bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived Racial Discrimination and DNA Methylation Among African American Women in the InterGEN Study
Authors: de Mendoza Veronica Barcelona , Huang Yunfeng , Crusto Cindy A. , Sun Yan V. , Taylor Jacquelyn Y. 
Published: February 2018

Introduction: Experiences of racial discrimination have been associated with poor health outcomes. Little is known, however, about how perceived racial discrimination influences DNA methylation (DNAm) among African Americans (AAs). We examined the association of experiences of discrimination with DNAm among AA women in the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure (InterGEN) study. Methods: The InterGEN study examines the effects of genetic and psychological factors on blood pressure among AA women and their children. Measures include the Major Life Discrimination (MLD) and the Race-Related Events (RES) scales. In the present analysis, we examined discrimination and DNAm at baseline in the InterGEN study. The 850K EPIC Illumina BeadChip was used for evaluating DNAm in this epigenome-wide association study (EWAS). Results: One hundred and fifty-two women contributed data for the RES-EWAS analysis and 147 for the MLD-EWAS analysis. Most were 30–39 years old, nonsmokers, had some college education, and had incomes <US$15,000/year. After controlling for age, smoking, and cell composition, MLD was significantly associated with DNAm at nine CpG (regions of DNA where a cytosine nucleotide is followed by a guanine nucleotide) sites (false discovery rate [FDR]-corrected p < .05). For the RES-EWAS analysis, no DNAm sites passed the epigenome-wide significance level after genomic control, though suggestive associations were observed at CpG sites after genomic control (raw p < 10−5). Conclusion: We observed significant epigenetic associations between disease-associated genes (e.g., schizophrenia, bipolar disorder, and asthma) and perceived discrimination as measured by the MLD Scale. Future health disparities research should include epigenetics in high-risk populations to elucidate functional consequences induced by the psychosocial environment.
Epigenetic Modifications Following Noxious Stimuli in Infants
Authors: Hatfield Linda A. , Hoffman Rebecca K. , Polomano Rosemary C. , Conley Yvette 
Published: February 2018

Purpose: To recruit healthy full- and preterm infants into genetic research and determine the effectiveness of a noninvasive DNA sampling technique for comparing epigenetic modifications. Background: Noxious stimuli during a vulnerable period of infant neuronal plasticity may trigger long-term epigenetic changes affecting neurodevelopment, pain modulation, and reactivity. Recognizing epigenetic pain findings is problematic because parents are reluctant to enroll newborns into genetic research. Methods: Design: Within-subject change over time candidate-gene DNA methylation association study. Setting/ sample: Urban teaching hospital’s neonatal intensive care unit and newborn nursery. Convenience sample of healthy full- (>37 weeks, n = 6) and preterm (<37 weeks, n = 6) infants. Procedure: Parents participated in a genetic presentation prior to informed consent. Infant buccal saliva was collected after admission to the unit and prior to discharge. Analysis: The methylation pattern at the 5′ end of µ-opioid receptor gene ( OPRM1) was examined. DNA was treated with bisulfite to convert all cytosines to uracil residues, leaving methylated cytosines unchanged. Sequencing of untreated and bisulfite-converted DNA was carried out. The sequences of unconverted and bisulfite-converted DNA were aligned with ClustalW, fidelity of the polymerase chain reaction and the sequencing reaction evaluated, and the methylation pattern identified. Results: Recruitment and assessment of a noninvasive DNA sampling technique for comparing epigenetic modifications were successful; however, infant stress did not produce a change in OPRM1 methylation expression. Relevance: This study established the feasibility of recruiting healthy full-term infants into genetic research and the effectiveness of noninvasive DNA sampling for comparing epigenetic modification in infants.
Multiple sclerosis–related fatigue: Altered resting-state functional connectivity of the ventral striatum and dorsolateral prefrontal cortex
Authors: Jaeger Sven , Paul Friedemann , Scheel Michael , Brandt Alexander , Heine Josephine , Pach Daniel , Witt Claudia M , Bellmann-Strobl Judith , Finke Carsten 
Published: February 2018

