bluuebunny/crossref_metadata_2025_split huggingface dataset:
Democracy and power in alcohol premises licensing: A qualitative interview study of the Scottish public health objective
Authors: Fitzgerald Niamh , Winterbottom Jo , Nicholls James 
Published: June 2018

AbstractIntroduction and AimsThere is international interest in how the availability of alcohol can be controlled to reduce harms. An objective of ‘protecting and improving public health’ was introduced to alcohol premises licensing in Scotland in 2005, resulting in public health actors engaging with licensing in new ways. We aimed to explore their experiences, including perceptions of the distribution of power, and constraints on their influence and that of the general public within the licensing system.Design and MethodsIn‐depth, semi‐structured interviews were conducted with 13 public health actors who had recent and extensive experience of involvement in local licensing in 20 Scottish licensing jurisdictions. Interviews were audio‐recorded and analysed using an inductive framework approach.ResultsPublic health actors reported experiencing the licensing process as inherently unfair, with structures and traditions that were largely unhelpful to their efforts to support the public health objective. These included influence exerted by local officials, the formal and quasi‐judicial conduct of licensing meetings, and the disparity in resources available to public health actors versus licence applicants—with many larger applicants engaging specialist lawyers to represent their interests. The influence of public opinion—through, for instance, elected representatives’ perceptions of public attitudes, consultation exercises and local ‘licensing forums’—was seen as having a limited effect on decision‐making.Discussion and ConclusionsChanges to Scottish alcohol licensing ostensibly designed to enhance democratic engagement and promote public health, were as yet insufficient to change the system, or empower stakeholders, to fully achieve those goals.
Language matters. Addressing the use of language in the care of people with diabetes: position statement of the English Advisory Group
Authors: Cooper A. , Kanumilli N. , Hill J. , Holt R. I. G. , Howarth D. , Lloyd C. E. , Kar P. , Nagi D. , Naik S. , Nash J. , Nelson H. , Owen K. , Swindell B. , Walker R. , Whicher C. , Wilmot E. 
Published: June 2018

AbstractThe language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day‐to‐day. At its best, good use of language, both verbal and written, can lower anxiety, build confidence, educate and help to improve self‐care. Conversely, poor communication can be stigmatizing, hurtful and undermining of self‐care and can have a detrimental effect on clinical outcomes. The language used in the care of those with diabetes has the power to reinforce negative stereotypes, but it also has the power to promote positive ones. The use of language is controversial and has many perspectives. The development of this position statement aimed to take account of these as well as the current evidence base. A working group, representing people with diabetes and key organizations with an interest in the care of people with diabetes, was established to review the use of language. The work of this group has culminated in this position statement for England. It follows the contribution of Australia and the USA to this important international debate. The group has set out practical examples of language that will encourage positive interactions with those living with diabetes and subsequently promote positive outcomes. These examples are based on a review of the evidence and are supported by a simple set of principles.
Unmasking and aggravation of polycythemia vera by canagliflozin
Authors: Das L. , Bhansali A. , Walia R. 
Published: June 2018

AbstractBackgroundSodium‐glucose co‐transporter‐2 inhibitors are novel antidiabetes drugs that act via inhibition of renal glucose reabsorption. This action causes osmotic diuresis, reduces intravascular volume and is associated with various adverse effects. In the present paper, we describe the first report on the unmasking of underlying polycythemia vera by canagliflozin in a person with Type 2 diabetes mellitus, which was temporally related to the use of the drug.Case reportA 51‐year‐old obese man with Type 2 diabetes was prescribed canagliflozin 100 mg for control of his glycaemia. He presented 6 months later with asymptomatic elevation of his haemogram measurements (haemoglobin: 16.9 g/dl; haematocrit: 55%; red cell number: 8.1 million/mm3; total leukocytes: 23010/mm3; platelet count: 9.7 *106/mm3). He had no history of smoking, exposure to high altitude or other drugs. Subsequent investigations revealed myeloproliferative neoplasm (polycythemia vera) on trephine biopsy of bone marrow, normal erythropoietin level and JAK2V617F positivity. Because of the possibility that the underlying condition had been unmasked by canagliflozin, the latter was stopped. This led to a remarkable improvement in the man's haematological profile, with no other significant intervention. The man subsequently restarted the drug of his own accord, causing his haematological profile to worsen again and thereby posing a challenge in monitoring of both polycythemia vera as well as diabetes mellitus.ConclusionThis report brings to light unmasking of a new adverse effect of sodium‐glucose co‐transporter‐2 inhibitors in clinical practice caused by volume loss, apart from hypotension and falls.
Genetic diversity of Amylostereum areolatum, the fungal symbiont of the invasive woodwasp Sirex noctilio in South Africa
Authors: Mlonyeni X. Osmond , Wingfield Michael J. , Greeff Jaco M. , Wingfield Brenda D. , Slippers Bernard 
Published: June 2018

