bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell-Specific Effects of GATA (GATA Zinc Finger Transcription Factor Family)-6 in Vascular Smooth Muscle and Endothelial Cells on Vascular Injury Neointimal Formation
Authors: Zhuang Tao , Liu Jie , Chen Xiaoli , Pi Jingjiang , Kuang Yashu , Wang Yanfang , Tomlinson Brain , Chan Paul , Zhang Qi , Li Ying , Yu Zuoren , Zheng Xiangjian , Reilly Muredach , Morrisey Edward , Zhang Lin , Liu Zhongmin , Zhang Yuzhen 
Published: April 2019

Objective—
Transcription factor GATA (GATA zinc finger transcription factor family)-6 is highly expressed in vessels and rapidly downregulated in balloon-injured carotid arteries and viral delivery of GATA-6 to the vessels limited the neointimal formation, however, little is known about its cell-specific regulation of in vivo vascular smooth muscle cell (VSMC) phenotypic state contributing to neointimal formation. This study aims to determine the role of vascular cell-specific GATA-6 in ligation- or injury-induced neointimal hyperplasia in vivo.

Approach and Results—
Endothelial cell and VSMC-specific GATA-6 deletion mice are generated, and the results indicate that endothelial cell-specific GATA-6 deletion mice exhibit significant decrease of VSMC proliferation and attenuation of neointimal formation after artery ligation and injury compared with the wild-type littermate control mice. PDGF (platelet-derived growth factor)-B is identified as a direct target gene, and endothelial cell-GATA-6-PDGF-B pathway regulates VSMC proliferation and migration in a paracrine manner which controls the neointimal formation. In contrast, VSMC-specific GATA-6 deletion promotes injury-induced VSMC transformation from contractile to proliferative synthetic phenotype leading to increased neointimal formation. CCN (cysteine-rich 61/connective tissue growth factor/nephroblastoma overexpressed family)-5 is identified as a novel target gene, and VSMC-specific CCN-5 overexpression in mice reverses the VSMC-GATA-6 deletion-mediated increased cell proliferation and migration and finally attenuates the neointimal formation.

Conclusions—
This study gives us a direct in vivo evidence of GATA-6 cell lineage-specific regulation of PDGF-B and CCN-5 on VSMC phenotypic state, proliferation and migration contributing to neointimal formation, which advances our understanding of in vivo neointimal hyperplasia, meanwhile also provides opportunities for future therapeutic interventions.
Safety and Outcome of Intravenous Thrombolysis in Stroke Patients on Prophylactic Doses of Low Molecular Weight Heparins at Stroke Onset
Authors: Cooray Charith , Mazya Michael , Mikulik Robert , Jurak Lubomir , Brozman Miroslav , Ringleb Peter , Dixit Anand , Toni Danilo , Ahmed Niaz 
Published: April 2019

Background and Purpose—
There are limited data on intravenous thrombolysis treatment in patients with ischemic stroke who have received prophylactic doses of low molecular weight heparins (LMWHs). We aimed to evaluate the safety and outcomes of intravenous thrombolysis treatment in stroke patients taking thromboprophylactic doses of LMWH.

Methods—
We analyzed 109 291patients treated with intravenous thrombolysis, recorded in the Safe Implementation of Treatments in Stroke International Thrombolysis Register between 2003 and 2017 not taking oral anticoagulants or therapeutic doses of heparin at stroke onset. One thousand four hundred eleven patients (1.3%) were on prophylactic LMWH for deep venous thrombosis prevention. Outcome measures were symptomatic intracerebral hemorrhage, parenchymal hematoma, death within 7 days and 3 months, and functional dependency at 3 months.

Results—
Patients on LMWH were older, had more severe strokes, more prestroke disability, and comorbidities than patients without LMWH. There was no significant increase in adjusted odds ratios (aOR) for symptomatic intracerebral hemorrhage (aOR, 1.02 [95% CI, 0.48–2.17] as per Safe Implementation of Treatments in Stroke -MOST, aOR, 0.95 [0.59–1.53] per ECASS II]), nor for 7-day mortality (aOR, 1.14 [0.82–1.59]), in the prophylactic LMWH group. The LMWH group had a higher aOR for 3-month mortality (aOR, 1.94 [1.49–2.53]) and functional dependency, aOR, 1.44 (1.10–1.90). Propensity score analysis matching patients on baseline characteristics removed differences between groups on all outcomes except 3-month mortality.