Objective: Since recent studies suggested a role of the striatum and prefrontal cortex for multiple sclerosis (MS)-related fatigue, we investigated resting-state functional connectivity alterations of striatal subdivisions and the dorsolateral prefrontal cortex (dlPFC). Methods: Resting-state functional magnetic resonance imaging was acquired in 77 relapsing–remitting MS patients (38 fatigued (F-MS), 39 non-fatigued (NF-MS)) and 41 matched healthy controls (HC). Fatigue severity was assessed using the fatigue severity scale. Seed-based connectivity analyses were performed using subregions of the striatum and the dlPFC as regions of interest applying non-parametric permutation testing. Results: Compared to HC and NF-MS patients, F-MS patients showed reduced caudate nucleus and ventral striatum functional connectivity with the sensorimotor cortex (SMC) and frontal, parietal, and temporal cortex regions. Fatigue severity correlated negatively with functional connectivity of the caudate nucleus and ventral striatum with the SMC and positively with functional connectivity of the dlPFC with the rostral inferior parietal gyrus and SMC. Conclusion: MS-related fatigue is associated with reduced functional connectivity between the striatum and sensorimotor as well as attention and reward networks, in which the ventral striatum might be a key integration hub. Together with increased connectivity between the dlPFC and sensory cortical areas, these connectivity alterations shed light on the mechanisms of MS-related fatigue.
Development of a tool to assess client-centered practice on a domestic violence hotline
Authors: Grossmann Jessica , Shor Rachel , Schaefer Karen , Bennett Cattaneo Lauren 
Published: February 2018

Summary Client-centered practice, also termed survivor-centered practice in the context of domestic violence, has broad support as a set of strategies for working effectively with trauma survivors. However, research, evaluation and staff training are limited by a lack of measurement tools. This paper describes the process of developing an index of hotline caller reactions to practitioners’ client-centered practices. Findings The project was a collaborative effort between academic researchers and practitioners working in a community agency. To generate and refine the items, researchers consulted the scholarly literature and agency materials, had discussions with practitioners, and coded a group of 25 recorded calls to the agency’s hotline. The resulting tool separates two phases of the hotline calls and identifies 23 client reactions to advocate behaviors that indicate the client-centeredness of the interaction. Application The collaborative nature of the process ensured that the final product included multiple vantage points on client-centered practice. The tool developed in this study, the Client-Centered Hotline Assessment Tool (C-CHAT), may be used for research, evaluation, and training. Future research could explore the generalizability and, consequently, predictive utility of the tool in outcomes of interest to practitioners. In evaluation, the tool allows agencies, in assessing client experience, to go beyond client self-report of general satisfaction, and to improve services in response. Finally, in training, the tool allows supervisors to assess the level of fidelity to the client-centered model, and to pinpoint particular aspects of interactions that suggest strengths or growth areas for staff, ultimately improving the quality of services.
The work-related well-being of social workers: Framing job demands, psychological well-being, and work engagement
Authors: Tesi Alessio , Aiello Antonio , Giannetti Enrichetta 
Published: February 2018

Summary Social workers’ occupational health has become a central theme in the psychosocial literature. This study aimed at exploring how specific job demands and psychological well-being are related to work engagement. A sample of 140 Italian social workers was analyzed in accordance with the job demands–resources model. Participants were asked to complete a written questionnaire containing several measurement scales. Findings Multiple regression analyses showed that social workers’ psychological well-being was positively related to work engagement. Moderation analyses also indicated that, when psychological well-being was high (vs. low), job demands were associated to higher levels of work engagement, thus highlighting the buffering role of psychological well-being as a specific personal resource. When job demands were high (vs. low), the psychological well-being appeared to be strongly related to lowest levels of work engagement, showing that high job demands could reduce the fostering role of psychological well-being on social workers’ work engagement. Applications While administration of job demands may often be difficult in social work contexts, managers should be encouraged, as part of a systemic approach to training, to promote specific measures for improving social workers’ psychological well-being as a personal resource for promoting work engagement.
The Significance of Doppler Ultrasound in the Causes of Varicose Veins
Authors: Manzoor Iqra , Bacha Raham , Gilani Syed Amir 
Published: February 2018

