bluuebunny/crossref_metadata_2025_split huggingface dataset:
Choice and control in social care: Experiences of older self‐funders in England
Authors: Baxter Kate , Heavey Emily , Birks Yvonne 
Published: August 2019

AbstractThis paper considers the experiences of older self‐funders in England in the context of policies promoting choice and control. Self‐funders are people who are not state‐funded; they pay for social care from their own resources. Choice and control have been operationalized through personal budgets, based on the assumption that managing resources enhances ability to access appropriate care and support. This paper uses data from 40 qualitative interviews with self‐funders and their relatives, and 19 with professionals. It explores the impact of the financial and social capital that self‐funders are assumed to have and asks how older self‐funders experience choice and control. The study found that older self‐funders drew on personal experiences, family, and friends for information; were reluctant to spend their wealth on care due to competing priorities; and felt they had more control over the timing of decisions than people who were state‐funded. Personal wealth appears to be perceived differently to funds “gifted” to people through cash for care schemes.
Who Are Conspiracy Theorists? A Comprehensive Approach to Explaining Conspiracy Beliefs
Authors: Enders Adam M. , Smallpage Steven M. 
Published: August 2019

ObjectiveThis study disentangles the known correlates of conspiracy beliefs—such as the general predisposition toward conspiratorial thinking, authoritarianism, and partisan and ideological predispositions—in order to better understand the psychological antecedents of such beliefs and answer the question: Who are conspiracy theorists?MethodsWe use classification and regression tree models to explain individual beliefs in specific conspiracy theories, employing a large set of known correlates of conspiratorial thinking.ResultsDepending on the characteristics of the conspiracy theory employed on the survey, we find that political orientations and conspiratorial thinking provide the most analytical leverage in predicting individual conspiracy beliefs. Furthermore, paranormal beliefs were more predictive than previous literature suggests, while psychological biases demonstrated very limited predictive utility.ConclusionsThe psychological antecedents of conspiracy beliefs used to explain those beliefs vary considerably by the stimuli or events at the center of a given conspiracy theory. Therefore, disproportionately favoring one type of conspiracy theory on one's survey may result in inferences about conspiracy theorists that do not translate across studies. Furthermore, though we are not yet capable of fully determining who conspiracy theorists are, conspiratorial thinking, paranormal beliefs, and political orientations are more predictive of particular conspiracy beliefs than other attitudes, predispositions, and orientations.
Medical training in private and public
Authors: Phillips Stephanie , Xia Vivianne , Zhuang Donna , Klein Linda 
Published: August 2019

SummaryBackgroundGlobally, the need for medical student training to be undertaken in the private sector is likely to increase. In Australia, it has increased by 250 per cent in the last decade. Effective clinical education is highly dependent on the attitudes and willingness to participate of both patients and medical staff. We aimed to examine these attitudes in both private and public hospitals.MethodsPatients and medical staff at a private and a public hospital in Sydney were surveyed during December 2016 and January 2017 to investigate attitudes to medical student training. Attitudes were compared between hospitals. We also compared recent attitudes in the private hospital with those obtained in 2012.ResultsPatients at the public hospital were significantly more likely to want a student present at a consultation than those at a private hospital. Public hospital doctors had more positive attitudes towards medical students than their private colleagues. The negative financial impact of teaching was more significant for those in private practice. Since 2012, attitudes of private hospital patients towards medical students became significantly more positive whereas doctors’ attitudes became less positive.The expansion of clinical education into the private sector is likely to increase globallyDiscussionThe willingness of patients to participate in medical student training in both public and private hospitals is encouraging for future expansion into the private sector. The reduced willingness amongst private hospital medical staff over time and, in comparison to public hospital staff, suggests a need to address barriers for staff in the private sector.
Subcellular dynamics of proteins and metabolites under abiotic stress reveal deferred response of the Arabidopsis thaliana hexokinase‐1 mutant gin2‐1 to high light
Authors: Küstner Lisa , Fürtauer Lisa , Weckwerth Wolfram , Nägele Thomas , Heyer Arnd G. 
Published: August 2019

