bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a context-specific nutrient profiling system for food policy in Samoa
Authors: Reeve Erica , Naseri Take , Martyn Tim , Bollars Caroline , Thow Anne-Marie 
Published: October 2018

Abstract
The objective of this study was to develop a transparent system for defining ‘less healthy’ foods to underpin effective policy to reduce noncommunicable diseases in Samoa, replacing a fatty-meat ban lifted for accession to the WTO. In the absence of nutrition survey data, we calculated nutrient availability using food acquisition data from Samoa's Household Income and Expenditure Surveys. Together with published literature and local food composition data, we identified foods and nutrients (i) consumed in amounts greater than those recommended for good health and (ii) with a demonstrated causal link to health conditions of concern. Nutrient thresholds were developed based on desired level of decrease per nutrient per person necessary to reduce population intake in line with specific targets. We found average energy and sodium consumption to be higher than recommended, and foods high in sugar and saturated fat being consumed in large amounts. We selected a threshold-based, category-specific model to provide straightforward policy administration and incentivise healthy production and import, and then applied and tested nutrient thresholds across 7 threshold groups. The validation process indicated that the development of a nutrient profiling system to identify less healthy food items in Samoa provided a stronger basis for local policymaking. This study contributes to global understanding of approaches to developing a robust and transparent basis for policies to improve diets in lower income countries, and is relevant to other settings with high rates of noncommunicable diseases and similar resource and data constraints.
The whole and inclusive university: a critical review of health promoting universities from Aotearoa New Zealand
Authors: Came Heather A , Tudor Keith 
Published: October 2018

SummaryAs well as serving as a critic and conscience for societies, universities are elite sites of privilege which, at a surface level, are unlikely locations for health promotion interventions. This paper provides a critical review of the existing health promoting universities (HPU) approaches which is informed by health promotion values. It explores the silence in the global literature around issues of structural discrimination such as the sexism, homophobia and institutional racism that can thrive within university settings. The existing literature also reveals a very limited engagement about positive mental health or indigeneity. In response, this paper brings together these three factors—structural discrimination, mental health, and indigeneity—all of which the authors consider are criterial to health and its promotion. The authors introduce the New Zealand university landscape, in which there are eight Western universities and three whare wānanga (Māori universities), and, drawing on a survey of their Charters and other official statements, offer a moemoeā (vision or dream) of an HPU that addresses structural discrimination, is based on holistic conceptions of health, and is centred on indigenous worldviews and concerns.
Exploring causality of the association between smoking and Parkinson’s disease
Authors: Gallo Valentina , Vineis Paolo , Cancellieri Mariagrazia , Chiodini Paolo , Barker Roger A , Brayne Carol , Pearce Neil , Vermeulen Roel , Panico Salvatore , Bueno-de-Mesquita Bas , Vanacore Nicola , Forsgren Lars , Ramat Silvia , Ardanaz Eva , Arriola Larraitz , Peterson Jesper , Hansson Oskar , Gavrila Diana , Sacerdote Carlotta , Sieri Sabina , Kühn Tilman , Katzke Verena A , van der Schouw Yvonne T , Kyrozis Andreas , Masala Giovanna , Mattiello Amalia , Perneczky Robert , Middleton Lefkos , Saracci Rodolfo , Riboli Elio 
Published: October 2018

Abstract

Background
The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson’s disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait.

Methods
A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset.

Results
Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose–response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking <20 years were 0.84 [95% confidence interval (CI) 0.67–1.07], 20–29 years 0.73 (95% CI 0.56–0.96) and >30 years 0.54 (95% CI 0.43–0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose–response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49–0.99) ruled out the effect of unmeasured confounding.