Varicose veins could be clinically diagnosed with visual inspection but the use of Doppler ultrasound (US) in varicose veins is to identify the cause of varicose veins. Need for an extensive systematic review is therefore felt to itemize different causes of varicose veins. Relevant literature was searched and systematic analysis was performed with the aim to show the significance of US in the diagnosis of various causes of varicose veins. Various causes can be diagnosed with color and spectral Doppler US which can be usual causes and unusual causes as well including neovascularization, chronic venous ulceration, obesity, incompetency of the perforating veins, deep vein thrombosis, saphenofemoral junction incompetence, recurrence of the varicose veins after surgical treatment, vulvoperineal varicosities, intraosceous perforating vein incompetence, round ligament varicosity, persistent sciatic vein incompetence, congenital venous malformation and Klippel– Trenaunay syndrome, portosystemic collateral–related varicose veins, and pelvic congestion syndrome. It is concluded that duplex ultrasonography plays an important role in the diagnosis of the various causes of varicose veins.
Comparison of phase-contrast MR and flow simulations for the study of CSF dynamics in the cervical spine
Authors: Lindstrøm Erika Kristina , Schreiner Jakob , Ringstad Geir Andre , Haughton Victor , Eide Per Kristian , Mardal Kent-Andre 
Published: February 2018

Background Investigators use phase-contrast magnetic resonance (PC-MR) and computational fluid dynamics (CFD) to assess cerebrospinal fluid dynamics. We compared qualitative and quantitative results from the two methods. Methods Four volunteers were imaged with a heavily T2-weighted volume gradient echo scan of the brain and cervical spine at 3T and with PC-MR. Velocities were calculated from PC-MR for each phase in the cardiac cycle. Mean pressure gradients in the PC-MR acquisition through the cardiac cycle were calculated with the Navier-Stokes equations. Volumetric MR images of the brain and upper spine were segmented and converted to meshes. Models of the subarachnoid space were created from volume images with the Vascular Modeling Toolkit. CFD simulations were performed with a previously verified flow solver. The flow patterns, velocities and pressures were compared in PC-MR and CFD flow images. Results PC-MR images consistently revealed more inhomogeneous flow patterns than CFD, especially in the anterolateral subarachnoid space where spinal nerve roots are located. On average, peak systolic and diastolic velocities in PC-MR exceeded those in CFD by 31% and 41%, respectively. On average, systolic and diastolic pressure gradients calculated from PC-MR exceeded those of CFD by 11% and 39%, respectively. Conclusions PC-MR shows local flow disturbances that are not evident in typical CFD. The velocities and pressure gradients calculated from PC-MR are systematically larger than those calculated from CFD.
A 24/7 hospital toxicology service: Experience of a new start-up
Authors: Arciaga Gabriel Joseph , Tan Hock Heng , Kuan Kaibin Kelvin , Mong Rupeng , Kant Abhay 
Published: February 2018

Objectives: A toxicology team providing round-the-clock consultations for poisoning was established in Changi General Hospital in November 2014. This study aims to describe the epidemiology of patients referred to this service in 2015. Methods: A retrospective electronic and paper records review of all patients referred to the toxicology service from January to December 2015 was performed for demographics, poisoning, clinical, and outcome data. The cases were graded for poisoning severity score (PSS), likelihood of poisoning exposure and relative contribution to fatality for death cases. Results: A total of 306 cases were referred to this service in 2015. The median age was 34 years with majority being females (54%). The most common cause of poisoning was deliberate self-harm (62%) and the most common route of poisoning was oral (85%). Analgesics (21%) and sedatives (19%) were the most common poisoning classes. Six per cent of patients received decontamination and 17% received antidotes. The likelihood of poisoning exposure was probable to definite certainty for 85% of the cases. Mild poisoning (PSS 0–1) constituted 76% of the cohort, while 22% had moderate to severe poisoning (PSS 2–3). Out of the five fatalities, three were exposure-related fatalities contributing to a fatality rate of 1%. Fifty-four per cent of patients were admitted to the emergency department observation unit, 17% to general inpatient wards and 9% to either intensive care unit or high dependency wards. Conclusions: Although most poisoning cases resulted in mild clinical effects, a small but significant number of severe acuity cases occurred in this cohort.
Outcomes of arthroscopic capsular release for the diabetic frozen shoulder in Asian patients
Authors: Puah Ken Lee , Salieh Muhammad Sabith , Yeo William , Tan Andrew Hwee Chye 
Published: February 2018