SummaryStress responses in plants imply spatio‐temporal changes in enzymes and metabolites, including subcellular compartment‐specific re‐allocation processes triggered by sudden changes in environmental parameters. To investigate interactions of primary metabolism with abiotic stress, the gin2‐1 mutant, defective in the sugar sensor hexokinase 1 (HXK1) was compared with its wildtype Landsberg erecta (Ler) based on time resolved, compartment‐specific metabolome and proteome data obtained over a full diurnal cycle. The high light sensitive gin2‐1 mutant was substantially delayed in subcellular re‐distribution of metabolites upon stress, and this correlated with a massive reduction in proteins belonging to the ATP producing electron transport chain under high light, while fewer changes occurred in the cold. In the wildtype, compounds specifically protecting individual compartments could be identified, e.g., maltose and raffinose in plastids, myo‐inositol in mitochondria, but gin2‐1 failed to recruit these substances to the respective compartments, or responded only slowly to high irradiance. No such delay was obtained in the cold. At the whole cell level, concentrations of the amino acids, glycine and serine, provided strong evidence for an important role of the photorespiratory pathway during stress exposure, and different subcellular allocation of serine may contribute to the slow growth of the gin2‐1 mutant under high irradiance.
Metabolic impact of red blood cell exchange with rejuvenated red blood cells in sickle cell patients
Authors: Gehrke Sarah , Shah Nirmish , Gamboni Fabia , Kamyszek Reed , Srinivasan Amudan J. , Gray Alan , Landrigan Matthew , Welsby Ian , D'Alessandro Angelo 
Published: August 2019

BACKGROUNDRed blood cell exchange (RCE) transfusions are a mainstay in the treatment of sickle cell anemia (SCA), and allow a temporary restoration of physiological parameters with respect to erythrocyte oxygen carrying capacity and systems metabolism. Recently, we noted that 1) RCE significantly impacts recipients' metabolism in SCA; 2) fresh and end‐of‐storage red blood cell (RBC) units differently impact systems of metabolism in healthy autologous recipients; and 3) phosphate/inosine/pyruvate/adenine (PIPA) solution reverses the metabolic age of stored RBCs. Therefore, we hypothesized that RCE with PIPA‐treated RBC units could further increase the metabolic benefits of RCE in SCA patients.STUDY DESIGN AND METHODSCirculating plasma and erythrocytes were collected from patients with SCA before and after RCE, with either conventional or PIPA‐treated RBC units, prior to metabolomics analyses.RESULTSConsistent with prior work, RCE significantly decreased circulating levels of markers of systemic hypoxemia (lactate, succinate) and decreased plasma levels of acyl‐carnitines and amino acids. However, PIPA‐treated exchanges were superior to untreated RCEs, with a higher energy state and an increased capacity to activate the pentose phosphate pathway and glutamine metabolism. In addition, RBCs and plasma from recipients of PIPA‐treated RBC units resulted in significantly decreased levels of post‐transfusion plasticizers, though at the expense of higher circulating levels of oxidized purines (hypoxanthine, xanthine, and the antioxidant urate).CONCLUSIONTransfusion of PIPA‐treated RBCs further increases the metabolic benefits of RCE to patients with SCA, significantly reducing the levels of post‐transfusion plasticizers.
Prevalence of Babesia in Canadian blood donors: June–October 2018
Authors: Tonnetti Laura , O'Brien Sheila F. , Grégoire Yves , Proctor Melanie C. , Drews Steven J. , Delage Gilles , Fearon Margaret A. , Brès Vanessa , Linnen Jeffrey M. , Stramer Susan L. 
Published: August 2019

BACKGROUNDThe erythrocytic protozoan parasite Babesia microti, the cause of human babesiosis, is transmitted not only by tick bites but also via blood transfusion. B. microti is endemic in the northeastern/upper midwestern United States, where partial screening of blood donations has been implemented. In Canada, a 2013 study of approximately 14,000 donors found no B. microti antibody‐positive samples, suggesting low risk at that time.METHODSBetween June and October 2018, 50,752 Canadian donations collected from sites near the US border were tested for Babesia nucleic acid by transcription‐mediated amplification (TMA). Reactive donations were tested for B. microti by IgG immunofluorescence assay and polymerase chain reaction. A subset of 14,758 TMA nonreactive samples was also screened for B. microti antibody. Donors who tested reactive/positive were deferred, asked about risk factors, and were requested to provide a follow‐up sample for supplemental testing.RESULTSOne sample from Winnipeg, Manitoba, was TMA and antibody reactive. Of the 14,758 TMA‐nonreactive donations tested for antibody, four reactive donations were identified from southwestern Ontario near Lake Erie. None of the interviewed donors remembered any symptoms, likely tick exposure, or relevant travel within Canada or the United States.CONCLUSIONSThis is the largest B. microti prevalence study performed in Canada. The results indicate very low prevalence, with only one TMA‐confirmed‐positive donation of 50,752 tested. This donor was from the only region in Canada where autochthonous infection has been reported. Seropositive donations in southwestern Ontario suggest low prevalence; travel should not be ruled out given the proximity to the US border.
Effects of acellular equine amniotic allografts on the healing of experimentally induced full‐thickness distal limb wounds in horses
Authors: Fowler Alexander W. , Gilbertie Jessica M. , Watson Victoria E. , Prange Timo , Osborne Jason A. , Schnabel Lauren V. 
Published: August 2019

