bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing Rates of Self-Harm and Mental Disorders by Sex in Youths Presenting to Ontario Emergency Departments: Repeated Cross-Sectional Study
Authors: Gardner William , Pajer Kathleen , Cloutier Paula , Zemek Roger , Currie Lisa , Hatcher Simon , Colman Ian , Bell Dayna , Gray Clare , Cappelli Mario , Duque Daniel Rodriguez , Lima Isac 
Published: June 2019

Objective: To document the rates of intentional self-harm and mental disorders among youths aged 13 to 17 years visiting Ontario emergency departments (EDs) from 2003-2017. Methods: This was a repeated cross-sectional observational design. Outcomes were rates of adolescents with (1) at least 1 self-harm ED visit and (2) a visit with a mental disorder code. Results: Rates of youths with self-harm visits fell 32% from 2.6/1000 in 2003 to 1.8 in 2009 but rose 135% to 4.2 by 2017. The slope of the trend in self-harm visits changed from –0.18 youths/1000/year (confidence interval [CI], –0.24 to –0.13) during 2003 to 2009 to 0.31 youths/1000/year (CI, 0.27 to 0.35) during 2009 to 2017 ( P < 0.001). Rates of youths with mental health visits rose from 11.7/1000 in 2003 to 13.5 in 2009 (15%) and to 24.1 (78%) by 2017. The slope of mental health visits changed from 0.22 youths/1000/year (CI, 0.02 to 0.42) during 2003 to 2009 to 1.84 youths/1000/year (CI, 1.38 to 2.30) in 2009 to 2017 ( P < 0.001). Females were more likely to have self-harm ( P < 0.001) and mental health visits ( P < 0.001). Rates of increase after 2009 were greater for females for both self-harm ( P < 0.001) and mental health ( P < 0.001). Conclusions: Rates of adolescents with self-harm and mental health ED visits have increased since 2009, with greater increases among females. Research is required on the determinants of adolescents’ self-harm and mental health ED visits and how they can be addressed in that setting. Sufficient treatment resources must be supplied to address increased demands for services.
Suicide Mortality in Canada after the Death of Robin Williams, in the Context of High-Fidelity to Suicide Reporting Guidelines in the Canadian Media
Authors: Whitley Rob , Fink David S. , Santaella-Tenorio Julian , Keyes Katherine M. 
Published: June 2019

Background: Evidence suggests that suicide mortality increases after high-profile suicide deaths. Indeed, suicide in the United States increased disproportionately after the suicide by suffocation of well-known comedian Robin Williams in August 2014. Such increases are often attributed to irresponsible media coverage of the suicide contributing to “copycat suicides.” However, recent research indicates that the mainstream Canadian media have significantly improved their suicide coverage, with high fidelity to suicide reporting guidelines after Williams’ death. As such, the aim of the present study is to examine suicide mortality in Canada after Robin Williams’ suicide. Methods: We obtained deidentified monthly suicide count data from January 1999 to December 2015 stratified by age, sex, and method of suicide from Statistics Canada. We used time-series analyses to estimate the expected number of suicides in the months following Robin Williams’ death. This was done using a seasonal autoregressive integrated moving averages (SARIMA) method. Expected suicides were then compared with observed suicides. Results: August 2014 was the month with the highest number of suicides from 2010 to 2015. The time-series model indicated a 16% increase in the expected number of suicides during the months from August to December 2014 inclusive. Moreover, males over 30 had the greatest number of excess suicides, and suicides by suffocation (the method used by Robin Williams) were also higher in August and the following months. Interpretation: Suicides increased in Canada after Robin Williams’ death, despite the improved mainstream media coverage witnessed in other studies. Other factors (e.g., social and alternative media) may have contributed to the observed increase in suicide.
The Effect of Teamwork on Children With Cleft Lip and Palate and Their Mother’s Quality of Life
Authors: Khanchezar Fatemeh , Moradi Negin , Tahmasebi Fard Neda , Latifi Seyyed Mahmoud , Bassak Nejad Soodabeh , Hosseini Beidokhti Masoume 
Published: June 2019