Conclusions
These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect.
European Asylum Policies and the Stranded Asylum Seekers in Southeastern Europe
Authors: Valenta Marko , Lønning Moa Nyamwathi , Jakobsen Jo , Župarić-Iljić Drago 
Published: October 2018

Abstract
This article focuses on the restrictive European asylum policies and on their humanitarian consequences in Southeastern Europe. We discuss two interrelated topics: (i) the dynamic of the migration of asylum seekers to Europe and (ii) the specific position of Southeastern European countries and the situation of stranded migrants in the region. We identify central elements in the European asylum system and suggest that different parts of the system may be seen as a set of interacting lines of deterrence used to curb asylum migrations. It is argued herein that Greece and the other countries at the southern borders of the European Union have an idiosyncratic position within the European system of deterrence. Furthermore, we discuss how European deterrence policies and local responses influence the migration patterns of asylum seekers in Southeastern Europe. It is maintained that the deterrence measures have contributed to increasing the number of stranded asylum seekers in the region, especially in Greece with clear and regrettable humanitarian consequences.
Positive Luminex and negative flow cytometry in kidney transplantation: a systematic review and meta-analysis
Authors: Buttigieg Jesmar , Ali Hatem , Sharma Ajay , Halawa Ahmed 
Published: October 2018

AbstractThe presence of pre-formed donor-specific antibodies (DSAs) in kidney transplantation is associated with worse overall outcomes compared with DSA-negative transplantation. A positive complement-dependant cytotoxic crossmatch presents a high immunological risk, while a negative flow cytometry crossmatch is at the lower end of the risk spectrum. Yet, the presence of low-level DSA detected by Luminex alone, that is, positive Luminex and negative flow (PLNF) cytometry crossmatch lacks robust scientific exploration. In this systematic review and pooled analysis, we investigate the glomerular filtration rate, acute rejection (AR), graft survival and patient survival of PLNF transplants compared with DSA-negative transplants. Our analysis identified seven retrospective studies consisting of 429 PLNF transplants and 10 677 DSA-negative transplants. Pooled analysis identified no significant difference in the incidence of AR at 1 year [relative risk (RR) = 1.35, 95% confidence interval (CI) 0.90–2.02, Z = 1.46, P = 0.14, I2 = 0%], graft failure at 1 year (RR = 1.66, 95% CI 0.94–2.94, Z = 1.75, P = 0.08, I2 = 23%), graft failure at 5 years (RR = 1.29, 95% CI 0.90–1.87, Z = 1.38, P = 0.17, I2 = 0%), patient mortality at 1 year (RR = 0.89, 95% CI 0.31–2.56, Z = 0.22, P = 0.82, I2 = 0%) and patient mortality at 5 years (RR = 1.76, 95% CI 0.48–6.48, Z = 0.85, P = 0.39, I2 = 61%). Pooled analysis of graft function was not possible due to insufficient data. Current evidence suggests that low-level DSA detected by Luminex alone does not pose significant risk at least in the short–medium term. Considering the shortage of kidney transplants and the ever-increasing waiting time, the avoidance of PLNF transplants may be unwarranted especially in patients who have been enlisted for a long time.
Knowledge and Awareness of Added Sugar in Cigarettes
Authors: Seidenberg Andrew B , Jo Catherine L , Ribisl Kurt M 
Published: October 2018

Abstract

Introduction
Sugars naturally occur in tobacco leaf but are also commonly added to cigarettes by tobacco companies. Added sugar increases levels of toxic chemicals in cigarette smoke. Little is known about smokers’ knowledge of added sugar in cigarettes and awareness of its effects.

Methods
Adult cigarette smokers were recruited through Amazon Mechanical Turk to participate in an online experiment on electronic cigarette advertising. After completing the experiment, participants (N = 4351) answered two items assessing knowledge and awareness of added sugar in cigarettes. Participants had the option of providing open-ended comments about the overall study, and two reviewers read and independently coded comments pertaining to the sugar items.