AbstractObjectiveTo characterize the growth factors contained in equine amniotic membrane allograft (eAM; StemWrap scaffold and StemWrap+ injection) and to evaluate the effect of eAM on equine distal limb wound healing.Study designProspective experimental controlled study.Sample populationEight adult horses.MethodsTransforming growth factor (TGF)‐β1, vascular endothelial growth factor (VEGF), epidermal growth factor, platelet‐derived growth factor‐BB, and prostaglandin E2 (PGE2) concentrations in StemWrap+ were assessed with enzyme‐linked immunosorbent assay. Two full‐thickness 6.25‐cm2 skin wounds were created on each metacarpus. On one forelimb, one wound was treated with eAM, and the other was left untreated (eAM control). On the contralateral limb, one wound was treated with a silicone dressing, and the other served as negative control. Three‐dimensional images were obtained to determine wound circumference and surface area analyses at each bandage change until healed. Excessive granulation tissue was debrided once weekly for 4 weeks. Biopsy samples were taken to evaluate quality of wound healing via histologic and immunohistochemistry assays.ResultsStemWrap+ contained moderate concentrations of TGF‐β1 (494.10 pg/mL), VEGF (212.52 pg/mL), and PGE2 (1811.61 pg/mL). Treatment of wounds with eAM did not affect time to healing or histologic quality of the healing compared with other groups but was associated with increased granulation tissue production early in the study, particularly on day 7.ConclusionApplication of eAM resulted in increased granulation tissue production while maintaining appropriate healing of experimental wounds.Clinical significanceUse of eAM is likely most beneficial for substantial wounds in which expedient production of large amounts of granulation tissue is desirable.
Chronic and recurrent non-infectious paediatric-onset uveitis: a French cohort
Authors: Morelle Guillaume , Gueudry Julie , Uettwiller Florence , Wouters Carine , Bader-Meunier Brigitte , Robert Mathieu P , Monnet Dominique , Bodaghi Bahram , Grall-lerosey Martine , Quartier Pierre 
Published: August 2019

ObjectiveTo evaluate the demographics, aetiologies, complications, treatments and visual prognoses of chronic and recurrent non-infectious paediatric-onset uveitis in France.MethodsDescriptive, retrospective and bicentric study in patients whose disease started before 17 and who were followed up in two centres from January 2010 to May 2017.ResultsWe included 147 patients with 268 affected eyes. Eighty-two had juvenile idiopathic arthritis-associated chronic uveitis, 58 were antinuclear antibody (ANA) positive and 24 were ANA negative, 36 had idiopathic uveitis, 9 had enthesitis-related arthritis-associated uveitis, 9 had sarcoidosis-associated uveitis and 11 had other inflammatory aetiologies. These patients cumulated 161 complications: ocular hypertension, cataract, band keratopathy, macular oedema, optic disk oedema and decreased visual acuity, including permanent visual loss for 31 patients. The most used treatments were corticosteroid (CS) eye drops (82%), systemic CSs (34%), methotrexate (58%) and biologics (38%). At the latest follow-up, 45 patients had achieved remission of uveitis without any treatment, 56 had inactive uveitis on topical steroids and 48 still had active uveitis.ConclusionPaediatric-onset uveitis are associated with a high rate of complications. However, following the introduction of biologics and particularly antitumour necrosis factor alpha antibodies, a significant proportion of uveitis became inactive on or even off treatment.
Development of an acute care surgery service in Rwanda
Authors: Abahuje Egide , Sibomana Isaie , Rwagahirima Elisee , Urimubabo Christian , Munyaneza Robert , Rickard Jennifer 
Published: August 2019

