bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards a Culture Shift: Advocating for Diversity, Equity, and Inclusion for Women in Child Psychiatry
Authors: Hua Phoebe , Park Valentina , Sinha Sumedha R. , Rahmani Mariam , Khan Christina T. , Richards Misty C. , Hajirnis Aditi
Published: February 2024

“Diversity is being asked to the party. Inclusion is being asked to dance.” – Verna Myers, American activist1. This simple quote captures the essence of diversity and inclusion perfectly. Equity involves understanding a person’s journey, meeting them where they are, and providing what they need to achieve an equal footing in life.
Lay It On Thick
Authors: Ayobello Ayotunde
Published: February 2024

I came across my first clinical case of peripartum depression during adult psychiatry training. I was struck by the debilitating nature of the illness and quickly recognized the immediate impact it had on my patient. As I went on to fellowship training, I recognized, in a way I hadn’t before, the far-reaching, generational impact of the condition. I was sobered by its lasting effects on children – and energized by opportunities to intervene and make a difference in their lives.
When Your Patients Are Binge Watching: Challenges Associated With Streaming Television in Child and Adolescent Psychiatry
Authors: Gansner Meredith
Published: February 2024

Brief Case Illustration: Sierra is a 16-year old girl who is in psychiatric treatment for major depressive disorder without psychotic features. Several months after starting treatment, Sierra’s mother brought her into the office for an urgent safety assessment. Sierra had been sent home from school after reporting new onset command auditory hallucinations to harm herself and perceptions that she was not in control of her body’s actions. Sierra described hearing an unknown male voice that instructed her to kill herself; while Sierra had not acted on this, she was scared that she could no longer keep herself safe. During the emergent psychiatric appointment, Sierra revealed that she first heard the voice shortly after watching the streaming television show Black Mirror on Netflix. Specifically, Sierra had watched the Black Mirror film Bandersnatch, which piloted a novel interactive format where the show’s viewers could direct the actions of the show’s teenage protagonist through use of a remote control, trackpad or computer mouse. Decisions made for the protagonist ranged from choosing his breakfast cereal to choosing to physically assault another character. Sierra’s mother was unaware that her daughter had watched Bandersnatch, and was unfamiliar with the episode’s interactive format. Sierra’s psychiatrist, however, had recently watched Bandersnatch and recognized both the show’s underlying theme of loss of free will and the viewer’s unique ability to “become” the show’s protagonist. Sierra’s psychiatrist explored possible connections between the new symptoms and the show, to which Sierra responded positively. Sierra reported often feeling affected by screen media, but never before for this long or with this symptomatology. Sierra reported significant symptom improvement at the end of the appointment. This acute improvement, coupled with the lack of other indicators of organic psychosis, led the psychiatrist to recommend continued treatment at the outpatient level of care with watchful waiting and increased surveillance. One week following their onset, Sierra’s symptoms resolved without additional intervention.
Using COVID-19 as an Opportunity to Build Collaborations With Schools
Authors: Schreiber Justin , Acharya Ajjya , Mock Christopher , Mejia-Garcia Daniel
Published: February 2024

Within this context, this student developed symptoms of aggression, school absenteeism, suicidal ideation, cutting, and depression. What is more, now with the addition of the COVID-19 pandemic, her once stable institution, school, is removed and she works from home without the typical check-in from teachers and school behavioral health.
Families Pay the Price of False Hope in Parity Enforcement
Authors: Morgan Brian , Rogers Christopher
Published: February 2024

We all see it. The frustration. The fear. The loss of hope in a system that has let them down again and again. Words like “does not meet medical necessity” translate to “your child’s suffering is not that important.” Again. “Not taking new patients” begins to mean “you are on your own.” Again. “Not a covered benefit” becomes “the safety of your children doesn’t

matter.” Again. And again.
Coverage Denied: The Burden of Prior Authorization for Child and Adolescent Psychiatry and the Impacts on Patient Care
Authors: Sica Angelo A. , Koss Debra
Published: February 2024

So, What Went Wrong? COVERAGE was DENIED. The patient’s fluoxetine, one of the most commonly prescribed psychotropic medications with well-established US Food and Drug Administration (FDA) indications, was no longer approved by the patient’s insurance provider due to formulary changes. An integral part of his stabilization was thus not afforded. What resulted was an unfortunate adverse event in which the patient went days and weeks without his medications as a cumbersome administrative appeal took place via a prior authorization (PA) procedure.
Special Issue: Mental Health and Sexual and Gender Minority Youth
Authors: Zelin Nix S.
Published: February 2024

As a third-year medical student, I once made a pediatric patient scream. A young teen with poorly controlled chronic health issues and a difficult home situation, “Alex” had received

no visitors over the preceding 5 days of her hospitalization and made it clear that the medical staff were a poor substitute. As I worked with Alex, she gradually opened up and became curious—about medicine, about what it means to be a medical doctor versus a medical student, and about me—where I was from, what television shows I liked, and if I knew about her favorite YouTube stars.
They Didn’t Teach That in Medical School: Running for Office as a Child and Adolescent Psychiatrist
Authors: Bergquist Avanti , Bergquist Steve
Published: February 2024

