bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing Prudent Healthcare in the NHS in Wales; what are the barriers and enablers for clinicians?
Authors: Addis Samia , Holland‐Hart Daniella , Edwards Adrian , Neal Richard D. , Wood Fiona 
Published: August 2018

AbstractRationalePrudent Healthcare is a strategy adopted by the Welsh Government in response to the challenge of improving health care during times of austerity and when needs and demand are rising. Four principles underlie Prudent Healthcare: to achieve health and wellbeing through co production; care for those with the greatest health needs first; do only what is needed; and reduce inappropriate variation. For Prudent Healthcare to be implemented in Wales, it is necessary for health professionals to adopt these principles in practice.ObjectiveThis paper reports a qualitative evaluation of clinicians' awareness, experiences, and views about Prudent Healthcare, identifying barriers and enablers to implementation from the clinician's perspective.MethodsSemi‐structured interviews (n = 28) and five focus groups (with 23 participants) were undertaken with a diverse range of health professionals working in primary and secondary care. Analysis was underpinned by the COM‐B model which provides a framework to understand behaviour change in context using three domains, Capability, Opportunity, and Motivation.ResultsClinicians reported the importance and challenges of accessing and sharing information and evidence to inform practice (Capability). Reduced staffing levels and service availability were highlighted as possible barriers to Prudent Healthcare implementation while multidisciplinary working and reorganization of staff roles and services were considered enablers (Opportunity). Finally, although the principles of Prudent Healthcare were broadly welcomed (Motivation), a lack of awareness of the initiative and the management of patient expectations presented barriers.ConclusionWhile there was a positive response and widespread support for the principles of Prudent Healthcare by clinicians, increasing awareness of the initiative and improvement to systems to enable information sharing and the monitoring of patient outcomes could improve the consistency of implementation.
Forestry conflict in Spain: Rethinking peasant protest and resistance
Authors: Serrano‐Álvarez José A. 
Published: August 2018

AbstractThis article examines forestry conflict in the Spanish province of León and the struggle between village communities and the state over the control of common lands and forests. One of this article's conclusions is that forestry conflict reflected, on the one hand, the struggle for economic control not only between the peasants and the state but also between the peasants themselves and, on the other hand, the clash between the market economy championed by the state and the traditional arrangements, values, and solidarities defended by the peasants. Another conclusion is that widely used concepts such as “weapons of the weak” or “environmentalism of the poor” are deemed inadequate regarding the peasant protest and resistance analysed here, which in turn calls for a definition of these new forms of rural resistance or a reformulation of those already in use.
Association between a national quality improvement program and excisional treatment of cervical dysplasia in Australia
Authors: Foster Leon , Robson Stephen J. 
Published: August 2018

AbstractAimIn Australia, the National Cervical Screening and HPV Vaccination Programs aim to reduce the incidence of cervical cancer. Identification and treatment of preinvasive disease is important, but excisional treatment has been associated with adverse pregnancy outcomes. A national quality improvement program (Cervical Quality Improvement Program [c‐QuIP]) aimed to reduce the rate of excisional treatment in young human papilloma virus (HPV)‐vaccinated women. This study examined national trends in the rate of excisional treatment in young women.MethodsComprehensive national data were obtained from Medicare Australia regarding incidence rates of excisional treatment for the 10‐year period 2007 to 2016 inclusive. These data were used to calculate age‐stratified incidence rates of excisional treatment in young (20–24 years), intermediate (25–34 years) and older (35–60 years) women.ResultsThe rate of excisional treatment (procedures per 10 000 women) fell in young women (from 25 to 6/7, P < 0.005) and women of intermediate age (from 23 to 13, P < 0.005), but there was no significant change in the rate in women aged 35 to 60 years (from 7 to 6.5).ConclusionIn the decade since introduction of the National HPV Vaccination Program the rate of excisional treatment of the cervix in Australia has fallen in women aged less than 35 years but has not changed for older women. The introduction of a national program aiming to reduce the rate appeared to have little impact.
Use of proton pump inhibitors and risk of iron deficiency: a population‐based case–control study
Authors: Tran‐Duy A. , Connell N. J. , Vanmolkot F. H. , Souverein P. C. , de Wit N. J. , Stehouwer C. D. A. , Hoes A. W. , de Vries F. , de Boer A. 
Published: August 2018