AbstractAmylostereum areolatum is a wood‐decaying homobasidiomycete fungal symbiont of Sirex noctilio. Together, they cause serious damage to pine plantations in the Southern Hemisphere. The fungus reproduces asexually and is vertically transmitted by S. noctilio females, which results in extensive spread of clones. Specific A. areolatum clones are often dominant in areas invaded by the wasp. This is in contrast with the high diversity and complex invasion pattern of S. noctilio in most of these regions. In South Africa, for example, nuclear and mitochondrial ribosomal loci and vegetative compatibility group (VCG) markers on a small number of isolates have shown that only one genotype is present in the country. The aim of this study was to develop microsatellite markers for A. areolatum and determine the genetic diversity and structure of a relatively large collection of isolates of the fungus in South Africa. From five sequenced A. areolatum genomes, a total of 233 microsatellite primer pairs were designed, of which 57 were polymorphic among the genomes. Eleven of these polymorphic markers were then used in a population genetics study including 55 South African isolates. In a surprising manner, nine multilocus genotypes were found among these isolates, and with no population structure among different regions across South Africa. The single VCG previously identified for isolates from the country clearly do not correspond to a clone. The detected A. areolatum variation has relevance for the biology of the Sirex‐Amylostereum symbiosis, its introduction history into South Africa and its management through biocontrol. The microsatellite primers and data emerging from them also provide powerful tools for the study of A. areolatum populations in other parts of the world.
Rationality, strategic uncertainty, and belief diversity in non‐cooperative games
Authors: Zambrano Eduardo 
Published: June 2018

AbstractI investigate the existence of epistemic models of complete information games that satisfy the following properties: players do not rule out their opponent's use of rational ex ante strategies for deriving their choices; they do not rule out, ex ante, that they can come to know the action profile that is ultimately played; and they do not rule out strategic uncertainty. In this paper I show that for a large class of games there are no epistemic models that satisfy these three properties.
Investigation of antimicrobial properties and in‐vitro bioactivity of Ce3+‐Sr2+dual‐substituted nano hydroxyapatites
Authors: Sundarabharathi Lakshmanaperumal , Chinnaswamy Mahendran , Ponnamma Deepalekshmi , Parangusan Hemalatha , Al‐Maadeed Mariam Al Ali 
Published: June 2018

AbstractDual doped calcium apatite has been widely focused as it enhances the osteoconductive property for the possible applications in orthopedic and dental implants. In this work, we investigate the antimicrobial and bioactive properties of cerium/strontium (Ce3+/Sr2+) co‐substituted hydroxyapatite (HA) nanoparticles synthesized by sol‐gel assisted precipitation method. The structure, morphology, functional groups, photoluminescence, and thermal stability of the developed systems are examined. The comparative studies performed among the pure HA, Sr2+, and Ce3+‐substituted HA nanoparticles illustrate higher antibacterial activity with lowered apatite‐forming ability and biocompatibility for the Ce3+‐substituted HA. However, the Ce3+/Sr2+co‐substituted HA exhibits better biocompatibility, apatite‐forming ability, and good antimicrobial properties. Sr2+ ion inclusion leads to better biological properties and compromise the cytotoxic nature of the Ce3+‐HA. In addition, the Ce3+/Sr2+‐HA nanoparticles prevent thermal decomposition up to 700°C, pointing also toward the possibility of this co‐substituted HA in bone implant applications.
The use of mechanistic evidence in drug approval
Authors: Aronson Jeffrey K. , La Caze Adam , Kelly Michael P. , Parkkinen Veli‐Pekka , Williamson Jon 
Published: June 2018