As a child psychiatrist, I could see some improvements in individual patients and families with whom I worked, but frustration with the overall system of mental health was leading to burn out. After my husband, Steve Bergquist, was elected to the Washington State House of Representatives, I met Frank Chopp, the Washington State Speaker of the House, who then recruited me for his mental health task force. As a new graduate from child and adolescent psychiatry fellowship, I was able to overcome my “imposter syndrome” and eventually realized I was qualified to participate in this task force. I started to see how influencing policy-making could create change in the system that had been the cause of frustration for me and most importantly, for my patients and families. As I learned about the impact of policy-making on patient care, and saw my husband create important change in the system, I looked for other ways I could create improvements. I began attending school board meetings to learn more about our school district and community, and contemplated running for a position. When a member unfortunately passed away in 2017, I was appointed to the Renton School Board, Director District 2, and subsequently elected to the position in November 2017 after running unopposed.
State-Level Advocacy for the Child and Adolescent Psychiatrist: Changing the Rules of the Game
Authors: Rogers Christopher , Fritsch Sandra
Published: February 2024

Child and adolescent psychiatrists commonly face barriers to treating patients that extend beyond the practice setting. These barriers include lack of available treatment resources and modalities, inadequate support for youth in schools, and paucity of funding or significant stigma in the community. These are all challenges that can be addressed with advocacy efforts. While many practicing child and adolescent psychiatrists may not feel qualified to tackle these social issues, in 2015 the Accreditation Council for Graduate Medical Education (ACGME) set “advocacy competencies” throughout patient care, medical knowledge, and systems-based practice milestones.1 For those who may not feel proficient in advocacy skills, this article will offer guidance on steps clinicians can take to advocate at the local and state level.
Anti-NMDA Receptor Encephalitis: Diagnosis Delayed Is Almost Treatment Denied
Authors: Upadhyay Anu
Published: February 2024

D.M. is a 17-year-old Asian-Indian young woman with no prior psychiatric or medical history. She was in her usual state of health until she began experiencing difficulties with memory, attention, concentration, and erratic sleep patterns. D.M. described herself to her parents as “Not myself…everything is bad…I am going down.” Alarmed, D.M.’s parents brought her to an emergency department (ED) to be evaluated. She was assessed and medically cleared the same day and returned home with a plan to follow up with her primary physician.
Boys’ Club: Sexual Dimorphism in Autism Spectrum Disorder
Authors: Slat Emily A. , Glowinski Anne L.
Published: February 2024

Autism spectrum disorder (ASD) is a complex and heterogeneous disorder of development. Its heterogeneity presents a challenge for the creation of diagnostic criteria that will encompass all affected individuals without misdiagnosing other developmental disorders, or missing individuals entirely. Our current definition recognizes a spectrum of persistent deficits in socialization, communication, and restricted interests/repetitive behaviors.1 Even though DSM guidelines for diagnosis of autism have changed over time, there is a persistent sexual dimorphism in the ASD population, with far more males receiving the diagnosis than females. Sex ratios vary from one study to the next, with an average 4:1 male-to-female ratio across the spectrum.2 However, there is great variation in this sex ratio when patients with ASD are subdivided based on level of function. The high-functioning ASD population, formerly diagnosed with Asperger’s disorder, has a male-to-female ratio of 10:1,3 while children with intellectual disability in addition to ASD have male-to-female ratios much closer to 1:1.3,4 Many explanations for this sexual dimorphism have been proposed, but no single factor can account for this phenomenon.
The Challenge of Bullying Victimization for Adolescents With Autism Spectrum Disorder
Authors: Harrison Marcus A , van Schalkwyk Gerrit
Published: February 2024

Bullying victimization is defined as a repetitive and aggressive behavior that can be physically, socially, and emotionally harmful towards the victim.1 Prior research has identified that youth who lack positive peer interactions and have poor social skills are at greater risk of being bullied.2 However, there has been limited study regarding the nature of bullying specifically among children with autism spectrum disorder (ASD). ASD is a psychiatric diagnosis characterized by impairments in communication and in social interaction and reciprocity, and youth with ASD have been found to have significant challenges in building and maintaining friendships. 3 Perhaps unsurprisingly given these challenges, children with ASD are about four times more likely to experience bullying in their lifetimes when compared to their typically developing peers.2,4 It is therefore vital that clinicians have an understanding of how to assess and address the problem of bullying in this vulnerable population of youth.
Review of Possible Etiologies and Treatment Options in a Teen With Coprophagia
Authors: Giles Candace L.
Published: February 2024

Case: An 18-year-old, single, unemployed Bahamian male with a diagnosis of new-onset schizophrenia was treated with risperidone (Risperdal) on the inpatient unit, then discharged home to his family. Later that day, he became physically aggressive when family members attempted to prevent him from eating his own feces. They physically restrained him until police arrived, after which he was brought to a different hospital, given family members’ continued concerns that the patient was a danger to himself. At the hospital, the patient demonstrated signs of psychosis, including disorganized behaviors, internal preoccupation, and thought blocking. He was laughing and smiling as he spoke both of eating his own feces and of his earlier aggression towards his family members. Given his clinical presentation and concern at that time that he presented an acute danger both to himself and others, the treatment team decided that he required involuntary admission to a psychiatric inpatient unit.
“Holy Psychotherapy, Batman!” Diagnosing Mental Illness in Superheroes
Authors: Miller Keith
Published: February 2024

