bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘It’s like being conscripted, one volunteer is better than 10 pressed men’: A qualitative study into the views of people who plan to opt‐out of organ donation
Authors: Miller Jordan , Currie Sinéad , McGregor Lesley M. , O’Carroll Ronan E. 
Published: January 2020

ObjectivesTo overcome the shortage of organ donors, Scotland and England are introducing an opt‐out organ donor registration system in 2020. This means individuals will be automatically considered to consent for donation unless they actively opt‐out of the register. Research has found that emotional barriers play a key role in donor decisions under opt‐in legislation, yet little is known about factors that influence donor decisions under opt‐out consent. Our objectives were to investigate attitudes towards organ donation and opt‐out consent from individuals who plan to opt‐out, and to explore the reasons why they plan to opt‐out.DesignQualitative interview study.MethodsSemi‐structured interviews were conducted with 15 individuals from Scotland (n = 14) and England (n = 1) who self‐reported the intention to opt‐out of the register following the legislative change to opt‐out. The interviews were transcribed verbatim and analysed using thematic analysis.ResultsThree main themes were identified: (1) consent versus coercion, which describes the perception of freedom of choice under an opt‐in system and fears of ‘government interference’ and threatened autonomy under opt‐out, (2) self‐protection, encompassing fears of medical mistrust, bodily integrity concerns, and apprehension regarding the recipient selection process, and lastly, (3) ‘riddled with pitfalls’, which includes the notion that opt‐out consent may increase susceptibility of stigma and reproach when registering an opt‐out decision.ConclusionsThis study reinforces existing opt‐in literature surrounding medical mistrust and bodily integrity concerns. A threat to one’s autonomous choice and heightened reactance arising from perceptions of unwarranted government control have emerged as novel barriers.
Statement of contribution

What is already known about this subject?

Although around 90% of individuals in the United Kingdom support organ donation, just 40% are actively registered as donors. As part of measures to improve rates of organ transplantation, Scotland and England are moving to an opt‐out organ donation consent system in 2020.

Existing research has shown that feelings and emotions are important factors that influence donor relevant decisions under the current opt‐in system, but little research has explored potential deterrents under the new plans for opt‐out consent.

Minimizing the number of people opting out of the donor register is key to ensure sustained rates of transplantation.

What does this study add?

This study explored why people plan to opt‐out of the new system in Scotland and England.

Medical mistrust and bodily integrity concerns remain as salient barriers under opt‐out laws.

Fears of unwarranted government control and a perceived threat to one’s freedom of choice emerged as a novel barrier.
Metastatic role of mammalian target of rapamycin signaling activation by chemoradiotherapy in advanced rectal cancer
Authors: Shiratori Hiroshi , Kawai Kazushige , Okada Masamichi , Nozawa Hiroaki , Hata Keisuke , Tanaka Toshiaki , Nishikawa Takeshi , Shuno Yasutaka , Sasaki Kazuhito , Kaneko Manabu , Murono Koji , Emoto Shigenobu , Ishii Hiroaki , Sonoda Hirofumi , Ushiku Tetsuo , Ishihara Soichiro 
Published: January 2020

AbstractPostoperative distant metastasis dramatically affects rectal cancer patients who have undergone neoadjuvant chemoradiotherapy (NACRT). Here, we clarified the association between NACRT‐mediated mammalian target of rapamycin (mTOR) signaling pathway activation and rectal cancer metastatic potential. We performed immunohistochemistry for phosphorylated mTOR (p‐mTOR) and phosphorylated S6 (p‐S6) on surgical specimen blocks from 98 rectal cancer patients after NACRT (cohort 1) and 80 colorectal cancer patients without NACRT (cohort 2). In addition, we investigated the association between mTOR pathway activity, affected by irradiation, and the migration ability of colorectal cancer cells in vitro. Based on the results of the clinical study, p‐mTOR was significantly overexpressed in cohort 1 (with NACRT) as compared to levels in cohort 2 (without NACRT) (P < .001). High p‐mTOR and p‐S6 levels correlated with the development of distant metastasis only in cohort 1. Specifically, high p‐S6 expression (HR 4.51, P = .002) and high pathological T‐stage (HR 3.73, P = .020) after NACRT were independent predictors of the development of distant metastasis. In vitro, p‐S6 levels and migration ability increased after irradiation in SW480 cells (TP53 mutation‐type) but decreased in LoVo cells (TP53 wild‐type), suggesting that irradiation modulates mTOR signaling and migration through cell type‐dependent mechanisms. We next assessed the expression level of p53 by immunostaining in cohort 1 and demonstrated that p‐S6 was overexpressed in samples with high p53 expression as compared to levels in samples with low p53 expression (P = .008). In conclusion, p‐S6 levels after NACRT correlate with postoperative distant metastasis in rectal cancer patients, suggesting that chemoradiotherapy might modulate the mTOR signaling pathway, promoting metastasis.
Clear‐cell variant of superficial cutaneous leiomyosarcoma associated with RB1 mutation: Clinical, dermoscopic, and histopathological characteristics
Authors: Atzori Laura , Pilloni Luca , Zanniello Ramona , Ferreli Caterina , Rongioletti Franco 
Published: January 2020

