bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing New Zealand’s Cannabis Legalization and Control Bill: prospects and challenges
Authors: Wilkins Chris , Rychert Marta 
Published: July 2020

AbstractBackgroundFew countries have developed detailed legislative proposals for legalizing cannabis. New Zealand recently released the Cannabis Legalization and Control Bill (CLCB) that will be the subject of a referendum in September 2020.AimsTo assess the CLCB, drawing on emerging evidence from cannabis legalization overseas, public health research on alcohol and tobacco and the attempt to establish a regulated market for ‘legal highs’ in New Zealand.DiscussionThe CLCB proposes a strictly regulated commercial cannabis market that resembles the Canadian approach, but notably without on‐line sales or regional heterogeneity in retail distribution. The objective of the CLCB of lowering cannabis use over time appears at odds with the largely commercial cannabis sector that will focus on expanding sales. The CLCB includes provision for home cultivation and social benefit operators, but it is not clear what priority these operators will receive. A potency cap of 15% tetrahydrocannabinol (THC) for cannabis plants is included, and this is at the high end of black‐market cannabis. The proposed progressive product tax based on THC will be challenging to implement. There is no formal minimum price, but rather discretionary powers to raise the excise if the price drops too much. The CLCB includes a comprehensive ban on advertising, but non‐conventional on‐line promotion will be difficult to suppress. The central government cannabis authority is tasked with developing local retail outlet policies. We caution against the temptation to employ an interim regulatory regime following a positive referendum result, because a partially regulated market will expose users to health risks and undermine public support.ConclusionsNew Zealand’s Cannabis Legalization and Control Bill’s objective of reducing cannabis use via a commercial market will be challenging to achieve. The bill could be strengthened with formal minimum pricing, lower potency cap and greater clarity concerning social benefit operators and the role of local government.
A pilot randomized controlled trial of assertive treatment including family involvement and home delivery of medication for young adults with opioid use disorder
Authors: Fishman Marc , Wenzel Kevin , Vo Hoa , Wildberger Jared , Burgower Rachael 
Published: July 2020

AbstractBackground and AimsAlthough medications for opioid use disorder (OUD), including extended‐release naltrexone (XR‐NTX), have demonstrated effectiveness, adherence is often low. We tested the preliminary efficacy of youth opioid recovery support (YORS), a multi‐component intervention designed to improve engagement and medication adherence for young adults with OUD.DesignSingle‐site randomized controlled trial with 24‐week follow‐up.SettingCommunity substance use disorder treatment program in Baltimore, MD, USA.ParticipantsYoung adults aged 18–26 years enrolled in inpatient/residential OUD treatment intending to pursue outpatient OUD treatment with XR‐NTX. Twenty‐one participants were randomized to YORS and 20 to treatment as usual (TAU). The analyzed sample was 65.8% male.Intervention and comparatorComponents of YORS include: (1) home delivery of XR‐NTX; (2) family engagement; (3) assertive outreach; and (4) contingency management for receipt of XR‐NTX doses. The comparator was TAU, which consisted of a standard referral to outpatient care following an inpatient stay.MeasurementsPrimary outcomes were number of XR‐NTX doses received over 24 weeks and relapse to opioid use (defined as ≥ 10 days of use within 28 days) at 24 weeks.FindingsParticipants in the YORS condition received more XR‐NTX doses [mean = 4.28; standard deviation (SD) = 2.3] compared with those in TAU (mean = 0.70; SD = 1.2), P < 0.01. Participants in the YORS group compared with TAU had lower rates of relapse (61 versus 95%; P < 0.01). Survival analyses revealed group differences on time to relapse with participants in TAU being more likely to relapse sooner compared with participants in the YORS condition [hazard ratio (HR) = 2.72, 95% confidence interval (CI) = 1.26–5.88, P < 0.01].ConclusionsThe youth opioid recovery support intervention for extended‐release naltrexone adherence and opioid relapse prevention among young adults with opioid use disorder appeared to improve treatment and relapse outcomes compared with standard treatment.
Impact of psychological stress measured in three different scales on testis function: A cross‐sectional study of 1362 young men
Authors: Nordkap Loa , Priskorn Lærke , Bräuner Elvira V. , Marie Hansen Åse , Kirstine Bang Anne , Holmboe Stine A. , Winge Sofia B. , Egeberg Palme Dorte L. , Mørup Nina , Erik Skakkebæk Niels , Kold Jensen Tina , Jørgensen Niels 
Published: July 2020

