bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detachable low dead space syringes for the prevention of hepatitis C among people who inject drugs in Bristol, UK: an economic evaluation
Authors: Hancock Elizabeth , Ward Zoe , Ayres Rachel , Neale Jane , Hussey Deborah , Kesten Joanna May , Hickman Matthew , Vickerman Peter 
Published: October 2019

AbstractBackground and AimsTraditional detachable syringes used by people who inject drugs (PWID) retain larger volumes of blood when the plunger is depressed than syringes with fixed needles—referred to as high (HDSS) and low dead space syringes (LDSS), respectively. Evidence suggests that using HDSS may result in greater hepatitis C virus (HCV) transmission risk than LDSS. We evaluated the cost‐effectiveness of an intervention to introduce detachable LDSS in a needle and syringe programme (NSP).DesignHCV transmission and disease progression model with cost‐effectiveness analysis using a health‐care perspective. Detachable LDSS are associated with increased costs (£0.008) per syringe, yearly staff training costs (£536) and an estimated decreased risk (by 47.5%) of HCV transmission compared with HDSS. The intervention was modelled for 10 years, with costs and health benefits (quality‐adjusted life‐years: QALYs) tracked over 50 years.SettingBristol, UK.Participants and CasesPWID attending NSP.Intervention and comparatorGradual replacement of HDSS at NSP, with 8, 58 and 95% of HDSS being replaced by detachable LDSS in 2016, 2017 and 2018, respectively. Comparator was continuing use of HDSS.MeasurementsNet monetary benefit. Benefits were measured in QALYs.FindingsIntroducing detachable LDSS was associated with a small increase in intervention costs (£21 717) compared with not introducing detachable LDSS, but considerable savings in HCV‐related treatment and care costs (£4 138 118). Overall cost savings were £4 116 401 over 50 years and QALY gains were 1000, with an estimated 30% reduction in new infections over the 10‐year intervention period. In all sensitivity analyses, detachable LDSS resulted in cost savings and additional QALYs. Threshold analyses suggested that detachable LDSS would need to reduce HCV transmission risk of HDSS by 0.26% to be cost‐saving and 0.04% to be cost‐effective.ConclusionsReplacing high dead space syringes with detachable low dead space syringes in needle and syringe programmes in the United Kingdom is likely to be a cost‐saving approach for reducing hepatitis C virus transmission.
Aggressive behavior in cattle is associated with a polymorphism in the MAOA gene promoter
Authors: Eusebi P. G. , Sevane N. , Cortés O. , Contreras E. , Cañon J. , Dunner S. 
Published: October 2019

SummaryMolecular mechanisms underlying aggressive behavior are primitive and similar among the subphylum Vertebrata. In humans, a primary goal in the study of aggression is to determine the neurobehavioral molecular factors triggering violence. Although several species have been used to study agonistic responses, researchers are limited by the difficulty of artificially inducing aggression in animals not selected for it. Conversely, the Lidia cattle breed has been selected since the eighteenth century to display agonistic responses based on traits such as aggressiveness, ferocity and mobility, all of them showing significant heritability values. This intensive selection may have driven shifts in specific allele frequencies. In a previous analysis across the autosomes, we revealed long‐term selection regions including genes involved in behavioral development. In the present study, we focus on mapping recent signatures of selection associated with aggressiveness at chromosome X, by comparing Lidia cattle samples with two non‐specialized Spanish breeds showing tamed behavior. The most significant markers peaked around the monoamine oxidase A (MAOA) gene, and thus the associations of three functionally important regions located near the promoter of this gene were further investigated. A polymorphism consisting of a variable number of tandem repeats of the nucleotide ‘C’ (BTX:105,462,494) and displaying lower number of repetitions in the Lidia breed when compared with the tamed breeds was detected. In silico analyses predicted that the g.105,462,494delsinsC variant may code for the Sp1 binding motif, one of the major transcription factors controlling the core promoter and expression of the MAOA gene in humans.
Expanded FDA regulation of health and wellness apps
Authors: Kasperbauer T. J. , Wright David E. 
Published: October 2019