AbstractLeiomyosarcoma is a relatively rare soft tissue tumor whose clear‐cell variant has only been reported in leiomyosarcomas of the uterus. We report here for the first time a primary cutaneous clear‐cell leiomyosarcoma in the trunk skin of a 49‐year‐old man, characterized by a very indolent clinical and dermoscopic presentation, mimicking a dermatofibroma. Genetic analysis of the otherwise healthy patient revealed a germline mutation in the retinoblastoma 1 gene (RB1); the same mutation was found in his son, who had previously developed retinoblastoma. Moreover, the mother of the patient had died of uterine leiomyosarcoma with clear‐cell changes. Mutations in the RB1 gene occur commonly in human neoplasms. In this patient, we were able to link his clear‐cell variant of cutaneous leiomyosarcoma with the loss of retinoblastoma protein expression, as revealed by immunohistochemical staining analysis.
“Thinking and Working Politically”: The case of donor‐supported reform coalitions in the Philippines
Authors: Clarke Gerard 
Published: January 2020

AbstractMotivationReform coalitions represent a potential means for donors to support macro‐political reform in developing countries, enabling them to avoid the limitations of micro‐political or public sector reform where appropriate circumstances exist. Donor support for reform coalitions, however, is difficult to engineer and fraught with political risk, including the risk of partisan taint.PurposeThis article therefore explores the efforts of Australian Aid and the World Bank to promote reform coalitions and constituencies in the Philippines during the presidency of Benigno S. Aquino III (2010–2016) and to institutionalize the reform agenda of his administration.Approach and MethodsIt draws on a range of sources including programme design documents, mid‐term and end‐of‐term reviews, and contextual policy documents. It also draws on economic and governance data sets to explore relevant correlations.FindingsIt finds that second‐generation reform coalitions brought together stakeholders from government, the private sector and civil society and promoted economic and other reforms. These donor strategies arguably failed, however, with the election of Rodrigo Duterte in May 2016. He was critical of Aquino’s record in office and ostensibly committed to reverse engineering many of the Aquino administration’s achievements. The article critiques a governance‐centric explanatory chain of causation and proposes an expanded politics‐centric chain.Policy ImplicationsIn conceptual terms, planning of reform coalition activities must better account for dominant coalitions and the political settlements which they underpin, and must set out explicit theories of change, specifying distinct political pathways to change. In operational terms, donors must work to avoid traditional “transactional” relationships in favour of more innovative “transformative” ones and must balance “strategic opportunism” with strategic retreat and adaptation where necessary.
Higher early recurrence risk and potential benefit of dual antiplatelet therapy for minor stroke with watershed infarction: subgroup analysis of CHANCE
Authors: Pu Y. , Liu X. , Wang Y. , Meng X. , Jing J. , Zou X. , Pan Y. , Wang A. , Zhao X. , Johnston S. C. , Wang Y. , Atchaneeyasakul K. , Liebeskind D. S. , Liu L. ,   the CHANCE Investigators
Published: January 2020