Objective: Maintaining and improving patients’ quality of life (QOL) are regarded as the most important aims in health-care systems. These are directly associated with intervention of health-care providers across the world. The aim of the present study was to evaluate the impact of teamwork on frequency of care provided to children with cleft lip and palate and their mothers’ QOL. Methods: This analytical epidemiology study was conducted on 101 children with cleft lip and palate and their mothers who were divided into 2 groups: a multidisciplinary team and a group of individual providers. Data were collected using convenience sampling. Quality of Life Questionnaire (Short Form-36) was assessed. The statistical analysis was performed using the χ2 test, independent t test, and Mann-Whitney U test in SPSS (20). Results: Both groups were matched. There was a significant statistical difference among the members of multidisciplinary team who received surgery, genetic counseling, and dental care ( P ≤ .043) and the individual providers groups. The 2 groups did not have significant difference in receiving the hearing test, speech therapy, and dental care 12 months before the interview. There were significant differences in QOL scores between the multidisciplinary team and the group of individual providers ( P = .013). Conclusions: The services provided as a multidisciplinary team leads to a better outcome and improves the QOL of our patients and their families. It is recommended that services should be provided in the team approach for patients with cleft lip and palate.
Use of zebrafish to model chemotherapy and targeted therapy gastrointestinal toxicity
Authors: Van Sebille Ysabella ZA , Gibson Rachel J , Wardill Hannah R , Carney Thomas J , Bowen Joanne M 
Published: June 2019

Gastrointestinal toxicity arising from cancer treatment remains a key reason for treatment discontinuation, significantly compromising remission. There are drawbacks to the currently used in vitro and rodent models, and a lack of translatability from in vitro to in vivo work. A screening-amenable alternative in vivo model such as zebrafish would, therefore, find immediate application. This study utilized a transgenic reporter line of zebrafish, Tg(cyp2k18:egfp), that shows eGFP induction as an indicator of drug-induced pathology. Here, we investigate its utility as an alternative vertebrate model to bridge the gap between simple in vitro cellular studies and complex in vivo models for understanding gastrointestinal toxicity induced by chemotherapy and targeted therapy. Transgenic zebrafish larvae were administered afatinib or SN38, and assessed for viability and eGFP induction. Adult zebrafish were administered afatinib via oral gavage, and SN38 via intraperitoneal injection. Fish were killed after 24 h, and had gastrointestinal tracts removed and assessed for histopathological damage, goblet cell changes, and apoptosis. While treatment with either compound did not induce eGFP in the gastrointestinal tract of larvae, SN38 caused histopathological damage to adult intestines. The lack of eGFP induction may be due to poor solubility of the drugs. Chemotherapy agents with high solubility and permeability would be more amenable to these models. Further progress in this area would be greatly facilitated by the generation of robust and reproducible genetic models of zebrafish intestinal toxicity that mimic the known pathobiological pathways in rodents and humans, and can be readily induced in a short time-frame. Impact statement Gastrointestinal toxicity secondary to cancer treatment remains a major reason for the termination of cancer drug candidates in the development pipeline as well as withdrawal or restrictions of marketed drugs. Current cancer treatment-induced gastrointestinal toxicity models available are limited to in vitro and rodent models that lack translatability and are prohibitively expensive and time consuming. An alternative model to study cancer treatment-induced gastrointestinal toxicity that allows rapid, miniaturized, multi-organ toxicity, screening-amenable testing is therefore warranted. The newly developed Tg( cyp2k18:egfp) zebrafish reporter line was found to induce eGFP in the gastrointestinal tract if toxicity was induced in this area. This paper explored utilizing this reporter line for cancer treatment-induced gastrointestinal toxicity, but found that it was not a useful reporter line in this setting. Further progress in this area would be greatly facilitated by the generation of robust and reproducible genetic models of zebrafish intestinal toxicity that mimic the known pathobiological pathways.
Molecular engineering strategies for visualizing low-affinity protein complexes
Authors: Ming Qianqian , Gonzalez-Perez David , Luca Vincent C 
Published: June 2019

