bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Practical Screener for Deep Vein Thrombosis after Total Hip Replacement
Authors: McNally M.A. , Crone M.D. , Mollan R.A.B. 
Published: May 2019

A new non-invasive screener for the detection of proximal deep vein thrombosis was evaluated in two consecutive series of patients undergoing primary total hip replacement. The system, which utilises computerised strain gauge venous occlusion plethysmography, was simple to use and allowed serial screening of large numbers of patients without complication. Comparison with venography in 112 patients gave a specificity of 96% (106/110) and a sensitivity of 100% (2/2) for clinically important proximal DVT. Based on this study, a larger management study was performed. After total hip replacement, 516 patients were serially screened and all were followed to at least four months (mean 7.6 months) from surgery. Venography was only requested after a positive screening test. The screener correctly identified proximal and major calf thrombi in this group allowing early treatment. There were no fatal pulmonary emboli. This initial assessment suggests that computerised strain gauge plethysmography may be useful in identifying those patients with silent venous thrombosis after total replacement.
Trauma and thyroid-stimulating hormone abnormalities in pediatric patients
Authors: Aggarwal Shefali , Fogel Joshua , Kumar Krishan , Shabbir Nadeem 
Published: May 2019

Background There is limited literature on trauma and endocrine abnormalities in the pediatric trauma setting. Aim We studied demographic, medical history, injury experience, and mortality factors to determine their association with abnormal thyroid-stimulating hormone in pediatric trauma patients. Methods The 414 pediatric trauma patients were from those seen at an emergency department. The primary outcome variable was abnormal thyroid-stimulating hormone. Secondary outcome variables were abnormal high and abnormal low thyroid-stimulating hormone. Predictor variables were demographics (age, sex, race/ethnicity, body mass index), medical history (thyroid disease, diabetes mellitus, autoimmune disease, psychiatric disease), injury experience (injury cause, injury severity score ≥ 15, moderate/severe traumatic brain injury, length of stay), and mortality (mortality, survival probability). Multivariate logistic regression analyses were conducted. Results There were 8.0% ( n = 33) with any abnormal thyroid-stimulating hormone value. In the analysis for abnormal thyroid-stimulating hormone, females (odds ratio:4.95, 95% confidence interval: 2.01, 12.21, p < 0.01) and traumatic brain injury (odds ratio: 8.11, 95% confidence interval: 2.51, 26.16, p < 0.001) were each significantly associated with increased odds. In the analysis for abnormal high thyroid-stimulating hormone (odds ratio: 3.75, 95% confidence interval: 1.37, 10.24, p < 0.05), traumatic brain injury (odds ratio: 11.59, 95% confidence interval: 3.45, 38.97, p < 0.001), and mortality (odds ratio: 35.59, 95% confidence interval: 1.40, 906.57, p < 0.05) were each significantly associated with increased odds. In the analysis for abnormal low thyroid-stimulating hormone, only females (odds ratio: 11.10, 95% confidence interval: 1.26, 97.60, p < 0.05) were significantly associated with increased odds. Conclusion In conclusion, females and traumatic brain injury have increased odds for abnormal thyroid-stimulating hormone. Mortality has increased odds for abnormal high thyroid-stimulating hormone. We suggest that clinicians in the pediatric trauma setting carefully monitor females and traumatic brain injury patients with abnormal thyroid-stimulating hormone.
Stigma: a linguistic analysis of the UK red-top tabloids press’ representation of schizophrenia
Authors: Bowen M , Kinderman P , Cooke A 
Published: May 2019

Aims: Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods: Using corpus linguistic methods, a sample of newspaper articles over a 24-month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, while supported by statistical tests (log-likelihood) to compare the data sets and identify words with a high relative frequency. Results: Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. ‘schizo’) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency ( n = 108) and most commonly to name individuals who had committed acts of violence. Discussion: The study suggests that while the press has largely avoided the use of words that press guidance has steered them away from (e.g. ‘schizo’ and ‘psycho’), they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend with.
Prevalence of visual impairment among school children in three primary schools of Sekela Woreda, Amhara regional state, north-west Ethiopia
Authors: Zelalem Mengistu , Abebe Yekoye , Adamu Yilikal , Getinet Tewodros 
Published: May 2019