Results
Only 5.5% of participants responded “yes” to the question: “Is sugar added to cigarettes?”, and only 3.8% of participants indicated being aware that added sugar increases toxins in cigarette smoke. Forty-eight participants mentioned the sugar items when asked to comment about the overall questionnaire. Fifty-two percent of these comments expressed an interest in obtaining more information about added sugar, and 23% described the sugar items as interesting or informative. Three participants commented that learning about added sugar motivated them to quit or cut down on smoking.

Conclusions
Among a large sample of smokers, few reported knowledge of added sugar in cigarettes and awareness of its effects. Further, several smokers expressed an interest in learning more about added sugar. Messages about added sugar in cigarettes may be a promising new angle for campaigns to discourage smoking.

Implications
Few American smokers are aware that sugar is added to cigarettes, and some participants expressed a desire to learn more about this additive. Given such low awareness, the interest among smokers, and increased popular concerns about added sugar in foods and beverages, messaging about added sugar in cigarettes should be developed and tested for inclusion in public health media campaigns.
Prevalence of hepatitis B virus infection and uptake of hepatitis B vaccine among healthcare workers, Makueni County, Kenya 2017
Authors: Kisangau E N , Awour A , Juma B , Odhiambo D , Muasya T , Kiio S N , Too R , Lowther S A 
Published: October 2018

Abstract

Background
Hepatitis B virus (HBV) is a vaccine-preventable infection that can spread in healthcare setting. Data on HBV infections and vaccine in African healthcare workers (HCWs) are limited. We estimated HBV infection prevalence, hepatitis B vaccination status and identified factors associated with vaccination in one Kenyan county.

Methods
Randomly selected HCWs completed a questionnaire about HBV exposure and self-reported immunization histories, and provided blood for testing of selected HBV biomarkers to assess HBV infection and vaccination status: HBV core antibodies (anti-HBc), HBV surface antigen (HBsAg) and HBV surface antibodies (anti-HBs). Prevalence odds ratios (OR) with 95% confidence intervals (95% CI) were calculated to identify factors associated with vaccination.

Results
Among 312 HCWs surveyed, median age was 31 years (range: 19–67 years). Of 295 blood samples tested, 13 (4%) were anti-HBc and HBsAg-positive evidencing chronic HBV infection; 139 (47%) had protective anti-HBs levels. Although 249 (80%) HCWs received ≥1 HBV vaccine dose, only 119 (48%) received all three recommended doses. Complete vaccination was more likely among those working in hospitals compared to those working in primary healthcare facilities (OR = 2.5; 95% CI: 1.4–4.3).

Conclusion
We recommend strengthening county HCW vaccination, and collecting similar data nationally to guide HBV prevention and control.
The New Keynesian Transmission Mechanism: A Heterogeneous-Agent Perspective
Authors: Broer Tobias , Harbo Hansen Niels-Jakob , Krusell Per , Öberg Erik 
Published: October 2018

Abstract
We present a tractable heterogeneous-agent version of the New Keynesian model that allows us to study the interaction between inequality and monetary policy. Though formulated as a precautionary-saving model à la Huggett–Aiyagari, its reduced form is a two-agent model with a highly concentrated wealth distribution. When prices are sticky and wages flexible, as in the textbook representative-agent model, monetary policy affects the distribution of consumption, but has no effect on output as workers choose not to change their hours worked in response to wage movements. This highlights a transmission mechanism of the textbook model that we find implausible: in response to a monetary stimulus, the representative worker’s labor supply is greatly affected by the profits she receives. First, the lower profits induced by higher wages raise labor supply through a wealth effect and, secondly, the mere presence of profits reduces the negative income effect of a wage rise. When wages are rigid, in contrast, our model exhibits plausible responses of output and hours worked to monetary policy shocks.
Paracingulate Sulcus Morphology and Hallucinations in Clinical and Nonclinical Groups
Authors: Garrison Jane R , Fernyhough Charles , McCarthy-Jones Simon , Simons Jon S , Sommer Iris E C 
Published: October 2018