Conclusions—
Intravenous thrombolysis in patients with acute ischemic stroke on treatment with prophylactic doses of LMWH at stroke onset is not associated with an increased risk of symptomatic intracerebral hemorrhage or early death.
Numerical Simulations of Seasonal Variations of Rainfall over the Island of Hawaii
Authors: Huang Yu-Fen , Chen Yi-Leng 
Published: April 2019

AbstractThe seasonal variations of rainfall over the island of Hawaii are studied using the archives of the daily model run from the fifth-generation Pennsylvania State University–NCAR Mesoscale Model (MM5) from June 2004 to February 2010. Local effects mainly drive the rainfall on the Kona coast in the early morning and the lower slopes in the afternoon. During the summer, the incoming trade winds are more persistent and moister than in winter. The moisture content in the wake zone is higher than open-ocean values because of the convergent airflow associated with dual counterrotating vortices. As the westerly reversed flow moves toward the Kona coast, it decelerates with increasing moisture and a moisture maximum over the coastal area, especially in the afternoon hours in summer months. The higher afternoon rainfall on the Kona lower slopes in summer than in winter is caused by a moister (>6 mm) westerly reversed flow bringing moisture inland and merging with a stronger upslope flow resulting from solar heating. Higher nocturnal rainfall off the Kona coast in summer than in winter is caused by the low-level convergence between a moister westerly reversed flow and offshore flow. On the windward slopes, the simulated rainfall accumulation in winter is higher because of frequently occurring synoptic disturbances during the winter storm season. Nevertheless, early morning rainfall along the windward coast and afternoon rainfall over the windward slopes of the Kohala Mountains is lower in winter because the incoming trades are drier.
Interruptions and Delivery of Care in the Intensive Care Unit
Authors: Drews Frank A. , Markewitz Boaz A. , Stoddard Gregory J. , Samore Matthew H. 
Published: April 2019

Objective: This study samples interruption frequency in intensive care unit (ICU) settings to assess the relationship between interruptions and common patient hazards. Background: Task interruptions are accident contributors in numerous industries. Recently, studies on health care interruptions and their impact on patient hazards have received attention. Method: Seven ICUs in four hospitals participated in a 24-month study. Experienced ICU nurses directly observed nursing tasks, interruptions, and patient hazards (delays in care, breaks in device task protocols, and patient safety hazards). Results: During 1,148 hours of observation, 175 nurses performed 74,733 nursing tasks. Interruptions occurred at a rate of 4.95 per hour, and 8.4% of tasks were interrupted. Interruptions originated mostly from humans (65.9%), alarms (24.1%), and others (10%). A total of 774 patient hazards were observed, with a hazard occurring on average every 89 minutes. Relative to noninterrupted tasks, device alarm interrupted nonstructured tasks were associated with increased rates of delays in care and safety hazards (rate ratio [RR] = 3.19). In contrast, rate of delays in care and safety hazards did not increase during human interrupted tasks (RR = 1.13). Rates of protocol nonadherence varied by device type and were highest during artificial airway, medication administration, chest tube, and supplemental oxygen management. Conclusion: Interruptions in the ICU are frequent and contribute to patient hazards, especially when caused by device alarms during nonstructured tasks. Nonadherence to protocols is common and contributed to patient hazards. Application: The findings suggest a need for improvement in task and device design to reduce patient hazards.
EAT-PAD: Educating about psychiatric advance directives in India
Authors: Philip Sharad , Chandran Dhanya , Stezin Albert , Viswanathaiah Geetha C , Gowda Guru S , Moirangthem Sydney , Kumar Channaveerachari Naveen , Math Suresh Bada 
Published: April 2019