Background: Although there are limited studies, recent data are lacking to determine the prevalence of eye problems in Ethiopia accurately and there is no scientific evidence of such study in Sekela Woreda. The purpose of this study was to determine the prevalence of visual impairment among school children in Sekela Woreda, Ethiopia. Methods: The study design was a community-based analytical cross-sectional with a multi-stage cluster random sampling technique from September to November 2016.Visual acuity was tested using Snellen’s “E” chart while color vision was tested using Ishihara chart. The data were analyzed using SPSS version 20 software, and binary logistic regression was used to identify factors associated with visual impairment. Results: A total of 875 participants, 466 (53.3%) males and 409 (46.7%) females, with an age range of 8–18 years were screened for visual acuity and color vision deficiency. The prevalence of visual impairment (visual acuity ⩽ 6/12) in “either eye” was 70 (8.0%). Among these, 37 (52.9%) were males and 33 (41.1%) were females. The prevalence of low vision (visual acuity [Formula: see text]) and blindness (visual acuity < 3/60) in “either eye” were 28 (3.2%) and 10 (1.1%), respectively. Thirty two (3.7%) had mild visual impairment [Formula: see text]. The prevalence of color vision deficiency was 36 (4.1%). Among these, 27 (3%) were males and 9 (1.1%) were females. The variables age (adjusted odds ratio (95% confidence interval) = 1.14 (1.01–1.28) and color blindness (adjusted odds ratio (95% confidence interval) = 3.93(1.69–9.09) were significantly associated with visual impairment. Conclusion: The prevalence of blindness and low vision in school children were higher than the national prevalence in Ethiopia. Increasing age and color defective vision were factors associated with the children’s visual impairment. The Woreda health office ought to work with responsible stakeholders to tackle the situation in early childhood.
Cholesteatoma in a cat
Authors: Alexander Akash , Mahoney Paul , Scurrell Emma , Baines Stephen 
Published: May 2019

Case summary A 14-year-old neutered female Burmese cat was referred for investigation of a caudal oropharyngeal mass. CT showed a thin walled cyst-like structure filling and expanding from the right tympanic bulla. Histopathology showed fragments of mildly dysplastic squamous epithelium and aggregates of keratin. These findings were considered consistent with a diagnosis of cholesteatoma. Relevance and novel information To the best of our knowledge, this is the first reported case of a cholesteatoma in a cat. Cholesteatoma should be considered a differential diagnosis for cats presenting with a caudal oropharyngeal mass, a history of chronic ear disease or a history of previous, surgically managed middle ear disease. Advanced imaging and biopsies should be considered important in the diagnosis of these lesions.
Massage for Symptom Management in Adult Inpatients With Hematologic Malignancies
Authors: Kuon Carla , Wannier Rae , Harrison James , Tague Carolyn 
Published: May 2019

Background Patients undergoing hematopoietic stem cell transplant often suffer from a predictable constellation of side effects related to therapy. Nonpharmacologic treatments for these side effects are attractive adjuncts to therapy due to a low side-effect profile. Objective To develop, implement, and evaluate a pilot program of massage therapy for symptom management in adult patients with hematologic malignancies admitted to the bone marrow transplant (BMT) service at a large academic medical center. Methods A single-arm feasibility study of massage therapy was conducted. Pre- and postintervention surveys were collected to assess the usefulness in management of 7 symptoms. Results Over an 11.5-month period, 109 patients received 142 massage treatments. one in five patients received more than one massage. We received surveys on 134 massage treatments. Patients reported significant reductions in anxiety, distress, fatigue, pain, and tension ( P < .01) and improved sleep as a result of massage therapy. Conclusion Based on this pilot, massage therapy is a feasible and safe intervention to administer during BMT hospitalizations. It proved useful in managing a constellation of 5 side effects including, anxiety, distress, fatigue, pain, and tension.
Hepatic leukemia factor is a novel leukemic stem cell regulator in DNMT3A, NPM1, and FLT3-ITD triple-mutated AML
Authors: Garg Swati , Reyes-Palomares Armando , He Lixiazi , Bergeron Anne , Lavallée Vincent-Philippe , Lemieux Sébastien , Gendron Patrick , Rohde Christian , Xia Jianglong , Jagdhane Prarabdha , Müller-Tidow Carsten , Lipka Daniel B. , Imren Suzan , Humphries R. Keith , Waskow Claudia , Vick Binje , Jeremias Irmela , Richard-Carpentier Guillaume , Hébert Josée , Sauvageau Guy , Zaugg Judith B. , Barabé Frédéric , Pabst Caroline 
Published: May 2019