Abstract
Hallucinations are a characteristic symptom of psychotic mental health conditions that are also experienced by many individuals without a clinical diagnosis. Hallucinations in schizophrenia have been linked to differences in the length of the paracingulate sulcus (PCS), a structure in the medial prefrontal cortex which has previously been associated with the ability to differentiate perceived and imagined information. We investigated whether this putative morphological basis for hallucinations extends to individuals without a clinical diagnosis, by examining whether nonclinical individuals with hallucinations have shorter PCS than nonclinical individuals without hallucinations. Structural MRI scans were examined from 3 demographically matched groups of individuals: 50 patients with psychotic diagnoses who experienced auditory verbal hallucinations (AVHs), 50 nonclinical individuals with AVHs, and 50 healthy control subjects with no life-time history of hallucinations. Results were verified using automated data-driven gyrification analyses. Patients with hallucinations had shorter PCS than both healthy controls and nonclinical individuals with hallucinations, with no difference between nonclinical individuals with hallucinations and healthy controls. These findings suggest that the association of shorter PCS length with hallucinations is specific to patients with a psychotic disorder. This presents challenges for full-continuum models of psychosis and suggests possible differences in the mechanisms underlying hallucinations in clinical and nonclinical groups.
Testing for Human Papillomavirus Strains 16 and 18 Helps Predict the Presence of Anal High-Grade Squamous Intraepithelial Lesions
Authors: Sambursky Jacob A. , Terlizzi Joseph P. , Goldstone Stephen E. 
Published: October 2018

BACKGROUND:
More than 90% of anal cancers are caused by human papillomavirus, and human papillomavirus strains 16 and 18 are the most oncogenic. Anal high-grade squamous intraepithelial lesions are cancer precursors. Treating these high-grade intraepithelial lesions likely reduces the risk of cancer, but cytology is an imperfect screening test.

OBJECTIVE:
The purpose of this study was to determine whether human papillomavirus 16 and/or 18 testing better predicts the presence of high-grade squamous intraepithelial lesions.

DESIGN:
In this retrospective study, 894 consecutive patients underwent anal dysplasia screening with digital anorectal examination, anal cytology, high-risk human papillomavirus testing, and high-resolution anoscopy with biopsy. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of each test and for a novel screening protocol. The absolute and relative risk of high-grade squamous intraepithelial lesions for all of the cytology/human papillomavirus combinations were also calculated.

SETTINGS:
The study was conducted at a single practice specializing in anal dysplasia.

PATIENTS:
Ninety-two percent of participants were men who have sex with men. Forty-four percent were HIV-positive individuals who were well controlled on antiretroviral therapy. The median age was 50 years.

MAIN OUTCOME MEASURES:
The presence of high-grade squamous intraepithelial lesions as a function of human papillomavirus and the cytology results were measured.

RESULTS:
High-risk human papillomavirus testing alone demonstrated better sensitivity (96% vs 89%; p = 0.03) and negative predictive value (99% vs 96%; p = 0.008) over cytology. Human papillomavirus 16/18 testing increased specificity (48% to 71%; p < 0.0001) and positive predictive value (24% to 37%; p = 0.003) over testing for all of the high-risk strains. For each cytology category, high-grade squamous intraepithelial lesions were more prevalent when human papillomavirus 16/18 was detected. Benign cytology with 16/18 had a 31-fold increased risk of high-grade squamous intraepithelial lesions.

LIMITATIONS:
This study was conducted in a single private practice specializing in anal dysplasia screening with a mostly male population, and results might not be generalizable.