AbstractThe role of mechanistic evidence tends to be under‐appreciated in current evidence‐based medicine (EBM), which focusses on clinical studies, tending to restrict attention to randomized controlled studies (RCTs) when they are available. The EBM+ programme seeks to redress this imbalance, by suggesting methods for evaluating mechanistic studies alongside clinical studies. Drug approval is a problematic case for the view that mechanistic evidence should be taken into account, because RCTs are almost always available. Nevertheless, we argue that mechanistic evidence is central to all the key tasks in the drug approval process: in drug discovery and development; assessing pharmaceutical quality; devising dosage regimens; assessing efficacy, harms, external validity, and cost‐effectiveness; evaluating adherence; and extending product licences. We recommend that, when preparing for meetings in which any aspect of drug approval is to be discussed, mechanistic evidence should be systematically analysed and presented to the committee members alongside analyses of clinical studies.
Cephalometric, muscular and swallowing changes in patients with OSAS
Authors: Valarelli L. P. , Corradi A. M. B. , Grechi T. H. , Eckeli A. L. , Aragon D. C. , Küpper D. S. , Almeida L. A. , Sander H. H. , de Felício C. M. , Trawitzki L. V. V. , Valera F. C. P. 
Published: June 2018

SummaryObstructive Sleep Apnoea Syndrome (OSAS) is believed to be associated with craniofacial and neuromuscular changes, although the interplay among these variables still is poorly recognised. The objective of this study was to identify hyoid, muscular and swallowing changes associated with OSAS, and to correlate these alterations with OSAS severity. Cross‐sectional study, in a tertiary referral centre. Seventy‐two adult individuals participated in this study: 12 controls (without apnoea) and 60 patients with apnoea (mild, moderate and severe OSAS—20 individuals in each group). All participants were initially evaluated by otorhinolaryngologist and neurologist and underwent polysomnography for OSAS stratification. Cephalometric data, clinical myofunctional status and swallow videofluoroscopy exam were assessed. A hybrid effect model was used to analyse swallowing parameters; dependent variables were age, body mass index (BMI) and cephalometric measures. Individuals with OSAS presented lower hyoid position and narrower posterior airway distance when compared to controls. These parameters correlated to OSAS severity. Additionally, OSAS patients exhibited significantly lower myofunctional scores. Both velum and hyoid contraction times were significantly lower in the OSAS group at videofluoroscopy, regardless of its severity. Premature leakage into pharynx was more common in OSAS groups. Laryngeal penetration phenomenon occurred only in two patients (both from OSAS group). Our results suggest that hyoid bone position is associated with OSAS severity. Muscular pattern and swallowing are impaired in OSAS patients, irrespective of OSAS severity and facial profile. These findings indicate a higher predisposition of OSAS patients to present an inferior hyoid positioning, accompanied by myofunctional and swallowing disorders.
Trends in late‐onset sepsis in a neonatal intensive care unit following implementation of infection control bundle: A 15‐year audit
Authors: Pharande Pramod , Lindrea Kwee B , Smyth John , Evans Margaret , Lui Kei , Bolisetty Srinivas 
Published: June 2018

