bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survey on self-reported psychotropic drug prescribing practices of eating disorder psychiatrists for the treatment of young people with anorexia nervosa
Authors: Y Beykloo Maedeh , Nicholls Dasha , Simic Mima , Brauer Ruth , Mills Elizabeth , Wong Ian C K 
Published: September 2019

ObjectivesTo survey current prescribing practices of psychotropic drugs by child and adolescent eating disorder (CAED) psychiatrists in the treatment of anorexia nervosa (AN).DesignCross-sectional self-administered survey.SettingAll children and young people eating disorder services (CYP EDS) in England during a national training programme.Participants44 CAED psychiatrists practising in CYP EDS in England.Primary and secondary outcome measuresCAED psychiatrists completed a questionnaire regarding the pattern of psychopharmacological care in AN that they provide and the medication treatment pattern at their CYP EDS. Secondary outcome measures included the process of continuing pharmacotherapy from secondary care to primary care.ResultsOf the 77 CYP EDS representing every team in England, 44 teams represented by a CAED psychiatrist responded, despite 13 having no psychiatrists in post at the time of the study (response rate 69%). Most (40%) respondents estimated that <10% of patients with AN were prescribed psychotropic medications. Olanzapine was reported as the most commonly prescribed medication for AN by 38% of the respondents, followed by fluoxetine (29%) and sertraline (10%). The most common minimum olanzapine initiation dose in this study was at 2.5 mg/day for a duration of 2–4 weeks, reaching a maximum dose of 5 mg/day. Most (68%) reviewed medications every week (30%) or every 2 weeks (38%). Over 50% of the respondents reported continuation of olanzapine prescribing within the CYP EDS teams.ConclusionsThis nationally representative survey showed that despite a lack of evidence, psychotropic medications are commonly prescribed to a minority of patients, most frequently, olanzapine. Further evidence is needed on which patients may potentially benefit from pharmacotherapy as an adjunct to psychological interventions.
How far is too far? A nationwide cross-sectional study for establishing optimal hospital access time for Korean pregnant women
Authors: Kwak Mi Young , Lee Seung Mi , Kim Hyun Joo , Eun Sang Jun , Jang Won Mo , Jung Hyemin , Kim Yoon , Lee Jin Yong 
Published: September 2019

ObjectivesAccess to a delivery unit is a major factor in determining maternal morbidity and mortality. However, there is little information about the optimal access time to a delivery unit. This study aimed to establish the optimal hospital access time (OHAT) for pregnant women in South Korea.DesignNationwide cross-sectional study.SettingWe used the National Health Insurance System database of South Korea.ParticipantsWe analysed the data of 371 341 women who had experienced pregnancy in 2013.Primary and secondary outcome measuresAccess time to hospital was defined as the time required to travel from the patient’s home to the delivery unit. The incidence of obstetric complications was plotted against the access time to hospital. Change-point analysis was performed to identify the OHAT by determining a point wherein the incidence of obstetric complications changed significantly. As a final step, the risk of obstetric complications was compared by type among pregnant women who lived within the OHAT against those who lived outside the OHAT.ResultsThe OHAT associated with each adverse pregnancy outcomes were as follows: inadequate prenatal care, 41–50 min; preeclampsia, 51–60 min; placental abruption, 51–60 min; preterm delivery, 31–40 min; postpartum transfusion, 31–40 min; uterine artery embolisation, 31–40 min; admission to intensive care unit, 31–40 min; and caesarean hysterectomy, 31–40 min. Pregnant women who lived outside the OHAT had significantly higher risk for obstetric complications than those who lived within the OHAT.ConclusionsOur results showed that the OHAT for each obstetric complication ranged between 31 and 60 min. The Korean government should take the OHAT under consideration when establishing interventions for pregnant women who live outside OHAT to reduce maternal morbidity and mortality.
Self-aligning prosthetic device for older patients with vascular-related amputations: protocol for a randomised feasibility study (the STEPFORWARD study)
Authors: Mitchell Natasha , Coleman Elizabeth , Watson Judith , Bell Kerry , McDaid Catriona , Barnett Cleveland , Twiste Martin , Jepson Fergus , Salawu Abayomi , Harrison Dennis , Vanicek Natalie 
Published: September 2019