AbstractBackgroundStudies have reported associations between psychological stress and semen quality, but most have been performed on selected populations using different stress measures. Thus, it is uncertain which stress scale best quantifies the effects of stress on testicular function.ObjectiveTo study the association between three different measures of stress and testicular function in young men.Material and MethodsIn total, 1362 men (median age 19 years) delivered semen and blood samples. They also answered a questionnaire including information from three stress scales: Stress Symptoms, Stressful Life Events and Perceived Stress. Various statistical analyses for associations between stress and testicular function (semen quality and reproductive hormones) were performed.ResultsPerceived Stress was negatively associated with sperm concentration, total count and motility and positively associated with serum FSH. Men with the highest scores (>30 points) had 38% (95% CI 3‐84%) lower sperm concentration, 42% (95% CI 5‐91%) lower total count and 22% (95% CI 2‐32%) lower proportion of motile spermatozoa than men with the lowest scores (0‐10 points). For the stress symptoms score, men with highest scores (>95th percentile vs. lower) had lower sperm concentration, total sperm count, motility and serum Inhibin‐B/FSH‐ratio. Although men with highest stress levels were characterized by an unhealthier lifestyle, adjusting for lifestyle factors did not attenuate results suggesting that the associations between stress and testicular function were not mediated by lifestyle. Stressful Life Events were not associated with testicular function.Discussion and ConclusionThe linear association between Perceived Stress and semen parameters and lack of dose‐response association for the other two stress scales indicated that perceived stress was the most sensitive marker of stress affecting semen quality in young men. The lack of associations between Stressful Life Events and testis function confirmed that the perception of stressful events rather than the stressful event per se matters.
Neuromuscular responses to fatiguing locomotor exercise
Authors: Brownstein Callum G. , Millet Guillaume Y. , Thomas Kevin 
Published: July 2020

AbstractOver the last two decades, an abundance of research has explored the impact of fatiguing locomotor exercise on the neuromuscular system. Neurostimulation techniques have been implemented prior to and following locomotor exercise tasks of a wide variety of intensities, durations, and modes. These techniques have allowed for the assessment of alterations occurring within the central nervous system and the muscle, while techniques such as transcranial magnetic stimulation and spinal electrical stimulation have permitted further segmentalization of locomotor exercise‐induced changes along the motor pathway. To this end, the present review provides a comprehensive synopsis of the literature pertaining to neuromuscular responses to locomotor exercise. Sections of the review were divided to discuss neuromuscular responses to maximal, severe, heavy and moderate intensity, high‐intensity intermittent exercise, and differences in neuromuscular responses between exercise modalities. During maximal and severe intensity exercise, alterations in neuromuscular function reside primarily within the muscle. Although post‐exercise reductions in voluntary activation following maximal and severe intensity exercise are generally modest, several studies have observed alterations occurring at the cortical and/or spinal level. During prolonged heavy and moderate intensity exercise, impairments in contractile function are attenuated with respect to severe intensity exercise, but are still widely observed. While reductions in voluntary activation are greater during heavy and moderate intensity exercise, the specific alterations occurring within the central nervous system remain unclear. Further work utilizing stimulation techniques during exercise and integrating new and emerging techniques such as high‐density electromyography is warranted to provide further insight into neuromuscular responses to locomotor exercise.
Healthcare use, work loss and total costs in incident and prevalent Crohn's disease and ulcerative colitis: results from a nationwide study in Sweden
Authors: Khalili Hamed , Everhov Åsa H. , Halfvarson Jonas , Ludvigsson Jonas F. , Askling Johan , Myrelid Pär , Söderling Jonas , Olen Ola , Neovius Martin ,   SWIBREG Group
Published: July 2020

