bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Direct‐Acting Antivirals for Chronic Hepatitis C in a Large Cohort of Older Adults in the United States
Authors: Pan Calvin Q. , Gayam Vijay , Rabinovich Charles , Normatov Milana , Fidman Bazhena , Wang Dan , Garlapati Pavani 
Published: October 2019

OBJECTIVESData on the virologic response and tolerability of direct‐acting antivirals (DAAs) are lacking in older people because these individuals are underrepresented in clinical trials. This study aimed to assess the effectiveness and tolerability of DAA regimens in older individuals in a large cohort of real‐life clinical practice.METHODSIn this retrospective study, patients with chronic hepatitis C infection between 2017 and 2018 were divided into patients aged 65 years and older and those younger than 65 years. We evaluated the sustained virologic response rates (SVRs) in both groups. Further subgroup analyses on the SVRs for patients aged 65 to 74, 75 to 84, and 85 years and older were performed. We also analyzed the predictors of treatment response in older individuals.RESULTSAmong 1151 eligible patients, 516 were in the older group and 635 were in the younger group. The overall treatment response in the entire cohort was 97.7%. A significantly higher percentage of patients presented with advanced stages of fibrosis in the older group (53.1% vs 39.5%; P = <.001). The SVR rates were similar between the two groups (98.3% vs 97.7%; P = .18). In multivariate models, age was not predictive of SVR after adjusting for confounders. Subgroup analyses in the age groups of 65 to 74, 75 to 84, and older than 85 years showed similar treatment response rates (97.4%, 97.2%, and 86.7, respectively; P = .06) and advanced fibrosis (50.8%, 61.5%, and 53.3%, respectively; P = .14).CONCLUSIONAlthough older people exhibit a significantly higher frequency of fibrosis, DAAs produce high rates of SVR in all age groups, and the age of the patient does not seem to have a significant impact on the efficacy of DAAs including patients in the oldest age category (≥75 y). Treatment should not be withheld in older individuals. J Am Geriatr Soc 68:379–387, 2020
Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study
Authors: Shmuel Shahar , Lund Jennifer L. , Alvarez Carolina , Hsu Christine D. , Palta Priya , Kucharska‐Newton Anna , Jordan Joanne M. , Nelson Amanda E. , Golightly Yvonne M. 
Published: October 2019

OBJECTIVESPolypharmacy may affect frailty, a common and costly condition among older adults. Frailty prevalence is elevated among racial/ethnic minorities and persons living in the US South, and research is needed to inform future pharmacologic interventions in these populations. Our aim was to quantify the prevalence of frailty and polypharmacy, and to estimate the association between polypharmacy and incident frailty.DESIGNProspective cohort study.SETTINGA community‐based cohort study of adults residing in Johnston County, North Carolina.PARTICIPANTSWhite and African American adults aged 50 to 95 years (n=1697).MEASUREMENTSAt each study visit, all prescription and over‐the‐counter medications were recorded. We calculated annual polypharmacy (5‐9 medications) and excessive polypharmacy (≥10 medications) prevalence at the 2006‐2010 visit (n = 1697) and operationalized the Fried frailty phenotype to describe prevalent and incident frailty at two consecutive visits (2006‐2010 and 2013‐2015). We estimated risk ratios (RRs) and 95% confidence intervals (CIs) for the association between polypharmacy and incident frailty using weighted log‐binomial regression to account for measured confounding and attrition using inverse probability of treatment and attrition weights, respectively.RESULTSAt the 2006‐2010 visit, 678 (41%) and 260 (16%) participants were exposed to polypharmacy and excessive polypharmacy, respectively. Overall, 353 (21%) participants and 180 (21%) participants were frail at the 2006‐2010 and 2013‐2015 visits, respectively. Frailty was more common among participants identifying as white, women, and having less educational attainment relative to those without these characteristics. Incident frailty at the 2013‐2015 visit was 15% (mean follow‐up = 5.5 years). Our results suggest that polypharmacy is positively associated with incident frailty (weighted RR = 1.4; 95% CI = .9‐2.0), yet estimates are imprecise and should be interpreted with caution.CONCLUSIONConsistent with the current weight of evidence, our results suggest an association between polypharmacy and incident frailty. Prospective studies evaluating deprescribing interventions are needed to clarify whether reducing polypharmacy decreases frailty incidence. J Am Geriatr Soc 67:2482–2489, 2019
Overview and critical revision of clinical assessment tools in chemotherapy‐induced peripheral neurotoxicity
Authors: Park Susanna B. , Alberti Paola , Kolb Noah A. , Gewandter Jennifer S. , Schenone Angelo , Argyriou Andreas A. 
Published: October 2019