Superheroes and doctors don’t have the best history. In fact, it was psychiatrist Dr. Frederick Wertham, and not supervillain Dr. Doom, who raised significant concern that comic books were negatively impacting children in his provocative book, Seduction of the Innocent. Although Dr. Wertham nearly destroyed the comic book industry, it thankfully has recovered—as has the relationship between superheroes and the field of medicine. There has been a recent explosion of interest in graphic medicine, the intersection between comics, medical education, and patient care. Comics are now used to deliver public health education, 1-3 to communicate diagnostic criteria and informed consent to patients,4,5 and to help patients process their own illnesses.6,7
The Tarasoff Duty to Warn in Child and Adolescent Psychiatry
Authors: Masters Kim J.
Published: February 2024

Case: “John” is a 15-year-old male being evaluated for the first time by a child and adolescent psychiatrist for depression. During the clinical interview, John says that he has been thinking about killing himself with a rope or a rifle that he uses for target practice. His symptoms have become much more acute in the last week, when his 14-year-old girlfriend told him that she wanted to end their relationship. He says he cannot imagine living without her and is contemplating killing her as well as himself. How should the clinician proceed?
Global Child and Adolescent Psychiatry: Challenges and Opportunities in a Flattening World
Authors: Skokauskas Norbert , Guerrero Anthony P.S. , Milavic Gordana , Leventhal Bennett L.
Published: February 2024

In the December 2012 edition of World Child and Adolescent Psychiatry (World CAP), the e-journal of the World Psychiatric Association, Child and Adolescent Psychiatry Section (WPA-CAP), the late John (“Jack”) F. McDermott, MD, who once chaired the section, concluded in an interview that “[a]s the world is flattening out, we are likely to see… a child and adolescent psychiatry… that becomes more globally encompassing in diagnosis as well as treatment….”1 This article aims to promote his vision of global youth mental health through a review of current WPA-CAP section activities.
Combining Inspiration and Practical Tips to Help Mentees Find Their “Jack”
Authors: Horner Michelle S.
Published: February 2024

Do you have a mentor? Do you want to be a mentor? This issue of JAACAP Connect inspires us to step into mentorship. Having had mentors at many, but not all, stages of my career, it is almost impossible to imagine a successful career without mentorship. However, I spent most of my formative years, including medical school, not realizing what a mentor was or how they could be helpful. I thought mentorship was only for would-be researchers or the elite few. Now I know with certainty: mentorship is for everyone.
It’s a Family Affair: The Professional Family, Mentorship, and Development
Authors: Henderson Schuyler W.
Published: February 2024

There’s a lovely line, attributed to Twain, about how when he was a boy, his father was so ignorant, he couldn’t stand to have him around, but when he reached adulthood, he was astonished at how much the old man had learned. It’s a tender and wry reminder of how the conflict between adulthood and childhood—a mutual distrust, a pessimistic capacity to think the worst and an instinctive contempt—is a two-way street (David Bowie captured

another side in “Changes”: “And these children that you spit on/as they try to change their worlds/are immune to your consultations/they’re quite aware of what they’re going through”).
Intersectionality (or, the Whole I s Greater Than the Sum of Its Parts): Informing Sociocultural Formulation and Improving Mental Health Inequities
Authors: Holmes Patrice Janell
Published: February 2024

A tense climate of race relations, conflict over sociocultural identity, and the ongoing problem of discrimination have been highlighted in recent events across the nation. Children and families fall across a broad spectrum of cultures, ethnic backgrounds, races, genders, and sexual orientations. The conceptualization of these varied identities deepens our understanding of families and their access or barriers to care. As child and adolescent psychiatrists providing care for diverse families, we must consider whether the connection between a given provider and family is culturally appropriate. Is the provider’s conceptualization of the family formed from a full picture, complete with an understanding of their culture, or are key parts excluded through the omission of the unfamiliar? For example, within the social sciences, the concept of intersectionality has been presented as a means of formulating, among other things, relevant aspects of oppression and privilege, given that people’s social standings often expose them to privilege, marginalization, or a combination of the two. Incorporating intersectionality can thus enrich a biopsychosocial formulation of sociocultural identity.1
BEHAVIORAL HEALTH INTEGRATION WITHIN PRIMARY CARE: A PRIMER
Authors: Jeffrey Jessica , Martini D. Richard
Published: February 2024

Behavioral health symptoms are a common presenting complaint within the primary care setting. In fact, behavioral health symptoms account for 15% of chief complaints1 and inform 50% of presentations within outpatient pediatric practices.2 As a universal access point, primary care settings are associated with less stigma of behavioral health treatment among patients than mental health clinics, and are opportune locations to treat psychiatric conditions. Despite the convenience for patients of treating behavioral health symptoms within the primary care setting, barriers to the provision of behavioral healthcare by pediatricians exist. These barriers include short appointment times,3 inadequate reimbursement for behavioral health services,4 limited specialized training in behavioral health issues,1 and challenges to accessing child psychiatrists for consultation.5
“I’M TAKING HER HOME!” FIVE COMMON SCENARIOS OF PARENTAL PSYCHIATRIC HOSPITALIZATION REFUSAL AFTER A CHILD’S SUICIDE ATTEMPT
Authors: Spiegel T. Eric , Glowinski Anne L.
Published: February 2024