IntroductionThe majority of older patients with a transtibial amputation are prescribed a standard (more rigid, not self-aligning) prosthesis. These are mostly suitable for level walking, and cannot adjust to different sloped surfaces. This makes walking more difficult and less energy efficient, possibly leading to longer term disuse. A Cochrane Review concluded that there was insufficient evidence to recommend any individual type of prosthetic ankle-foot mechanism. This trial will establish the feasibility of conducting a large-scale trial to assess the effectiveness and cost-effectiveness of a self-aligning prosthesis for older patients with vascular-related amputations and other health issues compared with a standard prosthesis.Methods and analysisThis feasibility trial is a pragmatic, parallel group, randomised controlled trial (RCT) comparing standard treatment with a more rigid prosthesis versus a self-aligning prosthesis. The target sample size is 90 patients, who are aged 50 years and over, and have a transtibial amputation, where amputation aetiology is mostly vascular-related or non-traumatic. Feasibility will be measured by consent and retention rates, a plausible future sample size over a 24-month recruitment period and completeness of outcome measures. Qualitative interviews will be carried out with trial participants to explore issues around study processes and acceptability of the intervention. Focus groups with staff at prosthetics centres will explore barriers to successful delivery of the trial. Findings from the qualitative work will be integrated with the feasibility trial outcomes in order to inform the design of a full-scale RCT.Ethics and disseminationEthical approval was granted by Yorkshire and the Humber—Leeds West Research Ethics Committee on 4 May 2018. The findings will be disseminated via peer-reviewed research publications, articles in relevant newsletters, presentations at relevant conferences and the patient advisory group.Trial registration numberISRCTN15043643.
Geographical and ethnic differences of osteoarthritis-associated hip and knee replacement surgeries in New Zealand: a population-based cross-sectional study
Authors: Lao Chunhuan , Lees David , Patel Sandeep , White Douglas , Lawrenson Ross 
Published: September 2019

ObjectivesTo (1) explore the regional and ethnic differences in rates of publicly funded osteoarthritis-associated hip and knee replacement surgeries and (2) investigate the mortality after surgery.DesignPopulation-based, retrospective, cross-sectional study.SettingGeneral population in New Zealand.ParticipantsPatients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005–2017. Patients aged 14–99 years were included.Primary and secondary outcome measuresAge-standardised rate, standardised mortality ratio (SMR) and 30 days, 90 days and 1 year mortality.ResultsWe identified 53 439 primary hip replacements and 50 072 primary knee replacements with a diagnosis of osteoarthritis. The number and age-standardised rates of hip and knee replacements increased over time. Māori had the highest age-standardised rate of hip replacements, followed by European/others and Pacific, and Asian had the lowest rate. Pacific had the highest age-standardised rate of knee replacements, followed by Māori and European/others, and Asian had the lowest rate. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. The SMRs of patients undergoing hip and knee replacements were lower than the general population: 0.92 (95% CI 0.89 to 0.95) for hip and 0.79 (95% CI 0.76 to 0.82) for knee. The SMRs were decreasing over time. The patterns of 30 days, 90 days and 1 year mortality were similar to the SMR.ConclusionsThe numbers of publicly funded osteoarthritis-associated primary hip and knee replacements are steadily increasing. Māori people had the highest age-standardised rate of hip replacements and Pacific people had the highest rate of knee replacements. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. Compared with the general population, patients who had hip and knee replacements have a better life expectancy.
Trends in malaria prevalence and health related socioeconomic inequality in rural western Kenya: results from repeated household malaria cross-sectional surveys from 2006 to 2013
Authors: Were Vincent , Buff Ann M , Desai Meghna , Kariuki Simon , Samuels A M , Phillips-Howard Penelope , ter Kuile Feiko O , Kachur S P , Niessen Louis Wilhelmus 
Published: September 2019

