bluuebunny/crossref_metadata_2025_split huggingface dataset:
A pharmacist‐driven antimicrobial stewardship intervention targeting cytomegalovirus viremia in ambulatory solid organ transplant recipients
Authors: Wang Nan , Athans Vasilios , Neuner Elizabeth , Bollinger Jessica , Spinner Michael , Brizendine Kyle 
Published: September 2018

AbstractBackgroundThere is a growing need for robust antimicrobial stewardship interventions in both ambulatory and solid organ transplant (SOT) populations.MethodsA retrospective quasi‐experiment was conducted to evaluate the impact of a pharmacist‐driven antimicrobial stewardship intervention targeting cytomegalovirus (CMV) viremia in ambulatory SOT recipients. The intervention consisted of (a) real‐time CMV DNA surveillance and result notification conducted by the pharmacist and (b) recommendations for the optimization of drug therapy provided at the time of result notification. The intervention period was compared to a pre‐intervention period of usual care. Of 431 adult SOT recipients who had an initial quantifiable CMV viral load in the ambulatory setting, 185 received antiviral induction therapy and were included for analysis.ResultsSignificantly fewer patients in the intervention period reached a CMV viral load >10 000 IU/mL immediately prior to treatment (10.6% vs 27.3%; P = 0.004), and a significantly greater proportion of patients in the intervention period achieved CMV eradication at 21 days (84.5% vs 71.7%; P = 0.038). Additional differences favoring the intervention period were antiviral initiation within 5 days of the first quantifiable CMV DNA (62.4% vs 55.0%; P = 0.02) and time‐to‐CMV eradication (25.5 vs 28.9 days; P = 0.003). Although not significant, there were also numerical reductions in CMV‐related hospital admissions (11.9% vs 19.0%; P = 0.188) and CMV disease (5.9% vs 12.0%; P = 0.151) during the intervention period, as well as fewer episodes of CMV resistance at 1‐year (2.3% vs 4.0%; P = 0.689).ConclusionTogether, these findings suggest a potential role for pharmacist involvement in CMV surveillance and treatment optimization in ambulatory SOT recipients.
Impact of antiretroviral regimen on renal transplant outcomes in HIV‐infected recipients
Authors: Sparkes Tracy , Manitpisitkul Wana , Masters Brian , Bartlett Stephen T. , Davis Charles , Husson Jennifer , Amoroso Anthony , Haririan Abdolreza 
Published: September 2018

AbstractBackgroundProtease inhibitors (PI) pose a challenge post‐transplant due to significant drug interactions with calcineurin inhibitors, prompting many clinicians to convert patients to non‐interacting regimens prior to transplant. The purpose of this study was to examine the impact of PI‐based regimens on graft outcomes in HIV‐infected renal transplant recipients.MethodsIn this retrospective cohort study, 50 HIV‐infected renal allograft recipients (27 receiving a PI regimen, 23 receiving a non‐PI regimen) transplanted between 2003‐2015 were analyzed.ResultsCumulative rejection rates at 12 and 36 months were 41% and 54% in the PI group vs 52% and 86% in the non‐PI group. At last follow‐up, the overall risk of acute rejection in the PI group was 46% lower compared with the non‐PI cohort (P = 0.12). Patients who received a PI‐based regimen had significantly reduced graft failure rates (P = 0.027). There was no difference between groups in the degree of interstitial fibrosis/tubular atrophy, arteriolar hyalinosis, arterial sclerosis, or glomerular sclerosis on available biopsies, despite longer follow‐up time in the PI group.ConclusionsOur study suggests that PI‐based antiretroviral therapy regimens are associated with improved graft survival and that patients can achieve adequate outcomes on a PI‐based regimen when necessary. Due to study limitations, further studies are needed to determine the optimal immunosuppression/antiretroviral therapy regimen post‐transplant.
How Culture and Biology Interact to Shape Language and the Language Faculty
Authors: Smith Kenny 
Published: September 2018