The growing availability of complex structures in the Protein Data Bank has provided key insight into the molecular architecture of protein–protein interfaces. The remarkable diversity observed in protein binding modes is paralleled by a tremendous variation in binding affinities, with interaction half-lives ranging from days to milliseconds. Within the protein interactome, low-affinity binding events have been particularly difficult to visualize by traditional structural methods, which has spurred the development of innovative strategies for reconstituting these short-lived yet biologically essential assemblies. An important takeaway from structural studies of low-affinity systems is that there is no universal solution for stabilizing protein complexes, and approaches such as single-chain fusions, biochemical linkages, and affinity-maturation have each been successful in certain contexts. In this article, we review how advances in molecular engineering have been used to capture weakly associated complexes for structure determination, and we provide perspectives on how the continued application of these methods can shed new light on the “hidden world” of low-affinity interactions.Impact statementLow-affinity protein interactions, while biologically essential, have been difficult to visualize by traditional methods in structural biology. In this review, we describe a series of innovative molecular engineering strategies that have been used to stabilize weakly bound protein complexes for structure determination. By highlighting several examples from the literature along with potential advantages and disadvantages of the individual approaches, we hope to provide an introductory resource for structural biologists studying low-affinity systems.
Research methodology and practical issues relating to the conduct of a medical device registry
Authors: Bisdas Theodosios , Bohan Patrick , Lescan Mario , Zeebregts Clark J , Tessarek Jörg , van Herwaarden Joost , van den Berg Jos C , Setacci Carlo , Riambau Vincent 
Published: June 2019

Background The postmarket research goal is to assess “generalizability” or “external validity” to see if the early results of clinical trials with investigational devices are reproducible in everyday practice in the real world and the longer term. Registries have an important but ambivalent role in achieving this goal. Methods Although registries are common, in practice they follow the regulatory processes that appear designed primarily for pharmaceutical clinical trials and confirmatory studies. We review the literature to assess different definitions and the role of registries in the hierarchy of scientific evidence. We analyze common characteristics affecting registry design, implementation, and governance as well as safety reporting and off-label use while describing the experience of setting up an international, prospective registry for an endovascular device used to treat abdominal aortic aneurysms. Results Key areas in which to distinguish registries from trials are as follows: eligibility, setting (patients and institutions), device configurations and iterations, the use of design and quality “spaces,” a focus on systematic quality checks (rather than source data monitoring), open-ended follow-up, flexibility in the definition of end points and sample sizes, data sharing, and publishing commitments. Conclusion Both clinical trials and registries are essential and complementary research methods and the strengths and weaknesses of each need to be recognized. The specific characteristics of registry research deserve to be acknowledged and safeguarded in the regulations governing clinical investigations with medical devices.
Use of the model of Inner Strength for analysing reflective interviews in a group of healthy middle-aged adults
Authors: Lundman Berit , Hammarström Anne , Ahlgren Christina , Norberg Astrid 
Published: June 2019

Objective: Inner Strength has been described as a human resource that promotes well-being linked to health. The aim of this study was to explore how Inner Strength and its four dimensions are manifested in interviews in a group of middle-aged healthy women and men. Methods: Retrospective reflective interviews with middle-aged healthy women (n = 5) and men (n = 4) selected from a population study were content analysed deductively. Results: The following themes and their constituents were found in the respective dimensions of the Model of Inner Strength. Firmness: having a drive to act, being purposeful, having trust in one’s competence, and having a positive view of life. Connectedness: being in community, receiving and giving support, and, receiving and giving care. Creativity: changing unsatisfactory life situations, seeing new opportunities, and realizing dreams. Stretchability: balancing between options, and extending oneself. Conclusions: Expressions that were interpreted as belonging to Inner Strength could be referred the different dimensions of Inner Strength. The Model of Inner Strength is suitable for analysing Inner Strength among middle-aged men and women. The findings indicate that Inner Strength can be identified in human beings’ narratives if asked for.
Is dialysis vintage a perioperative risk for end-stage renal disease patients receiving total knee and hip arthroplasty
Authors: Wang Yi-Chia , Cheng Ya-Jung , Yang Ju-Yeh , Chao Chia-Der , Huang Jenq-Wen , Hung Kuan-Yu 
Published: June 2019