Case: A 14-year-old female patient is admitted to a children’s hospital after a suicide attempt. She ingested 40 tablets of acetaminophen 500mg and initially required N-acetylcysteine and observation in the pediatric intensive care unit. She admits to having made another suicide attempt in the past, which her parents did not know about. The patient is later moved to the general pediatrics floor, where her mother repeatedly states she is “ready to take her daughter home now.” When the consulting child psychiatrist, who is meeting the family and the patient for the first time, arrives to conduct an evaluation, the patient’s mother is waiting at the door with her arms crossed, and states immediately: “We’re not going anywhere but home.”
ADDRESSING THE AFTERMATH OF ADVERSE CHILDHOOD EXPERIENCES IN YOUR PRACTICE: A Call to Implement the ACE Score
Authors: Strait Joshua , Gandhi Kevin , Ostrander Brett , Cupit Ginger , Guenther Elisabeth
Published: February 2024

In 2012, there were 3.4 million referrals alleging childhood trauma to Child Protective Services in the United States.1 While this number is startling, it does not include the millions of undocumented cases, nor does it portray the long-term consequences of abuse. Providers of pediatric and adolescent care are on the front lines of identification and prevention of childhood trauma, and without proper tools, health care providers may be ill equipped to address the long-term negative health outcomes.2,3 However, the Adverse Childhood Experiences (ACEs) score is an available and perhaps underutilized tool that can better equip providers to recognize and understand the impact of childhood trauma on physical, mental, and behavioral health.
STAYING RELEVANT IN THE TECHNICAL ERA? There’s an App for That!
Authors: Jojic Mirjana
Published: February 2024

A recent Pew Research Center survey found that nearly 80% of teenagers own cell phones, and more than half have smartphones.1 These advanced computing devices go beyond the basics of phone calls and texting, now allowing teens to quickly communicate with one another via social media sites and instantaneously access information on the Internet. The rapid proliferation of smartphones has not only brought these devices into the mainstream but has led to the development of thousands of apps marketed as productivity, gaming, and most recently therapeutic tools. While some physicians have embraced these technological advancements in their personal lives and practices, others have been left questioning, “There’s a what for that?”
Functionally refined encoding of threat memory by distinct populations of basal forebrain cholinergic projection neurons
Authors: Rajebhosale Prithviraj , Ananth Mala R , Kim Ronald , Crouse Richard , Jiang Li , López-Hernández Gretchen , Zhong Chongbo , Arty Christian , Wang Shaohua , Jone Alice , Desai Niraj S , Li Yulong , Picciotto Marina R , Role Lorna W , Talmage David A
Published: February 2024

Neurons of the basal forebrain nucleus basalis and posterior substantia innominata (NBM/SIp) comprise the major source of cholinergic input to the basolateral amygdala (BLA). Using a genetically encoded acetylcholine (ACh) sensor in mice, we demonstrate that BLA-projecting cholinergic neurons can ‘learn’ the association between a naive tone and a foot shock (training) and release ACh in the BLA in response to the conditioned tone 24 hr later (recall). In the NBM/SIp cholinergic neurons express the immediate early gene, Fos following both training and memory recall. Cholinergic neurons that express Fos following memory recall display increased intrinsic excitability. Chemogenetic silencing of these learning-activated cholinergic neurons prevents expression of the defensive behavior to the tone. In contrast, we show that NBM/SIp cholinergic neurons are not activated by an innately threatening stimulus (predator odor). Instead, VP/SIa cholinergic neurons are activated and contribute to defensive behaviors in response to predator odor, an innately threatening stimulus. Taken together, we find that distinct populations of cholinergic neurons are recruited to signal distinct aversive stimuli, demonstrating functionally refined organization of specific types of memory within the cholinergic basal forebrain of mice.
Replication of “null results” – Absence of evidence or evidence of absence?
Authors: Pawel Samuel , Heyard Rachel , Micheloud Charlotte , Held Leonhard
Published: February 2024

In several large-scale replication projects, statistically non-significant results in both the original and the replication study have been interpreted as a “replication success”. Here we discuss the logical problems with this approach: Non-significance in both studies does not ensure that the studies provide evidence for the absence of an effect and “replication success” can virtually always be achieved if the sample sizes are small enough. In addition, the relevant error rates are not controlled. We show how methods, such as equivalence testing and Bayes factors, can be used to adequately quantify the evidence for the absence of an effect and how they can be applied in the replication setting. Using data from the Reproducibility Project: Cancer Biology, the Experimental Philosophy Replicability Project, and the Reproducibility Project: Psychology we illustrate that many original and replication studies with “null results” are in fact inconclusive. We conclude that it is important to also replicate studies with statistically non-significant results, but that they should be designed, analyzed, and interpreted appropriately.
Thoracic SMARCA4-deficient tumors: a clinicopathological analysis of 52 cases with SMARCA4-deficient non-small cell lung cancer and 20 cases with thoracic SMARCA4-deficient undifferentiated tumor
Authors: Zhou Ping , Fu Yiyun , Tang Yuan , Jiang Lili , Wang Weiya
Published: February 2024

Background

Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a distinct clinicopathological entity with an aggressive clinical course. Additionally, SMARCA4/BRG1 deficiency can be observed in a few patients with non-small cell lung cancer (NSCLC). We aimed to compare the clinicopathological, immunohistochemical and prognostic features of SMARCA4-deficient NSCLC (SMARCA4-dNSCLC) with those of thoracic SMARCA4-UT.