AbstractRecent work suggests that linguistic structure develops through cultural evolution, as a consequence of the repeated cycle of learning and use by which languages persist. This work has important implications for our understanding of the evolution of the cognitive basis for language; in particular, human language and the cognitive capacities underpinning it are likely to have been shaped by co‐evolutionary processes, where the cultural evolution of linguistic systems is shaped by and in turn shapes the biological evolution of the capacities underpinning language learning. I review several models of this co‐evolutionary process, which suggest that the precise relationship between evolved biases in individuals and the structure of linguistic systems depends on the extent to which cultural evolution masks or unmasks individual‐level cognitive biases from selection. I finish by discussing how these co‐evolutionary models might be extended to cases where the biases involved in learning are themselves shaped by experience, as is the case for language.
Sustained vasomotor control of skin microcirculation in Sherpas versus altitude‐naive lowlanders: Experimental evidence from Xtreme Everest 2
Authors: Davies Thomas , Gilbert‐Kawai Edward , Wythe Stephen , Meale Paula , Mythen Monty , Levett Denny , Mitchell Kay , Grocott Michael , Clough Geraldine , Martin Daniel ,   for the Xtreme Everest 2 Research Group
Published: September 2018

New Findings
What is the central question of this study?Do Sherpa highlanders, when exposed to graded hypobaric hypoxia, exhibit enhanced vasomotor and neurovascular control to maintain microcirculatory flux, and thus tissue oxygenation, when compared with altitude‐naive lowlanders?
What is the main finding and its importance?Sherpas, when exposed to hypobaric hypoxia at high altitude, demonstrated superior preservation of their peripheral microcirculatory perfusion, a greater oxygen unloading rate and sustained microvascular reactivity with enhanced vasomotion, when compared with altitude‐naive lowlanders. These differences have not been reported previously and may improve our understanding of the multifactorial responses to sustained environmental hypoxia.
AbstractEnhanced oxygen delivery, consequent to an increased microvascular perfusion, has been postulated to play a key role in the physiological adaptation of Tibetan highlanders to the hypobaric hypoxia encountered at high altitude. We tested the hypothesis that Sherpas, when exposed to graded hypobaric hypoxia, demonstrate enhanced vasomotor and neurovascular control to maintain microcirculatory flux, and thus tissue oxygenation, when compared with altitude‐naive lowlanders. Eighty‐three lowlanders [39 men and 44 women, 38.8 (13.1) years old; mean (SD)] and 61 Sherpas [28 men and 33 women, 27.9 (6.9) years old] were studied on ascent to Everest Base Camp over 11 days. Skin blood flux and tissue oxygen saturation were measured simultaneously using combined laser Doppler fluximetry and white light spectroscopy at baseline, 3500 and 5300 m. In both cohorts, ascent resulted in a decline in the sympathetically mediated microvascular constrictor response (P < 0.001), which was more marked in lowlanders than in Sherpas (P < 0.001). The microvascular dilator response evaluated by postocclusive reactive hyperaemia was significantly greater in Sherpas than in lowlanders at all sites (P < 0.002). Spectral analysis of the blood flux signals revealed enhanced myogenic (vasomotion) activity in Sherpas, which was unaffected by ascent to 5300 m. Although skin tissue oxygenation was lower in Sherpas than in lowlanders, the oxygen unloading rate was faster, and deoxyhaemoglobin levels higher, at all altitudes. Together, these data suggest that Sherpas, when exposed to hypobaric hypoxia, demonstrated superior preservation of peripheral microcirculatory perfusion compared with altitude‐naive lowlanders. The physiological differences in local microvasculature vasomotor and neurovascular control may play a key role in Sherpa adaptation to high‐altitude hypobaric hypoxia by sustaining local perfusion and tissue oxygenation.
Effect of different geographic altitudes on the performance of a conventional solar still with arsenic and boron removal efficiency in an arid zone
Authors: Chavez Yavara Wladimir Antonio , Torres Betzabé Andrea Paiva , Zambra Carlos Enrique Sazo 
Published: September 2018

