bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Breast Pain with Malignancy
Authors: Holbrook Anna I , Zhang James , D’amico Kelly , Liu Yuan , Newell Mary S 
Published: July 2019

Abstract

Objective
Breast pain is a common reason for imaging evaluation; however, the limited literature available suggests a low incidence of malignancy with isolated pain. The goal of this study is to calculate the risk of cancer in patients with breast pain, and to compare to the screening mammography cancer detection rates.

Methods
This retrospective, institutional review board–approved study included all patients for whom a breast pain history sheet was filled out between November 3, 2013, and July 28, 2016. Those without at least two years of follow-up were excluded. From the medical record, any malignancy found at the site of pain at presentation or within two years was noted. Screening cancer detection rate was calculated from the mammography tracking software, and the Chi-square test was used to evaluate the significance of the difference between the cancer detection rates in patients with pain versus that detected by screening.

Results
Of 421 patients who met the inclusion criteria, 4 (1.0%) had cancer at the site of pain, with a rate of malignancy of 9.5/1000 (95% CI: 3.5/1000 to 25.2/1000). The screening cancer detection rate was 7.3/1000 (P = 0.403), which was not significantly different. All cancers occurred in patients with coexisting palpable abnormalities; none was found when pain was the only symptom.

Conclusion
The rate of malignancy in patients with breast pain did not differ significantly from that detected by screening mammography. In patients with isolated breast pain without a palpable abnormality, there were no cases of malignancy. Imaging patients for the sole purpose of evaluating breast pain may not be necessary.
Internet-Based Patient Education Prior to Colonoscopy: Prospective, Observational Study of a Single Center’s Implementation, with Objective Assessment of Bowel Preparation Quality and Patient Satisfaction
Authors: Trasolini Roberto , Nap-Hill Estello , Suzuki Matthew , Galorport Cherry , Yonge Jordan , Amar Jack , Bressler Brian , Ko Hin Hin , Lam Eric C S , Ramji Alnoor , Rosenfeld Gregory , Telford Jennifer J , Whittaker Scott , Enns Robert A 
Published: July 2019

Abstract

Background
Nonpharmacologic factors, including patient education, affect bowel preparation for colonoscopy. Optimal cleansing increases quality and reduces repeat procedures. This study prospectively analyzes use of an individualized online patient education module in place of traditional patient education.

Aims
To determine the effectiveness of online education for patients, measured by the proportion achieving sufficient bowel preparation. Secondary measures include assessment of patient satisfaction.

Methods
Prospective, single-center, observational study. Adults aged 19 years and over, with an e-mail account, scheduled for nonurgent colonoscopy, with English proficiency (or someone who could translate for them) were recruited. Demographics and objective bowel preparation quality were collected. Patient satisfaction was assessed via survey to assess clarity and usefulness of the module.

Results
Nine hundred consecutive patients completed the study. 84.6% of patients achieved adequate bowel preparation as measured by Boston bowel preparation score ≥ 6 and 90.1% scored adequately using Ottawa bowel preparation score ≤7. 94.2% and 92.1% of patients rated the web-education module as ‘very useful’ and ‘very clear’, respectively (≥8/10 on respective scales).

Conclusions
Our analysis suggests that internet-based patient education prior to colonoscopy is a viable option and achieves adequate bowel preparation. Preparation quality is comparable to previously published trials. Included patients found the process clear and useful. Pragmatic benefits of a web-based protocol such as time and cost savings were not formally assessed but may contribute to greater satisfaction for endoscopists and patients.
Myeloperoxidase Deficiency Manifesting as Pseudoneutropenia with Low Mean Peroxidase Index and High Monocyte Count in 4 Adult Patients
Authors: Roh Soongki , Ham Ji Yeon , Song Kyung Eun , Hwang Narae , Lee Nan Young 
Published: July 2019

