bluuebunny/crossref_metadata_2025_split huggingface dataset:
3,3-Diindolylmethane (DIM): a nutritional intervention and its impact on breast density in healthy BRCA carriers. A prospective clinical trial
Authors: Yerushalmi Rinat , Bargil Sharon , Ber Yaara , Ozlavo Rachel , Sivan Tuval , Rapson Yael , Pomerantz Adi , Tsoref Daliah , Sharon Eran , Caspi Opher , Grubsrein Ahuvah , Margel David 
Published: May 2020

Abstract
Women who carry the BRCA mutation are at high lifetime risk of breast cancer, but there is no consensus regarding an effective and safe chemoprevention strategy. A large body of evidence suggests that 3,3-diindolylmethane (DIM), a dimer of indole-3-carbinol found in cruciferous vegetables, can potentially prevent carcinogenesis and tumor development. The primary aim of this prospective single-arm study was to investigate the effect of DIM supplementation on breast density, a recognized predictive factor of breast cancer risk. Participants were 23 healthy female BRCA carriers (median age 47 years; 78% postmenopausal) who were treated with oral DIM 100 mg × 1/day for 1 year. The amount of fibroglandular tissue (FGT) and background parenchymal enhancement (BPE) on magnetic resonance imaging (MRI) performed before and after the intervention was scored by two independent expert radiologists using the Breast Imaging and Reporting Data System. The results showed a decrease in the average score for FGT amount from 2.8 ± 0.8 at the onset to 2.65 ± 0.84 after 1 year (P = 0.031), with no significant change in BPE (P = 0.429). A group of DIM-untreated age- and menopausal-status-matched women from the BRCA clinic did not show a significant change in FGT amount (P = 0.33) or BPE (P = 0.814) in a parallel year. Mean estradiol level decreased from 159 to 102 pmol/l (P = 0.01), and mean testosterone level decreased from 0.42 to 0.31 pmol/l (P = 0.007). Side effects were grade 1. In conclusion, 1 year’s supplementation with DIM 100 mg × 1/day in BRCA carriers was associated with a significant decline in FGT amount on MRI. Larger randomized studies are warranted to corroborate these findings.
Glioma-derived extracellular vesicles promote tumor progression by conveying WT1
Authors: Tsutsui Taishi , Kawahara Hironori , Kimura Ryouken , Dong Yu , Jiapaer Shabierjiang , Sabit Hemragul , Zhang Jiakang , Yoshida Takeshi , Nakada Mitsutoshi , Hanayama Rikinari 
Published: May 2020

Abstract
Glioma persists as one of the most aggressive primary tumors of the central nervous system. Glioma cells are known to communicate with tumor-associated macrophages/microglia via various cytokines to establish the tumor microenvironment. However, how extracellular vesicles (EVs), emerging regulators of cell–cell communication networks, function in this process is still elusive. We report here that glioma-derived EVs promote tumor progression by affecting microglial gene expression in an intracranial implantation glioma model mouse. The gene expression of thrombospondin-1 (Thbs1), a negative regulator of angiogenesis, was commonly downregulated in microglia after the addition of EVs isolated from different glioma cell lines, which endogenously expressed Wilms tumor-1 (WT1). Conversely, WT1-deficiency in the glioma-derived EVs significantly attenuated the Thbs1 downregulation and suppressed the tumor progression. WT1 was highly expressed in EVs obtained from the cerebrospinal fluid of human patients with malignant glioma. Our findings establish a novel model of tumor progression via EV-mediated WT1–Thbs1 intercellular regulatory pathway, which may be a future diagnostic or therapeutic target.
Clinical Impact of Accelerate Pheno Rapid Blood Culture Detection System in Bacteremic Patients
Authors: Dare Ryan K , Lusardi Katie , Pearson Courtney , McCain Kelsey D , Daniels K Baylee , Van Serena , Rico Juan Carlos , Painter Jacob , Lakkad Mrinmayee , Rosenbaum Eric R , Bariola J Ryan 
Published: May 2020

Abstract

Background
Accelerate Pheno blood culture detection system (AXDX) provides rapid identification and antimicrobial susceptibility testing results. Limited data exist regarding its clinical impact. Other rapid platforms coupled with antimicrobial stewardship program (ASP) real-time notification (RTN) have shown improved length of stay (LOS) in bacteremia.