AbstractChemotherapy‐induced peripheral neurotoxicity (CIPN) is a major toxicity of cancer treatment, leading to dose reduction and premature treatment cessation, potentially affecting patient function, and quality of life. The development of accurate and sensitive assessment tools for CIPN is essential to enable clinical monitoring during treatment, follow‐up of long‐term outcomes and measurement of toxicity in clinical trials. This review examines CIPN clinical assessment scales incorporating clinician‐based, composite, and patient‐reported outcomes (PROs), providing a systematic review of their properties and an updated critical analysis of recommendations on current evidence for their use. This systematic review of CIPN assessment tools identified 50 papers containing 41 assessment tools, across 4 categories (common toxicity criteria; composite neurological scale; PROs; pain scale). The majority of these tools were PROs, underscoring the importance of patient‐based assessment of symptoms. While there has been considerable work in the field over the past 10 years, this review highlights significant gaps, including a lack of evaluation of responsiveness and problematic neuropathic pain evaluation. There remains a need for consensus on the best available tool and the need to modify existing instruments to improve utility.
Longitudinal changes in moderate‐to‐vigorous‐intensity physical activity in children and adolescents: A systematic review and meta‐analysis
Authors: Farooq Abdulaziz , Martin Anne , Janssen Xanne , Wilson Mathew G. , Gibson Ann‐Marie , Hughes Adrienne , Reilly John J. 
Published: October 2019

SummaryModerate‐to‐vigorous‐intensity physical activity (MVPA) is important for childhood obesity prevention and treatment, yet declines with age. Timing and magnitude of the decline in MVPA in children and adolescents are unclear but important for informing effective obesity intervention development. This systematic review aimed to determine and compare the year‐to‐year changes in MVPA among children and adolescents. Longitudinal studies were identified by searching 10 relevant databases up to December 2018. Studies were eligible for inclusion if they reported accelerometer‐assessed MVPA (min day−1) separately for boys and girls and had follow‐up duration of at least 1 year. After screening 9,232 studies, 52 were included representing 22,091 aged 3 to 18 year olds (boys=8,857; girls=13,234). Pooled‐analysis of the relative change in MVPA per year showed a decline of −3.4% (95% CI, −5.9 to −0.9) in boys and −5.3% (95% CI, −7.6 to −3.1) in girls, across all age groups. There were notable declines in MVPA at age 9 for both boys (−7.8%, 95% CI, −11.2 to −4.4) and girls (−10.2%, 95% CI, −14.2 to −6.3). The relative decline in MVPA affects both sexes from an early age; however, it is greater among girls. Interventions to promote MVPA should start before adolescence.
Case report: giant parotid sialolith presenting in a two‐year‐old boy ‐ an important differential diagnosis in paediatric facial pain
Authors: Shelswell J. , Horisk N. , Reid J. 
Published: October 2019

AbstractPaediatric sialolithiasis is rare, with most sialoliths under 10 mm in their largest dimension and usually found in the submandibular gland. We present a case of a 25 mm parotid sialolith in a two‐year‐old boy. He presented to the emergency department with recurrent right‐sided facial swelling and was admitted for management of suspected parotitis. An ultrasound completed the next day revealed massive dilatation of the right Stensen's duct throughout its length. After 24 h of intravenous co‐amoxiclav did not relieve symptoms, the patient was listed for examination under general anaesthesia. A 25 mm calculus was dissected from the right parotid duct alongside copious free‐flowing pus, with follow‐up showing normal healing. This case highlights the importance of not omitting this differential diagnosis in paediatric facial swelling, despite its rarity in children.
Econometric models applied to aquaculture as tools for sustainable production
Authors: Peñalosa Martinell Daniel , Vergara‐Solana Francisco Javier , Almendarez‐Hernández Luis César , Araneda‐Padilla Marcelo Eduardo 
Published: October 2019