Background: With India enacting the Mental Health Care Act (MHCA; No. 10 of 2017a), Psychiatric Advance Directives (PADs) have been legalised and have become binding orders for psychiatrists treating patients. There is a paucity of research into acceptability of PADs in Indian mental health care, likely due to a lack of awareness. There are no educational measures about PADs provided for in this Act. Facilitators and facilitation methods have not been elaborated upon as well. Aim: The aim of this study is (a) to develop/evaluate the effectiveness of a structured Education-cum-Assessment Tool (EAT) in providing information regarding PADs and (b) to evaluate modes of facilitation required by patients to complete PADs. Methods: A tool was developed as per provisions regarding PADs in the Mental Health Care Bill of 2013. This tool was administered to patients ( n = 100), purposively sampled from the adult psychiatry review out-patient department (OPD). Patients were evaluated on retention of information, completion of PADs, modes of facilitation and time taken to write one. Results: Mean years of education was 8.28 (±5.74) years and mean duration of illness was 8.30 (±7.04) years. In all, 65% had Below-Poverty Line (BPL) status. All participants completed valid PADs in an average of 15 minutes. About 93% required facilitation via assistance in writing and reminding. The mean EAT scores implied above 70% retention but did not relate to types of facilitation. Conclusions: EAT scores can be used as an approximate measure of the patient’s ability to understand and retain information which is a part of decisional capacity. Types of facilitation can help in understanding patient’s ability to communicate their choices. Service providers may find EAT a time-effective tool for uniformly educating service users regarding PADs and indirectly assessing competence.
Intralingual Mucous Extravasation Cyst: An Uncommon Lingual Cyst
Authors: Diom Evelyne S. , Fagan Johannes J. , Bolding Ellen 
Published: April 2019

Objective: We report a rare case of an intralingual ranula. The differential diagnosis, etiology, diagnostic features, and management are discussed. Case Report: An 18-year-old man presented with a mass that extended along the ventral surface of the tongue and up to the tip. The computed tomography scan clearly defined the extent of a cystic lesion. The pathologic diagnosis of an intralingual ranula was made. Conclusion: Lingual cysts have a varied etiology. Diagnosis hinges on histological examination of the cyst wall. Conservative resection and histological examination is the standard of care.
WITHDRAWN—Administrative Duplicate Publication: Communicating about bullying: Examining disclosure among gifted students
Authors: Jumper Rachel Leah 
Published: April 2019

Jumper RL (2019) Communicating about bullying: Examining disclosure among gifted students. Gifted Education International. Epub ahead of print: 03 April 2019. Ahead of Print article withdrawn by publisher. Due to an administrative error, this article was accidentally published twice Online First with different DOI. The correct and citable version of the article remains: Jumper RL (2019) Communicating about bullying: Examining disclosure among gifted students. Gifted Education International 35(2): 110-120. DOI: 10.1177/0261429418824113
Differential diagnosis of hepatic cancerous nodules and cirrhosis nodules by spectral CT imaging: a feasibility study
Authors: Gao Lu , Lv Yi , Jin Yingying , Han Fang , Yao Zhenwei , Yang Jian , Zhang Jiawen 
Published: April 2019

Background It is difficult to distinguish atypical cancerous nodule from cirrhosis nodule. Purpose To investigate the value of spectral computed tomography (CT) imaging parameters in differentiating hepatic cancerous nodules from cirrhosis nodules. Material and Methods Forty-six patients with hepatic nodules underwent contrast-enhanced CT scans in spectral mode. Monochromatic CT images and iodine/water-based material-decomposition images were synthesized. CT values were measured at 70 keV monochromatic images and the difference of CT value in the arterial phase (AP) and delayed phase (DP) (△CT1); AP and portal venous phase (PP) (△CT2) were calculated. Normalized to the iodine concentration in the aorta (NIC), lesion to normal liver parenchyma iodine concentration ratio (LNR) was calculated. Slope of the spectral HU curve (λHU) was obtained. Intraclass correlation coefficient (ICC) was used for consistency test. Receiver operating characteristic (ROC) curves were also generated. Results There were 23 hepatic cancerous nodules and 23 cirrhosis nodules. All gemstone spectral imaging (GSI) parameters had significantly larger value in cancerous nodules than in cirrhosis nodules, except NIC in DP. The LNR in AP had the largest area under the curve (AUC) of 0.96, indicating its highest ability to differentiate hepatic cancerous nodules from cirrhosis nodules. Using 1.99 as a threshold value for LNR in AP we could obtain sensitivity of 95.65% and specificity of 91.30%. Conclusion We have demonstrated in this feasibility study that spectral CT imaging provides multiple quantitative parameters which may be used to help differentiating hepatic cancerous nodules from cirrhosis nodules.
The usefulness of the Evaluation of Social Interaction in a mother and baby mental health unit
Authors: Williams Belinda , Chard Gill 
Published: April 2019