Abstract
FLT3, DNMT3A, and NPM1 are the most frequently mutated genes in cytogenetically normal acute myeloid leukemia (AML), but little is known about how these mutations synergize upon cooccurrence. Here we show that triple-mutated AML is characterized by high leukemia stem cell (LSC) frequency, an aberrant leukemia-specific GPR56highCD34low immunophenotype, and synergistic upregulation of Hepatic Leukemia Factor (HLF). Cell sorting based on the LSC marker GPR56 allowed isolation of triple-mutated from DNMT3A/NPM1 double-mutated subclones. Moreover, in DNMT3A R882-mutated patients, CpG hypomethylation at the HLF transcription start site correlated with high HLF mRNA expression, which was itself associated with poor survival. Loss of HLF via CRISPR/Cas9 significantly reduced the CD34+GPR56+ LSC compartment of primary human triple-mutated AML cells in serial xenotransplantation assays. HLF knockout cells were more actively cycling when freshly harvested from mice, but rapidly exhausted when reintroduced in culture. RNA sequencing of primary human triple-mutated AML cells after shRNA-mediated HLF knockdown revealed the NOTCH target Hairy and Enhancer of Split 1 (HES1) and the cyclin-dependent kinase inhibitor CDKN1C/p57 as novel targets of HLF, potentially mediating these effects. Overall, our data establish HLF as a novel LSC regulator in this genetically defined high-risk AML subgroup.
The enhancer RNA ARIEL activates the oncogenic transcriptional program in T-cell acute lymphoblastic leukemia
Authors: Tan Shi Hao , Leong Wei Zhong , Ngoc Phuong Cao Thi , Tan Tze King , Bertulfo Fatima Carla , Lim Mei Chee , An Omer , Li Zhenhua , Yeoh Allen Eng Juh , Fullwood Melissa J. , Tenen Daniel G. , Sanda Takaomi 
Published: May 2019

Abstract
The oncogenic transcription factor TAL1 regulates the transcriptional program in T-ALL. ARID5B is one of the critical downstream targets of TAL1, which further activates the oncogenic regulatory circuit in T-ALL cells. Here, we elucidated the molecular functions of the noncoding RNA, ARID5B-inducing enhancer associated long noncoding RNA (ARIEL), in T-ALL pathogenesis. We demonstrated that ARIEL is specifically activated in TAL1+ T-ALL cases, and its expression is associated with ARID5B enhancer activity. ARIEL recruits mediator proteins to the ARID5B enhancer, promotes enhancer-promoter interactions, and activates the expression of ARID5B, thereby positively regulating the TAL1-induced transcriptional program and the MYC oncogene. The TAL1 complex coordinately regulates the expression of ARIEL. Knockdown of ARIEL inhibits cell growth and survival of T-ALL cells in culture and blocks disease progression in a murine xenograft model. Our results indicate that ARIEL plays an oncogenic role as an enhancer RNA in T-ALL.
Patrolling monocytes scavenge endothelial-adherent sickle RBCs: a novel mechanism of inhibition of vaso-occlusion in SCD
Authors: Liu Yunfeng , Zhong Hui , Bao Weili , Mendelson Avital , An Xiuli , Shi Patricia , Chou Stella T. , Manwani Deepa , Yazdanbakhsh Karina 
Published: May 2019