Methods

Patients with BRG1-deficient tumors in the lung or thorax were enrolled in the study from the Department of Pathology of West China Hospital, Sichuan University, from January 2014 to June 2022. We retrospectively collected the clinicopathological and immunohistochemical features and outcomes of these patients.

Results

Seventy-two patients had tumors in the lung or thorax with BRG1-deficient expression, including 52 patients with SMARCA4-dNSCLC and 20 patients with thoracic SMARCA4-UT. Among the patients with SMARCA4-dNSCLC, 98.1% were male, 85.7% were smokers, and 79.5% (35/44) had tumor-node-metas­tasis (TNM) III-IV tumors. Among the patients with thoracic SMARCA4-UT, all were males who smoked, and 93.75% (15/16) had TNM III-IV tumors. Pure solid architecture and necrosis were the predominant pathological features. Rhabdoid morphology was observed in some SMARCA4-dNSCLCs (10/52, 19.2%) and thoracic SMARCA4-UTs (11/20, 55%). In most patients with thoracic SMARCA4-UT, the tumors exhibited scattered weak expression or negative expression of epithelial markers, and positive expression of CD34 and Syn. Overall survival (OS) and progression-free survival (PFS) were not significantly different between patients with SMARCA4-dNSCLC and patients with thoracic SMARCA4-UT (p = 0.63 and p = 0.20, respectively).

Conclusions

Thoracic SMARCA4-DTs include SMARCA4-dNSCLC and thoracic SMARCA4-UT. Both have overlapping clinicopathological features and poor prognosis. We hypothesize that thoracic SMARCA4-UT may be the undifferentiated or dedifferentiated form of SMARCA4-dNSCLC. However, further studies with larger cohorts and longer follow-up periods are needed.
A Concept of Hydroponic System in Horticultural Crops
Authors: Sharma Richa , Barnwal Prashant , Vaishnav Tikam Das , Mishra Saket , Ekka Shashi Kant , Kushwaha Akhilesh
Published: February 2024

In now a day’s soil based cultivation is major difficulties due to different man made reason such as urbanization and industrialization. Hydroponic system such as the deep flow technique, nutrient film technique and aeroponic systems are essential tools in plant factories more over sudden natural disaster, climate change and unlimited use of chemical for agriculture purpose lead to reduction in soil fertility and quality. That’s why scientist have evolved a new alternative approach to the agriculture system is called as hydroponic system.   Hydroponic is a technique of growing plants in a water based and nutrient rich solution by hydroponic large number of crops for plants can be grown easily. The quality of yield and nutritive value of end products produced by hydroponically is generally greater than the natural soil based cultivation. This type of cultivation is diseases free, eco-friendly and growing popularity across the whole world including the both developed and developing countries.
Long-Term Monitoring of Oil Spill Impacted Vegetation in the Niger Delta Region of Nigeria: A Google Earth Engine Derived Vegetation Indices Approach
Authors: Wekpe Vremudia Onyeayana , Idisi Benjamin Evi
Published: February 2024

New and emerging cases of oil spill incidents are reported almost on a weekly basis in the Niger Delta region of Nigeria with accusations and counter-accusations as to the claims made by interested parties on perceived impacts of the spills on the environment and its associated constituents. This study applied the capabilities offered by the Google Earth Engine (GEE) platform to monitor long-term vegetation dynamics as a result of exposure to pollution emanating from crude oil spills in the Niger Delta region of Nigeria. The capabilities offered by GEE provide a platform for rapid access to big data for the assessment of environmental change, especially in the Niger Delta with its difficult terrain and security concerns. This study considered oil spill incidents in vegetated terrestrial locations in the Niger Delta across ten years. Fifteen locations spread across the region with oil spill incidents identified as large incidents being selected (>50 <5000bbl). Results of the statistical analysis performed on the vegetation indices data generated from GEE suggest that the analysis of long-term vegetation indices using GEE can provide a broad view of the impact of oil spills on vegetation over time if the spills are relatively large or the spills are repetitive. However, when the spills were relatively small, there was no statistically significant variation in the spectral signatures of the vegetation over time. This suggests that for large spills, GEE-derived vegetation indices can be a very useful synoptic tool in monitoring oil spill occurrence and impact on vegetated terrestrial environments in the Niger Delta and elsewhere where environmental accessibility is a challenge.
Consideration of the Process of Lymph Node Metastasis in Invasive Breast Cancer With Squamous Cell Differentiation
Authors: Aoki Mayu , Fujii Takaaki , Honda Chikako , Nakazawa Yuko , Ogino Misato , Obayashi Sayaka , Shirabe Ken
Published: February 2024

Background

Breast cancer with squamous differentiation is a relatively rare condition. Clinically, lymph node metastasis is uncommon in metaplastic carcinoma We treated a patient with lymph node metastasis of the ductal carcinoma component of invasive ductal carcinoma with squamous cell differentiation.