Objectives: Report the exploratory study results of the performance of a conventional solar still prototype using seawater and brackish water (river and well) at three locations in northern Chile at different geographical heights. Materials and methods: A solar still with an effective distillation area of 0.54 m2 was used. Three tests were performed with seawater, 1 with river water and 1 with well water. The temperatures and environmental parameters were measured every 10 minutes for 36 continuous hours. The efficiency was evaluated in terms of seawater and the capacity to remove natural contaminants from brackish water. Results and discussion: The productivity in the three selected areas was 3 and 4 L/m2 for seawater and brackish water, respectively. The removal of boron and arsenic complies with the regulations of the country. Conclusion: The results obtained are of exploratory character for the zones, where the geographic height and the total dissolved solids are factors that determine the performance of a passive solar still, which is higher when water is used with low concentrations of solids.
Removal of a Membrane Anchor Reveals the Opposing Regulatory Functions of Vibrio cholerae Glucose-Specific Enzyme IIA in Biofilms and the Mammalian Intestine
Authors: Vijayakumar Vidhya , Vanhove Audrey S. , Pickering Bradley S. , Liao Julie , Tierney Braden T. , Asara John M. , Bronson Roderick , Watnick Paula I. 
Published: September 2018

The
V. cholerae
phosphoenolpyruvate phosphotransferase system (PTS) is a well-conserved, multicomponent phosphotransfer cascade that regulates cellular physiology and virulence in response to nutritional signals. Glucose-specific enzyme IIA (EIIA
Glc
), a component of the PTS, is a master regulator that coordinates bacterial metabolism, nutrient uptake, and behavior by direct interactions with protein partners. We show that an amphipathic helix (AH) at the N terminus of
V. cholerae
EIIA
Glc
serves as a membrane association domain that is dispensable for interactions with cytoplasmic partners but essential for regulation of integral membrane protein partners. By removing this amphipathic helix, hidden, opposing roles for cytoplasmic partners of EIIA
Glc
in both biofilm formation and metabolism within the mammalian intestine are revealed. This study defines a novel paradigm for AH function in integrating opposing regulatory functions in the cytoplasm and at the bacterial cell membrane and highlights the PTS as a target for metabolic modulation of the intestinal environment.
Patterns and correlates of use of evidence-based interventions to control diabetes by local health departments across the USA
Authors: Tabak Rachel G , Parks Renee G , Allen Peg , Jacob Rebekah R , Mazzucca Stephanie , Stamatakis Katherine A , Poehler Allison R , Chin Marshall H , Dobbins Maureen , Dekker Debra , Brownson Ross C 
Published: September 2018

ObjectiveThe nearly 3000 local health departments (LHDs) nationwide are the front line of public health and are positioned to implement evidence-based interventions (EBIs) for diabetes control. Yet little is currently known about use of diabetes-related EBIs among LHDs. This study used a national online survey to determine the patterns and correlates of the Centers for Disease Control and Prevention Community Guide-recommended EBIs for diabetes control in LHDs.Research design and methodsA cross-sectional study was conducted to survey a stratified random sample of LHDs regarding department characteristics, respondent characteristics, evidence-based decision making within the LHD, and delivery of EBIs (directly or in collaboration) within five categories (diabetes-related, nutrition, physical activity, obesity, and tobacco). Associations between delivering EBIs and respondent and LHD characteristics and evidence-based decision making were explored using logistic regression models.ResultsAmong 240 LHDs there was considerable variation among the EBIs delivered. Diabetes prevalence in the state was positively associated with offering the Diabetes Prevention Program (OR=1.28 (95% CI 1.02 to 1.62)), diabetes self-management education (OR=1.32 (95% CI 1.04 to 1.67)), and identifying patients and determining treatment (OR=1.27 (95% CI 1.05 to 1.54)). Although all organizational supports for evidence-based decision making factors were related in a positive direction, the only significant association was between evaluation capacity and identifying patients with diabetes and determining effective treatment (OR=1.54 (95% CI 1.08 to 2.19)).ConclusionSupporting evidence-based decision making and increasing the implementation of these EBIs by more LHDs can help control diabetes nationwide.
Longitudinal body weight and sputum conversion in patients with tuberculosis, Southwest Ethiopia: a retrospective follow-up study
Authors: Filate Mersha , Mehari Zelalem , Alemu Yihun Mulugeta 
Published: September 2018