AbstractBackgroundHypochlorhydric states are an important cause of iron deficiency (ID). Nevertheless, the association between therapy with proton pump inhibitors (PPIs) and ID has long been a subject of debate. This case–control study aimed to investigate the risk of ID associated with the use of PPIs using the UK Clinical Practice Research Datalink (CPRD) database.MethodsCases were patients aged 19 years or older with first‐time diagnosis of ID between 2005 and 2016 (n = 26 806). The dates of first diagnosis of ID in cases defined the index dates. For each case, one control was matched by age, gender and general practice. A PPI “full” user (PFU) was defined as a subject who had received PPIs for a continuous duration of at least 1 year prior to the index date. A PPI “limited” users (PLU) was a subject who intermittently received PPI therapy. A PPI non‐user (PNU) was a subject who received no PPI prescriptions prior to the index date. The odds ratio of ID in PFU and PLU compared to PNU was estimated using conditional logistic regression.ResultsAmong cases, 2960 were PFU, 6607 PLU and 17 239 PNU. Among controls, 1091 were PFU, 5058 PLU and 20 657 PNU. Adjusted odds ratio of ID in PFU and PLU compared to PNU was 3.60 (95%CI, [3.32–3.91]) and 1.51 (95% CI, [1.44–1.58]). Positive dose–response and time–response relationships were observed.ConclusionsChronic PPI use increases the risk of ID. Physicians should consider this when balancing the risks and benefits of chronic PPI prescription.
The weight of nutrients: kynurenine metabolites in obesity and exercise
Authors: Dadvar S. , Ferreira D. M. S. , Cervenka I. , Ruas J. L. 
Published: August 2018

AbstractObesity ultimately results from an imbalance between energy intake and expenditure. However, in addition to their bioenergetic value, nutrients and their metabolites can function as important signalling molecules in energy homeostasis. Indeed, macronutrients and their metabolites can be direct regulators of metabolism through their actions on different organs. In turn, target organs can decide to use, store or transform the incoming nutrients depending on their physiological context and in coordination with other cell types. Tryptophan‐kynurenine metabolites are an example of a family of compounds that can serve as systemic integrators of energy metabolism by signalling to different cell types. These include adipocytes, immune cells and muscle fibres, in addition to the well‐known effects of kynurenine metabolites on the central nervous system. In the context of energy metabolism, several of the effects elicited by kynurenic acid are mediated by the G‐protein‐coupled receptor, GPR35. As GPR35 is expressed in tissues such as the adipose tissue, immune cells and the gastrointestinal tract, this receptor could be a potential therapeutic target for the treatment of obesity, diabetes and other metabolic diseases. In addition, metabolic disorders often coincide with states of chronic inflammation, which further highlights GPR35 as an integration node in conditions where inflammation skews metabolism. Defining the molecular interplay between different tissues in the regulation of energy homeostasis can help us understand interindividual variability in the response to nutrient intake and develop safe and efficient therapies to fight obesity and metabolic disease.
Anticancer properties of lipid and poly(ε-caprolactone) nanocapsules loaded with ferrocenyl-tamoxifen derivatives
Authors: Najlaoui Feten , Pigeon Pascal , Aroui Sonia , Pezet Mylène , Sancey Lucie , Marrakchi Naziha , Rhouma Ali , Jaouen Gérard , De Waard Michel , Busser Benoit , Gibaud Stéphane 
Published: August 2018

Abstract

Objective
We synthesized new tamoxifen derivatives as anticancer drug candidates and elaborated on convection-enhanced delivery (CED) as a strategy for delivery.

Methods
To overcome the issue of their poor solubility, these ferrocenyl-tamoxifen derivatives were esterified and encapsulated into different nanocarriers, that is lipid (LNC) and polymeric nanocapsules (PNL-NC). We describe the chemistry, the encapsulation and the physicochemical characterization of these formulations.

Key findings
Starting compounds [phthalimido-ferrocidiphenol and succinimido-ferrocidiphenol], esterified prodrugs and their nanocapsules formulations were characterized.
These drug candidates displayed a strong in vitro activity against breast and glioblastoma cancer cells. The ester prodrugs were toxic for glioblastoma cells (IC50 = 9.2 × 10−2 μm and 6.7 × 10−2 μm, respectively). The IC50 values for breast cancer cells were higher for these compounds. The encapsulation of the esterified compounds in LNCs (≈50 nm) or PCL-NCs (≈300 nm) did not prevent their efficacy on glioblastoma cells. These anticancer effects were due to both blockade in the S-phase of the cell cycle and apoptosis. Moreover, the tamoxifen derivatives-loaded nanocapsules induced no toxicity for healthy astrocytes and showed no haemolytic properties. Loaded Lipid Nanocapsules (LNCs) presented interesting profiles for the optimal delivery of active compounds.