Case Report

An 84-year-old postmenopausal Japanese woman had a left-breast mass with an enlarged lymph node in the left axilla. A biopsy revealed an invasive ductal carcinoma with squamous cell differentiation. A left mastectomy with axillary lymph node dissection was performed. The histologic evaluation revealed invasive ductal carcinoma with squamous cell differentiation. One lymph node was positive for metastasis consisting of ductal carcinoma without squamous cell differentiation.

Conclusion

This case suggests that lymph node metastasis in ductal carcinoma with squamous differentiation may first involve the ductal carcinoma component, and then differentiation may occur in the involved lymph nodes. This is an interesting case highlighting the process of the progression of lymph node metastasis in cases with breast cancer with squamous cell differentiation.
A cross‐coupling reference model control algorithm
Authors: Xiao Y. , Zhu K. Y.
Published: May 2005

This paper presents an extended cross‐coupling generalized predictive control algorithm with reference models for multi‐axis coordinated motion systems. It is obtained by minimization of a modified performance index in which the synchronization errors between different motion axes are embedded. Therefore, through adequately adjusting the control parameters the resulting control system may provide an improved performance in terms of tracking and synchronization. An application of the proposed algorithm to an electro‐hydraulic process is completed, and the simulation results demonstrating the good performance are also given. Copyright © 2005 John Wiley & Sons, Ltd.
Identification of high frequency of Y chromosome deletions in patients with sex chromosome mosaicism and correlation with the clinical phenotype and Y‐chromosome instability
Authors: Patsalis Philippos C , Skordis Nicos , Sismani Carolina , Kousoulidou Ludmila , Koumbaris George , Eftychi Christina , Stavrides George , Ioulianos Antonis , Kitsiou‐Tzeli Sophia , Galla‐Voumvouraki Angeliki , Kosmaidou Zoe , Hadjiathanasiou Charalambos G , McElreavey Ken
Published: May 2005

A mosaic karyotype consisting of a 45,X cell line and a second cell line containing a normal or an abnormal Y chromosome is relatively common and is associated with a wide spectrum of clinical phenotypes. The aim of this study was to investigate patients with such a mosaic karyotype for Y chromosome material loss and then study the possible association of the absence of these regions with the phenotype, diagnosis, and Y‐chromosome instability. We studied 17 clinically well‐characterized mosaic patients whose karyotype consisted of a 45,X cell line and a second cell line containing a normal or an abnormal Y chromosome. The presence of the Y chromosome centromere was verified by fluorescence in situ hybridization (FISH) and was then characterized by 44 Y‐chromosome specific‐sequence tagged site (STS) markers. This study identifies a high frequency of Yq chromosome deletions (47%). The deletions extend from interval 5 to 7 sharing a common deleted interval (6F), which overlaps with the azoospermia factor region (AZF) region. This study finds no association between Y‐chromosome loci hosting genes other than SRY, and the phenotypic sex, the diagnosis, and the phenotype of the patients. Furthermore, this study shows a possible association of these deletions with Y‐chromosome instability. © 2005 Wiley‐Liss, Inc.
Gene expression profiling of minor salivary glands clearly distinguishes primary Sjögren's syndrome patients from healthy control subjects
Authors: Hjelmervik Trond Ove R. , Petersen Kjell , Jonassen Inge , Jonsson Roland , Bolstad Anne Isine
Published: May 2005

Objective

To identify gene expression signatures in minor salivary glands (MSGs) from patients with primary Sjögren's syndrome (SS).

Methods

A 16K complementary DNA microarray was used to generate gene expression profiles in MSGs obtained from 10 patients with primary SS and 10 control subjects. The data were analyzed by 2 different strategies, one strict primary analysis and one subanalysis that allowed for inclusion of genes with no signal in more than 3 samples from each group. The results were validated by quantitative reverse transcriptase–polymerase chain reaction techniques.

Results

We found a distinct difference in gene expression levels in MSGs, enabling a simple class prediction method to correctly classify 19 of the 20 samples as either patient or control, based on the top 5 differentially expressed genes. The 50 most differentially expressed genes in the primary SS group compared with the control group were all up‐regulated, and a clear pattern of genes involved in chronic inflammation was found. CXCL13 and CD3D were expressed in ≥90% of primary SS patients and in ≤10% of the controls. Lymphotoxin β, as well as a number of major histocompatibility complex genes, cytokines, and lymphocyte activation factors, manifested its role in the pathogenesis of SS. Numerous type I interferon genes related to virus infection were found among the top 200 genes, with increased expression in primary SS. Interestingly, the expression of carbonic anhydrase II, which is essential in saliva production and secretion, and the apoptosis regulator Bcl‐2–like 2 were down‐regulated in primary SS patients.