SummaryBackgroundThere are limited data on population‐wide assessment of cost in Crohn's disease (CD) and ulcerative colitis (UC).AimTo estimate the societal cost of actively treated CD and UC in Sweden.MethodsWe identified 10 117 prevalent CD and 19 762 prevalent UC patients, aged ≥18 years on 1 January 2014 and 4028 adult incident CD cases and 8659 adult incident UC cases (2010‐2013) from Swedish Patient Register. Each case was matched to five population comparators. Healthcare costs were calculated from medications, outpatient visits, hospitalisations and surgery. Cost of productivity losses was derived from disability pension and sick leave.ResultsThe mean annual societal costs per working‐age patient (18‐64 years) with CD and UC were $22 813 (vs $7533 per comparator) and $14 136 (vs $7351 per comparator), respectively. In patients aged ≥65 years, the mean annual costs of CD and UC were $9726 and $8072 vs $3875 and $4016 per comparator, respectively. The majority of cost for both CD (56%) and UC (59%) patients originated from productivity losses. Higher societal cost of working‐age CD patients as compared to UC patients was related to greater utilisation of anti‐TNF (22.2% vs 7.4%) and increased annual disability pension (44 days vs 25 days). Among incident CD and UC patients, the mean total cost over the first year per patient was over three times higher than comparators.ConclusionIn Sweden, the societal cost of incident and prevalent CD and UC patients was consistently two to three times higher than the general population.
Prostate cancer survivorship essentials framework: guidelines for practitioners
Authors: Dunn Jeff , Green Anna , Ralph Nicholas , Newton Robert U. , Kneebone Andrew , Frydenberg Mark , Chambers Suzanne K. 
Published: July 2020

ObjectiveTo develop contemporary and inclusive prostate cancer survivorship guidelines for the Australian setting.Participants and MethodsA four‐round iterative policy Delphi was used, with a 47‐member expert panel that included leaders from key Australian and New Zealand clinical and community groups and consumers from diverse backgrounds, including LGBTQIA people and those from regional, rural and urban settings. The first three rounds were undertaken using an online survey (94–96% response) followed by a fourth final face‐to‐face panel meeting. Descriptors for men’s current prostate cancer survivorship experience were generated, along with survivorship elements that were assessed for importance and feasibility. From these, survivorship domains were generated for consideration.ResultsSix key descriptors for men’s current prostate cancer survivorship experience that emerged were: dealing with side effects; challenging; medically focused; uncoordinated; unmet needs; and anxious. In all, 26 survivorship elements were identified within six domains: health promotion and advocacy; shared management; vigilance; personal agency; care coordination; and evidence‐based survivorship interventions. Consensus was high for all domains as being essential. All elements were rated high on importance but consensus was mixed for feasibility. Seven priorities were derived for immediate action.ConclusionThe policy Delphi allowed a uniquely inclusive expert clinical and community group to develop prostate cancer survivorship domains that extend beyond traditional healthcare parameters. These domains provide guidance for policymakers, clinicians, community and consumers on what is essential for step change in prostate cancer survivorship outcomes.
Outside in: Roles of complement in autophagy
Authors: King Ben C. , Kulak Klaudia , Colineau Lucie , Blom Anna M. 
Published: July 2020