AbstractAquaculture production must keep increasing if seafood demand is to be met. This increase in production has substantial impacts on the three pillars of sustainability (i.e. economy, society and environment). To fairly assess the effects that industry has, several tools have been used, mainly theoretical bioeconomic analysis. Even though theoretical models are essential for the assessment of sustainability, the application of econometric models that rely on empirical data to validate the theory proposed is a priority. The objective of this work was to analyse state of the art related to the use of econometric models in aquaculture industry and categorize findings according to their relationship with any of the three pillars of sustainability to promote the implementation of tools that allow balancing growth of the sector with rational use of resources. The study is divided into five sections. First, the introduction describes the current state of aquaculture, difficulties in management and use of econometric models as tools for improving it. Second, the methods used to develop the bibliometric and bibliographic review are described alongside the research questions. Third, the results of the literature review and categorization are proposed according to the sustainability pillars. Fourth, possible new applications of econometric models are discussed to assess sustainability challenges. Finally, a conclusion of the research is provided stating the benefits and challenges of the use of econometric models in aquaculture.
Effects of Insurance Incentives on Road Safety: Evidence from a Natural Experiment in China*
Authors: Dionne Georges , Liu Ying 
Published: October 2019

AbstractWe contribute to the growing body of literature on moral hazard by offering empirical evidence of the effectiveness of insurance pricing incentives at improving road safety. We do this by comparing the claim frequency following a regulatory reform introduced in a pilot city in China, with the experience of another city unaffected by the reform. By using a difference‐in‐differences methodology, we find that improving insurance pricing on past claims and on traffic violations with full industry commitment reduces moral hazard and insured drivers’ claim frequency by 12 percent. The treatment effects are, however, heterogeneous with respect to insured drivers’ wealth and their history of past claims.
‘We don't know much about Bees!’ Techno‐Optimism, Techno‐Scepticism, and Denial in the American large‐scale Beekeeping Industry
Authors: Cilia Laurent 
Published: October 2019

AbstractThis article examines how U.S large‐scale beekeepers explain and resolve the plight of the honey bee. Using in‐depth interviews with beekeepers and scientists, field notes, and qualitative online data, I find that while beekeepers invest in and hope for technoscientific developments, they are also sceptical of the promises of technoscience. I describe this paradox as a form of denial. As both agents and victims (with their bees) of industrial agriculture, they turn doubtfully to technoscience, which saves them from deconstructing and reconsidering the system they are an integral part of and benefit from. While technoscientific promises keep beekeepers hopeful and provide them with a sense of agency, they also prevent them from challenging the larger sociocultural mode of food production at the root cause of the plight of managed honey bees. In their attempt to save their bees and their livelihoods, beekeepers’ conversations are performed to fit the dominant technoscientific imaginary and fail to seriously consider causes and solutions in the larger eco‐social context.
Dual conditionality in welfare and housing for lone parents in Ireland: Change and continuity?
Authors: Murphy Mary 
Published: October 2019

AbstractThis article focuses on multiple conditionalities in benefits and housing from the perspective of lone parents in Ireland. The Irish case echoes historical experiences elsewhere and is offered not as an exceptional or extreme case but as an in‐depth single case study and a lens for comparison. Although contemporary forms and combinations of conditionalities are new to Ireland, the experience of multiple conditionalities in benefits and housing is not new. Hence, a historical perspective is used to examine contemporary multiple conditionalities in benefits and housing. In the past, conditional regimes for lone parents were justified in terms of moral reformation for first time mothers and avoiding moral contagion of mothers with subsequent pregnancies. In contemporary times, in the case of employment, lone parents are problematised as working part‐time and “nesting” on in‐work‐benefits, and in the case of homelessness, lone parents who prioritise the security of tenure embedded in social housing are accused of “gaming” the system. While acknowledging ambiguities, the paper finds the overlap of welfare and housing discourses contribute, intentionally or unintentionally, to epistemological foundations or understandings of lone parents, shifting public perceptions, and framing them as “problems” to be solved. They simultaneously temper lone parents' expectations. Increased precarity and disempowerment is associated with dual conditionality, and ontological uncertainty is multiplied when experienced cumulatively across employment, social protection, and housing regimes in a context of generally poor public services and labour market precarity and in the historical context of stigmatisation. Nonetheless, lone parents demonstrate considerable agency.
Serologic screening and infectious disease consultation (IDC): Indicated in heart, lung, liver (HLL) solid organ transplants (SOT) for measles, mumps, rubella, and varicella
Authors: Seckin Zeynep Idil , Brumble Lisa M. , Libertin Claudia R. 
Published: October 2019

