bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized clinical trial of mobile phone motivational interviewing for alcohol use problems in Kenya
Authors: Harder Valerie S. , Musau Abednego M. , Musyimi Christine W. , Ndetei David M. , Mutiso Victoria N. 
Published: November 2019

AbstractAimTo test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems.DesignA randomized clinical trial of mobile MI and standard in‐person MI with 1‐ and 6‐month follow‐up, including a 1‐month waitlist control followed by mobile MI.SettingA primary health center in rural Kenya.ParticipantsThree hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n = 89), in‐person MI (n = 65) or delayed mobile MI (n = 76) for waiting‐list controls 1 month after no treatment, with 70 unable to be reached for intervention.Intervention and comparatorOne MI session was provided either immediately by mobile phone, in‐person at the health center or delayed by 1 month and then provided by mobile phone.MeasurementsAlcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT‐C. The primary outcome was difference in alcohol score 1 month after no intervention for waiting‐list control versus 1 month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in‐person MI versus mobile MI one and 6 months after MI.FindingsFor our primary outcome, average AUDIT‐C scores were nearly three points higher (difference = 2.88, 95% confidence interval = 2.11, 3.66) for waiting‐list controls after 1 month of no intervention versus mobile MI 1 month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in‐person and mobile MI at 1 month (Bayes factor = 0.22), but were inconclusive at 6 months (Bayes factor = 0.41).ConclusionMobile phone‐based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas to reach patients needing treatment for alcohol use problems.
Understanding registered nurse decision‐making, communication and care delivery between emergency departments and residential aged care facilities: A research protocol
Authors: Gurung Apil , Broadbent Marc , Bakon Shannon , Hocking Julia , Glenwright Amanda , Shaw Christine , Tweddell Sheryl , Clark Sean 
Published: November 2019

AbstractObjectivesNursing staff in residential aged care facilities (RACF)s often make decisions about the transfer of residents to the emergency department (ED). This paper describes the protocol of a study that aims to understand decision‐making process utilised by RACF registered nurses (RNs) and to explore the perceptions of RNs about the decision and communication process between RACF and ED.MethodsThe proposed mixed‐method study will survey and interview RACF RNs to understand their decision to transfer a resident and collect information about older people referred to the ED. Data collection will involve telephone survey, ED information system (EDIS) data and semistructured interviews.ResultsThe project outcomes will provide an understanding of existing ED service provision, communication between facilities and the reasons for transfer of older person to ED. This may inform redesign in communication processes between the ED and local RACFs and outreach care from the ED to RACFs.
Therapeutic and prophylactic deletion of IL‐4Ra‐signaling ameliorates established ovalbumin induced allergic asthma
Authors: Khumalo Jermaine , Kirstein Frank , Scibiorek Martyna , Hadebe Sabelo , Brombacher Frank 
Published: November 2019

AbstractBackgroundAllergic asthma is a chronic inflammatory airway disease driven predominantly by a TH2 immune response to environmental allergens. IL‐4Rα‐signaling is essential for driving TH2‐type immunity to allergens. Anti‐TH2 therapies have the potential to effectively reduce airway obstruction and inflammation in allergic asthma.ObjectiveWe investigated potential therapeutic effects of selective inhibition of this pathway in mice with established allergic airway disease. We further investigated whether IL‐4Rα disruption in systemically sensitized mice can prevent the onset of the disease.MethodsWe used RosacreERT2IL‐4Rα−/lox mice, a tamoxifen (TAM)‐inducible IL‐4Rα knockdown model to investigate the role of IL‐4/IL‐13 signaling prior to the onset of the disease and during the effector phase in the ovalbumin‐induced allergic airway disease.ResultsInducible deletion of IL‐4Rα demonstrated therapeutic effects, on established allergic airway disease, and prevented the development of ovalbumin‐induced airway hyperreactivity, eosinophilia, and goblet cell metaplasia in allergen‐sensitized mice. Interestingly, IL‐4Rα knockdown after allergic sensitization did not induce TH17, a neutrophilic inflammatory response as observed in global IL‐4Rα‐deficient mice after intranasal allergen challenge.ConclusionAbrogation of IL‐4Rα signaling after allergic sensitization would have significant therapeutic benefit for TH2‐type allergic asthma.
The impact of modifiable risk factors on the long‐term outcomes of non‐alcoholic fatty liver disease
Authors: Paik James M. , Deshpande Rati , Golabi Pegah , Younossi Issah , Henry Linda , Younossi Zobair M. 
Published: November 2019