Background: End-stage renal disease is an independent risk factor for postoperative mortality and cardiovascular events, but dialysis vintage and its relationship with perioperative complication is not well studied. We did a population-based study to investigate this issue. Materials and methods: We identified patients who had total knee arthroplasty (TKA) or total hip arthroplasty (THA) surgeries during 1999–2010 from the National Health Insurance Research Database of Taiwan. Patients who had regular dialysis before surgery were recruited in our analysis. The outcome of interest was mortality, morbidities, intensive care unit admission rate, hospitalization duration, readmission rate, and medical costs. We did multivariate regression to adjust for age, sex, and Charlson comorbidity index (CCI) and to analyze the relationship of dialysis vintage and clinical outcomes. Results: A total of 518 patients were enrolled for analysis. A total of 286 patients had TKA surgeries and 232 patients had THA surgeries. Patients who had TKA surgery were older and had more medical comorbidities than patients who had THA. After adjustment for age, sex, and CCI, TKA patients who had dialysis vintage <3 years had significantly higher medical costs ( p < 0.05). For THA patients, dialysis vintage is not an independent risk factor for outcomes of interest. Conclusion: Perioperative complication is associated with age and medical comorbidities. Longer dialysis vintage is not related to perioperative morbidities and mortalities or higher medical costs in either TKA or THA patients.
An etiological role for the Epstein-Barr virus in the pathogenesis of classical Hodgkin lymphoma
Authors: Murray Paul G. , Young Lawrence S. 
Published: June 2019

Abstract
Although a pathogenic role for the Epstein-Barr virus (EBV) is largely undisputed for tumors that are consistently EBV genome positive (eg, nasopharyngeal carcinoma, endemic Burkitt lymphoma), this is not the case for classical Hodgkin lymphoma (cHL), a tumor with only a variable EBV association. In light of recent developments in immunotherapeutics and small molecules targeting EBV, we believe it is now timely to reevaluate the role of EBV in cHL pathogenesis.
Elucidation of relationship between clothing silhouette and motifs with Indian Mughal architecture
Authors: Kumari Annu 
Published: June 2019

AbstractFashion adopts numerous creative ideas and the designers source them. Architecture is also not left out from the eye of designers. Fashion designers used to take their inspiration from architectural buildings normally to create new clothing silhouettes. But what is important to understand here is the nature of relationship between these two disciplines which made them to do so. Keeping this fact in mind, researcher tried to find the connection between ‘Fashion’ and ‘Architecture,’ which can serve as fashion element for designers. Clothing Silhouette and motif were the two criteria on which the relationship was investigated. Indian Mughal architectural monuments were selected, since Mughals were considered as the most influential rulers on Indian sub-continent, having unique heritage in terms of religion, arts, music and other ornamental techniques which are in vogue even in the modern era. The outcomes show that similar kind of motifs was used to ornament both textiles as well as walls of architectural monuments at same time frame. Clothing silhouettes of that time were also inspired from the outer shape of the monument. Further, while investigating, a functional aspect—one of the common causes of relationship in terms of comfort in both the disciplines was also found.
Case study of creativity in asynchronous online discussions
Authors: Corfman Timothy , Beck Dennis 
Published: June 2019