Abstract
Myeloperoxidase (MPO) deficiency, one of the most common inherited phagocyte defects, and may exist as a transient phenomenon in combination with some clinical condition. Hematological analyzer ADVIA 2120i is used to identify the different types of leukocytes based on their size and staining properties, and by mean peroxidase index (MPXI). When MPO deficiency is present, neutrophils may be incorrectly counted as monocytes with lower MPXI values. We encountered a few cases of MPO deficiency with abnormally high monocytes counts resulting in pseudoneutropenia. These abnormal reports could lead to a mistaken diagnosis of severe neutropenia, which could result in unnecessary therapy. Manual differential count exhibited the normal differential count in every case. Every case yielded a markedly low MPXI value below -20. In conclusion, we suggest that MPO deficiency must be considered in patients especially when abnormally high monocyte counts combined with low MPXI values are observed.
The Troubled Friendship of Clemens Brentano and Rahel Levin in the Shadow of the Christlich-deutsche Tischgesellschaft*
Authors: Hertz Deborah 
Published: July 2019

Abstract
This article reconstructs the friendship between the Romantic author Clemens Brentano and the Jewish salonnière Rahel Levin, and explores her motivations for maintaining a friendship with him in spite of his public and private attacks on contemporary Jews, including her. Through analysis of his 1811 speech at the Christlich-deutsche Tischgesellschaft and the letters they exchanged, the article shows how limited Levin’s options were for balancing her identity as a Jew with her social and intellectual ambitions.
Oxford Handbook of Psychiatry
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This fourth edition of what has become an indispensable pocket guide to general psychiatry and the subspecialties continues to provide portable reassurance to health professionals at all levels of experience when dealing with psychiatric issues. As well as a comprehensive overview of the common presentations in psychiatry, this handbook includes practical guidance on the principles of management for individual conditions. Subspecialties, including old age psychiatry, substance misuse, child and adolescent psychiatry, forensic psychiatry, intellectual disability, liaison psychiatry, and psychotherapy are covered in separate chapters, as are overarching considerations such as legal issues, cultural context, and therapeutics. As in previous editions, the handbook is indexed alphabetically, by ICD-10/DSM-5 codes, and by acute presentations for quick access to topics. The text is peppered with clinical observations, guidance, and commentary, reflecting the authors’ own experiences of working in psychiatry. This new edition has been thoroughly revised and updated to include the latest clinical guidelines, new licensed drug indications, changes to the legislature impacting on psychiatric practice across the United Kingdom and Ireland, the new DSM-5 classification system, and the anticipated ICD-11 changes to diagnostic coding.
Neuropsychiatry
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This chapter covers neuropsychiatry in the medical sense (behavioural neurology and neuropsychiatry). Starting with the psychiatric presentations of organic illness and neurological examinations and investigations in psychiatry, it covers movement disorders, neurodevelopmental disorders, epilepsy, Parkinson’s disease and other related syndromes, and the psychiatric effects of central nervous system infections and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Outlining both the aetiology and treatment for dementia and Alzheimer’s disease, other specific neurodegenerative conditions are also featured.
Depressive illness
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This chapter covers depression. After a historical perspective, it describes the symptoms, caseness, and clinical presentations to aid in diagnosis. Epidemiology and aetiology of the disease are both covered, and specific investigations for diagnosis are outlined. The course and prognosis are discussed, and management principles are covered. Both inpatient and outpatient treatment are covered. Treatment methods for depression both with and without psychotic features are defined, and treatment-resistant depression management is also discussed. Antidepressants, including schedules for swapping or stopping drugs, are covered, including tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs), as well as assorted other pharmaceutical interventions. Electroconvulsive therapy (ECT) is covered in detail.
Eating and impulse-control disorders
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This chapter covers eating disorders. For anorexia nervosa, an overview, the physical consequences, methods of assessment, and in- and outpatient management are discussed. Similarly, the definitions and management for bulimia are also described, with a brief overview of binge eating disorder. Impulse-control disorders are subsequently defined, from pyromania, kleptomania, and intermittent explosive disorder to gambling and trichotillomania. Newer addictive disorders, such as gaming disorder, are also covered.
Personality disorders
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This chapter covers personality disorders, using the framework of defining a ‘normal’ personality to classify different disorders. Psychopathy and severe personality disorder are defined, including assessment, diagnosis, and aetiology of these disorders. The relationship between personality disorders and other mental health conditions are discussed, and assessment is also described. Management is described, from general aspects to specific pharmacological treatments and psychotherapy.
Old age psychiatry
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This chapter covers old age psychiatry, including both psychiatric illnesses in older people and specific aspects of illness with regard to the elderly, from neuroses and psychoses to mood disorders. New disorders owing to specific old age-related issues, such as bereavement, isolation, and the changing physiology of the brain, are covered, as well as pre-existing illnesses in the ageing patient. The increasing recognition of elder abuse is defined, and responses outlined. End of life considerations, such as power of attorney and advanced directives, are included.
Liaison psychiatry
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
This chapter concerns liaison psychiatry and the assessment and management of psychiatric and psychological illnesses in the general medical population. It covers the 12 most common referral types, assessment of depressive and anxiety symptoms, psychotic symptoms and confusion, depression in physical illness, delirium, and management after self-harm. Focusing on capacity and consent, as well as differential diagnoses and potential management principles for medically unexplained symptoms, it covers the basis of working as a psychiatrist in a hospital.
Difficult and urgent situations
Authors: Semple David , Smyth Roger 
Published: July 2019