AbstractBackgroundSolid organ transplant (SOT) recipients are a special group of patients who require comprehensive evaluation for preventable infectious diseases before transplantation. The main aim of our study was to investigate the number of heart, lung, and liver (HLL) transplant recipients who were evaluated for their immune status against measles, mumps, rubella (MMR), and varicella (VZV). As a secondary aim, we investigated whether pre‐transplant infectious disease consultation (IDC) improves vaccination rates.MethodsThis study was an institution‐based retrospective analysis of HLL transplant recipients born in or after 1957 and evaluated at Mayo Clinic, FL Transplant Center between January 1st, 2016 and December 31st, 2017. Data collection was obtained from electronic medical records. The vaccination rates were compared by univariate analysis based on IDC and no ID consultation (NIDC).ResultsOne hundred and eighty‐seven (77%) of a total 242 patients received an IDC pre‐transplantation. Varicella IgG levels were screened in all 187 IDC candidates. Among the 187 IDC patients, mumps, measles, and rubella IgG serologies were performed in 9 (5%), 21 (11%), and 51 (27%), respectively. Among all 242 patients, vaccines given included 2 (0.8%) MMR, 10 (4.1%) varicella and 85 (35.12%) Zostavax. Univariate analysis revealed that Zostavax was given to 76 (40.6%) pre‐transplant IDC patients and only in 9 (16.7%) NIDC patients (P < .001).ConclusionsDespite the relatively high IDC rate, patients’ screened numbers for MMR IgG levels were low. Results pointed out the need for MMR protocol‐driven serologic screening as well as for VZV and IDC prior to transplantation to increase vaccination rates.
Intronic heterochromatin prevents cryptic transcription initiation in Arabidopsis
Authors: Zhou Jincong , Liu Liangyu , Li Qin , Xu Wei , Li Kuan , Wang Zhi‐Wei , Sun Qianwen 
Published: October 2019

SummaryIntronic transposable elements (TEs) comprise a large proportion in eukaryotic genomes, but how they regulate the host genes remains to be explored. Our forward genetic screen disclosed the plant‐specific RNA polymerases IV and V in suppressing intronic TE‐mediated cryptic transcription initiation of a chimeric transcripts at FLC (FLCTE). Initiation of FLCTE transcription is blocked by the locally formed intronic heterochromatin, which is directly associated with RNA Pol V to inhibit the entry of RNA Pol II and the occupancy of H3K4 methylation. Genome‐wide Pol II Ser5p native elongation transcription sequencing revealed that a significant number of intronic heterochromatin‐containing genes undergo this mechanism. This study sheds light on deeply understanding the function of intronic heterochromatin on host genes expression in eukaryotic genome.
GUN1 influences the accumulation of NEP‐dependent transcripts and chloroplast protein import in Arabidopsis cotyledons upon perturbation of chloroplast protein homeostasis
Authors: Tadini Luca , Peracchio Carlotta , Trotta Andrea , Colombo Monica , Mancini Ilaria , Jeran Nicolaj , Costa Alex , Faoro Franco , Marsoni Milena , Vannini Candida , Aro Eva‐Mari , Pesaresi Paolo 
Published: October 2019