CONCLUSIONS:
Testing of high-risk human papillomavirus strains 16/18 improves specificity and positive predictive value over cytology for anal dysplasia screening. Patients testing positive for strains 16/18 are at a high risk for high-grade squamous intraepithelial lesions and should undergo high-resolution anoscopy regardless of the cytology result. See Video Abstract at http://links.lww.com/DCR/A654.
Glaucoma Gel Implant Learning Curve in a Teaching Tertiary Hospital
Authors: Marques Raquel Esteves , Ferreira Nuno Pinto , Sousa David Cordeiro , Pinto Joana , Barata André , Sens Paula , Abegão Pinto Luís 
Published: October 2018

Purpose:
The XEN gel stent is a minimally invasive surgical device aimed at creating a subconjunctival drainage of aqueous humor, thereby reducing intraocular pressure (IOP). Being a novel device, doubts remain with regard to the efficacy and safety of its implantation in the early stage of new users. This paper illustrates the XEN implantation learning curve, assessed through several surgeons of different expertise.

Methods:
This was a retrospective study on the first 6 XEN implants performed by each of the 10 certified ophthalmic surgeons. Simultaneous cataract surgery was allowed (phaco-XEN). Primary outcomes were as follows: surgical time; intraoperative and postoperative surgical complications. Secondary outcomes were as follows: IOP; the number of topical drugs in use; the need for needling procedures. Outcome data were collected preoperatively and at postoperative days 1, 7, 15, 30, 60, and 90. Statistical analysis was performed with STATA 14.1 and SPSS.

Results:
Sixty patients were included (56.7% female patients). Mean age was 73 years (45 to 89). Mean preoperative IOP was 23.8±8.95 mm Hg. From the included patients, 29 (48.3%) were submitted to simple XEN implant and 31 (51.7%) to phaco-XEN. In both groups, mean surgical time decreased by 9 minutes throughout the 6-implant learning curve. Final IOP was 15±7.27 mm Hg in the stent group (−43% than baseline), and 14.92±3.32 mm Hg in the phaco-XEN group (−16% than baseline). On average, patients decreased 2 topical IOP-lowering drugs. Needling procedures were performed in 17 patients (28.3%).

Conclusions:
XEN gel stent was associated with a fast learning curve, by both experienced surgeons and novice residents. By the sixth implant, both groups had considerably decreased mean surgical time and complication rates.
Prognostic Nutritional Index, Tumor-infiltrating Lymphocytes, and Prognosis in Patients with Esophageal Cancer
Authors: Okadome Kazuo , Baba Yoshifumi , Yagi Taisuke , Kiyozumi Yuki , Ishimoto Takatsugu , Iwatsuki Masaaki , Miyamoto Yuji , Yoshida Naoya , Watanabe Masayuki , Baba Hideo 
Published: October 2018

Objective:
To determine whether prognostic nutritional index (PNI) affects clinical outcome through local immunity in esophageal cancers.

Background:
PNI is an indicator of nutritional status and systemic immune competence, and has attracted attention as a prognostic biomarker. Tumor-infiltrating lymphocytes (TILs) are a specific histological feature of human cancers, reflecting an individual's immunological tumor response.

Methods:
Using a nonbiased database of 337 curatively resected esophageal cancers, we evaluated the relationship between PNI, TILs status, CD8 expression by immunohistochemical staining, and clinical outcome.

Results:
Compared with PNI-high cases (n = 220), PNI-low cases (n = 117) showed significantly worse overall survival (log-rank P < 0.001; hazard ratio: 2.23; 95% confidence interval: 1.56–3.18; P < 0.001; multivariate hazard ratio: 1.67; 95% confidence interval: 1.14–2.44; P = 0.008). The TILs status was also significantly correlated with overall survival (P < 0.001). In addition, PNI was significantly associated with TILs status (P < 0.001) and the CD8-positive cell count (P = 0.041). A significant relationship between the peripheral blood lymphocyte count and TILs status was also observed (P < 0.001).

Conclusions:
PNI and TILs score expression were associated with clinical outcome in esophageal cancer, supporting their roles as prognostic biomarkers. Considering the relationship between PNI and TILs, nutritional status and systemic immune competence may influence patient prognosis through local immune response.