Abstract
Covering difficult and emergency situations encountered in psychiatric practice, this chapter informs the reader how to deal with crisis situations. It includes suggestions for dealing with patients responding to paranoid delusions, antisocial or borderline traits, the depressed person, and those experiencing acute stress. A multidisciplinary approach to suicide attempts in hospital is detailed. Severe behavioural disturbance and guidelines for rapid tranquillization (RT) are also covered. Issues of child protection and how to deal with patients who are manipulative or act against medical advice, and common clinical scenarios are all discussed.
Screening
Authors: Raffle Angela E. , Mackie Anne , Gray J. A. Muir 
Published: July 2019

Abstract
Muir Gray, Anne Mackie and Angela Raffle have been at the forefront of achieving improvements in UK screening over recent years, and they bring a wealth of experience to this non-technical introductory guide covering all aspects of screening. As USA expert Gilbert Welch describes it, this book is “A readable yet encyclopaedic guide to screening: its history, its key design elements, its implementation and policy challenges… A must read for clinicians, managers, and policy makers who would like to assist Raffle Mackie and Gray in achieving their goal: ‘to sort out the mess’.” The first four chapters deal with concepts, methods and evidence, explaining what screening is and how it is evaluated. Chapters five to eight describe practical aspects, for example how to make policy, and how to deliver screening to a high standard. The book includes numerous examples and real-life case histories, giving important reminders of the need to be vigilant for the hidden influence of commercial incentives and ‘bad science’ if we are to achieve best value health and healthcare. A comprehensive glossary makes medical terms accessible to all, and each chapter concludes with a summary and self-test questions. Reference is made to the UK National Health Service, a leader in screening, but the book is internationally relevant because the principles of good screening apply in any setting. The controversies, paradoxes, uncertainties, and ethical dilemmas of screening are explained in a balanced way.
What screening is, and is not
Authors: Raffle Angela E. , Mackie Anne , Gray J. A. Muir 
Published: July 2019

Abstract
This chapter reviews the different ways in which the term ‘screening’ has been and is used, and defines the meaning used throughout the rest of the book. Growth of screening programmes in the twentieth century led to a range of activities which vary widely in purpose and process, from bloodspot tests in newborn babies, through to whole body scans for the wealthy worried well. This chapter explains the different kinds of testing done on healthy people, and how these differ from diagnostic tests for solving problems that patients bring to clinicians. It explains where screening fits in the pathway of disease development. It describes the basic system that makes up a screening programme as opposed to just a screening test. It explains, using infant phenylketonuria as a case history, why screening needs to be delivered as a proper programme if it is to successfully achieve risk reduction. We describe the variation in screening delivery across different countries and emphasise that this book focuses on systematic screening programmes, aimed at risk reduction for the screened individual, based on sound evidence that harm, benefit and affordability are well balanced, and delivered to pre-agreed policy and standards.
Formation of Second Generation Stars in Globular Clusters
Authors: Calura F , D’Ercole A , Vesperini E , Vanzella E , Sollima A 
Published: July 2019