Background and purposeThe aim was to explore the risk of early stroke recurrence within 3 months after watershed infarction and to investigate whether early dual antiplatelet therapy is more effective in decreasing such risk.MethodsPatients enrolled in the Clopidogrel in High‐risk Patients with Acute Non‐disabling Cerebrovascular Events (CHANCE) trial and who had acute infarction on diffusion‐weighted imaging were included in this subgroup analysis. All magnetic resonance images were read centrally by two neurologists who were blinded to the patients’ baseline and outcome information. The primary outcome was any stroke recurrence within 3 months. The hazard ratios were adjusted by known predictors of stroke recurrence.ResultsOf the 1089 patients with magnetic resonance imaging data enrolled in CHANCE, 834 (76.58%) patients had acute infarcts on diffusion‐weighted imaging. The median and range of duration from randomization to stroke recurrence was 1.5 (1–6) days. Patients with watershed infarction had higher risk of stroke recurrence than those without (17.20% vs. 6.34%) within the first week after initial stroke; the hazard ratio (95% confidence interval) was 2.799 (1.536–5.101) adjusted by age, sex, smoking, body mass index, medical history, time to randomization, open‐label aspirin dose at first day, single or dual antiplatelet therapy, National Institutes of Health Stroke Scale score at randomization, in‐hospital treatment and white matter lesions,P < 0.001. There was no interaction between antiplatelet therapy and the presence of watershed infarction (P = 0.544).ConclusionsMinor stroke with watershed infarction has high recurrent risk in the first week. Dual antiplatelet therapy may be safely implemented, yet watershed infarction mechanisms of hypoperfusion and emboli may not be addressed.
Clinical implications of head‐shaking nystagmus in central and peripheral vestibular disorders: is perverted head‐shaking nystagmus specific for central vestibular pathology?
Authors: Yang T.‐H. , Lee J.‐H. , Oh S.‐Y. , Kang J.‐J. , Kim J.‐S. , Dieterich M. 
Published: January 2020

AbstractBackground and purposeThe patterns of head‐shaking nystagmus (HSN) aid in differentiation between central and peripheral vestibular disorders, and perverted HSN (pHSN) has been considered a central sign. The aim was to determine the characteristics of HSN in a large number of patients with either peripheral or central vestibular disorders in a dizziness clinic of a university hospital.MethodsThe medical records of 7544 dizzy patients were reviewed during a year and 822 patients with a clinical diagnosis of vestibular disorders were recruited. The findings of spontaneous nystagmus (SN) and HSN in these patients were compared with those of healthy controls (n = 48).ResultsA total of 217 of the 822 patients (26.4%) were classified as having a central vestibular disorder, whilst 397 (48.3%) had a peripheral vestibular disorder. In the peripheral vestibular disorder group, SN was observed in 14.1% and HSN in 40.8%, amongst whom 24.1% were the pHSN form. In the central group, SN was observed in 17.5% and HSN in 24.0% of whom 57.7% was pHSN. HSN was more frequently observed in the peripheral vestibular disorder group than in the central group (40.8% vs. 24.0%, P < 0.01). However, the proportion of pHSN was significantly increased in the central group compared to the peripheral vestibular patient group (57.7% vs. 24.1%, P < 0.01).ConclusionsSince pHSN is not specific for central vestibular disorders, other clinical features should be considered in pursuing a central lesion in patients with pHSN.
Stabilization of the TAK1 adaptor proteins TAB2 and TAB3 is critical for optimal NF‐κB activation
Authors: Braun Harald , Staal Jens 
Published: January 2020

TAB2 and TAB3 bind to K63‐linked polyubiquitin chains and recruit the critical kinase MAP3K7 (TAK1). The polyubiquitin‐recruited TAK1/TAB2/TAB3 complex comes in close proximity with the IKK (IKKα/IKKβ/IKKγ) complex, which is recruited to M1‐linked polyubiquitin chains via the IKKγ (NEMO) component. Together, the two complexes activate the NF‐κB family of transcription factors. NF‐κB transcription factors are critical mediators of pro‐inflammatory signals and must be tightly regulated at multiple levels. Recently, it was discovered that one such point of regulation occurs at the level of TAB2 and TAB3 protein stability by the deubiquitinase USP15.Comment on: https://doi.org/10.1111/febs.15202
Temperature elevation reduces the sensitivity of invasive cladoceran Daphnia lumholtzi to filamentous cyanobacterium Raphidiopsis raciborskii
Authors: Wejnerowski Łukasz , Sikora‐Koperska Anna , Dawidowicz Piotr 
Published: January 2020

Abstract

Exotic cladoceran Daphnia lumholtzi is a highly invasive species in the north and south American continents and can potentially also invade European freshwaters and outcompete native Daphnia populations. However, European waterbodies are frequently dominated by less edible filamentous cyanobacteria including also invaders such as Raphidiopsis raciborskii, which might affect the fitness of D. lumholtzi. Furthermore, temperature may influence the sensitivity of D. lumholtzi to R. raciborskii filaments.