AbstractThis paper argues that the Food and Drug Administration’s (FDA) policy for health and wellness apps is ethically problematic. Currently, the FDA does not regulate health and wellness apps that are not intended for medical use. As a result of this hands‐off policy, preventing harm to consumers is left primarily to developers and app marketplaces. We argue that the FDA’s duties to prevent harm and maintain accountability to the American public require that they play a much stronger role. We also discuss concerns about efficiency and fostering innovation, and argue that while they should help shape FDA regulation of health and wellness apps, they do not justify complete absence of FDA involvement.
Informing about mammographic screening: Ethical challenges and suggested solutions
Authors: Hofmann Bjørn 
Published: October 2019

AbstractProviding high quality and user oriented information about mammographic screening is no easy task, as screening has been subject to heated professional and public debates. Although the information has to be developed and provided in context for each screening program, the basic challenges are very much the same for all programs. Accordingly, the objective of this article is to analyze key ethical challenges in informing about mammographic screening, and based on these, to suggest some guiding principles for practical solutions. A literature review identifies five crucial issues with respect to informing women about mammographic screening. By analyzing and addressing these issues, five guiding principles are suggested: the content and the form of information should be developed through open and transparent processes with strong stakeholder involvement. Facts should be presented in a balanced way and uncertainties should be acknowledged, e.g., by presenting outcomes in ranges. Information should be layered without attempts to frame information. Attending mammographic screening should be as easy as not attending. Although apparently trivial, the suggested principles can be useful for elaborating specific information material about mammographic screening in a field of great ethical controversy.
Für dermatologische Notfallpatienten benötigte Ressourcen: Eine zwölfmonatige prospektive Datenerhebung aus Deutschland
Authors: Ansorge Claudia , Miocic Johannes M. , von Bubnoff Dagmar , Technau‐Hafsi Kristin 
Published: October 2019

ZusammenfassungHintergrund und ZieleDie steigenden Zahlen von Patienten, die Notfalleinrichtungen aufsuchen, sind mit einem zunehmenden Bedarf an Material und Personal verbunden. Um diese Ressourcen besser quantifizieren zu können, haben wir die diagnostischen Verfahren, die Art der Behandlung und die Anzahl und den Ausbildungsstand der Mitarbeiter untersucht, die an Notfallkonsultationen beteiligt sind.Patienten und MethodenDie Studie wurde als monozentrische prospektive Beobachtungsstudie über zwölf Monate an der dermatologischen Klinik eines deutschen Universitätskrankenhauses durchgeführt. In die konsekutive Stichprobe wurden 3155 Konsultationen eingeschlossen.ErgebnisseBei 29 % aller Konsultationen wurden diagnostische Tests wie z.B. mikrobiologische Abstriche, Blutuntersuchungen oder Stanzbiopsien durchgeführt. In 70 % der Fälle verordneten die Ärzte eine Therapie, wobei Steroide und Antihistaminika die häufigsten topischen und systemischen Therapeutika waren. Alle Patienten wurden von mindestens einem Arzt und einer Pflegekraft versorgt, in 25 % der Fälle war ein weiterer Arzt beteiligt. Bei der überwiegenden Mehrzahl der Fälle reichten weniger als 30 Minuten für die Konsultation aus. Im Durchschnitt nahmen Notfallkonsultationen pro Tag zwei Stunden der Arbeitszeit des behandelnden Arztes in Anspruch. Die Arbeitszeit anderer beteiligter Mitarbeiter wie Pflegekräfte oder Laboranten wurde dabei nicht miteinbezogen.SchlussfolgerungenDiese Studie gibt einen Einblick in den Umfang der Ressourcen, die bei dermatologischen Notfallkonsultationen aufgewendet werden.
Dermatologische Komplikationen unter Therapie mit Biologika bei entzündlichen Autoimmunerkrankungen
Authors: Sondermann Wiebke , Herz Saskia , Sody Elsa , Körber Andreas 
Published: October 2019