SummaryCorrect chloroplast development and function require co‐ordinated expression of chloroplast and nuclear genes. This is achieved through chloroplast signals that modulate nuclear gene expression in accordance with the chloroplast's needs. Genetic evidence indicates that GUN1, a chloroplast‐localized pentatricopeptide repeat (PPR) protein with a C‐terminal Small MutS‐Related (SMR) domain, is involved in integrating multiple developmental and stress‐related signals in both young seedlings and adult leaves. Recently, GUN1 was found to interact physically with factors involved in chloroplast protein homeostasis, and with enzymes of tetrapyrrole biosynthesis in adult leaves that function in various retrograde signalling pathways. Here we show that following perturbation of chloroplast protein homeostasis: (i) by growth in lincomycin‐containing medium; or (ii) in mutants defective in either the FtsH protease complex (ftsh), plastid ribosome activity (prps21‐1 and prpl11‐1) or plastid protein import and folding (cphsc70‐1), GUN1 influences NEP‐dependent transcript accumulation during cotyledon greening and also intervenes in chloroplast protein import.
Agency and responsibility over virtual movements controlled through different paradigms of brain−computer interface
Authors: Nierula Birgit , Spanlang Bernhard , Martini Matteo , Borrell Mireia , Nikulin Vadim V. , Sanchez‐Vives Maria V. 
Published: October 2019

Key points
Embodiment of a virtual body was induced and its movements were controlled by two different brain−computer interface (BCI) paradigms – one based on signals from sensorimotor versus one from visual cortical areas.
BCI‐control of movements engenders agency, but not equally for all paradigms.
Cortical sensorimotor activation correlates with agency and responsibility.
This has significant implications for neurological rehabilitation and neuroethics.
AbstractAgency is the attribution of an action to the self and is a prerequisite for experiencing responsibility over its consequences. Here we investigated agency and responsibility by studying the control of movements of an embodied avatar, via brain–computer interface (BCI) technology, in immersive virtual reality. After induction of virtual body ownership by visuomotor correlations, healthy participants performed a motor task with their virtual body. We compared the passive observation of the subject's ‘own’ virtual arm performing the task with (1) the control of the movement through activation of sensorimotor areas (motor imagery) and (2) the control of the movement through activation of visual areas (steady‐state visually evoked potentials). The latter two conditions were carried out using a BCI and both shared the intention and the resulting action. We found that BCI‐control of movements engenders the sense of agency, which is strongest for sensorimotor area activation. Furthermore, increased activity of sensorimotor areas, as measured using EEG, correlates with levels of agency and responsibility. We discuss the implications of these results for the neural basis of agency.
Volumetric laser endomicroscopy features of dysplasia at the gastric cardia in Barrett’s oesophagus: results from an observational cohort study
Authors: Trindade Arvind J , Raphael Kara L , Inamdar Sumant , Stewart Molly , Berkowitz Joshua , Vegesna Anil , McKinley Matthew J , Benias Petros C , Kahn Allon , Leggett Cadman L , Lee Calvin , Sejpal Divyesh V , Rishi Arvind 
Published: October 2019

ObjectiveVolumetric laser endomicroscopy (VLE) is an advanced imaging modality used in Barrett’s oesophagus (BE) to help identify dysplasia in the oesophagus. VLE criteria exist for oesophageal dysplasia but not for dysplasia in the gastric cardia. The aim of this study was to determine if there are in vivo VLE features that can predict gastric cardia dysplasia in BE.DesignThis was a single-centre observational cohort study from August 2016 to August 2018. Patients were included if they had BE, were undergoing a VLE exam as standard of care, and had a suspicious target laser marked at the gastric cardia. The following VLE features were correlated to histology to determine if an association existed between histology subtype and VLE feature: wide crypts, irregular surface, one large isolated gland, multiple glands, and complex glands.ResultsA total of 110 in vivo gastric cardia targets in 77 patients with BE were analysed. The following abnormalities were identified: 61 wide crypts, 34 isolated glands, 16 irregular surfaces, 15 multiple glands, and 11 complex glands. Complex glands were the only VLE feature that correlated to any histology subtype. They were present in 71% of targets with high-grade dysplasia (HGD), T1a cancer or T1b cancer and had a sensitivity, specificity, and accuracy of 71%, 99%, and 85%, respectively. Of the 10 patients with complex glands on VLE and HGD/cancer on histology, 4 had a normal-appearing mucosa (40%) on endoscopy.ConclusionIdentification of complex glands on VLE may aid in detection of HGD or early cancer in the gastric cardia in BE. This is particularly important, as dysplasia at the gastric cardia can be difficult to see endoscopically.