Abstract
By means of grid-based, 3D hydrodynamical simulations we study the formation of second generation (SG) stars in a young globular cluster (GC) of mass 107 M⊙, the possible progenitor of an old GC with a present mass ∼ (1 − 5) 106 M⊙. The cluster accretes external gas as its first generation (FG) asymptotic giant branch (AGB) stars release their ejecta and SG stars form. We consider two models characterised by different densities of the external gas. In both cases, we find that a very compact SG subsystem with central density >105 M⊙/pc3 forms in the innermost regions of the cluster. The low-density model forms a population of extreme SG stars with high helium enhancement, followed by the formation of another SG group out of a mix of pristine gas and AGB ejecta and characterised by a modest helium enhancement. On the other hand, the high-density model forms in prevalence SG stars with modest helium enhancement. Our simulations illustrate the dynamical processes governing the formation of SG populations in GCs and shed light on the structural properties emerging at the end of this phase. The newly born SG groups have different concentrations, with more extreme SG stars more centrally concentrated than those with less extreme chemical abundances. The very high density of the SG subsystems implies that SG massive stars, if formed, might suffer frequent close encounters, collisions and gas stripping, thus possibly contributing further gas to the SG formation.
The supernova-regulated ISM – VI. Magnetic effects on the structure of the interstellar medium
Authors: Evirgen C C , Gent F A , Shukurov A , Fletcher A , Bushby P J 
Published: July 2019

ABSTRACT
We explore the effect of magnetic fields on the vertical distribution and multiphase structure of the supernova-driven interstellar medium in simulations that admit dynamo action. As the magnetic field is amplified to become dynamically significant, gas becomes cooler and its distribution in the disc becomes more homogeneous. We attribute this to magnetic quenching of vertical velocity, which leads to a decrease in the cooling length of hot gas. A non-monotonic vertical distribution of the large-scale magnetic field strength, with the maximum at |z| ≈ 300 pc causes a downward pressure gradient below the maximum which acts against outflow driven by SN explosions, while it provides pressure support above the maximum.
Linking long- and short-term emission variability in pulsars
Authors: Brook P R , Karastergiou A , Johnston S 
Published: July 2019

ABSTRACT
It is now known that the emission from radio pulsars can vary over a wide range of time-scales, from fractions of seconds to decades. However, it is not yet known if long- and short-term emission variability are caused by the same physical processes. It has been observed that long-term emission variability is often correlated with rotational changes in the pulsar. We do not yet know if the same is true of short-term emission variability, as the rotational changes involved cannot be directly measured over such short time-scales. To remedy this, we propose a continuous pulsar monitoring technique that permits the statistical detection of any rotational changes in nulling and mode-changing pulsars with certain properties. Using a simulation, we explore the range of pulsar properties over which such an experiment would be possible.
Vitamin C protects carboplatin-exposed oocytes from meiotic failure
Authors: Zhou Changyin , Zhang Xue , Zhang Yuwei , ShiYang Xiayan , Li Yu , Shi Xiaoyan , Xiong Bo 
Published: July 2019

AbstractCBP (carboplatin) is a second-generation chemotherapeutic drug of platinum compound commonly applied in the treatment of sarcomas and germ cell tumours. Although it is developed to replace cisplatin, which has been proven to have a variety of side effects during cancer treatment, CBP still exhibits a certain degree of toxicity including neurotoxicity, nephrotoxicity, hematotoxicity and myelosuppression. However, the underlying mechanisms regarding how CBP influences the female reproductive system especially oocyte quality have not yet been fully determined. Here, we report that CBP exposure led to the oocyte meiotic defects by impairing the dynamics of the meiotic apparatus, leading to a remarkably aberrant spindle organisation, actin polymerisation and mitochondrial integrity. Additionally, CBP exposure caused compromised sperm binding and fertilisation potential of oocytes by due to an abnormal distribution of cortical granules and its component ovastacin. More importantly, we demonstrated that vitamin C supplementation prevented meiotic failure induced by CBP exposure and inhibited the increase in ROS levels, DNA damage accumulation and apoptotic incidence. Taken together, our findings demonstrate the toxic effects of CBP exposure on oocyte development and provide a potential effective way to improve the quality of CBP-exposed oocytes in vitro.
PUB4, a CERK1-Interacting Ubiquitin Ligase, Positively Regulates MAMP-Triggered Immunity in Arabidopsis
Authors: Desaki Yoshitake , Takahashi Shohei , Sato Kenta , Maeda Kanako , Matsui Saki , Yoshimi Ikuya , Miura Takaki , Jumonji Jun-Ichi , Takeda Jun , Yashima Kohei , Kohari Masaki , Suenaga Takayoshi , Terada Hayato , Narisawa Tomoko , Shimizu Takeo , Yumoto Emi , Miyamoto Koji , Narusaka Mari , Narusaka Yoshihiro , Kaku Hanae , Shibuya Naoto 
Published: July 2019