Abstract
Painful vaso-occlusive crisis (VOC) is the most common complication of sickle cell disease (SCD). Increasing evidence suggests that vaso-occlusion is initiated by increased adherence of sickle red blood cells (RBCs) to the vascular endothelium. Thus, the mechanisms that remove endothelial-attached sickle RBCs from the microvasculature are expected to be critical for optimal blood flow and prevention of VOC in SCD. We hypothesized that patrolling monocytes (PMos), which protect against vascular damage by scavenging cellular debris, could remove endothelial-adherent sickle RBCs and ameliorate VOC in SCD. We detected RBC (GPA+)-engulfed material in circulating PMos of patients with SCD, and their frequency was further increased during acute crisis. RBC uptake by PMos was specific to endothelial-attached sickle, but not control, RBCs and occurred mostly through ICAM-1, CD11a, and CD18. Heme oxygenase 1 induction, by counteracting the cytotoxic effects of engulfed RBC breakdown products, increased PMo viability. In addition, transfusions, by lowering sickle RBC uptake, improved PMo survival. Selective depletion of PMos in Townes sickle mice exacerbated vascular stasis and tissue damage, whereas treatment with muramyl dipeptide (NOD2 ligand), which increases PMo mass, reduced stasis and SCD associated organ damage. Altogether, these data demonstrate a novel mechanism for removal of endothelial attached sickle RBCs mediated by PMos that can protect against VOC pathogenesis, further supporting PMos as a promising therapeutic target in SCD VOC.
Osteopontin mediates murine transfusion-related acute lung injury via stimulation of pulmonary neutrophil accumulation
Authors: Kapur Rick , Kasetty Gopinath , Rebetz Johan , Egesten Arne , Semple John W. 
Published: May 2019

AbstractTransfusion-related acute lung injury (TRALI) is one of the leading causes of transfusion-related fatalities and is characterized by the onset of acute respiratory distress within 6 hours upon blood transfusion. Specific therapies are unavailable. Preexisting inflammation is a risk factor for TRALI and neutrophils (polymorphonuclear neutrophils [PMNs]) are considered to be the major pathogenic cells. Osteopontin (OPN) is a multifunctional protein expressed at sites of inflammation and, for example, is involved in pulmonary disorders, can regulate cellular migration, and can function as a PMN chemoattractant. We investigated whether OPN is involved in TRALI induction by promoting PMN recruitment to the lungs. Using a previously established murine TRALI model, we found that in contrast to wild-type (WT) mice, OPN knockout (KO) mice were resistant to antibody-mediated PMN-dependent TRALI induction. Administration of purified OPN to the OPN KO mice, however, restored the TRALI response and pulmonary PMN accumulation. Alternatively, blockade of OPN in WT mice using an anti-OPN antibody prevented the onset of TRALI induction. Using pulmonary immunohistochemistry, OPN could be specifically detected in the lungs of mice that suffered from TRALI. The OPN-mediated TRALI response seemed dependent on macrophages, likely the cellular source of OPN and OPN polymerization, and independent from the OPN receptor CD44, interleukin 6 (IL-6), and other PMN chemoattractants including macrophage inflammatory protein-2 (MIP-2). These data indicate that OPN is critically required for induction of antibody-mediated murine TRALI through localization to the lungs and stimulation of pulmonary PMN recruitment. This suggests that anti-OPN antibody therapy may be a potential therapeutic strategy to explore in TRALI patients.
Sociodemographic and educational characteristics of doctors applying for psychiatry training in the UK: secondary analysis of data from the UK Medical Education Database project
Authors: Lambe Paul J. , Gale Thomas C. E. , Price Tristan , Roberts Martin J. 
Published: May 2019

Aims and methodWorkforce shortages in psychiatry are common worldwide. The international literature provides insights into factors influencing decisions to train in psychiatry but is predominately survey based. This national cohort study aimed to identify the characteristics of doctors who were most likely to apply to psychiatry training programmes. The sample comprised doctors who entered UK medical schools in 2007/8 and who made first-time specialty training applications in 2015. The association between application to psychiatry and doctors' sociodemographic and educational characteristics was examined using multivariable logistic regression.ResultsThose most likely to apply were White, privately educated older doctors with below average performance at medical school.Clinical implicationsTo reduce workforce shortages, psychiatry must make itself more attractive to all doctors, especially those from underrepresented groups such as state-educated Black and minority ethnic individuals. Otherwise, national policies to widen participation in the study of medicine by such groups may exacerbate the current recruitment crisis.
Subsequent Breast Cancer in Female Childhood Cancer Survivors in the St Jude Lifetime Cohort Study (SJLIFE)
Authors: Ehrhardt Matthew J. , Howell Carrie R. , Hale Karen , Baassiri Malek J. , Rodriguez Carol , Wilson Carmen L. , Joshi Surekha S. , Lemond Thomas C. , Shope Sheila , Howell Rebecca M. , Wang Zhaoming , Srivastava Deokumar , Mulrooney Daniel A. , Zhang Jinghui , Robison Leslie L. , Ness Kirsten K. , Hudson Melissa M. 
Published: May 2019