ObjectivesTo describe the association between change in body weight and sputum smear conversion and to identify factors linked with body weight and sputum smear conversion in Jimma University Specialized Hospital, Southwest Ethiopia.DesignA retrospective follow-up study.SettingTeaching hospital in Southwest Ethiopia.ParticipantsA total of 450 patients with tuberculosis (TB) were included in the follow-up between 2011 and 2013.Main outcome measuresThe association between body weight and sputum conversion was measured using joint modelling.ResultsThe association between change in body weight and change in sputum conversion was −0.698 (p<0.001). A strong inverse association between change in body weight and change in sputum conversion was observed. The study variables sex, age, type of TB, HIV status, dose of anti-TB drug and length of enrolment to TB treatment were significantly associated with change in body weight of patients with TB. The study variables age, type of TB, dose of anti-TB drug and length of enrolment were significantly associated with change in sputum status of patients with TB.ConclusionsAmong patients with TB who were on anti-TB treatment, increase in body weight and positive sputum status were inversely related over time. TB prevention and control strategies should give emphasis on factors such as female sex, older age, non-pulmonary positive type of TB, HIV-positive, lower dose of anti-TB drug and length of enrolment to TB treatment during monitoring of trends in body weight and sputum status.
Identifying important health system factors that influence primary care practitioners’ referrals for cancer suspicion: a European cross-sectional survey
Authors: Harris Michael , Vedsted Peter , Esteva Magdalena , Murchie Peter , Aubin-Auger Isabelle , Azuri Joseph , Brekke Mette , Buczkowski Krzysztof , Buono Nicola , Costiug Emiliana , Dinant Geert-Jan , Foreva Gergana , Gašparović Babić Svjetlana , Hoffman Robert , Jakob Eva , Koskela Tuomas H , Marzo-Castillejo Mercè , Neves Ana Luísa , Petek Davorina , Petek Ster Marija , Sawicka-Powierza Jolanta , Schneider Antonius , Smyrnakis Emmanouil , Streit Sven , Thulesius Hans , Weltermann Birgitta , Taylor Gordon 
Published: September 2018

ObjectivesCancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners’ (PCPs’) referral decisions is lacking.This study analyses health system factors potentially influencing PCPs’ referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.DesignBased on a content-validity consensus, a list of 45 items relating to a PCP’s decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs’ referral decision-making.SettingA primary care study; 25 participating centres in 20 European countries.Participants1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.Outcome measuresThe factors derived from items related to PCPs’ referral decision-making. Mean factor scores were produced for each country, allowing comparisons.ResultsFactor analysis identified five underlying factors: PCPs’ ability to refer; degree of direct patient access to secondary care; PCPs’ perceptions of being under pressure; expectations of PCPs’ role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.ConclusionsFive healthcare system factors influencing PCPs’ referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.
Electronic healthcare databases in Europe: descriptive analysis of characteristics and potential for use in medicines regulation
Authors: Pacurariu Alexandra , Plueschke Kelly , McGettigan Patricia , Morales Daniel R , Slattery Jim , Vogl Dagmar , Goedecke Thomas , Kurz Xavier , Cave Alison 
Published: September 2018