SummaryBackgroundCardiovascular (CV) disease is the leading cause of mortality in patients with non‐alcoholic fatty liver disease (NAFLD). The American Heart Association (AHA) developed 7 CV health metrics (poor, intermediate and ideal health) to improve CV health.AimTo assess population‐attributable fractions (PAFs) of CV health metrics to all‐cause and CV mortality among NAFLD patientsMethodsWe included adult participants from National Health and Nutrition Examination Survey (NHANES 1988‐1994) with clinical and mortality data. NAFLD was defined as the presence of hepatic steatosis on ultrasonography in the absence of other chronic liver diseases and excessive alcohol use.ResultsA total of 4040 adults with NAFLD and 7515 without were included. NAFLD had fewer ideal health metrics than non‐NAFLD (age‐standardised prevalence: 20% vs 10% for ≤1 ideal health metric; 5.1% vs 8.7% for ≥6, all P < .001). Following median follow‐up of 19.2 years (IQR: 17.5‐21.0 years), 1,136 NAFLD subjects (327 CV deaths) and 1600 non‐NAFLD subjects (447 CV deaths) died. Increased number of ideal health metrics (all trend P < .0001) correlated with lower risk for all‐cause and CV mortality. If all NAFLD subjects achieved 7 ideal health metrics, 66% of all‐cause deaths and 83% of CV deaths were preventable. Among NAFLD subjects, lack of glycaemic control (adjusted PAF = 28.3% all‐cause; 38.1% CV) and hypertension (adjusted PAF of 23% all‐cause; 52.8% CV) were the largest mortality contributors. Ideal physical activity level obtainment provided an adjusted PAF = 13.9% all‐cause and 13.8% CV mortality.ConclusionsAttainment of ideal CV health metrics provides protection against all‐cause and CV deaths in NAFLD.
New prognosis score including absolute lymphocyte/monocyte ratio, red blood cell distribution width and beta‐2 microglobulin in patients with diffuse large B‐cell lymphoma treated with R‐CHOP: Spanish Lymphoma Group Experience (GELTAMO)
Authors: Bento Leyre , Díaz‐López Antonio , Barranco Gilberto , Martín‐Moreno Ana M. , Baile Mónica , Martín Alejandro , Sancho Juan M. , García Olga , Rodríguez Mario , Sánchez‐Pina Jose M. , Novelli Silvana , Salar Antonio , Bastos Mariana , Rodríguez‐Salazar M José , González de Villambrosia Sonia , Córdoba Raul , García‐Recio M. , Martínez‐Serra J. , del Campo Raquel , Luzardo Hugo , García Daniel , Hong Azueg , Abrisqueta Pau , Sastre‐Serra Jorge , Roca Pilar , Rodríguez José , Gutiérrez Antonio ,   the Grupo Español de Linfomas y Trasplante Autólogo (GELTAMO)
Published: November 2019

SummaryThe International Prognostic Index (IPI) is the most widely used score for non‐Hodgkin lymphoma but lacks the ability to identify a high‐risk population in diffuse large B‐cell lymphoma (DLBCL). Low absolute lymphocyte count and high monocytes have proved to be unfavourable factors. Red‐cell distribution width (RDW) has been associated with inflammation and beta‐2 microglobulin (B2M) with tumour load. The retrospective study included 992 patients with DLBCL treated with R‐CHOP. In the multivariate analysis, age, Eastern Cooperative Oncology Group performance status (ECOG‐PS), stage, bulky mass, B2M, RDW, and lymphocyte/monocyte ratio (LMR) were independently related to progression‐free survival (PFS). A new prognosis score was generated with these variables including age categorized into three groups (0, 1, 2 points); ECOG ≥ 3–4 with two; stage III/IV, bulky mass, high B2M, LMR < 2·25 and RDW > 0·96 with one each; for a maximum of 9. This score could improve the discrimination of a very high‐risk subgroup with five‐year PFS and overall survival (OS) of 19% and 24% versus 45% and 59% of R (revised)‐IPI respectively. This score also showed greater predictive ability than IPI. A new score is presented including complete blood cell count variables and B2M, which are readily available in real‐life practice without additional tests. Compared to R‐IPI, it shows a more precise high‐risk assessment and risk discrimination for both PFS and OS.
Unionization, information asymmetry and the de‐location of firms
Authors: de Pinto Marco , Lingens Jörg 
Published: November 2019