Methods
A single-center, quasi-experimental study of bacteremic inpatients before and after AXDX implementation was conducted comparing clinical outcomes from 1 historical and 2 intervention cohorts (AXDX and AXDX + RTN).

Results
Of 830 bacteremic episodes, 188 of 245 (77%) historical and 308 (155 AXDX, 153 AXDX + RTN) of 585 (65%) intervention episodes were included. Median LOS was shorter with AXDX (6.3 days) and AXDX + RTN (6.7 days) compared to historical (8.1 days) (P = .001). In the AXDX and AXDX + RTN cohorts, achievement of optimal therapy (AOT) was more frequent (93.6% and 95.4%, respectively) and median time to optimal therapy (TTOT) was faster (1.3 days and 1.4 days, respectively) compared to historical (84.6%, P ≤ .001 and 2.4 days, P ≤ .001, respectively). Median antimicrobial days of therapy (DOT) was shorter in both intervention arms compared to historical (6 days each vs 7 days; P = .011). Median LOS benefit during intervention was most pronounced in coagulase-negative Staphylococcus bacteremia (P = .003).

Conclusions
LOS, AOT, TTOT, and total DOT significantly improved after AXDX implementation. Addition of RTN did not show further improvement over AXDX and an already active ASP. These results suggest that AXDX can be integrated into healthcare systems with an active ASP even without the resources to include RTN.
Isavuconazole Is as Effective as and Better Tolerated Than Voriconazole for Antifungal Prophylaxis in Lung Transplant Recipients
Authors: Samanta Palash , Clancy Cornelius J , Marini Rachel V , Rivosecchi Ryan M , McCreary Erin K , Shields Ryan K , Falcione Bonnie A , Viehman Alex , Sacha Lauren , Kwak Eun Jeong , Silveira Fernanda P , Sanchez Pablo G , Morrell Matthew , Clarke Lloyd , Nguyen M Hong 
Published: May 2020

Abstract

Background
Invasive fungal infections (IFIs) are common following lung transplantation. Isavuconazole is unstudied as prophylaxis in organ transplant recipients. We compared effectiveness and tolerability of isavuconazole and voriconazole prophylaxis in lung transplant recipients.

Methods
A single-center, retrospective study of patients who received isavuconazole (September 2015–February 2018) or voriconazole (September 2013–September 2015) for antifungal prophylaxis. IFIs were defined by EORTC/MSG criteria.

Results
Patients received isavuconazole (n = 144) or voriconazole (n = 156) for median 3.4 and 3.1 months, respectively. Adjunctive inhaled amphotericin B (iAmB) was administered to 100% and 41% of patients in the respective groups. At 1 year, 8% of patients receiving isavuconazole or voriconazole developed IFIs. For both groups, 70% and 30% of IFIs were caused by molds and yeasts, respectively, and breakthrough IFI (bIFI) rate was 3%. Outcomes did not significantly differ for patients receiving or not receiving iAmB. Independent risk factors for bIFI and breakthrough invasive mold infection (bIMI) were mold-positive respiratory culture and red blood cell transfusion &gt;7 units at transplant. Bronchial necrosis &gt;2 cm from anastomosis and basiliximab induction were also independent risk factors for bIMI. Isavuconazole and voriconazole were discontinued prematurely due to adverse events in 11% and 36% of patients, respectively (P = .0001). Most common causes of voriconazole and isavuconazole discontinuation were hepatotoxicity and lack of oral intake, respectively. Patients receiving ≥90 days prophylaxis had fewer IFIs at 1 year (3% vs 9%, P = .02). IFIs were associated with increased mortality (P = .0001) and longer hospitalizations (P = .0005).