ObjectiveThe objective of this analysis was to examine trends in malaria parasite prevalence and related socioeconomic inequalities in malaria indicators from 2006 to 2013 during a period of intensification of malaria control interventions in Siaya County, western Kenya.MethodsData were analysed from eight independent annual cross-sectional surveys from a combined sample of 19 315 individuals selected from 7253 households. Study setting was a health and demographic surveillance area of western Kenya. Data collected included demographic factors, household assets, fever and medication use, malaria parasitaemia by microscopy, insecticide-treated bed net (ITN) use and care-seeking behaviour. Households were classified into five socioeconomic status and dichotomised into poorest households (poorest 60%) and less poor households (richest 40%). Adjusted prevalence ratios (aPR) were calculated using a multivariate generalised linear model accounting for clustering and cox proportional hazard for pooled data assuming constant follow-up time.ResultsOverall, malaria infection prevalence was 36.5% and was significantly higher among poorest individuals compared with the less poor (39.9% vs 33.5%, aPR=1.17; 95% CI 1.11 to 1.23) but no change in prevalence over time (trend p value <0.256). Care-seeking (61.1% vs 62.5%, aPR=0.99; 95% CI 0.95 to 1.03) and use of any medication were similar among the poorest and less poor. Poorest individuals were less likely to use Artemether-Lumefantrine or quinine for malaria treatment (18.8% vs 22.1%, aPR=0.81, 95% CI 0.72 to 0.91) while use of ITNs was lower among the poorest individuals compared with less poor (54.8% vs 57.9%; aPR=0.95; 95% CI 0.91 to 0.99), but the difference was negligible.ConclusionsDespite attainment of equity in ITN use over time, socioeconomic inequalities still existed in the distribution of malaria. This might be due to a lower likelihood of treatment with an effective antimalarial and lower use of ITNs by poorest individuals. Additional strategies are necessary to reduce socioeconomic inequities in prevention and control of malaria in endemic areas in order to achieve universal health coverage and sustainable development goals.
Isometric versus isotonic exercise for greater trochanteric pain syndrome: a randomised controlled pilot study
Authors: Clifford Christopher , Paul Lorna , Syme Grant , Millar Neal L 
Published: September 2019

ObjectivesGreater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. Limited evidence exists for the effectiveness of exercise for GTPS. This study aimed to compare the effectiveness of isometric and isotonic exercise for individuals with GTPS.MethodsThis randomised controlled pilot trial recruited 30 participants with GTPS. Both programmes consisted of daily, progressive home exercise for 12 weeks with 8 individual physiotherapy sessions over the trial period. The primary outcome measure was the Victorian Institute of Sport Assessment-Gluteal (VISA-G) and secondary outcome measures included the Numeric Pain Rating Scale (0–10) and an 11-point Global Rating of Change Scale. Outcome measures were assessed at baseline, 4 and 12 weeks.ResultsTwenty-three participants completed the trial. After 12 weeks, mean VISA-G scores improved in both groups; 55–65 in the isometric group and 62–72 in the isotonic group. 55% of the isometric group and 58% of the isotonic group achieved a reduction in pain of at least 2 points (minimally clinically important difference (MCID)) on the Numeric Pain Rating Scale. 64% of the isometric group and 75% of the isotonic group had improved by at least 2 points (MCID) on the Global Rating of Change Scale.ConclusionIsometric and isotonic exercise programmes appear to be effective for individuals with GTPS and should be considered in the loading management of patients with this condition.
Integrated paired-end enhancer profiling and whole-genome sequencing reveals recurrentCCNE1andIGF2enhancer hijacking in primary gastric adenocarcinoma
Authors: Ooi Wen Fong , Nargund Amrita M , Lim Kevin Junliang , Zhang Shenli , Xing Manjie , Mandoli Amit , Lim Jing Quan , Ho Shamaine Wei Ting , Guo Yu , Yao Xiaosai , Lin Suling Joyce , Nandi Tannistha , Xu Chang , Ong Xuewen , Lee Minghui , Tan Angie Lay-Keng , Lam Yue Ning , Teo Jing Xian , Kaneda Atsushi , White Kevin P , Lim Weng Khong , Rozen Steven G , Teh Bin Tean , Li Shang , Skanderup Anders J , Tan Patrick 
Published: September 2019