The complement system is a well‐characterized cascade of extracellular serum proteins that is activated by pathogens and unwanted waste material. Products of activated complement signal to the host cells via cell surface receptors, eliciting responses such as removal of the stimulus by phagocytosis. The complement system therefore functions as a warning system, resulting in removal of unwanted material. This review describes how extracellular activation of the complement system can also trigger autophagic responses within cells, up‐regulating protective homeostatic autophagy in response to perceived stress, but also initiating targeted anti‐microbial autophagy in order to kill intracellular cytoinvasive pathogens. In particular, we will focus on recent discoveries that indicate that complement may also have roles in detection and autophagy‐mediated disposal of unwanted materials within the intracellular environment. We therefore summarize the current evidence for complement involvement in autophagy, both by transducing signals across the cell membrane, as well as roles within the cellular environment.Linked ArticlesThis article is part of a themed issue on Canonical and non‐canonical functions of the complement system in health and disease. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.14/issuetoc
Activated inducible co-stimulator-positive programmed cell death 1-positive follicular helper T cells indicate disease activity and severity in ulcerative colitis patients
Authors: Long Y , Zhao X , Liu Chang , Xia C , Liu Chen 
Published: July 2020

Summary
Inducible co-stimulator-positive (ICOS) and programmed cell death 1-positive (PD-1) are important markers for follicular helper T cells (Tfh); however, their roles and clinical values in ulcerative colitis (UC) remain unknown. In this study, we recruited 68 UC patients and 34 healthy controls. Circulating ICOS+, PD-1+ and ICOS+PD-1+ Tfh subsets were analyzed by flow cytometry. Twelve active UC patients achieving remission after treatment with 5-aminosalicylic acid were followed-up and Tfh subset changes were analyzed. Serum immunoglobulin (Ig)G, C-reactive protein (CRP), interleukin (IL)-4 and IL-21 levels and B cell subsets were analyzed and Mayo scores were calculated. Correlation analyses were performed between Tfh subsets and the clinical indicators. Receiver operating characteristic (ROC) curves were generated to evaluate the efficiency of Tfh subsets for disease monitoring. We found that levels of ICOS+, PD-1+ and ICOS+PD-1+ Tfh cells were significantly increased in active UC and significantly decreased when achieving clinical remission. Activated ICOS+PD-1+Tfh cells were positively correlated with serum CRP and Mayo scores. Furthermore, ICOS+PD-1+ Tfh cells were significantly correlated with circulating new memory B cells and plasmablasts, as well as serum IgG, IL-4 and IL-21. ROC analyses showed that when ICOS+PD-1+ Tfh cells were used in combination with PD-1+ Tfh cells, the diagnostic efficacy in distinguishing active UC from stable remission patients was higher than that of any one used alone, with area under curve (AUC) value 0·931. Our findings suggest that increased ICOS+PD-1+ Tfh cells are associated with the activation of B cells in the pathogenesis of UC, and may be a potential biomarker for UC disease monitoring.
Childhood Ethics: An ontological advancement for childhood studies
Authors: Carnevale Franco A. , Collin‐Vézina Delphine , Macdonald Mary Ellen , Ménard Jean‐Frédéric , Talwar Victoria , Van Praagh Shauna 
Published: July 2020

AbstractWe describe an ontological approach to childhood studies that we refer to asChildhood Ethics. This involves an interdisciplinary hermeneutic orientation towards examining the morally meaningful dimensions of matters that affect young people. We draw on our empirical research with young people from 3‐ to 17‐years old, examining their experiences in a diversity of contexts and geographical settings. Our investigations challenge dominant binary conceptions of young people along lines of decisional in/capacity and im/maturity. We argue for a view of children as active agents with meaningful relational engagements and participation interests and capacities and outline corresponding implications for research and practice.
Video consultation for new colorectal patients
Authors: Sellars H. , Ramsay G. , Sunny A. , Gunner C. K. , Oliphant R. , Watson A. J. M. 
Published: July 2020