PURPOSE Anthracycline-associated risk for subsequent breast cancer in childhood cancer survivors is hypothesized to be mediated by TP53 mutation-related gene-environment interactions. We characterized treatment/genetic risks and the impact of screening for breast cancer in the St Jude Lifetime Cohort. PATIENTS AND METHODS Female participants underwent risk-based assessments, prior health event validation, chest radiation dosimetry, and whole genome sequencing. Breast biopsy reports were reviewed. A subgroup (n = 139) underwent both breast magnetic resonance imaging and mammography. Multivariable regression was used to calculate hazard ratios (HRs) and 95% CIs. RESULTS Among 1,467 women, 56 developed 68 breast cancers at a median age 38.6 (range, 24.5 to 53.0) years. Cumulative incidences at age 35 years were 1% (no chest radiation) and 8% (≥ 10 Gy of chest radiation). In adjusted models, breast cancer was associated with 20 Gy or more of chest radiation versus none (HR, 7.6; 95% CI, 2.9 to 20.4), anthracycline exposure versus none (1 to 249 mg/m2: HR, 2.6; 95% CI, 1.1 to 6.2; ≥ 250 mg/m2: HR, 13.4, 95% CI, 5.5 to 32.5), and having a breast cancer predisposition gene mutation (HR, 23.0; 95% CI, 7.3 to 72.2). Anthracyclines 250 mg/m2 or greater remained significantly associated with increased risk of breast cancer in models excluding survivors with cancer predisposition gene mutations, chest radiation 10 Gy or greater, or both. Sensitivity/specificity were 53.8%/96.3% for mammography, 69.2%/91.4% for magnetic resonance imaging, and 85.8%/99.7% for dual imaging. Breast cancers detected by imaging and/or prophylactic mastectomy compared with physical findings were more likely to be in situ carcinomas, smaller, without lymph node involvement, and treated without chemotherapy. CONCLUSION Higher doses of anthracyclines are associated with increased risk of breast cancer independent of mutations in known cancer predisposition genes. Surveillance imaging identifies breast cancers less likely to require chemotherapy than those detected by physical findings.
Sex-Specific Association of Circulating Ferritin Level and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Studies
Authors: Jiang Li , Wang Kai , Lo Kenneth , Zhong Yueyang , Yang Aimin , Fang Xuexian , Akezhuoli Hailati , Song Zijun , Chen Liyun , An Peng , Xu Mingqing , Min Junxia , Wang Fudi 
Published: May 2019

AbstractContextAlthough the role of iron in the development of type 2 diabetes (T2D) has long been a concern, prospective studies directly linking body iron stores to T2D risk in a sex-dependent context have been inconsistent.ObjectiveA systematic meta-analysis was conducted to explore the sex-specific association of circulating ferritin with T2D risk.Data SourcesWe searched PubMed, Web of Science, and EMBASE databases to identify available prospective studies through 1 August 2018.ResultsFifteen prospective studies comprising 77,352 participants and 18,404 patients with T2D, aged 20 to 80 years, and with ∼3 to 17 years of follow-up were identified. For each 100-μg/L increment in ferritin levels of overall participants, T2D risk increased by 22% (RR, 1.22; 95% CI, 1.14 to 1.31). Of note, major heterogeneities by sex were identified, with increased ferritin level having an apparently greater effect on T2D risk in women (RR, 1.53; 95% CI, 1.29 to 1.82) than in men (RR, 1.21; 95% CI, 1.15 to 1.27) after exclusion of a study with high heterogeneity (41,512 men and 6974 women for sex-specific analyses; P = 0.020 for sex difference). Further nonlinear analysis between circulating ferritin and T2D risk also showed sex-dimorphic association in that the T2D risk of women was twice as strong in magnitude as that of men at the same ferritin level.ConclusionsGreater circulating ferritin levels were independently associated with increased T2D risk, which appeared stronger among women than men. Our findings provide prospective evidence for further testing of the utility of ferritin levels in predicting T2D risk in a sex-specific manner.