ZusammenfassungHintergrund und ZielKutane unerwünschte Ereignisse (cutaneous adverse events; CAE) treten bei bis zu 10 % der Patienten mit immunvermittelten entzündlichen Erkrankungen (IMID) auf, die mit Tumornekrosefaktor‐α (TNFα)‐Blockern behandelt werden. Ziel dieser klinischen Studie war es, den Verlauf von CAE bei allen Therapien mit Biologika nachzuverfolgen und zu beobachten.Patienten und MethodikDie Studienpopulation bestand aus Patienten mit CAE unter einer Biologikatherapie, die von erfahrenen Fachärzten der Dermatologie in der Ambulanz der Hautklinik des Universitätsklinikums Essen untersucht wurden.ErgebnisseInsgesamt wurden 39 Patienten mit 45 CAE in diese Studie eingeschlossen. In 60 % der Fälle wurde eine paradoxe Psoriasis diagnostiziert. Bei zwei Dritteln (66,6 %) der Patienten mit CAE wurde als Grunderkrankung eine chronisch‐entzündliche Darmerkrankung (CED) diagnostiziert. Die auslösenden Faktoren waren in etwa 95 % der Fälle TNFα‐Antagonisten. Bei nahezu der Hälfte der Fälle (46,2 %) musste die Biologikatherapie umgestellt werden. Beinahe 90 % der Patienten zeigten ein vollständiges (42,1 %) oder teilweises Ansprechen (47 %).SchlussfolgerungenDas Management von CAE unter einer Therapie mit Biologika kann in der klinischen Praxis eine Herausforderung darstellen. Gastroenterologen, Rheumatologen und Dermatologen sollten Fallbesprechungen durchführen, um für Patienten mit CAE die bestmögliche Behandlung zu erzielen und unnötige Therapieumstellungen zu vermeiden.
Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage: A re‐evaluation of a long‐term clinical study
Authors: Lauridsen Eva , Andreasen Jens O. , Bouaziz Oliver , Andersson Lars 
Published: October 2019

AbstractBackground/AimsAnkylosis and subsequent tooth loss is a serious complication following tooth avulsion and replantation. The aim of the study was to evaluate the risk of ankylosis of human teeth replanted after various periods of dry storage prior to replantation. The material originates from a previously reported clinical study of 400 replanted teeth.MethodsInitial treatment, clinical and radiological examination and follow‐up were conducted according to a standardized protocol. PDL was not removed. Follow‐up periods ranged from 0.2 to 20 years (mean 5.1 years). The risk of ankylosis was analysed using the Cox regression model including stage of root development, length of dry time and age > 20 years.ResultsThe risk of ankylosis significantly increased with increasing length of dry time (hazard ratio: 1.22, P = .002) and was significantly higher for teeth with mature root development than for teeth with immature root development (hazard ratio: 2.1 P < .0001). The estimated risks of ankylosis after 900 days for teeth with immature root development were: dry time < 20 minutes: 33.9% (95% confidence interval (CI): 25.4‐42.7), dry time 20‐40 minutes: 49.6% (95% CI: 37.5‐64.8), dry time 40‐60 minutes: 54.4% (95% CI: 37.1‐71.3) and dry time > 60 minutes: 60.0% (95% CI: 45.0‐75.8). The risks for teeth with mature root development were: dry time < 20 minutes: 59.4% (95% CI: 51.6‐66.5), dry time 20‐40 minutes: 78.3% (95% CI: 69.5‐86.2), dry time 40‐60 minutes: 81.9% (95% CI: 67.2‐92.4) and dry time > 60 minutes: 86.4% (95% CI: 79.7; 92.9).ConclusionThe risk of ankylosis rose with increasing length of dry time. However, some teeth may heal without ankylosis even after 60 minutes of dry time. Immature teeth have a lower risk of developing ankylosis. Replantation should therefore always be considered for avulsed teeth.
The neurobiological basis of sex differences in learned fear and its inhibition
Authors: Day Harriet L. L. , Stevenson Carl W. 
Published: October 2019

AbstractLearning that certain cues or environments predict threat enhances survival by promoting appropriate fear and the resulting defensive responses. Adapting to changing stimulus contingencies by learning that such cues no longer predict threat, or distinguishing between these threat‐related and other innocuous stimuli, also enhances survival by limiting fear responding in an appropriate manner to conserve resources. Importantly, a failure to inhibit fear in response to harmless stimuli is a feature of certain anxiety and trauma‐related disorders, which are also associated with dysfunction of the neural circuitry underlying learned fear and its inhibition. Interestingly, these disorders are up to twice as common in women, compared to men. Despite this striking sex difference in disease prevalence, the neurobiological factors involved remain poorly understood. This is due in part to the majority of relevant preclinical studies having neglected to include female subjects alongside males, which has greatly hindered progress in this field. However, more recent studies have begun to redress this imbalance and emerging evidence indicates that there are significant sex differences in the inhibition of learned fear and associated neural circuit function. This paper provides a narrative review on sex differences in learned fear and its inhibition through extinction and discrimination, along with the key gonadal hormone and brain mechanisms involved. Understanding the endocrine and neural basis of sex differences in learned fear inhibition may lead to novel insights on the neurobiological mechanisms underlying the enhanced vulnerability to develop anxiety‐related disorders that are observed in women.
Managing grazing intensity to reduce the global warming potential in integrated crop–livestock systems under no‐till agriculture
Authors: Ribeiro Ricardo H. , Ibarr Mariana A. , Besen Marcos R. , Bayer Cimelio , Piva Jonatas T. 
Published: October 2019