Statement of context: Perinatal services treat mothers with mental health problems while supporting and enabling mother–infant bonding and attachment alongside the occupational demands of safe and effective parenting. Critical reflection on practice: Robust assessment and evidence-based interventions appropriate to this setting are required, but the efficacy of these for mothers diagnosed with mental health problems in the perinatal period is unknown. The Evaluation of Social Interaction was introduced into a mother and baby mental health unit to address this need. Implications for practice: The Evaluation of Social Interaction provided specific information on social interaction skills that supported and limited competent social interactions necessary for mothering, enabling mothers to understand strengths and limitations when interacting with their babies and other key social partners during parenting occupations.
Challenges of achieving clinical remission in a national cohort of juvenile-onset systemic lupus erythematosus patients
Authors: Abdelrahman N , Beresford M W , Leone V ,   on behalf of the UK Juvenile-onset Systemic Lupus Erythematosus Study Group
Published: April 2019

Background and objectives The multisystem involvement and variable course of juvenile-onset systemic lupus erythematosus (JSLE) make it difficult to assess disease activity over time. International consensus definitions of inactive disease and clinical remission have been proposed. The aim of this study was to determine the proportion of patients meeting these criteria in a large national cohort of JSLE patients and the association between achieving inactive disease and clinical remission with disease activity at presentation and time to diagnosis. Methods Patients diagnosed with JSLE aged ≤17 years with a minimum of 12 months follow-up participating in the UK JSLE Cohort Study were assessed against these criteria at baseline, 1 year and final clinic visit. Results A total of 218 patients with mean follow-up duration of 4.7 years were included and analyzed at baseline visit, of which 93 and 209 were available for analysis at the 1-year and the last follow-up visits, respectively. Eighty-five percent at 1 year and 62% at final follow-up still had active disease while only 6% and 9%, respectively, achieved inactive disease according to the proposed criteria. The majority of patients continued to require immunosuppressive treatment despite their prolonged follow-up with only two patients achieving clinical remission on medication and none off medication. A large number of patients did not meet the criteria for inactive disease due to isolated laboratory abnormalities such as reduced lymphocyte count. Isolated low lymphocyte count was the reason for not fulfilling the inactive disease criteria in 20/79 (25%) patients at 1 year and 14/130 (11%) patients at final follow-up visit. No statistically significant differences in relation to time to diagnosis and disease activity at presentation were found between patients achieving inactive disease compared to those who did not, at 1 year and final follow-up. Conclusion The majority of patients failed to achieve the proposed criteria for inactive disease and continued to require immunosuppressive treatment. This reflects the high burden of disease in JSLE despite immunosuppressive therapy. A significant proportion of patients had isolated laboratory abnormalities of potentially limited clinical significance, suggesting that some modifications of the proposed criteria may be required.
Overall mortality in men and women in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Authors: Pinsky Paul F , Miller Eric A , Zhu Claire S , Prorok Philip C 
Published: April 2019

Objective To assess the secondary outcome of overall mortality in the randomized Prostate, Lung, Colorectal, and Ovarian cancer screening trial. Methods In the Prostate, Lung, Colorectal, and Ovarian trial, subjects were randomized to usual care or intervention. In the intervention arm, men and women received annual chest radiographs and two sigmoidoscopy exams. Men also received annual prostate-specific antigen tests and digital rectal exams, and women also received annual CA125 tests and trans-vaginal ultrasounds. Poisson regression and Cox proportional hazards models were used to assess differences across trial arms in overall mortality and overall mortality excluding deaths from trial cancers (OMEX). Due to slight age imbalances in later trial years, age-adjusted rate ratios and hazard ratios were computed. Results There were 76,678 men and 78,209 women randomized, with median follow-up of 17 years. In men there was a significant reduction in both overall mortality (age-adjusted rate ratio = 0.966; 95% CI: 0.943–0.989; p = 0.004) and OMEX (age-adjusted rate ratio = 0.970, 95% CI: 0.946–0.995; p = 0.02) in the intervention versus usual care arm. In women, no reduction was seen in either overall mortality (age-adjusted rate ratio = 1.002) or OMEX (age-adjusted rate ratio = 1.006). In both sexes combined, there was a significant reduction in overall mortality (age-adjusted rate ratio = 0.980; 95% CI: 0.963–0.999; p = 0.036) but not OMEX (age-adjusted rate ratio = 0.985; 95% CI: 0.965–1.004; p = 0.13). Results were similar using age-adjusted hazard ratios. Conclusion In the Prostate, Lung, Colorectal, and Ovarian trial, there was a small but significant reduction in overall mortality in men, and in both sexes combined, and a small but significant reduction in overall mortality excluding trial cancer deaths in men.
“To suit the occasion, I wore my schizophrenic fancy dress”1 – the life of Janet Frame
Authors: Lim Xinhui , Galletly Cherrie 
Published: April 2019