In this study, we determined whether the presence of R. raciborskii could obstruct the invasion of Europe by D. lumholtzi, through reducing its fitness, and whether this depends on temperature. We compared the population growth rate (r) and the somatic growth rate of D. lumholtzi maintained at two temperatures (20 or 26°C) and fed with two diets: green microalgae alone or green microalgae mixed with filaments of R. raciborskii. Three clones of D. lumholtzi were used to evaluate potential variation in response to the treatments among different clones.

At 20°C, the population growth rate of D. lumholtzi fed with cyanobacterial filaments declined sharply. This reduction was caused by increased egg abortion, egg degeneration, and mortality of newborn daphnids. At 26°C, R. raciborskii lost its harmful effect on the population growth of D. lumholtzi. The presence of cyanobacteria did reduce the somatic growth rate of D. lumholtzi at both temperatures and in all three clones except for one that had a similar somatic growth rate on both diets at 26°C.

The presence of filamentous cyanobacteria does affect growth in D. lumholtzi and may thereby substantially reduce its invasive potential, but only at lower temperatures. Therefore, the presence of filamentous cyanobacteria may not present an obstacle to the invasion of Europe by D. lumholtzi in a warmer future climate.
Oral health knowledge, beliefs and practices among community‐dwelling older adults in Shanghai, China: A cross‐sectional analysis
Authors: Ye Sheng , Chen Liqun 
Published: January 2020

AbstractObjectiveTo assess oral health knowledge, beliefs and practices among community‐dwelling older adults in Shanghai, China.BackgroundChina is ageing faster than other developing countries. Four National Oral Health Surveys have been carried out in China between 1983 and 2015, focused on clinical oral examinations.Materials and methodsA cross‐sectional study was conducted among 983 participants aged 60‐93 years old, drawn from two community health service centres of Pudong New Area in Shanghai. Data were collected using a Chinese language questionnaire of oral health knowledge, beliefs and practices based on the Knowledge, Attitudes (beliefs) and Practices (KAP) model. The scale ranges were knowledge 0‐19, beliefs 0‐17 and practices 0‐55, where a higher score indicated a more accurate perception. Multivariate analysis explored the related factors using IBM SPSS Statistics version 22.0.ResultsMean (SD) scores of this questionnaire were oral health knowledge 13.0 (3.6), beliefs 13.0 (3.2) and practices 31.2 (11.2). Geographic location, age group, employment status, education and monthly household income showed significant statistical association with these scores (P < .001). Only three sociodemographic variables (education, age group and employment status) remained significant after further multiple regression analysis (P < .001).ConclusionsThe level of oral health knowledge, beliefs and practices among older adults in Shanghai, China, was not high. Younger and working individuals with higher level of education showed good oral health knowledge, beliefs and practices. Community‐based oral health strategies are needed to increase oral health knowledge, in particular of oral daily cleaning, and improve beliefs and practices in regular dental visits.
A qualitative evaluation of participants' experiences of using co‐design to develop a collective leadership educational intervention for health‐care teams
Authors: Pallesen Kirsten Siig , Rogers Lisa , Anjara Sabrina , De Brún Aoife , McAuliffe Eilish 
Published: January 2020

AbstractIntroductionCo‐design involves stakeholders as design partners to ensure a better fit to user needs. Many benefits of involving stakeholders in design processes have been proposed; however, few studies have evaluated participants’ experience of co‐design in the development of educational interventions. As part of a larger study, health‐care professionals, researchers and patients co‐designed a collective leadership intervention for health‐care teams. This study evaluated their experiences of the co‐design process.MethodsSemi‐structured interviews were conducted with individuals (n = 10) who took part in the co‐design workshops. Interviews were audio‐recorded, transcribed verbatim and analysed thematically.ResultsFour key themes were identified from the data: (a) Managing expectations in an open‐ended process; (b) Establishing a positive team climate; (c) Focusing on frustrations—challenging but informative; and (d) Achieving a genuine co‐design partnership.ConclusionsThe development of a positive team climate is essential to the co‐design process. Organizers should focus on building strong working relationships from the beginning to enable open discussion. Organizers of co‐design should be conscious of establishing and maintaining a genuine partnership where participants are involved as equal partners and co‐creators. This can be done through the continuous use of feedback to allow participants to influence the workshop directions, and through limiting researcher domination. Lastly, co‐design can be daunting, but organizers can positively impact participants’ experience by acknowledging the emergent nature of the process in order to reduce participant apprehension, thereby limiting the barriers to participation.
‘Social Citizenship’ at the Street Level? EU Member State Administrations Setting a Firewall
Authors: Heindlmaier Anita 
Published: January 2020