AbstractWe analyze the effects of unionization on the decision of a firm to de‐locate internationally. In a model in which home and foreign workers are perfect substitutes and firms have an informational advantage concerning their productivity, the union offers a menu of wage–employment contracts. Because firms' outside options (producing abroad) depend on productivity, the problem is characterized by countervailing incentives. With the foreign profit sufficiently increasing in productivity, the overstating incentive dominates in equilibrium. Contracts are then characterized by overemployment. The union also affects the extensive margin. High‐productivity firms are excluded because this narrows the possibility to overstate productivity, which saves on information rent. Using a numerical simulation, we show that these effects are quantitatively sizable.
Phase I study of vorinostat with gefitinib in BIM deletion polymorphism/epidermal growth factor receptor mutation double‐positive lung cancer
Authors: Takeuchi Shinji , Hase Tetsunari , Shimizu Shinobu , Ando Masahiko , Hata Akito , Murakami Haruyasu , Kawakami Takahiro , Nagase Katsuhiko , Yoshimura Kenichi , Fujiwara Tadami , Tanimoto Azusa , Nishiyama Akihiro , Arai Sachiko , Fukuda Koji , Katakami Nobuyuki , Takahashi Toshiaki , Hasegawa Yoshinori , Ko Tun Kiat , Ong S. Tiong , Yano Seiji 
Published: November 2019

AbstractPatients with epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung cancer (NSCLC) harboring BIM deletion polymorphism (BIM deletion) have poor responses to EGFR TKI. Mechanistically, the BIM deletion induces preferential splicing of the non‐functional exon 3‐containing isoform over the functional exon 4‐containing isoform, impairing TKI‐induced, BIM‐dependent apoptosis. Histone deacetylase inhibitor, vorinostat, resensitizes BIM deletion‐containing NSCLC cells to EGFR‐TKI. In the present study, we determined the safety of vorinostat‐gefitinib combination and evaluated pharmacodynamic biomarkers of vorinostat activity. Patients with EGFR‐mutated NSCLC with the BIM deletion, pretreated with EGFR‐TKI and chemotherapy, were recruited. Vorinostat (200, 300, 400 mg) was given daily on days 1‐7, and gefitinib 250 mg was given daily on days 1‐14. Vorinostat doses were escalated based on a conventional 3 + 3 design. Pharmacodynamic markers were measured using PBMC collected at baseline and 4 hours after vorinostat dose on day 2 in cycle 1. No dose‐limiting toxicities (DLT) were observed in 12 patients. We determined 400 mg vorinostat as the recommended phase II dose (RP2D). Median progression‐free survival was 5.2 months (95% CI: 1.4‐15.7). Disease control rate at 6 weeks was 83.3% (10/12). Vorinostat preferentially induced BIM mRNA‐containing exon 4 over mRNA‐containing exon 3, acetylated histone H3 protein, and proapoptotic BIMEL protein in 11/11, 10/11, and 5/11 patients, respectively. These data indicate that RP2D was 400 mg vorinostat combined with gefitinib in BIM deletion/EGFR mutation double‐positive NSCLC. BIM mRNA exon 3/exon 4 ratio in PBMC may be a useful pharmacodynamic marker for treatment.
Outcomes research on children with medical complexity: A scoping review of gaps and opportunities
Authors: Looman Wendy S. , Park Young Shin , Gallagher Tiffany T. , Weinfurter Elizabeth V. 
Published: November 2019

AbstractBackgroundThere has been a recent, rapid increase in the number of studies of children with medical complexity (CMC) and their families. There is a need for attention to gaps and patterns in this emerging field of study.ObjectivesThe purpose of this scoping review was to identify patterns and gaps in the evidence related to classification systems, data, and outcomes in studies of CMC.Data SourcesWe searched peer‐reviewed journals for reports of quantitative studies focused on CMC outcomes published between 2008 and 2018. On the basis of a structured screening process, we selected 63 reports that met our inclusion criteria.Study Appraisal and SynthesisWe used the methodological framework for scoping studies described by Arskey and O'Malley to map relevant literature in the field and the ECHO model to categorize studies according to three health outcome domains (economic, clinical, and humanistic).ResultsThe terminology used to describe and classify CMC differed across studies depending on outcome domain. Two thirds of the reports focused on economic outcomes; fewer than a quarter included child or family quality of life as an outcome. A majority of studies used a single source of data, with robust analyses of administrative, payer, and publicly available data.Conclusions and Implications of Key FindingsResearch on CMC and their families would benefit from standardization of terms and classification systems, the use of measurement strategies that map humanistic outcomes as trajectories, and more attention to outcomes identified as most meaningful to CMC and their families.
Psychosocial functioning in children with phenylketonuria: Relationships between quality of life and parenting indicators
Authors: Morawska Alina , Mitchell Amy E. , Etel Evren , Kirby Grace , McGill James , Coman David , Inwood Anita 
Published: November 2019