Introduction: Diabetic patients have been known to have a higher incidence of frozen shoulder. Arthroscopic capsular release has been described for diabetic frozen shoulder refractory to non-surgical treatment. We describe our single-surgeon experience of this procedure done in Asian patients presenting with diabetic frozen shoulder. Results: Data were prospectively collected from 25 patients from 2007 to 2008, who underwent arthroscopic capsular release for frozen shoulder with diabetes mellitus. This included the University of California–Los Angeles (UCLA) Shoulder Score by an independent observer. Mean follow-up duration was 44.3 ± 22 months with the age of 57.3 ± 10.9 years at the time of surgery. Mean duration of symptoms prior to surgery was 8.9 ± 7.5 months. Ten right shoulders and 15 left shoulders were operated on. Arthroscopic capsular release was performed in the beach chair position with the aid of a 90° electrocautery hook, from the rotator interval to posterior capsule. Significant improvement was observed in the UCLA scores post-operatively (preoperative total score 15.8 ± 3.6 vs. post-operative 33.3 ± 2.5, p < 0.00), including all domains of pain (3.9 ± 1.8 vs. 9.4 ± 0.9, p < 0.00), function (4.8 ± 1.7 vs. 9.4 ± 1.4, p < 0.00), active forward flexion (2.6 ± 0.7 vs. 4.6 ± 0.6, p < 0.00) and satisfaction (0.0 ± 0.0 vs. 5.0 ± 0.0, p < 0.00). No significant correlation between duration of symptoms and UCLA scores. Significant improvement was observed in forward flexion (preoperative 100.4 ± 18.8° vs. post-operative 157.6 ± 15.9°, p < 0.00) and external rotation (preoperative 14.4 ± 6.34° vs. post-operative 63.8 ± 8.3°, p < 0.00). Although the duration of symptoms correlated significantly with preoperative forward flexion ( r = 0.443 and p < 0.027), there was no significant correlation with post-operative forward flexion ( r = 0.023 and p < 0.91). No axillary nerve palsy observed. Conclusion: The diabetic frozen shoulder can be treated favourably with arthroscopic capsular release and the duration of symptoms prior to surgery does not affect the outcomes.
Back to Sports After Arthroscopic Revision Bankart Repair
Authors: Buckup Johannes , Welsch Frederic , Gramlich Yves , Hoffmann Reinhard , Roessler Philip P. , Schüttler Karl F. , Stein Thomas 
Published: February 2018

Background: Recurrent instability following primary arthroscopic stabilization of the shoulder is a common complication. Young, athletic patients are at the greatest risk of recurring instability. To date, the literature contains insufficient description regarding whether return to sports is possible after revision arthroscopic Bankart repair. Hypothesis: Patients presenting with recurrent instability after primary arthroscopic stabilization should expect limitations in terms of their ability to partake in sporting activities after revision surgery. Study Design: Case series; Level of evidence, 4. Methods: Twenty athletes who underwent arthroscopic revision stabilization of the shoulder after failed primary arthroscopic Bankart repair were included in the study after completing inclusion and exclusion criteria surveys. Athletic Shoulder Outcome Scoring System (ASOSS), Shoulder Sport Activity Score (SSAS), and the Subjective Patient Outcome for Return to Sports (SPORTS) scores were determined to assess the participants’ ability to partake in sporting activities. Furthermore, sport type and sport level were classified and recorded. To assess function and stability, Rowe, American Shoulder and Elbow Surgeons, Constant-Murley, and Walch-Duplay scores were measured and recorded. Results: Follow-up consultations were carried out after a mean of 28.7 months. The mean age at follow-up examination was 27.75 years. At the time of follow-up, 70% of the patients were able to return to their original sporting activities at the same level. However, 90% of patients described a limitation in their shoulder when participating in their sports. At 28.7 months after surgery, the mean ASOSS score was 76.8; the SSAS score decreased from 7.85 before first-time dislocation to 5.35 at follow-up ( P < .005). The SPORTS score was 5.2 out of 10 at the follow-up consultation. Function- and instability-specific scores showed good to excellent results. The mean external rotational deficit for high external rotation was 9.25°, and for low external rotation it was 12°. Conclusion: Patients can return to their original type and level of sport after arthroscopic revision Bankart repair, but they must expect persistent deficits and limitations to the shoulder when put under the strains of sporting activity. Patients with shoulder injuries who partake in sports that put greater demand on the shoulder show the smallest probabilities of returning to sporting activity.
Significantly Increased Odds of Reporting Previous Shoulder Injuries in Female Marines Based on Larger Magnitude Shoulder Rotator Bilateral Strength Differences
Authors: Eagle Shawn R. , Connaboy Chris , Nindl Bradley C. , Allison Katelyn F. 
Published: February 2018