AbstractAgricultural intensification has been associated with increased greenhouse gas (GHG) emissions. Using integrated crop–livestock systems (ICLs) under no‐till agriculture can increase soil organic carbon (SOC) accumulation, thereby helping mitigate such emissions. The aim of this study was to assess the net global warming potential (net GWP) of no‐till ICLs at variable grazing intensities of winter black oat pasture in a subtropical ecosystem. A 3.5‐year field experiment involving three different grazing intensities (i.e., intensive, moderate and light as defined by a pasture height of 10, 20 and 30 cm, respectively) and grazing exclusion in winter and no‐till soybean cropping in summer was conducted on a Ferralsol in southern Brazil. Net GWP, in Mg CO2eq ha−1year−1, was assessed in terms of SOC sequestration relative to intensive grazing as a reference, including methane (CH4) and nitrous oxide (N2O) emissions, and energy costs of farming operations and inputs. Moderate grazing reduced net GWP relative to intensive grazing (from 0.09 to 4.92 Mg CO2eq ha−1year−1), the latter leading to the highest GWP levels. The decrease in net GWP was mainly the result of SOC accumulation, which offset 34–98% of all GHG emissions. Light grazing and grazing exclusion proved to be less efficient than moderate grazing in decreasing net GWP (1.84 Mg CO2eq ha−1year−1on average), mainly as a result of decreased SOC accumulation. Based on our findings, moderate grazing (20 cm high pasture) of winter black oat pasture is an effective strategy to reduce the C‐footprint of ICLs in subtropical no‐till agriculture.HighlightsOn‐farm assessment of net GWP in subtropical no‐till ICLsConversion from intensive to moderate grazing reduced net GWPSOC accumulation is the main driver of net GWP reduction under no‐till ICLs.
Complex patterns of dopamine‐related gene expression in the ventral tegmental area of male zebra finches relate to dyadic interactions with long‐term female partners
Authors: Alger Sarah J. , Kelm‐Nelson Cynthia A. , Stevenson Sharon A. , Juang Charity , Gammie Stephen C. , Riters Lauren V. 
Published: October 2019

AbstractDopaminergic projections from the ventral tegmental area (VTA) to multiple efferent targets are implicated in pair bonding, yet the role of the VTA in the maintenance of long‐term pair bonds is not well characterized. Complex interactions between numerous neuromodulators modify activity in the VTA, suggesting that individual differences in patterns of gene expression in this region may explain individual differences in long‐term social interactions in bonded pairs. To test this hypothesis we used RNA‐seq to measure expression of over 8000 annotated genes in male zebra finches in established male‐female pairs. Weighted gene co‐expression network analysis identified a gene module that contained numerous dopamine‐related genes with TH found to be the most connected gene of the module. Genes in this module related to male agonistic behaviors as well as bonding‐related behaviors produced by female partners. Unsupervised learning approaches identified two groups of males that differed with respect to expression of numerous genes. Enrichment analyses showed that many dopamine‐related genes and modulators differed between these groups, including dopamine receptors, synthetic and degradative enzymes, the avian dopamine transporter and several GABA‐ and glutamate‐related genes. Many of the bonding‐related behaviors closely associated with VTA gene expression in the two male groups were produced by the male's partner, rather than the male himself. Collectively, results highlight numerous candidate genes in the VTA that can be explored in future studies and raise the possibility that the molecular/genetic organization of the VTA may be strongly shaped by a social partner and/or the strength of the pair bond.
Update on treatments for erosive vulvovaginal lichen planus
Authors: Dunaway Spencer , Tyler Kelly , Kaffenberger Jessica 
Published: October 2019