AbstractEuropean integration, and especially the European Court of Justice, has challenged the national character of social rights; the latter have become increasingly transnational. This contribution examines the impact of the Court at the street level. It analyses how Member State administrations handle the social rights of mobile EU citizens in practice in case they are granted discretion. Therefore, a framework of shades of compliance is developed that captures Member State responses to EU law beyond the dichotomy of compliance and non‐compliance. I argue that Member State administrations tend to make the access to social benefits difficult. Still, there may be differences in the shade of compliance on the ground. Surprisingly, these differences cannot be explained by the party‐political environment but depend to a high degree on exposedness. The claim is empirically supported by a comparative study of Austrian welfare (and migration) administrations' practices.
Social capital and periodontal disease in Hispanic/Latino adults in the United States: Results from the Hispanic Community Health Study/Study of Latinos
Authors: Laniado Nadia , Badner Victor M. , Sanders Anne E. , Singer Richard H. , Finlayson Tracy L. , Hua Simin , Kaste Linda M. , Isasi Carmen R. 
Published: January 2020

AbstractAimsTo examine the association of social capital with periodontal disease severity.Materials and MethodsWe analysed data obtained from 3,994 men and women aged 18–74 years in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS). From 2008 to 2011, dentists assessed periodontitis status with a full‐mouth periodontal examination. Periodontitis was classified using standardized case definitions. Multivariable logistic regression estimated odds of moderate–severe periodontitis associated with two measures of social capital: structural support (Social Network Index) and functional support (Interpersonal Support Evaluation List).ResultsFor US‐born participants, for each additional person in their social network, the adjusted odds of moderate–severe periodontitis was reduced 17% (OR = 0.83, 95% CI = 0.71, 0.96). However, no association was found between functional support and periodontal disease severity.ConclusionsGreater structural social support was associated with a lower prevalence of moderate–severe periodontitis in US‐born Hispanics/Latinos. These findings suggest that US‐born Hispanics/Latinos with less social support represent a vulnerable segment of the population at high‐risk group for periodontal disease.
Phenotypic switch to eczema in patients receiving biologics for plaque psoriasis: a systematic review
Authors: Al‐Janabi A. , Foulkes A.C. , Mason K. , Smith C.H. , Griffiths C.E.M. , Warren R.B. 
Published: January 2020

AbstractThe use of biologic therapies for the treatment of chronic plaque psoriasis has been linked to the development of atopic eczema, amongst other cutaneous adverse events. This can cause diagnostic confusion and create difficulty in the management of patients with plaque psoriasis. The main objective of this systematic review was to review all cases of eczema, including atopic eczema, reported in patients treated with biologics for chronic plaque psoriasis. PubMed, Medline and Embase databases were used to identify studies reporting eczema in patients treated with biologic therapy for chronic plaque psoriasis. A total of 92 patients were identified from 24 studies, with patients treated with either: adalimumab; etanercept; infliximab; ixekizumab; secukinumab; or ustekinumab. Factors common to some reported cases include: a prior history of atopy; eosinophilia; raised serum immunoglobulin E. Twenty‐three had documented treatment outcomes; 14 had biologic therapy discontinued or switched. Management strategies included topical or oral corticosteroids, and treatment with alternative systemic agents such as ciclosporin or apremilast. This adverse event occurred in 1.0–12.1% of patients within trial data and observational studies. This review demonstrates that there are consistent reports of a switch to an atopic eczema phenotype from psoriasis in patients taking biologics inhibiting tumour necrosis factor alpha and the interleukin (IL)‐17/IL‐23 axis. The majority stopped the implicated biologic, but conservative management was successful in some cases. Those with an atopic diathesis may be more at risk. Elucidation of mechanisms and risk factors would contribute to optimal therapy selection for individual patients.