AbstractIt is vital for online educators to know whether the strategies they use help students gain twenty-first-century skills like creativity. Unfortunately, very little research exists on this topic. Thus, the purpose of this study was to determine whether participation in online courses can help students develop creativity using asynchronous online discussions, textbooks, and teacher developed materials. A case-study approach was used and one professor, recognized by her peers for her expertise in online education, and three of her students were interviewed. Asynchronous online discussions (29) were also collected and analyzed using a sequential process of building an explanation, checking the explanation against the data, and repeating the process. Key results from the study indicated that project-based prompts, problem-based prompts, and heuristics used in asynchronous online discussions can help promote creativity. Future research should explore a more diverse group of participants and academic subject areas.
Presentation, Treatment, Histology, and Outcomes in Adrenal Medullary Hyperplasia Compared With Pheochromocytoma
Authors: Falhammar Henrik , Stenman Adam , Calissendorff Jan , Juhlin Carl Christofer 
Published: June 2019

Abstract

Context
Information about adrenal medullary hyperplasia (AMH) is scarce.

Objective
To study a large cohort of AMHs.

Design, Setting, and Participants
Nineteen AMH cases were compared with 95 pheochromocytomas (PCCs) without AMH. AMH without (n = 7) and with PCC (n = 12) were analyzed separately.

Results
Of 936 adrenalectomies, 2.1% had AMH. Mean age was 47.2 ± 15.1 years. Only two (11%) AMHs had no concurrent PCC or adrenocortical adenoma. In AMHs, a genetic syndrome was present in 58% vs 4% in PCCs (P < 0.001). The noradrenaline/metanephrine levels were lower in AMHs, whereas suppression of dexamethasone was less than in PCCs. Cushing syndrome was found in 11% of AMHs. More AMHs were found during screening and less as incidentalomas. PCC symptoms were less prevalent in AMHs. Surgical management was similar; however, fewer of the AMHs were pretreated with alpha-blockers. Adrenalectomy improved blood pressure slightly less in AMHs. The disappearance of glycemic disturbances was similar to the PPCs. During a period of 11.2 ± 9.4 years, a new PCC developed in 32% of patients with AMH, 11% died, but no PCC metastasis occurred (PCCs: 4%, P < 0.001; 14% and 5%). AMHs without PCC had milder symptoms but more often Cushing disease than patients with PCC, whereas AMH with PCC more often displayed a familiar syndrome with more PCC recurrences.

Conclusion
A total of 2.1% of all adrenalectomies displayed AMH. AMH seemed to be a PCC precursor. The symptoms and signs were milder than PCCs. AMHs were mainly found due to screening. Outcomes seemed favorable, but new PCCs developed in many during follow-up.
A cognitive map in a poison frog
Authors: Liu Yuxiang , Day Lainy B. , Summers Kyle , Burmeister Sabrina S. 
Published: June 2019

ABSTRACTA fundamental question in cognitive science is whether an animal can use a cognitive map. A cognitive map is a mental representation of the external world, and knowledge of one's place in this world, that can be used to determine efficient routes to any destination. Many birds and mammals are known to employ a cognitive map, but whether other vertebrates can create a cognitive map is less clear. Amphibians are capable of using beacons, gradients and landmarks when navigating, and many are proficient at homing. Yet only one prior study directly tested for a cognitive map in amphibians, with negative results. Poison frogs exhibit unusually complex social and spatial behaviors and are capable of long-distance homing after displacement, suggesting that they may be using complex spatial navigation strategies in nature. Here, we trained the poison frog Dendrobates auratus in a modified Morris water maze that was designed to suppress thigmotaxis to the maze wall, promoting exploration of the arena. In our moat maze, the poison frogs were able to use a configuration of visual cues to find the hidden platform. Moreover, we demonstrate that they chose direct paths to the goal from multiple random initial positions, a hallmark of a cognitive map. The performance of the frogs in the maze was qualitatively similar to that of rodents, suggesting that the potential to evolve a cognitive map is an evolutionarily conserved trait of vertebrates.