BackgroundAcute care surgery (ACS) encompasses trauma, critical care, and emergency general surgery. Due to high volumes of emergency surgery, an ACS service was developed at a referral hospital in Rwanda. The aim of this study was to evaluate the epidemiology of ACS and understand the impact of an ACS service on patient outcomes.MethodsThis is a retrospective observational study of ACS patients before and after introduction of an ACS service. χ2test and Wilcoxon rank-sum test were used to describe the epidemiology and compare outcomes before (pre-ACS)) and after (post-ACS) implementation of the ACS service.ResultsData were available for 120 patients before ACS and 102 patients after ACS. Diagnoses included: intestinal obstruction (n=80, 36%), trauma (n=38, 17%), appendicitis (n=31, 14%), and soft tissue infection (n=17, 8%) with no difference between groups. The most common operation was midline laparotomy (n=138, 62%) with no difference between groups (p=0.910). High American Society of Anesthesiologists (ASA) score (ASA ≥3) (11% vs. 40%, p<0.001) was more common after ACS. There was no difference in intensive care unit admission (8% vs. 8%, p=0.894), unplanned reoperation (22% vs. 13%, p=0.082), or mortality (10% vs. 11%, p=0.848). The median length of hospital stay was longer (11 days vs. 7 days, p<0.001) before ACS.ConclusionsAn ACS service can be implemented in a low-resource setting. In Rwanda, ACS patients are young with few comorbidities, but high rates of mortality and morbidity. In spite of more patients who are critically ill in the post-ACS period, implementation of an ACS service resulted in decreased length of hospital stay with no difference in morbidity and mortality.Level of evidencePrognostic and epidemiologic study type, level III.
The Goldilocks Window of Personalized Chemotherapy: Getting the Immune Response Just Right
Authors: Park Derek S. , Robertson-Tessi Mark , Luddy Kimberly A. , Maini Philip K. , Bonsall Michael B. , Gatenby Robert A. , Anderson Alexander R.A. 
Published: August 2019

Abstract

The immune system is a robust and often untapped accomplice of many standard cancer therapies. A majority of tumors exist in a state of immune tolerance where the patient's immune system has become insensitive to the cancer cells. Because of its lymphodepleting effects, chemotherapy has the potential to break this tolerance. To investigate this, we created a mathematical modeling framework of tumor-immune dynamics. Our results suggest that optimal chemotherapy scheduling must balance two opposing objectives: maximizing tumor reduction while preserving patient immune function. Successful treatment requires therapy to operate in a “Goldilocks Window” where patient immune health is not overly compromised. By keeping therapy “just right,” we show that the synergistic effects of immune activation and chemotherapy can maximize tumor reduction and control.

Significance:
To maximize the synergy between chemotherapy and antitumor immune response, lymphodepleting therapy must be balanced in a “Goldilocks Window” of optimal dosing.
Mapping and Making Sense of Noncoding Mutations in the Genome
Authors: Yang Jiekun , Adli Mazhar 
Published: August 2019

Abstract
Whole-genome sequencing efforts of tumors and normal tissues have identified numerous genetic mutations, both somatic and germline, that do not overlap with coding genomic sequences. Attributing a functional role to these noncoding mutations and characterizing them using experimental methods has been more challenging compared with coding mutations. In this review, we provide a brief introduction to the world of noncoding mutations. We discuss recent progress in identifying noncoding mutations and the analytic and experimental approaches utilized to interpret their functional roles. We also highlight the potential mechanisms by which a noncoding mutation may exert its effect and discuss future challenges and opportunities.
Prediagnostic Level of Dietary and Urinary Isoflavonoids in Relation to Risk of Liver Cancer in Shanghai, China
Authors: Zhang Wei , Wang Jing , Gao Jing , Li Hong-Lan , Han Li-Hua , Lan Qing , Rothman Nathaniel , Zheng Wei , Shu Xiao-Ou , Xiang Yong-Bing 
Published: August 2019

Abstract

Background:
No epidemiologic studies have directly assessed the association between dietary and urinary isoflavonoids and risk of liver cancer in humans.

Methods:
A nested case–control study, including 217 incident cases of liver cancer and 427 individually matched control subjects, was conducted in Shanghai, China. Dietary isoflavonoid intakes were assessed through a validated food-frequency questionnaire and the Chinese Food Composition Tables. Urinary excretion levels of four major isoflavonoids were measured by the reversed-phase high-performance liquid chromatography. ORs and 95% confidence intervals (CI) were derived using conditional logistic regression models.

