulation Database as the source of the relevant laws and regulations of China’s industrial policies from 2003 to 2015. On this basis, it empirically examines the impact of industrial policies on economic growth. The study finds that China’s industrial policy has significant positive effects on economic growth and that industrial structure rationalization is an important channel of industrial policy to improve economic growth. The findings are also valid under a series of robustness tests and endogenous corrections. The results of heterogeneity tests confirm that there are heterogeneous effects pertaining to industrial policy on economic growth among different sub-regional areas, administrative levels, industrial development stages, and industrial policy types. Overall, this paper supports the hypothesis that industrial policy has positive effects on economic growth and, accordingly, provides a basis for industrial policy implementation.
Leaps and bounds: geographical and ecological distance constrained the colonisation of the Afrotemperate by Erica
Authors: Pirie Michael D. , Kandziora Martha , Nürk Nicolai M. , Le Maitre Nicholas C. , Mugrabi de Kuppler Ana , Gehrke Berit , Oliver Edward G. H. , Bellstedt Dirk U. 
Published: December 2019

Abstract
Background
The coincidence of long distance dispersal (LDD) and biome shift is assumed to be the result of a multifaceted interplay between geographical distance and ecological suitability of source and sink areas. Here, we test the influence of these factors on the dispersal history of the flowering plant genus Erica (Ericaceae) across the Afrotemperate. We quantify similarity of Erica climate niches per biogeographic area using direct observations of species, and test various colonisation scenarios while estimating ancestral areas for the Erica clade using parametric biogeographic model testing.

Results
We infer that the overall dispersal history of Erica across the Afrotemperate is the result of infrequent colonisation limited by geographic proximity and niche similarity. However, the Drakensberg Mountains represent a colonisation sink, rather than acting as a “stepping stone” between more distant and ecologically dissimilar Cape and Tropical African regions. Strikingly, the most dramatic examples of species radiations in Erica were the result of single unique dispersals over longer distances between ecologically dissimilar areas, contradicting the rule of phylogenetic biome conservatism.

Conclusions
These results highlight the roles of geographical and ecological distance in limiting LDD, but also the importance of rare biome shifts, in which a unique dispersal event fuels evolutionary radiation.
Massive expansion and diversity of nicotinic acetylcholine receptors in lophotrochozoans
Authors: Jiao Yu , Cao Yanfei , Zheng Zhe , Liu Ming , Guo Ximing 
Published: December 2019

Abstract
Background
Nicotinic acetylcholine receptors (nAChRs) are among the oldest and most conserved transmembrane receptors involved in signal transduction. Despite the prevalence and significance of cholinergic signaling, the diversity and evolution of nAChRs are not fully understood.

Result
By comparative genomic analysis, we found massive expansions of nAChR genes in molluscs and some other lophotrochozoans. The expansion is particularly pronounced in stationary bivalve molluscs with simple nervous systems, with the number of nAChR genes ranging from 99 to 217 in five bivalves, compared with 10 to 29 in five ecdysozoans and vertebrates. The expanded molluscan nAChR genes tend to be intronless and in tandem arrays due to retroposition followed by tandem duplication. Phylogenetic analysis revealed diverse nAChR families in the common ancestor of bilaterians, which subsequently experienced lineage-specific expansions or contractions. The expanded molluscan nAChR genes are highly diverse in sequence, domain structure, temporal and spatial expression profiles, implying diversified functions. Some molluscan nAChR genes are expressed in early development before the development of the nervous system, while others are involved in immune and stress responses.

Conclusion
The massive expansion and diversification of nAChR genes in bivalve molluscs may be a compensation for reduced nervous systems as part of adaptation to stationary life under dynamic environments, while in vertebrates a subset of specialized nAChRs are retained to work with advanced nervous systems. The unprecedented diversity identified in molluscs broadens our view on the evolution and function of nAChRs that are critical to animal physiology and human health.