AimLate‐onset sepsis (LOS) is a frequent and important cause of morbidity and mortality in newborn infants admitted to neonatal intensive care units (NICUs). The objective of this study is to evaluate the impact of various infection control quality measures introduced as a bundle on the trends of the LOS in a NICU.MethodsThis was a prospective quality improvement study involving all neonates admitted to a NICU over a 15‐year period between 2002 and 2016. The main focus areas of the bundle included collaborative team effort, hand hygiene, education, central line insertion and maintenance bundles and parenteral nutrition. The main outcome measures were LOS and central line‐associated bloodstream infections.ResultsYearly admissions increased during study period, from 776 in 2002 to 952 in 2016. There was a progressive decrease in LOS rate, from 4.3 to 1.6 per 1000 patient days (B coefficient −0.17, 95% confidence interval −0.25, −0.09; P < 0.001), and the central line‐associated bloodstream infection rate dropped from 25 in 2003 to 5 in 2016 per 1000 central line days (B coefficient −1.20, 95% confidence interval −1.84, −0.56; P = 0.001). Hand hygiene compliance rates remained consistent, over 80%. During the study period, coagulase‐negative staphylococcus caused 56% and Gram‐negative organisms 18% of the total infections.ConclusionMultifaceted infection control bundle practices with a concerted team effort in the implementation, with continuing education, feedback and reinforcement of best infection control practices, can sustain the gains achieved by infection control for a long period of time.
Real‐world outcomes of unrestricted direct‐acting antiviral treatment for hepatitis C in Australia: The South Australian statewide experience
Authors: Haridy J. , Wigg A. , Muller K. , Ramachandran J. , Tilley E. , Waddell V. , Gordon D. , Shaw D. , Huynh D. , Stewart J. , Nelson R. , Warner M. , Boyd M. , Chinnaratha M. A. , Harding D. , Ralton L. , Colman A. , Liew D. , Iyngkaran G. , Tse E. ,   the Adelaide Liver Group
Published: June 2018

SummaryIn March 2016, the Australian government offered unrestricted access to direct‐acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) to the entire population. This included prescription by any medical practitioner in consultation with specialists until sufficient experience was attained. We sought to determine the outcomes and experience over the first twelve months for the entire state of South Australia. We performed a prospective, observational study following outcomes of all treatments associated with the state's four main tertiary centres. A total of 1909 subjects initiating DAA therapy were included, representing an estimated 90% of all treatments in the state. Overall, SVR12 was 80.4% in all subjects intended for treatment and 95.7% in those completing treatment and follow‐up. 14.2% were lost to follow‐up (LTFU) and did not complete SVR12 testing. LTFU was independently associated with community treatment via remote consultation (OR 1.50, 95% CI 1.04‐2.18, P = .03), prison‐based treatment (OR 2.02, 95% CI 1.08‐3.79, P = .03) and younger age (OR 0.98, 95% CI 0.97‐0.99, P = .05). Of the 1534 subjects completing treatment and follow‐up, decreased likelihood of SVR12 was associated with genotype 2 (OR 0.23, 95% CI 0.07‐0.74, P = .01) and genotype 3 (OR 0.23, 95% CI 0.12‐0.43, P ≤ .01). A significant decrease in treatment initiation was observed over the twelve‐month period in conjunction with a shift from hospital to community‐based treatment. Our findings support the high responses observed in clinical trials; however, a significant gap exists in SVR12 in our real‐world cohort due to LTFU. A declining treatment initiation rate and shift to community‐based treatment highlight the need to explore additional strategies to identify, treat and follow‐up remaining patients in order to achieve elimination targets.
CD56bright natural killer cells induce HBsAg reduction via cytolysis and cccDNA decay in long‐term entecavir‐treated patients switching to peginterferon alfa‐2a
Authors: Shi A. , Zhang X. , Xiao F. , Zhu L. , Yan W. , Han M. , Luo X. , Chen T. , Ning Q. 
Published: June 2018

SummaryHBV surface antigen (HBsAg) reduction is well observed in chronic hepatitis B (CHB) patients treated with pegylated interferon alpha‐2a (PegIFNα). However, the mechanism of HBsAg suppression has not been fully elucidated. Twenty‐seven of 55 entecavir‐treated CHB e antigen positive patients were switched to PegIFNα treatment (Group A) whereas 28 patients continued entecavir treatment (Group B). The percentage or absolute number of CD56bright/CD56dim NK cells, expression of receptors and cytokines were evaluated by flow cytometry for 48 weeks and correlated with treatment efficacy. In vitro, purified NK cells were co‐cultured with HepAD38 cells for measurement of HBsAg, apoptosis and covalently closed circular DNA (cccDNA). In association with a reduction of HBsAg, the percentage and absolute number of CD56bright NK cells was significantly elevated in patients in group A, especially in Virologic Responders (VRs, HBsAg decreased). Furthermore, the percentage of NKp30+, NKp46+, TRAIL+, TNF‐α+ and IFNγ+CD56bright NK cells were significantly expanded in Group A, which were positively correlated with the decline of HBsAg at week 48. In vitro, peripheral NK cells from Group A induced a decline of HBsAg in comparison with NK cells from Group B which was significantly inhibited by anti‐TRAIL, anti‐TNF‐α and anti‐IFNγ antibodies. Furthermore, apoptosis of HepAD38 cells and levels of cccDNA, were significantly reduced by TRAIL+ and TNF‐α+/IFNγ+NK cells from Group A, respectively. A functional restoration of CD56bright NK cells in entecavir‐treated patients who were switched to PegIFNα contributes to HBsAg and cccDNA clearance through TRAIL‐induced cytolysis and TNF‐α/IFNγ‐mediated noncytolytic pathways.
Viral dominance patterns in chronic hepatitis delta determine early response to interferon alpha therapy
Authors: Lutterkort G. L. , Wranke A. , Hengst J. , Yurdaydin C. , Stift J. , Bremer B. , Hardtke S. , Keskin O. , Idilman R. , Manns M. P. , Dienes H. P. , Falk C. , Wedemeyer H. , Heidrich B. 
Published: June 2018