Results:
The adjusted ORs (95% CIs) for liver cancer across increasing quartiles of urinary genistein levels were 1.00 (reference), 0.55 (95% CI, 0.22–1.36), 0.57 (95% CI, 0.23–1.43), and 0.19 (95% CI, 0.06–0.59) (Ptrend = 0.008) in women and 1.00 (reference), 1.22 (0.52–2.86), 1.17(0.47–2.90), and 1.23 (0.55–2.76) in men, respectively. These associations were consistent by limiting the cases to primary malignant neoplasm of liver or malignant neoplasms of the intrahepatic bile ducts, or among participants without self-reported liver disease or cirrhosis at the baseline survey. No associations were found between dietary isoflavonoids and liver cancer risk.

Conclusions:
Our study suggests for the first time that urinary excretion of genistein may be associated with reduced risk of liver cancer in women.

Impact:
In this nested case–control study in China, we found that urinary excretion of genistein was associated with lower risk of liver cancer in women, and not in men.
Statin Use and Prostate Cancer Incidence in Manitoba, Canada: A Population-Based Nested Case–Control Study
Authors: Righolt Christiaan H. , Bisewski Robert , Mahmud Salaheddin M. 
Published: August 2019

Abstract

Background:
A link between statin use and prostate cancer risk has been proposed. Epidemiologic evidence is, however, inconclusive, and data for specific statin types as well as for period, duration, and dose of use are lacking.

Methods:
We conducted a population-based nested case– control study using administrative data in Manitoba, Canada. Prostate cancer cases were matched to cancer-free controls, and their statin use (including period, duration, and dose of use) was assessed (with adjustment for prostate cancer screening) for statins as a class and for each specific statin.

Results:
We matched 9,384 prostate cancer cases to 46,749 cancer-free controls. Ever use of any statin was not associated with prostate cancer risk, odds ratio (OR) 0.96 (95% confidence interval, 0.90–1.03). Except for pravastatin, 0.82 (0.71–0.96), individual statins were not associated with prostate cancer risk. There was no dose or duration response for pravastatin (or any other statin).

Conclusions:
We found limited evidence of an association between statin use and prostate cancer risk. The association between pravastatin and prostate cancer risk may be due to chance.

Impact:
We show that statin use is not associated with prostate cancer risk after adjustment for screening for a large population with data going back to the mid-1990s.
Exposure to Polybrominated Diphenyl Ethers and a Polybrominated Biphenyl and Risk of Thyroid Cancer in Women: Single and Multi-Pollutant Approaches
Authors: Deziel Nicole C. , Alfonso-Garrido Javier , Warren Joshua L. , Huang Huang , Sjodin Andreas , Zhang Yawei 
Published: August 2019

Abstract

Background:
Thyroid cancer incidence is the most rapidly increasing malignancy; rates are three times higher in women than men. Thyroid hormone–disrupting flame-retardant chemicals, including polybrominated diphenyl ethers (PBDE) and polybrominated biphenyls (PBB), may contribute to this trend.

Methods:
We investigated the relationship between PBDE/PBB exposure and papillary thyroid cancer (PTC) in 250 incident female papillary thyroid cancer cases and 250 female controls frequency-matched on age. Interviews and postdiagnostic serum samples were collected from 2010 to 2013. Serum samples were analyzed for 11 congeners. We calculated ORs and 95% confidence intervals (95% CI) using single-pollutant logistic regression models for continuous and categorical lipid-adjusted serum concentrations of PBDE/PBB, adjusted for age, alcohol consumption, and education. We applied three multi-pollutant approaches [standard multipollutant regression models, hierarchical Bayesian logistic regression modeling (HBLR), principal components analysis (PCA)] to investigate associations with PBDE/PBB mixtures.

Results:
In single-pollutant models, a decreased risk was observed at the highest (&gt;90th percentile) versus lowest (&lt;median) category of BDE-209 concentrations (OR, 0.47; 95% CI, 0.23–0.98); an elevated PTC risk was observed at the highest versus lowest category of BB-153 concentrations (OR, 1.81; 95% CI, 0.96–3.39). In standard multi-pollutant models, an interquartile range increase in BDE-100 concentrations was associated with increased PTC risk (OR, 1.18; 95% CI, 1.01–1.38). HBLR and PCA yielded no statistically significant results.

Conclusions:
Our results using single- and multi-pollutant modeling do not generally support a positive association with PBDE/PBB and PTC risk.

Impact:
Prospective studies with more advanced statistical approaches to analyze mixtures and populations with higher exposures could reveal new insights.