AbstractAimFor patients, an outpatient review can lead to a stressful journey to hospital with the resultant risks associated with breaching social distancing. Despite this, video consultations (VCs) have not been frequently used in colorectal practice. We assessed outcomes, including the economic and environmental impact, of a VC clinic for new colorectal referrals.MethodThis was a prospective observational study. Fifty consecutive patients attending a VC colorectal appointment were reviewed between March 2019 and February 2020. Face‐to‐face appointments during the same time period were also assessed. The distance, time, cost and carbon emissions of journeys were estimated using web‐based resources. Estimated loss of earnings used data from the Office for National Statistics. The subsequent management plans were also recorded.ResultsOf 50 patients using VC, 40 used home devices and 10 used equipment in their local medical facility. Three patients had difficulties with the technology and converted to telephone review. Failure to attend VC appointments was less than for face‐to‐face appointments (4% vs 6.1%). VC appointments saved 6685 miles of travel (range 2–364 miles), 148 h travelling time and £1767 costs. Additional savings for loss of earnings were approximately £33.56 per patient. The carbon emissions saved was 4659 lb CO2 equivalent, corresponding to over 250 000 charges of a smartphone.ConclusionThe use of VC resulted in significant savings related to travel and reduced time and costs for patients who chose to use the service, in addition to the environmental benefits. In this current climate VC clinics have a central role in outpatient care for both new patients and follow‐ups.
No evidence that rapid adaptation impedes biological control of an invasive plant
Authors: Stastny M. , Russell‐Mercier J.L. , Sargent R.D. 
Published: July 2020

AbstractBiological control is a popular tool for invasive species management, but its success in nature is difficult to predict. One risk is that invasive plants, which may have adapted to lower herbivore pressure in the introduced range, could rapidly evolve defences upon re‐association with their biocontrol agent(s). Previous studies have demonstrated that populations of the invasive plant purple loosestrife (Lythrum salicaria) exposed to biocontrol exhibit traits consistent with the rapid evolution of defence. However, to date, no one has tested this hypothesis under field‐natural levels of herbivory. Using seed from 17 populations of purple loosestrife growing in eastern Canada, that varied in their history of exposure to their biocontrol agent, the leaf beetle Neogalerucella spp., we transplanted 1,088 seedlings from 136 maternal families into a common garden under ambient herbivory. Over the following three and half years, we assessed plant performance in the face of biocontrol by measuring early‐season plant size, defoliation, flowering, and season‐end biomass. We discovered that a population history with biocontrol explained little variation in herbivory or plant performance, suggesting that adaptation is not hindering biocontrol effectiveness. Instead, plant size, subsequent defoliation, and spatio‐temporal variables were the main predictors of plant growth and flowering during the study. The high individual variability we observed in plant performance underscores that flexible strategies of allocation and phenology are important contributors to the persistence of invasive plants. Our findings suggest that plant adaptation to biocontrol is unlikely to be a strong impediment to biological control in this species, however, the high survival and variable defoliation of plants in our study also indicate that biocontrol alone is unlikely to result in significant population decline. We recommend that the application of multiple forms of control simultaneously (e.g. thinning plus biocontrol) could help to prevent the existence of refuges of large, reproductive individuals.
Fasten the seat belt: Increasing safety of CAR T‐cell therapy
Authors: Simon Bianca , Uslu Ugur 
Published: July 2020

AbstractAfter the recent success and approvals of chimeric antigen receptor (CAR) T cells in haematological malignancies, its efficacy is currently evaluated in a broad spectrum of tumor entities including melanoma. However, severe and potentially life‐threatening side effects like cytokine release syndrome, neurologic toxicities, and the competing risk of morbidity and mortality from the treatment itself are still a major limiting factor in the current CAR T‐cell landscape. In addition, especially in solid tumors, the lack of ideal target antigens to avoid on‐target/off‐tumor toxicities also restricts its use. While various groups are working on strategies to boost CAR T‐cell efficacy, mechanisms to increase engineered T‐cell safety should not move out of focus. Thus, the aim of this article is to summarize and to discuss current and potential future strategies and mechanisms to increase CAR T‐cell safety in order to enable the wide use of this promising approach in melanoma and other tumor entities.