Conclusion

We have identified distinct gene expression profiles in MSGs from patients with primary SS that provide new knowledge about groups of genes that are up‐regulated or down‐regulated during disease, constituting an excellent platform for forthcoming functional studies.
The relationship between depression, clinical pain, and experimental pain in a chronic pain cohort
Authors: Giesecke Thorsten , Gracely Richard H. , Williams David A. , Geisser Michael E. , Petzke Frank W. , Clauw Daniel J.
Published: May 2005

Objective

Individuals with chronic pain frequently display comorbid depression, but the impact of symptoms of depression on pain processing is not completely understood. This study evaluated the effect of symptoms of depression and/or clinically diagnosed major depressive disorder (MDD) on pain processing in patients with fibromyalgia (FM).

Methods

Results of quantitative sensory testing and neural responses to equally painful pressure stimuli (measured by functional magnetic resonance imaging [fMRI]) were compared with the levels of symptoms of depression and comorbid MDD among patients with FM.

Results

Neither the level of symptoms of depression nor the presence of comorbid MDD was associated with the results of sensory testing or the magnitude of neuronal activation in brain areas associated with the sensory dimension of pain (primary and secondary somatosensory cortices). However, symptoms of depression and the presence of MDD were associated with the magnitude of pain‐evoked neuronal activations in brain regions associated with affective pain processing (the amygdalae and contralateral anterior insula). Clinical pain intensity was associated with measures of both the sensory dimension of pain (results of sensory testing) and the affective dimension of pain (activations in the insula bilaterally, contralateral anterior cingulate cortex, and prefrontal cortex).

Conclusion

In patients with FM, neither the extent of depression nor the presence of comorbid major depression modulates the sensory‐discriminative aspects of pain processing (i.e., localizing pain and reporting its level of intensity), as measured by sensory testing or fMRI. However, depression is associated with the magnitude of neuronal activation in brain regions that process the affective‐motivational dimension of pain. These data suggest that there are parallel, somewhat independent neural pain‐processing networks for sensory and affective pain elements. The implication for treatment is that addressing an individual's depression (e.g., by prescribing an antidepressant medication that has no analgesic properties) will not necessarily have an impact on the sensory dimension of pain.
Association of the risk of osteoarthritis with high innate production of interleukin‐1β and low innate production of interleukin‐10 ex vivo, upon lipopolysaccharide stimulation
Authors: Riyazi Naghmeh , Slagboom Eline , de Craen Anton J. M. , Meulenbelt Ingrid , Houwing‐Duistermaat Jeanine J. , Kroon Herman M. , van Schaardenburg Dirkjan , Rosendaal Frits R. , Breedveld Ferdinand C. , Huizinga Tom W. J. , Kloppenburg Margreet
Published: May 2005

Objective

In a sibpair study of osteoarthritis (OA) patients, we investigated whether, upon stimulation with lipopolysaccharide (LPS), variations in the innate ex vivo production of interleukin‐1β (IL‐1β), IL‐1 receptor antagonist (IL‐1Ra), IL‐10, and tumor necrosis factor α (TNFα) in whole‐blood assays contribute to the risk of OA.

Methods

Data from 305 patients with OA at multiple sites (hand, knee, hip, and spine), whose median age was 60 years (range 43–79 years), were compared with those from 137 controls. OA was defined in accordance with the American College of Rheumatology criteria. Whole‐blood samples were stimulated with LPS (10 ng/ml). In the supernatants, cytokines were measured by enzyme‐linked immunosorbent assay. Odds ratios (ORs) were used as measures of the relative risk of OA in relation to quartiles of IL‐1β, IL‐1Ra, TNFα, and IL‐10 production. The ORs were adjusted for sex and age, and 95% confidence intervals (95% CIs) were computed using robust standard errors to take into account the intrafamily effect.

Results

Subjects in the highest quartile of IL‐1β and IL‐1Ra had an increased risk of OA (OR 3.3, 95% CI 1.4–7.9 and OR 8.0, 95% CI 3.7–17.4, respectively), while subjects in the lowest quartile of IL‐10 had a 3‐fold increased risk of OA (OR 3.1, 95% CI 1.5–6.5). High innate ex vivo production of TNFα was not associated with an increased risk of OA.

Conclusion

Subjects with a high innate ex vivo production of IL‐1β and IL‐1Ra and low innate ex vivo production of IL‐10 have an increased risk of OA. These results suggest that a proportion of the genetic susceptibility to OA may be encoded for by variations in innate cytokine activity.
Gene therapy targeting the Tie2 function ameliorates collagen‐induced arthritis and protects against bone destruction
Authors: Chen Ying , Donnelly Edwin , Kobayashi Hanako , DeBusk Laura M. , Lin P. Charles
Published: May 2005

Objective

In a previous study, we demonstrated that Tie2 regulates angiogenesis in arthritis. The current study was performed to determine whether systemic delivery of a soluble Tie2 receptor (ExTek) using an adenoviral vector (AdExTek) as a Tie2 inhibitor affects arthritis development and progression in an animal model.

Methods

We used a collagen‐induced arthritis (CIA) mouse model to study the outcome of treatment with either AdExTek or a control vector. The onset, incidence, and severity of arthritis were quantified. Immunohistologic analysis of endothelium obtained from the paws was performed. Bone destruction in paws was analyzed using phase‐contrast radiography.