ObjectiveGenomic structural variations (SVs) causing rewiring ofcis-regulatory elements remain largely unexplored in gastric cancer (GC). To identify SVs affecting enhancer elements in GC (enhancer-based SVs), we integrated epigenomic enhancer profiles revealed by paired-end H3K27ac ChIP-sequencing from primary GCs with tumour whole-genome sequencing (WGS) data (PeNChIP-seq/WGS).DesignWe applied PeNChIP-seq to 11 primary GCs and matched normal tissues combined with WGS profiles of >200 GCs. Epigenome profiles were analysed alongside matched RNA-seq data to identify tumour-associated enhancer-based SVs with altered cancer transcription. Functional validation of candidate enhancer-based SVs was performed using CRISPR/Cas9 genome editing, chromosome conformation capture assays (4C-seq, Capture-C) and Hi-C analysis of primary GCs.ResultsPeNChIP-seq/WGS revealed ~150 enhancer-based SVs in GC. The majority (63%) of SVs linked to target gene deregulation were associated with increased tumour expression. Enhancer-based SVs targetingCCNE1, a key driver of therapy resistance, occurred in 8% of patients frequently juxtaposing diverse distal enhancers toCCNE1proximal regions.CCNE1-rearranged GCs were associated with highCCNE1expression, disruptedCCNE1topologically associating domain (TAD) boundaries, and novel TAD interactions inCCNE1-rearranged primary tumours. We also observedIGF2enhancer-based SVs, previously noted in colorectal cancer, highlighting a common non-coding genetic driver alteration in gastric and colorectal malignancies.ConclusionIntegrated paired-end NanoChIP-seq and WGS of gastric tumours reveals tumour-associated regulatory SV in regions associated with both simple and complex genomic rearrangements. Genomic rearrangements may thus exploit enhancer-hijacking as a common mechanism to drive oncogene expression in GC.
Differing reflections of paediatric classical Hodgkin’s lymphoma on local and distant immunological microenvironments: a flow cytometric study
Authors: Savaşan Süreyya , AlQanber Batool , Henry Meret , Buck Steven , Gadgeel Manisha 
Published: September 2019

AimsTo compare immunological microenvironments in local and distant lymphoid tissues in Hodgkin’s lymphoma (HL) in children.MethodsWe have analysed diagnostic bone marrow (BM) samples in 22 and corresponding involved lymph node (LN) in eight and peripheral blood (PB) in eight cases of HL by flow cytometry and sought correlations with clinical features retrospectively.ResultsWhile there were significant differences in lymphocyte compositions of BM and LN tissues, the distribution of lymphocyte subsets mimicked each other in BM and PB. CD8-positive cytotoxic T cells predominate the bone marrow in contrast to CD4-positive helper T cells in LN tissue with corresponding CD4/CD8 ratios (0.85 and 5.3, respectively; p=0.002). Additionally, T-large granular lymphocytes population was much higher in BM in comparison to LN tissue (10.5% vs 4.5%; p=0.036).ConclusionsLocal immunological microenvironment appears to be highly influenced by HL tumour cells and distant site lymphocyte composition reflects immune response to control the neoplastic process.
The prognostic roles of and correlation betweenALKandMYCNprotein expression in neuroblastoma
Authors: Chang Hsiu-Hao , Lu Meng-Yao , Yang Yung-Li , Chou Shu-Wei , Lin Dong-Tsamn , Lin Kai-Hsin , Hsu Wen-Ming , Jeng Yung-Ming , Jou Shiann-Tarng 
Published: September 2019

AimsTo investigate the relations between anaplastic lymphoma kinase (ALK) and v-myc myelocytomatosis viral related oncogene neuroblastoma derived homolog (MYCN) protein expression and their prognostic roles in neuroblastoma tumours.MethodsSixty-one neuroblastoma tumours obtained at diagnosis were stained with anti-MYCNand anti-ALKantibodies by immunohistochemical staining. The correlations between protein expression ofMYCN,ALKand clinicopathological and biological variables of neuroblastoma tumours were analysed.ResultsHigh expression ofALKprotein could be detected in 25 (41%) and high expression ofMYCNprotein could be detected in 24 (39.3%) of the 61 neuroblastoma tumours, respectively. The majority of neuroblastoma tumours with evident ofALKorMYCNprotein high expression exhibited undifferentiated or poorly differentiated histology (30/35, 85.7%).ALKorMYCNprotein high expression in neuroblastoma tumours was associated with adverse clinical prognostic factors andALKprotein high expression was significantly associated withMYCNprotein high expression. In addition, eitherALKorMYCNprotein high expression in neuroblastoma tumours was the independent adverse prognostic factor and also predicted worse survival outcomes for neuroblastoma patients withMYCNnon-amplified status or non-high-risk Children’s Oncology Group grouping.ConclusionsOur study showed a novel coordinately prognostic role ofALKandMYCNprotein expression in neuroblastoma and is the first report to demonstrate the correlation betweenALKandMYCNprotein expression in primary neuroblastoma tumours.
Early clinical experience with Cascade: a novel temporary neck bridging device for embolization of intracranial aneurysms
Authors: Sirakov Stanimir , Sirakov Alexander , Minkin Krasimir , Karakostov Vasil , Raychev Radoslav 
Published: September 2019