Background: Musculoskeletal injuries to the extremities are a primary concern for the United States (US) military. One possible injury risk factor in this population is side-to-side strength imbalance. Purpose: To examine the odds of reporting a previous shoulder injury in US Marine Corps Ground Combat Element Integrated Task Force volunteers based on side-to-side strength differences in isokinetic shoulder strength. Study Design: Cohort study; Level of evidence, 3. Methods: Male (n = 219) and female (n = 91) Marines were included in this analysis. Peak torque values from 5 shoulder internal/external rotation repetitions were averaged and normalized to body weight. The difference in side-to-side strength measurements was calculated as the absolute value of the limb difference divided by the mean peak torque of the dominant limb. Participants were placed into groups based on the magnitude of these differences: <10%, 10% to 20%, and >20%. Odds ratios (ORs) and 95% CIs were calculated. Results: When separated by sex, 13.2% of men reported an injury, while 5.5% of women reported an injury. Female Marines with >20% internal rotation side-to-side strength differences demonstrated increased odds of reporting a previous shoulder injury compared with female Marines with <10% strength differences (OR, 15.4; 95% CI, 1.4-167.2; P = .03 ) and female Marines with 10% to 20% strength differences (OR, 13.9; 95% CI, 1.3-151.2; P = .04). No significant ORs were demonstrated in male Marines. Conclusion: Marines with larger magnitude internal rotation strength differences demonstrated increased odds of reporting a previous shoulder injury compared with those with lesser magnitude differences. Additionally, female sex appears to drastically affect the increased odds of reporting shoulder injuries (OR, 13.9-15.4) with larger magnitude differences (ie, >20%) compared with those with lesser magnitude differences (ie, <10% and 10%-20%). The retrospective cohort design of this study cannot delineate cause and effect but establishes a relationship between female Marines and greater odds of larger magnitude strength differences after returning from an injury.
Survival is influenced by approaches to local treatment of Ewing sarcoma within an international randomised controlled trial: analysis of EICESS-92
Authors: Whelan Jeremy , Hackshaw Allan , McTiernan Anne , Grimer Robert , Spooner David , Bate Jessica , Ranft Andreas , Paulussen Michael , Juergens Herbert , Craft Alan , Lewis Ian 
Published: February 2018

Abstract
Background
Two national clinical trial groups, United Kingdom Children’s Cancer and Leukaemia Group (CCLG) and the German Paediatric Oncology and Haematology Group (GPOH) together undertook a randomised trial, EICESS-92, which addressed chemotherapy options for Ewing’s sarcoma. We sought the causes of unexpected survival differences between the study groups.

Methods
647 patients were randomised. Cox regression analyses were used to compare event-free survival (EFS) and overall survival (OS) between the two study groups.

Results
5-year EFS rates were 43% (95% CI 36–50%) and 57% (95% CI 52–62) in the CCLG and GPOH patients, respectively; corresponding 5-year OS rates were 52% (95% CI 45–59%) and 66% (95% CI 61–71). CCLG patients were less likely to have both surgery and radiotherapy (18 vs. 59%), and more likely to have a single local therapy modality compared to the GPOH patients (72 vs. 35%). Forty-five percent of GPOH patients had pre-operative radiotherapy compared to 3% of CCLG patients. In the CCLG group local recurrence (either with or without metastases) was the first event in 22% of patients compared with 7% in the GPOH group. After allowing for the effects of age, metastases, primary site, histology and local treatment modality, the risk of an EFS event was 44% greater in the CCLG cohort (95% CI 10–89%, p = 0.009), and the risk of dying was 30% greater, but not statistically significant (95% CI 3–74%, p = 0.08).

Conclusions
Unexpected differences in EFS and OS occurred between two patient cohorts recruited within an international randomised trial. Failure to select or deliver appropriate local treatment modalities for Ewing’s sarcoma may compromise chances of cure.
Trial registration Supported by Deutsche Krebshilfe (Grants No. DKH M43/92/Jü2 and DKH 70-2551 Jü3), and European Union Biomedicine and Health Programme (Grants No. BMH1-CT92-1341 and BMH4-983956), and Cancer Research United Kingdom. Clinical trial information can be found for the following: NCT0000251