Conclusions
Isavuconazole was effective and well tolerated as antifungal prophylaxis following lung transplantation.
Ulysses’ journey home to Ithaca: a new metaphor for understanding the General Theory
Authors: Togati Teodoro Dario 
Published: May 2020

Abstract
This paper argues that in order to remedy the lack of alternative methods in current macroeconomics it is necessary to clarify the ontology of Keynes’s General Theory. One of the reasons why Keynes lost his generality battle is that he left many gaping holes in the ‘correct’ articulation of his research programme—especially in terms of the specification of hard-core ‘cosmological’ beliefs concerning stability, value and aggregate behaviour—yet to be filled by the post-Keynesian literature. In order to start filling the gaps, this paper proposes a new agenda called ‘The General Theory 4.0’ based on the new ‘Ulysses’ journey’ metaphor, which, it shows, is better than alternative ones, such as Farmer’s ‘windy boat’ and Akerlof and Shiller’s ‘rollercoaster’, for improving understanding of Keynes’s book.
Riskscapes and the socio-spatial challenges of climate change
Authors: Davies Anna , Hooks Gregory , Knox-Hayes Janelle , Liévanos Raoul S 
Published: May 2020

AbstractAnthropogenic climate change is increasing the frequency and severity of the physical threats to human and planetary wellbeing. However, climate change risks, and their interaction with other “riskscapes”, remain understudied. Riskscapes encompass different viewpoints on the threat of loss across space, time, individuals and collectives. This Special Issue of the Cambridge Journal of Regions, Economy, and Society enhances our understanding of the multifaceted and interlocking dimensions of climate change and riskscapes. It brings together rigorous and critical international scholarship across diverse realms on inquiry under two, interlinked, themes: (i) governance and institutional responses and (ii) vulnerabilities and inequalities. The contributors offer a forceful reminder that when considering climate change, social justice principles cannot be appended after the fact. Climate change adaptation and mitigation pose complex and interdependent social and ethical dilemmas that will need to be explicitly confronted in any activation of “Green New Deal” strategies currently being developed internationally. Such critical insights about the layered, unequal and institutional dimensions of risks are of paramount import when considering other riskscapes pertaining to conflict and war, displaced people and pandemics like the 2019–2020 global COVID-19 pandemic.
Neuroimmune interactions in cardiovascular diseases
Authors: Carnevale Daniela , Lembo Giuseppe 
Published: May 2020

AbstractOur body is continuously in contact with external stimuli that need a fine integration with the internal milieu in order to maintain the homoeostasis. Similarly, perturbations of the internal environment are responsible for the alterations of the physiological mechanisms regulating our main functions. The nervous system and the immune system represent the main interfaces between the internal and the external environment. In carrying out these functions, they share many similarities, being able to recognize, integrate, and organize responses to a wide variety of stimuli, with the final aim to re-establish the homoeostasis. The autonomic nervous system, which collectively refers to the ensemble of afferent and efferent neurons that wire the central nervous system with visceral effectors throughout the body, is the prototype system controlling the homoeostasis through reflex arches. On the other hand, immune cells continuously patrol our body against external enemies and internal perturbations, organizing acute responses and forming memory for future encounters. Interesting to notice, the integration of the two systems provides a further unique opportunity for fine tuning of our body’s homoeostasis. In fact, the autonomic nervous system guides the development of lymphoid and myeloid organs, as well as the deployment of immune cells towards peripheral tissues where they can affect and control several physiological functions. In turn, every specific immune cell type can contribute to regulate neural circuits involved in cardiovascular function, metabolism, and inflammation. Here, we review current understanding of the cross-regulation between these systems in cardiovascular diseases.
Revisiting the Past in the Age of Posts: Rememory in Toni Morrison’s God Help the Child and Gisèle Pineau’s Femmes des Antilles
Authors: Gras Delphine 
Published: May 2020

AbstractIn this article, I examine how Toni Morrison and Gisèle Pineau provide timely pieces against the historical amnesia characteristic of post-racial discourse in the USA and in France. Studying Morrison’s God Help the Child (2015) and Pineau’s Femmes des Antilles: Traces et Voix (1998) side by side reveals how Morrison’s rememory is a global concept as pertinent today as when first coined in Beloved (1987). The term’s original use in the context of slavery also suggests a lens through which to read Morrison’s non-slavery era works like God Help the Child. What ultimately comes to the fore in both authors’ potent expositions of the specter of slavery haunting black women in the USA, France, and the West Indies is a rejection of historical silencing.
Appraisal of the PIBD-classes Criteria: A Multicentre Validation
Authors: Ledder Oren , Sonnino Micol , Birimberg-Schwartz Liron , Escher Johanna C , Russell Richard K , Orlanski-Meyer Esther , Matar Manar , Assa Amit , Tzion Raffi Lev , Shteyer Eyal , Griffiths Anne , Turner Dan 
Published: May 2020