BackgroundTemporary placement of a retrievable neck bridging device, allowing parent vessel flow, is an attractive alternative to balloon remodeling for treatment of ruptured intracranial aneurysms.ObjectiveTo present, in a single-center study, our initial experience with Cascade (Perflow, Israel) in the treatment of ruptured intracranial aneurysms.MethodsDuring a period of 1.5 months, 12 patients with aneurysmal subarachnoid hemorrhage underwent coil embolization in conjunction with Cascade in our center. Retrospective analysis of prospectively collected angiographic and clinical data was conducted to assess the safety and efficacy of the device.ResultsAmong all treated patients, 41.7% (5/12) were female, the median age was 55 (47–77) years, the median aneurysm dome size was 5.75 mm (3–9.1), and the median neck size was 3.55 mm (2.3–7.9). Complete obliteration (Raymond 1) was achieved in 75% (9/12) of cases, and intentional residual neck (Raymond 2) was left in three cases (25%). None of the patients received any oral or intravenous antiplatelet therapy perioperatively. No thromboembolic complications, device-related spasm, vessel perforation, or coil entanglement were detected in any of the treated patients.ConclusionsIn our initial experience, treatment of wide-neck ruptured intracranial aneurysms with Cascade is safe and effective, without the need for adjuvant antiplatelet therapy. Long-term follow-up data in larger cohorts are needed to confirm these preliminary findings.
Effect of electric heating and ice added to the bowl on mainstream waterpipe semivolatile furan and other toxicant yields
Authors: Brinkman Marielle C , Teferra Andreas A , Kassem Noura O , Kassem Nada OF 
Published: September 2019

ObjectivesWe examined mainstream total particulate matter, nicotine, cotinine, menthol, pyrene, carbon monoxide (CO) and semivolatile furan yields from a commercial waterpipe with two methods for heating the tobacco, quick-light charcoal (charcoal) and electric head (electric) and two water bowl preparations: with (ice) and without ice (water).MethodsEmissions from a single brand of popular waterpipe tobacco (10 g) were generated using machine smoking according to a two-stage puffing regimen developed from human puffing topography. Tobacco and charcoal consumption were calculated for each machine smoking session as mass lost, expressed as a fraction of presmoking mass.ResultsThe heating method had the greatest effect on toxicant yields. Electric heating resulted in increases in the fraction of tobacco consumed (2.4 times more, p<0.0001), mainstream nicotine (1.4 times higher, p=0.002) and semivolatile furan yields (1.4 times higher, p<0.03), and a decrease in mainstream CO and pyrene yields (8.2 and 2.1 times lower, respectively, p<0.001) as compared with charcoal. Adding ice to the bowl resulted in higher furan yields for electric heating. Menthol yields were not different across the four conditions and averaged 0.16±0.03 mg/session. 2-Furaldehyde and 5-(hydroxymethyl)−2-furaldehyde yields were up to 230 and 3900 times higher, respectively, than those reported for cigarettes.ConclusionWaterpipe components used to heat the tobacco and water bowl preparation can significantly affect mainstream toxicant yields. Mainstream waterpipe tobacco smoke is a significant source of inhalation exposure to semivolatile furans with human carcinogenic and mutagenic potential. These data highlight the need for acute and chronic inhalation toxicity data for semivolatile furans and provide support for the establishment of limits governing sugar additives in waterpipe tobacco and educational campaigns linking waterpipe tobacco smoking behaviours with their associated harm.