Objective: Janet Frame (1924–2004) was one of New Zealand’s most celebrated authors. Much of her work stems from her experiences as a psychiatric patient. She was hospitalised for about eight years with a diagnosis of schizophrenia. Treatments included insulin coma therapy and unmodified electroconvulsive therapy. Her doctors then planned for her to have a leucotomy, which was cancelled upon discovery that one of her works had won a prestigious literary award. She subsequently moved to England and was assessed at the Maudsley Hospital by Sir Aubrey Lewis. She was found to never have suffered from schizophrenia; her condition was instead attributed to the effects of overtreatment and prolonged hospitalisation. She reflected profoundly on these experiences in her writing, and those who are interested in psychiatry are truly fortunate to have access to her autobiographies, fiction and poetry. Conclusions: Janet Frame has written both autobiographical and fictional accounts of her many years of psychiatric treatment, describing individuals, interpersonal relationships, and everyday life in these institutions. Her own life story demonstrates extraordinary recovery and achievement.
Pediatric Complex Chronic Conditions: Does the Classification System Work for Infants?
Authors: Lindley Lisa C. , Fortney Christine A. 
Published: April 2019

Background: One widely accepted approach to identify children with life-limiting health problems is the complex chronic conditions (CCCs) classification system. Although considered the “gold standard” for classifying children with serious illness, little is known about its performance, especially among infants. Objective/Hypothesis: This research examined the prevalence of CCCs and the infant characteristics related to a CCC classification. Methods: Multivariate regression analysis was conducted with 2012 Kids’ Inpatient Database, Healthcare Cost and Utilization Project data files, using a national sample of infant decedents less than 1 year. Results: Our findings showed that 40% of the infants were classified with a CCC. African Americans were negatively associated with a CCC classification (adjusted odds ratio [aOR] = 0.63; 95% confidence interval [CI] = 0.543-0.731). When infants had other insurance coverage, they were less likely (aOR = 0.63; 95% CI = 0.537-0.748) to have a CCC classification. Infants who resided in nonurban areas (aOR = 1.21; 95% CI =1.034-1.415) and had comorbidities (aOR = 38.19; 95% CI = 33.12-44.04) had greater odds of having a CCC classification. Conclusions: The findings suggested that the infants are not commonly classified with a CCC and highlighted the significant variation in race with African American infants exhibiting different CCC classifications than Caucasian infants. Given the importance of reducing disparities in palliative care, critical attention to using CCC classifications in research is warranted.
Comprehension of Online Educational Material Regarding Orofacial Clefts
Authors: Jodeh Diana S. , Pringle Aleshia J. , Rottgers S. Alex 
Published: April 2019

Background: Cleft lip and palate are among the common birth defects in the United States. Management is complex and may be difficult for parents and patients to understand. The goal of this study was to evaluate the readability of online educational material provided by the American Society of Plastic Surgeons (ASPS) and the American Cleft Palate-Craniofacial Association (ACPA) websites regarding cleft lip and palate and to assess parents’ comprehension. Methods: Parents of children younger than 10 years of age presenting to the plastic and reconstructive surgery clinic at Johns Hopkins All Children’s Hospital for conditions other than cleft lip and palate were recruited for participation. Parents were given the literature published on the ASPS and ACPA web sites to review and were asked to complete a 5-question test specifically targeted to the content of the passage they reviewed. We tested the readability of the 2 online passages using Readability Studio software (Oleander Software Solutions Ltd). Results: Sixty parents completed the study. Across all groups, the mean score was 4.35 of a possible 5. The mean score was 4.4 for the ASPS web site and 4.29 for the ACPA web site. Fifty-three percent of participants answered all questions correctly. No significant difference in scores was noted between web sites ( P = .48). Conclusions: Despite containing content of varying reading-level difficulty, the literature posted on the ACPA and ASPS web sites concerning cleft lip and palate conveyed information equally well to the target parent demographic with high levels of comprehension.