SummaryChronic hepatitis D is caused by coinfection of hepatitis B and hepatitis D virus. While HDV is the dominant virus over HBV in the majority of cases, mechanisms and consequences of viral dominance are largely unknown. We aimed to investigate associations between viral dominance patterns and patients’ characteristics and inflammatory features; 109 HDV‐infected patients treated with PEG‐IFNa‐2α within the international multicentre, prospective HIDIT‐2 trial were studied. Patients were classified as D‐ or B‐dominant if the viral load of one virus exceeded that of the other virus by more than 1log10. Otherwise, no viral dominance (ND) was described. We used Luminex‐based multiplex technology to study 50 soluble immune mediators (SIM) in pretreatment samples of 105 HDV RNA‐positive patients. Dominance of HDV was evident in the majority (75%) of cases. While only 7% displayed B‐dominance, 17% showed nondominance. D‐dominance was associated with downregulation of 4 interleukins (IL‐2ra, IL‐13, IL‐16 and IL‐18) and 5 chemokines/cytokines (CTACK (CCL27), MCP‐1 (CCL2), M‐CSF, TRAIL and ICAM‐1) while no analyte was increased. In addition, D‐dominance could be linked to a delayed HDV RNA response to pegylated interferon as patients with B‐dominance or nondominance showed higher early HDV RNA responses (61% at week 12) than D‐dominant patients (11%; P < .001). In conclusion, this study revealed unexpected effects of viral dominance on clinical and immunological features in chronic hepatitis delta patients. Individualizing PEG‐IFNa‐2α treatment duration should consider viral dominance. Overall, our findings suggest an activated but exhausted IFN system in D‐dominant patients.
Thermal evolution of the early Moon
Authors: Sahijpal Sandeep , Goyal Vishal 
Published: June 2018

AbstractThe early thermal evolution of Moon has been numerically simulated to understand the magnitude of the impact‐induced heating and the initially stored thermal energy of the accreting moonlets. The main objective of the present study was to understand the nature of processes leading to core–mantle differentiation and the production and cooling of the initial convective magma ocean. The accretion of Moon was commenced over a time scale of 100 yr after the giant impact event around 30–100 million years in the early solar system. We studied the dependence of the planetary processes on the impact scenarios, the initial average temperature of the accreting moonlets, and the size of the protomoon that accreted rapidly beyond the Roche limit within the initial 1 yr after the giant impact. The simulations indicate that the accreting moonlets should have a minimum initial averaged temperature around 1600 K. The impacts would provide additional thermal energy. The initial thermal state of the moonlets depends upon the environment prevailing within the Roche limit that experienced episodes of extensive vaporization and recondensation of silicates. The initial convective magma ocean of depth more than 1000 km is produced in the majority of simulations along with the global core–mantle differentiation in case the melt percolation of the molten metal through porous flow from bulk silicates was not the major mode of core–mantle differentiation. The possibility of shallow magma oceans cannot be ruled out in the presence of the porous flow. Our simulations indicate the core–mantle differentiation within the initial 102to 103 yr of the Moon accretion. The majority of the convective magma ocean cooled down for crystallization within the initial 103to 104 yr.