Conclusions
Phthalimido- and Succinimido-esters represent an innovative approach to treat cancers with cerebral localizations such as glioblastoma or brain metastases from breast cancers.
Understanding facilitators and barriers of direct‐acting antiviral therapy for hepatitis C virus infection in prison
Authors: Lafferty Lise , Rance Jake , Grebely Jason , Lloyd Andrew R. , Dore Gregory J. , Treloar Carla ,   the SToP‐C Study Group
Published: August 2018

SummaryHepatitis C virus (HCV) infection is a major public health concern. Globally, 15% of those incarcerated are HCV‐antibody positive (anti‐HCV). Even where HCV treatment is available within prisons, treatment uptake has remained low. This qualitative study was conducted to understand the barriers and facilitators for the delivery of HCV treatment in prisons from the perspectives of prisoners. This is important to inform health messaging for HCV treatment within correctional institutions. Thirty‐two prisoners (including eight women) with a history of injecting drug use participated in this qualitative study. Participants were equally recruited across four correctional centres (n = 8 per site). Overall, 16 participants (50%) had chronic HCV at their most recent test, and two participants were awaiting test results at time of interview. Structural (eg proximity of health clinic) and patient‐level (routine and motivation) factors were viewed as facilitators of HCV treatment within the prison setting. Structural (eg risk of reinfection) and social (eg lack of confidentiality and lack of social support) factors were perceived as barriers to prison‐based HCV care and treatment. In conclusion, to increase HCV treatment uptake, prison‐based programmes should implement (or advocate for) patient‐centred treatment approaches that protect privacy, provide social support, and promote access to clean needles and substitution therapy to protect prisoners from reinfection.
Findings from a large Asian chronic hepatitis C real‐life study
Authors: Lim Seng Gee , Phyo Wah Wah , Shah Samir R. , Win Khin Maung , Hamid Saeed , Piratvisuth Teerha , Tan Soek Siam , Dan Yock Young , Lee Yin Mei , Ahmed Taufique , Yang Wei Lyn , Chen Kok Pun , Kamat Mrunal , Wadhawan Manav , Madan Kaushal , Mehta Rajiv , Shukla Akash , Dhore Prashant , Eapen Chundamannil E. , Abraham Priya , Tyagi Satyendra , Koshy Abraham , Bwa Aung Hlaing , Jafri Wasim , Abid Shahab , Arisar Fakhar Ali Qazi , Tanwandee Tewesak , Yin Thing Phee , Tee Hoi Poh , Hj Md Said Rosaida Binti , Goh Khean Lee , Ho Shiaw Hooi , Mohamed Rosmawati , Abu Bakar Norasiah 
Published: August 2018

SummaryThere is a paucity of information on chronic hepatitis C (CHC) patients treated with direct antiviral agents (DAAs) in Asia. We invited Asia‐Pacific physicians to collate databases of patients enrolled for CHC treatment, recording baseline clinical, virologic and biochemical characteristics, sustained virologic response at week 12 (SVR12) and virologic failure. SVR12 outcome was based on intention to treat (ITT). Multivariate analysis was used to assess independent risk factors for SVR12 using SPSS version 20. A total of 2171 patients from India (n = 977), Myanmar (n = 552), Pakistan (n = 406), Thailand (n = 139), Singapore (n = 72) and Malaysia (n = 25) were collected. At baseline, mean age was 49 years, 50.2% were males, and 41.8% had cirrhosis. Overall, SVR12 was 89.5% and by genotype (GT) based on ITT and treatment completion, respectively, was 91% and 92% for GT1, 100% and 100% for GT2, 91% and 97% for GT3, 64% and 95% for GT4, 87% and 87% for GT6 and 79% and 91% for GT untested. Patients with cirrhosis had SVR12 of 85% vs 93% for noncirrhosis (P < 0.001) (RR 2.1, 95% CI 1.4‐3.1, P = 0.0002). Patients with GT1 and GT3 treated with sofosbuvir/ribavirin (SR) had 88% and 89% SVR12, respectively, but those GT6 treated with sofosbuvir/ledipasvir (SL) had only 77.6% SVR12. Multivariate analysis showed absence of cirrhosis was associated with higher SVR12 (OR 2.0, 95% CI 1.3‐3.1, P = 0.002).In conclusion, patients with GT1 and GT3 with/without cirrhosis had surprisingly high efficacy using SR, suggesting that Asians may respond better to some DAAs. However, poor GT6 response to SL suggests this regimen is suboptimal for this genotype.
Similar recovery of liver function after response to all‐oral HCV therapy in patients with cirrhosis with and without HIV coinfection
Authors: Macías Juan , Granados Rafael , Téllez Francisco , Merino Dolores , Pérez Montserrat , Morano Luis E. , Palacios Rosario , Paniagua María , Frías Mario , Merchante Nicolás , Pineda Juan A. ,   On behalf of the HEPAVIR GEHEP, RIS‐HEP07 study groups
Published: August 2018