AbstractObjectiveThis study aimed to assess the impact of phenylketonuria (PKU) and its treatment on parent and child health‐related quality of life (HRQoL) and to identify the parenting‐related correlates of parent and child HRQoL, as well as metabolic control.MethodsEighteen mothers of 2‐ to 12‐year‐old children with PKU participated and completed a series of self‐report questionnaires including the PKU Impact and Treatment Quality of Life Questionnaire (PKU‐QOL).ResultsMothers reported that the most significant impact of PKU on HRQoL was in relation to the impact of their child's anxiety during blood tests on their own HRQoL and guilt related to poor adherence to dietary restrictions and supplementation regimens. Higher reported intensity of child emotional and behavioural difficulties and parenting stress were associated with higher scores for PKU symptoms on the PKU‐QOL, higher scores for emotional, social, and overall impact of PKU, and higher scores for the impact of dietary restriction. Where mothers reported greater use of overreactivity as a parenting strategy, children tended to have better lifetime phenylalanine levels; however, the overall impact of PKU and the impact of supplement administration on mothers' HRQoL were worse for these families.ConclusionsThese findings have implications for a holistic family‐centred approach to the care of children with PKU and their families.
Reducing unintentional injuries in under fives: Development and testing of a mobile phone app
Authors: Jones Felicity , Whitehouse Ali , Dopson Amy , Palaghias Niklas , Aldiss Susie , Gibson Faith , Shawe Jill 
Published: November 2019

AbstractBackgroundUnintentional injuries are a leading cause of preventable death and a major cause of ill health and disability in children under 5 years of age. A health promotion mobile phone application, “Grow up Safely” (GUS), was developed to support parents and carers in reducing unintentional injuries in this population of children.MethodsA prototype of the mobile application was developed to deliver health education on unintentional injury prevention linked to stages of child development. In order to explore the usability of the app and refine its content, three focus groups were conducted with 15 mothers. Data were analysed using thematic analysis.ResultsThe majority of participants reported previous use of health apps, mainly related to pregnancy and recommended by health professionals. The app was considered user‐friendly and easy to navigate. Participants in two focus groups found the app informative and offered new information, and they would consider using it. Participants in the “young mum's” group considered the advice to be “common sense” but found the language too complex. All participants commented that further development of push‐out notifications and endorsement by a reputable source would increase their engagement with the app.ConclusionThe GUS mobile phone app, aimed at reducing unintentional injuries in children under five, was supported by mothers as a health promotion app. They would consider downloading it, particularly if recommended by a health professional or endorsed by a reputable organization. Further development is planned with push‐out notifications and wider feasibility testing to engage targeted groups, such as young mothers, fathers, and other carers.
Season of birth, childhood asthma and allergy in a nationwide cohort—Mediation through lower respiratory infections
Authors: Almqvist Catarina , Ekberg Sara , Rhedin Samuel , Fang Fang , Fall Tove , Lundholm Cecilia 
Published: November 2019