AbstractIntroductionThe PIBD-classes criteria were developed to standardise the classification of children with inflammatory bowel disease [IBD], from Crohn’s disease [CD], through IBD-unclassified [IBD-U], to typical ulcerative colitis [UC]. We aimed to further validate the criteria and to explore possible modifications.MethodsThis was a multicentre retrospective cohort study of children diagnosed with IBD with at least 1 year of follow-up. Clinical, radiological, endoscopic, and histological data were recorded at diagnosis and latest follow-up, as well as the 23 items of the PIBD-classes criteria. The PIBD-classes criteria were assessed for redundant items, and a simplified algorithm was proposed and validated on the original derivation cohort from which the PIBD-classes algorithm was derived.ResultsOf the 184 included children [age at diagnosis 13 ± 3 years, 55% males], 122 [66%] were diagnosed by the physician with CD, 17 [9%] with IBD-U, and 45 [25%] with UC. There was high agreement between physician-assigned and PIBD-classes generated diagnosis for CD [93%; eight patients moved to IBD-U] and for UC [84%; six moved to IBD-U and one to CD]. A simplified version of the algorithm with only 19 items is suggested, with comparable performance to the original algorithm [81% sensitivity and 81% specificity vs 78% and 83% for UC; and 79% and 95% vs 80% and 95% for CD, respectively].ConclusionsThe PIBD-classes algorithm is a useful tool to facilitate standardised objective classification of IBD subtypes in children. A modified version of the PIBD-classes maintains accuracy of classification with a simplified algorithm.
Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology
Authors: Pessoa-Amorim Guilherme , Camm Christian F , Gajendragadkar Parag , De Maria Giovanni Luigi , Arsac Celine , Laroche Cecile , Zamorano José Luis , Weidinger Franz , Achenbach Stephan , Maggioni Aldo P , Gale Chris P , Poppas Athena , Casadei Barbara 
Published: May 2020

Abstract

Aims
The COVID-19 pandemic required a significant redeployment of worldwide healthcare resources. Fear of infection, national lockdowns and altered healthcare priorities have the potential to impact utilisation of healthcare resources for non-communicable diseases. To survey health professionals’ views of the impact of the COVID-19 pandemic on the rate and timing of admission of patients with ST-elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) administered an internet-based questionnaire to cardiologists and cardiovascular nurses across 6 continents.

Methods and results
3101 responses were received from 141 countries across 6 continents. 88.3% responded that their country was in “total lockdown” and 7.1% in partial lockdown. 78.8% responded that the number of patients presenting with STEMI was reduced since the coronavirus outbreak and 65.2% indicated that the reduction in STEMI presentations was &gt;40%. Approximately 60% of all respondents reported that STEMI patients presented later than usual and 58.5% that &gt;40% of STEMI patients admitted to hospital presented beyond the optimal window for primary percutaneous intervention (PCI) or thrombolysis. Independent predictors of the reported higher rate of delayed STEMI presentation were a country in total lockdown, &gt;100 COVID-19 cases admitted locally, and the complete restructuring of the local cardiology service.

Conclusion
The survey indicates that the impact of COVID-19 on STEMI presentations is likely to be substantial, with both lower presentations and a higher rate of delayed presentations occurring. This has potentially important ramifications for future healthcare and policy planning in the event of further waves of this pandemic.
Comparison of health care utilization among users of public and private community health centres in urban China
Authors: Shen Menghan , He Wen , Li Linyan , Wu Yushan 
Published: May 2020