SummaryAmong patients with cirrhosis, recovery of liver function after SVR to all‐oral direct‐acting antivirals (DAA) in HIV/HCV coinfection could be different to that in HCV monoinfection. Because of this, we compared the changes in several markers of liver function between HCV‐monoinfected and HIV/HCV‐coinfected patients with cirrhosis who achieved SVR12 to DAA combinations. In this retrospective cohort study, cirrhotics included in the HEPAVIR‐DAA and GEHEP‐MONO cohorts were selected if they had SVR12 to all‐oral DAAs. Patients treated with atazanavir were excluded. Liver function improvement was defined as Child‐Pugh‐Turcotte (CPT) decrease ≥1 and/or MELD decrease ≥2 between baseline and SVR12. Liver function worsening was defined as a CPT increase ≥1 and/or MELD increase ≥2 and/or decompensations between baseline and SVR12. We included 490 patients, 270 (55%) of them with HIV coinfection. Liver function improved in 50 (56%) HCV‐infected individuals and in 82 (57%) HIV/HCV‐coinfected patients (P = 0.835). Liver function worsened in 33 (15%) HCV‐monoinfected patients and in 33 (13%) HIV/HCV‐coinfected patients (P = 0.370). Factors independently related with liver function improvement were male gender [adjusted OR (AOR) 2.1 (95% confidence interval, 95% CI: 1.03‐4.2), P = 0.040], bilirubin < 1.2 mg/dL (AOR 1.8 [95% CI: 1.004‐3.3], P = 0.49), and INR < 1.3 (AOR 2.4 [95% CI: 1.2‐5.0], P = 0.019) at baseline. After multivariate analysis, albumin < 3.5 g/dL was associated with liver function worsening (AOR 6.1 [95% CI: 3‐12.5], P < 0.001). Liver function worsening and improvement rates after responding to DAA are similar among HCV‐monoinfected and HIV/HCV‐coinfected cirrhotics. Gender, INR, bilirubin, and albumin levels were associated with liver function changes after response to DAAs.
High prevalence and diversity of hepatitis B and hepatitis delta virus in Gabon
Authors: Groc Soraya , Abbate Jessica Lee , Le Gal Frédéric , Gerber Athenaïs , Tuaillon Edouard , Albert Jean‐Louis , Nkoghé Dieudonné , Leroy Eric M. , Roche Benjamin , Becquart Pierre 
Published: August 2018

SummaryAlthough central Africa is classified as having a high endemicity of hepatitis B virus (HBV) and hepatitis D virus (HDV) infection, there is paucity of prevalence studies. For the first time on a country‐wide level in Central Africa, we show in Gabon an overall 7.4% prevalence of Hepatitis B surface antigen (HBsAg) and that more than 25% of the HBsAg‐positive population are infected by HDV. Although HBV prevalence did not differ significantly between provinces, there is a north‐south split in the distribution of HDV seroprevalence, with the highest rates (>66.0%) correlating with the presence of specific ethnic groups in the northeastern provinces. Genotyping revealed high genetic diversity of the HBV and HDV strains circulating in Gabon, including many restricted to this region of the globe. This work confirmed that high exposure to HBV and HDV infection reported in selected regions of Gabon holds true across the whole country.
Romantic ecocriticism: History and prospects
Authors: Davies Jeremy 
Published: August 2018