AbstractBackgroundPrevious studies have suggested an association between season of birth and risk of childhood asthma and allergic disease. The association may be modified by birth year and region, or mediated by respiratory tract infections.ObjectiveWe aimed to estimate the association between season of birth and risk of childhood asthma/wheeze or allergic rhinoconjunctivitis in a population‐based setting, and the mediating effect of lower respiratory infections.MethodsTwo population‐based cohorts were identified from the nationwide Swedish Medical Birth, Patient and Prescribed Drug Registers. The association between birth month/season and asthma/wheeze incidence was analysed using Cox proportional regression in the younger cohort born 2005‐2010 (n = 582 494) and asthma/allergic rhinoconjunctivitis prevalence during the 7th year of life using log‐binomial models in the older cohort born 2001‐2004 (n = 367 583). Interactions were formally tested. Mediation analyses to address the effect of lower respiratory infections were performed in the older cohort using the R package “medflex.”ResultsChildren born during fall and winter had an increased risk of asthma/wheeze after 2 years of age in the younger cohort: hazard ratio 1.24 (95% confidence interval, CI 1.17, 1.33) for winter and risk of prevalent asthma during their 7th year of life in the older cohort; prevalence ratio (PR) 1.12 (95% CI 1.08, 1.16) for winter. These estimates were partly mediated by lower respiratory infections; the indirect effect for winter compared with summer was PR 1.03 (95% CI 1.03, 1.04). The association was similar for allergic rhinoconjunctivitis in the 7th year of life, but not mediated by respiratory infections.ConclusionWe found that the association between season of birth and risk of childhood asthma/wheeze, but not allergic rhinoconjunctivitis, is partly mediated through lower respiratory infections.Clinical relevanceThis has important implications for patient care, such as asthma management programmes to notify timing of seasonality for viral respiratory tract infections.
Unusual subcutaneous dedifferentiated liposarcoma exhibiting coexistence of meningothelial‐like whorls and inflammatory myofibroblastic tumor‐like structures
Authors: Chen Shuai , He Shujin , Huang Haining , Li Lei , Wang Wei , Cui Zhihong , Zhang Renya 
Published: November 2019

AbstractTo explore the clinicopathological features of a rare dedifferentiated liposarcoma (DDLPS) with meningothelial‐like whorls, we retrospectively analyzed 46 reported cases and 1 case that we encountered. Fluorescence in situ hybridization (FISH) analysis of the MDM2 amplification status of our case was also performed. Our case involved a 73‐year‐old male patient who had a mass in the upper part of his left arm for 10 years and was treated by surgical ablation of the tumor because of the mass' recent rapid enlargement. Microscopically, the tumor tissues showed coexistence of well‐differentiated and dedifferentiated components, the latter of which included meningothelial‐like whorls and inflammatory myofibroblastic tumor‐like structures. The dedifferentiated components diffusely expressed vimentin, MDM2, CDK4, p16, and smooth muscle actin. They were also focally positive for desmin but negative for S‐100, CD117, CD34, ALK, EMA, SOX‐10, p53, and β‐catenin. FISH detection showed MDM2 amplification. In conclusion, subcutaneous DDLPS with meningothelial‐like whorls and inflammatory myofibroblastic tumor‐like features is rare. This case broadens the histopathological lineage of DDLPS, and confirms DDLPS with myogenic differentiation. The use of the combination of MDM2, CDK4, p16, and FISH to detect MDM2 amplification is a reliable basis for the diagnosis of DDLPS with meningothelial‐like whorls.
Potential feedback mediated by soil microbiome response to warming in a glacier forefield
Authors: Wang Yuwan , Ma Anzhou , Liu Guohua , Ma Jianpeng , Wei Jing , Zhou Hanchang , Brandt Kristian Koefoed , Zhuang Guoqiang 
Published: November 2019

AbstractMountain glaciers are retreating at an unprecedented rate due to global warming. Glacier retreat is widely believed to be driven by the physiochemical characteristics of glacier surfaces; however, the current knowledge of such biological drivers remains limited. An estimated 130 Tg of organic carbon (OC) is stored in mountain glaciers globally. As a result of global warming, the accelerated microbial decomposition of OC may further accelerate the melting process of mountain glaciers by heat production with the release of greenhouse gases, such as carbon dioxide (CO2) and methane. Here, using short‐term aerobic incubation data from the forefield of Urumqi Glacier No. 1, we assessed the potential climate feedback mediated by soil microbiomes at temperatures of 5°C (control), 6.2°C (RCP 2.6), 11°C (RCP 8.5), and 15°C (extreme temperature). We observed enhanced CO2‐C release and heat production under warming conditions, which led to an increase in near‐surface (2 m) atmospheric temperatures, ranging from 0.9°C to 3.4°C. Warming significantly changed the structures of the RNA‐derived (active) and DNA‐derived (total) soil microbiomes, and active microbes were more sensitive to increased temperatures than total microbes. Considering the positive effects of temperature and deglaciation age on the CO2‐C release rate, the alterations in the active microbial community structure had a negative impact on the increased CO2‐C release rate. Our results revealed that glacial melting could potentially be significantly accelerated by heat production from increased microbial decomposition of OC. This risk might be true for other high‐altitude glaciers under emerging warming, thus improving the predictions of the effects of potential feedback on global warming.