AbstractBackgroundIn China, the government has encouraged the participation of private sector facilities in primary care to improve health care quality.ObjectiveWe compare health care utilization patterns among patients who select private versus public community health centres (CHCs) for reimbursed outpatient services.MethodsThis paper uses data from the Urban Employee Basic Medical Insurance scheme from 2013 to 2016 in one of the largest cities in China. We used a Poisson model and a logistic model to examine outcomes on monthly outpatient visits and the probability of hospitalization, respectively.ResultsCompared with being a user of a public CHC, being a user of a private CHC is associated with a 26.2% lower incidence rate of outpatient visits to hospitals [95% confidence interval (CI): 30.1–21.8%] and no difference in rates of visits to CHCs or hospitalization. Among patients with diabetes or hypertension, being a user of a private CHC is associated with a 12.9% lower incidence rate of outpatient visits to CHCs (95% CI: 19.8–5.4%), a 25.6% lower incidence rate of outpatient visits to hospitals (95% CI: 21.4–19.5%) and 22.3% higher odds of hospitalization (95% CI: 3.5–44.7%).ConclusionBeing a user of a private CHC is associated with a reduction in outpatient visits to hospitals, which aligns with the goal of reducing hospital congestion at the outpatient level. For patients with chronic diseases, being a user of a private CHC is associated with a higher probability of hospitalization. More research is needed to understand the reason for this difference.
Shared Intimacies: Women’s Sexuality in Foreign Workers’ Camps, 1940–1945
Authors: Fauroux Camille 
Published: May 2020

Abstract
By examining judicial records as well as corporate archives, this article argues that the camp played an important role in the management of foreign workers’ sexuality in Nazi Germany. A means of housing foreigners or controlling the workforce, the segregation of workers along racial and gendered lines in barracks also ensured their reproducing bodies could be controlled to avoid their ‘settling down’ on Reich territory. This microhistorical study of French women living in Berlin between 1940 and 1945 argues that although camp housing was primarily intended to control heterosexuality, it also had profound consequences for queer relationships. In illuminating this previously unacknowledged aspect of biopolitics in Nazi Germany, the article addresses issues of spatial domination and agency in romantic and sexual encounters.
Driver License Renewal Laws and Older Adults’ Daily Driving, United States, 2003–2017
Authors: Shen Sijun , Ratnapradipa Kendra L , Pervall Gina C , Sweeney Meredith , Zhu Motao 
Published: May 2020

Abstract

Objectives
Around the world, aging populations pose significant concerns regarding their community mobility and transportation safety. Most previous studies in the United States have focused on the associations between driver license renewal laws and crash outcomes among older adults (65 years and older). Few studies have evaluated the impact of driver license renewal laws on older adults’ community mobility. This study aimed to identify the associations between driver license renewal laws and older males’ and females’ daily driving likelihood and duration.

Method
The 2003–2017 American Time Use Survey data were merged with driver license renewal legislation using ages 55–64 to control for effects of non-licensure factors (e.g., gasoline price). Weighted Poisson and linear regression models were used to estimate the associations of various driver licensure provisions with older males’ and females’ daily driving likelihood and duration.

Results
A shorter in-person renewal period and the presence of mandatory reporting laws for physicians were associated with a lower daily driving likelihood and shorter driving duration among females aged 75 years or older. The presence of mandatory reporting laws was also associated with reduced daily driving likelihood and duration for males aged 65–74 years.

Discussion
Policymakers should be aware that males and females may respond differently to older driver licensure laws, which may require distinct interventions to preserve their mobility. Future studies should consider the gender disparities when examining the association between driver licensure policies and older adults’ transportation safety and mobility.
A non-conventional proximal inflow for the radial artery coronary graft
Authors: Gatti Giuseppe , Taffarello Pierpaolo , De Groodt Jasmina , Benussi Bernardo 
Published: May 2020

Abstract
Despite good outcomes, the use of the radial artery as a coronary graft is not widespread. Concerns regarding its low versatility and the risk of hand ischaemia, as well as the lack of reliable information regarding the best storage solution of the graft, and regarding the treatment for preventing spasms have limited its use. In this manuscript, the (numerous) benefits and (few) drawbacks of the proximal inflow for the radial artery from the in situ right internal thoracic artery proximal stump are discussed. Outcomes are reported from a limited series of patients undergoing totally arterial myocardial revascularization using this composite graft and both internal thoracic arteries.