AbstractThis essay examines the origins, development, and future of Romantic ecocriticism. British Romanticism has always been central to discussions of literature and the environment. Here, I offer the most extensive assessment to date of relevant scholarship. I concentrate on book‐length studies of British literature circa 1780–1830, generally excluding books about individual authors. I close by outlining a new agenda for the field. Instead of claiming to reveal the origins of contemporary environmental sensibilities, I argue, Romantic ecocritics should work towards a critical history of regimes of environmental exploitation. Part one of the essay analyses the paths taken and not taken in ecocritical studies of the Romantic period between 1970 and 2000. Part two parses the diversity of Romantic ecocriticism in the early twenty‐first century. Part three argues that Romantic ecocriticism's central concern should be the environmental changes associated with the industrial revolution.
Assisted reproductive technologies in captive rhinoceroses
Authors: Pennington Parker M. , Durrant Barbara S. 
Published: August 2018

Abstract

Survival of the five remaining rhinoceros species is threatened. Four of the five species are in managed collections, but captive populations are not self‐sustaining and low reproductive rates make population growth slow.

Slow population growth, coupled with behavioural incompatibilities, acyclicity, low genetic diversity, and disease susceptibility, creates the need for assisted reproductive technologies (ARTs) to maintain genetic diversity while bolstering population numbers.

Both published and unpublished data are included in this review of ARTs, to facilitate understanding consistencies and variations between and within each rhinoceros species.

Progress has been made to address species‐specific characteristics of reproductive physiology in rhinoceroses. This review outlines the ARTs that have been performed and identifies areas in need of research. In vivo technologies have resulted in live calves by artificial insemination, created genetic reservoirs through semen collection, and provided new avenues of gamete retrieval via ovum pickup. In vitro technologies have enabled genetic rescue post mortem and support early stage embryo production through oocyte maturation and fertilisation.

As conservation efforts focus on rhinoceroses, improvement of existing techniques and development of new technologies will allow for a broader application of successful rhinoceros ARTs.
Mitonuclear genomics challenges the theory of clonality in Trypanosoma congolense: Reply to Tibayrenc and Ayala
Authors: Van den Broeck Frederik , Tavernier Lisse J.M. , Vermeiren Lieve , Dujardin Jean‐Claude , Van Den Abbeele Jan 
Published: August 2018

AbstractWe recently published the first genomic diversity study of Trypanosoma congolense, a major aetiological agent of Animal African Trypanosomiasis. We demonstrated striking levels of SNP and indel diversity in the Eastern province of Zambia as a consequence of hybridization between divergent trypanosome lineages. We concluded that these and earlier findings in T. congolense challenge the predominant clonal evolution (PCE) model. In a recent comment, Tibayrenc and Ayala claim that there are many features in T. congolense supporting their theory of clonality. While we can follow the reasoning of the authors, we also identify major limitations in their theory and interpretations that resulted in incorrect conclusions. First, we argue that each T. congolense subgroup should be analysed independently as they may represent different (sub)species rather than “near‐clades”. Second, the authors neglect major findings of two robust population genetic studies on Savannah T. congolense that provide clear evidence of frequent recombination. Third, we reveal additional events of introgressive hybridization in T. congolense by analysing the maxicircle coding region using next‐generation sequencing analyses. At last, we pinpoint two important misinterpretations by the authors and show that there are no spatially and temporally widespread clones in T. congolense. We stand by our earlier conclusions that the clonal framework is unlikely to accurately model the population structure of T. congolense. Other theoretical frameworks such as Maynard Smith's epidemic model may better represent the complex ancestry seen in T. congolense, where clones delimited in space and time arise against a background of recombination.
Cost share‐induced technological change and Kaldor’s stylized facts
Authors: Kemp‐Benedict Eric 
Published: August 2018

AbstractThis paper presents a theory of induced technological change in which firms pursue a random, local, and bounded search for productivity‐enhancing innovations. Firms implement profitable innovations at fixed prices, which then spread through the economy. After diffusion, all firms adjust prices and wages. The model is consistent with a variety of price‐setting behaviors, which determine equilibrium positions characterized by constant cost shares and productivity growth rates. A fixed mark‐up can yield Marx‐biased technological change. Target‐return pricing yields Harrod‐neutral technological change with a fixed wage share as a stable equilibrium, consistent with Kaldor's stylized facts, while allowing for deviations from equilibrium, as observed in the longer historical record.