Results

The data showed that systemic delivery of ExTek before disease development significantly inhibited the onset, incidence, and severity of arthritis. When AdExTek was given after disease onset, the severity of disease in mice treated with AdExTek was significantly lower than that in the control group at 35 days postimmunization, which correlated with significantly diminished angiogenesis in mouse paws. Strikingly, AdExTek treatment protected bone from erosion in the CIA model and reduced levels of RANKL. No differences in collagen‐specific antibodies were detected between these 2 groups.

Conclusion

We demonstrated that blocking Tie2 receptor activation inhibits angiogenesis and arthritis development and protects against bone destruction in a CIA mouse model. These findings identify Tie2 as a therapeutic target for arthritis treatment and imply that interventions designed to target the Tie2 pathway could be clinically beneficial.
An international cohort study of cancer in systemic lupus erythematosus
Authors: Bernatsky S. , Boivin J. F. , Joseph L. , Rajan R. , Zoma A. , Manzi S. , Ginzler E. , Urowitz M. , Gladman D. , Fortin P. R. , Petri M. , Edworthy S. , Barr S. , Gordon C. , Bae S. C. , Sibley J. , Isenberg D. , Rahman A. , Aranow C. , Dooley M. A. , Steinsson K. , Nived O. , Sturfelt G. , Alarcón G. , Senécal J. L. , Zummer M. , Hanly J. , Ensworth S. , Pope J. , El‐Gabalawy H. , McCarthy T. , St. Pierre Y. , Ramsey‐Goldman R. , Clarke A.
Published: May 2005

Objective

There is increasing evidence in support of an association between systemic lupus erythematosus (SLE) and malignancy, but in earlier studies the association could not be quantified precisely. The present study was undertaken to ascertain the incidence of cancer in SLE patients, compared with that in the general population.

Methods

We assembled a multisite (23 centers) international cohort of patients diagnosed as having SLE. Patients at each center were linked to regional tumor registries to determine cancer occurrence. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers. Cancers expected were determined by multiplying person‐years in the cohort by the geographically matched age, sex, and calendar year–specific cancer rates, and summing over all person‐years.

Results

The 9,547 patients from 23 centers were observed for a total of 76,948 patient‐years, with an average followup of 8 years. Within the observation interval, 431 cancers occurred. The data confirmed an increased risk of cancer among patients with SLE. For all cancers combined, the SIR estimate was 1.15 (95% confidence interval [95% CI] 1.05–1.27), for all hematologic malignancies, it was 2.75 (95% CI 2.13–3.49), and for non‐Hodgkin's lymphoma, it was 3.64 (95% CI 2.63–4.93). The data also suggested an increased risk of lung cancer (SIR 1.37; 95% CI 1.05–1.76), and hepatobiliary cancer (SIR 2.60; 95% CI 1.25, 4.78).

Conclusion

These results support the notion of an association between SLE and cancer and more precisely define the risk of non‐Hodgkin's lymphoma in SLE. It is not yet known whether this association is mediated by genetic factors or exogenous exposures.
Development of proteoglycan‐induced arthritis is critically dependent on Fcγ receptor type III expression
Authors: Kaplan Charles D. , Cao Yancia , Verbeek J. Sjef , Tunyogi‐Csapo Miklos , Finnegan Alison
Published: May 2005

Objective

To study the necessity for activating Fcγ receptor types I and III (FcγRI and FcγRIII) in proteoglycan‐induced arthritis (PGIA), a murine model of rheumatoid arthritis, and to determine whether usage of FcγRI or FcγRIII correlates with the Th1 phenotype or the autoantibody isotype in PGIA.

Methods

PGIA was induced by immunizing FcγRI−/−, FcγRIII−/−, and wild‐type (WT) littermate mice with human PG. The development and severity of arthritis were monitored over time. PG‐specific T cell interleukin‐2 (IL‐2) production and B cell antibody responses were assessed. FcγRIII blocking antibodies were used to inhibit arthritis in an adoptive transfer system. Inflammation in the hind paws was evaluated by assessing cytokine and chemokine messenger RNA (mRNA) transcripts by real‐time polymerase chain reaction.

Results

FcγRI−/− mice developed arthritis with similar kinetics and severity as WT littermate controls, whereas FcγRIII−/− mice failed to develop the disease. Both FcγRI−/− and FcγRIII−/− mice produced similar amounts of PG‐specific antibody and IL‐2 as littermate controls. Transfer of arthritis was successfully blocked in mice treated with a blocking antibody against FcγRIII. FcγRIII−/− mice displayed a significant decrease in cytokine and chemokine mRNA transcripts obtained from the hind paws of immunized mice, whereas FcγRI−/− mice demonstrated a similar increase in cytokine and chemokine transcripts as controls.

Conclusion

These results demonstrate that FcγRIII expression is critical to the development of PGIA, and usage of FcγRIII correlates with the IgG1 isotype of the PG‐specific antibody response. FcγRIII expression appears to be important in the effector phase of arthritis, possibly by activating cytokine‐ and chemokine‐secreting cells in the joint.