AbstractVulvovaginal lichen planus (VVLP) is a debilitating disease that causes significant pain and psychological distress. Management is made difficult by the chronic course of the disease and its resistance to treatment. While topical steroids have been accepted as the first‐line treatment, they fail to achieve symptomatic control in approximately 40% of patients. Second‐line therapies include other topical treatments such as calcineurin inhibitors, systemic therapies including oral steroids, methotrexate, mycophenolate mofetil, biologics, and tacrolimus, and procedural options including surgery and dilation, photodynamic therapy, and ultrasound. This review provides an overview of the current treatments and explores the level of evidence supporting each of them.
A topoclimate model for Quaternary insular speciation
Authors: García‐Olivares Víctor , Patiño Jairo , Overcast Isaac , Salces‐Castellano Antonia , López de Heredia Unai , Mora‐Márquez Fernando , Machado Antonio , Hickerson Michael J. , Emerson Brent C. 
Published: October 2019

AbstractAimUnderstanding the drivers of speciation within islands is key to explain the high levels of invertebrate diversification and endemism often observed within islands. Here, we propose an insular topoclimate model for Quaternary diversification (ITQD), and test the general prediction that, within a radially eroded conical island, glacial climate conditions facilitate the divergence of populations within species across valleys.LocationGran Canaria, Canary Islands.TaxonThe Laparocerus tessellatus beetle species complex (Coleoptera, Curculionidae).MethodsWe characterize individual‐level genomic relationships using single nucleotide polymorphisms produced by double‐digest restriction site associated DNA sequencing (ddRAD‐seq). A range of parameter values were explored in order to filter our data. We assess individual relatedness, species boundaries, demographic history and spatial patterns of connectivity.ResultsThe total number of ddRAD‐seq loci per sample ranges from 4,576 to 512, with 11.12% and 4.84% of missing data respectively, depending on the filtering parameter combination. We consistently infer four genetically distinct ancestral populations and two presumed cases of admixture, one of which is largely restricted to high altitudes. Bayes factor delimitation support the hypothesis of four species, which is consistent with the four inferred ancestral gene pools. Landscape resistance analyses identified genomic relatedness among individuals in two out of the four inferred species to be best explained by annual precipitation during the last glacial maximum rather than geographic distance.Main conclusionsOur data reveal a complex speciation history involving population isolation and admixture, with broad support for the ITQD model here proposed. We suggest that further studies are needed to test the generality of our model, and enrich our understanding of the evolutionary process in island invertebrates. Our results demonstrate the power of ddRAD‐seq data to provide a detailed understanding of the temporal and spatial dynamics of insular biodiversity.
Addressing the problem of inaccuracy of measured 24‐hour urine collections due to incomplete collection
Authors: Mann Samuel J. , Gerber Linda M. 
Published: October 2019

AbstractThe 24‐hour urine collection is widely considered the gold standard for assessing 24‐hour excretion of various analytes. Yet, studies show that >30% of collections are incomplete and hence understate the true 24‐hour excretion. We previously validated an equation for estimating an individual's 24‐hour creatinine excretion, based on weight, sex, race, and age. The present study examines whether routinely correcting measured 24‐hour excretion of an analyte using the ratio of estimated to measured 24‐hour urine creatinine mitigates the misleadingly low values that result from undercollection. Ninety‐nine participants, recruited from an outpatient hypertension clinic, submitted a 24‐hour urine collection for measurement of creatinine and sodium excretion. The urine collections were dichotomized into complete (n = 63) and incomplete (n = 36) collections based on previously described criteria for expected 24‐hour creatinine excretion. To adjust for possible incompleteness of collections, the measured 24‐hour values were then corrected by multiplying them by the ratio of estimated to measured 24‐hour urine creatinine. The mean 24‐hour creatinine excretion was 1682 mg/d among complete collectors. Among incomplete collectors, the mean was 1211 mg/d before and 1695 mg/d after, adjustment. Similarly, mean 24‐hour sodium excretion was 156 mEq/d among complete collectors, whereas among incomplete collectors it was 121 mEq/d before and 171 mEq/d after, adjustment. Undercollection of 24‐hour urines is a common problem and results in misleadingly low values for excretion of analytes being measured. Routine adjustment of 24‐hour urine values using estimated values for 24‐hour creatinine excretion can greatly mitigate artifactually low 24‐hour excretion results.