Abstract
Lysin motif (LysM) receptor-like kinase CERK1 is a co-receptor essential for plant immune responses against carbohydrate microbe-associated molecular patterns (MAMPs). Concerning the immediate downstream signaling components of CERK1, receptor-like cytoplasmic kinases such as PBL27 and other RLCK VII members have been reported to regulate immune responses positively. In this study, we report that a novel CERK1-interacting E3 ubiquitin ligase, PUB4, is also involved in the regulation of MAMP-triggered immune responses. Knockout of PUB4 resulted in the alteration of chitin-induced defense responses, indicating that PUB4 positively regulates reactive oxygen species generation and callose deposition but negatively regulates MAPK activation and defense gene expression. On the other hand, detailed analyses of a double knockout mutant of pub4 and sid2, a mutant of salicylic acid (SA) synthesis pathway, showed that the contradictory phenotype of the pub4 mutant was actually caused by abnormal accumulation of SA in this mutant and that PUB4 is a positive regulator of immune responses. The present and recent findings on the role of PUB4 indicate that PUB4 is a unique E3 ubiquitin ligase involved in the regulation of both plant immunity and growth/development.
Cardiovascular autonomic dysfunction, altered sleep architecture, and muscle overactivity during nocturnal sleep in pediatric patients with narcolepsy type 1
Authors: Vandi Stefano , Rodolfi Sara , Pizza Fabio , Moresco Monica , Antelmi Elena , Ferri Raffaele , Mignot Emmanuel , Plazzi Giuseppe , Silvani Alessandro 
Published: July 2019

AbstractStudy ObjectivesArterial blood pressure (ABP) decreases during sleep compared with wakefulness and this change is blunted in mouse models of and adult patients with narcolepsy type 1 (NT1). We tested whether: (1) pediatric patients with NT1 have similar cardiovascular autonomic abnormalities during nocturnal sleep; and (2) these abnormalities can be linked to hypocretin-1 cerebrospinal fluid concentration (CSF HCRT-1), sleep architecture, or muscle activity.MethodsLaboratory polysomnographic studies were performed in 27 consecutive drug-naïve NT1 children or adolescents and in 19 matched controls. Nocturnal sleep architecture and submentalis (SM), tibialis anterior (TA), and hand extensor (HE) electromyographic (EMG) activity were analyzed. Cardiovascular autonomic function was assessed through the analysis of pulse transit time (PTT) and heart period (HP).ResultsPTT showed reduced lengthening during total sleep and REM sleep compared with nocturnal wakefulness in NT1 patients than in controls, whereas HP did not. NT1 patients had altered sleep architecture, higher SM EMG during REM sleep, and higher TA and HE EMG during N1–N3 and REM sleep when compared with controls. PTT alterations found in NT1 patients were more severe in subjects with lower CSF HRCT-1, but did not cluster or correlate with sleep architecture alterations or muscle overactivity during sleep.ConclusionOur results suggest that pediatric NT1 patients close to disease onset have impaired capability to modulate ABP as a function of nocturnal wake–sleep transitions, possibly as a direct consequence of hypocretin neuron loss. The relevance of this finding for cardiovascular risk later in life remains to be determined.