ObjectiveElectronic healthcare databases (EHDs) are useful tools for drug development and safety evaluation but their heterogeneity of structure, validity and access across Europe complicates the conduct of multidatabase studies. In this paper, we provide insight into available EHDs to support regulatory decisions on medicines.MethodsEHDs were identified from publicly available information from the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance resources database, textbooks and web-based searches. Databases were selected using criteria related to accessibility, longitudinal dimension, recording of exposure and outcomes, and generalisability. Extracted information was verified with the database owners.ResultsA total of 34 EHDs were selected after applying key criteria relevant for regulatory purposes. The most represented regions were Northern, Central and Western Europe. The most frequent types of data source were electronic medical records (44.1%) and record linkage systems (29.4%). The median number of patients registered in the 34 data sources was 5 million (range 0.07–15 million) while the median time covered by a database was 18.5 years. Paediatric patients were included in 32 databases (94%). Completeness of information on drug exposure was variable. Published validation studies were found for only 17 databases (50%). Some level of access exists for 25 databases (73.5%), and 23 databases (67.6%) can be linked through a personal identification number to other databases with parent–child linkage possible in 7 (21%) databases. Eight databases (23.5%) were already transformed or were in the process of being transformed into a common data model that could facilitate multidatabase studies.ConclusionA Few European databases meet minimal regulatory requirements and are readily available to be used in a regulatory context. Accessibility and validity information of the included information needs to be improved. This study confirmed the fragmentation, heterogeneity and lack of transparency existing in many European EHDs.
Bifurcation Analysis of an Age Structured HIV Infection Model with Both Virus-to-Cell and Cell-to-Cell Transmissions
Authors: Zhang Xiangming , Liu Zhihua 
Published: September 2018

We make a mathematical analysis of an age structured HIV infection model with both virus-to-cell and cell-to-cell transmissions to understand the dynamical behavior of HIV infection in vivo. In the model, we consider the proliferation of uninfected CD[Formula: see text] T cells by a logistic function and the infected CD[Formula: see text] T cells are assumed to have an infection-age structure. Our main results concern the Hopf bifurcation of the model by using the theory of integrated semigroup and the Hopf bifurcation theory for semilinear equations with nondense domain. Bifurcation analysis indicates that there exist some parameter values such that this HIV infection model has a nontrivial periodic solution which bifurcates from the positive equilibrium. The numerical simulations are also carried out.
Induction of Paracrine Signaling in Metastatic Melanoma Cells by PPARγ Agonist Rosiglitazone Activates Stromal Cells and Enhances Tumor Growth
Authors: Pich Christine , Meylan Patrick , Mastelic-Gavillet Beatris , Nguyen Thanh Nhan , Loyon Romain , Trang Bao Khanh , Moser Hélène , Moret Catherine , Goepfert Christine , Hafner Jürg , Levesque Mitchell P. , Romero Pedro , Jandus Camilla , Michalik Liliane 
Published: September 2018

AbstractIn addition to improving insulin sensitivity in type 2 diabetes, the thiazolidinedione family of compounds and the pharmacologic activation of their best-characterized target PPARγ have been proposed as a therapeutic option for cancer treatment. In this study, we reveal a new mode of action for the thiazolidinedione rosiglitazone that can contribute to tumorigenesis. Rosiglitazone activated a tumorigenic paracrine communication program in a subset of human melanoma cells that involves the secretion of cytokines, chemokines, and angiogenic factors. This complex blend of paracrine signals activated nonmalignant fibroblasts, endothelial cells, and macrophages in a tumor-friendly way. In agreement with these data, rosiglitazone promoted human melanoma development in xenografts, and tumors exposed to rosiglitazone exhibited enhanced angiogenesis and inflammation. Together, these findings establish an important tumorigenic action of rosiglitazone in a subset of melanoma cells. Although studies conducted on cohorts of diabetic patients report overall benefits of thiazolidinediones in cancer prevention, our data suggest that exposure of established tumors to rosiglitazone may be deleterious.Significance: These findings uncover a novel mechanism by which the thiazolidinedione compound rosiglitazone contributes to tumorigenesis, thus highlighting a potential risk associated with its use in patients with established tumors. Cancer Res; 78(22); 6447–61. ©2018 AACR.